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issues in oncology

Challenges Related to Informed Consent and Information-Sharing for Minors With Cancer

Here we discuss a complex and often emotionally wrenching challenge related to informed consent in the provision of pediatric cancer care. For example, what legal and ethical claims do young patients have to information about their cancer diagnosis and treatment recommendations? What are the...

bladder cancer
genomics/genetics

Germline-Somatic Interactions in Advanced Urothelial Cancer and Their Role in Disease Progression

In a study reported in Nature Communications, Bishoy M. Faltas, MD, of the Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, and colleagues identified common germline-somatic variant interactions in advanced urothelial cancer, with these...

covid-19

Life and Death Under COVID-19

Victoria was a 79-year-old woman living alone in a London suburb. Having no children of her own, she visited us regularly here in the United States. She was one of three sisters and my sister-in-law. I knew her for more than 50 years, and she always reminded me of Audrey Hepburn, both in looks and ...

solid tumors
immunotherapy

Naxitamab for High-Risk Neuroblastoma in Bone or Bone Marrow

On November 25, 2020, naxita­mab-gqgk (Danyelza) was granted accelerated approval for use in combination with granulocyte-macrophage colony-stimulating factor (GM-CSF) for pediatric patients 1 year of age and older and adult patients with relapsed or refractory high-risk neuroblastoma in the bone...

Expert Point of View: C. Kent Osborne, MD

C. Kent Osborne, MD, Founding Director of the Dan L. Duncan Comprehensive Cancer Center and the Dudley and Tina Sharp Chair for Cancer Research, Baylor College of Medicine, Houston, said in a press briefing that the results of the study were clear, but the explanation for the findings is less so....

lymphoma
immunotherapy

Initial Therapy for Asymptomatic Follicular Lymphoma: Start With Watch and Wait or Rituximab

For patients with indolent follicular lymphoma, generally take a conservative approach to treatment unless the patient is symptomatic, advised John P. Leonard, MD, Executive Vice-Chair of Weill Department of Medicine at Weill-Cornell Medicine/NewYork-Presbyterian, New York.1 “Prognostic scores are...

breast cancer

RxPONDER: Many Postmenopausal Patients With Node-Positive Breast Cancer Can Avoid Chemotherapy

Just in are the results of the SWOG S1007 RxPONDER trial, which evaluated the benefit of chemotherapy in women with early-stage hormone receptor–positive, HER2-negative breast cancer and node-positive disease.1 The data showed that many postmenopausal women can skip adjuvant chemotherapy, based on ...

2020 FDA Approvals of Drugs for Cancer Treatment

Over the past year (January to December 2020), the U.S. Food and Drug Administration (FDA) granted approval to several novel drugs and new indications for older therapeutic agents used in oncology and hematology. A brief review of new approvals appears here. For complete prescribing information for ...

multiple myeloma
genomics/genetics

Identifying Multiple Myeloma Prognostic Subgroups With Distinct Genetic and Clinical Features

Multiple myeloma is the second most common blood cancer, after non-Hodgkin lymphoma, diagnosed in the United States. In 2020, it is estimated that about 32,270 people will be diagnosed with the cancer, and despite advances in more effective treatments, nearly 13,000 will die of the disease.1...

hematologic malignancies

Transplant May Improve Survival in Older Patients With High-Risk Myelodysplastic Syndrome, Study Reports

Stem cell transplants are not frequently offered to older patients with high-risk myelodysplastic syndromes (MDS). According to a study from the Blood and Marrow Transplant Clinical Trials Network (BMTCTN 1102), these patients may indeed achieve a survival benefit from stem cell transplant. As...

prostate cancer

FDA Approves First Oral Hormone Therapy for Treating Advanced Prostate Cancer

Today, the U.S. Food and Drug Administration (FDA) approved relugolix (Orgovyx) for the treatment of adult patients with advanced prostate cancer.  “Today’s approval marks the first oral drug in this class and it may eliminate some patients’ need to visit the clinic for treatments that require...

breast cancer
genomics/genetics
immunotherapy

Joyce V. Lee, PhD, on Triple-Negative Breast Cancer: MYC as a Predictor of Treatment Response

Joyce V. Lee, PhD, of the University of California, San Francisco, discusses data that suggest the MYC oncogene may indicate whether a patient with triple-negative breast cancer will respond to immunotherapy. Dr. Lee’s study is the first to describe MYC downregulation of MHC-I and to demonstrate...

issues in oncology

Overcoming the Challenges of Addressing Race, Culture, and Structural Inequality in Medical Education

In 2017, a workgroup task force, made up of medical students and faculty at George Washington University, Texas Christian University, and the University of North Texas Health Science Center, conducted a literature review to identify best practices for teaching and learning about race and culture in ...

gastroesophageal cancer
issues in oncology

Study Finds Incidence of Young-Onset Esophageal Adenocarcinoma Is Rapidly Increasing

A new study published by Codipilly et al in Cancer Epidemiology, Biomarkers & Prevention investigated the trends in incidence, stage at presentation, and survival outcomes of young-onset esophageal adenocarcinoma—defined as patients aged 50 and younger at diagnosis—over the past 4 decades....

Strict Adherence to Algorithm Required

A prospective cohort study found sentinel lymph node biopsy had a 96% sensitivity rate and a 99% negative predictive value for detecting nodal metastasis among patients with clinical stage I low-grade and high-grade endometrial cancer.1 “Our study suggests that [sentinel lymph node biopsy] has...

gynecologic cancers

Study Shows Sentinel Lymph Node Biopsy to Be 'Viable Option' for Surgical Staging of Endometrial Cancer

Sentinel lymph node biopsy “had similar diagnostic accuracy and prognostic ability as lymphadenectomy in patients with high-grade endometrial cancer at greatest risk for nodal metastases,” according to the SENTOR trial, a prospective cohort study of 156 patients with clinical stage I disease. Using ...

leukemia

Study Finds Survival Disparities and Mutational Differences for Black Patients Younger Than 60 With AML

It has been well documented that, collectively, Black individuals have the highest death rates and shortest survival of any racial/ethnic group in the United States for most cancers. Black men also have the highest cancer incidence.1 Although the causes of these inequities are complex and include...

lung cancer
immunotherapy

Updated Results of CASPIAN Trial: Addition of Durvalumab With or Without Tremelimumab to Chemotherapy in Extensive-Stage SCLC

As reported in The Lancet Oncology by Goldman et al, updated results from the phase III CASPIAN trial showed maintained improvement in overall survival with first-line durvalumab plus platinum/etoposide vs platinum/etoposide in patients with extensive-stage small cell lung cancer (SCLC). However,...

breast cancer
immunotherapy

FDA Approves Margetuximab-cmkb Plus Chemotherapy for Previously Treated Patients With Metastatic HER2-Positive Breast Cancer

On December 16, the U.S. Food and Drug Administration (FDA) approved margetuximab-cmkb (Margenza) in combination with chemotherapy for the treatment of adult patients with metastatic HER2-positive breast cancer who have received two or more prior anti-HER2 regimens, at least one of which was for...

breast cancer
supportive care

Patricia A. Ganz, MD, on Younger Breast Cancer Survivors: Managing Depression

Patricia A. Ganz, MD, of the University of California, Los Angeles, discusses study findings that showed mindfulness meditation and survivorship education may effectively reduce depression and related symptoms such as fatigue and sleep disturbance, which pose serious threats to younger women’s...

palliative care
symptom management

Reducing the Risk of Lymphedema in Patients With Cancer

Although the exact incidence of treatment-related lymphedema among cancer survivors is unknown—most likely due to its prolonged latency period—it can be a lifelong chronic side effect that negatively impacts survivors’ quality of life. Although the condition is often linked to treatment for breast...

covid-19

Changes in Care and Well-Being Among Patients With Cancer During Initial Stage of the COVID-19 Pandemic

In a Dutch study reported in JAMA Oncology, van de Poll-Franse et al found that a substantial proportion of patients with cancer had changes in care within 4 to 6 weeks after the first announcement of a COVID-19–related lockdown. Patients with cancer surveyed reported levels of quality of life,...

prostate cancer

Radiation Facility Volume and Overall Survival in Patients With Node-Positive Prostate Cancer Treated With External-Beam Radiation Therapy and Androgen-Deprivation Therapy

In a National Cancer Database analysis reported in JAMA Network Open, Patel et al found that treatment at facilities with high vs low radiation case volumes was associated with improved overall survival in men with node-positive prostate cancer receiving curative-intent external-beam radiation...

bladder cancer
immunotherapy

ESMO Immuno-Oncology 2020: Adjuvant Atezoliumab for Patients With Muscle-Invasive Urothelial Cancer and Presence of Postsurgical ctDNA

Patients with muscle-invasive urothelial cancer and postsurgical circulating tumor DNA (ctDNA) positivity have high risk of disease recurrence following cystectomy and experienced improved clinical outcomes with adjuvant atezolizumab as compared to patients undergoing observation. These...

covid-19

FDA Authorizes Antigen Test as First Over-the-Counter, Fully At-Home Diagnostic Test for COVID-19

On December 15, the U.S. Food and Drug Administration (FDA) issued an emergency use authorization (EUA) for the first over-the-counter, fully at-home diagnostic test for COVID-19. The Ellume COVID-19 Home Test is a rapid, lateral-flow antigen test, a type of test that runs a liquid sample along a...

issues in oncology

Trends in AYA Cancer Incidence in the United States Over 4 Decades

Cancer cases in adolescents and young adults (AYAs) have risen by 30% during the past 4 decades, with rates of kidney cancer increasing at the greatest rate, according to findings published by Scott et al in JAMA Network Open. The team said further research into screening, diagnosis, and treatment...

issues in oncology

Postoperative Cancer Surgery Mortality Rates Have Improved, but Gap Still Exists Between Black and White Patients

Mortality rates after cancer surgery declined for Black as well as White patients during a recent 10-year period, although the mortality gap between the two groups did not narrow, according to new research published by Miranda Lam, MD, MBA, and colleagues in JAMA Network Open. The findings present...

lymphoma

ASH 2020: ctDNA May Indicate Increased Risk of Relapse After Stem Cell Transplant in Patients With DLBCL

Many patients with diffuse large B-cell lymphoma (DLBCL) may be cured by autologous stem cell transplant, but as many as half eventually relapse. New research presented by Reid Merryman, MD, and colleagues at the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition suggests...

breast cancer

SABCS 2020: CTC Enumeration May Be Predictive of Survival During Treatment for Metastatic Breast Cancer

The number of circulating tumor cells (CTCs) assessed at baseline and about 1 month after cancer-directed treatment was associated with overall survival in patients with metastatic breast cancer, according to findings from a large retrospective pooled analysis reported by Wolfgang Janni, MD, PhD,...

covid-19

FDA Issues Emergency Use Authorization for First COVID-19 Vaccine

On December 11, the U.S. Food and Drug Administration (FDA) issued the first emergency use authorization (EUA) for a vaccine for the prevention of COVID-19 caused by SARS-CoV-2 in individuals aged 16 and older. The EUA allows the Pfizer-BioNTech COVID-19 vaccine to be distributed in the United...

breast cancer

SABCS 2020: RxPONDER Study Shows Postmenopausal Patients With Node-Positive Breast Cancer May Be Able to Avoid Chemotherapy

Just in are the results of the SWOG S1007 RxPONDER trial, which evaluated the benefit of chemotherapy in women with early-stage, hormone receptor (HR)-positive, node-positive breast cancer. Based on the findings, many postmenopausal women may be able to safely skip adjuvant chemotherapy. However,...

breast cancer

SABCS 2020: Follow-up Data From monarchE Show Continued Abemaciclib Benefit in High-Risk, HR-Positive, HER2-Negative Breast Cancer

Extended follow-up results from the phase III monarchE trial showed that adding the cyclin-dependent kinase inhibitor abemaciclib to standard adjuvant endocrine therapy continued to improve invasive disease­–free survival in patients with high-risk, node-positive, early-stage, hormone receptor...

breast cancer
survivorship

SABCS 2020: Can Mindfulness Meditation and Survivorship Education Help to Reduce Depression in Young Breast Cancer Survivors?

New research showed that behavioral interventions—mindfulness meditation and survivorship education classes—may be effective in reducing depressive symptoms in younger breast cancer survivors. This patient population often experiences the highest levels of depression, stress, and fatigue, which may ...

issues in oncology
covid-19

Potential Impact of State Government Crisis Standards-of-Care Guidelines on Resource Allocation for Patients With Cancer

In a study reported in JAMA Oncology, Hantel et al found that among U.S. states with crisis standards-of-care guidelines, 55% deprioritized some patients with cancer in resource allocation and 26% included cancer-related categorical exclusions. As stated by the investigators, “State crisis...

issues in oncology

The Problem of ­Heterogeneity Within Stage

The more senior of this duo grew up with prognostication by disease stage and was taught that all stage IV cancers behaved the same. In the past 3 decades, we have become much more cognizant of the heterogeneity in outcome within stage. Individual Kaplan-Meier plots by stage separate well but hide...

Career Development Award Winner Dr. Aparna Parikh on the Emerging Importance of Liquid Biopsies for GI Cancers

Systematic liquid biopsies are transforming treatment approaches for patients with gastrointestinal (GI) cancers. Many GI tumors are detected late, which ultimately reduces 5-year overall survival rates. Liquid biopsies may become increasingly important both in the early detection and treatment...

issues in oncology

Project Orbis: Partnering With International Regulatory Agencies to Bring Earlier Global Access to Novel Cancer Treatments

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, Preeti Narayan, MD, a medical oncologist and clinical reviewer on the Breast and Gynecologic Disease Team,...

breast cancer
immunotherapy

Improved Outcomes With Neoadjuvant Paclitaxel Plus Trastuzumab/Lapatinib vs Paclitaxel/Trastuzumab in HER2-Positive Breast Cancer

In a 7-year follow-up of the phase III CALGB 40601/Alliance trial reported in the Journal of Clinical Oncology, ­Aranzazu Fernandez-Martinez, MD, of Lineberger Comprehensive Center, University of North Carolina, Chapel Hill, and colleagues found that neoadjuvant paclitaxel combined with a dual...

hepatobiliary cancer
immunotherapy

ASCO Releases Guideline on Systemic Therapy for Advanced Hepatocellular Carcinoma

ASCO has released a new evidence-based clinical practice guideline to assist in clinical decision-making for patients with advanced hepatocellular carcinoma.1 “Advanced hepatocellular carcinoma has transitioned from a disease where we had a single approved therapy for patients to one where we now...

Bristol Myers Squibb Foundation and National Medical Fellowships Launch Program to Increase Diversity in Clinical Trials

The Bristol Myers Squibb Foundation and National Medical Fellowships recently announced their new partnership, which is aimed at improving diversity in clinical trials. Leveraging $100 million of the previously announced commitment to diversity and inclusion from Bristol Myers Squibb and the...

leukemia

What Is the Measure of Minimal Residual Disease in AML?

Relapse is the primary obstacle to cure in leukemia. The term minimal residual disease (MRD) was coined in the early 1990s to describe finding a disease-specific marker in the context of a morphologic-appearing remission. The technique first used for MRD detection was the Southern blot (!), but the ...

leukemia

Meta-analysis Shows Superior Disease-Free and Overall Survival With Measurable Residual Disease Negativity in AML

In a systematic review and meta-analysis reported in JAMA Oncology, Nicholas J. Short, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, found that measurable residual disease (MRD) negativity is associated with superior disease-free and overall survival in patients with...

lung cancer

The Lung Microbiome May Affect Lung Cancer Pathogenesis and Prognosis

Enrichment of the lungs with oral commensal microbes was associated with advanced-stage disease, worse prognosis, and tumor progression in patients with lung cancer, according to results from a study published in Cancer Discovery, a journal of the American Association for Cancer Research.1 “The...

immunotherapy
solid tumors
sarcoma

Progress Report on Checkpoint Inhibitors in Rare Tumors

Immune checkpoint inhibitors may prove to be effective in treating patients with two rare cancer types—leptomeningeal metastases and angiosarcoma, according to early-phase clinical trials reported at the 2020 Annual Meeting of the Society for Immunotherapy of Cancer (SITC), which was held virtually ...

breast cancer
immunotherapy

Immunotherapy for Triple-Negative Breast Cancer: An Evolving Story

Immunotherapy with checkpoint inhibitors, established as a treatment of many solid tumors, may be finding a role in the treatment of breast cancer. The current state of the art regarding immunotherapy for triple-negative breast cancer was the focus of a talk by Heather L. McArthur, MD, MPH, Medical ...

breast cancer

Understanding Breast Cancer Diagnosis and Treatment Disparities in Resource-Challenged Nations

Cancer is the second leading cause of death in the Caribbean. Adding to this growing burden, many of the nations in this geographically spread region have under-resourced health-care systems and a lack of cohesive approaches to the delivery of cancer care. To shed light on the public health...

head and neck cancer

Researchers Join $10 Million Project to Better Understand Sex Differences in Brain Cancer Outcomes

Researchers from Penn State College of Medicine are participating in a $10 million project to better understand why men and women with a common and deadly type of brain cancer have different survival rates. The investigators hope the study results can be used to develop new therapeutic approaches...

Physician-Scientist Judah Folkman, MD, Faced Years of Skepticism Before His Theory of Angiogenesis Was Proven

That Moses Judah Folkman would buck tradition, breaking his family’s long line of rabbinical succession and pursuing a career in science and medicine instead, was evident from the time he was a young child. Born in Cleveland on February 24, 1933, the first child of Rabbi Jerome and Bessie Folkman, ...

leukemia

Front-Line Nonchemotherapy Regimens May Improve Long-Term Outcomes in CLL

An assortment of agents has been approved in the United States for the first-line treatment of chronic lymphocytic leukemia (CLL), and all of them are effective, explained Richard Furman, MD, of Weill-Cornell Medical College, NewYork-Presbyterian Hospital, New York. In the modern era, most patients ...

lung cancer
immunotherapy

Lung Cancer Progression-Free Survival With Immunotherapy Varies Significantly by Tumor-Mutation Subtype, Real-World Data Show

A real-world study of single-agent immune checkpoint inhibitors in driver-mutated non–small cell lung cancer (NSCLC) has demonstrated significant variation in progression-free survival between mutation subtypes, according to data presented during the International Association for the Study of Lung...

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