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CMS Finalizes Updates to E&M Codes, Establishes MIPS Value Pathways

The Centers for Medicare & Medicaid Services (CMS) released its final rule for the 2020 Medicare Physician Fee Schedule (MPFS) and other changes to Medicare Part B reimbursement policies, including proposals related to the Quality Payment Program (QPP). The estimated impact of the final MPFS...

ASCO and IASLC Collaborate to Improve the Quality of Lung Cancer Care in Brazil

Medical oncologists in Brazil are being encouraged to take advantage of a new measure set for assessing the quality of care they provide to patients with lung cancer. Lung cancer is one of the most prevalent and deadly types of cancer in Brazil.1 Providing a platform for health-care providers to...

breast cancer

Trastuzumab and Hyaluronidase-oysk for Subcutaneous Use in HER2-Positive Breast Cancer

Early in 2019, trastuzumab and the endoglycosidase hyaluronidase-oysk for subcutaneous injection was approved in the treatment of HER2-positive breast cancer.1,2 The agent is indicated for adjuvant treatment of patients with HER2-overexpressing node-positive or node-negative (estrogen...

lymphoma
immunotherapy

Rituximab-abbs: Biosimilar to Rituximab for Non-Hodgkin Lymphoma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Late in 2018, rituximab-abbs was approved as the first...

multiple myeloma

Taking a Reasonable Approach to Treating Newly Diagnosed Multiple Myeloma

Multiple myeloma is a malignancy characterized by clonal proliferation of terminally differentiated plasma cells within the bone marrow. Although it leads to a host of different issues within the body, overall survival has steadily improved in recent years. “This is largely because of better...

lymphoma
immunotherapy

KEYNOTE-013 and KEYNOTE-170: Improving the Precision of Checkpoint Blockade in Patients With Diffuse Large B-Cell Lymphoma

Primary mediastinal B-cell lymphoma is an uncommon but distinct clinicopathologic variant of diffuse large B-cell lymphoma (DLBCL) that typically presents with an aggressive mediastinal mass and invasion of local structures. Most patients are young, typically in their 20s and 30s, and there is a...

issues in oncology

Time to Treatment Is a Priority

Dr. Smith called us on a Tuesday afternoon. “I have a patient who has an abnormal mammogram showing a large mass. I’m suspecting cancer and am referring her to you for diagnosis and treatment. She’s very anxious. I hope you can help.” We were able to get Dr. Smith’s patient in the next day for...

breast cancer

Expert Point of View: Steven J. Isakoff, MD, PhD

Steven J. Isakoff, MD, PhD, a medical oncologist at Massachusetts General Hospital, Boston, commented on the results of the DESTINY-Breast01 trial. “These data are extraordinarily encouraging, suggesting we will have another new option for patients with metastatic HER2-positive breast cancer. The...

breast cancer

Swedish Study of Risk-Adapted Screening Starting Ages for Relatives of Patients With Breast Cancer

In a study reported in JAMA Oncology, Trasias Mukama, MPH, and colleagues identified risk-adapted screening starting ages for relatives of patients with breast cancer according to the number of affected first-degree and second-degree relatives and the age at diagnosis of affected relatives. The...

prostate cancer

Sequencing of Enzalutamide and Abiraterone Acetate in Metastatic Castration-Resistant Prostate Cancer

In a Canadian phase II crossover trial reported in The Lancet Oncology, Kim N. Chi, MD, and colleagues found that time to second prostate-specific antigen (PSA) progression from start of treatment was longer with crossover from abiraterone acetate/prednisone to enzalutamide vs the reverse sequence ...

lung cancer
bladder cancer
colorectal cancer
hematologic malignancies
myelodysplastic syndromes
breast cancer
head and neck cancer
immunotherapy

FDA Pipeline: Priority Reviews in SCLC, Bladder Cancer, Colorectal Cancer

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Reviews for treatments in extensive-stage small cell lung cancer (SCLC), non–muscle invasive bladder cancer, and BRAF V600E–mutant colorectal cancer. The Agency also recently issued multiple Breakthrough Therapy designations and ...

Explaining Risk Factors Related to Anal Cancer

A recent study found rising rates of squamous cell carcinoma of the anus, “particularly advanced-stage disease, and a similar rise in mortality.”1 The authors concluded: “Improved prevention strategies are urgently needed to mitigate the rising [squamous cell carcinoma of the anus] burden among a...

solid tumors

Incidence of Squamous Cell Carcinoma of the Anus Has ‘Increased Dramatically’ in Older Women and Young Black Men

“Squamous cell carcinoma of the anus incidence has increased dramatically in elderly women and young black men,” according to a study of recent trends in incidence and mortality. “Advanced-stage [anal squamous cell carcinoma] incidence tripled with a prominent rise in … mortality,” researchers...

leukemia
immunotherapy

Fractionated Tisagenlecleucel Infusion for Adults With B-Cell Acute Lymphoblastic Leukemia May Improve Safety Without Reducing Efficacy

As reported by Noelle V. Frey, MD, and colleagues in the Journal of Clinical Oncology, single-center experience with the anti-CD19 chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel has shown that high-dose fractionated infusion with the ability to modify dosing in case of early signs...

gynecologic cancers

The Antiseptic Era: 1876–1900

The text and photographs here are excerpted from a four-volume series of books titled Oncology: Tumors & Treatment, A Photographic History, The Antiseptic Era: 1876–1900 by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. The photographs appear courtesy of Dr. Burns and The Burns Archive. To ...

Dana-Farber Researcher Receives Victoria Mock New Investigator Award From ONS

Robert Knoerl, PhD, RN, an Instructor in Medicine and Nurse Scientist in the Phyllis F. Cantor Center for Research in Nursing and Patient Care Services at Dana-Farber Cancer Institute, has been awarded the 2020 Oncology Nursing Society’s Victoria Mock New Investigator Award. Dr. Knoerl was...

lung cancer

Global Survey Shows Misperceptions About Lung Cancer Among the General Public

Only one in five people (22%) disagrees with the statement “generally, patients with lung cancer have caused their illness through their lifestyle choices and behaviors,” according to a global, omnibus survey conducted by Ipsos MORI and sponsored by the Lung Ambition Alliance. The results were...

breast cancer

Companion Diagnostic Approved for Alpelisib/Fulvestrant Therapy

On December 4, the U.S. Food and Drug Administration (FDA) approved FoundationOne CDx to be used as a companion diagnostic for alpelisib in combination with fulvestrant for the treatment of postmenopausal women as well as male patients with hormone receptor–positive, HER2-negative, PIK3CA-mutated,...

American Cancer Society and Flatiron Health Launch Real-World Data Impact Award

The American Cancer Society (ACS) and Flatiron Health has announced the launch of the American Cancer Society & Flatiron Health Real-World Data Impact Award. This joint grant-making program supports both organizations’ goals of accelerating cancer research and improving treatment and care...

leukemia

Gilteritinib for Relapsed or Refractory AML With FLT3 Mutation

Late in 2018, the FLT3 inhibitor gilteritinib was approved for the treatment of adult patients who have relapsed or refractory acute myeloid leukemia (AML) with a FLT3 mutation, as detected by a U.S. Food and Drug Administration (FDA)-approved test.1,2 The FDA also approved an expanded indication...

leukemia

Selected Abstracts From the 2019 ASH Annual Meeting & Exposition

To complement The ASCO Post’s comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic regimens for acute myeloid leukemia (AML). For full details of these...

lymphoma

The WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Syed Ali Abutalib, MD, and L. Jeffrey Medeiros, MD, explore the updated World Health Organization (WHO) classification of hematopoietic and lymphoid ...

skin cancer

Pembrolizumab in Adjuvant Treatment of Melanoma With Involvement of Lymph Nodes After Complete Resection

In early 2019, pembrolizumab was approved for the adjuvant treatment of patients with melanoma with involvement of lymph node(s) following complete resection.1,2 Supporting Efficacy Data Approval was based on findings in the double-blind EORTC 1325/KEYNOTE-054 trial (ClinicalTrials.gov identifier...

Grief Symptom Levels in Parents of Children Who Have Died of Cancer

In a Swedish study reported in the Journal of Clinical Oncology, Pohlkamp et al identified factors associated with levels of prolonged grief symptoms in parents of children who have died of cancer, with factors being found to differ between mothers and fathers.1 As stated by the investigators,...

head and neck cancer
integrative oncology
symptom management

Acupuncture May Reduce Radiation-Induced Dry Mouth for Patients With Head and Neck Cancer

After receiving acupuncture treatment 3 days a week during the course of radiation treatment, patients with head and neck cancer experienced less dry mouth, according to study results published by Garcia et al in JAMA Network Open. The results are from the first randomized, placebo-controlled,...

lymphoma
leukemia

Acalabrutinib for Adult Patients With Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

On November 21, 2019, the Bruton’s tyrosine kinase (BTK) inhibitor acalabrutinib was approved for the treatment of adults with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).1,2 The review resulting in approval was conducted under Project Orbis, an initiative of the U.S....

supportive care

ASCO/NCODA Release Standards for Medically Integrated Dispensing of Oral Anticancer Drugs

ASCO and the National Community Oncology Dispensing Association (NCODA) have published recommended standards for medically integrated dispensing of oral anticancer therapies and supportive care medications in the oncology clinic.1 “The NCODA created quality standards 6 years ago and recognized the ...

issues in oncology

ASCO’s National Cancer Opinion Survey Finds Gaps in Knowledge on Cancer Prevention and the Dangers of E-Cigarettes

As in the previous 2 years, the results from ASCO’s 2019 Cancer Opinion Survey revealed some startling answers about the public’s understanding of cancer, its risk factors, and strategies to prevent the disease. Although a majority of Americans (57%) said they were concerned about developing...

multiple myeloma

Relapsed or Refractory Multiple Myeloma Outcomes Improving Exponentially

Emerging treatments for relapsed or refractory multiple myeloma include options beyond triplet regimens, including immunotherapy and mutation-driven therapy. Several exciting drugs are poised to be available in the clinic in 2020, according to speakers at the recent JADPRO Live, the annual...

Expert Point of View: Thierry Facon, MD, and Michael Jain, MD, PhD

Thierry Facon, MD, Professor of Hematology at Lille University Hospital in France, and Michael Jain, MD, PhD, of Moffitt Cancer Center, Tampa, were interviewed by The ASCO Post on the second-generation chimeric antigen receptor (CAR) T-cell products for treating multiple myeloma. According to Dr. ...

immunotherapy
multiple myeloma

Phase Ib/II Studies Explore Next-Generation BCMA-Targeted CAR T-Cell Therapies in Multiple Myeloma

In patients with relapsed or refractory multiple myeloma, two novel dual-target chimeric antigen receptor (CAR) T-cell strategies are yielding early and durable responses, with seemingly less cytokine-release syndrome and neurotoxicity than first-generation CAR T-cell products, according to the...

prostate cancer
issues in oncology

Commercial Gene-Expression Tests for Prostate Cancer May Not Accurately Predict Disease Progression in African American Men

A study examining the differences in gene expression between African American and European American men with prostate cancer for three commercially available prostate cancer prognostic biomarker panels—Oncotype DX Prostate Score, Prolaris, and Decipher—has found that these tests may not accurately...

hepatobiliary cancer
immunotherapy

Does Second-Line Pembrolizumab in Patients With Advanced Hepatocellular Carcinoma Previously Treated With Sorafenib Confer a Survival Benefit?

As reported in the Journal of Clinical Oncology by Richard S. Finn, MD, and colleagues, the phase III KEYNOTE-240 trial has shown no statistically significant progression-free or overall survival benefit with pembrolizumab vs placebo in patients with advanced hepatocellular carcinoma who were...

breast cancer

Veliparib/Chemotherapy Combination Active in HER2-Negative BRCA-Positive Advanced Breast Cancer

The addition of the poly (ADP-ribose) polymerase (PARP) inhibitor veliparib to carboplatin/paclitaxel chemotherapy significantly improved progression-free survival in patients with advanced HER2-negative breast cancer and germline BRCA mutation compared with placebo plus chemotherapy, according to...

skin cancer

ASTRO Issues Clinical Guideline on Radiation Therapy for Basal Cell and Cutaneous Squamous Cell Carcinomas

A new clinical guideline from the American Society for Radiation Oncology (ASTRO) provides recommendations on the use of radiation therapy to treat patients diagnosed with the most common types of skin cancers. The guideline details when radiation treatments are appropriate as stand-alone therapy...

issues in oncology

Survey of Anticipation and Experience of Adverse Effects in Patients Receiving Radiotherapy

In a study reported in the Journal of Oncology Practice, Reshma Jagsi, MD, DPhil, and colleagues found that most patients undergoing radiation therapy for cancer reported that they did not experience anticipated radiotherapy adverse effects, or that the adverse effect was no worse than expected....

breast cancer

Recurrence Risk in Black and White Women With Borderline Estrogen Receptor–Positive Breast Cancer

In a study reported in the Journal of the National Cancer Institute, Benefield et al found that black women with borderline estrogen receptor (ER)-positive breast cancer had significantly poorer disease-free interval compared with those with ER-positive disease, irrespective of whether they...

colorectal cancer
head and neck cancer
pancreatic cancer

Early Research Shows Potential New Targets in Treating Glioblastoma, Colorectal Cancer, and Pancreatic Ductal Adenocarcinoma

Glioblastoma multiforme, colorectal cancer, and pancreatic ductal adenocarcinoma represent some of the most difficult-to-treat cancers and collectively cause more than 114,000 deaths each year in the United States. A trio of recently published basic research studies in these cancers have found...

issues in oncology
genomics/genetics

A Systematic Approach to Identifying the Molecular Factors That Lead to Cancer Progression

Although gene mutations are the primary drivers of carcinogenesis, an array of complex and tumor-specific molecular interaction networks determine cancer cell behavior. To learn more about this line of inquiry, The ASCO Post recently spoke with Andrea Califano, Dr., Professor of Chemical Biology...

issues in oncology

People With Mental Illness Receive Less Cancer Screening vs General Population

Results from a systematic review and comparative meta-analysis show that despite increased mortality from cancer in people with mental illness, this population receives less cancer screening compared to the general population. These findings were published by Solmi et al in The Lancet Psychiatry....

breast cancer

Study Links Sustained Weight Loss to Reduced Breast Cancer Risk

A new study finds that women who lost weight after age 50 and kept it off had a lower risk of breast cancer than women whose weight remained stable, helping answer a vexing question in cancer prevention.1 The reduction in risk increased with the amount of weight lost and was specific to women not...

head and neck cancer
immunotherapy

Immunotherapy for Head/Neck Squamous Cell Carcinoma: Questions Raised by KEYNOTE-048

There is a new first-line treatment option for patients with newly diagnosed, recurrent, or metastatic head and neck squamous cell carcinoma. As reported by Burtness et al in The Lancet, pembrolizumab improved overall survival vs the standard-of-care regimen of cetuximab and platinum-based...

kidney cancer

TIVO-3: Third- or Fourth-Line Tivozanib vs Sorafenib in Metastatic Renal Cell Carcinoma

As reported in The Lancet Oncology by Brian I. Rini, MD, and colleagues, the phase III TIVO-3 trial has shown a statistically significant increase in progression-free survival with tivozanib vs sorafenib as a third- or fourth-line treatment for advanced renal cell carcinoma. Study Details The...

breast cancer

Marie-Jeanne T.F.D. Vrancken Peeters, MD, PhD, on Omitting Breast Surgery: Results of the MICRA Trial

Marie-Jeanne T.F.D. Vrancken Peeters, MD, PhD, of the Netherlands Cancer Institute, discusses an interim study analysis showing that ultrasound-guided core biopsies of the breast in patients with excellent response on MRI after neoadjuvant systemic therapy may not be accurate enough to safely...

breast cancer
immunotherapy

Ariella B. Hanker, PhD, on Therapeutic Implications of HER2 and HER3 Mutations in Breast Cancer

Ariella B. Hanker, PhD, of UT Southwestern Medical Center, discusses data showing that breast cancers expressing co-occurring HER2 and HER3 mutations may require the addition of a phosphoinositide 3-kinase alpha inhibitor to a HER2 tyrosine kinase inhibitor (Abstract GS6-04).

breast cancer

Joerg Heil, MD, PhD, on Image-Guided Vacuum-Assisted Breast Biopsy

Joerg Heil, MD, PhD, of the University Hospital Heidelberg, discusses findings on how accurately this technique can diagnose residual disease and pathologic complete response after neoadjuvant chemotherapy in patients with breast cancer. These data may help tailor, de-escalate, and potentially...

breast cancer
genomics/genetics

Belinda Kingston, MB ChB, on the Genomic Landscape of Breast Cancer Based on ctDNA Analysis

Belinda Kingston, MB ChB, of the Institute of Cancer Research London, discusses next-generation sequencing results from the plasmaMATCH trial, including the incidence of gene alterations overall, as well as the associations with clinical and pathologic features that may help direct treatment...

breast cancer

Tari A. King, MD, on Molecular Differences Between Primary and Metastatic Breast Tumors

Tari A. King, MD, of Brigham and Women’s Hospital and Dana-Farber/ Brigham and Women’s Cancer Center, discusses retrospective findings from the AURORA U.S. Network on molecular differences between primary tumors and metastases, a better understanding of which may help lead to more effective...

breast cancer

SABCS 2019: Oral vs Intravenous Paclitaxel for Patients With Metastatic Breast Cancer

Patients with metastatic breast cancer who received an oral formulation of paclitaxel had better response and survival and less neuropathy than patients who received intravenous paclitaxel, according to results of a phase III trial presented at by Umanzor et al at the San Antonio Breast Cancer...

breast cancer

SABCS 2019: ctDNA May Be an Independent Predictor of Disease Recurrence in Patients With Early-Stage Triple-Negative Breast Cancer

The detection of circulating tumor DNA (ctDNA) in patients with early-stage triple-negative breast cancer treated with surgery following neoadjuvant chemotherapy is an independent predictor of disease recurrence, according to a phase II study investigating the potential of using ctDNA to detect...

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