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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...

solid tumors

FDA Approves First Treatment for Rare Adrenal Tumors

On July 30, 2018, the U.S. Food and Drug Administration (FDA) approved iobenguane I 131 injection (Azedra) for intravenous use in the treatment of adults and adolescents aged 12 and older with unresectable pheochromocytoma or paraganglioma that have spread beyond the original tumor site and require ...

leukemia
issues in oncology
immunotherapy

Guidelines for Pediatric CAR T-Cell Therapy Developed

Almost 1 year after the U.S. Food and Drug Administration (FDA) approval of chimeric antigen receptor (CAR) T-cell therapy for children with acute lymphoblastic leukemia (ALL), researchers at The University of Texas MD Anderson Cancer Center and the Pediatric Acute Lung Injury and...

breast cancer

Utilization of Hypofractionated Radiation Therapy in Breast Cancer

Researchers at the Feinstein Institute for Medical Research and Northwell Health’s Department of Radiation Medicine have identified methods to increase use of the radiation therapy hypofractionation in patients with breast cancer. These findings, published by Gilbo et al...

lung cancer
issues in oncology

Lung Cancer Screening Guidelines May Be Inadequate for High-Risk Minorities

Data from a lung cancer screening program at the University of Illinois at Chicago (UIC) provides evidence that national lung cancer screening guidelines, which were developed based on the National Lung Screening Trial (NLST) in 2011 and recommend screening based on age and smoking history, may be...

breast cancer

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

On July 18, 2018, the U.S. Food and Drug Administration (FDA) expanded the indication for ribociclib (Kisqali), in combination with an aromatase inhibitor for pre/perimenopausal women with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer, as initial endocrine-based...

supportive care
integrative oncology

Reishi Mushroom

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 use of reishi...

lymphoma
skin cancer

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

Today, the U.S. Food and Drug Administration approved mogamulizumab-kpkc (Poteligeo) injection for intravenous use for 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...

solid tumors
hematologic malignancies

FDA Warns of Increased Risk of Cancer Relapse With Long-Term Use of Azithromycin After Allogeneic Stem Cell Transplant

The U.S. Food and Drug Administration (FDA) is warning that the antibiotic azithromycin should not be given on a long-term basis to prevent the inflammatory lung condition bronchiolitis obliterans syndrome in patients with cancers of the blood or lymph nodes who undergo a donor stem cell...

skin cancer
issues in oncology

Research Finds Failings in Some Apps Used for the Diagnosis of Skin Cancer

In the scramble to bring successful apps for the diagnosis of skin cancer to market, there is a concern that a lack of testing is risking public safety, according to research led by the University of Birmingham. The research, outlined at the British Association of Dermatologists Annual...

issues in oncology

Information Valued by Patients in Selecting a Hospital for Cancer Surgery

In a study reported in the Journal of Oncology Practice, Yang et al found that most patients who had undergone surgery for cancer reported that hospital reputation would have been important to them in choosing a hospital for surgery and that they would have used a listing of best hospitals for...

supportive care
symptom management

Lack of Congruence Among Tools Used to Assess Cancer-Related Cognitive Dysfunction

THE ASSESSMENT of cognitive dysfunction in patients who have undergone chemotherapy is complex, and although a number of strategies are available, each has its limitations, according to Karin Olson, RN, PhD, Professor in the Faculty of Nursing at the University of Alberta, Edmonton, Canada.  At...

lymphoma
immunotherapy

CAR T-Cell Therapy in Lymphoma: Challenges Come With Success

THE EMERGENCE of chimeric antigen receptor (CAR) T-cell therapy has sparked a wave of optimism in hematologic malignancies, but as experience in using CAR T-cell therapy has grown, new challenges have surfaced. A pioneer in the field, David G. Maloney, MD, PhD, enlightened attendees on these issues ...

multiple myeloma

New Frontiers Being Explored in Multiple Myeloma

BEFORE TOO LONG, oncologists can expect to have an entirely new arsenal in the fight against multiple myeloma. Cutting-edge therapies on the near horizon were described in a presentation by Kenneth Anderson, MD, at the 2018 American Association of Cancer Research’s (AACR’s) inaugural conference on...

prostate cancer

Abiraterone or Enzalutamide for Newly Diagnosed Metastatic Castrate-Resistant Prostate Cancer?

WHAT IS THE best choice of treatment for a man with newly diagnosed metastatic castration-resistant prostate cancer after treatment with androgen-deprivation therapy—abiraterone acetate (Zytiga) plus prednisone, or enzalutamide (Xtandi)? Both drugs achieve similar cancer control in this setting,...

issues in oncology

Medical Preparedness for Nuclear Disaster

ROBERT PETER GALE, MD, PhD, DSc (hc), was on the faculty of the University of California, Los Angeles, School of Medicine for 20 years and has served as Chairman of the Scientific Advisory Committee of the Center for International Blood and Marrow Transplant Research. In 1986, he was asked by the...

issues in oncology
legislation

Why Oncologists Should Decline to Participate in the Right to Try Act

ON MAY 30, 2018, President Donald J. Trump signed into law the Trickett Wendler, Frank Mongiello, Jordan McLinn, and Matthew Bellina Right to Try Act of 2017.1 This law creates an additional and alternative pathway for patients with a “life-threatening disease or condition” to access...

prostate cancer

Enzalutamide Prolongs Metastasis-Free Survival in Patients With Nonmetastatic, Castration-Resistant Prostate Cancer

AS REPORTED in The New England Journal of Medicine by Maha Hussain, MD, of the Robert H. Lurie Comprehensive Cancer Center, Northwestern University, and colleagues, the phase III PROSPER trial has shown a 71% reduction in the risk of metastasis or death with enzalutamide (Xtandi) vs placebo in men ...

skin cancer

Immunosuppressants and Cutaneous Squamous Cell Carcinoma in Organ Transplant Recipients

Research published by Jung et al in OncoImmunology showed organ transplant recipients may reduce their risk of developing secondary skin cancer by changing their immunosuppressant medication. University of Queensland (UQ) researchers have studied the impact of such medications on the immune...

hematologic malignancies
leukemia
immunotherapy

FDA Approves Ivosidenib for Relapsed or Refractory Acute Myeloid Leukemia

On July 20, 2018, the U.S. Food and Drug Administration approved ivosidenib (Tibsovo) for adult patients with relapsed or refractory acute myeloid leukemia (AML) with a susceptible IDH1 mutation as detected by an FDA-approved test. Approval was based on an open-label, single-arm, multicenter...

Clinical Cancer Researcher Gini Fleming, MD, Firmly Believes in the Power of Ideas

Gini Fleming, MD, had a peripatetic path to her destination as a gynecologic and breast cancer expert. As a child, she moved around a lot, living in about 10 or 12 different places, so she had no real sense of being born and reared in any particular place. “My parents married young, when my father ...

issues in oncology

Real-World Evidence Gaining Credibility and Practicality in Treatment Evaluation

In a Friends of Cancer Research (Friends) meeting devoted to real-world evidence, members of the cancer community generally agreed that its use has an increasingly important role to play in gathering the data necessary to test, evaluate, and bring new therapeutic agents to market. This Friends...

breast cancer

Abemaciclib as Initial Therapy for Hormone Receptor–Positive, HER2-Negative Advanced or Metastatic Breast Cancer

Early in 2018, abemaciclib (Verzenio) in combination with an aromatase inhibitor was approved as initial endocrine-based therapy for postmenopausal women with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer.1,2 Supporting Efficacy Data Approval was based on findings in ...

skin cancer

Dabrafenib/Trametinib Combination Receives CHMP Recommendation for the Adjuvant Treatment of BRAF V600 Mutation–Positive Melanoma

The Committee for Medicinal Products for Human Use (CHMP) of the European Medicines Agency (EMA) has adopted a positive opinion recommending approval of dabrafenib (Tafinlar) in combination with trametinib (Mekinist) for the adjuvant treatment of adult patients with stage III melanoma...

gynecologic cancers

Use of Analgesics and Ovarian Cancer–Specific Survival

In a prospective cohort study reported in The Lancet Oncology, Merritt et al found evidence that recent use of aspirin or nonaspirin nonsteroidal anti-inflammatory drugs (NSAIDs) after diagnosis appears to improve ovarian cancer–specific survival.   Study Details The study involved...

prostate cancer

No Benefit of Adding Abiraterone to Enzalutamide in Metastatic Castration-Resistant Prostate Cancer With Increasing PSA

The PLATO trial failed to show benefit of adding abiraterone (Zytiga)/prednisone to ongoing enzalutamide (Xtandi) vs abiraterone/prednisone in men with metastatic castration-resistant prostate cancer exhibiting rising prostate-specific antigen (PSA) during enzalutamide treatment. Results of the...

breast cancer
gastroesophageal cancer
gastrointestinal cancer
immunotherapy

European Commission Approves Trastuzumab Biosimilar

The European Commission (EC) has approved Trazimera, a biosimilar to trastuzumab (Herceptin), for the treatment of human epidermal growth factor (HER2)–overexpressing breast cancer and HER2-overexpressing metastatic gastric or gastroesophageal junction adenocarcinoma. This approval...

prostate cancer

SPOP-Mutant Prostate Cancer Subtype, High PSA, and Prognosis

Conventional wisdom suggests that a high level of the protein prostate-specific antigen (PSA) in men with prostate cancer means a poor prognosis. However, this may not always be the case in men with a particular subtype of prostate cancer, according to a new study from Weill Cornell Medicine and...

skin cancer

Indocyanine Green in Sentinel Lymph Node Biopsy for Merkel Cell Carcinoma

High rates of regional lymph node involvement and metastases are not uncommon in Merkel cell carcinoma. National Comprehensive Cancer Network (NCCN) Guidelines recommend sentinel lymph node biopsy (SLNB) for staging purposes in this malignancy. In a study by Knanckstedt et al in ...

lung cancer
immunotherapy

Ado-Trastuzumab Emtansine in HER2-Mutant Lung Cancer

As reported by Li and colleagues in the Journal of Clinical Oncology, the HER2-targeted antibody-drug conjugate ado-trastuzumab emtansine (Kadcyla) showed activity in advanced HER2-mutant lung adenocarcinoma. Study Details The current report involves a cohort of patients with HER2-mutant lung...

breast cancer

Surgeon Attitudes Toward the Omission of Axillary Dissection in Early Breast Cancer

In a study reported in JAMA Oncology, Morrow and colleagues found that surgeon acceptance of more limited surgery in early breast cancer was more likely among high-volume surgeons and those preferring a surgical margin of “no ink on tumor.” As noted by the authors, the American College ...

prostate cancer

Robot-Assisted Laparoscopic Prostatectomy vs Open Radical Retropubic Prostatectomy in Newly Diagnosed Prostate Cancer

In an Australian phase III trial reported in The Lancet Oncology, Coughlin et al found similar functional outcomes at 2 years with robot-assisted laparoscopic prostatectomy and open radical retropubic prostatectomy in men with newly diagnosed clinically localized prostate cancer. Study Details In ...

issues in oncology

Complementary Therapy for Cancer and Refusal of Conventional Treatment

People who received complementary therapy for curable cancers were more likely to refuse at least one component of their conventional cancer treatment, and were more likely to die as a result, according to researchers from Yale Cancer Center and the Cancer Outcomes, Public Policy and Effectiveness...

lymphoma
immunotherapy

Julie M. Vose, MD, MBA, and David G. Maloney, MD, PhD, on NHL: Update on CAR T-Cell Therapies

Julie M. Vose, MD, MBA, of the University of Nebraska Medical Center, and David G. Maloney, MD, PhD, of Fred Hutchinson Cancer Research Center and winner of this year’s Oliver Press Memorial Award, discuss three CAR T-cell products for lymphoma treatment, comparing their efficacy, toxicity, ease of ...

leukemia

Susan M. O’Brien, MD, on CLL: Sequencing Therapy Options

Susan M. O’Brien, MD, of the University of California, Irvine, discusses three oral agents for the treatment of chronic lymphocytic leukemia/small lymphocytic lymphoma, and the use of chemotherapy for the disease.

breast cancer
genomics/genetics

Multiple-Gene Sequencing vs BRCA1/2-Alone Testing After Breast Cancer Diagnosis

In a retrospective cohort study reported in JAMA Oncology by Allison W. Kurian, MD, of Stanford University School of Medicine, and colleagues found that use of germline multiple-gene sequencing has become more common than BRCA1/2-alone sequencing after breast cancer diagnosis in clinical practice. ...

New International Journal Advances in Cell & Gene Therapy Now Available, Names Editors-in-Chief, Deputy Editors

A NEW INTERNATIONAL JOURNAL, Advances in Cell & Gene Therapy, recently published its inaugural issue in May 2018. The new publication aims to provide a forum for authors to share their newest results, views, and visions in the field of cell and gene therapy. The journal will be published on a...

integrative oncology
breast cancer

Be Prepared to Answer—and Ask—Questions About Integrative Therapy

ASCO HAS ENDORSED the recommendations in the Society for Integrative Oncology (SIO) clinical practice guidelines for integrative therapies during and after breast cancer.1,2 The guidelines “are clear, thorough, and based on the most relevant scientific evidence,” wrote the ASCO expert panel that...

breast cancer
integrative oncology

ASCO Endorses Guidelines for Integrative Therapies During and After Breast Cancer Treatment

RECOMMENDATIONS IN the Society for Integrative Oncology (SIO) clinical practice guidelines for integrative therapies during and after breast cancer treatment “are clear, thorough, and based on the most relevant scientific evidence,” concluded an ASCO expert panel that reviewed the guidelines.1,2...

issues in oncology
health-care policy

Is the Move to a Value-Based Health-Care Delivery System Feasible?

In 2015, Congress passed the Medicare Access and CHIP Reauthorization ACT (MACRA), which aims to move Medicare toward reimbursement based more on outcomes and values, a goal, in theory, shared by the oncology community. To shed light on the complicated and problematic attempt to restructure the...

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