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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...

gastroesophageal cancer
gastrointestinal cancer

Trifluridine/Tipiracil in Recurrent, Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma

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 February 22, trifluridine/tipiracil...

leukemia

FDA Approves First-Line Ivosidenib for IDH1-Mutated AML

On May 2, the U.S. Food and Drug Administration (FDA) expanded its approval of ivosidenib (Tibsovo) to include newly diagnosed acute myeloid leukemia (AML) with a susceptible IDH1 mutation, as detected by an FDA-approved test, in patients who are at least 75 years old or who have comorbidities that ...

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...

colorectal cancer
symptom management

ESMO World GI 2019: REARRANGE Trial Examines Flexible Regorafenib Dosing in Refractory Metastatic Colorectal Cancer

Regorafenib is often administered to patients with refractory metastatic colorectal cancer. However, some of the adverse events related to the use of this drug often limit its use in clinical practice. A study reported by Argilés et al at the European Society for Medical Oncology (ESMO)...

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...

ASCO Endorses Tobacco-Free Youth Act

Senate Majority Leader Mitch McConnell (R-KY) and Senator Tim Kaine (D-VA) introduced the “Tobacco-Free Youth Act,” which will work to protect youth from tobacco products and electronic nicotine delivery systems by raising the national age of sale from 18 to 21. ASCO endorsed the legislation in a...

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...

pancreatic cancer

APACT Trial: Nab-paclitaxel/Gemcitabine vs Gemcitabine Alone in Adjuvant Treatment of Pancreatic Cancer

The largest adjuvant trial in pancreatic adenocarcinoma, the global phase III APACT trial, evaluated the combination of adjuvant nab-paclitaxel/gemcitabine vs gemcitabine monotherapy in patients with resected pancreatic cancer. Results of the study were reported by Margaret A. Tempero, MD, of the...

Expert Point of View: Carlos H. Barrios, MD

“Margetuximab pLUS capecitabine may represent a new alternative combination for third-line treatment of HER2-positive metastatic breast cancer,” said -SOPHIA’s invited discussant Carlos H. Barrios, MD, of the Centro de Pesquisa em Oncologia and Latin American Cooperative Oncology Group in Porto...

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...

gastrointestinal cancer

Study Supports Neoadjuvant Chemotherapy in Operable Colon Cancer

For patients with operable colon cancer, neoadjuvant chemotherapy resulted in numerous benefits in the FOxTROT trial but did not reach target significance for the primary endpoint. The study was presented at the 2019 ASCO Annual Meeting by Matthew T. Seymour, MD, of the University of Leeds School...

colorectal cancer
immunotherapy

Targeting FOLFOXIRI Plus Bevacizumab to a Metastatic Colorectal Cancer Subset

In a population of patients with metastatic colorectal cancer deemed to be at high risk by the presence of circulating tumor cells (CTCs), first-line treatment with FOLFOXIRI plus bevacizumab improved progression-free survival by about 3 months, compared with modified FOLFOX plus bevacizumab,...

lung cancer

Advances in Targeted Therapy for Non–Small Cell Lung Cancer

Targeted therapies for non–small cell lung cancer (NSCLC) are a hotbed of investigation. Two new targeted therapies are promising for patients with lung tumors that are either EGFR exon 20 insertions or RET-rearranged. At the 2019 ASCO Annual Meeting, attendees heard early data on therapies...

Expert Point of View: Maximilian Diehn, MD, PhD

Neoadjuvant immunotherapy is potentially attractive because it addresses micrometastases early in the course of treatment and may improve compliance with systemic therapy, said formal discussant Maximilian Diehn, MD, PhD, of Stanford Cancer Institute, Stanford University School of Medicine, Palo...

Expert Point of View: Eric P. Winer, MD, FASCO, and Sandra M. Swain, MD, FACP, FASCO

Eric P. Winer, MD, FASCO, Thompson Chair in Breast Cancer Research and Professor of Medicine, Harvard Medical School, and Director of the Breast Cancer Program at Dana-Farber Cancer Institute, Boston, commented on Dr. Sparano’s presentation for The ASCO Post. “We already use information in...

breast cancer

Clinical Risk Enhances Utility of TAILORx Findings in Young Women With Breast Cancer

Clinical risk factors add prognostic information that complements the 21-gene recurrence score, according to a new analysis from the landmark TAILORx trial.1,2 The integration of clinical risk with the recurrence score provides greater precision in determining recurrence risk and guiding the use of ...

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 ...

symptom management
immunotherapy

Treatment of Immune Checkpoint Inhibitor Immune-Related Cutaneous Adverse Events

In a study reported in the Journal of Clinical Oncology, Phillips et al found that immune-related cutaneous adverse events in patients receiving immune checkpoint inhibitors generally responded to symptom- and phenotype-directed dermatologic therapies, and that biologic therapies were effective in...

lung cancer

Extended Follow-up From the National Lung Screening Trial Reported

Early detection and treatment through screening with low-dose computed tomography (LDCT) has been investigated as a potential means of reducing lung cancer mortality for more than 2 decades. In 2011, a large U.S. study—the randomized National Lung Screening Trial (NLST)—reported a 20%...

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...

solid tumors
gynecologic cancers
lymphoma
multiple myeloma

FDA Pipeline: Applications Accepted in Gynecologic Cancers, Targeted Therapies

Recently, the U.S. Food and Drug Administration (FDA) accepted a new drug application for niraparib in the treatment of certain pretreated gynecologic cancers; granted Fast Track designation to a T-cell product; accepted investigational new drug applications for a myelopreservation agent and an...

cns cancers
colorectal cancer
gynecologic cancers
kidney cancer
lung cancer

FDA Approves Bevacizumab Biosimilar for Five Cancer Types

On June 28, the U.S. Food and Drug Administration (FDA) approved bevacizumab-bvzr (Zirabev), a biosimilar to bevacizumab (Avastin), for the treatment of five types of cancer: metastatic colorectal cancer; unresectable, locally advanced, recurrent, or metastatic nonsquamous non–small cell ...

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...

breast cancer

Breast Cancer Screening With Addition of MRI to Mammography in Women With Familial Risk

The Dutch FaMRIsc study, reported in The Lancet Oncology by Saadatmand et al, found that the addition of screening magnetic resonance imaging (MRI) to mammography resulted in identification of more breast cancers—and identification at an earlier stage—vs mammography alone among women...

prostate cancer

Failure-Free Survival With Ultrahypofractionated vs Conventionally Fractionated Radiotherapy in Prostate Cancer

In the Scandinavian phase III HYPO-RT-PC trial reported in The Lancet, Widmark et al found that ultrahypofractionated radiotherapy was noninferior to conventionally fractionated radiotherapy in failure-free survival in patients with intermediate- to high- risk prostate cancer. Study Details In...

immunotherapy
head and neck cancer

Immune Therapies Emerging in Disease-Specific Treatment of HPV-Positive Head and Neck Cancer

Patients with human papillomavirus (HPV)-related head and neck cancer stand to benefit greatly from immunotherapy, according to Nabil F. Saba, MD, FACP, Director, Head and Neck Medical Oncology Program, Winship Cancer Institute of Emory University, Atlanta. He added, immunotherapy will likely play...

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:...

head and neck cancer
immunotherapy

Expert Point of View: Vanita Noronha, MD

The KEYNOTE-048 trial is practice-changing, according to its invited discussant, Vanita Noronha, MD, Professor of Oncology at Tata Memorial Centre in Mumbai, India. Although a number of questions remain to be answered, she said the take-home message is that the study “met most of its primary...

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...

Expert Point of View: Charles Drake, MD, PhD

IN A SEPARATE interview with The ASCO Post, Charles Drake, MD, PhD, commented on the clinical implications of the ENZAMET and TITAN trials, as well as studies of apalutamide, abiraterone acetate, and docetaxel used in metastatic hormone-sensitive prostate cancer. Dr. Drake is Director of...

prostate cancer

Apalutamide Improves Survival Outcomes in Castration-Sensitive Metastatic Prostate Cancer in TITAN Trial

Adding apalutamide to androgen-deprivation therapy (ADT) significantly improved survival in men with metastatic castration-sensitive (also termed hormone-sensitive) prostate cancer, according to the results of the phase III TITAN trial, which were presented at the 2019 ASCO Annual Meeting and...

head and neck cancer
immunotherapy

FDA Approves Pembrolizumab for the First-Line Treatment of Head and Neck Squamous Cell Carcinoma

On June 10, the U.S. Food and Drug Administration (FDA) approved the anti–programmed cell death protein 1 immunotherapy pembrolizumab (Keytruda) for the first-line treatment of patients with metastatic or unresectable recurrent head and neck squamous cell carcinoma. Pembrolizumab was approved for...

pancreatic cancer

Expert Point of View: Wells Messersmith, MD, and Allyson Ocean, MD

“THE RATIONALE for the POLO study is sound,” said invited study discussant Wells Messersmith, MD. “There’s clearly an unmet need in pancreatic cancer, and there are promising data for poly (ADP-ribose) polymerase (PARP) inhibitors in other BRCA-mutated tumors.” Dr. Messersmith is Professor and Head ...

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...

prostate cancer

Chemotherapy and/or Hormonal Agents: Differing Perspectives

WHEN ASKED which treatment to start with—docetaxel or enzalutamide, Dr. Sweeney said, “Patients fit for chemotherapy with high-volume disease can receive chemotherapy [docetaxel] and come back to these newer hormonal treatments or start with anyone of the hormonal options. Choosing among the newer...

prostate cancer

ENZAMET Trial Shows Enzalutamide Improves Overall Survival in Hormone-Sensitive Metastatic Prostate Cancer

Agents that improve survival in metastatic castration-resistant prostate cancer when added to background androgen-deprivation therapy (ADT) are showing success in treating metastatic prostate cancer earlier while it is still hormone-sensitive. These agents include docetaxel (chemotherapy) and...

issues in oncology

FDA Announces Project Facilitate to Access Investigational Therapies for Patients With Cancer

The Oncology Center of Excellence of the U.S. Food and Drug Administration (FDA) recently announced a new pilot program to assist oncology health-care professionals in requesting access to unapproved therapies for patients with cancer. A new call center designated Project Facilitate will be a...

Ask Your Patients About Complementary and Alternative Therapies

The most common reason that patients with cancer do not tell their physicians about using complementary and alternative medicines is that their physicians do not ask, according to a nationwide survey.1 Among 3,118 survey participants who reported a history of cancer, 1,023 (33.3%) had used a...

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...

issues in oncology
legislation

Curbside Consults: New Liability Risks to Avoid When You Are Not a Patient’s Physician

Like most clinicians, oncologists often informally consult their colleagues, both asking questions and seeking suggestions on how best to care for their patients.1,2 These informal or “curbside” consults (sometimes called “sidewalk,” “elevator,” or “hallway” consults) are valuable, because the...

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

ARAMIS Trial: Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer

In a phase III ARAMIS trial reported in The New England Journal of Medicine, Karim Fizazi, MD, of the Institut Gustave Roussy, Universite Paris-Sud, Villejuif, France, and colleagues found that the androgen-receptor antagonist darolutamide significantly prolonged metastasis-free survival vs placebo ...

skin cancer
immunotherapy

Comparison of Combination Dosing Schedules of Neoadjuvant Ipilimumab/Nivolumab in Macroscopic Stage III Melanoma

In the phase II OpACIN-neo study reported in The Lancet Oncology, Rozeman et al identified a promising dosing schedule for neoadjuvant ipilimumab/nivolumab in macroscopic stage III melanoma. Study Design The trial included 86 evaluable patients with resectable stage III melanoma involving the...

issues in oncology

AACR Environmental Carcinogenesis: Silicone-Based Wristbands for Detection of Occupational Environmental Exposures for Firefighters

First responders such as paramedics and firefighters may be exposed to hazardous occupational environmental exposures, but linking these exposures to conditions such as cancers is difficult due to the latency period of disease, magnitude of potential exposure, and potential interactions of...

colorectal cancer
issues in oncology

AACR Environmental Carcinogenesis: Lowering Exposure to Nitrates in Drinking Water May Reduce U.S. Cancer Cases

Nitrate levels in water resources have increased in many areas of the world, largely due to the use of inorganic fertilizer and animal manure in agricultural areas. Research has shown that the risk of specific cancers and birth defects may be increased when nitrate is ingested under conditions that ...

breast cancer
issues in oncology

AACR Environmental Carcinogenesis: Study Finds Environmental Quality Linked With Distant/Metastatic Breast Cancer Risk

Although many risk factors increase a woman’s chance of developing breast cancer—including genetic and hormonal causes—there is increasing evidence suggesting an environmental link. A study investigating the effects of the cumulative environmental quality on aggressive breast...

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...

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...

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