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issues in oncology
survivorship

Proposed Categories of Cancer Survivors Aim to Bring Survivorship Into Precision Medicine Era

Care for people who have survived or are living with cancer should acknowledge the heterogeneity of their needs and experiences and should reflect the same level of personalization that is now guiding active cancer therapy. At a time when more people are surviving cancer than ever before, new...

Leave a Legacy of Hope

By including a planned gift to the Conquer Cancer Foundation in your estate plans, you can help make a dramatic difference for cancer patients years—even decades—into the future. With just one small change to your will or trust, your planned gift of any size will deliver a big impact, and:  Your...

lung cancer

Combination Therapy With Pembrolizumab in Metastatic Nonsquamous NSCLC

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.  On May 10, 2017, pembrolizumab (Keytruda) was granted accelerated...

breast cancer

Targeting the Androgen Receptor in Breast Cancer

One of the most active areas of research in breast cancer involves the targeting of the androgen receptor. Trials underway for androgen receptor antagonists and modulators, alone and in various combinations of available agents and novel therapies, are yielding encouraging early results. At the 2017 ...

breast cancer
symptom management

Lymphedema Risk: It’s Not Just About the Surgery

In a study from the Mayo Clinic, Rochester, Minnesota, the risk of lymphedema in a population-based breast cancer cohort was related to multimodality therapy and not axillary surgery alone, investigators reported at the American Society of Breast Surgeons (ASBrS) Annual Meeting.1 “Most patients...

head and neck cancer

Proton Therapy Associated With Fewer Sequelae in the Treatment of Head and Neck Cancer

Radiation oncology is vital to the management of patients with cancer of the head and neck, and for certain patients, proton therapy may offer significant benefit over intensity-modulated radiation therapy, according to Walter J. Curran, MD, Executive Director of the Winship Cancer Institute of...

issues in oncology
cost of care

Value-Based Decision-Making Tools: The View Ahead

As new treatment decision-making tools make their way toward and into the clinic, oncologists are getting a sense of how they may affect clinical practice—and beginning to look farther down the road. “What do you see ahead for clinicians?” asked Christian Downs, JD, Executive Director of the...

lung cancer

ALEX Trial: Alectinib vs Crizotinib in Untreated Advanced ALK-Positive NSCLC

As reported at the recent ASCO Annual Meeting and in The New England Journal of Medicine by Peters et al, the phase III ALEX trial has shown improvement in progression-free survival with alectinib (Alecensa) vs crizotinib (Xalkori) in the first-line treatment of advanced ALK-positive...

bladder cancer

European Commission Approves Nivolumab for Previously Treated, Locally Advanced, Unresectable or Metastatic Urothelial Cancer

On June 2, the European Commission (EC) approved nivolumab (Opdivo) for the treatment of locally advanced unresectable or metastatic urothelial carcinoma in adults after failure of prior platinum-containing therapy. This makes nivolumab the first immuno-oncology agent approved in the European Union ...

lung cancer

Adjuvant Gefitinib Delays Recurrence in EGFR-Positive NSCLC

Adjuvant therapy with gefitinib (Iressa), an epidermal growth factor receptor (EGFR)-targeted agent, was more successful at preventing recurrence than standard-of-care chemotherapy, in a phase III study of patients with EGFR-positive non–small cell lung cancer (NSCLC).1 Gefitinib extended...

lung cancer

Effect of Previous Radiotherapy on Outcome With Pembrolizumab in NSCLC

In a single-site experience reported in The Lancet Oncology by Shaverdian et al, patients with advanced non–small cell lung cancer (NSCLC) in the phase I KEYNOTE-001 trial of pembrolizumab (Keytruda) were found to have better outcomes if they had received prior radiotherapy. Study Details...

lung cancer

ASCO 2017: Research Suggests Possible New Treatment for EGFR-Positive Lung Cancer

Findings from a phase III clinical trial point to a potential new treatment for patients newly diagnosed with advanced, epidermal growth factor receptor (EGFR)-positive non–small cell lung cancer (NSCLC). Compared to the EGFR inhibitor gefitinib (Iressa), one of the standard targeted...

prostate cancer

LATITUDE Trial: Adding Abiraterone and Prednisone to Androgen-Deprivation Therapy in Metastatic Castration-Sensitive Prostate Cancer

As reported in the Plenary Session at the 2017 ASCO Annual Meeting and in The New England Journal of Medicine by Fizazi et al, the phase III LATITUDE trial has shown that the addition of abiraterone acetate (Zytiga) and prednisone to androgen-deprivation therapy resulted in marked improvements in...

symptom management

ASCO 2017: Web-Based System for Self-Reporting Symptoms Helps Patients Live Longer

A randomized clinical trial of 766 patients shows that a simple intervention—a Web-based tool that enables patients to report their symptoms in real time, triggering alerts to clinicians—can have major benefits, including longer survival. Patients with metastatic cancer who used the...

solid tumors

ASCO 2017: Larotrectinib Shows Durable Efficacy Across Diverse Pediatric and Adult Cancers

Scientists may have developed the first targeted, oral, tumor-type agnostic therapy—an agent that works comparably well across many kinds of cancer, regardless of patient age. In clinical trials of adults and children with 17 different types of advanced cancer, larotrectinib treatment...

solid tumors

ASCO 2017: New High-Intensity Genomic Sequencing Approach Detects Circulating Tumor DNA at a High Rate

In a study of 124 patients with advanced breast, lung, and prostate cancers, a new high-intensity genomic sequencing approach detected circulating tumor DNA at a high rate. In 89% of patients, at least one genetic change detected in the tumor was also detected in the blood. Overall, 627 (73%)...

breast cancer
survivorship

ASCO 2017: Pregnancy After Breast Cancer Does Not Increase Chance of Recurrence

Findings from a retrospective study of 1,200 women provide reassurance to breast cancer survivors who are contemplating pregnancy. In the study, women who became pregnant after an early breast cancer diagnosis, including those with estrogen receptor–positive tumors, did not have a higher...

supportive care

ASCO 2017: CALM Intervention Relieves Distress in Patients With Advanced Cancer

Advanced cancer triggers enormous distress and brings challenges that can seem overwhelming. Yet most cancer centers lack systematic approaches to help patients and families manage the practical and emotional toll of advanced cancer. Findings from a randomized clinical trial of 305 patients with...

lung cancer
issues in oncology

ATS 2017: Among All Cancers, Lung Cancer Appears to Put Patients at Greatest Suicide Risk

A lung cancer diagnosis appears to put patients at the greatest risk of suicide when compared to the most common types of non-skin cancers, according to new research presented at the 2017 American Thoracic Society International Conference (Abstract 8321). Researchers analyzed 3,640,229 patients in ...

breast cancer

Study Finds Hypofractionated Whole-Breast Irradiation Leads Breast Cancer Radiation Therapies in Cost-Effectiveness, Quality of Life

In a study of three radiation therapies for early-stage breast cancer, one treatment option stands out as offering the most value based on factors including health outcomes, cost-effectiveness, and quality of life. The treatment—hypofractionated whole-breast irradiation—also requires...

gynecologic cancers

Pembrolizumab in Advanced PD-L1–Positive Endometrial Cancer

Pembrolizumab (Keytruda) showed activity in previously treated patients with advanced programmed cell death ligand 1 (PD-L1)–positive endometrial cancer in a cohort of the phase Ib KEYNOTE-028 study. These findings were reported in the Journal of Clinical Oncology by Ott et al. Study Details ...

genomics/genetics

At the Forefront of Cancer Genetics, Bert Vogelstein, MD, Calls for Focus on Early Detection and Prevention

Bert Vogelstein, MD, was born on June 2, 1949, at The Johns Hopkins Hospital in Baltimore, Maryland, the same renowned institution where he would later make his mark in the field of cancer genetics. As a young teen, he was an enthusiast and independent consumer of books, one of which helped shape...

Eliezer Robinson, MD, Traveled a Long, Hard Road and Became an International Leader in Oncology

Eliezer Robinson, MD, was born in Vienna, Austria, on June 17, 1931. At that time, Vienna, a bustling and prosperous city, was an important center of Jewish culture and education. Jews made up a large portion of the city’s professional class of doctors, lawyers, bankers, and artists. Dr. Robinson...

head and neck cancer

Waun Ki Hong, MD, FACP, Helped Change the Standard of Care in Laryngeal Cancer, Now Focuses on Chemoprevention and Precision Medicine

Waun Ki Hong, MD, FACP, one of the nation’s leading experts in head and neck and lung cancers, was born in South Korea and grew up in a tiny village outside the nation’s capital of Seoul. Number six of seven siblings, Dr. Hong described his early life in the cozy village as blissful, until the...

breast cancer

Final Overall Survival Results of TH3RESA Trial in Breast Cancer

The final overall survival results of the phase III TH3RESA trial indicate a 32% reduction in risk of death with ado-trastuzumab emtansine (Kadcyla) vs treatment of physician’s choice in patients with previously treated HER2-positive metastatic breast cancer. The findings were reported in The ...

genomics/genetics

Nobel Laureate David Baltimore, PhD, Plays Integral Role in Linking Cell Biology and Cancer Genetics

David Baltimore, PhD, whose work profoundly influenced international science, was born on March 7, 1938, in Queens, New York, to Gertrude and Richard Baltimore. While he was in second grade, the family moved to Great Neck, New York, a middle-class suburb with top-notch public schools. “My father...

breast cancer

ASCO and CAP Invite Comment on Focused Update to HER2 Testing Guideline in Breast Cancer

Draft recommendations as part of a focused update to the ASCO/College of American Pathologists (CAP) evidence-based guideline for human epidermal growth factor receptor 2 (HER2) testing in breast cancer are now open for public comment through June 12, 2017. For patients with invasive breast...

breast cancer

Tai Chi Chih vs Cognitive Behavioral Therapy for Insomnia in Breast Cancer Survivors

In a study reported in the Journal of Clinical Oncology by Irwin et al, Tai Chi Chih, a form of movement meditation, was noninferior to insomnia-specific cognitive behavioral therapy in improving insomnia in breast cancer survivors. Study Details In the study, 90 patients with insomnia from the...

breast cancer
symptom management

OPTIMIZE-2 Trial Offers Reassuring Data on Deescalation of Bisphosphonate Therapy for Breast Cancer–Related Bone Metastases

Bisphosphonates were first synthesized more than a century ago, with their initial usage restricted to a range of industrial processes until their potential clinical relevance was appreciated in the late 1960s.1 Then, following development for the treatment of osteoporosis and Paget’s disease of...

breast cancer
symptom management

Zoledronic Acid Every 12 Weeks Noninferior to Every 4 Weeks in Skeletal-Related Event Rate for Breast Cancer With Bone Metastases

In the phase III OPTIMIZE-2 trial reported in JAMA Oncology, Gabriel N. Hortobagyi, MD, of The University of Texas MD Anderson Cancer Center, and colleagues found that an every-12-week schedule of zoledronic acid was noninferior to an every-4-week schedule with regard to skeletal-related event...

lung cancer

Osimertinib in Metastatic EGFR T790M–Mutant NSCLC After EGFR Inhibitor Therapy

On March 30, 2017, osimertinib (Tagrisso) was granted regular approval for the treatment of patients with metastatic epidermal growth factor receptor (EGFR) T790M–mutant non–small cell lung cancer (NSCLC), as detected by a U.S. Food and Drug Administration (FDA)-approved test, who have progressed...

breast cancer
issues in oncology

Unique Challenges Facing Young Women With Breast Cancer

According to the American Cancer Society, over 252,700 new cases of invasive breast cancer will be diagnosed in 2017, and about 40,610 women will die of their disease. Between 7% and 10% of those new cases will be diagnosed in women younger than age 40, accounting for more than 40% of all cancer...

breast cancer

Palbociclib Combined With Aromatase Inhibitor in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

On March 31, 2017, palbociclib (Ibrance) was granted regular approval for treatment of hormone receptor–positive, HER2-negative advanced or metastatic breast cancer in combination with an aromatase inhibitor as initial endocrine-based therapy in postmenopausal women.1,2 Palbociclib received...

gynecologic cancers

Niraparib in Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

On March 27, 2017, the oral poly ADP-ribose polymerase (PARP) inhibitor niraparib (Zejula) was approved for maintenance treatment of patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy.1,2...

prostate cancer

What Is Appropriate Treatment of Oligometastatic Hormone-Sensitive Prostate Cancer?

As the subtleties of metastatic prostate cancer become increasingly recognized, treatment should evolve accordingly, said Jessica M. Clement, MD, Assistant Professor of Medicine at the University of Connecticut Health System and Neag Cancer Center, Farmington. Of particular interest to Dr. Clement ...

breast cancer

Effect of Fixed Second Appointments on Breast Cancer Screening Attendance

In a UK study reported in The Lancet Oncology, Allgood et al found that provision of a second timed appointment for breast cancer screening improved screening rates among women who did not attend a first offered appointment. Study Details In the study, women who were invited for breast screening...

skin cancer

New Immunotherapy Combinations Gain Ground in Advanced Melanoma, but Results Preliminary

Attention is focused among the cancer community on identifying the optimal immunotherapy combinations, with more than 800 ongoing trials of combination therapy. Two studies presented at the 2017 Annual Meeting of the American Association for Cancer Research (AACR) reported promising preliminary...

bladder cancer

CheckMate 275 Supports FDA Approval of Nivolumab in Metastatic Urothelial Carcinoma After Platinum Therapy

As reported in The Lancet Oncology by Padmanee Sharma, MD, PhD, of MD Anderson Cancer Center, and colleagues, the phase II CheckMate 275 trial has shown that nivolumab (Opdivo) produced durable responses in patients with metastatic urothelial cancer who had received at least one prior...

breast cancer

Atezolizumab Improves Overall Survival in Small Subset of Patients With Triple‑Negative Breast Cancer

Triple-negative breast cancer is an aggressive disease with no approved targeted therapy, and it remains challenging to treat. Early data from a phase I study suggest that the PD-L1 inhibitor atezolizumab (Tecentriq) can extend the lives of a subset of women who respond to this checkpoint...

supportive care
breast cancer

Anticipate Sexual Dysfunction in Patients on Aromatase Inhibitors

For patients with breast cancer starting on aromatase inhibitors, sexual dysfunction is commonly reported. Early intervention may lessen its impact—but it’s not an easy fix, says a specialist in this area, Leslie R. Schover, PhD. Dr. Schover is Founder of Will2Love, an online sexual health program ...

breast cancer

Expert Point of View: Julie Margenthaler, MD

“This study of 2,759 patients with ductal carcinoma in situ provides data for women who are considering their surgical options,” said Julie Margenthaler, MD, a breast surgeon at Washington University of Medicine, St. Louis, and Communications Chair of the American Society of Breast Surgeons...

kidney cancer

Managing Small Renal Masses: A Point-by-Point Consideration of ASCO’s Clinical Practice Guideline

As reviewed in this issue of The ASCO Post, a recent issue of the Journal of Clinical Oncology featured an ASCO Clinical Practice Guideline on the management of small renal masses reported by Finelli and colleagues.1 This comprehensive guideline is written by a group of well-regarded and...

breast cancer
genomics/genetics

Germline Genetic Testing and Treatment Decisions in Early-Stage Breast Cancer

As reported in the Journal of Clinical Oncology by Allison W. Kurian, MD, of Stanford University School of Medicine, and colleagues, surveys in a population-based sample of patients recently diagnosed with breast cancer indicate that many undergo genetic risk testing without seeing a genetics...

breast cancer
genomics/genetics

Provision of Genetic Services to Women With Breast Cancer: We Must Do Much Better

Genetic testing for inherited cancer susceptibility is increasingly part of the care of cancer patients and their relatives. Early clinical guidelines recommended BRCA1/2 testing for women diagnosed with breast or ovarian cancer if they also have a significant family cancer history or Ashkenazi...

breast cancer
genomics/genetics

Suboptimal Genetic Testing and Counseling Among Women With Newly Diagnosed Breast Cancer

In a population-based study reported in a research letter in JAMA, Allison W. Kurian, MD, of Stanford University School of Medicine, and colleagues found that genetic testing and genetic counseling are suboptimal among women with newly diagnosed breast cancer.1 Study Details The study involved...

palliative care

Pediatric Oncology Patient and Parent Attitudes on Early Palliative Care Integration

Few pediatric oncology patients or their parents expressed negative attitudes toward early integration of palliative care during cancer treatment, in a study by Deena R. Levine, MD, of the Division of Quality of Life and Palliative Care, St Jude Children’s Research Hospital, and colleagues reported ...

skin cancer

Immunotherapy Clinical Trials in Metastatic Melanoma

A Danish study reported in the European Journal of Cancer by Marco Donia, MD, PhD, of the Center for Cancer Immune Therapy, Herlev Hospital, Denmark, and colleagues indicates that more than half of patients with metastatic melanoma do not satisfy requirements for enrollment in phase III trials of...

ASCO CEO Reflects on His First Year in Office and What Is Ahead

June 27, 2017, marks the 1-year anniversary since Clifford A. Hudis, MD, FACP, FASCO, began his tenure as Chief Executive Officer of ASCO. With the launch of the national Cancer Moonshot and the changes in the White House and Congress, it has been a year of tremendous activity drawing on all of...

Expect Questions From Patients Who ‘Do Everything Right’ but Still Develop Cancer

A study reported in Science found that more than two-thirds of human cancers are caused by random mutations made during DNA replication.1 “The main message we would like to convey is that even for many patients who follow all of the guidelines from the advisory bodies—they don’t smoke, exercise...

hepatobiliary cancer

Expert Point of View: Lipika Goyal, MD

Commenting on the BILCAP study, Lipika Goyal, MD, an oncologist at Massachusetts General Hospital, Boston, said: “These results are very intriguing. There is no current standard of care for adjuvant therapy of biliary tract cancer. Our high-risk patients [ie, patients with node-positive disease,...

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