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head and neck cancer

SITC Publishes First Clinical Immunotherapy Guidelines for Treatment of Head/Neck Squamous Cell Carcinoma

The Society for Immunotherapy of Cancer (SITC) has published the first clinical immunotherapy guidelines for squamous cell carcinoma of the head and neck, providing oncologists and other advanced practice providers with a clinical roadmap to treating this disease with immunotherapies approved in...

issues in oncology

Hey Siri, Should I Get a Medical Degree?

I received a coffee mug from a physician colleague some years ago with the tag line: “Please do not confuse your Google search with my Medical Degree.” Physicians of all stripes and colors can relate to the agony of debunking a “Dr. Google” diagnosis. However, in a fast-evolving health-care...

issues in oncology

How Patient Advocacy Is Integral to High-Quality Oncology Care

Karen M. Winkfield, MD, PhD, has made patient advocacy—with a specific emphasis on health equity and access to high-quality care—front and center of her oncology practice since she completed her residency at the Harvard Radiation Oncology Program in Boston, where she noticed that most of the...

issues in oncology

2019 Quality Care: Intervention to Improve Rates of Resident Advanced Care Planning Documentation

In a single-center study reported at the ASCO Quality Care Symposium and simultaneously published in the Journal of Oncology Practice, Switzer et al found that an intervention consisting of a resident training module and use of a best practice alert (BPA) in electronic medical records (EMRs)...

symptom management
pain management

2019 Quality Care: Improving Documentation of Pain and Constipation Assessment and Management

In a study reported at the ASCO Quality Care Symposium and simultaneously published in the Journal of Oncology Practice, Chineke et al found that a Quality Oncology Practice Initiative (QOPI) initiated in collaboration with ASCO at the Georgia Cancer Center for Excellence (GCCE) at Grady Health...

hepatobiliary cancer

Real-Time ctDNA Evaluation in Patients With Hepatocellular Carcinoma

In a study published in the Journal of Gastrointestinal Oncology, Mody et al described results from patients with hepatocellular carcinoma undergoing circulating tumor DNA (ctDNA) testing in a real-time clinical context. The authors wrote, “[ctDNA assessment] holds incredible promise for early...

integrative oncology

Light Intervention for Cancer-Related Fatigue, Depression, and Sleep Disturbance

GUEST EDITOR  Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief of Integrative Medicine Service at Memorial Sloan Kettering Cancer Center, New York. Cancer and its treatments are associated with severe fatigue, depression, ...

skin cancer

Stage IV Melanoma: What Current Role Should Surgery Play?

Advanced melanoma has become a different entity in the era of immunotherapy and targeted agents. Considering the potential for good outcomes from systemic therapy in advanced disease, has the role of surgery changed? Should it be offered up front or limited to patients with oligometastatic ...

evista
soltamox

USPSTF Recommendation on Medication Use to Reduce Breast Cancer Risk

In a statement published in JAMA, the U.S. Preventive Services Task Force (USPSTF) recommended that clinicians offer to prescribe risk-reducing medications to women who are at an increased risk of breast cancer and at low risk of adverse events related to medications. However, the Task Force...

First-Line Nivolumab and Ipilimumab vs Sunitinib in Advanced Renal Cell Carcinoma

This week, we’ll be talking about an extended follow-up of a phase III trial that investigated first-line nivolumab and ipilimumab vs sunitinib in advanced renal cell carcinoma. Then we’ll go over a research letter that identified strong predictors of response to immune checkpoint inhibitor...

gynecologic cancers

Does PTSD Increase the Risk of Developing Ovarian Cancer?

Women who experienced six or more symptoms of posttraumatic stress disorder (PTSD) at some point in life had a twofold greater risk of developing ovarian cancer compared with women who never experienced any PTSD symptoms. These findings were published by Roberts et al in Cancer Research. The...

pancreatic cancer

ASTRO Guideline on Use of Radiation Therapy for Patients With Pancreatic Cancer

A new clinical guideline from the American Society for Radiation Oncology (ASTRO) provides recommendations on the use of radiation therapy to treat patients diagnosed with pancreatic cancer, including when radiation treatments are appropriate, as well as the optimal dosing, timing, and...

breast cancer

Menopausal Hormone Therapy Use and Risk of Breast Cancer

In a study reported in The Lancet, the Collaborative Group on Hormonal Factors in Breast Cancer found that the use of menopausal hormone therapy is associated with an increased risk of breast cancer, with risk increasing as the duration of use increases, in both current and past users. Study...

symptom management

ASCO and MASCC/ISOO Release a Clinical Practice Guideline on Medication-Related Osteonecrosis of the Jaw

ASCO and the Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) have published a clinical practice guideline on medication-related osteonecrosis of the jaw in the Journal of Clinical Oncology.1 The guideline outlines the latest recommendations ...

multiple myeloma

Is It Time to Intervene in Smoldering Myeloma?

Early intervention in smoldering multiple myeloma prevents progression to symptomatic disease and should be strongly considered for patients meeting new criteria for high risk, according to Sagar Lonial, MD, Professor and Chair of Hematology and Medical Oncology and the Anne and Bernard Gray...

survivorship

Solid Organ Transplantation in Aging Survivors of Childhood Cancer

A retrospective analysis from the Childhood Cancer Survivor Study reported in The Lancet Oncology by Dietz et al found that the need for solid organ transplantation was infrequent in aging survivors of childhood cancer, with greater organ-specific risk being associated with particular therapeutic...

issues in oncology

2019 Quality Care: End-of-Life Care in Western Washington State vs Alberta, Canada

In a study to be presented by Khaki et al at the 2019 ASCO Quality Care Symposium, researchers found more aggressive end-of-life measures—including use of chemotherapy and admissions to the intensive care unit (ICU)—were employed in the last 30 days of life in Western Washington state vs Alberta,...

issues in oncology
cost of care

2019 Quality Care: Cost of Treatment, Prior Authorization of Treatment Plans May Cause Barriers to Care

Drug costs and requirements for prior authorization of treatment plans pose barriers to cancer treatment and can potentially affect outcomes for many patients, according to two studies that will be presented at the ASCO Quality Care Symposium. The studies respectively examine how the high...

prostate cancer

TITAN Trial: Apalutamide Adds to Options for Men With Metastatic Hormone-Sensitive Prostate Cancer

Androgen-deprivation therapy has been, and remains, the standard of care for patients with metastatic prostate cancer. Patients are often surprised to know that was all we would do to control their disease and sometimes asked why they would not get chemotherapy, as for other cancers. I would take...

prostate cancer

Addition of Apalutamide to Androgen-Deprivation Therapy in Metastatic Castration-Sensitive Prostate Cancer

As reported in The New England Journal of Medicine by Kim N. Chi, MD, of BC Cancer and Vancouver Prostate Centre, and colleagues, the first analysis of the phase III TITAN trial has shown that the addition of apalutamide to androgen-deprivation therapy improved radiographic progression-free and...

issues in oncology

FDA Recommendation on Duodenoscopes With Disposable Components

The U.S. Food and Drug Administration (FDA) has recommended that duodenoscope manufacturers and health-care facilities transition to different types of duodenoscopes that may pose less risk to patient safety. Specifically, because of challenges with cleaning these devices for reuse and persistent...

hematologic malignancies
issues in oncology

Reducing Time to Chemotherapy Initiation in Patients Electively Admitted to a Hematologic Malignancy Service

In a single-institution study reported in the Journal of Oncology Practice, Galeas et al found that intervention in key drivers in the care process could reduce the time to initiation of chemotherapy in patients with elective admission to a hematologic malignancy service. Study Details The goal of...

immunotherapy

Key Predictors of Response Rates to PD-1/PD-L1 Inhibitor Therapy Across Cancer Types

In a study reported in JAMA Oncology, Lee and Ruppin found that CD8-positive T-cell abundance, tumor mutational burden, and high PD1 gene expression were the strongest predictors of response to anti–programmed cell death protein 1/programmed cell death ligand 1 (PD-1/PD-L1) treatment across cancer...

prostate cancer

Many Choices Now for Men With Metastatic Hormone-Sensitive Prostate Cancer: How to Decide?

Based on the recently published ENZAMET, ARCHES, and TITAN trials,1-3 we now have several choices of systemic combination therapies for men with metastatic hormone-sensitive prostate cancer; the ENZAMET trial is reviewed in this issue of The ASCO Post. In 2019, men are now faced with decisions of...

prostate cancer

Enzalutamide Improves Survival vs Standard First-Line Treatment in Hormone-Sensitive Metastatic Prostate Cancer

As reported in The New England Journal of Medicine by Ian D. Davis, MBBS, PhD, FRACP, FAChPM, of Monash University and Eastern Health in Melbourne, and colleagues, the phase III ENZAMET trial has shown that the androgen receptor inhibitor enzalutamide improved progression-free and overall survival ...

issues in oncology

Exposure to Secondhand E-Cigarette Aerosols Increasing Among Middle and High School Students

A growing number of middle and high school students are being exposed to secondhand aerosols from electronic cigarettes (e-cigarettes) by living with or being around individuals who are vaping, according to data from a national survey. Such exposure increased rapidly in 2018 compared to the years...

issues in oncology
survivorship

High-Deductible Health Plans, Access to Care, and Emergency Department Use Among Cancer Survivors

In a study reported in the Journal of Oncology Practice, Zheng et al found that patients with cancer and high-deductible health plans had increases in delayed/forgone care, an effect that was attenuated for those with health savings accounts. Emergency department use was similar across insurance...

solid tumors

FDA Clears Next-Generation Scalp-Cooling Device

ON JUNE 27, 2019, the U.S. Food and Drug Administration (FDA) granted clearance of the DigniCap Delta scalp-cooling system to Dignitana, for use by health-care providers in the United States. The device is a fourth generation of the DigniCap scalp-cooling system. It is indicated to reduce the...

kidney cancer
prostate cancer
immunotherapy

Novel Treatments Under Study in Renal Cell Carcinoma and Prostate Cancer

There were numerous notable presentations at the 2019 Genitourinary Cancers Symposium, many of which were covered in The ASCO Post over the past few months. To add to our continued coverage of this meeting, here are some highlights from studies focusing on novel therapeutics in renal cell carcinoma ...

Newly Updated ASCO Answers Resource to Help Your Patients Quit Tobacco

THE ASCO ANSWERS Stopping Tobacco Use After a Cancer Diagnosis booklet offers people with cancer and their caregivers information on why and how to quit tobacco use. With information on available treatments and resources, the guide gives patients practical tools to work with their health-care team ...

gastrointestinal cancer

New NCCN Guidelines®: First to Address Small Intestine Cancers

THE NATIONAL COMPREHENSIVE Cancer Network® (NCCN®) recently announced the publication of a new set of recommendations focused on cancers in the small intestine. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Small Bowel Adenocarcinoma are the first treatment guidelines in...

prostate cancer

Darolutamide for Nonmetastatic Castration-Resistant Prostate Cancer

On July 30, 2019, darolutamide was approved for the treatment of patients with nonmetastatic castration-resistant prostate cancer.1,2 Approval was based on findings in the double-blind phase III ARAMIS trial (ClinicalTrials.gov identifier NCT02200614), in which 1,509 patients were randomly assigned ...

breast cancer

Tumor Size and Grade Matter, and Ovarian Ablation by Chemotherapy May Explain Subgroup Anomaly in TAILORx

At the 2019 ASCO Annual Meeting, and simultaneously in The New England Journal of Medicine, we heard the third paper reporting results from TAILORx.1,2 The first, in 2015,3 indicated that women with node-negative breast cancers with Oncotype DX recurrence scores less than 11 did extremely well...

kidney cancer
prostate cancer
immunotherapy

Novel Treatments Under Study in Renal Cell Carcinoma and Prostate Cancer

There were numerous notable presentations at the 2019 Genitourinary Cancers Symposium, many of which were covered in The ASCO Post over the past few months. To add to our continued coverage of this meeting, here are some highlights from studies focusing on novel therapeutics in renal cell carcinoma ...

breast cancer

Can Some Women With HER2-Positive Breast Cancer Forgo Surgery?

Breast cancer researchers at The University of Texas MD Anderson Cancer Center, Houston, are beginning to select patients with HER2-positive breast cancer who might forgo surgery after neoadjuvant chemotherapy. While this fine-tuning is currently intended to inform clinical trials—in particular, to ...

multiple myeloma

Selinexor in Relapsed or Refractory Multiple Myeloma

In the Clinic provides overviews of novel hematology and 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 July 3, 2019, the oral nuclear export...

supportive care
symptom management

Virtual Reality May Improve Pain, Vision, Functioning in Patients With Cancer

Virtual reality can be used to improve functioning in patients with cancer, according to David Rhew, MD, Chief Medical Officer, Vice President and General Manager of Enterprise Healthcare, Samsung Electronics America. Research has shown that this technology can decrease pain and improve vision, as...

issues in oncology
geriatric oncology

Polypharmacy Associated With Functional Decline in Older Patients With Advanced Cancer

Polypharmacy (ie, the concurrent use of eight or more medications) and potentially inappropriate medications may be associated with functional impairment in older adults with advanced cancer, according to research presented by ­Mostafa Mohamed, MBBCh, at the Multinational Association of Supportive...

solid tumors

FDA Clears Next-Generation Scalp-Cooling Device

ON JUNE 27, 2019, the U.S. Food and Drug Administration (FDA) granted clearance of the DigniCap Delta scalp-cooling system to Dignitana, for use by health-care providers in the United States. The device is a fourth generation of the DigniCap scalp-cooling system. It is indicated to reduce the...

issues in oncology
pain management

Opioids for Cancer Pain: A Review of the Evidence and Current Challenges

In the wake of the opioid crisis in the United States, patients with cancer pain are often undeservedly confronted with rigid barriers to receiving the opioids they need. To compound this problem, the research around opioids in cancer pain has been limited—placebo-controlled trials are lacking,...

health-care policy
immunotherapy

CMS Finalizes Decision to Cover CAR T-Cell Therapy for Medicare Beneficiaries

ON AUGUST 7, the Centers for Medicare & Medicaid Services (CMS) finalized the decision to cover U.S. Food and Drug Administration (FDA)-approved chimeric antigen receptor (CAR) T-cell therapy among recipients of Medicare benefits. FDA-approved CAR T-cell therapies are approved to treat patients ...

lung cancer
immunotherapy

Optimal First-Line Therapy for Stage IV Non–Small Cell Lung Cancer: Immunotherapy Alone or With Chemotherapy?

Recent studies in non–small cell lung cancer (NSCLC) have shown benefit for combining checkpoint inhibitors with chemotherapy. Should combinations, therefore, be the first choice for treating patients with newly diagnosed stage IV disease? Two lung cancer experts debated this point at the 2019...

issues in oncology
geriatric oncology

All Oncologists Are Geriatric Oncologists...They Just Don’t Know It Yet

You don’t have to be a geriatrician to properly evaluate and manage older patients with cancer. The wave of older patients with cancer predicted over 30 years ago is now fully upon us. The oncology community finds itself ill-prepared to manage the increased number of older patients. It is not just...

solid tumors

Exploratory Analysis Shows DNA Methylation Assay Highly Specific for Cancer Detection

A cell-free DNA test based on the presence of DNA methylation has proven highly specific as a multicancer detection test and appears especially good at detecting high-risk malignancies. In most cases, it can also accurately pinpoint the tumor’s tissue of origin, researchers reported at the 2019...

immunotherapy

What Causes Liver Injury During Treatment With Pembrolizumab

Immunotherapy as a treatment for advanced solid cancers has rapidly evolved over the past decade—often yielding remarkable results. However, its use has also given way to new adverse effects, including drug-induced gastrointestinal and liver toxicities. “Checkpoint inhibitors are a game changer...

immunotherapy
skin cancer

5-Year Follow-Up of KEYNOTE-006 Trial of Immunotherapy Regimens in Advanced Melanoma

In a post hoc 5-year follow-up of the KEYNOTE-006 trial reported in The Lancet Oncology, Caroline Robert, MD, PhD, and colleagues found that pembrolizumab maintained overall and progression-free survival benefits over ipilimumab in patients with advanced melanoma. In the primary analysis from the...

Pexidartinib for Tenosynovial Giant Cell Tumor

On August 2, the oral colony-stimulating factor 1 receptor inhibitor pexidartinib was approved for treatment of adult patients with symptomatic tenosynovial giant cell tumor associated with severe morbidity or functional limitations and not amenable to improvement with surgery.1,2 It is the first...

ASTRO Elects Four New Officers to Board of Directors

The members of the American Society for Radiation Oncology (ASTRO) have elected four new officers to ASTRO’s Board of Directors. Laura Dawson, MD, FASTRO, will begin her term as President-Elect in September during ASTRO’s 61st Annual Meeting in Chicago. Neha Vapiwala, MD, was elected as ASTRO’s new ...

survivorship
supportive care
integrative oncology

Healthy Lifestyle for Young Adult Cancer Survivors

GUEST EDITOR Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief of Integrative Medicine Service at Memorial Sloan Kettering Cancer Center, New York.   The survival rates of adolescent and young adults with cancer have risen ...

breast cancer

Almost 20 Years Later, Breast Fitness Is More Relevant Than Ever

BOOKMARK Title: Breast Fitness: An Optimal Exercise and Health Plan for Reducing Your Risk of Breast CancerAuthors: Anne McTiernan, MD, PhD; Julie Gralow, MD; and Lisa TalbottPublisher: St. Martin’s PressPublication Date: October 2000 (first edition)Price: $48.75, hardcover, 352 pages   The...

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