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The Bomb

I sit paralyzed at my desk. Everyone else has left the clinic. I can hear the sound of the broom in the hall as the after-hours cleaning begins. No phones ring, no patients hurry to appointments, no chatter lingers in the air. The silence is oppressive, the air is heavy, and the distance from my...

Growing Up in a Medical Family Planted the Seed for a Career in Oncology for Karen Gelmon, MD

Karen Gelmon, MD, was born and reared in Saskatoon, the largest city in the Canadian province of Saskatchewan. It is surrounded by vast prairie and situated along the Trans-Canada Yellowhead Highway and is home to the University of Saskatchewan. “We lived close to the University,” she shared. “My...

breast cancer
issues in oncology

Does Radioactive Iodine Treatment for Hyperthyroidism Increase the Risk of Cancer Mortality?

Findings from a study of patients who received radioactive iodine treatment for hyperthyroidism show a modest association between the dose of treatment and long-term risk of death from solid cancers, including breast cancer. The study, led by researchers at the National Cancer Institute (NCI), was...

lung cancer

Risk-Prediction Model Aims to Predict Incident Lung Cancer in Patients With a Pulmonary Nodule

A risk-prediction model developed using clinical and radiologic features could stratify individuals presenting with a lung nodule as having a high or low risk for lung cancer, according to a study published by Nemesure et al in Cancer Prevention Research. “While lung nodules are not...

kidney cancer
issues in oncology
immunotherapy

Benefit Seen With Targeted Therapies in Elderly and Medically Complex Patients With Metastatic RCC

Many elderly and medically complex patients with metastatic renal cell carcinoma (RCC)—who are often underrepresented in clinical trials—saw overall survival benefits from treatment with targeted therapies, according to a study that analyzed 13 years of data on Medicare patients...

colorectal cancer

ESMO World GI 2019: BEACON CRC: Encorafenib/Binimetinib/Cetuximab Improves Survival in BRAF V600E–Mutated Metastatic Colorectal Cancer

The three-drug combination of encorafenib, binimetinib, and cetuximab significantly improved overall survival in patients with BRAF-mutated metastatic colorectal cancer, according to results of the phase III BEACON CRC clinical trial. These findings were presented by Kopetz et al at the European...

issues in oncology
gastrointestinal cancer

ESMO World GI 2019: Incidence of Gastric Cancer in Younger Individuals

The incidence of gastric cancer has been increasing in younger individuals, and those under 40 with chronic digestive symptoms should be more actively investigated. These findings follow new data from a retrospective, observational study in Mexico, which showed that 1 in 7 of over 2,000...

Positive Findings From Two TAPUR Study Cohorts Presented at the 2019 ASCO Annual Meeting

Positive findings from fully enrolled cohorts in non–small cell lung cancer and metastatic breast cancer from ASCO’s Targeted Agent and Profiling Utilization Registry (TAPUR™) study were presented in poster sessions at the 2019 ASCO Annual Meeting. In addition, the study is being expanded to...

2019 Presidential Address: Caring for Every Patient, Learning From Every Patient

Welcome, everyone. We are so glad that you are all here today. Those of you attending your first ASCO Annual Meeting: Welcome to this amazing organization. What I’d like to do is to show you some of what ASCO offers, and challenge you all to join in to make a powerful future a reality. We have a...

multiple myeloma

FDA Grants Accelerated Approval to Selinexor in Combination With Dexamethasone in Pentarefractory Multiple Myeloma

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to selinexor (Xpovio) in combination with dexamethasone for adult patients with relapsed or refractory multiple myeloma who have received at least four prior therapies and whose disease is refractory to at least two...

immunotherapy
lung cancer

Combination Immunotherapy and Inhibitors of DNA Damage Repair in the Treatment of Small Cell Lung Cancer

Unlike non–small cell lung cancer (NSCLC), which has seen a paradigm shift in treatment modalities with the discovery of genetic signatures (including EGFR mutations) that are responsive to targeted drugs, systemic treatment of small cell lung cancer (SCLC) has remained largely unchanged for over...

head and neck cancer
lung cancer
issues in oncology

Do Statins Lower the Risk of Cardiovascular Complications in Patients Treated With Radiotherapy to the Chest, Neck, or Head?

Patients with cancer who took cholesterol-lowering statin medication following radiation therapy of the chest, neck, or head had significantly reduced risk of suffering a stroke—and possibly other cardiovascular complications—according to research published by Boulet et al in...

colorectal cancer

IDEA Collaboration Turns to Duration of Adjuvant Treatment in Stage II Colon Cancer

The findings of the landmark IDEA trial in stage III colorectal cancer, presented at the 2017 ASCO Annual Meeting and subsequently published in The New England Journal of Medicine,1 were upheld by a subsequent analysis by the same group, the International Duration Evaluation of Adjuvant...

Winning the Lottery

I was born at the beginning of World War II in a country half way around the world from the fighting. As a child, I was immune to the carnage. My father was too old to be included, although his elder brother had been killed in World War I. Thousands of families in many countries lost a father, a...

breast cancer

CLEOPATRA End-of-Study Analysis in Metastatic Breast Cancer: 37% Alive at 8 Years

The end-of-study analysis of the landmark CLEOPATRA trial shows that 37% of patients with HER2-positive metastatic breast cancer are still alive at 8 years, according to principal investigator Sandra M. Swain, MD, FACP, FASCO, Associate Dean for Research Development at Georgetown University Medical ...

gynecologic cancers
issues in oncology

Implementation of Minimum Hospital Volume Standards Could Impact Ovarian Cancer Surgical Care

Limiting ovarian cancer surgery to high-volume hospitals could improve survival but may also reduce access for many rural and underserved patients, a study from researchers at Columbia University Vagelos College of Physicians and Surgeons has found. The findings were published by Wright et al...

solid tumors

SNMMI 2019: Peptide Receptor Radionuclide Therapy May Be Effective in High-Grade Neuroendocrine Neoplasms

Peptide receptor radionuclide therapy (PRRT) has been shown to be safe and effective for patients with grade 3 neuroendocrine neoplasms, according to research presented at the 2019 Annual Meeting of the Society of Nuclear Medicine and Molecular Imaging (SNMMI) and published by Zhang et al in The...

prostate cancer

SNMMI 2019: PSMA PET During Lu-177–PSMA Radioligand Therapy May Help Guide Treatment

Prostate-specific membrane antigen (PSMA) positron-emission tomography (PET) imaging of patients with metastatic castration-resistant prostate cancer after two cycles of lutetium-177 (Lu-177)-PSMA radioligand therapy has shown a significant predictive value for patient survival. The research was...

lymphoma

15-ICML: Can Serum Biomarkers Provide Prognostic Information in Relapsed Mantle Cell Lymphoma?

Data presented by Lokhande et al at the 15th International Conference on Malignant Lymphoma (ICML; Abstract 360) focused on noninvasive strategies to guide patient stratification for relapsed mantle cell lymphoma. Researchers used an antibody-based platform to identify serum proteins in patients...

hematologic malignancies
multiple myeloma

IMWG Consensus Recommendations on Imaging in Monoclonal Plasma Disorders

Just as newer drugs have significantly improved outcomes for patients with multiple myeloma in the past decade, newer imaging techniques are upgrading detection of the disease, leading to earlier treatment, but standards to help guide clinicians on the optimal use of advanced imaging have lagged...

issues in oncology

Transition to Outpatient Infusional EPOCH-Based Chemotherapy at a Safety Net Hospital

In a report published in the Journal of Oncology Practice, Keshvani et al found that transitioning from inpatient to outpatient ambulatory infusional EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin)-based chemotherapy in patients with lymphoma at a safety net hospital...

issues in oncology

Accelerated Approval Program: For the Benefit of Patients

A DIAGNOSIS of any life-threatening cancer or other serious illness has always been a world-shaking event for those touched by significant disease, and most of us have known—or will know—the frustration, helplessness, and desperate sense of urgency provoked by the words, “The disease is worsening,...

2019 ASCO Educational Book Explores Practice-Changing Cancer Research

The 2019 ASCO Annual Meeting included groundbreaking science that has the potential to influence oncology care for years to come—but how should that science be applied in practice? The National Library of Medicine–indexed 2019 ASCO Educational Book aims to answer that question with compelling,...

issues in oncology

ASCO Launches Task Force to Address the Cancer Care Gap in Rural America

Despite progress being made in cancer survivorship—there are currently nearly 17 million cancer survivors in the United States1—not everyone is benefiting equally, especially those patients living in rural communities across America. According to “The State of Oncology Practice in America, 2018:...

prostate cancer

Two Studies Question the Role of Continuous LHRH Antagonists in Metastatic Castration‑Resistant Prostate Cancer

In the field of prostate cancer, the use of androgen-deprivation therapy (ADT) in men with metastatic castration-resistant prostate cancer is received wisdom. When experts are asked why ADT is continued once the disease has figured out how to evade hormone suppression, the answer invariably is...

leukemia
immunotherapy

Fixed-Duration Venetoclax Plus Obinutuzumab as First-Line Treatment in Older Patients With CLL Who Have Comorbidities

A fixed-duration regimen of venetoclax plus obinutuzumab demonstrated superior progression-free survival, complete response rates, and minimal residual disease (MRD) negativity compared with chlorambucil plus obinutuzumab as first-line therapy for older patients with chronic lymphocytic leukemia...

pancreatic cancer

POLO Trial Shows Maintenance Olaparib Improves Progression-Free Survival in Metastatic Pancreatic Cancer

In patients with metastatic pancreatic cancer and germline mutations in BRCA1 or BRCA2, maintenance therapy with olaparib doubled the time to disease progression and the proportion of patients who were progression-free at 2 years, in the phase III POLO trial.1 “Maintenance olaparib provided a...

issues in oncology
colorectal cancer

Solving the Mystery of Why Colorectal Cancer Is on the Rise in Young Adults

Excluding skin cancer, colorectal cancer is the third most prevalent and lethal cancer among both men and women in the United States.1 Although the risk of developing colorectal cancer increases with age—more than 90% of cases occur in people aged 50 or older2—recent research shows that the...

issues in oncology

An ASCO Survey, Hope, and Conventional Therapies

HOW DO YOU respond when patients with a good prognosis want to delay chemotherapy to try an anticancer diet for a few months or visit an unregulated clinic for unproven therapies? I’m asking because of an alarming finding of ASCO’s 2018 National Cancer Opinion Survey: “Nearly 4 in 10 Americans...

supportive care

Are Your Patients Using Complementary and Alternative Therapies? You Might Not Know If You Don’t Ask

Nearly one-third of patients with cancer who reported that they used complementary and alternative therapies in a nationwide survey did not tell their physicians about the use of those therapies, and the most frequently cited reason for not telling their physicians was that their physicians did...

prostate cancer

Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer: Delaying Overt Metastatic Disease Is a Major Advance

Nonmetastatic (M0) castration-resistant prostate cancer arises in the subset of men with biochemically recurrent disease (ie, rising prostate-specific antigen [PSA] level after definitive therapy in the absence of metastases) who develop PSA progression after chronic exposure to...

prostate cancer
issues in oncology

Exposure to Specific Carcinogens and Prostate Cancer Risk Among World Trade Center First Responders

Since the attacks on the World Trade Center on September 11, 2001, studies have shown an increased risk of several cancers—including multiple myeloma and prostate, head and neck, and thyroid cancers—among first responders to the scene. The results from a new study by Gong et al...

hepatobiliary cancer

Link Between Poor Oral Health and Increased Liver Cancer Risk

Poor oral health is associated with an increased risk of hepatocellular carcinoma, according to new research published by Jordão et al in the United European Gastroenterology Journal. Methods “Poor oral health has been associated with the risk of several chronic diseases, such as...

colorectal cancer

Colorectal Cancer Alliance Opens 2019 Young-Onset Colorectal Cancer Survey

The Colorectal Cancer Alliance is calling on allies to participate in its 2019 Young-Onset Colorectal Cancer Survey. The survey enables the Alliance to learn about and track the self-reported medical, psychosocial, and quality-of-life experiences of patients, survivors, and...

hematologic malignancies

Gait Speed Identifies Frailty, Could Help Predict Outcomes in Older Patients With Hematologic Cancers

The speed at which older individuals with blood cancers are able to walk 4 meters (about 13 feet) holds information about their overall health and may help to predict survival and unplanned hospital visits, according to study published by Liu et al in Blood. The association was...

What We Remember: From D-Day to Cancer Care

I RECENTLY returned from Normandy, France, where my wife and I attended events honoring the 75th Anniversary of D-Day and the millions, including close friends and family, who fought and died in the Second World War. My wife and a journalist from Los Angeles laid a wreath on Omaha Beach in honor of ...

sarcoma

Cediranib in Alveolar Soft-Part Sarcoma

In the phase II CASPS trial reported in The Lancet Oncology, Judson et al found evidence of activity of cediranib in alveolar soft-part sarcoma. In the double-blind trial, 48 patients from 12 sites in the United Kingdom, Spain, and Australia were randomly assigned 2:1 between July 2011 and July...

lung cancer
issues in oncology

Radiotherapy Increases Adverse Cardiovascular Event Risk for Patients With Lung Cancer

A new retrospective study led by investigators from Brigham and Women’s Hospital and Dana-Farber Cancer Institute examined outcomes for patients after receiving treatment for locally advanced non–small cell lung cancer (NSCLC), finding that the average radiation dose delivered to the...

cns cancers
lymphoma

Cytoreductive Surgery for Primary Central Nervous System Lymphoma

Through a systematic review of published studies, researchers report they have identified a distinct subtype of primary central nervous system (PCNS) lymphoma that should be considered for surgical removal, suggesting a major shift in how this type of tumor is evaluated and managed. These findings...

hepatobiliary cancer
pancreatic cancer

Serum MicroRNAs for the Diagnosis of Pancreatic and Biliary Tract Cancers

Diagnosis of pancreatic and biliary tract cancers is complex and challenging due to the lack of symptoms and/or the difficulty of direct, invasive, and imaging-based methods of diagnosis. In an effort to develop better diagnostic markers for these diseases, Kim et al analyzed the genome-wide...

colorectal cancer
hepatobiliary cancer
myelodysplastic syndromes
immunotherapy

FDA Pipeline: Designations and Reviews in Myelofibrosis, Myelodysplastic Syndromes, Biliary Tract Cancer, and T-Cell Receptor Therapy

Recently, the U.S. Food and Drug Administration (FDA) granted Fast Track designation for momelotinib in myelofibrosis, granted Priority Review to a biologics license application for luspatercept in myelodyslastic syndromes and beta-thalassemia, granted Orphan Drug designation for a new chemical...

issues in oncology
supportive care

Patient Perceptions of Management of Cancer-Related Pain, Fatigue, and Emotional Distress in Community Oncology Centers

In a study reported in the Journal of Clinical Oncology, Smith et al found that a high proportion of patients in community cancer centers did not report discussing, getting advice, or receiving desired help for cancer-related pain, fatigue, or emotional distress. The study involved surveys of...

skin cancer
immunotherapy

2019 ASCO: OPTiM Study on T-VEC for Unresectable Melanoma

New research on the immunotherapy talimogene laherparepvec (T-VEC)—an injectable oncolytic virus—for patients with unresectable melanoma was presented by Milhem et al at the 2019 ASCO Annual Meeting (Abstract 9524). Researchers reported the ad hoc analysis of progression-free survival...

prostate cancer

2019 ASCO: TOPARP-B Finds Olaparib Shows Efficacy in Men With BRCA-Mutant Prostate Cancer

The poly (ADP-ribose) polymerase (PARP) inhibitor olaparib may benefit some men with prostate cancer, according to findings from the phase II TOPARP-B trial presented by Mateo et al at the 2019 ASCO Annual Meeting (Abstract 5005).   Olaparib previously showed activity against metastatic...

issues in oncology

2019 ASCO: Discrimination, Gender Bias in Oncology Training and Professional Meetings

Two studies that explored types of discrimination and gender bias in health-care organizations were presented at the 2019 ASCO Annual Meeting. Discrimination Experienced by Fellows An abstract that reviewed discrimination and inclusion among hematology and oncology trainees was presented by...

cns cancers

As My Outside World Became Smaller, My Family Focus Became Larger

As I write this, I think I’m making sense but am not 100% sure. My brain is a little scrambled after nearly 4 years of treatment for grade 4 glioblastoma multiforme, but I think the essence of my humor and humanity is still intact. When I experienced my first partial seizure while riding my...

issues in oncology
health-care policy

Major Settlement Raises Questions About Evidence-Based Value in Cancer Care

An Oklahoma jury recently awarded $25.5 million to the widower of a 53-year-old woman diagnosed with stage IV nasopharyngeal cancer who was denied coverage for proton therapy by her health insurer, Aetna. The patient’s family subsequently raised $92,000 to cover her proton therapy at The University ...

hematologic malignancies

Selected Abstracts From the 2019 ASCO Annual Meeting

To complement The ASCO Post’s comprehensive coverage of the 2019 ASCO Annual Meeting, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic regimens for plasma cell dyscrasias, particularly multiple myeloma. For full details of these study abstracts, visit ...

lung cancer
immunotherapy

2019 ASCO: NEOSTAR: Neoadjuvant Nivolumab Plus Ipilimumab in Early-Stage, Resectable NSCLC

Neoadjuvant treatment with nivolumab plus ipilimumab resulted in an overall major pathologic response rate of 33% of treated patients with early-stage, resectable non–small cell lung cancer (NSCLC). With these results, the combination immunotherapy met the prespecified trial...

skin cancer

UMass Lowell Student Wins Award for Research in Skin Cancers

Tyler Iorizzo, a PhD candidate in physics at UMass Lowell’s Advanced Biophotonics Laboratory, has won international recognition for his work in developing an imaging device that could lead to improved diagnosis and treatment of certain skin cancers. Mr. Iorizzo received an Educational Award from...

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