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head and neck cancer

Adding Nimotuzumab to Chemoradiation Improved Survival in Locally Advanced Head and Neck Cancer

IN PATIENTS with locally advanced squamous cell carcinoma of the head and neck, nimotuzumab—a humanized monoclonal antibody against the epidermal growth factor receptor—in combination with cisplatin and radiotherapy was superior to cisplatin and radiotherapy alone in improving progression-free...

hematologic malignancies

FDA Approves First Nonchemotherapy Combination Regimen for Patients With Waldenström’s Macroglobulinemia

ON AUGUST 27, 2018, the U.S. Food and Drug Administration (FDA) approved the combination of ibrutinib (Imbruvica) and rituximab (Rituxan) for patients with Waldenström’s macroglobulinemia. The recent approval expands the label for ibrutinib in Waldenström’s macroglobulinemia beyond its current...

lymphoma

Relapsed or Refractory Hodgkin Lymphoma: Optimizing Salvage Therapy

As novel therapies come on board for treating relapsed or refractory Hodgkin lymphoma, the field is advancing toward more personalized therapy. The goal, even in the advanced-disease setting, is to increase the chances of complete response and negative positron-emission tomography (PET), while...

breast cancer

Proteomics May Be Used to Predict Treatment Outcomes in Triple-Negative Breast Cancer

In triple-negative breast cancer, researchers have so far been unable to identify markers that can classify patients by prognosis or probability of responding to different treatments. In a study published by Zagorac et al in Nature Communications, researchers from the Spanish National Cancer...

sarcoma
immunotherapy

Immune Checkpoint Inhibitors in Patients With HIV-Associated Kaposi Sarcoma

Widespread use of antiretroviral therapy in the treatment of patients infected with human immunodeficiency virus (HIV) has led to a decline in the incidence of HIV-related Kaposi sarcoma, an incurable malignancy associated with HIV. Nevertheless, about 15% of these patients will go on to...

prostate cancer

Treating Nonmetastatic Castration-Resistant Prostate Cancer: Implications of the PROSPER Trial

A MAN in his early 70s sits in our office. His general health is good, and he is feeling well. Yet he is deeply worried. Four years ago, when his prostate-specific antigen (PSA) level rapidly increased after radical prostatectomy and subsequent radiation therapy, he was started on...

skin cancer

Overall Survival Improved With Encorafenib/Binimetinib Combination in BRAF-Mutant Melanoma

IN PATIENTS with advanced BRAF V600–mutant melanoma, combining the BRAF inhibitor encorafenib (Braftovi) with the MEK inhibitor binimetinib (Mektovi) improved overall survival compared to vemurafenib (Zelboraf) or encorafenib as monotherapy, with a favorable toxicity profile, according to updated...

issues in oncology
global cancer care

NCCN and CAOH Develop Guidelines to Improve Cancer Care in the Caribbean

The National Comprehensive Cancer Network® (NCCN®) is embarking on a new collaboration with the Caribbean Association for Oncology & Hematology (CAOH) to develop a library of NCCN Harmonized Guidelines™ for the Caribbean. The archipelago that extends from the Bahamas in the north to Trinidad...

pancreatic cancer

Protein-Metabolite Panel for Detection of Early-Stage Pancreatic Cancer

In a study reported in the Journal of the National Cancer Institute, Fahrmann et al developed and validated a plasma-derived metabolite panel that distinguished early-stage pancreatic ductal adenocarcinoma (PDAC) with high accuracy. Accuracy was further improved with the addition of a previously...

supportive care
integrative oncology

Coriolus versicolor

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. Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, present information on the potential...

breast cancer

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

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 July 18, 2018, the indication for ribociclib (Kisqali) ...

Love in the Time of Cancer

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

gastrointestinal cancer
colorectal cancer

Ipilimumab in Combination With Nivolumab for MSI-H or dMMR Metastatic Colorectal Cancer

On July 10, 2018, ipilimumab (Yervoy) was granted accelerated approval for use in combination with nivolumab (Opdivo) for the treatment of patients at least 12 years of age with microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) metastatic colorectal cancer progressing...

health-care policy
issues in oncology

Medical Groups Release Letter on Proposed Changes to Medicare Physician Payment Rule

The American Medical Association and about 150 medical groups sent the following letter to Seema Verma, Administrator of the Centers for Medicare and Medicaid Services (CMS), regarding the administration’s proposals included in the 2019 Medicare physician payment rule. The full text of...

lung cancer

FDA Approves cobas EGFR Mutation Test v2 as Companion Diagnostic With Gefitinib in First-Line Treatment of NSCLC

The U.S. Food and Drug Administration (FDA) recently approved the cobas EGFR Mutation Test v2 as a companion diagnostic test with gefitinib (Iressa) for the first-line treatment of patients with non–small cell lung cancer (NSCLC). A companion diagnostic test provides information that is...

prostate cancer
cost of care

ICER Report on Clinical Benefits and Value of Different Antiandrogen Therapies for Men With Nonmetastatic Castration-Resistant Prostate Cancer

The Institute for Clinical and Economic Review (ICER) has released an evidence report assessing the comparative clinical effectiveness and value of antiandrogen therapies for the treatment of nonmetastatic castration-resistant prostate cancer. The report focuses on three antiandrogen...

lung cancer
immunotherapy

Baseline Steroids and Efficacy of PD-1/PD-L1 Inhibitors in NSCLC

In a study reported in the Journal of Clinical Oncology, Arbour et al found that baseline treatment with corticosteroids was associated with poorer efficacy of programmed cell death protein 1 (PD-1) or programmed death cell ligand 1 (PD-L1) inhibitors in patients with non–small cell lung...

lymphoma
immunotherapy

FDA Approves Ibrutinib Plus Rituximab for Waldenström’s Macroglobulinemia

The U.S. Food and Drug Administration (FDA) has approved ibrutinib (Imbruvica) plus rituximab (Rituxan) for the treatment of adult patients with Waldenström's macroglobulinemia (WM). With this approval, the ibrutinib prescribing information now includes combination use with rituximab,...

issues in oncology

New Software Aims to Predict Patients’ Resistance to Cancer Treatment

New computer software may be used to predict how cancers may respond to a new drug—before it has ever been given to patients. Researchers hope that this new tool could transform the discovery of cancer drugs by predicting how tumors become resistant to treatment before it first becomes...

breast cancer

Dutch Quality-of-Life Study With One- vs Two-Stage Breast Reconstruction in Skin-Sparing Mastectomy

In a Dutch study reported in The Lancet Oncology, Negenborn et al found no differences in quality of life (QOL) between women receiving one-stage implant-based breast reconstruction (IBBR) with an acellular dermal matrix (ADM) vs standard two-stage IBBR. A previously reported safety analysis from...

issues in oncology

Most Oncologists Have Discussed Medical Marijuana With Patients, Survey Finds

DATA FROM a new survey show that as many as 80% of oncologists have discussed medical marijuana use with their patients. According to the authors, this is the first nationally representative survey to examine oncologists’ practices and beliefs on the subject since the implementation of state...

Fox Chase Cancer Center Welcomes Surgeon Shreyas S. Joshi, MD

  FOX CHASE CANCER CENTER recently announced the hiring of Shreyas S. Joshi, MD, an attending surgeon who recently completed a 2-year urologic oncology fellowship at the institution. Dr. Joshi is board-eligible in urology and earned his medical degree from Indiana University School of Medicine. He ...

breast cancer

I Am Too Young for Breast Cancer

Two years ago, when I began having pain and bloody discharge in my left breast, I thought it was the return of a solitary intraductal papilloma I had had in that breast when I was a college student 6 years earlier, so the symptoms didn’t initially alarm me. It wasn’t until I noticed that the mass...

leukemia
immunotherapy

Blinatumomab in Adult and Pediatric Patients With B-Cell Precursor Acute Lymphoblastic Leukemia

EARLY IN 2018, blinatumomab (Blincyto) was granted accelerated approval for the treatment of adult and pediatric patients with B-cell precursor acute lymphoblastic leukemia (ALL) in first or second complete remission with minimal residual disease ≥ 0.1%.1,2 Supporting Efficacy Data APPROVAL WAS...

leukemia

Ivosidenib for Relapsed or Refractory Acute Myeloid Leukemia

ON JULY 20, 2018, the U.S. Food and Drug Administration (FDA) approved ivosidenib (Tibsovo) for the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with a susceptible isocitrate dehydrogenase-1 (IDH1) mutation, as detected by an FDA-approved test.1,2 The FDA...

issues in oncology

Psycho-oncology: After Decades of Acceptance, Still an Emerging Field

As the field of psycho-oncology continues to mature, new studies are being conducted to evaluate ways to better address the needs of patients with cancer and their families. The ASCO Post recently spoke with Michael Hoerger, PhD, MSCR, Assistant Professor of Psychology, Psychiatry, and Oncology at ...

issues in oncology

New ESMO Tumor DNA Scale Helps Match Patients to Optimal Targeted Treatments

A new scale for tumor DNA mutations called ESCAT (European Society for Medical Oncology [ESMO] Scale for Clinical Actionability of Molecular Targets) is aiming to simplify and standardize choices for targeted cancer treatment. Information about the development and use of the scale in practice was...

bladder cancer
immunotherapy

FDA Updates Prescribing Information for Pembrolizumab and Atezolizumab in Urothelial Carcinoma

On August 16, 2018, the U.S. Food and Drug Administration (FDA) updated the prescribing information for pembrolizumab (Keytruda) and atezolizumab (Tecentriq) to require the use of an FDA-approved companion diagnostic test to determine programmed cell death ligand 1 (PD-L1) levels in tumor tissue...

Newly Updated! ASCO Resource to Help Patients Quit Tobacco

ASCO Answers: Stopping Tobacco Use After a Cancer Diagnosis offers people with cancer and their caregivers information on why and how to quit tobacco use. With information on available treatments and resources, this booklet gives patients practical tools to work with their health-care team to stop ...

issues in oncology

2019 Physician Fee Schedule and Quality Payment Program Proposed Rules Released

The Centers for Medicare & Medicaid Services (CMS) released its proposed rule for 2019 Medicare physician reimbursement.  CMS estimates that in 2019, the overall impact for the hematology/oncology specialty will be a 4% reduction in reimbursement and a 2% reimbursement reduction for...

hematologic malignancies
multiple myeloma
immunotherapy

Daratumumab in Newly Diagnosed Transplant-Ineligible Multiple Myeloma

In May 2018, daratumumab (Darzalex) was approved for use in combination with VMP (bortezomib, melphalan, and prednisone) in the treatment of patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplantation.1 Supporting Efficacy Data Approval was based on...

issues in oncology

Obesity and Cancer: Complex Interplay of Multiple Factors

The evolving concept that dietary fat plays an important role in the etiology of human cancer emerged more than 50 years ago. Ernst Wynder, MD, whose seminal epidemiologic work led to identifying smoking as a contributory cause of lung cancer, presented a paper in 1967 showing a decided correlation ...

prostate cancer

Enzalutamide in Nonmetastatic Castration-Resistant Prostate Cancer

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 July 13, 2018, enzalutamide (Xtandi) was approved for...

issues in oncology

Navigating the ‘New Normal’: NCCN Summit Examines Access to High-Quality Cancer Care

It’s not just the leaps in development of precision medicines, the soaring costs, the new payment models, clinical trial designs, sources of data, and federal policies. It’s all of them plus the rapidity with which change is happening that makes this era of oncology exceptional. “I would say...

pain management

Expert Point of View: Ian Olver, AM, MD, PhD

Though many case studies and anecdotal reports have touted the effectiveness of cannabinoids for cancer pain, in randomized studies, the areas in which they are effective are “fairly borderline,” according to Ian Olver, AM, MD, PhD, Immediate Past President of the Multinational Association of...

supportive care

Cannabinoids for Cancer Pain: Dangerous or Beneficial?

Cannabis has been used in health care for millennia, and its use has been well documented, albeit never definitively integrated into clinical practice. Recent societal changes and the increasing acceptance and availability of cannabis have reignited the medical and public debate around its role in...

supportive care

Therapeutic Applications for Cannabinoids in Oncology: The Debate Continues

In the early part of the 20th century, the U.S. government classified cannabis as a Schedule 1 drug: a dangerous substance with no medical value. For many years, that classification prevented systematic research in cannabinoid use in medicine. As a result of societal changes and an intense and...

issues in oncology

Stakeholders Agree: ‘Value’ in Cancer Care Depends on Perspective

In a roundtable discussion moderated by Clifford Goodman, PhD, of The Lewin Group, Falls Church, Virginia, representatives of the patient advocacy community, public and private payers, large and small clinics, and the pharmaceutical industry did not always see eye to eye on what “value” means nor ...

hematologic malignancies
lymphoma

FDA Approves Mogamulizumab-kpkc for Two Rare Types of Non-Hodgkin Lymphoma

On August 8, the U.S. Food and Drug Administration approved mogamulizumab-kpkc (Poteligeo) injection for intravenous use in the treatment of adult patients with relapsed or refractory mycosis fungoides or Sézary syndrome after at least one prior systemic therapy. This approval provides a new...

issues in oncology

Medical Marijuana: Research Not Anecdotes

For patients with cancer, marijuana may be valuable in controlling pain and chemotherapy-induced nausea and vomiting. Furthermore, it may have efficacy as an appetite stimulant. No randomized clinical trial has investigated the utility of whole-plant medical marijuana to alleviate these symptoms in ...

lymphoma
immunotherapy

For Hodgkin Lymphoma, PD-1 Blockade Is Not the Final Answer

Although programmed cell death protein 1 (PD-1) blockade is highly effective in Hodgkin lymphoma, not all patients respond, and not all responses are durable. Stephen M. Ansell, MD, PhD, Chair of the Mayo Clinic Lymphoma Group and Professor of Medicine at the Mayo Clinic, Rochester, described...

lung cancer

Broad-Based Genomic Sequencing in Advanced NSCLC in the Community Oncology Setting

In a study reported in JAMA, Presley et al found that use of broad-based genomic sequencing vs routine testing for EGFR mutations or ALK rearrangements alone directed treatment in a minority of patients with advanced non–small cell lung cancer (NSCLC) in the community oncology setting and was ...

palliative care

Impact of Peer-Review Intervention on Radiotherapy Schedules for Palliative Treatment of Bone Metastases

In a single-center study reported in the Journal of Oncology Practice, Walker et al found that institution of a peer-review process resulted in shorter fractionation schedules for palliation of bone metastases, consistent with current guidelines. As stated by the authors, “Shorter...

issues in oncology

Assay Uses Big Data to Predict Responses to Immunotherapy

In the age of big data, cancer researchers are discovering new ways to monitor the effectiveness of immunotherapy treatments. Researchers at the Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy developed a new way to use bioinformatics as a gathering tool to determine how ...

Leading International Cancer Organizations Call on United Nations Members to Reduce Disease Burden

ASCO AND the European Society for Medical Oncology (ESMO) are calling on leaders and health ministers of the 193 United Nations (UN) member countries to reduce the burden of all noncommunicable diseases (NCDs), including cancer. The two organizations issued a joint statement in advance of the third ...

AMA House of Delegates Adopt ASCO Resolutions

ASCO DELEGATES participated in the American Medical Association’s (AMA) June Annual Meeting of the House of Delegates (HOD). The AMA HOD is the principal policy-making body of AMA and meets twice a year to discuss pressing issues and establish association policies.  This year, delegates approved...

breast cancer

TAILORx: How to Apply This Landmark Study

TAILORx changes the configuration of the ball field and the shape of the ball in deciding which women will be recommended chemotherapy after resection of node-negative, hormone receptor–positive breast cancer. TAILORx was presented by Joseph Sparano, MD, at the 2018 ASCO Plenary Session and...

skin cancer

Encorafenib Plus Binimetinib in Unresectable or Metastatic Melanoma With BRAF Mutations

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. This past June, encorafenib (Braftovi) and binimetinib...

issues in oncology

Ensuring Quality With Patient-Reported Outcomes and Electronic Health Records

Accurately assessing the quality of cancer care over the continuum of treatment requires a special set of metrics and data-gathering methods. Moreover, with a growing number of cancer survivors, the post-treatment care involves primary care providers who are adept at managing the comorbidities...

issues in oncology

The Story of a Notorious Cluster of Childhood Cancers

BOOKMARK Title: Toms River: A Story of Science and SalvationAuthor: Dan FaginPublisher: Random HouseOriginal publication date: March 2013Price: $28.00, hardcover, 560 pages The Toms River emerges in the Pine Barrens of northern Ocean County, New Jersey, and zigzags through wetlands, emptying into...

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