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issues in oncology

Matthew G. Vander Heiden, MD, PhD, and Karen H. Vousden, PhD: A Conversation About the Role of Diet in Cancer

Karen H. Vousden, PhD, of The Francis Crick Institute, and Matthew G. Vander Heiden, MD, PhD, of the Koch Institute for Integrative Cancer Research at MIT, discuss emerging evidence that diet may affect which nutrients are available to tumor cells, which can influence both tumor growth and response ...

issues in oncology

Ralph R. Weichselbaum, MD, on Oligometastasis: Biologic Basis and Therapeutic Opportunities

Ralph R. Weichselbaum, MD, of the University of Chicago, discusses oligometastasis as a part of the metastatic spectrum where ablative therapies, such as surgery or stereotactic body radiotherapy, may be curative alone or with systemic agents, as well as some potential biomarkers to guide treatment ...

immunotherapy
issues in oncology

Charlotte E. Ariyan, MD, PhD, on Metastasectomy After Immunotherapy: Is It Effective?

Charlotte E. Ariyan, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses improved outcomes with metastasectomy in the setting of checkpoint inhibitors, with the removal of residual disease and “escape” lesions. Surgical outcomes may also be better than targeted treatments, although...

issues in oncology

Jeanne Tie, MD, MBChB, on Circulating Tumor DNA, Minimal Residual Disease, and Adjuvant Treatment

Jeanne Tie, MD, MBChB, of the Peter MacCallum Cancer Centre, discusses how to improve the current, somewhat imprecise, approach based on pathologic staging alone, used to select patients for adjuvant treatment. Circulating tumor DNA analysis after curative-intent treatment may detect minimal...

issues in oncology

Joann G. Elmore, MD, MPH, on Cancer Diagnosis: When Pathologists Disagree, Artificial Intelligence May Help

Joann G. Elmore, MD, MPH, of the UCLA Fielding School of Public Health, discusses previous studies that show wide variability in cancer diagnoses, the uncertainties introduced by computer-aided detection tools, and new research on artificial intelligence and machine learning that may lead to more...

issues in oncology

Gabrielle A. Zecha, PA-C, MHA, and Aaron Begue, MS, RN, NP-C, OCN: The Role of Advanced Practice Providers in Oncology Care

Gabrielle A. Zecha, PA-C, MHA, of Fred Hutchinson Cancer Research Center and Seattle Cancer Care Alliance, and Aaron Begue, MS, RN, NP-C, OCN, of Memorial Sloan Kettering Cancer Center, discuss how advanced practice providers are recruited and trained, ways to retain these valuable health-care...

issues in oncology

Robert Winn, MD, on Strategies for Reducing Racial Disparities in Oncology

Robert Winn, MD, of the Virginia Commonwealth University Massey Cancer Center, discusses the creation of a health equity report card to track how institutions are dealing with disparities in oncology care, ways to recognize bias in care, and adding health equity experts to guideline panels and...

issues in oncology

Shivan J. Mehta, MD, MBA, on Preventing and Controlling HPV-Associated Cancers

Shivan J. Mehta, MD, MBA, of Abramson Cancer Center at the University of Pennsylvania, discusses how insights from behavioral economics could be harnessed to improve HPV vaccination rates, thus lowering the rate of cervical, genital, and head/neck cancers, all of which are linked to HPV.

lung cancer
issues in oncology

Jill Feldman on Diversifying the Criteria for Inclusion in Clinical Trials

Jill Feldman, a patient advocate and lung cancer survivor, discusses the current challenges and potential solutions to including more people of color and those in underserved communities in clinical trial research (Abstract PL04.06).

gastrointestinal cancer
issues in oncology

Afsaneh Barzi, MD, PhD, on Disparities in Access to Screening and Treatment of GI Cancers

Afsaneh Barzi, MD, PhD, of the City of Hope Comprehensive Cancer Center and the University of Southern California, discusses reasons for the incomplete understanding of the molecular landscape of minority patients with cancer, lack of screening chief among them. This underrepresentation, Dr. Barzi...

hematologic malignancies
lymphoma
multiple myeloma
issues in oncology
palliative care

Lena E. Winestone, MD, MSHP, on Health-Care Disparities in Hematologic Cancers: Real-World Data

Lena E. Winestone, MD, MSHP, of the University of California, San Francisco and Benioff Children’s Hospital, reviews different aspects of bias in treatment delivery, including patient selection for clinical trials; racial and ethnic disparities in survival for indolent non-Hodgkin diffuse large...

hematologic malignancies
issues in oncology

Radhika Gangaraju, MD, and Smita Bhatia, MD, MPH, on Coronary Heart Disease Risk in Blood or Marrow Transplant Survivors

Smita Bhatia, MD, MPH, and Radhika Gangaraju, MD, both of the Institute for Cancer Outcomes and Survivorship, University of Alabama at Birmingham, discuss findings that showed survivors of bone marrow transplants are at a 7- to 12-fold higher risk of coronary heart disease than a sibling comparison ...

issues in oncology
leukemia

Ann-Kathrin Eisfeld, MD, on AML in Black Patients: Racial Disparities in Survival Outcomes

Ann-Kathrin Eisfeld, MD, of The Ohio State University Comprehensive Cancer Center, discusses SEER data showing that patients with acute myeloid leukemia who are Black and younger than age 60 may have poor survival outcomes, a disparity that should be addressed and further studied to establish...

lung cancer
issues in oncology

Daniel G. Petereit, MD, on Disparities in Lung Cancer Care for Northern Plains American Indians

Daniel G. Petereit, MD, of the John T. Vucurevich Cancer Care Institute and Monument Health, discusses the Walking Forward health-care program designed for a South Dakota–based Native American population, whose members have high smoking and death rates from lung cancer as well as limited access to...

issues in oncology
pain management

James D. Murphy, MD, on Opioid Use Among Patients With Cancer

James D. Murphy, MD, of the University of California, San Diego, discusses the possible reasons for a decline in long-term opioid use in patients with cancer, even as short-term use is rising, as well as the racial and socioeconomic disparities of opioid use in this population (Abstract 187).

issues in oncology

Cardinale B. Smith, MD, PhD, on Redesigning Care Coordination From the Patient’s Perspective

Cardinale B. Smith, MD, PhD, of the Icahn School of Medicine at Mount Sinai, discusses results of a pilot study suggesting dedicated lay staff members, who facilitated admissions and discharges for patients with cancer across care settings, could improve health-care utilization, quality, and the...

issues in oncology
covid-19

Cardinale B. Smith, MD, PhD, on Telehealth Disparities During the COVID-19 Pandemic

Cardinale B. Smith, MD, PhD, of the Icahn School of Medicine at Mount Sinai, discusses findings showing Black, Hispanic, and Asian patients with cancer used telehealth less often during the COVID-19 pandemic than White patients with cancer, a negative trend that will become more problematic as this ...

issues in oncology

Katherine Enright, MD, MPH, on Improving the Quality of Oral Cancer Drug Delivery

Katherine Enright, MD, MPH, of Trillium Health Partners in Ontario, discusses a model of quality improvement, which potentially could be adapted across health systems to improve oral systemic cancer care (Abstract 184).

issues in oncology

Joseph M. Unger, PhD, on Patient Interest in Clinical Trial Enrollment: A New Analysis

Joseph M. Unger, PhD, of Fred Hutchinson Cancer Research Center, discusses study results showing that more than half of all patients with cancer, regardless of race or ethnicity, agree to take part in clinical trials, a finding that upends conventional beliefs. He talks about removing the barriers...

issues in oncology

Antoni Ribas, MD, PhD, on Turning Science Into Life-Saving Care

Antoni Ribas, MD, PhD, of the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, summarizes the opening plenary session that addressed epigenetics and early detection, how the aging microenvironment governs response to therapy, AI-driven precision medicine, reprogramming...

issues in oncology

Leonard B. Saltz, MD, on Interventional Pharmacoeconomics: A Pathway to Better Cancer Care

Leonard B. Saltz, MD, of Memorial Sloan Kettering Cancer Center, discusses interventional pharmacoeconomics as an important tool that can offer patients with cancer more efficacious and cost-effective care. Pharmacoeconomics may help reduce the high costs of cancer therapy, with evidence-based...

issues in oncology

Antoni Ribas, MD, PhD, on Racism and Racial Inequities in Cancer Research

Antoni Ribas, MD, PhD, of the University of California, Los Angeles, Jonsson Comprehensive Cancer Center, summarizes a special panel discussion on ways to eliminate cancer health disparities among racial and ethnic minorities. Increasing minority representation in clinical trials, thus ensuring...

issues in oncology
leukemia

Alfonso Bencomo Álvarez, PhD, on ALL, AML, and CML: Survival for Hispanic Patients Living Near the US/Mexico Border

Alfonso Bencomo Álvarez, PhD, of Texas Tech University Health Sciences Center, discusses his retrospective study of the incidence and survival for patients with hematologic malignancies residing at the United States/Mexico border. The analysis showed that 10-year survival rates for Hispanic...

issues in oncology

Stacey A. Fedewa, PhD, on Cancers in Younger Populations: Current Trends

Stacey A. Fedewa, PhD, of the American Cancer Society, discusses the increasing incidence rates of colorectal, breast, kidney, thyroid, uterine corpus, and cervical disease in younger patients. Data show that colorectal cancer is increasing most rapidly, while breast cancer—the most common cancer...

issues in oncology

Adam C. Palmer, PhD, on Immune Checkpoint Inhibitors: Additive to or Synergistic With Other Treatments?

Adam C. Palmer, PhD, of the University of North Carolina at Chapel Hill, discusses combining immune checkpoint inhibitors with other cancer therapies to provide patients with more chances of a response. In principle, similar benefits may result from sequential or biomarker-stratified treatments,...

issues in oncology
cost of care

Mark J. Ratain, MD, and Daniel Goldstein, MD, on Value in Cancer Care: How the Paradigm Is Shifting

Mark J. Ratain, MD, of the University of Chicago, and Daniel Goldstein, MD, of the Rabin Medical Center, discuss the challenges of achieving cancer care value, evolution of the “more-is-better” philosophy when it comes to oncology drugs, and highlights of the First International Summit on...

issues in oncology

Deborah Schrag, MD, MPH, on Clinical Trial Design: Statistical Options and Challenges

Deborah Schrag, MD, MPH, of Dana-Farber Cancer Institute, offers her perspective on near-equivalence, Bayesian noninferiority, and the value of cancer drug optimization.

issues in oncology

Deborah Schrag, MD, MPH, on Clinical Trial Design: Statistical Options and Challenges

Deborah Schrag, MD, MPH, of Dana-Farber Cancer Institute, offers her perspective on near-equivalence, Bayesian noninferiority, and the value of cancer drug optimization.

issues in oncology

Reshma Jagsi, MD, DPhil, and Narjust Duma, MD, on Diversity in Oncology: A Discussion of Evidence-Based Transformation

Reshma Jagsi, MD, DPhil, of the University of Michigan, and Narjust Duma, MD, of the University of Wisconsin Carbone Cancer Center, discuss the state of diversity in the hematology-oncology workforce, mechanisms that lead to inequities, promising interventions, and where the field should go next...

issues in oncology

Lourdes Gil Deza on Caring for Transgender Patients With Cancer

Professor Lourdes Gil Deza, of the Instituto Oncológico Henry Moore, Buenos Aires, discusses her findings on the shortcomings of medical training when it comes to treating transgender patients, and the need to deepen clinical and communication skills to assist this population (Abstract 11002).

issues in oncology

Kimlin T. Ashing, PhD, on Tobacco and Vape Shops in Neighborhoods With Lower-Income and Minority Populations

Kimlin T. Ashing, PhD, of City of Hope National Medical Center, discusses analyses that showed neighborhoods with lower-income and minority populations had a greater number of tobacco and vape shops, increased use of electronic nicotine delivery systems, and lower-priced tobacco products. This...

issues in oncology

Barbara DeVivo, PhD, MBA, on Tumor Boards: The Influence of Social Hierarchy on Cancer Treatment Decision-Making

Barbara DeVivo, PhD, MBA, of Westmont College, talks about how the culture and structure of tumor boards—and their invisible status hierarchies—may hamper collaboration and influence the way providers treat patients with cancer (Abstract BPI20-020).

issues in oncology
symptom management

Karen Wonders, PhD, on Benefits of Exercise During Cancer Treatment

Karen Wonders, PhD, of Wright State University, discusses the safety and efficacy of exercise during cancer treatment in minimizing toxicities and addressing the short- and long-term effects of cancer therapy. Dr. Wonders suggests that exercise becomes a standard of care for patients with cancer...

head and neck cancer
issues in oncology

Jill Gilbert, MD, on HPV-Associated Oropharyngeal Cancer: Challenges in De-intensifying Systemic Therapies

Jill Gilbert, MD, of Vanderbilt University Medical Center, discusses this ongoing area of investigation and which patients can safely undergo a de-intensification of treatment. Based on two randomized trials, cetuximab should not be substituted for cisplatin as a de-intensification strategy in...

issues in oncology
palliative care

Robert Olson, MD, on Quality-of-Life Outcomes After Stereotactic Ablative Radiotherapy vs Standard-of-Care Palliative Treatments

Robert Olson, MD, of the BC Cancer Centre for the North, discusses a secondary analysis of the SABR-COMET trial, which showed there was a small magnitude decline in quality of life in both arms of the study but no associated detriment with stereotactic ablative radiotherapy (Abstract 148).

issues in oncology
solid tumors

Daniel M. Trifiletti, MD, on Optimizing Whole-Brain Radiotherapy Dose and Fractionation for Patients With Brain Metastases

Daniel M. Trifiletti, MD, of the Mayo Clinic, discusses study findings showing that, between two different radiation doses (30 Gy/10 fractions vs 37.5 Gy/15 fractions), there was no difference in the time to cognitive failure, tumor control, or overall survival for patients with brain metastases...

issues in oncology
health-care policy

Justin Barnes, MS, on the Affordable Care Act and Risk of Suicide in Patients With Cancer

Justin Barnes, MS, of the St. Louis University School of Medicine, discusses his findings on the risk of suicide, which is higher in patients with cancer than in other adults but can be reduced by health policy interventions, including components of the Affordable Care Act (Abstract LBA9).

issues in oncology
global cancer care

Michael Kenneth Keng, MD, on an ASCO Quality Training Program: 5-Year Review

Michael Kenneth Keng, MD, of the University of Virginia, gives a status update on this international program, and discusses future initiatives which include coaching mentorship and publishing articles on quality care (Abstract 7).

issues in oncology

Manali I. Patel, MD, on Community Practices: Enhancing Delivery of Value-Based Cancer Care

Manali I. Patel, MD, of Stanford Cancer Center, discusses enhancing value for patients with cancer treated by community practitioners at the end of life by also utilizing trained lay health workers in a novel intervention that reduced the use of acute care and emergency department visits while...

issues in oncology

Cary P. Gross, MD, on Creating and Implementing Clinical Pathways: Where is the Patient’s Voice?

Cary P. Gross, MD, of Yale School of Medicine, discusses the challenges of implementing pathways and guiding patient decision-making on treatment.

issues in oncology

Joseph O. Jacobson, MD, on Suffering, Systems, and Safety: The Joseph V. Simone Award Lecture

Joseph O. Jacobson, MD, of Dana-Farber Cancer Institute, and this year’s recipient of the award for excellence in quality cancer care, discusses the need for quality improvement (QI) to encompass systems of care, the role of QI in preventing suffering, how poor quality affects patient safety, and...

issues in oncology

Nadine Housri, MD, on Online Tumor Boards: A New Resource for Practicing Oncologists

Nadine Housri, MD, of the Yale School of Medicine, talks about a new paradigm in sharing knowledge from tumor board discussions at NCI-designated comprehensive cancer centers, with community oncologists on themednet.org. Currently, thoracic, breast, and GI cancers are included, with plans to expand ...

issues in oncology

Matthew B. Schabath, PhD, on Addressing Cultural Barriers to Equality in Oncology Among Sexual and Gender Minorities

Matthew B. Schabath, PhD, of H. Lee Moffitt Cancer Center and Research Institute, discusses the disparities in cancer care among members of the LGBTQ community and the need to collect more data in order to close that gap.

issues in oncology

Lauren M. Hamel, PhD, on Race and Doctor-Patient Behavior

Lauren M. Hamel, PhD, of Wayne State University/Karmanos Cancer Institute, discusses her findings on the ways in which nonverbal behavior between doctors and patients of the same or different races can affect their relationship, quality of communication, and ultimately, perhaps outcomes as well...

issues in oncology

Mallika Sharma, MPH, on Eliminating Prior Authorizations, Anxiety, Delay in Care, Higher Costs

Mallika Sharma, MPH, of Seattle Cancer Care Alliance, discusses her findings that, by doing away with the many prior authorization denials based on administrative errors, providers may offer higher-value care by eliminating unnecessary anxiety among patients, administrative burdens, and increased...

issues in oncology

Grace C. Hillyer, EdD, MPH, on Enrolling Patients in Clinical Trials: Improving Clinician-Patient Communication

Grace C. Hillyer, EdD, MPH, of Columbia University Mailman School of Public Health, discusses the many barriers to enrolling patients in clinical trials, most notably different attitudes toward and perceptions about research studies among clinicians vs patients. Her findings point to the need for...

issues in oncology

Elena Martinez, PhD, MPH, on Diversity in Precision Oncology

Elena Martinez, PhD, MPH, of Moores Cancer Center at the University of California, San Diego, discusses the challenges of ensuring diversity in precision oncology and potential solutions to address the challenges.

cost of care
issues in oncology

Ryan Huey, MD, on the Financial Toxicity of Early-Phase Clinical Trials

Ryan Huey, MD, of The University of Texas MD Anderson Cancer Center, discusses his findings that showed the large financial burden on lower-income patients enrolled in phase I trials (Abstract 8).

issues in oncology
health-care policy

Karen M. Winkfield, MD, PhD, on Policy and Business Solutions to Address Disparities in Cancer Care

Karen M. Winkfield, MD, PhD, of the Wake Forest Baptist Medical Center, discusses cultural factors that contribute to cancer care disparities, the role of national policy in addressing inequities in access to care, and what local institutions can do to improve the situation.

issues in oncology

Racial Reporting and Representation in Oncology Trials

New research published by Loree et al in JAMA Oncology found that race and race subgroup analysis reporting does not occur frequently and that black and Hispanic populations are underrepresented in oncology trials that have led to U.S. Food and Drug Administration (FDA) approvals. The study raises...

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