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issues in oncology

No Man Is an Island: Reflections From an ASCO IDEA Recipient

IT WAS a chilly Chicago morning, and I was sitting at the lobby of my hotel when I saw a smiling gentleman cheerfully waving at me from his car. It was Lawrence H. Einhorn, MD, picking me up for our drive to Indiana. I was one of the recipients of the ASCO International Development and Education...

colorectal cancer

Becoming Acquainted With Cancer

Just weeks after my wedding in late summer of 2017, I had a sudden bout of abdominal pain so severe that it sent me to the emergency room. I was just 29 years old and in great physical shape. In the emergency room, a physician examined me and was about to release me with a prescription for a...

issues in oncology

Physicians and the Threat of Nuclear War

The Hippocratic Oath calls on physicians to “use treatment to help the sick according to my ability and judgment,” but not all versions of the oath call on us to prevent disease. Here we urge our colleagues to acknowledge that additional mandate and renew their commitment to preventing what could ...

A Compassionate Family Doctor Sparked an Interest in Medicine for Lori Pierce, MD, FASTRO, FASCO

GUEST EDITOR Jame Abraham, MD, FACP Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic. For this installment of the Living a Full Life series of articles, guest editor Jame Abraham, MD,...

supportive care

Integrative Medicine in Pediatric and Adolescent Patients With Cancer

GUEST EDITOR Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief of Integrative Medicine Service at Memorial Sloan Kettering Cancer Center, New York. The ASCO Post’s Integrative Oncology series is intended to facilitate the...

issues in oncology
genomics/genetics

Emerging Interest in Metabolic Pathways to Tumorigenesis

Although genetic aberrations are considered a major reason for cancer development, the importance of metabolic alterations in cancer development has emerged as a crucial aspect of contemporary cancer research. Better understanding of the metabolic traits in cancer cells could aid researchers in...

Laughter in Oncology Is More Common Than You Think

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,...

colorectal cancer
issues in oncology

Rates of Colorectal Cancer Diagnosis in Adults Younger Than Age 50

A new study published by Virostko et al in Cancer found that the proportion of adults diagnosed with colorectal cancer under age 50 in the United States has continued to increase over the past decade, and younger adults are diagnosed with more advanced disease. To determine recent trends in...

multiple myeloma

Stratification Tool to Predict VTE in Patients With Multiple Myeloma Treated With Immunomodulatory Drugs

New research published by Li et al in JNCCN–Journal of the National Comprehensive Cancer Network has identified a way to help clinicians caring for patients with multiple myeloma to predict blood clots in order to take preventive action. The researchers established a set of risk factors to...

lung cancer
issues in oncology

Poorer Outcomes for Patients With Lung Cancer Undergoing Radiotherapy During Disaster-Level Hurricanes

Patients who experienced a disaster-level hurricance during radiotherapy for lung cancer had worse overall survival than those who completed treatment in normal circumstances, with longer disaster declarations associated with increasingly worse survival. These findings come from a...

pancreatic cancer

Biliary Microbiome Altered in Patients Undergoing Surgery After Neoadjuvant Therapy for Pancreatic Cancer

The biliary microbiome was altered in patients who received neoadjuvant therapy prior to undergoing surgery for pancreatic cancer, according to a study published by Goel et al in HPB. Additionally, more bacteria in patients who underwent surgery after neoadjuvant therapy were resistant to...

breast cancer

Role of Regulatory T Cells in Predicting Breast Cancer Relapse

Blood and intratumoral regulatory T-cell activity may one day provide a method for predicting breast cancer relapse, according to findings published by Wang et al in Nature Immunology. “This is the first success linking a solid tumor with blood biomarkers—an indicator of whether a...

solid tumors

Subtypes of Pancreatic Neuroendocrine Tumors and Effect on Disease Recurrence

Researchers have discovered two distinct subtypes of pancreatic neuroendocrine tumors (pNETs) associated with different risks of recurrence following surgical treatment. The finding could yield predictive tests while focusing vigilant follow-up monitoring on patients with pNETs that have a higher...

hepatobiliary cancer

KIR-HLA System Gene Loci Imbalance and Biliary Tract Cancer

Patients with biliary tract cancer have an altered genetic architecture in some immune system receptor systems, according to research published by Cornillet et al in Gastroenterology. Research Findings Researchers at Karolinska Institutet investigated the genetic architecture of two large genetic ...

multiple myeloma
immunotherapy

How Immunologic Dysregulation in the Multiple Myeloma Microenvironment May Affect Response to CAR T-Cell Therapy

Despite an avalanche of novel therapies approved by the U.S. Food and Drug Administration (FDA) over the past decade in the treatment of multiple myeloma, including proteasome inhibitors and immunomodulatory drugs, this blood cancer remains largely incurable, and nearly 13,000 people are expected...

The Bomb

I sit paralyzed at my desk. Everyone else has left the clinic. I can hear the sound of the broom in the hall as the after-hours cleaning begins. No phones ring, no patients hurry to appointments, no chatter lingers in the air. The silence is oppressive, the air is heavy, and the distance from my...

Growing Up in a Medical Family Planted the Seed for a Career in Oncology for Karen Gelmon, MD

Karen Gelmon, MD, was born and reared in Saskatoon, the largest city in the Canadian province of Saskatchewan. It is surrounded by vast prairie and situated along the Trans-Canada Yellowhead Highway and is home to the University of Saskatchewan. “We lived close to the University,” she shared. “My...

colorectal cancer

ESMO World GI 2019: BEACON CRC: Encorafenib/Binimetinib/Cetuximab Improves Survival in BRAF V600E–Mutated Metastatic Colorectal Cancer

The three-drug combination of encorafenib, binimetinib, and cetuximab significantly improved overall survival in patients with BRAF-mutated metastatic colorectal cancer, according to results of the phase III BEACON CRC clinical trial. These findings were presented by Kopetz et al at the European...

2019 Presidential Address: Caring for Every Patient, Learning From Every Patient

Welcome, everyone. We are so glad that you are all here today. Those of you attending your first ASCO Annual Meeting: Welcome to this amazing organization. What I’d like to do is to show you some of what ASCO offers, and challenge you all to join in to make a powerful future a reality. We have a...

immunotherapy
lung cancer

Combination Immunotherapy and Inhibitors of DNA Damage Repair in the Treatment of Small Cell Lung Cancer

Unlike non–small cell lung cancer (NSCLC), which has seen a paradigm shift in treatment modalities with the discovery of genetic signatures (including EGFR mutations) that are responsive to targeted drugs, systemic treatment of small cell lung cancer (SCLC) has remained largely unchanged for over...

Expert Point of View: Jiping Wang, MD, PhD

“The jury is still out,” said APACT’s invited discussant, Jiping Wang, MD, PhD, a biostatistician and hepatobiliary pancreas surgical oncologist at Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston. “The final overall survival analysis is needed to know the real benefit from...

pancreatic cancer

APACT Trial: Nab-paclitaxel/Gemcitabine vs Gemcitabine Alone in Adjuvant Treatment of Pancreatic Cancer

The largest adjuvant trial in pancreatic adenocarcinoma, the global phase III APACT trial, evaluated the combination of adjuvant nab-paclitaxel/gemcitabine vs gemcitabine monotherapy in patients with resected pancreatic cancer. Results of the study were reported by Margaret A. Tempero, MD, of the...

bladder cancer
immunotherapy

Enfortumab Vedotin After Checkpoint Inhibition in Metastatic Urothelial Cancer

A phase II study found that treatment with the antibody-drug conjugate enfortumab vedotin achieved responses in 44% of patients with locally advanced or metastatic urothelial cancer previously treated with platinum chemotherapy and a checkpoint inhibitor. This is a noteworthy study because it...

prostate cancer

SNMMI 2019: Phase I/II Trial of Lutetium-177–PSMA-617 Plus Idronoxil in Metastatic Castration-Resistant Prostate Cancer

A novel therapy using two targeted treatments for prostate cancer has been shown to maximize efficacy while reducing side effects, according to research presented at the 2019 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) and published by Emmett et al in The Journal ...

colorectal cancer

IDEA Collaboration Turns to Duration of Adjuvant Treatment in Stage II Colon Cancer

The findings of the landmark IDEA trial in stage III colorectal cancer, presented at the 2017 ASCO Annual Meeting and subsequently published in The New England Journal of Medicine,1 were upheld by a subsequent analysis by the same group, the International Duration Evaluation of Adjuvant...

Winning the Lottery

I was born at the beginning of World War II in a country half way around the world from the fighting. As a child, I was immune to the carnage. My father was too old to be included, although his elder brother had been killed in World War I. Thousands of families in many countries lost a father, a...

issues in oncology

Project Facilitate: FDA’s Plan to Ease Expanded Access to Novel Therapies

The U.S. Food and Drug Administration (FDA) plans to provide oncologists with greater help in acquiring expanded access to investigational therapies. Deemed Project Facilitate, the pilot program was announced at a press briefing during the 2019 ASCO Annual Meeting. Project Facilitate is essentially ...

Expert Point of View: John T. Cole, MD, and Carlos H. Barrios, MD

“The end-of-study analysis of the CLEOPATRA trial demonstrates and confirms the long-term benefit of combined HER2-antibody therapy, with a significant number of ongoing responders,” said John T. Cole, MD, breast cancer specialist and Director of Clinical Cancer Research at Ochsner Health System...

breast cancer

CLEOPATRA End-of-Study Analysis in Metastatic Breast Cancer: 37% Alive at 8 Years

The end-of-study analysis of the landmark CLEOPATRA trial shows that 37% of patients with HER2-positive metastatic breast cancer are still alive at 8 years, according to principal investigator Sandra M. Swain, MD, FACP, FASCO, Associate Dean for Research Development at Georgetown University Medical ...

lung cancer

Extended Follow-up From the National Lung Screening Trial Reported

Early detection and treatment through screening with low-dose computed tomography (LDCT) has been investigated as a potential means of reducing lung cancer mortality for more than 2 decades. In 2011, a large U.S. study—the randomized National Lung Screening Trial (NLST)—reported a 20%...

solid tumors
gynecologic cancers
lymphoma
multiple myeloma

FDA Pipeline: Applications Accepted in Gynecologic Cancers, Targeted Therapies

Recently, the U.S. Food and Drug Administration (FDA) accepted a new drug application for niraparib in the treatment of certain pretreated gynecologic cancers; granted Fast Track designation to a T-cell product; accepted investigational new drug applications for a myelopreservation agent and an...

hematologic malignancies
multiple myeloma

IMWG Consensus Recommendations on Imaging in Monoclonal Plasma Disorders

Just as newer drugs have significantly improved outcomes for patients with multiple myeloma in the past decade, newer imaging techniques are upgrading detection of the disease, leading to earlier treatment, but standards to help guide clinicians on the optimal use of advanced imaging have lagged...

symptom management
immunotherapy

Multidisciplinary Approach for Addressing Immunotherapy-Related Toxicities

New research published in JNCCN—Journal of the National Comprehensive Cancer Network and presented by Jarushka Naidoo, MBBCh, at the NCCN 2019 Annual Conference suggests that institutions and networks that utilize immunotherapy should consider establishing multidisciplinary teams for...

issues in oncology

Accelerated Approval Program: For the Benefit of Patients

A DIAGNOSIS of any life-threatening cancer or other serious illness has always been a world-shaking event for those touched by significant disease, and most of us have known—or will know—the frustration, helplessness, and desperate sense of urgency provoked by the words, “The disease is worsening,...

Register Early for ASCO’s Research Community Forum 2019 Annual Meeting

EARLY REGISTRATION is now open for the ASCO Research Community Forum (RCF) 2019 Annual Meeting. The ASCO RCF Annual Meeting brings together physician investigators and research staff from across the country for 2 days of learning and collaboration. The meeting offers colleagues from a variety of...

head and neck cancer
immunotherapy

Synergistic Relationship Between Radiotherapy and Immunotherapy for Squamous Cell Carcinoma of the Head and Neck

Recent technologic improvements in radiotherapy now offer an unprecedented opportunity to enhance immune response, and going forward, may play a role in the definitive treatment of head and neck cancer, according to William Stokes, MD, Assistant Professor in the Department of Radiation Oncology at...

immunotherapy
head and neck cancer

Immune Therapies Emerging in Disease-Specific Treatment of HPV-Positive Head and Neck Cancer

Patients with human papillomavirus (HPV)-related head and neck cancer stand to benefit greatly from immunotherapy, according to Nabil F. Saba, MD, FACP, Director, Head and Neck Medical Oncology Program, Winship Cancer Institute of Emory University, Atlanta. He added, immunotherapy will likely play...

issues in oncology

ASCO Launches Task Force to Address the Cancer Care Gap in Rural America

Despite progress being made in cancer survivorship—there are currently nearly 17 million cancer survivors in the United States1—not everyone is benefiting equally, especially those patients living in rural communities across America. According to “The State of Oncology Practice in America, 2018:...

head and neck cancer
immunotherapy

Expert Point of View: Vanita Noronha, MD

The KEYNOTE-048 trial is practice-changing, according to its invited discussant, Vanita Noronha, MD, Professor of Oncology at Tata Memorial Centre in Mumbai, India. Although a number of questions remain to be answered, she said the take-home message is that the study “met most of its primary...

leukemia
immunotherapy

Fixed-Duration Venetoclax Plus Obinutuzumab as First-Line Treatment in Older Patients With CLL Who Have Comorbidities

A fixed-duration regimen of venetoclax plus obinutuzumab demonstrated superior progression-free survival, complete response rates, and minimal residual disease (MRD) negativity compared with chlorambucil plus obinutuzumab as first-line therapy for older patients with chronic lymphocytic leukemia...

Expert Point of View: Charles Drake, MD, PhD

IN A SEPARATE interview with The ASCO Post, Charles Drake, MD, PhD, commented on the clinical implications of the ENZAMET and TITAN trials, as well as studies of apalutamide, abiraterone acetate, and docetaxel used in metastatic hormone-sensitive prostate cancer. Dr. Drake is Director of...

prostate cancer

Apalutamide Improves Survival Outcomes in Castration-Sensitive Metastatic Prostate Cancer in TITAN Trial

Adding apalutamide to androgen-deprivation therapy (ADT) significantly improved survival in men with metastatic castration-sensitive (also termed hormone-sensitive) prostate cancer, according to the results of the phase III TITAN trial, which were presented at the 2019 ASCO Annual Meeting and...

pancreatic cancer

Expert Point of View: Wells Messersmith, MD, and Allyson Ocean, MD

“THE RATIONALE for the POLO study is sound,” said invited study discussant Wells Messersmith, MD. “There’s clearly an unmet need in pancreatic cancer, and there are promising data for poly (ADP-ribose) polymerase (PARP) inhibitors in other BRCA-mutated tumors.” Dr. Messersmith is Professor and Head ...

pancreatic cancer

POLO Trial Shows Maintenance Olaparib Improves Progression-Free Survival in Metastatic Pancreatic Cancer

In patients with metastatic pancreatic cancer and germline mutations in BRCA1 or BRCA2, maintenance therapy with olaparib doubled the time to disease progression and the proportion of patients who were progression-free at 2 years, in the phase III POLO trial.1 “Maintenance olaparib provided a...

issues in oncology
colorectal cancer

Solving the Mystery of Why Colorectal Cancer Is on the Rise in Young Adults

Excluding skin cancer, colorectal cancer is the third most prevalent and lethal cancer among both men and women in the United States.1 Although the risk of developing colorectal cancer increases with age—more than 90% of cases occur in people aged 50 or older2—recent research shows that the...

issues in oncology

An ASCO Survey, Hope, and Conventional Therapies

HOW DO YOU respond when patients with a good prognosis want to delay chemotherapy to try an anticancer diet for a few months or visit an unregulated clinic for unproven therapies? I’m asking because of an alarming finding of ASCO’s 2018 National Cancer Opinion Survey: “Nearly 4 in 10 Americans...

prostate cancer

Chemotherapy and/or Hormonal Agents: Differing Perspectives

WHEN ASKED which treatment to start with—docetaxel or enzalutamide, Dr. Sweeney said, “Patients fit for chemotherapy with high-volume disease can receive chemotherapy [docetaxel] and come back to these newer hormonal treatments or start with anyone of the hormonal options. Choosing among the newer...

prostate cancer

ENZAMET Trial Shows Enzalutamide Improves Overall Survival in Hormone-Sensitive Metastatic Prostate Cancer

Agents that improve survival in metastatic castration-resistant prostate cancer when added to background androgen-deprivation therapy (ADT) are showing success in treating metastatic prostate cancer earlier while it is still hormone-sensitive. These agents include docetaxel (chemotherapy) and...

hematologic malignancies
lymphoma

Transitioning From Healthy Physician to Patient With Cancer

As you probably already know, physicians do not make the best patients. When I began experiencing the early signs of Hodgkin lymphoma, in 2007, including a persistent cough, unusual fatigue, and pruritus, I self-diagnosed allergic rhinitis and began treatment with intranasal corticosteroids....

breast cancer

Denosumab Prevents Neither Breast Cancer Relapse Nor Death

The recently published report of Austrian Breast and Colorectal Cancer Study Group’s Study 18 (ABCSG-18)1 for the secondary endpoint of disease-free survival suggests that denosumab given in a low dose of 60 mg subcutaneously every 6 months during aromatase inhibitor adjuvant therapy is...

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