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The Bomb

I sit paralyzed at my desk. Everyone else has left the clinic. I can hear the sound of the broom in the hall as the after-hours cleaning begins. No phones ring, no patients hurry to appointments, no chatter lingers in the air. The silence is oppressive, the air is heavy, and the distance from my...

Growing Up in a Medical Family Planted the Seed for a Career in Oncology for Karen Gelmon, MD

Karen Gelmon, MD, was born and reared in Saskatoon, the largest city in the Canadian province of Saskatchewan. It is surrounded by vast prairie and situated along the Trans-Canada Yellowhead Highway and is home to the University of Saskatchewan. “We lived close to the University,” she shared. “My...

gastroesophageal cancer
gastrointestinal cancer

Trifluridine/Tipiracil in Recurrent, Metastatic Gastric and Gastroesophageal Junction Adenocarcinoma

In the Clinic provides overviews of novel hematology and 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 February 22, trifluridine/tipiracil...

lung cancer

Risk-Prediction Model Aims to Predict Incident Lung Cancer in Patients With a Pulmonary Nodule

A risk-prediction model developed using clinical and radiologic features could stratify individuals presenting with a lung nodule as having a high or low risk for lung cancer, according to a study published by Nemesure et al in Cancer Prevention Research. “While lung nodules are not...

kidney cancer
issues in oncology
immunotherapy

Benefit Seen With Targeted Therapies in Elderly and Medically Complex Patients With Metastatic RCC

Many elderly and medically complex patients with metastatic renal cell carcinoma (RCC)—who are often underrepresented in clinical trials—saw overall survival benefits from treatment with targeted therapies, according to a study that analyzed 13 years of data on Medicare patients...

colorectal cancer

ESMO World GI 2019: BEACON CRC: Encorafenib/Binimetinib/Cetuximab Improves Survival in BRAF V600E–Mutated Metastatic Colorectal Cancer

The three-drug combination of encorafenib, binimetinib, and cetuximab significantly improved overall survival in patients with BRAF-mutated metastatic colorectal cancer, according to results of the phase III BEACON CRC clinical trial. These findings were presented by Kopetz et al at the European...

colorectal cancer
symptom management

ESMO World GI 2019: REARRANGE Trial Examines Flexible Regorafenib Dosing in Refractory Metastatic Colorectal Cancer

Regorafenib is often administered to patients with refractory metastatic colorectal cancer. However, some of the adverse events related to the use of this drug often limit its use in clinical practice. A study reported by Argilés et al at the European Society for Medical Oncology (ESMO)...

issues in oncology
gastrointestinal cancer

ESMO World GI 2019: Incidence of Gastric Cancer in Younger Individuals

The incidence of gastric cancer has been increasing in younger individuals, and those under 40 with chronic digestive symptoms should be more actively investigated. These findings follow new data from a retrospective, observational study in Mexico, which showed that 1 in 7 of over 2,000...

supportive care
palliative care

Improve Quality of Life With This Palliative Care Education Resource for Your Patients

Do your patients know that supportive care can help them manage their symptoms and side effects, regardless of age, cancer type, or disease stage? Make sure your patients understand the benefits of palliative care and where to access services with the ASCO Answers Palliative Care booklet. Your...

2019 Presidential Address: Caring for Every Patient, Learning From Every Patient

Welcome, everyone. We are so glad that you are all here today. Those of you attending your first ASCO Annual Meeting: Welcome to this amazing organization. What I’d like to do is to show you some of what ASCO offers, and challenge you all to join in to make a powerful future a reality. We have a...

multiple myeloma

FDA Grants Accelerated Approval to Selinexor in Combination With Dexamethasone in Pentarefractory Multiple Myeloma

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to selinexor (Xpovio) in combination with dexamethasone for adult patients with relapsed or refractory multiple myeloma who have received at least four prior therapies and whose disease is refractory to at least two...

immunotherapy
lung cancer

Combination Immunotherapy and Inhibitors of DNA Damage Repair in the Treatment of Small Cell Lung Cancer

Unlike non–small cell lung cancer (NSCLC), which has seen a paradigm shift in treatment modalities with the discovery of genetic signatures (including EGFR mutations) that are responsive to targeted drugs, systemic treatment of small cell lung cancer (SCLC) has remained largely unchanged for over...

bladder cancer

Actively Recruiting Clinical Trials for Muscle-Invasive and Non–Muscle-Invasive Bladder Cancers

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical research trials for both muscle-invasive and non–muscle-invasive bladder cancers. The studies listed here are evaluating the safety and efficacy of combinations of chemotherapy and...

Expert Point of View: Jiping Wang, MD, PhD

“The jury is still out,” said APACT’s invited discussant, Jiping Wang, MD, PhD, a biostatistician and hepatobiliary pancreas surgical oncologist at Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston. “The final overall survival analysis is needed to know the real benefit from...

Expert Point of View: Carlos H. Barrios, MD

“Margetuximab pLUS capecitabine may represent a new alternative combination for third-line treatment of HER2-positive metastatic breast cancer,” said -SOPHIA’s invited discussant Carlos H. Barrios, MD, of the Centro de Pesquisa em Oncologia and Latin American Cooperative Oncology Group in Porto...

head and neck cancer
lung cancer
issues in oncology

Do Statins Lower the Risk of Cardiovascular Complications in Patients Treated With Radiotherapy to the Chest, Neck, or Head?

Patients with cancer who took cholesterol-lowering statin medication following radiation therapy of the chest, neck, or head had significantly reduced risk of suffering a stroke—and possibly other cardiovascular complications—according to research published by Boulet et al in...

solid tumors

SNMMI 2019: Vest to Personalize Lu-177 Dotatate Therapy for Neuroendocrine Tumors

Researchers at the University of Washington are developing a user-friendly vest with technology that collects data to tailor personalized therapy for patients with metastatic, somatostatin receptor 2–positive neuroendocrine tumors (NETs). Their study was presented at the 2019 Annual Meeting...

Expert Point of View: Jordan Berlin, MD

Jordan Berlin, MD, the Ingram Professor of Cancer Research and Professor of Medicine at Vanderbilt University Medical Center, Nashville, discussed the FOxTROT study at the oral session. “FOxTROT did reach its targeted hazard ratio, but the bottom line is the P value did not quite make it to where...

gastrointestinal cancer

Study Supports Neoadjuvant Chemotherapy in Operable Colon Cancer

For patients with operable colon cancer, neoadjuvant chemotherapy resulted in numerous benefits in the FOxTROT trial but did not reach target significance for the primary endpoint. The study was presented at the 2019 ASCO Annual Meeting by Matthew T. Seymour, MD, of the University of Leeds School...

Expert Point of View: Hanna K. Sanoff, MD, MPH

Study discussant Hanna K. Sanoff, MD, MPH, of the University of North Carolina Lineberger Comprehensive Center, summarized the key results of VISNU-1: first, survival is shorter for patients with high circulating tumor cell (CTC) count; second, the incremental benefit from FOLFOXIRI (fluorouracil...

Expert Point of View: Christine Lovly, MD, PhD

Formal discussant of the studies on TAK-788 and BLU-667, Christine Lovly, MD, PhD, of the Vanderbilt Ingram Cancer Center, in Nashville, called both studies “very exciting.” “In 2019, we have a plethora of information on genomic drivers in lung cancer. There are a lot of great initiatives to drive ...

Expert Point of View: Maximilian Diehn, MD, PhD

Neoadjuvant immunotherapy is potentially attractive because it addresses micrometastases early in the course of treatment and may improve compliance with systemic therapy, said formal discussant Maximilian Diehn, MD, PhD, of Stanford Cancer Institute, Stanford University School of Medicine, Palo...

Expert Point of View: Eric P. Winer, MD, FASCO, and Sandra M. Swain, MD, FACP, FASCO

Eric P. Winer, MD, FASCO, Thompson Chair in Breast Cancer Research and Professor of Medicine, Harvard Medical School, and Director of the Breast Cancer Program at Dana-Farber Cancer Institute, Boston, commented on Dr. Sparano’s presentation for The ASCO Post. “We already use information in...

breast cancer

Clinical Risk Enhances Utility of TAILORx Findings in Young Women With Breast Cancer

Clinical risk factors add prognostic information that complements the 21-gene recurrence score, according to a new analysis from the landmark TAILORx trial.1,2 The integration of clinical risk with the recurrence score provides greater precision in determining recurrence risk and guiding the use of ...

Winning the Lottery

I was born at the beginning of World War II in a country half way around the world from the fighting. As a child, I was immune to the carnage. My father was too old to be included, although his elder brother had been killed in World War I. Thousands of families in many countries lost a father, a...

issues in oncology

Project Facilitate: FDA’s Plan to Ease Expanded Access to Novel Therapies

The U.S. Food and Drug Administration (FDA) plans to provide oncologists with greater help in acquiring expanded access to investigational therapies. Deemed Project Facilitate, the pilot program was announced at a press briefing during the 2019 ASCO Annual Meeting. Project Facilitate is essentially ...

Expert Point of View: John T. Cole, MD, and Carlos H. Barrios, MD

“The end-of-study analysis of the CLEOPATRA trial demonstrates and confirms the long-term benefit of combined HER2-antibody therapy, with a significant number of ongoing responders,” said John T. Cole, MD, breast cancer specialist and Director of Clinical Cancer Research at Ochsner Health System...

lung cancer

Extended Follow-up From the National Lung Screening Trial Reported

Early detection and treatment through screening with low-dose computed tomography (LDCT) has been investigated as a potential means of reducing lung cancer mortality for more than 2 decades. In 2011, a large U.S. study—the randomized National Lung Screening Trial (NLST)—reported a 20%...

prostate cancer

SNMMI 2019: PSMA PET During Lu-177–PSMA Radioligand Therapy May Help Guide Treatment

Prostate-specific membrane antigen (PSMA) positron-emission tomography (PET) imaging of patients with metastatic castration-resistant prostate cancer after two cycles of lutetium-177 (Lu-177)-PSMA radioligand therapy has shown a significant predictive value for patient survival. The research was...

prostate cancer
survivorship

Evaluation of PROMIS Measures After Radical Prostatectomy

In a study reported in the Journal of Clinical Oncology, Agochukwu et al validated the sexual interest and sexual satisfaction single-item measures of the Patient-Reported Outcome Measurement Information System (PROMIS) in men who underwent radical prostatectomy for prostate cancer. The study ...

lymphoma

15-ICML: Can Serum Biomarkers Provide Prognostic Information in Relapsed Mantle Cell Lymphoma?

Data presented by Lokhande et al at the 15th International Conference on Malignant Lymphoma (ICML; Abstract 360) focused on noninvasive strategies to guide patient stratification for relapsed mantle cell lymphoma. Researchers used an antibody-based platform to identify serum proteins in patients...

hematologic malignancies
multiple myeloma

IMWG Consensus Recommendations on Imaging in Monoclonal Plasma Disorders

Just as newer drugs have significantly improved outcomes for patients with multiple myeloma in the past decade, newer imaging techniques are upgrading detection of the disease, leading to earlier treatment, but standards to help guide clinicians on the optimal use of advanced imaging have lagged...

symptom management
immunotherapy

Multidisciplinary Approach for Addressing Immunotherapy-Related Toxicities

New research published in JNCCN—Journal of the National Comprehensive Cancer Network and presented by Jarushka Naidoo, MBBCh, at the NCCN 2019 Annual Conference suggests that institutions and networks that utilize immunotherapy should consider establishing multidisciplinary teams for...

health-care policy
issues in oncology

Leading Organizations Call on Congress to Help Eliminate HPV-Related Cancers

Today, the American Association for Cancer Research, Moffitt Cancer Center, and Biden Cancer Initiative hosted a congressional briefing titled “Let’s End HPV-Related Cancers” in Washington, DC. In conjunction with this briefing, leading health organizations and...

issues in oncology

Accelerated Approval Program: For the Benefit of Patients

A DIAGNOSIS of any life-threatening cancer or other serious illness has always been a world-shaking event for those touched by significant disease, and most of us have known—or will know—the frustration, helplessness, and desperate sense of urgency provoked by the words, “The disease is worsening,...

Trainee and Early-Career Members: Tips for Maximizing Your Benefit From ASCO Membership

ASCO is one of the premier professional societies that is guiding oncologists throughout the world. Whether you are a medical student or an early-career oncologist, ASCO has a lot to offer. A main focus of ASCO is to promote and provide guidance to trainees and early-career oncologists. I consider...

2019 ASCO Educational Book Explores Practice-Changing Cancer Research

The 2019 ASCO Annual Meeting included groundbreaking science that has the potential to influence oncology care for years to come—but how should that science be applied in practice? The National Library of Medicine–indexed 2019 ASCO Educational Book aims to answer that question with compelling,...

head and neck cancer

Actively Recruiting Clinical Trials for Oral, Head, and Neck Cancers

THIS CLINICAL TRIALS Resource Guide includes actively recruiting clinical studies that focus on different techniques; treatments; and technology for oral, head, and neck cancers. More specifically, these trials are evaluating different drug combination regimens for both tumor treatment and pain...

head and neck cancer
immunotherapy

Synergistic Relationship Between Radiotherapy and Immunotherapy for Squamous Cell Carcinoma of the Head and Neck

Recent technologic improvements in radiotherapy now offer an unprecedented opportunity to enhance immune response, and going forward, may play a role in the definitive treatment of head and neck cancer, according to William Stokes, MD, Assistant Professor in the Department of Radiation Oncology at...

immunotherapy
head and neck cancer

Immune Therapies Emerging in Disease-Specific Treatment of HPV-Positive Head and Neck Cancer

Patients with human papillomavirus (HPV)-related head and neck cancer stand to benefit greatly from immunotherapy, according to Nabil F. Saba, MD, FACP, Director, Head and Neck Medical Oncology Program, Winship Cancer Institute of Emory University, Atlanta. He added, immunotherapy will likely play...

issues in oncology

ASCO Launches Task Force to Address the Cancer Care Gap in Rural America

Despite progress being made in cancer survivorship—there are currently nearly 17 million cancer survivors in the United States1—not everyone is benefiting equally, especially those patients living in rural communities across America. According to “The State of Oncology Practice in America, 2018:...

cns cancers
immunotherapy

Update on Early-Stage Studies of Novel Treatments in Glioblastoma

Outcomes are typically grim for patients with recurrent glioblastoma multiforme. At the 2019 Annual Scientific Meeting of the American Association of Neurological Surgeons (AANS), three early-stage studies hinted at ways that standard treatments might be made more effective. Metronomic Dosing of...

head and neck cancer
immunotherapy

Expert Point of View: Vanita Noronha, MD

The KEYNOTE-048 trial is practice-changing, according to its invited discussant, Vanita Noronha, MD, Professor of Oncology at Tata Memorial Centre in Mumbai, India. Although a number of questions remain to be answered, she said the take-home message is that the study “met most of its primary...

leukemia
immunotherapy

Fixed-Duration Venetoclax Plus Obinutuzumab as First-Line Treatment in Older Patients With CLL Who Have Comorbidities

A fixed-duration regimen of venetoclax plus obinutuzumab demonstrated superior progression-free survival, complete response rates, and minimal residual disease (MRD) negativity compared with chlorambucil plus obinutuzumab as first-line therapy for older patients with chronic lymphocytic leukemia...

Expert Point of View: Charles Drake, MD, PhD

IN A SEPARATE interview with The ASCO Post, Charles Drake, MD, PhD, commented on the clinical implications of the ENZAMET and TITAN trials, as well as studies of apalutamide, abiraterone acetate, and docetaxel used in metastatic hormone-sensitive prostate cancer. Dr. Drake is Director of...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Expert Point of View: Ian Chau, MD

IAN CHAU, MD, a consultant medical oncologist at the Gastrointestinal and Lymphoma Units of The Royal Marsden NHS Foundation Trust in London and Surrey, United Kingdom, was the invited discussant of KEYNOTE-062. In an interview with The ASCO Post, he first commented that although single-agent...

pancreatic cancer

POLO Trial Shows Maintenance Olaparib Improves Progression-Free Survival in Metastatic Pancreatic Cancer

In patients with metastatic pancreatic cancer and germline mutations in BRCA1 or BRCA2, maintenance therapy with olaparib doubled the time to disease progression and the proportion of patients who were progression-free at 2 years, in the phase III POLO trial.1 “Maintenance olaparib provided a...

issues in oncology
colorectal cancer

Solving the Mystery of Why Colorectal Cancer Is on the Rise in Young Adults

Excluding skin cancer, colorectal cancer is the third most prevalent and lethal cancer among both men and women in the United States.1 Although the risk of developing colorectal cancer increases with age—more than 90% of cases occur in people aged 50 or older2—recent research shows that the...

issues in oncology

An ASCO Survey, Hope, and Conventional Therapies

HOW DO YOU respond when patients with a good prognosis want to delay chemotherapy to try an anticancer diet for a few months or visit an unregulated clinic for unproven therapies? I’m asking because of an alarming finding of ASCO’s 2018 National Cancer Opinion Survey: “Nearly 4 in 10 Americans...

prostate cancer

Chemotherapy and/or Hormonal Agents: Differing Perspectives

WHEN ASKED which treatment to start with—docetaxel or enzalutamide, Dr. Sweeney said, “Patients fit for chemotherapy with high-volume disease can receive chemotherapy [docetaxel] and come back to these newer hormonal treatments or start with anyone of the hormonal options. Choosing among the newer...

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