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issues in oncology

Navigating the ‘New Normal’: NCCN Summit Examines Access to High-Quality Cancer Care

It’s not just the leaps in development of precision medicines, the soaring costs, the new payment models, clinical trial designs, sources of data, and federal policies. It’s all of them plus the rapidity with which change is happening that makes this era of oncology exceptional. “I would say...

supportive care

Cannabinoids for Cancer Pain: Dangerous or Beneficial?

Cannabis has been used in health care for millennia, and its use has been well documented, albeit never definitively integrated into clinical practice. Recent societal changes and the increasing acceptance and availability of cannabis have reignited the medical and public debate around its role in...

supportive care

Therapeutic Applications for Cannabinoids in Oncology: The Debate Continues

In the early part of the 20th century, the U.S. government classified cannabis as a Schedule 1 drug: a dangerous substance with no medical value. For many years, that classification prevented systematic research in cannabinoid use in medicine. As a result of societal changes and an intense and...

lymphoma

Venetoclax and Beyond: Successfully Targeting BCL2

Although many agents have been able to successfully inhibit the proliferative capacity of cancer cells or disable mutations that spur cancer growth, one area that has proven elusive is the apoptotic pathway—the cell’s means of resisting death. That is until recently. Dysregulation of B-cell...

breast cancer

FDA Grants Clearance of PowerLook Density Assessment for Digital Breast Tomosynthesis

iCAD has announced U.S. Food and Drug Administration (FDA) clearance of its artificial intelligence software program, PowerLook Density Assessment Version 3.4, which provides an automated method of determining breast density. The software is compatible with iCAD’s digital breast...

gynecologic cancers

Apatinib and Oral Etoposide in Platinum-Resistant/Refractory Ovarian Cancer

In a Chinese single-center phase II study reported in The Lancet Oncology, Lan et al found a high response rate with oral apatinib plus oral etoposide in patients with platinum-resistant or refractory ovarian cancer. Study Details The study included 35 patients with progression within 6 months...

gynecologic cancers

FDA Approves HPV Test for First-Line Cervical Cancer Screening

ON JULY 30, 2018, Roche announced approval by the U.S. Food and Drug Administration (FDA) of its cobas HPV Test in first-line screening for cervical cancer in women 25 years and older using cervical specimens collected in SurePath preservative fluid. The FDA first approved the cobas HPV test...

palliative care
immunotherapy

Meeting the Challenges of Immunotherapy-Related Toxicities

In 2011, the U.S. Food and Drug Administration (FDA) approved ipilimumab (Yervoy), an anticytotoxic T-lymphocyte– associated antigen 4 (CTLA-4), the first checkpoint inhibitor for the treatment of advanced melanoma.1 Since then, several more checkpoint inhibitors directed at both the programmed...

lung cancer
issues in oncology

Lung Cancer Screening Guidelines May Be Inadequate for High-Risk Minorities

Data from a lung cancer screening program at the University of Illinois at Chicago (UIC) provides evidence that national lung cancer screening guidelines, which were developed based on the National Lung Screening Trial (NLST) in 2011 and recommend screening based on age and smoking history, may be...

supportive care
integrative oncology

Reishi Mushroom

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, present information on the use of reishi...

multiple myeloma

New Tool for Assessing Frailty in Patients With Newly Diagnosed Multiple Myeloma

A NEW “frailty index” may predict overall survival for patients newly diagnosed with multiple myeloma, according to a study published in JCO Clinical Cancer Informatics.1 Frailty is a critical factor in treatment decision-making for many patients with multiple myeloma, as many of these patients are ...

supportive care
symptom management

Lack of Congruence Among Tools Used to Assess Cancer-Related Cognitive Dysfunction

THE ASSESSMENT of cognitive dysfunction in patients who have undergone chemotherapy is complex, and although a number of strategies are available, each has its limitations, according to Karin Olson, RN, PhD, Professor in the Faculty of Nursing at the University of Alberta, Edmonton, Canada.  At...

prostate cancer

Abiraterone or Enzalutamide for Newly Diagnosed Metastatic Castrate-Resistant Prostate Cancer?

WHAT IS THE best choice of treatment for a man with newly diagnosed metastatic castration-resistant prostate cancer after treatment with androgen-deprivation therapy—abiraterone acetate (Zytiga) plus prednisone, or enzalutamide (Xtandi)? Both drugs achieve similar cancer control in this setting,...

issues in oncology

Medical Preparedness for Nuclear Disaster

ROBERT PETER GALE, MD, PhD, DSc (hc), was on the faculty of the University of California, Los Angeles, School of Medicine for 20 years and has served as Chairman of the Scientific Advisory Committee of the Center for International Blood and Marrow Transplant Research. In 1986, he was asked by the...

issues in oncology
legislation

Why Oncologists Should Decline to Participate in the Right to Try Act

ON MAY 30, 2018, President Donald J. Trump signed into law the Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017.1 This law creates an additional and alternative pathway for patients with a “life-threatening disease or condition” to access...

gynecologic cancers

careHPV Test Receives WHO Prequalification Status for Cervical Cancer Screening

The careHPV Test, a molecular diagnostic for high-risk human papillomavirus (HPV) designed to screen women in low-resource settings, has been added to the World Health Organization (WHO) list of prequalified in vitro diagnostics (IVDs). HPV is the primary cause of cervical cancer, so ...

breast cancer

Abemaciclib as Initial Therapy for Hormone Receptor–Positive, HER2-Negative Advanced or Metastatic Breast Cancer

Early in 2018, abemaciclib (Verzenio) in combination with an aromatase inhibitor was approved as initial endocrine-based therapy for postmenopausal women with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer.1,2 Supporting Efficacy Data Approval was based on findings in ...

lung cancer
issues in oncology
global cancer care

Lung Cancer Mortality Among Women Projected to Increase by 43% Worldwide by 2030

According to a report by the International Agency for Research on Cancer, cancer is among the leading causes of morbidity and mortality worldwide, with an estimated incidence of 14 million new cases of the disease and 8.2 million cancer deaths in 2012. A study analyzing breast and female lung...

lung cancer

Adding Cisplatin to First-Line Treatment of Elderly Patients With Advanced NSCLC

A joint analysis of parallel phase III trials reported in the Journal of Clinical Oncology by Gridelli et al found no overall survival benefit of adding cisplatin to first-line treatment of elderly patients with advanced non–small cell lung cancer (NSCLC) without an EGFR mutation. Study...

lung cancer
immunotherapy

Ado-Trastuzumab Emtansine in HER2-Mutant Lung Cancer

As reported by Li and colleagues in the Journal of Clinical Oncology, the HER2-targeted antibody-drug conjugate ado-trastuzumab emtansine (Kadcyla) showed activity in advanced HER2-mutant lung adenocarcinoma. Study Details The current report involves a cohort of patients with HER2-mutant lung...

breast cancer

New Study Calls for Continued Aggressive Treatment for Breast Cancer in Women Under 40

A new study from the Stanford Cancer Institute found that young women who are treated with chemotherapy for breast cancer but have residual tumor in either the breast or lymph nodes have higher chances of recurrence compared to those with no evidence of any residual invasive...

breast cancer
integrative oncology

ASCO Endorses Guidelines for Integrative Therapies During and After Breast Cancer Treatment

RECOMMENDATIONS IN the Society for Integrative Oncology (SIO) clinical practice guidelines for integrative therapies during and after breast cancer treatment “are clear, thorough, and based on the most relevant scientific evidence,” concluded an ASCO expert panel that reviewed the guidelines.1,2...

issues in oncology

Opportunities, Issues, and Challenges for Biosimilars in Oncology

In an article published recently in TheNew England Journal of Medicine, Gary H. Lyman, MD, MPH, FACP, FRCP (Edin), FASCO, of Fred Hutchinson Cancer Research Center in Seattle, and colleagues reviewed opportunities, issues, and challenges posed by the advent of biosimilar medications, focusing on...

cns cancers
issues in oncology

Pediatric CT Scans and Subsequent Malignancy Risk

A new study by Meulepas et al in the Journal of the National Cancer Institute suggests that computed tomography (CT) scans may increase the risk of brain tumors. The use of CT scans has increased dramatically over the past 2 decades. CT scans greatly improve diagnostic capabilities,...

breast cancer

Olaparib for Germline BRCA-Mutated Metastatic Breast Cancer

EARLY IN 2018, olaparib tablets (Lynparza) were granted regular approval for treatment of patients with deleterious or suspected deleterious germline BRCA-mutated, HER2-negative metastatic breast cancer who have been treated with chemotherapy in the neoadjuvant, adjuvant, or metastatic setting.1,2...

hematologic malignancies

Answers to Hematology Expert Review Questions

Question 1  Which of the following is one of the four major criteria for the diagnosis of essential thrombocythemia?  Correct Answer: A. Platelet count ≥ 450 × 109/L.  Expert Perspective  The diagnosis of essential thrombocythemia requires that all four major criteria or the first three major...

leukemia

FDA Approves Ivosidenib for IDH1-Mutated AML

Today, the U.S. Food and Drug Administration (FDA) approved ivosidenib (Tibsovo) tablets for the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) who have a specific genetic mutation. This is the first drug in its class (isocitrate dehydrogenase-1 [IDH1]...

issues in oncology

In Case You Missed It: Update on Breast Cancer Research

The ASCO Post presents these brief summaries of important studies in breast cancer, presented at the 2018 ASCO Annual Meeting. Ribociclib Plus Fulvestrant in Metastatic Breast Cancer The benefit of an inhibitor of cyclin-dependent kinase 4/6 (CDK4/6) added to fulvestrant has now been proven to...

colorectal cancer
immunotherapy

Nivolumab Plus Low-Dose Ipilimumab Approved for Second-Line Treatment of MSI-H/dMMR Metastatic Colorectal Cancer

On July 11, the U.S. Food and Drug Administration (FDA) approved nivolumab (Opdivo) plus low-dose ipilimumab (Yervoy) for the treatment of adult and pediatric patients aged 12 years and older with microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) metastatic colorectal...

palliative care
colorectal cancer
lung cancer
cost of care

Geographic Differences in End-of-Life Cancer Care

When it comes to how much end-of-life care a patient with cancer receives, geography may, indeed, be destiny, according to new research led by Harvard Medical School that found differences in this type of cancer care across different parts of the country. The findings, published by Keating et al...

breast cancer

8-Year Update of SOFT and TEXT Trials: Positive but Not Definitive

At the 2017 San Antonio Breast Cancer Symposium (SABCS), the International Breast Cancer Study Group (IBCSG) and its collaborators presented the 8-year updates of the key modern trials of ovarian function suppression after local treatment for young women with resected breast cancer.1 These updates...

skin cancer
immunotherapy

Immunotherapy in Merkel Cell Carcinoma: ‘Field Has Been Thrown on Its Head’

At the 2018 ASCO Annual Meeting, investigators presented long-term follow-up data for immunotherapy in patients with Merkel cell carcinoma and new data for its use in the neoadjuvant setting. The results drew high interest from attendees and a number of questions were raised following the...

pancreatic cancer

Early Study Shows Elasticity of Cancer Cells May Determine Where Pancreatic Cancer Metastases Form

Pancreatic cancer often metastasizes to the liver or lungs. The prognosis is better for patients with metastases in the lungs. However, the organ that is more likely to be affected depends on the cancer cells’ ability to alter their characteristics and shape—as a research team at the...

issues in oncology
pain management

Statement by FDA Commissioner on Opioid Access for Patients With Chronic and End-of-Life Pain

U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, recently issued the following statement. The opioid epidemic continues to take an emotional, physical, and financial toll on Americans. The FDA is committed to taking every possible step to address the many facets of this...

colorectal cancer
immunotherapy

FDA Approves Nivolumab Plus Low-Dose Ipilimumab for Second-Line Treatment of MSI-H/dMMR Metastatic Colorectal Cancer

Today, the U.S. Food and Drug Administration (FDA) approved  nivolumab (Opdivo) plus low-dose ipilimumab (Yervoy) for the treatment of adult and pediatric patients aged 12 years and older with microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR)...

lymphoma

FDA Grants Orphan Drug Designation to CPI-613 for Treatment of Burkitt Lymphoma

The U.S. Food and Drug Administration (FDA) has granted Orphan Drug designation to CPI-613 for the treatment of Burkitt lymphoma. Burkitt lymphoma is a highly aggressive hematologic B-cell malignancy classically characterized by the overexpression of c-Myc. Due to the rapid proliferation rate of...

cns cancers

Intratumoral Recombinant Poliovirus in Grade IV Glioblastoma

In a study reported in The New England Journal of Medicine, Desjardins and colleagues found that convection-enhanced intratumoral delivery of a recombinant nonpathogenic polio–rhinovirus chimera (PVSRIPO) was not associated with neurovirulence in patients with recurrent grade IV glioma and...

A Humble Beginning Built on Commitment: The Life and Times of Lee S. Schwartzberg, MD, FACP

  In this edition of the Living a Full Life series, guest editor Jame Abraham, MD, interviewed medical oncologist Lee S. Schwartzberg, MD, FACP, Executive Director at the West Cancer Center, Memphis. Dr. Schwartzberg’s major research interests are new therapeutic approaches to breast cancer,...

skin cancer
immunotherapy

Treatment Beyond Disease Progression in Melanoma: Challenge Centers on Knowing Who May Benefit

Dr. Weiss is Assistant Professor (Medical Oncology), Developmental Therapeutics, Melanoma Program, Yale Cancer Center. Dr. Sznol is Professor of Medicine (Medical Oncology); Co-Director, Cancer Immunology Program, Yale Cancer Center Co-Director, Yale SPORE in Skin Cancer, New Haven, Connecticut.  ...

skin cancer

Expert Point of View: Jedd Wolchok, MD, PhD

“THIS IS a wonderful presentation and a very exciting trial,” said formal discussant Jedd Wolchok, MD, PhD, of Memorial Sloan Kettering Cancer Center, New York. Despite the remarkable advances achieved with anti–programmed cell death protein 1 and ligand 1 (anti–PD-1/anti–PD-L1) treatment, “there...

lymphoma

Chemotherapy-Free Regimen Comparable to Rituximab-Chemotherapy as Front-Line Therapy for Follicular Lymphoma

IN PATIENTS with previously untreated advanced follicular lymphoma, the chemotherapy-free combination of rituximab (Rituxan) plus lenalidomide (Revlimid), the so-called R-squared (R2) regimen, yielded outcomes as good as those in patients who received standard rituximab-chemotherapy, in the interim ...

cns cancers

Surgery Followed by Salvage Stereotactic Radiosurgery vs Whole-Brain Radiotherapy for Four or Fewer Brain Metastases

In a Japanese phase III noninferiority trial (JCOG0504) reported in the Journal of Clinical Oncology, Kayama et al found that salvage stereotactic radiosurgery (SRS) was noninferior to whole brain radiation therapy (WBRT) for survival in patients with 1 to 4 resected brain metastases. In the...

gynecologic cancers

Analgesic Use and Risk of Ovarian Cancer

In a study of Ovarian Cancer Cohort Consortium data reported in the Journal of the National Cancer Institute, Trabert et al found that daily aspirin use was associated with a modest reduction in the risk of ovarian cancer. The study included prospective individual-level data from 13 studies in the ...

prostate cancer
immunotherapy

Apalutamide in Nonmetastatic Castration-Resistant Prostate Cancer

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Earlier this year, apalutamide (Erleada) was approved for ...

solid tumors
head and neck cancer
issues in oncology

Socioeconomic and Racial Disparities in Management of Brain Metastases

Increasing use of a potentially life-saving treatment for metastatic cancer is leaving many vulnerable patients behind, according to a new study from Yale Cancer Center/Smilow Cancer Hospital published by Benjamin H. Kann, MD, of Yale University School of Medicine, and colleagues in the Journal of ...

solid tumors
lung cancer
issues in oncology
supportive care

Racial/Ethnic Disparities in End-of-Life Care Among Patients With Lung Cancer

Significant disparities in the quality of end-of-life lung cancer care were found among racial/ethnic minorities, with higher odds of experiencing potentially preventable medical encounters during end of life as compared with non-Hispanic whites. These findings were published by Siddharth Karanth, ...

solid tumors
prostate cancer

Oxybutynin for Androgen Deprivation–Associated Hot Flashes in Prostate Cancer

In a letter to the editor of The New England Journal of Medicine, Thomas J. Smith, MD, of Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, and colleagues described the successful use of oxybutynin to treat hot flashes in a patient receiving androgen-deprivation therapy (ADT) for ...

solid tumors
skin cancer

FDA Approves Encorafenib and Binimetinib in Combination for Unresectable or Metastatic Melanoma With BRAF Mutations

On June 27, 2018, the U.S. Food and Drug Administration (FDA) approved the combination of the BRAF inhibitor encorafenib (Braftovi) and the MEK inhibitor binimetinib (Mektovi) in patients with advanced BRAF V600–mutant melanoma, as detected by an FDA-approved test.1 Dual targeting of the MAPK...

sarcoma

Addition of Dose-Intensified Doxorubicin to Standard Chemotherapy in Rhabdomyosarcoma

As reported by Bisogno et al in The Lancet Oncology, a phase III trial (EpSSG RMS 2005) has shown no benefit of adding doxorubicin to standard IVA (ifosfamide, vincristine, dactinomycin) in 3-year event-free survival among patients with high-risk rhabdomyosarcoma. Study Details In the open-label...

integrative oncology
supportive care

Mindfulness in Cancer Care: Hype or Help?

GUEST EDITOR Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief, Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York.   “Mindfulness” has gained significant popularity in the lay press in recent...

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