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issues in oncology
health-care policy

Major Settlement Raises Questions About Evidence-Based Value in Cancer Care

An Oklahoma jury recently awarded $25.5 million to the widower of a 53-year-old woman diagnosed with stage IV nasopharyngeal cancer who was denied coverage for proton therapy by her health insurer, Aetna. The patient’s family subsequently raised $92,000 to cover her proton therapy at The University ...

hematologic malignancies

Dana-Farber Opens Center for the Prevention of Progression for Precursor Hematologic Conditions

Against the backdrop of the online crowd-sourcing initiative PCROWD and other research by faculty investigators on precursor conditions that may develop into leukemia, myelodysplastic syndromes (MDS), or multiple myeloma, Dana-Farber Cancer Institute has opened the Center for the Prevention of...

hematologic malignancies

Selected Abstracts From the 2019 ASCO Annual Meeting

To complement The ASCO Post’s comprehensive coverage of the 2019 ASCO Annual Meeting, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic regimens for plasma cell dyscrasias, particularly multiple myeloma. For full details of these study abstracts, visit ...

lymphoma
multiple myeloma
prostate cancer
immunotherapy

FDA Pipeline: Reviews and Designations in Multiple Myeloma, Lymphoma, Prostate Cancer

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review for daratumumab in combination with a triplet therapy in multiple myeloma, Breakthrough Therapy designation to copanlisib for marginal zone lymphoma, and Fast Track designation for ARV-110 in metastatic...

lung cancer
immunotherapy

2019 ASCO: NEOSTAR: Neoadjuvant Nivolumab Plus Ipilimumab in Early-Stage, Resectable NSCLC

Neoadjuvant treatment with nivolumab plus ipilimumab resulted in an overall major pathologic response rate of 33% of treated patients with early-stage, resectable non–small cell lung cancer (NSCLC). With these results, the combination immunotherapy met the prespecified trial...

hepatobiliary cancer
gynecologic cancers

Aspirin Use and Cancer Prevention: Long-Term Data Needed on Benefits and Risks

In addition to its well-known cardioprotective benefits, aspirin has a substantial body of observational, preclinical, and clinical evidence supporting its efficacy in preventing cancer, most strongly for colorectal cancer.1 The strength of this evidence led the U.S. Preventive Services Task...

skin cancer

UMass Lowell Student Wins Award for Research in Skin Cancers

Tyler Iorizzo, a PhD candidate in physics at UMass Lowell’s Advanced Biophotonics Laboratory, has won international recognition for his work in developing an imaging device that could lead to improved diagnosis and treatment of certain skin cancers. Mr. Iorizzo received an Educational Award from...

Northern New England Clinical Oncology Society Supports 2019 International Development and Education Award and Merit Awards

The Northern New England Clinical Oncology Society (NNECOS) is a tristate regional affiliate of ASCO serving oncology practices within Maine, New Hampshire, and Vermont. A long-time supporter of Conquer Cancer®, the ASCO Foundation, and its Young Investigator Award (YIA) program, NNECOS expanded...

Ruxolitinib Approved for Acute Graft-vs-Host Disease

On May 24, the U.S. Food and Drug Administration (FDA) approved ruxolitinib (Jakafi) for steroid-refractory acute graft-vs-host disease (GVHD) in adult and pediatric patients 12 years and older. Approval was based on the REACH1 trial/Study INCB 18424-271, an open-label, single-arm, multicenter...

head and neck cancer

NovoTTF-100L System in Combination With Chemotherapy Approved for Malignant Pleural Mesothelioma

On May 23, the U.S. Food and Drug Administration (FDA) approved the NovoTTF-100L System in combination with pemetrexed plus platinum-based chemotherapy for the first-line treatment of unresectable locally advanced or metastatic malignant pleural mesothelioma. NovoTTF-100L is a noninvasive,...

breast cancer

Alpelisib Plus Fulvestrant Approved for PIK3CA-Mutated Breast Cancer

On May 24, the U.S. Food and Drug Administration (FDA) approved the PIK3CA inhibitor alpelisib (Piqray) tablets to be used in combination with the FDA-approved endocrine therapy fulvestrant to treat postmenopausal women and men with hormone receptor–positive, HER2-negative, PIK3CA-mutated, advanced ...

issues in oncology

How Have We Got It So Wrong?

The past 20 years have seen an unprecedented increase in the development of effective drugs for the management of cancer. The advent of immunotherapy offers even the promise of cure for some previously highly resistant diseases. The science is brilliant, the need is ever increasing—but the cost is ...

issues in oncology
health-care policy

ACA Increases Access to Health Care, Early Diagnosis, and Timely Treatment for Patients With Cancer

  The evidence is in: the Affordable Care Act (ACA) has enabled improved access to earlier diagnosis, earlier care, and reduced racial disparities in access to care for patients with cancer, according to two studies presented at the 2019 ASCO Annual Meeting. In states that adopted Medicaid...

Expert Point of View: Harold Burstein, MD, PhD, FASCO, and Jame Abraham, MD, FACP

Harold Burstein, MD, PhD, FASCO, Associate Professor of Medicine at Dana-Farber Cancer Institute, Boston, and Jame Abraham, MD, FACP, Director of the Breast Oncology Program at Taussig Cancer Institute and Co-Director of the Cleveland Clinic Comprehensive Breast Cancer Program, commented on what...

solid tumors
issues in oncology

2019 ASCO: Study Finds Proton Therapy Reduces Adverse Events, Results in Similar Survival vs Photon Therapy

In a trial presented by Baumann et al at the 2019 ASCO Annual Meeting (Abstract 6521), patients with locally advanced cancer treated with proton chemoradiotherapy instead of traditional photon chemoradiotherapy were at a lower risk of experiencing side effects. However, cure rates were almost...

2019 ASCO: mCODE, a Core Set of Common Cancer Data Standards, Established

In an effort to advance cancer data sharing and improve the quality and coordination of patient care, three health and technology organizations have established a core set of data elements and recommended technical specifications (the Minimal Common Oncology Data Elements [mCODE]) that are...

pain management

2019 ASCO: Pain Management Program for Patients Undergoing Robotic Urologic Surgery

A specialized pain management program for patients who underwent robotic surgery for urologic cancers resulted in 8% of patients going home with narcotics after discharge, compared to 100% who would have received them without this enhanced recovery protocol. The group of patients...

lymphoma
immunotherapy

2019 ASCO: Rituximab, Lenalidomide, and Ibrutinib Prior to Chemotherapy in DLBCL

Results of the phase II Smart Start trial revealed that combination targeted therapy consisting of rituximab, lenalidomide, and ibrutinib had an 84.6% overall response rate (ORR) and 38.5% complete response rate (CRR) when given prior to any chemotherapy for newly diagnosed patients with a...

gastrointestinal cancer

Does Adding HIPEC to Cytoreductive Surgery Improve Outcomes in Patients With Gastric Cancer and Peritoneal Metastases?

In a propensity score analysis reported in the Journal of Clinical Oncology, Bonnot et al found that the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to cytoreductive surgery improved outcomes among patients with gastric cancer with peritoneal metastases. The study included 277...

breast cancer

Adam Brufsky, MD, PhD, on HER2-Positive Metastatic Breast Cancer: NALA Trial on Neratinib vs Lapatinib Plus Capecitabine

Adam Brufsky, MD, PhD, of Magee-Womens Hospital and the Hillman Cancer Center at the University of Pittsburgh Medical Center, discusses phase III study findings on neratinib plus capecitabine vs lapatinib plus capecitabine in patients previously treated for HER2-positive metastatic breast cancer...

lymphoma
immunotherapy

Jason Westin, MD, on Diffuse Large B-Cell Lymphoma: Rituximab, Lenalidomide, and Ibrutinib Prior to Chemotherapy

Jason Westin, MD, of The University of Texas MD Anderson Cancer Center, discusses findings of the Smart Start study on the chemotherapy-free combination of rituximab, lenalidomide, and ibrutinib in newly diagnosed diffuse large B-cell lymphoma (Abstract 7508).

breast cancer

Jame Abraham, MD, on NALA Trial Findings in HER2-Positive Metastatic Breast Cancer

Jame Abraham, MD, of the Cleveland Clinic, provides commentary on the NALA study findings on neratinib plus capecitabine vs lapatinib plus capecitabine in patients previously treated with HER2-positive metastatic breast cancer (Abstract 1002).

leukemia

Kerry A. Rogers, MD, on Chronic Lymphocytic Leukemia: Acalabrutinib With Obinutuzumab in Treatment-Naive and Relapsed or Refractory Disease

Kerry A. Rogers, MD, of The Ohio State University, discusses a 3-year follow-up of phase Ib safety and efficacy findings with the selective BTK inhibitor acalabrutinib and the anti-CD20 monoclonal antibody obinutuzumab in patients with CLL (Abstract 7500).  

leukemia
lymphoma
immunotherapy

William G. Wierda, MD, PhD, on Immunotherapy for Relapsed/Refractory CLL/SLL: Results From TRANSCEND CLL 004

William G. Wierda, MD, PhD, of The University of Texas MD Anderson Cancer Center, discusses the TRANSCEND CLL 004 trial, which studied the use of an experimental CD19-directed CAR T-cell product in heavily pretreated patients with chronic lymphocytic leukemia or small lymphocytic lymphoma (Abstract ...

breast cancer

Yeon Hee Park, MD, on Metastatic Breast Cancer: Palbociclib, Exemestane, and GnRH Agonist

Yeon Hee Park, MD, of the Samsung Medical Center, discusses phase II study findings that showed exemestane plus palbociclib with ovarian suppression improved progression-free survival compared with capecitabine in premenopausal estrogen receptor–positive metastatic breast cancer (Abstract 1007).

skin cancer
immunotherapy

Ahmad A. Tarhini, MD, PhD, on High-Risk Melanoma: Adjuvant Ipilimumab vs High-Dose Interferon-α2b

Ahmad A. Tarhini, MD, PhD, of Emory University and Winship Cancer Institute, discusses phase III findings from the U.S. Intergroup E1609 trial, which showed survival benefits for patients with resected high-risk melanoma—for the first time in the history of melanoma adjuvant therapy (Abstract...

issues in oncology

Richard Pazdur, MD, on the Launch of Project Facilitate

Richard Pazdur, MD, Director of the U.S. Food and Drug Administration (FDA) Oncology Center of Excellence and Acting Director of the Office of Hematology and Oncology Products in the FDA’s Center for Drug Evaluation and Research, discusses the launch of Project Facilitate, a new pilot program to...

issues in oncology

2019 ASCO: Survey Finds 'Knowledge Gap' in Molecular Profiling Among Oncologists

A questionnaire aimed at assessing how well community oncologists understand “molecular profiling” results from tumor specimens found that 69% of participants either said they didn't know the answers or they responded incorrectly. In six different clinical scenarios, the oncologists...

breast cancer

2019 ASCO: Partial- vs Whole-Breast Irradiation in Early-Stage Breast Cancer

Partial-breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole-breast irradiation for many women with low-risk, early-stage breast cancer, according to new data from the NRG Oncology/NSABP B-39/RTOG 0413 trial. Results were presented by Ganz et al...

breast cancer

Sara A. Hurvitz, MD, on HR+/HER2− Advanced Breast Cancer: MONALEESA-7 Trial on Endocrine Therapy With or Without Ribociclib

Sara A. Hurvitz, MD, of the UCLA Jonsson Comprehensive Cancer Center, discusses the first study of ribociclib plus endocrine therapy vs endocrine therapy alone to demonstrate significantly longer overall survival in peri- and premenopausal women with advanced breast cancer (Abstract LBA1008).

colorectal cancer
immunotherapy

Javier Sastre, MD, PhD, on Colorectal Cancer: Bevacizumab and FOLFOXIRI in Metastatic Disease

Javier Sastre, MD, PhD, of Hospital Clinico San Carlos, discusses phase III findings on the assessment of circulating tumor cells as a prognostic factor and FOLFOXIRI plus bevacizumab combination outcomes for patients with poor-prognosis colorectal cancer (Abstract 3507).  

multiple myeloma

Sagar Lonial, MD, on Smoldering Multiple Myeloma: Delaying Disease Progression With an Immunomodulatory Agent

Sagar Lonial, MD, of Winship Cancer Institute of Emory University, discusses the potentially practice-changing phase III findings showing that lenalidomide substantially delayed progression of smoldering multiple myeloma to aggressive disease when compared with observation alone (Abstract 8001).

sarcoma
immunotherapy

William D. Tap, MD, on Soft-Tissue Sarcomas: ANNOUNCE Trial on Doxorubicin and Olaratumab

William D. Tap, MD, of Memorial Sloan Kettering Cancer Center, discusses negative study findings on doxorubicin plus olaratumab vs doxorubicin plus placebo, which showed no difference in overall survival between the two treatments in patients with advanced soft-tissue sarcomas. The manufacturer is...

gynecologic cancers

Panagiotis A. Konstantinopoulos, MD, PhD, on Endometrial Cancer: Avelumab in Microsatellite-Stable and -Instable Disease

Panagiotis A. Konstantinopoulos, MD, PhD, of Dana-Farber Cancer Institute, discusses his phase II study on the response to avelumab in microsatellite-stable and -instable recurrent or persistent endometrial cancer with a polymerase epsilon mutation (Abstract 5502).

hepatobiliary cancer

Angela Lamarca, MD, PhD, on Biliary Tract Cancers: Active Symptom Control With Oxaliplatin and Fluorouracil

Angela Lamarca, MD, PhD, of The Christie NHS Foundation Trust and the University of Manchester, discusses phase III findings from a multicenter study of active symptom control alone or active symptom control with oxaliplatin and fluorouracil for patients with locally advanced or metastatic biliary...

gynecologic cancers

Richard T. Penson, MD, and Don S. Dizon, MD, on Ovarian Cancer: SOLO3 Trial on Olaparib vs Chemotherapy in Relapsed Disease

Don S. Dizon, MD, of the Lifespan Cancer Institute, and Richard T. Penson, MD, of Massachusetts General Hospital Cancer Center, discuss phase III study findings on the PARP inhibitor olaparib, which showed a significantly higher objective response rate vs nonplatinum chemotherapy for patients with...

lung cancer
immunotherapy

Gilberto Lopes, MD, MBA, on the RELAY Trial in Metastatic NSCLC: Erlotinib and Ramucirumab in EGFR Mutant–Positive Disease

Gilberto Lopes, MD, MBA, of the Sylvester Comprehensive Cancer Center at the University of Miami, offers commentary on phase III findings from the RELAY study, which showed that erlotinib plus ramucirumab led to superior progression-free survival in previously untreated patients with EGFR...

multiple myeloma

Michael A. Thompson, MD, PhD, on Smoldering Multiple Myeloma: Reassessing Risk Stratification Models

Michael A. Thompson, MD, PhD, of Advocate Aurora Health, discusses the implications of the revised diagnostic criteria for multiple myeloma, which removed patients at the highest risk of disease progression from the smoldering group, and a new model for smoldering disease that incorporates revised...

multiple myeloma

Francesca Gay, MD, on Multiple Myeloma: Carfilzomib/Lenalidomide/Dexamethasone With or Without Transplantation

Francesca Gay, MD, of GIMEMA, European Myeloma Network, discusses the results of the FORTE trial on the efficacy of carfilzomib/lenalidomide/dexamethasone with or without autologous stem cell transplantation according to risk status in newly diagnosed disease (Abstract 8002).  

prostate cancer

Kim N. Chi, MD, on Metastatic Castration-Sensitive Prostate Cancer: First Results From the TITAN Trial

Kim N. Chi, MD, of BC Cancer, discusses the first phase III findings from the TITAN study of apalutamide vs placebo in patients with metastatic castration-sensitive prostate cancer receiving androgen-deprivation therapy (Abstract 5006).

prostate cancer

Kim N. Chi, MD, on Castration-Resistant Prostate Cancer: Cabazitaxel vs Abiraterone or Enzalutamide in the Metastatic Setting

Kim N. Chi, MD, of BC Cancer, discusses updated results from a phase II study of cabazitaxel vs abiraterone or enzalutamide in patients with poor-prognosis metastatic castration-resistant prostate cancer (Abstract 5003).

kidney cancer
immunotherapy

Ziad Bakouny, MD, and Toni K. Choueiri, MD, on Renal Cell Carcinoma: Checkpoint Inhibitors and Genomic Characterization of Sarcomatoid/Rhabdoid Disease

Toni K. Choueiri, MD, and Ziad Bakouny, MD, both of Dana-Farber Cancer Institute, discuss a retrospective review of genomically profiled patients with sarcomatoid/rhabdoid renal cell cancer who were found to have better outcomes with immune checkpoint inhibitors and to harbor mutations associated...

prostate cancer

Michael J. Morris, MD, on Metastatic Prostate Cancer: Adding Abiraterone Acetate to Enzalutamide

Michael J. Morris, MD, of Memorial Sloan Kettering Cancer Center, discusses the phase III findings from the Alliance A031201 trial, which showed that adding abiraterone acetate to enzalutamide did not improve survival in men with metastatic castration-resistant prostate cancer (Abstract 5008).

bladder cancer

Brian C. Baumann, MD, on Locally Advanced Bladder Cancer: Adjuvant Radiotherapy After Radical Cystectomy

Brian C. Baumann, MD, of Washington University School of Medicine, discusses study findings suggesting postoperative radiotherapy may be an option for patients with locally advanced bladder cancer after radical cystectomy who are unable or unwilling to use adjuvant chemotherapy (Abstract 4507).  

solid tumors

Brian C. Baumann, MD, on Locally Advanced Cancer: Proton vs Photon Therapy

Brian C. Baumann, MD, of Washington University School of Medicine, discusses study findings that showed, for adults with locally advanced cancer across five different disease sites, proton chemoradiotherapy was associated with significantly reduced acute adverse events, with no difference in...

colorectal cancer

Thomas J. George, MD, on Locally Advanced Rectal Cancer: Total Neoadjuvant Therapy

Thomas J. George, MD, of NRG Oncology and The University of Florida Health Cancer Center, discusses the initial phase II results from a clinical trial using total neoadjuvant therapy (including veliparib and chemoradiation treatment) for locally advanced rectal cancer (Abstract 3505).

breast cancer

Patricia A. Ganz, MD, on Breast Cancer: Whole- vs Partial-Breast Irradiation

Patricia A. Ganz, MD, of NRG Oncology and Jonsson Comprehensive Cancer Center at UCLA, discusses the NRG/NSABP phase III findings, which showed that partial-breast irradiation was more convenient and resulted in less fatigue but slightly poorer cosmesis at 36 months in patients who did not receive...

solid tumors
immunotherapy

Sarah Abou Alaiwi, MD, and Toni K. Choueiri, MD, on Checkpoint Inhibitors: Overall Survival and Polybromo-Associated Mutations

Toni K. Choueiri, MD, and Sarah Abou Alaiwi, MD, both of Dana-Farber Cancer Institute, discuss the association of polybromo-associated BAF-type mutations with overall survival in patients with different solid tumors treated with checkpoint inhibitors (Abstract 103).

multiple myeloma
immunotherapy

Paul G. Richardson, MD, on Relapsed or Refractory Multiple Myeloma: Adding Isatuximab to Pomalidomide and Low-Dose Dexamethasone

Paul G. Richardson, MD, of Dana-Farber Cancer Institute, discusses findings from the phase III ICARIA-MM trial showing that isatuximab, pomalidomide, and low-dose dexamethasone significantly improved progression-free survival and overall response vs pomalidomide and dexamethasone (Abstract 8004).  

prostate cancer

Miriam Knoll, MD, and Zachery Reichert, MD, PhD, on Prostate Cancer: Focal Radiation for Oligometastatic Castration-Resistant Disease

Miriam Knoll, MD, and Zachery Reichert, MD, PhD, discuss the FORCE trial, which is examining whether radiation can create a more durable response to systemic therapy, and whether using newer, more sensitive imaging technologies can improve outcomes (Abstract TPS5096).

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