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MACRA Implementation Has Begun: Will You Avoid a 4% Reimbursement Penalty?

As most oncology professionals know, the Quality Payment Program (QPP), established by the Medicare Access and CHIP Reauthorization Act (MACRA), began on January 1, 2017—but did you know that 2017 is a transition year, meaning you can “Pick Your Pace” when implementing QPP in your practice? “Pick...

pancreatic cancer

Onset of Diabetes or Its Rapid Deterioration Can Be an Early Warning Sign of Pancreatic Cancer

The onset of diabetes, or a rapid deterioration in existing diabetes that requires more aggressive treatment, could be a sign of early, hidden pancreatic cancer, according to research presented by Autier et al at the 2017 European Cancer Congress ­(Abstract 540).1 Study Design and Key Findings...

ASCO Honors Researchers, Scientists for Significant Advances in Cancer Treatment and Care

ASCO and the Conquer Cancer Foundation (CCF) proudly announce the winners of ASCO’s Special Awards, the Society’s highest honors, and the CCF Women Who Conquer Cancer Mentorship Award. The recipients of these awards include researchers, patient advocates, and global oncology leaders who have worked ...

James Mohler, MD, Receives 2017 Rodger Winn Award

An accomplished urologic oncologist and longtime senior leader at Roswell Park Cancer Institute, James Mohler, MD, received the 2017 Rodger Winn Award at the National Comprehensive Cancer Network (NCCN) 22nd Annual Conference in Orlando, Florida. Dr. Mohler is Associate Director and Senior Vice...

breast cancer

Decision Aid Improves Breast Cancer Patients’ Knowledge of Surgical Options

A Web-based decision aid that allows women with early breast cancer to easily compare surgical treatment options helps them make more informed decisions, suggests a randomized trial reported at the 2017 Society of Surgical Oncology (SSO) Annual Cancer Symposium.1 “Having knowledge of surgical...

issues in oncology
health-care policy

An Oncology Care Model: One Institute’s Experience

At this year’s ASCO Quality Care Symposium, Blase N. Polite, MD, MPP, Associate Professor of Medicine at The University of Chicago Medical Center, examined his practice’s experience with the Oncology Care ­Model, a Centers for Medicare & Medicaid Services test payment and delivery program...

colorectal cancer

Machine Learning Model Predicts Colorectal Cancer Recurrence

A machine learning model that uses a set or ensemble of algorithms has good accuracy for predicting colorectal cancer recurrence, investigators reported during a plenary session at the 2017 Society of Surgical Oncology (SSO) Annual Cancer Symposium.1 Persistent key questions in managing early...

bladder cancer

FDA Grants Atezolizumab Accelerated Approval as Initial Treatment for Some Advanced Bladder Cancers

On April 17, the U.S. Food and Drug Administration (FDA) granted accelerated approval to atezolizumab (Tecentriq) for the treatment of patients with locally advanced or metastatic urothelial carcinoma who are not eligible for cisplatin chemotherapy. Atezolizumab was previously approved for people...

ASCO Releases Position Statement on Access to Investigational Drugs

ASCO strongly supports increasing access to investigational new treatment options for patients with cancer, while raising serious concerns about recently proposed federal “right-to-try” legislation as well as state-enacted right-to-try laws. In a position statement released April 4, 2017, ASCO said ...

head and neck cancer

Deintensifiying Treatment of HPV-Positive Oropharyngeal Cancer Could Reduce Toxicity While Maintaining Function and Survival

“The status quo for HPV [human papillomavirus]-associated oropharyngeal squamous cell carcinoma is not sufficient.… Our treatment is effective, but the toxicity associated with it is not tolerable.” And HPV-associated oropharyngeal cancer “is a cancer of relatively younger patients,” said Nishant...

supportive care

Attrition High but Positive Trends Observed in Web-Based Intervention Addressing Caregiver Burden

High attrition but positive trends such as increased “benefit finding” were observed with a Web-based intervention designed to address the psychosocial burden on informal caregivers, according to Allison J. Applebaum, PhD, a licensed clinical psychologist at Memorial Sloan Kettering Cancer Center...

colorectal cancer

Dual HER2 Targeting of HER2-Positive Metastatic Colorectal Cancer Shows Clinical Benefit

The combination of trastuzumab (Herceptin) plus lapatinib (Tykerb) achieved positive results in patients with heavily pretreated, HER2-positive metastatic colorectal cancer, according to the final results of the phase II HERACLES-A trial. This two-pronged, HER2-directed approach achieved clinical...

lymphoma

Final Results of European Trial in Mucosa-Associated Lymphoid Tissue Lymphoma

The final results of the European phase III International Extranodal Lymphoma Study Group (IELSG)-19 trial, reported in the Journal of Clinical Oncology by Zucca et al, showed that event-free and progression-free survival were better with rituximab (Rituxan) plus chlorambucil vs either agent alone...

solid tumors

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 Apolo et al in the Journal of Clinical Oncology. This patient cohort is part of the...

issues in oncology

AACR 2017: Telomere Length May Predict Cancer Risk, According to Large Epidemiologic Study

The length of the telomeres that protect the tips of chromosomes may predict cancer risk and be a potential target for future therapeutics, University of Pittsburgh Cancer Institute (UPCI) scientists reported at the 2017 American Association for Cancer Research (AACR) Annual Meeting in...

breast cancer

Ribociclib in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

On March 13, the cyclin-dependent kinase (CDK) 4/6 inhibitor ribociclib (Kisqali) was approved for use in combination with an aromatase inhibitor as initial endocrine-based therapy for the treatment of postmenopausal women with hormone receptor–positive, HER2-negative advanced or metastatic breast ...

gastrointestinal cancer
colorectal cancer
issues in oncology

Increased Recognition of Colorectal Cancer in Young Adults, Even Those Aged 20 to 29, as Evidence Continues to Accumulate

The incidence of colorectal cancer continues to increase among young adults, with the sharpest increase among those aged 20 to 29, according to a recent article in the Journal of the National Cancer Institute.1 This trend has been called disturbing and ominous, but the widely reported results of...

palliative care

Practice-Changing Research: Making Palliative Care a Routine Part of Cancer Care in the United States and Abroad

With its recently issued clinical practice guideline update, reviewed in this issue of The ASCO Post, ASCO has spoken: Interdisciplinary palliative care teams improve the outcomes of cancer care; patients live longer and feel better.1 There is no doubt. Multiple well-designed studies show the...

survivorship

ASCO Clinical Practice Guideline on Prevention and Monitoring of Cardiac Dysfunction in Survivors of Adult Cancers

As reported in the Journal of Clinical Oncology by Saro H. Armenian, DO, MPH, of City of Hope, and colleagues, ASCO has released a clinical practice guideline on prevention and monitoring of cardiac dysfunction in survivors of adult cancers.1 Recommendations were developed by an expert panel...

geriatric oncology

New Constructs for Use in the Identification of Depression in Older Patients With Cancer

Elderly patients with cancer are far less likely to be diagnosed with depression than patients in any other age group for two primary reasons: There is an overlap between cancer symptoms/treatment side effects and the diagnostic criteria for depression, and older adults are more likely to present...

palliative care

Use of ‘Triggers’ for Palliative Care Consultation on Solid Tumor Oncology Service

In a study reported in the Journal of Oncology Practice, Adelson et al found that using standardized criteria for palliative care consultation on a solid tumor oncology service resulted in increased hospice referral and reduced rates of hospital readmission and chemotherapy use after discharge....

head and neck cancer

Pembrolizumab 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. Results of the trial were reported by Bauml et al in the Journal of Clinical Oncology....

skin cancer

Gut Bacteria May Enhance, or Hamper, Response to Anti–PD-1 Agents

The microbiome has become an area of intense interest for many health-related reasons. Add to this list the potential for a positive or a negative effect on responsiveness to immunotherapy. Gut microbiota that were more diverse, and that contained an abundance of a particular bacterial species,...

hematologic malignancies

‘Non-Engineered’ T-Cell Therapy Produces Durable Responses in Hematologic Malignancies

Adoptive T-cell therapy using “non-engineered” T cells has been showing activity in hematologic malignancies, according to a presentation by Ann M. Leen, PhD, at the 2017 ASCO-SITC Clinical Immuno-Oncology Symposium.1 Dr. Leen is an immunologist and works at the Center for Cell and Gene Therapy,...

issues in oncology

The Mystery of Grace

The day after I told Nell she had seven metastases to her brain, she sent me flowers. She was my patient; I was her oncologist. I had met her 1 year prior, when she was well into her cancer journey, stage IV breast cancer at diagnosis. I took over from her current oncologist, who was moving. At...

breast cancer

AACR 2017: Patients With Triple-Negative Breast Cancer Who Responded to Atezolizumab Had Long-Term Survival Benefit

Among patients with metastatic triple-negative breast cancer who were treated with the anti–programmed death-ligand 1 (PD-L1) immunotherapy atezolizumab (Tecentriq), those who responded to the treatment had a longer overall survival compared with those who did not respond, according to data...

lung cancer

AACR 2017: 5-Year Survival Rate for Nivolumab-Treated Advanced Lung Cancer Higher Than Historical Rate in Early-Phase Trial

Treatment with the immune checkpoint inhibitor nivolumab (Opdivo) yielded durable responses in some patients with advanced non–small cell lung cancer (NSCLC), with a 5-year survival rate of 16%, according to data from a phase I clinical trial presented by Brahmer et al at the American...

cns cancers

AACR 2017: Addition of TTFields to Temozolomide Treatment Improves Survival for Patients With Glioblastoma

Patients with glioblastoma who wore a medical device that delivers alternating electrical fields in addition to being treated with the chemotherapeutic temozolomide had significantly improved median overall survival compared with those treated with temozolomide only, according to final results from ...

solid tumors

AACR 2017: Cancer Type and Mutation Identity Influenced Response to Neratinib in a Basket Clinical Trial

In the phase II SUMMIT clinical trial, the likelihood that a patient’s cancer responded to the investigational pan-HER–targeted therapeutic neratinib was influenced by both the cancer type and the identity of the gene mutation present in the cancer, according to results presented by...

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, according to a study by Levine et al reported in JAMA Oncology. Study Details The study involved completion of surveys by 129 patient-parent dyads...

breast cancer
gynecologic cancers

Significant Increase in Number of Women Tested for BRCA Gene, but Many High-Risk Patients Remain Unidentified

About 5% to 10% of breast cancer cases and 10% to 18% of ovarian cancer cases can be attributed to two BRCA genetic mutations. Testing for these genetic abnormalities has risen steadily over the past decade. Previously, mainly women with a history of cancer were referred for genetic testing, but as ...

solid tumors

Pembrolizumab in PD-L1–Positive Malignant Pleural Mesothelioma

In an interim analysis of the phase IB KEYNOTE-028 trial reported in The Lancet Oncology, Alley et al found that pembrolizumab (Keytruda) treatment produced durable responses in patients with malignant pleural mesothelioma. Study Details The current report involves 25 patients with previously...

lung cancer

Assessment of Immunohistochemistry Assays for PD-L1 Expression in NSCLC

In a study of four immunohistochemistry programmed cell death ligand 1 (PD-L1) expression assays registered with the U.S. Food and Drug Administration (FDA), scoring was highly concordant for expression in tumor cells but poorly concordant for scoring in immune cells in non–small cell lung...

hematologic malignancies

Intestinal Microbiota and Relapse After Allogeneic Hematopoietic Cell Transplantation

A retrospective study has shown that the presence and abundance of a particular bacterial group in the intestinal microbiota are associated with a significantly lower risk of relapse or disease progression after allogeneic hematopoietic cell transplantation. The findings were reported by Peled et...

lymphoma

Interleukin-15 Levels Associated With Lymphoma Response to CAR T-Cell Treatment

As reported by Kochenderfer et al in the Journal of Clinical Oncology, remission in patients with advanced lymphoma induced by treatment with chimeric antigen receptor (CAR) T cells targeting CD19 (CAR-19) is associated with elevated serum interleukin-15 (IL-15) levels. Study Details The study...

breast cancer

Effect of Polypharmacy on Adherence to Adjuvant Endocrine Therapy for Breast Cancer

In a retrospective cohort study reported in the Journal of Oncology Practice, Calip et al found that polypharmacy overall was associated with increased adherence to adjuvant endocrine therapy for breast cancer. However, frequent use of some medication classes was associated with decreased...

lung cancer

3-Year Follow-up of Japanese Trial of Alectinib in ALK-Positive NSCLC

Promising 3-year outcomes were found in patients from a Japanese phase I/II study of alectinib (Alecensa) in previously treated patients with ALK-positive non–small cell lung cancer (NSCLC). The findings were reported by Tamura et al in the Journal of Clinical Oncology. Study Details In the ...

breast cancer

Mammography-Detected Small Breast Cancers May Represent Overdiagnosis, With Declining Mortality Reflecting Improved Systemic Therapy

In a study using Surveillance, Epidemiology, and End Results (SEER) data reported in The New England Journal of Medicine, H. Gilbert Welch, MD, of Dartmouth Institute for Health Policy and Clinical Practice, and colleagues found that screening mammography has resulted in a substantial increase in...

head and neck cancer

Delays in Radiotherapy for Head and Neck Cancer in Insured and Indigent Populations

In a study reported in the Journal of Oncology Practice, Thomas et al found that interruption of radiotherapy for head and neck cancer was more frequent and treatment outcomes were poorer among indigent populations vs commercially or Medicare-insured populations within a single academic health...

supportive care
palliative care

Examining the Impact of ‘Death With Dignity’ Legislation

Despite the controversy surrounding “Death With Dignity” laws, which allow physicians to prescribe life-ending drugs to terminally ill patients, they have a long history of majority support from Americans. According to a Gallup poll taken in 2015, nearly 7 in 10 Americans (68%) agreed that...

Discrimination in Medical Education—Another Perspective

I read with great interest Dr. ­Robert E. Montenegro’s comments in the The ASCO Post, January 25, 2017, where he felt “marginalized” when questioned about his country of origin or the quality of his English. As physicians, we constantly deal in a world of uncertainties and are required to address...

supportive care
integrative oncology
symptom management
breast cancer

Acupuncture for the Management of Hot Flashes

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, authors Jun J. Mao, MD, MSCE, and Jyothirmai Gubili, MS, present a case study...

lung cancer

Markedly Improved Progression-Free Survival With First-Line Ceritinib vs Platinum Chemotherapy in ALK-Rearranged NSCLC

In the phase III ASCEND-4 trial reported in The Lancet, Jean-Charles Soria, MD, of Institut Gustave Roussy, and colleagues found that ceritinib (Zykadia) improved progression-free survival vs platinum-based chemotherapy in the first-line treatment of advanced anaplastic lymphoma kinase...

health-care policy
pain management

ASCO Addresses New Policies That Threaten Access to Opioids

Since the mid-2000s, medication and illicit drug abuse in the United Sates has steadily increased, creating what has now been termed an “opioid epidemic.” In response, Congress and the Bush and Obama Administrations have launched intervention and regulatory proposals to help turn the troubling...

lymphoma

For One Hematologist, No Disease Progressions in Follicular Lymphoma With Rituximab Maintenance

Patients with follicular lymphoma are clearly living longer without disease progression, but what clinician has had no patients progress? Michael Auerbach, MD, a hematologist/oncologist in private practice in Baltimore and Clinical Professor of Medicine at Georgetown University, may have these...

lung cancer

Plinabulin Improves Survival in Subset of Patients With Non–Small Cell Lung Cancer

The investigational small-molecule plinabulin yielded some interesting benefits when added to docetaxel in previously treated patients with stage III/IV non–small cell lung cancer (NSCLC), in a phase II study.1 Although the benefit of the doublet was modest in the overall study population, the...

head and neck cancer

Developing Better Multidisciplinary Strategies

“More than any other disease, head and neck cancer requires constant interplay between a number of different specialties,”  Sandeep Samant, MD, Chief, Head and Neck Surgery, Northwestern Medicine, and Chair of the Multidisciplinary Head & Neck Symposium sponsored by the Robert H. Lurie...

head and neck cancer

Making the Case for Sentinel Node Biopsy in Early Cancers of the Oral Cavity

“The majority of patients with oral cavity cancers will undergo an unnecessary operation,” ­Sandeep Samant, MD, stated at a session on managing N0 neck cancer at the 2016 Lurie Cancer Center Multidisciplinary Head & Neck Symposium in Chicago.1 That operation is elective neck dissection, and it ...

breast cancer
symptom management
survivorship

Search Continues for Effective Way to Prevent Lymphedema in Breast Cancer Survivors

There was no difference in the incidence of lymphedema at 18 months in breast cancer patients randomized to a physical therapy intervention with education materials compared with a control.1 Although poor adherence to the intervention may have been a factor, these results, described as “very...

colorectal cancer

Moderate Activity May Improve Overall and Progression-Free Survival in Patients With Metastatic Colorectal Cancer

Patients with metastatic colon cancer who exercise may live longer, according to an analysis of the CALGB/SWOG 80405 trial presented at the 2017 Gastrointestinal Cancers Symposium.1 According to the authors, this is the first study to demonstrate an association between physical activity and...

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