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issues in oncology
global cancer care

Who I Am and What I Will Do

I am a radiation oncologist from Zambia, where we only have one cancer center offering radiotherapy—and I will beat cancer. This bold statement often evokes a look of surprise. However, if the conversation is allowed to go on, I’ll say cancer is beatable even where resources are thin. I am...

hematologic malignancies

Advances in Haploidentical Transplantation and Cellular Therapies

With advances in the field, the number of haploidentical stem cell transplants being performed (ie, using human leukocyte antigen [HLA] half-matched donor stem cells) has been increasing. In recognition of evolving strategies to improve outcomes, a group of transplant physicians started the...

Damon Runyon Cancer Research Foundation Scientists Receive 2019 Innovation Award

The Damon Runyon Cancer Research Foundation named nine scientists with novel approaches to fighting cancer the 2019 recipients of the Damon Runyon-Rachleff Innovation Award. Five early career scientists will receive initial grants of $400,000 over 2 years. Another 4 awardees who demonstrated...

lung cancer
immunotherapy

Nicolas Guibert, MD, PhD, on Non–Small Cell Lung Cancer: Predicting Response to PD-1 Inhibitors With cfDNA

Nicolas Guibert, MD, PhD, of Toulouse University Hospital, discusses a simple algorithm built to predict durable outcomes of patients with advanced non–small cell lung cancer that has been treated with immunotherapy. He notes that early changes in circulating tumor DNA burden may also predict...

supportive care
palliative care

Innovative Research to Improve the Supportive Care Needs of Cancer Survivors

First launched in 2014, the Palliative Care in Oncology Symposium introduced a nascent interdisciplinary approach to the treatment of both the physical and psychological symptoms of cancer to improve disease outcome and quality of life for patients. Today, it has evolved into a leading forum for...

head and neck cancer

Effect of PET/CT on Surgical Planning for Head and Neck Cancer

In a study reported in the Journal of Clinical Oncology, Lowe et al found that 18F-fluorodeoxyglucose positron-emission tomography/computed tomography (PET/CT) had a high negative predictive value in the clinically N0 neck in patients with newly diagnosed head and neck squamous cell carcinoma, with ...

breast cancer

Long-Term Study Finds Axillary Radiotherapy Safe and Effective After Positive Sentinel Node Biopsy

Following identification of a positive sentinel lymph node, surgical axillary lymph node dissection and axillary radiation therapy provide comparable locoregional control and survival, according to a 10-year follow-up of the large European Organisation for Research and Treatment of Cancer AMAROS...

breast cancer

Biologic Age and Elevated Breast Cancer Risk

Biologic age—a DNA-based estimate of a person’s age—may be associated with development of breast cancer, according a report published by Kresovich et al in the Journal of the National Cancer Institute. Study Methods Scientists from the National Institute of Environmental Health...

breast cancer

More Data Show Small Benefit From Extended Endocrine Therapy

Two studies presented at the 2018 San Antonio Breast Cancer Symposium validated a small benefit of extending adjuvant aromatase inhibitor therapy beyond thestandard 5 years for postmenopausal women with hormone receptor–positive breast cancer. In a meta-analysis of 24,912 patients from 12...

Expert Point of View: Parag J. Parikh, MD

Parag J. Parikh, MD, Director of Gastrointestinal Radiation Oncology, Henry Ford Cancer Institute, Detroit, commented that KEYNOTE-128 “unfortunately found a very low rate of response to single-agent pembrolizumab.” He said he would not use this approach in any patients with neuroendocrine tumors...

immunotherapy
gastrointestinal cancer

Study Shows Limited Antitumor Activity of Pembrolizumab in Neuroendocrine Tumors

Neuroendocrine tumors appear resistant to single-agent immunotherapy, according to the results of the KEYNOTE-028 trial of pembrolizumab. “Pembrolizumab monotherapy showed limited antitumor activity but a manageable safety profile in patients with previously treated, advanced neuroendocrine...

prostate cancer

Radioligand Therapy Achieves Responses in Metastatic Prostate Cancer

In a prospective, single-center, single-arm phase II trial reported at the 2019 Genitourinary Cancers Symposium, a novel approach using a tumor-specific radioligand therapy that binds to prostate-specific membrane antigen (PSMA) (lutetium-177 PSMA-617 -[LuPSMA]) achieved responses in a majority of...

issues in oncology

10 Patient-Centered Principles for More Conservative Cancer Diagnosis

Although diagnostic errors date back to antiquity, in recent years, they have begun to receive attention as an important patient safety issue. This culminated in the National Academy of Medicine’s 2015 landmark report, which concluded that most people in the United States would experience at...

pancreatic cancer

Mutations in DNA Damage Repair Predict Benefit With Platinum Agents in Pancreatic Cancer

Patients with advanced pancreatic cancer who have homologous repair damage response mutations may derive considerable benefit from treatment with platinum agents, according to an analysis of patients in the Know Your Tumor Program presented by Michael Pishvaian, MD, PhD, of Georgetown University,...

Expert Point of View: Lori Wood, MD

Formal discussant of KEYNOTE-426, Lori Wood, MD, of Dalhousie University, Halifax, Nova Scotia, Canada, called both KEYNOTE-426 and JAVELIN-101 “practice-changing.” “In 2019, we have a new standard of care,” Dr. Wood declared. “The majority of patients with clear cell advanced renal cell carcinoma ...

kidney cancer

Pembrolizumab/Axitinib Combination Improves Outcomes vs Sunitinib in Kidney Cancer

The checkpoint inhibitor pembrolizumab plus the vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor axitinib significantly improved overall survival, progression-free survival, and objective response rates vs sunitinib as first-line therapy for clear cell metastatic renal cell...

issues in oncology

Statement on the NIH’s Efforts to Address Sexual Harassment in Science

Leadership from the National Institutes of Health (NIH) issued the following statement yesterday: As the NIH Director stated in September, sexual harassment is about power. The goal of the perpetrator, most commonly but not exclusively a man, is to objectify, exclude, demoralize,...

solid tumors
immunotherapy

TAT 2019: Use of the Lung Immune Prognostic Index in Stratifying Outcomes in Patients Treated With Immune Checkpoint Inhibitors

The Lung Immune Prognostic Index (LIPI) calculated prior to the initiation of treatment may be used to stratify patients with diverse tumor types into groups that significantly associate with outcome following immune checkpoint inhibitor therapy, according to a retrospective study presented at the...

prostate cancer
issues in oncology

AACR 2019: Does Treatment With Abiraterone Acetate Benefit Patients With Advanced Prostate Cancer and Preexisting Cardiovascular Disease?

Patients with advanced prostate cancer who had preexisting cardiovascular disease had a higher risk of mortality in the 6 months after starting abiraterone acetate treatment compared with those who had no preexisting cardiovascular disease, according to data presented by Lu-Yao et al at a presscast ...

skin cancer
immunotherapy

AACR 2019: Diet May Influence Gut Microbiome and Response to Immunotherapy

Among patients with melanoma treated with anti–programmed cell death protein 1 (PD-1) immunotherapy, consumption of a high-fiber diet was associated with higher gut microbiome diversity and better response to treatment, according to data presented by Spencer et al at a presscast in advance of ...

colorectal cancer
issues in oncology

AACR 2019: Survey Finds Young-Onset Colorectal Cancer Is Often Misdiagnosed, Treated at Later Stages

A recent study by the American Cancer Society (ACS) has found that while colorectal cancer incidence in the United States is rapidly declining overall, colorectal cancer rates are increasing among young adults. According to the study, compared with adults born in the 1950s, those born in the 1990s...

lung cancer

AACR 2019: Liquid Biopsy–Based Test May Be Reliable in Identifying Treatment for Non–Small Cell Lung Cancer

The number of guideline-recommended biomarkers to be assessed in patients with newly diagnosed, metastatic non–small cell lung cancer (NSCLC) is increasing. These biomarkers include both predictive targets—including EGFR, ALK, ROS1, BRAF, RET, MET, and ERBB2—and prognostic...

issues in oncology
cost of care

Medical Expenses in Patients With Coronary Artery Disease and Cancer

New research published by Chopra et al in JNCCN—Journal of the National Comprehensive Cancer Network calls for much greater integration between cardiologists and oncologists for patients with coronary artery disease who are diagnosed with cancer. Coronary artery disease is the most...

Luspatercept May Reduce the Need for Transfusion in Lower-Risk Myelodysplastic Syndromes

IN THE RANDOMIZED, double-blind, phase III MEDALIST trial, the experimental drug luspatercept significantly reduced the need for frequent red blood cell transfusions in patients with lower-risk myelodysplastic syndromes (MDS) and ring sideroblasts. With luspatercept, 37.8% of patients remained...

Front-Line Ibrutinib Improves Progression-Free Survival in Older Patients With Chronic Lymphocytic Leukemia

IN A PHASE III TRIAL reported during the Plenary Session at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition and published in The New England Journal of Medicine, single-agent ibrutinib and ibrutinib/rituximab were associated with superior progression-free survival vs...

head and neck cancer
immunotherapy

In Era of Immunotherapy, Radiation Therapy May Become Essential Component of Systemic Treatments of Cancer

“IN THIS era of immunotherapy, it is highly possible, and potentially probable, that radiation therapy may become not just a form of locoregional and palliative treatment, but an essential component of our systemic treatments of cancer,” according to Zachary S. Morris, MD, PhD, Vice-Chair,...

head and neck cancer
immunotherapy
symptom management

Immunotherapy for Head and Neck Cancer Expands, but Concerns Persist About Patient Selection and Toxicities

SOME PATIENTS with advanced head and neck cancer may achieve durable responses with immunotherapy, and recent trial results suggest first-line immunotherapy may increase survival among patients with recurrent or metastatic disease. However, concerns remain about selecting patients most likely to...

lymphoma
immunotherapy

Update on FDA-Approved CAR T-Cell Products

AXICABTAGENE CILOLEUCEL (also known as CAR19) is an anti-CD19 chimeric antigen receptor (CAR) T-cell product approved by U.S. Food and Drug Administration to treat selected hematologic malignancies.1 To appreciate the clinical trial findings summarized here, from selected abstracts presented at the ...

lymphoma
leukemia
immunotherapy

Update on FDA-Approved CAR T-Cell Products

TISAGENLECLEUCEL IS an anti-CD19 chimeric antigen receptor (CAR) T-cell product approved by U.S. Food and Drug Administration to treat selected hematologic malignancies.1,2 To appreciate the clinical trial findings summarized here, from selected abstracts presented at the 2018 American Society of...

hematologic malignancies

FDA Approves Caplacizumab-yhdp for Acquired Thrombotic Thrombocytopenic Purpura

ON FEBRUARY 6, 2019, the U.S. Food and Drug AdministrationFDA approved caplacizumab-yhdp (Cablivi) injection, in combination with plasma exchange and immunosuppressive therapy, for the treatment of adult patients with acquired thrombotic thrombocytopenic purpura (aTTP). “Patients with aTTP endure...

multiple myeloma

FDA Approves Split-Dosing Regimen of Therapy for Multiple Myeloma

ON FEBRUARY 12 , 2019, the U.S. Food and Drug Administration (FDA) approved a split-dosing regimen for daratumumab (Darzalex), providing health-care professionals and patients with multiple myeloma an option to split the first infusion over 2 consecutive days. Daratumumab is a CD38-directed...

leukemia
myelodysplastic syndromes
lymphoma
multiple myeloma
immunotherapy

Highlights From the 2018 ASH Annual Meeting & Exposition

TO ADD to our ongoing coverage of the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition, we bring readers of The ASCO Post these summaries of an assortment of interesting studies. They focus on novel therapies under investigation in the treatment of acute lymphoblastic...

breast cancer

Prognostic Value of Disseminated Tumor Cells in Early Breast Cancer

IN THE PADDY TRIAL, involving more than 10,000 women with early invasive breast cancer, the presence of disseminated tumor cells at diagnosis or primary surgery was an independent prognostic factor for overall, disease-free, and distant disease–free survival. The study findings were presented at...

breast cancer

SABCS Presentations Offer New Data on Biomarkers and Novel Treatment Approaches in Early and Metastatic Breast Cancers

REPORTERS FOR The ASCO Post captured the following summaries of noteworthy studies presented at the 2018 San Antonio Breast Cancer Symposium. In HER2-Negative Metastatic Disease, CTCs Frequently HER2-Positive ALMOST HALF of all patients with HER2-negative metastatic breast cancer have circulating...

hepatobiliary cancer

BRAF/MEK Targeting May Yield Benefit in Treating Biliary Tract Cancer

ROUTINE TESTING for BRAF V600E mutations in patients with biliary tract cancer may prove to be a good idea, based on the findings of a phase II study in which treatment with dabrafenib plus trametinib showed activity.1 The results suggest there may be a benefit to testing patients with biliary...

colorectal cancer
immunotherapy

Expert Point of View: Michael J. Overman, MD

INVITED STUDY discussant Michael J. Overman, MD, Professor of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, is a co-investigator on CheckMate 142, which led to the approval of another immunotherapy doublet—nivolumab plus ipilimumab—in patients...

colorectal cancer
immunotherapy

Durvalumab and Tremelimumab Combination Active in Refractory Microsatellite-Stable Colorectal Cancer

THE COMBINATION of durvalumab and tremelimumab prolonged median overall survival by 2.5 months compared with best supportive care alone in patients with advanced treatment-refractory colorectal cancer. These findings, which are from the randomized phase II Canadian Cancer Trials Group (CCTG) CO.26...

issues in oncology
survivorship

How to Improve Care for Young Sexual and Gender Minority Cancer Survivors

IN 2017, ASCO issued its recommendations for addressing the oncology care needs of sexual and gender minority cancer survivors and the unique challenges they face.1 There are myriad reasons for cancer disparities in this population compared to heterosexual cisgender cancer survivors, including...

issues in oncology
health-care policy

‘Curve 2’ and Oncology: What Those in Charge Don’t Understand … or Ignore

THERE IS little doubt that the U.S. health-care system is under assault from many directions.1 It is clear that the costs of health management are no longer sustainable, and the United States has one of the highest per capita health costs among the 36 member nations of the Organisation for...

pancreatic cancer

Expert Point of View: Andrew X. Zhu, MD, PhD

ANDREW X. ZHU, MD, PhD, of Massachusetts General Hospital Cancer Center and Harvard Medical School, noted that Prep-02/ JSAP-05 is the first study to show the value of neoadjuvant chemotherapy in patients with resectable pancreatic adenocarcinoma. However, the findings are applicable only to Asian ...

pancreatic cancer

Emerging Role for Neoadjuvant Treatment of Resectable Pancreatic Cancer

SEVERAL STUDIES presented at the 2019 Gastrointestinal Cancers Symposium evaluated the benefits of neoadjuvant treatment in patients with pancreatic cancer—and in patients deemed fully resectable, not just “borderline” resectable.1-3 Although the standard of care for resectable pancreatic ductal...

hematologic malignancies

Crizanlizumab Improves Prevention of Vaso-occlusive Crises in Patients With Sickle Cell Disease

For the first time in more than 20 years, patients with sickle cell disease may have another treatment option to reduce painful vaso-occlusive crises, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Results of the phase II, randomized,...

Expert Point of View: Mark Crowther, MD, MSc, FRCPC

Moderator of the session, Mark Crowther, MD, MSc, FRCPC, Professor of Clinical Epidemiology and Biostatistics, Leo Pharma Chair in Thromboembolism Research at McMaster University, in Ontario, Canada, said that the CASSINI study represents a major advance in the management and prevention of a very...

Expert Point of View: Kenneth Shain, MD, PhD, and Vincent Rajkumar, MD

In interviews with The ASCO Post, Kenneth Shain, MD, PhD, Director of the Myeloma Working Group at Moffitt Cancer Center, Tampa, Florida, and Vincent Rajkumar, MD, Professor of Medicine at the Mayo Clinic in Rochester, Minnesota, commented on the findings of the MAIA trial. “The study shows that...

hematologic malignancies
multiple myeloma

Daratumumab, Lenalidomide, and Dexamethasone in Patients With Newly Diagnosed Multiple Myeloma: Outcomes From the MAIA Trial

In patients with newly diagnosed multiple myeloma who are not eligible for stem cell transplantation, the addition of daratumumab to lenalidomide and dexamethasone significantly reduced the risk of death or disease progression by 44%, according to a late-breaking abstract presentation by Thierry...

solid tumors
leukemia
lung cancer
lymphoma

FDA Pipeline: Priority Reviews in Solid Tumors and Lymphoma; Plus an sNDA in Acute Myeloid Leukemia

Over the past week, the U.S. Food and Drug Administration (FDA) granted multiple Priority Reviews and accepted a supplemental new drug application: Priority Review for Entrectinib in NTRK Fusion–Positive Solid Tumors and Metastatic, ROS1-Positive NSCLC This week, the FDA accepted new drug...

issues in oncology

Former JAMA Editor Offers Perspective on Challenges Past and Present in American Health Care

BOOKMARK Title: Severed Trust: Why American Medicine Hasn’t Been FixedAuthor: George D. Lundberg, MD, With James StaceyPublisher: Basic BooksPublication date: March 2001Price: $28.00, hardcover, 336 pages Pathologist George D. Lundberg, MD, served as Editor-in-Chief of The Journal of the American...

gynecologic cancers

Link Discovered Between Microbiome and Cervical Cancer

Bacteria may play an important role in whether a woman develops cervical cancer, according to global health research published by scientists from the University of Nebraska–Lincoln and the Ocean Road Cancer Institute in Dar es Salaam, Tanzania, in mBio. Part of a growing body of research...

breast cancer

Adherence to Endocrine Therapy for Breast Cancer in Black Women and White Women

In a study reported in the Journal of the National Cancer Institute, Stephanie B. Wheeler, MPH, PhD, of the Department of Health Policy and Management, University of North Carolina, Chapel Hill, and colleagues found that black women reported nonadherence to endocrine therapy for breast cancer more ...

hematologic malignancies
multiple myeloma

Cancer Has Given Me the Life I Was Meant to Live

The first symptom of my multiple myeloma appeared 6 months before I received the official diagnosis. I began having some discomfort, not pain exactly, in my right hip, and developed a pronounced limp. I had recently left my medical practice to launch Global Girls Global Women, a nonprofit...

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