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neuroendocrine tumors

Telotristat Ethyl: A Novel Therapy for Carcinoid Syndrome—Not a Panacea but a Step in the Right Direction

The multihumoral manifestations of neuroendocrine tumors include diarrhea, cutaneous flushing, wheezing, and right-sided valvular heart disease.1 Serotonin, a biogenic amine and product of tryptophan metabolism,2 mediates several of these symptoms.3,4 Diarrhea is a cardinal and often disabling...

lung cancer

Expert Point of View: Fiona Blackhall, PhD, FRCP

“There has undoubtedly been extremely rapid progress made in establishing effective therapies for anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC) patients in less than a decade,” said Fiona Blackhall, PhD, FRCP, Chair of Thoracic Oncology and medical oncologist at the...

myelodysplastic syndromes

Expert Point of View: Steven D. Gore, MD, and Rami Komrokji, MD

Steven D. Gore, MD, Director of Hematologic Malignancies at Yale School of Medicine, New Haven, Connecticut, applauded Dr. Stein for “accruing a terrible patient population, mutation-wise” and called the preliminary findings for the benefit of enasidenib in patients with ASXL1 mutations...

breast cancer
symptom management

Randomized Trial Demonstrates Benefit of Scalp-Cooling in Prevention of Chemotherapy-Induced Hair Loss

A scalp-cooling device was found safe and effective in preventing chemotherapy-induced hair loss in women undergoing adjuvant treatment for breast cancer in an interim analysis of the first prospective, randomized trial of a modern scalp-cooling system. The study was presented at the 2016 San...

cost of care

The Cost of a Patient’s Last Ride

It was a call from a referring physician who wanted the patient to be transferred to our major academic center. The patient had a history of a lethal malignancy in a very advanced stage. The patient was already outside the bell curve, for she had survived far longer than expected for a malignancy...

colorectal cancer

Dual Inhibition Proves Effective for BRAF-Mutated Colorectal Tumors

In patients with metastatic colorectal cancer who have mutations in BRAF V600, the addition of the BRAF inhibitor vemurafenib (Zelboraf) to cetuximab ­(Erbitux) and irinotecan significantly improved progression-free survival, results of the phase II Southwest Oncology Group (SWOG) 1406 trial have...

skin cancer

ECCO 2017: Melanoma Death Rates Will Fall by 2050, but Number of Deaths Will Increase

By 2050, the death rates from malignant melanoma will have decreased from their current levels, but the numbers of people dying from the disease will have increased due to the aging of populations. However, if new treatments for the deadly skin cancer prove to be effective, the numbers of deaths...

breast cancer

ECCO 2017: Some Patients With Early-Stage Breast Cancer May Benefit More From Breast-Conserving Therapy Than Mastectomy

Breast-conserving therapy (breast-conserving surgery combined with radiation therapy) may be superior to mastectomy in certain patients with breast cancer, according to results from the largest study on this topic to date, presented at the 2017 European Cancer Congress (Abstract 4LBA). Although...

leukemia

High Financial Burden for CML Patients Enrolled in Medicare Part D Receiving Targeted Oral Therapy

In a study reported in the Journal of Oncology Practice, Shen et al found that more than three-quarters of patients receiving targeted oral therapy for chronic myeloid leukemia (CML) reached the catastrophic phase of the Medicare Part D benefit within the calendar year of starting such treatment....

head and neck cancer

ECCO 2017: Twice-Daily Radiation Therapy May Reduce Mortality in Head and Neck Cancer

Treating patients with head and neck cancer with hyperfractionated twice-daily radiation therapy combined with chemotherapy could potentially reduce mortality, according to new research presented by Petit et al at the 2017 European Cancer Congress (ECCO) (Abstract 823). The study, led by Claire...

SWOG Launches National Immunotherapy Clinical Trial for Rare Cancers

People with rare cancers now have the option of joining a national clinical trial testing leading-edge immunotherapies for a wide variety of tumor types. It’s the first federally funded immunotherapy trial devoted to rare cancers. Despite their name, rare cancers make up more than 20% of...

What Have We Got to Lose?

Tuesday morning was the regular time for the departmental meeting—an opportunity to discuss cases, troubleshoot, debrief, and expedite the necessary allied health referrals. As usual, patient cases were being discussed in alphabetical order of the attending oncologist. We were already three...

issues in oncology

An Insider’s Account of the AIDS Epidemic

On June 5, 1981, the Centers for Disease Control and Prevention published a Morbidity and Mortality Weekly Report (MMWR) describing cases of a rare lung infection in five young gay men in Los Angeles. The men had other unusual infections as well, indicating their immune systems were compromised....

Jennifer Lycette, MD, Takes Pride in Delivering Cancer Care to Those Most in Need in Northwest Oregon

Born and reared in Anchorage, a city located in Southcentral Alaska, farther north than St. Petersburg, Russia, Jennifer Lycette, MD, grew up during the 1970s and 1980s. “We were fairly isolated from the lower 48. We didn’t have cable TV in Anchorage, and I remember my father would turn off the TV ...

hematologic malignancies
symptom management

Ibrutinib: A Potential Option for Chronic Graft-vs-Host Disease?

Currently, there is no U.S. Food and Drug Administration (FDA)-approved therapy for chronic graft-vs-host disease—a life-threatening consequence of stem cell or bone marrow transplant—that has not responded to corticosteroids, but this may be about to change. Ibrutinib (Imbruvica) achieved...

issues in oncology

Addressing Discrimination and Bias in Medical Education

“As a medical student, I often felt marginalized from my medical community. I have been told that my name is ‘not American,’ fallen prey to being confused for support staff such as a janitor (even while wearing my white coat) and been asked questions like, ‘Where are you really from?’ or ‘How old...

issues in oncology
health-care policy

ASCO’s State Affiliate Council: Helping Practices to Meet the Challenges Ahead

ASCO’s State Affiliate Council serves as an advisory group to ­ASCO’s Board of Directors on issues relating to its State/Regional Affiliates and their members, and serves as a vehicle for effective communications between the Board and domestic membership. The Council is made up of physician...

genomics/genetics

Understanding Cancer Epigenetics and Its Clinical Implications

The field of epigenetics emerged in the 1990s and has been described with somewhat variable meanings. In 2008, a meeting at the Cold Spring Harbor laboratory arrived at a definition of epigenetics by consensus: “A stably heritable phenotype resulting from changes in a chromosome without...

geriatric oncology

Falls in Older Patients With Cancer: Recognizing and Reducing the Risk

In older patients, a current or previous cancer diagnosis confers a 15% to 20% greater risk of suffering a fall.1 Defined as an “unexpected event in which the participant comes to rest on the ground, floor, or lower level,” a fall occurs in 30% to 50% of cancer patients 65 years of age or...

head and neck cancer

Nivolumab in Squamous Cell Carcinoma of the Head and Neck in CheckMate 141: Game Not Over

Most patients with squamous cell carcinoma of the head and neck present with locally advanced disease. With combined-modality approaches, the chance of cure ranges from < 50% to up to 80%, depending on the site, stage, and other risk factors, such as human papillomavirus (HPV) status. When...

breast cancer
issues in oncology

Managing Breast Cancer in a Pregnant Patient

“One of the most challenging oncologic situations that I face as a clinician is the diagnosis of breast cancer in a young pregnant patient,” ­Jacqueline Jeruss, MD, PhD, Director of the Breast Care Center at the University of Michigan Comprehensive Cancer Center, Ann Arbor, told the more than 250...

lymphoma

CAR T-Cell Therapy KTE-C19 Appears Successful in Aggressive B-Cell Lymphoma

Chimeric antigen receptor (CAR) T-cell therapy continues to have impressive showings in patients with aggressive hematologic malignancies and no other good treatment options. Interim results of the pivotal phase II ZUMA-1 trial, the first multicenter trial of the experimental CAR T-cell therapy...

multiple myeloma

Expert Point of View: Philip ­McCarthy, MD

The ASCO Post asked Philip ­McCarthy, MD, Professor of Oncology and Internal Medicine at Roswell Park Cancer, Buffalo, and Director of the Blood and Marrow Transplant Center there, to comment on these study findings. He first addressed the need to study earlier intervention for smoldering ...

breast cancer

Selected Abstracts From the 2016 San Antonio Breast Cancer Symposium

Each year, The ASCO Post asks Jame Abraham, MD, Director of the Breast Oncology Program at Taussig Cancer Institute and Co-Director of the Cleveland Clinic Comprehensive Breast Cancer Program, to give his picks for the most important research presented at the San Antonio Breast Cancer Symposium....

breast cancer

Expert Point of View: Howard A. “Skip” Burris, MD

Howard A. “Skip” Burris, MD, President of Clinical Operations and Chief Medical Officer at Sarah Cannon Research Institute, Nashville, commented on the poster presentation for The ASCO Post. He said the results “fit the whole paradigm” that is desired for triple-negative breast cancer, which is to ...

breast cancer

Tucatinib Shows Clinical Benefit in Phase I Trial in HER2-Positive Breast Cancer

Phase I clinical trial data published by Moulder-Thompson et al in Clinical Cancer Research reported that the investigational anticancer agent tucatinib (formerly ONT-380) showed 'notable activity' in the treatment of HER2-positive breast cancer with . The 50 women treated had disease...

gastroesophageal cancer

2017 GI Cancers Symposium: PET Scans Can Inform and Improve Treatment for Patients With Esophageal Cancer

Findings from a federally funded clinical trial—CALGB 80803 (Alliance)—point to a new way to improve the outlook for patients with esophageal cancer: using positron-emission tomography (PET) scans to assess tumor response to initial chemotherapy may allow doctors to tailor further...

prostate cancer

Prostate Cancer Treatment Rates Drop, Reflecting Change in Screening Recommendations

As some national guidelines now recommend against routine prostate cancer screening, the overall rate of men receiving treatment for the disease declined 42% between 2007 and 2012, a new study published by Borza et al in Health Affairs found. The decline reflects efforts to decrease overdiagnosis...

breast cancer
colorectal cancer
issues in oncology

Has the Affordable Care Act Reduced Socioeconomic Disparities in Cancer Screening?

Out-of-pocket expenditures are thought to be a significant barrier to receiving cancer preventive services, especially for individuals of lower socioeconomic status. A new study published by Cooper et al in Cancer looked at how the Affordable Care Act (ACA), which eliminated such out-of-pocket...

gynecologic cancers

Endometrial Cancer Mutations May Be Detectable in Uterine Lavage Fluid Before Cancer Is Diagnosed

Mutations that have been linked to endometrial cancer can be found in the uterine lavage fluid of pre- and postmenopausal women both with and without detectable cancer, according to a study published by Nair et al in PLOS Medicine. “Today, there are no effective screening methods for...

leukemia

Treating the Whole Person

Twenty-five years ago, I was a physically fit woman of 45 in training to run a marathon, which had been a lifelong goal. I was feeling fine and had no hint of the illness that would nearly take my life and has forever changed it. While ramping up to go the 26.2-mile distance, I decided to have a...

breast cancer
geriatric oncology

Expect Questions About Screening Mammography for Women Aged 75 Years and Older

A study finding that there is no clear cutoff age to stop breast cancer screening has received national coverage in newspapers and CNN as well as in health and medical publications. “I am glad this is catching fire, because it really needs to be out there,” Cindy S. Lee, MD, the study’s lead...

issues in oncology
breast cancer
geriatric oncology

Study Suggests No Evidence for Screening Mammography Cutoff Age

An analysis of data from nearly 6 million screening mammograms found no evidence for a clear cutoff age to stop breast cancer screening. Screening mammography among women aged 75 years was associated with higher cancer detection and lower recall rates than among younger women in the study. These...

global cancer care
issues in oncology

Exploring Practical Strategies for Cancer Care in Low-Resource Settings

One of the featured “Big Debates” at the 2016 World Cancer Congress in Paris addressed this question: Are scarce resources best applied to prevention rather than treatment? Many experts do not see prevention vs treatment in such stark terms or even as a realistic scenario. It’s a false dichotomy,...

breast cancer

Expert Point of View: Myles Brown, MD, Carlos L. Arteaga, MD, and Eric Winer, MD

Myles Brown, MD, Director of the Center for Functional Cancer Epigenetics at Dana-Farber Cancer Institute, Boston, suggested the failure of the endocrine therapy to increase the pathologic complete response rates “may be related to the fact that the aromatase inhibitor was not the optimal...

breast cancer

Expert Point of View: Carlos L. Arteaga, MD

Press conference moderator ­Carlos L. Arteaga, MD, said: “This drug is not necessarily the same as palbociclib [Ibrance] or ribociclib. There are subtle differences among these three [cyclin-dependent kinase (CDK) 4/6] inhibitors. The tissue analysis provides us with an enormous opportunity to...

breast cancer
genomics/genetics

Genomic Landscape of Metastatic Breast Cancer Differs From That of Primary Breast Cancer

Researchers working on whole-exome and transciptome sequencing of endocrine-resistant estrogen receptor–positive metastatic breast cancer have shown that the mutational landscape differs from that of estrogen receptor–positive primary breast cancer, and these differences have the potential to...

lymphoma

Expert Point of View: Lawrence Kaplan, MD

“This study is important because R-CHOP [rituximab and cyclophosphamide, doxorubicin, vincristine, prednisone] has been the standard of care for many years. CHOP, the chemotherapy backbone, has withstood challenges from more aggressive regimens in the past. The excellent clinical outcomes observed ...

cns cancers

Accelerating Progress in the Treatment of Glioblastoma Multiforme

W.K. Alfred Yung, MD, has wanted a career in medicine since he was a high-school student and has spent nearly 4 decades fulfilling that dream, specifically in the research and treatment of one of the deadliest cancers, malignant brain tumor, especially glioblastoma multiforme, the most common...

multiple myeloma

Expert Point of View: Sergio A. Giralt, MD

Sergio A. Giralt, MD, Chief of the Adult Bone Marrow Transplant Service at Memorial Sloan Kettering Cancer Center, New York, and the Melvin Berlin Family Chair in Multiple Myeloma, commented on the findings of the StaMINA trial for The ASCO Post. He said the results of the largest randomized U.S....

Lawrence N. Shulman, MD, FACP, Named Chair of American College of Surgeons’ Commission on Cancer

Lawrence N. Shulman, MD, FACP, Professor of Medicine in the Perelman School of Medicine and Deputy Director for Clinical Services of the Abramson Cancer Center at the University of Pennsylvania, has been named the new Chair of the Commission on Cancer of the American College of Surgeons. The...

leukemia

Expert Point of View: Amir T. Fathi, MD

“In the past few years, there has been increased reporting of other, less traditional, response criteria in acute myeloid leukemia (AML), including morphologic leukemia-free state, partial response, and complete remission [or complete response] with incomplete recovery. There is some concern that...

Women in Oncology: Breaking Down Barriers and Looking to the Future

There has been no better time than the present for women in the field of oncology: Women at all stages of their careers are finding more opportunities and avenues to excel. At the time of the last ASCO workforce survey, women made up 28.4% of the oncologist workforce, and that proportion is rising...

leukemia

Achieving Complete Response Is Key to Improving Survival in Older Patients With AML

The importance of achieving complete response after intensive therapy in older adults with acute myeloid leukemia (AML) was confirmed in a follow-up analysis of the E2906 North American Intergroup trial.1 Patients in complete response had superior survival in this landmark analysis. This finding...

leukemia

Reduced-Intensity Chemotherapy Leads to More Relapses in Childhood ALL

Children with acute lymphoblastic leukemia (ALL) considered at standard risk for relapse should continue to receive standard-intensity regimens, according to findings from the international randomized AIEOP-BFM ALL 2000 trial.1 A reduced-intensity treatment for children with ALL considered to have ...

breast cancer

Expert Point of View: Michael Gnant, MD

Michael Gnant, MD, Professor of Surgery at the Medical University of Vienna in Austria and President of the Austrian Breast & Colorectal Cancer Study Group, was the invited discussant of the three studies of extended endocrine therapy. “The trials did not reach the necessary statistical levels ...

breast cancer

Benefit of Extended Adjuvant Endocrine Therapy Not Upheld in Multiple Studies Reported in San Antonio

Extended endocrine therapy with an aromatase inhibitor did not improve disease-free survival in patients with hormone receptor–positive breast cancer enrolled in three studies presented at the 2016 San Antonio Breast Cancer Symposium. The results stand in contrast to the phase III National Cancer...

breast cancer
issues in oncology

ESMO Asia 2016: Almost 20% of Swedish Breast Cancer Patients Fail to Complete Prescribed Endocrine Therapy

Around 20% of patients with breast cancer in Sweden do not complete endocrine therapy, according to research that will be reported at the ESMO Asia 2016 Congress (Abstract 62O_PR), to be held December 16–19 in Singapore.The study in over 5,500 women found that younger patients and those who...

Expect Questions About Cardiovascular Risk Factors Among Cancer Survivors

Reports of rare, but in some cases fatal, cardiac complications when the checkpoint inhibitors ipilimumab (Yervoy) and nivolumab (Opdivo) are used in combination should be taken seriously but should not scare patients away from potentially life-saving drugs, according to Javid J. Moslehi, MD. Dr....

SABCS 2016: Women Experiencing Menopausal Symptoms Less Likely to Adhere to Medication in IBIS-1 Trial

Among women enrolled in the International Breast Cancer Intervention Study I (IBIS-I), those who had certain symptoms of menopause—nausea/vomiting and headaches—were significantly less likely to be adherent to the assigned medication 4.5 years after starting the treatment, according to...

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