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The following essay by Howard A. (Skip) Burris III, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org....
Osimertinib Improves Progression-Free Survival for EGFR-Positive NSCLC in the Phase III FLAURA Trial
On July 27, it was announced that the phase III FLAURA trial showed a statistically significant and clinically meaningful progression-free survival benefit with osimertinib (Tagrisso) compared to current first-line standard-of-care treatment (erlotinib [Tarceva] or gefitinib [Iressa]) in previously ...
FDA Announces Comprehensive Regulatory Plan to Shift Trajectory of Tobacco-Related Disease, Death
On July 28, the U.S. Food and Drug Administration (FDA) announced a new comprehensive plan for tobacco and nicotine regulation that will serve as a multiyear roadmap to better protect children and significantly reduce tobacco-related disease and death. The approach places nicotine and the issue of...
An Expert on End-of-Life Care Shares Her Stories
“In the sufferer let me see only the human being.” So said Maimonides, the medieval Jewish philosopher and physician who espoused treating the patient rather than the illness, a philosophy that modern oncology had to relearn. This brief quote greets readers of a new book called Extreme Measures:...
A Deep and Incisive Look Into the Health-Care System
The seemingly impossible-to-cure maladies of our $3 trillion per year health-care system have been hyperanalyzed, fiercely debated, and voluminously written about by the country’s leading public health experts, opinionated doctors, and policymakers on Capitol Hill. The Affordable Care Act extended ...
I Live My Life in 3- to 6-Month Increments
I first noticed a lump in my left breast in 2001 while taking a shower and shrugged it off. After all, men don’t get breast cancer. To assuage my wife’s concern that I at least have the lump examined, I consented to see our family physician, who agreed that men don’t get breast cancer because, he...
The X-Ray Era 1901–1915
The text and photograph on this page are excerpted from a four-volume series of books titled Oncology Tumors & Treatment: A Photographic History, by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. The photo below is from the volume titled “The X-Ray Era: 1901–1915.” The photograph appears...
Trastuzumab-Based Regimens in Older Women With Early Breast Cancer
A comparative analysis of outcomes with two different trastuzumab (Herceptin)-based adjuvant regimens in older women with early HER2-positive breast cancer found little difference in safety and efficacy between treatments. The study was reported by Reeder-Hayes et al in the Journal of Clinical...
Searching for Happiness
This is the story, told through their own photographs, of a group of adolescent patients with cancer in their search for happiness. Their images relay their hopes and fears, their desire to be normal, and their urge to escape. These photographs are the outcome of a creative arts–based support...
Fertility Preservation Resources for AYAs With Cancer
The websites listed here provide educational resources for adolescents and young adults (AYAs) with cancer and health-care providers on cancer-related fertility risks and treatment options, as well as financial assistance programs for fertility preservation services. Alliance for Fertility...
How to Help Young Patients Preserve Their Fertility
GUEST EDITOR Adolescent and Young Adult Oncology explores the unique physical, psychosocial, social, emotional, sexual, and financial challenges adolescents and young adults with cancer face. The column is guest edited by Brandon Hayes-Lattin, MD, FACP, Professor of Medicine and Medical Director...
One Size May Not Fit All: Thoughts on the New Adjuvant Bisphosphonate Guideline for Early-Stage Breast Cancer
The oncology community has now conducted several prospectively designed, hypothesis-driven randomized clinical trials among women with breast cancer to address this question: Do adjuvant bisphosphonates decrease the risk of breast cancer bone metastases and other recurrence? A meta-analysis1 by...
Cancer Care Ontario and ASCO Clinical Practice Guideline: Use of Adjuvant Bisphosphonates and Other Bone-Modifying Agents in Breast Cancer
As reported in the Journal of Clinical Oncology by Sukhbinder Dhesy-Thind, MD, MSc, FRCPC, of Juravinski Cancer Centre, Hamilton Health Sciences, and colleagues, Cancer Care Ontario and ASCO have issued a clinical practice guideline on the use of adjuvant bisphosphonates and other bone-modifying...
Advances in the Treatment of Triple-Negative Breast Cancer
WITHIN THE SPECTRUM of breast cancer subtypes, triple-negative disease is “particularly troubling,” but better scientific understanding of this malignancy is leading to advances in its treatment, according to breast cancer expert Nancy Davidson, MD. Triple-negative breast cancer does not express...
Financial Toxicity: Cancer Supportive Care Professionals Consider the Side Effects of Soaring Costs
IS IT POSSIBLE to identify patients with cancer who are at risk for financial stress and intervene to reduce that risk? And could reducing financial stress—or financial toxicity, as it is often called in the context of cancer care—improve both health-related quality of life and physical health?...
Convergence of Precision Medicine and Immuno-oncology
“THE CONVERGENCE of two very hot and interesting topics—precision medicine and immuno-oncology”—is being advanced by next-generation sequencing, Douglas B. Johnson, MD, MSCI, made clear at the inaugural OncoSET Symposium: Emerging Approaches to Precision Medicine,” sponsored by the Robert H. Lurie ...
New Data Reported on Vemurafenib, Vitamin D, Selective Internal Radiotherapy, and Circulating Tumor DNA in Colorectal Cancer
RESULTS OF the IDEA trial, which showed that some patients with stage III low-risk colon cancer may require less oxaliplatin therapy (see the June 25 issue of The ASCO Post), were among the findings highlighted at the 2017 ASCO Annual Meeting Plenary Session. Other studies of interest in colorectal ...
Expert Point of View: Frank Sinicrope, MD
FRANK SINICROPE, MD, Professor of Oncology and Co-Leader of the GI Cancer Program at the Mayo Clinic, Rochester, said CHARTA addressed whether patient outcomes can be improved with a triplet regimen plus bevacizumab (Avastin) vs a standard doublet plus bevacizumab. This was based upon the finding...
FDA Actions Yield Extended Approvals of Novel Agents, Advisory Committee Votes Favorably on Two Biosimilars and Pediatric Indication for CAR T-Cell Therapy
DURING JULY, the U.S. Food and Drug Administration (FDA) and its Oncologic Drugs Advisory Committee (ODAC) made a number of approvals and recommendations on a variety of oncology products. Neratinib ON JULY 1 7, the FDA approved neratinib (Nerlynx) for the extended adjuvant treatment of adult...
In Case You Missed It: Short Takes on Current Cancer Research
MOST ONCOLOGISTS are familiar with the findings of the plenary sessions featured at the 2017 ASCO Annual Meeting, with topics ranging from the duration of adjuvant oxaliplatin-based therapy in stage III colon cancer to patient-reported outcomes for symptom monitoring during routine cancer...
FDA’s First Site-Agnostic Drug Approval Marks a Paradigm Shift in Regulatory Criteria
IN MAY, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for patients with solid tumors that have the microsatellite instability–high (MSI-H) or mismatch repair deficient (dMMR) biomarker, which disrupts the ability of cells to repair DNA. The...
Tissue Specimens in Clinical Trials: A Double-Edged Sword
AN INCREASING number of clinical trials require the submission of tissue specimens, either from archived specimens or increasingly from fresh biopsies taken after enrollment into the trial. These specimens can be either mandatory, required to determine whether a given patient has the required...
A New Triumvirate in Estrogen Receptor–Positive Metastatic Breast Cancer
THE BODY OF EVIDENCE supporting the use of cell-cycle inhibitors in combination with endocrine therapy for estrogen receptor–positive metastatic breast cancer now has another agent in the spotlight. The phase III MONARCH 2 trial—reported at the 2017 ASCO Annual Meeting and by Sledge et al in the...
Cancer on the Global Stage: Incidence and Cancer-Related Mortality in Angola
The ASCO Post is pleased to continue this special feature on the worldwide cancer burden. Each installment focuses on a country from one of the six regions of the world, as defined by the World Health Organization (ie, Africa, the Americas, South-East Asia, Europe, Eastern Mediterranean, and...
An Educational Program for Safe Handling of Opioids
Improper storage, use, and disposal of prescribed opioids can lead to diversion or accidental overdose. Given that opioids are the mainstay of cancer pain treatment, this issue is particularly germane in the oncology community. The ASCO Post recently spoke with Akhila Reddy, MD, and Maxine de la...
MammaPrint Test Addressed in ASCO Breast Cancer Guideline Update
New recommendations on the use of the MammaPrint genomic test issued on July 10 will help guide decisions on adjuvant systemic therapy for women with early breast cancer. The recommendations update the ASCO 2016 clinical practice guideline on the use of biomarkers in these patients. The guideline ...
First Oncologist Elected AMA President, Barbara L. McAneny, MD, Advocates for Access to Health Care for Everyone
Since the founding of the American Medical Association (AMA) in 1847, Barbara L. McAneny, MD, is the fourth woman and first oncologist to be elected President of the venerable medical association. “I’m a generic Midwesterner. I was born in Missouri and raised in Madison County, Illinois, and went...
Launch of Watson-Powered Genomic Sequencing Service to Help Physicians Bring Precision Cancer Treatments to Patients Nationwide
On July 27, IBM Watson Health and Quest Diagnostics announced the launch of IBM Watson Genomics from Quest Diagnostics, a new service that helps advance precision medicine by combining cognitive computing with genomic tumor sequencing. Memorial Sloan Kettering Cancer Center (MSK) will...
Two San Diego Nonprofits to Receive 2017 ASTRO Survivor Circle Grants
The American Society for Radiation Oncology (ASTRO) will award its annual Survivor Circle grants to two San Diego–based cancer support charities: Cancer Angels of San Diego and The Seany Foundation. Each organization will receive an $8,500 grant to support its programs for those who have been...
FDA Approves Enasidenib in Relapsed or Refractory Acute Myeloid Leukemia
Today, the U.S. Food and Drug Administration (FDA) approved enasidenib (Idhifa) for the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) who have a specific genetic mutation. The drug is approved for use with a companion diagnostic, the RealTime IDH2 Assay, which ...
FDA Grants Acalabrutinib Breakthrough Therapy Designation for the Treatment of Mantle Cell Lymphoma
Today, the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy Designation for acalabrutinib for the treatment of patients with mantle cell lymphoma (MCL) who have received at least one prior therapy. Acalabrutinib is a highly selective, potent Bruton tyrosine kinase (BTK)...
Fulvestrant Receives EC Approval as First-Line Therapy for Advanced Breast Cancer
On July 26, the European Commission (EC) approved fulvestrant (Falsodex) for the treatment of estrogen receptor–positive, locally advanced or metastatic breast cancer in postmenopausal women not previously treated with endocrine therapy. The EC approval is based on pivotal data from the...
FDA Grants Durvalumab Breakthrough Therapy Designation for Patients With Locally Advanced Unresectable NSCLC
On July 31, AstraZeneca and MedImmune (AstraZeneca’s global biologics research and development arm) announced that the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy designation for durvalumab (Imfinzi) for the treatment of patients with locally advanced,...
Study Finds HER2 Mutations in 3% of Lung Cancers
The Lung Cancer Mutation Consortium at the University of Colorado Cancer Center reported that 24 of 920 patients (3%) with advanced-stage lung cancer in a recent study had mutations in the gene HER2. According to the study, published by Pillai et al in Cancer, 71% of these patients were...
Association Between Vasectomy and Prostate Cancer
A systematic review and meta-analysis has found no association between vasectomy and high-grade, advanced, or fatal prostate cancer but a weak association with any prostate cancer. These findings were reported in JAMA Oncology by Bhindi et al. Study Details The analysis involved 53 studies,...
Classifying Gastric Cancers by Subtype May Provide Tailored Treatment Options
Gastric cancer is the third leading cause of cancer death in both men and women worldwide. In 2014, The Cancer Genome Atlas (TCGA) project discovered there are four molecular subtypes of gastric cancer: Epstein-Barr virus (EBV), microsatellite instability (MSI), genomically stable (GS), and...
NCI-COG Pediatric MATCH Trial to Test Targeted Drugs in Childhood Cancers
Today, investigators at the National Cancer Institute (NCI) and the Children’s Oncology Group (COG) announced the opening of enrollment for a unique precision medicine clinical trial. NCI-COG Pediatric Molecular Analysis for Therapy Choice (Pediatric MATCH) is a nationwide trial to explore...
FDA Expands Approval of Ipilimumab to Include Pediatric Patients 12 Years and Older With Unresectable or Metastatic Melanoma
Today, the U.S. Food and Drug Administration (FDA) expanded the indication for ipilimumab (Yervoy) injection for intravenous use to now include the treatment of unresectable or metastatic melanoma in pediatric patients 12 years of age and older. Ipilimumab was evaluated in 2 trials of pediatric...
COX-2 Inhibitors May Reverse IDO1-Mediated Immunosuppression in Some Cancers
In preclinical studies, tumors that consitutively expressed the protein indoleamine 2,3-dioxygenase (IDO1) responded to the cyclooxygenase-2 (COX-2) inhibitor celecoxib (Celebrex) and had improved infiltration of certain subsets of T cells, making them more likely to respond to...
Social Interaction May Affect Patients’ Response to Chemotherapy
How well patients with cancer fared after chemotherapy was affected by their social interaction with other patients during treatment, according to a new study by researchers at the National Human Genome Research Institute (NHGRI), part of the National Institutes of Health, and the University of...
ASCO-AACI’s Best Practices in Cancer Clinical Trials Initiative: Streamlining Adverse Events Reporting and Research Community Forum Activities
Research sites and investigators face an ever-increasing number of challenges in the conduct and management of cancer clinical trials. Many of these challenges stem from the multitude of requirements for clinical trials that sponsors and regulatory and administrative agencies have set. In...
The Art of Networking: Advice for the Oncologist-in-Training
It was Friday night of the 2016 ASCO Annual Meeting in Chicago. I planned to meet a friend, another 2nd-year heme-onc fellow, at a “free drink thing,” as she called it. I sheepishly entered the hotel bar, made a nametag at the insistence of the greeter, and started edging my way through the crowd. ...
Solange Peters, MD, PhD, Elected 2020–2021 ESMO President
THE EUROPEAN SOCIETY for Medical Oncology (ESMO) has announced that the President of the Society for the 2020–2021 term will be Solange Peters, MD, PhD, Head of the Medical Oncology Service and Chair of Thoracic Oncology, Oncology Department at the Centre Hospitalier Universitaire Vaudois in...
Pembrolizumab and Cetuximab-Treated Head and Neck Cancer: Activity Confirmed But No Surprises
WITH THE RECENT efficacy findings, improvements in survival, and resultant U.S. Food and Drug Administration (FDA) approvals of programmed cell death protein 1 (PD-1) immune checkpoint inhibitors across multiple solid tumor indications, the publication of yet another positive trial adds to the...
Understanding and Managing Radiation-Induced Bystander Effect
More than half of patients with cancer undergo radiotherapy. Due to a phenomenon known as radiation-induced bystander effect, in which irradiated cells leak chemical signals that can travel some distance to damage unexposed healthy cells, many suffer side effects such as hair loss, fatigue, and...
Analysis Reveals Genomic Alterations, Oncogenes Driving Medulloblastoma Subtypes
The most comprehensive analysis yet of medulloblastoma has identified genomic changes responsible for more than 75% of the brain tumors, including two new suspected cancer genes that were found exclusively in the least understood disease subgroups. The study from an international research...
NCCN Panelists Relay ‘What’s Hot’ in Their Fields
AT THE NATIONAL Comprehensive Cancer Network® (NCCN®) 22nd Annual Conference, experts from several fields met with journalists to highlight “what’s hot” in their specialties. The ASCO Post captured that conversation. Myeloproliferative Neoplasms Guidelines NCCN HAS LAUNCHED new NCCN Clinical...
Digital Tomosynthesis vs Mammography in Unmasking Breast Cancer
DIGITAL TOMOSYNTHESIS is rapidly replacing full-field digital mammography, because “it allows a more efficient diagnostic workflow and leads to a more confident interpretation,” according to Elizabeth A. Morris, MD, FACR, Chief of the Breast Imaging Service, Memorial Sloan Kettering Cancer Center, ...
Breast Cancer and Brain Metastases: Whole-Brain Radiotherapy May Not Be the Answer
FOR PATIENTS WITH BREAST CANCER who have metastases to the central nervous system (CNS), clinicians should think twice before administering whole-brain radiotherapy, according to Kimberly Blackwell, MD, Professor of Medicine and Assistant Professor of Radiation Oncology at Duke University Medical...
Are Wearable Physical Activity Monitors Coming of Age in Oncology?
COMMERCIALLY AVAILABLE wearable physical activity monitors have been making their way into clinical research in recent years; however, most studies on these devices have been related to non-cancer conditions including obesity, depression, and physical activity. Their application in the field of...
