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Talking About Physician Burnout: Practical Strategies for Starting the Conversation

Would you rather explain the benefits of three cycles of bleomycin, etoposide, and cisplatin to a hostile crowd of bored teenagers than talk to your program director, supervisor, or colleagues about feeling burned out? It is an understandable feeling. Professional burnout is a difficult concept to...

lymphoma

Tisagenlecleucel for B-Cell Acute Lymphoblastic Leukemia

On August 30, 2017, tisagenlecleucel (Kymriah) was granted regular approval for the treatment of patients up to age 25 years with B-cell precursor acute lymphoblastic leukemia (ALL) that is refractory or in second or later relapse.1,2 Tisagenlecleucel is the first chimeric antigen receptor (CAR)...

issues in oncology

Balancing Harms and Benefits of Cancer Screening: The Debate Continues

Over the past several decades, widespread cancer screening has saved lives from various cancer types. However, despite advances in early-detection technologies, many cancers still remain undetected until they become symptomatic, conferring poor prognoses and outcomes. Moreover, some methods of...

palliative care

How Early Palliative Care May Benefit Patients With Incurable Cancer

Palliative care provided soon after a patient is diagnosed with incurable cancer not only helps improve the patient’s overall quality of life but also improves communication about the patient’s wishes for end-of-life care, according to a study by Jennifer S. Temel, MD, Clinical Director of Thoracic ...

leukemia

Inotuzumab Ozogamicin for Relapsed/Refractory B-Cell Precursor ALL

On August 17, 2017, inotuzumab ozogamicin (Besponsa) was approved for the treatment of adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).1,2  Supporting Efficacy Data  APPROVAL WAS BASED on complete remission rates in the open-label phase III INO-VATE ALL...

solid tumors
lymphoma

FDA Recent Approvals Include First Oncology Biosimilar

ON SEPTEMBER 14, 2017, the U.S. Food and Drug Administration (FDA) approved bevacizumab-awwb (Mvasi) as a biosimilar to bevacizumab (Avastin) for the treatment of multiple types of cancer. Bevacizumab-awwb is the first biosimilar approved in the United States for the treatment of cancer....

issues in oncology

Duration Studies in Oncology Have Often Been Poorly Designed and Analyzed

The ASCO Post is pleased to introduce “At Microphone 1,” an occasional column written by Steven E. Vogl, MD, of Bronx, New York. When he’s not in his clinic, Dr. Vogl can generally be found at major oncology meetings, and often at the microphone where he stands ready with important questions for...

thyroid cancer
prostate cancer
lung cancer
survivorship
palliative care

News From JCO and JOP

STAYING UP-TO-DATE in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology (JCO) and the Journal of Oncology Practice (JOP). Future installments...

sarcoma

Sarcoma Management Is Slowly Evolving

THE BACKBONE treatment for soft-tissue sarcomas has long been anthracycline-based, but new approaches are coming. These novel strategies were discussed at the 2017 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia, by Melinda L. Yushak, MD, MPH, Assistant Professor ...

cns cancers

Small Steps Forward in Brain Tumor Therapy

SOME RECENT ADVANCES in the treatment of brain tumors are promising, but others are less so, according to Jeffrey J. Olson, MD, Professor of Neurosurgery at Emory University, Atlanta. At the 2017 Debates and Didactics in Hematology and Oncology Conference, held in Sea Island, Georgia, and...

skin cancer

Is Complete Lymphadenectomy Still Standard of Care in Melanoma?

DOES COMPLETE lymph node dissection for sentinel node–positive melanoma still have a role in the management of this disease? That’s debatable. Although it does not improve overall survival over observation alone, complete lymphadenectomy may have other benefits, according to a dialogue at the...

hematologic malignancies

Amyloidosis: Pearls for Simplifying the Diagnosis

AMYLOIDOSIS REMAINS a challenging and nuanced diagnosis. At the 2017 Debates and Didactics in Hematology and Oncology Conference, held in Sea Island, Georgia, Jonathan L. Kaufman, MD, discussed his approach to diagnosing amyloid light-chain amyloidosis. Dr. Kaufman is Associate Professor of...

gynecologic cancers

Update on Nonimmunotherapy Advances in Endometrial, Cervical, and Ovarian Cancers

AT THE 12TH ANNUAL New Orleans Summer Cancer Meeting, Thomas Herzog, MD, Deputy Director of the University of Cincinnati Cancer Institute and Professor of the Division of Gynecologic Oncology at the University of Cincinnati College of Medicine, delivered an update on nonimmunotherapy advances in...

hematologic malignancies
lymphoma

New Response Evaluation Criteria for Lymphoma Clinical Trials: RECIL 2017

New criteria for evaluating response in lymphoma clinical trials—RECIL 2017—have been developed by an International Working Group with the aim of harmonizing criteria with the RECIST criteria used for solid tumors.1 The new criteria were reported by Anas Younes, MD, of Memorial Sloan Kettering...

breast cancer

Religiously Tailored Educational Intervention to Encourage Mammography in American Muslim Women

Despite the U.S. Preventive Services Task Force recommendation that women between the ages of 50 and 74 undergo mammography every 2 years, only about 50% of American Muslim women do so, compared with 67% of all American women. A study by Padela et al investigating the mammography-related barrier...

skin cancer

Expert Point of View: Reinhard Dummer, MD, and Jeffrey Weber, MD, PhD

ASSUMING THE regimens evaluated in COMBI-AD and CheckMate 238 are both approved by the U.S. Food and Drug Administration for the treatment of high-risk resected melanoma, clinicians may be faced with a tough choice. ESMO experts and the study’s investigators weighed in on this issue in a lively...

skin cancer

Significant Improvement in Outcomes Reported With Adjuvant Therapy for Melanoma

FOR PATIENTS with malignant melanoma, the significant improvement in outcomes with targeted agents and antibodies against the programmed cell death protein 1 (PD-1) has now been observed in the adjuvant setting. Two landmark studies presented at the European Society for Medical Oncology (ESMO) 2017 ...

supportive care
symptom management

Tibetan Yoga Practice May Improve Sleep Quality for Patients With Breast Cancer Undergoing Chemotherapy

Participating in twice-weekly practice of Tibetan yoga may reduce sleep disturbances and improve sleep quality in breast cancer patients receiving chemotherapy, according to a study published by Chaoul et al in Cancer. The study, led by researchers from The University of Texas MD Anderson Cancer...

leukemia

Positive Results from Phase III MURANO Trial Evaluating Venetoclax in Combination With Rituximab in Relapsed/Refractory CLL

The phase III MURANO study of venetoclax (Venclexta) tablets in combination with rituximab (Rituxan) met its primary endpoint. Results showed that the combination prolonged progression-free survival in patients with relapsed/refractory chronic lymphocytic leukemia (CLL) compared with bendamustine...

health-care policy
issues in oncology

AACR Releases 2017 Cancer Progress Report: Harnessing Research Discoveries to Save Lives

Federally funded research that provides a deep understanding of cancer is spurring advances against many types of the disease. With a strong bipartisan commitment from Congress to keep investment in biomedical research a national priority, we can accelerate our pace of progress and save more lives...

issues in oncology

New ASCO Guideline Aims to Improve Clinician Communication With Patients

A new guideline from ASCO published by Gilligan et al in the Journal of Clinical Oncology outlines best practices for cancer clinicians when communicating with patients and their loved ones. The Patient-Clinician Communication: American Society of Clinical Oncology Consensus Guideline...

bladder cancer

Adjuvant Chemotherapy vs Observation After Neoadjuvant Therapy and Radical Cystectomy for Bladder Cancer

In an analysis reported in JAMA Oncology, Seisen et al found that adjuvant chemotherapy was associated with a survival benefit vs observation in patients with adverse prognostic features after neoadjuvant therapy and radical cystectomy for urothelial carcinoma of the bladder. Study Details The...

multiple myeloma

NCCN Guidelines to Include Categories of Preference

The National Comprehensive Cancer Network® (NCCN®) has instituted Categories of Preference for recommendations within the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®). Initially, Categories of Preference will be published for drugs and biologics recommended within...

issues in oncology

ESMO 2017: Patients Struggle With Key Aspects of Clinical Trial Methodology

Clinical trials are fundamental to the development of new treatments for cancer, yet the annual accrual to cancer clinical trials worldwide is low, estimated at 3%–5%. A nationwide study in Ireland, the preliminary results of which were presented at the European Society for Medical Oncology...

head and neck cancer

ESMO 2017: KEYNOTE-040 Evaluates Pembrolizumab in Head and Neck Cancer

Immunotherapy with the checkpoint inhibitor pembrolizumab (Keytruda) may be a better option than standard treatments for patients whose head and neck cancer has spread or recurred after an initial round of chemotherapy, according to results of the KEYNOTE-040 trial presented at the European Society ...

issues in oncology

ESMO 2017: Abdominal to Peripheral Fat Ratio May Predict Risk of Cancer Diagnosis in Postmenopausal Women

Body fat distribution in the trunk is more influential than body weight when it comes to cancer risk in postmenopausal women, according to a study presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 1408P_PR). The findings put a new spin on weight...

breast cancer

ESMO 2017: MONARCH 3: Abemaciclib as Initial Therapy Improves Outcome in Endocrine-Sensitive Advanced Breast Cancer

The results of the MONARCH 3 trial, presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 236O_PR), showed that adding the cyclin-dependent kinase (CDK) 4/6 inhibitor abemaciclib to endocrine therapy improved progression-free survival compared to endocrine...

issues in oncology
survivorship

ESMO 2017: NOR-CAYACS Trial: Factors That May Limit Work Ability of Young Adult Cancer Survivors

Factors that may limit the ability of young adult cancer survivors to work were reported at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 1110PD_PR). Late side effects can occur months or years after cancer treatment. In patients diagnosed with cancer in young...

lymphoma

FDA Approves Copanlisib for Adults With Relapsed Follicular Lymphoma

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to copanlisib (Aliqopa) for the treatment of adults with relapsed follicular lymphoma who have received at least two prior systemic therapies. “For patients with relapsed follicular lymphoma, the cancer often...

cns cancers
gynecologic cancers
kidney cancer
lung cancer
gastroesophageal cancer

FDA Approves First Biosimilar for the Treatment of Cancer

The U.S. Food and Drug Administration today approved bevacizumab-awwb (Mvasi) as a biosimilar to bevacizumab (Avastin) for the treatment of multiple types of cancer. Bevacizumab-awwb is the first biosimilar approved in the U.S. for the treatment of cancer. “Bringing new biosimilars to...

gynecologic cancers

ESMO 2017: Study Confirms Chemoradiation Is Best Treatment for Locally Advanced Cervical Cancer

A 14-year randomized trial in more than 600 patients has concluded that chemoradiation should remain the standard treatment for patients with locally advanced cervical cancer. The findings were reported at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 928O_PR). ...

issues in oncology
supportive care

ESMO 2017: Patients May Feel Psychosocial Impact of Chemotherapy More Acutely Than Physical Side Effects

The preliminary results of a study presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid show that sociopsychological factors have become more significant for patients today than physical side effects such as nausea and vomiting, which were among the top concerns in...

breast cancer

Whole-Genome Sequencing Reveals Breast Cancers With Mismatch-Repair Deficiencies

Cancers caused by mismatch repair (MMR)-deficiency involve gene mutations that affect the ability of the cell to repair the mistakes that may occur during the DNA replication process. MMR-deficient tumors have 10 to 100 times more mutations than tumors with intact MMR pathways. A study...

prostate cancer

ESMO 2017: Patients With High-Risk Prostate Cancer May Benefit From Addition of Docetaxel or Abiraterone/Prednisolone to Long-Term Hormone Therapy

Patients with high-risk prostate cancer starting long-term hormone therapy may benefit from two new treatments, according to late-breaking results from the STAMPEDE trial presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (LBA31_PR). Long-term hormone therapy...

prostate cancer

Alzheimer’s Disease Risk in Medicare Patients Receiving Androgen-Deprivation Therapy for Prostate Cancer

As reported by Baik et al in the Journal of Clinical Oncology, Medicare patients who received androgen-deprivation therapy for prostate cancer do not appear to be at increased risk for Alzheimer’s disease and may have an extremely small increased risk for dementia. Study Details The study...

issues in oncology

ESMO 2017: Some Stroke Survivors May Have Underlying Cancer

Some stroke survivors may have underlying cancer, according to an observational study presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 1412P_PR). “Postmortem studies have suggested that cancer can develop after a stroke, but the magnitude of...

lung cancer

ESMO 2017: Phase III IFCT-0302 Trial Assesses Minimal vs CT Scan–Based Follow-up for Completely Resected NSCLC

The optimal follow-up protocol for patients with completely resected non–small cell lung cancer (NSCLC) remains elusive after results of the IFCT-0302 trial, presented at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid, did not show a difference in overall survival...

issues in oncology

ESMO 2017: Overuse of Tumor Marker Tests in Primary and Secondary Care

The vast majority of tumor marker tests in primary and secondary care are not necessary, according to a study presented at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid (Abstract 1410P_PR). The tests assisted with a cancer diagnosis in just 2% of patients....

lung cancer

Association of Supplemental Vitamin B Use and Lung Cancer in VITAL Cohort

In a study reported in the Journal of Clinical Oncology, Brasky et al found that the use of individual source supplemental vitamins B6 and B12 was associated with an increased risk of lung cancer among men in the Vitamins and Lifestyle (VITAL) cohort. Several B vitamins, including B6, B9 (folate),...

colorectal cancer

Study Finds Gut Microbes May Promote Immune Responses Against Colorectal Cancer

Colorectal cancer is the third leading cancer-related cause of death worldwide, accounting for 774,000 deaths in 2015, according to the World Health Organization. Now, a study presented at the third CRI-CIMT-EATI-AACR International Cancer Immunotherapy Conference: Translating Science Into Survival, ...

issues in oncology

FDA Pilot Program Aims to Encourage Students to Pursue STEM Careers

When I was in high school, I spent summers working as a restaurant dishwasher, grocery store stock boy, and gardener in northwest Indiana. The idea of spending those weeks learning about science and medicine would not have been an option for me at that time. Yet it is precisely those students who...

gastrointestinal cancer

Relationship Between Molecular Subtypes of Gastric Cancer and Prognosis

In 2014, The Cancer Genome Atlas (TCGA) project discovered there are four molecular subtypes of gastric cancer: Epstein-Barr virus (EBV), microsatellite instability, genomically stable, and chromosomal instability. However, their clinical significance is unknown.  Now, a study by Bo Hwa Sohn, PhD,...

cns cancers

Zika Virus Shows Oncolytic Activity Against Glioblastoma Stem Cells in Preclinical Trial

Although Zika virus causes devastating damage to the brains of developing fetuses, it someday may prove to be an effective treatment for glioblastoma. New research from Washington University School of Medicine in St. Louis and the University of California San Diego School of Medicine showed that...

survivorship

Financial Burden Among Survivors of Childhood Cancer

Findings from the Childhood Cancer Survivor Study, reported in the Journal of Clinical Oncology by Nipp et al, indicate that childhood cancer survivors are more likely than unaffected siblings to spend a higher percentage of income on out-of-pocket medical costs, potentially leading to reduced use...

skin cancer

Immune-Related Toxicity and Time to Treatment Failure With Nivolumab Plus Ipilimumab in Advanced Melanoma

As reported in JAMA Oncology by Shoushtari et al, a single-center experience has shown a very high rate of clinically significant immune-related adverse events with nivolumab (Opdivo) plus ipilimumab (Yervoy) for advanced melanoma. Their findings suggest that the full course of four doses of...

cns cancers

Expect Questions About Glioblastoma Symptoms

WITH THE MANY NEWS REPORTS about Senator John McCain being diagnosed with glioblastoma, patients may be asking if symptoms such as headaches and vision or speech problems should signal the need for screening or diagnostic tests. “There has never been any suggestion that doing routine screening,...

cns cancers

‘Substantial Improvements’ in the Treatment of Glioblastoma

NEWS ARTICLES about Senator John McCain’s diagnosis of glioblastoma accurately describe glioblastoma as aggressive and having a poor prognosis. But as Walter J. Curran, Jr, MD, pointed out in one of those reports, “substantial improvements in surgical approaches” have enabled more patients to...

Control

Many Type A personalities deal with problems by controlling all aspects of the problem. Sometimes this works. Sometimes it works for a while. Sometimes it doesn’t work at all. The health-care system—hospitals, clinics, and doctors’ offices—have policies (specific office hours and strict...

Addressing the Challenges of Intimacy After Cancer

The literature has documented the stress and damage that intimacy problems cause among women undergoing cancer treatment and during survivorship. A new book, Sex and Cancer: Intimacy, Romance, and Love After Diagnosis and Treatment, by Saketh R. Guntupalli, MD, and Maryann Karinch tackles the...

Get to Know Your ASCO President-Elect: Monica M. Bertagnolli, MD, FASCO

Monica M. Bertagnolli, MD, FASCO, a long-time member and volunteer, began her term as ASCO President-Elect in June 2017; she will serve as 2018–2019 ASCO President. An active ASCO member since 1995, Dr. Bertagnolli is Chief of the Division of Surgical Oncology at Dana-Farber/Brigham and Women’s...

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