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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,...
When Illness and Culture Collide
“‘Sickness’ is what is happening to the patient. Listen to him. Disease is what is happening to science and to populations.” —Lawrence Weed, MD, 1978 America’s massive health-care system is highly complex, with its own unique language, methods, technologies, and scientific approaches, developed and ...
Electronic ‘Datarrhea’ and Wellness
THE INTRODUCTION of the electronic health record (EHR) was supposed to lead us to a utopian world for health-care delivery in America. The Patient Protection and Affordable Care Act, signed into law on March 23, 2010, promoted its implementation by providing financial incentives.1 The Centers for...
The Abscopal Effect: A Reemerging Field of Interest
For the past 50 years or more, oncologists have designed their treatment plans around the three pillars: surgery, chemotherapy, and radiation. Now, with a series of recent successes, immunotherapy is rapidly reemerging as the fourth pillar in the oncologic armamentarium. Despite major advancements...
Iobenguane I-131 for Advanced Pheochromocytoma or Paraganglioma
ON JULY 30, 2018, the radiotherapeutic agent iobenguane I-131 (Azedra) was approved for the treatment of adult and pediatric patients (aged ≥ 12 years) with iobenguane scan–positive, unresectable, locally advanced or metastatic pheochromocytoma or paraganglioma who require systemic anticancer...
FDA Approves Elotuzumab Plus Pomalidomide and Dexamethasone for Relapsed or Refractory Multiple Myeloma
ON NOVEMBER 6, 2018, following Priority Review, the U.S. Food and Drug Administration (FDA) approved elotuzumab (Empliciti) injection for intravenous use in combination with pomalidomide (Pomalyst) and dexamethasone for the treatment of adult patients with multiple myeloma who have received at...
2019 ASCO Election Candidates
The ASCO Nominating Committee has selected 15 distinguished ASCO members as candidates for open leadership positions within the Society, including: The office of President-Elect Three seats on the Society’s Board of Directors Three seats on the Nominating Committee Biographical information and...
Your Voice Matters: Vote in the ASCO Election by December 3
Each year, we call upon the ASCO members to place their votes to select our Society’s future leaders. This year, we are asking that you not only vote for the open leadership positions, but also for a proposed bylaw change. ASCO’s mission is more urgent than ever in today’s landscape of fast-moving ...
Cemiplimab-rwlc for Metastatic or Locally Advanced Cutaneous Squamous Cell Carcinoma
On September 28, 2018, cemiplimab-rwlc (Libtayo) was approved for the treatment of patients with metastatic cutaneous squamous cell carcinoma or locally advanced cutaneous squamous cell carcinoma who are not candidates for curative surgery or curative radiation.1 Supporting Efficacy Data Approval...
Patients With Cancer in Rural America Remain Underserved
Despite growing national awareness of health-care inequities, the plight of rural Americans diagnosed with cancer has persistently remained inadequate. Speaking with The ASCO Post, Jan Probst, PhD, Professor at the Arnold School of Public Health, University of South Carolina, Columbia, noted, “We...
Duvelisib in Resistant Chronic Lymphocytic Leukemia: Expanding the Treatment Armamentarium
The phase III DUO trial, reported by Flinn et al and reviewed in this issue of The ASCO Post, has led to the U.S. Food and Drug Administration (FDA) approval of a novel B-cell receptor (BCR) kinase inhibitor, duvelisib (Copiktra), which targets phosphoinositide 3-kinase (PI3K)-δ/γ in patients...
Duvelisib vs Ofatumumab in Relapsed or Refractory CLL/SLL
As reported in Blood by Ian W. Flinn, MD, PhD, Director of the Lymphoma Research Program at Sarah Cannon Research Institute, and colleagues, the phase III DUO trial has shown significantly prolonged progression-free survival with the phosphoinositide 3-kinase (PI3K)-δ/γ inhibitor duvelisib...
Dacomitinib for Metastatic EGFR-Mutant NSCLC
On September 27, 2018, dacomitinib (Vizimpro) received approval for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R substitution mutations, as detected by a test approved by the...
Ibrutinib Plus Rituximab in Adult Patients With Waldenström’s Macroglobulinemia
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 August 27, 2018, ibrutinib (Imbruvica) was approved...
Azacitidine Plus Nivolumab in Relapsed or Refractory AML
A combination of the chemotherapy drug azacitidine with the immune checkpoint inhibitor nivolumab (Opdivo) demonstrated an encouraging response rate and overall survival in patients with relapsed or refractory acute myeloid leukemia (AML), according to findings from a phase II study published...
Neoadjuvant Chemotherapy vs Upfront Debulking Surgery in Advanced Tubo-Ovarian Cancer
As reported in The Lancet Oncology by Vergote et al, a pooled analysis of individual patient data in long-term follow-ups of the phase III EORTC 55971 and CHORUS trials indicated that overall survival is similar with neoadjuvant therapy vs upfront debulking surgery in advanced tubo-ovarian cancer....
Steven A. Rosenberg, MD, PhD, Works to Unmask Cancer’s Achilles Heel
Steven A. Rosenberg, MD, PhD, knew from the start of his medical career that if treatments for cancer were to become curative, research in new therapies would have to move away from the mainstay one-size-fits-all approach of systemic chemotherapy to an innovative, personalized strategy that...
ASTRO/ASCO/AUA Guideline for Early-Stage Prostate Cancer Supports Use of Hypofractionated Radiotherapy
Three prominent medical organizations have issued a new clinical guideline for physicians treating men with early-stage prostate cancer using external-beam radiation therapy (EBRT). Developed by a panel of experts from the American Society for Radiation Oncology (ASTRO), ASCO, and the American...
Building Improved and Sustainable Health-Care Systems Through Telemedicine
Telemedicine—the remote diagnosis and treatment of patients via telecommunications technology—has changed the way oncology care is delivered in rural parts of the world. Patients in rural areas are now able to connect remotely with their physicians without having to deal with the time, expense, and ...
Study Identifies Suitable Partner for Bevacizumab in Recurrent Ovarian Cancer
For patients with recurrent ovarian cancer who receive platinum-based retreatment, the more suitable partner for bevacizumab (Avastin) may be carboplatin plus pegylated liposomal doxorubicin, rather than carboplatin and gemcitabine, according to the results of a phase III ENGOT/GCIG Intergroup...
Expert Point of View: Caroline Robert, MD, PhD
The paper’s invited discussant, Caroline Robert, MD, PhD, of the Institut de Cancérologie Gustave Roussy, Villejuif, France, said OpACIN-neo attained its goal of reducing toxicity and maintaining efficacy. The regimen of two courses of ipilimumab (Yervoy) at 1 mg/kg plus nivolumab (Opdivo) at 3...
Neoadjuvant Therapy With Reduced-Dose Immunotherapy for Stage III Melanoma
In patients with stage III melanoma, a reduced-dose neoadjuvant immunotherapy combination was well tolerated and led to high pathologic response rates, in the phase II OpACIN-neo trial presented at the European Society for Medical Oncology (ESMO) 2018 Congress.1 “Neoadjuvant ipilimumab (Yervoy) at...
Treatment With Radium-223 Plus Abiraterone Not Advisable in Metastatic Prostate Cancer
The combination of radium-223 plus AAP (abiraterone acetate [Zytiga] and prednisone) was not superior to placebo plus AAP in the phase III ERA 223 trial, which enrolled men with asymptomatic bone-predominant metastatic castration-resistant prostate cancer.1 Patients treated with the combination had ...
Immunotherapy and Tyrosine Kinase Inhibitor Combination in Advanced Renal Cell Carcinoma
In the JAVELIN Renal 101 phase III study, the combination of the immune checkpoint inhibitor avelumab (Bavencio), a programmed death ligand-1 (PD-L1) blocking antibody, plus the tyrosine kinase inhibitor axitinib (Inlyta) significantly improved progression-free survival in previously untreated...
Phase III Study Supports Use of Cisplatin Over Cetuximab in HPV-Positive Oropharyngeal Cancer
In the United States and European countries, many oncologists are using cetuximab (Erbitux)/radiotherapy instead of cisplatin/radiotherapy in the treatment of human papillomavirus (HPV)-positive oropharyngeal cancer, based on the belief that cetuximab is equally effective with less toxicity than...
Pembrolizumab Improves Survival in Advanced Head and Neck Cancer
An overall survival advantage has now been shown for first-line immunotherapy in recurrent or metastatic head and neck cancer, researchers reported at the European Society for Medical Oncology (ESMO) 2018 Congress.1 In the phase III KEYNOTE-048 trial, treatment with the anti–programmed cell death...
Expert Point of View: Julien Taieb, MD, PhD
The invited discussant for the CheckMate-142 findings was Julien Taieb, MD, PhD, Professor of Medicine at Paris Descartes University in France. Dr. Taieb called the findings “impressive” but said longer follow-up is needed, especially since median outcomes have not yet been reached. After a...
First-Line Immunotherapy Shows Benefit in Metastatic Colorectal Cancer Subset
In previously untreated patients with metastatic colorectal cancer and tumors demonstrating microsatellite instability–high (MSI-high) or mismatch repair deficiency (dMMR), immunotherapy with nivolumab (Opdivo) and low-dose ipilimumab (Yervoy) produced a durable clinical benefit in the...
ACS Report Looks at Ways to Improve Outcomes for Cancer Survivors and Caregivers
Growing numbers of cancer survivors, provider shortages, rising health-care costs, and socioeconomic disparities in health outcomes have created an urgent need to provide coordinated, comprehensive, personalized care for cancer survivors. A new report from the American Cancer Society (ACS) creates...
Neoadjuvant Immunotherapy Yields Major Response in Colon Cancer Subset
In a small study of patients with early-stage colon cancer, neoadjuvant ipilimumab (Yervoy) plus nivolumab (Opdivo) produced major pathologic responses in 100% of patients with mismatch repair (MMR)-deficient tumors but in none of the patients with MMR-proficient tumors, researchers reported at the ...
Adding Pelvic Node Radiation and Short-Term Hormone Therapy to Salvage Radiation Provides Significant Benefit in Prostate Cancer
For patients with prostate cancer who have persistent or rising prostate-specific antigen (PSA) levels after radical prostatectomy, the addition of short-term androgen-deprivation therapy and radiotherapy to the pelvic lymph nodes demonstrated increased rates of freedom from disease progression,...
Adverse Mental Health Outcomes in Breast Cancer Survivors
In a systematic review of the literature reported in the Journal of the National Cancer Institute, Carreira et al found that most evidence strongly supports increased risk of anxiety, depression, neurocognitive dysfunction, and other forms of psychological issues in survivors of breast...
Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC
In a global phase II study reported in The Lancet Oncology, Solomon et al found that lorlatinib (Lorbrena) showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were treatment-naive or who had received crizotinib (Xalkori)...
Sequential vs Combination Fluoropyrimidine, Irinotecan, and Bevacizumab in Metastatic Colorectal Cancer
In a German phase III noninferiority trial (XELAVIRI) reported by Modest et al in the Journal of Clinical Oncology, noninferiority of first-line sequential vs combination fluoropyrimidine, irinotecan, and bevacizumab (Avastin) was not demonstrated in metastatic colorectal cancer (CRC). Benefit of...
Radiotherapy Reduces Risk of Recurrence by More Than 70% in Some Patients With Ductal Carcinoma in Situ
Radiation therapy after breast-conserving surgery reduced the already-low risk of recurrence by more than 70% in patients with defined “good-risk” breast cancer, according to a long-term clinical trial report presented at the 2018 Annual Meeting of the American Society for Radiation Oncology...
Lung Cancer Screening: Proven Effective but Still Fighting for Acceptance
In 2010, the long-awaited findings from the National Lung Screening Trial (NLST) revealed that participants who received low-dose helical computed tomography (CT) scans had a 15% to 20% lower risk of dying of lung cancer than participants who received standard chest x-rays. In response, the U.S....
Expert Point of View: Nadia Harbeck, MD, PhD, and Fatima Cardoso, MD
Serving as European Society for Medical Oncology (ESMO) expert at a press briefing, Nadia Harbeck, MD, PhD, Head of the Breast Center at the University of Munich, called the findings “practice-changing” in some parts of the world and “practice-reinforcing” in others. She said the 10-month...
Impact of Palbociclib on Survival in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer
Much anticipated overall survival data for palbociclib (Ibrance) plus fulvestrant (Faslodex) in advanced breast cancer were presented at the European Society for Medical Oncology (ESMO) 2018 Congress.1 Although overall survival in PALOMA-3 was not designed to detect a statistically significant...
NCRI 2018: HiLo Trial: Rate of Thyroid Cancer Recurrence After Adjuvant Lower-Dose Radiation
Patients with thyroid cancer whose disease is at low risk of returning can be treated safely with a smaller amount of radiation following surgery, according to results from the HiLo trial presented by Wadsley et al at the 2018 National Cancer Research Institute (NCRI) Cancer Conference (Abstract...
NCRI 2018: Mortality in Men With Malignant Melanoma
The rate of men dying from malignant melanoma has risen in populations around the world, whereas in some countries, mortality rates for the disease are steady or falling for women, according to research presented by Yang et al at the 2018 National Cancer Research Institute (NCRI) Cancer Conference...
Neoadjuvant Chemotherapy With vs Without Anthracyclines Plus Dual HER2 Inhibitors in HER2-Positive Breast Cancer
In the Dutch Breast Cancer Research Group’s phase III TRAIN-2 trial reported in The Lancet Oncology, van Ramshorst et al found no difference in pathologic complete response rate with neoadjuvant chemotherapy with vs without an anthracycline plus dual HER2 blockade in women with HER2-positive...
ME STRONG Joins With ASCO’s Conquer Cancer Foundation to Support Research for Men’s Cancers and Neuroblastoma
ME STRONG, a nonprofit public charity in Deland, Florida, is one of the newest supporters of Conquer Cancer. Linda Ryan, ME STRONG co-founder and 16-year cancer survivor, understands the importance of research: it saved her life decades ago, and she’s relying on experimental treatment as she...
First Oncology Practice in Romania Certified by U.S. Quality Cancer Care Program
THE NUMBER of international practices certified in delivering high-quality cancer care based on rigorous standards established by ASCO is increasing. The Medisprof Cancer Center in Romania joins six other practices in Brazil, Greece, and Spain in achieving ASCO’s Quality Oncology Practice...
CONVERT Trial: Concurrent Chemoradiotherapy to Treat Elderly Patients With Limited-Stage SCLC
Elderly patients with limited-stage small cell lung cancer (SCLC) showed similar survival and toxicity compared to younger patients when treated with concurrent chemoradiotherapy. These study findings were published by Christodoulou et al in the Journal of Thoracic Oncology. SCLC constitutes ...
Outcomes in Melanoma With Active Brain Metastases After Treatment With Pembrolizumab
As reported in the Journal of Clinical Oncology by Kluger et al, pembrolizumab (Keytruda) showed activity in brain metastases in patients with melanoma enrolled in a phase II study. The study included 23 patients with melanoma with one or more asymptomatic untreated 5- to 20-mm brain metastasis...
Dysregulation of Immune Pathways in AML Relapse After Allogeneic HSCT
In a study reported in The New England Journal of Medicine, Christopher et al found that acute myeloid leukemia (AML) relapse after allogeneic hematopoietic stem cell transplantation (HSCT) was accompanied by dysregulation of immune pathways, including downregulation of major histocompatibility...
Durvalumab With or Without Tremelimumab in Recurrent or Metastatic HNSCC With Low/No PD-L1 Expression
In a randomized phase II trial reported in JAMA Oncology, Siu et al found that the combination of the programmed cell death ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) plus the cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) inhibitor tremelimumab and durvalumab alone showed evidence ...
PERSIST-5: 5-Year Adjuvant Imatinib in Resected Intermediate- or High-Risk Primary Gastrointestinal Stromal Tumor
In the phase II PERSIST-5 study reported in JAMA Oncology, Raut et al found that 5 years of adjuvant imatinib therapy was associated with little risk of recurrence in patients with resected intermediate- or high-risk primary gastrointestinal stromal tumor (GIST). As noted by the investigators, 3...
Patient-Reported Cosmetic Outcomes With Radiotherapy in Early Breast Cancer
As reported in the Journal of Clinical Oncology by Shaitelman et al, 3-year outcomes of a phase III noninferiority trial indicate that hypofractionated whole-breast irradiation (HF-WBI) followed by a tumor bed boost is not inferior to conventionally fractionated whole-breast irradiation (CF-WBI)...
Molecular and Clinical Heterogeneity in Histologically Diagnosed CNS-PNET
As reported by Hwang et al in the Journal of Clinical Oncology, subsequent molecular profiling of histologically diagnosed central nervous system supratentorial primitive neuroectodermal tumors (CNS-PNET) in patients showed molecular and clinical heterogeneity that strongly affected prognosis. The ...
