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bladder cancer
immunotherapy

FDA Restricts Use of Pembrolizumab or Atezolizumab to Treat Urothelial Cancer Due to Efficacy Concerns in Some Patients

As of June 20, the U.S. Food and Drug Administration (FDA) has restricted the use of pembrolizumab (Keytruda) and atezolizumab (Tecentriq) for patients with locally advanced or metastatic urothelial cancer who are not eligible for cisplatin-containing therapy. The restriction results from a...

In Continued Effort to Address Physician Burnout, AMA Adopts Policy to Improve Physician Access to Mental Health Care

With growing concern among the medical community and the public regarding physician and medical student depression, burnout, and suicide, the American Medical Association (AMA) adopted policy during its Annual Meeting that continues its efforts aimed at improving physician access to mental health...

lung cancer
immunotherapy

FDA Expands Approval of Pembrolizumab for First-Line Treatment of NSCLC

The U.S. Food and Drug Administration (FDA) recently granted accelerated approval to the immune checkpoint inhibitor pembrolizumab (Keytruda) for use in combination with chemotherapy as a first-line treatment for patients with metastatic non–small cell lung cancer (NSCLC). KEYNOTE-021 This...

breast cancer

Long-Term Results of Adjuvant Endocrine Therapy in Premenopausal Breast Cancer

In an analysis of long-term outcomes in the SOFT and TEXT trials reported at the 2018 ASCO Annual Meeting and in The New England Journal of Medicine, Francis et al found that the addition of ovarian suppression to adjuvant tamoxifen significantly improved 8-year rates of disease-free and overall...

lung cancer

Disparities Found in Lung Cancer Care, Survival in United States vs England

DESPITE STEADY declines in death rates in recent years, lung cancer remains the leading cause of cancer deaths in wealthy countries. In a study published by Anita Andreano, MD, of the University of Milan-Ciocco, and colleagues in the Journal of Thoracic Oncology,1 Yale researchers collaborated with ...

gynecologic cancers

FDA Grants Priority Review to Expanded Use of Gardasil 9 in Women and Men Aged 27 to 45 for the Prevention of Certain HPV-Related Cancers and Diseases

On June 13, the U.S. Food and Drug Administration (FDA) accepted for review a new supplemental biologics license application (sBLA) for recombinant human papillomavirus (HPV) 9-valent vaccine (Gardasil  9). The application is seeking approval for an expanded age...

issues in oncology

Statement From FDA Commissioner on Agency Efforts to Advance the Patient Voice in Medical Product Development and Regulatory Decision-Making

U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, recently issued the following statement: Over the past decade, advances in our understanding of the basic biology of serious and life-threatening diseases has led to the development and FDA approval of targeted treatments for ...

leukemia

Suboptimal Use of Initial Chemotherapy in Newly Diagnosed AML

In a study of National Cancer Database data reported in Blood Advances, Bhatt et al found that 25% of patients with newly diagnosed acute myeloid leukemia (AML) did not receive initial chemotherapy, despite evidence that chemotherapy is associated with a survival benefit and improvement in symptoms ...

hematologic malignancies

From Italy to Boston, A Love of Molecular Diagnostics Shapes a Career for Valentina Nardi, MD

Valentina Nardi, MD, is a staff pathologist at Massachusetts General Hospital, and her current clinical work includes implementing molecular assays for hematologic malignancies at the Center for Integrated Diagnostics. “I was born in Rome, but I did my high school and college education in Genoa. I ...

palliative care

How Learning What’s on Your Patient’s Bucket List May Improve Care

It may sound too good to be true, but asking patients a simple question about what is on their bucket list can actually spark a dialogue about how best to make their cancer care and survivorship fit into their life plans, as well as be an effective way to identify their end-of-life care goals,...

issues in oncology
palliative care

Voluntarily Stopping Eating and Drinking Is Legal—and Ethical—for Terminally Ill Patients Looking to Hasten Death

Terminally ill patients with cancer will sometimes ask their clinicians for help with assisted or hastened death.1 Although palliative care and hospice care can usually address the concerns of most patients, some have physical or existential suffering that is refractory to comfort and supportive...

Meet Federal Reporting Requirements With QOPI® Reporting Registry

The QOPI® Reporting Registry, a Qualified Clinical Data Registry (QCDR) brought to you by ASCO and the American Society for Radiation Oncology (ASTRO), is your one-stop shop for 2018 Centers for Medicare and Medicaid Services (CMS) Merit-based Incentive Payment System (MIPS) reporting. The new...

breast cancer

Regular Mammograms Linked to Less Aggressive Treatment in Patients With Breast Cancer

A STUDY evaluating the impact of breast cancer screening has shown that the benefits of regular mammograms extend well beyond reduced mortality. According to data presented at the American Society of Breast Surgeons (ASBrS) 2018 Annual Meeting, women with breast cancer who underwent regular...

breast cancer

AJCC Breast Cancer Staging System More Clinically Relevant

THE RECENTLY issued 8th revision to the American Joint Committee on Cancer (AJCC) Breast Cancer Staging System incorporates tumor biology and prognostic stage groups and thus has become more accurate and clinically relevant, according to two speakers at the 2018 Miami Breast Cancer Conference.1,2...

solid tumors
prostate cancer

Prostate Cancer Therapy in Evolution: Time to Rethink and Redirect?

The ASCO updated guidelines on the treatment of metastatic non-castrate prostate cancer penned by Morris and his colleagues1 provide valuable information annotated to the strengths of evidence in recently reported prostate cancer studies. CHAARTED, GETUG-AFU 15, LATITUDE, and STAMPEDE have...

solid tumors
prostate cancer

De Novo Metastatic Prostate Cancer: Positive Recent News, Many Open Questions

After about 70 years with no significant progress, the landscape for men with de novo metastatic prostate cancer has changed dramatically in the past 4 years, with statistically significant and highly clinically meaningful survival improvement reported from multiple phase III trials when...

prostate cancer

DNA Test Identifies Men With Sixfold Increased Risk of Prostate Cancer

A major new study of more than 140,000 men has identified 63 new genetic variations in the DNA code that increase the risk of prostate cancer. These findings were published by Schumacher et al in Nature Genetics. Researchers devised a new test combining these single-letter genetic variants with...

issues in oncology

Parents See Cancer Prevention Potential as Best Reason for HPV Vaccination

Parents of adolescents believed that the potential to prevent certain types of cancer is the best reason for their children to receive the human papillomavirus (HPV) vaccine, whereas other reasons health-care providers often give were far less persuasive. Findings from this study were published by...

solid tumors
prostate cancer

ASCO Clinical Practice Guideline: Optimizing Anticancer Therapy in Metastatic Non-castrate Prostate Cancer

As reported in the Journal of Clinical Oncology by Michael J. Morris, MD, of Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, and colleagues, ASCO has released a clinical practice guideline on optimizing anticancer therapy in men with metastatic non-castrate prostate cancer.1 To ...

solid tumors
lung cancer

Nivolumab Plus Ipilimumab Improves Progression-Free Survival in NSCLC With High Tumor Mutational Burden

The combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) improved progression-free survival compared with chemotherapy as first-line treatment for patients with advanced non–small cell lung cancer (NSCLC) and a high tumor mutational burden irrespective of programmed cell death ligand 1...

solid tumors
gastrointestinal cancer

Optimizing Biologics in Metastatic Colon Cancer

Biologics are credited with increasing median overall survival in colorectal cancer to approximately 30 months. Their optimal use was discussed by Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, in an article he coauthored for the Journal of Oncology Practice 1...

solid tumors
gastrointestinal cancer
colorectal cancer

Care for Colorectal Cancer Costs Twice as Much in Western Washington vs British Columbia, With Similar Survival

It is widely acknowledged that the costs of cancer care are much higher in the United States than in Canada, with outcomes that are thought to be similar. A new study presented at the 2018 ASCO Annual Meeting supports that view, by documenting and quantifying the differences in health-care costs...

Expert Point of View: Kenneth C. Anderson, MD, FASCO, Adam D. Cohen, MD, Craig Hofmeister, MD, MPH, and Bruce Cheson, MD

Kenneth C. Anderson, MD, FASCO, of Dana-Farber Cancer Institute, Boston, noted that the iNNOVATE trial is the first randomized comparison of ibrutinib (Imbruvica) plus rituximab (Rituxan) vs “a very active control—rituximab—to which 50% of patients responded.” The study showed that “the...

Expert Point of View: Andrew Epstein, MD

“This is a very important study,” said ASCO expert Andrew Epstein, MD, of Memorial Sloan Kettering Cancer Center (MSK), New York. “Hyperthermic intraperitoneal chemotherapy is used in the United States and elsewhere, even though the benefits are unknown. This study shows there are no benefits, and ...

Expert Point of View: Charles G. Drake, MD, PhD and Hatem H. Soliman, MD

Formal discussant of the GeparNuevo presentation, Charles G. Drake, MD, PhD, of the Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center, New York, said, “It is important that neoadjuvant immunotherapy combinations are being studied. There is a lot of enthusiasm for...

hematologic malignancies
leukemia

Minimal Residual Disease Testing in AML: Still a Shifting Target

Testing for minimal residual disease (MRD) has become an established part of the management of acute lymphoblastic leukemia (ALL), but in acute myeloid leukemia (AML), the technology still warrants validation. To address issues and set new standards, the European LeukemiaNet Working Party recently ...

hematologic malignancies

EHA 2018: Ruxolitinib Reduces Risk of Thrombosis, Death in Patients With Polycythemia Vera

A new comparison study showed that among polycythemia vera patients who were resistant or intolerant to hydroxyurea, those treated with ruxolitinib (Jakavi) had a significantly reduced risk of thrombosis and death compared to those who received best available therapy. The study findings are based...

Expert Point of View: Colin D. Weekes, MD, PhD and Andrew Epstein, MD

Colin D. Weekes, MD, PhD, of Massachusetts General Hospital and Harvard Medical School, called the results of the PRODIGE trial “practice-changing.” Dr. Weekes was the invited discussant of the study and was interviewed by The ASCO Post. “The magnitude of effect is beyond what we have ever seen in...

solid tumors
pancreatic cancer

Adjuvant Modified FOLFIRINOX Yields Unprecedented Survival in Pancreatic Cancer

Adjuvant treatment with modified FOLFIRINOX resulted in the longest overall survival yet reported for patients with resected pancreatic cancer, according to the results of the phase III Unicancer GI PRODIGE 24/CCTG PA.6 trial, presented at the 2018 ASCO Annual Meeting.1 With adjuvant modified...

breast cancer
solid tumors

FDA Clears Expanded Indication of Scalp-Cooling System

Paxman’s advanced scalp-cooling system has now been cleared by the US Food and Drug Administration (FDA) for use during treatment of patients with solid tumors. The system is now indicated to reduce the likelihood of chemotherapy-induced alopecia in cancer patients with solid tumors such as...

issues in oncology

ASCO Guideline for Geriatric Oncology: Practical Assessment and Management of Vulnerabilities in Older Patients Receiving Chemotherapy

As reported in the Journal of Clinical Oncology by Supriya G. Mohile, MD, of the University of Rochester Medical Center, and colleagues, ASCO has produced a guideline on the practical assessment and management of vulnerabilities in geriatric patients receiving chemotherapy. To develop the...

breast cancer
issues in oncology
survivorship

Study Finds Breast Cancer Survivors Are Not Getting Recommended Number of Mammograms Postsurgery

Breast cancer survivors are not getting the recommended level of screening postsurgery, according to a study by Ruddy et al in JNCCN–Journal of the National Comprehensive Cancer Network. The study was led by Kathryn Ruddy, MD, MPH, Director of Cancer Survivorship for the Department of...

issues in oncology

Opportunities, Issues, and Challenges for Biosimilars in Oncology

In an article in The New England Journal of Medicine, Lyman et al reviewed opportunities, issues, and challenges posed by the advent of biosimilar medications, focusing on biosimilars in cancer treatment. Although these agents could help to meet the health-care goals of high quality care with cost...

breast cancer
lung cancer

Characteristics and Screening of Brain Metastases in Breast Cancer and NSCLC

In a research letter published in JAMA Oncology, Cagney et al found that brain metastases were more advanced and more likely to be symptomatic in patients with breast cancer compared to patients with non–small cell lung cancer (NSCLC). Current guidelines recommend magnetic resonance imaging...

gynecologic cancers
immunotherapy

FDA Approves Bevacizumab Plus Chemotherapy in Advanced Ovarian Cancer Following Initial Surgery

Today, the U.S. Food and Drug Administration (FDA) approved bevacizumab (Avastin) in combination with chemotherapy (carboplatin and paclitaxel) followed by bevacizumab as a single agent for the treatment of women with advanced (stage III or IV) ovarian cancer following initial surgical resection....

breast cancer

ASCO Clinical Practice Guideline Focused Update: Selection of Optimal Adjuvant Chemotherapy and Targeted Therapy for Early Breast Cancer

As reported by Neelima Denduluri, MD, of US Oncology Network, Virginia Cancer Specialists, and colleagues in the Journal of Clinical Oncology, ASCO has issued a focused update on the clinical practice guideline on optimal chemotherapy and targeted therapy in early breast cancer. To develop the...

prostate cancer

AUA 2018: Finasteride Reduces Risk of Prostate Cancer and Is Safe, Long-Term Results Show

Twenty-five years after it opened for enrollment, the Prostate Cancer Prevention Trial (PCPT) has delivered a final verdict: finasteride, a common hormone-blocking drug, reduces men's risk of getting prostate cancer without increasing their risk of dying from the disease. Initial study...

leukemia
lymphoma
immunotherapy

Rapid Progression of Adult T-Cell Leukemia/Lymphoma During PD-1 Inhibitor Therapy

In a letter to the editor in The New England Journal of Medicine, Ratner et al describe rapid progression of adult T-cell leukemia/lymphoma (ATLL) in three consecutive patients receiving programmed cell death protein 1 (PD-1) inhibitor therapy with nivolumab (Opdivo). As stated by the authors,...

ASTRO Collaborates With ASCO and Conquer Cancer to Support Methods Workshop

For the third year, the American Society for Radiation Oncology (ASTRO) is supporting the ASCO/American Association for Cancer Research (AACR) Workshop on Methods in Clinical Cancer Research, to take place July 18–August 3, 2018, at Vail Mountain Marriott Resort in Vail, Colorado.  Celebrating its ...

lung cancer

Early Evidence of Neoadjuvant PD-1 Blockade in Non–Small Cell Lung Cancer

A NOVEL APPROACH using two doses of nivolumab (Opdivo) prior to surgery achieved major pathologic responses in 45% of patients with resectable stages I to IIIA non–small cell lung cancer (NSCLC), according to the results of a small Stand Up 2 Cancer–Cancer Research Institute Dream Team study...

gynecologic cancers
pain management

Study Evaluates Effect of Restrictive Opioid Protocol After Gynecologic Surgery

THE NUMBER of opioids prescribed after surgery for gynecologic cancer decreased significantly after implementation of an ultra-restrictive opioid prescription protocol, with no apparent negative effect on patient satisfaction or pain, according to research presented by Jaron Mark, MD, and...

gynecologic cancers

Expert Point of View: Oliver Dorigo, MD, PhD

COMMENTING ON the study, invited discussant Oliver Dorigo, MD, PhD, of Stanford University, said that tumor size and disease site are useful clinical parameters for predicting nonresponse to immunotherapy and should be considered when selecting and “unselecting” patients for immunotherapy...

lung cancer
symptom management
cns cancers

Quick Takes From Original Research Presented at the 2018 NCCN Annual Conference

THE QUANTITY of original research presented at the National Comprehensive Cancer Network® (NCCN®) Annual Conference has been growing, and at the 2018 meeting, 121 researchers presented their work. The ASCO Post captured some of the findings for this report.  Blood Markers Correlate With Anti–PD-1...

pancreatic cancer

Using Neoadjuvant Therapy to Reduce Early Recurrences, Increase Survival in Patients With Pancreatic Cancer

USE OF THE FOLFIRINOX regimen (fluorouracil, leucovorin, irinotecan, and oxaliplatin) was associated with a 4.9-month improvement in overall survival compared to gemcitabine/ nab-paclitaxel (Abraxane) in the neoadjuvant treatment of resectable and borderline-resectable pancreatic head...

breast cancer
symptom management

Early Detection and Intervention Reduce Breast Cancer–Related Lymphedema

A NEW STUDY has found that early detection along with a simple intervention can be highly effective in preventing breast cancer–related lymphedema for at-risk women. According to data presented at the 2018 Annual Meeting of the American Society of Breast Surgeons,1 82% of women identified at an...

breast cancer

Recurrence Rates After Lumpectomy Significantly Improved in Patients Receiving ‘Modern-Era’ Therapy

A STUDY OF local recurrence rates following lumpectomy has shown significant improvement in patients receiving modern, multimodal therapies, suggesting breast-conserving surgery may be an option for more patients with breast cancer, according to data presented at the 2018 American Society of Breast ...

issues in oncology
geriatric oncology

Geriatric Assessment Improves Communication Between Oncologists and Older Patients

A FEDERALLY FUNDED randomized study demonstrated that use of geriatric assessment in the routine care of older adults with advanced cancer significantly improved doctor-patient communication about age-related concerns as well as patient satisfaction with the communication. The study was presented...

head and neck cancer

Mobile and Sensor Technology May Lead to Reduced Symptoms of Head and Neck Cancer and Its Treatment

A RANDOMIZED clinical trial evaluating the use of mobile and sensor technology to remotely monitor symptoms in patients receiving radiation therapy for head and neck cancer found that use of this technology reduced the severity of symptoms related to cancer and its treatment compared with usual...

lung cancer

Immunotherapy Benefits Survival, Improves Safety, vs Platinum-Based Chemotherapy for PD-L1–Expressing NSCLC

IMMUNOTHERAPY WITH pembrolizumab (Keytruda) improved overall survival compared with investigator’s choice of platinum-based chemotherapy as first-line treatment for patients with advanced non–small cell lung cancer (NSCLC) in the KEYNOTE-042 trial. Median overall survival was improved by 4 to 8...

‘Pearls of Wisdom’ for Leadership and Success in Academic Medicine Gathered Over a 35-Year Career

Dr. Hayes, ASCO President 2016–2017, is Professor of Internal Medicine; Stuart B. Padnos Professor in Breast Cancer; and Clinical Director of the Breast Oncology Program at the University of Michigan Comprehensive Cancer Center, Ann Arbor. AS I COMPLETE my 3-year term as ASCO President, I am...

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