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cost of care
issues in oncology

As More Biosimilars Move Toward U.S. Market, Questions Remain About Cost Savings and Uptake by Physicians and Patients

The U.S. Food and Drug Administration (FDA) approved its first biosimilar drug, filgrastim-sndz (Zarxio), in 2015, allowing it to compete with the granulocyte colony-stimulating factor filgrastim (Neupogen) to treat neutropenia in chemotherapy patients. So far, filgrastim-sndz is the only...

Expert Point of View: Celeste Lebbé, MD

Invited discussant Celeste Lebbé, MD, of the Hospital Saint Louis in Paris, noted that the study met its primary endpoints and produced “very impressive data”; however, “major toxicity” was a concern. She said that in this small study of 18 patients (10 for efficacy), several lessons were learned: ...

breast cancer
genomics/genetics

Chemotherapy May Be Avoidable in Some Women With Early-Stage Breast Cancer Based on Clinical and Genomic Risks

In the phase III MINDACT trial reported in The New England Journal of Medicine, Fatima Cardoso, MD, of Champalimaud Clinical Center–Champalimaud Foundation, Lisbon, and colleagues found that adjuvant chemotherapy may be avoidable in women with early-stage breast cancer who are at high clinical...

breast cancer

Is Observation Without Surgery a Viable Strategy for Managing Ductal Carcinoma in Situ?

In a spirited debate, abounding with citations of clinical trials and other evidence, but not without humor and mutual respect, E. Shelley Hwang, MD, MPH, and Armando E. Giuliano, MD, reviewed the data and their clinical experience managing ductal carcinoma in situ and reached opposite...

pancreatic cancer

Vaccines May Boost Immune Responsiveness of Pancreatic Tumors

Pancreatic cancer has been notably unresponsive to immunotherapeutic approaches, but a Stand Up 2 Cancer Dream Team believes their research can change that. Team co-leader Elizabeth Jaffee, MD, Deputy Director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, ...

breast cancer

1 in 6 Women Diagnosed With Breast Cancer Have a Symptom Other Than a Lump

Around one in six women (17%) diagnosed with breast cancer go to their doctor with a symptom other than a lump—the most commonly reported breast cancer symptom—according to new research presented by Koo et al at the 2016 National Cancer Research Institute (NCRI) Cancer Conference in...

survivorship

Adult Survivors of Childhood Cancers Report Long-Term Health Issues

Although progress in treatment and supportive care for children with cancer has resulted in improved survival of these patients, some survivors experience ongoing medical conditions from their cancer or its treatment, including poor general health, poor mental health, functional impairment,...

skin cancer

Combination Strategies Harness the Power of the Oncolytic Virus Talimogene Laherparepvec

The injectable oncolytic immunotherapy talimogene laherparepvec (also known as T-VEC, Imlygic) may become a valuable component of combination immunotherapy approaches in melanoma, a strategy believed to help overcome resistance of tumors to single-agent immunotherapies. “[Talimogene laherparepvec] ...

head and neck cancer

Better Quality of Life Reported in Patients With Head and Neck Cancer Receiving Nivolumab vs Chemotherapy

Standard treatment for advanced head and neck cancer—including chemotherapy and radiation—causes painful side effects that impair quality of life, as well as the ability to socialize and engage in daily life activities. A new study of patients with platinum-refractory recurrent, metastatic head...

lung cancer

Improved Outcome Reported With Local Consolidative Therapy in Oligometastatic NSCLC Without Progression After First-Line Systemic Therapy

In a phase II trial reported in The Lancet Oncology, Gomez et al found that local consolidative therapy (with or without maintenance therapy) improved progression-free survival in patients with stage IV non–small cell lung cancer (NSCLC) who had up to three metastatic disease lesions and no...

skin cancer

Gut Microbes Linked to Immunotherapy Response in Patients With Melanoma

Patients with malignant melanoma are more likely to respond to immunotherapy treatment if they have greater diversity in their gut bacteria, according to new research presented by Wargo et al at the National Cancer Research Institute's (NCRI) Cancer Conference in Liverpool, United Kingdom....

bladder cancer

KEYNOTE-045 Trial Finds Pembrolizumab Improves Survival Over Chemotherapy in Advanced Urothelial Cancer

The phase III KEYNOTE-045 trial, investigating the use of the anti–PD-1 (programmed cell death protein 1) therapy pembrolizumab (Keytruda) in patients with previously treated advanced urothelial cancer, met the primary endpoint of overall survival, according to a news release issued by Merck. In...

lung cancer

Pembrolizumab, but Not Nivolumab, Improves Outcomes in Front-Line Setting for PD-L1–Positive Advanced NSCLC

Checkpoint inhibitors have revolutionized the treatment of advanced non–small cell lung cancer (NSCLC), but evidence of their benefit was restricted to the second-line setting. However, early-phase trials with both pembrolizumab (Keytruda) and nivolumab (Opdivo) demonstrated favorable results in...

Introduction

As expensive cancer biologics move off patent, biosimilar products are coming on board. These are highly similar versions of licensed biologics that demonstrate near-fingerprint identity to their reference products in terms of structure and potency. Biosimilars represent a major opportunity for...

lung cancer

Pembrolizumab Plus Chemotherapy Improves Outcomes Over Chemotherapy Alone in Advanced NSCLC

Combining immunotherapy with a standard chemotherapy doublet appears to be an attractive option for the front-line treatment of advanced nonsquamous non–small cell lung cancer (NSCLC), according to the results of a phase II study presented at the 2016 European Society for Medical Oncology (ESMO)...

kidney cancer

Phase III Study of Sunitinib Is First to Show Benefit in Adjuvant Setting for Treatment of Renal Cell Carcinoma

Sunitinib (Sutent) improved disease-free survival by more than 1 year when used as adjuvant treatment for high-risk locoregional renal cell carcinoma following nephrectomy, but with the cost of toxicity. S-TRAC is the first phase III trial showing a benefit for adjuvant therapy in renal cell...

issues in oncology

Putting Patients First: My Journey in Advocacy

When I lost my only sister to breast cancer in 1986, patients like her had devastatingly few choices. Over the intervening decades, sustained commitment to biomedical research at the National Institutes of Health (NIH) and major technologic advances have led to transformative changes in cancer...

health-care policy

How ASCO Is Preparing Members for MACRA

On October 14, 2016, the Centers for Medicare & Medicaid Services (CMS) announced its final policy on what physicians need to do to begin implementing the Quality Payment Program outlined in the Medicare Access and CHIP Reauthorization Act of 2015 ­(MACRA). The Quality Payment Program is a...

health-care policy

ASCO Launches COME HOME Initiative to Give Oncology Practices Concrete Path Toward Alternative Payment System

On November 2, ASCO and Innovative Oncology Business Solutions, Inc, (IOBS) announced a new collaboration, ASCO COME HOME, an oncology medical home program designed to transition community oncology practices from volume-based to value-based care by structuring reimbursement around the full...

breast cancer

Study Raises Concerns About Timely Follow-up to Positive Mammogram for the Uninsured

A study by University of North Carolina (UNC) Lineberger Comprehensive Cancer Center researchers has found that younger, uninsured women in North Carolina had higher odds of missing a 60-day window for getting follow-up after an abnormal mammogram, even though research underscores the importance of ...

colorectal cancer

Study Shows International Trends in Anal Cancer Incidence Rates

A new American Cancer Society study finds that incidence of anal cancer has been increasing in women or in both men and women in 13 of 18 countries studied, particularly in the Americas, Northern/Western Europe, and Australia. The authors say population-based preventive measures, including human...

colorectal cancer

New Blood Test for Colorectal Cancer Recurrence Is Twice as Sensitive as CEA Test

In a new report published by Young et al in Cancer Medicine, a two-gene circulating tumor DNA (ctDNA) blood test for postsurgical monitoring of colorectal cancer (CRC) recurrence has been shown to detect twice the number of recurrence cases as carcinoembryonic antigen (CEA) testing, a standard of...

bladder cancer

KEYNOTE-045 Studying Pembrolizumab in Advanced Bladder Cancer Meets Primary Endpoint and Stops Early

Merck announced October 21, 2016, that the phase III KEYNOTE-045 trial investigating the use of pembrolizumab (Keytruda), the company’s anti–PD-1 (programmed cell death protein 1) therapy in patients with previously treated advanced urothelial cancer, met the primary endpoint of overall ...

leukemia

Minimal Residual Disease Assessment and Prediction of Outcome in CLL Responders

Assessment of minimal residual disease was associated with improved prediction of outcome in responders, as well as complete responders, in patients with chronic lymphocytic leukemia (CLL) who respond to treatment. Kovacs et al reported these findings, which are based on an analysis of two phase...

head and neck cancer

Pembrolizumab in Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma

As reported in the Journal of Clinical Oncology by Laura Q. Chow, MD, of the University of Washington, and colleagues, a fixed-dose reduced-frequency pembrolizumab (Keytruda) regimen produced durable responses in the phase IB KEYNOTE-012 expansion cohort of patients with recurrent or metastatic...

head and neck cancer

Genetic Characteristics of Recurrent and Metastatic Head and Neck Cancers

Next-generation sequencing of recurrent or metastatic head and neck tumors at Memorial Sloan Kettering Cancer Center (MSK) has provided insight into the molecular characteristics of these tumors, which may aid in the implementation of precision treatment. Luc G. Morris, MD, MSc, of Memorial Sloan...

gynecologic cancers

ASCO Issues Global Recommendations to Increase Cervical Cancer Screening

Earlier this month, ASCO issued a new global guideline on screening for cervical cancer.1 The guideline provides evidence-based recommendations for screening, follow-up of positive screening results, and treatment of women with cervical precancers in countries worldwide.  ASCO’s guideline...

National Heart, Lung, and Blood Institute Selects Moffitt Cancer Center as One of Five Cell Therapies Processing Facilities

Moffitt Cancer Center has been selected as a Cell Therapies Processing Facility by the National Heart, Lung, and Blood Institute (NHLBI), part of the National Institutes of Health. Moffitt is one of five institutions that make up the NHLBI’s Production Assistance for Cellular Therapies group. The...

Face Mask for Radiation Therapy

By the 1930s, the dangers of radiation were well known. American Martyr’s to Science Through the Roentgen Rays, published in 1936, documented the dead heroes of American radiology, from Clarence Daly, Thomas Edison’s associate, to Elizabeth Fleischman, the only woman in the group, who was a U.S....

issues in oncology

New American Cancer Society Report Reveals Gaps, Identifies Unique Barriers in Pediatric Cancer Research

A first-of-its-kind joint report from the American Cancer Society and the Alliance for Childhood Cancer has compiled the latest information related to pediatric cancer, including statistics and trends; a current list of drugs used to treat pediatric cancers; ongoing pediatric cancer clinical...

palliative care

Quality Improvement Project Results in Timelier Hospice Referrals

A quality improvement project conducted within the OhioHealth system showed that oncologists can change their behavior and refer patients earlier to hospice care. After a relatively minor intervention, 18 medical oncologists in private practice doubled the mean length of stay in hospice care for...

palliative care

Food as Medicine: Study Sets Out to Prove Its Effectiveness

Could the quality of life of patients with advanced-stage cancer be improved by personal delivery of nutritious, medically tailored meals? Researchers at the New York University School of Medicine Perlmutter Cancer Center think so, and they have set out to prove it in a randomized clinical trial....

hematologic malignancies
palliative care

Palliative Care Still in Its Infancy in Hematologic Malignancies

Palliative care is slowly but surely being integrated into the treatment of patients with solid tumors, but its role in the hematopoietic stem cell transplant setting is still lagging, speakers said at the 2016 Palliative Care in Oncology Symposium. “There is a huge symptom burden among patients...

leukemia

Donor Selection for HLA-Matched Hematopoietic Cell Transplantation

Question 1: Which statement about donor selection for allogeneic hematopoietic cell transplant is correct? Correct Answer: C. If a donor is available, the genotypic identity between the patient and his brother should be established by typing the patient’s parents; if this is not possible, the...

gastrointestinal cancer

New NCCN Patient Resources Assist Decision-Making for Patients With Stomach Cancer

According to the American Cancer Society, it is estimated that more than 26,000 people will be diagnosed with stomach cancer in the United States this year, with nearly 1 million new cases diagnosed worldwide each year, according to the World Health Organization. Because there are no early symptoms ...

genomics/genetics

Using Pharmacogenetics to Predict Cancer Prognosis, Response to Treatment, and Toxicity

Although clinical trials are helpful in determining the effectiveness of a specific drug across a patient population, they are not as reliable at pinpointing how well a particular patient will respond to the drug or dosing regimen or how the drug may impact the patient’s quality of life from...

head and neck cancer

Rise in Oropharyngeal Cancer Incidence in the UK Not Solely Driven by HPV

The rise in the incidence of oropharyngeal squamous cell carcinoma in the United Kingdom from 2002 to 2011 was not solely attributable to a rise in the incidence of human papillomavirus (HPV)-positive disease, according to a study published in Cancer Research,1 which reported that the proportion of ...

colorectal cancer

ESMO 2016: Dabrafenib/Trametinib/Panitumumab Improves Efficacy in BRAF Mutation–Positive Metastatic Colorectal Cancer

Patients with metastatic colorectal cancer and tumors harboring the BRAF V600E mutation who received triple therapy with dabrafenib (Tafinlar), trametinib (Mekinist), and panitumumab (Vectibix) showed an improved best overall response and prolonged progression-free survival compared to...

issues in oncology

Barriers and Opportunities Reported in the Study of Human Papillomavirus Education and Immunization Efforts

Human papillomavirus (HPV) vaccination rates remain low across the United States, with fewer than 40% of girls and just over 21% of boys receiving the recommended vaccine series. Research from Roswell Park Cancer Institute has identified barriers that need to be overcome to improve vaccination...

solid tumors
hematologic malignancies

ESMO 2016: Vemurafenib Shows Clinical Benefit in Diverse BRAF V600–Mutated Tumors

Findings from a phase II trial of vemurafenib in previously treated patients with advanced disease and BRAF-mutated tumors indicate that the drug is effective in patients with diverse BRAF V600­–mutated tumors but not in patients with BRAF non-V600 mutations. After a mean treatment...

skin cancer

Personalized Vaccines May Protect Patients With High-Risk Melanoma

The field of cancer vaccines may be reinvigorated by a new understanding, and the therapeutic leveraging, of neoantigens. Researchers from Dana-Farber Cancer Institute in Boston are exploring this novel approach as a means of protecting patients with high-risk melanoma from recurrence. Early...

Arti Hurria, MD: From Leadership Development Program to Board of Directors

Arti Hurria, MD, a geriatric oncologist at City of Hope in Duarte, California, is the first graduate of ASCO’s Leadership Development Program to be elected to ASCO’s Board of Directors. Within 5 years of completing the program, Dr. Hurria went from learning leadership skills to applying them to...

gynecologic cancers

What We Know and What We Need to Know About Neoadjuvant Chemotherapy in Advanced Ovarian Cancer

Ever since the landmark studies of Griffiths and colleagues in the 1970s,1 primary cytoreductive surgery followed by chemotherapy with the objective of achieving minimal residual disease has been the standard approach for women with advanced-stage epithelial ovarian cancer. However, what is...

skin cancer

Adjuvant Ipilimumab Improves Survival in High-Risk Melanoma

Patients with stage III melanoma who were considered to be at high risk for recurrence derived an overall survival benefit from adjuvant treatment with ipilimumab (Yervoy), although it came at the price of considerable toxicity, according to updated survival results from the phase III European...

head and neck cancer

With Changing Strategies for Laryngeal Cancer, Multidisciplinary Team Approach Is Key

The treatment of cancer of the larynx has changed dramatically in recent years. With organ preservation now possible in many cases, it is more important than ever for patients to receive guidance from every corner of the field. In a recent article in the Journal of Oncology Practice (JOP),1 a...

breast cancer
supportive care

Consensus on Defining and Measuring Lymphedema Is Needed to Advance Efforts to Intervene Early and Prevent Progression

“Early intervention might prevent lymphedema progression,” Alphonse Taghian, MD, PhD, said at the 18th Annual Lynn Sage Breast Cancer Symposium in Chicago, but the lack of a universal definition of lymphedema and agreement on how to optimally measure it impedes phase III studies to test that...

breast cancer

Breast Cancer Study Finds Higher Mortality Rate in Black Women Than White Women, and the Disparity Is Growing

The Avon Foundation for Women recently released a new study on the racial disparities in breast cancer mortality in the 50 largest cities in the United States between 2005 and 2014. Published in Cancer Epidemiology,1 the study was conducted by Sinai Urban Health Institute in collaboration with the...

cns cancers

Stereotactic Radiosurgery Achieves Better Quality of Life and Improved Cognition Than Whole-Brain Radiotherapy

Two separate randomized trials presented at the 58th Annual Meeting of the American Society of Radiation Oncology (ASTRO) affirmed the value of stereotactic radiosurgery as an option for postoperative treatment of the surgical cavity of resected brain metastases, potentially avoiding the cognitive...

prostate cancer

Safety of Extreme Hypofractionation Reassuring in Intermediate-Risk Prostate Cancer

Giving patients larger fractions of radiation over shorter periods (ie, hypofractionation) is gaining ground in several types of cancers. This approach is attractive for patients’ convenience, shortening treatment and travel times, and also for resource utilization. Several studies have shown that ...

lung cancer

Retrospective Studies Confirm Survival Benefit of Stereotactic Body Radiotherapy in Early-Stage NSCLC

Stereotactic body radiation therapy is becoming more widely adopted for the treatment of early-stage non–small cell lung cancer (NSCLC). Along with its increasing uptake, survival has significantly increased over the past decade, according to two large retrospective studies presented at the 58th...

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