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breast cancer
immunotherapy

Vaccine Plus Trastuzumab in Preventing Recurrence of HER2–Low-Expressing Breast Cancer

IN HIGH-RISK patients with breast cancer and low expression of HER2 (HER2 low), a peptide vaccine targeting HER2, combined with granulocyte-macrophage colony-stimulating factor (GM-CSF), and given concurrently with trastuzumab, may help to prevent recurrence. Final analysis of a randomized phase...

genomics/genetics

Human Gene Therapy: Progress and Oversight

The early debate over the social and ethical implications of gene therapy led the National Institutes of Health (NIH) to establish the Recombinant DNA Advisory Committee in 1974. However, the risks of human gene therapies were largely unknown until 1999, when a patient died of a massive immune...

immunotherapy

The Future of Immunotherapy: Building on Checkpoint Blockade

THE EMERGENCE of anticancer agents that block immune checkpoints has transformed the field of oncology, leading to durable responses and improvements in overall survival in melanoma, renal cell carcinoma, head/neck squamous cell carcinoma, urothelial bladder cancer, and non–small cell lung cancer....

issues in oncology
cns cancers

Fine-Tuning an ‘Airport Diagnosis’

HIS HEAD WAS DIFFERENT from those of the other people in line. He bore a matrix of white rows of circular patches on his shaved scalp like a wig. The patches were electrodes, connected by cords to a power supply in a satchel around his shoulder. I was able to make an instant and unfortunate...

issues in oncology

Full Disclosure: What Oncologists Must Tell Patients About Their Experience and Training

Informed consent is an important part of delivering quality cancer care. Traditional ethical and legal rules require clinicians to disclose three types of information: (1) the patient’s diagnosis; (2) the nature of the proposed intervention and its intended benefits, risks, and adverse effects;...

kidney cancer
immunotherapy

Expert Point of View: Tracy Rose, MD, MPH

THE FORMAL DISCUSSANT of the KEYNOTE-427 trial, Tracy Rose, MD, MPH, of the University of North Carolina, Chapel Hill, told listeners: “I think pembrolizumab should now be considered an option for non–clear cell kidney cancer. Response rates, however, remain inferior to those seen in clear cell...

pancreatic cancer

Trends in Neoadjuvant Therapy for Resectable Pancreatic Cancer

SEVERAL STUDIES at the 2019 Gastrointestinal Cancers Symposium evaluated the benefits of neoadjuvant treatment in patients with pancreatic cancer—and in patients deemed fully resectable, not just “borderline” resectable.1-3 Although the standard of care for resectable pancreatic ductal...

kidney cancer
immunotherapy

JAVELIN Renal 101: Avelumab Plus Axitinib vs Sunitinib in the First-Line Treatment of Advanced Kidney Cancer

THE PROGRAMMED cell death-ligand 1 (PD-L1) inhibitor, avelumab, was combined with the multitargeted vascular growth endothelial factor (VEGF) agent, axitinib, and compared to monotherapy with sunitinib in the first-line treatment of patients with metastatic renal cell carcinoma. Toni K. Choueiri,...

solid tumors

AACR 2019: Phase I Trial Evaluates LOXO-195 in Patients With NTRK-Positive Solid Tumors

The investigational anticancer therapeutic LOXO-195, which targets a family of proteins called tropomyosin receptor kinases (TRKs), was safe, tolerable, and showed signs of clinical activity in patients who had solid tumors that harbored NTRK gene fusions and had become resistant to other...

issues in oncology
symptom management

Differences in Medical Cannabis Use in Patients With and Without Cancer

People with and without cancer are more likely, over time, to use a more potent form of medical marijuana with increasingly higher amounts of tetrahydrocannabinol (THC), a new study published by Kim et al in the Journal of Palliative Medicine has shown. “Although there is growing...

hematologic malignancies

Racial Disparities in Matched Volunteer Stem Cell Donors

Although the pool of registered bone marrow donors has increased in recent years, a new study suggests that most patients of southern European and non-European descent are unlikely to have a suitable match if they need a bone marrow transplant. If an immediate registry search does not identify a...

prostate cancer

ASCO Endorses Active Surveillance Guideline for Low-Risk Prostate Cancer

ASCO ENDORSES and reinforces the evidence-based American Urological Association (AUA), American Society for Radiation Oncology (ASTRO), and the Society of Urologic Oncology (SUO) Guideline published in 2018 in the Journal of Urology. ASCO’s endorsement of a guideline on clinically localized...

prostate cancer

Prostatectomy vs Watchful Waiting: Clinical Dilemma Centers on Aggressive vs Indolent Disease

THE MANAGEMENT of localized prostate cancer remains controversial. Although the widespread use of prostate-specific antigen (PSA) testing has resulted in a dramatic increase in the diagnosis and treatment of prostate cancer, many men do not benefit from intervention because the disease is either...

multiple myeloma
immunotherapy

Expert Point of View: Ajay K. Nooka, MD, MPH

THE ASCO POST asked Ajay K. Nooka, MD, MPH, Associate Professor, Division of Bone Marrow Transplant at Winship Cancer Institute, Emory University, to comment on studies involving daratumumab. “After the phase III SWOG S0777 trial demonstrated a survival benefit with a 3-drug induction regimen...

immunotherapy
multiple myeloma

ASH Reports Show Benefit of Adding Daratumumab to Initial Therapy in Multiple Myeloma

DARATUMUMAB APPEARS to be the “gift that keeps on giving” to the myeloma community. “It seems we can add daratumumab to almost anything and make the regimen better. It’s got good activity and a good safety profile,” said Kenneth Shain, MD, PhD, Director of the Myeloma Working Group at Moffitt...

City of Hope Awarded Lymphoma SPORE Grant

CITY OF HOPE announced recently that it received its third lymphoma Specialized Programs of Research Excellence (SPORE) grant from the National Cancer Institute (NCI). The grant covers a 5-year period and totals $12.5 million. SPORE grants involve both basic as well as clinical and applied...

prostate cancer

Expert Point of View: Emmanuel S. Antonarakis, MD

EMMANUEL S. ANTONARAKIS, MD, Associate Professor of Oncology, Johns Hopkins University, Baltimore, commented on the state of current knowledge about poly (ADP-ribose) polymerase (PARP) inhibitors in prostate cancer. “PARP inhibitors are definitely making inroads in the management of patients with...

colorectal cancer
neuroendocrine tumors
gastrointestinal cancer
hepatobiliary cancer

New Data in Colorectal, Neuroendocrine, Gastric, and Hepatocellular Cancers

THE ANNUAL GASTROINTESTINAL CANCERS SYMPOSIUM took place earlier this year in San Francisco. In addition to important studies captured in our past few issues, The ASCO Post here briefly summarizes additional interesting studies. Adjuvant Hyperthermic Intraperitoneal Chemotherapy in Colon Cancer...

issues in oncology

Caring: Isn’t That Why We Went to Medical School?

YOU CANNOT write about caring; you must practice it. None of us went to medical school thinking we would be an oncologist or a neurosurgeon or a stem cell biologist. But we did have vague aspirations of wanting to help others: to be involved in other lives. It was an altruistic avocation; how...

lung cancer

Ultradeep Next-Generation Sequencing in Patients With Lung Cancer

A new method of determining the sequence of molecules in DNA can be used to detect small fragments of cancerous genetic material in blood samples from patients with lung cancer with a high degree of accuracy, according research published by Li et al in Annals of Oncology. Liquid Biopsies and...

issues in oncology

Infertility in Women and Low Absolute Risk of Cancer

A study of over 64,000 women of childbearing age in the United States has found that infertility is associated with a higher risk of developing cancer compared to a group of over 3 million women without fertility problems—although the absolute risk is very low, at just 2%. These findings ...

breast cancer
issues in oncology

Number of Pregnancies May Influence Breast Cancer Risk in Women With BRCA Mutations

Researchers have found the lower risk of breast cancer associated with multiple pregnancies and breastfeeding in the general population extends to those at the highest risk of breast cancer. These results were published by Terry et al in the JNCI Cancer Spectrum. Methods and Findings The...

hepatobiliary cancer

Demographic Factors Increasing Risk of Liver Cancer Development in Patients With Fatty Liver Disease

A new study published by Zarrinpar et al in Liver International has found that elderly, diabetic, and Hispanic patients with steatohepatitis—fatty liver disease—may have a higher risk of developing liver cancer. Ali Zarrinpar, MD, PhD, Associate Professor of Surgery at the...

lung cancer
issues in oncology

Shraddha M. Dalwadi, MD, MBA, on Non–Small Cell Lung Cancer: What Contributes to Disparities in Treating Stage I Disease

Shraddha M. Dalwadi, MD, MBA, of Baylor College of Medicine, discusses the nearly 12% of potentially curable patients with stage I NSCLC who do not receive treatment, the various socioeconomic reasons why, and how some patients may benefit from minimally invasive therapies (Abstract 127).

Use Technology and Appreciate the Importance of Partners

Most oncologists are comfortable treating lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patients with cancer, according to a survey of 149 oncologists from 45 National Cancer Institute–designated Comprehensive Cancer Centers, but not as confident in their knowledge of the...

issues in oncology

Knowing Gender Identity and Sexual Orientation of Patients Is a Vital Aspect of Medical Care

A survey of oncologists from National Cancer Institute (NCI)-designated Comprehensive Cancer Centers found that 95.3% of oncologists who responded are comfortable with treating lesbian, gay, and bisexual patients with cancer, and 82.5% are comfortable treating transgender patients with cancer.1...

breast cancer

Restarting My Life After Terminal Cancer

At the end of 2015, I was dying. I was just 50 years old and a wife and mother of 2 teenage boys. Twelve years earlier, I had been diagnosed with ductal carcinoma in situ in my left breast. Despite a modified radical mastectomy and removal of nearly all of the lymph nodes in my left underarm—which ...

Obesity, Examined and Explained

BOOKMARK Title: The Obesity Code: Unlocking the Secrets of Weight LossAuthor: Jason Fung, MDPublisher: Greystone BooksDate: March 2016Price: $18.95, paperback; 296 pages According to data from the National Cancer Institute (NCI), obesity plays a significant role in developing at least 12 different ...

gynecologic cancers
issues in oncology

SGO 2019: HPV Vaccine Uptake in the Deep South

A study by Pierce et al presented at the Society of Gynecologic Oncology’s (SGO) 50th Annual Meeting on Women’s Cancer showed that human papillomavirus (HPV) vaccination rates in Alabama are highest in counties with high incidence rates of HPV-related cancer (Abstract 13).  ...

palliative care
supportive care

Sweet Surrender

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,...

WebMD Recognizes Seven Cancer Innovators With Its Health Heroes Award

On January 15, 2019, WebMD, an online and print health-care resource for consumers, presented its 2018 Health Heroes Award in New York City to 7 people who are making a difference in oncology care. The honorees include Karen M. Winkfield, MD, PhD, Associate Professor of Radiation Oncology at Wake...

issues in oncology

The Risks of Drug Approval Based on Shaky Evidence

Two recent publications in The New England Journal of Medicine (NEJM), and the resulting drug approval applications that have already been filed, lead to concern that the basis of medical practice on valid evidence may be corrupted. Each involves statistically shaky analysis leading to a striking...

solid tumors
bladder cancer

Johns Hopkins Greenberg Bladder Cancer Institute Awards Research Grants to Women’s Bladder Cancer Projects

The Johns Hopkins Greenberg Bladder Cancer Institute awarded research grants to four projects that focus on bladder cancer treatments in women and how biology could offer new targets for cancer therapy.The Institute awards grants of $25,000 to $50,000. David McConkey, PhD, Director of the...

ASCO President-Elect Howard A. Burris III, MD, FACP, FASCO, Gained Leadership Skills From His Experience at West Point

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic. In this installment of Living a Full Life, guest editor Jame Abraham, MD, spoke with Howard A. “Skip” Burris III, MD, FACP,...

prostate cancer

EAU 2019: Testosterone Replacement Therapy May Slow Recurrence in Low-Risk Prostate Cancer

Researchers have shown that testosterone replacement may slow the recurrence of prostate cancer in low-risk patients. Findings from the study were presented by Towe et al at the European Association of Urology (EAU) 2019 Congress (Abstract 646). Practitioners have long regarded testosterone as a...

issues in oncology

Assessing the Clinical Utility of ASCO’s and ESMO’s Value Frameworks

In 2015, ASCO and the European Society for Medical Oncology (ESMO) introduced value frameworks that utilize algorithmic scales to evaluate the clinical benefit of cancer therapies and provide an objective assessment of outcomes and treatment toxicities experienced by patients.1,2 Although the two...

breast cancer
leukemia
multiple myeloma
issues in oncology

FDA Pipeline: Assay Approval, Breakthrough Designations for AI Technology and CLL, and More

In the past week, the U.S. Food and Drug Administration (FDA) approved a companion diagnostic assay, granted Breakthrough Device and Breakthrough Therapy designations, and extended the review period of a proposed treatment. The agency also published four draft guidances and one final guidance...

cns cancers

Does Postoperative Conformal Radiotherapy Improve Survival in Pediatric Patients With Ependymoma?

Treatment with conformal radiation therapy immediately following surgery in children with ependymoma may greatly improve survival. The findings were published by Merchant et al in the Journal of Clinical Oncology. “Historically, children under the age of 3 with ependymoma have a worse...

skin cancer

What Is the Best Field-Directed Treatment for Actinic Keratosis?

In a Dutch study reported in The New England Journal of Medicine, Jansen et al found that 5% fluorouracil cream was the best of four field-directed treatments for actinic keratosis, the most common premalignant skin disease in the white population. Study Details The study examined the...

issues in oncology

Lack of Genetic Diversity in Common Cancer Cell Lines

Researchers have found that some commercial cancer cell lines used for laboratory studies have mislabeled ancestry when it comes to minorities. These findings were published by Hooker et al in Cancer Epidemiology, Biomarkers & Prevention. “A lack of diversity is prevalent in every level...

breast cancer

We Need Better Screening Methods for Detecting Breast Cancer

MY BREAST CANCER was probably a decade in the making, although I only became aware that there might be a problem in 2014, when I noticed some slight pain in my left breast. A routine mammogram and ultrasound found benign cysts in my dense breasts, which most likely explained the pain, I was told,...

A Peaceful Transformation: The Origin of the Frederick National Laboratory

JUST 2 MONTHS before Congress passed what to this day is America’s most sweeping anticancer legislation, President Richard Nixon came to Fort Detrick in Frederick, Maryland, to declare his administration’s historic commitment to the fight. “I have come here today for the purpose of making an...

issues in oncology

Health-Care Fraud Prosecutions Are on the Rise

Prosecuting health-care fraud is a top priority for the U.S. Department of Justice (DOJ) and other federal government agencies.1,2 After all, the government earns a $6 return for every $1 that it spends on enforcement. In December 2018, the DOJ announced that it had obtained more than $2.5 billion...

multiple myeloma

Reshaping the Treatment Landscape in Refractory Multiple Myeloma

THE TREATMENT approaches for multiple myeloma, both newly diagnosed and relapsed disease, continue to undergo major transformation as new agents and combinations are being introduced.1 This change has been driven by the introduction of novel drug classes such as monoclonal antibodies, as well as...

lung cancer

Although Evidence Is Clear That Lung Cancer Screening Saves Lives, Adoption Rates Remain Low

The findings of the National Lung Screening Trial (NLST), reported in 2011, revealed that participants who received low-dose helical computed tomography (CT) scans had a 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. Despite these results,...

issues in oncology

Position Paper Addresses Shortages of Chemotherapy and Supportive Care Agents for Pediatric Oncology Patients

Shortages of essential chemotherapy drugs for children undergoing cancer treatment have been an increasingly frequent obstacle for patients and hospitals in the United States. These shortages can result in increased medication errors, delayed administration of life-saving therapy, inferior...

breast cancer
issues in oncology
cost of care

Patients With Breast Cancer Provide Recommendations to Ease Financial Toxicity

A qualitative study yielded nine patient-driven recommendations across circumstances that include changes to insurance, supportive services, and financial assistance to reduce long-term, breast cancer–related economic burden. The study was published by Dean et al in Cancer. Unique...

skin cancer
issues in oncology

2019 AAD: Disadvantages and Potential Improvements of Artificial Intelligence in Skin Cancer Detection

While artificial intelligence (AI) systems for skin cancer detection have shown promise in research settings, there is still a lot of work to be done before the technology is appropriate for real-world use. This was the topic of a scientific session at the 2019 American Academy of Dermatology (AAD) ...

issues in oncology

Eliminating the Taboo of Cancer

All homes and all families have or have had their own cancer experiences. Speaking about it dissolves the taboo and allows for earlier diagnosis, less discrimination, increased awareness, and higher commitment by authorities. It also helps those struggling with the disease feel like part of a...

issues in oncology
global cancer care

Who I Am and What I Will Do

I am a radiation oncologist from Zambia, where we only have one cancer center offering radiotherapy—and I will beat cancer. This bold statement often evokes a look of surprise. However, if the conversation is allowed to go on, I’ll say cancer is beatable even where resources are thin. I am...

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