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issues in oncology
lung cancer

Adding the Patient’s Voice to Collaborative Clinical Trial Efforts

THE INTERNATIONAL Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer was the largest in its history. One of the key themes of the meeting was to focus on the patient. Here are highlights of presentations from this conference that demonstrate the role of the...

prostate cancer

Expert Point of View: Robert Bristow, MD, PhD; Ignacio Duran, MD; Karim Fizazi, MD

FORMAL DISCUSSANT Robert G. Bristow, MD, PhD, of the Manchester Cancer Research Centre, Manchester, United Kingdom, called this trial “an exemplar.” “Radiation to the prostate should be considered standard of care in the setting of hormone-sensitive low-metastatic burden. The treatment is well...

issues in oncology

Cancer Taught Me to Help Patients Find Healing Hope

AS AN INTERNIST, I strived to give patients hope by prescribing therapies that increased their chance—their hope—of the best outcome and by encouraging them with hopeful words. My own hope was to care for patients until I was old. Just weeks after celebrating my 36th birthday, I was diagnosed with ...

lung cancer

Expert Point of View: Fiona Blackhall, MD, PhD

FORMAL STUDY discussant, Fiona Blackhall, MD, PhD, of the University of Manchester, UK, welcomed brigatinib (Alunbrig) as a new first-line option for ALK-positive patients but said, “In the absence of comparisons of next-generation ALK inhibitors, it will take some time to determine if there is...

symptom management

Can Patients Use Topical Skin Creams During Radiation Therapy?

Contrary to the advice most patients with cancer receive when they go through radiation treatment, topical skin treatments, unless applied very heavily, may not increase the radiation dose to the skin and can be used in moderation before daily radiation treatments, according to findings from a new...

breast cancer

Final Analysis of SWOG POEMS: Goserelin and Chemotherapy in Breast Cancer

Final results of SWOG Cancer Research Network’s international Prevention of Early Menopause Study (POEMS) showed continued evidence that women who get injections of the hormone drug goserelin along with standard breast cancer chemotherapy are more likely to become pregnant, without developing ...

skin cancer

Combining Genetic and Sun Exposure Data May Improve Prediction of Skin Cancer Risk

By combining data on individuals’ lifetime sun exposure and their genetics, researchers may be able to generate improved predictions of their risk of skin cancer, according to findings presented by Fontanillas et al at the 2018 American Society of Human Genetics Annual Meeting (Abstract PgmNr ...

hematologic malignancies
leukemia
genomics/genetics

Without Genomic Sequencing, I Would Not Be Alive Today

The extreme fatigue I experienced during the winter of my fourth year in medical school, in 2003, was easily attributable to the rigors of my medical training and the lack of sleep that comes from trying to keep up with an intensely busy schedule. I was looking forward to resting and recuperating...

Living a Full Life After a Diagnosis of Cancer

BOOKMARK Title: Here We Grow: Mindfulness Through Cancer and BeyondAuthor: Paige DavisPublisher: She Writes PressDate: May 2018Price: $22.95, paperback, 154 pages Since the publication of Dr. Paul Kalanithi’s best-selling book, When Breath Becomes Air, about his diagnosis of cancer and untimely...

Family Archivist Holds Joyful Memories Amid Grief of Losing Loved Ones

BOOKMARK Title: The Trail to Tincup: Love Stories at Life’s EndEditors: Joyce Lynnette HockerPublisher: She Writes PressPublication date: May 2018Price: $23.95, hardcover, 288 pages Human mortality is embedded in the day-to-day challenges of clinical oncology; a cancer diagnosis is a reality...

issues in oncology

Cancer Care in the U.S. Prison System

A health-care system is evaluated by various metrics: one is how it cares for its most vulnerable patients. The United States spends far more on health care than any nation in the world, yet access to high-quality oncology services remains elusive to certain minority populations—none more so than...

issues in oncology
cost of care

Findings From the National Cancer Opinion Survey: Alternative Therapies, Cost of Care, and More

Nearly 4 in 10 Americans believe cancer can be cured solely through alternative therapies, according to ASCO's second annual National Cancer Opinion Survey. This is despite research showing that patients who use alternative therapies instead of standard cancer treatments have much higher...

solid tumors
breast cancer

The Persephone Trial Reconsidered

Persephone is a 4,088-patient trial that Helena Margaret Earl, MBBS, PhD, reported at the 2018 ASCO Annual Meeting as establishing that 6 months of trastuzumab (Herceptin) is not inferior to 12 months in 4-year survival without invasive or local regional recurrence or distant metastases. Dr. Earl...

solid tumors
breast cancer

The Persephone Trial Reconsidered

The Persephone presentation by Helena Margaret Earl, MBBS, PhD, got a lot of publicity after a pre–ASCO Annual Meeting press release, suggesting that 6 months of adjuvant trastuzumab (Herceptin) is enough. The advice of experts has been that the evidence is inconclusive, but I have not heard a...

breast cancer

ESMO 2018: HOBOE-2: Zoledronic Acid in Premenopausal Hormone Receptor–Positive Early Breast Cancer

Adjuvant treatment with zoledronic acid, plus hormonal therapy with the aromatase inhibitor letrozole, significantly increases disease-free survival compared to tamoxifen in premenopausal women with hormone receptor–positive early breast cancer, according to results reported by Perrone et al...

Many Patients With Early-Stage Follicular Lymphoma May Not Receive Guideline-Recommended Radiation Therapy

Radiation therapy for early-stage follicular lymphoma “is underused,” Joanna C. Yang, MD, MPH, and Joachim Yahalom, MD, declared in a recent editorial in the Journal of Clinical Oncology.1 This underuse of radiation therapy can result in overtreatment with systemic therapies or overconfidence in...

Humbled by Challenges, Renowned Hematologist Kanti R. Rai, MD, Recalls a Rich Career

For this installment of the Living a Full Life series, guest editor, Jame Abraham, MD, interviewed Kanti R. Rai, MD, Professor of Medicine at the Karches Center for Oncology Research, Feinstein Institute for Medical Research, Manhasset; Professor of Medicine at Zucker School of Medicine at...

I’m Not Dying of Cancer: I’m Living With Cancer

I’m a psychiatrist, so I don’t say this lightly: receiving a diagnosis of stage IV gastric adenocarcinoma made me insane. I had remembered the horrible deaths due to abdominal cancer I had seen during my medical training and was terrified that would be my fate as well. I knew from looking at the...

Big Data and Breast Cancer: Moving the Field Forward Through Comprehensive Analysis

To gain further insight into, among other things, optimizing big data and the latest on hormonal breast cancer treatment, The ASCO Post recently spoke with pioneering oncologist Christopher C. Benz, MD, a breast cancer specialist and Director of the Cancer & Developmental Therapeutics Program, ...

Has the Promise of Precision Medicine Been Oversold?

Recently, the term “personalized medicine” in oncology care has been overtaken by the more contemporary concept of “precision medicine.” According to the National Research Council of the National Academies of Science, Engineering, and Medicine, the newer terminology shifts the focus to improving...

Overcoming Long-Term Health and Economic Impact of Cancer on Young Adult Survivors

A pair of studies showcased the potentially devastating long-term health and financial consequences cancer has on adult survivors of childhood cancer compared with other adults, as well as survival disparities based on health insurance status.1,2 Despite increasing survival rates among the more...

On the Frontier of Breast Cancer Research With Joyce A. O’Shaughnessy, MD

Nationally regarded breast cancer researcher and clinician Joyce A. O’Shaughnessy, MD, was born in upstate New York, just outside of Albany, where she attended grade school before her family moved to Beverly, Massachusetts, a suburban town 26 miles from Boston, where her family’s roots were....

solid tumors
head and neck cancer

The Sontag Foundation: Turning a Difficult Diagnosis Into Action to Benefit Patients With Brain Cancer

When Frederick B. Sontag’s wife, Susan, was diagnosed in 1994 with grade III astrocytoma, the couple was understandably overwhelmed to hear that her expected survival was 3 years. At that time, there were few organizations providing resources to patients with brain tumors and their families. While...

issues in oncology
legislation

Labeling Act to Keep Drug Label Information Up-to-Date Introduced to Senate

Friends of Cancer Research (Friends) recognized Senators Orrin Hatch (R–UT) and Michael Bennet (D–CO) for responding to a recently identified public health issue and proposing a solution to an issue impacting patients and their physicians. Senators Hatch and Bennet jointly introduced the Making...

supportive care
pain management

The Opioid Crisis From the Oncology Perspective

As the nation battles an escalating opioid-overdose crisis, which claims more than 100 lives per day, a new study presented at the 2018 ASCO Quality Care Symposium was designed to answer a heretofore unanswered question: How common are opioid-related deaths in patients with cancer?1 Unintended...

FDA Awards Research Grants in Development of Treatments of Rare Diseases, Cancers

The U.S. Food and Drug Administration (FDA) has announced that it has awarded 12 new clinical trial research grants totaling more than $18 million over the next 4 years to enhance the development of medical products for patients with rare diseases. These new grants were awarded to principal...

immunotherapy

Assay Uses Big Data to Predict Responses to Immunotherapy

In the age of big data, cancer researchers are discovering new ways to monitor the effectiveness of immunotherapy treatments. Researchers at the Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy developed a new way to use bioinformatics as a gathering tool to determine how a...

solid tumors
hepatobiliary cancer

Cabozantinib in Advanced Hepatocellular Cancer: Call for Revision of Practice Standards

As reported in The New England Journal of Medicine by Ghassan K. Abou-Alfa, MD, and colleagues, and reviewed in this issue of The ASCO Post, the phase III CELESTIAL trial has demonstrated that cabozantinib (Cabometyx) improved the median overall survival to 10.2 months in comparison to 8 months...

hematologic malignancies
lymphoma

Novel Treatment Approaches in Early Relapse of Follicular Lymphoma

“Patients with follicular lymphoma who relapse early after treatment are a minority of patients, fortunately, but they are clearly patients with a different disease,” according to Jonathon B. Cohen, MD, of Emory University School of Medicine. At Emory’s 2018 Debates and Didactics in Hematology and...

breast cancer

ESMO 2018: PALOMA-3: Palbociclib in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

Treatment with the cyclin-dependent kinase (CDK) 4/6 inhibitor palbociclib (Ibrance) achieved a clinically meaningful improvement in overall survival in patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer that has relapsed or ...

Expert Point of View: Everett Vokes, MD

“PACIFIC is a positive trial, with a 32% improvement in survival, and maintenance durvalumab is a new standard of care,” stated formal discussant Everett Vokes, MD, Chair of the Department of Medicine at the University of Chicago and a pioneer in the concurrent use of chemotherapy and radiotherapy ...

How the Nobel Prize Could Spur More Cancer Advances

Even before James P. Allison, PhD, made an appearance at the Fourth International Cancer Immunotherapy Conference: Translating Science Into Survival in New York City, the excitement among attendees was palpable. Earlier that day, October 1, 2018, Dr. Allison and Tasuku Honjo, MD, PhD, of Kyoto...

Expert Point of View: Hossein Borghaei, MS, DO

Formal discussant, Hossein Borghaei, MS, DO, of Fox Chase Cancer Center, was guardedly optimistic about the IMpower132 trial results. “The study met its primary endpoint, and investigator-assessed progression-free survival was superior in the investigational arm. Overall survival was not mature,...

breast cancer

ESMO 2018: Short-HER Trial Examines Abbreviated Course of Trastuzumab in Some HER2-Positive Early Breast Cancers

Women with HER2-positive early breast cancer with small tumors have similar disease-free survival and lower risk of cardiac toxicity with a 9-week course of adjuvant trastuzumab (Herceptin) compared to those treated for 1 year, according to a subgroup analysis of the Short-HER trial reported by...

breast cancer
issues in oncology

Report Examines Shortages of Oncologists, Variation in Cancer Rates

Doximity has released a new study detailing a concerning trend that could potentially impact cancer care in the United States. Doximity researchers examined retirement trends, percentage of state-trained specialists, and prevalence of breast cancer on a city-by-city basis. The report is the...

Learning to Listen and Returning to the Art of Medicine

Bernard Lown, MD, was born in Lithuania, the son of a rabbi. He immigrated to the United States at the age of 14, where his scientific precocity bloomed. After attaining his medical degree from John Hopkins University School of Medicine, he pursued his passion of raising international awareness of...

On Aging and the Wellness Industry

Only a few centuries ago, the major source of moral and scientific authority in Western culture was religion, which requires trusting one of numerous supernatural deities. However, the presumption that medicine is based on evidence-based and peer-reviewed science is what gives it authority in...

breast cancer

An Early Love of Literature Gives Way to a Career in Breast Cancer Research for Jennifer K. Litton, MD

Breast cancer specialist Jennifer K. Litton, MD, was born and reared in Leominster, Massachusetts, a small city in the north central part of the state. “I went to parochial schools until seventh grade and then went on to high school in Worcester. Although I enjoyed science early on, I was...

immunotherapy

James Allison, PhD, and Tasuku Honjo, MD, PhD, Win 2018 Nobel Prize in Physiology or Medicine

JAMES ALLISON, PHD, Chair of Immunology and Executive Director of the Immunotherapy Platform at The University of Texas MD Anderson Cancer Center, and Tasuku Honjo, MD, PhD, Distinguished Professor at the Kyoto University Institute for Advanced Study and Professor of Immunology and Genomic Medicine ...

issues in oncology
palliative care

Closing the Gender Divide in Preference for Palliative Care

Eight years ago, a survey of the preferences of Dutch patients with cancer for health care found that while gender was one aspect influencing how men and women approach cancer care, it was the most important, with men, generally, regarding most care aspects as less important than women. The study...

colorectal cancer
issues in oncology

Sex-Linked Differences in Cancer May Identify Specific Genetic Drivers, Predict Responses to Treatment

Analysis of male- and female-derived tumor samples revealed differences in prognostic biomarkers, genes that drive cancer, and in regulation of key pathways that may predict responses to treatment, according to results published in two studies in Cancer Research, one by Li et al and the other...

head and neck cancer
immunotherapy

DNA Vaccine Leads to Immune Responses in HPV-Related Head and Neck Cancer in Small Study

A therapeutic vaccine may boost antibodies and T cells, helping them infiltrate human papillomavirus (HPV)-related head and neck cancer tumors. Researchers from the Abramson Cancer Center of the University of Pennsylvania tested the immunotherapy approach in two groups of patients with...

Updated ASCO Answers Fact Sheets for Your Practice

Be sure to check out these newly updated ASCO Answers fact sheets: Chronic Lymphocytic Leukemia Lung Cancer Melanoma Multiple Myeloma Pancreatic Cancer Prostate Cancer Thrombocytopenia When Cancer Spreads to the Bone These one-page (front and back) introductions include a topic overview; an...

issues in oncology

ASCO Analysis Finds Some Pharmacy Benefit Manager Practices May Erode Patient Access to Cancer Care

ASCO warns that some of the practices used by pharmacy benefit manager (PBM) companies could hinder patient access to timely, high-quality cancer care. While PBM practices may be intended to help control costs in cancer care, in a new position statement, ASCO describes a range of practices that...

hematologic malignancies
multiple myeloma

Emerging Options and Sequencing Therapy in Relapsed Multiple Myeloma

Advances in the treatment of multiple myeloma have led to longer progression-free survival, but the majority of patients will still relapse despite newer treatments. A number of new drugs and combinations are under study in the hope of improving outcomes. “Multiple myeloma is a complex disease...

hematologic malignancies
leukemia

Beat AML Trial Seeking to Change Treatment Paradigm

The Beat AML Master Clinical Trial seeks to change the treatment paradigm and outcomes in acute myeloid leukemia (AML) by personalizing therapy and ultimately facilitating the approval of novel targeted agents. Co-investigator William Blum, MD, of the Winship Cancer Institute at the Emory...

hematologic malignancies
lymphoma

The Relevance of the RELEVANCE Trial in Follicular Lymphoma

We have seen remarkable progress in the outcomes of patients with advanced-stage follicular lymphoma over the past 2 decades.1 Recent manuscripts and presentations describing long-term follow-up of randomized trials comparing various chemotherapy platforms (all combined with anti-CD20 antibodies)...

lung cancer

WCLC 2018: Study Analyzes Use of Thoracic Radiotherapy for Limited-Stage SCLC

A study has demonstrated that using involved-field radiotherapy (IFRT) and irradiating postchemotherapy residual primary tumor volume for limited-stage small cell lung cancer (SCLC) did not result in increased recurrence of the cancer. Xiao Hu, MD, PhD, of the Department of Thoracic Radiotherapy,...

solid tumors
immunotherapy

Cancer Vaccine Shows Clinical Benefit in Phase I Study of Patients With HER2-Positive Cancers

A preclinical study showing that a vaccination with a recombinant adenovirus expressing a truncated ErbB-2 antigen can cure advanced established murine breast cancer as well as extensive established metastatic lung cancer led to the launch of a small phase I study investigating a therapeutic cancer ...

James Allison, PhD, and Tasuku Honjo, MD, PhD, Win 2018 Nobel Prize in Physiology or Medicine

James Allison, PhD, Chair of Immunology and Executive Director of the Immunotherapy Platform at The University of Texas MD Anderson Cancer Center, and Tasuku Honjo, MD, PhD, Distinguished Professor at the Kyoto University Institute for Advanced Study and Professor of Immunology...

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