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A Peaceful Transformation: The Origin of the Frederick National Laboratory

JUST 2 MONTHS before Congress passed what to this day is America’s most sweeping anticancer legislation, President Richard Nixon came to Fort Detrick in Frederick, Maryland, to declare his administration’s historic commitment to the fight. “I have come here today for the purpose of making an...

issues in oncology

Health-Care Fraud Prosecutions Are on the Rise

Prosecuting health-care fraud is a top priority for the U.S. Department of Justice (DOJ) and other federal government agencies.1,2 After all, the government earns a $6 return for every $1 that it spends on enforcement. In December 2018, the DOJ announced that it had obtained more than $2.5 billion...

hepatobiliary cancer

Cabozantinib for Hepatocellular Carcinoma Previously Treated With Sorafenib

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On January 14, 2019, cabozantinib was approved for the...

multiple myeloma

Addition of Elotuzumab to Pomalidomide and Dexamethasone in Previously Treated Patients With Multiple Myeloma

AS REPORTED in The New England Journal of Medicine by Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, and colleagues, the phase II ELOQUENT-3 trial has shown that the addition of elotuzumab to pomalidomide and dexamethasone significantly prolonged...

lung cancer

Although Evidence Is Clear That Lung Cancer Screening Saves Lives, Adoption Rates Remain Low

The findings of the National Lung Screening Trial (NLST), reported in 2011, revealed that participants who received low-dose helical computed tomography (CT) scans had a 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. Despite these results,...

skin cancer

New Patient Resource: NCCN Guidelines for Patients With Squamous Cell Skin Cancer

The National Comprehensive Cancer Network® (NCCN) has published a new book of patient information that explains prevention, diagnosis, and treatment for squamous cell skin cancer. Squamous cell and basal cell skin cancers are responsible for about 5 million annual incidents of nonmelanoma...

solid tumors
issues in oncology

Effect of Adjuvant Treatment for Early Testicular Cancer on Reproductive Potential

Men with early-stage testicular cancer can safely receive one course of adjuvant chemotherapy or radiotherapy without it having a long-term effect on their reproductive potential, according to a study published by Weibring et al in Annals of Oncology. Although it is known already that several...

breast cancer
gynecologic cancers
hematologic malignancies
leukemia
lymphoma
symptom management

FDA Pipeline: Updates on Treatments for Cervical Cancer, Myelofibrosis, Chemotherapy-Induced Nausea and Vomiting, and More

The FDA recently issued announcements on a Fast Track designation, a Priority Review, two supplemental new drug applications, an investigational new drug application, and a marketing clearance. The agency also released a safety communication on cancer-related surgery. Fast Track Designation for...

skin cancer
issues in oncology

2019 AAD: Disadvantages and Potential Improvements of Artificial Intelligence in Skin Cancer Detection

While artificial intelligence (AI) systems for skin cancer detection have shown promise in research settings, there is still a lot of work to be done before the technology is appropriate for real-world use. This was the topic of a scientific session at the 2019 American Academy of Dermatology (AAD) ...

lymphoma

First-Line Treatment of Indolent Non-Hodgkin Lymphoma or Mantle Cell Lymphoma With Bendamustine/Rituximab vs R-CHOP or R-CVP

As reported in the Journal of Clinical Oncology by Flinn et al, 5-year follow-up of the phase III BRIGHT trial has shown improved outcomes with first-line bendamustine/rituximab vs R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) or R-CVP (rituximab plus...

issues in oncology

More Than 50 Groups Sign Letter Urging HHS to Reject Proposed Changes to Medicare Part D

ASCO, along with over 50 other organizations, signed a letter from the American Cancer Society Cancer Action Network to the Department of Health and Human Services (HHS) urging the agency to reject proposed changes to Medicare Part D that could harm patient access to essential therapies, including...

supportive care
palliative care

National Consensus Project Releases 4th Edition of Clinical Practice Guidelines for Quality Palliative Care

As reported by Betty R. Ferrell, PhD, MA, FAAN, FPCN, of the Division of Nursing Research and Education, City of Hope Medical Center, Duarte, California, and colleagues in the Journal of Palliative Medicine, the National Consensus Project (NCP) of the National Coalition for Hospice and Palliative ...

breast cancer

Neoadjuvant Palbociclib Plus Letrozole Reduces Ki67 Levels

In the neoadjuvant setting, adding palbociclib to letrozole significantly enhanced the suppression of malignant cell proliferation, as measured by Ki67 levels, in patients with primary estrogen receptor–positive breast cancer but did not increase the clinical response rate over 14 weeks, according ...

lung cancer
immunotherapy

2019 ASCO-SITC: Efficacy and Safety of Less Frequent Dosing of Second-Line Nivolumab for Non–Small Cell Lung Cancer

Researchers reported similar efficacy and safety with an every-4-week regimen of nivolumab in the second-line setting compared to an every-2-week schedule in patients with non–small cell lung cancer (NSCLC). Edward B. Garon, MD, and colleagues presented the results of an interim analysis of...

breast cancer

Long-Term Study Finds Axillary Radiotherapy Safe and Effective After Positive Sentinel Node Biopsy

Following identification of a positive sentinel lymph node, surgical axillary lymph node dissection and axillary radiation therapy provide comparable locoregional control and survival, according to a 10-year follow-up of the large European Organisation for Research and Treatment of Cancer AMAROS...

breast cancer

More Data Show Small Benefit From Extended Endocrine Therapy

Two studies presented at the 2018 San Antonio Breast Cancer Symposium validated a small benefit of extending adjuvant aromatase inhibitor therapy beyond thestandard 5 years for postmenopausal women with hormone receptor–positive breast cancer. In a meta-analysis of 24,912 patients from 12...

Expert Point of View: Parag J. Parikh, MD

Parag J. Parikh, MD, Director of Gastrointestinal Radiation Oncology, Henry Ford Cancer Institute, Detroit, commented that KEYNOTE-128 “unfortunately found a very low rate of response to single-agent pembrolizumab.” He said he would not use this approach in any patients with neuroendocrine tumors...

immunotherapy
gastrointestinal cancer

Study Shows Limited Antitumor Activity of Pembrolizumab in Neuroendocrine Tumors

Neuroendocrine tumors appear resistant to single-agent immunotherapy, according to the results of the KEYNOTE-028 trial of pembrolizumab. “Pembrolizumab monotherapy showed limited antitumor activity but a manageable safety profile in patients with previously treated, advanced neuroendocrine...

issues in oncology

10 Patient-Centered Principles for More Conservative Cancer Diagnosis

Although diagnostic errors date back to antiquity, in recent years, they have begun to receive attention as an important patient safety issue. This culminated in the National Academy of Medicine’s 2015 landmark report, which concluded that most people in the United States would experience at...

pancreatic cancer

Mutations in DNA Damage Repair Predict Benefit With Platinum Agents in Pancreatic Cancer

Patients with advanced pancreatic cancer who have homologous repair damage response mutations may derive considerable benefit from treatment with platinum agents, according to an analysis of patients in the Know Your Tumor Program presented by Michael Pishvaian, MD, PhD, of Georgetown University,...

kidney cancer

Pembrolizumab/Axitinib Combination Improves Outcomes vs Sunitinib in Kidney Cancer

The checkpoint inhibitor pembrolizumab plus the vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor axitinib significantly improved overall survival, progression-free survival, and objective response rates vs sunitinib as first-line therapy for clear cell metastatic renal cell...

prostate cancer

Addition of Radium-223 to Abiraterone Acetate and Prednisone or Prednisolone in Metastatic Castration-Resistant Prostate Cancer

In the phase III ERA 223 trial reported in The Lancet Oncology, Smith et al found that the addition of radium-223 to abiraterone acetate and prednisone or prednisolone did not improve symptomatic skeletal event-free survival and was associated with increased risk of fracture in patients with...

breast cancer
immunotherapy

Addition of Pembrolizumab to Trastuzumab in PD-L1–Positive, Trastuzumab-Resistant, HER2-Positive Breast Cancer

In the phase II portion of a phase Ib/II trial reported in The Lancet Oncology, Loi et al found evidence of activity of pembrolizumab plus trastuzumab in programmed cell death protein ligand 1 (PD-L1)-positive, trastuzumab-resistant, HER2-positive advanced breast cancer. Study Details In the...

Newly Discovered Mutation in BCL2 Protein Impacts Outcomes in Patients With Progressive CLL

INVESTIGATORS FROM Australia have identified a genetic mutation that causes resistance to the targeted drug venetoclax in patients with chronic lymphocytic leukemia (CLL), according to research presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition1 and...

First-Line Ibrutinib/Rituximab Combination Shows Benefit for Younger Patients With CLL

FIRST-LINE therapy with the combination of ibrutinib and rituximab reduced disease progression by two-thirds compared with standard chemotherapy using fludarabine, cyclophosphamide, and rituximab (FCR) in younger patients with chronic lymphocytic leukemia (CLL), according to the late-breaking...

Front-Line Ibrutinib Improves Progression-Free Survival in Older Patients With Chronic Lymphocytic Leukemia

IN A PHASE III TRIAL reported during the Plenary Session at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition and published in The New England Journal of Medicine, single-agent ibrutinib and ibrutinib/rituximab were associated with superior progression-free survival vs...

lung cancer
immunotherapy

Pembrolizumab in Combination With Chemotherapy in First-Line Treatment of Metastatic Squamous NSCLC

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On October 30, 2018, pembrolizumab in combination with...

JCO Fast Track Presubmission, Rapid Review Programs Shorten Publication Time

THE JOURNAL of Clinical Oncology’s (JCO) author-friendly submission programs are taking time off the publication process for health-care professionals. JCO’s quick review process programs, Fast Track Presubmission and Rapid Review, aim to make the journal submission and review process easier for...

ASCO Convenes Stakeholders to Build Consensus for a Clinical Trial Data-Sharing Policy Among Journals That Publish Clinical Cancer Research

Jeffrey M. Drazen, MD, Editor-in-Chief of The New England Journal of Medicine, wrote in a 2016 editorial, “Data Sharing and the Journal,” that “[W]e believe there is a moral obligation to the people who volunteer to participate in these trials to ensure that their data are widely and responsibly...

head and neck cancer
immunotherapy

In Era of Immunotherapy, Radiation Therapy May Become Essential Component of Systemic Treatments of Cancer

“IN THIS era of immunotherapy, it is highly possible, and potentially probable, that radiation therapy may become not just a form of locoregional and palliative treatment, but an essential component of our systemic treatments of cancer,” according to Zachary S. Morris, MD, PhD, Vice-Chair,...

head and neck cancer
immunotherapy
symptom management

Immunotherapy for Head and Neck Cancer Expands, but Concerns Persist About Patient Selection and Toxicities

SOME PATIENTS with advanced head and neck cancer may achieve durable responses with immunotherapy, and recent trial results suggest first-line immunotherapy may increase survival among patients with recurrent or metastatic disease. However, concerns remain about selecting patients most likely to...

leukemia
myelodysplastic syndromes
lymphoma
multiple myeloma
immunotherapy

Highlights From the 2018 ASH Annual Meeting & Exposition

TO ADD to our ongoing coverage of the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition, we bring readers of The ASCO Post these summaries of an assortment of interesting studies. They focus on novel therapies under investigation in the treatment of acute lymphoblastic...

hepatobiliary cancer

BRAF/MEK Targeting May Yield Benefit in Treating Biliary Tract Cancer

ROUTINE TESTING for BRAF V600E mutations in patients with biliary tract cancer may prove to be a good idea, based on the findings of a phase II study in which treatment with dabrafenib plus trametinib showed activity.1 The results suggest there may be a benefit to testing patients with biliary...

issues in oncology
survivorship

How to Improve Care for Young Sexual and Gender Minority Cancer Survivors

IN 2017, ASCO issued its recommendations for addressing the oncology care needs of sexual and gender minority cancer survivors and the unique challenges they face.1 There are myriad reasons for cancer disparities in this population compared to heterosexual cisgender cancer survivors, including...

issues in oncology
health-care policy

‘Curve 2’ and Oncology: What Those in Charge Don’t Understand … or Ignore

THERE IS little doubt that the U.S. health-care system is under assault from many directions.1 It is clear that the costs of health management are no longer sustainable, and the United States has one of the highest per capita health costs among the 36 member nations of the Organisation for...

hematologic malignancies

PAUSE Study Establishes Simple Approach to Perioperative Management of Direct Oral Anticoagulants

The largest study to date addressing the common problem of perioperative direct oral anticoagulant (DOAC) management has shown that patients with atrial fibrillation can safely stop taking their anticoagulant for 1 day before and after procedures with a low risk of bleeding and for 2 days before...

hematologic malignancies

Crizanlizumab Improves Prevention of Vaso-occlusive Crises in Patients With Sickle Cell Disease

For the first time in more than 20 years, patients with sickle cell disease may have another treatment option to reduce painful vaso-occlusive crises, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Results of the phase II, randomized,...

hematologic malignancies

Pilot Study Tests Novel Approach to Gene Therapy for Sickle Cell Disease

Initial findings from a first-in-human trial have provided proof of principle for a groundbreaking approach to gene therapy for sickle cell disease, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Early results of genetic targeting of...

prostate cancer
symptom management

Patient-Reported Outcomes With Enzalutamide in PROSPER Trial

As reported by Tombal et al in The Lancet Oncology, treatment with enzalutamide was associated with clinically meaningful delays in pain progression, symptom worsening, and deterioration in functional status vs placebo in the phase III PROSPER trial in nonmetastatic, castration-resistant prostate...

lung cancer

No Survival Benefit With Avelumab vs Docetaxel in Platinum-Treated, Advanced, PD-L1–Positive NSCLC

As reported in The Lancet Oncology by Fabrice Barlesi, MD, and colleagues, the phase III JAVELIN Lung 200 trial has shown no overall survival benefit with avelumab vs docetaxel in patients with platinum pretreated programmed cell death ligand 1 (PD-L1)–positive advanced non–small cell lung cancer ...

breast cancer

Increased Risk of Bone Loss Extends to Younger Women Treated for Breast Cancer

Younger women who have been treated for breast cancer have a higher risk for osteopenia and osteoporosis than do their cancer-free peers, and that risk seems to rise when treatment involves chemotherapy plus hormone therapy or aromatase inhibitors alone. Researchers from Johns Hopkins Bloomberg...

issues in oncology

Physician Wellness: Time to Heal the Healer

Physician wellness is emblazoned upfront in the news with attention-seeking headlines on a daily basis. The fact that one or two physicians commit suicide every day in this country sometimes elicits more of a sympathetic acknowledgment than a committed call to address it. Moreover, these sobering...

issues in oncology

Artificial Intelligence and the Brave New World of Cancer Diagnostics

A study published in Nature Medicine found that an artificial intelligence program could distinguish between the histologic diagnosis of adenocarcinoma and squamous cell carcinoma.1 Experienced pathologists often struggle to differentiate these tumor types without confirmatory tests. The artificial ...

Norman E. Sharpless, MD: From Director of a Comprehensive Cancer Center to Director of the NCI

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic. In this installment of the Living a Full Life series of articles, guest editor Jame Abraham, MD, FACP, interviewed Norman E. ...

breast cancer

Benefit of Annual Screening in Women Aged 35–39 With a Family History of Breast Cancer

Annual screening for women aged 35–39 who have a family history of breast cancer may be highly effective in detecting tumors earlier, according to findings published by Evans et al in The Lancet’s online journal EClinicalMedicine. The FH02 trial found that annual mammograms for...

lymphoma

DYNAMO: Duvelisib in Refractory Indolent Non-Hodgkin Lymphoma

In the phase II DYNAMO trial reported in the Journal of Clinical Oncology, Flinn et al found a response rate of nearly 50% with duvelisib, an oral dual inhibitor of phosphoinositide 3-kinase (PI3K)-γ and -δ, in indolent non-Hodgkin lymphoma refractory to rituximab and either...

prostate cancer

2019 GU Cancers Symposium: ARAMIS: Darolutamide in Nonmetastatic, Castration-Resistant Prostate Cancer

In the phase III ARAMIS trial reported by Fizazi et al at the 2019 Genitourinary Cancers Symposium (Abstract 140) and simultaneously published in The New England Journal of Medicine, researchers found that the androgen receptor antagonist darolutamide significantly prolonged metastasis-free...

skin cancer
immunotherapy

FDA Approves Adjuvant Pembrolizumab for Melanoma

On February 15, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) for the adjuvant treatment of patients with melanoma with lymph node involvement following complete resection. Approval was based on the phase III EORTC1325/KEYNOTE-054 trial, a randomized, double-blind,...

gynecologic cancers

Two-Year Interim Analysis of Conservatively Managed Ovarian Tumors

In an interim analysis of a prospective cohort study (IOTA5) reported in The Lancet Oncology, Froyman et al found that the risk of malignancy and acute complications is low when adnexal masses with benign ultrasound findings are managed conservatively. In the study, patients with at least 1...

lymphoma

Living My Best Life

Five years ago, I was living my dream life. I was under contract as a commentator on Fox News, which necessitated commuting weekly from my home in Los Angeles to New York, and was building a new home in Palm Springs with my partner, Matt Lashey. Not only was my career and personal life going well,...

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