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skin cancer
immunotherapy

Real-World Treatment Impact of Newer Agents on Survival of Patients With Metastatic Melanoma

The approval of several new agents for metastatic melanoma in the past several years has led to changes in how the disease is treated and managed. Treatments such as the programmed cell death protein 1 (PD-1) inhibitors pembrolizumab, ipilimumab, and nivolumab; BRAF inhibitors; and MEK inhibitors...

Expert Point of View: Steven Gore, MD, Eyten Stein, MD, and Elihu H. Estey, MD

In discussions after these presentations, several points were made by several experts. To begin, Steven Gore, MD, Director of Hematologic Malignancies at Yale Medical School, called the study of venetoclax plus 10-day decitabine “very important,” but he raised the issue of appropriate dosing. He...

lung cancer

Progress With ALK Inhibitors: When Will We Consider ALK-Positive Lung Cancer a ‘Chronic Disease’?

As reported by Solomon et al in The Lancet Oncology1 and reviewed in this issue of The ASCO Post, results from a global phase II study of the third-generation ALK inhibitor lorlatinib showed a high overall response rate and high intracranial response rate for patients with advanced ALK-positive...

geriatric oncology

Changing Perceptions on Surgical Intervention for Geriatric Patients With Cancer: Role of the SIOG Surgical Task Force

Surgery is an integral part of treatment of elderly patients with solid malignancies. The times we are living in will be remembered by health-care providers for the significant “contradictions” in the medical and surgical care of elderly patients with cancer. On the one hand, it has been...

lymphoma

Outcomes With AHCT Consolidation in Younger Patients With Mantle Cell Lymphoma in the Rituximab Era

In a retrospective study reported in the Journal of Clinical Oncology, Gerson et al found evidence that autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy was associated with a progression-free survival benefit in patients with mantle cell lymphoma aged...

hematologic malignancies
leukemia

Remnants of Cancer Remain, but Demons Are Now Gone

In the summer of 2002, I was a physically active 17-year-old boy on the cusp of adulthood. I was about to enter my senior year in high school, and like other teens my age, I was excited about college and the promise of the undreamed-of opportunities that lay ahead. At first, the lethargy I was...

New NCCN Member Institution: Abramson Cancer Center of the University of Pennsylvania

In November, the National Comprehensive Cancer Network® (NCCN) announced that Abramson Cancer Center (ACC) of the University of Pennsylvania will become the organization’s 28th Member Institution. The Abramson Cancer Center’s membership will include the Hospital of the University of Pennsylvania...

hematologic malignancies
multiple myeloma
immunotherapy

Front-Line Daratumumab Combination Regimen Improves Outcomes in Multiple Myeloma

In patients with newly diagnosed multiple myeloma who are not eligible for stem cell transplantation, the addition of daratumumab (Darzalex) to lenalidomide (Revlimid) and dexamethasone significantly reduced the risk of death or disease progression by 44%, according to a late-breaking abstract...

skin cancer

Encorafenib and Binimetinib: A New Benchmark in Metastatic Melanoma Therapy?

IN JULY 2018, the U.S. Food and Drug Administration (FDA) approved the combination of the oral BRAF inhibitor encorafenib (Braftovi) and the oral MEK inhibitor binimetinib (Mektovi) for BRAF V600E– or V600K– positive metastatic melanoma. The FDA approval was based on the results of the COLUMBUS...

issues in oncology

Focus on the Rocky Mountain Oncology Society

Formed in 1991, the Rocky Mountain Oncology Society (RMOS), a Chapter Member of the Association of Community Cancer Centers (ACCC) and State Affiliate of ASCO, serves as the voice for Colorado’s multidisciplinary cancer care teams and the patients they serve. Representing the common interests of...

issues in oncology

Novel Physician-Driven Practice Model Offers Alternative to Community Oncologists

Three leading oncology practices have united with partners in technology and finance to launch OneOncology, a physician-driven company that aims to unite more than 225 community oncology providers from 60-plus locations. Altogether, OneOncology will treat nearly 158,000 cancer patients a year. The...

hematologic malignancies
leukemia
genomics/genetics

Without Genomic Sequencing, I Would Not Be Alive Today

The extreme fatigue I experienced during the winter of my fourth year in medical school, in 2003, was easily attributable to the rigors of my medical training and the lack of sleep that comes from trying to keep up with an intensely busy schedule. I was looking forward to resting and recuperating...

prostate cancer

ESMO 2018: Survival Results From STAMPEDE: Local Radiotherapy in Newly Diagnosed Metastatic Prostate Cancer With Low Disease Burden

Radiotherapy to the prostate improved overall survival in men newly diagnosed with metastatic prostate cancer who have a low metastatic disease burden, but not in those with higher burden of disease, according to results from a preplanned analysis of a large comparison study reported by Parker et...

supportive care
pain management

The Opioid Crisis From the Oncology Perspective

As the nation battles an escalating opioid-overdose crisis, which claims more than 100 lives per day, a new study presented at the 2018 ASCO Quality Care Symposium was designed to answer a heretofore unanswered question: How common are opioid-related deaths in patients with cancer?1 Unintended...

hematologic malignancies
lymphoma

Novel Treatment Approaches in Early Relapse of Follicular Lymphoma

“Patients with follicular lymphoma who relapse early after treatment are a minority of patients, fortunately, but they are clearly patients with a different disease,” according to Jonathon B. Cohen, MD, of Emory University School of Medicine. At Emory’s 2018 Debates and Didactics in Hematology and...

leukemia

Adding Lomustine to Conventional Chemotherapy in Older Patients With AML Without Unfavorable Cytogenetics

As reported in the Journal of Clinical Oncology by Pigneux et al, a French phase III trial (LAM-SA 2007 FILO) has shown an overall survival benefit with the addition of lomustine to conventional chemotherapy in older patients with acute myeloid leukemia (AML) without unfavorable cytogenetics....

hematologic malignancies
leukemia

Beat AML Trial Seeking to Change Treatment Paradigm

The Beat AML Master Clinical Trial seeks to change the treatment paradigm and outcomes in acute myeloid leukemia (AML) by personalizing therapy and ultimately facilitating the approval of novel targeted agents. Co-investigator William Blum, MD, of the Winship Cancer Institute at the Emory...

lung cancer

WCLC 2018: Poziotinib in Stage IV NSCLC With Genetic Mutations

Findings presented at the International Association for the Study of Lung Cancer (IASLC) 19th World Conference on Lung Cancer (WCLC) showed poziotinib demonstrates clinical activity among patients with stage IV NSCLC with genetic mutations that have previously not responded to treatment....

issues in oncology
pain management

2018 Quality Care: Opioid Deaths Are 10 Times Less Likely to Occur in Patients With Cancer Compared to the General Population

According to the U.S. Department of Health and Human Services, in 2016, over 42,000 Americans died from opioid overdose, making the epidemic a top public health concern. Although opioids are commonly used for cancer-associated pain, the risks for overdose in patients with cancer were unknown. A...

leukemia

Origins and Genetics Associated With Mixed-Phenotype Acute Leukemia

Investigators have unraveled the origins and identified mutations associated with mixed-phenotype acute leukemia. The study, published by Alexander et al in Nature, potentially lays the foundation for more effective treatment of patients with this high-risk cancer. Mixed-phenotype acute...

issues in oncology

Are E-Cigarettes a Dangerous Alternative to Traditional Cigarettes?

Several studies published earlier this year present preliminary but compelling evidence that electronic cigarettes, also known as e-cigarettes, which deliver nicotine through aerosols without burning tobacco, may pose serious health consequences to users, including cardiovascular disease and...

issues in oncology

Ensuring Quality With Patient-Reported Outcomes and Electronic Health Records

Accurately assessing the quality of cancer care over the continuum of treatment requires a special set of metrics and data-gathering methods. Moreover, with a growing number of cancer survivors, the post-treatment care involves primary care providers who are adept at managing the comorbidities...

prostate cancer

Abiraterone or Enzalutamide for Newly Diagnosed Metastatic Castrate-Resistant Prostate Cancer?

WHAT IS THE best choice of treatment for a man with newly diagnosed metastatic castration-resistant prostate cancer after treatment with androgen-deprivation therapy—abiraterone acetate (Zytiga) plus prednisone, or enzalutamide (Xtandi)? Both drugs achieve similar cancer control in this setting,...

Four Generations of Doctors, One Oncologist, in the Family of Hanna K. Sanoff, MD, MPH

Medicine is a family tradition for Hanna K. Sanoff, MD, MPH. “I was born and reared in a suburb just outside of Philadelphia and lived there my whole life until after college. I was one of those people who always knew they wanted to be a doctor. There were four generations of physicians on my...

colorectal cancer

By Sending Tests by Mail, Researchers Boost Colorectal Cancer Screening Rates Among Medicaid Patients

Mailing colorectal cancer screening tests to patients insured by Medicaid increased screening rates for this population, reported researchers at the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center. In collaboration with the Mecklenburg County Health Department in...

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,...

solid tumors
prostate cancer

ASCO Clinical Practice Guideline: Optimizing Anticancer Therapy in Metastatic Non-castrate Prostate Cancer

As reported in the Journal of Clinical Oncology by Michael J. Morris, MD, of Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, and colleagues, ASCO has released a clinical practice guideline on optimizing anticancer therapy in men with metastatic non-castrate prostate cancer.1 To ...

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...

solid tumors
gynecologic cancers

HPV Vaccine Could Have Prevented My Cancer

In the fall of 2015, I was feeling great. At age 37, I had just completed running my fourth half-marathon and regularly hiked trails near my home in Arlington, Texas, to stay fit in-between races. The only symptom that foretold what was in my future was some light watery discharge I was...

hematologic malignancies
lymphoma

Hematopoietic Cell Transplantation for Follicular Lymphoma

Many patients with follicular lymphoma relapse within 2 years of initial therapy, and for a number of these individuals, hematopoietic cell transplantation is a good treatment option. Transplant, however, both autologous and allogeneic, is vastly underutilized in these patients, according to Mehdi ...

breast cancer

Education Came First for Breast Cancer Expert Beverly Moy, MD, MPH, Daughter of Chinese Immigrants

Beverly Moy, MD, MPH, grew up in Brooklyn, New York, in a modest working-class home. Both her parents were immigrants from China. “Education is highly prized in Chinese culture, and my home life was no exception. I didn’t speak any English when I began kindergarten, so that was a bit challenging,...

hematologic malignancies
immunotherapy

Logistics of CAR T-Cell Therapy in Real-World Practice

With the U.S. Food and Drug Administration (FDA) approvals of tisagenlecleucel (Kymriah)1 and axicabtagene ciloleucel (Yescarta),2 chimeric antigen receptor (CAR) T-cell therapy has moved into real-world practice, offering new potentially curative options for incurable hematologic malignancies. Its ...

lung cancer

ESTRO 37: Elderly Patients With NSCLC May Be Less Likely to Benefit From Concurrent Chemoradiotherapy

An analysis of elderly patients with non–small cell lung cancer (NSCLC) treated in a phase II trial of radiotherapy combined with chemotherapy has shown that they were less likely to benefit than younger patients if the two treatments were given at the same time. These findings were presented ...

hematologic malignancies

FDA Approves Fostamatinib Disodium Hexahydrate for Chronic Immune Thrombocytopenia in Adult Patients

On April 17, the U.S. Food and Drug Administration (FDA) approved fostamatinib disodium hexahydrate (Tavalisse) for the treatment of thrombocytopenia in adult patients with chronic immune thrombocytopenia who have had an insufficient response to a previous treatment. Fostamatinib is an oral spleen ...

issues in oncology

2018 Quality Payment Program: ASCO’s Top 10 Things to Know

The second year of the Quality Payment Program (QPP), established by the Medicare Access and CHIP Reauthorization Act (MACRA), began on January 1, 2018. This year, oncology practices face more robust quality reporting requirements to successfully participate in QPP and avoid a financial penalty in...

cns cancers

A Clinician’s Guide to Treating Patients With Glioblastoma

Glioblastoma, a grade 4 astrocytoma, is the most common and most aggressive form of primary brain tumors in adults. The most recent guidance on molecular profiling, diagnostic and prognostic factors, and treatments for newly diagnosed and recurrent diseases was described in the Journal of Oncology ...

breast cancer
immunotherapy

2018 Treatment Algorithm for Metastatic HER2-Positive Breast Cancer

How should clinicians position anti-HER2 agents and also incorporate endocrine therapies in the treatment of metastatic HER2-positive breast cancer? At the 2018 Miami Breast Cancer Conference, this question was explored by Sunil Verma, MD, Medical Director of the Tom Baker Cancer Center and...

prostate cancer

ASCO Clinical Practice Guideline: Optimizing Anticancer Therapy in Metastatic Noncastrate Prostate Cancer

As reported in the Journal of Clinical Oncology by Michael J. Morris, MD, of Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, and colleagues, ASCO has released a clinical practice guideline on optimizing anticancer therapy in men with metastatic noncastrate prostate cancer. To...

Expert Point of View: Ezra Cohen, MD, PhD

Discussant for the abstract, Ezra Cohen, MD, PhD, of the University of California, San Diego, pointed out that although this subgroup may be responsive to checkpoint inhibition, it may not necessarily be anti–programmed cell death protein 1 (anti–PD-1) therapy. “There are emerging data suggesting...

solid tumors
breast cancer

Mentorship From a Past ASCO President and Others Steers a Career to Academic Research

  Breast cancer specialist Stacy L. Moulder, MD, was born and reared in Brookhaven, Mississippi, a small town southwest of the state capital of Jackson. “I was always interested in math and science, and I had a wonderful biology teacher in high school. It was when the advanced placement courses...

ASCO Data-Sharing Initiatives Support Innovative Cancer Research

  At the heart of every ASCO program—every clinical practice guideline, every policy statement, every scientific meeting—is evidence. What do the data say? Evidence informs decision-making across the spectrum of cancer care, from the question a bench researcher will investigate to the treatment a...

breast cancer

EXPERT POINT OF VIEW: C. Kent Osborne, MD, and Joseph Sparano, MD

“ONCOLOGISTS WANT to find drugs that will delay the use of chemotherapy, and cyclin-dependent kinase (CDK) 4/6 inhibitors provide that. These agents work better than chemotherapy and with less toxicity,” said press conference moderator C. Kent Osborne, MD, Director of the Duncan Cancer Center at...

breast cancer

CDK 4/6 Inhibitors May Be Effective but More Toxic in Older Women

OLDER WOMEN with breast cancer derive benefit from treatment with cyclin-dependent kinase (CDK) 4/6 inhibitors as part of initial endocrine-based therapy for hormone receptor–positive, HER2-negative, metastatic breast cancer, according to a retrospective pooled subgroup analysis of women aged 70 or ...

The Puzzle Table

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,...

geriatric oncology

Broadening the Evidence Base for Older Patients: FDA-ASCO Workshop Explores Emerging Strategies

In the not-so-distant past, clinical trials were considered an option only for the young and fit. Enrolling older people “used to be thought unethical,” said Janet Woodcock, MD, Director of the U.S. Food and Drug Administration (FDA)’s Center for Drug Evaluation and Research (CDER), as she opened...

hematologic malignancies
lymphoma

Born in Chicago, Lymphoma Specialist Sonali M. Smith, MD, Never Left the Windy City

Nationally recognized lymphoma expert Sonali M. Smith, MD, was born and reared in Chicago to a mother who was a pediatrician and allergist, and a father who was an engineer. Her parents were first-generation immigrants from India who placed the value of education second to none. “I became used to...

hematologic malignancies
multiple myeloma

Evidence-Based Support for Triplet Therapies in Multiple Myeloma

Over the past 15 years, multiple myeloma has garnered among the highest number of regulatory approvals by the U.S. Food and Drug Administration (FDA) for the management of all phases of the disease. This fast-expanding repertoire of treatment options has pushed the median survival of multiple...

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...

issues in oncology

Fleeing a Revolution, Becoming an Oncologist

Nicaragua, situated between Costa Rica and Honduras, is the poorest country in Central America. Following the U.S. occupation in 1912, the Somoza family began a brutal political dynasty that would end in 1979 during the bloody Nicaraguan Revolution.  Marcela G. del Carmen, MD, MPH, Chief Medical...

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...

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