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breast cancer

I Live My Life in 3- to 6-Month Increments

I first noticed a lump in my left breast in 2001 while taking a shower and shrugged it off. After all, men don’t get breast cancer. To assuage my wife’s concern that I at least have the lump examined, I consented to see our family physician, who agreed that men don’t get breast cancer because, he...

prostate cancer

Adverse Pathologic Findings in Low-Volume Intermediate-Risk Prostate Cancer

In a single-center analysis reported in JAMA Oncology, Patel et al found that among men undergoing elective radical prostatectomy, those with low-volume intermediate-risk disease had significantly higher rates of adverse pathologic findings compared than did those with very low-risk and low-risk...

breast cancer

Cancer Care Ontario and ASCO Clinical Practice Guideline: Use of Adjuvant Bisphosphonates and Other Bone-Modifying Agents in Breast Cancer

As reported in the Journal of Clinical Oncology by Sukhbinder Dhesy-Thind, MD, MSc, FRCPC, of Juravinski Cancer Centre, Hamilton Health Sciences, and colleagues, Cancer Care Ontario and ASCO have issued a clinical practice guideline on the use of adjuvant bisphosphonates and other bone-modifying...

breast cancer

Advances in the Treatment of Triple-Negative Breast Cancer

WITHIN THE SPECTRUM of breast cancer subtypes, triple-negative disease is “particularly troubling,” but better scientific understanding of this malignancy is leading to advances in its treatment, according to breast cancer expert Nancy Davidson, MD.  Triple-negative breast cancer does not express...

hematologic malignancies
multiple myeloma
lymphoma
leukemia
myelodysplastic syndromes

Selected Abstracts on Novel Therapies for Hematologic Malignancies

THE 22ND CONGRESS of the European Hematology Association (EHA) was held in June in Madrid, drawing hematologists and allied professionals from every subspecialty of hematology from around the world. Among the extensive educational and scientific program, the EHA Congress provides a forum for...

colorectal cancer

New Data Reported on Vemurafenib, Vitamin D, Selective Internal Radiotherapy, and Circulating Tumor DNA in Colorectal Cancer

RESULTS OF the IDEA trial, which showed that some patients with stage III low-risk colon cancer may require less oxaliplatin therapy (see the June 25 issue of The ASCO Post), were among the findings highlighted at the 2017 ASCO Annual Meeting Plenary Session. Other studies of interest in colorectal ...

breast cancer
leukemia
supportive care
gastrointestinal cancer

FDA Actions Yield Extended Approvals of Novel Agents, Advisory Committee Votes Favorably on Two Biosimilars and Pediatric Indication for CAR T-Cell Therapy

DURING JULY, the U.S. Food and Drug Administration (FDA) and its Oncologic Drugs Advisory Committee (ODAC) made a number of approvals and recommendations on a variety of oncology products.  Neratinib  ON JULY 1 7, the FDA approved neratinib (Nerlynx) for the extended adjuvant treatment of adult...

sarcoma

Clinical Trials Actively Recruiting Patients With Sarcomas

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on sarcomas. These studies are focusing on anticancer vaccines, T-cell therapy, combination chemotherapy, pathway inhibitors, preoperative radiotherapy, and more. All of the...

issues in oncology
solid tumors

FDA’s First Site-Agnostic Drug Approval Marks a Paradigm Shift in Regulatory Criteria

IN MAY, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for patients with solid tumors that have the microsatellite instability–high (MSI-H) or mismatch repair deficient (dMMR) biomarker, which disrupts the ability of cells to repair DNA. The...

issues in oncology

Tissue Specimens in Clinical Trials: A Double-Edged Sword

AN INCREASING number of clinical trials require the submission of tissue specimens, either from archived specimens or increasingly from fresh biopsies taken after enrollment into the trial. These specimens can be either mandatory, required to determine whether a given patient has the required...

breast cancer

A New Triumvirate in Estrogen Receptor–Positive Metastatic Breast Cancer

THE BODY OF EVIDENCE supporting the use of cell-cycle inhibitors in combination with endocrine therapy for estrogen receptor–positive metastatic breast cancer now has another agent in the spotlight. The phase III MONARCH 2 trial—reported at the 2017 ASCO Annual Meeting and by Sledge et al in the...

issues in oncology
health-care policy

First Oncologist Elected AMA President, Barbara L. McAneny, MD, Advocates for Access to Health Care for Everyone

Since the founding of the American Medical Association (AMA) in 1847, Barbara L. McAneny, MD, is the fourth woman and first oncologist to be elected President of the venerable medical association. “I’m a generic Midwesterner. I was born in Missouri and raised in Madison County, Illinois, and went...

leukemia

Asparaginase-Associated Pancreatitis in Childhood Acute Lymphoblastic Leukemia

An observational study reported in The Lancet Oncology by Wolthers et al in the Ponte di Legno Toxicity Working Group identified characteristics and the course of asparaginase-associated pancreatitis in childhood acute lymphoblastic leukemia. Study Details The study involved merged data from...

skin cancer

Standard-Dose Pembrolizumab Plus Reduced-Dose Ipilimumab in Advanced Melanoma

In the phase IB KEYNOTE-029 study, standard-dose pembrolizumab (Keytruda) plus reduced-dose ipilimumab (Yervoy) produced high response rates in patients with advanced melanoma. These results were reported by Long et al in The Lancet Oncology. Study Details In the study, 153 patients with...

prostate cancer

Association Between Vasectomy and Prostate Cancer

A systematic review and meta-analysis has found no association between vasectomy and high-grade, advanced, or fatal prostate cancer but a weak association with any prostate cancer. These findings were reported in JAMA Oncology by Bhindi et al. Study Details The analysis involved 53 studies,...

breast cancer

Genetic Study Identifies Susceptibility Loci Modifying Risk for Breast Cancer After Radiation Therapy for Childhood Cancer

As reported in the Journal of the National Cancer Institute, Morton et al have identified gene loci associated with radiation-related risk of breast cancer in survivors of childhood cancer. Study Details The study was a genome-wide association study of breast cancer in female survivors of...

prostate cancer

Surgery vs Observation in Localized Prostate Cancer: Long-Term Follow-up of PIVOT Trial

After 19.5 years of follow-up in the PIVOT trial, radical prostatectomy was not associated with significantly improved all-cause or prostate cancer mortality vs observation among men with localized prostate cancer. The long-term follow-up data were reported in The New England Journal of Medicine by ...

solid tumors

NCI-COG Pediatric MATCH Trial to Test Targeted Drugs in Childhood Cancers

Today, investigators at the National Cancer Institute (NCI) and the Children’s Oncology Group (COG) announced the opening of enrollment for a unique precision medicine clinical trial. NCI-COG Pediatric Molecular Analysis for Therapy Choice (Pediatric MATCH) is a nationwide trial to explore...

skin cancer

FDA Expands Approval of Ipilimumab to Include Pediatric Patients 12 Years and Older With Unresectable or Metastatic Melanoma

Today, the U.S. Food and Drug Administration (FDA) expanded the indication for ipilimumab (Yervoy) injection for intravenous use to now include the treatment of unresectable or metastatic melanoma in pediatric patients 12 years of age and older. Ipilimumab was evaluated in 2 trials of pediatric...

solid tumors

COX-2 Inhibitors May Reverse IDO1-Mediated Immunosuppression in Some Cancers

In preclinical studies, tumors that consitutively expressed the protein indoleamine 2,3-dioxygenase (IDO1) responded to the cyclooxygenase-2 (COX-2) inhibitor celecoxib (Celebrex) and had improved infiltration of certain subsets of T cells, making them more likely to respond to...

Register Now for QOPI® QCDR for 2017 CMS MIPS Reporting: One Patient, One Measure, No Penalty

ASCO is pleased to announce that its Quality Oncology Practice Initiative (QOPI®) Qualified Clinical Data Registry (QCDR) is available now for the Centers for Medicare and Medicaid Services (CMS) Merit-Based Incentive Payment System (MIPS) reporting. By using the QOPI® QCDR for MIPS reporting,...

head and neck cancer

Pembrolizumab and Cetuximab-Treated Head and Neck Cancer: Activity Confirmed But No Surprises

WITH THE RECENT efficacy findings, improvements in survival, and resultant U.S. Food and Drug Administration (FDA) approvals of programmed cell death protein 1 (PD-1) immune checkpoint inhibitors across multiple solid tumor indications, the publication of yet another positive trial adds to the...

head and neck cancer

Pembrolizumab Is Active in Platinum- and Cetuximab-Refractory Head and Neck Cancer

IN THE PHASE II KEYNOTE-055 trial, pembrolizumab (Keytruda) was found to produce durable responses in patients with platinum- and cetuximab (Erbitux)-refractory head and neck squamous cell carcinoma.1 Results of the trial were reported by Joshua Bauml, MD, of the University of Pennsylvania,...

bladder cancer

Pembrolizumab in Second-Line Therapy for Advanced Urothelial Carcinoma

THE TREATMENT OF metastatic urothelial carcinoma experienced a long period of stagnation until the recognition that targeting the programmed cell death protein 1 (PD-1) pathway could yield deep and durable responses.1-3 Cisplatin-based combination chemotherapy has been the reference standard for...

cns cancers

Analysis Reveals Genomic Alterations, Oncogenes Driving Medulloblastoma Subtypes

The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75% of the brain tumors, including two new suspected cancer genes that were found exclusively in the least understood disease subgroups. The study from an international research...

bladder cancer

Pembrolizumab Improves Overall Survival vs Chemotherapy in Second-Line Therapy for Advanced Urothelial Carcinoma

IN THE PHASE III KEYNOTE-045 trial reported in The New England Journal of Medicine, Joaquim Bellmunt, MD, PhD, of Dana-Farber Cancer Institute, and colleagues found that pembrolizumab (Keytruda) significantly improved overall survival vs investigator choice of chemotherapy as second-line treatment ...

gynecologic cancers

Expert Point of View: Ritu Salani, MD, MBA

STUDY DISCUSSANT Ritu Salani, MD, MBA, of The Ohio State University Wexner Medical Center, Columbus, agreed with the LION trial investigators.  “Omitting systemic lymph node dissection in patients who have both radiographic and clinically negative lymph nodes is acceptable,” she said. “I always...

cost of care

ASCO Offers Path to Addressing Affordability of Cancer Drugs in New Position Statement

Today, ASCO issued a position statement aimed at contributing to the national dialogue on rising cancer drug prices. The statement, which asserts that any solutions must also preserve patients' access to care and foster innovation, analyzes a wide array of options and recommends that a panel of...

skin cancer

Educating Young People on Sun-Safe Behaviors and Reducing the Risk of Melanoma

“If minors don’t tan, then they may never become adult tanners,” Jeffrey E. Gershenwald, MD, said in explaining the emphasis on teaching sun safety behaviors to young children as part of the Melanoma Moon Shot Program at The University of Texas MD Anderson Cancer Center, Houston. Dr. Gershenwald is ...

lung cancer

Prophylactic Cranial Irradiation vs Observation in Extensive-Disease Small Cell Lung Cancer

A Japanese phase III trial has shown no survival benefit of prophylactic cranial irradiation vs observation in patients with extensive-disease small cell lung cancer who had any response to platinum-based doublet chemotherapy and no brain metastases at baseline. These findings were reported in The...

bladder cancer

Avelumab in Refractory Metastatic Urothelial Carcinoma

The programmed cell death ligand 1 (PD-L1)–inhibitor avelumab (Bavencio) has shown activity in patients with refractory metastatic urothelial cancer, according to findings in a phase Ib study reported by Andrea B. Apolo, MD, of the Genitourinary Malignancies Branch, Center for Cancer Research,...

integrative oncology

Shiitake Mushroom: Insufficient Evidence to Support It Boosts Immune System

In the June 25 issue of The ASCO Post, the Integrative Oncology column by Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, focused on how to counsel a patient about shiitake mushroom. They concluded: “We advised our patient that it is safe to take shiitake mushroom to boost her immune system.”...

A Frank Memoir About Doctors, Patients, and the Health-Care System

“In 1981, 2 days after my older brother Matthew was born, my father sawed off the tip of his index finger.” So begins No Apparent Distress: A Doctor’s Coming of Age on the Front Lines of American Medicine, a memoir by Rachel Pearson, MD, who is currently a resident at Seattle Children’s Hospital. ...

multiple myeloma
survivorship

Living With Cancer Survivorship Guilt

Although I was officially diagnosed with multiple myeloma in 1997, the first sign of the cancer was evident 2 years earlier, when a single lesion (a plasmacytoma) was found in a bone in my lower back. The bone was replaced with two thin stainless steel rods, and after a course of radiation therapy, ...

supportive care
palliative care

Ensuring Advance Directives Are Followed and Lawsuits Are Avoided

Thaddeus Mason Pope, JD, PhD, has focused his legal career on improving medical care decision-making and protecting patients’ rights at the end of life. His specific areas of legal expertise include patients’ rights, informed consent, and end-of-life medicine. Dr. Pope is the coauthor of The Right ...

supportive care
palliative care

Advance Care Planning: Ensuring Patients’ End-of-Life Wishes Are Honored

When Amy Berman, BSN, LHD (aged 58), stood in front of the mirror to perform a routine breast self-exam and saw redness and dimpling on her right breast, she feared they were the telltale signs of inflammatory breast cancer. “I have never self-diagnosed myself before, but I had recently read an...

lung cancer

Adding Pravastatin to Chemotherapy in Small Cell Lung Cancer

Following early reports associating favorable outcomes in cancer patients with the use of statins,1,2 further observational studies in this area have provided mixed findings.3 As recently reported in the Journal of Clinical Oncology, and reviewed in this issue of The ASCO Post, Seckl and colleagues ...

lung cancer

No Survival Benefit When Pravastatin Is Added to Standard Chemotherapy in Small Cell Lung Cancer

In a UK phase III study (LUNGSTAR) reported in the Journal of Clinical -Oncology, Michael J. Seckl, MD, PhD, of Imperial College London, and colleagues found that adding pravastatin to first-line standard chemotherapy did not improve overall survival in patients with small cell lung cancer...

breast cancer

Neoadjuvant Radiation Reduces Risk of Secondary Tumors in Early-Stage Breast Cancer

Moffitt Cancer Center researchers conducted a first-of-its-kind study comparing the long-term benefits of radiation therapy in women with breast cancer in the neoadjuvant and adjuvant settings. Their study, published by Poleszczuk et al in Breast Cancer Research, found that patients who have...

issues in oncology

The Immune System: Deciphering Recent Advances

Over the past decade, there has been renewed interest in developing immunologic therapies in cancer. The U.S. Food and Drug Administration (FDA) has approved several new biologic agents that target a patient’s immune system, some of which have produced profound clinical responses. However, the...

issues in oncology

FDA Takes Action Against 14 Companies for Selling Illegal Cancer Treatments

On April 25, the U.S. Food and Drug Administration (FDA) posted warning letters addressed to 14 U.S.-based companies illegally selling more than 65 products that fraudulently claim to prevent, diagnose, treat, or cure cancer. The products are marketed and sold without FDA approval, most commonly...

breast cancer

FDA Approves Neratinib for Extended Adjuvant Treatment of Early-Stage HER2-Positive Breast Cancer

Today, the U.S. Food and Drug Administration approved neratinib (Nerlynx) for the extended adjuvant treatment of adult patients with early-stage HER2-overexpressed/amplified breast cancer, to follow adjuvant trastuzumab (Herceptin)-based therapy. ExteNET Trial Approval was based on the ExteNET...

issues in oncology

Cancer Risk May Be Higher Among Holocaust Survivors

A new study indicates that survivors of the Holocaust have experienced a small but consistent increase in the risk of developing cancer. Published by Sadetzki et al in Cancer, the findings offer an example of how extreme population-level tragedies can have an impact on health. Holocaust survivors...

skin cancer

Overall Survival With Nivolumab vs Chemotherapy in Ipilimumab-Refractory Advanced Melanoma

As reported in the Journal of Clinical Oncology by Larkin et al, the phase III CheckMate 037 trial has shown no difference in overall survival with nivolumab (Opdivo) vs investigator’s choice of chemotherapy in ipilimumab (Yervoy)-refractory advanced melanoma. More chemotherapy patients never ...

breast cancer

Effect of Patient-Reported Symptoms on Adherence to Preventive Treatment for Breast Cancer

In an analysis of the UK cohort of the International Breast Cancer Intervention Study (IBIS-I) reported in the Journal of Clinical Oncology, Smith et al found similar effects of predefined symptoms on nonadherence in both tamoxifen and placebo recipients. IBIS-I randomized women at high risk of...

multiple myeloma

FDA Places Clinical Hold on Three Studies Evaluating Pembrolizumab in Multiple Myeloma

On July 5, Merck announced that the U.S. Food and Drug Administration (FDA) has placed a clinical hold on KEYNOTE-183, KEYNOTE-185, and KEYNOTE-023, three combination studies of pembrolizumab (Keytruda), an anti–programmed cell death protein 1 (PD-1) therapy, in multiple myeloma. This...

pancreatic cancer

Has a New Standard Really Been Established for the Adjuvant Treatment of Pancreatic Cancer?

THE PAST YEAR has undoubtedly been a disappointing one as far as clinical advances in pancreatic cancer go. No fewer than five high-profile randomized phase II or III trials in this setting reported negative results in 2016, ranging from next-generation cytotoxic agents1 to novel immunotherapeutic ...

lymphoma

Encouraging Results With Pembrolizumab in Relapsed/Refractory Classical Hodgkin Lymphoma

AN EFFECTIVE antitumor immune response relies on cytotoxic T cells that are activated and able to target the malignant clone. As T cells become activated, they upregulate suppressive receptors including programmed cell death protein 1 (PD-1). Upregulation of inhibitory signals is important to...

lymphoma

Pembrolizumab Is Highly Active in Relapsed/Refractory Classical Hodgkin Lymphoma

AS REPORTED in the Journal of Clinical Oncology by Robert Chen, MD, of City of Hope National Medical Center, and colleagues, the phase II KEYNOTE-087 trial has shown that the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda) is highly active in patients with relapsed/...

ASCO’s New MACRA Decision Tree Tool Helps Determine Which QPP Reporting Requirements Apply to Your Practice

Believe it or not, we’re halfway through the 1st year of the Quality Payment Program (QPP). ASCO, the Centers for Medicare & Medicaid Services (CMS), and other stakeholders have released guidance on successfully complying with QPP, but tailored information addressing a practice’s specific...

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