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issues in oncology
breast cancer
genomics/genetics

Obligation to Evaluate Racial/Ethnic Features That May Affect Outcomes for Patients With Breast Cancer

"WE ABSOLUTELY have an obligation to evaluate all of the features describing our patients with cancer when we are trying to figure out why some patients do better than others,” Lisa A. Newman, MD, MPH, reminded the nearly 700 participants at the 2018 Lynn Sage Breast Cancer Symposium, hosted by...

A Pediatric Oncologist Recounts 7 Years at a Hospital in Jerusalem

Elisha Waldman, MD, is a pediatric oncologist and Associate Chief in the Division of Palliative Care at the Ann and Robert H. Lurie Children’s Hospital in Chicago. He grew up in a Connecticut suburb, the son of a conservative rabbi. Early on, Dr. Waldman majored in religious studies and felt...

Founder of the Harvard Stem Cell Institute Relates the History of Cancer Research

Cancer memoirs are generally written by people who have an intimate relationship with the disease, mostly survivors, sometimes by those who are dying while writing, such as the breathtaking book, The Bright Hour: A Memoir of Living and Dying, by the poet Nina Riggs. Once in a while, a scientist or...

integrative oncology

Probiotics

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. Shelly Latte-Naor, MD, and Jyothirmai Gubili, MS, explore some of the beneficial effects attributed ...

lung cancer

Nivolumab for Third-Line Treatment of Metastatic Small Cell Lung Cancer

ON AUGUST 16, 2018, nivolumab (Opdivo) was granted accelerated approval for treatment of patients with metastatic small cell lung cancer (SCLC) with disease progression after platinum-based chemotherapy and at least one other line of therapy.1,2 Supporting Efficacy Data APPROVAL WAS BASED on...

issues in oncology

Focus on the Rocky Mountain Oncology Society

Formed in 1991, the Rocky Mountain Oncology Society (RMOS), a Chapter Member of the Association of Community Cancer Centers (ACCC) and State Affiliate of ASCO, serves as the voice for Colorado’s multidisciplinary cancer care teams and the patients they serve. Representing the common interests of...

At Sea

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,...

How to Tell Patients They Have Cancer

The following essay by Stan Winokur, MD, is adapted, with permission, from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and...

ASH Honors Cage S. Johnson, MD, and José A. López, MD, With Award for Leadership in Promoting Diversity

DURING THE 2018 American Society of Hematology (ASH) Annual Meeting & Exposition in San Diego this December, ASH will honor Cage S. Johnson, MD, Professor Emeritus of Medicine, Physiology, and Biophysics at the University of Southern California, and José A. López, MD, Professor of Medicine...

lung cancer

Lung Cancer Researcher Melissa Johnson, MD, Benefits From Father’s Perspective as Career Military Officer

Lung cancer researcher Melissa Johnson, MD, is a self-described “military brat,” whose father was a career officer in the Marine Corps, serving for more than 35 years. She was born in Oklahoma City and moved nine times during her childhood. When Dr. Johnson was in high school, her father was...

When Illness and Culture Collide

“‘Sickness’ is what is happening to the patient. Listen to him. Disease is what is happening to science and to populations.” —Lawrence Weed, MD, 1978 America’s massive health-care system is highly complex, with its own unique language, methods, technologies, and scientific approaches, developed and ...

issues in oncology

Electronic ‘Datarrhea’ and Wellness

THE INTRODUCTION of the electronic health record (EHR) was supposed to lead us to a utopian world for health-care delivery in America. The Patient Protection and Affordable Care Act, signed into law on March 23, 2010, promoted its implementation by providing financial incentives.1 The Centers for...

A Career Path Shaped by Unlimited Possibilities for Clifford A. Hudis, MD, FACP, FASCO

In this installment of the Living a Full Life series, guest editor Jame Abraham, MD, interviewed Clifford A. Hudis, MD, FACP, FASCO, ASCO’s Chief Executive Officer. Prior to his current position, Dr. Hudis served in a variety of roles at ASCO, including President during ASCO’s 50th anniversary...

issues in oncology
immunotherapy

The Abscopal Effect: A Reemerging Field of Interest

For the past 50 years or more, oncologists have designed their treatment plans around the three pillars: surgery, chemotherapy, and radiation. Now, with a series of recent successes, immunotherapy is rapidly reemerging as the fourth pillar in the oncologic armamentarium. Despite major advancements...

solid tumors

Iobenguane I-131 for Advanced Pheochromocytoma or Paraganglioma

ON JULY 30, 2018, the radiotherapeutic agent iobenguane I-131 (Azedra) was approved for the treatment of adult and pediatric patients (aged ≥ 12 years) with iobenguane scan–positive, unresectable, locally advanced or metastatic pheochromocytoma or paraganglioma who require systemic anticancer...

issues in oncology

ASCO President-Elect Candidates Identify Key Issues Facing the Field of Oncology

Lori J. Pierce, MD, FASTRO, FASCO, of the University of Michigan, and Carolyn D. Runowicz, MD, FASCO, of Herbert Wertheim College of Medicine, Florida International University, Miami, were selected by the ASCO Nominating Committee as candidates for President-Elect. Why do you want to serve as ASCO...

skin cancer

Cemiplimab-rwlc for Metastatic or Locally Advanced Cutaneous Squamous Cell Carcinoma

On September 28, 2018, cemiplimab-rwlc (Libtayo) was approved for the treatment of patients with metastatic cutaneous squamous cell carcinoma or locally advanced cutaneous squamous cell carcinoma who are not candidates for curative surgery or curative radiation.1 Supporting Efficacy Data Approval...

issues in oncology

Patients With Cancer in Rural America Remain Underserved

Despite growing national awareness of health-care inequities, the plight of rural Americans diagnosed with cancer has persistently remained inadequate. Speaking with The ASCO Post, Jan Probst, PhD, Professor at the Arnold School of Public Health, University of South Carolina, Columbia, noted, “We...

hematologic malignancies
leukemia

Duvelisib in Resistant Chronic Lymphocytic Leukemia: Expanding the Treatment Armamentarium

The phase III DUO trial, reported by Flinn et al and reviewed in this issue of The ASCO Post, has led to the U.S. Food and Drug Administration (FDA) approval of a novel B-cell receptor (BCR) kinase inhibitor, duvelisib (Copiktra), which targets phosphoinositide 3-kinase (PI3K)-δ/γ in patients...

pain management
supportive care

Parenteral Opioid Shortage Threatens Appropriate Pain Care for Patients With Cancer

In response to the opioid-overdose epidemic, several measures have been put in place, such as the reclassification of hydrocodone as a Schedule II opioid and new requirements for physician review of prescription drug–monitoring program databases in most states. Moreover, the Surgeon General and...

global cancer care

UPMC Opens New Radiotherapy Center in Italy

The University of Pittsburg Medical Center (UPMC) recently announced the opening of a new radiotherapy center in Villa Maria, Italy, which will become part of the UPMC Hillman Cancer Center network when it opens to patients later this year. The new center, named the UPMC Hillman Cancer Center at...

issues in oncology

Inflammation, DNA Damage, and Cancer

The link between inflammation and cancer is a field of growing interest in the oncology community. Biologists have theorized that simultaneous DNA damage and cell division during inflammation could lead to cancer. To shed light on this important issue, The ASCO Post recently spoke with Jennifer...

solid tumors
hepatobiliary cancer

Global Liver Institute Supports More Frequent Liver Cancer Screening

When detected early, liver cancer is highly treatable and, in many cases, curable, yet the number of new cases of liver cancer in the United States has increased by 43% in the past 16 years, whereas the incidence of other cancers is on the decline. This past October, during Liver Cancer Awareness...

lung cancer

Dacomitinib for Metastatic EGFR-Mutant NSCLC

On September 27, 2018, dacomitinib (Vizimpro) received approval for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R substitution mutations, as detected by a test approved by the...

hematologic malignancies

Ibrutinib Plus Rituximab in Adult Patients With Waldenström’s Macroglobulinemia

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. On August 27, 2018, ibrutinib (Imbruvica) was approved...

prostate cancer
issues in oncology

Undertreatment of High-Risk Prostate Cancer in Latino Men

New research by Lichtensztajn et al in JNCCN—Journal of the National Comprehensive Cancer Network examined disparities in care for Latino men with prostate cancer. A team of researchers from UCSF Helen Diller Family Comprehensive Cancer Center, Stanford Cancer Institute, and...

leukemia
immunotherapy

Azacitidine Plus Nivolumab in Relapsed or Refractory AML

A combination of the chemotherapy drug azacitidine with the immune checkpoint inhibitor nivolumab (Opdivo) demonstrated an encouraging response rate and overall survival in patients with relapsed or refractory acute myeloid leukemia (AML), according to findings from a phase II study published...

Steven A. Rosenberg, MD, PhD, Works to Unmask Cancer’s Achilles Heel

Steven A. Rosenberg, MD, PhD, knew from the start of his medical career that if treatments for cancer were to become curative, research in new therapies would have to move away from the mainstay one-size-fits-all approach of systemic chemotherapy to an innovative, personalized strategy that...

prostate cancer

ASTRO/ASCO/AUA Guideline for Early-Stage Prostate Cancer Supports Use of Hypofractionated Radiotherapy

Three prominent medical organizations have issued a new clinical guideline for physicians treating men with early-stage prostate cancer using external-beam radiation therapy (EBRT). Developed by a panel of experts from the American Society for Radiation Oncology (ASTRO), ASCO, and the American...

Atlantic Health System Announces Collaboration to Further Patient Access to Innovative Cancer Therapies

The Atlantic Health System, an integrated health-care delivery system, recently announced a partnership with the Translational Genomics Research Institute, an affiliate of City of Hope, and Origin Commercial Ventures to create a new platform to deliver economically viable immunotherapies and other...

issues in oncology
global cancer care

Building Improved and Sustainable Health-Care Systems Through Telemedicine

Telemedicine—the remote diagnosis and treatment of patients via telecommunications technology—has changed the way oncology care is delivered in rural parts of the world. Patients in rural areas are now able to connect remotely with their physicians without having to deal with the time, expense, and ...

Charles Gawad, MD, PhD, Receives NIH Director’s New Innovator Award

Charles Gawad, MD, PhD, an assistant member in the Departments of Oncology and Computational Biology at St. Jude Children’s Research Hospital, has been selected by the National Institutes of Health (NIH) to receive a Director’s New Innovator Award. Established in 2007, this award supports...

issues in oncology

Modern Clinical Trials: Engaging Stakeholders at the Front Lines of Care

Randomized clinical trials have been providing high-quality evidence for decades, but there are limitations to the traditional design. At the 2018 ASCO Quality Care Symposium, George J. Chang, MD, MS, FACS, FASCRS, discussed the need to modernize clinical trials, so they continue to provide...

Expert Point of View: Sandro Pignata, MD

The study’s invited discussant, Sandro Pignata, MD, of the Istituto Nazionale Tumori di Napoli in Italy, called the data from AGO OVAR 2.21 “very strong.” He added: “We now have robust evidence from a trial of more than 600 patients, in which previous bevacizumab (Avastin) was allowed, that...

Expert Point of View: Caroline Robert, MD, PhD

The paper’s invited discussant, Caroline Robert, MD, PhD, of the Institut de Cancérologie Gustave Roussy, Villejuif, France, said OpACIN-neo attained its goal of reducing toxicity and maintaining efficacy. The regimen of two courses of ipilimumab (Yervoy) at 1 mg/kg plus nivolumab (Opdivo) at 3...

Expert Point of View: Daniel Heinrich, MD, and Silke Gillessen, MD

Formal discussant of the ERA 223 trial, Daniel Heinrich, MD, of Akershus University Hospital, Lørenskog, Norway, reminded listeners at the European Society for Medical Oncology (ESMO) 2018 Congress that radium-223 was developed in Norway. “When the ALSYMPCA results came out, we were celebrating....

Expert Point of View: Viktor Grünwald, MD, PhD

Formal discussant Viktor Grünwald, MD, PhD, of the Hannover Medical School, Germany, agreed that the results of JAVELIN Renal 101 were impressive, but he was more cautious about accepting avelumab (Bavencio)/axitinib (Inlyta) as a new standard of care without longer follow-up and quality-of-life...

kidney cancer
immunotherapy

Immunotherapy and Tyrosine Kinase Inhibitor Combination in Advanced Renal Cell Carcinoma

In the JAVELIN Renal 101 phase III study, the combination of the immune checkpoint inhibitor avelumab (Bavencio), a programmed death ligand-1 (PD-L1) blocking antibody, plus the tyrosine kinase inhibitor axitinib (Inlyta) significantly improved progression-free survival in previously untreated...

Expert Point of View: Amanda Psyrri, MD, PhD

Formal discussant of this trial, Amanda Psyrri, MD, PhD, of the University of Athens Medical School, Attikon Hospital, Athens, Greece, commented on these results, suggesting they would affect clinical practice “tomorrow.” “Cisplatin/radiotherapy remains the standard of care for low-risk human...

head and neck cancer

Phase III Study Supports Use of Cisplatin Over Cetuximab in HPV-Positive Oropharyngeal Cancer

In the United States and European countries, many oncologists are using cetuximab (Erbitux)/radiotherapy instead of cisplatin/radiotherapy in the treatment of human papillomavirus (HPV)-positive oropharyngeal cancer, based on the belief that cetuximab is equally effective with less toxicity than...

palliative care
survivorship
myelodysplastic syndromes
leukemia

Suleika Jaouad on Making the Most of a Life Interrupted: A Young Adult Perspective on Cancer

Suleika Jaouad, an Emmy Award–winning writer, advocate, and cancer survivor who was diagnosed at age 22 with myelodysplastic syndrome and acute myeloid leukemia, discusses what she has learned about coping with cancer, learning from it, and growing beyond it.

Expert Point of View: Jean-Pascal Machiels, MD, PhD, and Tanguy Seiwert, MD

Invited discussant Jean-Pascal Machiels, MD, PhD, Head of the Department of Medical Oncology at the Cliniques universitaires Saint-Luc, UCLouvain, Brussels, called the study “very important,” especially for showing that in patients with high expression of programmed cell death ligand 1 (PD-L1),...

head and neck cancer
immunotherapy

Pembrolizumab Improves Survival in Advanced Head and Neck Cancer

An overall survival advantage has now been shown for first-line immunotherapy in recurrent or metastatic head and neck cancer, researchers reported at the European Society for Medical Oncology (ESMO) 2018 Congress.1 In the phase III KEYNOTE-048 trial, treatment with the anti–programmed cell death...

solid tumors
head and neck cancer

Ivy Brain Tumor Center to Study Treatments for Brain Malignancies

The Ben and Catherine Ivy Foundation, in partnership with the Barrow Neurological Institute in Phoenix, has awarded a $50 million grant to establish a new translational science program focusing on early-phase, pharmacodynamic- and pharmacokinetic-driven clinical trials for aggressive brain tumors. ...

Expert Point of View: George Coukos, MD, PhD

George Coukos, MD, PhD, Director of the Department of Oncology at the University Hospitals of Canton Vaud and Director of the Lausanne branch of the Ludwig Institute for Cancer Research at the University of Lausanne in Switzerland, was the invited discussant of the NICHE study at the European...

prostate cancer

Adding Pelvic Node Radiation and Short-Term Hormone Therapy to Salvage Radiation Provides Significant Benefit in Prostate Cancer

For patients with prostate cancer who have persistent or rising prostate-specific antigen (PSA) levels after radical prostatectomy, the addition of short-term androgen-deprivation therapy and radiotherapy to the pelvic lymph nodes demonstrated increased rates of freedom from disease progression,...

issues in oncology

Dealing With the Challenges Presented by the Parenteral Opioid Shortage

The opioid drug problem in the United States is a crisis, with unprecedented numbers of overdose deaths. The reaction to this has resulted in new federal laws and regulations aimed at restricting overuse and overprescribing of opioids. However, these well-intentioned actions, along with other...

lung cancer

Lung Cancer Screening: Proven Effective but Still Fighting for Acceptance

In 2010, the long-awaited findings from the National Lung Screening Trial (NLST) revealed that participants who received low-dose helical computed tomography (CT) scans had a 15% to 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. In response, the U.S....

Expert Point of View: Nadia Harbeck, MD, PhD, and Fatima Cardoso, MD

Serving as European Society for Medical Oncology (ESMO) expert at a press briefing, Nadia Harbeck, MD, PhD, Head of the Breast Center at the University of Munich, called the findings “practice-changing” in some parts of the world and “practice-reinforcing” in others. She said the 10-month...

breast cancer

Impact of Palbociclib on Survival in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

Much anticipated overall survival data for palbociclib (Ibrance) plus fulvestrant (Faslodex) in advanced breast cancer were presented at the European Society for Medical Oncology (ESMO) 2018 Congress.1 Although overall survival in PALOMA-3 was not designed to detect a statistically significant...

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