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integrative oncology
breast cancer

Be Prepared to Answer—and Ask—Questions About Integrative Therapy

ASCO HAS ENDORSED the recommendations in the Society for Integrative Oncology (SIO) clinical practice guidelines for integrative therapies during and after breast cancer.1,2 The guidelines “are clear, thorough, and based on the most relevant scientific evidence,” wrote the ASCO expert panel that...

breast cancer
integrative oncology

ASCO Endorses Guidelines for Integrative Therapies During and After Breast Cancer Treatment

RECOMMENDATIONS IN the Society for Integrative Oncology (SIO) clinical practice guidelines for integrative therapies during and after breast cancer treatment “are clear, thorough, and based on the most relevant scientific evidence,” concluded an ASCO expert panel that reviewed the guidelines.1,2...

issues in oncology
health-care policy

Is the Move to a Value-Based Health-Care Delivery System Feasible?

In 2015, Congress passed the Medicare Access and CHIP Reauthorization ACT (MACRA), which aims to move Medicare toward reimbursement based more on outcomes and values, a goal, in theory, shared by the oncology community. To shed light on the complicated and problematic attempt to restructure the...

issues in oncology

Opportunities, Issues, and Challenges for Biosimilars in Oncology

In an article published recently in TheNew England Journal of Medicine, Gary H. Lyman, MD, MPH, FACP, FRCP (Edin), FASCO, of Fred Hutchinson Cancer Research Center in Seattle, and colleagues reviewed opportunities, issues, and challenges posed by the advent of biosimilar medications, focusing on...

solid tumors
prostate cancer

When Can Patients With Gleason 6 Prostate Cancer Safely Undergo Active Surveillance?

Prior to ASCO’s 2016 endorsement of the Cancer Care Ontario (CCO) guideline on active surveillance in the management of localized prostate cancer,1 most men—over 90%—diagnosed with low-risk localized disease were treated with active therapy.2 Today, about 50% of American men with low-risk disease...

integrative oncology

Acupressure for Cancer-Related Fatigue

Difficult-to-treat, cancer-related fatigue is a common, distressing clinical issue. It impedes daily activities, severely affecting patients’ quality of life. Compounding the problem is a lack of consensus on an effective pharmacologic intervention. Acupressure is a traditional Chinese medicine...

breast cancer

Olaparib for Germline BRCA-Mutated Metastatic Breast Cancer

EARLY IN 2018, olaparib tablets (Lynparza) were granted regular approval for treatment of patients with deleterious or suspected deleterious germline BRCA-mutated, HER2-negative metastatic breast cancer who have been treated with chemotherapy in the neoadjuvant, adjuvant, or metastatic setting.1,2...

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...

prostate cancer

Abiraterone Plus Prednisone in High-Risk Metastatic Castration-Sensitive Prostate Cancer

EARLY IN 2018, abiraterone acetate tablets (Zytiga) in combination with prednisone were approved for the treatment of metastatic high-risk castration-sensitive prostate cancer.1,2  Supporting Efficacy Data  APPROVAL WAS based on the findings of the phase III LATITUDE trial, in which 1,199 patients...

Four Generations of Doctors, One Oncologist, in the Family of Hanna K. Sanoff, MD, MPH

Medicine is a family tradition for Hanna K. Sanoff, MD, MPH. “I was born and reared in a suburb just outside of Philadelphia and lived there my whole life until after college. I was one of those people who always knew they wanted to be a doctor. There were four generations of physicians on my...

colorectal cancer

By Sending Tests by Mail, Researchers Boost Colorectal Cancer Screening Rates Among Medicaid Patients

Mailing colorectal cancer screening tests to patients insured by Medicaid increased screening rates for this population, reported researchers at the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center. In collaboration with the Mecklenburg County Health Department in...

gynecologic cancers
health-care policy

Study Evaluates Effects of Affordable Care Act on Young Women With Gynecologic Cancer

The gains in insurance coverage with the Patient Protection and Affordable Care Act (ACA) have already translated into improved health for young women with gynecologic cancers, who are getting diagnosed at earlier stages of their disease because of ACA benefits. That’s the conclusion of a new ...

kidney cancer

Meta-Analysis of Patients With Early Kidney Cancer Treated With Robotic Partial Nephrectomy

For patients with early kidney cancer, surgically removing a portion of the kidney instead of the whole organ is often a preferred treatment, because the procedure can effectively remove tumors while preserving kidney function. But when it comes to the best surgical approach—robotic,...

lung cancer

Brain Metastases in ROS1-Positive Lung Cancer and Treatment With Crizotinib

A study published by Patil et al in the Journal of Thoracic Oncology explores the occurrence and treatment of brain metastases in stage IV ROS1-positive non–small cell lung cancer. ROS1-Positive Disease vs Other Genetic Mutations Importantly, and in contrast with the findings ...

multiple myeloma

Phase III TOURMALINE-MM3 Trial of Ixazomib as Maintenance Therapy in Patients With Multiple Myeloma Posttransplant

The randomized, phase III TOURMALINE-MM3 study met its primary endpoint, demonstrating single-agent oral ixazomib (Ninlaro) as a maintenance therapy resulted in a statistically significant improvement in progression-free survival (PFS) vs placebo. The trial evaluated the effect of ixazomib as a...

issues in oncology

In Cases Where Early Detection of Metastatic Disease Offers No Advantage, Why Conduct Routine Surveillance?

“What is a reasonable plan of follow-up for patients with cancers for which early detection of metastatic disease offers no advantage?” Posing that question during his Presidential Address at the 2018 Society of Surgical Oncology (SSO) Annual Cancer Symposium, Kelly M. McMasters, MD,PhD,...

issues in oncology

NCI and VA Launch NAVIGATE to Boost Veterans’ Access to Cancer Clinical Trials

Veterans with cancer who receive treatment from the U.S. Department of Veterans Affairs (VA) will now have easier access to clinical trials of novel cancer treatments, thanks to an agreement between the VA and the National Cancer Institute (NCI), part of the National Institutes of Health. The NCI...

solid tumors
head and neck cancer

Study Finds Gender Disparities in Head and Neck Cancer Treatment and Outcomes

An analysis of cancer registry data from a California hospital system showed that women with head and neck cancer were less likely to receive intensive chemotherapy (35% vs 46%) and radiation (60% vs 70%) compared to men. Controlling for factors such as age and serious medical conditions, a...

issues in oncology

In Case You Missed It: Update on Breast Cancer Research

The ASCO Post presents these brief summaries of important studies in breast cancer, presented at the 2018 ASCO Annual Meeting. Ribociclib Plus Fulvestrant in Metastatic Breast Cancer The benefit of an inhibitor of cyclin-dependent kinase 4/6 (CDK4/6) added to fulvestrant has now been proven to...

issues in oncology

In Case You Missed It: Short Takes on Current Cancer Research

It would be impossible to cover all of the important presentations from the 5,000-plus abstracts accepted for the 2018 ASCO Annual Meeting. In addition to our regular meeting coverage of the top news stories, the following highlights focus on novel investigational approaches to therapy for various...

solid tumors
breast cancer

Oral Taxane Shows Strong Activity and Good Tolerability in Metastatic Breast Cancer

As first-line treatment for metastatic breast cancer, the oral taxane tesetaxel produced a 45% confirmed response rate and was well tolerated, producing little alopecia or neuropathy, according to Andrew D. Seidman, MD, and colleagues from several cancer centers. Dr. Seidman, of Memorial Sloan...

palliative care
colorectal cancer
lung cancer
cost of care

Geographic Differences in End-of-Life Cancer Care

When it comes to how much end-of-life care a patient with cancer receives, geography may, indeed, be destiny, according to new research led by Harvard Medical School that found differences in this type of cancer care across different parts of the country. The findings, published by Keating et al...

breast cancer

FDA Expands Ribociclib Indication in Hormone Receptor–Positive, HER2-Negative Advanced or Metastatic Breast Cancer

Today, the U.S. Food and Drug Administration (FDA) expanded the indication for ribociclib (Kisqali) in combination with an aromatase inhibitor for premenopausal or perimenopausal women with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer as initial...

issues in oncology
genomics/genetics

MSI-High Status and Lynch Syndrome Found in Surprising Variety of Cancers

In a study that many consider to be practice-changing, Lynch syndrome, a hereditary cancer predisposition syndrome, was found in many persons who would not ordinarily be suspected of having it.1 The study, which was presented at the 2018 ASCO Annual Meeting, has implications for broader testing...

Expert Point of View: David Graham, MD, FASCO and Richard Schilsky, MD, FACP, FASCO, FSCT

ASCO expert David Graham, MD, FASCO, of the Levine Cancer Institute in Charlotte, North Carolina, was encouraged by the IMpower131 findings. “This is one more example of how immunotherapy is making steady gains against a number of cancers. Immunotherapy has been shown to be effective in other...

lung cancer
immunotherapy

Atezolizumab Plus Chemotherapy Extends Survival in Squamous NSCLC Regardless of PD-L1 Level

Patients with advanced squamous non–small cell lung cancer (NSCLC) had a greater benefit from first-line treatment with the combination of atezolizumab (Tecentriq) plus chemotherapy vs chemotherapy alone in the randomized, phase III, IMpower131 clinical trial.1 At the landmark of 12-month...

breast cancer

8-Year Update of SOFT and TEXT Trials: Positive but Not Definitive

At the 2017 San Antonio Breast Cancer Symposium (SABCS), the International Breast Cancer Study Group (IBCSG) and its collaborators presented the 8-year updates of the key modern trials of ovarian function suppression after local treatment for young women with resected breast cancer.1 These updates...

Expert Point of View: Selma Ugurel, MD

Selma Ugurel, MD, of the Skin Cancer Center Essen at the University of Duisburg-Essen, Germany, discussed the Merkel cell carcinoma presentations at the 2018 ASCO Annual Meeting. “Immunotherapy is of high interest in Merkel cell because of the high immunogenicity of the tumor—viral-induced and...

skin cancer
immunotherapy

Immunotherapy in Merkel Cell Carcinoma: ‘Field Has Been Thrown on Its Head’

At the 2018 ASCO Annual Meeting, investigators presented long-term follow-up data for immunotherapy in patients with Merkel cell carcinoma and new data for its use in the neoadjuvant setting. The results drew high interest from attendees and a number of questions were raised following the...

Expert Point of View: Colin D. Weekes, MD, PhD and Manish A. Shah, MD, FASCO

Two pancreatic cancer specialists commented on the PREOPANC-1 study for The ASCO Post: Colin D. Weekes, MD, PhD, of Massachusetts General Hospital and Harvard Medical School, Boston, who had discussed the abstract at the ASCO Annual Meeting, and Manish A. Shah, MD, FASCO, Chief of the Solid Tumor...

pancreatic cancer

Early Study Shows Elasticity of Cancer Cells May Determine Where Pancreatic Cancer Metastases Form

Pancreatic cancer often metastasizes to the liver or lungs. The prognosis is better for patients with metastases in the lungs. However, the organ that is more likely to be affected depends on the cancer cells’ ability to alter their characteristics and shape—as a research team at the...

issues in oncology

American Cancer Society Outlines Blueprint for Cancer Control in the 21st Century

The American Cancer Society (ACS) is outlining its vision for cancer control in the decades ahead in a series of articles that began publishing in early July in CA: A Cancer Journal for Clinicians. The series of articles forms the basis of a national cancer control plan, with a blueprint...

issues in oncology

NCI and VA Launch NAVIGATE to Boost Veterans’ Access to Cancer Clinical Trials

Veterans with cancer who receive treatment from the U.S. Department of Veterans Affairs (VA) will now have easier access to clinical trials of novel cancer treatments, thanks to an agreement between the VA and the National Cancer Institute (NCI), part of the National Institutes of Health. The NCI...

palliative care
issues in oncology

Palliative Care Preferences in Male Patients With Cancer

Men with advanced cancer are 30% less likely than women to consider palliative care, according to a University of Rochester Medical Center (URMC) study. Researchers believe the findings reflect social norms about gender roles, as well as widespread messages in the media and society about...

skin cancer

Human Papillomavirus Vaccine in Cutaneous Basaloid Squamous Cell Carcinomas

Squamous cell carcinoma is the second-most-common form of skin cancer. Evidence suggests the human papillomavirus (HPV) plays a role in the development of some types of this skin cancer. Two years ago, a 97-year-old woman whose right leg was covered with squamous cell tumors went to see...

issues in oncology
pain management

Statement by FDA Commissioner on Opioid Access for Patients With Chronic and End-of-Life Pain

U.S. Food and Drug Administration (FDA) Commissioner Scott Gottlieb, MD, recently issued the following statement. The opioid epidemic continues to take an emotional, physical, and financial toll on Americans. The FDA is committed to taking every possible step to address the many facets of this...

gynecologic cancers
issues in oncology

ESHRE 2018: Large Population Study Does Not Find Causal Link Between Assisted Reproduction and Ovarian Cancer Risk

Following concerns over many years that hormonal stimulation of the ovaries necessary for in vitro fertilization (IVF) may increase the risk of ovarian cancer, a nationwide cohort study from Denmark has now concluded that any perceived increase in risk is actually a statistical bias resulting from...

issues in oncology

ESHRE 2018: Early-Stage Research Shows Potential of Artificial Ovary for Fertility Preservation Without the Risk of Reintroducing Malignancy

Important steps in the development of an artificial ovary have been successfully completed. Researchers from the Rigshospitalet in Copenhagen, Denmark, reported that they have—for the first time—isolated and grown human follicles to a point of biofunctionality on a bioengineered ovarian ...

head and neck cancer

Adding Motolimod to Standard Chemotherapy and Cetuximab in Squamous Cell Carcinoma of the Head and Neck

In a phase II trial (Active8) reported in JAMA Oncology, Ferris et al found that the addition of the toll-like receptor 8 (TLR8) agonist motolimod to platinum-fluorouracil plus cetuximab (Erbitux) did not improve progression-free survival among all patients with recurrent or metastatic squamous...

pancreatic cancer

Study Finds Inherited Gene Variants in 10% of Patients With Pancreatic Cancer

A large study of pancreatic cancer patients found that almost 10% harbored inherited genetic variations or mutations that may have increased their susceptibility to the disease. At the same time, some of these mutations were associated with more favorable responses to certain chemotherapy agents,...

ASCO Supports NCI-Designated Cancer Centers’ Goal of Eliminating HPV-Related Cancers

ASCO HAS officially endorsed a statement by the 70 National Cancer Institute (NCI)-designated cancer centers calling for increased human papillomavirus (HPV) vaccination and screening to eliminate HPV-related cancers. The full uptake of the vaccine and screening could prevent 12,000 cervical...

Excerpt From the 2018 ASCO Presidential Address: ‘Delivering Discoveries: Expanding the Reach of Precision Medicine’

In my area of research, lung cancer, precision medicine is indeed transforming the treatment of this disease and has important implications for other cancers and for the future of our patients with cancer. Today’s achievement of being able to systematically identify genomic changes that can be...

solid tumors
survivorship

Testicular Cancer Survivors and Adequate Screening for Long-Term Heart Disease

TESTICULAR CANCER is among the most common cancers in young men. The majority of patients are cured of their disease, but a newly published study shows many remain at risk for later complications from chemotherapy or other treatments. The study, published by Mohammad Abu Zaid, MD, Assistant...

A Humble Beginning Built on Commitment: The Life and Times of Lee S. Schwartzberg, MD, FACP

  In this edition of the Living a Full Life series, guest editor Jame Abraham, MD, interviewed medical oncologist Lee S. Schwartzberg, MD, FACP, Executive Director at the West Cancer Center, Memphis. Dr. Schwartzberg’s major research interests are new therapeutic approaches to breast cancer,...

skin cancer
immunotherapy

Treatment Beyond Disease Progression in Melanoma: Challenge Centers on Knowing Who May Benefit

Dr. Weiss is Assistant Professor (Medical Oncology), Developmental Therapeutics, Melanoma Program, Yale Cancer Center. Dr. Sznol is Professor of Medicine (Medical Oncology); Co-Director, Cancer Immunology Program, Yale Cancer Center Co-Director, Yale SPORE in Skin Cancer, New Haven, Connecticut.  ...

lung cancer

Expert Point of View: David Rimm, MD, PhD

“TUMOR MUTATIONAL burden is an emerging biomarker independent of programmed cell death ligand 1 (PD-L1) level. There are a few reasons for enthusiasm. Tumor mutational burden is a compelling biomarker for response and progression-free survival. Six-month progression-free survival is 50% with a...

lung cancer

Evidence Builds for Tumor Mutational Burden as Biomarker in Lung Cancer

TUMOR MUTATIONAL burden is emerging as a predictive biomarker for the combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) in non–small cell lung cancer (NSCLC), as well as other tumor types. However, experts say tumor mutational burden has hurdles to overcome. At the 2018 Annual Meeting of...

skin cancer

Expert Point of View: Jedd Wolchok, MD, PhD

“THIS IS a wonderful presentation and a very exciting trial,” said formal discussant Jedd Wolchok, MD, PhD, of Memorial Sloan Kettering Cancer Center, New York. Despite the remarkable advances achieved with anti–programmed cell death protein 1 and ligand 1 (anti–PD-1/anti–PD-L1) treatment, “there...

breast cancer

Expert Point of View: Harold Burstein, MD, PhD

HAROLD BURSTEIN, MD, PhD, of Dana-Farber Cancer Institute and Harvard Medical School, where he is Associate Professor of Medicine, commented on the SANDPIPER trial during a press briefing at the 2018 ASCO Annual Meeting. PIK3 mutations are probably the most common mutation in breast cancer, and...

breast cancer

Study of PI3K Inhibitor Added to Fulvestrant in Advanced Breast Cancer Affirms Proof-of-Principle

IN PATIENTS with advanced breast cancer harboring a PIK3CA mutation, the addition of the PI3 kinase (PI3K) inhibitor taselisib to endocrine therapy with fulvestrant (Faslodex) significantly improved progression-free survival compared with fulvestrant alone, in the international phase III SANDPIPER...

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