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ASH Recognized Choosing Wisely Champions at 2019 Annual Meeting & Exposition

The American Society of Hematology (ASH) recognized three Choosing Wisely® Champions, practitioners working to tackle the overuse of hematology tests and treatments, at its 2019 Annual Meeting & Exposition in Orlando: Stephen L. Wang, MD, of Kaiser Permanente Santa Clara Medical Center, Santa...

Databases: Where Math Meets Medicine

About 4 decades ago, as a young physician, I observed that most surgeons were numerator doctors; they remembered their successes and their failures, but they did not remember the frequency of either. There was no denominator. Worse, the approach to any specific surgical problem was always the...

multiple myeloma
geriatric oncology

ASH 2019: Is Autologous Hematopoietic Stem Cell Transplant Safe and Effective for Patients Aged 70 or Older With Multiple Myeloma?

Even though autologous hematopoietic stem cell transplantation (AHCT) is an effective treatment for multiple myeloma, only 4 out of 10 patients receive this therapy. A new study presented by Munshi et al at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 782) ...

multiple myeloma
immunotherapy

ASH 2019: Dose-Climbing Trial of Dual-Target CAR T-Cell Therapy for Relapsed or Refractory Multiple Myeloma

More than three out of four patients with relapsed multiple myeloma, or myeloma that was refractory to at least two therapies, remained in remission 7 months after treatment with a novel chimeric antigen receptor (CAR) T-cell therapy targeting two proteins that are frequently found on myeloma...

breast cancer
immunotherapy

Promising New Treatments for Triple-Negative Breast Cancer: Immunotherapy and Other Targeted Therapies

Clinical trials continue to demonstrate that combining immunotherapy with chemotherapy and other targeted therapies can improve survival for patients with triple-negative breast cancer, according to results presented at the 21st Annual Lynn Sage Breast Cancer Symposium in Chicago. Nearly 700...

prostate cancer

Is Nonmetastatic Castration-Resistant Prostate Cancer a Valid Disease Category?

Does nonmetastatic castration-resistant prostate cancer really exist? Although it is considered a disease category, it turns out that the definition depends on the type of imaging used. Many patients with castration-resistant prostate cancer who were categorized as “nonmetastatic” on conventional...

breast cancer

‘Unexpected’ Survival Benefit With Trilaciclib Plus Chemotherapy in Triple-Negative Breast Cancer

An unanticipated result of a randomized phase II study was the improvement in overall survival achieved with the investigational CDK4/6 inhibitor trilaciclib in women with metastatic triple-negative breast cancer. The drug was not being evaluated for its anticancer effects, but rather as a means of ...

prostate cancer

RSNA 2019: MRI-Guided Ultrasound Treatment for Localized Prostate Cancer

A novel magnetic resonance imaging (MRI)-guided procedure that uses therapeutic ultrasound may effectively treat prostate cancer with minimal side effects, according to a new study presented at the 2019 annual meeting of the Radiological Society of North America (RSNA) (Abstract SSC07-07)....

supportive care

Checkpoint Inhibitor Pneumonitis: A Pulmonologist’s Perspective

Oncologists have become accustomed to seeing pneumonitis associated with immune checkpoint inhibitor treatment in non–small cell lung cancer (NSCLC), requiring intervention by pulmonologists in the management of severe cases. At CHEST 2019, the annual meeting of the American College of Chest...

kidney cancer
immunotherapy

Immunotherapy Strategies in Renal Cell Carcinoma: Present and Future

Immunotherapy with checkpoint inhibitors is now considered a standard of care for the front-line treatment of advanced renal cell carcinoma. Despite better outcomes with these agents, there is still room for improvement. At the 2019 Chemotherapy Foundation Symposium, Robert J. Motzer, MD, of...

supportive care
pain management

Assessing Cancer Pain Management in the Era of the Opioid Epidemic

A vast majority of patients with cancer receiving opioids for the management of pain will adhere to the opioids as prescribed and will have no major difficulties with dose reduction and even treatment discontinuation if the pain syndrome resolves. However, about 20% of patients with cancer are at...

skin cancer
immunotherapy

Updated Data From Clinical Trials on Nivolumab/Ipilimumab in Advanced Melanoma

More than one out of two patients with metastatic melanoma treated with the combination of nivolumab plus ipilimu-mab is still alive after 5 years, according to the longest follow-up of patients receiving this combination. In two additional studies, the immunotherapy duet also proved to be active...

MSKCC Awards Young Investigators 2019 Paul Marks Prize for Cancer Research

Memorial Sloan Kettering Cancer Center (MSK) has named three investigators as the recipients of this year’s Paul Marks Prize for Cancer Research. The award recognizes scientists for their accomplishments in the area of cancer research. The winners for 2019 are Nathanael S. Gray, PhD; Joshua...

ASCO President-Elect Candidates Discuss Key Issues in Oncology

Patrick J. Loehrer, MD, FASCO, of the Indiana University Melvin and Bren Simon Cancer Center, and Everett E. Vokes, MD, FASCO, of the University of Chicago Medicine Comprehensive Cancer Center, were selected by the ASCO Nominating Committee as candidates for President-Elect. Below, they discuss...

Using the Nobel Prize to Champion Curiosity-Driven Research in Cancer

William G. Kaelin, Jr, MD, Sidney Farber Professor of Medicine and Howard Hughes Medical Institute Investigator at Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Harvard Medical School, admits that early in his research career, he and his late wife, Carolyn, would have fun...

breast cancer

When to Consider Local Therapy for Stage IV Breast Cancer

Local therapy for stage IV breast cancer has not been proven to increase overall survival, yet there are some cases where local therapy could be considered outside a clinical trial. For patients with intact asymptomatic primary tumors, local therapy could be offered if distant disease is well...

Expert Point of View: Oreofe Olukemi Odejide, MD, MPH

Discussant of the abstract by Rao et al, Oreofe Olukemi Odejide, MD, MPH, a medical oncologist at Dana-Farber Cancer Institute, Boston, underscored the issues associated with intense health-care utilization near the end of life. “Several studies have shown that intense health-care utilization...

lung cancer

Despite Challenges, Pioneer in CT Screening for Early Lung Cancer Works to Move the Field Forward

In 1999, a team of researchers from Weill Cornell Medical College advocated the use of a then-novel practice: low-dose radiation CT screening for lung cancer. It captures a full thoracic image in a single breath hold, and can recognize a tumor in its earliest stages when the chance for cure is...

issues in oncology

A Call to Action for Oncology Clinicians to Help Patients ‘Move Through Cancer’

“There is clear evidence that patients are more likely to exercise if their oncologist tells them to do so,” reported representatives from 17 organizations participating in the Second Roundtable on Exercise and Cancer Prevention and Control. In an article published in CA: A Cancer Journal for...

symptom management

Oncology Massage Therapy for Chemotherapy-Induced Peripheral Neuropathy

Oncology massage therapy might be a helping hand for patients suffering from chronic chemotherapy-induced peripheral neuropathy, according to data presented at the 2019 Supportive Care in Oncology Symposium.1 The results of the pilot study supported the premise that patients who received massages...

Thomas Gajewski, MD, PhD, Receives 2019 ESMO Award for Immuno-Oncology

The European Society for Medical Oncology (ESMO) has selected Thomas Gajewski, MD, PhD, to receive the 2019 ESMO Award for Immuno-Oncology. The award is given in recognition of his groundbreaking work elucidating why some patients are resistant to immunotherapy and how to restore the anticancer...

A Need for Human Connection Led to a Rewarding Career in Geriatric Oncology for Lodovico Balducci, MD

Older adults are the fastest-growing segment of our population, and more than 65% of patients with newly diagnosed cancer are 65 years of age or older. Although we now recognize the special needs of older patients with cancer, the field of geriatric oncology emerged quietly, with early growing...

An Oncologist’s Thoughtful Examination of Cancer and Personal Loss

“I could not have written this book when I was 30 years old. It is not because of any great discoveries I have made or research papers I have published since. It is because of the experience the intervening decades have given me as I cared for thousands of cancer patients and accompanied many to...

immunotherapy
solid tumors

Study Finds Durvalumab Retreatment Active in Some Patients With Advanced Solid Tumors

Immunotherapy with checkpoint inhibitors offers a proportion of patients a chance at long-term disease control, resembling cure in some patients. Among the many questions about immunotherapy that remain to be resolved is whether patients who discontinue therapy and develop progressive disease can...

issues in oncology

Physicians Should Lead by Example to Combat the Obesity Epidemic

American patients are suffering from an obesity crisis, where it is estimated that 300,000 deaths per year are due to obesity.1 The obesity trend is predicted to worsen, where it is projected that 85% of U.S. adults will be overweight or obese by 2030.2 Consequently, obesity-related illnesses are...

issues in oncology
survivorship

Addressing the Obesity Epidemic and Barriers to Implementing Weight Management Programs for Cancer Survivors

Earlier this year, ASCO published the results of its new study on oncologists’ perceptions and practice behaviors regarding obesity, weight management, and related lifestyle factors in their patients both during and after cancer treatment.1 The findings from the online survey of 971 oncology...

supportive care
pain management

Expert Point of View: Richard T. Lee, MD

Richard T. Lee, MD, Associate Professor at Case Comprehensive Cancer Center and University Hospitals Seidman Cancer Center, discussed the abstract by Galloway et al at the 2019 Supportive Care in Oncology Symposium. He remarked that starting a new palliative care consultation can sometimes feel...

issues in oncology
global cancer care

Affirming Universal Health Care as a Fundamental Human Right

This year’s meeting of the World Cancer Leaders’ Summit: Cancer and Universal Health Coverage, held on October 15–17 in Nur-Sultan, Kazakhstan, brought together more than 350 global health leaders, including ministers of health, first ladies, and industry leaders, from 82 countries to discuss how...

Expert Point of View: Arndt Vogel, MD and Angela Lamarca, MD, PhD

Arndt Vogel, MD, of Hannover Medical School in Germany, who served as discussant of the two studies of immunotherapy in hepatocellular carcinoma, said the findings point to a promising future in the treatment of this malignancy. He commented that the responses observed with nivolumab in CheckMate...

hematologic malignancies
immunotherapy

Answers to Hematology Expert Review Questions

Question 1 Which of the following statements about cytokine-release syndrome and neurotoxicity after tisagenlecleucel infusion is correct? Correct answer: B. The median time to onset of cytokine-release syndrome is 3 days. Expert Perspective Following tisagenlecleucel infusion, cytokine-release...

lung cancer

What Is the Best Palliation for End-Stage Lung Cancer?

Patients with advanced lung cancer can experience burdensome symptoms at the end of life. Pulmonologists can alleviate some of this suffering, but it’s a balancing act between doing too much and not enough, according to specialists who spoke at CHEST 2019, the annual meeting of the American College ...

issues in oncology

Two Societies Issue Statements on E-Cigarettes

Today, the American Cancer Society (ACS) announced an update to the organization’s position on e-cigarettes, and the American Medical Association (AMA) called for a total ban on all e-cigarette and vaping products that do not meet U.S. Food and Drug Administration (FDA) approval as cessation ...

issues in oncology

Does Testosterone Replacement Therapy Benefit Young Male Cancer Survivors?

Young male cancer survivors may significantly benefit from testosterone replacement therapy—especially after testicular cancer. Research published by Walsh et al in PLOS Medicine looked at one of the most common late-onset side effects experienced by young male survivors—reduced levels of the male...

skin cancer

Reflections on Long-Term Outcomes With BRAF/MEK Inhibition in Advanced Melanoma

For the treatment of BRAF V600-mutated advanced melanoma, we now have three BRAF/MEK inhibitor combinations that are approved by the U.S. Food and Drug Administration: dabrafenib/trametinib, vemurafenib/cobimetinib, and encorafenib/binimetinib. Although the toxicity profiles for these combinations ...

gastrointestinal cancer

Pivotal Phase III Study Evaluates Investigational TKI in Fourth-Line Setting for Advanced GIST

In a late-breaking, oral presentation at the ESMO Congress 2019, Margaret von Mehren, MD, presented results from ­INVICTUS, a pivotal phase III clinical trial of ripretinib in patients with advanced gastrointestinal stromal tumor (GIST).1 Ripretinib is an investigational tyrosine kinase inhibitor...

gynecologic cancers

Phase III Trials Suggest Paradigm Shift With PARP Inhibitors in Ovarian Cancer

At the ESMO Congress 2019, ovarian cancer was a topic of heightened interest, particularly due to findings reported in several important phase III studies of PARP inhibitors in front-line maintenance therapy for patients with newly diagnosed advanced disease—and not just those with BRCA mutations....

issues in oncology
hepatobiliary cancer

Financial Burdens of Patients With Cirrhosis and Impact on Screening for HCC

Data from a new study presented by Singal et al at The Liver Meeting found that patients with cirrhosis in the United States have substantial financial burden and this is associated with underuse of surveillance for hepatocellular carcinoma (HCC) (Abstract 201). Improved intervention strategies are ...

New JCO CCI Article Discusses Difficulties in Gathering Real-World Evidence

A new JCO Clinical Cancer Informatics (JCO CCI) article highlights the challenges in—and need for—obtaining real-world evidence for assessing the effectiveness of precision medicine on areas such as survival, quality of life, cost, and health disparities. The paper, titled “Clinical Molecular...

issues in oncology
hematologic malignancies
leukemia

How Clonal Hematopoiesis of Indeterminate Potential Increases the Risk of Heart Disease and Blood Cancers as People Age

Although stem cells throughout the body acquire genetic mutations over time, usually these alterations do not affect how the stem cells function or cause disease. However, recent research in clonal hematopoiesis and aging has found an association between clonal expansion of hematopoietic cells with ...

lung cancer
issues in oncology

Early Lung Cancer Detection Followed by Minimally Invasive Surgery Saves Lives

Lung cancer remains the number one cancer killer, leading to about 150,000 deaths per year in the United States and accounting for approximately 25% of all cancer deaths in the nation. Early detection has improved survival in other malignancies such as breast, colon, and cervical cancers, but...

How Patients Add Life to Their Days

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

survivorship

The Role of Oncologists in Helping Cancer Survivors to Quit Smoking

Several oncology organizations have created guidelines for oncology specialists to help patients with cancer to quit smoking. ASCO has far-reaching goals aimed at tobacco reduction, including cessation tools and other resources. To shed light on the current work in this area, The ASCO Post spoke...

gastrointestinal cancer

Machine-Learning Model May Predict Unplanned Hospitalizations After Radiation Therapy for Gastrointestinal Cancer

Unplanned hospitalizations may be common among patients with cancer, but they diminish quality of care while racking up high costs for patients and the health-care system alike. According to data presented at the 2019 ASCO Quality Care Symposium, however, a new predictive model may help providers...

An Early Love of Nature’s Biodiversity Leads to a Career in Cancer Research for Lisa Coussens, PhD

Founded in 1887, the Oregon Health Sciences University (OHSU) is located in Portland, Oregon, and is home to the cutting-edge Coussens Lab, which focuses on the role of immune cells and their mediators as critical regulators of cancer development. The lab’s eponymous Director, Lisa Coussens, PhD,...

Expert Point of View: Ana Oaknin, MD, PhD

“The main goal in ovarian cancer is to avoid relapse after first-line therapy because otherwise, the probability of cure is quite low,” said European Society for Medical Oncology (ESMO) discussant of the PAOLA-1 trial, Ana Oaknin, MD, PhD, of the Vall d’Hebron Institute of Oncology, Barcelona....

gynecologic cancers

PAOLA-1 Trial: Front-Line Olaparib/Bevacizumab Maintenance Benefits Women With Advanced Ovarian Cancer

In women with newly diagnosed ovarian cancer, front-line maintenance therapy with olaparib plus bevacizumab reduced the risk of disease progression by 41% overall and by 69% in the subset of patients with BRCA-mutated disease, vs bevacizumab and placebo, in the phase III PAOLA-1/ENGOT-ov25 trial...

breast cancer

Scientific Session on Breast Cancer Explores Studies on Partial-Breast Irradiation, Chemoradiotherapy

Women with early-stage breast cancer treated with lumpectomy followed by radiation therapy rated the cosmetic results for whole-breast and partial-breast irradiation to be equivalent, according to a new analysis of results from the phase III NRG Oncology/NSABP B39-RTOG 0413 clinical trial. Results...

colorectal cancer

American College of Physicians Issues Guidance on Colorectal Cancer Screening for Average-Risk, Asymptomatic Adults Aged 50 to 75 Years

The American College of Physicians has issued a new guidance statement on colorectal cancer screening, which recommends screening for average-risk adults who do not have symptoms and are between the ages of 50 and 75 years. The guidelines were published by Qaseem et al in Annals of Internal...

issues in oncology
cost of care

Study Finds Nearly One in Four Oncologists Rarely or Never Mention Cost When Discussing Genomic Testing

Nearly one in four oncologists report rarely or never discussing the costs of genomic testing with their patients, according to a new study led by American Cancer Society investigators. The study, published by Yabroff et al in the Journal of the National Cancer Institute, found that oncologists...

lymphoma

Omitting Radiation From Treatment for Early-Stage Hodgkin Lymphoma Increases Risk of Recurrence

Two presentations at the American Society for Radiation Oncology (ASTRO) Annual Meeting offered more evidence that omitting radiation therapy leads to higher rates of recurrence for patients with early-stage Hodgkin lymphoma.1,2 Both studies involve work by the German Hodgkin Study Group among...

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