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issues in oncology
health-care policy

Is the Move to a Value-Based Health-Care Delivery System Feasible?

In 2015, Congress passed the Medicare Access and CHIP Reauthorization ACT (MACRA), which aims to move Medicare toward reimbursement based more on outcomes and values, a goal, in theory, shared by the oncology community. To shed light on the complicated and problematic attempt to restructure the...

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...

solid tumors
prostate cancer

When Can Patients With Gleason 6 Prostate Cancer Safely Undergo Active Surveillance?

Prior to ASCO’s 2016 endorsement of the Cancer Care Ontario (CCO) guideline on active surveillance in the management of localized prostate cancer,1 most men—over 90%—diagnosed with low-risk localized disease were treated with active therapy.2 Today, about 50% of American men with low-risk disease...

kidney cancer

Meta-Analysis of Patients With Early Kidney Cancer Treated With Robotic Partial Nephrectomy

For patients with early kidney cancer, surgically removing a portion of the kidney instead of the whole organ is often a preferred treatment, because the procedure can effectively remove tumors while preserving kidney function. But when it comes to the best surgical approach—robotic,...

issues in oncology

NCI and VA Launch NAVIGATE to Boost Veterans’ Access to Cancer Clinical Trials

Veterans with cancer who receive treatment from the U.S. Department of Veterans Affairs (VA) will now have easier access to clinical trials of novel cancer treatments, thanks to an agreement between the VA and the National Cancer Institute (NCI), part of the National Institutes of Health. The NCI...

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...

solid tumors
breast cancer

Oral Taxane Shows Strong Activity and Good Tolerability in Metastatic Breast Cancer

As first-line treatment for metastatic breast cancer, the oral taxane tesetaxel produced a 45% confirmed response rate and was well tolerated, producing little alopecia or neuropathy, according to Andrew D. Seidman, MD, and colleagues from several cancer centers. Dr. Seidman, of Memorial Sloan...

Expert Point of View: Shannon Westin, MD

Shannon Westin, MD, Associate Professor, Department of Gynecologic Oncology and Reproductive Medicine at The University of Texas MD Anderson Cancer Center, Houston, served as an ASCO expert for the press briefing and made several comments. “What we’re learning is that among tumors with...

Expert Point of View: David Graham, MD, FASCO and Richard Schilsky, MD, FACP, FASCO, FSCT

ASCO expert David Graham, MD, FASCO, of the Levine Cancer Institute in Charlotte, North Carolina, was encouraged by the IMpower131 findings. “This is one more example of how immunotherapy is making steady gains against a number of cancers. Immunotherapy has been shown to be effective in other...

lung cancer
immunotherapy

Atezolizumab Plus Chemotherapy Extends Survival in Squamous NSCLC Regardless of PD-L1 Level

Patients with advanced squamous non–small cell lung cancer (NSCLC) had a greater benefit from first-line treatment with the combination of atezolizumab (Tecentriq) plus chemotherapy vs chemotherapy alone in the randomized, phase III, IMpower131 clinical trial.1 At the landmark of 12-month...

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...

issues in oncology

NCI and VA Launch NAVIGATE to Boost Veterans’ Access to Cancer Clinical Trials

Veterans with cancer who receive treatment from the U.S. Department of Veterans Affairs (VA) will now have easier access to clinical trials of novel cancer treatments, thanks to an agreement between the VA and the National Cancer Institute (NCI), part of the National Institutes of Health. The NCI...

skin cancer

Human Papillomavirus Vaccine in Cutaneous Basaloid Squamous Cell Carcinomas

Squamous cell carcinoma is the second-most-common form of skin cancer. Evidence suggests the human papillomavirus (HPV) plays a role in the development of some types of this skin cancer. Two years ago, a 97-year-old woman whose right leg was covered with squamous cell tumors went to see...

gynecologic cancers
issues in oncology

ESHRE 2018: Large Population Study Does Not Find Causal Link Between Assisted Reproduction and Ovarian Cancer Risk

Following concerns over many years that hormonal stimulation of the ovaries necessary for in vitro fertilization (IVF) may increase the risk of ovarian cancer, a nationwide cohort study from Denmark has now concluded that any perceived increase in risk is actually a statistical bias resulting from...

pancreatic cancer

Study Finds Inherited Gene Variants in 10% of Patients With Pancreatic Cancer

A large study of pancreatic cancer patients found that almost 10% harbored inherited genetic variations or mutations that may have increased their susceptibility to the disease. At the same time, some of these mutations were associated with more favorable responses to certain chemotherapy agents,...

breast cancer

Body Mass Index, Age, and Premenopausal Breast Cancer Risk

In a multicohort study reported by researchers from the Premenopausal Breast Cancer Collaborative Group in JAMA Oncology, Schoemaker et al found that increasing adiposity was associated with a significantly reduced risk of premenopausal breast cancer across the entire spectrum of body mass index...

New Fellows Begin 2018–2019 ASCO Health Policy Fellowship Program

TREVOR ROYCE, MS, MD, MPH, and Sheetal Kircher, MD, are the 2018–2019 ASCO Health Policy Fellows. Now entering its third year, the fellowship program offers oncologists the opportunity to gain the knowledge, skills, and experience necessary to shape regulatory and legislative policies that directly ...

Today’s Breakthroughs Require Year-Round Support

PROMISING BREAKTHROUGHS in cancer care don’t just happen overnight; they result after years of hard work by the brightest minds in cancer research. Yet many are unaware of the vast resources necessary to fuel cutting-edge research projects. Increasing awareness around this issue is vital to...

Excerpt From the 2018 ASCO Presidential Address: ‘Delivering Discoveries: Expanding the Reach of Precision Medicine’

In my area of research, lung cancer, precision medicine is indeed transforming the treatment of this disease and has important implications for other cancers and for the future of our patients with cancer. Today’s achievement of being able to systematically identify genomic changes that can be...

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

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...

lung cancer
immunotherapy

KEYNOTE-407: Pembrolizumab Plus Chemotherapy Benefits Response, Survival in Squamous NSCLC

THE COMBINATION of pembrolizumab (Keytruda) plus platinum-based chemotherapy improved overall survival, response rates, and duration of response in patients with advanced squamous cell non–small cell lung cancer (NSCLC) compared with chemotherapy alone irrespective of programmed cell death ligand 1 ...

survivorship

Many Childhood Cancer Survivors Not Concerned About Their Future Health

A research team led by a St. Jude Children’s Research Hospital epidemiologist has conducted the largest analysis to date of how adult survivors of childhood cancer view their health risk. The scientists found that a surprisingly high number of survivors showed a lack of concern for their...

Lessons in the Chill of Early Morning

The following essay by Sushil Bhardwaj, MD, is adapted, with permission, from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and...

bladder cancer

STAG2 Genetic Test Could Reduce Overtreatment in Some Patients With Bladder Cancer

A new genetic test in bladder cancer could be key to reducing the cost of care while avoiding overtreatment in some patients, according to research published by Waldman et al in Clinical Cancer Research. Deciding whether to treat bladder cancer aggressively can be difficult—predictive...

issues in oncology
survivorship

Raising Awareness of the Financial Impact of Cancer on Young Adult Survivors

GUEST EDITOR Adolescent and Young Adult Oncology explores the unique physical, psychosocial, social, emotional, sexual, and financial challenges adolescents and young adults with cancer face. The column is guest edited by Brandon Hayes-Lattin, MD, FACP, Associate Professor of Medicine and Medical...

kidney cancer

Percutaneous Ablation vs Nephrectomy in T1a Kidney Cancer

Many cases of early-stage kidney cancer can be treated with a relatively new, nonsurgical procedure used to destroy tumors, a new study by Talenfeld et al in Annals of Internal Medicine suggests. The procedure, called percutaneous ablation, involves the insertion of a needle through the skin into...

colorectal cancer
survivorship

Dietary Insulin Load and Risk of Disease Recurrence in Stage III Colon Cancer

New research led by Dana-Farber Cancer Institute investigators suggests that patients treated for nonmetastatic colon cancer may sharply reduce the risk that the disease will return by following a diet low in carbohydrates and other foods that raise insulin levels. In a study published by...

Inside Story on the Genesis of Teen Cancer America

THANK YOU for publishing the excellent article “We Need to Fill the Gap Between Pediatric and Adult Oncology Care” by Sarah Stream (as told to Jo Cavallo) in the March 25, 2018, issue of The ASCO Post. Sarah’s story and her connection to Teen Cancer America actually go much deeper than she reported ...

lymphoma

I’m Proud to Have Contributed to the FDA Approval of CAR T-Cell Therapy

When I was diagnosed with diffuse large B-cell lymphoma (DLBCL) in 2013, I used to joke that if I had to get cancer, this wasn’t a bad one to have. At just 32, I was otherwise healthy, and my prognosis for a cure was good, according to my oncologist. So I felt confident that once I underwent...

Colorectal Cancer Alliance Announces Available Research Funding

THE COLORECTAL CANCER Alliance has announced up to $775,000 in available funding for up to five grants supporting research in young-onset colorectal cancer, rectal cancer, and colorectal cancer prevention. The Colorectal Cancer Alliance is committed to investing $10 million in research by 2021,...

Richard D. Schulick, MD, MBA, Named Director of University of Colorado Cancer Center

RICHARD D. SCHULICK, MD, MBA, a cancer surgeon and administrative leader, has been named Director of the University of Colorado Cancer Center, a consortium of three universities and three academic teaching hospitals. The University of Colorado Cancer Center is the hub of cancer research in the...

palliative care

How Learning What’s on Your Patient’s Bucket List May Improve Care

It may sound too good to be true, but asking patients a simple question about what is on their bucket list can actually spark a dialogue about how best to make their cancer care and survivorship fit into their life plans, as well as be an effective way to identify their end-of-life care goals,...

issues in oncology
palliative care

Voluntarily Stopping Eating and Drinking Is Legal—and Ethical—for Terminally Ill Patients Looking to Hasten Death

Terminally ill patients with cancer will sometimes ask their clinicians for help with assisted or hastened death.1 Although palliative care and hospice care can usually address the concerns of most patients, some have physical or existential suffering that is refractory to comfort and supportive...

Meet Federal Reporting Requirements With QOPI® Reporting Registry

The QOPI® Reporting Registry, a Qualified Clinical Data Registry (QCDR) brought to you by ASCO and the American Society for Radiation Oncology (ASTRO), is your one-stop shop for 2018 Centers for Medicare and Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS) reporting. The new...

Updated: Cancer.Net Mobile App for Your Patients

Tell your patients about Cancer.Net’s award-winning mobile app! Recently updated, the newest version features several performance upgrades to improve the user experience, plus all the same great features offered before, including filtering capabilities, calendar integration, and native Spanish...

issues in oncology

Resilience While Caring for Seriously Ill Patients: Skills and Strategies to Prevent Burnout

A career in oncology can be extremely rewarding. Fast-paced advances in research and treatment, exciting changes in the practice environment, and the opportunity to build strong relationships with and provide critical support to patients can be incredibly professionally satisfying—but they can...

breast cancer

AJCC Breast Cancer Staging System More Clinically Relevant

THE RECENTLY issued 8th revision to the American Joint Committee on Cancer (AJCC) Breast Cancer Staging System incorporates tumor biology and prognostic stage groups and thus has become more accurate and clinically relevant, according to two speakers at the 2018 Miami Breast Cancer Conference.1,2...

Folakemi Odedina, PhD, Awarded Fellowship for Oncology Clinical Trials in Africa

FOLAKEMI ODEDINA, PhD, Professor of Pharmacotherapy and Translational Research at the University of Florida College of Pharmacy, has been awarded a 2018 Carnegie African Diaspora Fellowship to help expand oncology clinical trials in Africa.  Dr. Odedina will travel to South Africa to collaborate...

solid tumors
prostate cancer

Prostate Cancer Therapy in Evolution: Time to Rethink and Redirect?

The ASCO updated guidelines on the treatment of metastatic non-castrate prostate cancer penned by Morris and his colleagues1 provide valuable information annotated to the strengths of evidence in recently reported prostate cancer studies. CHAARTED, GETUG-AFU 15, LATITUDE, and STAMPEDE have...

prostate cancer

DNA Test Identifies Men With Sixfold Increased Risk of Prostate Cancer

A major new study of more than 140,000 men has identified 63 new genetic variations in the DNA code that increase the risk of prostate cancer. These findings were published by Schumacher et al in Nature Genetics. Researchers devised a new test combining these single-letter genetic variants with...

11 New Institutions Join AACR Project GENIE Consortium

The number of institutions participating in the American Association for Cancer Research (AACR) initiative, AACR Project Genomics Evidence Neoplasia Information Exchange (GENIE), has increased by 11 participants. The 11 new institutions of the AACR Project GENIE consortium and their related cancer...

solid tumors
gastrointestinal cancer

Optimizing Biologics in Metastatic Colon Cancer

Biologics are credited with increasing median overall survival in colorectal cancer to approximately 30 months. Their optimal use was discussed by Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, in an article he coauthored for the Journal of Oncology Practice 1...

Expert Point of View: Charles G. Drake, MD, PhD and Hatem H. Soliman, MD

Formal discussant of the GeparNuevo presentation, Charles G. Drake, MD, PhD, of the Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center, New York, said, “It is important that neoadjuvant immunotherapy combinations are being studied. There is a lot of enthusiasm for...

solid tumors
kidney cancer

Nephrectomy May Be Avoided in Some Patients With Advanced Renal Cell Carcinoma

In the modern era of targeted therapy, some patients with metastatic renal cell carcinoma may be able to forgo nephrectomy and be treated with sunitinib (Sutent) alone, according to results of the phase III CARMENA trial reported during the Plenary Session at the 2018 ASCO Annual Meeting.1 The...

solid tumors
skin cancer

The Raven

The call from the dermatologist came at noon on Good Friday, just after my wife left with our two young daughters for a week on her family’s tree farm in Northern Michigan. I was on call for the hospital inpatient leukemia service, so I could not join them. When the dermatologist solemnly began,...

hematologic malignancies
leukemia

Minimal Residual Disease Testing in AML: Still a Shifting Target

Testing for minimal residual disease (MRD) has become an established part of the management of acute lymphoblastic leukemia (ALL), but in acute myeloid leukemia (AML), the technology still warrants validation. To address issues and set new standards, the European LeukemiaNet Working Party recently ...

Expert Point of View: Colin D. Weekes, MD, PhD and Andrew Epstein, MD

Colin D. Weekes, MD, PhD, of Massachusetts General Hospital and Harvard Medical School, called the results of the PRODIGE trial “practice-changing.” Dr. Weekes was the invited discussant of the study and was interviewed by The ASCO Post. “The magnitude of effect is beyond what we have ever seen in...

lymphoma
immunotherapy

EHA 2018: Tisagenlecleucel Demonstrates More Than 1-Year Durability of Response in Adults With Relapsed or Refractory DLBCL

Fourteen-month results from the JULIET clinical trial showed ongoing durable responses are achievable with tisagenlecleucel (Kymriah) when administered to adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). This updated analysis was presented by Borchmann et al at ...

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