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issues in oncology

First Large-Scale Survey of Advanced Practice Providers in Oncology Shows Growing Role for Nurse Practitioners and Physician Assistants

Advanced practice providers (APPs) have increasingly become integral members of the oncology care delivery team, according to the first large-scale study of nurse practitioners (NPs) and physician assistants (PAs) in oncology published by Bruinooge et al in the Journal of Oncology Practice....

breast cancer

Dutch Quality-of-Life Study With One- vs Two-Stage Breast Reconstruction in Skin-Sparing Mastectomy

In a Dutch study reported in The Lancet Oncology, Negenborn et al found no differences in quality of life (QOL) between women receiving one-stage implant-based breast reconstruction (IBBR) with an acellular dermal matrix (ADM) vs standard two-stage IBBR. A previously reported safety analysis from...

lymphoma
skin cancer

Mogamulizumab vs Vorinostat in Previously Treated Cutaneous T-Cell Lymphoma

As reported by Kim and colleagues in The Lancet Oncology, the phase III MAVORIC trial showed that the anti-C-C chemokine receptor 4 (CCR4) monoclonal antibody mogamulizumab (Poteligeo) significantly improved progression-free survival vs vorinostat (Zolinza) among patients with previously treated...

issues in oncology

Most Oncologists Have Discussed Medical Marijuana With Patients, Survey Finds

DATA FROM a new survey show that as many as 80% of oncologists have discussed medical marijuana use with their patients. According to the authors, this is the first nationally representative survey to examine oncologists’ practices and beliefs on the subject since the implementation of state...

skin cancer

Activity of T Cells in Metastatic Melanoma Resistant to Immune Checkpoint Inhibitor Treatment

In a study reported in the Annals of Oncology, Andersen et al found that tumor-infiltrating lymphocytes isolated from metastatic melanoma lesions in patients with disease progression after checkpoint inhibitor therapy remain functional. Moreover, they concluded these tumor-infiltrating lymphocytes...

skin cancer

Cutaneous Squamous Cell Carcinoma of the Lip and Risk of Nodal Metastasis

In a study reported in JAMA Dermatology, Wang et al found that the risk of nodal metastasis was higher for cutaneous squamous cell carcinoma of the lip with vermilion vs cutaneous location. Disease-specific and overall survival were similar for the two locations. Chrysalyne D. Schmults, MD, of the...

On Not Being Ready

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,...

breast cancer

I Am Too Young for Breast Cancer

Two years ago, when I began having pain and bloody discharge in my left breast, I thought it was the return of a solitary intraductal papilloma I had had in that breast when I was a college student 6 years earlier, so the symptoms didn’t initially alarm me. It wasn’t until I noticed that the mass...

issues in oncology
cns cancers

A Firsthand Account of Cancer and Mental Illness

Brain tumors are among the most challenging clinical scenarios faced by the oncology community. Along with devastating physiologic damage, brain tumors often have a dramatic effect on the patient’s cognitive, neurologic, and psychological functions. However, the body of literature focusing on...

leukemia

FDA Grants Orphan Drug Designation to ASLAN003 in Acute Myeloid Leukemia

The U.S. Food and Drug Administration (FDA) has granted ASLAN003 Orphan Drug designation as a treatment for acute myeloid leukemia (AML). ASLAN003 is an orally active, potent inhibitor of human dihydroorotate dehydrogenase (DHODH) that has the potential to be a first-in-class drug in AML. The FDA...

gynecologic cancers

Adding Sorafenib to Topotecan in Platinum-Resistant Ovarian Cancer

In a German phase II trial reported in The Lancet Oncology, Chekerov et al found that the addition of sorafenib (Nexavar) to topotecan improved progression-free survival in women with platinum-resistant ovarian cancer. Study Details In the multicenter investigator-initiated double-blind trial,...

bladder cancer
immunotherapy

FDA Updates Prescribing Information for Pembrolizumab and Atezolizumab in Urothelial Carcinoma

On August 16, 2018, the U.S. Food and Drug Administration (FDA) updated the prescribing information for pembrolizumab (Keytruda) and atezolizumab (Tecentriq) to require the use of an FDA-approved companion diagnostic test to determine programmed cell death ligand 1 (PD-L1) levels in tumor tissue...

sarcoma

Addition of Vincristine and Irinotecan to Vincristine, Dactinomycin, and Cyclophosphamide in Pediatric Intermediate-Risk Rhabdomyosarcoma

In a phase III Children’s Oncology Group study reported in the Journal of Clinical Oncology, Hawkins et al found that substituting vincristine and irinotecan (VI) for half of vincristine, dactinomycin, and cyclophosphamide (VAC) courses did not improve event-free survival in pediatric...

leukemia
immunotherapy

Bendamustine Followed by Obinutuzumab Plus Venetoclax in Treatment-Naive and Relapsed/Refractory CLL

In a German phase II trial reported in The Lancet Oncology, Cramer et al found promising response rates with bendamustine followed by obinutuzumab (Gazyva) plus venetoclax (Venclexta) in both treatment-naive and relapsed/refractory chronic lymphocytic leukemia (CLL). In the trial, patients with an ...

issues in oncology

2019 Physician Fee Schedule and Quality Payment Program Proposed Rules Released

The Centers for Medicare & Medicaid Services (CMS) released its proposed rule for 2019 Medicare physician reimbursement.  CMS estimates that in 2019, the overall impact for the hematology/oncology specialty will be a 4% reduction in reimbursement and a 2% reimbursement reduction for...

Breast Cancer Surgeon Hannah Hazard-Jenkins, MD, Deftly Balances Career and Family

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic. For this installment of the Living a Full Life series, guest editor Jame Abraham, MD, spoke with breast cancer surgeon...

issues in oncology

Obesity and Cancer: Complex Interplay of Multiple Factors

The evolving concept that dietary fat plays an important role in the etiology of human cancer emerged more than 50 years ago. Ernst Wynder, MD, whose seminal epidemiologic work led to identifying smoking as a contributory cause of lung cancer, presented a paper in 1967 showing a decided correlation ...

Be Prepared to Assist Patients to Make Informed Decisions About Breast Reconstruction Options

Two studies about postmastectomy breast reconstruction were recently published in JAMA Surgery. One study found overall complication rates of 32.9% at 2 years after reconstruction, with women having autologous reconstruction more likely to have complications than those having implant...

breast cancer

Breast Reconstruction: ‘A Process Not a Procedure’ With Potential Short- and Long-Term Complications

The complication rate among women who underwent postmastectomy breast reconstruction was 32.9% at 2 years postoperatively, and women undergoing autologous reconstruction “had significantly higher odds of developing any complication compared with those undergoing expander-implant reconstruction,”...

issues in oncology

Navigating the ‘New Normal’: NCCN Summit Examines Access to High-Quality Cancer Care

It’s not just the leaps in development of precision medicines, the soaring costs, the new payment models, clinical trial designs, sources of data, and federal policies. It’s all of them plus the rapidity with which change is happening that makes this era of oncology exceptional. “I would say...

supportive care

Cannabinoids for Cancer Pain: Dangerous or Beneficial?

Cannabis has been used in health care for millennia, and its use has been well documented, albeit never definitively integrated into clinical practice. Recent societal changes and the increasing acceptance and availability of cannabis have reignited the medical and public debate around its role in...

supportive care

Therapeutic Applications for Cannabinoids in Oncology: The Debate Continues

In the early part of the 20th century, the U.S. government classified cannabis as a Schedule 1 drug: a dangerous substance with no medical value. For many years, that classification prevented systematic research in cannabinoid use in medicine. As a result of societal changes and an intense and...

hematologic malignancies
lymphoma

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

On August 8, the U.S. Food and Drug Administration approved mogamulizumab-kpkc (Poteligeo) injection for intravenous use in 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...

lymphoma

Venetoclax and Beyond: Successfully Targeting BCL2

Although many agents have been able to successfully inhibit the proliferative capacity of cancer cells or disable mutations that spur cancer growth, one area that has proven elusive is the apoptotic pathway—the cell’s means of resisting death. That is until recently. Dysregulation of B-cell...

issues in oncology

Unraveling the Mystery of What Gives Exceptional Responders Their Superpower

Once dismissed as rare medical miracles that overcame overwhelming odds to thwart cancer, exceptional responders to cancer treatment are now the subject of intense study. In 2015, the National Cancer Institute (NCI) announced the launch of its Exceptional Responders Initiative, with the goal of...

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...

bladder cancer

VB4-845 Granted Fast Track Designation by FDA for Treatment of Non–Muscle Invasive Bladder Cancer

The U.S. Food and Drug Administration (FDA) has granted Fast Track designation to VB4-845 for the treatment of bacillus Calmette-Guérin (BCG)–unresponsive, high-grade, non–muscle invasive bladder cancer. VB4-845 is currently being evaluated in a phase III registration...

multiple myeloma

Drug Combination Design for Multiple Myeloma Using an AI Platform

A multidisciplinary team of researchers from the National University of Singapore (NUS) has developed an artificial intelligence (AI) technology platform that could potentially change the way drug combinations are being designed, hence enabling doctors to determine the most effective drug...

colorectal cancer
immunotherapy

FDA Grants Breakthrough Therapy Designation for Encorafenib Plus Binimetinib and Cetuximab in BRAF V600E–Mutant Metastatic Colorectal Cancer

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation for encorafenib (Braftovi) in combination with binimetinib (Mektovi) and cetuximab (Erbitux) for the treatment of patients with BRAF V600E–mutant metastatic colorectal cancer (mCRC), as detected by...

gynecologic cancers

Apatinib and Oral Etoposide in Platinum-Resistant/Refractory Ovarian Cancer

In a Chinese single-center phase II study reported in The Lancet Oncology, Lan et al found a high response rate with oral apatinib plus oral etoposide in patients with platinum-resistant or refractory ovarian cancer. Study Details The study included 35 patients with progression within 6 months...

Cory Wiegert Named New CEO of CancerLinQ LLC

Cory Wiegert has been named Chief Executive Officer (CEO) of CancerLinQ LLC, a wholly owned nonprofit subsidiary of ASCO. Mr. Wiegert, a proven expert in building and successfully launching innovative technology solutions, began his new role today (August 13, 2018), overseeing the continued...

breast cancer

ESR1 Fusions and Metastasis in Estrogen Receptor–Positive Breast Cancer

Estrogen receptor–positive breast cancer is the most common type of breast cancer, but resistance to therapy is common, and eventual development of metastatic disease is a leading cause of death. In research published by Lei et al in Cell Reports, researchers from Baylor College of...

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 ...

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...

gynecologic cancers

FDA Approves HPV Test for First-Line Cervical Cancer Screening

ON JULY 30, 2018, Roche announced approval by the U.S. Food and Drug Administration (FDA) of its cobas HPV Test in first-line screening for cervical cancer in women 25 years and older using cervical specimens collected in SurePath preservative fluid. The FDA first approved the cobas HPV test...

palliative care
immunotherapy

Meeting the Challenges of Immunotherapy-Related Toxicities

In 2011, the U.S. Food and Drug Administration (FDA) approved ipilimumab (Yervoy), an anticytotoxic T-lymphocyte– associated antigen 4 (CTLA-4), the first checkpoint inhibitor for the treatment of advanced melanoma.1 Since then, several more checkpoint inhibitors directed at both the programmed...

lung cancer

My Incidentally Discovered Cancer

In February 2015, there was no indication that my life was about to radically change. I was a practicing attorney and happily raising two young children with my husband. At 40 years old, I was healthy—or so I thought—and had no physical symptoms to alert me to the devastating news that was about to ...

breast cancer

CXCR4 Antagonist Plus Eribulin in HER2-Negative Metastatic Breast Cancer

Findings in a phase I trial reported in The Lancet Oncology by Pernas and colleagues indicate activity of the combination of the CXCR4 chemokine receptor antagonist balixafortide plus eribulin (Halaven) in previously treated HER2-negative metastatic breast cancer. The CXCR4–stromal cell-derived...

genomics/genetics

Is Some DNA Worthless?

BOOKMARK Title: Junk DNA: A Journey Through the Dark Matter of the GenomeAuthor: Nessa CareyPublisher: Columbia University PressOriginal publication date: April 2015Price: $22.95, paperback, 360 pages When biologists first delved into the human wonder of genes in the 1970s, they eventually...

issues in oncology

ASCO and Friends Submit Recommendations to FDA Aimed at Reducing Barriers to Clinical Trial Participation

ASCO and Friends of Cancer Research (Friends) have submitted recommended language to the U.S. Food and Drug Administration (FDA) for five guidance documents on ways to broaden eligibility criteria for cancer clinical trials. The recommendations are part of an ASCO...

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...

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...

symptom management
head and neck cancer

Novel Therapy Reduces Duration of Chemoradiotherapy-Induced Mucositis in Patients With Head and Neck Cancer

GC4419, A SMALL molecule superoxide dismutase mimetic, reduced the duration, incidence, and severity of chemoradiotherapy-induced mucositis in patients with locally advanced head and neck cancer, with a safety profile comparable to that of placebo. This finding comes from a randomized phase IIb...

lymphoma
immunotherapy

More Antibody-Drug Conjugates Expected to Impact Treatment of Lymphoma

FOR THE TREATMENT of lymphoma, antibody-drug conjugates (ADCs) are becoming an important class of drugs, as described at the 2018 Pan Pacific Lymphoma Conference by Brad Kahl, MD, Professor of Medicine at Washington University School of Medicine, St. Louis.1  “We have one ADC—brentuximab vedotin...

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...

issues in oncology
survivorship

Screening for Financial Issues in Adult Survivors of Childhood Cancer

Adult survivors of childhood cancer should be screened for financial problems that might cause them to delay or skip medical care or to suffer psychological distress. The recommendation from St. Jude Children’s Research Hospital researchers followed an analysis that found 65% of...

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