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lymphoma
immunotherapy

Tisagenlecleucel for Adults With Relapsed or Refractory Large B-Cell Lymphoma

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 May 1, 2018, tisagenlecleucel (Kymriah), a...

issues in oncology
cost of care
immunotherapy

Weighing the Cost and Value of CAR T-Cell Therapy

This past year’s approval by the U.S. Food and Drug Administration (FDA) of two chimeric antigen receptor (CAR) T-cell therapies heralded a new era in both effective cancer treatments and the most expensive cancer drugs ever. Tisagenlecleucel (Kymriah) was initially approved for the treatment of...

symptom management

FDA Approves First Epoetin Alfa Biosimilar for the Treatment of Anemia

On May 15, 2018, the U.S. Food and Drug Administration (FDA) approved epoetin alfa-epbx (Retacrit) as a biosimilar to epoetin alfa (Epogen/-Procrit) for the treatment of anemia caused by chronic kidney disease, chemotherapy, or use of zidovudine in patients with HIV infection. The biosimilar is...

symptom management
immunotherapy

Both Patients and Clinicians Face Challenges in Recognizing and Reporting Immune-Related Adverse Events

The publication of ASCO’s toxicity management guidelines for immune checkpoint antibodies by Brahmer and colleagues,1 reviewed in this issue of The ASCO Post, has been long awaited, considering more than 15 distinct indications have been granted by the U.S. Food and Drug Administration (FDA). The ...

symptom management
immunotherapy

ASCO Clinical Practice Guideline on Managing Immune-Related Adverse Events: Next Big Step for Immune Checkpoint Inhibitors

The publication of the ASCO clinical practice guideline for the management of immune therapy–related adverse events—reviewed in this issue of The ASCO Post—represents an important next step in the incorporation of checkpoint blocking antibodies as standard cancer treatment modalities.1 The U.S....

issues in oncology

Here’s How ASCO Is Joining With Other Organizations to Reduce Obesity and Cancer Rates

GUEST EDITOR Prevention in Oncology is guest edited by Jennifer A. Ligibel, MD, Chair of ASCO’s Energy Balance Working Group and a member of ASCO’s Cancer Survivorship and Cancer Prevention Committees. Dr. Ligibel is Director of the Leonard P. Zakim Center for Integrative Therapies at Dana-Farber...

solid tumors
prostate cancer

Ultrahypofractionated Radiotherapy for Prostate Cancer Appears Safe and Effective

Radiotherapy given in high doses over a shorter period of time is safe and effective for patients with prostate cancer, according to research from a phase III trial presented at the European Society for Radiotherapy & Oncology (ESTRO) 37 Conference.1 The treatment—called ultrahypofractionated...

solid tumors
immunotherapy

New Data on ALK Inhibitors and CAR T-Cell Therapies

The 2018 American Association for Cancer Research (AACR) Annual Meeting was abuzz with more than 22,000 attendees from around the world who came to Chicago to hear the latest in basic science and clinical trial results. Here we present summaries of a few of the highlights from the AACR meeting...

Expert Point of View: Alexander Drilon, MD

Formal discussant of the study on BLU-667, Alexander Drilon, MD, Clinical Director, Early Drug Development Service at Memorial Sloan Kettering Cancer Center, New York, was enthusiastic about these early results. “We’ve known about RET for more than 30 years. To date, no targeted therapy has been...

solid tumors

First Selective RET Inhibitor Shows Efficacy in Multiple Cancers

A first-in-human study provides proof of concept that a novel oral agent targeted to RET genetic alterations is safe and active in RET-driven cancers. The agent, called BLU-667, achieved durable disease control in patients with lung and thyroid cancers harboring the RET oncogene, according to the...

symptom management

The Pharmacist’s Role in Educating the Health-Care Team About Adverse Effects of Immune Checkpoint Inhibitors

Named by ASCO as Advance of the Year for both 2016 and 2017,1 and with more than 10 U.S. Food and Drug Administration–approved indications—and more on the way—it’s safe to say the era of cancer immunotherapy is upon us. To prepare, physicians must understand not only which patients will benefit,...

issues in oncology
cost of care

Curbing Financial Toxicity: What Might Work, and What Won’t Work

To stem the rising tide of financial toxicity in cancer care, creative physician reimbursement strategies, by themselves, will not work, according to a thought leader in the field who advocated for elimination of the federal mandate against price negotiation, curbing the power of monopolies, and...

cns cancers
immunotherapy

Treating Pediatric Glioma With Bevacizumab and Standard Treatment

Children with nonbrainstem high-grade glioma could benefit from potentially life-extending treatment if genetic testing was used to personalize therapy as it is in many adults, new research published by Mackay et al in Cancer Cell reported.  Scientists analyzed the DNA of children taking an...

pancreatic cancer

Early Research May Unlock How Pancreatic Cancer Metastasizes to the Liver

Douglas Fearon, MD, Professor at Cold Spring Harbor Laboratory, and colleagues may have discovered how pancreatic cancer metastasizes to the liver following surgery, as reported by Pommier et al in Science. “This discovery is significant because for patients who undergo pancreatic cancer...

colorectal cancer
breast cancer
hepatobiliary cancer
lung cancer
kidney cancer
prostate cancer
cns cancers
leukemia

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2018 Guidelines Updates

In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®) covering 8 tumor types. Guidelines are now published for more than 60 tumor types and topics. Some of the key updates were presented at NCCN’s 23rd...

skin cancer
immunotherapy

Surgery After Checkpoint Blockade for Selected Patients With Metastatic Melanoma

“In the era of improved systemic therapy, checkpoint blockade for metastatic melanoma and the ability to surgically resect all disease after treatment are associated with survival of 75%, better than what has been previously reported,” Danielle M. Bello, MD, said in summarizing study results during ...

solid tumors
breast cancer

Endocrine Therapy: An Important Treatment Limited by Major Challenges

“Endocrine therapy remains the most effective and least toxic treatment for breast cancer, but we have many problems to solve. And there will have to be many different solutions,” according to George W. Sledge, MD, FASCO, Professor of Medicine and Chief of the Division of Oncology at Stanford...

Expert Point of View: Howard Weinstein, MD

“These are excellent results, both overall and for patients randomly assigned to nelarabine with either high-dose methotrexate or escalated-dose methotrexate,” said Howard Weinstein, MD, Chief of Pediatric Hematology/Oncology at Massachusetts General Hospital, Boston, who was not involved in this...

hematologic malignancies

Upfront Use of Nelarabine Plus Chemotherapy Improves Disease-Free Survival in T-Cell Malignancies

Upfront use of nelarabine plus standard Children’s Oncology Group–augmented Berlin-Frankfurt-Münster (aBFM) chemotherapy boosted survival rates in children and young adults with newly diagnosed T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic leukemia (T-LL), according to the...

Serving as ASCO President Is One of the Best Jobs in the World

The opportunity to serve as ASCO President is the greatest honor of my professional career. It has been a pleasure and a highly rewarding experience to interact with our members and members of ASCO’s Board, executive leadership, and professional staff during my tenure. The year has allowed me to...

ASCO’s Incoming President Sets Her Goals for the Next Year

  With all the advances in oncology care over the past decade, the most important contribution to high-quality care remains the personal connection between oncologist and patient, said Monica M. Bertagnolli, MD, FACS, FASCO, ASCO President-Elect, who will take the reins as ASCO’s 55th President...

Expert Point of View: William M. Sikov, MD and Sunil Verma, MD

The ASCO Post obtained comments about the Persephone trial results from two breast cancer experts. William M. Sikov, MD, is Associate Director of Clinical Research at the Program in Women’s Oncology at Women and Infants Hospital of Rhode Island and Associate Professor of Medicine and of...

symptom management

Rivaroxaban May Reduce Risk of Venous Thromboembolism in Patients With Cancer

Patients with cancer have an increased risk of developing blood clots, with roughly one in five experiencing venous thromboembolism (VTE)—either deep-vein thrombosis (DVT) or pulmonary embolism (PE). Although there are many causes and risk factors for VTE, patients with cancer are...

breast cancer

Risk of Breast Cancer After Negative Screening Mammography

In a study reported in JAMA Oncology, McCarthy et al identified the risk of interval breast cancer after negative screening mammography, including risk of poor-prognosis breast cancer. Study Details The study involved mammography data from the Population-Based Research Optimizing Screening...

gynecologic cancers

Long-Term Follow-up of Women With Vaginal and Cervical Clear Cell Adenocarcinoma Associated With DES Exposure

In a letter to the editor of The New England Journal of Medicine, Huo et al described long-term outcomes of women with vaginal and cervical clear cell adenocarcinoma associated with prenatal exposure to the synthetic nonsteroidal estrogen diethylstilbestrol (DES). As noted by the authors, women...

National Comprehensive Cancer Network Announces New Chief Medical Officer

The National Comprehensive Cancer Network® (NCCN®) has named Wui-Jin Koh, MD, as Senior Vice President, Chief Medical Officer, a newly created position for the nonprofit alliance of top U.S. cancer centers. Dr. Koh will add additional physician representation at NCCN headquarters, which...

symptom management

FDA Approves First Epoetin Alfa Biosimilar for the Treatment of Anemia

On May 15, the U.S. Food and Drug Administration (FDA) approved epoetin alfa-epbx (Retacrit) as a biosimilar to epoetin alfa (Epogen/Procrit) for the treatment of anemia caused by chronic kidney disease, chemotherapy, or use of zidovudine in patients with HIV infection. Epoetin alfa-epbx is also...

2018 ASCO: Adding Nelarabine to Standard Chemotherapy Improves Survival in Children and Young Adults With T-Cell Cancers

A large randomized phase III clinical trial by the Children’s Oncology Group (COG) investigating the safety and efficacy of adding nelarabine (Arranon) to COG-augmented Berlin-Frankfurt-Munster chemotherapy (aBFM) to treat newly diagnosed patients with T-cell acute lymphoblastic...

survivorship
symptom management

2018 ASCO: More Choices for Treating Insomnia in Cancer Survivors: Acupuncture and Cognitive Behavioral Therapy

A Patient-Centered Outcomes Research Institute (PCORI)-supported randomized clinical trial of cancer survivors showed that 8 weeks of either acupuncture or cognitive behavioral therapy for insomnia (CBT-I) decreased the severity of insomnia among cancer survivors, though improvements were greatest...

lung cancer

2018 ASCO: Upfront, Comprehensive Genetic Testing in Advanced Lung Cancer Is Cost-Effective

An economic model comparing different types of genetic testing in metastatic non–small cell lung cancer (NSCLC) found that using next-generation sequencing to test for all known lung cancer–related gene changes at the time of diagnosis was more cost-effective and faster than testing one ...

lung cancer

2018 ASCO: Majority of Heavy Smokers Not Screened for Lung Cancer, Despite USPSTF Recommendations

An analysis of 1,800 lung cancer screening sites nationwide found that only 1.9% of more than 7 million current and former heavy smokers were screened for lung cancer in 2016, despite U.S. Preventive Services Task Force (USPSTF) and ASCO screening recommendations. Results from this study—the...

skin cancer

Outcomes for Cutaneous SCC of the Lip With Vermilion vs Cutaneous Location

In a study reported in JAMA Dermatology, Wang et al found that risk of nodal metastasis was higher for cutaneous squamous cell carcinoma (SCC) of the lip with vermilion vs cutaneous location. Disease-specific and overall survival were similar for the two locations. Study Details The retrospective ...

palliative care
lung cancer

Racial/Ethnic Disparities in the Quality of End-of-Life Care Among Patients With Lung Cancer

Significant disparities in the quality of end-of-life lung cancer care were found among racial/ethnic minorities, with higher odds of experiencing potentially preventable medical encounters during end of life as compared with non-Hispanic whites. These findings were published by Karanth et al in...

bladder cancer

Intravesical Instillation of Gemcitabine Postsurgery May Aid in Preventing Bladder Cancer Recurrence

Flushing the bladder with a common chemotherapy drug immediately after surgery significantly reduces the chances of bladder cancer returning, according to a study by Messing et al published in JAMA and led by SWOG. First author Edward M. Messing, MD, is Professor of Urology and...

issues in oncology
symptom management

National Survey Examines Oncologists' Practices, Beliefs on Medical Marijuana Use

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...

solid tumors

FDA Grants Fast Track Designation to Debio 1347 for Unresectable or Metastatic Tumors With a Specific FGFR Gene Alteration

Debiopharm International SA (Debiopharm) recently announced that the U.S. Food and Drug Administration (FDA) has granted Fast Track designation to Debio 1347, an inhibitor of fibroblast growth factor receptors 1, 2, and 3 (FGFR1–3), for the treatment of patients with unresectable or...

Listen Now to “Remembering Dad”: Latest Release from Your Stories: Conquering Cancer Podcast

HOW DO patients really feel when they are in your care? What does it feel like to cure a cancer? How are the children of oncologists affected when grief is a parent’s occupational hazard? These are the personal topics explored in the candid and inspirational mini-podcast series, Your Stories:...

Thriving at Your First ASCO Annual Meeting

The ASCO Annual Meeting is the world’s largest multidisciplinary oncology conference, attracting over 30,000 attendees each year. Countless advances are unveiled in Chicago year after year. The sense of excitement generated by knowing that clinical practice may change for the bettering of our...

State-Level Cancer Policy Priorities, Advocacy Discussed in Statehouses and on ASCO in Action Podcast

WITH THE MAJORITY of state legislatures currently in session, ASCO and state societies across the country continue to work together to ensure lawmakers understand how legislation impacts the cancer care delivery system.  For example, in Rhode Island and Washington, ASCO worked with the Rhode Island ...

ASCO Hosts Inaugural State of Cancer Care in America Event to Examine Issues in Precision Medicine

Precision medicine is changing cancer care in profound ways. It is expected that the number of patients who benefit from precision medicine will continue to increase in the coming years, as treatments become more effective and research yields more insights on patient populations who are most likely ...

legislation
cost of care

New Laws Reduce Costs of Oral Cancer Drugs, but Not for All

The rising cost of anticancer drugs not only adds fiscal pressure to our overburdened health-care system, but also increases the stress on patients with cancer and their families. High out-of-pocket spending may cause significant financial toxicity, even for patients with good health insurance...

lung cancer

Afatinib in Previously Untreated Metastatic NSCLC With Nonresistant EGFR Mutations

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 January 12, 2018, afatinib (Gilotrif) was approved...

issues in oncology

Now More Than Ever, the Oncology Pharmacist Can Play a Variety of Roles on the Health-Care Team

Susannah E. Koontz, PharmD, BCOP, FHOPA, is a consultant for clinical pharmacy services, research, and education in the areas of pediatric hematology/oncology, stem cell transplantation, and cellular therapy. She has held positions at the Children’s Cancer Hospital at The University of Texas MD...

symptom management

Planning for Potential Adverse Effects of Oral Chemotherapy

THE USE OF oral chemotherapy drugs is becoming more and more prevalent—for many types and stages of cancer, during different treatment phases, and for varying lengths of time. So it’s vital that physicians, nurses, and advanced practitioners understand all the potential adverse events of these...

health-care policy

COA Practice Impact Report Details Consolidation, Shift of Cancer Care System Into Hospital Setting

THE COMMUNITY ONCOLOGY Alliance (COA) has released the 2018 Community Oncology Practice Impact Report,1 which tracks data on the changing landscape of cancer care in the United States. It details a decade-long trend of closure and consolidation in the U.S. cancer system that has resulted in a...

skin cancer

Updated ASCO/SSO Guideline on Sentinel Lymph Node Biopsy in Melanoma: Addressing Fundamental Clinical Questions

Dr. Thompson is Professor of Melanoma and Surgical Oncology, Sydney Medical School, The University of Sydney, and Senior Surgeon, Melanoma Institute Australia, Sydney. IN THE MID-1990s, the surgical management of patients presenting with primary cutaneous melanomas changed forever when the...

skin cancer

Sentinel Lymph Node Biopsy and Management of Regional Lymph Nodes in Melanoma: ASCO/SSO Clinical Practice Guideline Update

AS REPORTED IN the Journal of Clinical Oncology by Sandra L. Wong, MD, of Dartmouth-Hitchcock Medical Center, and colleagues, ASCO and the Society of Surgical Oncology (SSO) have issued an update to the ASCO/SSO clinical practice guideline on sentinel lymph node biopsy and management of regional...

survivorship

Obesity in Cancer Survivors: Identifying Teachable Moments

OBESITY IS associated with poor survival in patients with cancer, but when research is translated into survivorship care, obese and overweight patients can experience better outcomes, according to Karen Basen-Engquist, PhD, MPH, Professor of Behavioral Science and Director of the Center for Energy...

gynecologic cancers

Follow-up Too Short in Ovarian Cancer, Too Long in Other Gynecologic Malignancies

A STANDARDIZED 5-year period of surveillance by a gynecologic oncologist was found to be inadequate for some gynecologic cancers and excessive for others, according to research presented by Robert Dood, MD, of The University of Texas MD Anderson Cancer Center, Houston, at the 2018 Society of...

gynecologic cancers

Expert Point of View: Oliver Dorigo, MD, PhD

COMMENTING ON THE study by Cybulska et al, invited discussant Oliver Dorigo, MD, PhD, of Stanford University, said several important questions still need answers. “Tumor immune scores differ between metastatic sites, but how do these immune scores predict response to immunotherapy? And how does...

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