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issues in oncology
health-care policy

New Report Reviews Methods for Reducing Waste, Improving Efficiency With Expensive Injectable Medications

Every year, significant amounts of drugs left over and unused from single-dose vials are discarded, but because of the way drugs are priced and paid for in the United States, the cost of the discarded amount cannot be recouped, according to a new congressionally mandated report from the National...

Standardized, Streamlined Processes Key to Implementing Electronic Prior Authorization

On December 23, 2020, ASCO submitted comments to the Centers for Medicare & Medicaid Services (CMS) in response to the Reducing Provider and Patient Burden and Promoting Patients’ Electronic Access to Health Information proposed rule. This rule builds on the CMS Interoperability and Patient...

issues in oncology

New Framework to Address Cancer Care Disparities in Medically Underserved Populations

A new article published in JCO Oncology Practice puts forth a framework to guide researchers, health-care leaders, advocates, community- and patient-focused service organizations, and policy leaders in their work to address and promote health equity in cancer care access and treatment outcomes.1...

gastrointestinal cancer

ASCO Names Advance of the Year: Molecular Profiling Drives Progress in Gastrointestinal Cancers

Molecular profiling allows clinicians to identify the molecular and genetic signatures that help to deliver treatments that are highly specific to a tumor. This tool has made possible a number of advances in the past year that are improving care for patients with gastrointestinal cancers. In...

hematologic malignancies

In Case You Missed It: Brief Highlights From ASH 2020

In case you missed these while attending the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, below is a sampler of highlights that were not included in our first round of meeting coverage. Many of these reports are on early-phase clinical trials of agents that may raise...

global cancer care

Cancer on the Global Stage: Incidence and Cancer-Related Mortality in Kenya

The ASCO Post is pleased to continue this occasional special focus on the worldwide cancer burden. In this issue, we feature a close look at the cancer incidence and mortality rates in Kenya. The aim of this special feature is to highlight the global cancer burden for various countries of the...

survivorship
issues in oncology

When to Start a Conversation With Patients About Subsequent Primary Cancers

Among patients who survive a primary cancer, concern about recurrence, especially metastatic disease, is extremely common; however, information about future risk for subsequent primary cancers is seldom communicated to these patients, leading to missed opportunities to prevent or detect subsequent...

breast cancer

The CARG-BC Score: Novel Tool for Predicting Chemotherapy Toxicity in Early-Stage Breast Cancer

As reported in the Journal of Clinical Oncology, Allison Magnuson, DO, of the University of Rochester Medical Center & Wilmot Cancer Institute, and Mina S. Sedrak, MD, MS, of the City of Hope National Medical Center, along with colleagues, have developed a novel risk tool—the Cancer and Aging...

leukemia
immunotherapy

Genome-Edited Donor-Derived Anti-CD19 CAR T-Cell Therapy Is Active in B-Cell Acute Lymphoblastic Leukemia

Pooled results of two phase I studies, reported in The Lancet by Reuben Benjamin, MBBS, of the Department of Haematological Medicine, King’s College Hospital, London, and colleagues, indicate that the genome-edited donor-derived allogeneic anti-CD19 chimeric antigen receptor (CAR) T-cell product...

leukemia

Novel Approaches in Chronic Lymphocytic Leukemia

To complement The ASCO Post’s continued comprehensive coverage of the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic approaches in chronic lymphocytic leukemia (CLL). For full...

gastrointestinal cancer

FGFR2 Inhibitor Infigratinib Active in Chemotherapy-Refractory Cholangiocarcinoma

The novel targeted agent infigratinib (BGJ398) showed clinically meaningful activity against chemotherapy-refractory cholangiocarcinoma in patients with fibroblast growth factor receptor (FGFR2) fusions and rearrangements. The confirmed overall response rate was 23% (34% confirmed/unconfirmed), the ...

lymphoma
immunotherapy

B-Cell and T-Cell Non-Hodgkin Lymphomas

To complement The ASCO Post’s continued comprehensive coverage of the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on the assessment and treatment of patients with B-cell and T-cell non-Hodgkin...

gastrointestinal cancer

Updated Findings Bolster the Use of Checkpoint Inhibitors in Treatment of Liver Cancer

Although optimal regimens are still being determined, checkpoint inhibition has clearly established itself in the treatment of hepatocellular carcinoma, as judged by the number of abstracts on the topic at the 2021 Gastrointestinal Cancers Symposium. The ASCO Post brings readers short summaries of ...

Expert Point of View: Meredith Regan, ScD, and Sara Hurvitz, MD

In the San Antonio meeting’s closing session, “View From the Trenches: What Will You Do Monday Morning?” Meredith Regan, ScD, and Sara Hurvitz, MD, offered their thoughts on the use of RSClin in the clinic, as described at the San Antonio Breast Cancer Symposium by Joseph Sparano, MD.1 Dr. Regan...

breast cancer

Prognostic Tool RSClin Introduced for Early Breast Cancer

Data from the TAILORx study and several National Surgical Adjuvant Breast and Bowel Project (NSABP) trials have been used to develop a new prognostic tool, RSClin, which aims to individualize the estimate of recurrence risk in early breast cancer and to more accurately predict the risk-reduction...

leukemia

Chemotherapy-Induced ‘Dormancy’ in AML Allows Cancer Cell Survival, May Contribute to Relapse

Researchers have identified a cellular resilience mechanism through which acute myeloid leukemia (AML) cells survive cancer treatment and repopulate, leading to disease relapse. The research, published by Cihangir Duy, PhD, MS, and colleagues in Cancer Discovery, also suggests that certain drugs...

multiple myeloma
issues in oncology

New Recommendations Aim to Eliminate Racial Disparities in Multiple Myeloma Therapies and Trials

Recommendations designed to address the underrepresentation of Black patients in clinical trials for multiple myeloma were recently released. Details about the initiative, published by Gormley et al in Blood Cancer Discovery, form a road map for designing multiple myeloma clinical trials to...

bladder cancer

Hypofractionated vs Conventionally Fractionated Radiotherapy for Locally Advanced Bladder Cancer

In an individual patient-level meta-analysis of two phase III trials reported in The Lancet Oncology, Choudhury et al found that a hypofractionated radiotherapy regimen was associated with improved invasive locoregional control and similar toxicity vs a standard fractionation regimen in patients...

hematologic malignancies
supportive care
symptom management

Ruxolitinib Improves Outcomes in Steroid-Refractory or Steroid-Dependent Graft-vs-Host Disease

Ruxolitinib was superior to best available therapy in achieving efficacy as determined by best overall response and duration of response, with acceptable safety in adolescents and adults with steroid-dependent or steroid-refractory chronic graft-vs-host disease effects. These findings were shown in ...

multiple myeloma
immunotherapy

Expert Point of View: Sagar Lonial, MD, FACP

Sagar Lonial, MD, FACP, the Anne and Bernard Gray Family Chair in Cancer, Chair and Professor of Hematology and Medical Oncology, Emory University School of Medicine, Atlanta, commented on the APOLLO trial for The ASCO Post. “APOLLO is a highly awaited study, as the use of daratumumab plus...

multiple myeloma
immunotherapy

Subcutaneous Daratumumab Meets Primary Endpoint in APOLLO Trial in Myeloma

The first phase III study to evaluate the subcutaneous form of daratumumab has met its primary endpoint, investigators of the APOLLO trial reported at the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition.1 The triplet of daratumumab, pomalidomide, and low-dose dexamethasone ...

hematologic malignancies
leukemia
lymphoma
multiple myeloma

Novel Therapies and New Indications for Use in Treatment of Hematologic Malignancies

Selinexor: On December 18, 2020, the U.S. Food and Drug Administration (FDA) approved selinexor (Xpovio) in combination with bortezomib (Velcade) and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least one prior therapy. Venetoclax: On October 16,...

leukemia

Study Finds Asciminib Safer, More Effective Than Bosutinib in Chronic-Phase CML

Since the introduction of imatinib almost 18 years ago, similar next-generation tyrosine kinase inhibitors have been approved for chronic myeloid leukemia (CML), including dasatinib, nilotinib, bosutinib, and ponatinib. These drugs attack a similar target, making it more likely that resistance to...

leukemia
lymphoma
multiple myeloma
immunotherapy

ASH 2020 Meeting Highlights

The world of hematologic malignancies continues to move forward at a robust pace despite the challenges of the COVID era. Although some areas of clinical trials and basic research suffered short-term stoppages or delays due to the pandemic, the studies presented at the 2020 American Society of...

lung cancer

Roy S. Herbst, MD, PhD, on LUNG-MAP, Circulating Tumor DNA, and Tissue Molecular Analysis

Roy S. Herbst, MD, PhD, of Yale University, discusses results from the LUNG-MAP Master Protocol, which support the planned use of circulating tumor DNA for enrollment onto LUNG-MAP substudies, with a positive finding meriting inclusion in study; a negative finding, while considered inconclusive,...

covid-19
issues in oncology

Joint ASCO/ACS CAN Letter: States Must Include Patients With Cancer on Their COVID-19 Vaccine Priority Lists

In the midst of growing concerns that patients with cancer have limited access to the COVID-19 vaccines, the Association for Clinical Oncology (ASCO) and American Cancer Society Cancer Action Network (ACS CAN), the advocacy affiliate of the American Cancer Society, issued a joint letter to every...

Prevalence of Cisplatin-Related Hearing Loss in Pediatric, Adolescent, and Young Adult Patients

Cisplatin is one of the most effective chemotherapy agents, used in just under half of pediatric cancer cases. Permanent hearing loss is a common side effect of this medication, but previous studies have been too small and too varied to accurately characterize this risk. In a new study published by ...

multiple myeloma

Updated Recommendations on the Treatment of Multiple Myeloma–Related Bone Disease From the Bone Working Group of the International Myeloma Working Group

In a policy review reported in The Lancet Oncology, Terpos et al presented updated recommendations from the Bone Working Group of the International Myeloma Working Group on the treatment of multiple myeloma–related bone disease. The recommendations cover: bisphosphonate use/dosing and management of ...

lung cancer
immunotherapy

KEYNOTE-598 Trial: Addition of Ipilimumab to Pembrolizumab in Previously Untreated Patients With Metastatic NSCLC and High PD-L1 Expression

As reported in the Journal of Clinical Oncology by Michael Boyer, MBBS, PhD, and colleagues, an interim analysis in the phase III KEYNOTE-598 trial showed no improvement in overall or progression-free survival with the addition of ipilimumab to pembrolizumab in previously untreated patients with...

breast cancer

Have Breast Cancer Mortality Rates Stopped Declining for Younger Women?

Breast cancer death rates have stopped declining for women in the United States younger than age 40, ending a trend that existed from 1987 to 2010, according to a report published by Hendrick et al in Radiology. Breast cancer is the most common nonskin cancer and the second most common cause of...

lymphoma

Optimal Radiotherapy Dose for Follicular and Marginal Zone Lymphomas: 24 vs 4 Gy

As reported in The Lancet Oncology by Peter Hoskin, MD, and colleagues, 5-year follow-up of the phase III noninferiority FoRT trial showed that radiotherapy at 24 vs 4 Gy continued to be associated with superior freedom from local disease progression in patients with follicular or marginal zone...

skin cancer
immunotherapy

Fecal Microbiota Transplants May Help Patients With Advanced Melanoma Respond to Immunotherapy

For patients with melanoma who do not respond to treatment with immunotherapy, adjusting the composition of microorganisms in the intestines through the use of fecal transplants may aid in overcoming resistance to therapy. These findings were published by Davar et al in Science. In the study, some...

prostate cancer

Update From ACIS Trial of Apalutamide Plus Abiraterone/Prednisone in Metastatic Prostate Cancer

The phase III ACIS trial met its primary endpoint at 6 months, showing that apalutamide plus abiraterone acetate/prednisone extended radiographic progression-free survival vs abiraterone acetate/prednisone alone in patients with chemotherapy-naive metastatic castration-resistant prostate cancer. An ...

leukemia
symptom management
covid-19

FDA Pipeline: Breakthrough Designations in CML and for Cachexia, EUA for COVID-19

Recently, the U.S. Food and Drug Administration (FDA) issued a Breakthrough Therapy designation to asciminib for chronic myeloid leukemia (CML); a Breakthrough Device designation to an assay designed to help select patients with cachexia for treatment with an investigational therapeutic; and an...

supportive care
symptom management

ASH 2021 Guidelines for Prevention and Treatment of Venous Thromboembolism in Patients With Cancer

As reported in Blood Advances by Gary H. Lyman, MD, MPH, FASCO, FRCP, and colleagues, the American Society of Hematology (ASH) has issued evidence-based guidelines intended to assist patients, clinicians, and other health-care professionals in decisions regarding the prevention and treatment of...

lung cancer
immunotherapy

Nivolumab/Ipilimumab vs Chemotherapy as First-Line Treatment for Unresectable Malignant Pleural Mesothelioma: CheckMate 743 Trial

As reported in The Lancet by Paul Baas, MD, and colleagues, a prespecified interim analysis in the phase III CheckMate 743 trial has shown improved overall survival with first-line nivolumab/ipilimumab vs platinum-based chemotherapy in patients with unresectable malignant pleural mesothelioma. The...

ASCO Advocates for Priority Status for Patients With Cancer in COVID-19 Vaccine Distribution Plans, Provides Information on Safety and Efficacy of Vaccinations

The American Society of Clinical Oncology and the Association for Clinical Oncology, collectively referred to as ASCO, understand the challenges faced by ASCO members and patients with cancer in dealing with the COVID-19 pandemic, in determining the best treatment for patients, and in addressing...

head and neck cancer

Chinese Society of Clinical Oncology and ASCO Approve First Joint Guideline for Treatment of Stage II to IVA Nasopharyngeal Carcinoma

The Chinese Society of Clinical Oncology (CSCO) and ASCO have approved a joint guideline for the treatment of stage II to IVA nasopharyngeal carcinoma.1 The guideline was drafted by a panel of Chinese and U.S. experts and provides, for the first time, a clear set of recommendations for the use of...

skin cancer

High-Risk Cutaneous Squamous Cell Carcinomas: The Present and Future

Cutaneous squamous cell carcinoma is the second most common type of skin cancer, with more than 1 million cases diagnosed in the United States annually.1 Historically, cutaneous squamous cell carcinoma is grouped together with basal cell carcinoma and collectively referred to as nonmelanoma skin...

breast cancer
immunotherapy

Expert Point of View: William Gradishar, MD

William Gradishar, MD, the Betsy Bramsen Professor of Breast Oncology at Northwestern University Feinberg School of Medicine and Deputy Director for the Clinical Network of the Lurie Cancer Center, commented on the findings of the ASCENT biomarker analysis in the closing panel discussion. The...

multiple myeloma
immunotherapy

Novel Insights Into Multiple Myeloma

“Knowledge has a beginning but no end.” —Geeta Iyengar To complement The ASCO Post’s continued comprehensive coverage of the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, here are three abstracts selected from the meeting proceedings focusing on novel therapies for...

covid-19

COVID Virus–Specific T Cells: Potential Treatment of Severe COVID-19 Infection Under Study

It may be possible to exploit T cells from healthy volunteers who have recovered from COVID-19 as a treatment for this viral infection. Researchers at the Center for Cell and Gene Therapy at Baylor College of Medicine have designed an off-the-shelf COVID virus–specific T-cell product (called...

colorectal cancer

Expert Point of View: Michael J. Overman, MD

The study’s invited discussant, Michael J. Overman, MD, Professor of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, said the findings of the study presented by Henriksen et al1 add to a convincing body of data showing that “the use of circulating...

colorectal cancer

Predicting Postoperative Recurrence in Stage I to III Colorectal Cancer With Circulating Tumor DNA

Patients with stage I to III colorectal cancer who have a high risk for recurrence may be identified by serial testing of circulating tumor DNA (ctDNA) after resection, according to a study in which ctDNA proved more reliable than carcinoembryonic antigen (CEA) surveillance or standard radiologic...

hepatobiliary cancer

Expert Point of View: Rachna T. Shroff, MD

Invited discussant of the ClarIDHy trial, Rachna T. Shroff, MD, Associate Professor of Medicine, University of Arizona, and Chief of GI Medical Oncology at the University of Arizona Cancer Center, said positive findings for ivosidenib support the notion that “biliary cancer is a perfect example of...

solid tumors

Stereotactic Ablative Body Radiotherapy in Extracranial Oligometastatic Cancers

In a registry-based observational study reported in The Lancet Oncology, Anastasia Chalkidou, PhD, and colleagues found that stereotactic ablative body radiotherapy (SABR) was associated with high overall survival and low rates of toxicity in patients with extracranial oligometastatic cancers. The...

lung cancer

Roy S. Herbst, MD, PhD, on NSCLC: Osimertinib and Patient-Reported Outcomes

Roy S. Herbst, MD, PhD, of Yale University, discusses two key abstracts from the ADAURA trial: the use of osimertinib as adjuvant therapy for resected EGFR-mutated non–small cell lung cancer; and patient-reported outcomes, which showed a benefit in disease-free survival and maintenance of...

issues in oncology

Understanding Patients’ Needs and Preferences: Cancer Care Stakeholders Explore Barriers and Best Practices

The keynote speaker did not mince words. “I tell everyone, do not use the term age-appropriate therapy,” said Jan White, a cancer survivor and patient advocate who described her own experience with stage IV non-Hodgkin lymphoma. “Patients with cancer,” she said, “are more than their age, gender,...

leukemia

MURANO Trial: Venetoclax Plus Rituximab Achieves Durable Progression-Free Survival in Resistant CLL

Patients with relapsed or refractory chronic lymphocytic leukemia (CLL) treated with the combination of fixed-duration venetoclax/rituximab had a longer overall survival and progression-free survival at 5 years compared with those treated with bendamustine/rituximab, according to a 5-year analysis...

covid-19

HERO-TOGETHER: Opportunity for Health-Care Workers to Share Their Experience With COVID-19 Vaccination

HERO-TOGETHER is an opportunity for people working in health care who receive a COVID-19 vaccine to help the public understand how people fare after vaccination. The COVID-19 pandemic is a once-in-a-generation challenge that health-care providers everywhere have worked together to face. On the...

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