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issues in oncology
survivorship

Sexual Minority Cancer Survivors and Need for Improved Access to Care

Results from a study published early by Boehmer et al in Cancer point to the need for improved access to medical care for sexual minority cancer survivors—in particular, sexual minority women. In women who are sexual minority cancer survivors, poor access to care is more strongly related to...

breast cancer

FDA Approves Alpelisib in Combination With Fulvestrant for PIK3CA-Mutated, Hormone Receptor–Positive Advanced Breast Cancer

On May 24, the U.S. Food and Drug Administration (FDA) approved alpelisib (Piqray) tablets to be used in combination with the FDA-approved endocrine therapy fulvestrant to treat postmenopausal women, and men, with hormone receptor (HR)-positive, human epidermal growth factor receptor 2...

breast cancer
survivorship

Risk of Subsequent Breast Cancer in Female Childhood Cancer Survivors

As reported by Ehrhardt et al in the Journal of Clinical Oncology, high doses of anthracyclines were associated with increased breast cancer risk in female childhood cancer survivors in the St. Jude Lifetime Cohort Study, with the association being independent of mutations in cancer risk...

lung cancer

FDA Approves the NovoTTF-100L System in Combination With Chemotherapy for Malignant Pleural Mesothelioma

On May 23, the U.S. Food and Drug Administration (FDA) approved the NovoTTF-100L System in combination with pemetrexed plus platinum-based chemotherapy for the first-line treatment of unresectable locally advanced or metastatic malignant pleural mesothelioma. NovoTTF-100L is a noninvasive,...

Emily Whitehead, Early Recipient of CAR T-Cell Therapy for ALL, Celebrates 7 Years Cancer-Free

Among the success stories in the treatment of acute lymphoblastic leukemia (ALL) in children and young adults is the development of chimeric antigen receptor (CAR) T-cell therapy. The field of cellular immunotherapy was still in its infancy in 2012 when Emily Whitehead, then 7, became the first...

hepatobiliary cancer

Triplet Chemotherapy in Unresectable Locally Advanced or Metastatic Biliary Tract Cancers

In a phase II trial reported in JAMA Oncology, Rachna T. Shroff, MD, and colleagues found that the addition of nab-paclitaxel to standard gemcitabine and cisplatin resulted in promising outcomes in patients with unresectable locally advanced or metastatic biliary tract cancers. The study included...

breast cancer

Fulvestrant/Anastrozole in Metastatic Breast Cancer

As reported in The New England Journal of Medicine by Rita S. Mehta, MD, and colleagues, the final overall survival results of the phase III SWOG S0226 trial show that the addition of first-line fulvestrant to anastrozole was associated with improved overall survival in postmenopausal women with...

AYA Survivors Should Be Allowed to Participate in Adult Clinical Trials

When strangers ask me how many children I have, I’m not quite sure how to respond. Do I still have four children even though one has died? A year and a half after my son Brent’s death, at the age of 18, from complications of acute myeloid leukemia (AML), I’m still struggling with knowing the...

Unlocking the Secrets of the Immune System, Story by Story

The story of immunotherapy is one of the most interesting and provocative in medical history. William B. Coley, MD, first harnessed the immune system against cancer in the late 19th century by injecting mixtures of live and inactivated bacteria into patients’ tumors. For various reasons,...

An Insider’s Account of the Nobel Prize–Winning Race to Uncover the Secret of the Ribosome

Situated in the nucleus of the human cell is DNA, the secret of life discovered by the Nobel Prize laureates Drs. Watson and Crick. More recently, another scientist, Venki Ramakrishnan, PhD, won a Nobel Prize for his work in uncovering another secret within the human cell: the structure of the...

pancreatic cancer

Lifestyle Modifications and Screening of Patients at High Risk Can Reduce Deaths From Pancreatic Cancer

After disclosing that he had been diagnosed with stage IV pancreatic cancer, Alex Trebek, longtime host of the popular television game show Jeopardy!, vowed that he would beat the disease despite the low associated survival rate. His statement has brought pancreatic cancer back into the public...

cns cancers

Rookie

His steps generated a low rumble that propagated through the floor like a tsunami, flowed up through my desk, and ended as tiny waves visible through the clear plastic of my water bottle. His custom Lucchese ostrich boots made a distinctive clicking sound as they rhythmically struck the tile floor, ...

hepatobiliary cancer

FDA Approves Ramucirumab for Hepatocellular Carcinoma

ON MAY 10, the U.S. Food and Drug Administration (FDA) approved ramucirumab (Cyramza) as a single agent for hepatocellular carcinoma in patients who have an alpha fetoprotein (AFP) level ≥ 400 ng/mL and have been previously treated with sorafenib. REACH-2 Trial APPROVAL WAS based on the REACH-2...

pain management
health-care policy

Debating the Role of Opioids in the Management of Chronic Cancer Pain

Despite the increasing public awareness of the danger of the overuse of prescription opioids, drug overdose deaths continue to rise in the United States. According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2017, nearly 400,000 people died of an overdose involving...

Otis W. Brawley, MD, MACP, FASCO: Doctor, Policy Advocate, Writer, and Champion of the Underserved

  In this installment of Living a Full Life, guest editor Jame Abraham, MD, FACP, spoke with Otis W. Brawley, MD, MACP, FASCO, a global leader in cancer research and health disparities. Dr. Brawley, who served as Chief Medical and Scientific Officer for the American Cancer Society (ACS) and...

issues in oncology
gynecologic cancers
global cancer care

Barriers to Cervical Cancer Screening Among HIV-Infected Women in Tanzania

Population screening programs and the advent of human papillomavirus (HPV) vaccination have made cervical cancer largely a preventable disease. Despite these advances, ­cervical cancer remains a leading cause of cancer death for ­women in low- and middle-income countries. A recent study identified...

integrative oncology

Capsaicin

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, Shelly Latte-Naor, MD, and Jyothirmai Gubili, MS, explore the use of...

breast cancer
global cancer care

Ghanaian Oncologist Yehoda M. Martei, MD, Seeks Ways to Improve Outcomes in the Developing World

Breast cancer remains the most commonly diagnosed cancer among women globally. Due to a lack of early interventions, most women in low- and middle-income countries have advanced disease at the time of diagnosis, conferring a grim prognosis. Yehoda M. Martei, MD, of the Department of Medicine,...

global cancer care

Uniting the Global Cancer Community to Reduce Deaths From Noncommunicable Diseases

It has been well documented that noncommunicable diseases, including cancer, cardiovascular disease, and diabetes, now pose the greatest health threat to people living in low- and middle-income countries, surpassing infectious diseases like HIV/AIDS as the leading cause of death and disability.1...

ASH President Comments on Medicare Proposal for CAR T-Cell Therapy

Recently, the Centers for Medicare & Medicaid Services (CMS) proposed to improve the reimbursement currently given to hospitals that provide chimeric antigen receptor (CAR) T-cell therapy to patients with blood cancer as part of the Fiscal Year 2020 Inpatient Prospective Payment System...

issues in oncology
cost of care
survivorship

How Cancer Affects Adolescents and Young Adults

The statistics are alarming: according to the National Cancer Institute (NCI), about 70,000 adolescents and young adults (AYAs) are diagnosed with cancer each year1—a recent report by the University of California put that figure at 87,000.2 Although overall cancer survival rates continue to improve ...

issues in oncology
immunotherapy

NCCN Roundtable Tackles Issues With Innovative Immunotherapies

Immunotherapies are radically changing outcomes, but while helping patients, they are creating complexities surrounding their cost. At the 2019 Annual Conference of the National Comprehensive Cancer Network® (NCCN®), a roundtable of experts, including clinicians and payers, discussed how chimeric...

solid tumors
bladder cancer

Erdafitinib for Metastatic Urothelial Carcinoma

On April 12, 2019, erdafitinib was granted accelerated approval for patients with locally advanced or metastatic urothelial carcinoma with susceptible fibroblast growth factor receptor 3 (FGFR3) or FGFR2 genetic alterations, when the disease has progressed during or following platinum-containing...

lung cancer

FDA Expands Pembrolizumab Indication for NSCLC in First-Line Setting

On April 14, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) for the first-line treatment of patients with stage III non–small cell lung cancer (NSCLC) who are not candidates for surgical resection or definitive chemoradiation, or those with metastatic NSCLC....

hematologic malignancies
leukemia

FDA Approves First-Line Ivosidenib for IDH1-Mutated AML

On May 2, the U.S. Food and Drug Administration (FDA) expanded its approval of ivosidenib (Tibsovo) to include newly diagnosed acute myeloid leukemia (AML) with a susceptible IDH1 mutation, as detected by an FDA-approved test, in patients who are at least 75 years old or who have comorbidities that ...

hematologic malignancies
lymphoma

Combination Immunotherapy With Lenalidomide Plus Rituximab in Indolent NHL: Time to Replace Rituximab Monotherapy?

With increasing knowledge on the key role of the tumor microenvironment in lymphomagenesis, treatments for indolent B-cell lymphoma, especially follicular lymphoma, are mechanistically moving toward a more immunomodulatory approach. Chemotherapy-free regimens are an attractive alternative to...

hematologic malignancies
lymphoma

AUGMENT Trial: Addition of Lenalidomide to Rituximab in Relapsed or Refractory Indolent Lymphoma

In the phase III AUGMENT trial, reported in the Journal of Clinical Oncology, John P. Leonard, MD, of Meyer Cancer Center, Weill Cornell Medicine and NewYork-Presbyterian Hospital, and colleagues found that the addition of lenalidomide to rituximab significantly prolonged progression-free survival...

issues in oncology

2019 NCCN Posters Explore Next-Generation Sequencing, Cancer Burden vs Funding, Cardiac Monitoring, and Scalp Cooling

Posters presented at the National Comprehensive Cancer Network® (NCCN®) Annual Conference continue to grow in number and in quality. The ASCO Post presents a few that we found interesting at the recent 2019 meeting. Next-Generation Sequencing Not Always Helpful in Practice The value of...

hematologic malignancies

Prolonged Exposure to Ibrutinib May Increase Effectiveness of CAR T-Cell Therapy in Patients With CLL

Chimeric antigen receptor (CAR) T-cell therapy has shown remarkable efficacy in the treatment of certain hematologic malignancies, including several types of large B-cell non-Hodgkin lymphomas (NHLs) and acute lymphoblastic leukemia (ALL). The U.S. Food and Drug Administration (FDA) has approved...

breast cancer

Risk of Breast Cancer Among Transgender People

In a Dutch study published by de Blok et al in The BMJ, researchers found an increased risk of breast cancer in transgender women compared with cisgender men, and a lower risk of breast cancer in transgender men than in cisgender women. Methods This retrospective, nationwide cohort study...

cns cancers

Targeted Brachytherapy May Improve Outcomes in Recurrent Brain Tumors

For recurrent, previously irradiated brain tumors, innovative treatment with surgically targeted brachytherapy yielded good local control and overall survival, as compared to historic controls, neurosurgeons reported at the 2019 Annual Scientific Meeting of the American Association of Neurological...

prostate cancer

Prostate-Only vs Whole-Pelvis Radiotherapy in Gleason Grade 5 Prostate Cancer

In a retrospective analysis published in European Urology, Sandler et al examined the protocol for treating aggressive prostate cancer. Researchers aimed to study the impact of whole-pelvis radiation on men with Gleason grade 5 disease who had been treated with external-beam radiotherapy with...

colorectal cancer
survivorship

Factors Associated With Major Adverse Cardiovascular Events in Survivors of Colorectal Cancer

Colorectal cancer survivors’ risk for heart attack—five times that of the average person—may be linked to the amount of fat stored within the abdomen and abdominal muscles, not to body mass index (BMI), according to a new study of 2,800 colon cancer survivor health outcomes...

kidney cancer
immunotherapy

IMmotion151: First-Line Atezolizumab/Bevacizumab vs Sunitinib in Metastatic Renal Cell Carcinoma

In the phase III IMmotion151 trial reported in The Lancet, Rini et al found that atezolizumab plus bevacizumab prolonged progression-free survival vs sunitinib in patients with previously untreated, programmed cell death ligand 1 (PD-L1)-positive, metastatic renal cell carcinoma. Study Details...

multiple myeloma

OPTIMISMM: Addition of Pomalidomide to Bortezomib/Dexamethasone in Pretreated Relapsed or Refractory Multiple Myeloma

In the phase III OPTIMISMM trial, reported by Richardson et al in The Lancet Oncology, researchers found that the addition of pomalidomide to bortezomib/dexamethasone improved progression-free survival in relapsed or refractory multiple myeloma previously treated with lenalidomide. Study Details...

hematologic malignancies

T-Cell Therapy for EBV-Associated Posttransplant Lymphoproliferative Disorder With CNS Involvement

An “off-the-shelf” allogeneic T-cell product, tabelecleucel, may effectively treat patients who develop Epstein-Barr virus (EBV)-associated posttransplant lymphoproliferative disorder with central nervous system (CNS) involvement, researchers from Memorial Sloan Kettering Cancer Center reported at...

hepatobiliary cancer
immunotherapy

Early-Stage Study of Nivolumab Alone or in Combination With Cisplatin/Gemcitabine in Biliary Tract Cancer

In a Japanese phase I trial reported by Ueno et al in The Lancet Gastroenterology & Hepatology, researchers found nivolumab showed activity and had a manageable safety profile in patients with unresectable or recurrent biliary tract cancer. Methods The open-label phase I trial was conducted...

breast cancer

Study Finds Timing of Therapy Does Not Influence Outcomes in HER2-Positive Breast Cancer

The sequencing of trastuzumab administration with chemotherapy in the neoadjuvant setting seems to have no effect on outcomes for patients with HER2-positive breast cancer, according to data presented at the 2019 Society of Surgical Oncology Annual Cancer Symposium.1 The results of a phase III...

breast cancer

Locoregional Recurrence After Mastectomy for DCIS More Common Among Younger Women, Study Finds

Young age appears to be a risk factor for locoregional recurrence after mastectomy for ductal carcinoma in situ (DCIS) with or without microinvasion, according to data presented at the 2019 Society of Surgical Oncology Annual Cancer Symposium.1 The retrospective analysis of more than 3,000 cases...

breast cancer

Trastuzumab Emtansine in Treatment of Residual Breast Cancer After Neoadjuvant Therapy: Who Will Benefit?

The discovery of trastuzumab has been revolutionary in the treatment of HER2-positive breast cancer, both in the metastatic and early-stage settings.1-6 This cannot be disputed. In the early-stage setting, the addition of trastuzumab to standard chemotherapy has led to a 50% gain in...

breast cancer

Adjuvant Trastuzumab Emtansine vs Standard Trastuzumab in Residual HER2-Positive Breast Cancer After Neoadjuvant Therapy

In the phase III KATHERINE trial reported in The New England Journal of Medicine,1Gunter von Minckwitz, MD, of the German Breast Group, Neu-Isenburg, and colleagues found that adjuvant treatment with the antibody-drug conjugate trastuzumab emtansine (T-DM1) improved invasive disease–free survival...

prostate cancer

Alterations in the RB1 Gene and Outcomes in Metastatic Castration-Resistant Prostate Cancer

Scientists have identified a genetic mutation in the tumors of some men with prostate cancer that is linked to very poor survival, and which could be used to help select certain patients for more intensive treatment. These findings were published by Abida et al in the Proceedings of the...

lung cancer

Evidence Mounts for Tumor Mutational Burden as Biomarker of Immune Checkpoint Inhibitor Benefit in NSCLC

The search for biomarkers to identify patients who are likely to respond to immunotherapy continues. According to biomarker tissue and blood analysis of patients enrolled in the phase III MYSTIC trial, high tumor mutational burden in both tissue and blood identified patients with non–small cell...

bladder cancer
immunotherapy

Lenvatinib Plus Pembrolizumab Shows Activity in Advanced Urothelial Cancer

THE COMBINATION of lenvatinib plus pembrolizumab has demonstrated antitumor activity in patients with advanced urothelial cancer, including patients receiving later-line treatment. Results of a phase Ib/II trial showed an objective response rate of 25% and a median progression-free survival of 5.4...

bladder cancer

Sacituzumab Govitecan Shows Activity in Heavily Pretreated Bladder Cancer

PRELIMINARY EVIDENCE suggests that the antibody-drug conjugate sacituzumab govitecan is active in patients previously treated with chemotherapy or checkpoint inhibitor therapy for metastatic urothelial cancer. These results from a phase I/II basket study of this agent were presented at the 2019...

prostate cancer

Enzalutamide Plus Androgen Deprivation Therapy in Metastatic Hormone-Sensitive Prostate Cancer

Adding enzalutamide to androgen-deprivation therapy (ADT) significantly prolonged radiographic progression-free survival in men with metastatic hormone-sensitive prostate cancer, reducing the risk of disease progression or death by 61% compared with ADT plus placebo, according to the results of the ...

kidney cancer

Expert Point of View: Daniel George, MD

The CARMENA trial presented at the 2018 ASCO Annual Meeting, published simultaneously in The New England Journal of Medicine,1,2 and reported in this supplement to The ASCO Post, evaluated the role of nephrectomy in patients with metastatic renal cell carcinoma. Formal discussant of the trial,...

prostate cancer

LATITUDE Trial in Newly Diagnosed, Metastatic Prostate Cancer: Final Overall Survival Analysis

As reported in The Lancet Oncology by Karim Fizazi, MD, PhD, and colleagues, the final overall survival analysis in the phase III LATITUDE trial has shown a significant benefit with the addition of abiraterone acetate plus prednisone to androgen deprivation therapy (ADT) in newly diagnosed,...

kidney cancer

Retrospective Study Evaluates Cabozantinib in Advanced Non–Clear Cell Renal Cell Carcinoma

Cabozantinib, a kinase inhibitor, is approved in metastatic renal cell carcinoma on the basis of studies in clear cell histology. Its activity in non–clear cell renal cell carcinoma is poorly defined. In a retrospective cohort study, Nieves Martinez Chanzá, MD, and colleagues reported that...

pancreatic cancer

Study Shows Rucaparib Active as Maintenance Therapy in Pancreatic Cancer

The poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib holds promise as maintenance therapy for advanced, platinum-sensitive, BRCA- or PALB2-mutated pancreatic cancer, according to an interim analysis of an ongoing phase II clinical trial presented at the 2019 Annual Meeting of the American...

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