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solid tumors
breast cancer

Making Our Future Plans Happen Now

The following essay by Hope S. Rugo, 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. I was in...

supportive care
integrative oncology

Turmeric

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

solid tumors
hematologic malignancies

Unraveling the Complexities of Cellular Immunotherapy and Its Potential to Cure Some Cancers

This past fall, the Fred Hutchinson Cancer Research Center in Seattle opened an all-encompassing 9,222-square foot outpatient cellular immunotherapy clinic, specifically designed to serve patients participating in the center’s novel immunotherapy clinical trials, which mainly focus on chimeric...

breast cancer

Triple-Negative Breast Cancer: Practical Approach, Promising Research

Triple-negative breast cancer has a reputation for being a particularly challenging malignancy, but breast cancer specialist Nancy Davidson, MD, Senior Vice President of the Clinical Research Division at the Fred Hutchinson Cancer Research Center, Seattle, put this in perspective in a recent...

lung cancer

ASCO Guideline on Stage IV NSCLC Therapy Updated

An update of the ASCO clinical practice guideline on the systemic treatment of patients with stage IV non–small cell lung cancer (NSCLC) clarifies the role of immunotherapy in this setting. The update, published by Hanna et al in the Journal of Clinical Oncology, also provides new...

issues in oncology

Short-Term Risk of Arterial Thromboembolism in Newly Diagnosed Patients With Cancer

Patients newly diagnosed with cancer may have a substantially increased short-term risk of arterial thromboembolism, according to a study published by Navi et al in the Journal of the American College of Cardiology. Patients with cancer face an increased risk of medical complications. However, the ...

breast cancer

Partial-Breast and Reduced-Dose Radiotherapy After Breast-Conserving Surgery

The UK IMPORT LOW phase III trial has shown noninferiority in local relapse for partial-breast and reduced-dose vs standard whole-breast radiotherapy after breast-conserving surgery in early breast cancer. These study results were reported by Coles et al in The Lancet. Study Details In the...

lung cancer

Lung Cancer Clinical Trial Eligibility Criteria Increase in Number, Complexity

With the advent of molecular targeted therapies and immunotherapy, eligibility criteria have increased in number and complexity for lung cancer clinical trials, according to an analysis published by Garcia et al in the Journal of Thoracic Oncology. Despite calls to streamline cancer clinical trial...

breast cancer

Genomic Characteristics and Immune Infiltration in Triple-Negative Breast Cancer

In a study reported in JAMA Oncology, Karn et al found that triple-negative breast cancers with high immune gene expression levels were characterized by lower clonal heterogeneity, reduced copy number alterations, and lower somatic mutation and neoantigen loads. Study Details In the study, DNA...

cost of care

Out-of-Pocket Costs Remain High, Even for Insured Patients With Cancer

One-third of insured people with cancer end up paying more out-of-pocket than they expected, despite having health insurance coverage, researchers at the Duke Cancer Institute have found. The data showed that costs such as copays and deductibles could lead to financial distress among insured...

prostate cancer

First-Line Cabazitaxel vs Docetaxel in Metastatic Castration-Resistant Prostate Cancer

The phase III FIRSTANA trial has shown no difference in overall survival with two dose regimens of cabazitaxel (Jevtana) vs docetaxel in the first-line treatment of metastatic castration-resistant prostate cancer. Results were reported by Oudard et al in the Journal of Clinical Oncology....

colorectal cancer

Imaging and Biomarker Test Could More Accurately Predict Longer-Term Patient Response to Regorafenib in Colorectal Cancer

Administering a magnetic resonance imaging (MRI) scan and a blood test to patients with metastatic colorectal cancer may help to select those who would benefit from a targeted cancer treatment, a new study published by Khan et al in Gutreported. Researchers found that after only 2 weeks on the...

gynecologic cancers

Increased Endometrial Cancer Rates Found in Women With Increased Levels of Cadmium

Through a 5-year observational study recently published by McElory et al in PLOS One, researchers at the University of Missouri (MU) found that women with increased levels of cadmium—a metal commonly found in foods such as kidney, liver, and shellfish, as well as tobacco—had an...

health-care policy
issues in oncology

FDA to Expand Public Education Campaign to Focus on Prevention of Youth E-Cigarette Use

On August 8, the U.S. Food and Drug Administration (FDA) announced it would pursue a strategic, new public health education campaign aimed at discouraging the use of e-cigarettes and other electronic nicotine delivery systems (ENDS) by children. The agency plans to expand its “The Real...

gynecologic cancers

New Device to Test for Cervical Cancer May Be Less Painful for Patients, Produce Better Results

When a woman has an abnormal Papanicolaou (Pap) smear, she usually undergoes colposcopy—a procedure physicians use to closely examine the cervix, vagina, and vulva for signs of disease. Typically, a metal instrument is used to obtain a small sampling of cells inside the cervix, which is...

issues in oncology

Identifying Essential Genes for Cancer Immunotherapy

A new study published by Patel et al in Nature identifies genes that are necessary in cancer cells for immunotherapy to work—addressing the problem of why some tumors don’t respond to immunotherapy, or respond initially but then stop as tumor cells develop resistance to...

breast cancer
issues in oncology

Perioperative Anti-inflammatory, Antistress Drugs May Reduce Postsurgical Metastatic Disease Recurrence

Most cancer-related deaths are the result of postsurgical metastatic recurrence. A new Tel Aviv University (TAU) study published by Shaashua et al in Clinical Cancer Research found a specific drug regimen administered prior to and after surgery significantly reduces the risk of postsurgical cancer...

cns cancers
survivorship

Study Maps Mutation That May Drive Meningioma Development in Childhood Cancer Survivors

Neuroscientists may have uncovered the genetic basis for why many long-term survivors of childhood cancer develop meningiomas, the most common adult brain tumor, decades after their treatment with cranial radiation. The findings, published by Agnihotri et al in Nature Communications, show that...

palliative care

Physician Orders for Life-Sustaining Treatment Form Use and End-of-Life Quality-of-Care Metrics in Cancer Patients

In a study reported in the Journal of Oncology Practice, Pedraza et al found that patients with advanced cancer who had Physician Orders for Life-Sustaining Treatment (POLST) forms in place were more likely to have hospice admission and death out of the hospital than those with only advance...

lung cancer

Fat Intake and Lung Cancer Risk

According to a study reported by Yang et al in the Journal of Clinical Oncology, high dietary intake of total fat and saturated fat was associated with an increased risk of lung cancer, with the association with saturated fat being particularly evident among current smokers. Study Details The...

ASCO President Bruce E. Johnson Seeks to Bring Personalized Medicine, Real-Time Data to Every Oncology Practice

Dedicating one’s career and livelihood to the pursuit of treating and possibly curing cancer is, for many, a decision that stems from deeply personal and, often, tragic experience. For 2017–2018 ASCO President Bruce E. Johnson, MD, FASCO, the event that greatly influenced his decision was the...

leukemia

Blinatumomab in Advanced Acute Lymphoblastic Leukemia: A Brighter Therapeutic Outlook

NEW DRUGS that will improve the outcome of adult patients who develop a deadly disease such as acute leukemia are badly needed; combinations of cytotoxic chemotherapeutic drugs may have reached an upper limit of utility. Agents that eradicate leukemia by alternative mechanisms would be of...

leukemia

Improved Overall Survival With Blinatumomab vs Chemotherapy in Advanced Acute Lymphoblastic Leukemia

IN THE PHASE III TOWER TRIAL reported in The New England Journal of Medicine, Hagop Kantarjian, MD, of The University of Texas MD Anderson Cancer Center, and colleagues found that blinatumomab (Blincyto) treatment improved overall survival vs chemotherapy in heavily pretreated patients with B-cell ...

lung cancer

Alectinib: A New Standard for First-Line Therapy of ALK-Rearranged NSCLC?

ANAPLASTIC LYMPHOMA KINASE (ALK) was first identified in anaplastic large cell lymphoma. The ALK gene itself is not oncogenic, but it can become oncogenic by at least three mechanisms: by forming a fusion gene with a number of other partner genes, by copy number gain, or by mutations in the gene....

thyroid cancer

U.S. Preventive Services Task Force Recommends Against Screening for Thyroid Cancer in Asymptomatic Individuals

AS REPORTED in JAMA, the U.S. Preventive Services Task Force (USPSTF) has recommended against thyroid cancer screening in asymptomatic individuals.1 The current USPSTF statement is an update of a 1996 USPSTF recommendation statement. The recommendation was based on Task Force review of evidence on ...

thyroid cancer

Are Thyroid Cancer Incidence and Mortality Rates Truly Increasing in the United States?

THYROID CANCER diagnoses are increasing at a rate faster than any other malignancy in the United States. In 2017, there will be 56,870 new cases, accounting for 3.4% of all cancers, and 2,010 people will die of thyroid cancer.1 This represents a more than 200% increase in incidence since the...

cost of care

Cost of Hospitalization for Cancer-Related Neutropenia or Fever

In a study of 2012 data, Eric Tai, MD, of the Division of Cancer Prevention and Control, Centers for Disease Control and Prevention, and colleagues estimated that average costs per hospital stay for cancer-related neutropenia or fever were approximately $25,000, with a total cost of more than $2.7 ...

lung cancer

Sacituzumab Govitecan in Metastatic NSCLC

As reported by Rebecca Suk Heist, MD, MPH, of Massachusetts General Hospital, and colleagues in the Journal of Clinical Oncology, the antibody-drug conjugate sacituzumab govitecan showed activity in patients with previously treated metastatic non–small cell lung cancer (NSCLC). Sacituzumab targets ...

Sylvia

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....

health-care policy

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...

A Textbook That Fills a Special Need in Oncology: Uncommon Cancers

A cancer diagnosis provokes a sea of emotions, fear and anxiety over the future foremost. However, being diagnosed with a common cancer such as breast or prostate cancer has a hard-won comfort zone, in that both patients and physicians are armed with a plethora of data and resources on how to treat ...

breast cancer

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...

prostate cancer

Adverse Pathologic Findings in Low-Volume Intermediate-Risk Prostate Cancer

In a single-center analysis reported in JAMA Oncology, Patel et al found that among men undergoing elective radical prostatectomy, those with low-volume intermediate-risk disease had significantly higher rates of adverse pathologic findings compared than did those with very low-risk and low-risk...

breast cancer

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...

issues in oncology
survivorship

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...

breast cancer

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...

breast cancer

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...

cost of care

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?...

hematologic malignancies
multiple myeloma
lymphoma
leukemia
myelodysplastic syndromes

Selected Abstracts on Novel Therapies for Hematologic Malignancies

THE 22ND CONGRESS of the European Hematology Association (EHA) was held in June in Madrid, drawing hematologists and allied professionals from every subspecialty of hematology from around the world. Among the extensive educational and scientific program, the EHA Congress provides a forum for...

genomics/genetics

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 ...

colorectal cancer

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 ...

colorectal cancer

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...

breast cancer
leukemia
supportive care
gastrointestinal cancer

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...

sarcoma
cns cancers
lymphoma
survivorship

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...

issues in oncology
solid tumors

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...

issues in oncology

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...

breast cancer

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...

global cancer care

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...

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