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breast cancer
cost of care

Deviation From NCCN Guidelines May Result in Greater Costs for Patients With Metastatic Breast Cancer

A study published by Williams et al in JNCCN—Journal of the National Comprehensive Cancer Network found that direct costs for patients with metastatic breast cancer increased when their treatment differed from recommendations found in the NCCN Clinical Practice Guidelines in Oncology® (NCCN...

lupron

Cancer Taught Me What It Means to Be a Man

Let’s face it, men don’t go to the doctor as often as we should. At least that has been my experience. I felt compelled to finally make an appointment with my primary care physician after I began working as a research assistant at the Smidt Heart Institute at Cedars-Sinai in 2014, as it felt...

calquence
bendeka
fludara
imbruvica
gazyva
rituxan
venclexta

Younger, Fit Patients With CLL: Goal Remains Undetectable Minimal Residual Disease and Time-Limited Therapy

As reviewed in this issue of The ASCO Post, Shanafelt and colleagues recently published the interim analysis of E1912, a U.S. Intergroup–led randomized phase III trial comparing ibrutinib/rituximab, followed by ibrutinib to disease progression vs 6 months of fludarabine, cyclophosphamide, and...

Reflecting on My First National Presentation

I gave my first national presentation of my original clinical research on a topic that was to become a professional obsession: finding a cure for esophageal cancer. (Spoiler, I failed.) It was late May 1982. Writing about this now is undoubtedly predicated on my recent retirement, my desire to...

head and neck cancer
geriatric oncology

ESMO 2019: Personalized Treatment for Head and Neck Cancer Based on Geriatric Assessment

Fit elderly patients aged 70 years and older with head and neck squamous cell carcinoma were able to undergo rigorous treatment that provided benefit similar to that observed in younger patients. However, elderly patients with head and neck squamous cell carcinoma classified by geriatric assessment ...

colorectal cancer

Addition of Selective Internal Radiotherapy to Chemotherapy May Improve Resectability of Colorectal Cancer Liver Metastases

In a report published by Garlipp et al in the British Journal of Surgery, the addition of selective internal radiotherapy (SIRT) to modified FOLFOX6-based chemotherapy (mFOLFOX6; oxaliplatin/leucovorin/fluorouracil) improved the resectability of initially unresectable colorectal cancer liver...

head and neck cancer

Maura L. Gillison, MD, PhD, Pioneer in HPV-Related Head and Neck Cancer, Has Often Changed Lanes in Her Career

When The ASCO Post asked physician-scientist Maura L. Gillison, MD, PhD, where she was from, she answered, “North America.” Actually, she was born in Canada, but her father worked for a large international company, so the family moved regularly through Canada, the United States, and Mexico. “I...

prostate cancer

Looking at Prostate Cancer–Specific Mortality by Gleason Score and Race

Black men suffer disproportionately from prostate cancer, both in terms of incidence and mortality, compared with their white counterparts. However, a newer study conducted by investigators at the University of California, San Francisco, and Dana-Farber Cancer Institute, Boston, found that black...

issues in oncology

Cancer in Adults Aged 85 and Older: Rates, Screening, and Survival

A new report published by DeSantis et al in CA: A Cancer Journal for Clinicians examined cancer statistics in adults 85 and older and found incidence and mortality trends are generally similar to those in people aged 65 to 84 years, but disease screening rates are unexpectedly high and survival is...

rituxan
dacogen
imbruvica
venclexta

Highlights in Geriatric Hematology From the ASH Annual Meeting & Exposition

GUEST EDITOR Geriatrics for the Oncologist is guest edited by Stuart M. Lichtman, MD, FACP, FASCO, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Dr. Lichtman is an Attending Physician at Memorial Sloan Kettering Cancer Center, Commack, New York, and...

survivorship

Preserving Sexuality and Restoring Sexual Function in Male and Female Cancer Survivors

Intimacy changes after a cancer diagnosis. Both male and female survivors can experience significant sexual dysfunction, pain with sex, loss of desire, and a slew of other clinical and psychological sequelae. To make matter worse, sexual function is often not discussed by patients and their...

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,...

Expert Point of View: Christine Lovly, MD, PhD

Formal discussant of the studies on TAK-788 and BLU-667, Christine Lovly, MD, PhD, of the Vanderbilt Ingram Cancer Center, in Nashville, called both studies “very exciting.” “In 2019, we have a plethora of information on genomic drivers in lung cancer. There are a lot of great initiatives to drive ...

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...

issues in oncology

FDA Announces Project Facilitate to Access Investigational Therapies for Patients With Cancer

The Oncology Center of Excellence of the U.S. Food and Drug Administration (FDA) recently announced a new pilot program to assist oncology health-care professionals in requesting access to unapproved therapies for patients with cancer. A new call center designated Project Facilitate will be a...

hematologic malignancies

Gait Speed Identifies Frailty, Could Help Predict Outcomes in Older Patients With Hematologic Cancers

The speed at which older individuals with blood cancers are able to walk 4 meters (about 13 feet) holds information about their overall health and may help to predict survival and unplanned hospital visits, according to study published by Liu et al in Blood. The association was...

genomics/genetics

Two Pediatric Trials Find Targets for Treatment-Refractory Cancers

An interim analysis of the large Pediatric MATCH trial found that 24% of children and young adolescents with cancers refractory to current treatments had been assigned to treatment with investigational targeted study agents based on genetic alterations detected in their tumors,1 which is more than...

issues in oncology

FDA Announces Project Facilitate

Today, the U.S. Food and Drug Administration (FDA) Oncology Center of Excellence announced a new pilot program to assist oncology health-care professionals in requesting access to unapproved therapies for patients with cancer. A new call center designated Project Facilitate will be a single point...

An Aspiring Musician Changes Course and Becomes a Breast Cancer Specialist Who Makes Music

Internationally renowned breast cancer expert, Larry Norton, MD, FASCO, spent his formative years in a Long Island town that rubbed shoulders with the border of New York City. Making music was Dr. Norton’s first passion and a cheap subway ride landed him in Greenwich Village, the Holy Grail of the ...

Radiation Oncologist Lori J. Pierce, MD, FASCO, FASTRO, Enjoys Balancing Administrative and Clinical Roles

Lori J. Pierce, MD, FASCO, FASTRO, grew up in Washington, DC, and moved with her family to Philadelphia while in high school. She still considers the fast-paced DC–Philadelphia corridor her home, but her passion for a career in medicine, in part, took seed in a small town located in North...

breast cancer
issues in oncology
global cancer care

Breast Cancer Specialist Focuses on Educational Side of Oncology, Connecting Patients With Cancer Around the World

Internationally renowned breast cancer specialist Daniel A. Vorobiof, MD, was born in Santa Fe, Argentina, a province in the northeastern region of the country that is prone to catastrophic flooding. Asked about any early influences in his desire to pursue a career in medicine, Dr. Vorobiof...

Unlocking the Secrets of the Immune System, Story by Story

The story of immunotherapy is one of the most interesting and provocative in medical history. William B. Coley, MD, first harnessed the immune system against cancer in the late 19th century by injecting mixtures of live and inactivated bacteria into patients’ tumors. For various reasons,...

pain management
health-care policy

Debating the Role of Opioids in the Management of Chronic Cancer Pain

Despite the increasing public awareness of the danger of the overuse of prescription opioids, drug overdose deaths continue to rise in the United States. According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2017, nearly 400,000 people died of an overdose involving...

breast cancer
global cancer care

Ghanaian Oncologist Yehoda M. Martei, MD, Seeks Ways to Improve Outcomes in the Developing World

Breast cancer remains the most commonly diagnosed cancer among women globally. Due to a lack of early interventions, most women in low- and middle-income countries have advanced disease at the time of diagnosis, conferring a grim prognosis. Yehoda M. Martei, MD, of the Department of Medicine,...

Expert Point of View: Armin Shahrokni, MD

“Older and frail adults with cancer are the types of patients we deal with every day,” said Armin Shahrokni, MD, a geriatric oncologist at Memorial Sloan Kettering Cancer Center in New York. “The GO2 study is important, and I suspect it will be practice-changing,” he predicted. Older and frail...

gastroesophageal cancer

2019 ASCO: Reduced Chemotherapy Dosages in Elderly Patients With Advanced Gastroesophageal Cancer

A phase III randomized clinical study evaluating the optimum dose of a combination chemotherapy regimen of oxaliplatin and capecitabine in the treatment of advanced gastroesophageal cancer in frail and elderly patients has found that the patients prescribed the lowest dose tested experienced less...

lung cancer
issues in oncology
immunotherapy

ELCC 2019: Immunotherapy in Elderly Patients With Advanced NSCLC

Two studies reported at the European Lung Cancer Congress (ELCC) 2019 provided new insights on the efficacy and safety of immunotherapy in elderly patients with advanced non–­small cell lung cancer (NSCLC). Although around half of all people newly diagnosed with NSCLC are elderly (Pallis ...

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...

lung cancer

Heather A. Wakelee, MD, on Advanced Non–Small Cell Lung Cancer: State-of-the-Art Treatment for EGFR-Positive and ALK-Positive Diseases

Heather A. Wakelee, MD, of Stanford University, discusses the most recent FDA-approved tyrosine kinase inhibitors that target EGFR and ALK mutations, how these agents fit into the treatment landscape, and the rapidly evolving field of TKI resistance.

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,...

hematologic malignancies
multiple myeloma

Daratumumab, Lenalidomide, and Dexamethasone in Patients With Newly Diagnosed Multiple Myeloma: Outcomes From the MAIA Trial

In patients with newly diagnosed multiple myeloma who are not eligible for stem cell transplantation, the addition of daratumumab to lenalidomide and dexamethasone significantly reduced the risk of death or disease progression by 44%, according to a late-breaking abstract presentation by Thierry...

issues in oncology

Physician Wellness: Time to Heal the Healer

Physician wellness is emblazoned upfront in the news with attention-seeking headlines on a daily basis. The fact that one or two physicians commit suicide every day in this country sometimes elicits more of a sympathetic acknowledgment than a committed call to address it. Moreover, these sobering...

skin cancer
immunotherapy

Real-World Treatment Impact of Newer Agents on Survival of Patients With Metastatic Melanoma

The approval of several new agents for metastatic melanoma in the past several years has led to changes in how the disease is treated and managed. Treatments such as the programmed cell death protein 1 (PD-1) inhibitors pembrolizumab, ipilimumab, and nivolumab; BRAF inhibitors; and MEK inhibitors...

Expert Point of View: Steven Gore, MD, Eyten Stein, MD, and Elihu H. Estey, MD

In discussions after these presentations, several points were made by several experts. To begin, Steven Gore, MD, Director of Hematologic Malignancies at Yale Medical School, called the study of venetoclax plus 10-day decitabine “very important,” but he raised the issue of appropriate dosing. He...

lung cancer

Progress With ALK Inhibitors: When Will We Consider ALK-Positive Lung Cancer a ‘Chronic Disease’?

As reported by Solomon et al in The Lancet Oncology1 and reviewed in this issue of The ASCO Post, results from a global phase II study of the third-generation ALK inhibitor lorlatinib showed a high overall response rate and high intracranial response rate for patients with advanced ALK-positive...

geriatric oncology

Changing Perceptions on Surgical Intervention for Geriatric Patients With Cancer: Role of the SIOG Surgical Task Force

Surgery is an integral part of treatment of elderly patients with solid malignancies. The times we are living in will be remembered by health-care providers for the significant “contradictions” in the medical and surgical care of elderly patients with cancer. On the one hand, it has been...

lymphoma

Outcomes With AHCT Consolidation in Younger Patients With Mantle Cell Lymphoma in the Rituximab Era

In a retrospective study reported in the Journal of Clinical Oncology, Gerson et al found evidence that autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy was associated with a progression-free survival benefit in patients with mantle cell lymphoma aged...

hematologic malignancies
leukemia

Remnants of Cancer Remain, but Demons Are Now Gone

In the summer of 2002, I was a physically active 17-year-old boy on the cusp of adulthood. I was about to enter my senior year in high school, and like other teens my age, I was excited about college and the promise of the undreamed-of opportunities that lay ahead. At first, the lethargy I was...

New NCCN Member Institution: Abramson Cancer Center of the University of Pennsylvania

In November, the National Comprehensive Cancer Network® (NCCN) announced that Abramson Cancer Center (ACC) of the University of Pennsylvania will become the organization’s 28th Member Institution. The Abramson Cancer Center’s membership will include the Hospital of the University of Pennsylvania...

hematologic malignancies
multiple myeloma
immunotherapy

Front-Line Daratumumab Combination Regimen Improves Outcomes in Multiple Myeloma

In patients with newly diagnosed multiple myeloma who are not eligible for stem cell transplantation, the addition of daratumumab (Darzalex) to lenalidomide (Revlimid) and dexamethasone significantly reduced the risk of death or disease progression by 44%, according to a late-breaking abstract...

skin cancer

Encorafenib and Binimetinib: A New Benchmark in Metastatic Melanoma Therapy?

IN JULY 2018, the U.S. Food and Drug Administration (FDA) approved the combination of the oral BRAF inhibitor encorafenib (Braftovi) and the oral MEK inhibitor binimetinib (Mektovi) for BRAF V600E– or V600K– positive metastatic melanoma. The FDA approval was based on the results of the COLUMBUS...

issues in oncology

Focus on the Rocky Mountain Oncology Society

Formed in 1991, the Rocky Mountain Oncology Society (RMOS), a Chapter Member of the Association of Community Cancer Centers (ACCC) and State Affiliate of ASCO, serves as the voice for Colorado’s multidisciplinary cancer care teams and the patients they serve. Representing the common interests of...

issues in oncology

Novel Physician-Driven Practice Model Offers Alternative to Community Oncologists

Three leading oncology practices have united with partners in technology and finance to launch OneOncology, a physician-driven company that aims to unite more than 225 community oncology providers from 60-plus locations. Altogether, OneOncology will treat nearly 158,000 cancer patients a year. The...

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...

prostate cancer

ESMO 2018: Survival Results From STAMPEDE: Local Radiotherapy in Newly Diagnosed Metastatic Prostate Cancer With Low Disease Burden

Radiotherapy to the prostate improved overall survival in men newly diagnosed with metastatic prostate cancer who have a low metastatic disease burden, but not in those with higher burden of disease, according to results from a preplanned analysis of a large comparison study reported by Parker et...

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...

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...

leukemia

Adding Lomustine to Conventional Chemotherapy in Older Patients With AML Without Unfavorable Cytogenetics

As reported in the Journal of Clinical Oncology by Pigneux et al, a French phase III trial (LAM-SA 2007 FILO) has shown an overall survival benefit with the addition of lomustine to conventional chemotherapy in older patients with acute myeloid leukemia (AML) without unfavorable cytogenetics....

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...

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