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issues in oncology

Value: Is the Benefit Worth the Cost?

AS A YOUNG CLINICIAN, I was interested in making a difference; it did not matter how much of a difference, as long as I could claim some patient benefit. And I really didn’t care what benefit: better survival, less local recurrence, shorter hospital stays, fewer narcotics—the specifics did not...

multiple myeloma

Redefining What It Means to Have Precursor Myeloma

Studies have shown that all patients diagnosed with multiple myeloma had a preceding asymptomatic expansion of clonal plasma cells, clinically recognized as monoclonal gammopathy of undetermined significance or smoldering multiple myeloma. According to C. Ola Landgren, MD, PhD, Professor of...

prostate cancer

ASCO Endorses Cancer Care Ontario Guideline on Bone Health and Bone-Targeted Therapies for Prostate Cancer

ASCO recently endorsed the Cancer Care Ontario (CCO) guideline “Bone Health and Bone-Targeted Therapies for Prostate Cancer,” which was originally approved by CCO in 2017.1 The recommendations were based on a systematic review and meta-analysis of relevant research and clinical trial reports...

sarcoma

Immunogenomic Profiling of Osteosarcoma

Comprehensive profiling of tumor samples taken from patients with osteosarcoma showed that multiple factors contribute to the traditionally poor responses observed with immune checkpoint inhibitor treatment in patients with this malignancy, according to new research published by Wu et al in Nature...

issues in oncology
survivorship

Late Mortality and Chronic Health Conditions in Long-Term Survivors of AYA Cancers

A retrospective analysis from the Childhood Cancer Survivor Study, reported in The Lancet Oncology by Eugene Suh, MD, and colleagues, showed that as with survivors of childhood cancers, survivors of adolescent and young adult (AYA) cancers are at increased risk of earlier mortality and chronic...

gynecologic cancers
genomics/genetics

New ASCO Guideline Highlights Need to Improve Germline, Somatic Tumor Testing in Epithelial Ovarian Cancer

A new ASCO clinical practice guideline provides clinicians and other health-care professionals with evidence-based recommendations on genetic and tumor testing for women diagnosed with epithelial ovarian cancer.1 “We wanted to go over the evidence and make strong statements and recommendations...

Jason Luke, MD, FACP, Receives Sy Holzer Endowed Immunotherapy Research Award

University of Pittsburgh Medical Center (UPMC) Hillman Cancer Center immunologist Jason Luke, MD, FACP, has been presented with the Sy Holzer Endowed Immunotherapy Research Fund Award to advance innovative research in cancer immunotherapy. Dr. Luke, a medical oncologist and clinical investigator,...

breast cancer

Using Antioxidants and Other Supplements With Chemotherapy May Increase Risk of Breast Cancer Recurrence and Mortality

Using antioxidants and other dietary supplements before and during adjuvant chemotherapy for breast cancer may increase the risk of recurrence and “to a lesser extent, death,” according to an analysis of dietary and nutritional data from a phase III trial, published in the Journal of Clinical...

Searching for Evidence-Based Reassurance Where None Could Be Found

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
genomics/genetics

Neoadjuvant Cisplatin for BRCA-Mutation Carriers: Pruning the Dead Branches

At the 2019 San Antonio Breast Cancer Symposium, Nadine Tung, MD, of Beth Israel Deaconess Medical Center, presented a multisite study called INFORM, run by the Translational Breast Cancer Research Consortium.1 It compared single-agent cisplatin with a “classic” combination of doxorubicin and...

Rami K. Daya, MD, Leads Perlmutter Cancer Center’s New Location in Sunset Park, Brooklyn

Hematologist/oncologist Rami K. Daya, MD, will lead a team of cancer experts at New York University (NYU)/Langone Perlmutter Cancer Center’s new multidisciplinary, ambulatory location in Sunset Park, Brooklyn. As Director of Medical Oncology at NYU Langone Hospital–Brooklyn, he will oversee all...

issues in oncology

Using Machine Learning to Prompt Serious Illness Conversations

Despite research showing that among patients with cancer, early advance care planning conversations lead to care that is in alliance with patients’ goals and wishes, especially at the end of life,1 most patients die without having discussions about their treatment goals and end-of-life preferences ...

geriatric oncology

Poster to Bedside: Geriatric Oncology Research Updates From 2019 ASCO Annual Meeting

Functional status impairment, limited mobility, comorbidities, polypharmacy, and other aging-related manifestations are common in older individuals. These conditions complicate the oncologic management of older adults, who are underrepresented in clinical trials, even though they form the majority ...

Stand Up To Cancer Announces Gastric Cancer Interception Research Team

Stand Up To Cancer (SU2C) recently announced that an international team of experts will take a new approach to fighting gastric cancer. The SU2C Gastric Cancer Interception Research Team: Early Detection and Interception of Diffuse and Intestinal Gastric Cancer was introduced at the SU2C Scientific ...

leukemia
lymphoma
multiple myeloma
immunotherapy

Highlights From ASH 2019 Included New Data in Leukemia, Lymphoma, and Multiple Myeloma

The ASH 2019 Annual Meeting & Exposition featured countless important sessions and lectures. It would be impossible to attend all the symposia, oral presentations, poster presentations, and special events. Below, we have selected some presentation highlights to supplement our coverage of the...

immunotherapy
multiple myeloma

Next-Generation BCMA-Targeted CAR T-Cell Therapies for Relapsed or Refractory Multiple Myeloma Explored in Early-Phase Trials

Two novel dual-target chimeric antigen receptor (CAR) T-cell strategies are yielding early and durable responses for patients with relapsed or refractory multiple myeloma, as well as potentially less cytokine-release syndrome and neurotoxicity compared with first-generation CAR T-cell products,...

immunotherapy
hematologic malignancies

Early Data Suggest Efficacy of Innovative CAR NK-Cell Therapy for B-Cell Malignancies

FT596, a novel off-the-shelf chimeric antigen receptor natural killer cell (CAR-NK) product, was as effective as existing CAR T-cell platforms in killing cancer cells in vivo, and the combination of FT596 plus rituximab killed lymphoma cancer cells that were no longer responding to CAR T-cell...

immunotherapy
lymphoma

Bispecific Antibody Shows Activity in Post–CAR T-Cell Therapy for Non-Hodgkin Lymphoma

Mosunetuzumab, an ­investigational ­bispecific antibody, demonstrated activity in preliminary studies of patients with non-Hodgkin lymphoma (NHL), including those who are refractory to or relapsed after third-line chimeric antigen receptor (CAR) T-cell therapy. With further study, mosunetuzumab,...

immunotherapy
leukemia

Blinatumomab Post-reinduction Consolidation Improves Event-Free, Overall Survival vs Chemotherapy in Young Patients With B-Cell ALL

Among children, adolescents, and young adults with B-cell acute lymphoblastic leukemia (ALL), the bispecific T-cell engager blinatumomab improved event-free survival and overall survival, compared with standard chemotherapy, as post-reinduction consolidation therapy at first relapse prior to...

immunotherapy
lymphoma

Will Bispecific Antibodies Compete With CAR T-Cell Therapy in Lymphoma?

Are second-generation bispecific antibodies the next big thing in lymphoma? Studies of these drugs were among the highlights of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition. Years ago, the bispecific T-cell engager blinatumomab validated the concept of bispecific...

kidney cancer
immunotherapy

Ziad Bakouny, MD, on Sarcomatoid and Rhabdoid RCC: Potential Determinants of Poor Prognosis and Treatment Response

Ziad Bakouny, MD, of Dana-Farber Cancer Institute, discusses two types of renal cell cancer that are associated with poor prognosis. Because recent early data suggest these tumors respond well to immune checkpoint inhibitors, the authors characterized the tumors in an integrative molecular and...

breast cancer
immunotherapy

No Improved Pathologic Complete Response With Atezolizumab in Early Triple-Negative Breast Cancer

The addition of the checkpoint inhibitor atezolizumab to chemotherapy with carboplatin and nab-paclitaxel failed to significantly improve pathologic complete response rates compared with chemotherapy alone in patients with early high-risk, locally advanced triple-negative breast cancer. According...

gynecologic cancers

Proteomic Analysis of Endometrial Cancer

A comprehensive molecular study of endometrial cancer published by Dou et al in Cell has further defined the contributions of key genes and proteins to the disease. The overview suggests new treatment approaches that could be tailored for each patient, as well as potential biologic targets for...

skin cancer

States With Highest Rates of Cutaneous Melanoma Due to Ultraviolet Exposure

A new study found a wide state-by-state variation in rates of melanoma caused by ultraviolet (UV) exposure, with highest rates in several states on the east and west coasts (including Hawaii), but also a few landlocked states (including Utah, Vermont, and Minnesota). The report, published by Islami ...

lung cancer
immunotherapy

ASCO/CCO Update Guideline for Selecting Systemic Treatment in Stage IV NSCLC Without Driver Mutations

ASCO and Cancer Care Ontario (CCO) have published an update to a joint guideline on systemic therapy for stage IV non–small cell lung cancer (NSCLC) without driver mutations.1 “The treatment of stage IV NSCLC has become increasingly more complicated, and, with the advent of immunotherapy and the...

pancreatic cancer

Expert Point of View: Andrea Wang-Gillam, MD, PhD

Andrea Wang-Gillam, MD, PhD, Clinical Director of the GI Oncology Program and Director of Developmental Therapeutics at Washington University in St. Louis, was the invited discussant of SEQUOIA and HALO 109-301. She tried to make sense of the two negative studies of pegylated agents in advanced...

breast cancer
immunotherapy

Addition of Pembrolizumab to Neoadjuvant Chemotherapy in Early-Stage HER2-Negative Breast Cancer

As reported in JAMA Oncology by Rita Nanda, MD, and colleagues, findings from the ongoing phase II I-SPY 2 trial indicated that the addition of pembrolizumab to standard neoadjuvant chemotherapy improved pathologic complete response rates in patients with high-risk stage II/III HER2-negative breast ...

breast cancer

Hongchao Pan, PhD, on an Update on 5 Years of Endocrine Therapy for Early Breast Cancer

Hongchao Pan, PhD, of the University of Oxford, discusses an analysis of 86,000 women in the Early Breast Cancer Trialists’ Collaborative Group database, which showed that the risk of distant recurrence 20 years after a diagnosis of node-negative, estrogen receptor–negative early-stage breast...

lung cancer

IASLC Early Lung Imaging Confederation Initiative for Analysis of Low-Dose CT Images

As reported by James L. Mulshine, MD, and colleagues in JCO Clinical Cancer Informatics, the International Association for the Study of Lung Cancer (IASLC) is developing the Early Lung Imaging Confederation (ELIC) “to serve as an open-source, international, universally accessible environment to...

Congress Increases Federal Investment in Cancer Research, Raises Tobacco Purchasing Age

President Trump recently signed a bill that funds the federal government, including the National Institutes of Health (NIH), the National Cancer Institute (NCI), and the U.S. Food and Drug Administration (FDA), for Fiscal Year (FY) 2020. Importantly, the bill also raises the purchasing age of...

ASCO Analysis Demonstrates Need to Harmonize Disclosure Policies Across Medicine

An analysis by ASCO shows substantial discordance between disclosures to ASCO and to Open Payments, confirming the need for consistent and simpler financial disclosure systems in medicine.1 The paper examined disclosures from 93 presenters at the 2018 ASCO Annual Meeting and 70 published authors in ...

A Hopeful Look Ahead in Oncology

“They’re all charlatans,” my professor assured me when, in medical school in the mid-1970s, I expressed an interest in oncology. The treatment of cancer with drugs, despite popular but inaccurate descriptions of its history, began in 1944 when Goodman and Gilman at Yale conducted contract research...

lymphoma
immunotherapy
geriatric oncology
cost of care

Real-World Data for CAR T-Cell Therapy Show Benefit in Older Patients With Lymphoma, Lower Subsequent Health-Care Costs

Once considered highly experimental, chimeric antigen receptor (CAR) T-cell therapy is now an established third-line treatment option for B-cell lymphomas and leukemias. CAR T-cell therapy has saved the lives of people who would otherwise have run out of treatment options. But the question is...

Stand Up To Cancer Announces Initiative to Increase Diversity in Clinical Trials

Stand Up To Cancer (SU2C) recently announced an initiative to increase minority representation in cancer clinical trials. All future SU2C-supported research grant proposals will now be required to include and address crucial issues related to recruitment and retention of patients from ethnic groups ...

breast cancer
immunotherapy

Neoadjuvant and Adjuvant Pembrolizumab Improves Pathologic Complete Response Rate in Triple-Negative Breast Cancer

The addition of pembrolizumab to neoadjuvant and adjuvant chemotherapy achieves higher rates of pathologic complete response compared with placebo in patients with triple-negative breast cancer, according to results of the phase III KEYNOTE-522 trial presented at the 2019 San Antonio Breast Cancer...

breast cancer
genomics/genetics
issues in oncology

Study Finds Women With Variants in Breast Cancer–Associated Genes May Not Always Be Receiving Guideline-Concordant Care

Women with early-stage breast cancer who test positive for an inherited genetic variant are not always receiving cancer treatment that follows current treatment guidelines, according to findings from a new study published by Allison W. Kurian, MD, MSc, and colleagues in JAMA Oncology. An inherited ...

head and neck cancer
issues in oncology

Do Socioeconomic Factors Play a Role in Outcomes for HPV-Positive Head and Neck Cancer?

Survival outcomes for patients with human papillomavirus (HPV)-positive squamous cell carcinoma of the head and neck have made significant gains in recent years, but new research published by Pike et al in JNCCN—Journal of the National Comprehensive Cancer Network has found some groups have not...

lymphoma
immunotherapy
symptom management

Expert Point of View: Jeremy S. Abramson, MD

Jeremy S. Abramson, MD, Director of the Jon and JoAnn Hagler Center for Lymphoma at Massachusetts General Hospital and Associate Professor of Medicine at Harvard Medical School, Boston, commented on the study by Topp et al for The ASCO Post. “Earlier use of steroids with axicabtagene ciloleucel...

Damon Runyon Cancer Research Foundation Awards Early-Career Scientists

The Damon Runyon Cancer Research Foundation recently announced that 12 scientists with novel approaches to fighting cancer have been named the 2020 recipients of the Damon Runyon-Rachleff Innovation Award. Six initial grants of $400,000 over 2 years were awarded to seven early-career scientists...

Prevent Cancer Foundation Benefits Global Cancer Research

The gaming community showed their support to the oncology community by donating proceeds throughout a 10th Anniversary celebration of a week-long, 24-hour, speedrunning marathon. The charity event, Awesome Games Done Quick (AGDQ), concluded on January 12, 2020, raising a total of $3.13 million, the ...

lymphoma
immunotherapy
symptom management

Early Steroid Use May Reduce Toxicity With CAR T-Cell Therapy

In patients with large B-cell lymphoma undergoing chimeric antigen receptor (CAR) T-cell therapy with axicabtagene ciloleucel, earlier-than-usual intervention with corticosteroids and tocilizumab may reduce the incidence of severe cytokine-release syndrome, according to the findings of a...

A Retired Oncologist Remains Involved in the Science and Policy of Oncology

The history of medicine once was featured in medical school curricula. That is becoming less common due to time restriction and the increased prevalence of more technical topics. However, the importance of the history of medicine cannot be overstated: It shapes every aspect of our cultural,...

colorectal cancer

Incidence Increases in New Colorectal Cancer Diagnoses Among Patients Between 49 and 50 Years Old

A year-by-year age analysis of colorectal cancer rates among adults in the United States has found a 46% increase in new diagnoses from ages 49 to 50, indicating that many latent cases of the disease are likely going undiagnosed until routine screenings begin at 50, according to a new study by...

lung cancer

ASCO Guideline Addresses Surveillance of Lung Cancer After Curative-Intent Therapy

ASCO has released a new guideline providing recommendations to practicing clinicians on radiographic imaging and biomarker surveillance strategies after definitive, curative-intent therapy in patients with stage I to III non–small cell lung cancer or small cell lung cancer. These guideline...

gynecologic cancers

Diffusion-Weighted MRI May Help Predict Treatment Response in Patients With Advanced Ovarian Cancer

A simple test using a magnetic resonance imaging (MRI) scan may be used to predict how well people with advanced epithelial ovarian cancer will respond to treatment, according to the results of a new study published by Winfield et al in Radiology. In a large clinical trial, scientists have shown a...

global cancer care

WHO, IARC Release Reports in Response to Government’s Role in Cancer Control

The World Health Organization (WHO) and the International Agency for Research on Cancer (IARC) released two coordinated reports in light of World Cancer Day in response to government calls for more research into the scope and potential policies and programs to improve cancer control. WHO Report...

CAR T-Cell Gene Therapy in Non-Hodgkin Lymphomas: Present and Future

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 immunotherapies for patients with different types of non-Hodgkin...

Selected ASH Abstracts on Myelodysplastic Syndromes

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 myelodysplastic syndromes (MDS), including the...

Actively Recruiting Clinical Trials for Cervical Cancer

This Clinical Trials Resource Guide lists actively recruiting clinical trials that focus on cervical cancer. They are examining the efficacy of adding nelfinavir to treatment regimens, using atezolizumab as an immunotherapy primer, combining metformin and doxycycline, adjuvant chemotherapy in...

breast cancer

Real-World Use of Palbociclib and Abemaciclib Explored in Two Studies Based on Electronic Health Records Database

Cyclin-dependent kinase 4 and 6 (CDK4/6) inhibitors are changing the landscape of the treatment of hormone receptor (HR)-positive/HER2-negative breast cancer. Three CDK4/6 inhibitors are approved by the U.S. Food and Drug Administration—ribociclib, palbociclib, and abemaciclib—as first- or...

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