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issues in oncology
pain management

EXPECT QUESTIONS ABOUT THE RISK OF OPIOID ADDICTION

INTENSE MEDIA COVERAGE of the opioid crisis has ranged from the dire statistics of addiction and death to some hopeful stories of treatment and recovery, but what may raise questions and concerns are the reports of people who start with a prescription opioid and then in a few weeks or months are...

pain management

Relieving Pain During an Opioid Epidemic

“WE’VE GOT A CHALLENGING TIME right now, trying to relieve pain during the time of an opioid epidemic,” Judith A. Paice, RN, PhD, acknowledged at the 2017 Lynn Sage Breast Cancer Symposium in Chicago.1 She cited a recent study reporting that up to 40% of cancer survivors are living with pain, and...

Luigi Naldini, MD, PhD, and Marina Cavazzana, MD, PhD, to Present 2017 ASH Ernest Beutler Lecture

THE AMERICAN SOCIETY OF HEMATOLOGY (ASH) will honor Luigi Naldini, MD, PhD, of the San Raffaele Telethon Institute for Gene Therapy in Milan, and Marina Cavazzana, MD, PhD, of Paris Descartes University, Necker-Enfants Malades Hospital, and Imagine Institute of Genetic Diseases, AP-HP, Inserm in...

hematologic malignancies

Recent Study Findings in Hematologic Malignancies

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 clonal myeloid disorders, acute lymphoblastic leukemia, lymphoma, and plasma cell dyscrasias.  Clonal Myeloid Disorders  STUDY:...

NIH Partners With 11 Biopharmaceutical Companies on PACT Collaboration

On October 12, 2017, the National Institutes of Health (NIH) and 11 leading biopharmaceutical companies launched the Partnership for Accelerating Cancer Therapies (PACT), a 5-year public-private research collaboration totaling $215 million as part of the Cancer Moonshot. PACT will initially focus...

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

Experts Address Cancer Health Disparities in Facebook Live Session at AACR Meeting

Although it has long been known that certain cancer types disproportionately affect individuals from underserved and underrepresented populations, the sources of these disparities are still not entirely clear. In a “Facebook Live” session at the 2017 American Association for Cancer Research (AACR)...

Susan G. Komen Launches Crowdfunding Initiative to Support Metastatic Breast Cancer Research

Individuals and organizations looking to contribute to advancements in metastatic breast cancer research can now do so by participating in Susan G. Komen’s inaugural crowdfunding initiative. Through this initiative, donors have the opportunity to contribute directly to the pioneering work of four...

solid tumors
breast cancer

Gene-Expression Assays in Early-Stage Breast Cancer: Who Should Order Them and When?

A deeper understanding of biology has allowed significant advances in the treatment of breast cancer. In the early-stage setting, standard pathology measures can help identify which subset of patients with hormone receptor–positive breast cancers are more likely to experience benefit from...

solid tumors
breast cancer

Genomic Profiling With Multidisciplinary Collaboration: Improving Breast Cancer Outcomes Through Timely Chemotherapy Initiation

As reviewed in this issue of The ASCO Post, Losk and colleagues from Dana-Farber/Brigham and Women’s Cancer Center report their institution’s implementation of a protocol of surgeon-initiated genomic profiling of estrogen receptor–positive tumors in women with early breast cancer that resulted in ...

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...

supportive care
palliative care
cost of care
issues in oncology

Palliative Care Intervention Reduces Total Health-Care Costs in Patients With Advanced Cancer

A matched case-controlled study among Medicare beneficiaries with metastatic lung, colorectal, breast, and prostate cancers has found that palliative care consultation significantly reduced total health-care costs following intervention. According to data presented at the 2017 Palliative and...

supportive care
palliative care

Digital Palliative Care Curriculum Improves Knowledge, Skills, and Opioid Prescribing Behavior

A new electronic curriculum delivered via e-mail with push technology may provide an efficient, cost-effective solution to the shortage of palliative care faculty serving the nation’s oncology fellowship programs. According to data presented at the 2017 Palliative and Supportive Care in Oncology...

supportive care
palliative care

Early Integrated Palliative Care Improves Patient Coping Strategies, Quality of Life, and Symptoms of Depression

A new study has shed light on how palliative care interventions may improve patient outcomes. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 patients with incurable cancer who received early integrated palliative care had an increased use of active...

issues in oncology

Informed Consent and the Oncologist: Legal Duties to Discuss Costs of Treatment

For 50 years, clinicians in the United States have had a legal duty to disclose to patients with cancer the risks, benefits, and alternatives to a proposed cancer treatment. Until recently, however, it has been unclear whether clinicians have a similar duty to discuss the costs of that treatment....

Stephanie Lee, MD, MPH, Elected ASH Vice President; Two Councillors Appointed to 4-Year Terms

THE AMERICAN SOCIETY OF HEMATOLOGY (ASH) has elected Stephanie Lee, MD, MPH, a member of the Clinical Research Division at Fred Hutchinson Cancer Research Center (Fred Hutch), as its Vice President. Dr. Lee will begin her 1-year term after the 2017 ASH Annual Meeting & Exposition in December...

genomics/genetics

Role of the E7 Gene in High-Risk HPV

NATIONAL CANCER INSTITUTE (NCI) researchers have found that for the most common high-risk type of human papillomavirus (HPV) to cause cervical cancer, an important viral gene may need to have a precise DNA sequence. The findings, published by Mirabello et al in Cell,1 contribute to a better...

issues in oncology

Fleeing a Revolution, Becoming an Oncologist

Nicaragua, situated between Costa Rica and Honduras, is the poorest country in Central America. Following the U.S. occupation in 1912, the Somoza family began a brutal political dynasty that would end in 1979 during the bloody Nicaraguan Revolution.  Marcela G. del Carmen, MD, MPH, Chief Medical...

integrative oncology
symptom management

Cognitive Behavior Therapy for Insomnia: Sleeping Well With Cancer and Beyond

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Sheila N. Garland, PhD, R Psych, and Jun J. Mao, MD, MSCE, present...

ACCC Honors Barbara L. McAneny, MD, FASCO, MACP, With Annual Achievement Award

In recognition of her work in value-based care, Barbara McAneny, MD, FASCO, MACP, was honored with the Annual Achievement Award of the Association of Community Cancer Centers (ACCC). Her work in developing the grant-funded COME HOME oncology medical home initiative demonstrated reduced costs and...

New Head Named to Fred Hutch Cancer Prevention Program

On October 1, 2017, nutritional epidemiologist Marian Neuhouser, PhD, RD, became head of the Cancer Prevention Program in the Public Health Sciences Division at the Fred Hutchinson Cancer Research Center (Fred Hutch). She replaces Acting Program Head Johanna Lampe, PhD, RD, Associate Director of...

solid tumors
gastrointestinal cancer

Pembrolizumab in Advanced Gastric Cancer

On September 22, 2017, pembrolizumab (Keytruda) was granted accelerated approval for treatment of recurrent locally advanced or metastatic, gastric or gastroesophageal junction adenocarcinoma with tumors expressing programmed cell death ligand 1 (PD-L1), as determined by a U.S. Food and Drug...

breast cancer

Long-Term Risk of Breast Cancer Recurrence After 5 Years of Endocrine Therapy

In a meta-analysis reported in The New England Journal of Medicine by Pan et al for the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG), it was found that breast cancer recurs at a steady incidence following cessation of adjuvant endocrine therapy after 5 years, with the risk...

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...

Restorative Effects of Painting Offset the Demands of Oncology

Oncologists are apt to give patients the worst news of their lives: You have cancer. Yet studies show that, by and large, despite the stressful aspects of treating people with a life-threatening disease, oncologists report one of the highest percentages of professional satisfaction among medical...

Expert Point of View: Eric Van Cutsem, MD, PhD

Invited discussant Eric Van Cutsem, MD, PhD, of the University Hospitals Leuven in Belgium, put the JACOB trial findings in context of what is known for HER2-positive metastatic gastric/gastroesophageal junction cancer, where two targeted agents are approved: trastuzumab (Herceptin) in the first...

genomics/genetics
solid tumors
lymphoma
multiple myeloma

Update on NCI-MATCH Precision Medicine Trial

THE NATIONAL CANCER INSTITUTE (NCI) Molecular Analysis for Therapy Choice (MATCH) clinical trial has achieved the goal of screening nearly 6,000 patients in just under 2 years, according to data presented at the 2017 American Association for Cancer Research–NCI–European Organisation for Research...

hematologic malignancies

A Pioneer in Bloodless Transplant Discusses Advances in Blood Management

Bloodless stem cell transplantation, performed without the transfusion of allogeneic blood or blood products, has numerous clinical advantages, especially among populations of patients who prefer, for religious or other reasons, no blood methods of medical and surgical treatment. Patricia A. Ford, ...

lymphoma

FDA Approves CAR T-Cell Therapy for Adults With Certain Types of Large B-Cell Lymphoma

ON OCTOBER 18, the U.S. Food and Drug Administration (FDA) approved axicabtagene ciloleucel (Yescarta), a cell-based gene therapy, to treat adult patients with certain types of large B-cell lymphoma who have not responded to or who have relapsed after at least two other kinds of treatment....

IDEA Trial: ‘Going Beyond Statistics’ in Stage III Colon Cancer

According to Alberto Sobrero, MD, Head of Medical Oncology at Ospedale San Martino in Genova, Italy, the results of the pivotal IDEA trial, which evaluated the optimal duration of adjuvant chemotherapy for stage III colon cancer, were not clear to clinicians.1 The combined analysis of six...

Expert Point of View: Hope S. Rugo, MD

The Formal discussant of this presentation, Hope S. Rugo, MD, of the University of California, San Francisco, said, “Tailoring treatment to biology results in incremental improvements in outcome.” She continued: “This analysis gives us excellent data on the natural history of mostly hormone...

skin cancer

Melanoma Mutations: What You Need to Know

CLINICIANS ARE now well acquainted with BRAF mutations in advanced melanoma, but there is more to genomics in this disease than identifying BRAF and prescribing a BRAF inhibitor.  At the 2017 Debates and Didactics Conference, held at Sea Island, Georgia, Melinda L. Yushak, MD, MPH, of Emory...

This #GivingTuesday, Help Conquer Cancer

TUESDAY, NOVEMBER 28, marks the 6th consecutive year of #GivingTuesday, a global day of giving that celebrates philanthropy. Taking place on the heels of Black Friday and Cyber Monday, #GivingTuesday serves as a reminder that the holiday season is about giving back as well as giving gifts.  Those...

solid tumors
breast cancer

About One in Four Women With Small Breast Tumors May Benefit From Chemotherapy

A large subset analysis of the MINDACT trial suggests that oncologists may be undertreating women with small (< 1 cm) node-negative breast tumors, which are clinically considered to be low risk but can be genomically high risk. About one in four women with small node-negative breast tumors <...

Cast Your Vote in ASCO Election by December 4

The ASCO Nominating Committee, which is itself elected by ASCO members, is charged with selecting candidates for future Society leadership. This job is both a great pleasure and a real challenge, since ASCO has so many dedicated members who have the desire, insight, and ability to lead our...

Expert Point of View: Nadia Harbeck, MD, PhD

Invited discussant Nadia Harbeck, MD, PhD, Head of the Breast Center of the University of Munich (LMU), Germany, said the UNICANCER-NeoPAL trial points toward the future of endocrine therapy in early breast cancer—using cyclin-dependent kinase 4/6 (CDK4/6) inhibitors as a means of “enhancing” this ...

breast cancer

Antidepressant for Aromatase Inhibitor–Associated Arthralgia in Early-Stage Breast Cancer

The phase III SWOG S1202 trial has shown benefit of the antidepressant agent duloxetine in reducing aromatase inhibitor–associated joint pain in women with early-stage breast cancer. These results were reported in the Journal of Clinical Oncology by Henry et al. Study Details In the...

colorectal cancer

ESMO Asia 2017: AXEPT Trial: New Second-Line Therapy for Metastatic Colorectal Cancer Is Effective and Safe

A randomized trial in 650 patients has confirmed the safety and efficacy of a new second-line treatment for metastatic colorectal cancer, researchers reported at the European Society for Medical Oncology (ESMO) Asia 2017 Congress (Abstract LBA3_PR). Oral fluorinated pyrimidines have been...

solid tumors
breast cancer

Pathologic Complete Response Rates Not Improved With Neoadjuvant Letrozole/Palbociclib

As neoadjuvant treatment of women with high-risk luminal breast cancer, the combination of letrozole and palbociclib (Ibrance) did not reduce the residual cancer burden or improve the rates of breast-conserving surgery, in the phase II UNICANCER- NeoPAL study presented at the 2017 European Society ...

solid tumors
lung cancer

Brigatinib in Crizotinib-Pretreated Metastatic ALK-Positive Non–Small Cell Lung Cancer

On April 28, 2017, brigatinib (Alunbrig) was granted accelerated approval for the treatment of patients with metastatic anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC) who have had disease progression on or are intolerant to crizotinib (Xalkori).1,2 Supporting Efficacy...

solid tumors
lung cancer

Dabrafenib and Trametinib in BRAF V600E–Mutant Metastatic NSCLC

On June 22, 2017, regular approvals were granted to dabrafenib (Tafinlar) and trametinib (Mekinist) given in combination for the treatment of patients with metastatic non–small cell lung cancer (NSCLC) with BRAF V600E mutation as detected by a U.S. Food and Drug Administration (FDA)-approved...

Stand Up To Cancer Launches ‘Cancer Interception’ Teams to Detect and Treat Cancer at Earliest Stages

Stand Up To Cancer, joined by the Lustgarten Foundation for Pancreatic Cancer Research, LUNGevity, and the American Lung Association, announced that four teams of top researchers will study lung and pancreatic cancers using a new approach of “cancer interception” at their earliest stages. “The...

solid tumors
lung cancer

Unraveling PD-L1 Assays in NSCLC: Are They Interchangeable?

With the availability of at least five checkpoint inhibitors to treat non–small cell lung cancer (NSCLC) and other solid tumors, appropriate patient selection for these expensive treatments remains key. The hope is that testing the level of programmed cell death ligand 1 (PD-L1) expression in tumor ...

solid tumors
breast cancer

Neratinib for Extended Adjuvant Treatment of Early-Stage HER2-Positive Breast Cancer

On July 17, 2017, neratinib (Nerlynx) a dual inhibitor of HER2 and epidermal growth factor receptor (EGFR), was approved for extended adjuvant treatment of adults with early-stage HER2-overexpressed/amplified breast cancer following adjuvant trastuzumab (Herceptin)-based therapy.1,2 Supporting...

solid tumors
breast cancer

Abemaciclib in Hormone Receptor–Positive, HER2-Negative Breast Cancer

On September 28, 2017, the cyclin-dependent kinases 4 and 6 (CDK4/6) inhibitor abemaciclib (Verzenio) was approved for use in combination with fulvestrant (Faslodex) for women with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer with disease progression following...

breast cancer

Computer-Based Support May Allow Physicians to Spend More Time on ‘Human Aspects of Cancer Care’

As computer-based physician support systems for decision-making in cancer management continue to evolve, “we will come to embrace this as something that liberates us to spend more time on the human aspects of cancer care,” Andrew D. Seidman, MD, told participants at the 2017 Lynn Sage Breast Cancer ...

breast cancer

What Can We Do Differently for Premenopausal Patients With Breast Cancer?

While age remains a major risk factor for breast cancer, with nearly 80% of new cases occurring in women aged 50 years and older, women diagnosed at a younger age generally have poorer outcomes. This is partly because premenopausal women are more likely to have triple-negative breast cancer, which ...

solid tumors
breast cancer

Where Are We Now in Triple-Negative Breast Cancer?

The treatment of triple-negative breast cancer is rapidly evolving, as clinical trials continue to test chemotherapy agents and combinations and immunotherapy studies promise potentially “game-changing” interventions early in the course of disease, Joyce O’Shaughnessy, MD, reported at the 19th...

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