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issues in oncology

Sex-Based Approaches to Oncology in the Era of Precision Oncology: Upcoming ESMO Workshop

Sex-based approaches to studying and treating disease have remained largely unexplored in medical oncology, despite the field’s growing interest in precision medicine and accumulating evidence that sex is a major factor in disease risk and response to treatment. At an upcoming European...

issues in oncology

Cancer May Be Linked to Poor Prognosis in Patients With Broken Heart Syndrome

Cancer may be linked to an increased risk of death and prehospitalization in patients with broken heart syndrome, according to research presented by Santoro et al at the 2018 European Society of Cardiology Congress. Study author Francesco Santoro, MD, of the University of Foggia, Italy, said, ...

hepatobiliary cancer

Nonalcoholic Fatty Liver Disease May Be Risk Factor for Liver Cancer

Nonalcoholic fatty liver disease is a common disease, and with the incidence of liver cancer rising across the country, little has been understood about the link between it and hepatocellular carcinoma. To establish a better understanding of the link between hepatocellular carcinoma risk and...

lung cancer

Tumor Mutation Burden and Prognosis in Resected NSCLC

In a study reported in the Journal of Clinical Oncology, Devarakonda et al found that high nonsynonymous tumor mutation burden was associated with improved outcomes in patients undergoing resection for non–small cell lung cancer (NSCLC). Study Details The study (Lung Adjuvant Cisplatin...

health-care policy
issues in oncology

Medical Groups Release Letter on Proposed Changes to Medicare Physician Payment Rule

The American Medical Association and about 150 medical groups sent the following letter to Seema Verma, Administrator of the Centers for Medicare and Medicaid Services (CMS), regarding the administration’s proposals included in the 2019 Medicare physician payment rule. The full text of...

gynecologic cancers

U.S. Preventive Services Task Force Recommendation Statement on Screening for Cervical Cancer

As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF) has updated its 2012 recommendations on screening for cervical cancer. Key Recommendations The key USPSTF recommendations on screening are as follows: The USPSTF recommends screening for cervical cancer every 3 years with...

gynecologic cancers
head and neck cancer
issues in oncology

HPV Vaccine Completion Up 5% From 2016 to 2017

The number of adolescents who are up to date on human papillomavirus (HPV) vaccination—meaning they started and completed the HPV vaccine series—increased 5 percentage points from 2016 to 2017, according to results from a national survey published by Walker et al in Morbidity and...

prostate cancer
cost of care

ICER Report on Clinical Benefits and Value of Different Antiandrogen Therapies for Men With Nonmetastatic Castration-Resistant Prostate Cancer

The Institute for Clinical and Economic Review (ICER) has released an evidence report assessing the comparative clinical effectiveness and value of antiandrogen therapies for the treatment of nonmetastatic castration-resistant prostate cancer. The report focuses on three antiandrogen...

cns cancers

Oncology Organizations Remember Senator John McCain

United States Senator from Arizona John McCain passed away on August 25 of the brain cancer glioblastoma multiforme (GBM). Numerous medical societies issued statements in light of his death, reprinted below. ASCO  ASCO President Monica M. Bertagnolli, MD, FACS, FASCO, issued the following...

leukemia
lymphoma
immunotherapy

CAR T-Cell Therapy in Europe: Differing Decisions on Approval of Two Agents

The European Commission (EC) recently approved the chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel (Kymriah) in the European Union (EU) for the treatment of pediatric and young adult patients up to 25 years of age with B-cell acute lymphoblastic leukemia (ALL) that is...

issues in oncology

New Software Aims to Predict Patients’ Resistance to Cancer Treatment

New computer software may be used to predict how cancers may respond to a new drug—before it has ever been given to patients. Researchers hope that this new tool could transform the discovery of cancer drugs by predicting how tumors become resistant to treatment before it first becomes...

prostate cancer

Early-Life Alcohol Intake May Increase the Odds of High-Grade Prostate Cancer Later in Life

Compared with nondrinkers, men who consumed at least 7 drinks per week during adolescence (ages 15–19) had 3 times the odds of being diagnosed with clinically significant prostate cancer, according to results published by Michael et al in Cancer Prevention Research. “The prostate...

issues in oncology

First Large-Scale Survey of Advanced Practice Providers in Oncology Shows Growing Role for Nurse Practitioners and Physician Assistants

Advanced practice providers (APPs) have increasingly become integral members of the oncology care delivery team, according to the first large-scale study of nurse practitioners (NPs) and physician assistants (PAs) in oncology published by Bruinooge et al in the Journal of Oncology Practice....

issues in oncology

Most Oncologists Have Discussed Medical Marijuana With Patients, Survey Finds

DATA FROM a new survey show that as many as 80% of oncologists have discussed medical marijuana use with their patients. According to the authors, this is the first nationally representative survey to examine oncologists’ practices and beliefs on the subject since the implementation of state...

skin cancer

Cutaneous Squamous Cell Carcinoma of the Lip and Risk of Nodal Metastasis

In a study reported in JAMA Dermatology, Wang et al found that the risk of nodal metastasis was higher for cutaneous squamous cell carcinoma of the lip with vermilion vs cutaneous location. Disease-specific and overall survival were similar for the two locations. Chrysalyne D. Schmults, MD, of the...

On Not Being Ready

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

I Am Too Young for Breast Cancer

Two years ago, when I began having pain and bloody discharge in my left breast, I thought it was the return of a solitary intraductal papilloma I had had in that breast when I was a college student 6 years earlier, so the symptoms didn’t initially alarm me. It wasn’t until I noticed that the mass...

issues in oncology

Focus on the Empire State Hematology & Oncology Society

The Empire State Hematology & Oncology Society (ESHOS), a State Affiliate of ASCO, was formed in January 2017 as a merger of three separate hematology and oncology professional organizations in New York. Stuart P. Feldman, MD, of the New York State Society of Medical Oncologists &...

issues in oncology
cns cancers

A Firsthand Account of Cancer and Mental Illness

Brain tumors are among the most challenging clinical scenarios faced by the oncology community. Along with devastating physiologic damage, brain tumors often have a dramatic effect on the patient’s cognitive, neurologic, and psychological functions. However, the body of literature focusing on...

issues in oncology
survivorship

Oncofertility: An Emerging and Much-Needed Field

The American Cancer Society estimated that in 2015 in the United States, more than 86,000 women younger than age 45 were diagnosed with cancer. Many of them face reproduction and fertility concerns, which could lead to long-term distress and impaired quality of life in survivorship. To shed light...

leukemia
immunotherapy

Blinatumomab in Adult and Pediatric Patients With B-Cell Precursor Acute Lymphoblastic Leukemia

EARLY IN 2018, blinatumomab (Blincyto) was granted accelerated approval for the treatment of adult and pediatric patients with B-cell precursor acute lymphoblastic leukemia (ALL) in first or second complete remission with minimal residual disease ≥ 0.1%.1,2 Supporting Efficacy Data APPROVAL WAS...

leukemia

Ivosidenib for Relapsed or Refractory Acute Myeloid Leukemia

ON JULY 20, 2018, the U.S. Food and Drug Administration (FDA) approved ivosidenib (Tibsovo) for the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with a susceptible isocitrate dehydrogenase-1 (IDH1) mutation, as detected by an FDA-approved test.1,2 The FDA...

issues in oncology

Psycho-oncology: After Decades of Acceptance, Still an Emerging Field

As the field of psycho-oncology continues to mature, new studies are being conducted to evaluate ways to better address the needs of patients with cancer and their families. The ASCO Post recently spoke with Michael Hoerger, PhD, MSCR, Assistant Professor of Psychology, Psychiatry, and Oncology at ...

SMARTIE Initiative for Advanced Practitioners in Oncology Recognized by Alliance for Continuing Education

AN ONGOING educational initiative, the Study to Measure Advanced Practitioner Retention of Targeted Information and Education (SMARTIE), measures oncology learning and how it is used with advanced practitioners and their patients with cancer. The initiative, conducted by Harborside Medical...

gynecologic cancers

NCCN Publishes Guidelines for Gestational Trophoblastic Neoplasia to Optimize Therapy, Preserve Fertility in Pregnant Women With Rare Cancer

THE NATIONAL Comprehensive Cancer Network® (NCCN®) has released new treatment guidelines for a group of rare cancers that impact women during pregnancy. Gestational trophoblastic neoplasia, also known as gestational trophoblastic disease, can occur when tumors develop in the cells that would...

issues in oncology

New ESMO Tumor DNA Scale Helps Match Patients to Optimal Targeted Treatments

A new scale for tumor DNA mutations called ESCAT (European Society for Medical Oncology [ESMO] Scale for Clinical Actionability of Molecular Targets) is aiming to simplify and standardize choices for targeted cancer treatment. Information about the development and use of the scale in practice was...

skin cancer
immunotherapy

Gene-Expression Predictor for Immunotherapy Response in Melanoma

In a new study, researchers developed a gene expression predictor that can indicate whether melanoma in a specific patient is likely to respond to treatment with immune checkpoint inhibitors. Their research was published by Auslander et al in Nature Medicine. “There is a critical need to be...

head and neck cancer
immunotherapy

Cetuximab With Radiotherapy Found to Be Inferior to Standard Treatment in HPV-Positive Oropharyngeal Cancer

An interim analysis of data from a randomized clinical trial of patients with human papillomavirus (HPV)-positive oropharyngeal cancer found that treatment with radiation therapy and cetuximab (Erbitux) is associated with worse overall and progression-free survival compared to the current standard...

lung cancer
immunotherapy

FDA Approves Nivolumab for Certain Patients With Previously Treated Small Cell Lung Cancer

Today, nivolumab (Opdivo) received approval from the U.S. Food and Drug Administration (FDA) for patients with metastatic small cell lung cancer (SCLC) whose cancer has progressed after platinum-based chemotherapy and at least one other line of therapy. Approval for this indication has been...

breast cancer
gynecologic cancers
issues in oncology

BRCA Testing in Medically Underserved Women in Southeastern United States

Medically underserved women in the Southeast region of the United States diagnosed with breast cancer or ovarian cancer may have not received genetic testing that could have helped them and their relatives make important decisions about their health, according to new research from Vanderbilt-Ingram ...

issues in oncology

ASCO Statement: Step Therapy Creates Barriers to Care for Medicare Advantage Beneficiaries With Cancer

ASCO strongly opposes the Centers for Medicare & Medicaid Services (CMS) decision to allow Medicare Advantage plans to employ step therapy across physician-administered and self-administered drugs under Medicare Part B and Part D. “In modern cancer care, there is frequently a lack of...

issues in oncology

2019 Physician Fee Schedule and Quality Payment Program Proposed Rules Released

The Centers for Medicare & Medicaid Services (CMS) released its proposed rule for 2019 Medicare physician reimbursement.  CMS estimates that in 2019, the overall impact for the hematology/oncology specialty will be a 4% reduction in reimbursement and a 2% reimbursement reduction for...

gynecologic cancers

Inaugural Award Recipient Studies Potential of HE4 Blockade as a Novel Immune Therapy in Ovarian Cancer

In 2018, Bristol-Myers Squibb (BMS) provided funds for Conquer Cancer to establish a Young Investigator Award (YIA) supporting female researchers and underscore the importance of gender diversity in oncology practice and research.  “We provided this grant as part of our commitment to empowering...

Breast Cancer Surgeon Hannah Hazard-Jenkins, MD, Deftly Balances Career and Family

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic. For this installment of the Living a Full Life series, guest editor Jame Abraham, MD, spoke with breast cancer surgeon...

hematologic malignancies
multiple myeloma
immunotherapy

Daratumumab in Newly Diagnosed Transplant-Ineligible Multiple Myeloma

In May 2018, daratumumab (Darzalex) was approved for use in combination with VMP (bortezomib, melphalan, and prednisone) in the treatment of patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplantation.1 Supporting Efficacy Data Approval was based on...

issues in oncology

Obesity and Cancer: Complex Interplay of Multiple Factors

The evolving concept that dietary fat plays an important role in the etiology of human cancer emerged more than 50 years ago. Ernst Wynder, MD, whose seminal epidemiologic work led to identifying smoking as a contributory cause of lung cancer, presented a paper in 1967 showing a decided correlation ...

prostate cancer

Enzalutamide in Nonmetastatic Castration-Resistant Prostate Cancer

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 July 13, 2018, enzalutamide (Xtandi) was approved for...

Be Prepared to Assist Patients to Make Informed Decisions About Breast Reconstruction Options

Two studies about postmastectomy breast reconstruction were recently published in JAMA Surgery. One study found overall complication rates of 32.9% at 2 years after reconstruction, with women having autologous reconstruction more likely to have complications than those having implant...

breast cancer

Breast Reconstruction: ‘A Process Not a Procedure’ With Potential Short- and Long-Term Complications

The complication rate among women who underwent postmastectomy breast reconstruction was 32.9% at 2 years postoperatively, and women undergoing autologous reconstruction “had significantly higher odds of developing any complication compared with those undergoing expander-implant reconstruction,”...

issues in oncology

Navigating the ‘New Normal’: NCCN Summit Examines Access to High-Quality Cancer Care

It’s not just the leaps in development of precision medicines, the soaring costs, the new payment models, clinical trial designs, sources of data, and federal policies. It’s all of them plus the rapidity with which change is happening that makes this era of oncology exceptional. “I would say...

supportive care

Cannabinoids for Cancer Pain: Dangerous or Beneficial?

Cannabis has been used in health care for millennia, and its use has been well documented, albeit never definitively integrated into clinical practice. Recent societal changes and the increasing acceptance and availability of cannabis have reignited the medical and public debate around its role in...

supportive care

Therapeutic Applications for Cannabinoids in Oncology: The Debate Continues

In the early part of the 20th century, the U.S. government classified cannabis as a Schedule 1 drug: a dangerous substance with no medical value. For many years, that classification prevented systematic research in cannabinoid use in medicine. As a result of societal changes and an intense and...

issues in oncology

Stakeholders Agree: ‘Value’ in Cancer Care Depends on Perspective

In a roundtable discussion moderated by Clifford Goodman, PhD, of The Lewin Group, Falls Church, Virginia, representatives of the patient advocacy community, public and private payers, large and small clinics, and the pharmaceutical industry did not always see eye to eye on what “value” means nor ...

lymphoma

Venetoclax and Beyond: Successfully Targeting BCL2

Although many agents have been able to successfully inhibit the proliferative capacity of cancer cells or disable mutations that spur cancer growth, one area that has proven elusive is the apoptotic pathway—the cell’s means of resisting death. That is until recently. Dysregulation of B-cell...

issues in oncology

Medical Marijuana: Research Not Anecdotes

For patients with cancer, marijuana may be valuable in controlling pain and chemotherapy-induced nausea and vomiting. Furthermore, it may have efficacy as an appetite stimulant. No randomized clinical trial has investigated the utility of whole-plant medical marijuana to alleviate these symptoms in ...

lung cancer
issues in oncology

Small Study Looks at Physician-Patient Discussions About Lung Cancer Screening

National guidelines advise doctors to discuss the benefits and harms of lung cancer screening with high-risk patients. A small study (n = 14) by researchers from the University of North Carolina Lineberger Comprehensive Cancer Center reported there is a gap between what guidelines...

issues in oncology

Unraveling the Mystery of What Gives Exceptional Responders Their Superpower

Once dismissed as rare medical miracles that overcame overwhelming odds to thwart cancer, exceptional responders to cancer treatment are now the subject of intense study. In 2015, the National Cancer Institute (NCI) announced the launch of its Exceptional Responders Initiative, with the goal of...

lymphoma
immunotherapy

For Hodgkin Lymphoma, PD-1 Blockade Is Not the Final Answer

Although programmed cell death protein 1 (PD-1) blockade is highly effective in Hodgkin lymphoma, not all patients respond, and not all responses are durable. Stephen M. Ansell, MD, PhD, Chair of the Mayo Clinic Lymphoma Group and Professor of Medicine at the Mayo Clinic, Rochester, described...

bladder cancer

VB4-845 Granted Fast Track Designation by FDA for Treatment of Non–Muscle Invasive Bladder Cancer

The U.S. Food and Drug Administration (FDA) has granted Fast Track designation to VB4-845 for the treatment of bacillus Calmette-Guérin (BCG)–unresponsive, high-grade, non–muscle invasive bladder cancer. VB4-845 is currently being evaluated in a phase III registration...

skin cancer

Prognostic Model for Treatment Outcomes in BRAF V600–Mutated Metastatic Melanoma

In a study reported in JAMA Oncology, Hauschild et al identified baseline lactate dehydrogenase (LDH), performance status, disease burden, and gene signature as potential determinants of treatment outcomes in BRAF V600–mutant metastatic melanoma treated with BRAF and/or MEK inhibitors. Study ...

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