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breast cancer

SABCS 2017: Adjuvant Trastuzumab Did Not Improve Outcomes for Patients With HER2-Low Breast Cancer

Adding trastuzumab (Herceptin) to standard adjuvant chemotherapy did not improve invasive disease–free survival for patients with early-stage breast cancer found to have low levels of HER2, defined as immunohistochemistry (IHC) 1–positive or IHC 2-positive and/or in situ hybridization...

lung cancer

Combination Therapy for Previously Untreated Stage IV NSCLC

As reported in The Lancet Oncology by Herbst et al, the phase III SWOG S0819 trial showed no overall benefit of adding cetuximab (Erbitux) to carboplatin/paclitaxel both with and without bevacizumab (Avastin) in patients with previously untreated stage IV non–small cell lung cancer (NSCLC). A ...

breast cancer

Extended Intermittent vs Continuous Adjuvant Therapy for Postmenopausal Women With Breast Cancer

The phase III SOLE trial has shown no disease-free survival benefit with extended intermittent vs continuous adjuvant letrozole in postmenopausal women with breast cancer. These findings were reported by Colleoni et al in The Lancet Oncology. As noted by the investigators, the findings suggest an...

solid tumors

FDA Announces Approval, CMS Proposes Coverage of First Breakthrough-Designated Test to Detect Extensive Number of Cancer Biomarkers

On November 30, the U.S. Food and Drug Administration (FDA) approved the FoundationOne CDx (F1CDx), the first breakthrough-designated, next-generation sequencing–based in vitro diagnostic test that can detect genetic mutations in 324 genes and 2 genomic signatures in any solid tumor type. The ...

sarcoma

NCCN Introduces New Guidelines for Patients With AIDS-Related Kaposi Sarcoma

The National Comprehensive Cancer Network® (NCCN®) has created a new resource for patients living with human immunodeficiency virus (HIV) who develop acquired immune deficiency syndrome (AIDS)-related Kaposi sarcoma. This newly released NCCN Clinical Practice Guidelines in Oncology (NCCN...

lung cancer

EU Expert Group Releases Position Statement on Lung Cancer Screening in Europe

As reported in The Lancet Oncology by Oudkerk et al, a European Union (EU) expert group has issued a position statement on low-dose computed tomography (CT) screening for lung cancer, proposing a near-term phased implementation of screening in high-risk regions within 18 months and extension to all ...

lung cancer

Comparison of EGFR Inhibitors in Untreated Advanced EGFR-Mutant NSCLC

As reported in The New England Journal of Medicine by Soria et al, the phase III FLAURA trial has shown a significant progression-free survival benefit with the third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) osimertinib (Tagrisso) vs standard EGFR TKIs in...

gastroesophageal cancer

Immunotherapy in Advanced Esophageal Carcinoma

As reported in the Journal of Clinical Oncology by Doi et al, pembrolizumab (Keytruda) showed activity in patients with previously treated advanced esophageal carcinoma in the phase Ib multicohort KEYNOTE-028 study. Study Details In the study, eligible patients with squamous cell carcinoma or...

solid tumors

The Runner

The following essay by Robert J. Green, 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...

A Vivid Look Back, a Cogent Look Forward

Cancer memoirs come in a variety of literary styles and voices. Not surprisingly, the most poignant cancer memoirs are by those who are writing, in essence, their final words before departing this earth. The most widely read of that variety has been the beautifully written best seller When Breath...

hematologic malignancies
breast cancer
lung cancer
lymphoma

FDA Approvals in November 2017: Novel Drugs, New Indications

THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) approved a number of novel drugs and new indications in November 2017. Several of them are listed here.  Fulvestrant/Abemaciclib Combination in Breast Cancer  ON NOVEMBER 15 , the FDA approved fulvestrant (Faslodex) in combination with abemaciclib...

cns cancers

Gene Therapy Shows Early Efficacy Against Recurrent Brain Cancer

MORE THAN A QUARTER of patients with recurrent high-grade glioma treated with the retroviral vector Toca 511 and the prodrug of the chemotherapy fluorouracil (5-FU), Toca FC, were alive more than 3 years after treatment, according to data from a subset of patients in a phase I clinical trial, Toca ...

issues in oncology
pain management

EXPECT QUESTIONS ABOUT THE RISK OF OPIOID ADDICTION

INTENSE MEDIA COVERAGE of the opioid crisis has ranged from the dire statistics of addiction and death to some hopeful stories of treatment and recovery, but what may raise questions and concerns are the reports of people who start with a prescription opioid and then in a few weeks or months are...

pain management

Relieving Pain During an Opioid Epidemic

“WE’VE GOT A CHALLENGING TIME right now, trying to relieve pain during the time of an opioid epidemic,” Judith A. Paice, RN, PhD, acknowledged at the 2017 Lynn Sage Breast Cancer Symposium in Chicago.1 She cited a recent study reporting that up to 40% of cancer survivors are living with pain, and...

Luigi Naldini, MD, PhD, and Marina Cavazzana, MD, PhD, to Present 2017 ASH Ernest Beutler Lecture

THE AMERICAN SOCIETY OF HEMATOLOGY (ASH) will honor Luigi Naldini, MD, PhD, of the San Raffaele Telethon Institute for Gene Therapy in Milan, and Marina Cavazzana, MD, PhD, of Paris Descartes University, Necker-Enfants Malades Hospital, and Imagine Institute of Genetic Diseases, AP-HP, Inserm in...

issues in oncology
supportive care

Helping Oncologists to Become Better Communicators With Their Patients

Timothy Gilligan, MD, FASCO, Co-Chair of ASCO’s Expert Panel on Patient-Physician Communications Guideline and Vice-Chair for Education and Associate Professor of Medicine at the Cleveland Clinic Taussig Cancer Institute, spends half of his professional time treating patients with urologic...

issues in oncology
supportive care

ASCO Releases Guideline to Help Oncologists Improve Communication With Patients—and Their Own Well-Being

In September 2017, ASCO published a new guideline in the Journal of Clinical Oncology that outlines best practices for communicating effectively with patients and their family members.1 The guideline is the result of recommendations from a multidisciplinary panel of experts in a number of fields,...

solid tumors
lung cancer

Addressing Disparities in Use of Lung Cancer Screening With Community Outreach

African Americans and members of other communities of lower socioeconomic status have higher burdens of lung cancer mortality. Therefore, targeting underserved patient populations with lung cancer screening is of the utmost importance, according to Christopher Lathan, MD, MS, MPH, a medical...

issues in oncology

Experts Address Cancer Health Disparities in Facebook Live Session at AACR Meeting

Although it has long been known that certain cancer types disproportionately affect individuals from underserved and underrepresented populations, the sources of these disparities are still not entirely clear. In a “Facebook Live” session at the 2017 American Association for Cancer Research (AACR)...

Susan G. Komen Launches Crowdfunding Initiative to Support Metastatic Breast Cancer Research

Individuals and organizations looking to contribute to advancements in metastatic breast cancer research can now do so by participating in Susan G. Komen’s inaugural crowdfunding initiative. Through this initiative, donors have the opportunity to contribute directly to the pioneering work of four...

solid tumors
breast cancer

Gene-Expression Assays in Early-Stage Breast Cancer: Who Should Order Them and When?

A deeper understanding of biology has allowed significant advances in the treatment of breast cancer. In the early-stage setting, standard pathology measures can help identify which subset of patients with hormone receptor–positive breast cancers are more likely to experience benefit from...

issues in oncology
cost of care

Tackling the High Cost of Cancer Care

AT THE 2017 ASCO ANNUAL MEETING, the leaders of the newly formed Value in Cancer Care Consortium (vi3c; vi3c.org) met to discuss the group’s plan to study how to improve the affordability of cancer drugs and make them more accessible to patients. The goal of the Value in Cancer Care Consortium is...

supportive care
palliative care
cost of care
issues in oncology

Palliative Care Intervention Reduces Total Health-Care Costs in Patients With Advanced Cancer

A matched case-controlled study among Medicare beneficiaries with metastatic lung, colorectal, breast, and prostate cancers has found that palliative care consultation significantly reduced total health-care costs following intervention. According to data presented at the 2017 Palliative and...

supportive care
palliative care

Advancing Care Across the Cancer Continuum

Addressing the need to integrate palliative and supportive care practices into medical specialties to ensure optimal patient-centered care across the cancer continuum and the evidence-based remedies to accomplish that goal were the focus of the nearly 300 study abstracts presented at the 2017...

The Man in the Vest

It had been an uneventful Sunday morning, and I was writing my final note for the day, hopeful to make a stealth exit and perhaps join my family at church. But as I closed the chart and looked up, I saw Ruthie, my oncology fellow, approaching with a grim expression. “I just left the room of a...

leukemia

Novel Risk-Assessment Model for Acute Myeloid Leukemia

A RECENTLY PUBLISHED STUDY in JAMA Oncology, led by Mohamed Sorror, MD, MSc, and Elihu Estey, MD, of the Fred Hutchinson Cancer Research Center (Fred Hutch), involving five collaborating institutions, provides a novel model to predict 1-year survival rates of patients after beginning treatment...

genomics/genetics
solid tumors
lymphoma
multiple myeloma

Update on NCI-MATCH Precision Medicine Trial

THE NATIONAL CANCER INSTITUTE (NCI) Molecular Analysis for Therapy Choice (MATCH) clinical trial has achieved the goal of screening nearly 6,000 patients in just under 2 years, according to data presented at the 2017 American Association for Cancer Research–NCI–European Organisation for Research...

hematologic malignancies

A Pioneer in Bloodless Transplant Discusses Advances in Blood Management

Bloodless stem cell transplantation, performed without the transfusion of allogeneic blood or blood products, has numerous clinical advantages, especially among populations of patients who prefer, for religious or other reasons, no blood methods of medical and surgical treatment. Patricia A. Ford, ...

IDEA Trial: ‘Going Beyond Statistics’ in Stage III Colon Cancer

According to Alberto Sobrero, MD, Head of Medical Oncology at Ospedale San Martino in Genova, Italy, the results of the pivotal IDEA trial, which evaluated the optimal duration of adjuvant chemotherapy for stage III colon cancer, were not clear to clinicians.1 The combined analysis of six...

skin cancer

Melanoma Mutations: What You Need to Know

CLINICIANS ARE now well acquainted with BRAF mutations in advanced melanoma, but there is more to genomics in this disease than identifying BRAF and prescribing a BRAF inhibitor.  At the 2017 Debates and Didactics Conference, held at Sea Island, Georgia, Melinda L. Yushak, MD, MPH, of Emory...

President-Elect Candidates Discuss ASCO’s Role in Shaping Global Oncology Community

Howard A. “Skip” Burris III, MD, FACP, FASCO, of Sarah Cannon and Tennessee Oncology, and Therese Marie Mulvey, MD, FASCO, of Massachusetts General Hospital North Shore Cancer Center, were selected by the ASCO Nominating Committee as candidates for ASCO President-Elect. Below, the candidates share...

Cast Your Vote in ASCO Election by December 4

The ASCO Nominating Committee, which is itself elected by ASCO members, is charged with selecting candidates for future Society leadership. This job is both a great pleasure and a real challenge, since ASCO has so many dedicated members who have the desire, insight, and ability to lead our...

Expert Point of View: Nadia Harbeck, MD, PhD

Invited discussant Nadia Harbeck, MD, PhD, Head of the Breast Center of the University of Munich (LMU), Germany, said the UNICANCER-NeoPAL trial points toward the future of endocrine therapy in early breast cancer—using cyclin-dependent kinase 4/6 (CDK4/6) inhibitors as a means of “enhancing” this ...

gynecologic cancers

PARP Inhibitors in BRCA-Related Ovarian Cancer—and Beyond!

Poly (ADP ribose) polymerase (PARP) inhibitors are among the most exciting new classes of oncology drugs, and their development has coincided with the increasing recognition of the therapeutic vulnerability in targeting DNA damage response and DNA repair. The initial clinical testing of PARP...

issues in oncology

ASCO Survey Reveals Concerning Trends in Americans’ Knowledge About Cancer Risks and Impact of Costs on Compliance

Although most Americans, 78%, recognize that smoking is a major risk factor for cancer, just 31% say obesity—the second-leading preventable cause of cancer after smoking—is a risk factor for the disease, according to the results of ASCO’s National Cancer Opinion Survey, which polled over 4,000...

health-care policy
issues in oncology
legislation

Hospital Groups File Lawsuit to Stop Significant Payment Cuts for 340B Hospitals

The American Hospital Association (AHA), the Association of American Medical Colleges (AAMC), and America’s Essential Hospitals have filed a lawsuit against the U.S. Department of Health and Human Services (HHS) in the U.S. District Court for the District of Columbia to prevent significant...

survivorship

Novel Psychosocial Intervention for Fear of Cancer Recurrence

An Australian trial has shown that a novel theoretically/empirically based intervention (ConquerFear) reduced the fear of cancer recurrence compared with relaxation therapy among patients treated for curable cancers. These results were reported by Butow et al in the Journal of Clinical Oncology....

breast cancer

Predisposition to Breast Cancer due to Mutations Other Than BRCA1/BRCA2 in Ashkenazi Jewish Women

A cohort study in Ashkenazi Jewish women with breast cancer identified mutations other than BRCA1 and BRCA2 founder alleles that were associated with cancer risk. These results were reported by Walsh et al in JAMA Oncology. Among Ashkenazi Jewish women, three mutations in BRCA1 and BRCA2...

breast cancer

Ovarian Function Recovery During Anastrozole Therapy in Postmenopausal Patients With Breast Cancer

In the phase III DATA trial reported in the Journal of the National Cancer Institute by Vivianne C.G. Tjan-Heijnen, MD, PhD, of the Maastricht University Medical Centre, the Netherlands, and colleagues, 12% of women with breast cancer who had chemotherapy-induced ovarian function failure...

Life With Death in the Room

It began, as so many do, with what a doctor often calls “a small spot,” a vague description that makes a potentially fatal disease sound like something that, with a slight bit of attention, can be ridded, like erasing a misplaced comma. In 2015, during a routine mammogram, doctors found one “small ...

breast cancer

Higher Risk of Breast Cancer Does Not Motivate Cancer Screening in Many Women

Some women, because of genetic predisposition, personal, or family history, have a higher-than-average lifetime risk of developing breast cancer. For those women, earlier magnetic resonance imaging (MRI) is recommended for cancer screening. But according to new findings presented at the American...

skin cancer

Balancing Immune-Related Adverse Events With Efficacy of Dual Checkpoint Inhibitor Therapy in Melanoma

MUCH PROGRESS has been made in the past decade in the treatment of patients with newly diagnosed metastatic melanoma. In the front-line setting, programmed cell death protein 1 (PD-1) monotherapy (nivolumab [Opdivo] and pembrolizumab [Keytruda]) and combined PD-1 plus cytotoxic...

leukemia

Fat Cells May Inactivate Chemotherapeutic Drug and Contribute to Poorer Survival in ALL

It is well established that obesity increases the risk for cancer mortality, although no mechanisms have been proven to explain the reason for this association. Now a laboratory study investigating how obesity might alter the effectiveness of daunorubicin in the treatment of acute lymphoblastic...

survivorship
lymphoma

Life After Treatment: Managing Lymphoma Survivors

According to Surveillance, Epidemiology, and End Results (SEER) data, patients with Hodgkin lymphoma and non-Hodgkin lymphoma (NHL) have 5-year survival rates of 86% and 71%, respectively.1 Although the increased number of survivors is welcome proof of the success of new treatment regimens, it also ...

supportive care
palliative care

How Effective Communication Is Integral to Patient-Centered Care

Communicating effectively with patients with advanced cancer not only helps patients and their family members successfully transition to palliative and end-of-life care, it can prevent physicians from experiencing professional burnout, according to Robert M. Arnold, MD, Distinguished Service...

breast cancer
gynecologic cancers

International Trials Reveal New Findings in the Management of Breast and Ovarian Cancers

The European Society for Medical Oncology (ESMO) 2017 Congress, held in Madrid, featured important news including at least seven practice-changing or potentially practice-changing trials, which are covered in recent issues of The ASCO Post. Here we present additional highlights of studies in breast ...

lung cancer

EXPERT POINT OF VIEW: Joan H. Schiller, MD

JOAN H. SCHILLER, MD, Deputy Director of Inova Schar Cancer Institute in Fairfax, Virginia, pointed out that no one particular chemotherapy regimen has been shown to improve overall survival vs other standard regimens. “So if we can’t identify one best chemotherapy, what else can we do to make...

issues in oncology

Changes in Uninsured Status Among Nonelderly Cancer Patients Under the Affordable Care Act

In a research letter in JAMA Oncology, Soni et al reported reductions in the proportion of nonelderly adult cancer patients who were uninsured between 2010 and 2013 vs 2014, after institution of the Affordable Care Act (ACA). Study Details The study used data from the Surveillance, Epidemiology,...

hepatobiliary cancer

The Liver Meeting: Direct-Acting Antiviral Medications as Hepatitis C Treatment May Reduce Risk of Liver Cancer

A new study presented at The Liver Meeting—held by the American Association for the Study of Liver Diseases—found that eradication of the hepatitis C virus induced by direct-acting antiviral medications is associated with a 71% reduction in the risk of liver cancer (Abstract 142)....

pain management

Jeremy Hirst, MD, on My Patient Needs Opiates and Benzodiazepines: What Should I Do?

Jeremy Hirst, MD, of the University of California, San Diego, offers concrete advice on assessing the need for these medications, using them safely, and knowing when to deprescribe them.

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