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Emily Johnston, MD, MS, thinks about death a lot. “I wish we would stop saying people ‘lost a battle’ with cancer when someone dies,” she said. Dr. Johnston specializes in pediatric oncology at Children’s of Alabama hospital. Conquering cancer, she believes, doesn’t simply mean surviving it—it...
CMS Finalizes Updates to E&M Codes, Establishes MIPS Value Pathways
The Centers for Medicare & Medicaid Services (CMS) released its final rule for the 2020 Medicare Physician Fee Schedule (MPFS) and other changes to Medicare Part B reimbursement policies, including proposals related to the Quality Payment Program (QPP). The estimated impact of the final MPFS...
Trastuzumab and Hyaluronidase-oysk for Subcutaneous Use in HER2-Positive Breast Cancer
Early in 2019, trastuzumab and the endoglycosidase hyaluronidase-oysk for subcutaneous injection was approved in the treatment of HER2-positive breast cancer.1,2 The agent is indicated for adjuvant treatment of patients with HER2-overexpressing node-positive or node-negative (estrogen...
Taking a Reasonable Approach to Treating Newly Diagnosed Multiple Myeloma
Multiple myeloma is a malignancy characterized by clonal proliferation of terminally differentiated plasma cells within the bone marrow. Although it leads to a host of different issues within the body, overall survival has steadily improved in recent years. “This is largely because of better...
KEYNOTE-013 and KEYNOTE-170: Improving the Precision of Checkpoint Blockade in Patients With Diffuse Large B-Cell Lymphoma
Primary mediastinal B-cell lymphoma is an uncommon but distinct clinicopathologic variant of diffuse large B-cell lymphoma (DLBCL) that typically presents with an aggressive mediastinal mass and invasion of local structures. Most patients are young, typically in their 20s and 30s, and there is a...
Pembrolizumab in Relapsed or Refractory Primary Mediastinal Large B-Cell Lymphoma: KEYNOTE-013 and KEYNOTE-170
Findings in the phase Ib KEYNOTE-013 and phase II KEYNOTE-170 trials, reported in the Journal of Clinical Oncology by Philippe Armand, MD, PhD, of DanaFarber Cancer Institute, and colleagues, indicate that pembrolizumab is active in relapsed or refractory primary mediastinal large B-cell...
Pembrolizumab vs Cetuximab Plus Chemotherapy in Recurrent or Metastatic Head/Neck Squamous Cell Cancer
As reported in The Lancet by Barbara Burtness, MD, of the Department of Medicine, Yale University School of Medicine, and colleagues, the phase III KEYNOTE-048 trial has shown improved overall survival with first-line pembrolizumab plus chemotherapy vs cetuximab plus chemotherapy among patients...
Time to Treatment Is a Priority
Dr. Smith called us on a Tuesday afternoon. “I have a patient who has an abnormal mammogram showing a large mass. I’m suspecting cancer and am referring her to you for diagnosis and treatment. She’s very anxious. I hope you can help.” We were able to get Dr. Smith’s patient in the next day for...
Novel Antibody-Drug Conjugate Shows Efficacy in Women With Pretreated, Metastatic HER2-Positive Breast Cancer
The novel antibody-drug conjugate [fam-] trastuzumab deruxtecan (T-DXd) achieved high response rates and durable responses in heavily pretreated patients with HER2-positive metastatic breast cancer, according to results of the phase II DESTINY-Breast 01 trial presented at the 2019 San Antonio...
FDA Pipeline: Priority Reviews in SCLC, Bladder Cancer, Colorectal Cancer
Recently, the U.S. Food and Drug Administration (FDA) granted Priority Reviews for treatments in extensive-stage small cell lung cancer (SCLC), non–muscle invasive bladder cancer, and BRAF V600E–mutant colorectal cancer. The Agency also recently issued multiple Breakthrough Therapy designations and ...
FDA Approves Fam-Trastuzumab Deruxtecan-nxki for Patients With Unresectable or Metastatic HER2-Positive Breast Cancer
On December 20, the U.S. Food and Drug Administration (FDA) granted accelerated approval to fam-trastuzumab deruxtecan-nxki (Enhertu) for patients with unresectable or metastatic HER2-positive breast cancer who have received two or more prior anti–HER2-based regimens in the metastatic setting....
Fractionated Tisagenlecleucel Infusion for Adults With B-Cell Acute Lymphoblastic Leukemia May Improve Safety Without Reducing Efficacy
As reported by Noelle V. Frey, MD, and colleagues in the Journal of Clinical Oncology, single-center experience with the anti-CD19 chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel has shown that high-dose fractionated infusion with the ability to modify dosing in case of early signs...
The Antiseptic Era: 1876–1900
The text and photographs here are excerpted from a four-volume series of books titled Oncology: Tumors & Treatment, A Photographic History, The Antiseptic Era: 1876–1900 by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. The photographs appear courtesy of Dr. Burns and The Burns Archive. To ...
Global Survey Shows Misperceptions About Lung Cancer Among the General Public
Only one in five people (22%) disagrees with the statement “generally, patients with lung cancer have caused their illness through their lifestyle choices and behaviors,” according to a global, omnibus survey conducted by Ipsos MORI and sponsored by the Lung Ambition Alliance. The results were...
Gilteritinib for Relapsed or Refractory AML With FLT3 Mutation
Late in 2018, the FLT3 inhibitor gilteritinib was approved for the treatment of adult patients who have relapsed or refractory acute myeloid leukemia (AML) with a FLT3 mutation, as detected by a U.S. Food and Drug Administration (FDA)-approved test.1,2 The FDA also approved an expanded indication...
Selected Abstracts From the 2019 ASH Annual Meeting & Exposition
To complement The ASCO Post’s comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic regimens for acute myeloid leukemia (AML). For full details of these...
Pembrolizumab in Adjuvant Treatment of Melanoma With Involvement of Lymph Nodes After Complete Resection
In early 2019, pembrolizumab was approved for the adjuvant treatment of patients with melanoma with involvement of lymph node(s) following complete resection.1,2 Supporting Efficacy Data Approval was based on findings in the double-blind EORTC 1325/KEYNOTE-054 trial (ClinicalTrials.gov identifier...
Long-Term Data on Brigatinib in First-Line Setting of ALK-Positive Non–Small Cell Lung Cancer
Updated data from the phase III ALTA-1L trial were presented by D. Ross Camidge, MD, PhD, of the University of Colorado Cancer Center, Aurora, during the Presidential Session at the European Society for Medical Oncology (ESMO) Asia Congress 2019 in Singapore.1 The trial evaluated brigatinib vs...
Coexisting With Cancer and Depression
Among the highlights at the 2019 Supportive Care in Oncology Symposium in October was the keynote address by Thomas J. Smith, MD, FACP, FASCO, FAAHPM, the Harry J. Duffey Family Professor of Palliative Medicine and Director of Palliative Medicine at Johns Hopkins Medicine and Professor of Oncology ...
Improved Prevention of Graft-vs-Host Disease Reported With Posttransplant Cyclophosphamide
Following allogeneic hematopoietic stem cell transplantation, cyclophosphamide significantly reduced grades II to IV acute and chronic extensive graft-vs-host disease compared with conventional immunosuppression, investigators reported during the Plenary Session at the 2019 American Society of...
Acalabrutinib for Adult Patients With Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma
On November 21, 2019, the Bruton’s tyrosine kinase (BTK) inhibitor acalabrutinib was approved for the treatment of adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).1,2 The review resulting in approval was conducted under Project Orbis, an initiative of the U.S....
First-Line Weekly Dose-Dense Chemotherapy in Epithelial Ovarian Cancer: ICON8 Trial
In the phase III Gynecologic Cancer Intergroup ICON8 trial reported in The Lancet, Clamp et al found that first-line weekly dose-dense chemotherapy did not improve progression-free survival vs standard 3-weekly chemotherapy in a predominantly European population with epithelial ovarian cancer....
ASCO/NCODA Release Standards for Medically Integrated Dispensing of Oral Anticancer Drugs
ASCO and the National Community Oncology Dispensing Association (NCODA) have published recommended standards for medically integrated dispensing of oral anticancer therapies and supportive care medications in the oncology clinic.1 “The NCODA created quality standards 6 years ago and recognized the ...
Nivolumab for Mismatch Repair–Deficient Noncolorectal Cancers
In a study (NCI-MATCH trial subprotocol, arm Z1D) reported in the Journal of Clinical Oncology, Azad et al found that nivolumab was active in mismatch repair–deficient noncolorectal cancers. As stated by the investigators, “The National Cancer Institute Molecular Analysis for Therapy Choice...
Relapsed or Refractory Multiple Myeloma Outcomes Improving Exponentially
Emerging treatments for relapsed or refractory multiple myeloma include options beyond triplet regimens, including immunotherapy and mutation-driven therapy. Several exciting drugs are poised to be available in the clinic in 2020, according to speakers at the recent JADPRO Live, the annual...
Expert Point of View: Thierry Facon, MD, and Michael Jain, MD, PhD
Thierry Facon, MD, Professor of Hematology at Lille University Hospital in France, and Michael Jain, MD, PhD, of Moffitt Cancer Center, Tampa, were interviewed by The ASCO Post on the second-generation chimeric antigen receptor (CAR) T-cell products for treating multiple myeloma. According to Dr. ...
Phase Ib/II Studies Explore Next-Generation BCMA-Targeted CAR T-Cell Therapies in Multiple Myeloma
In patients with relapsed or refractory multiple myeloma, two novel dual-target chimeric antigen receptor (CAR) T-cell strategies are yielding early and durable responses, with seemingly less cytokine-release syndrome and neurotoxicity than first-generation CAR T-cell products, according to the...
ESMO Immuno-Oncology 2019: Safety Analysis Results for First-Line Durvalumab Plus Platinum/Etoposide in Extensive-Stage SCLC
Few grade 3 or higher immune-related adverse events were observed in patients treated with first-line durvalumab plus platinum/etoposide for extensive-stage small cell lung cancer (SCLC), according to findings from the safety analysis of the phase III CASPIAN study presented by Özgüroğlu et al at...
How to Give Effective Presentation Feedback
Giving an effective scientific presentation, like all public speaking, is an acquired skill that takes practice to perfect. When delivered successfully, an oral presentation can be an invaluable opportunity to showcase your latest research results among your colleagues and peers. It can also...
Veliparib/Chemotherapy Combination Active in HER2-Negative BRCA-Positive Advanced Breast Cancer
The addition of the poly (ADP-ribose) polymerase (PARP) inhibitor veliparib to carboplatin/paclitaxel chemotherapy significantly improved progression-free survival in patients with advanced HER2-negative breast cancer and germline BRCA mutation compared with placebo plus chemotherapy, according to...
Pembrolizumab in Refractory Metastatic Castration-Resistant Prostate Cancer
In the phase II KEYNOTE-199 study, reported in the Journal of Clinical Oncology by Antonarakis et al, pembrolizumab showed activity and had an acceptable safety profile in patients with treatment-refractory metastatic castration-resistant prostate cancer. Study Details The trial was conducted at 85 ...
Early Research Shows Potential New Targets in Treating Glioblastoma, Colorectal Cancer, and Pancreatic Ductal Adenocarcinoma
Glioblastoma multiforme, colorectal cancer, and pancreatic ductal adenocarcinoma represent some of the most difficult-to-treat cancers and collectively cause more than 114,000 deaths each year in the United States. A trio of recently published basic research studies in these cancers have found...
First-Line Atezolizumab Plus Nab-paclitaxel in Advanced Triple-Negative Breast Cancer: Second Overall Survival Interim Analysis
As reported in The Lancet Oncology by Peter Schmid, MD, and colleagues, the prespecified second interim analysis of overall survival in the phase III IMpassion130 trial has shown no overall survival benefit with the addition of atezolizumab to nab-paclitaxel as first-line treatment of unresectable, ...
Study Links Sustained Weight Loss to Reduced Breast Cancer Risk
A new study finds that women who lost weight after age 50 and kept it off had a lower risk of breast cancer than women whose weight remained stable, helping answer a vexing question in cancer prevention.1 The reduction in risk increased with the amount of weight lost and was specific to women not...
FDA Approves Enzalutamide for Patients With Metastatic Castration-Sensitive Prostate Cancer
On December 16, the U.S. Food and Drug Administration (FDA) approved enzalutamide (Xtandi) for patients with metastatic castration-sensitive prostate cancer. The FDA previously approved enzalutamide for patients with castration-resistant prostate cancer. ARCHES Trial Efficacy was investigated in...
Immunotherapy for Head/Neck Squamous Cell Carcinoma: Questions Raised by KEYNOTE-048
There is a new first-line treatment option for patients with newly diagnosed, recurrent, or metastatic head and neck squamous cell carcinoma. As reported by Burtness et al in The Lancet, pembrolizumab improved overall survival vs the standard-of-care regimen of cetuximab and platinum-based...
Evaluation of Residual Disease in Patients With Multiple Myeloma Using IMWG Flow Cytometry Criteria
In a study reported in the Journal of Clinical Oncology, Paiva et al examined the applicability of International Myeloma Working Group (IMWG) criteria for next-generation flow cytometry assessment of minimal residual disease (MRD) in multiple myeloma. They found that the IMWG flow MRD-negative...
ESMO Immuno-Oncology 2019: CXCR4 Inhibitor in Combination With Pembrolizumab/Chemotherapy for Metastatic Pancreatic Cancer
When the CXCR4 inhibitor BL-8040 was combined with the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab plus chemotherapy in the second-line setting, the regimen showed promising antitumor activity in patients with metastatic pancreatic ductal adenocarcinoma. These findings were...
ESMO Immuno-Oncology 2019: Sitravatinib/Tislelizumab Shows Antitumor Activity in Ovarian Cancer
Results from a phase Ib study reported at the European Society for Medical Oncology (ESMO) Immuno-Oncology Congress 2019 showed manageable safety and encouraging antitumor activity in patients with advanced ovarian cancer treated with the novel combination of sitravatinib and tislelizumab. These...
SABCS 2019: Oral vs Intravenous Paclitaxel for Patients With Metastatic Breast Cancer
Patients with metastatic breast cancer who received an oral formulation of paclitaxel had better response and survival and less neuropathy than patients who received intravenous paclitaxel, according to results of a phase III trial presented at by Umanzor et al at the San Antonio Breast Cancer...
SABCS 2019: Breast Cancer Incidence With Estrogen/Progestin vs Estrogen Alone in Postmenopausal Women
A study investigating the long-term influence of estrogen plus progestin compared with estrogen alone on breast cancer incidence in postmenopausal women has found that the menopausal hormone therapies had opposite effects on breast cancer incidence. While estrogen alone decreased breast cancer...
SABCS 2019: 6-Year Analysis of the Addition of Pertuzumab to Trastuzumab Plus Chemotherapy as Adjuvant Therapy
Data from the 6-year analysis of the APHINITY trial showed that adding pertuzumab to the previous standard treatment of trastuzumab plus chemotherapy after surgery continued to reduce the risk of recurrence and death in patients with HER2-positive early breast cancer, according to findings...
SABCS 2019: 10-Year Follow-up of Adjuvant Accelerated Partial-Breast Irradiation vs Adjuvant Whole-Breast Irradiation
A 10-year follow-up study of patients with breast cancer who had been treated with accelerated partial-breast irradiation (APBI) after surgery showed that their rates of disease recurrence were similar to those of patients who had received whole-breast irradiation (WBI), according to data presented ...
SABCS 2019: IBIS-II Study Finds Long-Term Preventive Benefit With Anastrozole Among Postmenopausal Women at High Risk for Breast Cancer
A 10-year median follow-up analysis of the IBIS-II trial on the efficacy and safety of the aromatase inhibitor anastrozole for healthy postmenopausal women at increased risk of developing breast cancer has found that the therapy reduced the likelihood of breast cancer incidence by 50% and had few...
ASH 2019: Blinatumomab vs Standard Chemotherapy for Pediatric Patients With Relapsed B-ALL
Blinatumomab improved survival in children with relapsed B-acute lymphoblastic leukemia (B-ALL) compared with standard chemotherapy, accordings to findings from a study presented by Brown et al at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract LBA-1)....
ASH 2019: Oral Azacitidine Improves Survival in Older Patients With AML in First Remission
Treatment with an investigational oral form of azacitidine, CC-486, improved overall survival in older patients with newly diagnosed acute myeloid leukemia (AML) who were in remission following standard induction chemotherapy with or without consolidation therapy, according to a phase III study...
Hematologist/Oncologist Augustine L. Perrotta, DO, Dies at 80
On November 24, hematologist/oncologist Augustine L. Perrotta, DO, died, days before his 81st birthday. Ironically, Dr. Perrotta died of renal cell carcinoma, presenting with metastasis to the spine, a topic about which he had written and lectured extensively. Clinical Professor of Medicine at...
Nivolumab Plus Bevacizumab in Relapsed Ovarian Cancer
In a phase II trial reported in JAMA Oncology, Joyce F. Liu, MD, MPH, and colleagues found evidence of the activity of combined nivolumab and bevacizumab in relapsed ovarian cancer, with activity appearing to be greater in platinum-sensitive disease. Study Details In the trial, 38 women with...
Having Cancer Should Not Make You Homeless
In the spring of 2005, I was launching a new career as a sales consultant for a startup graphics company and wanted to cross off a few essential things on my to-do list, including getting my annual mammogram and physical, before I started my new job. Although I was surprised when I got a call from ...
Study Investigates Quality-of-Life Scores as Prognostic Factors in Patients With Cancer
Patients with cancer who report on their own quality of life can provide information important in predicting the outcome of their disease, according to researchers from the European Organisation for Research and Treatment of Cancer (EORTC). Until recently, reports from clinicians on issues such as...
