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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...

multiple myeloma
immunotherapy

FDA Approves Daratumumab/VMP Combination for Newly Diagnosed Multiple Myeloma

On May 7, the U.S. Food and Drug Administration(FDA) approved daratumumab (Darzalex) in combination with bortezomib (Velcade), a proteasome inhibitor; melphalan, an alkylating agent; and prednisone—VMP—for the treatment of patients with newly diagnosed multiple myeloma who are ineligible for...

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....

Robert M. Arnold, MD, Receives 2018 Association of Specialty Professors Award

Robert M. Arnold, MD, a researcher and physician at the University of Pittsburgh Medical Center (UPMC), has been recently recognized by the Alliance for Academic Internal Medicine for his efforts to train clinicians to have difficult end-of-life conversations. Dr. Arnold accepted the 2018 Eric G....

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...

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...

lymphoma
immunotherapy

FDA Expands Tisagenlecleucel Approval to Include Relapsed or Refractory Large B-Cell Lymphoma

On May 1, 2018, the U.S. Food and Drug Administration (FDA) approved tisagenlecleucel (Kymriah) for adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including diffuse large B-cell lymphoma (DLBCL) not otherwise specified, high grade...

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...

ASCO and ABIM Announce Collaboration on Maintenance of Certification Pathway

ASCO and the American Board of Internal Medicine (ABIM) have announced that they are working to co-create a pathway to provide doctors with a flexible way to maintain board certification. Beginning in 2020, oncologists will be able to choose from two different assessment pathways. They may take an ...

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...

colorectal cancer

GAME Score for Patients With Metastatic Colorectal Cancer

Surgical oncologists at the Johns Hopkins University School of Medicine may have developed an improved scoring system for predicting survival in people with colorectal cancers that have metastasized to the liver. According to the researchers, the system, called the Genetic and Morphological...

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: Mobile and Sensor Technology May Lead to Reduced Symptom Severity in Patients With Head and Neck Cancer

A randomized clinical trial evaluating the use of mobile and sensor technology to remotely monitor symptoms in patients receiving radiation therapy for head and neck cancer found that use of this technology reduced severe symptoms related to cancer and its treatment compared with usual care....

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...

sarcoma

FDA Grants Orphan Drug Designation to CLR 131 in Rhabdomyosarcoma

The U.S. Food and Drug Administration’s (FDA) Office of Orphan Products Development recently granted Orphan Drug designation to CLR 131 for the treatment of rhabdomyosarcoma, a rare pediatric cancer. “Rhabdomyosarcoma is the most common type of tissue sarcoma in children.  While...

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...

cns cancers

Genetic Counseling and Testing for Patients With Medulloblastoma

Researchers have identified six genes that predispose carriers to develop medulloblastoma and have used the discovery to craft genetic counseling and screening guidelines. The study was published by Waszak et al in The Lancet Oncology. St. Jude Children’s Research Hospital,...

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...

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...

AACR Welcomes New Leadership at 2018 Annual Meeting

THE AMERICAN ASSOCIATION FOR CANCER RESEARCH (AACR) welcomes Elizabeth M. Jaffee, MD, Deputy Director for the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins and Associate Director of the Bloomberg~Kimmel Institute for Cancer Immunotherapy, as President of AACR for 2018–2019....

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...

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...

AACR Announces 2018 Special Recognition Awards

THE AMERICAN ASSOCIATION for Cancer Research (AACR) presented Special Recognition Awards to the following four individuals whose work has made extraordinary contributions to the AACR’s mission to accelerate the prevention and cure of all cancers through research, education, communication, and...

leukemia
genomics/genetics

Minimal Residual Disease in Acute Myeloid Leukemia: Mutation Matters

A RECENT article in The New England Journal of Medicine explored the nuances of minimal/measurable residual disease testing after induction treatment of acute myeloid leukemia (AML)1 and David P. Steensma, MD, and Benjamin L. Ebert, MD, PhD, of Dana-Farber Cancer Institute and Harvard Medical...

issues in oncology

Evolving Standards and Quality Metrics Ensure High-Quality Cancer Programs

Dr. Shulman is Deputy Director, Clinical Services, and Director of the Center for Global Cancer Medicine, Abramson Cancer Center; and Professor of Medicine, Hospital of the University of Pennsylvania, Philadelphia. IN 2008, WHEN ALLEN LICHTER, MD, FASCO, then Chief Executive Officer of ASCO,...

issues in oncology

Parenting Concerns Affect Emotional Well-Being in Mothers With Advanced Cancer

Parenting concerns contributed significantly to the psychological distress of mothers with late-stage cancer, according to a study by University of North Carolina (UNC) Lineberger Comprehensive Cancer Center researchers published by Park et al in the journal Cancer. Cancer is the leading cause of...

lung cancer
immunotherapy

FDA Accepts sBLA, Grants Priority Review to Atezolizumab for Initial Treatment of Metastatic Nonsquamous NSCLC

The U.S. Food and Drug Administration (FDA) recently accepted a supplemental biologics license application (sBLA) and granted Priority Review for atezolizumab (Tecentriq) in combination with bevacizumab (Avastin), paclitaxel, and carboplatin for the first-line treatment of metastatic nonsquamous...

multiple myeloma
immunotherapy

FDA Approves Daratumumab in Combination With VMP for Newly Diagnosed Patients With Multiple Myeloma Who Are Transplant-Ineligible

On May 7, the U.S. Food and Drug Administration (FDA) approved daratumumab (Darzalex) in combination with bortezomib (Velcade), a proteasome inhibitor; melphalan, an alkylating agent; and prednisone—VMP—for the treatment of patients with newly diagnosed multiple myeloma who are...

breast cancer

ASBrS 2018: Early Detection and Intervention Effective for Preventing Breast Cancer–Related Lymphedema

Early, ongoing screening of lymphatic function and immediate patient-administered therapies as needed are highly effective in improving outcomes for women at high risk for breast cancer–related lymphedema (BCRL). These were the findings of a new study presented at the American Society of ...

breast cancer

ASBrS 2018: Modern Therapies Minimize Recurrence After Breast-Conserving Surgery

Modern, multimodality lumpectomy treatment significantly reduces the incidence of breast cancer recurrence at the original tumor site compared to historical protocols, according to a new study presented at the American Society of Breast Surgeons (ASBrS) 19th Annual Meeting (Abstract...

breast cancer

ASBrS 2018: Breast Cancer Genetic Testing Guidelines Exclude Almost Half of High-Risk Patients

Current restrictive genetic testing guidelines exclude many patients who harbor high-risk breast cancer mutations, according to two new studies presented at the American Society of Breast Surgeons (ASBrS) 19th Annual Meeting (Abstracts 402910, 404340). One study found that whether or not patients...

breast cancer

ASBrS 2018: Regular Mammograms May Mean Earlier Breast Cancer Diagnosis and Less Aggressive Treatment

Women with breast cancer who underwent regular mammographic screening were diagnosed with earlier-stage disease and treated with significantly less aggressive therapies than those who delayed or never underwent screening, according to new research presented at the American Society of Breast...

breast cancer

Targeting Chemotherapy With Genetic Testing in Advanced Triple-Negative Breast Cancer

Researchers have found that women with advanced triple-negative breast cancer with a BRCA mutation were twice as likely to benefit from carboplatin as docetaxel—the current standard of care for these patients. These findings were published by Tutt et al in Nature Medicine. The trial is set...

skin cancer

FDA to Conduct Priority Review of Cemiplimab as a Potential Treatment for Advanced Cutaneous Squamous Cell Carcinoma

On April 30, the U.S. Food and Drug Administration (FDA) accepted for priority review the biologics license application (BLA) for cemiplimab for the treatment of patients with metastatic cutaneous squamous cell carcinoma or patients with locally advanced cutaneous squamous cell carcinoma who...

solid tumors
skin cancer

FDA Approves Drug Combination for Adjuvant Treatment of BRAF V600–Mutant Melanoma

On April 30, 2018, the U.S. Food and Drug Administration (FDA) approved dabrafenib (Tafinlar) in combination with trametinib (Mekinist) for the adjuvant treatment of patients with melanoma with BRAF V600E or V600K mutations, as detected by an FDA-approved test, and lymph node involvement following...

solid tumors
head and neck cancer

HPV-Related Cancers Like Mine Are Avoidable, So Why Aren’t More Kids Being Vaccinated?

The latest news from the Centers for Disease Control and Prevention about vaccination rates in the United States for human papillomavirus (HPV) is disappointing. It shows that in 2016, just 43.4% of adolescents (49.5% of females and 37.5% of males) were up-to-date with the recommended 3-dose HPV...

Anticipate Concerns About Radiotherapy For Breast Cancer

A study examining the patient’s perspective on breast radiotherapy found that 68% of the patients surveyed responded that they had little or no prior knowledge of radiotherapy at the time of breast cancer diagnosis, making that an excellent time for physicians and other health-care professionals to ...

solid tumors

FDA Approves Dabrafenib/Trametinib Combination for BRAF-Positive Anaplastic Thyroid Cancer

Today, the U.S. Food and Drug Administration approved dabrafenib (Tafinlar) and trametinib (Mekinist), administered together, for the treatment of unresectable, metastatic, BRAF V600E mutation–positive anaplastic thyroid cancer. Anaplastic thyroid cancer accounts for about 1% to 2% of all...

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