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prostate cancer

Expert Point of View: Cora Sternberg, MD

FORMAL DISCUSSANT of the STAMPEDE trial, Cora Sternberg, MD, Chief of the Department of Medical Oncology, San Camillo Forlanini Hospital, Rome, commended the study design. “This multiarm, multistage design is very innovative. The investigators plan up to 10 trials over 20 years. The first results...

head and neck cancer

Expert Point of View: Paul Harari, MD

COMMENTING ON THIS STUDY, ASTRO President Paul Harari, MD, was enthusiastic about the results. Dr. Harari is the Jack Fowler Professor and Chairman of the Department of Human Oncology at the University of Wisconsin School of Medicine and Public Health and Associate Director of the University of...

head and neck cancer

Cutting Radiation Exposure by 50% Appears Safe and Effective in HPV-Positive Head and Neck Cancer

AGGRESSIVE REDUCTION in radiation therapy appears to be a potential win-win situation for patients with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma, according to the results of a phase II trial presented at the 2017 Annual Meeting of the American Society for...

solid tumors

Immunotherapy Plus Radiation Appears Active in Patients With Solid Tumors and Lung or Liver Metastases

THE NOVEL COMBINATION of immunotherapy with ipilimumab (Yervoy) plus radiation achieved a clinical benefit in up to 57% of patients with solid tumors and metastases to the lungs or liver, according to evidence from a phase II trial presented at the 2017 Annual Meeting of the American Society for...

issues in oncology

Smashing the Glass Ceiling in Medicine

IT IS A SAD TRUTH that academic medicine, like many other professions, has a glass ceiling that hampers its ambitions. In medicine, this glass ceiling blocks women and minority faculty from reaching the highest ranks of leadership. Even if the root cause is not yet known, we want to eliminate...

supportive care
integrative oncology

Melatonin

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, present information on...

lymphoma

FDA Approves CAR T-Cell Therapy to Treat Adults With Certain Types of Large B-Cell Lymphoma

On October 18, the U.S. Food and Drug Administration (FDA) approved axicabtagene ciloleucel (Yescarta), a cell-based gene therapy, to treat adult patients with certain types of large B-cell lymphoma who have not responded to or who have relapsed after at least two other kinds of treatment....

solid tumors
lung cancer

ASCO Guideline on Stage IV NSCLC Therapy Updated

An update of the ASCO clinical practice guideline on the systemic treatment of patients with stage IV non–small cell lung cancer (NSCLC) clarifies the role of immunotherapy in this setting. The update was published by Hanna et al in the Journal of Clinical Oncology.1 “This guideline update...

lung cancer

IASLC 2017: Treatment Based on BRCA1 Level Does Not Increase Survival of Stage II/III NSCLC Node-Positive Resected Patients

New research shows that treating stage II and III non–small cell lung cancer (NSCLC) node-positive resected patients with customized chemotherapy based on their specific BRCA1 expression levels, as opposed to providing the standard treatment, did not increase overall survival rates among...

lung cancer

IASLC 2017: Integration of Smoking Cessation With CT Lung Cancer Screenings

A study that integrated robust smoking cessation programs into an organized low-dose computed tomography (CT) lung cancer screening program found that the inclusion of both interventions has the potential to decrease mortality rates—while being relatively cost-effective. William Evans,...

lung cancer

IASLC 2017: Race, Socioeconomic Factors Are Influential in NSCLC Survival Rates

New research found race and specific socioeconomic factors to have a significant influence on disparities in the survival rates of non–small cell lung cancer (NSCLC) patients. Yanyan Lou, MD, PhD, of the Mayo Clinic, presented these findings at the International Association for the Study of...

lung cancer

IASLC 2017: Lorlatinib in ALK-Positive and ROS1-Positive Advanced Non–Small Cell Lung Cancer

At the International Association for the Study of Lung Cancer (IASLC) 18th World Conference on Lung Cancer in Yokohama, Japan, Pfizer announced full results from the phase II clinical trial of the investigational, next-generation tyrosine kinase inhibitor lorlatinib. The agent exhibited clinically...

lung cancer

IASLC 2017: CheckMate-032: Nivolumab Alone or With Ipilimumab in Recurrent SCLC With High Tumor Mutation Burden

At the International Association for the Study of Lung Cancer (IASLC) 18th World Conference on Lung Cancer in Yokohama, Japan, Bristol-Myers Squibb announced data evaluating nivolumab (Opdivo) and nivolumab plus ipilimumab (Yervoy) in previously treated small cell lung cancer (SCLC) patients whose...

colorectal cancer

Immunotherapy for Metastatic Mismatch Repair–Deficient Colorectal Cancer: Game-Changer for Small Group of Patients

PATIENTS WITH DNA mismatch repair–deficient (dMMR) metastatic colorectal cancer display a high level of microsatellite instability (MSI-H)1 and demonstrate poor chemosensitivity and shorter overall survival than patients with mismatch repair–proficient (pMMR) metastatic metastatic colorectal...

colorectal cancer

Nivolumab in Advanced DNA Mismatch Repair–Deficient or Microsatellite Instability–High Colorectal Cancer

THE PHASE II CHECKMATE 142 TRIAL has shown that nivolumab (Opdivo) produces durable responses in previously treated recurrent or metastatic DNA mismatch repair–deficient (dMMR)/ microsatellite instability–high (MSI-H) colorectal cancer. These study findings were reported in The Lancet Oncology...

breast cancer

Selective PI3K Inhibitor Boosts Effect of Letrozole in Neoadjuvant Setting

FOR THE first time, an inhibitor of the phosphoinositide 3-kinase (PI3K) pathway (taselisib) used in combination with endocrine therapy in the neoadjuvant setting improved response rates over endocrine therapy alone—with good tolerability—in women with early breast cancer, according to the phase...

gynecologic cancers

Strong Showing for Rucaparib Maintenance Therapy for Platinum-Sensitive Ovarian Cancer

EVIDENCE CONTINUES to mount for the benefits of poly (ADP-ribose) polymerase (PARP) inhibition in ovarian cancer. Rucaparib (Rubraca) maintenance therapy after response to platinum-containing therapy significantly improved progression-free survival in patients with recurrent ovarian cancer compared ...

Journal of Clinical Oncology Literature Update

STAYING UP-TO-DATE in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology.  Sorafenib Dosing and Outcomes in Hepatocellular Cancer  IN A...

skin cancer

MSLT-II Completion Lymph Node Dissection Trial: Practice Changing but Not Likely Practice Abandoning

PROBABLY THE MOST IMPORTANT advance in the treatment of newly diagnosed primary melanoma has been the incorporation of sentinel lymph node biopsy as part of initial surgical management. The routine use of sentinel lymph node biopsy, often termed “sentinel lymphadenectomy,” in appropriately...

issues in oncology

Can We Have a Successful Vaccine Against Cancer?

EARLY IN our careers, few of us imagined that a vaccine could one day prevent cancer. Now, there is a vaccine that keeps the risks from human papillomavirus (HPV) at bay, and yet universal adoption of the HPV vaccine has been incomplete. As a result of misinformation about the vaccine—and its...

breast cancer

What Is the Most Important Factor Women Consider in Deciding on SERM Use to Reduce Their Risk of Breast Cancer?

Currently, two medications have been approved by the U.S. Food and Drug Administration to reduce the risk of breast cancer: tamoxifen and raloxifene. Both medications, selective estrogen receptor modulators (SERMs), have been shown to reduce the risk for breast cancer by up to 50% in prevention...

solid tumors
prostate cancer

Association Between Vasectomy and Prostate Cancer

A systematic review and meta-analysis has found no association between vasectomy and high-grade, advanced, or fatal prostate cancer but a weak association with any prostate cancer. These findings were reported in JAMA Oncology by Bimal Bhindi et al. R. Jeffrey Karnes, MD, of the Mayo Clinic,...

issues in oncology

Study Finds Liquid Biopsy May Provide Predictive Biomarkers for Checkpoint Inhibitor Response

Although checkpoint inhibitor–based immunotherapy has revolutionized treatment for a variety of cancers, the majority of patients with cancer do not respond to the therapy, and a subset of patients may even experience hyperprogression. Many patients also experience some degree of...

solid tumors
bladder cancer

Durvalumab in Advanced Urothelial Carcinoma Progressing After Platinum Therapy

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 May 1, 2017, durvalumab (Imfinzi) was granted...

issues in oncology

Increasing Racial and Ethnic Diversity in the Oncology Workforce

Although significant progress has been made in cancer incidence and mortality in the United States over the past 2 decades—the death rate fell 23% between 1991 and 20121—not everyone is benefiting equally. According to the American Cancer Society, blacks have the highest death rate and shortest...

solid tumors
breast cancer

Adjuvant Pertuzumab in HER2-Positive Breast Cancer: Value Yet to Be Demonstrated

The ASCO Post issue of June 25, 2017, did an excellent job of summarizing the results and controversy generated by the initial results of the APHINITY trial, reported at the 2017 ASCO Annual Meeting and published simultaneously online in The New England Journal of Medicine.1 With a median follow-up ...

issues in oncology
cost of care

With Financial Toxicity in Oncology Care on the Rise, Providers Need to Help Address Patients’ Financial Issues

At the 2017 ASCO Quality Care Symposium, Dan Sherman, MA, LPC, discussed potential solutions to the persistent challenge of financial toxicity in the oncology setting. Mr. Sherman is a clinical financial consultant and Founder and President of The Navectis Group, Caledonia, Michigan. Rather than...

issues in oncology

Recognizing the Importance of a Work-Life Balance in Oncology

The ASCO Post introduces this new department, Living a Full Life, in which we will share insightful narratives of oncology professionals highlighting personal aspects of these clinicians’ lives separate from the world of oncology. We also intend to open a dialogue about the challenges that today’s...

health-care policy

ASTRO 2017: Uninsured Patients With Cancer Saw Increased Coverage for Care Following Medicaid Expansion

A new study found that Medicaid expansion enacted as part of the Patient Protection and Affordable Care Act (ACA) improved coverage for care for patients with cancer receiving radiation therapy and potentially decreased health-care disparities. Analysis of more than 197,000 patient records from one ...

issues in oncology

Changes in Insurance Coverage and Diagnosis Stage After Affordable Care Act Implementation

Jemal et al found decreases in the percentage of uninsured patients and trends toward earlier diagnosis among nonelderly patients with cancer after implementation of the Affordable Care Act (ACA). Their findings were reported in the Journal of Clinical Oncology. Study Details The study used...

gynecologic cancers

ASTRO 2017: GOG-249 Confirms Adjuvant Pelvic Radiation as Standard of Care for High-Risk, Early-Stage Endometrial Cancer

In a new phase III trial report from the National Clinical Trial Network group, NRG Oncology, recurrence-free and overall survival rates for women with stage I–II high-risk endometrial cancer were not superior following adjuvant vaginal cuff brachytherapy plus chemotherapy when compared with...

issues in oncology

ASTRO 2017: Distress in Patients Receiving Radiation Associated With Missed Appointments, Hospitalization

Psychological distress has long been associated with negative health outcomes for patients with cancer, though specific reasons remain unclear. A new study has found that roughly half of all patients who reported having severe distress, which the National Comprehensive Cancer Network® (NCCN)...

Adding Midostaurin to Chemotherapy in AML With FLT3 Mutation

In a phase III trial (Cancer and Leukemia Group B 10603 [RATIFY]/Alliance) reported in The New England Journal of Medicine, Stone et al found that the addition of midostaurin (Rydapt) to standard chemotherapy improved overall survival in patients with newly diagnosed acute myeloid leukemia (AML)...

breast cancer

Tumor-Infiltrating Lymphocytes in African Americans and European Americans With Triple-Negative Breast Cancer

Triple-negative breast cancer is a highly aggressive breast cancer that lacks hormone receptors and overexpression of human epidermal growth factor receptor 2 (HER2/neu), and, therefore, there are no targeted treatments available for the cancer. Triple-negative breast cancer afflicts African...

ACS Awards Grants to Reduce Colorectal Cancer Disparities in American Indian and Alaska Native Populations

The American Cancer Society (ACS) has awarded $100,000 in grants to five community health centers across the country to reduce colon cancer disparities in American Indian and Alaska Native populations through the Community Health Advocates implementing Nationwide Grants for Empowerment and Equity...

Bringing Oncology Care to Rural Communities

The organizations and programs listed here are helping to address and reduce disparities in cancer care in rural communities. ASCO University Disparities in Cancer Care: Take Action (http://university.asco.org/disparities-cancer-care-take-action). This free slide-based course is designed to help...

Stemming the Growing Cancer Crisis in Rural Appalachia

A pair of recent studies show a troubling trend: Despite a 20% decrease in cancer mortality rates nationwide over the past 2 decades,1 Americans living in rural regions of the United States are more likely to die of cancer than persons living in metropolitan areas of the country. An analysis of...

integrative oncology

Rhodiola

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Jun J. Mao, MD, MSCE, and Jyothirmai Gubili, MS, present information on...

prostate cancer

Emotional and Psychological Distress Associated With Prostate Cancer

A cancer diagnosis presents emotional and psychological challenges for patients and caregivers, and prostate cancer has some unique challenges, in part because management is not writ in stone. At several points along the trajectory of illness, men with prostate cancer face decisions that can be...

issues in oncology

Overdiagnosis of Those in Higher Income Brackets

According to researchers from the Dartmouth Institute for Health Policy and Clinical Practice, being in a high-income bracket may lead to overdiagnosis of cancer and the subsequent harms associated with unnecessary medical treatments. To shed light on this interesting finding and its broader...

issues in oncology

Duration Studies in Oncology Have Often Been Poorly Designed and Analyzed

The ASCO Post is pleased to introduce “At Microphone 1,” an occasional column written by Steven E. Vogl, MD, of Bronx, New York. When he’s not in his clinic, Dr. Vogl can generally be found at major oncology meetings, and often at the microphone where he stands ready with important questions for...

cns cancers

Small Steps Forward in Brain Tumor Therapy

SOME RECENT ADVANCES in the treatment of brain tumors are promising, but others are less so, according to Jeffrey J. Olson, MD, Professor of Neurosurgery at Emory University, Atlanta. At the 2017 Debates and Didactics in Hematology and Oncology Conference, held in Sea Island, Georgia, and...

hematologic malignancies

Amyloidosis: Pearls for Simplifying the Diagnosis

AMYLOIDOSIS REMAINS a challenging and nuanced diagnosis. At the 2017 Debates and Didactics in Hematology and Oncology Conference, held in Sea Island, Georgia, Jonathan L. Kaufman, MD, discussed his approach to diagnosing amyloid light-chain amyloidosis. Dr. Kaufman is Associate Professor of...

gynecologic cancers

Update on Nonimmunotherapy Advances in Endometrial, Cervical, and Ovarian Cancers

AT THE 12TH ANNUAL New Orleans Summer Cancer Meeting, Thomas Herzog, MD, Deputy Director of the University of Cincinnati Cancer Institute and Professor of the Division of Gynecologic Oncology at the University of Cincinnati College of Medicine, delivered an update on nonimmunotherapy advances in...

hepatobiliary cancer

Hepatocellular Carcinoma: Current Thoughts on Liver Transplantation

LIVER TRANSPLANT offers the highest rates of long-term survival for patients with hepatocellular carcinoma, according to Maria Russell, MD, Assistant Professor of Surgery at Emory University, Atlanta. At the 2017 Debates and Didactics in Hematology and Oncology Conference at Sea Island, Georgia,...

skin cancer

Significant Improvement in Outcomes Reported With Adjuvant Therapy for Melanoma

FOR PATIENTS with malignant melanoma, the significant improvement in outcomes with targeted agents and antibodies against the programmed cell death protein 1 (PD-1) has now been observed in the adjuvant setting. Two landmark studies presented at the European Society for Medical Oncology (ESMO) 2017 ...

leukemia

Combination of Inotuzumab Ozogamicin and Low-Intensity Chemotherapy in Relapsed or Refractory Ph-Negative ALL

In a single-center phase II trial reported in JAMA Oncology, Jabbour et al found that the combination of inotuzumab ozogamicin (Besponsa) and low-intensity chemotherapy produced promising results in patients with relapsed or refractory Philadelphia chromosome (Ph)-negative acute lymphoblastic...

lymphoma

Addition of Bortezomib to R-CHOP in Non–Germinal Center B-Cell–Like Lymphoma

A phase II trial reported in the Journal of Clinical Oncology by Leonard et al showed no significant progression-free survival benefit of adding bortezomib (Velcade) to R-CHOP (rituximab [Rituxan], cyclophosphamide, doxorubicin, vincristine, and prednisone) in previously untreated patients with...

issues in oncology

ESMO 2017: Patients Struggle With Key Aspects of Clinical Trial Methodology

Clinical trials are fundamental to the development of new treatments for cancer, yet the annual accrual to cancer clinical trials worldwide is low, estimated at 3%–5%. A nationwide study in Ireland, the preliminary results of which were presented at the European Society for Medical Oncology...

issues in oncology
survivorship

ESMO 2017: NOR-CAYACS Trial: Factors That May Limit Work Ability of Young Adult Cancer Survivors

Factors that may limit the ability of young adult cancer survivors to work were reported at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 1110PD_PR). Late side effects can occur months or years after cancer treatment. In patients diagnosed with cancer in young...

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