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Searching for Evidence-Based Reassurance Where None Could Be Found

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,...

issues in oncology

Using Machine Learning to Prompt Serious Illness Conversations

Despite research showing that among patients with cancer, early advance care planning conversations lead to care that is in alliance with patients’ goals and wishes, especially at the end of life,1 most patients die without having discussions about their treatment goals and end-of-life preferences ...

immunotherapy

Expert Point of View: Basem M. William, MD, MRCP

Basem M. William, MD, MRCP, Director of the T-Cell Lymphoma Program and Cutaneous Lymphoma Multidisciplinary Clinic at The Ohio State University Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute, Columbus, commented on the newly reported findings...

immunotherapy

Strong Activity Shown for Lisocabtagene Maraleucel CAR T-Cell Therapy in Aggressive Large B-Cell Lymphoma

Another CD19-directed chimeric antigen receptor (CAR) T-cell therapy may be poised to enter the marketplace for aggressive relapsed or refractory large B-cell lymphoma, based on a high rate of rapid and durable complete responses achieved with lisocabtagene maraleucel. The phase I TRANSCEND NHL...

geriatric oncology

Poster to Bedside: Geriatric Oncology Research Updates From 2019 ASCO Annual Meeting

Functional status impairment, limited mobility, comorbidities, polypharmacy, and other aging-related manifestations are common in older individuals. These conditions complicate the oncologic management of older adults, who are underrepresented in clinical trials, even though they form the majority ...

leukemia
lymphoma
multiple myeloma
immunotherapy

Highlights From ASH 2019 Included New Data in Leukemia, Lymphoma, and Multiple Myeloma

The ASH 2019 Annual Meeting & Exposition featured countless important sessions and lectures. It would be impossible to attend all the symposia, oral presentations, poster presentations, and special events. Below, we have selected some presentation highlights to supplement our coverage of the...

immunotherapy
leukemia

Pivotal Trial Evaluates Second-Generation BTK Inhibitor Alone and in Combination With Obinutuzumab for First-Line Treatment of CLL

The second-generation Bruton’s tyrosine kinase (BTK) inhibitor acalabrutinib, alone, or in combination with obinutuzumab significantly improved progression-free survival compared with a standard combination of obinutuzumab/chlorambucil in treatment-naive patients with chronic lympocytic leukemia...

immunotherapy
multiple myeloma

Expert Point of View: Thierry Facon, MD, and Michael Jain, MD, PhD

Thierry Facon, MD, of Lille University Hospital in France, and Michael Jain, MD, PhD, of Moffitt Cancer Center, Tampa, were interviewed by The ASCO Post on the second-generation chimeric antigen receptor (CAR) T-cell products for treating multiple myeloma. According to Dr. Facon, essentially...

immunotherapy
multiple myeloma

Next-Generation BCMA-Targeted CAR T-Cell Therapies for Relapsed or Refractory Multiple Myeloma Explored in Early-Phase Trials

Two novel dual-target chimeric antigen receptor (CAR) T-cell strategies are yielding early and durable responses for patients with relapsed or refractory multiple myeloma, as well as potentially less cytokine-release syndrome and neurotoxicity compared with first-generation CAR T-cell products,...

immunotherapy
hematologic malignancies

Early Data Suggest Efficacy of Innovative CAR NK-Cell Therapy for B-Cell Malignancies

FT596, a novel off-the-shelf chimeric antigen receptor natural killer cell (CAR-NK) product, was as effective as existing CAR T-cell platforms in killing cancer cells in vivo, and the combination of FT596 plus rituximab killed lymphoma cancer cells that were no longer responding to CAR T-cell...

immunotherapy
lymphoma

Will Bispecific Antibodies Compete With CAR T-Cell Therapy in Lymphoma?

Are second-generation bispecific antibodies the next big thing in lymphoma? Studies of these drugs were among the highlights of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition. Years ago, the bispecific T-cell engager blinatumomab validated the concept of bispecific...

prostate cancer

HSD3B1 Genotype and Its Effect on Castration Resistance and Overall Survival in Prostate Cancer

As reported in JAMA Oncology, Nima Sharifi, MD, and colleagues have found that the adrenal-permissive HSD3B1 genotype is associated with earlier onset of castration resistance and poorer overall survival in men with low-volume metastatic prostate cancer. As noted by the investigators, the...

skin cancer

States With Highest Rates of Cutaneous Melanoma Due to Ultraviolet Exposure

A new study found a wide state-by-state variation in rates of melanoma caused by ultraviolet (UV) exposure, with highest rates in several states on the east and west coasts (including Hawaii), but also a few landlocked states (including Utah, Vermont, and Minnesota). The report, published by Islami ...

lung cancer
immunotherapy

ASCO/CCO Update Guideline for Selecting Systemic Treatment in Stage IV NSCLC Without Driver Mutations

ASCO and Cancer Care Ontario (CCO) have published an update to a joint guideline on systemic therapy for stage IV non–small cell lung cancer (NSCLC) without driver mutations.1 “The treatment of stage IV NSCLC has become increasingly more complicated, and, with the advent of immunotherapy and the...

pancreatic cancer

Expert Point of View: Andrea Wang-Gillam, MD, PhD

Andrea Wang-Gillam, MD, PhD, Clinical Director of the GI Oncology Program and Director of Developmental Therapeutics at Washington University in St. Louis, was the invited discussant of SEQUOIA and HALO 109-301. She tried to make sense of the two negative studies of pegylated agents in advanced...

breast cancer
immunotherapy

Addition of Pembrolizumab to Neoadjuvant Chemotherapy in Early-Stage HER2-Negative Breast Cancer

As reported in JAMA Oncology by Rita Nanda, MD, and colleagues, findings from the ongoing phase II I-SPY 2 trial indicated that the addition of pembrolizumab to standard neoadjuvant chemotherapy improved pathologic complete response rates in patients with high-risk stage II/III HER2-negative breast ...

H pylori Infection and Gastric Cancer Risk

First, we’ll discuss a Korean trial that looked at the role of H pylori infection and gastric cancer risk. Next, we’ll turn to a modeling study that examined HPV vaccination and cervical cancer incidence in low-income and lower–middle-income countries. Last this week, we’ll look at data presented...

hematologic malignancies
immunotherapy

Anti-CD19 CAR-NK Therapy in Relapsed or Refractory CD19-Positive Lymphoid Tumors

In a phase I/II trial reported in The New England Journal of Medicine, Liu et al found that anti-CD19 chimeric antigen receptor (CAR) natural killer (NK) cells produced rapid responses in patients with CD19-positive lymphoid tumors, without the toxicities associated with CAR T-cell therapy in this...

breast cancer

Low-Fat Diets With Increased Vegetable, Fruit, and Grain Intake Linked to Reduced Risk of Breast Cancer Mortality in Postmenopausal Women

As reported in the Journal of Clinical Oncology by Rowan T. Chlebowski, MD, PhD, and colleagues, 20-year follow-up of the Women’s Health Initiative Dietary Modification trial has shown a maintained reduction in non–breast cancer-related mortality after breast cancer diagnosis and the emergence of a ...

gastroesophageal cancer

PANGEA Trial Shows Personalized Antibody Selection May Improve Outcomes in Gastroesophageal Cancer

A personalized approach to selecting antibody therapy for patients with newly diagnosed stage IV gastroesophageal adenocarcinoma resulted in a 1-year overall survival rate of 66% and a median overall survival of 16.4 months in the PANGEA study (see Table 1).1 The study used a novel clinical...

lung cancer

IASLC Early Lung Imaging Confederation Initiative for Analysis of Low-Dose CT Images

As reported by James L. Mulshine, MD, and colleagues in JCO Clinical Cancer Informatics, the International Association for the Study of Lung Cancer (IASLC) is developing the Early Lung Imaging Confederation (ELIC) “to serve as an open-source, international, universally accessible environment to...

leukemia

Dengue Virus Infection May Increase Risk of Developing Leukemia

Compared to individuals without a history of dengue virus infection, those previously infected with the virus had over twice the risk of developing leukemia, with the highest risk occurring between 3 and 6 years after infection. The results of a study conducted in Taiwan were published by Chien et...

gynecologic cancers

Modeling the Impact of HPV Vaccination and Cervical Screening on Cervical Cancer Elimination in Low-Income and Lower-Middle—Income Countries

In a modeling study reported in The Lancet, Brisson et al in the World Health Organization (WHO)-sponsored Cervical Cancer Elimination Modelling Consortium (CCEMC) found that high human papillomavirus (HPV) vaccine uptake in girls could lead to cervical cancer elimination in most low-income and...

ASCO Analysis Demonstrates Need to Harmonize Disclosure Policies Across Medicine

An analysis by ASCO shows substantial discordance between disclosures to ASCO and to Open Payments, confirming the need for consistent and simpler financial disclosure systems in medicine.1 The paper examined disclosures from 93 presenters at the 2018 ASCO Annual Meeting and 70 published authors in ...

Overcoming Barriers to Alleviating Cancer-Related Pain in Ethiopia

According to the World Health Organization (WHO), approximately 70% of deaths from cancer occur in low- and middle-income countries, where late-stage presentation and inaccessibility to diagnosis and treatment are common.1 In the sub-Saharan African country of Ethiopia, cancer is becoming an...

A Hopeful Look Ahead in Oncology

“They’re all charlatans,” my professor assured me when, in medical school in the mid-1970s, I expressed an interest in oncology. The treatment of cancer with drugs, despite popular but inaccurate descriptions of its history, began in 1944 when Goodman and Gilman at Yale conducted contract research...

prostate cancer

Five-Year Patient-Reported Outcomes for Various Prostate Cancer Treatments

A 5-year follow-up study of more than 2,000 U.S. men who received prostate cancer treatment—radiation, surgery, or active surveillance—in patients of all ages and ethnicities is creating a road map for the future regarding long-term bowel, bladder, and sexual function in order to clarify...

lung cancer
immunotherapy
symptom management

ASCO-SITC 2020: Low Incidence of Nivolumab-Induced Radiation Recall Pneumonitis Among Patients With NSCLC

A multicenter retrospective study investigating the incidence of pneumonitis and the incidence, risk factors, and clinical characteristics of radiation recall pneumonitis in patients with non–small cell lung cancer (NSCLC) who had received nivolumab found the incidence of radiation recall...

breast cancer

Triple-Negative Breast Cancer Responds to Novel Therapy

The phase II KEYNOTE-890 trial is a small but interesting study in patients with inoperable advanced triple-negative breast cancer. After one injection of intratumoral tavokinogene telseplasmid, a plasmid encoding the proinflammatory cytokine interleukin-12 (IL-12), followed by electroporation and...

breast cancer
immunotherapy

Neoadjuvant and Adjuvant Pembrolizumab Improves Pathologic Complete Response Rate in Triple-Negative Breast Cancer

The addition of pembrolizumab to neoadjuvant and adjuvant chemotherapy achieves higher rates of pathologic complete response compared with placebo in patients with triple-negative breast cancer, according to results of the phase III KEYNOTE-522 trial presented at the 2019 San Antonio Breast Cancer...

A Retired Oncologist Remains Involved in the Science and Policy of Oncology

The history of medicine once was featured in medical school curricula. That is becoming less common due to time restriction and the increased prevalence of more technical topics. However, the importance of the history of medicine cannot be overstated: It shapes every aspect of our cultural,...

issues in oncology

Comparing Prescribing Habits in Academic and Nonacademic Oncology Settings

The art of oncology practice is tailored to the individual patient with cancer, and with the advent of highly personalized targeted therapies, patient outcomes have improved markedly over the past several decades. Although much of oncology practice is guideline- or protocol-driven, chemotherapy...

colorectal cancer

Incidence Increases in New Colorectal Cancer Diagnoses Among Patients Between 49 and 50 Years Old

A year-by-year age analysis of colorectal cancer rates among adults in the United States has found a 46% increase in new diagnoses from ages 49 to 50, indicating that many latent cases of the disease are likely going undiagnosed until routine screenings begin at 50, according to a new study by...

skin cancer

Circulating Tumor Cell Assessment to Predict Melanoma Relapse

A study published by Anthony Lucci, MD, and colleagues in Clinical Cancer Research showed that the presence of circulating tumor cells was independently associated with relapse of melanoma, suggesting circulating tumor cell assessment may be a useful tool for identifying patients at risk for...

lung cancer

Effect of Volume-Based CT Screening on Lung Cancer Mortality in High-Risk Patients

As reported in The New England Journal of Medicine by Harry J. de Koning, MD, PhD, and colleagues, the Dutch/Belgian NELSON trial has shown a significant reduction in 10-year lung cancer mortality with volume-based low-dose computed tomography (CT) screening vs no screening in high-risk men. Male...

lung cancer

ASCO Guideline Addresses Surveillance of Lung Cancer After Curative-Intent Therapy

ASCO has released a new guideline providing recommendations to practicing clinicians on radiographic imaging and biomarker surveillance strategies after definitive, curative-intent therapy in patients with stage I to III non–small cell lung cancer or small cell lung cancer. These guideline...

global cancer care

WHO, IARC Release Reports in Response to Government’s Role in Cancer Control

The World Health Organization (WHO) and the International Agency for Research on Cancer (IARC) released two coordinated reports in light of World Cancer Day in response to government calls for more research into the scope and potential policies and programs to improve cancer control. WHO Report...

CAR T-Cell Gene Therapy in Non-Hodgkin Lymphomas: Present and Future

To complement The ASCO Post’s continued comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel immunotherapies for patients with different types of non-Hodgkin...

Selected ASH Abstracts on Myelodysplastic Syndromes

To complement The ASCO Post’s continued comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapies for myelodysplastic syndromes (MDS), including the...

ASCO’s Inaugural Breakthrough Global Summit Showcased Evolving Technologies Poised to Revolutionize Cancer Care

Unlike ASCO’s Annual Meeting, symposia, and conferences, which highlight the current scientific advances in specific cancers and how they are improving cancer outcomes for the more than 18.1 million people worldwide diagnosed with cancer each year,1 ASCO Breakthrough: A Global Summit for Oncology...

lung cancer

Patient Aid Improved Lung Cancer Screening Informed Decision-Making

In the first comparative clinical trial of lung cancer screening decision aid vs standard educational information, researchers from The University of Texas MD Anderson Cancer Center showed that a decision aid delivered through tobacco quitlines effectively reaches a screening-eligible population...

prostate cancer

Novel Guideline Addresses the Clinical Utility of Molecular Biomarkers in Localized Prostate Cancer

In men, prostate cancer has the highest incidence of any neoplasm and is the second-leading cause of cancer-related mortality. A plethora of tissue-based biomarkers are available to inform the diagnosis and prognosis for men with newly diagnosed, clinically localized prostate cancer. However, to...

head and neck cancer
pain management

Gabapentin and Methadone for Patients Undergoing Treatment of Head and Neck Cancer

With nearly all patients who undergo treatment for cancer of the head and neck experiencing oral mucositis, effective pain control is one of the main goals of physicians and care teams. Looking to provide more effective relief for patients—while also reducing the need for opioid painkillers—a team...

breast cancer
colorectal cancer
legislation
health-care policy

Late-Stage Cancer Diagnoses After Massachusetts Health Insurance Reform Law

Advanced-stage cancer diagnoses declined following health insurance expansion in Massachusetts, likely due to increased access to screening and diagnostic services that identified cancers earlier, according to new research published by Sabik et al in the journal Medical Care. The analysis...

colorectal cancer
immunotherapy

Heinz-Josef Lenz, MD, on Metastatic Colorectal Cancer: Nivolumab Plus Low-Dose Ipilimumab as First-Line Therapy

Heinz-Josef Lenz, MD, of USC Norris Comprehensive Cancer Center, discusses how treating microsatellite instability–high/DNA mismatch repair–deficient metastatic colorectal cancer with nivolumab once every 2 weeks plus low-dose ipilimumab every 6 weeks may represent a new option for patients...

issues in oncology

Few Patients Enroll in Clinical Trials of First-Line Therapies

Patient enrollment in clinical trials as the first course of treatment after cancer diagnosis is low, despite the fact that enrollment may increase life expectancy, according to research published by Zaorsky et al in JNCCN–Journal of the National Comprehensive Cancer Network. Researchers also found ...

issues in oncology
skin cancer

Obstacles to Early Detection of Skin Cancer in Patients Living in Rural Western States

Residents of rural, sparsely populated “frontier counties” in the western United States have a higher incidence of skin cancer and related mortality rates. New research published by Jensen et al in Psychology, Health & Medicine indicated that the biggest obstacle to early detection and...

Expert Point of View: A. Jo Chien, MD

The formal discussant of this abstract on the ATEMPT trial, A. Jo Chien, MD, Associate Professor at UCSF’s Helen Diller Comprehensive Cancer Center, San Francisco, said that a median follow-up of 3-years is relatively short for this trial, considering about 75% of patients had hormone...

breast cancer
immunotherapy

Study Reports Similar Efficacy but No Less Toxicity With Adjuvant T-DM1 vs Taxane/Trastuzumab in Early Breast Cancer

The antibody-drug conjugate ado-trastuzumab emtansine (T-DM1) failed to show improved safety when compared with paclitaxel plus trastuzumab as adjuvant therapy in patients with stage 1 HER2-positive breast cancer. These results of the randomized, phase II ATEMPT trial were presented at the 2019 San ...

issues in oncology

Surgeon General Releases Report Focused on Smoking Cessation

Three decades after the first Surgeon General's report on smoking cessation, the Surgeon General has released a new report that reviews and updates evidence on the importance of quitting smoking. The report finds that more than two-thirds of U.S. adult cigarette smokers report an interest in...

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