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The Puzzle Table

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,...

breast cancer

Dose-Dense Chemotherapy in Early Breast Cancer: A ‘Win-Win’ Treatment Approach

INCREASING THE DOSE density of chemotherapy lowers the risk of recurrence and breast cancer death by about 15% in women with early breast cancer, according to a large, meticulously conducted meta-analysis by the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG).1 The trials included in...

lymphoma

Front-Line Brentuximab Plus AVD vs Standard ABVD in Advanced Hodgkin Lymphoma

FRONT-LINE TREATMENT of advanced Hodgkin lymphoma with brentuximab vedotin (Adcetris) plus doxorubicin/ vinblastine/dacarbazine (A+AVD) achieved superior outcomes compared with the standard four-drug regimen of doxorubicin/bleomycin/vinblastine/dacarbazine (ABVD). The substitution of brentuximab...

solid tumors

Future Directions for CAR T-Cell Therapy

Chimeric antigen receptor (CAR) T-cell therapy burst upon the scene as an innovative approach to the treatment of hematologic malignancies, mainly for patients who have exhausted all other treatment options. Recently two CAR T-cell products were approved by the U.S. Food and Drug Administration...

Highlights From the Conquer Cancer Foundation’s Third Annual Career Development Retreat

The Conquer Cancer Foundation of ASCO is committed to supporting the research and career development of young researchers through its Grants & Awards Program. In October 2017, Conquer Cancer hosted its third Scientific and Career Development Retreat at ASCO Headquarters in Alexandria,...

issues in oncology
global cancer care

Launching Harmonized NCCN Guidelines for Sub-Saharan Africa

Cancer care in Sub-Saharan Africa, as in other low-resource settings, can be a challenge: The right medications and equipment may be in short supply, maintaining equipment can be a problem, basic chemotherapy drugs may be unaffordable, and patients may not see doctors until the cancer is advanced....

A Vivid Look Back, a Cogent Look Forward

Cancer memoirs come in a variety of literary styles and voices. Not surprisingly, the most poignant cancer memoirs are by those who are writing, in essence, their final words before departing this earth. The most widely read of that variety has been the beautifully written best seller When Breath...

issues in oncology
supportive care

Helping Oncologists to Become Better Communicators With Their Patients

Timothy Gilligan, MD, FASCO, Co-Chair of ASCO’s Expert Panel on Patient-Physician Communications Guideline and Vice-Chair for Education and Associate Professor of Medicine at the Cleveland Clinic Taussig Cancer Institute, spends half of his professional time treating patients with urologic...

issues in oncology
supportive care

ASCO Releases Guideline to Help Oncologists Improve Communication With Patients—and Their Own Well-Being

In September 2017, ASCO published a new guideline in the Journal of Clinical Oncology that outlines best practices for communicating effectively with patients and their family members.1 The guideline is the result of recommendations from a multidisciplinary panel of experts in a number of fields,...

solid tumors
lung cancer

Addressing Disparities in Use of Lung Cancer Screening With Community Outreach

African Americans and members of other communities of lower socioeconomic status have higher burdens of lung cancer mortality. Therefore, targeting underserved patient populations with lung cancer screening is of the utmost importance, according to Christopher Lathan, MD, MS, MPH, a medical...

issues in oncology
cost of care

Tackling the High Cost of Cancer Care

AT THE 2017 ASCO ANNUAL MEETING, the leaders of the newly formed Value in Cancer Care Consortium (vi3c; vi3c.org) met to discuss the group’s plan to study how to improve the affordability of cancer drugs and make them more accessible to patients. The goal of the Value in Cancer Care Consortium is...

The Man in the Vest

It had been an uneventful Sunday morning, and I was writing my final note for the day, hopeful to make a stealth exit and perhaps join my family at church. But as I closed the chart and looked up, I saw Ruthie, my oncology fellow, approaching with a grim expression. “I just left the room of a...

solid tumors
breast cancer

Gauging the Impact of Weight Loss Intervention on Breast Cancer Outcomes

“Growing research suggests that body weight is not only related to the risk of developing malignancy, but also prognosis after diagnosis, especially in breast cancer,” said Jennifer A. Ligibel, MD, of Dana-Farber Cancer Institute and Harvard Medical School, at the 19th Annual Lynn Sage Breast...

issues in oncology

ASCO Survey Reveals Concerning Trends in Americans’ Knowledge About Cancer Risks and Impact of Costs on Compliance

Although most Americans, 78%, recognize that smoking is a major risk factor for cancer, just 31% say obesity—the second-leading preventable cause of cancer after smoking—is a risk factor for the disease, according to the results of ASCO’s National Cancer Opinion Survey, which polled over 4,000...

A Revolutionary Technology Offers Hope and Ethical Concern

Aldous Huxley’s classic 1932 dystopian novel Brave New World pictures an eerie future where humans are genetically bred, altered to create worthy citizens. Welcome back to the future. First there was the astounding feat of sequencing the entire human genome; now, thanks to a revolutionary...

symptom management

Early Study Suggests Potential Role of Paclitaxel in Peripheral Neuropathy and Possible Preventive Measures

In discovering how certain chemotherapy drugs cause peripheral neuropathy, researchers at Dana-Farber Cancer Institute have found a potential approach to preventing this common and troublesome side effect of cancer treatment. Their findings were published by Pease-Raissi et al in Neuron. The...

skin cancer

Adjuvant BRAF/MEK Inhibition Improves Survival in Resectable Melanoma

FOR PATIENTS with locally advanced, resectable melanoma harboring BRAF mutations, adjuvant treatment with BRAF/ MEK inhibition significantly improves overall survival, results of the COMBI-AD trial have shown. The study was presented at the European Society for Medical Oncology (ESMO) 2017...

solid tumors

Expert Point of View: Brian G. Czito, MD, and Phuoc T. Tran, MD, PhD

“THESE PRELIMINARY STUDY RESULTS suggest that combining these modalities [immunotherapy and radiation therapy] can halt tumor growth in 30% to 57% of patients, with the radiation-induced tumor response acting as a sort of vaccine in combination with immunotherapy. This cutting-edge strategy...

colorectal cancer
issues in oncology

Could the Rising Rates of Colorectal Cancer in AYAs Be Linked to HPV Infection?

TWO STUDIES published this year examining the incidence of colorectal cancer in adolescents and young adults (AYAs) show an undeniable and sobering trend: Colorectal cancer rates are increasing in this age group, and younger people are dying of the cancer at slightly higher rates than in previous...

issues in oncology

Cancers Associated With Overweight and Obesity Make Up 40% of Cancers Diagnosed in the United States

Overweight and obesity are associated with increased risk of 13 types of cancer—and these cancers account for about 40% of all cancers diagnosed in the United States in 2014—according to the latest Vital Signs report by the Centers for Disease Control and Prevention (CDC). Overall, the...

solid tumors
breast cancer

Cancer Has Plagued My Family

My father, who was a physician, taught me at an early age to pay attention to any changes in my body. His advice has stood me in good stead for more than 83 years and probably saved my life more than once. In 1984, just before I turned 50, something was bothering me about my right breast. I could...

issues in oncology
cost of care

With Financial Toxicity in Oncology Care on the Rise, Providers Need to Help Address Patients’ Financial Issues

At the 2017 ASCO Quality Care Symposium, Dan Sherman, MA, LPC, discussed potential solutions to the persistent challenge of financial toxicity in the oncology setting. Mr. Sherman is a clinical financial consultant and Founder and President of The Navectis Group, Caledonia, Michigan. Rather than...

How a Child With Cancer Moved From Vulnerability to Resilience

At the time this article was published in the Journal of Clinical Oncology, Dr. Danaher was practicing at Monash -University, -Melbourne, Australia; Drs. Brand and Mack, at Dana-Farber Cancer Institute, Boston; Dr. Pickard, at the Imperial College -Healthcare NHS Trust, London; and Dr. Berry,...

Douglas R. Lowy, MD, and John T. Schiller, PhD, Receive 2017 Lasker Award

Two scientists at the National Cancer Institute (NCI) received the 2017 Lasker-DeBakey Clinical Medical Research Award for their significant research leading to the development of human papillomavirus (HPV) vaccines. The award is the country’s most prestigious biomedical research prize and was...

Talking About Physician Burnout: Practical Strategies for Starting the Conversation

Would you rather explain the benefits of three cycles of bleomycin, etoposide, and cisplatin to a hostile crowd of bored teenagers than talk to your program director, supervisor, or colleagues about feeling burned out? It is an understandable feeling. Professional burnout is a difficult concept to...

palliative care

How Early Palliative Care May Benefit Patients With Incurable Cancer

Palliative care provided soon after a patient is diagnosed with incurable cancer not only helps improve the patient’s overall quality of life but also improves communication about the patient’s wishes for end-of-life care, according to a study by Jennifer S. Temel, MD, Clinical Director of Thoracic ...

skin cancer

Expert Point of View: Reinhard Dummer, MD, and Jeffrey Weber, MD, PhD

ASSUMING THE regimens evaluated in COMBI-AD and CheckMate 238 are both approved by the U.S. Food and Drug Administration for the treatment of high-risk resected melanoma, clinicians may be faced with a tough choice. ESMO experts and the study’s investigators weighed in on this issue in a lively...

issues in oncology

ESMO 2017: Patients Struggle With Key Aspects of Clinical Trial Methodology

Clinical trials are fundamental to the development of new treatments for cancer, yet the annual accrual to cancer clinical trials worldwide is low, estimated at 3%–5%. A nationwide study in Ireland, the preliminary results of which were presented at the European Society for Medical Oncology...

issues in oncology

ESMO 2017: DNA Sequencing Could Open Up New Drug Indications for Patients With Rare Cancers

Due to DNA sequencing, patients with rare cancers for which no standard treatment is available could receive existing therapies that work in patients treated for different cancers but who carry the same genetic mutations. The first results of a multidrug and multitumor clinical trial (Abstract...

skin cancer

ESMO 2017: Combination Targeted Adjuvant Therapy Doubles Relapse-Free Survival in Stage III Melanoma

Combination targeted adjuvant therapy with dabrafenib (Tafinlar) and trametinib (Mekinist) doubles relapse-free survival in patients with stage III BRAF-mutant melanoma, according to late-breaking results from the COMBI-AD trial presented on September 11 at the European Society for Medical Oncology ...

breast cancer

ESMO 2017: MINDACT Study in Early-Stage Breast Cancer Shows Even Small Tumors Can Be Aggressive

Even small tumors in the breast can be aggressive, according to a study in patients with early-stage breast cancer presented at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid (Abstract 150O_PR). Researchers found that 24% of small tumors were aggressive, and patients...

Douglas R. Lowy, MD, and John T. Schiller, PhD, to Receive 2017 Lasker Award

Two scientists at the National Cancer Institute (NCI) will receive the 2017 Lasker-DeBakey Clinical Medical Research Award for their significant research leading to the development of human papillomavirus (HPV) vaccines. The award is the country’s most prestigious biomedical research prize,...

To the Last Drop

It was 2:15 PM, and my afternoon clinic had not yet begun. The morning had been particularly trying as a result of disastrous clinical developments for two of my long-standing patients. Jessica had metastatic breast cancer, and I had been taking care of her for 7 years. Multiple lines of...

Get to Know Your ASCO President-Elect: Monica M. Bertagnolli, MD, FASCO

Monica M. Bertagnolli, MD, FASCO, a long-time member and volunteer, began her term as ASCO President-Elect in June 2017; she will serve as 2018–2019 ASCO President. An active ASCO member since 1995, Dr. Bertagnolli is Chief of the Division of Surgical Oncology at Dana-Farber/Brigham and Women’s...

issues in oncology

Initiating the Topic of Weight and Health With Patients With Obesity

Rates of obesity have been steadily rising over the past 3 decades in both adults and children. Today, more than one-third of American adults and about 17% of children and adolescents, ages 6 to 19, have obesity.1 Cancer rates have risen in tandem with obesity rates, making obesity the second...

prostate cancer
kidney cancer
bladder cancer

Maha Hussain, MD, FACP, FASCO, Credits Collaboration for Her Contributions to Genitourinary Cancer

Internationally recognized genitourinary oncologist Maha Hussain, MD, FACP, FASCO, was born and reared in Baghdad, Iraq. “I came from a family that stressed the value of higher education and especially medicine. I have three uncles who are physicians, and my father encouraged my three siblings and...

prostate cancer

On My Way to Hospice Care, Immunotherapy Saved My Life

Two years ago, I was on my way to hospice care after numerous treatments, including surgery, chemotherapy, and radiation therapy failed to stop the progression of my stage IV castration-resistant prostate cancer. A last-minute call from my oncologist about a phase I trial of combination...

solid tumors

Detection of Early-Stage Cancers With Circulating Tumor DNA

In a bid to detect cancers early and in a noninvasive way, scientists at the Johns Hopkins Kimmel Cancer Center, Baltimore, reported they have developed a test that spots tiny amounts of cancer-specific DNA in blood, and have used it to accurately identify more than half of 138 people with...

solid tumors
breast cancer

A Personal Tribute to Angela H. Brodie, PhD, a Scientist Who Transformed Breast Cancer Treatment

Angela H. Brodie, PhD, a pioneer in breast cancer research, passed away on June 7, 2017, from complications of Parkinson’s disease and pancreatic cancer. An obituary for Dr. Brodie was published previously in the June 25, 2017, issue of The ASCO Post. Here, Dr. Balkees Abderrahman shares a...

solid tumors
prostate cancer

On My Way to Hospice Care, Immunotherapy Saved My Life

Two years ago, I was on my way to hospice care after numerous treatments, including surgery, chemotherapy, and radiation therapy failed to stop the progression of my stage IV castration-resistant prostate cancer. A last-minute call from my oncologist about a phase I combination trial of the...

solid tumors
hematologic malignancies

Unraveling the Complexities of Cellular Immunotherapy and Its Potential to Cure Some Cancers

This past fall, the Fred Hutchinson Cancer Research Center in Seattle opened an all-encompassing 9,222-square foot outpatient cellular immunotherapy clinic, specifically designed to serve patients participating in the center’s novel immunotherapy clinical trials, which mainly focus on chimeric...

breast cancer

Triple-Negative Breast Cancer: Practical Approach, Promising Research

Triple-negative breast cancer has a reputation for being a particularly challenging malignancy, but breast cancer specialist Nancy Davidson, MD, Senior Vice President of the Clinical Research Division at the Fred Hutchinson Cancer Research Center, Seattle, put this in perspective in a recent...

gynecologic cancers

Increased Endometrial Cancer Rates Found in Women With Increased Levels of Cadmium

Through a 5-year observational study recently published by McElory et al in PLOS One, researchers at the University of Missouri (MU) found that women with increased levels of cadmium—a metal commonly found in foods such as kidney, liver, and shellfish, as well as tobacco—had an...

gynecologic cancers

New Device to Test for Cervical Cancer May Be Less Painful for Patients, Produce Better Results

When a woman has an abnormal Papanicolaou (Pap) smear, she usually undergoes colposcopy—a procedure physicians use to closely examine the cervix, vagina, and vulva for signs of disease. Typically, a metal instrument is used to obtain a small sampling of cells inside the cervix, which is...

issues in oncology
survivorship

How to Help Young Patients Preserve Their Fertility

GUEST EDITOR Adolescent and Young Adult Oncology explores the unique physical, psychosocial, social, emotional, sexual, and financial challenges adolescents and young adults with cancer face. The column is guest edited by Brandon Hayes-Lattin, MD, FACP, Professor of Medicine and Medical Director...

cost of care

Financial Toxicity: Cancer Supportive Care Professionals Consider the Side Effects of Soaring Costs

IS IT POSSIBLE to identify patients with cancer who are at risk for financial stress and intervene to reduce that risk? And could reducing financial stress—or financial toxicity, as it is often called in the context of cancer care—improve both health-related quality of life and physical health?...

issues in oncology
survivorship

Poor Social Functioning in Adolescent and Young Adult Cancer Survivors

A new study indicates many young adults who survived the disease struggle with “getting back to normal” as much as 2 years after their initial diagnosis. The longitudinal study, published by Husson et al in Cancer, is among the first seeking to understand the social functioning among...

The Art of Networking: Advice for the Oncologist-in-Training

It was Friday night of the 2016 ASCO Annual Meeting in Chicago. I planned to meet a friend, another 2nd-year heme-onc fellow, at a “free drink thing,” as she called it. I sheepishly entered the hotel bar, made a nametag at the insistence of the greeter, and started edging my way through the crowd. ...

2017 ASTRO Gold Medalists Named

THE AMERICAN SOCIETY FOR RADIATION ONCOLOGY (ASTRO) has announced the 2017 ASTRO Gold Medalists. Søren M. Bentzen, DSc, PhD; Louis B. Harrison, MD, FASTRO; and Michael L. Steinberg, MD, FASTRO, have been awarded the annual honor given to ASTRO members who have made outstanding lifetime...

A Social Media Guide by a Doctor for Doctors

Today’s brave new world of digital technology has both enhanced and compromised the day-to-day operational efficiency of ultrabusy oncologists who are struggling to balance patient care with the rapid evolution of technology. Like all scientific advances, health-care technology is a double-edged...

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