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The Wake

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,...

lung cancer

A Diagnosis of Advanced Lung Cancer Is No Longer a Death Sentence

In hindsight, the symptoms I began experiencing in the winter of 2013, including pains in my chest and shoulders and a persistent cough, should have rung loud alarm bells. However, having undergone a pancreatectomy and splenectomy to cure a history of mucinous cystic neoplasms of the pancreas 5...

Prominent Surgeon and Teacher LaSalle D. Leffall, Jr, MD, Promotes Hard Work and Education to Overcome Boundaries

LaSalle D. Leffall, Jr, MD, the Charles R. Drew Professor of Surgery at Howard University College of Medicine in Washington, DC, died on May 25, 2019, at the age of 89. The ASCO Post paid tribute to Dr. Leffall in its July 10, 2019, issue. Here, as part of our 10-Year Anniversary Series, we...

New, Updated ASCO eLearning Courses Put Oncology Education at Your Fingertips

As medical professionals increasingly turn to online learning opportunities in the midst of COVID-19 restrictions on travel and gatherings, ASCO eLearning delivers valuable, up-to-date clinical care courses for physicians, nurses, and advanced practitioners on a robust platform that can be easily...

Cultivating Emotional Equanimity: Pause, Reflect, and Feel Meaning in Life, No Matter What

For many cultures that are addicted to the relentless quest to feel happy, perhaps as an unconscious attempt to bypass disavowed misery, grief is sort of a taboo, often pathologized and avoided by multiple means of denial. When we grieve, we’re told by well-meaning friends and relatives to “think...

prostate cancer

Leading Organizations Release New Clinical Guideline on Advanced Prostate Cancer

The American Urological Association (AUA), American Society for Radiation Oncology (ASTRO), and Society of Urologic Oncology (SUO) recently announced a new clinical practice guideline for the diagnosis and treatment of advanced prostate cancer. Prostate cancer is one of the most commonly diagnosed...

lymphoma
immunotherapy

Role of Rituximab in the Treatment of Children and Adolescents With Mature B-Cell Non-Hodgkin Lymphoma

Minard-Colin et al recently reported for the European Intergroup for Childhood Non-Hodgkin Lymphoma/Children’s Oncology Group (EICNHL/COG) a significant improvement in event-free survival among children and adolescents (aged 6 months to 18 years) with high-risk mature B-cell non-Hodgkin lymphoma...

If You Have Self-Doubt When Caring for a Loved One With Cancer

When taking care of a loved one with cancer, it’s natural to feel flooded with emotions—grief, guilt, and just plain old exhaustion. Feelings of inadequacy, doubt, or fear can sometimes pop up, too. Maybe you feel like you do not have the necessary skills to be a caregiver; maybe you feel like you...

head and neck cancer

New Guideline for Locally Advanced Esophageal Cancer Supports Multimodality Therapy and Multidisciplinary Treatment

ASCO has released a new guideline for the treatment of locally advanced esophageal cancer that will provide a context for the current standards of care, fill gaps in clinicians’ knowledge of therapy options, and help define future treatment.1 An expert panel developed the guideline based on 17...

Expert Point of View: Marcus Noel, MD, and Susan Tsai, MD, MHS

Marcus Noel, MD, Associate Professor of Medicine at Lombardi Comprehensive Cancer Center and MedStar Georgetown University Hospital, Washington, DC, included SWOG S1505 in the presentation of the Gastrointestinal Cancer Highlights during the ASCO20 Virtual Scientific Program. Susan Tsai, MD, MHS, ...

pancreatic cancer

SWOG S1505 Trial Evaluates Neoadjuvant Regimens in Pancreatic Cancer

The much-anticipated SWOG S1505 trial has failed to show that one preoperative regimen is better than another in resectable pancreatic cancer.1 “Perioperative modified FOLFIRINOX and gemcitabine/nab-paclitaxel appear to have similar efficacy, with acceptable safety and resectability rates,”...

Expert Point of View: Erika Hamilton, MD, and Nikhil Wagle, MD

Erika Hamilton, MD, Director of the Breast Cancer and Gynecologic Cancer Research Program, Sarah Cannon Research Institute at Tennessee Oncology, Nashville, who gave the Metastatic Breast Cancer Highlights presentation, and Nikhil Wagle, MD, Assistant Professor of Medicine, Harvard Medical...

breast cancer

Phase III PADA-1 Trial Examines the Impact of ESR1 Mutations in Metastatic Breast Cancer

ESR1 mutations are known to confer resistance to endocrine therapy in the metastatic breast cancer setting. These mutations herald a poor prognosis, so their clearance early in the treatment course may greatly reduce the risk of recurrence, according to the early results of the prospective phase...

covid-19

Two Cohort Studies Identify Risk Factors for Mortality in Patients With Cancer and COVID-19

Two studies recently reported in The Lancet have identified risk factors for mortality among patients with cancer and COVID-19.1,2 As reported by Lennard Y.W. Lee, DPhil, of the Institute of Cancer and Genomic Sciences, University of Birmingham, and colleagues,1 a UK prospective cohort study...

Expert Point of View: Komal Jhaveri, MD

“Surprisingly, the phase II PARSIFAL trial did not show a statistical superiority in progression-free survival for fulvestrant plus palbociclib over letrozole plus palbociclib in the first-line treatment of patients with endocrine-sensitive, metastatic breast cancer. The noninferiority hypothesis...

breast cancer

When Paired With Palbociclib, Fulvestrant and Letrozole Yield Comparable Results in PARSIFAL Trial

When paired with palbociclib in the first-line treatment of metastatic breast cancer, fulvestrant and letrozole performed comparably, with no statistical superiority in progression-free or overall survival shown for either endocrine agent, in the phase II PARSIFAL study presented during the ASCO20...

covid-19
solid tumors
hematologic malignancies

In Case You Missed It: Quick Takes on Novel Therapies for Solid and Hematologic Malignancies

Because of the COVID-19 pandemic, oncology providers from around the world had to forgo their annual trip to McCormick Place—but the show did go on. We all realized important research can still be presented, clinicians and fellow researchers will still listen, and ASCO presentations will still...

breast cancer

Double PIK3CA Mutations and Response Benefit in Breast Cancer

Patients who have breast cancers with double PIK3CA mutations seem to have a more robust response to PI3Kα inhibitors than those with a single PIK3CA mutation, based on an analysis of the phase III SANDPIPER trial, which tested taselisib plus fulvestrant, according to a presentation during the 2020 ...

skin cancer
immunotherapy

Small Study Evaluates Neoadjuvant vs Adjuvant Nivolumab Plus Ipilimumab in Stage III Melanoma

The neoadjuvant combination of nivolumab and ipilimumab yielded a continued benefit in relapse-free survival vs adjuvant use of the same combination therapy in 20 patients with stage III macroscopic melanoma. This finding is based on 3-year follow-up results of the phase Ib OpACIN trial, presented...

Expert Point of View: Alexander Drilon, MD

Discussant of the TATTON study presentation, Alexander Drilon, MD, Chief of Early Drug Development at Memorial Sloan Kettering Cancer Center, New York, finds the idea of combination therapy with a MET inhibitor and an EGFR tyrosine kinase inhibitor attractive for the treatment of EGFR...

lung cancer
immunotherapy

Can Radiomics Predict Survival in Patients With NSCLC Receiving Immunotherapy?

Immunotherapy with immune checkpoint inhibitors has made great strides in the treatment of many cancers, but only between 25% and 50% of patients respond with clinical benefit, and these agents come with adverse events and high price tags. Thus, preselection of patients who are likely to respond to ...

lymphoma

Monumental Progress in the Treatment of Diffuse Large B-Cell Lymphoma

Some monuments are difficult to topple. At least that was the case dating back to 1976, when investigators from the Southwest Oncology Group demonstrated the importance of doxorubicin in the treatment of patients with a group of lymphoid malignancies then referred to as diffuse aggressive...

covid-19

The Need for Solid Data During a Global Pandemic

The rapid outbreak of COVID-19 disease on a global scale found the community of clinicians and scientists largely unprepared to face the devastating effects of the pandemic. The stress on health-care systems revealed their weaknesses and brought about associated financial crises. Defining the...

head and neck cancer
lung cancer

Nivolumab/Ipilimumab Shows Benefit in Patients With Non–Small Cell Lung Cancer and Brain Metastases

The combination of nivolumab plus ipilimumab was at least as effective as chemotherapy in front-line therapy for patients with advanced non–small cell lung cancer (NSCLC) and brain metastases at baseline, according to the results of a post hoc analysis from part 1 of the phase III CheckMate 227...

breast cancer
immunotherapy

T-DM1 in Patients With HER2-Positive Breast Cancer and Brain Metastases: KAMILLA Trial

An exploratory subgroup analysis of the KAMILLA trial represents the largest reported cohort of patients with HER2-positive breast cancer and brain metastases treated with the anti-HER2 antibody-drug conjugate ado-trastuzumab emtansine, or T-DM1, in a prospective setting. Researchers observed...

issues in oncology

Adam C. Palmer, PhD, on Immune Checkpoint Inhibitors: Additive to or Synergistic With Other Treatments?

Adam C. Palmer, PhD, of the University of North Carolina at Chapel Hill, discusses combining immune checkpoint inhibitors with other cancer therapies to provide patients with more chances of a response. In principle, similar benefits may result from sequential or biomarker-stratified treatments,...

prostate cancer
issues in oncology

EAU Virtual: EUPROMS Study Investigates Effect of Prostate Cancer Treatment on Quality of Life

Findings from the first international prostate cancer quality-of-life study showed that significant numbers of men treated for the disease are struggling with continence and sexual problems after treatment. Results suggest that any treatment apart from active surveillance may negatively affect...

covid-19

Study Finds Higher Risk for COVID-19 Infection Among Minorities and Patients With Cancer

According to the latest data from the Centers for Disease Control and Prevention, Native American or Alaska Native and non-Hispanic Black people have the highest rates of hospitalization or death from COVID-19, followed by Hispanics and Latinos. A large population-based study using a smartphone app ...

neuroendocrine tumors

Collaborative Guideline for the Diagnosis and Management of Lung Neuroendocrine Tumors

As reported in the Journal of Thoracic Oncology by Simron Singh, MD, MPH, and colleagues, the Commonwealth Neuroendocrine Tumour Research Collaboration (CommNETs) and North American Neuroendocrine Tumor Society (NANETS) have collaborated to produce a best practice guideline for the diagnosis and...

issues in oncology

ASCO and ACCC Join Forces to Increase Participation of Racial and Ethnic Minority Populations in Cancer Treatment Trials

The American Society of Clinical Oncology (ASCO) and Association of Community Cancer Centers (ACCC) have announced a new collaboration to foster participation in oncology clinical trials to more fully reflect the diversity of people at risk for or living with cancer. The joint ASCO-ACCC initiative...

covid-19

In Keynote Lecture, Anthony Fauci, MD, Explores What We Know About COVID-19 and What’s Being Done to Combat It

Kicking off the American Association for Cancer Research (AACR) Virtual Meeting: COVID-19 and Cancer earlier this week, Anthony Fauci, MD, gave the keynote lecture, “Coronavirus Infections: More Than Just the Common Cold.” As Dr. Fauci told listeners, “[COVID-19]—and other infectious...

covid-19
survivorship

Cancer Survivors Are Adhering to COVID-19–Related Preventive Behaviors, but Continuity of Care May Be Impacted

People of any age with serious underlying health conditions are at greater risk for contracting the coronavirus, and cancer survivors are particularly vulnerable to becoming infected with COVID-19, since many cancer therapies can lead to immunosuppression. To reduce exposure to the virus, the...

colorectal cancer

Adjuvant Chemotherapy vs Active Surveillance: Survival After Resection of Isolated Synchronous Colorectal Peritoneal Metastases

In a Dutch population-based observational cohort study reported in JAMA Oncology, Rovers et al found that adjuvant systemic chemotherapy was associated with improved overall survival vs active surveillance after upfront resection of isolated synchronous colorectal peritoneal metastases. Study...

survivorship

Eric Zhou, PhD, on Insomnia in Young Cancer Survivors: Online Program May Improve Quality of Life

Eric Zhou, PhD, of Dana-Farber Cancer Institute, discusses an existing online program called SHUTi (Sleep Healthy Using the Internet), that he and his team adapted to the needs of adolescent and young adult cancer survivors. After six online cognitive behavior therapy sessions delivered over 8...

leukemia
geriatric oncology

Expert Point of View: Alice Mims, MD

Alice Mims, MD, Associate Professor of Hematology at The Ohio State University Comprehensive Cancer Center–The James, shared her insights on the VIALE-A study. “The results of the VIALE-A study have been highly anticipated and are exciting, given the improvement seen in both overall survival and...

issues in oncology
lung cancer
supportive care

Study Links Mental Health Treatment to Possible Improved Cancer Survival

For people with cancer who have a mental health disorder, getting mental health treatment may help them live longer, a new study published by Berchuck et al in JAMA Oncology suggests. In the retrospective study, of more than 50,000 veterans treated for lung cancer within the Veterans Affairs (VA)...

immunotherapy
symptom management

Study Identifies Factors That May Predict Toxicities in Patients Treated With CAR T-Cell Therapy

Chimeric antigen receptor (CAR) T-cell therapy has proved to be a valuable treatment option for patients with lymphoma in whom other therapies have failed. In clinical trials, the cellular immunotherapy was shown to provide durable remissions for nearly 40% of patients with large B-cell lymphoma....

covid-19

Experimental COVID-19 Vaccine Generates Immune Response, Deemed Safe in Phase I Trial

According to a press release from the National Institutes of Health, an investigational vaccine designed to protect against SARS-CoV-2, the virus that causes COVID-19—mRNA-1273—was generally well tolerated and prompted neutralizing antibody activity in healthy adults. These interim results were...

survivorship

Effects of Exercise Intolerance on Adult Survivors of Childhood Cancer

In a study reported in JAMA Oncology, Hayek et al found that exercise intolerance was more common among adult survivors of childhood cancer than among matched controls and that it was associated with a greater likelihood of emotional distress, poorer attainment of social roles, and poorer...

Expert Point of View: Craig Hofmeister, MD, MPH

“The IKEMA trial is based on the interest of adding a CD38 naked antibody to a carfilzomib-plus-dexamethasone skeleton, a protocol nearly identical to the recently presented CANDOR trial,” said Craig Hofmeister MD, MPH, Associate Professor of Hematology and Oncology at the Winship Cancer Institute...

lymphoma

Mark J. Ratain, MD, on Chronic Lymphocytic Leukemia: Making a Case for Low-Dose Ibrutinib

Mark J. Ratain, MD, of the University of Chicago, talks about why ibrutinib—which can lead to cardiotoxicities—should be studied at a lower dose for patients with chronic lymphocytic leukemia. Data suggest a reduced dose may prevent dose interruption due to adverse events and may have a better...

geriatric oncology

The Importance of Measuring Health-Related Quality of Life in Older Adults

Compared with younger patients, older patients with cancer face unique challenges because many of them have age-related decreases in health-related quality of life. This can be a result of many factors, such as comorbidities, mental health, physical impairment, and financial stressors. A diagnosis...

colorectal cancer

Common Hypertension Medications May Also Reduce Risk of Colorectal Cancer

Medications commonly prescribed to treat high blood pressure may also reduce the risk of colorectal cancer, according to new research published by Cheung et al in the journal Hypertension. Angiotensin-converting enzyme (ACE) inhibitors or angiotensin II receptor blockers (ARB) are often prescribed...

breast cancer
health-care policy

Effect of Medicaid Expansion on Breast Cancer Stage at Diagnosis

In a study reported in JAMA Surgery, Le Blanc et al found that Medicaid expansion under the Affordable Care Act was associated with increased insurance coverage and reduction in rates of diagnosis of breast cancer at later stages. Study Details The study involved data from the National Cancer...

issues in oncology

American Cancer Society Updates Guideline for HPV Vaccination

The American Cancer Society (ACS) has updated its guideline for human papillomavirus (HPV) vaccination, adapting a 2019 update from the Federal Advisory Committee on Immunization Practices (ACIP). The ACS first issued a guideline for routine use of the HPV vaccine in 2007, with an update issued in...

head and neck cancer

Facing Death and Appreciating Life

I have had to come to terms with my own mortality three times in my life and I’m only 46. When I was 17, I was diagnosed with end-stage renal disease and experienced renal failure 2 years later. I underwent my first kidney transplant at 21, just before starting medical school. Finally, I thought my ...

Expect Questions About Minimally Invasive Surgery for Early-Stage Cervical Cancer

A recent systematic review and meta-analysis found that women with early-stage cervical cancer treated with minimally invasive radical hysterectomy had a 71% increased risk of disease recurrence and a 56% increased risk of death compared with those treated with open radical hysterectomy.1 “These...

gynecologic cancers

Higher Risk of Disease Recurrence and Death With Minimally Invasive vs Open Surgery for Early-Stage Cervical Cancer

Women with early-stage cervical cancer treated with minimally invasive radical hysterectomy had a 71% increased risk of recurrence and a 56% increased risk of death compared with those treated with open radical hysterectomy, according to a systematic review and meta-analysis of 15 studies involving ...

Neil Spector, MD, Physician-Scientist, Mentor, Author, Dies at 63

Neil Spector, MD, a physician-scientist, translational research leader, and oncology mentor died on June 14, 2020. He was 63. Dr. Spector was the Sandra Coates Associate Professor in the Department of Medicine, Associate Professor of Pharmacology and Cancer Biology, and a member of the Duke Cancer ...

lung cancer

Atezolizumab as First-Line Treatment of Metastatic NSCLC With High PD-L1 Expression and No EGFR or ALK Aberrations

On May 18, 2020, atezolizumab was approved for the first-line treatment of adult patients with metastatic non–small cell lung cancer (NSCLC) whose tumors have high PD-L1 expression and no EGFR or ALK genomic tumor aberrations. High PD-L1 expression is defined as PD-L1 staining of at least 50% of...

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