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solid tumors
prostate cancer

De Novo Metastatic Prostate Cancer: Positive Recent News, Many Open Questions

After about 70 years with no significant progress, the landscape for men with de novo metastatic prostate cancer has changed dramatically in the past 4 years, with statistically significant and highly clinically meaningful survival improvement reported from multiple phase III trials when...

prostate cancer

DNA Test Identifies Men With Sixfold Increased Risk of Prostate Cancer

A major new study of more than 140,000 men has identified 63 new genetic variations in the DNA code that increase the risk of prostate cancer. These findings were published by Schumacher et al in Nature Genetics. Researchers devised a new test combining these single-letter genetic variants with...

issues in oncology

Parents See Cancer Prevention Potential as Best Reason for HPV Vaccination

Parents of adolescents believed that the potential to prevent certain types of cancer is the best reason for their children to receive the human papillomavirus (HPV) vaccine, whereas other reasons health-care providers often give were far less persuasive. Findings from this study were published by...

solid tumors
lung cancer

Nivolumab Plus Ipilimumab Improves Progression-Free Survival in NSCLC With High Tumor Mutational Burden

The combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) improved progression-free survival compared with chemotherapy as first-line treatment for patients with advanced non–small cell lung cancer (NSCLC) and a high tumor mutational burden irrespective of programmed cell death ligand 1...

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
head and neck cancer

Esomeprazole With Aspirin in Patients With Barrett’s Esophagus

An updated analysis of a randomized phase III trial showed that taking a high dose of esomeprazole with low-dose aspirin for at least 7 years may moderately reduce the risk of developing high-grade dysplasia or esophageal cancer and may delay death from any cause in people with Barrett’s esophagus. ...

Expert Point of View: Richard L. Schilsky, MD

“This study shows us that it is possible to get equally good outcomes with lower costs. In the United States, we have no real way to constrain the costs of health care, including the cost of drugs. The U.S. Food and Drug Administration does not consider drug price in deliberations about bringing...

solid tumors
gastrointestinal cancer
colorectal cancer

Care for Colorectal Cancer Costs Twice as Much in Western Washington vs British Columbia, With Similar Survival

It is widely acknowledged that the costs of cancer care are much higher in the United States than in Canada, with outcomes that are thought to be similar. A new study presented at the 2018 ASCO Annual Meeting supports that view, by documenting and quantifying the differences in health-care costs...

hematologic malignancies
lymphoma

Outcomes in Waldenström’s Macroglobulinemia Improved With Ibrutinib Plus Rituximab

In patients with Waldenström’s macroglobulinemia, the risk of disease progression was reduced by 80% with the combination of ibrutinib (Imbruvica) and rituximab (Rituxan) over rituximab alone, in the international phase III iNNOVATE trial, reported at the 2018 ASCO Annual Meeting1 and...

Expert Point of View: Andrew Epstein, MD

“This is a very important study,” said ASCO expert Andrew Epstein, MD, of Memorial Sloan Kettering Cancer Center (MSK), New York. “Hyperthermic intraperitoneal chemotherapy is used in the United States and elsewhere, even though the benefits are unknown. This study shows there are no benefits, and ...

solid tumors
gastrointestinal cancer
colorectal cancer

Less Is More: No Benefit Reported for Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer

With a growing emphasis on value in cancer care, some types of resource-intensive therapies may need to be reconsidered. One such treatment may be hyperthermic intraperitoneal chemotherapy, which showed no benefit during surgery for colorectal cancer confined to the peritoneum in the PRODIGE 7...

Expert Point of View: Charles G. Drake, MD, PhD and Hatem H. Soliman, MD

Formal discussant of the GeparNuevo presentation, Charles G. Drake, MD, PhD, of the Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center, New York, said, “It is important that neoadjuvant immunotherapy combinations are being studied. There is a lot of enthusiasm for...

breast cancer
immunotherapy

Priming the Immune System: Neoadjuvant Durvalumab Plus Chemotherapy May Be Beneficial in Triple-Negative Breast Cancer

The addition of durvalumab -(Imfinzi) to anthracycline/taxane-based chemotherapy had encouraging results as neoadjuvant therapy for early triple-negative breast cancer in the randomized phase II GeparNuevo study presented at the 2018 ASCO Annual Meeting.1 The results were positive in a subgroup of...

Expert Point of View: Daniel George, MD, Robert J. Motzer, MD, and Paul Russo, MD

Formal discussant of the CARMENA trial, Daniel George, MD, of Duke University Medical Center, Durham, North Carolina, had reservations about the broad application of these results. “CARMENA was designed to reassess the value and role of nephrectomy in patients who present with metastatic renal...

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,...

hematologic malignancies
leukemia

Minimal Residual Disease Testing in AML: Still a Shifting Target

Testing for minimal residual disease (MRD) has become an established part of the management of acute lymphoblastic leukemia (ALL), but in acute myeloid leukemia (AML), the technology still warrants validation. To address issues and set new standards, the European LeukemiaNet Working Party recently ...

hematologic malignancies

EHA 2018: Ruxolitinib Reduces Risk of Thrombosis, Death in Patients With Polycythemia Vera

A new comparison study showed that among polycythemia vera patients who were resistant or intolerant to hydroxyurea, those treated with ruxolitinib (Jakavi) had a significantly reduced risk of thrombosis and death compared to those who received best available therapy. The study findings are based...

Expert Point of View: Colin D. Weekes, MD, PhD and Andrew Epstein, MD

Colin D. Weekes, MD, PhD, of Massachusetts General Hospital and Harvard Medical School, called the results of the PRODIGE trial “practice-changing.” Dr. Weekes was the invited discussant of the study and was interviewed by The ASCO Post. “The magnitude of effect is beyond what we have ever seen in...

solid tumors
pancreatic cancer

Adjuvant Modified FOLFIRINOX Yields Unprecedented Survival in Pancreatic Cancer

Adjuvant treatment with modified FOLFIRINOX resulted in the longest overall survival yet reported for patients with resected pancreatic cancer, according to the results of the phase III Unicancer GI PRODIGE 24/CCTG PA.6 trial, presented at the 2018 ASCO Annual Meeting.1 With adjuvant modified...

breast cancer
solid tumors

FDA Clears Expanded Indication of Scalp-Cooling System

Paxman’s advanced scalp-cooling system has now been cleared by the US Food and Drug Administration (FDA) for use during treatment of patients with solid tumors. The system is now indicated to reduce the likelihood of chemotherapy-induced alopecia in cancer patients with solid tumors such as...

palliative care
issues in oncology

AMA Rejects Recommendation to Reaffirm Opposition to Medical Aid in Dying

On June 11, the American Medical Association (AMA) House of Delegates voted 56% to 44% to reject a report by its Council on Ethical and Judicial Affairs (CEJA) that recommended the AMA maintain its Code of Medical Ethics’ opposition to medical aid in dying. Instead, the House of Delegates...

issues in oncology

Informed Consent Issues for Patients With Advanced Cancer in Phase I Trials

As reported by Hlubocky et al in the Journal of Oncology Practice, oncologists may not provide patients with advanced cancer participating in phase I clinical trials with sufficient information about prognosis and purposes of phase I testing during enrollment discussions. Study Details The study...

survivorship

Eating a High-Quality Diet Could Decrease Cancer Survivors’ Risk of Death by 65%

Cancer survivors who consumed a balanced, nutrient-dense diet had a 65% lower risk of dying from cancer than survivors who ate a poor-quality diet, according to findings published by Deshmukh et al in JNCI Cancer Spectrum. The study suggests that more than focusing on any particular food group,...

issues in oncology

AMA Releases New Physician Guide on Caring for the Caregiver

Every day in their treatment rooms, physicians encounter individuals who are making profound sacrifices to help a loved one who is seriously ill, often at the expense of their own well-being. To help physicians understand the day-to-day challenges and risk of burnout faced by informal caregivers,...

issues in oncology

Opportunities, Issues, and Challenges for Biosimilars in Oncology

In an article in The New England Journal of Medicine, Lyman et al reviewed opportunities, issues, and challenges posed by the advent of biosimilar medications, focusing on biosimilars in cancer treatment. Although these agents could help to meet the health-care goals of high quality care with cost...

lung cancer

Lung Cancer Incidence in Young Women vs Men in the United States

In a study reported in The New England Journal of Medicine, Jemal et al found that the incidence of lung cancer in young white and Hispanic women is now higher than that in men in the US. Study Details The study involved analysis of data from the North American Association of Central Cancer...

global cancer care

ESMO Emphasizes Importance of Cancer on the Global Health Agenda at the 71st World Health Assembly

At the 71st World Health Assembly in Geneva, the European Society for Medical Oncology (ESMO) delivered two statements positioning cancer as a priority on the global agenda of the World Health Organization (WHO). Presenting its recommendations for action to the international community,...

gynecologic cancers
immunotherapy

FDA Approves Pembrolizumab for Previously Treated Recurrent or Metastatic PD-L1–Expressing Cervical Cancer

On June 12, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) for the treatment of patients with recurrent or metastatic cervical cancer and disease progression on or after chemotherapy whose tumors express programmed cell death ligand 1 (PD-L1) [Combined Positive Score...

issues in oncology

Cancer Prevention Report Shows Consensus Among Global Experts on 10 Steps to Reduce Risk

An internationally released comprehensive analysis of research on lifestyle factors and cancer prevention confirms the critical links between cancer diagnoses and diet, physical activity, and weight. Independent experts from across the globe reviewed decades of scientific evidence to develop the...

prostate cancer

AUA 2018: Finasteride Reduces Risk of Prostate Cancer and Is Safe, Long-Term Results Show

Twenty-five years after it opened for enrollment, the Prostate Cancer Prevention Trial (PCPT) has delivered a final verdict: finasteride, a common hormone-blocking drug, reduces men's risk of getting prostate cancer without increasing their risk of dying from the disease. Initial study...

colorectal cancer

Surveillance Intensity Not Associated With Earlier Detection of Recurrence or Improved Survival in Patients With Colorectal Cancer

A national retrospective study led by researchers at The University of Texas MD Anderson Cancer Center found no association between intensity of posttreatment surveillance and detection of recurrence or overall survival (OS) in patients with stage I, II, or III colorectal cancer. Published by...

leukemia
lymphoma
immunotherapy

Rapid Progression of Adult T-Cell Leukemia/Lymphoma During PD-1 Inhibitor Therapy

In a letter to the editor in The New England Journal of Medicine, Ratner et al describe rapid progression of adult T-cell leukemia/lymphoma (ATLL) in three consecutive patients receiving programmed cell death protein 1 (PD-1) inhibitor therapy with nivolumab (Opdivo). As stated by the authors,...

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...

Resources to Help You Understand What Right-to-Try Legislation Means for Practices, Patients

WITH CONGRESS having recently passed federal “right-to-try” (RTT) legislation, ASCO has developed a suite of educational resources that will help members understand the impact of this law on cancer care and individuals with cancer. Educational resources include:  Podcast  THE LATEST ASCO in Action...

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...

ASTRO Collaborates With ASCO and Conquer Cancer to Support Methods Workshop

For the third year, the American Society for Radiation Oncology (ASTRO) is supporting the ASCO/American Association for Cancer Research (AACR) Workshop on Methods in Clinical Cancer Research, to take place July 18–August 3, 2018, at Vail Mountain Marriott Resort in Vail, Colorado.  Celebrating its ...

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...

lung cancer

Early Evidence of Neoadjuvant PD-1 Blockade in Non–Small Cell Lung Cancer

A NOVEL APPROACH using two doses of nivolumab (Opdivo) prior to surgery achieved major pathologic responses in 45% of patients with resectable stages I to IIIA non–small cell lung cancer (NSCLC), according to the results of a small Stand Up 2 Cancer–Cancer Research Institute Dream Team study...

gynecologic cancers
pain management

Study Evaluates Effect of Restrictive Opioid Protocol After Gynecologic Surgery

THE NUMBER of opioids prescribed after surgery for gynecologic cancer decreased significantly after implementation of an ultra-restrictive opioid prescription protocol, with no apparent negative effect on patient satisfaction or pain, according to research presented by Jaron Mark, MD, and...

gynecologic cancers

Poorer Outcomes Reported With Minimally Invasive Surgery Than Open Approach in Early Cervical Cancer

PATIENTS UNDERGOING minimally invasive radical hysterectomy for early cervical cancer had higher rates of disease recurrence and worse disease-free, progression-free, and overall survival than did women who had the open approach, according to results from the phase III LACC trial, presented by...

gynecologic cancers

Clinical Findings Predict Early Treatment Discontinuation in Patients Receiving Immunotherapy for Ovarian Cancer

PRETREATMENT CLINICAL findings may predict early treatment discontinuation in patients with ovarian cancer receiving checkpoint blockade immunotherapy agents. Data presented by MD candidate Julia L. Boland at the 2018 Society of Gynecologic Oncology Annual Meeting on Women’s Cancer revealed that...

lung cancer
symptom management
cns cancers

Quick Takes From Original Research Presented at the 2018 NCCN Annual Conference

THE QUANTITY of original research presented at the National Comprehensive Cancer Network® (NCCN®) Annual Conference has been growing, and at the 2018 meeting, 121 researchers presented their work. The ASCO Post captured some of the findings for this report.  Blood Markers Correlate With Anti–PD-1...

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...

cns cancers

Durable Responses Observed With Novel Oncolytic Therapy in Recurrent Glioma

IN A PILOT study of recurrent glioma, 26% of patients treated with the optimal dose of vocimagene amiretroprepvec (aka Toca 511), a novel oncolytic virus therapy, achieved durable, long-term responses and remained alive 3 or more years later. This outcome far exceeded “historical benchmarks” for...

breast cancer
symptom management

Early Detection and Intervention Reduce Breast Cancer–Related Lymphedema

A NEW STUDY has found that early detection along with a simple intervention can be highly effective in preventing breast cancer–related lymphedema for at-risk women. According to data presented at the 2018 Annual Meeting of the American Society of Breast Surgeons,1 82% of women identified at an...

breast cancer

Studies Challenge Relevance of Genetic Testing Guidelines for Breast Cancer

NEW RESEARCH suggests that current genetic testing guidelines for breast cancer are far too restrictive, excluding nearly half of high-risk patients. According to a pair of studies presented at the 2018 American Society of Breast Surgeons (ASBrS) Annual Meeting, women with breast cancer who did not ...

lung cancer
cost of care
genomics/genetics

Decision-Analytic Model Finds Upfront, Comprehensive Genetic Testing in Advanced Lung Cancer Is Cost-Efficient

AN ECONOMIC model comparing different types of genetic testing in metastatic non–small cell lung cancer (NSCLC) found using next-generation sequencing to test for all known lung cancer–related gene changes at the time of diagnosis was less costly and faster than sequentially testing one or a...

lung cancer

Despite USPSTF Recommendations, Majority of Heavy Smokers Not Screened for Lung Cancer

AN ANALYSIS of 1,800 lung cancer screening sites nationwide found that only 1.9% of more than 7 million eligible current and former heavy smokers were screened for lung cancer in 2016, despite U.S. Preventive Services Task Force (USPSTF) and ASCO screening recommendations. Results from this...

lung cancer

Expert Point of View: John Heymach, MD, PhD, and Leena Gandhi, MD

“THIS STUDY represents a true milestone in the field of lung cancer. For the first time, the vast majority of patients with non–small cell lung cancer (NSCLC) can receive immunotherapy with pembrolizumab (Keytruda),” said ASCO expert John Heymach, MD, PhD, of MD Anderson Cancer Center, Houston,...

‘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...

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