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issues in oncology
cost of care

Curbing Financial Toxicity: What Might Work, and What Won’t Work

To stem the rising tide of financial toxicity in cancer care, creative physician reimbursement strategies, by themselves, will not work, according to a thought leader in the field who advocated for elimination of the federal mandate against price negotiation, curbing the power of monopolies, and...

pancreatic cancer

Early Research May Unlock How Pancreatic Cancer Metastasizes to the Liver

Douglas Fearon, MD, Professor at Cold Spring Harbor Laboratory, and colleagues may have discovered how pancreatic cancer metastasizes to the liver following surgery, as reported by Pommier et al in Science. “This discovery is significant because for patients who undergo pancreatic cancer...

colorectal cancer
breast cancer
hepatobiliary cancer
lung cancer
kidney cancer
prostate cancer
cns cancers
leukemia

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2018 Guidelines Updates

In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®) covering 8 tumor types. Guidelines are now published for more than 60 tumor types and topics. Some of the key updates were presented at NCCN’s 23rd...

skin cancer
immunotherapy

Surgery After Checkpoint Blockade for Selected Patients With Metastatic Melanoma

“In the era of improved systemic therapy, checkpoint blockade for metastatic melanoma and the ability to surgically resect all disease after treatment are associated with survival of 75%, better than what has been previously reported,” Danielle M. Bello, MD, said in summarizing study results during ...

solid tumors
breast cancer

Endocrine Therapy: An Important Treatment Limited by Major Challenges

“Endocrine therapy remains the most effective and least toxic treatment for breast cancer, but we have many problems to solve. And there will have to be many different solutions,” according to George W. Sledge, MD, FASCO, Professor of Medicine and Chief of the Division of Oncology at Stanford...

ASCO’s Incoming President Sets Her Goals for the Next Year

  With all the advances in oncology care over the past decade, the most important contribution to high-quality care remains the personal connection between oncologist and patient, said Monica M. Bertagnolli, MD, FACS, FASCO, ASCO President-Elect, who will take the reins as ASCO’s 55th President...

Expert Point of View: William M. Sikov, MD and Sunil Verma, MD

The ASCO Post obtained comments about the Persephone trial results from two breast cancer experts. William M. Sikov, MD, is Associate Director of Clinical Research at the Program in Women’s Oncology at Women and Infants Hospital of Rhode Island and Associate Professor of Medicine and of...

breast cancer
immunotherapy

For Adjuvant Trastuzumab, 6 Months Is Noninferior to 12 Months

The noninferiority phase III Persephone trial could shake up the standard of care for adjuvant trastuzumab (Herceptin), showing that patients with early-stage HER2-positive breast cancer derived as much benefit from 6 months of trastuzumab as 12 months, according to research from the United Kingdom ...

breast cancer

Effect of GnRHa Treatment During Chemotherapy on Preservation of Ovarian Function and Fertility in Premenopausal Patients With Early Breast Cancer

A meta-analysis of patient-level data reported by Lambertini et al in the Journal of Clinical Oncology indicated that temporary ovarian suppression with gonadotropin-releasing hormone agonists (GnRHa) during chemotherapy was effective in preserving ovarian function and fertility in premenopausal...

breast cancer

Risk of Breast Cancer After Negative Screening Mammography

In a study reported in JAMA Oncology, McCarthy et al identified the risk of interval breast cancer after negative screening mammography, including risk of poor-prognosis breast cancer. Study Details The study involved mammography data from the Population-Based Research Optimizing Screening...

breast cancer
immunotherapy

2018 ASCO: Shortening Adjuvant Trastuzumab to 6 Months in Patients With HER2-Positive Early Breast Cancer Is Effective and Reduces Cardiac Toxicities

Persephone, a large phase III randomized noninferiority study conducted in the United Kingdom comparing 6 months to 12 months of trastuzumab (Herceptin) in patients with HER2-positive early breast cancer has found 6 months of trastuzumab to be noninferior to 12 months of the therapy. In addition,...

Thriving at Your First ASCO Annual Meeting

The ASCO Annual Meeting is the world’s largest multidisciplinary oncology conference, attracting over 30,000 attendees each year. Countless advances are unveiled in Chicago year after year. The sense of excitement generated by knowing that clinical practice may change for the bettering of our...

ASCO Hosts Inaugural State of Cancer Care in America Event to Examine Issues in Precision Medicine

Precision medicine is changing cancer care in profound ways. It is expected that the number of patients who benefit from precision medicine will continue to increase in the coming years, as treatments become more effective and research yields more insights on patient populations who are most likely ...

legislation
cost of care

New Laws Reduce Costs of Oral Cancer Drugs, but Not for All

The rising cost of anticancer drugs not only adds fiscal pressure to our overburdened health-care system, but also increases the stress on patients with cancer and their families. High out-of-pocket spending may cause significant financial toxicity, even for patients with good health insurance...

symptom management

Planning for Potential Adverse Effects of Oral Chemotherapy

THE USE OF oral chemotherapy drugs is becoming more and more prevalent—for many types and stages of cancer, during different treatment phases, and for varying lengths of time. So it’s vital that physicians, nurses, and advanced practitioners understand all the potential adverse events of these...

skin cancer

Updated ASCO/SSO Guideline on Sentinel Lymph Node Biopsy in Melanoma: Addressing Fundamental Clinical Questions

Dr. Thompson is Professor of Melanoma and Surgical Oncology, Sydney Medical School, The University of Sydney, and Senior Surgeon, Melanoma Institute Australia, Sydney. IN THE MID-1990s, the surgical management of patients presenting with primary cutaneous melanomas changed forever when the...

head and neck cancer

Circulating Tumor DNA May Guide Treatment Intensity in Advanced HPV-Associated Head and Neck Cancers

A MULTI-INSTITUTIONAL analysis of circulating tumor DNA extracted from the plasma of patients has shown that human papillomavirus type 16 (HPV16) DNA is detectable in the majority of cases of favorable-risk HPV-associated oropharyngeal squamous cell carcinoma and may be a clinically useful...

breast cancer

Can Some Patients With Early Breast Cancer Avoid Surgery?

RESEARCHERS AT The University of Texas MD Anderson Cancer Center are testing the possibility of safely eliminating surgery in patients with breast cancer who are “exceptional responders” to neoadjuvant therapy, according to Henry M. Kuerer, MD, PhD, a breast cancer surgeon who described this...

solid tumors
issues in oncology
symptom management

NCCN Debuts Three New Sets of Guidelines

THE NATIONAL Comprehensive Cancer Network® (NCCN®) debuted three sets of completely new guidelines for treating patients with uveal melanoma, for treating patients who have cancer and the human immunodeficiency virus (HIV), and for managing immune-related toxicities.  Cancer in People Living With...

skin cancer
immunotherapy

Adjuvant Pembrolizumab Improves Relapse-Free Survival in High-Risk Stage III Melanoma

ADJUVANT THERAPY with pembrolizumab (Keytruda) significantly prolonged recurrence-free survival compared with placebo for patients with resected high-risk stage III melanoma, according to the results of the EORTC 1325/KEYNOTE-054 trial.1 Patients who received pembrolizumab had a 43% reduction in...

issues in oncology

Evolving Standards and Quality Metrics Ensure High-Quality Cancer Programs

Dr. Shulman is Deputy Director, Clinical Services, and Director of the Center for Global Cancer Medicine, Abramson Cancer Center; and Professor of Medicine, Hospital of the University of Pennsylvania, Philadelphia. IN 2008, WHEN ALLEN LICHTER, MD, FASCO, then Chief Executive Officer of ASCO,...

lung cancer
immunotherapy

Pembrolizumab Plus Standard Chemotherapy Improves Survival in Newly Diagnosed Metastatic Non–Small Cell Lung Cancer

ADDING THE IMMUNE checkpoint inhibitor pembrolizumab (Keytruda) to standard chemotherapy with pemetrexed (Alimta) and a platinum as first-line therapy was superior to chemotherapy alone in the KEYNOTE-189 trial.1 Induction and maintenance therapies with the new triplet therapy improved overall...

cns cancers

Early-Phase Trial of Carboxyamidotriazole Orotate and Temozolomide in Glioblastoma

In a phase Ib trial reported in the Journal of Clinical Oncology, Omuro et al found evidence of activity of carboxyamidotriazole orotate plus temozolomide in patients with recurrent anaplastic gliomas or glioblastoma and previously untreated glioblastoma. Carboxyamidotriazole orotate is an...

breast cancer

ASBrS 2018: Early Detection and Intervention Effective for Preventing Breast Cancer–Related Lymphedema

Early, ongoing screening of lymphatic function and immediate patient-administered therapies as needed are highly effective in improving outcomes for women at high risk for breast cancer–related lymphedema (BCRL). These were the findings of a new study presented at the American Society of ...

breast cancer

ASBrS 2018: Breast Cancer Genetic Testing Guidelines Exclude Almost Half of High-Risk Patients

Current restrictive genetic testing guidelines exclude many patients who harbor high-risk breast cancer mutations, according to two new studies presented at the American Society of Breast Surgeons (ASBrS) 19th Annual Meeting (Abstracts 402910, 404340). One study found that whether or not patients...

issues in oncology

Doctoring Is a Family Tradition for Medical Oncologist Virginia G. Kaklamani, MD

Virginia G. Kaklamani, MD, Professor of Hematology/Oncology at the UT Health Science Center San Antonio and leader of the center’s breast cancer program, was born and reared in Athens, Greece. “I spent my formative years in Athens, where I attended school. My father is a physician and my mom’s a...

breast cancer

Long-Term Quality-of-Life Results Compared for Two Radiotherapy Strategies After Breast-Conserving Surgery

As reported in The Lancet Oncology by Schäfer et al, little difference in quality of life was observed over long-term follow-up between women receiving accelerated partial-breast irradiation (APBI) with interstitial brachytherapy vs whole-breast irradiation (WBI) after breast-conserving...

issues in oncology
legislation

Decision Aids Reflect Patients’ Values and Preferences for Care: So Why Aren’t More Oncologists Using Them?

Overwhelming evidence shows that patient decision aids, such as educational booklets, videos, or Web-based tools that take into account patients’ values and personal preferences, hold enormous promise for improving the informed consent process. Patient decision aids both reduce unwanted medical...

solid tumors
prostate cancer

Should We Treat Rising PSA in Men With Castrate Androgen Levels?

In rapid succession, the SPARTAN study results were presented at the 2018 Genitourinary Cancers Symposium, the data were published in The New England Journal of Medicine,1 and the drug apalutamide -(Erleada) was approved by the U.S. Food and Drug Administration (FDA) for men with previously...

skin cancer

Melanoma Research Alliance Announces New Grants

The Melanoma Research Alliance has announced funding for research grants totaling more than $11 million. The awards will fund researchers at 23 institutions across the United States, Australia, and Belgium to conduct research to advance the prevention, diagnosis, and treatment of melanoma. This...

solid tumors

FDA Grants Orphan Drug Designation to BN-Brachyury for the Treatment of Chordoma

On May 2, the U.S. Food and Drug Administration (FDA) granted orphan drug designation to the cancer vaccine BN-Brachyury for the treatment of chordoma. Chordoma is a rare type of cancer that develops along the spine, with presentation occurring at one of three main sites: sacrum, mobile spine, or...

skin cancer

Men With Nonmelanoma Skin Cancer History May Have Reduced Risk of Death From Melanoma

Skin cancer survivors know firsthand that the disease is most treatable when detected early, so they’re more likely to be vigilant about skin exams—and new research shows that such vigilance pays off. After studying more than 900 cases of melanoma reported through the Health...

breast cancer

New Breath and Urine Tests May Detect Early Breast Cancer More Accurately

A new method for early, more accurate breast cancer screening has been developed by researchers at Ben-Gurion University of the Negev and Soroka University Medical Center using commercially available technology. Their findings were published by Herman-Saffar et al in Computers in Biology and...

multiple myeloma

MGUS and Multiple Myeloma in 9/11 Firefighters

A study by Landgren et al in JAMA Oncology has found that New York City firefighters exposed to the 9/11 World Trade Center (WTC) disaster site face an increased risk for developing monoclonal gammopathy of undetermined significance (MGUS), a myeloma precursor disease. The study was conducted...

gynecologic cancers

Proportion of Cancer Cell Nuclei With High Chromatin Entropy and Outcome in Gynecologic Cancers

In a study reported in the Journal of the National Cancer Institute, Nielsen et al found significant associations between higher proportions of cancer cell nuclei with high chromatin entropy (associated with genomic instability) and poorer outcomes in gynecologic cancers. Study Details In the...

breast cancer

Many Economic Evaluations of Oncotype DX May Have Misleading Conclusions

Research from the Yale School of Public Health has found that the majority of published papers analyzing the cost-effectiveness of a widely used test for breast cancer used a study design that can increase bias. These findings were published by Wang et al in the Journal of Clinical Oncology....

skin cancer
immunotherapy

Immune-Related Toxicity With Combination Immunotherapy for Melanoma

As reported in JAMA Oncology by Alexander N. Shoushtari, MD, of the Memorial Sloan Kettering Cancer Center, and colleagues, a single-center experience has shown a very high rate of clinically significant immune-related adverse events with nivolumab (Opdivo) plus ipilimumab (Yervoy) for advanced...

Fabrice Barlesi, MD, PhD, Receives 2018 Heine H. Hansen Award

THE EUROPEAN SOCIETY for Medical Oncology (ESMO) and the International Association for the Study of Lung Cancer (IASLC) have announced that the 2018 Heine H. Hansen Award was given to Fabrice Barlesi, MD, PhD. The award was presented at the 2018 European Lung Cancer Congress (ELCC 2018) in early...

integrative oncology

Massage Therapy for Patients With Cancer

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Ting Bao, MD, DABMA, MS, reviews the current data on the use of massage to...

cost of care

Cancer Cost Planning and Accounting for Patients Under 65

A new study published by Banegas et al in JNCCN–Journal of the National Comprehensive Cancer Network has found that cancer care costs in the United States are higher for people under age 65—and that costs increase with disease stage. Despite the fact that nearly half of new cancer...

issues in oncology
survivorship

ASCO Clinical Practice Guideline Update: Fertility Preservation in Patients With Cancer

As reported in the Journal of Clinical Oncology by Kutluk Oktay, MD, PhD, of Yale University School of Medicine, and colleagues, ASCO has issued a clinical practice guideline update on fertility preservation in adults and children with cancer. The update was informed by an update panel systematic...

solid tumors
colorectal cancer

Nut Consumption in Patients With Stage III Colon Cancer

People with stage III colon cancer who regularly eat tree nuts are at significantly lower risk of cancer recurrence and mortality than those who don’t, according to findings published by Fadelu et al in the Journal of Clinical Oncology.1 Study Findings The study followed 826 participants in the...

cns cancers

A Clinician’s Guide to Treating Patients With Glioblastoma

Glioblastoma, a grade 4 astrocytoma, is the most common and most aggressive form of primary brain tumors in adults. The most recent guidance on molecular profiling, diagnostic and prognostic factors, and treatments for newly diagnosed and recurrent diseases was described in the Journal of Oncology ...

A Career Based on Service: Both Medical and Military

For this installment in the Living a Full Life series of articles, Edith Peterson Mitchell, MD, was interviewed by Guest Editor Jame Abraham, MD, FACP. Dr. Mitchell is Clinical Professor of Medicine and Medical Oncology in the Division of Medical Oncology at Thomas Jefferson University as well as ...

Expert Point of View: C. Kent Osborne, MD

C. Kent Osborne, MD, Director of the Dan L. Duncan Cancer Center at Baylor College of Medicine, Houston, and moderator of a press conference where the EMBRACA findings were presented, shared his thoughts on the study. While a few months’ improvement in the risk of disease progression may seem...

breast cancer

Talazoparib Reduces Risk of Disease Progression in BRCA-Mutated Breast Cancer

In patients with BRCA-positive advanced breast cancer, talazoparib reduced the risk of disease progression or death by 46% vs chemotherapy, according to the phase III EMBRACA trial presented at the 2017 San Antonio Breast Cancer Symposium.1 “We are very pleased that the EMBRACA trial—the largest...

supportive care
issues in oncology

Distress Screening: ‘Underestimated and Overlooked’ by Cancer Specialists

The National Comprehensive Cancer Network® (NCCN®) Distress Thermometer and Problem List for Patients have been around since 1999,1 and in 2015, the American College of Surgeons Commission on Cancer mandated routine distress screening at cancer centers.2  So how successful has the cancer community...

Leslie Bernstein, PhD, Receives AACR–American Cancer Society Award for Research Excellence

Biostatistician and epidemiologist Leslie Bernstein, PhD, Professor in the Division of Biomarkers of Early Detection and Prevention, Department of Population Sciences, at City of Hope, has been selected to receive the American Association for Cancer Research’s (AACR) 27th Annual American Cancer...

skin cancer
immunotherapy

AACR 2018: TLR9 Agonist CMP-001/Pembrolizumab Combination Shows Early Efficacy in Patients With Metastatic Melanoma Resistant to Anti–PD-1

A combination of CMP-001, an intratumoral Toll-like receptor 9 (TLR9) agonist, and pembrolizumab (Keytruda) was well tolerated and had clinical activity in patients with metastatic melanoma resistant to programmed cell death protein 1 (PD-1) checkpoint inhibition, according to preliminary data...

AACR 2018: Prototype Assays Suggest Highly Specific Blood Test to Screen for Cancer Is Feasible

Initial findings from the Circulating Cell-Free Genome Atlas (CCGA) study showed that prototype sequencing assays tested in this analysis may facilitate the development of a highly specific blood test for early cancer detection, according to data presented at the American Association for Cancer...

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