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lung cancer

2019 Thoracic Cancers Symposium: Effect of Structured Patient Exposure to the NCCN Guidelines for NSCLC

A new clinical trial found that exposing patients to tailored versions of the National Comprehensive Cancer Network (NCCN®) Guidelines for non–small cell lung cancer (NSCLC) may help drive smoking cessation, testing for potential biomarkers and, for early-stage disease, more...

breast cancer

Addition of Preoperative Breast MRI to Standard Evaluation in Local Ductal Carcinoma in Situ

In a French phase III trial reported in the Journal of Clinical Oncology, Balleyguier et al found that the addition of breast magnetic resonance imaging (MRI) to standard radiologic evaluation did not improve surgical reintervention rates in women with ductal carcinoma in situ undergoing...

breast cancer
gastroesophageal cancer
gastrointestinal cancer

FDA Approves Trastuzumab-qyyp in HER2-Overexpressing Breast and Gastric Cancers

The U.S. Food and Drug Administration (FDA) has approved trastuzumab-qyyp (Trazimera), a biosimilar to trastuzumab (Herceptin), for the treatment of human epidermal growth factor receptor-2 (HER2)-overexpressing breast cancer and HER2-overexpressing metastatic gastric or gastroesophageal...

gynecologic cancers

Conservatively Managing Ovarian Tumors

In an interim analysis of a prospective cohort study (IOTA5) reported in The Lancet Oncology, Wouter Froyman, MD, and colleagues found that the risk of malignancy and acute complications is low when adnexal masses with benign ultrasound findings are managed conservatively. In the study, patients...

breast cancer

Factors Influencing Conversion to Mastectomy in Ductal Carcinoma in Situ

In a prospective cohort clinical trial reported in JAMA Oncology, Constance D. Lehman, MD, PhD, and colleagues found that multiple factors, including magnetic resonance imaging (MRI) findings, played a role in conversion to mastectomy among women with ductal carcinoma in situ (DCIS) who were...

breast cancer

We Need Better Screening Methods for Detecting Breast Cancer

MY BREAST CANCER was probably a decade in the making, although I only became aware that there might be a problem in 2014, when I noticed some slight pain in my left breast. A routine mammogram and ultrasound found benign cysts in my dense breasts, which most likely explained the pain, I was told,...

integrative oncology

Omega-3 Fatty Acids

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. Gary Deng, MD, PhD, and Jyothirmai Gubili, MS, explore the use of omega-3 fatty acids, which have...

issues in oncology

Health-Care Fraud Prosecutions Are on the Rise

Prosecuting health-care fraud is a top priority for the U.S. Department of Justice (DOJ) and other federal government agencies.1,2 After all, the government earns a $6 return for every $1 that it spends on enforcement. In December 2018, the DOJ announced that it had obtained more than $2.5 billion...

hepatobiliary cancer

Cabozantinib for Hepatocellular Carcinoma Previously Treated With Sorafenib

In the Clinic provides overviews of novel 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 January 14, 2019, cabozantinib was approved for the...

multiple myeloma

Reshaping the Treatment Landscape in Refractory Multiple Myeloma

THE TREATMENT approaches for multiple myeloma, both newly diagnosed and relapsed disease, continue to undergo major transformation as new agents and combinations are being introduced.1 This change has been driven by the introduction of novel drug classes such as monoclonal antibodies, as well as...

skin cancer

New Patient Resource: NCCN Guidelines for Patients With Squamous Cell Skin Cancer

The National Comprehensive Cancer Network® (NCCN) has published a new book of patient information that explains prevention, diagnosis, and treatment for squamous cell skin cancer. Squamous cell and basal cell skin cancers are responsible for about 5 million annual incidents of nonmelanoma...

colorectal cancer

Combining Tumor Budding and Lymphocytic Infiltration May Improve Prognostic Accuracy in Colorectal Cancer

A study evaluating a prognostic signature derived from integrating tumor budding, lymphocyte infiltration, and their spatial relationship has found that the method could more accurately stratify patients with stage II colorectal cancer at high risk for disease-specific death compared with...

FDA Commissioner Scott Gottlieb, MD, Resigns

On March 5, 2019, Scott Gottlieb, MD, announced his resignation as Commissioner of the U.S. Food and Drug Administration (FDA), a post he began in 2017. Dr. Gottlieb’s resignation will be effective next month. In a resignation letter to Alex M. Azar II, Secretary of Health and Human Services ...

breast cancer
gynecologic cancers
hematologic malignancies
leukemia
lymphoma
symptom management

FDA Pipeline: Updates on Treatments for Cervical Cancer, Myelofibrosis, Chemotherapy-Induced Nausea and Vomiting, and More

The FDA recently issued announcements on a Fast Track designation, a Priority Review, two supplemental new drug applications, an investigational new drug application, and a marketing clearance. The agency also released a safety communication on cancer-related surgery. Fast Track Designation for...

skin cancer
issues in oncology

2019 AAD: Disadvantages and Potential Improvements of Artificial Intelligence in Skin Cancer Detection

While artificial intelligence (AI) systems for skin cancer detection have shown promise in research settings, there is still a lot of work to be done before the technology is appropriate for real-world use. This was the topic of a scientific session at the 2019 American Academy of Dermatology (AAD) ...

cns cancers
survivorship

Late Morbidity and Mortality in Survivors of Medulloblastoma

In a report from the Childhood Cancer Survivor Study published in the Journal of Clinical Oncology, Salloum et al found that changes in medulloblastoma therapy over 3 decades that have improved survival have also increased risk for subsequent neoplasms and debilitating health conditions. As noted...

QOPI Round 1 Now Open for Data Abstraction

As of January 9, ASCO’s Quality Oncology Practice Initiative (QOPI®) Round 1 of reporting is open for data abstraction. Round 1 will close on June 3, and final reports will be available approximately 2 weeks after the round closes. To get started, go to the registration portal and log in. A...

hematologic malignancies

Advances in Haploidentical Transplantation and Cellular Therapies

With advances in the field, the number of haploidentical stem cell transplants being performed (ie, using human leukocyte antigen [HLA] half-matched donor stem cells) has been increasing. In recognition of evolving strategies to improve outcomes, a group of transplant physicians started the...

supportive care
palliative care

National Consensus Project Clinical Practice Guidelines: Improving Education on the Tenets of Palliative Care

The provision of palliative care (primary or specialty) is paramount to providing excellent quality care to all patients with cancer. Palliative care is associated with improving the quality of life, mood, and survival in patients with cancer. In fact, ASCO guidelines recommend that patients with...

supportive care
palliative care

Innovative Research to Improve the Supportive Care Needs of Cancer Survivors

First launched in 2014, the Palliative Care in Oncology Symposium introduced a nascent interdisciplinary approach to the treatment of both the physical and psychological symptoms of cancer to improve disease outcome and quality of life for patients. Today, it has evolved into a leading forum for...

Expert Point of View: Aditya Bardia, MD, MPH

Aditya Bardia, MD, MPH, Assistant Professor of Medicine at Harvard Medical School and Director of Precision Medicine at the Center for Breast Cancer, Massachusetts General Hospital, Boston, found the PALLET study noteworthy in light of heightened interest in cyclin-dependent kinase 4/6 (CDK4/6)...

Expert Point of View: Eleftherios (Terry) P. Mamounas, MD, William Sikov, MD, and Laura Esserman, MD

Several breast cancer experts said the findings of the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) meta-analysis and the AERAS study are in line with data emerging from other studies of extended treatment with aromatase inhibitors. All of these studies suggest that extended...

breast cancer

More Data Show Small Benefit From Extended Endocrine Therapy

Two studies presented at the 2018 San Antonio Breast Cancer Symposium validated a small benefit of extending adjuvant aromatase inhibitor therapy beyond thestandard 5 years for postmenopausal women with hormone receptor–positive breast cancer. In a meta-analysis of 24,912 patients from 12...

Expert Point of View: Parag J. Parikh, MD

Parag J. Parikh, MD, Director of Gastrointestinal Radiation Oncology, Henry Ford Cancer Institute, Detroit, commented that KEYNOTE-128 “unfortunately found a very low rate of response to single-agent pembrolizumab.” He said he would not use this approach in any patients with neuroendocrine tumors...

immunotherapy
gastrointestinal cancer

Study Shows Limited Antitumor Activity of Pembrolizumab in Neuroendocrine Tumors

Neuroendocrine tumors appear resistant to single-agent immunotherapy, according to the results of the KEYNOTE-028 trial of pembrolizumab. “Pembrolizumab monotherapy showed limited antitumor activity but a manageable safety profile in patients with previously treated, advanced neuroendocrine...

prostate cancer

ARAMIS Trial Reports Darolutamide Improves Outcomes in High-Risk Nonmetastatic Prostate Cancer

Darolutamide—an investigational androgen receptor inhibitor—significantly improved metastasis-free survival in men with high-risk nonmetastatic castration-resistant prostate cancer vs placebo in the large phase III ARAMIS trial.1 Men treated with darolutamide had a median metastasis-free survival...

issues in oncology

10 Patient-Centered Principles for More Conservative Cancer Diagnosis

Although diagnostic errors date back to antiquity, in recent years, they have begun to receive attention as an important patient safety issue. This culminated in the National Academy of Medicine’s 2015 landmark report, which concluded that most people in the United States would experience at...

pancreatic cancer

Mutations in DNA Damage Repair Predict Benefit With Platinum Agents in Pancreatic Cancer

Patients with advanced pancreatic cancer who have homologous repair damage response mutations may derive considerable benefit from treatment with platinum agents, according to an analysis of patients in the Know Your Tumor Program presented by Michael Pishvaian, MD, PhD, of Georgetown University,...

Expert Point of View: Lori Wood, MD

Formal discussant of KEYNOTE-426, Lori Wood, MD, of Dalhousie University, Halifax, Nova Scotia, Canada, called both KEYNOTE-426 and JAVELIN-101 “practice-changing.” “In 2019, we have a new standard of care,” Dr. Wood declared. “The majority of patients with clear cell advanced renal cell carcinoma ...

breast cancer

FDA Approves Trastuzumab and Hyaluronidase-oysk for Subcutaneous Injection in Certain HER2-Positive Breast Cancers

On February 28, the U.S. Food and Drug Administration (FDA) approved trastuzumab and hyaluronidase-oysk (Herceptin Hylecta) for subcutaneous injection for the treatment of certain patients with HER2-positive early breast cancer (node-positive, or node-negative and estrogen receptor/progesterone...

solid tumors
immunotherapy

TAT 2019: Use of the Lung Immune Prognostic Index in Stratifying Outcomes in Patients Treated With Immune Checkpoint Inhibitors

The Lung Immune Prognostic Index (LIPI) calculated prior to the initiation of treatment may be used to stratify patients with diverse tumor types into groups that significantly associate with outcome following immune checkpoint inhibitor therapy, according to a retrospective study presented at the...

prostate cancer
issues in oncology

AACR 2019: Does Treatment With Abiraterone Acetate Benefit Patients With Advanced Prostate Cancer and Preexisting Cardiovascular Disease?

Patients with advanced prostate cancer who had preexisting cardiovascular disease had a higher risk of mortality in the 6 months after starting abiraterone acetate treatment compared with those who had no preexisting cardiovascular disease, according to data presented by Lu-Yao et al at a presscast ...

skin cancer
immunotherapy

AACR 2019: Diet May Influence Gut Microbiome and Response to Immunotherapy

Among patients with melanoma treated with anti–programmed cell death protein 1 (PD-1) immunotherapy, consumption of a high-fiber diet was associated with higher gut microbiome diversity and better response to treatment, according to data presented by Spencer et al at a presscast in advance of ...

prostate cancer

Addition of Radium-223 to Abiraterone Acetate and Prednisone or Prednisolone in Metastatic Castration-Resistant Prostate Cancer

In the phase III ERA 223 trial reported in The Lancet Oncology, Smith et al found that the addition of radium-223 to abiraterone acetate and prednisone or prednisolone did not improve symptomatic skeletal event-free survival and was associated with increased risk of fracture in patients with...

Newly Discovered Mutation in BCL2 Protein Impacts Outcomes in Patients With Progressive CLL

INVESTIGATORS FROM Australia have identified a genetic mutation that causes resistance to the targeted drug venetoclax in patients with chronic lymphocytic leukemia (CLL), according to research presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition1 and...

Large Single-Arm Trial of Hydroxyurea for Sickle Cell Anemia in Sub-Saharan Africa

THE LARGEST PROSPECTIVE trial of hydroxyurea for sickle cell anemia has shown that this treatment is feasible, accepted, well tolerated, and safe for children living in sub-Saharan Africa. Hydroxyurea has long been the standard of care for treating children with sickle cell anemia in developed...

Expert Point of View: Mrinal Patnaik, MBBS, and David P. Steensma, MD

Mrinal S. Patnaik, MBBS, Associate Professor of Internal Medicine and Oncology and a consultant in hematology at the Mayo Clinic, Rochester, commented on the MEDALIST trial for The ASCO Post. “Given its unique mode of action, relative ease of administration, and excellent tolerability,...

Front-Line Ibrutinib Improves Progression-Free Survival in Older Patients With Chronic Lymphocytic Leukemia

IN A PHASE III TRIAL reported during the Plenary Session at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition and published in The New England Journal of Medicine, single-agent ibrutinib and ibrutinib/rituximab were associated with superior progression-free survival vs...

hematologic malignancies

Conference Highlights From the 2018 American Society of Hematology Annual Meeting & Exposition

In sunny San Diego, the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition welcomed nearly 30,000 attendees who were eager to present, learn, network, and cheer the joint achievements of many researchers. The packed meeting was filled with important information from...

lung cancer
immunotherapy

Pembrolizumab in Combination With Chemotherapy in First-Line Treatment of Metastatic Squamous NSCLC

In the Clinic provides overviews of novel 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 October 30, 2018, pembrolizumab in combination with...

head and neck cancer
immunotherapy
symptom management

Immunotherapy for Head and Neck Cancer Expands, but Concerns Persist About Patient Selection and Toxicities

SOME PATIENTS with advanced head and neck cancer may achieve durable responses with immunotherapy, and recent trial results suggest first-line immunotherapy may increase survival among patients with recurrent or metastatic disease. However, concerns remain about selecting patients most likely to...

lymphoma
immunotherapy

Update on FDA-Approved CAR T-Cell Products

AXICABTAGENE CILOLEUCEL (also known as CAR19) is an anti-CD19 chimeric antigen receptor (CAR) T-cell product approved by U.S. Food and Drug Administration to treat selected hematologic malignancies.1 To appreciate the clinical trial findings summarized here, from selected abstracts presented at the ...

breast cancer

Prognostic Value of Disseminated Tumor Cells in Early Breast Cancer

IN THE PADDY TRIAL, involving more than 10,000 women with early invasive breast cancer, the presence of disseminated tumor cells at diagnosis or primary surgery was an independent prognostic factor for overall, disease-free, and distant disease–free survival. The study findings were presented at...

breast cancer

SABCS Presentations Offer New Data on Biomarkers and Novel Treatment Approaches in Early and Metastatic Breast Cancers

REPORTERS FOR The ASCO Post captured the following summaries of noteworthy studies presented at the 2018 San Antonio Breast Cancer Symposium. In HER2-Negative Metastatic Disease, CTCs Frequently HER2-Positive ALMOST HALF of all patients with HER2-negative metastatic breast cancer have circulating...

issues in oncology
survivorship

How to Improve Care for Young Sexual and Gender Minority Cancer Survivors

IN 2017, ASCO issued its recommendations for addressing the oncology care needs of sexual and gender minority cancer survivors and the unique challenges they face.1 There are myriad reasons for cancer disparities in this population compared to heterosexual cisgender cancer survivors, including...

issues in oncology
health-care policy

‘Curve 2’ and Oncology: What Those in Charge Don’t Understand … or Ignore

THERE IS little doubt that the U.S. health-care system is under assault from many directions.1 It is clear that the costs of health management are no longer sustainable, and the United States has one of the highest per capita health costs among the 36 member nations of the Organisation for...

pancreatic cancer

Expert Point of View: Andrew X. Zhu, MD, PhD

ANDREW X. ZHU, MD, PhD, of Massachusetts General Hospital Cancer Center and Harvard Medical School, noted that Prep-02/ JSAP-05 is the first study to show the value of neoadjuvant chemotherapy in patients with resectable pancreatic adenocarcinoma. However, the findings are applicable only to Asian ...

hematologic malignancies

PAUSE Study Establishes Simple Approach to Perioperative Management of Direct Oral Anticoagulants

The largest study to date addressing the common problem of perioperative direct oral anticoagulant (DOAC) management has shown that patients with atrial fibrillation can safely stop taking their anticoagulant for 1 day before and after procedures with a low risk of bleeding and for 2 days before...

Expert Point of View: Mark Crowther, MD, MSc, FRCPC

Moderator of the session, Mark Crowther, MD, MSc, FRCPC, Professor of Clinical Epidemiology and Biostatistics, Leo Pharma Chair in Thromboembolism Research at McMaster University, in Ontario, Canada, said that the CASSINI study represents a major advance in the management and prevention of a very...

hematologic malignancies

Pilot Study Tests Novel Approach to Gene Therapy for Sickle Cell Disease

Initial findings from a first-in-human trial have provided proof of principle for a groundbreaking approach to gene therapy for sickle cell disease, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Early results of genetic targeting of...

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