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issues in oncology

Suboptimal Insurance Linked to Worse Survival Outcomes in Positive Clinical Trials

Findings from a recent SWOG study could cast doubt on the generalizability of treatment effects observed in positive clinical trials, especially among underinsured patients. According to data presented at the 2019 ASCO Quality Care Symposium,1 patients with Medicaid or no insurance had no observed...

yervoy
keytruda
opdivo
alimta

Tumor Mutational Burden Disappoints as Biomarker for Treatment Response in Exploratory Analyses of Nonsquamous NSCLC

Tumor mutational burden failed to prove effective as a biomarker for response to chemotherapy plus checkpoint inhibitor or chemotherapy alone as first-line treatment for nonsquamous non–small cell lung cancer (NSCLC) in two different exploratory analyses of KEYNOTE trials.1,2 In both analyses,...

darzalex
revlimid
pomalyst

Benefits Reported With Addition of Isatuximab to Pomalidomide and Dexamethasone in Resistant Multiple Myeloma

In patients with relapsed or refractory multiple myeloma, isatuximab in combination with pomalidomide and low-dose dexamethasone nearly doubled progression-free survival when compared with pomalidomide and dexamethasone alone, with a manageable safety profile, according to data from a phase III...

issues in oncology
health-care policy
legislation

AACR Cancer Progress Report 2019 Released

Today, the American Association for Cancer Research (AACR) released the AACR Cancer Progress Report 2019, which highlights how research largely supported by federal investments in the National Institutes of Health (NIH) is spurring improvements in public health and innovations across the spectrum...

lung cancer
immunotherapy

ASTRO 2019: Patterns of Disease Progression in Patients With Unresectable Stage III NSCLC: Analysis of the PACIFIC Trial

Andreas Rimner, MD, of Memorial Sloan Kettering Cancer Center, presented an update of the landmark PACIFIC trial at the 61st Annual Meeting of the American Society for Radiation Oncology (ASTRO) (Abstract LBA-6). In earlier reports from the randomized phase III trial, Antonia et al had evaluated...

onivyde
lynparza

Targeting an Important Tumor Vulnerability With Maintenance Olaparib in Germline BRCA-Mutated Pancreatic Cancer

In the POLO trial, which is discussed in this issue of The ASCO Post, Golan and colleagues evaluated the potential benefit of maintenance olaparib after disease stability or response to a minimum of 4 months of platinum-based chemotherapy in patients with metastatic pancreatic cancer and a...

prostate cancer

ASTRO 2019: Long-Term Hormone Therapy May Increase Other-Cause Mortality in Men With Prostate Cancer Receiving Early Salvage Radiotherapy

Findings from the randomized phase III NRG Oncology/RTOG 9601 trial were initially reported in 2017, and showed that the addition of 2 years of antiandrogen therapy to postsurgical radiation treatment for men with recurrent prostate cancer increased their long-term overall survival rate. That study ...

head and neck cancer
symptom management

ASTRO 2019: Machine-Learning Model May Accurately Predict Radiation Side Effects in Patients With Head and Neck Cancers

A study by Reddy et al investigating the use of a machine-learning model to predict which patients with head and neck cancer being treated with radiation may experience significant weight loss, feeding tube placement, and unplanned hospitalization has found that the model accurately identified the...

breast cancer
issues in oncology

FDA Issues Drug Safety Communication on Lung Inflammation Due to Treatment With CDK4/6 Inhibitors

On September 13, the U.S. Food and Drug Administration (FDA) issued a drug safety communication warning that palbociclib, ribociclib, and abemaciclib—used to treat some patients with advanced breast cancer—may cause rare but severe inflammation of the lungs. The agency approved new warnings about...

velcade
fragmin
lipodox
savaysa
lixiana
etopophos
xarelto
nolvadex
soltamox
venclexta
velban

Conundrums in Managing Cancer-Associated Thrombosis

Although there may be a clear role for prophylactic anticoagulation in hospitalized patients and those undergoing surgery, indication for prophylactic anticoagulation for patients with cancer seen in the ambulatory setting has yet to emerge. Until clinical trial data on prophylactic...

issues in oncology
gynecologic cancers
health-care policy

ASTRO 2019: Effect of Closure of Women’s Health Clinics From 2010 to 2013 on Cervical Cancer Screening and Detection

Following the closure of nearly 100 women’s health clinics across the United States from 2010 to 2013, fewer women were screened for cervical cancer; more women were diagnosed with advanced stages of the disease; and disease mortality rates rose. Findings from a new analysis combining several...

prostate cancer

ASTRO 2019: ORIOLE Trial: Observation vs SABR for Oligometastatic Prostate Cancer

The randomized, phase II ORIOLE trial studying the efficacy of targeted high-dose radiation for men with oligometastatic prostate cancer has shown that stereotactic ablative radiation (SABR) is an effective and safe option for patients who wish to delay hormone-suppression therapy. Data from the...

breast cancer

Meta-analysis of Chemotherapy and Hormonal Treatments for Postmenopausal Women With Metastatic Breast Cancer

In a systematic review and network meta-analysis reported in The Lancet Oncology, Giuliano et al found that progression-free survival in postmenopausal women with hormone receptor (HR)-positive, HER2-negative metastatic breast cancer was improved with first- or second-line CDK4/6 inhibitors plus...

supportive care

Chef Uses Flavor to Fuel Her Mother’s Appetite During Cancer Treatment

The battle against cancer is typically waged by the surgeon and oncologist, but a Lexington, Kentucky–based, award-winning restaurateur and chef discovered her role as a foot soldier when she applied her culinary skills to deal with the debilitating side effects of her mother’s lung cancer...

lung cancer

WCLC 2019: Selpercatinib in RET Fusion–Positive NSCLC

Patients with RET fusion–positive non–small cell lung cancer (NSCLC) comprise up to 2% of all NSCLC cases, but there are no targeted therapies currently approved for patients with this form of lung cancer. Selpercatinib (also known as LOXO-292) is an oral and highly selective investigational drug...

solid tumors
immunotherapy

Liquid Biopsy to Determine Patient Response to Immune Checkpoint Blockade

Although studies have demonstrated that microsatellite instability (MSI) and high tumor mutational burden (TMB) are promising pan-tumor biomarkers for identifying patients for treatment with immune checkpoint blockade, obtaining tissue from unresectable or metastatic solid tumors for genetic...

issues in oncology

WCLC 2019: Declaration From IASLC on Tobacco Cessation After Cancer Diagnosis

The International Association for the Study of Lung Cancer (IASLC) used the platform of the 2019 World Conference on Lung Cancer (WCLC) to call attention to the importance of tobacco cessation after cancer diagnosis and urged all physicians to screen patients with cancer for tobacco use and...

issues in oncology

Oncology Communications Online: Pause and Think Before Hitting ‘Send’

The emergence of online technologies over the past few decades has fundamentally changed the way society communicates and shares information. This sea change has also had profound influence on the practice of medicine, from real-time information-sharing among colleagues, to having instant access...

lipodox
gemzar
lynparza
hycamtin

Olaparib Monotherapy Improves Outcomes in BRCA-Mutated, Platinum-Sensitive Relapsed Ovarian Cancer

Compared with treatment with nonplatinum-based chemotherapy, monotherapy with the PARP (poly [ADP ribose] polymerase) inhibitor olaparib led to statistically significant and clinically relevant improvements in overall response rate and progression-free survival in women with germline...

lung cancer
issues in oncology

WCLC 2019: Survey Findings on Evidence-Based Guidelines for Molecular Testing in Lung Cancer

One-third of those who responded to a survey reported they are unaware of evidence-based guidelines that support the use of molecular testing in lung cancer, according to results from the International Association for the Study of Lung Cancer (IASLC) Global Survey on Molecular Testing in Lung...

2019 Lasker Awards for Basic and Clinical Medical Research and Public Service Announced

On September 10, The Lasker Foundation announced the winners of its 2019 Lasker Awards: Max D. Cooper, MD, of Emory University, and Jacques Miller, AC, FRS, FAA, of the Walter and Eliza Hall Institute of Medical Research, will receive the Albert Lasker Basic Medical Research Award; H. Michael...

issues in oncology

FDA Proposes New Required Health Warnings With Images for Cigarette Packages and Advertisements

On August 15, the U.S. Food and Drug Administration (FDA) issued a proposed rule to require new health warnings on cigarette packages and in advertisements to promote greater public understanding of the negative health consequences of smoking. The proposed warnings, which feature photo-realistic...

Donald A.B. Lindberg, MD, Pathologist, Former Director of the National Library of Medicine, Dies at 85

The National Library of Medicine, located in Bethesda, Maryland, was started in 1836 as a small collection of medical books and journals in the office of the U.S. Army Surgeon General. In the ensuing years, the library grew to become the world’s largest and most prestigious biomedical library, with ...

John Hansen, MD, Transplant Expert Who Founded Volunteer Donor Registries, Dies at 76

Over the past few decades, our understanding of transplant immunology has moved from basic allograft rejection to the current molecular level that offers life-saving treatments for patients with cancer. The scientific elegance of this remarkable therapy’s arc from experimental to standard of care...

leukemia

Having Cancer as a Teenager Derailed My Life Course

In 1994, I was a normal, active 15-year-old, who loved cars, sports, and rock music, especially songs from my favorite group, The Clash. In fact, it was while jubilantly dancing alone in my room to one of their tunes that I vomited into my hands, an early symptom of acute myeloid leukemia (AML). I...

A Vigorous Life Through the Prism of Impending Death

“Live while you’re living, friends,” writes Julie Yip-­Williams in her memoir, The Unwinding of the Miracle: A Memoir of Life, Death, and Everything That Comes After. It was The New York Times bestseller when she died of stage IV colon cancer at the age of 42. She is the most recent of several...

breast cancer

Alpelisib for PIK3CA-Mutated Advanced Breast Cancer

On May 24, 2019, alpelisib was approved for use in combination with fulvestrant for postmenopausal women, and men, with hormone receptor–positive, HER2-negative, PIK3CA-mutated advanced or metastatic breast cancer, as detected by a U.S. Food and Drug Administration (FDA)-approved test following...

Not for the Squeamish: Surgery in the 19th Century

Imagine undergoing major surgery in a grimy operating room without any form of antisepsis. That was the grim reality in the 1800s, when the ruling theory was that damage from “bad air” was responsible for infections in surgical wounds. Hospitals simply aired out the surgical wards at midday to...

immunotherapy
gastroesophageal cancer

Pembrolizumab in Advanced Esophageal Squamous Cell Cancer With PD-L1 Expression of CPS ≥ 10

On July 30, 2019, pembrolizumab was approved for the treatment of patients with recurrent locally advanced or metastatic squamous cell carcinoma of the esophagus whose tumors express programmed cell death ligand 1 (PD-L1; Combined Positive Score [CPS] ≥ 10), as determined by a U.S. Food and Drug...

head and neck cancer
immunotherapy

Pembrolizumab in First-Line Treatment of Head/Neck Squamous Cell Carcinoma

On June 10, 2019, pembrolizumab was approved for the first-line treatment of patients with metastatic or unresectable recurrent head and neck squamous cell carcinoma.1,2 Pembrolizumab was approved for use in combination with platinum and fluorouracil (5-FU) for all patients and as a single agent...

Doctor, Where Art Thou?

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,...

immunotherapy
multiple myeloma

Daratumumab-Based Therapy for Patients With Newly Diagnosed Multiple Myeloma Who Are Ineligible for Transplantation

On June 27, 2019, daratumumab was approved for use in combination with lenalidomide and dexamethasone for patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplantation.1,2 Supporting Efficacy Data Approval was based on findings in the open-label phase...

breast cancer

Insightful Advice From a College Advisor Leads to an Unexpected Career in Oncology

For this installment of the Living a Full Life series, guest editor Jame Abraham, MD, FACP, spoke with Tatiana M. Prowell, MD, who currently serves as Associate Professor of Oncology in the Breast Cancer Program at the Johns Hopkins Kimmel Comprehensive Cancer Center and as a Medical Officer and...

lymphoma

Lenalidomide for Previously Treated Follicular and Marginal Zone Lymphomas

On May 28, 2019, lenalidomide was approved for use in combination with a rituximab product for previously treated follicular lymphoma and previously treated marginal zone lymphoma.1,2 Supporting Efficacy Data Approval was based on the findings of two clinical trials: AUGMENT (ClinicalTrials.gov...

issues in oncology

Confronting the Criticisms Facing Watson for Oncology

Over the past 2 years, IBM’s Watson for Oncology cognitive computing system, which uses artificial intelligence (AI) algorithms to generate treatment recommendations, has come under fire for allegedly not delivering on expectations to provide state-of-the-art personalized treatment for patients...

issues in oncology

Firing Your Patient: How to Terminate a Treatment Relationship

Many clinicians are confused by the evolving opioid prescribing guideline issued by the Centers for Disease Control and Prevention (CDC) meant to stem the rising epidemic of opioid addiction and overdose in the United States.1 Many are also worried about regulatory oversight by the U.S. Drug...

Bert Vogelstein, MD, and Irving L. Weissman, MD, Recognized for Revolutionizing Cancer Research

Two scientists, whose discoveries in stem cell and cancer cell biology have led to innovative advances in fields ranging from oncology and immunology to cancer genomics and regenerative medicine, will receive the 2019 Albany Medical Center Prize in Medicine and Biomedical Research. Bert Vogelstein, ...

New ASCO Ethical Framework for Including Research Biopsies in Clinical Trials

ASCO has released an ethical framework for researchers on incorporating research biopsies in cancer clinical trials. The framework, published in a statement in the Journal of Clinical Oncology on July 25, provides guidance on when to include optional and mandatory biopsies based on both participant ...

health-care policy

2020 Fee Schedule Proposal Outlines E&M Code and MIPS Changes

On July 29, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for the 2020 Medicare Physician Fee Schedule (MPFS) and other changes to Medicare Part B payment policies, including proposals related to the Quality Payment Program (QPP). At the same time, CMS released...

Nancy E. Davidson, MD, FASCO, and Jerry Radich, MD, Receive Endowed Chairs at Fred Hutchinson Cancer Research Center

Two researchers at the Fred Hutchinson Cancer Research Center in Seattle were recently awarded endowed chairs: Nancy E. Davidson, MD, FASCO, and Jerry Radich, MD. Raisbeck Endowed Chair for Collaborative Research Dr. Davidson was awarded the Raisbeck Endowed Chair for Collaborative Research at Fred ...

cns cancers
lymphoma

Primary Central Nervous System Lymphoma: Striving for a Curative Therapy

Primary central nervous system (CNS) lymphoma is a rare type of non-Hodgkin lymphoma in which standards of care have not been well established. In light of recent insights into its pathophysiology and the emergence of novel approaches, The ASCO Post asked Tracy T. Batchelor, MD, a specialist in...

$1 Million Gift for Epithelioid Hemangioendothelioma Research

The Epithelioid Hemangioendothelioma (EHE) Foundation and Cleveland Clinic recently received a $1 million gift from the Margie and Robert E. Petersen Foundation. The money will support EHE research conducted by Brian Rubin, MD, PhD, Chair of the Robert J. Tomsich Pathology & Laboratory Medicine ...

IU Simon Cancer Center Earns NCI’s Comprehensive Cancer Center Designation

The Indiana University Melvin and Bren Simon Cancer Center (IU Simon Cancer Center) has achieved the highest recognition from the National Cancer Institute (NCI): Comprehensive Cancer Center. With this federal designation signifying research excellence, it becomes the only NCI-designated...

lymphoma

Update on FDA-Approved CAR T-Cell Gene Therapy for B-Cell Lymphomas

On October 18, 2017, the U.S. Food and Drug Administration (FDA) granted approval to axicabtagene ciloleucel for the treatment of adult patients with relapsed or refractory large B-cell lymphoma. Specifically, this treatment can be used after two or more lines of systemic therapy for diffuse...

lung cancer

FDA Approves Entrectinib for NTRK-Fusion Cancers, ROS1-Positive NSCLC

On August 15, the U.S. Food and Drug Administration (FDA) granted accelerated approval to entrectinib (Rozlytrek) for adult and adolescent patients whose cancers have an NTRK (neurotrophic tyrosine receptor kinase) genetic fusion and for whom there are no effective treatments. Entrectinib was also...

issues in oncology

Hey Siri, Should I Get a Medical Degree?

I received a coffee mug from a physician colleague some years ago with the tag line: “Please do not confuse your Google search with my Medical Degree.” Physicians of all stripes and colors can relate to the agony of debunking a “Dr. Google” diagnosis. However, in a fast-evolving health-care...

issues in oncology

How Patient Advocacy Is Integral to High-Quality Oncology Care

Karen M. Winkfield, MD, PhD, has made patient advocacy—with a specific emphasis on health equity and access to high-quality care—front and center of her oncology practice since she completed her residency at the Harvard Radiation Oncology Program in Boston, where she noticed that most of the...

lung cancer
immunotherapy

WCLC 2019: Two Studies Show Tumor Mutational Burden Not Associated With Pembrolizumab Efficacy in NSCLC

At the International Association for the Study of Lung Cancer (IASLC) 2019 World Conference on Lung Cancer (WCLC), two presentations showed that tumor mutational burden is not associated with the efficacy of pembrolizumab in combination with chemotherapy in patients with non–small cell lung cancer...

issues in oncology

2019 Quality Care: Intervention to Improve Rates of Resident Advanced Care Planning Documentation

In a single-center study reported at the ASCO Quality Care Symposium and simultaneously published in the Journal of Oncology Practice, Switzer et al found that an intervention consisting of a resident training module and use of a best practice alert (BPA) in electronic medical records (EMRs)...

integrative oncology

Light Intervention for Cancer-Related Fatigue, Depression, and Sleep Disturbance

GUEST EDITOR  Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief of Integrative Medicine Service at Memorial Sloan Kettering Cancer Center, New York. Cancer and its treatments are associated with severe fatigue, depression, ...

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