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covid-19

On the Shoulders of Giants

Before the dawn of the modern antibiotic era and amid the chaos of World War II, future Professor of Radiology and Founding Dean of two American medical colleges, Dr. George T. Harrell,* penned what could now be argued was far too bold a statement. As the opening lines of his nonrandomized study...

covid-19

New Research Highlights Risk of Thromboembolic Complications in Patients With COVID-19

A special report published by Oudkerk et al in the journal Radiology outlined strategies for the prevention, diagnosis, and treatment of thromboembolic complications in patients with COVID-19. Based on recent reports that demonstrated a strong association between elevated D-dimer levels and poor...

pancreatic cancer

Risk-Prediction Model for Pancreatic Cancer

A risk-prediction model that combined genetic and clinical factors with circulating biomarkers may help to identify people at a significantly higher-than-normal risk of developing pancreatic cancer, according to results of a study published by Peter Kraft, PhD, and colleagues in Cancer...

genomics/genetics

AACR 2020: Cell-Free DNA Liquid Biopsy May Provide an Early Detection Test for Patients With Suspected Cancer

The Circulating Cell-free Genome Atlas Study is a large multicenter, case-controlled, observational study of 15,254 participants, 56% with cancer and 44% without cancer, with longitudinal follow-up to support the development of a cell-free DNA (cfDNA) multicancer early detection test. In this phase ...

covid-19

Hypercoagulability in Critically Ill Patients With COVID-19: Where Do We Stand?

“Life is short, art long, opportunity fleeting, experience treacherous, judgment difficult.” ―Hippocrates The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that occasionally quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Connors...

lung cancer

AACR 2020: ctDNA May Be a Prognostic Biomarker of Disease Recurrence in Patients With Lung Cancer

The TRACERx study investigated phylogenetic tracking and minimal residual disease (MRD) detection using circulating tumor DNA (ctDNA) profiling following resection in patients with stage I to III non–small cell lung cancer (NSCLC). Investigators found that ctDNA is an adjuvant biomarker capable of...

Adapting Adjuvant Endocrine Therapy by Patient Age and Risk

The individualization and optimization of adjuvant endocrine therapy for breast cancer are important and not always simple. Guidance on this issue was offered at the 2020 Miami Breast Cancer Conference by Joyce O’Shaughnessy, MD, the Celebrating Woman Chair in Breast Cancer Research at Baylor...

breast cancer

21-Gene Assay Recurrence Score and Risk of Locoregional Recurrence in Hormone Receptor–Positive, Node-Positive Breast Cancer

A retrospective analysis from the Southwest Oncology Group S8814 trial, reported by Wendy A. Woodward, MD, PhD, of the Department of Radiation Oncology, The University of Texas MD Anderson Cancer Center, and colleagues in JAMA Oncology,1 showed that a low 21-gene assay recurrence score was...

issues in oncology

Radon Exposure: A Leading Environmental Cause of Cancer Mortality in the United States

The Environmental Protection Agency (EPA) has concluded that about 21,000 people die each year of lung cancer related to radon gas exposure, making it the second leading cause of lung cancer death in the United States. Although the EPA and various other organizations, including the National Radon ...

immunotherapy
solid tumors

PD-1 Inhibition in Mismatch Repair–Deficient/Microsatellite Instability–High Cancers Other Than Colorectal Cancer

Mismatch repair (MMR)-deficiency and consequently high DNA microsatellite instability (MSI-H) are associated with high tumor mutational burden. A high mutational load increases the potential number of neoantigens that can be presented by the tumor cell and recognized by host lymphocytes. Detection...

lymphoma

Selected ASH Abstracts on Novel Treatments for Non-Hodgkin Lymphomas

To complement The ASCO Post’s continued comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapies for patients with non-Hodgkin lymphomas (NHLs). For full...

genomics/genetics

How CRISPR-Cas9 Gene Editing May Improve the Effectiveness of Cellular Therapeutics in Patients With Cancer

The results from the first in-human phase I clinical trial in the United States evaluating CRISPR-Cas9–edited T cells in patients with advanced cancer has shown that the therapy is both feasible and safe, representing a big step forward in the potential of using gene editing to boost the natural...

breast cancer

ASCENT Study Halted: Efficacy Shown Across Multiple Study Endpoints in Triple-Negative Breast Cancer

The phase III confirmatory ASCENT study of the antibody drug-conjugate sacituzumab govitecan will be stopped based on efficacy across multiple study endpoints following unanimous recommendation from the independent data safety monitoring committee, according to a news release issued earlier this...

breast cancer

Beyond CDK4/6 Inhibitors: What Subsequent Treatment Is Best?

Inhibitors of cyclin-dependent kinases 4 and 6 (CDK4/6) have changed the natural history of hormone receptor–positive metastatic breast cancer. While median progression-free survival on these drugs is approximately 27 months, the disease eventually progresses and clinicians must choose a subsequent ...

breast cancer

More Antibody-Drug Conjugates on the Horizon for Breast Cancer

Novel antibody-drug conjugates that target actionable cell-surface markers in metastatic breast cancer will soon expand the utility of the class that already includes ado-trastuzumab emtansine (T-DM1), according to two speakers at the 2020 Miami Breast Cancer Conference. These new agents were...

issues in oncology
immunotherapy

Do HIV Positivity and Autoimmune Disease Preclude Treatment With Checkpoint Inhibitors?

Can patients with cancer and preexisting autoimmune disorders safely benefit from immunotherapy? The answer has been unclear, with only retrospective studies and anecdotal reports guiding oncologists. This subpopulation of patients has largely been excluded from clinical trials out of concerns over ...

immunotherapy
breast cancer
skin cancer
lung cancer

What’s the Current Status of Neoadjuvant Immunotherapy?

For several tumor types, can the successes achieved with immunotherapy in the metastatic and adjuvant settings be replicated in the neoadjuvant setting? An explosion in clinical trials—with more than 300 listed on ClinicalTrials.gov—point to “yes.” “The neoadjuvant use of immunotherapy is of great ...

prostate cancer

Upfront Apalutamide Delays Time to Second Progression in Metastatic Castration-Sensitive Prostate Cancer

The addition of apalutamide to androgen-deprivation therapy (ADT) reduced the risk of second disease progression or death (PFS2) by 34% vs ADT alone in patients with metastatic castration-sensitive prostate cancer, in a post hoc analysis of the phase III TITAN trial presented at the 2020...

Merry-Jennifer Markham, MD, FACP, FASCO, Rose From Humble Beginnings to a Leadership Role in Oncology

Merry-Jennifer Markham, MD, FACP, FASCO, grew up in Fort White, Florida, a rural speck on the map in the northern part of the state. Fort White is home to the Ichetucknee River and Springs, a crystal-clear natural wonder known only to the locals until 1972, when it was declared a National Natural...

Conquer Cancer Researchers Remember Jane C. Wright, MD, FASCO

It’s 1964 in Chicago. Seven forward-thinking oncologists gather to brainstorm what will become the American Society of Clinical Oncology (ASCO). Among the group is Jane C. Wright, MD, FASCO, the only woman and African American among ASCO’s founders. It’s time for the 2011 ASCO Annual Meeting in...

FDA’s Draft Guidance Will Improve Evidence Base for Older Adults With Cancer

ASCO commends the U.S. Food and Drug Administration (FDA) for releasing draft guidance that encourages inclusion of older adults in clinical trials of drugs for the treatment of cancer. The guidance emphasizes the importance of including adults aged 75 or older in clinical trials to better enable...

head and neck cancer
immunotherapy

Pembrolizumab Plus Cetuximab Shows Antitumor Activity in Squamous Cell Head and Neck Cancer

The first trial to evaluate anti–­programmed cell death protein 1 (PD-1) blockade combined with epidermal growth factor receptor (EGFR) inhibition in head and neck squamous cell carcinoma demonstrates promising activity of the drug combination in patients with platinum-refractory or -ineligible...

lymphoma

It’s T Time for Peripheral T-Cell Lymphoma, a Much-Neglected Disease

The lymphomas are an incredibly complex assemblage of neoplastic diseases. They are not one disease, and, at least based on the World Health Organization (WHO) Classification of Tumors published in 2017, they represent a collection of approximately 80 different malignancies, a number that will...

Inoperable Carcinoma of the Breast

The text and photograph here are excerpted from a four-volume series of books titled Oncology: Tumors & Treatment, A Photographic History, The X-Ray Era: 1901–1915 by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. The photograph appears courtesy of Dr. Burns and The Burns Archive. To view ...

Chemotherapy and the Sweat Lodge

The ASCO Post is pleased to reproduce installments of 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, historical...

immunotherapy

Gut Microbiota Emerging as Key Player in Response to Immunotherapy

The microbiome—and the foods that feed it—is emerging as an important determinant of a patient’s response to immunotherapy. Much of the research in this area comes from The University of Texas MD Anderson Cancer Center, as described at the 2020 ASCO-SITC Clinical Immuno-Oncology Symposium by...

After Training Across Three Continents, a Hematologist Leads the Wisconsin Hematology/Oncology Division

In this edition of Living a Full Life, guest editor Jame Abraham, MD, FACP, spoke with hematologist Parameswaran Hari, MD, MRCP, Chief of the Division of Hematology and Oncology at the Medical College of Wisconsin, Milwaukee. In addition, Dr. Hari holds the Armand J. Quick/William F. Stapp Chair...

lymphoma

Vitamin D and Lymphoma: An Apparent Benefit, but Further Study Required

Vitamin D is a steroid-like hormone involved primarily in human calcium homeostasis. Obtained through sun exposure as well as food and dietary supplements,1 vitamin D in humans is metabolized in the liver and kidneys to its active form, 1,25-dihydroxyvitamin D (1,25[OH]2D).2 Other cell types,...

leukemia

Asparaginase Discontinuation and Outcomes in Pediatric ALL

In a Children’s Oncology Group analysis reported in the Journal of Clinical Oncology, Gupta et al found that discontinuation of pegylated asparaginase (PEG-ASNase) was associated with poorer disease-free survival among pediatric patients with high-risk acute lymphoblastic leukemia (ALL). However,...

breast cancer
issues in oncology

Effect of Payer’s Utilization Management Policy on Uptake of Hypofractionated Radiotherapy Among Eligible Patients With Early-Stage Breast Cancer

In a study reported in JAMA Oncology, Ravi B. Parikh, MD, MPP, and colleagues found that a large commercial payer’s utilization management policy was associated with increased use of hypofractionated radiotherapy among eligible women with early-stage breast cancer. The investigators noted,...

David A. Tuveson, MD, PhD, FAACR, Named AACR President-Elect for 2020–2021

The members of the American Association for Cancer Research (AACR) have elected David A. Tuveson, MD, PhD, FAACR, as their President-Elect for 2020–2021. He will officially become President-Elect on April 29, 2020, during the AACR’s Business Meeting of Members. He will assume the presidency in...

breast cancer
symptom management

Cognitive Impairment With Adjuvant Chemoendocrine vs Endocrine Therapy for Early Breast Cancer in the TAILORx Trial

In a study reported in the Journal of Clinical Oncology, Wagner et al found that patient-reported cognitive impairment was worse at 3 and 6 months in women with early breast cancer receiving adjuvant chemoendocrine therapy vs endocrine therapy alone in the TAILORx trial, with no significant...

covid-19

Celebrating the Role of Nurses in Meeting the Current Challenges of Cancer Care Delivery

The coronavirus pandemic is being compared to a battlefield, with health-care workers seen as the front-line soldiers in the war against the disease. There is certainly truth to that, insofar as doctors and nurses in many countries now face an unprecedented workload in saving lives, along with the...

prostate cancer

PSA Dynamics and Response to Androgen-Deprivation Therapy

Adaptive treatments based on evolutionary principles may be an effective approach to prostate cancer treatment by preventing the development of drug resistance and prolonging patient survival. In an article in Nature Communications, Brady-Nicholls et al provided a closer look at a model and data...

covid-19

Practical Approach to Management of Patients With Cancer During the COVID-19 Pandemic: An International Collaborative Group Statement

In an article published in The Oncologist, an international collaborative group outlined issues and potential management approaches for the treatment of patients with cancer during the COVID-19 pandemic. Key issues facing cancer treatment and some of the potential measures for addressing these...

immunotherapy
covid-19

Immune Checkpoint Inhibitor Treatment for Patients With Cancer During the COVID-19 Pandemic

In an article published in the journal Immunotherapy, Melissa Bersanelli, MD, of the Medical Oncology Unit, University Hospital of Parma, Italy, discusses controversies regarding the use of immune checkpoint inhibitor therapy in patients with cancer during the COVID-19 pandemic, suggesting that...

breast cancer

Delayed Targeted Intraoperative Radiotherapy vs Whole-Breast Radiotherapy in Early Breast Cancer

As reported in JAMA Oncology by Jayant S. Vaidya, MBBS, PhD, and colleagues, the phase III TARGIT-A trial showed that delayed second-procedure targeted intraoperative radiotherapy (TARGIT-IORT) was not noninferior to whole-breast external-beam radiotherapy (EBRT) in preventing local recurrence of...

skin cancer

Differences in Melanoma Incidence in Men vs Women by Age and Anatomic Site

In a study published by Olsen et al in JAMA Dermatology, researchers found that in predominantly fair-skinned populations, melanoma incidence differed by age and anatomic site in men and women. Methods A cross-sectional analysis of sex- and site-specific trends was performed for white patients...

colorectal cancer
immunotherapy

Neoadjuvant Immunotherapy in Early-Stage Colon Cancer

Patients with localized colon cancer may benefit from a short course of neoadjuvant immunotherapy, according to findings from the exploratory phase II NICHE study published by Myriam Chalabi, MD, and colleagues in Nature Medicine.  Study Results Forty patients with two colon cancer subtypes—either ...

covid-19

Outcomes of COVID-19 Infection in Patients With Cancer in Wuhan, China

In a retrospective cohort study reported in the Annals of Oncology, Li Zhang, MD, of the Department of Oncology, Tongji Hospital, Huazhong University of Science and Technology, Wuhan, China, and colleagues described characteristics and outcomes of COVID-19 infection in 28 patients with cancer from...

International Palliative Care Workshop in Russia Educates Providers, Improves Care Across Region

ASCO, in collaboration with international oncology societies, hosts International Palliative Care Workshops (IPCWs) designed to teach participants practical skills in patient communication and the management of cancer symptoms and pain. The IPCWs are led by ASCO member volunteers and local experts...

Breast Cancer Specialist Lawrence J. Solin, MD, FACR, FASTRO, Dies at Age 66

Lawrence J. Solin, MD, FACR, FASTRO, a champion of breast-conserving therapy for women with breast cancer, died unexpectedly on March 3 at the age of 66. At the time of his death, Dr. Solin was Professor Emeritus, Department of Radiation Oncology, Perelman School of Medicine, University of...

pancreatic cancer

Living A Full Life After Pancreatic Cancer

I have been a radiologic technologist for 47 years, so after going to the bathroom one Sunday morning in October 2018 and finding my urine had suddenly turned dark, I knew something was wrong. I wasn’t in any pain and did not have a urinary tract infection, which would explain the discoloration of...

City of Hope Deploys Platform, Makes Study Data Accessible

A $12 million federal grant enabled City of Hope and collaborators to deploy a novel cloud-computing platform, making an immense amount of data from a historic 25-year study more accessible and user-friendly. The ongoing California Teachers Study, which began in 1995, has already given researchers...

A Hallmark Moment

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,...

breast cancer
immunotherapy

Updates From Selected Clinical Trials in Breast Cancer

Each year, The ASCO Post asks Jame Abraham, MD, FACP, Chairman of the Department of Hematology and Medical Oncology at Taussig Cancer Institute and Professor of Medicine at the Cleveland Clinic Lerner College of Medicine, to offer his picks for the most important research presented at 2019 San...

lung cancer
pancreatic cancer
immunotherapy

Expert Point of View: Timothy A. Yap, MBBS, PhD, FRCP

Semaphorin 4D (SEMA4D, and its receptor, plexin B1) is broadly expressed in malignant tumors. Aside from other “normal functions” in tumors, SEMA4D influences the infiltration and distribution of leukocytes into the microenvironment, and its inhibition promotes functional immune infiltration....

lung cancer
pancreatic cancer
immunotherapy

SEMA4D Inhibition: A Novel Means of Improving Immune Response

A novel class of inhibitors may hold some promise for boosting responses to checkpoint inhibitors and for sensitizing poorly immunogenic tumors, such as pancreatic cancer, to immunotherapy. The drug targets semaphorin 4D (SEMA4D), a glycoprotein expressed on the cell membranes of many tumor types....

breast cancer
genomics/genetics

Should Restrictions on Genetic Testing Be Loosened?

The loosening of restrictions on genetic testing would mean that all health-care providers could help move this needle to where it should be, according to Kevin S. Hughes, MD, a surgeon at Massachusetts General Hospital, Professor of Surgery at Harvard Medical School, and Medical Director of the...

head and neck cancer
immunotherapy

Pembrolizumab Plus Radiotherapy Worthy of Further Study in Locally Advanced Squamous Cell Head and Neck Cancer

The combination of the checkpoint inhibitor pembrolizumab and definitive radiation therapy appears to be a safe and feasible option for patients with locally advanced head and neck cancer who are not eligible for cisplatin, according to data presented at the 2020 Multidisciplinary Head and Neck...

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