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issues in oncology

Joseph M. Unger, PhD, on the Impact of NCI-Sponsored Treatment Trials

Joseph M. Unger, PhD, of Fred Hutchinson Cancer Research Center, discusses findings from his study of the National Cancer Institute’s Clinical Trials Network, which has conducted publicly funded cancer research for more than 50 years. The substantial gains in life years for patients with cancer, he says, supports the critical role of government-sponsored cancer research (Abstract 1503O).

issues in oncology

John V. Cox, DO, MBA, on Reshaping Practice Models to Better Care for Patients With Cancer

John V. Cox, DO, MBA, of The University of Texas Southwestern Medical Center, summarizes his Joseph V. Simone Lecture, in which he stressed the need for coordinated care among practices. The concept of oncology medical homes, he says, has evolved to a broader-based model in which oncologists cooperate with other practices to manage patients and their comorbidities with optimal outcomes. Professional organizations such as the American College of Physicians and ASCO can provide clinicians with the tools they need to engage in this future of health care.

issues in oncology
palliative care

Divya Gupta, MD, on Improving Advance Care Planning Conversations With Patients

Divya Gupta, MD, of the Stanford Cancer Center, discusses an intervention utilizing a computer model and lay care coaches to improve advance care planning conversations with patients who have metastatic cancer. The study, Dr. Gupta reports, showed a trend toward less intensive care for patients at the end of life.

issues in oncology

Divya A. Parikh, MD, on Improving Care Documentation With a Patient Conversation Guide

Divya A. Parikh, MD, of Stanford University School of Medicine, discusses findings that suggest an evidence-based tool, the Serious Illness Conversation Guide, may engage patients with metastatic or recurrent urologic cancer in goals-of-care conversations, potentially resulting in an increase of documentation of their goals in the electronic medical record.

issues in oncology
survivorship

Courtney Williams, DrPH, on Cancer Survivors: Working Together to Improve Patient Adherence

Courtney Williams, DrPH, of the National Cancer Institute, discusses the costs associated with cancer survivors who don’t take their medications and cites the need for research to better understand whether residing in an urban or rural area may affect prescription adherence, and what interventions might help increase drug adherence and improve health outcomes.

issues in oncology

Benjamin W. Corn, MD, on Integrating Hope Into Clinical Oncology

Benjamin W. Corn, MD, of Shaare Zedek Medical Center in Jerusalem, discusses hope: what it takes for hope to thrive; how he and his colleagues are helping patients and providers become more hopeful through workshops; and his collaboration with the Southwest Oncology Group to aid patients, through hopefulness, to better adhere to treatment regimens.

issues in oncology

Sarah S. Mougalian, MD, on a Next-Day Access Program for Patients With Cancer

Sarah S. Mougalian, MD, of Yale Cancer Center, discusses the increasingly common problem of long wait times for access to oncology care. Her team developed a next-day access program in several of Yale’s oncology services, which was well received by patients and decreased the time to first visit.

issues in oncology
supportive care

Manali I. Patel, MD, MPH, on Community-Based Intervention and Cancer Care Disparity

Manali I. Patel, MD, MPH, of Stanford University School of Medicine, discusses data suggesting that community health workers and innovative payer models can better engage low-income and minority patients with cancer, improve their health-related quality of life, and reduce unwanted and unnecessary acute care.

prostate cancer
issues in oncology

Neeraj Agarwal, MD, on Treatment Patterns and Disparities in Patients With Prostate Cancer

Neeraj Agarwal, MD, of Huntsman Cancer Institute at the University of Utah, discusses three studies that examined real-world treatment patterns and utilization of advanced therapies in men with metastatic castration-sensitive prostate cancer, which served to highlight the ways in which Black men may be treated differently (Abstracts 5072, 5073, 5704).

prostate cancer
issues in oncology

Peter C. Black, MD, on Prostate Cancer Health-Care Disparities: Expert Perspective

Peter C. Black, MD, of the Vancouver Prostate Centre, University of British Columbia, reviews three studies on early detection and treatment of Black patients with prostate cancer: a large-scale analysis of genomic profiling; the use of PSA screening; and integrating a patient-specific genomic classifier to improve risk classification and treatment recommendations for Black men (Abstracts 5003, 5004, and 5005).

lung cancer
issues in oncology

Debora S. Bruno, MD, on NSCLC: Racial Disparities in Biomarker Testing and Clinical Trial Enrollment

Debora S. Bruno, MD, of Seidman Cancer Center at Cleveland Medical Center, discusses study findings that show Black patients with advanced or metastatic non–small cell lung cancer tend to be less likely to undergo biomarker testing or to be treated in clinical trials than White patients. Recommended broad-based testing, says Dr. Bruno, may help ensure equal access to quality care and clinical trials (Abstract 9005).

issues in oncology

Narjust Duma, MD, and Gladys I. Rodriguez, MD, on A First for Hispanic Women: Formation of a YIA for Latinas

Narjust Duma, MD, of the Carbone Cancer Center at the University of Wisconsin, Madison, and Gladys I. Rodriguez, MD, of South Texas Oncology and Hematology, talk about the underrepresentation of Hispanic individuals in medicine, especially in oncology, and their efforts to create the first Young Investigator Award in Recognition of an Outstanding Latina Researcher to encourage Hispanic women to enter medicine and cancer research.

issues in oncology
health-care policy
legislation

Jingxuan Zhao, MPH, on How Medicaid Expansion Affects Long-Term Cancer Survival

Jingxuan Zhao, MPH, of the American Cancer Society, discusses study findings that showed worse long-term survival among low-income patients with cancer who live in states that have not expanded Medicaid eligibility (Abstract 6512).

breast cancer
issues in oncology

John Marshall, MD, and Liza Marshall: When Cancer Strikes an Oncologist’s Family

John Marshall, MD, of the Lombardi Cancer Center at Georgetown University, and his wife, Liza Marshall, a breast cancer survivor, talk about the impact of her diagnosis, how it changed their view of cancer care and the way clinicians communicate, and why their memoir has an important message.

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 to therapy. Clinicians may be able to personalize dietary interventions to optimize patient care.

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 selection.

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 long-term data and biomarkers are needed to confirm these findings.

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 residual disease and might be used to predict recurrence and adjuvant treatment efficacy across multiple tumor types.

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 consistent and accurate diagnoses and prognoses, potentially improving treatment (Abstract SY01-03).

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 professionals in the face of burnout, metrics to measure their productivity, and their future role in cancer 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 other advisory groups.

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 says, is more marked in gastrointestinal malignancies than other solid tumors, and she recommends ways to improve the outlook.

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 B-cell lymphomas; and end-of-life hospitalization of patients with multiple myeloma, as well as outcome disparities (Abstracts 207-212).

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 group. They recommend aggressive management of cardiovascular risk factors to prevent morbidity from heart disease in this patient population (Abstract 73).

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 molecular risk profiles (Abstract 6).

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 low-dose CT scans.

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 patient experience (Abstract 6).

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 method of care continues to increase through subsequent waves of coronavirus infection and plays a larger role in standard treatment (Abstract 87).

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 to help more patients participate (Abstract 92).

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 human T cells, and opportunities for the future.

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 reductions in doses that maintain effective treatment.

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 diversity, and recognizing the accomplishments of minority scientists and clinicians in the cancer workforce are among the solutions discussed (Session VSS08).

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 patients with ALL, AML, and CML were significantly lower for those who lived in El Paso than for those who lived elsewhere in Texas (Abstract 4343).

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 among young women­­—is rising at a slower pace (Session ED35).

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, which could be valuable in cases where toxicities may prevent full-dose combinations (Abstract 1047).

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 Interventional Pharmacoeconomics.

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 (Abstract 11000).

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 information may help public health efforts address the high rates of vaping among teenagers in these communities (Abstract CT087).

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 (Abstract HSR20-110).

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 HPV-positive oropharyngeal cancer.

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 (Abstract 19).

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