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An Oncologist’s Thoughtful Examination of Cancer and Personal Loss

“I could not have written this book when I was 30 years old. It is not because of any great discoveries I have made or research papers I have published since. It is because of the experience the intervening decades have given me as I cared for thousands of cancer patients and accompanied many to...

immunotherapy
solid tumors

Study Finds Durvalumab Retreatment Active in Some Patients With Advanced Solid Tumors

Immunotherapy with checkpoint inhibitors offers a proportion of patients a chance at long-term disease control, resembling cure in some patients. Among the many questions about immunotherapy that remain to be resolved is whether patients who discontinue therapy and develop progressive disease can...

issues in oncology

Physicians Should Lead by Example to Combat the Obesity Epidemic

American patients are suffering from an obesity crisis, where it is estimated that 300,000 deaths per year are due to obesity.1 The obesity trend is predicted to worsen, where it is projected that 85% of U.S. adults will be overweight or obese by 2030.2 Consequently, obesity-related illnesses are...

Navneet S. Majhail, MD, MS, Was Inspired by His Father’s Career as a Military Doctor and His Mother’s Battle With Cancer

In this installment of the Living a Full Life series, guest editor Jame Abraham, MD, FACP, spoke with Navneet S. Majhail, MD, MS, about his journey from India to the Cleveland Clinic, where he is Director of the Blood and Marrow Transplant Program. He is also President of the American Society for...

2019 Mary Pazdur Award for Excellence in Advanced Practice in Oncology

The Advanced Practitioner Society for Hematology and Oncology (APSHO) recently awarded the 2019 Mary Pazdur Award for Excellence in Advanced Practice in Oncology to Jody Pelusi, PhD, FNP, AOCNP (center). Dr. Pelusi is with HonorHealth Research Institute in Scottsdale. The award was presented...

issues in oncology
survivorship

Addressing the Obesity Epidemic and Barriers to Implementing Weight Management Programs for Cancer Survivors

Earlier this year, ASCO published the results of its new study on oncologists’ perceptions and practice behaviors regarding obesity, weight management, and related lifestyle factors in their patients both during and after cancer treatment.1 The findings from the online survey of 971 oncology...

supportive care
pain management

With a Little Help From My Friends: Social Support Linked to Pain Reduction in Patients With Cancer

Pain may be one of the most common symptoms experienced by patients with cancer, but researchers are still unpacking its mysteries, with some surprising results. According to data presented at the 2019 Supportive Care in Oncology Symposium,1 greater social support may help mitigate pain in patients ...

head and neck cancer

Nivolumab vs Chemotherapy in Advanced Esophageal Cancer

Nivolumab improved overall survival compared with chemotherapy in previously treated patients with esophageal squamous cell carcinoma in the final analysis of the phase III ATTRACTION-3 study. The data were presented at the European Society for Medical Oncology (ESMO) Congress 2019 Presidential...

issues in oncology
survivorship

ASCO Provides Guidance on Managing Osteoporosis in Cancer Survivors

Cancer survivors are at an increased risk of osteoporotic fractures due to the accelerated loss of bone mineral density as a result of their treatment. Bone loss from cancer therapy is faster and more severe than bone less from aging; rates of bone loss are up to sevenfold higher when they occur...

issues in oncology
global cancer care

Affirming Universal Health Care as a Fundamental Human Right

This year’s meeting of the World Cancer Leaders’ Summit: Cancer and Universal Health Coverage, held on October 15–17 in Nur-Sultan, Kazakhstan, brought together more than 350 global health leaders, including ministers of health, first ladies, and industry leaders, from 82 countries to discuss how...

FDA Office of Hematology Oncology Products Reorganized, Renamed Office of Oncologic Diseases

As part of modernization plans approved in September 2019, the U.S. Food and Drug Administration (FDA) office responsible for reviewing applications for new and existing cancer therapies has reorganized and been renamed. The Center for Drug Evaluation and Research (CDER) Office of Hematology and...

ASH Names Recipients of Outstanding Abstract Achievement Awards

Each year, the American Society of Hematology (ASH) offers merit-based awards to support select trainees with high-achieving annual meeting abstracts who are chosen to present their work at the ASH Annual Meeting. Trainees include those who fall within one of the following categories: undergraduate ...

Expert Point of View: Arndt Vogel, MD and Angela Lamarca, MD, PhD

Arndt Vogel, MD, of Hannover Medical School in Germany, who served as discussant of the two studies of immunotherapy in hepatocellular carcinoma, said the findings point to a promising future in the treatment of this malignancy. He commented that the responses observed with nivolumab in CheckMate...

lymphoma

Answers to Hematology Expert Review Questions

Question 1 Which of the following statements about nodular lymphocyte-predominant HL is correct? Correct answer: A. Nodular lymphocyte-predominant HL can transform into large B-cell lymphoma. Expert Perspective Nodular lymphocyte-predominant HL is a B-cell neoplasm characterized by a nodular or...

immunotherapy
hepatobiliary cancer

‘Clinically Meaningful’ Outcomes Seen in Two Studies of First-Line Immunotherapy for Hepatocellular Carcinoma

In the first-line treatment of advanced hepatocellular carcinoma, checkpoint inhibitors led to favorable outcomes in studies reported at the European Society for Medical Oncology (ESMO) Congress 2019—though one study was technically negative. The current first-line standard of care for unresectable ...

lymphoma

The World Health Organization Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Medeiros explore the updated World Health Organization (WHO) classification of nodular lymphocyte-predominant Hodgkin lymphoma. For...

prostate cancer

Apalutamide for Metastatic Castration-Sensitive Prostate Cancer

On September 17, 2019, apalutamide was approved for the treatment of patients with metastatic castration-sensitive prostate cancer.1,2 Supporting Efficacy Data The approval is based on overall survival and radiographic progression-free survival findings in the phase III double-blind TITAN trial.2,3 ...

MD Anderson Names New Senior Vice President and Chief Legal Officer

The University of Texas MD Anderson Cancer Center has named Allyson Hancock Kinzel, JD, as Senior Vice President and Chief Legal Officer, effective November 1, 2019. Ms. Kinzel takes on this new role leading legal and regulatory affairs after serving as Chief Legal Officer since 2018. She will...

immunotherapy
symptom management

Maximizing Benefit in the Treatment of Immune-Mediated Colitis

Immune-related colitis is the second most common toxicity associated with checkpoint inhibitors, affecting up to 40% of patients. The ASCO Post interviewed Yinghong Wang, MD, PhD, Director of Medication-Induced Colitis and Enteritis, Director of Fecal Microbiota Transplantation, and Associate...

Confirmation Hearing for FDA Commissioner Nominee Stephen Hahn, MD

On November 20, 2019, Stephen Hahn, MD, President Trump’s nominee to be the next Commissioner of the U.S. Food and Drug Administration (FDA), appeared before the Senate Health, Education, Labor, and Pension Committee and answered wide-ranging questions relating to the many important roles the...

gastrointestinal cancer

Pivotal Study Reports Positive Findings in Fourth-Line Setting for Advanced GIST

In a late-breaking, oral presentation at the European Society for Medical Oncology (ESMO) 2019 Congress, Margaret von Mehren, MD, presented results from INVICTUS, a pivotal phase III clinical study of ripretinib in patients with advanced gastrointestinal stromal tumor (GIST).1 Ripretinib is an...

City of Hope’s Michael Caligiuri, MD, Formally Appointed to Deana and Stave Campbell Physician-in-Chief Distinguished Chair

Michael A. Caligiuri, MD, President of City of Hope National Medical Center, in Duarte, California, has been appointed the Deana and Steve Campbell Physician-in-Chief Distinguished Chair in Honor of Alexandra Levine, MD. The position was created in honor of Dr. Levine, a City of Hope Professor of...

National Comprehensive Cancer Network Oncology Research Program Supports Clinical Trial for Lung Cancer

The National Comprehensive Cancer Network (NCCN®) Oncology Research Program (ORP) has announced plans to support a phase II randomized trial for lung cancer patients. The study is titled, “TH-138: Phase II randomized trial of carboplatin + pemetrexed + bevacizumab, with or without atezolizumab in...

breast cancer

Breast Cancer Treatments Targeting Estrogen May Be Putting Patients at Risk for Long-Term Comorbidities

“The majority of breast cancers are hormone receptor–positive, and treatments that target the estrogen receptors are very effective, but they also cause havoc in many tissues that are dependent on estrogen for normal functioning. As a result, breast cancer survivors suffer from ongoing symptoms and ...

multiple myeloma

Selinexor/Dexamethasone in Refractory Multiple Myeloma: The STORM Has Arrived, but Does It Represent Climate Change?

The term “relapsed/refractory multiple myeloma” is often used to describe advanced myeloma that has progressed through primary or salvage therapy. The International Myeloma Working Group (IMWG) defined the term in 2011 as disease that is “nonresponsive while on salvage therapy or progresses...

breast cancer

ASCO Updates Breast Cancer Risk Reduction Guideline to Include Anastrozole

ASCO has updated a guideline on pharmacologic interventions for breast cancer risk reduction in postmenopausal women at increased risk of developing breast cancer.1 The original clinical practice recommendations for breast cancer risk reduction were published in 1999 and updated in 2002, 2009, and...

CDC Foundation Offers New Educational Resources to Prevent Infections in Patients With Cancer

The Centers for Disease Control and Prevention (CDC) Foundation commemorates the 10-year anniversary of the Preventing Infections in Cancer Patients (PICP) program by launching new resources that provide continued and improved support to patients with cancer undergoing chemotherapy. The new...

Prescribing Hope

“There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something tomorrow.” –Orison Swett Marden I was informed that my patient, a 58-year-old man recently diagnosed with pancreatic cancer, and his wife were becoming impatient waiting for me in the exam...

global cancer care

Challenging the Global Community to Deliver Equitable Cancer Care for All

For Her Royal Highness Princess Dina Mired of Jordan, ensuring that every patient with cancer receives high-quality care is not an abstract goal—it is personal. Princess Dina saw firsthand the life-and-death differences that access to state-of-the-art oncology care makes in a patient’s life when...

hematologic malignancies
immunotherapy

Answers to Hematology Expert Review Questions

Question 1 Which of the following statements about cytokine-release syndrome and neurotoxicity after tisagenlecleucel infusion is correct? Correct answer: B. The median time to onset of cytokine-release syndrome is 3 days. Expert Perspective Following tisagenlecleucel infusion, cytokine-release...

Project Socrates: An Educational Bridge From the FDA to the Public

OCE Insights is an occasional department developed for The ASCO Post by members of the Oncology Center of Excellence (OCE) at the U.S. Food and Drug Administration (FDA). In this installment, Jennifer J. Gao, MD, Acting Associate Director of Education in the OCE, and Richard Pazdur, MD, Director of ...

leukemia

Glasdegib in Older Patients With AML or Those With Comorbidities

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. Late in 2018, the Hedgehog pathway inhibitor glasdegib...

lung cancer
immunotherapy

Nivolumab/Ipilimumab: Another First-Line Option for Advanced NSCLC

The combination of nivolumab and ipilimumab improved overall survival compared with chemotherapy as first-line therapy for patients with advanced non–small cell lung cancer (NSCLC) and programmed cell death ligand 1 (PD-L1) expression of at least 1%, according to the results of CheckMate 227....

lung cancer

2019 State of Lung Cancer Report Released

More Americans than ever are surviving lung cancer. While the disease remains the leading cause of cancer deaths among both women and men, over the past decade, the survival rate has increased. A new report from the American Lung Association—the 2019 State of Lung Cancer—examines this promising...

skin cancer

Long-Term Analysis of Vemurafenib/Cobimetinib in Patients With BRAF-Mutated Melanoma

A phase Ib study evaluating the safety and long-term benefit of combination treatment with the BRAF inhibitor vemurafenib plus the MEK1 inhibitor cobimetinib in patients with advanced BRAF V600E–mutated melanoma has found that nearly 40% of the patients experienced extended survival of 4 to 5 years ...

head and neck cancer
immunotherapy

Pembrolizumab With or Without Chemotherapy vs Cetuximab Plus Chemotherapy in Recurrent or Metastatic HNSCC

As reported in The Lancet by Barbara Burtness, MD, and colleagues, the phase III KEYNOTE-048 trial has shown improved overall survival with first-line pembrolizumab plus chemotherapy vs cetuximab plus chemotherapy among patients with recurrent or metastatic squamous cell carcinoma of the head and...

lung cancer

What Is the Best Palliation for End-Stage Lung Cancer?

Patients with advanced lung cancer can experience burdensome symptoms at the end of life. Pulmonologists can alleviate some of this suffering, but it’s a balancing act between doing too much and not enough, according to specialists who spoke at CHEST 2019, the annual meeting of the American College ...

issues in oncology
pain management

Prescribed Opioid Use and Infection Risk in Patients With Cancer and Treatment-Associated Neutropenia

In a German study reported in a research letter in JAMA Internal Medicine, Jakob et al found that prescribed opioid use did not appear to increase risk of infection in hospitalized patients with cancer who developed treatment-associated neutropenia. According to the investigators, recent data have...

breast cancer

Expert Point of View: Charles L. Loprinzi, MD

Charles L. Loprinzi, MD, Regis Professor of Breast Cancer Oncology at the Mayo Clinic, Rochester, Minnesota, discussed this abstract on sexual health in women treated for breast cancer. Addressing patients’ questions, offering advice, and providing appropriate referrals should improve patient care, ...

breast cancer

Study Finds Sexual Health Issues Are a Concern Among Majority of Women With Breast Cancer

Endocrine therapy has been a lifesaver for women with estrogen receptor–positive breast cancer, but decreases in recurrence and cancer-related mortality have come with substantial side effects, according to data presented at the 2019 Supportive Care in Oncology Symposium.1 The results of a...

integrative oncology

Boswellia

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. In this installment, Gary Deng, MD, PhD, and Jyothirmai Gubili, MS, focus on the herbal extract...

skin cancer

Role of Voriconazole in Cutaneous Squamous Cell Carcinoma Development

For the last decade, medical experts have known that voriconazole—an antifungal medication used to prevent infections in patients with compromised immune systems—is linked to the development of particularly aggressive squamous cell carcinoma in skin exposed to ultraviolet (UV) rays. However, the...

issues in oncology

Disparities in Culturally Competent Cancer Care

Many nonwhite minority cancer survivors place importance on seeing doctors who share or understand their culture, but are less likely than non-Hispanic whites to be able to see such physicians, according to a new study. The study, which is one of the first nationally-representative studies to...

solid tumors
immunotherapy

Pembrolizumab in Noncolorectal MSI-H/dMMR Solid Tumors

As reported in the Journal of Clinical Oncology by Marabelle et al, the phase II KEYNOTE-158 trial has shown robust activity of pembrolizumab in patients with noncolorectal microsatellite instability­–high (MSI-H)/mismatch repair–deficient (dMMR) solid tumors. Findings in the study supported the...

colorectal cancer

Targeted Triplet Therapy Improved Overall Survival in BRAF-Mutated Colorectal Cancer

For patients with metastatic colorectal cancer harboring BRAF V600E mutations, three drugs seem to be better than two, the most recent analysis of the phase III BEACON CRC study has shown.1 The results, presented at the 2019 European Society for Medical Oncology (ESMO) Congress, were concurrently...

gastrointestinal cancer

Maximizing Benefit in the Treatment of Immune-Mediated Colitis

Immune-related colitis is the second most common toxicity associated with checkpoint inhibitors, affecting up to 40% of patients. The ASCO Post interviewed Yinghong Wang, MD, PhD, Director of Medication-Induced Colitis and Enteritis, Director of Fecal Microbiota Transplantation, and Associate...

lymphoma

FDA Grants Accelerated Approval to Zanubrutinib for Pretreated Mantle Cell Lymphoma

On November 14, the U.S. Food and Drug Administration (FDA) granted accelerated approval to zanubrutinib (Brukinsa) for adult patients with mantle cell lymphoma who have received at least one prior therapy. “Mantle cell lymphoma usually responds well to initial treatment, but eventually returns or ...

symptom management

Dexamethasone Plus Exercise May Reduce Fatigue in Patients With Advanced Cancer

A novel treatment approach may help to alleviate one of the most common and debilitating symptoms associated with cancer and its treatments—fatigue. According to data presented at the 2019 Supportive Care in Oncology Symposium,1 the combination of short-course dexamethasone plus standardized...

skin cancer

Reflections on Long-Term Outcomes With BRAF/MEK Inhibition in Advanced Melanoma

For the treatment of BRAF V600-mutated advanced melanoma, we now have three BRAF/MEK inhibitor combinations that are approved by the U.S. Food and Drug Administration: dabrafenib/trametinib, vemurafenib/cobimetinib, and encorafenib/binimetinib. Although the toxicity profiles for these combinations ...

skin cancer

5-Year Efficacy Outcomes With Dabrafenib Plus Trametinib in BRAF-Mutated Metastatic Melanoma

As reported in The New England Journal of Medicine by Caroline Robert, MD, PhD, of the Institut Gustave Roussy and Paris-Sud-Paris-Saclay University, Villejuif, and colleagues, the long-term follow-up of the phase III COMBI-d and COMBI-v trials has shown a pooled 5-year overall survival rate of 34% ...

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