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ASCO Updates Value in Cancer Care Framework

On May 31, 2016, ASCO published an updated framework for assessing the relative value of cancer therapies that have been compared in clinical trials. The framework, published by Schnipper et al,1 defines value as a combination of clinical benefit, side effects, and improvement in patient symptoms...

Breast Density Legislation: An Opportunity for Better Risk Assessment

Dense breasts are not an automatic indication for additional imaging. Instead, breast density generally provides an opportunity for improved risk assessment, according to Kevin Hughes, MD, of Massachusetts General Hospital, Boston. “More than 20 states have mandated that women be informed of...

The Importance of Listening to Patients

My experience with cancer, or more accurately, cancers, is complicated. In 2002, after returning from a medical mission to Honduras, I noticed a bean-sized lymph node above my left clavicle. As an oncology-certified nurse, I knew not to ignore any unusual nodules that pop up on the body and asked...

Rising

There were once two patients with leukemia. Other than their diagnoses and their ages, these two men had nothing in common. Meet Michael Michael was an artist—a sculptor. He had large, sensitive, blue eyes and a quiet, pensive manner. His acute observational power led him to ponder deep questions...

An Unusual Memoir of Cancer

“A book about the future must be written in advance. Later I won’t have the energy. So I will do it now.” So begins The Iceberg, a memoir set in Britain of a woman, Marion Coutts, whose husband was diagnosed with a brain tumor, which eventually killed him. Unfortunately, cancer memoirs flood the...

issues in oncology

Low-Dose Chemical Exposure and Cancer

According to estimates from the World Health Organization (WHO) and the International Agency for Research on Cancer (IARC), environmental toxic exposures are responsible for between 7% and 19% of human cancers. However, the 2008–2009 President’s Cancer Panel Annual Report estimated that the “true...

multiple myeloma

SIRIUS Trial Heralds a New Era of Promise in Treating Resistant Myeloma

Multiple myeloma cells uniformly overexpress CD38.1 Daratumumab (Darzalex), a CD38-targeting human IgG1 kappa monoclonal antibody, has been evaluated in a series of phase I/II trials involving patients with relapsed or relapsed and refractory myeloma who have received at least two or more prior...

issues in oncology

American Cancer Society Report Assesses Progress Against Goals Set for Nation 25 Years Ago

A new report assesses how the nation fared against the ambitious goal set by the American Cancer Society (ACS) to reduce cancer death rates by 50% over 25 years ending in 2015. The report finds areas where progress was substantial, and others where it was not. Published by Byers et al,1 the report ...

prostate cancer

Prostate Cancer: Opinions Vary on Gleason Scores and Surgery

Diagnosis and treatment of prostate cancer have been the source of heated debate for decades, most of which has centered on the clinical value of the prostate-specific antigen (PSA) test. In 2012, the U.S Preventive Services Task Force (USPSTF) gave the PSA test a D grade, which discourages many...

Lung Cancer Alliance Supports Two Young Investigator Awards

The Conquer Cancer Foundation of ASCO (CCF) has received generous support from Lung Cancer Alliance to fund a 2016 and 2017 Young Investigator Award (YIA) in lung cancer. Lung Cancer Alliance has a more than 20-year history of working to save lives and advance research by empowering those living...

Peter H. Wiernik, MD, Receives 2016 Walter Reed Distinguished Achievement Award From UVA Medical

The University of Virgina (UVA) Medical Alumni Association has recognized Peter H. Wiernik, MD, as co-recipient of its 2016 Walter Reed Distinguished Achievement Award. Dr. Wiernik received the award along with Charles W. Cummings, MD, former Chair of the Department of Otolaryngology–Head and Neck ...

breast cancer

PALOMA-3 Trial in HER2-Negative Metastatic Breast Cancer: Challenge of Moving Beyond Estrogen Receptor Positivity

Hormone receptor–positive breast cancer represents the largest therapeutic subgroup of the disease. The development of endocrine therapies has shaped the treatment paradigm for both advanced- and early-stage disease for decades.1 Still, despite their significant impact, advanced breast cancer...

supportive care

Learning About Fertility Is Important to Young Patients With Cancer

It is more and more common for people to wait until their 30s or 40s to have children. Consequently, many young adults have not completed their desired childbearing when they are diagnosed with cancer. Cancer treatments can impair fertility directly (usually via gonadotoxicity from chemotherapy,...

Expert Point of View: Michael O. Koch, MD

Session moderator, Michael O. Koch, MD, Professor of Urology and Chairman of the Department of Urology at Indiana University School of Medicine, Indianapolis, described the drug as a “game-changer for metastatic disease.” “The last [development] that was even similar to this was when the MVAC...

bladder cancer

Atezolizumab in Platinum-Treated Advanced Urothelial Carcinoma: A New Standard of Care?

Compared with a historic control rate, a phase II study of the programmed cell death ligand 1 (PD-L1) inhibitor atezolizumab (Tecentriq) has demonstrated clinically meaningful responses in patients with urothelial carcinoma who progressed after platinum-based chemotherapy.1 Hailed as a “major...

leukemia

Seattle Children’s Reports Promising Early Results With Immunotherapy in Relapsed ALL

Seattle Children’s announced that 39 of 42 patients treated in a phase I clinical trial using genetically reprogrammed T cells to treat relapsed or refractory acute lymphoblastic leukemia (ALL) have achieved complete remission, showing no detectable leukemia cells. Phase II of this trial, known as...

health-care policy

Moving the Needle on HPV Vaccination

In 2012–2013, members of the President’s Cancer Panel (prescancerpanel.cancer.gov) focused their efforts on accelerating widespread acceptance of and use of approved human papillomavirus (HPV) vaccines to prevent cancer. The topic is important, because HPVs cause most cases of cervical cancer and...

Vice President Joe Biden Addresses Attendees at ASCO 2016 Annual Meeting

Vice President Joe Biden offered remarks on the White House’s National Cancer Moonshot Initiative on Monday, June 6, to attendees at the 2016 ASCO Annual Meeting in Chicago. Essential Elements “The Moonshot Initiative can be a vehicle for major new progress against cancer, and ASCO’s Annual...

issues in oncology

How Will Value Framework Tools Be Used in Everyday Practice?

Value framework tools made a splash in 2015, with five different groups unveiling methods to help physicians and patients compare therapies based on efficacy, toxicity, and/or cost. Now these potential users are beginning to examine and debate the tools, including how and whether they will work in...

pancreatic cancer

Adjuvant Chemotherapy Improves Survival in Pancreatic Cancer

An adjuvant chemotherapy regimen improved overall survival in early-stage pancreatic cancer patients, in the large phase III European ESPAC-4 study reported at the 2016 ASCO Annual Meeting.1 The combination of gemcitabine and capecitabine almost doubled the 5-year survival rate, compared to...

cns cancers

Chemoradiotherapy Improves Survival in Patients Over Age 65 With Glioblastoma: A New Standard Option?

The combination of short-course radiotherapy and temozolomide followed by maintenance with temozolomide significantly improved survival compared with short-course radiotherapy alone in newly diagnosed elderly patients with glioblastoma, according to the results of a global cooperative group trial...

Expert Point of View: Harold J. Burstein, MD, and Ian Smith, MD

“There is a tremendous interest in longer aromatase inhibitor therapy. The Oxford Overview data, presented at ASCO, show the substantial risk of recurrence in years 5 to 15, despite an initial 5 years of adjuvant endocrine treatment. “Women with lower-risk breast cancer will be less inclined to...

Extending ASCO’s Influence Globally to Improve Patient Care

On June 27, 2016, Clifford A. Hudis, MD, FACP, FASCO, will begin his tenure as Chief Executive Officer of ASCO, succeeding Allen S. Lichter, MD, FASCO, who presided over the Society and the Conquer Cancer Foundation of ASCO since 2006. Dr. Hudis’ dedication to ASCO dates back more than 25 years...

multiple myeloma

Daratumumab Hits the Mark in Early Relapsed Multiple Myeloma

For relapsed or refractory multiple myeloma, daratumumab (Darzalex), combined with bortezomib (Velcade) and dexamethasone, reduced relapses by 61% in the phase III CASTOR study reported at the 2016 ASCO Annual Meeting.1 “The results are unprecedented in a randomized study comparing a novel...

head and neck cancer

ASCO 2016: Pembrolizumab Shows Significant Clinical Response in Recurrent/Metastatic Head and Neck Squamous Cell Carcinoma

Treating head and neck cancer patients with recurrent or metastatic disease with the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda) achieved significant clinical responses in nearly one-fifth of the patients from a phase II clinical trial, researchers from Dana-Farber...

ASCO 2016: Local Consolidative Therapy Improves Progression-Free Survival in Patients With Oligometastatic NSCLC vs Standard Chemotherapy

Lung cancer patients with oligometastases, defined as three or fewer sites of metastasis, may benefit from aggressive local therapy, surgery, or radiation, after standard chemotherapy, according to research led by The University of Texas MD Anderson Cancer Center. If validated in larger studies,...

head and neck cancer

ASCO 2016: Nivolumab Immunotherapy Improves Survival, Quality of Life in Metastatic or Recurrent Head and Neck Cancer

Treatment with nivolumab (Opdivo) doubled overall survival and improved quality of life, with fewer side effects, in a treatment-resistant and rapidly progressing form of head and neck carcinoma, reported a large, randomized international trial co-led by investigators at the University of...

breast cancer

ASCO 2016: Minority BRCA-Positive Breast Cancer Survivors Appear Less Likely to Receive Preventive Surgery

For breast cancer survivors who carry mutations in BRCA genes, preventive surgery may substantially reduce the risk of future breast and ovarian cancers. However, it appears that black women are far less likely to receive these widely recommended procedures than white or Hispanic...

multiple myeloma

ASCO 2016: Adding Daratumumab to Bortezomib and Dexamethasone Markedly Improves Outcomes in Recurrent/Refractory Multiple Myeloma

Initial findings from a pivotal phase III trial showed that daratumumab (Darzalex) added to a standard two-drug regimen (bortezomib [Velcade] and dexamethasone) markedly improved outcomes for patients with recurrent or refractory multiple myeloma. The daratumumab combination reduced the risk of...

multiple myeloma

ASCO 2016: Maintenance Lenalidomide After Autologous Stem Cell Transplantation Improves Survival in Multiple Myeloma

Several clinical trials have demonstrated that maintenance therapy with lenalidomide (Revlimid) after autologous hematopoietic stem cell transplant reduces the risk of disease progression in patients with multiple myeloma, but there have been no definitive results regarding overall...

issues in oncology

Lee S. Schwartzberg, MD, on Progress of the Institute for Clinical Immuno-Oncology

Lee S. Schwartzberg, MD, of The West Clinic, reports on progress of the now year-old ACCC initiative to speed adoption of immunotherapeutics in community practices.

breast cancer

ASCO 2016: Innovative Direct-to-Patient Outreach May Accelerate Breast Cancer Research

An innovative project launched in October 2015 may help expedite metastatic breast cancer genomics research and provide leads for development of new treatments. In the 7 months since the launch, more than 2,000 patients have enrolled in the research study designed to collect and...

breast cancer

ASCO 2016: Biosimilar Shows Comparable Efficacy and Safety to Trastuzumab in HER2-Positive Metastatic Breast Cancer

A biosimilar trastuzumab antibody (MYL-1401O) is comparable in efficacy and safety to trastuzumab (Herceptin) in women with HER2-positive advanced breast cancer, according to a randomized phase III study. The response rates were comparable among women who received trastuzumab and among...

gynecologic cancers

ASCO 2016: Adding Intraperitoneal Chemotherapy to Intravenous Chemotherapy Slows Ovarian Cancer Progression

For some women with advanced ovarian cancer that was successfully treated surgically, delivering chemotherapy intraperitoneally as well as intravenously appears more effective than intravenous chemotherapy alone. For women who were initially treated with chemotherapy prior to surgery, the ...

issues in oncology

ASCO Value Framework Update: A Statement by Julie M. Vose, MD, MBA, FASCO

ASCO today published an updated framework for assessing the relative value of cancer therapies that have been compared in clinical trials. The framework, published by Schnipper et al in the Journal of Clinical Oncology, defines value as a combination of clinical benefit, side effects, and...

QOPI-Certified Practices Eligible to Receive Discount on Medical Malpractice Rates

ASCO and its wholly owned subsidiary, Quality Oncology Practice Initiative (QOPI®) Certification Program, LLC (QCP), announced May 25 that The Doctors Company, the nation's largest physician-owned medical malpractice insurer, will recognize QOPI® Certification in its rate structure....

Noted Gastrointestinal Oncologist Leonard Saltz, MD, Tempers Optimism With Reality and Factors Cost Into the Equation of Value in Cancer Care

Leonard Saltz, MD, was born in New York, New York, and reared in Westchester County, in the suburbs of the City. Terrance Archer, his high-school biology teacher, whom Dr. Saltz described as a “force of nature,” a wonderful human being, and a major role model, influenced his nascent curiosity in...

In Memoriam

The ASCO Post remembers the following specialists in oncology who passed away in 2015–2016. Please write to editor@ASCOPost.com to recognize and pay tribute to others in a future issue. Mark R. Green, MD January 3, 1945–February 23, 2015 “Few people have impacted cancer clinical research in the...

Lisa A. Newman, MD, MPH, FACS, FASCO, Balances Her Passions of Surgical Breast Oncology and Breast Cancer Disparity Research, Both Home and Abroad

Lisa A. Newman, MD, MPH, FACS, FASCO, Director of the Henry Ford Health System’s Breast Oncology Program, was born in New York, New York and, according to her, was blessed to have had parents who lived the African American version of the “American Dream.” Dr. Newman’s father was the son of...

With a Strong Personal Connection to His Patients, Stephen P. Hunger, MD, Strives for a Cure for All Children With Leukemia

Nationally regarded children’s cancer specialist Stephen P. Hunger, MD, was born and reared in South Windsor, a small suburb of Hartford, Connecticut. Dr. Hunger grew up in the mid-1960s and 1970s, and in his words, “South Windsor was a pretty homogeneous experience. There wasn’t really any ethnic...

International Authority on Radiation Effects, Robert Peter Gale, MD, PhD, Has Pushed Scientific Boundaries in Search of Answers

It is widely reported that the first use of sargramostim (Leukine) in humans (granulocyte macrophage colony-stimulating factor; GM-CSF) was to treat victims of the Goiânia, Brazil, radiation accident in 1987. However, recently declassified documents show that sargramostim was first used a year...

Once a Vocational Nomad, Christine H. Chung, MD, Now Works to Promote Patient-Centered Care in Head and Neck Cancer

Christine H. Chung, MD, Chair of the Department of Head and Neck-Endocrine Oncology at Moffitt Cancer Center, Tampa, Florida, was born and reared in Seoul, Republic of Korea. Dr. Chung immigrated with her mother and two brothers to Los Angeles, where her family then resided. Dr. Chung did not speak ...

Allen S. Lichter, MD, FASCO, Reflects on His Career Path and His Tenure as ASCO CEO, and Predicts a Bright Future for Radiation Oncology

Choosing a career path is one of life’s most challenging decisions, but for Allen S. Lichter, MD, FASCO, deciding to become a doctor was inherently natural. He was born with a great mentor and role model: his father. “I was born and raised in Detroit. My father was a general practitioner in...

survivorship
symptom management

Monitoring Survivors of Childhood Cancers for Late Effects of Treatment

This past January, ASCO held its inaugural Cancer Survivorship Symposium, which brought together the fields of medical oncology and primary care to address the critical need for coordinated care for cancer survivors. Among the presenters at the symposium was Smita Bhatia, MD, MPH, who gave the...

ASCO’s State Affiliate Council Improves Communication Between ASCO and Community Physicians

ASCO established a State Affiliate Council in 2012 consisting of representatives from each of the Society’s 48 state or regional oncology societies. The Council met on April 21–22 at ASCO headquarters in Alexandria, Virginia. The ASCO Post talked with Paul Celano, MD, FACP, President, Maryland/DC...

$200 Million Gift Launches Lawrence J. Ellison Institute for Transformative Medicine of USC

Technology entrepreneur Larry Ellison has donated $200 million to establish the Lawrence J. Ellison Institute for Transformative Medicine of the University of Southern California (USC), a new center in Los Angeles that will combine interdisciplinary research with the holistic prevention and...

issues in oncology

ASCO Past-President Anticipates a New Position With an Ongoing Goal of Advancing the Field of Oncology

After an extensive national search, Hartford HealthCare has appointed ASCO Past-President Peter Paul Yu, MD, FACP, FASCO, as the first Physician-in-Chief of the Hartford HealthCare Cancer Institute. As Physician-in-Chief, Dr. Yu will be responsible for working closely and collaboratively with...

breast cancer

ExteNET Trial of Neratinib: One Size Does Not Fit All in HER2-Positive Breast Cancer

Neratinib is an oral anti-HER2 tyrosine kinase inhibitor that has shown promising activity in the treatment of HER2-positive metastatic breast cancer.1 It differs from monoclonal antibodies such as trastuzumab (Herceptin) because, as a small molecule, neratinib blocks the ATP binding site on the...

breast cancer

Dr. Susan Love: Time to Address ‘Collateral Damage’ of Breast Cancer Treatment

The “collateral damage” of cancer treatment is a topic that is familiar to Susan Love, MD, MBA. As a breast cancer surgeon and chief visionary officer of Dr. Susan Love Research Foundation, she has learned much about the consequences of cancer treatment. But she came by an important aspect of her...

Expert Point of View: Mahmoud El-Tamer, MD

Mahmoud El-Tamer, MD, a breast surgeon at Memorial Sloan Kettering Cancer Center, New York, who moderated the session where the results were presented, pointed out that although the results were provocative, the selection of patients was “biased,” as they had already presented to a breast surgery...

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