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health-care policy

Studies Show the U.S. Health-Care System Hampered by Waste and Trailing Other High-Income Countries

Recent studies show that at least one-quarter of our nation’s health-care expenditures are being consumed by waste, fraud, and abuse. Moreover, since 2004, annual reports from the Commonwealth Fund have consistently rated the performance of our health-care system last among high-income countries,...

Collaborative Trial to Evaluate Imaging Methods for Women With Dense Breasts

In a new effort to improve early breast cancer detection and reduce false-positive exams in women with dense breasts, the American College of Radiology (ACR), the Breast Cancer Research Foundation (BCRF), and GE Healthcare are partnering to support the Contrast-Enhanced Mammography Imaging...

An Early Interest in Biology and People Led to a Career in Oncology for Nina Shah, MD

Multiple myeloma expert Nina Shah, MD, was born and reared in the Northeast. During grade school, she developed a passion for science that would lead to an early decision to pursue a career in medicine. “My ninth-grade biology class really got me interested in human biology, and that’s when I...

kidney cancer

First-Line Pembrolizumab Plus Axitinib for Advanced Renal Cell Carcinoma

On April 19, 2019, pembrolizumab was approved for use in combination with the small-molecule tyrosine kinase inhibitor axitinib for the first-line treatment of patients with advanced renal cell carcinoma.1,2 Supporting Efficacy Data Approval was based on findings in the open-label phase III...

lung cancer

Erlotinib Plus Ramucirumab: Ready for Prime Time?

The treatment of epidermal growth factor receptor (EGFR)-positive lung cancer changed dramatically after the results of the FLAURA trial showed improved progression-free survival with the third-generation EGFR tyrosine kinase inhibitor osimertinib as first-line therapy compared with...

lymphoma

ASH 2019: Pilot Study of Next-Generation Sequencing for Undetectable Minimal Residual Disease in Patients With Follicular Lymphoma

Patients with follicular lymphoma who have been treated and are in remission for at least 2 years may no longer be incurable based on highly sensitive testing. This may mean they no longer need therapy or active follow-up, according to findings presented by Sarraf Yazdy et al at the 2019 American...

breast cancer

Trastuzumab Biosimilar HLX02 Shows Activity in HER2-Positive Metastatic Breast Cancer

The trastuzumab biosimilar HLX02—manufactured in China—achieved a similar overall response rate to reference trastuzumab in women with HER2-positive recurrent or previously untreated metastatic breast cancer, according to a large, randomized phase III study. Binghe Xu, MD, PhD, of the Department of ...

solid tumors

Making Inroads With Interventional Oncology in the Treatment of Solid Tumors

  At the recent 2019 Symposium on Clinical Interventional Oncology (CIO) in Miami, course directors Constantino Peña, MD, FSIR, and Ripal Gandhi, MD, FSIR, FSVM, had a lot to say about this burgeoning field of oncology. In particular, interventional oncology is making inroads in therapeutic...

FDA Approves Voxelotor for Sickle Cell Disease

On November 25, the U.S. Food and Drug Administration (FDA) granted accelerated approval to voxelotor (Oxbryta) for adults and pediatric patients 12 years of age and older with sickle cell disease. “[Voxelotor] is an inhibitor of deoxygenated sickle hemoglobin polymerization, which is the central...

lung cancer

Ramucirumab Plus Erlotinib Improves Progression-Free Survival in Previously Untreated EGFR-Mutated Advanced NSCLC

As reported in The Lancet Oncology by Kazuhiko Nakagawa, MD, of the Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, and colleagues, the phase III RELAY trial has shown that the addition of the VEGFR2 inhibitor ramucirumab to the EGFR inhibitor erlotinib improved...

Expert Point of View: Joshua Richter, MD

Joshua Richter, MD, Assistant Professor of Medicine, Hematology, and Medical Oncology at the Tisch Cancer Institute at Mount Sinai in New York, offered his thoughts on the CANDOR study, noting that the findings point to “a new and exciting treatment regimen for our patients with relapsed and...

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) ...

hematologic malignancies
immunotherapy

ASH 2019: CAR-NK Therapy for B-Cell Malignancies Shows Activity in Preclinical Studies

Preclinical studies have provided the first evidence that cellular immunotherapy for B-cell cancers could ultimately become an off-the-shelf product, capable of being uniformly manufactured in large quantities. The product—FT596—is among the first cellular immunotherapies to be based on...

immunotherapy
lymphoma

ASH 2019: Early Data Signal Potential for Bispecific Antibody in Non-Hodgkin Lymphoma

The investigational bispecific antibody mosunetuzumab is showing activity in preliminary studies of patients with non-Hodgkin lymphoma (NHL), including those who are refractory to or relapsed after third-line chimeric antigen receptor (CAR) T-cell therapy. If preliminary findings are validated by...

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...

pain management

Multidimensional Palliative Care: Fewer Opioids, More Pain Control in Patients With Advanced Cancer

For opioid-tolerant patients with advanced cancer experiencing pain, relief does not necessarily have to come from a higher dose of opioids, according to findings presented at the 2019 Supportive Care in Oncology Symposium.1 The results of a retrospective analysis of 300 patients with advanced...

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...

hematologic malignancies
geriatric oncology

Geriatric Assessment–Guided Multidisciplinary Care May Benefit Older Patients Undergoing Stem Cell Transplantation

Older adults with blood cancers may benefit from a team-based, holistic evaluation before undergoing transplantation, according to a study published by Derman et al in Blood Advances. The study, which reported on a multidisciplinary clinic at the University of Chicago Medical Center, found that...

prostate cancer

Activity of Anti-STEAP1 Antibody-Drug Conjugate in Patients With Metastatic Castration-Resistant Prostate Cancer

In a phase I trial reported in the Journal of Clinical Oncology, Danila et al found that the antibody-drug conjugate DSTP3086S, which targets the six-transmembrane epithelial antigen of the prostate 1 (STEAP1), had acceptable safety and evidence of activity in patients with metastatic...

FDA Approves Voxelotor for Sickle Cell Disease

On November 25, the U.S. Food and Drug Administration (FDA) granted accelerated approval to voxelotor (Oxbryta) for adults and pediatric patients 12 years of age and older with sickle cell disease. “[Voxelotor] is an inhibitor of deoxygenated sickle hemoglobin polymerization, which is the central...

breast cancer

ESMO Asia 2019: Trastuzumab Biosimilar HLX02 Shows Activity in HER2-Positive Metastatic Breast Cancer

The trastuzumab biosimilar HLX02—manufactured in China—achieved a similar overall response rate to reference trastuzumab in women with HER2-positive recurrent or previously untreated metastatic breast cancer, according to a large, randomized phase III study reported by Xu et al at the European...

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...

lung cancer

Long-Term Survival With PD-1/PD-L1 Inhibitors in NSCLC

Although many commentaries on studies featured in The ASCO Post call for scrutiny of the fine points, this is not the case for the recent report by Antonia et al in The Lancet Oncology (reviewed in the current issue of The ASCO Post).1 This article serves as a well-deserved victory lap for the...

leukemia

Calaspargase Pegol-mknl for Pediatric and Young Adult Patients With Acute Lymphoblastic Leukemia

In late 2018, calaspargase pegol-mknl, an asparagine-specific enzyme, was approved for use as a component of a multiagent chemotherapeutic regimen for acute lymphoblastic leukemia (ALL) in pediatric and young adult patients aged 1 month to 21 years.1,2 The new product provides for a longer interval ...

The Anesthesia Era: 1845–1875

The text and photograph on this page are excerpted from a four-volume series of books titled Oncology: Tumors & Treatment, A Photographic History, The Anesthesia Era: 1845–1875 by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. The photograph appears courtesy of Stanley B. Burns, MD, and...

gastroesophageal cancer
gastrointestinal cancer

Trifluridine/Tipiracil in Recurrent, Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma

Early in 2019, trifluridine/tipiracil tablets were approved for the treatment of adult patients with metastatic gastric or gastroesophageal junction adenocarcinoma previously treated with at least two prior lines of chemotherapy that included a fluoropyrimidine; a platinum; either a taxane or...

lung cancer

First-Line Nivolumab Plus Ipilimumab in Special Populations With Non–Small Cell Lung Cancer

First-line therapy consisting of nivolumab plus ipilimumab showed a consistent safety profile in special populations with advanced non–small cell lung cancer (NSCLC), according to research presented at the International Association for the Study of Lung Cancer (IASLC) 2019 World Conference on Lung ...

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

ASCO Provides Guidance on Managing Osteoporosis in Cancer Survivors

Cancer survivors are at an increased risk of osteoporotic fractures due to the accelerated loss of bone mineral density as a result of their treatment. Bone loss from cancer therapy is faster and more severe than bone less from aging; rates of bone loss are up to sevenfold higher when they occur...

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...

immunotherapy
hepatobiliary cancer

‘Clinically Meaningful’ Outcomes Seen in Two Studies of First-Line Immunotherapy for Hepatocellular Carcinoma

In the first-line treatment of advanced hepatocellular carcinoma, checkpoint inhibitors led to favorable outcomes in studies reported at the European Society for Medical Oncology (ESMO) Congress 2019—though one study was technically negative. The current first-line standard of care for unresectable ...

immunotherapy
symptom management

Maximizing Benefit in the Treatment of Immune-Mediated Colitis

Immune-related colitis is the second most common toxicity associated with checkpoint inhibitors, affecting up to 40% of patients. The ASCO Post interviewed Yinghong Wang, MD, PhD, Director of Medication-Induced Colitis and Enteritis, Director of Fecal Microbiota Transplantation, and Associate...

multiple myeloma

Selinexor/Dexamethasone in Refractory Multiple Myeloma: The STORM Has Arrived, but Does It Represent Climate Change?

The term “relapsed/refractory multiple myeloma” is often used to describe advanced myeloma that has progressed through primary or salvage therapy. The International Myeloma Working Group (IMWG) defined the term in 2011 as disease that is “nonresponsive while on salvage therapy or progresses...

Prescribing Hope

“There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something tomorrow.” –Orison Swett Marden I was informed that my patient, a 58-year-old man recently diagnosed with pancreatic cancer, and his wife were becoming impatient waiting for me in the exam...

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...

Friends of Cancer Research Launches ctDNA Pilot Project

Friends of Cancer Research (Friends) recently announced the launch of its latest project, ctMoniTR. This pilot project will aim to harmonize the use of circulating tumor DNA (ctDNA) to monitor treatment response in patients with cancer and test the feasibility of data comparison from different...

lung cancer

Gefitinib Alone vs Gefitinib Plus Chemotherapy in EGFR-Mutated Metastatic NSCLC

In the Japanese phase III NEJ009 trial reported in the Journal of Clinical Oncology, Hosomi et al found that the addition of first-line gefitinib to carboplatin/pemetrexed improved progression-free survival vs gefitinib alone in patients with EGFR-mutated metastatic non–small cell lung cancer...

multiple myeloma

Selinexor Plus Dexamethasone Studied in Triple-Class Refractory Multiple Myeloma

In a phase IIb study (STORM Part 2) reported in TheNew England Journal of Medicine, Ajai Chari, MD, of Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, and colleagues found that oral selinexor and dexamethasone were active in some patients with multiple myeloma refractory to prior...

gastrointestinal cancer

Maximizing Benefit in the Treatment of Immune-Mediated Colitis

Immune-related colitis is the second most common toxicity associated with checkpoint inhibitors, affecting up to 40% of patients. The ASCO Post interviewed Yinghong Wang, MD, PhD, Director of Medication-Induced Colitis and Enteritis, Director of Fecal Microbiota Transplantation, and Associate...

solid tumors

Long-Term Effects of Denosumab in Patients With Giant Cell Tumor of Bone

As reported by Chawla et al in The Lancet Oncology, long-term data from the final analysis of an international phase II study suggest that a favorable risk-benefit ratio is maintained over time with denosumab treatment of patients with giant cell tumor of bone. Benefit of denosumab was indicated in ...

prostate cancer
breast cancer
bladder cancer
pancreatic cancer
kidney cancer
thyroid cancer
gynecologic cancers
immunotherapy

ESMO Congress 2019: Quick Takes From Key Clinical Trials

The ESMO Congress continues to grow as a pivotal platform for research in clinical oncology. At the ESMO Congress 2019, important findings were showcased in more than 2,200 studies, including 93 late-breaking abstracts. The ASCO Post summarized much of that news in separate articles over several...

hepatobiliary cancer

Targeted Treatment Advances in Cholangiocarcinoma

For one of the rarest and most aggressive of tumors—cholangiocarcinoma—two novel molecularly targeted agents yielded encouraging outcomes in advanced disease in studies reported at the European Society for Medical Oncology (ESMO) Congress 2019. In the phase III ClarIDHy trial, the risk of disease...

prostate cancer

Phase III PROfound Study Evaluates Olaparib in Setting of Metastatic, Castration-Resistant Prostate Cancer

Treatment with the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib delayed disease progression and appears to improve survival, compared with newer hormonal agents in men with pretreated metastatic castration-resistant prostate cancer and homologous recombinant repair (HRR) genetic...

immunotherapy
gynecologic cancers

Immunotherapy Shows Strong Benefit in Two Gynecologic Cancers

In studies reported at the ESMO Congress 2019, immunotherapy yielded encouraging outcomes in two gynecologic cancer populations in need of new treatments, including patients with advanced cervical cancer that is microsatellite-stable and patients previously treated for advanced endometrial cancer.  ...

multiple myeloma

Selinexor Plus Dexamethasone Studied in Triple-Class Refractory Multiple Myeloma

In a phase IIb study (STORM Part 2) reported in The New England Journal of Medicine, Ajai Chari, MD, of Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, and colleagues found that oral selinexor and dexamethasone were active in some patients with multiple myeloma refractory to prior...

gynecologic cancers
immunotherapy

Checkpoint Inhibitors Benefit Women With Advanced Stages of Cervical, Endometrial Cancers

Immunotherapy studies reported at the ESMO Congress 2019 yielded encouraging outcomes in patients with advanced cervical cancer that is microsatellite-stable and patients previously treated for advanced endometrial cancer. The combination of nivolumab and ipilimumab, with two different dosing...

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...

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