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integrative oncology

Advancing the Science and Art of Integrative Oncology

In 2019, we will mark the 20th year of the establishment of the Integrative Medicine Service at Memorial Sloan Kettering Cancer Center (MSK), which helped lay the foundation for the emerging field of integrative oncology. Over the past 2 decades, academic cancer institutions, including The...

colorectal cancer

Direct-to-Consumer Genetic Test on Hereditary Colorectal Cancer Syndrome Receives FDA Clearance

ON JANUARY 22, 2019, 23andMe received U.S. Food and Drug Administration (FDA) clearance for a genetic health risk report on the hereditary colorectal cancer syndrome MUTYH-associated polyposis. The clearance follows the FDA’s authorization for 23andMe’s BRCA1/BRCA2 (Selected Variants) Genetic...

leukemia
lymphoma

FDA Approves Ibrutinib in Combination With Obinutuzumab in Treatment-Naive CLL/SLL

ON JANUARY 28, 2019, the U.S. Food and Drug Administration (FDA) approved ibrutinib (Imbruvica), a Bruton’s tyrosine kinase inhibitor, in combination with obinutuzumab in treatment-naive patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). This is the first approval of...

immunotherapy

How Turning ‘Cold’ Tumors Into ‘Hot’ Ones May Improve Response to Immunotherapy

The proliferation of immunotherapeutics in the treatment of cancer over the past decade has revolutionized the way many cancers are treated, especially lung cancer and melanoma, as well as some blood cancers, including leukemia and lymphoma, drastically improving outcomes for many patients with...

myelodysplastic syndromes

Novel Treatments of Myelodysplastic Syndromes

AS PART of The ASCO Post’s continued coverage of the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition, here is an update on seven different studies on new therapeutics in myelodysplastic syndromes (MDS). Among the treatments highlighted here are the erythroid maturation...

integrative oncology

Integrative Oncology Scholars Program: Model for Evidence-Based Complementary Care

THE FIRST full year of educational training in the practice of complementary therapies is now underway at the University of Michigan in Ann Arbor through its Integrative Oncology Scholars Program, which launched in 2017. The program, which is supported through a 5-year grant from the National...

immunotherapy

Machine Learning Identifies Multiple Underlying Factors Predicting Response to Immunotherapy

A research team is using a branch of artificial intelligence known as machine learning to better target immunotherapy to those who will benefit. In a recent study published by Leiserson et al in PLOS One, the team used data from a clinical trial of patients with bladder cancer to...

palliative care
issues in oncology

Site of Care May Affect Racial and Ethnic Minorities’ Access to Palliative Treatment

For patients at the end of life, palliative care can prolong survival and improve the quality of life for patients with a life-threatening illness and for their families—but studies have found that racial and ethnic minorities are less likely to receive end-of-life palliative care than...

hematologic malignancies
symptom management

Letter to the Editor: Survey on DOACs in Cancer-Related Venous Thromboembolism

This letter is a follow-up to a report published previously in The ASCO Post. Recent trials report comparable or improved efficacy of direct-acting oral coagulants (DOACs) over low–molecular-weight heparins (LMWH) in the treatment of cancer-related VTE (cVTE) at the expense of increased...

solid tumors

Impact of Stereotactic Ablative Radiotherapy on Survival for Patients With Advanced Cancers

The first report from a phase II, multicenter clinical trial has found that a newer, more aggressive form of radiation therapy—stereotactic ablative radiation—can extend long-term survival for some patients with stage IV cancers, while maintaining their quality of life. The study was...

breast cancer

Effect of Peer Review Within a Cancer Care Network on Use of Hypofractionated Radiotherapy for Early-Stage Breast Cancer

In a study reported in the Journal of Oncology Practice, Ganju et al found that implementation of a cancer care network–wide peer review process aimed at standardizing treatment resulted in increasing use of hypofractionated radiotherapy in early-stage breast cancer at community-based...

issues in oncology

American Lung Association's State of Tobacco Control Report Released

According to the American Lung Association’s recently released 2019 State of Tobacco Control report, states and the federal government have not taken meaningful action in establishing policies to prevent and reduce tobacco use, the nation's leading cause of preventable death and disease. ...

prostate cancer

Quality of Life in Men Living With Advanced and Localized Prostate Cancer

In a population-based study reported in The Lancet Oncology, Downing et al found little difference in health-related quality of life (HRQOL) between men with advanced vs localized prostate cancer. Sexual function problems were common among all patients—and often not addressed—and use of ...

issues in oncology

New Standards for Safe Handling of Hazardous Drugs Focus on Developing Evidence-Based Measures

ASCO recently published standards on the safe handling of hazardous drugs in the Journal of Clinical Oncology.1 ASCO’s standards largely endorse best practices issued by other stakeholder groups for safely handling hazardous drugs but offer alternatives in several key areas where more research is...

leukemia

Data Mount for Venetoclax as Add-on Therapy in Acute Myeloid Leukemia

The benefit of adding venetoclax to a hypomethylating agent or low-dose cytarabine in the front-line treatment of acute myeloid leukemia (AML) was evident from a number of studies reported at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition (see Table 1). For elderly...

Expert Point of View: Mrinal S. 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,...

breast cancer

Selected Abstracts From the San Antonio Breast Cancer Symposium

Each year, The ASCO Post asks Jame Abraham, MD, FACP, Director of the Breast Oncology Program at Taussig Cancer Institute and Professor of Medicine at the Cleveland Clinic Lerner College of Medicine, to offer his picks for the most important research presented at the 2018 San Antonio Breast Cancer ...

hepatobiliary cancer

Ramucirumab in Sorafenib-Pretreated Patients With Advanced HCC and Increased α-Fetoprotein

In the phase III REACH-2 trial reported in The Lancet Oncology, Zhu et al found that ramucirumab improved overall and progression-free survival vs placebo in patients with advanced hepatocellular carcinoma (HCC) and increased α-fetoprotein levels who had previously received sorafenib. Study...

immunotherapy
gastrointestinal cancer

First-Line Trastuzumab Plus Pembrolizumab Shows Efficacy in Patients With Metastatic Esophagogastric Cancer

When added to first-line chemotherapy in patients with untreated metastatic HER2-positive esophageal, gastroesophageal junction, and gastric adenocarcinoma, the combination of pembrolizumab and trastuzumab produced responses in 87% of patients, with 100% of patients experiencing disease control and ...

issues in oncology

Essential Elements of an Effective Clinical Trials System: Business and Mission

Clinical trials aimed to improve health and quality of life are the cornerstone of progress in medicine. Support comes from academic medical centers, philanthropy, the National Institutes of Health (NIH), industry, or combinations thereof. Clinical trials need to be hypothesis-driven and address...

lung cancer
immunotherapy

Lung-MAP Precision Medicine Trial Expands

The Lung Cancer Master Protocol (Lung-MAP), the first precision medicine trial in lung cancer supported by the National Cancer Institute (NCI), is undergoing a major expansion to include patients with all non–small cell lung cancers (NSCLCs). The trial previously tested treatments for people ...

skin cancer
immunotherapy

How Effective Is Talimogene Laherparepvec Injection in Metastatic Melanoma?

Injection of a genetically modified virus that induces the body’s own immune cells to attack metastatic melanoma effectively treated almost 40% of patients with tumors that could not be surgically removed, according to findings published by Louie et al in the Journal of the American...

gastroesophageal cancer

Effectiveness of EsophaCap Tool in the Diagnosis of Barrett’s Esophagus

Barrett’s esophagus is the only known precursor of esophageal adenocarcinoma. Although endoscopy and biopsy are standard methods for diagnosing Barrett’s esophagus, their high cost and risk limit their use as a screening modality. Researchers sought to develop a screening method based...

breast cancer
cost of care

Cost-Effectiveness Analysis of Gene-Expression Profiling Assay in Breast Cancer

A new report published by Wang et al in JNCCN—Journal of the National Comprehensive Cancer Network found that using Oncotype DX—the most commonly used test for predicting the benefit of adjuvant chemotherapy to reduce the risk of disease recurrence—is not...

prostate cancer

Long-Term Effects of Finasteride vs Placebo on Prostate Cancer Mortality

In a letter to the editor of The New England Journal of Medicine, Goodman et al reported a long-term follow-up of the Prostate Cancer Prevention Trial indicating that finasteride treatment was not associated with an increased risk of death from prostate cancer. Study Details As previously...

leukemia
lymphoma

FDA Approves Ibrutinib in Combination With Obinutuzumab in Treatment-Naive CLL/SLL

Today, the U.S. Food and Drug Administration (FDA) approved ibrutinib (Imbruvica), a Bruton's tyrosine kinase inhibitor, in combination with obinutuzumab in treatment-naive patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). This is the first approval of a...

leukemia
myelodysplastic syndromes

Combination Azacitidine and Lenalidomide as Salvage Therapy for Relapsed AML After Allogeneic Stem Cell Transplantation

In a phase I trial reported in the Journal of Clinical Oncology, Craddock et al found evidence that the sequential combination of azacitidine and lenalidomide may be an effective salvage therapy in patients with acute myeloid leukemia (AML) relapsing after allogeneic stem cell transplantation...

lymphoma

Hastening the Development of Novel Therapies for Peripheral T-Cell Lymphomas

Peripheral T-cell lymphomas (PTCLs) make up a small fraction of all non-Hodgkin lymphomas—just 15%—in the United States.1 Although rare in the United States, the incidence of PTCL is common across Asia, the Caribbean, and sub-Saharan Africa. Although the reason for such global variation in PTCL is...

Community Oncology Alliance Elects New Officers and Board Members

THE COMMUNITY Oncology Alliance (COA) recently announced that Michael Diaz, MD, a practicing medical oncologist at Florida Cancer Specialists & Research Institute, has been elected President of COA. His 1-year term began on January 1, 2019. In addition, Kashyap Patel, MD, a practicing...

Georgia Society of Clinical Oncology, Other Medical Associations Win Concessions in CVS/Aetna Merger

THE GEORGIA SOCIETY of Clinical Oncology (GASCO), in partnership with the Medical Association of Georgia, the Georgia Pharmacy Association, and Georgia Watch, worked with the Georgia Office of the Insurance Commissioner to secure what is described as “significant, one-of-a-kind concessions” from...

breast cancer
immunotherapy

Challenge Moving Forward in Breast Cancer Treatment: To Show That New Approaches Change Outcomes

ADVANCES IN treating breast cancer over the past 20 years have brought us to the point where treatment can be confidently de-escalated for some patients, and immunotherapy and precision decision-making may change the way breast cancer is treated for others, William Gradishar MD, FASCO, told the...

breast cancer

Preventing Locoregional Recurrence of Breast Cancer Should Not Deter Efforts to Decelerate Therapy

“SURGEONS AND radiation oncologists are obsessed with locoregional recurrence of breast cancer,” Monica Morrow, MD, FASCO, remarked at the 2018 Lynn Sage Breast Cancer Symposium, Chicago. Working to prevent locoregional recurrence, “even if it may not be the major threat to mortality, is...

breast cancer

Risk of Local Recurrence in Breast Cancer: Impact of Molecular Subtype and Surgical Approach

THE RISK of local recurrence in breast cancer “does not differ substantially based on the operation we perform, but it does differ substantially by subtype,” Tari A. King MD, FACS, stated at the 2018 Lynn Sage Breast Cancer Symposium in Chicago.1 At 10-year follow-up, Dr. King reported, local...

leukemia

Use of Isocitrate Dehydrogenase Inhibitors in Induction Therapy for Newly Diagnosed AML

IN AN OPEN-LABEL phase I study of 153 patients newly diagnosed with acute myeloid leukemia (AML) and mutations in isocitrate dehydrogenase-1 (IDH1) or IDH2, treatment with standard chemotherapy plus the oral IDH inhibitors ivosidenib and enasidenib led to high response rates and possibly impressive ...

symptom management
issues in oncology

Primary Prophylaxis With a Direct Oral Anticoagulation Agent Reduces Venous Thromboembolism Rate in Ambulatory Patients With Cancer

LATE-BREAKING results from the large, randomized, placebo-controlled CASSINI trial showed that primary prophylaxis with the direct oral anticoagulation agent rivaroxaban reduced the incidence of venous thromboembolism (VTE) as well as VTE-related deaths in high-risk patients with cancer who were...

breast cancer
symptom management

Expert Point of View: C. Kent Osborne, MD

COMMENTING ON the ACCRU study SC-1603, press conference moderator C. Kent Osborne, MD, Director of the Dan L Duncan Comprehensive Cancer Center at Baylor College of Medicine in Houston and Co-Director of the San Antonio Breast Cancer Symposium, said: “In patients who have breast cancer, I usually...

breast cancer
symptom management

Oxybutynin: A Novel Option for Managing Hot Flashes?

OXYBUTYNIN, AN ANTICHOLINERGIC drug approved for the treatment of overactive bladder, reduced the frequency and intensity of hot flashes in women who were suffering frequent hot flashes, including breast cancer survivors who were receiving tamoxifen or aromatase inhibitors. These results of the...

issues in oncology

ACCC 2018 Survey Finds Multiple Barriers to Cancer Program Growth

At a time of unprecedented advances in the science of cancer, growing complexity in cancer treatments, and ongoing health policy fluctuation, the Association of Community Cancer Centers (ACCC) 9th annual Trending Now in Cancer Care survey reveals how cancer programs across the country are ...

issues in oncology

HPV Vaccination Rates in Younger Adolescents

Only about 16% of U.S. adolescents have been fully vaccinated against human papillomavirus (HPV) by the time they turn 13, despite national recommendations that call for vaccination at 11 to 12 years of age. These findings, published by Bednarczyk et al in the Journal of Infectious Diseases,...

lymphoma

PET-Adapted Treatment in Newly Diagnosed Advanced Hodgkin Lymphoma

In the phase III AHL2011 trial reported in The Lancet Oncology, Casasnovas et al found that positron-emission tomography (PET)-guided treatment produced good outcomes in newly diagnosed advanced Hodgkin lymphoma, allowing de-escalation of induction to ABVD (doxorubicin, bleomycin, vinblastine, and...

immunotherapy
lung cancer

PACIFIC Trial of Durvalumab Sets Standard in Stage III Unresectable NSCLC

IMMUNOTHERAPY HAS revolutionized the treatment of lung cancer over the past several years. Although lung cancer is associated with immunosuppression at baseline for most patients, the addition of immune checkpoint inhibitors can overcome that suppression and lead to antitumor immune responses....

issues in oncology
cost of care

How to Save Billions on Cancer Care Costs: The Potential of Value-Based Prescribing in Oncology

IT IS TIME for value-based prescribing—the reduction of prescribing costs using basic pharmacologic principles—to be tested and deployed in oncology. The savings are real and there for the taking. If you are concerned about the high costs in cancer care, here is a chance to get maximum value for...

breast cancer

Expert Point of View: Virginia G. Kaklamani, MD; Monica Morrow, MD; and John Cole, MD

AT THE SAN ANTONIO Breast Cancer Symposium, several breast cancer experts interviewed by The ASCO Post noted that the approved dose of tamoxifen was arbitrarily set, and the optimal dose is actually unknown. Studies of lower-dose tamoxifen, therefore, are welcomed. Virginia G. Kaklamani, MD,...

breast cancer

Low-Dose Tamoxifen Halves Breast Cancer Risk in Women With Preinvasive Breast Lesions

A VERY LOW DOSE of tamoxifen—5 mg/d, given for 3 years rather than 5 years—halved the risk of breast cancer recurrence or new lesions over placebo in women with breast intraepithelial neoplasia, without producing the usual toxicities seen with the standard dose, Italian researchers reported at the...

health-care policy
lung cancer

Shared Decision-Making and Use of Low-Dose CT Screening for Lung Cancer

In a study reported in a research letter in JAMA Internal Medicine, Goodwin et al found that only a small proportion of Medicare enrollees undergoing low-dose computed tomography (CT) screening for lung cancer had a prescreening shared decision-making session, which is mandated by the Centers for...

colorectal cancer

23andMe Receives FDA Clearance for Direct-to-Consumer Genetic Test on a Hereditary Colorectal Cancer Syndrome

On January 22, 23andMe received U.S. Food and Drug Administration (FDA) clearance for a genetic health risk report on MUTYH-associated polyposis, a hereditary colorectal cancer syndrome. The clearance follows the FDA’s authorization for 23andMe’s BRCA1/BRCA2 (Selected Variants)...

kidney cancer

Personalized Treatment May Extend Life Expectancy for Patients With Chronic Kidney Disease and Small Renal Tumors

Personalized treatment plans may extend life expectancy for patients with early-stage kidney cancer who also have risk factors for worsening kidney disease, according to a new study published by Kang et al in Radiology. Kidney tumors are often discovered at an early stage and are frequently...

lymphoma

Survival With Combined Modality Therapy vs Chemotherapy Alone in Early-Stage Pediatric Hodgkin Lymphoma

In an observational cohort study reported in JAMA Oncology, Jhawar et al found that combined modality therapy (CMT) with chemotherapy followed by radiotherapy was associated with a survival advantage vs chemotherapy alone in early-stage pediatric Hodgkin lymphoma. The authors noted that use of...

issues in oncology

Established, Modifiable Cancer Risk Factors

According to a new American Cancer Society report published by Susan M. Gapstur, PhD, MPH, American Cancer Society Senior Vice President of Behavioral and Epidemiology Research, and colleages in CA: A Cancer Journal for Clinicians, the highest priority in a national cancer control plan is the...

immunotherapy
symptom management

Adoptive T-Cell Therapy for Progressive Multifocal Leukoencephalopathy

An emerging treatment known as adoptive T-cell therapy has proven effective in a phase II clinical trial for treating progressive multifocal leukoencephalopathy (PML), a rare and often fatal brain infection sometimes observed in patients with cancer and other diseases in which the immune system is...

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