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Drainage of Massive Ascites: Patient of Nicholas Senn, MD

Prior to the 20th century, there were very few specific therapies for disease. Many diseases, especially cancers and infections, resulted in accumulations of fluid or pus in body cavities. Physicians had to become masters of the trocar, needle, and catheter. They learned to artfully remove fluid...

breast cancer

Expect and Encourage Questions About Breast Reconstruction

An article in The New York Times about women who had chosen not to have reconstruction following breast cancer surgery might prompt questions from newly diagnosed patients considering their options.1 Deanna J. Attai, MD, FACS, told The ASCO Post that whenever an article on breast cancer appears in...

breast cancer

Helping Patients With Breast Cancer Decide Whether to Have Reconstruction

A “nascent movement to ‘go flat’” is how an article in The New York Times characterized the decisions by some women to opt out of reconstruction following surgery for breast cancer.1 The article examined the reasons several patients made that decision, which included avoiding multiple surgeries and ...

Dave, Dave, Dave

It was 1983, and I was in my third year as an attending physician at a major East Coast university medical center and just 5 years out of fellowship. As was common at the time, I saw and treated all malignancies except leukemia and gynecologic cancers. In the middle of a typically busy day at the ...

multiple myeloma

FDA Approves Daratumumab in Combination With Lenalidomide/Dexamethasone or Bortezomib/Dexamethasone in Multiple Myeloma

On November 21, 2016, the U.S. Food and Drug Administration (FDA) approved daratumumab (Darzalex) in combination with lenalidomide (Revlimid) and dexamethasone, or bortezomib (Velcade) and dexamethasone, for the treatment of patients with multiple myeloma who have received at least one prior...

Shirley A. Johnson, RN, MS, MBA, Joins Roswell Park Cancer Institute

Shirley A. Johnson, RN, MS, MBA, has been appointed as Roswell Park Cancer Institute’s Senior Vice President of Nursing and Patient Care Services and Chief Nursing Officer. Ms. Johnson officially joined the Roswell Park staff on October 31, 2016, bringing with her nearly 25 years of experience in...

Zhu Chen, MD, PhD, and Hugues de Thé, MD, PhD, to Present 2016 ASH Ernest Beutler Lecture

The American Society of Hematology (ASH) will honor Zhu Chen, MD, PhD, of Shanghai Institute of Hematology, and Hugues de Thé, MD, PhD, of Collège de France, with the 2016 Ernest Beutler Lecture and Prize for their significant research advances in the area of acute promyelocytic leukemia (APL)....

Dana-Farber Cancer Institute, Lifespan Partner to Advance Cancer Treatment and Expand Research

Dana-Farber Cancer Institute and Lifespan—Rhode Island’s first health system—leadership have signed a memorandum of understanding to form a partnership that will advance cancer treatment and expand research. The details will be finalized early next year. “Over the past 6 months, our staff members...

gynecologic cancers

Making Peace With Cancer

Next to me sounds the buzzing of my Lympha Press machine, which substitutes for the constant visits of the physiotherapist who performs the lymph drainage. This gives me more freedom, and we have more privacy at home. I can use the machine whenever I need it, and my 5-year-old daughter, Christina, ...

issues in oncology
cost of care

Understanding Biosimilars and Their Impending Role in Oncology Care

Biosimilars are among the newest threads in the fabric of cancer treatment in the United States, and they are spawning numerous questions for oncologists and patients with cancer. Many of these questions were taken up by participants in a recent Washington forum on “The Future of the U.S....

kidney cancer

Adjuvant Sunitinib for Renal Cell Carcinoma: Not Ready for Prime Time

In renal cell carcinoma and other cancer types, a consistent paradigm in drug development exists: Observe efficacy of a drug in the metastatic setting and move quickly to explore the agent in the adjuvant setting. In the cytokine era, there were multiple efforts to characterize whether adjuvant...

lung cancer

Pembrolizumab in First-Line Treatment of Metastatic Non–Small Cell Lung Cancer

On October 24, 2016, pembrolizumab (Keytruda) was approved for use in patients with metastatic non–small cell lung cancer (NSCLC) whose tumors have high programmed cell death ligand 1 (PD-L1) expression (tumor proportion score ≥ 50%) as determined by a U.S. Food and Drug Administration...

issues in oncology

Study Finds EXITS Gene Mutations May Contribute to Cancer Sex Bias

According to Surveillance, Epidemiology, and end Results (SEER) data from 2008 to 2012, American males have an excess risk of 20.4% of developing any cancer compared with females, and there is a ≥ 2:1 male predominance for some individual cancers. This excess risk results in approximately...

bladder cancer

Anti–PD-1 Contenders in Advanced Urothelial Cancer

Immunotherapy with anti–PD-1 (programmed cell death protein 1) and anti–PD-L1 (programmed cell death ligand 1) agents continues to advance in metastatic urothelial cancer, with positive showings in two clinical trials presented at the 2016 European Society for Medical Oncology (ESMO) Congress. The...

Expert Point of View: Florian Lordick, MD

Florian Lordick, MD, Professor of Oncology and Director of the University Cancer Center in Leipzig, Germany, offered some critical evaluation of the two studies. AGITG Phase II Trial For the AGITG’s phase II DOCTOR trial, he emphasized the need to show the impact on survival outcomes for...

gastroesophageal cancer

Locally Advanced Esophageal Cancer Outcomes Improved With Neoadjuvant Therapy

In studies presented at the 2016 European Society for Surgical Oncology (ESMO) Congress, two different neoadjuvant treatment approaches improved the outcomes of patients with esophageal cancer. Investigators from the Australasian Gastro-Intestinal Trials Group (AGITG) reported that the addition of...

lung cancer
skin cancer

Numerous ESMO Presentations Focused on Anti–PD-1 Therapy in Lung Cancer and Melanoma

The 2016 European Society for Medical Oncology (ESMO) Congress was jam-packed with studies of the anti–programmed cell death protein 1 (PD-1) antibodies in non–small cell lung cancer and melanoma, where they have clearly changed the treatment paradigm. Here is a roundup of some of those trials,...

breast cancer

Clinical Strategies for Improving Endocrine Therapy in Metastatic Breast Cancer

Most women with hormone receptor–positive breast cancer receive endocrine therapy as part of their treatment, but “the reality is that patients who receive antihormone therapy in the metastatic disease setting ultimately develop disease progression, ” William J. Gradishar, MD, stated at the 18th...

lymphoma
skin cancer

Encouraging First Study of Pembrolizumab in Cutaneous T-Cell Lymphoma

Immunotherapy with an anti–programmed cell death protein 1 (PD-1) inhibitor—pembrolizumab (Keytruda)—showed encouraging responses in patients with advanced cutaneous T-cell lymphoma (either mycosis fungoides or Sézary syndrome). Pembrolizumab achieved a 38% overall response rate and responses...

lymphoma
skin cancer

Prospective Cutaneous Lymphoma International Prognostic Index Initiative Moves Forward

A collaboration of international experts is tackling the challenges involved in understanding and managing the treatment of cutaneous lymphomas. The Prospective Cutaneous Lymphoma International Prognostic Index ­(PROCLIPI) study from the Cutaneous Lymphoma International Consortium brings together...

breast cancer

Updated ASTRO Guideline Expands Pool of Suitable Candidates for Accelerated Partial-Breast Irradiation

On November 17, the American Society for Radiation Oncology (ASTRO) issued an updated clinical practice statement for accelerated partial-breast irradiation for early-stage breast cancer. The updated guideline reflects recent evidence that greater numbers of patients can benefit from accelerated...

gynecologic cancers

Novel Urine Test May Predict High-Risk Cervical Cancer

Johns Hopkins Medicine specialists reported they have developed a urine test for the likely emergence of cervical cancer that is highly accurate compared to other tests based on genetic markers derived directly from cervical tissue. The new urine test, they said, is different because it analyzes...

sarcoma

Cautious Optimism About Olaratumab in Soft-Tissue Sarcoma

The current plethora of drugs in development for oncology is leading to the testing of novel agents in common as well as rare diseases. Targeted therapies have been a focus of great interest in soft-tissue sarcomas, with testing of a variety of oral tyrosine kinase inhibitors leading to the...

skin cancer

Fulminant, Fatal Myocarditis Reported in Two Patients After Starting Combined Immune Checkpoint Blockade Treatment

In an article in The New England Journal of Medicine, Johnson et al reported the occurrence of fulminant, fatal immune-related myocarditis in two patients who received combined ipilimumab (Yervoy) and nivolumab (Opdivo) for metastatic melanoma. Patient Courses One patient was a 65-year-old woman...

Expert Point of View: Alice T. Shaw, MD, PhD

Commenting on ASCEND-5, Alice T. Shaw, MD, PhD, Director of Thoracic Oncology at the Massachusetts General Hospital Cancer Center, Boston, noted that it is the first randomized study to examine how a second-generation anaplastic lymphoma kinase (ALK) inhibitor compares to standard second-line...

lung cancer

Studies Confirm Ceritinib’s Benefit in ALK-Positive Patients

For patients with advanced non–small cell lung cancer (NSCLC) harboring the ALK gene rearrangement, ceritinib (Zykadia) provided longer progression-free survival than chemotherapy in patients previously treated with chemotherapy and crizotinib (Xalkori), but gastrointestinal toxicity was...

sarcoma

Adding Olaratumab to Doxorubicin Increases Overall Survival in Advanced Soft-Tissue Sarcoma

As reported by William D. Tap, MD, of Memorial Sloan Kettering Cancer Center, and colleagues in The Lancet, the addition of the anti-PDGFRα (platelet-derived growth factor receptor alpha) antibody olaratumab to doxorubicin resulted in prolonged progression-free and overall survival in phase II...

Expert Point of View: Paul Baas, MD, PhD

Invited discussant Paul Baas, MD, PhD, of The Netherlands Cancer Institute, Amsterdam, first commented on the need for measures to improve outcomes in early-stage non–small cell lung cancer (NSCLC). “Even in stage I patients, we still have a failure rate of 30% to 40% at 5 years, and that...

lung cancer

Neoadjuvant Nivolumab Appears Safe and Feasible in Lung Cancer

Neoadjuvant immunotherapy with the programmed cell death protein 1 (PD-1) inhibitor nivolumab (Opdivo) is safe and feasible in early-stage non–small cell lung cancer (NSCLC). The results come from the first report of PD-1 blockade prior to surgery in this tumor, according to Patrick Forde, MD, of...

issues in oncology

The Emergence of Philanthropy to Fund High-Risk, High-Reward Cancer Research

Earlier this year, Sean Parker, the cofounder of the music streaming service Napster and an early president of Facebook, joined a growing list of entrepreneurs who are committing large portions of their wealth to funding cancer research. In April, Mr. Parker announced he was donating $250 million...

Memorial Sloan Kettering Long Island Branch Expands Site, Services

The Commack, Long Island–based hospital of Memorial Sloan Kettering (MSK) Cancer Center was opened in 2002, providing personalized cancer care closer to home for individuals living on eastern Long Island. Now, more than 14 years later, MSK is reinforcing its commitment to the local community in...

kidney cancer

Vaccine Therapy in Metastatic Renal Cell Carcinoma: Past, Present, and Future

As reviewed in this issue of The ASCO Post, Brian Rini, MD, and colleagues recently reported results from the phase III IMPRINT trial,1 which randomized HLA-A*02–positive patients with treatment-naive metastatic clear cell variant renal cell carcinoma, in favorable- and intermediate- risk...

Expert Point of View: Sandro Pignata, MD

“This study represents a significant step forward in the treatment of recurrent ovarian cancer,” stated formal discussant Sandro Pignata, MD, of the IRCCS National Cancer Institute “Fondazione G. Pascale,” Naples, Italy. He highlighted some key factors: Patients selected for the study were those...

pancreatic cancer

Recent Progress and Concepts in Pancreatic Cancer

November is National Pancreatic Cancer Awareness Month, the impetus for this article. Pancreatic cancer is a huge health challenge. It's the eighth most common cancer in the United States and the fourth most common cause of cancer deaths but is expected to become the second most common cause of...

lung cancer

Pembrolizumab as First-Line Therapy in Metastatic NSCLC: Practice-Changing Implications of KEYNOTE-024 Trial

We are in the midst of a paradigm shift in lung cancer. In the past 2 years, the anti–programmed cell death protein 1 (anti–PD-1) inhibitors nivolumab (Opdivo) and pembrolizumab (Keytruda) were found to improve overall survival in the second-line setting compared with docetaxel for patients with...

hematologic malignancies

Update on Neoplastic Hematology: Review of Recent Clinical Trials

Here is a brief look at the study findings and clinical implications of several recent and important clinical trials in neoplastic hematology. Attention is focused on myelodysplastic syndromes, multiple myeloma, and chronic lymphocytic leukemia. Myelodysplastic Syndromes Clinical Trial:...

Dafna Bar-Sagi, PhD, Receives NCI Outstanding Investigator Award

Cancer researcher Dafna Bar-Sagi, PhD, has made fundamental contributions to the understanding of the mechanisms that drive the disease. In recognition of her accomplishments, she has been named a recipient of the Outstanding Investigator Award, an honor presented by the National Cancer Institute...

lung cancer

New ALK Inhibitor, Brigatinib, Active in ALK-Rearranged Non–Small Cell Lung Cancer

In a phase I/II study reported in The Lancet Oncology, Gettinger et al found that the anaplastic lymphoma kinase (ALK) inhibitor brigatinib, which showed preclinical activity against ALK mutants resistant to crizotinib (Xalkori) and other ALK inhibitors, was active in patients with ALK-rearranged...

leukemia

Study Describes Genetic Model of Pro-B ALL

After nearly 2 decades of unsuccessful attempts, researchers from the University of Chicago Medicine and the Cincinnati Children's Hospital Medical Center have created the first mouse model for the most common form of infant leukemia. Their discovery, reported by Lin et al in Cancer Cell, could...

bladder cancer

SITC 2016: Immune Checkpoint Inhibitors Shrink Tumors in Some Patients With Metastatic Bladder Cancer

Combination immunotherapy is producing response rates ranging from 26% to 38% among patients with metastatic bladder cancer in the early stages of a three-arm clinical trial presented at the 2016 Society for Immunotherapy of Cancer (SITC) Annual Meeting in National Harbor, Maryland. “Until...

sarcoma

No Benefit Reported With Addition of Palifosfamide to Doxorubicin in Metastatic Soft-Tissue Sarcoma

In the phase III PICASSO III trial reported in the Journal of Clinical Oncology, Ryan et al found that adding palifosfamide to doxorubicin did not prolong progression-free survival among patients with metastatic soft-tissue sarcoma. Palifosfamide is the active metabolite of ifosfamide. In the...

survivorship

Do Cancer Survivors Use Medications for Anxiety and Depression at a Higher Rate Than Those Without Cancer?

In a study of population-based data reported in the Journal of Clinical Oncology, Hawkins et al found that adult cancer survivors receive medication for anxiety and depression at twice the rate of that in adults without cancer. The study involved data from the National Health Interview Survey for...

José R. Conejo-Garcia, MD, PhD, Joins Moffitt as Co-Leader of Immunology Program, Chair of Department of Immunology

José R. Conejo-Garcia, MD, PhD, has joined Moffitt Cancer Center as Coleader of the Immunology Program and Chair of the Department of Immunology. The Immunology Program is focused on defining the regulation role of immune checkpoint molecules in tumor immune surveillance and in identifying new...

lymphoma

Risk for Non-Hodgkin Lymphoma in HIV-Infected Patients

In the HIV-negative population, there is growing evidence suggesting that chronic hepatitis B virus (HBV) and hepatitis C virus (HCV) are both associated with the development of non-Hodgkin lymphoma (NHL), although the mechanisms underlying this association remain unclear. The incidence rate of NHL ...

Two Big 10 Universities Compete in Challenge and Help Raise More Than $5.9 Million for Childhood Cancer Research

The first-ever Wolverine–Badger challenge between C.S. Mott Children’s Hospital at the University of Michigan (Wolverines) and the University of Wisconsin’s American Family Children’s Hospital (Badgers) helped raise more than $5.9 million for pediatric cancer research. An October 1 football game...

pain management
symptom management
supportive care
issues in oncology

Expect Questions About Medical Marijuana

“Whether or not individual professionals support the clinical use of herbal cannabis, all clinicians will encounter patients who elect to use it and therefore need to be prepared to advise them on cannabis-related clinical issues despite limited evidence to guide care,” according to a recently...

supportive care
pain management
issues in oncology
symptom management

Medical Marijuana: The Topic You Can’t Escape

With reports about new marijuana dispensaries sprouting up as more states approve the legal use of medical marijuana, and patients and family members questioning how to get it, medical marijuana is a “topic you can’t escape,” noted Judith A. Paice, PhD, RN.1 Dr. Paice is Director of the Cancer...

Resuscitation During Surgery

During the 1890s, aseptic principles were extended only to the operative area of the patient, not the surgeon, although some surgeons did advocate the use of special white or colored uniforms, and hand washing had already been established. In 1895, just 7 years after Arpad Gerster, MD, published...

pancreatic cancer

Let’s Win: Innovative Online Community Offers Guidance to Patients With Pancreatic Cancer and Their Families

Let’s Win is an online community for persons with pancreatic cancer (www.letswinpc.org), but it is far more than a typical support group. Let’s Win propels interested users toward cutting-edge research, based on its founders’ commitment that no patient with pancreatic cancer should settle on the...

colorectal cancer

New Blood Test for Colorectal Cancer Recurrence: Twice as Sensitive as CEA Test

In a new report published by Young et al in Cancer Medicine,1 a two-gene circulating tumor DNA (ctDNA) blood test for postsurgical monitoring of colorectal cancer recurrence has been shown to detect twice the number of recurrence cases as carcinoembryonic antigen (CEA) testing, a standard-of-care...

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