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issues in oncology
survivorship

ASCO Provides Guidance on Managing Osteoporosis in Cancer Survivors

Cancer survivors are at an increased risk of osteoporotic fractures due to the accelerated loss of bone mineral density as a result of their treatment. Bone loss from cancer therapy is faster and more severe than bone less from aging; rates of bone loss are up to sevenfold higher when they occur...

issues in oncology
global cancer care

Affirming Universal Health Care as a Fundamental Human Right

This year’s meeting of the World Cancer Leaders’ Summit: Cancer and Universal Health Coverage, held on October 15–17 in Nur-Sultan, Kazakhstan, brought together more than 350 global health leaders, including ministers of health, first ladies, and industry leaders, from 82 countries to discuss how...

lymphoma

Answers to Hematology Expert Review Questions

Question 1 Which of the following statements about nodular lymphocyte-predominant HL is correct? Correct answer: A. Nodular lymphocyte-predominant HL can transform into large B-cell lymphoma. Expert Perspective Nodular lymphocyte-predominant HL is a B-cell neoplasm characterized by a nodular or...

lymphoma

The World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Medeiros explore the updated World Health Organization (WHO) classification of nodular lymphocyte-predominant Hodgkin lymphoma. For...

prostate cancer

Apalutamide for Metastatic Castration-Sensitive Prostate Cancer

On September 17, 2019, apalutamide was approved for the treatment of patients with metastatic castration-sensitive prostate cancer.1,2 Supporting Efficacy Data The approval is based on overall survival and radiographic progression-free survival findings in the phase III double-blind TITAN trial.2,3 ...

immunotherapy
symptom management

Maximizing Benefit in the Treatment of Immune-Mediated Colitis

Immune-related colitis is the second most common toxicity associated with checkpoint inhibitors, affecting up to 40% of patients. The ASCO Post interviewed Yinghong Wang, MD, PhD, Director of Medication-Induced Colitis and Enteritis, Director of Fecal Microbiota Transplantation, and Associate...

breast cancer

Breast Cancer Treatments Targeting Estrogen May Be Putting Patients at Risk for Long-Term Comorbidities

“The majority of breast cancers are hormone receptor–positive, and treatments that target the estrogen receptors are very effective, but they also cause havoc in many tissues that are dependent on estrogen for normal functioning. As a result, breast cancer survivors suffer from ongoing symptoms and ...

multiple myeloma

Selinexor/Dexamethasone in Refractory Multiple Myeloma: The STORM Has Arrived, but Does It Represent Climate Change?

The term “relapsed/refractory multiple myeloma” is often used to describe advanced myeloma that has progressed through primary or salvage therapy. The International Myeloma Working Group (IMWG) defined the term in 2011 as disease that is “nonresponsive while on salvage therapy or progresses...

breast cancer

ASCO Updates Breast Cancer Risk Reduction Guideline to Include Anastrozole

ASCO has updated a guideline on pharmacologic interventions for breast cancer risk reduction in postmenopausal women at increased risk of developing breast cancer.1 The original clinical practice recommendations for breast cancer risk reduction were published in 1999 and updated in 2002, 2009, and...

CDC Foundation Offers New Educational Resources to Prevent Infections in Patients With Cancer

The Centers for Disease Control and Prevention (CDC) Foundation commemorates the 10-year anniversary of the Preventing Infections in Cancer Patients (PICP) program by launching new resources that provide continued and improved support to patients with cancer undergoing chemotherapy. The new...

Prescribing Hope

“There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something tomorrow.” –Orison Swett Marden I was informed that my patient, a 58-year-old man recently diagnosed with pancreatic cancer, and his wife were becoming impatient waiting for me in the exam...

global cancer care

Challenging the Global Community to Deliver Equitable Cancer Care for All

For Her Royal Highness Princess Dina Mired of Jordan, ensuring that every patient with cancer receives high-quality care is not an abstract goal—it is personal. Princess Dina saw firsthand the life-and-death differences that access to state-of-the-art oncology care makes in a patient’s life when...

hematologic malignancies
immunotherapy

Answers to Hematology Expert Review Questions

Question 1 Which of the following statements about cytokine-release syndrome and neurotoxicity after tisagenlecleucel infusion is correct? Correct answer: B. The median time to onset of cytokine-release syndrome is 3 days. Expert Perspective Following tisagenlecleucel infusion, cytokine-release...

hematologic malignancies
immunotherapy

CAR T-Cell Gene Therapy: Toxicities and Management Principles

“Nothing in life is to be feared, it is only to be understood. Now is the time to understand more, so that we may fear less.”                                                                                                                  —Marie Curie The ASCO Post is pleased to present Hematology ...

Friends of Cancer Research Launches ctDNA Pilot Project

Friends of Cancer Research (Friends) recently announced the launch of its latest project, ctMoniTR. This pilot project will aim to harmonize the use of circulating tumor DNA (ctDNA) to monitor treatment response in patients with cancer and test the feasibility of data comparison from different...

Project Socrates: An Educational Bridge From the FDA to the Public

OCE Insights is an occasional department developed for The ASCO Post by members of the Oncology Center of Excellence (OCE) at the U.S. Food and Drug Administration (FDA). In this installment, Jennifer J. Gao, MD, Acting Associate Director of Education in the OCE, and Richard Pazdur, MD, Director of ...

skin cancer

MicroRNA Panel Could Aid in the Detection of Uveal Melanoma

A blood test could soon become a monitoring tool for the early detection of uveal melanoma. Stark et al discovered markers in the blood that can differentiate between a benign mole and a melanoma, while also determining whether the cancer has metastasized, according to findings they published in...

solid tumors

Machine Learning Algorithm for Genome-Derived Prediction of Tumor Type

In a study reported in JAMA Oncology, Penson et al developed a machine learning algorithmic classifier that may be successful in identifying tumor type and origin based on DNA-sequence data obtained at point of care. The study used machine learning to construct and train an algorithmic classifier...

skin cancer

Long-Term Analysis of Vemurafenib/Cobimetinib in Patients With BRAF-Mutated Melanoma

A phase Ib study evaluating the safety and long-term benefit of combination treatment with the BRAF inhibitor vemurafenib plus the MEK1 inhibitor cobimetinib in patients with advanced BRAF V600E–mutated melanoma has found that nearly 40% of the patients experienced extended survival of 4 to 5 years ...

FDA Approves Givosiran for Acute Hepatic Porphyria

On November 20, the U.S. Food and Drug Administration (FDA) approved givosiran (Givlaari) for adults with acute hepatic porphyria, a genetic disorder resulting in the buildup of toxic porphyrin molecules which are formed during the production of heme. “This buildup can cause acute attacks, known...

leukemia
lymphoma

FDA Approves Acalabrutinib for CLL/SLL as Part of Project Orbis

On November 21, as part of Project Orbis—a collaboration with the Australian Therapeutic Goods Administration (TGA) and Health Canada—the U.S. Food and Drug Administration (FDA) granted supplemental approval to acalabrutinib (Calquence) for the treatment of adults with chronic lymphocytic leukemia...

lung cancer

What Is the Best Palliation for End-Stage Lung Cancer?

Patients with advanced lung cancer can experience burdensome symptoms at the end of life. Pulmonologists can alleviate some of this suffering, but it’s a balancing act between doing too much and not enough, according to specialists who spoke at CHEST 2019, the annual meeting of the American College ...

issues in oncology

Does Testosterone Replacement Therapy Benefit Young Male Cancer Survivors?

Young male cancer survivors may significantly benefit from testosterone replacement therapy—especially after testicular cancer. Research published by Walsh et al in PLOS Medicine looked at one of the most common late-onset side effects experienced by young male survivors—reduced levels of the male...

leukemia

Late Bone Marrow Relapse Risk Stratification in Pediatric Patients With B-Cell Acute Lymphoblastic Leukemia

In an analysis of the German ALL-REZ BFM 2002 trial, reported in the Journal of Clinical Oncology, Eckert et al found that postinduction minimal residual disease (MRD)-based treatment stratification resulted in “excellent survival” in pediatric patients with late relapse of B-cell precursor acute...

breast cancer

Expert Point of View: Charles L. Loprinzi, MD

Charles L. Loprinzi, MD, Regis Professor of Breast Cancer Oncology at the Mayo Clinic, Rochester, Minnesota, discussed this abstract on sexual health in women treated for breast cancer. Addressing patients’ questions, offering advice, and providing appropriate referrals should improve patient care, ...

breast cancer

Study Finds Sexual Health Issues Are a Concern Among Majority of Women With Breast Cancer

Endocrine therapy has been a lifesaver for women with estrogen receptor–positive breast cancer, but decreases in recurrence and cancer-related mortality have come with substantial side effects, according to data presented at the 2019 Supportive Care in Oncology Symposium.1 The results of a...

integrative oncology

Boswellia

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. In this installment, Gary Deng, MD, PhD, and Jyothirmai Gubili, MS, focus on the herbal extract...

skin cancer

Role of Voriconazole in Cutaneous Squamous Cell Carcinoma Development

For the last decade, medical experts have known that voriconazole—an antifungal medication used to prevent infections in patients with compromised immune systems—is linked to the development of particularly aggressive squamous cell carcinoma in skin exposed to ultraviolet (UV) rays. However, the...

Expert Point of View: Alfredo Falcone, MD

The invited discussant of BEACON CRC, Alfredo Falcone, MD, of the Department of Oncology and Translational Medicine at the University of Pisa, Italy, commented: “The ‘story’ of BEACON represents a good example of the European Society for Medical Oncology Congress theme: Translating Science Into...

gastrointestinal cancer

Maximizing Benefit in the Treatment of Immune-Mediated Colitis

Immune-related colitis is the second most common toxicity associated with checkpoint inhibitors, affecting up to 40% of patients. The ASCO Post interviewed Yinghong Wang, MD, PhD, Director of Medication-Induced Colitis and Enteritis, Director of Fecal Microbiota Transplantation, and Associate...

Expert Point of View: Eduardo Bruera, MD, FAAHPM

Eduardo Bruera, MD, FAAHPM, Chair of the Department of Palliative, Rehabilitation, and Integrative Medicine at The University of Texas MD Anderson Cancer Center, Houston, explained the rationale behind this treatment approach. “We know that the tumor mass and the tumor function talk to the brain...

skin cancer

Reflections on Long-Term Outcomes With BRAF/MEK Inhibition in Advanced Melanoma

For the treatment of BRAF V600-mutated advanced melanoma, we now have three BRAF/MEK inhibitor combinations that are approved by the U.S. Food and Drug Administration: dabrafenib/trametinib, vemurafenib/cobimetinib, and encorafenib/binimetinib. Although the toxicity profiles for these combinations ...

hepatobiliary cancer

Targeted Treatment Advances in Cholangiocarcinoma

For one of the rarest and most aggressive of tumors—cholangiocarcinoma—two novel molecularly targeted agents yielded encouraging outcomes in advanced disease in studies reported at the European Society for Medical Oncology (ESMO) Congress 2019. In the phase III ClarIDHy trial, the risk of disease...

prostate cancer

Expert Point of View: Eleni Efstathiou, MD

Formal study discussant Eleni Efstathiou, MD, of MD Anderson Cancer Center, Houston, commented on results of the PROfound trial at the ESMO Congress 2019. “This is the first phase III targeted therapy trial to deliver a positive outcome in metastatic castration-resistant prostate cancer,” she...

prostate cancer

Phase III PROfound Study Evaluates Olaparib in Setting of Metastatic, Castration-Resistant Prostate Cancer

Treatment with the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib delayed disease progression and appears to improve survival, compared with newer hormonal agents in men with pretreated metastatic castration-resistant prostate cancer and homologous recombinant repair (HRR) genetic...

lung cancer
issues in oncology

Rates of Non–Guideline-Concordant Lung Cancer Treatment in the United States

Only about 6 in 10 patients with lung cancer in the United States receive the minimal lung cancer treatments recommended by National Comprehensive Cancer Network® (NCCN) Guidelines, according to new research published by Blom et al in the Annals of the American Thoracic Society. Erik F. Blom, MD,...

lung cancer

Osimertinib Improves Overall Survival vs Gefitinib, Erlotinib in Advanced EGFR-Mutated Non–Small Cell Lung Cancer: FLAURA Phase III Trial

The third-generation tyrosine kinase inhibitor osimertinib extended overall survival compared with the older tyrosine kinase inhibitors gefitinib and erlotinib in patients with EGFR-mutated advanced non–small cell lung cancer (NSCLC), according to late-breaking final overall survival results of the ...

gynecologic cancers

Phase III Trials Suggest Paradigm Shift With PARP Inhibitors in Ovarian Cancer

At the ESMO Congress 2019, ovarian cancer was a topic of heightened interest, particularly due to findings reported in several important phase III studies of PARP inhibitors in front-line maintenance therapy for patients with newly diagnosed advanced disease—and not just those with BRCA mutations....

issues in oncology
hepatobiliary cancer

Financial Burdens of Patients With Cirrhosis and Impact on Screening for HCC

Data from a new study presented by Singal et al at The Liver Meeting found that patients with cirrhosis in the United States have substantial financial burden and this is associated with underuse of surveillance for hepatocellular carcinoma (HCC) (Abstract 201). Improved intervention strategies are ...

New ASCO Answers Fact Sheet on Anxiety and Depression

Anxiety and depression can cause distress and suffering that make it harder to cope with cancer treatment. Help your patients recognize and record their symptoms by giving them the ASCO Answers Anxiety and Depression fact sheet. This handout includes: An overview of anxiety and depression How...

New JCO CCI Article Discusses Difficulties in Gathering Real-World Evidence

A new JCO Clinical Cancer Informatics (JCO CCI) article highlights the challenges in—and need for—obtaining real-world evidence for assessing the effectiveness of precision medicine on areas such as survival, quality of life, cost, and health disparities. The paper, titled “Clinical Molecular...

Advocates Urge Action on Cancer Care Access at ASCO Advocacy Summit

At the 2019 ASCO Advocacy Summit, ASCO members from 35 states held more than 160 Congressional meetings, urging members of Congress to take action to advance policy priorities that improve patient access to cancer care, including: The Covering Life-Saving Investigations Needed in Cancer and Other...

Make a Holiday Gift to Conquer Cancer®, the ASCO Foundation

Help fund breakthrough cancer research on behalf of someone you love this holiday season. Make a gift in honor or in memory of a loved one, and then send an e-card or mailed notification of your tribute. For many families, this time of year is marked by worry or grief rather than joy. With your...

Cancer.Net: Physician-Generated Content for Patients With Cancer Worldwide

Receiving a cancer diagnosis is a disorienting moment for our patients who are then faced with making difficult decisions regarding their treatment. In order to improve shared decision-making and to increase patient involvement in their care, it is essential to provide patients and their families...

issues in oncology
hematologic malignancies
leukemia

How Clonal Hematopoiesis of Indeterminate Potential Increases the Risk of Heart Disease and Blood Cancers as People Age

Although stem cells throughout the body acquire genetic mutations over time, usually these alterations do not affect how the stem cells function or cause disease. However, recent research in clonal hematopoiesis and aging has found an association between clonal expansion of hematopoietic cells with ...

Barry Paul Sleckman, MD, PhD, to Lead O’Neal Comprehensive Cancer Center

Barry Paul Sleckman, MD, PhD, a well-known cancer researcher who focuses on understanding how DNA double-strand breaks are generated and repaired—a key topic for cancer and immune system development and function—has been named Director of the O’Neal Comprehensive Cancer Center at the University of ...

lung cancer
issues in oncology

Early Lung Cancer Detection Followed by Minimally Invasive Surgery Saves Lives

Lung cancer remains the number one cancer killer, leading to about 150,000 deaths per year in the United States and accounting for approximately 25% of all cancer deaths in the nation. Early detection has improved survival in other malignancies such as breast, colon, and cervical cancers, but...

pancreatic cancer

Management of Locally Advanced Pancreatic Cancer: A Call for Action

Advances in systemic therapy and supportive care, as well as ongoing improvements in surgical techniques, have led to improved survival for many patients with pancreatic ductal adenocarcinoma. We have observed increased survival with FOLFIRINOX (leucovorin, fluorouracil, irinotecan,...

issues in oncology

The Oncology Care Model and Quality of Care: Defining, Measuring, and Implementing New Approaches to Cancer Care

The Oncology Care Model was instituted in 2016 by the Center for Medicare & Medicaid Innovation as a move away from the fee-for-service payment model and toward value-based care. It has sparked discussion ever since. How should quality be defined? Whose and what values should it reflect? How...

prostate cancer

Expert Point of View: Silke Gillessen, MD

Formal discussant Silke Gillessen, MD, of the Division of Cancer Sciences, University of Manchester, United Kingdom, agreed that this study is practice-changing. “The study was well designed and addressed an unmet clinical need that is commonly seen in the clinic. Until now we had no randomized...

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