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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...

supportive care
palliative care

Ensuring Advance Directives Are Followed and Lawsuits Are Avoided

Thaddeus Mason Pope, JD, PhD, has focused his legal career on improving medical care decision-making and protecting patients’ rights at the end of life. His specific areas of legal expertise include patients’ rights, informed consent, and end-of-life medicine. Dr. Pope is the coauthor of The Right ...

supportive care
palliative care

Advance Care Planning: Ensuring Patients’ End-of-Life Wishes Are Honored

When Amy Berman, BSN, LHD (aged 58), stood in front of the mirror to perform a routine breast self-exam and saw redness and dimpling on her right breast, she feared they were the telltale signs of inflammatory breast cancer. “I have never self-diagnosed myself before, but I had recently read an...

breast cancer
solid tumors

CDK4/6 Inhibitors Have a Manageable Toxicity Profile, Are Generally Well Tolerated in Patients With Breast Cancer

A class of oral drugs for treating breast cancer known as cyclin-dependent kinase (CDK) 4/6 inhibitors are generally well-tolerated, with a manageable toxicity profile for most patients. This is the conclusion of a comprehensive review of toxicities and drug interactions related to this class of...

issues in oncology

The Immune System: Deciphering Recent Advances

Over the past decade, there has been renewed interest in developing immunologic therapies in cancer. The U.S. Food and Drug Administration (FDA) has approved several new biologic agents that target a patient’s immune system, some of which have produced profound clinical responses. However, the...

issues in oncology

FDA Takes Action Against 14 Companies for Selling Illegal Cancer Treatments

On April 25, the U.S. Food and Drug Administration (FDA) posted warning letters addressed to 14 U.S.-based companies illegally selling more than 65 products that fraudulently claim to prevent, diagnose, treat, or cure cancer. The products are marketed and sold without FDA approval, most commonly...

solid tumors

Insertion and Deletion Mutations and Immunogenicity in Solid Tumors

In a study reported in The Lancet Oncology, Turajlic et al found that renal cell carcinomas were characterized by the highest proportion and number of frameshift insertion and deletion (indel) mutations among solid cancers and that these alterations were associated with augmented immunogenicity...

leukemia

Effect of Methotrexate and Corticosteroid Strategies on Neurocognitive Function in Patients With B-Lineage ALL

In a Children’s Oncology Group (COG) study (AALL06N1) reported in the Journal of Clinical Oncology, Hardy et al found that age < 10 years at diagnosis was associated with poorer neurocognitive function in patients with high-risk B-lineage acute lymphoblastic leukemia regardless of...

breast cancer

MammaPrint Scoring and Indolent Node-Negative Breast Cancer

In an analysis reported in JAMA Oncology, Esserman et al found that an ultralow-risk designation using the 70-gene MammaPrint assay is capable of identifying patients with node-negative disease who have a very low long-term risk of death from breast cancer after surgery without systemic therapy....

supportive care

Appropriate Distress Screening and Follow-up Leads to Fewer ER Visits and Hospitalizations in Patients With Cancer

Following a cancer diagnosis, all patients experience some level of distress—regardless of disease stage. When severe and left untreated, distress can have a significant impact on health outcomes, lead to greater mortality and morbidity, affect immune function, and result in higher...

issues in oncology

Cancer Risk May Be Higher Among Holocaust Survivors

A new study indicates that survivors of the Holocaust have experienced a small but consistent increase in the risk of developing cancer. Published by Sadetzki et al in Cancer, the findings offer an example of how extreme population-level tragedies can have an impact on health. Holocaust survivors...

cns cancers
issues in oncology

Study Demonstrates Potential for Artificial Intelligence and Whole-Genome Sequencing to Scale Access to Precision Medicine

In a study published by Wrzeszczynski et al in Neurology: Genetics, researchers at the New York Genome Center (NYGC), The Rockefeller University, and IBM illustrated the potential of IBM Watson for Genomics to analyze complex genomic data from state-of-the-art sequencing of whole genomes. The study ...

issues in oncology

New CDC Report Shows Cancer Death Rates Are Higher in Rural America

Despite decreases in cancer death rates nationwide, a new report from the Centers for Disease Control and Prevention (CDC) shows slower reduction in cancer death rates in rural America (a decrease of 1.0% per year) compared with urban America (a decrease of 1.6% per year), according to data...

lung cancer

FDA Approves First Companion Diagnostic Test to Simultaneously Screen for Multiple NSCLC Therapies

On June 22, the U.S. Food and Drug Administration (FDA) granted premarket approval to Thermo Fisher Scientific for the first next-generation sequencing–based test that simultaneously screens tumor samples for biomarkers associated with three FDA-approved therapies for non–small cell...

breast cancer

MammaPrint Test Addressed in ASCO Breast Cancer Guideline Update

New recommendations on the use of the MammaPrint genomic test issued on July 10 will help guide decisions on adjuvant systemic therapy for women with early breast cancer. The recommendations update the ASCO 2016 clinical practice guideline on the use of biomarkers in these patients. The...

health-care policy
issues in oncology

Narrow Network Insurance Plans More Likely to Exclude Doctors at NCI-Designated and NCCN Member Cancer Centers

Patients with cancer in the United States may be unable to access care at the nation’s top hospitals due to narrow insurance plan coverage—leaving patients to choose between lower premiums or access to higher-quality cancer care. A new study from the Perelman School of Medicine at the...

skin cancer
issues in oncology

Delaying Lymph Node Biopsy After Melanoma Diagnosis May Not Adversely Affect Survival Rates

Postponing lymph node biopsy more than 30 days after melanoma diagnosis does not adversely impact long-term clinical outcomes, according to findings published by Nelson et al in the Journal of the American College of Surgeons. Today, management of high-risk melanomas starts with surgical removal...

gynecologic cancers

Current Performance Measures for Cervical Cancer Screening

Health-care systems use performance measures for cervical cancer screening based on guidelines from such organizations as the American College of Obstetricians and Gynecologists to monitor the appropriateness of cervical cancer screening. According to the performance measure in the Healthcare...

solid tumors

FDA Grants 510(k) Clearance to Halcyon IMRT Treatment System

Varian Medical Systems has received U.S. Food and Drug Administration (FDA) 510(k) clearance for its Halcyon system, a new device for cancer treatment. Halcyon simplifies and enhances image-guided volumetric-intensity modulated radiotherapy (IMRT). “We are proud that Halcyon has now...

lymphoma

Encouraging Results With Pembrolizumab in Relapsed/Refractory Classical Hodgkin Lymphoma

AN EFFECTIVE antitumor immune response relies on cytotoxic T cells that are activated and able to target the malignant clone. As T cells become activated, they upregulate suppressive receptors including programmed cell death protein 1 (PD-1). Upregulation of inhibitory signals is important to...

A Great IDEA: Celebrating 15 Years of the International Development and Education Award

In 2017, ASCO and the Conquer Cancer Foundation of ASCO are proud to celebrate the 15th anniversary of the International Development and Education Award (IDEA). The IDEA program supports the professional development of early-career oncologists in low- and middle-income countries around the world....

geriatric oncology

Preparing for Future Challenges in Geriatric Surgical Oncology

In the past decade, advances in surgical oncology have been echoed in the field of geriatric oncology. The current literature regarding older people with cancer includes mainly retrospective cohort studies, focusing on alternatives to radical surgery in comorbid patients. More recently, work has...

ASCO’s New MACRA Decision Tree Tool Helps Determine Which QPP Reporting Requirements Apply to Your Practice

Believe it or not, we’re halfway through the 1st year of the Quality Payment Program (QPP). ASCO, the Centers for Medicare & Medicaid Services (CMS), and other stakeholders have released guidance on successfully complying with QPP, but tailored information addressing a practice’s specific...

ASCO’s TAPUR Study Continues Its Expansion of Sites, Participants, and Collaborators

ASCO’s Targeted Agent and Profiling Utilization Registry (TAPUR) Study continues to expand and now has more than 300 participants enrolled on study drugs, more than 100 sites in 20 states, new partnerships, and a -revised protocol to lower the age of eligibility. Recently, eight new centers in 36...

issues in oncology
survivorship

Second Cancers May Be Deadlier in Child, Adolescent, and Young Adult Patients

Second cancers in children and adolescents and young adults (AYAs) are far deadlier than they are in older adults and may partially account for the relatively poor outcomes of cancer patients between the ages of 15 and 39 overall, a new study by researchers at the University of California, Davis...

breast cancer

Neoadjuvant Studies of Endocrine Approaches in Breast Cancer Mandated Before Embarking on Large Adjuvant Studies

Largely based on studies demonstrating that letrozole can suppress plasma estradiol levels to a greater extent than anastrozole,1 the adjuvant activity of these endocrine agents were compared in 4,136 patients with node-positive breast cancer in the FACE trial. As reviewed in this issue of The ASCO ...

hematologic malignancies

Autologous and Allogeneic Hematopoietic Cell Transplantation

HERE ARE SEVERAL ABSTRACTS selected from the proceedings of the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition, highlighting clinical trials on autologous and allogeneic hematopoietic cell transplantation for various hematologic malignancies. Additional selected...

issues in oncology

What About Sharing Clinical Data?

IN RESPONSE to a question during the Lurie Cancer Center OncoSET Symposium about sharing clinical data, Warren Kibbe, PhD, Acting Deputy Director of the National Cancer Institute, acknowledged “it is still very problematic,” but “there is an opportunity for meaningful use.” He said that the...

solid tumors
genomics/genetics
hematologic malignancies

Update on NCI Projects Aimed at Advancing Precision Medicine

“PRECISION MEDICINE will lead to fundamental understanding of the complex interplay among genetics, epigenetics, nutrition, environment and clinical presentation, and direct effective, evidence-based prevention and treatment. We can’t measure all that all at once right now, but we are starting to...

breast cancer

Expert Point of View: Leisha A. Emens, MD, PhD

STUDY DISCUSSANT Leisha A. Emens, MD, PhD, of Bloomberg~Kimmel Institute for Cancer Immunotherapy at Johns Hopkins University, Baltimore, entitled her remarks, “Target Practice in Triple-Negative Breast Cancer,” referring to the fact that there is currently no validated target in this aggressive...

lung cancer

Retreatment With Checkpoint Inhibitors May Be Feasible for Some Patients With NSCLC

INCREASING NUMBERS of patients are being treated with checkpoint inhibitors, and about one-quarter to one-third will develop immune-related adverse events. One question on the minds of oncologists is can these patients be safely re-treated once their adverse events resolve?  One of the first...

Big Data and the Learning Machine

BOOKMARK Title: The Master Algorithm: How the Quest for the Ultimate Learning Machine Will Remake Our WorldAuthor: Pedro DomingosPublisher: Beacon PressPublication date: February 2017Price: $24.95, hardcover, 288 pages Technology is revolutionizing our understanding and treatment of diseases....

prostate cancer

I Reject the Notion I’m on a Cancer Journey

I was diagnosed with stage IV prostate cancer in 2002. I had no idea the disease and its treatment would cause me to gain more than 50 pounds and nearly cripple me with pain. I had a transurethral resection of the prostate following my diagnosis and have had multiple testosterone-suppression...

colorectal cancer

FDA Grants Marketing Approval to the Praxis Extended RAS Panel

On June 29, the U.S. Food and Drug Administration (FDA) granted marketing approval to the Praxis Extended RAS Panel, a next-generation sequencing test to detect certain genetic mutations in RAS genes in tumor samples of patients with metastatic colorectal cancer. The test is used to aid in the...

issues in oncology

Annual Report to the Nation: Cancer Death Rates Continue to Decline

Overall cancer death rates continue to decrease in men, women, and children for all major racial and ethnic groups, according to the latest Annual Report to the Nation on the Status of Cancer, 1975–2014, published by Jemal et al in the Journal of the National Cancer Institute.1 The report finds...

pain management
supportive care

Pediatric Cancer Pain May Be Misunderstood and Largely Undertreated

Cancer pain in children poses certain unique challenges. Over the past decade, insightful research into pediatric cancer pain has focused on pain management that incorporates nonopioid therapies into standard care. To shed light on this important issue, The ASCO Post spoke with Christine T....

multiple myeloma

CAR T-Cell Therapy in Multiple Myeloma Yields 100% Response Rate

Chinese investigators reported that 100% of patients with relapsed or refractory multiple myeloma responded to autologous chimeric antigen receptor (CAR) T-cell therapy, and 14 of 19 (74%) who were followed for a median of 4 months achieved a stringent complete response and have not recurred.1...

supportive care

New Supportive Care Resources From NCCN Help Patients With Cancer Confront Distress

All patients with cancer experience some level of distress associated with their cancer diagnosis and the effects of the disease and its treatment—regardless of the stage of disease. Not only does distress affect a patient’s mental and psychosocial well-being, but because distress is a risk...

issues in oncology

Overcoming Sexism in Academic Medicine

The troubling results from a survey1 investigating the sexual harassment and discrimination experiences of academic medical faculty show that such incidents continue to happen with unexpected frequency despite increasing awareness of the problem. The study by Reshma Jagsi, MD, DPhil, and...

cost of care

The Emperor’s New Clothes: Biosimilars and Cost in Oncology

Biosimilars are biologic products similar to the parent (branded) molecule in structure and function—such as erythropoietin and filgrastim (Neupogen).1 To truly bend the cost curve, we want to see a dramatic economic savings achieved as oncology biosimilars for rituximab (Rituxan), trastuzumab...

myelodysplastic syndromes

High-Risk Mutations Predict Poor Outcomes for Patients With Myelodysplastic Syndromes Undergoing Transplantation

Although several treatment options are available for patients with myelodysplastic syndromes (MDS), hematopoietic stem cell transplantation (HSCT) remains the only curative therapy.1 The risks of complications and death from transplantation can be substantial. Determining which patients may...

breast cancer

Pembrolizumab Moving Forward in Triple-Negative Breast Cancer

In the treatment of triple-negative breast cancer, checkpoint inhibition is making inroads in both early- and late-stage disease, and the line of treatment and expression of the programmed cell death ligand 1 (PD-L1) could be important in determining outcomes, according to studies reported at the...

breast cancer

Scalp Cooling to Prevent Chemotherapy-Induced Alopecia: Is It Now Ready for Prime Time?

In oncology, sometimes we forget about the small, everyday things that can significantly impact a patient’s life. When patients are explained the side effects of chemotherapy and chemotherapy-induced alopecia, most women will cry or become visibly upset. When a woman loses her hair, it represents...

palliative care
supportive care

Understanding the Cultural Differences Among Ethnic Minorities in Palliative and End-of-Life Care

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development.   Because cultural origins...

leukemia

Idelalisib in Resistant CLL: Benefit Shown, Questions Remain

As reported in The Lancet Oncology by Dr. Andrew Zelenetz and colleagues and reviewed in this issue of The ASCO Post, an international phase III trial in 416 patients with refractory or recurrent chronic lymphocytic leukemia (CLL) addressed the benefit of adding the first-in-class phosphoinositide...

health-care policy

FDA Unveils Plan to Eliminate Orphan Designation Backlog

Today, the U.S. Food and Drug Administration (FDA) unveiled a strategic plan to eliminate the agency’s existing Orphan Drug designation request backlog and ensure continued timely response to all new requests for designation with firm deadlines. The agency’s Orphan Drug Modernization...

health-care policy

FDA Takes Steps to Increase Drug Competition to Improve Patient Access

On June 27, the U.S. Food and Drug Administration (FDA) took two new, important steps to increase competition in the market for prescription drugs and facilitate entry of lower-cost alternatives. The agency published a list of off-patent, off-exclusivity branded drugs without approved generics, and ...

colorectal cancer

Underused Blood Test Could Improve Treatment for Large Swath of Patients With Colon Cancer

A simple blood test could improve treatment for more than one in six patients with stage II colon cancer, suggests new research from the Mayo Clinic. Researchers also discovered that many patients who could benefit from the test likely aren’t receiving it. These findings were published by...

leukemia

EHA 2017: Half of Chronic-Phase Philadelphia Chromosome–Positive CML Patients Stay in Treatment-Free Remission 2 Years After Stopping Nilotinib

New data from two clinical trials—ENESTfreedom and ENESTop—demonstrates that approximately half of adult patients with Philadelphia chromosome–positive chronic myeloid leukemia (CML) in the chronic phase, were able to maintain treatment-free remission after stopping treatment with ...

issues in oncology

Biden Cancer Initiative Launches

On June 26, at the Alexandria Center for Life Science, Vice President Joe Biden and Dr. Jill Biden launched the Biden Cancer Initiative, their new venture to continue the fight to make progress in cancer prevention, detection, treatment, and care. Initiative Overview The Biden Cancer Initiative...

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