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Has the Promise of Precision Medicine Been Oversold?

Recently, the term “personalized medicine” in oncology care has been overtaken by the more contemporary concept of “precision medicine.” According to the National Research Council of the National Academies of Science, Engineering, and Medicine, the newer terminology shifts the focus to improving...

immunotherapy

Assay Uses Big Data to Predict Responses to Immunotherapy

In the age of big data, cancer researchers are discovering new ways to monitor the effectiveness of immunotherapy treatments. Researchers at the Johns Hopkins Bloomberg~Kimmel Institute for Cancer Immunotherapy developed a new way to use bioinformatics as a gathering tool to determine how a...

hematologic malignancies
lymphoma

Novel Treatment Approaches in Early Relapse of Follicular Lymphoma

“Patients with follicular lymphoma who relapse early after treatment are a minority of patients, fortunately, but they are clearly patients with a different disease,” according to Jonathon B. Cohen, MD, of Emory University School of Medicine. At Emory’s 2018 Debates and Didactics in Hematology and...

lung cancer

Atezolizumab Plus Standard Chemotherapy Improves Progression-Free Survival in Stage IV NSCLC

The combination of atezolizumab (Tecentriq), a programmed cell death ligand 1 (PD-L1) inhibitor, plus carboplatin or cisplatin and pemetrexed (Alimta) as first-line therapy followed by pemetrexed plus atezolizumab maintenance therapy improved progression-free survival in patients with stage IV...

issues in oncology
cost of care

Douglas W. Blayney, MD, on Quality Care: Better, Safer, Cheaper

Douglas W. Blayney, MD, of Stanford University, and winner of the Joseph V. Simone Award for Excellence, summarizes his talk on the expense of cancer care and how we can reduce costs while maintaining safety and high value for people with cancer.

hematologic malignancies
lymphoma

The Relevance of the RELEVANCE Trial in Follicular Lymphoma

We have seen remarkable progress in the outcomes of patients with advanced-stage follicular lymphoma over the past 2 decades.1 Recent manuscripts and presentations describing long-term follow-up of randomized trials comparing various chemotherapy platforms (all combined with anti-CD20 antibodies)...

lung cancer

WCLC 2018: Nintedanib Plus Pemetrexed/Cisplatin Does Not Improve PFS or OS in Malignant Pleural Mesothelioma of Epithelioid Subtype

Findings from a recent study demonstrate that the triple angiokinase inhibitor nintedanib combined with standard-of-care pemetrexed (Alimta)/cisplatin does not impact progression-free survival (PFS) and overall survival (OS) for patients with unresectable malignant pleural mesothelioma with...

lung cancer

WCLC 2018: IMpower133: Atezolizumab May Improve Outcomes for SCLC When Added to Carboplatin and Etoposide

Findings from the IMpower 133 trial demonstrate that adding the anti­–programmed cell death ligand 1 antibody atezolizumab (Tecentriq) to standard first-line therapy with carboplatin and etoposide prolonged overall survival (OS) and progression-free survival (PFS) in patients with...

Chemotherapy for Acute Myeloid Leukemia: Where Should It Be Given?

USING THE National Cancer Database, Bhatt et al1 recently reported that of the 61,775 adults with acute myeloid leukemia (AML), those who received chemotherapy from 2003 to 2011 lived longer than those who, in those same years, did not; the study is reviewed in this issue of The ASCO Post....

leukemia

Suboptimal Use of Initial Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia

IN A STUDY of National Cancer Database data reported in Blood Advances, Vijaya Raj Bhatt, MD, of the University of Nebraska Medical Center, and colleagues found that 25% of patients with newly diagnosed acute myeloid leukemia (AML) did not receive initial chemotherapy, despite evidence that...

head and neck cancer

Adding Nimotuzumab to Chemoradiation Improved Survival in Locally Advanced Head and Neck Cancer

IN PATIENTS with locally advanced squamous cell carcinoma of the head and neck, nimotuzumab—a humanized monoclonal antibody against the epidermal growth factor receptor—in combination with cisplatin and radiotherapy was superior to cisplatin and radiotherapy alone in improving progression-free...

lung cancer

NGR-hTNF Combined With Investigator Choice of Therapy in Malignant Pleural Mesothelioma

The phase III NGR015 trial reported in The Lancet Oncology by Vanesa Gregorc, MD, of Ospedale San Raffaele, Milan, and colleagues found no benefit of adding NGR-hTNF to best investigator choice of treatment in patients with previously treated malignant pleural mesothelioma. NGR-hTNF consists of...

issues in oncology

New ESMO Tumor DNA Scale Helps Match Patients to Optimal Targeted Treatments

A new scale for tumor DNA mutations called ESCAT (European Society for Medical Oncology [ESMO] Scale for Clinical Actionability of Molecular Targets) is aiming to simplify and standardize choices for targeted cancer treatment. Information about the development and use of the scale in practice was...

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...

palliative care

Impact of Peer-Review Intervention on Radiotherapy Schedules for Palliative Treatment of Bone Metastases

In a single-center study reported in the Journal of Oncology Practice, Walker et al found that institution of a peer-review process resulted in shorter fractionation schedules for palliation of bone metastases, consistent with current guidelines. As stated by the authors, “Shorter...

Long-Term Pooled Safety Data for Palbociclib Combined With Endocrine Therapy in HR-Positive, HER2-Negative Breast Cancer

In an analysis of pooled safety data from the PALOMA trials of palbociclib (Ibrance) plus endocrine therapy in hormone receptor (HR)-positive, HER2-negative advanced breast cancer reported in the Journal of the National Cancer Institute, Diéras et al found no evidence of specific cumulative...

supportive care
integrative oncology

Reishi Mushroom

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, present information on the use of reishi...

symptom management
head and neck cancer

Expert Point of View: Rajesh Lalla, DDS, PhD

COMMENTING ON the results of this trial of GC4419, Rajesh V. Lalla, DDS, PhD, President of the Multinational Association of Supportive Care in Cancer, said, “This study demonstrated this agent’s strong potential for the management of oral mucositis in patients receiving head and neck radiation...

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...

issues in oncology

Real-World Evidence Gaining Credibility and Practicality in Treatment Evaluation

In a Friends of Cancer Research (Friends) meeting devoted to real-world evidence, members of the cancer community generally agreed that its use has an increasingly important role to play in gathering the data necessary to test, evaluate, and bring new therapeutic agents to market. This Friends...

ASCO, Conquer Cancer Congratulate 2018 Grant and Award Recipients

ASCO’s Conquer Cancer Foundation presented more than $7.3 million in grants and awards to exceptional oncology researchers at the 2018 ASCO Annual Meeting. ASCO and Conquer Cancer congratulate the recipients and offer their profound thanks to those who generously supported these awards. Visit...

hematologic malignancies

Answers to Hematology Expert Review Questions

Question 1  Which of the following is one of the four major criteria for the diagnosis of essential thrombocythemia?  Correct Answer: A. Platelet count ≥ 450 × 109/L.  Expert Perspective  The diagnosis of essential thrombocythemia requires that all four major criteria or the first three major...

pancreatic cancer

Actively Recruiting Clinical Trials Focused on Pancreatic Cancer

THE INFORMATION contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on pancreatic cancer. These studies are investigating radiotherapy; cancer vaccines; combination treatments; novel cell therapies; response prediction; and more. All of the studies ...

issues in oncology

Statement From FDA Commissioner on Agency Efforts to Advance the Patient Voice in Medical Product Development and Regulatory Decision-Making

U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, recently issued the following statement: Over the past decade, advances in our understanding of the basic biology of serious and life-threatening diseases has led to the development and FDA approval of targeted treatments for ...

issues in oncology
palliative care

Voluntarily Stopping Eating and Drinking Is Legal—and Ethical—for Terminally Ill Patients Looking to Hasten Death

Terminally ill patients with cancer will sometimes ask their clinicians for help with assisted or hastened death.1 Although palliative care and hospice care can usually address the concerns of most patients, some have physical or existential suffering that is refractory to comfort and supportive...

solid tumors
gastrointestinal cancer

Optimizing Biologics in Metastatic Colon Cancer

Biologics are credited with increasing median overall survival in colorectal cancer to approximately 30 months. Their optimal use was discussed by Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, in an article he coauthored for the Journal of Oncology Practice 1...

solid tumors
skin cancer

The Raven

The call from the dermatologist came at noon on Good Friday, just after my wife left with our two young daughters for a week on her family’s tree farm in Northern Michigan. I was on call for the hospital inpatient leukemia service, so I could not join them. When the dermatologist solemnly began,...

John V. Cox Reflects on 10 Years as Editor-in-Chief of the Journal of Oncology Practice

John V. Cox, DO, FASCO, of the Parkland Hospital and Health System/University of Texas Southwestern Medical Center, has served as the Editor-in-Chief of the Journal of Oncology Practice (JOP) since 2008. As a member of the journal’s inaugural Editorial Board, he has seen the publication evolve...

ASCO to Present Douglas W. Blayney, MD, FASCO, With Joseph V. Simone Award and Lecture

ASCO will recognize Douglas W. Blayney, MD, FASCO, medical oncologist and Professor at Stanford University School of Medicine, with the Joseph V. Simone Award and Lecture for Excellence in Quality and Safety in the Care of Patients with Cancer. Dr. Blayney will be presented with the award at the...

lung cancer

Expert Point of View: John V. Heymach, MD, PhD

FORMAL DISCUSSANT of this trial, John V. Heymach, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston, also was optimistic about these early findings. “This is a proof-of-concept study showing this approach is safe. Only modest activity was observed with standard [Response...

pancreatic cancer

Using Neoadjuvant Therapy to Reduce Early Recurrences, Increase Survival in Patients With Pancreatic Cancer

USE OF THE FOLFIRINOX regimen (fluorouracil, leucovorin, irinotecan, and oxaliplatin) was associated with a 4.9-month improvement in overall survival compared to gemcitabine/ nab-paclitaxel (Abraxane) in the neoadjuvant treatment of resectable and borderline-resectable pancreatic head...

‘Pearls of Wisdom’ for Leadership and Success in Academic Medicine Gathered Over a 35-Year Career

Dr. Hayes, ASCO President 2016–2017, is Professor of Internal Medicine; Stuart B. Padnos Professor in Breast Cancer; and Clinical Director of the Breast Oncology Program at the University of Michigan Comprehensive Cancer Center, Ann Arbor. AS I COMPLETE my 3-year term as ASCO President, I am...

solid tumors
skin cancer
head and neck cancer

Dabrafenib Plus Trametinib for Thyroid Cancer, Melanoma With BRAF Mutations

On May 4, 2018, dabrafenib (Tafinlar) and trametinib (Mekinist) in combination was granted approval for treatment of patients with locally advanced or metastatic anaplastic thyroid cancer with BRAF V600E mutation and no satisfactory locoregional treatment options.1-3 Dabrafenib is not indicated for ...

lung cancer

Valued Mentors and a Link Between Science and Medicine Paved the Road to Oncology for Alice Tsang Shaw, MD, PhD

Lung cancer expert Alice Tsang Shaw, MD, PhD, was born and reared in Gaithersburg, a small suburb located to the northwest of Washington, DC. Both her parents were chemists, and during high school, Dr. Shaw had a keen interest in science, particularly biology, yet the thought of pursuing a career...

head and neck cancer

Once-Weekly vs Every-3-Week Cisplatin Chemoradiation in Locally Advanced Head and Neck Cancer

In an Indian phase III trial reported in the Journal of Clinical Oncology, Vanita Noronha, MD, of Tata Memorial Hospital, Mumbai, and colleagues found that curative-intent adjuvant chemoradiation with cisplatin at 100 mg/m2 every 3 weeks produced better locoregional control vs cisplatin at 30...

Nancy L. Bartlett, MD, Moved From Engineering to Medicine After a Stint in the ER

Nationally recognized oncologist Nancy L. Bartlett, MD, had an early love for mathematics and a swooning aversion to the sight of blood. “I was born and reared in Kansas City, Missouri and am a Midwesterner at heart. No one in the family was involved in medicine. My mom was an elementary school...

prostate cancer

Role of MRI in Detection of Clinically Significant Prostate Cancer: ‘Practice-Affirming’ Results From The PRECISION Trial

Simultaneously presented at the 2018 European Association of Urology meeting and published in The New England Journal of Medicine, the PRECISION trial will go down as a landmark study for solidifying the role of magnetic resonance imaging (MRI) in prostate cancer diagnosis.1 This trial provides...

prostate cancer

MRI-Targeted vs Standard Biopsy in Prostate Cancer Diagnosis: The PRECISION Trial

In the international PRECISION trial reported in The New England Journal of Medicine, Veeru Kasivisvanathan, MRCS, of University College London, and colleagues found that magnetic resonance imaging (MRI)-targeted biopsy resulted in a significantly higher rate of diagnosis of clinically significant ...

solid tumors

First Selective RET Inhibitor Shows Efficacy in Multiple Cancers

A first-in-human study provides proof of concept that a novel oral agent targeted to RET genetic alterations is safe and active in RET-driven cancers. The agent, called BLU-667, achieved durable disease control in patients with lung and thyroid cancers harboring the RET oncogene, according to the...

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...

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...

supportive care
integrative oncology

Chamomile

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, Jun J. Mao, MD, MSCE, and Jyothirmai Gubili, MS, focus attention on chamomile ...

Linda D. Bosserman, MD, FACP, FASCO, Named Editor-in-Chief of Journal of Oncology Practice

Linda D. Bosserman, MD, FACP, FASCO, has been named Editor-in-Chief of ASCO’s Journal of Oncology Practice (JOP). She is a recognized leader in cancer care delivery with an understanding of the issues impacting all types of oncology practices. Dr. Bosserman will oversee the development of each...

multiple myeloma

Updated International Myeloma Working Group Criteria: Diagnostic Challenges

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Landgren review the underlying data that shaped the updated International Myeloma Working Group (IMWG) diagnostic criteria for...

health-care policy

Nancy Goodman, JD, MPP: Is the Federal Government a Productive Partner in Cancer Policy?

Nancy Goodman, JD, MPP, Executive Director, Kids V Cancer, speaks during Panel 1: Is the Federal Government a Productive Partner in Cancer Policy? at The Policy, Politics and Law of Cancer, presented by The Solomon Center for Health Law and Policy at Yale Law School, in collaboration with Smilow...

health-care policy

Nancy Goodman, JD, MPP: Is the Federal Government a Productive Partner in Cancer Policy?

Nancy Goodman, JD, MPP, Executive Director, Kids V Cancer, speaks during Panel 1: Is the Federal Government a Productive Partner in Cancer Policy? at The Policy, Politics and Law of Cancer, presented by The Solomon Center for Health Law and Policy at Yale Law School, in collaboration with Smilow...

health-care policy

Nancy Goodman, JD, MPP: Is the Federal Government a Productive Partner in Cancer Policy?

Nancy Goodman, JD, MPP, Executive Director, Kids V Cancer, speaks during Panel 1: Is the Federal Government a Productive Partner in Cancer Policy? at The Policy, Politics and Law of Cancer, presented by The Solomon Center for Health Law and Policy at Yale Law School, in collaboration with Smilow...

cns cancers
skin cancer
immunotherapy

Nivolumab/Ipilimumab or Nivolumab Alone in Melanoma Brain Metastases

In an Australian phase II trial reported in The Lancet Oncology, Long et al found that the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) and nivolumab alone showed intracranial activity in patients with melanoma brain metastases. Study Details In the open-label trial, 76 evaluable...

issues in oncology

How to Respond to a Patient’s Discriminatory Request for a Different Clinician

Some patients may make discriminatory requests for a different clinician for their health care.1-5 These individuals may want to avoid treatment with clinicians of a certain race, religion, gender, sexual orientation, or national origin. Oncologists are not exempt from this type of patient...

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