940 results match your criteria Am Soc Clin Oncol Educ Book[Journal]


Emerging Subtypes and New Treatments for Castration-Resistant Prostate Cancer.

Am Soc Clin Oncol Educ Book 2020 May;40:e319-e332

University of California, San Francisco, CA.

Genomic characterization of metastatic castration-resistant prostate cancer (mCRPC) has been remodeling the treatment landscape of this disease in the past decade. The emergence of molecularly defined subsets of mCRPC is altering the treatment paradigm from therapeutics with nonspecific activity across the spectrum, including androgen receptor (AR)-directed treatments, docetaxel, and cabazitaxel, to targeted approaches directed at molecular subsets of disease. The meaningful benefit of PARP inhibitors in mCRPC carrying mutations in DNA repair genes demonstrated in a phase III trial epitomizes this transition in the treatment paradigm of mCRPC and brings new challenges related to how to sequence and integrate the targeted therapies on top of the treatments with broad activity in all mCRPC. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_100025DOI Listing

Molecular Profiling in Drug Development: Paving a Way Forward.

Am Soc Clin Oncol Educ Book 2020 May;40:309-318

Sarah Cannon Research Institute, Nashville, TN.

As researchers learn more about tumor biology and the molecular mechanisms involved in tumorigenesis, metastasis, and tumor evolution, clinical trials are growing more complex and patient selection for clinical trials is becoming more specific. Rather than exploit certain phenotypic characteristics of tumor cells (e.g. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_100024DOI Listing

Strategic Combinations to Prevent and Overcome Resistance to Targeted Therapies in Oncology.

Am Soc Clin Oncol Educ Book 2020 May;40:e292-e308

UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA.

Recent advances in the understanding of underlying molecular signaling mechanisms of cancer susceptibility and progression have led to an increase in the use of targeted therapies for cancer treatment. Despite improvements in survival with new treatment options in oncology, resistance to therapy is a major obstacle to the long-term effectiveness of targeted agents in metastatic cancer treatment, culminating in insensitivity to treatment and tumor outgrowth. Adaptive resistance can play an important role in primary and upfront resistance to therapy as well as in secondary or acquired resistance. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280845DOI Listing

The Changing Health Insurance Coverage Landscape in the United States.

Am Soc Clin Oncol Educ Book 2020 May;40:e264-e274

University of Michigan Center for Value-Based Insurance Design, Ann Arbor, MI.

Changes in the health insurance coverage landscape in the United States during the past decade have important implications for receipt and affordability of cancer care. In this paper, we summarize evidence for the association between health insurance coverage and cancer prevention and treatment. We then discuss ongoing changes in health care coverage, including implementation of provisions of the Affordable Care Act, increasing prevalence of high-deductible health insurance plans, and factors that affect health care delivery, with a focus on vertical integration of hospitals and providers. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279951DOI Listing

Biomarkers in Precision Cancer Immunotherapy: Promise and Challenges.

Am Soc Clin Oncol Educ Book 2020 May;40:e275-e291

Huntsman Cancer Institute, University of Utah, Salt Lake City, UT.

The rapid expansion of modern cancer immunotherapeutics has led to a dramatic improvement in patient survival and sustained remission for otherwise refractory malignancies. However, a significant limitation behind these current treatment modalities is an irregularity in clinical response, which is especially pronounced among checkpoint inhibition. This unpredictability leads to significant side effects, financial costs, and health care burden, with unsatisfactory clinical benefit in the majority of treated patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280571DOI Listing

Integrating Genetic and Genomic Testing Into Oncology Practice.

Am Soc Clin Oncol Educ Book 2020 May;40:e259-e263

Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA.

Genetic information, both germline and somatic, is an increasingly important consideration in therapeutic decision-making in cancer. Germline mutations in genes associated with increased cancer risk can identify those individuals without cancer who may benefit from enhanced screening and prevention strategies. In individuals with cancer, germline and somatic mutations may help to guide local and systemic management decisions. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280607DOI Listing

ADCs, BiTEs, CARs, and Small Molecules: A New Era of Targeted Therapy in Non-Hodgkin Lymphoma.

Am Soc Clin Oncol Educ Book 2020 May;40:302-313

University of Chicago, Chicago, IL.

Novel immunotherapies and small molecular inhibitors are transforming our approach to previously treated and newly diagnosed patients across the spectrum of non-Hodgkin lymphomas (NHLs). Anti-CD19 CAR T cells are now indicated for the treatment of relapsed/refractory aggressive B-cell lymphomas after at least two previous lines of therapy in which durable remissions are achieved in approximately 40% of previously incurable patients. Second-line chemoimmunotherapy remains the standard of care at first relapse, but poor outcomes with conventional treatment in this setting creates an appealing rationale for earlier use of CAR T cells, which is currently under investigation, along with even earlier use in selected high-risk patients in the frontline setting. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279043DOI Listing

Selective CDK4/6 Inhibitors: Biologic Outcomes, Determinants of Sensitivity, Mechanisms of Resistance, Combinatorial Approaches, and Pharmacodynamic Biomarkers.

Am Soc Clin Oncol Educ Book 2020 May;40:115-126

Department of Experimental Radiation Oncology, The University of Texas MD Anderson Cancer Center, Houston, TX.

CDK4/6 inhibitors are now part of the standard armamentarium for hormone receptor-positive breast cancer. In this article, we review the biologic outcomes imposed by these drugs on cancer cells, determinants of response, mechanisms of intrinsic and acquired resistance, as well as combinatorial approaches emanating from mechanistic studies that may allow use of these agents to extend beyond breast cancer. In addition, we will address tumor-, imaging-, and blood-based pharmacodynamic biomarkers that can inform rationally designed trials as clinical development continues. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_281085DOI Listing

Prophylactic Cranial Irradiation for Small-Cell Lung Cancer: Time for a Reassessment.

Authors:
Martin J Edelman

Am Soc Clin Oncol Educ Book 2020 May;40:24-28

Fox Chase Cancer Center, Philadelphia, PA.

Prophylactic cranial irradiation (PCI) has been an accepted part of the management of both limited and small-cell lung cancer; however, the data that support its use in limited-stage disease is based on an analysis of trials done before currently accepted approaches to staging (i.e., brain MRI and/or PET scanning) were available. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_281041DOI Listing

Checkpoint Blockade in Lung Cancer With Driver Mutation: Choose the Road Wisely.

Am Soc Clin Oncol Educ Book 2020 May;40:372-384

Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD.

Immune checkpoint blockade with PD-(L)1 antibodies has revolutionized the treatment of advanced non-small cell lung cancer (NSCLC). Similarly, the identification and targeting of oncogene drivers in metastatic NSCLC has dramatically improved patient outcomes with an expanding list of potentially actionable alterations and targeted therapies. Many of these molecular aberrations are more common in patients with little or no smoking history and adenocarcinoma histology. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280795DOI Listing

Overcoming Resistance to Targeted Therapies in Gastrointestinal Cancers: Progress to Date and Progress to Come.

Am Soc Clin Oncol Educ Book 2020 May;40:161-173

Massachusetts General Hospital Cancer Center, Boston, MA.

Targeted therapies have transformed the treatment paradigm in diseases such as non-small cell lung cancer and melanoma but have shown relatively modest clinical benefit in gastrointestinal malignancies. Anti-EGFR therapy in wild-type colorectal cancer, anti-HER2 therapy in - amplified esophagogastric cancer, and FGFR and isocitrate dehydrogenase 1 (IDH1) inhibitors in fusion-positive and mutant biliary tract cancers offer antitumor efficacy, but the clinical benefit and durability of response in each case are typically limited. We review targeted therapies in each of these therapeutic areas and discuss their clinical efficacy, mechanisms of primary and acquired resistance, and strategies to overcome this resistance. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280871DOI Listing

From Theory to Practice: Implementation of Strategies to Reduce Acute Care Visits in Patients With Cancer.

Am Soc Clin Oncol Educ Book 2020 May;40:85-94

Department of Strategy and Innovation, Memorial Sloan Kettering Cancer Center, New York, NY.

Patients with cancer frequently seek acute care as a result of complications of their disease and adverse effects of treatment. This acute care comes at high cost to the health care system and often results in suboptimal outcomes for patients and their caregivers. The Department of Health and Human Services has identified this as a gap in our care of patients with cancer and has called for quality-improvement efforts to reduce this acute care. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_281139DOI Listing

What's the Price? Toxicities of Targeted Therapies in Breast Cancer Care.

Am Soc Clin Oncol Educ Book 2020 May;40:55-70

Division of Hematology and Oncology, Department of Internal Medicine, Wake Forest University School of Medicine, Winston-Salem, NC.

Agents with mechanisms novel to breast cancer care have been approved to treat breast cancer. These agents include drugs that target cyclin-dependent kinases, phosphoinositide 3-kinase gene mutations, PARP, checkpoint regulation, and novel antibody-drug conjugates. However, these novel approaches bring a risk of toxicities quite different from those of conventional cytotoxic chemotherapy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279465DOI Listing

How Technology Is Improving the Multidisciplinary Care of Sarcoma.

Am Soc Clin Oncol Educ Book 2020 May;40:445-462

Division of Molecular and Cellular Oncology, Department of Radiation Oncology, Jonsson Comprehensive Cancer Center Sarcoma Program, University of California Los Angeles, Los Angeles, CA.

Sarcomas are rare tumors but comprise a wide histologic spectrum. Advances in technology have emerged to address the biologic complexity and challenging diagnosis and treatment of this disease. The diagnostic approach to sarcomas has historically been based on morphologic features, but technologic advances in immunohistochemistry and cytogenetic/molecular testing have transformed the interdisciplinary work-up of mesenchymal neoplasms in recent years. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280729DOI Listing

Recent Advances in Managing Acute Lymphoblastic Leukemia.

Am Soc Clin Oncol Educ Book 2020 May;40:330-342

Cleveland Clinic Taussig Cancer Institute, Cleveland, OH.

Acute lymphoblastic leukemia (ALL) is characterized by chromosomal translocations and somatic mutations that lead to leukemogenesis. The incorporation of pediatric-type regimens has improved survival in young adults, and the incorporation of tyrosine kinase inhibitors for patients with Philadelphia chromosome-positive disease has led to further improvements in outcomes. However, older patients often have poor-risk biology and reduced tolerance to chemotherapy, leading to lower remission rates and overall survival. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280175DOI Listing

Dermatologic Adverse Events of Systemic Anticancer Therapies: Cytotoxic Chemotherapy, Targeted Therapy, and Immunotherapy.

Am Soc Clin Oncol Educ Book 2020 May;40:485-500

Division of Dermatology, Department of Internal Medicine, Albert Einstein College of Medicine, Bronx, NY.

Over the past 2 decades, rapid advancement in systemic anticancer therapeutics has led to astounding improvement in survival rates of patients with cancer. However, this celebrated progress has brought with it an evolving spectrum of drug toxicities that limit their prodigious capabilities. Cutaneous adverse events are of the most frequent of these toxicities, with substantial impact on quality of life and commonly resulting in dose reduction or change in therapy. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_289911DOI Listing

Immune Therapy Opportunities in Ovarian Cancer.

Am Soc Clin Oncol Educ Book 2020 May;40:1-13

Ludwig Institute for Cancer Research, University of Lausanne, and Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland.

Immunotherapy has emerged as a highly promising approach in the treatment of epithelial ovarian cancer (EOC). Immune checkpoint blockade (ICB) therapy, PARP inhibitors (PARPis), neoantigen vaccines, and personalized T-cell therapy have been associated with encouraging clinical activity in a small subset of patients. To increase the proportion of patients who are likely to derive benefit, it will be important not only to generate sufficient numbers of antitumor T cells but also to overcome multiple inhibitory networks in the ovarian tumor microenvironment (TME). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280539DOI Listing

Promising Immuno-Oncology Options for the Future: Cellular Therapies and Personalized Cancer Vaccines.

Am Soc Clin Oncol Educ Book 2020 May;40:1-6

Peter MacCallum Cancer Centre, Melbourne, Australia.

A common pathway for an effective immune anticancer response involves recognition of tumor neoantigens and subsequent targeting of cancer cells by T cells. In this article, we provide an overview of the current status of two approaches to directly enhance this interaction using either adoptive cell therapy or personalized cancer vaccines with focus on recent advances in solid tumors, including lung cancer. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_281101DOI Listing

Before It's Too Late: Multistakeholder Perspectives on Compassionate Access to Investigational Drugs for Pediatric Patients With Cancer.

Am Soc Clin Oncol Educ Book 2020 May;40:1-10

Department of Pediatrics, UT Southwestern Medical Center, Dallas, TX.

Patients and their families, physicians, drug companies, and regulatory agencies have common goals: to find effective therapies for life-threatening conditions. In oncology, the lines between clinical research and treatment are often blurred; parents and physicians of patients who have exhausted standard-of-care treatments and cannot participate in a clinical trial are likely to consider seeking compassionate use access to investigational drugs; however, knowledge and perspectives about compassionate use may differ among these groups. There are unique considerations associated with providing compassionate use to children diagnosed with cancer, including evaluation for potential developmental toxicities, the need for pediatric-specific dosing and formulations, informed consent, and, when appropriate, patient assent. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_278995DOI Listing

Recent Advances in the Management of High-Risk Localized Prostate Cancer: Local Therapy, Systemic Therapy, and Biomarkers to Guide Treatment Decisions.

Am Soc Clin Oncol Educ Book 2020 May;40:1-12

Vanderbilt University Medical Center, Nashville, TN.

High-risk prostate cancer accounts for approximately 15% of all prostate cancer diagnoses. Patients with high-risk disease have an increased risk of developing biochemical recurrence, metastases, and death from prostate cancer. As the optimal management of high-risk disease in patients with prostate cancer continues to evolve, the contemporary treatment paradigm is moving toward a multidisciplinary integrated approach of systemic and local therapy for patients with high-risk disease. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279459DOI Listing

Renal Cell and Urothelial Carcinoma: Biomarkers for New Treatments.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-11

Dana-Farber Cancer Institute, Boston, MA.

Therapies for genitourinary malignancies have evolved considerably in the past five years. Combination treatment targeting biologically relevant immune and angiogenic pathways is improving patient survival in metastatic renal cell carcinoma (RCC), whereas immune checkpoint blockade (ICB), novel targeted therapy, and antibody drug conjugates have changed the landscape of urothelial cancer (UC) treatment. A daily challenge for clinicians is identifying patients who derive a preferential benefit from the available therapeutic options. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279905DOI Listing

Direct-to-Consumer Advertising for Cancer Centers and Institutes: Ethical Dilemmas and Practical Implications.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-11

University of Hawai'i Cancer Center, Honolulu, HI.

In the United States, many cancer centers advertise their clinical services directly to the public. Although there are potential public benefits from such advertising, including increased patient awareness of treatment options and improved access to care and clinical trials, there is also potential for harm through misinformation, provision of false hope, inappropriate use of health care resources, and disruption in doctor-patient relationships. Although patient education through advertising is appropriate, misleading patients in the name of gaining market share, boosting profits, or even boosting trial accrual is not. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279963DOI Listing

PARP Inhibitors for Ovarian Cancer: Current Indications, Future Combinations, and Novel Assets in Development to Target DNA Damage Repair.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-16

Stephenson Cancer Center at the University of Oklahoma Health Sciences Center, Oklahoma City, OK.

PARP inhibitors (PARPIs) have revolutionized the treatment of epithelial ovarian cancer, first for BRCA-associated cancer, and, recently, for all epithelial cancers of serous or high-grade endometrioid subtypes in the front line. Although there is hope that PARPIs will help prevent recurrences when used following frontline maintenance, cancer will still recur in most women, and the need for active combination strategies as well as continued development of novel assets, either as monotherapy or in combination, will be urgently needed. This review article discusses the current indications for PARPIs in both frontline and recurrent settings, current research in combination approaches, and finally, ongoing research on novel methods to target DNA damage response in an effort to exploit the common susceptibility to DNA damage repair in epithelial ovarian cancer and improve outcomes for patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_288015DOI Listing

Expanding Access to Chimeric Antigen Receptor T-Cell Therapies: Challenges and Opportunities.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-8

Blood and Marrow Transplant Program, Cleveland Clinic, Cleveland, OH.

Chimeric antigen receptor (CAR) T-cell therapy is a major advancement in the treatment of lymphoid malignancies, especially diffuse large B-cell lymphoma and acute lymphoblastic leukemia (ALL). Since the U.S. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279151DOI Listing

Medical Decision-Making in Oncology for Patients Lacking Capacity.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-11

Division of Hematology/Oncology, University of Rochester Medical Center, Rochester, NY.

Modern oncology practice is built upon the idea that a patient with cancer has the legal and ethical right to make decisions about their medical care. There are situations in which patients might no longer be fully able to make decisions on their own behalf, however, and some patients never were able to do so. In such cases, it is critical to be aware of how to determine if a patient has the ability to make medical decisions and what should be done if they do not. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280279DOI Listing

The Globalization of Geriatric Oncology: From Data to Practice.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-9

Division of Oncology 2, Center for Drug Evaluation and Research, U.S. Food and Drug Administration, Silver Spring, MD.

Older adults with cancer are a unique group of patients who require specialized care and treatment. The field of geriatric oncology (GO) was born more than 3 decades ago to address the needs of this growing group of patients. Some challenges in the GO field include establishing a GO clinical service, educating and training personnel, and conducting research in GO. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279513DOI Listing

Immune Checkpoint Blockade for Prostate Cancer: Niche Role or Next Breakthrough?

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-18

Department of Medicine, Genitourinary Oncology Service, Memorial Sloan Kettering Cancer Center, New York, NY.

A number of trials have evaluated the use of single-agent immune checkpoint inhibitors for the treatment of metastatic castration-resistant prostate cancer (mCRPC). The benefit appears to be limited to a small subset of patients, such as those with tumors with microsatellite instability, highlighting the importance of biomarkers to identify which patients may be more likely to respond. Given the lack of efficacy for most patients with mCRPC, our understanding of the mechanisms of primary resistance to checkpoint inhibitors and of the tumor immune microenvironment in prostate cancer is critical. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_278853DOI Listing

The Practical Application of Emerging Technologies Influencing the Diagnosis and Care of Patients With Primary Brain Tumors.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-12

Comprehensive Cancer Center, Wake Forest Baptist Health, Winston-Salem, NC.

Over the past decade, a variety of new and innovative technologies has led to important advances in the diagnosis and management of patients with primary malignant brain tumors. New approaches to surgical navigation and tumor localization, advanced imaging to define tumor biology and treatment response, and the widespread adoption of a molecularly defined integrated diagnostic paradigm that complements traditional histopathologic diagnosis continue to impact the day-to-day care of these patients. In the neuro-oncology clinic, discussions with patients about the role of tumor treating fields (TTFields) and the incorporation of next-generation sequencing (NGS) data into therapeutic decision-making are now a standard practice. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280955DOI Listing

Taboo Topics in Adolescent and Young Adult Oncology: Strategies for Managing Challenging but Important Conversations Central to Adolescent and Young Adult Cancer Survivorship.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-15

Seattle Children's Research Institute, University of Washington, Seattle, WA.

Research on adolescents and young adults (AYAs) with cancer has flourished over the past decade, underscoring the unique medical and psychosocial needs of this vulnerable group. A cancer diagnosis during adolescence and young adulthood intersects with the developmental trajectory of AYAs, derailing critical physical, social, and emotional development. AYAs face these abrupt life changes needing age-appropriate information and resources to offset these challenges. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279787DOI Listing

Cutting to the Front of the Line: Immunotherapy for Childhood Acute Lymphoblastic Leukemia.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-12

Cincinnati Children's Hospital Medical Center, University of Cincinnati College of Medicine, Cincinnati, OH.

Although many children and young adults with B-cell acute lymphoblastic leukemia (B-ALL) are cured with modern, risk-adapted chemotherapy regimens, 10% to 15% of patients will experience relapse or have refractory disease. Recent efforts to further intensify cytotoxic chemotherapy regimens in the frontline setting have failed as a result of excessive toxicity or lack of improvement in efficacy. As a result, novel approaches will be required to achieve cures in more newly diagnosed patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_278171DOI Listing

The Resurgence of Antibody Drug Conjugates in Cancer Therapeutics: Novel Targets and Payloads.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-17

START (South Texas Accelerated Research Therapeutics), San Antonio, TX.

Antibody drug conjugates (ADCs) are an emerging class of therapeutics that consist of a cytotoxic agent linked covalently to an antibody, which is directed toward a specific cell surface target expressed by tumor cells and/or the microenvironment. ADCs leverage the specificity of the antibody such that it functions as a carrier to deliver the cytotoxic payload into the tumor. Four parameters are considered critical for this class of complex engineered therapeutics: target selection, antibody, cytotoxic payload, as well as conjugation and linker technology. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_281107DOI Listing

Newly Diagnosed Myeloma in 2020.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-15

Division of Hematology, The Ohio State University, Columbus, OH.

Over the last few years, there has been great progress in the treatment of multiple myeloma (MM), with many new agents and combinations having been approved and being now routinely incorporated into treatment strategies for newly diagnosed patients. As a result, patients are experiencing benefits in terms of survival and better tolerance. However, the multitude of treatment options also presents a challenge to select the best options tailored to the specific patient situation. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280221DOI Listing

Avoiding the Swell: Advances in Lymphedema Prevention, Detection, and Management.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-10

Department of Plastic Surgery, The University of Texas MD Anderson Cancer Center, Houston, TX.

Lymphedema is a feared complication of cancer treatments that negatively affects survivors' quality of life. The true incidence of lymphedema is difficult to determine given its long latency period. As the number of survivors of cancer is increasing in the United States, lymphedema is poised to be a major health concern. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280471DOI Listing

Beyond Tumor PD-L1: Emerging Genomic Biomarkers for Checkpoint Inhibitor Immunotherapy.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-11

Columbia University Medical Center, New York, NY.

Despite the success of immune checkpoint blockade as a strategy for activating an antitumor immune response and promoting cancer regression, only a subset of patients have durable clinical benefit. Efforts are ongoing to identify robust biomarkers that can effectively predict treatment response to immune checkpoint inhibitors (ICIs). Although PD-L1 expression is useful for stratifying patients, it is an imperfect tool. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_289967DOI Listing

Colorectal Cancer in the Young: Epidemiology, Prevention, Management.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-14

Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer Center, Baltimore, MD.

Colorectal cancer (CRC) incidence rates in the United States overall have declined since the mid-1980s because of changing patterns in risk factors (e.g., decreased smoking) and increases in screening. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279901DOI Listing

Best Foot Forward: Neoadjuvant Systemic Therapy as Standard of Care in Triple-Negative and HER2-Positive Breast Cancer.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-16

Department of Surgery, Dan L. Duncan Comprehensive Cancer Center, Baylor College of Medicine, Houston, TX.

Neoadjuvant systemic treatment of early-stage breast cancer has been used to improve resectability and reduce the extent of breast and axillary surgery. More recently, several other merits of neoadjuvant systemic treatment have emerged, including the ability to tailor clinically available adjuvant systemic therapy options based on pathologic response and to serve as a platform for early assessment of novel agents and response biomarkers and as an avenue for treatment optimization investigations (local and systemic therapy escalation and de-escalation trials guided by pathologic response). Attainment of a pathologic complete response (pCR) is associated with excellent long-term outcomes; conversely, the presence of residual disease is associated with a high risk of recurrence for patients with HER2-positive breast cancer and triple-negative breast cancer (TNBC). Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_281381DOI Listing

Making Checkpoint Inhibitors Part of Treatment of Patients With Locally Advanced Lung Cancers: The Time Is Now.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-12

The University of Texas MD Anderson Cancer Center, Houston, TX.

The PACIFIC trial of durvalumab administered for 1 year to patients with stage III lung cancers has set a new standard of care. PACIFIC established the role of immune checkpoint inhibitors (ICIs) for individuals with inoperable and unresectable locally advanced lung cancers that achieve disease control from concurrent chemoradiation. For patients with resectable and operable disease, ICIs administered before surgery, either alone (JHU/MSK, LCMC3, and NEOSTAR) or in combination with chemotherapy (Columbia/MGH and NADIM), have yielded high rates of major pathologic response in resection specimens, an outcome measure that correlates with improved progression-free survival and overall survival. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280807DOI Listing

And Now for Something Completely Different: Immunotherapy Beyond Checkpoints in Melanoma.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-12

Department of Medical Oncology and Therapeutics Research, City of Hope National Medical Center, Duarte, CA.

Advances in the understanding of biology and therapy of melanoma have occurred at an astonishing pace over the past approximately 15 years, and successful melanoma therapy has led the way for similar advances in many other solid tumors that are continuing to improve outcomes for all patients with cancer. Although the 2018 Nobel Prize was awarded to two investigators who discovered that therapeutic targeting of immune checkpoints held the key to major patient benefits, there are many additional immunotherapeutic strategies that warrant further study and discussion at scientific and medical meetings. This article provides the newest information on three areas of immunotherapy that have been successfully applied to melanoma and continue to pave the way for new developments: cytokines, adoptive cell therapies (ADTs), and intratumoral injection of immunomodulatory agents. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_79437DOI Listing

On the Shoulders of Giants: The Evolution of Renal Cell Carcinoma Treatment-Cytokines, Targeted Therapy, and Immunotherapy.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-18

Deptartment of Cancer Medicine, Institute Gustave Roussy, Villejuif, France.

The treatment of advanced renal cell carcinoma (RCC) has evolved dramatically over the past 30 years, as has a better understanding of the biology of the disease, knowledge of multiple subtypes with distinct molecular abnormalities, and improved comprehension of the perturbed pathways that lead to the development and growth of RCC. This is no longer a monolithic disease, although the majority of tumors are of the clear cell subtype. However, progress is being made in other subtypes as well, as molecular profiles are better understood and as new agents show activity. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280817DOI Listing

Toward Modernization of Geriatric Oncology by Digital Health Technologies.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-7

Lineberger Comprehensive Cancer Center, University of North Carolina at Chapel Hill, Chapel Hill, NC.

The number of older adults with cancer is increasing. Over the past 3 decades, geriatric oncology research has focused on improving the assessment of frailty and fitness of older adults with cancer as well as methods of improving their outcomes. At the same time, advances in digital health technologies have opened new frontiers for reaching this goal. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279505DOI Listing

Cancer Prevention in Low-Resource Countries: An Overview of the Opportunity.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-12

University of Texas, MD Anderson Cancer Center, Houston, TX.

Rising trends in the incidence of cancer in low- and middle-income countries (LMICs) add to the existing challenges with communicable and noncommunicable diseases. While breast and colorectal cancer incidence rates are increasing in LMICs, the incidence of cervical cancer shows a mixed trend, with rising incidence rates in China and sub-Saharan Africa and declining trends in the Indian subcontinent and South America. The increasing frequencies of unhealthy lifestyles, notably less physical activity, obesity, tobacco use, and alcohol consumption are causing a threat to health care in LMICs. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280625DOI Listing

Current Approaches to the Treatment of Advanced or Metastatic Renal Cell Carcinoma.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-10

UC Davis Comprehensive Cancer Center, Sacramento, CA.

The optimal management approach to advanced or metastatic renal cell cancer of the clear cell type continues to rapidly evolve. Risk stratification of patients into favorable-, intermediate-, and poor-risk categories is now routinely performed. In selected individuals with low-volume indolent disease, active surveillance may be an appropriate option. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279881DOI Listing

Escalating and De-escalating Therapy for Early-Stage HER2-Positive Breast Cancer.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-11

University of North Carolina at Chapel Hill, Chapel Hill, NC.

Untreated, HER2+ disease is the most aggressive breast cancer phenotype; however, the development of multiple highly effective HER2-targeting drugs has transformed treatment and survival. These drugs include the anti-HER2 monoclonal antibodies trastuzumab and pertuzumab; small molecule inhibitors lapatinib, neratinib, and tucatinib; and antibody-drug conjugates trastuzumab emtansine (T-DM1) and now trastuzumab deroxtecan. More complex regimens using these drugs continue to improve outcomes, but the incremental benefits of these advances are often modest. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_100023DOI Listing

Successful Strategies to Address Disparities: Insurer and Employer Perspectives.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-9

Johns Hopkins University School of Medicine and Bloomberg School of Health, Baltimore, MD.

Disparities in cancer have been documented for decades and continue to persist despite clinical advancements in cancer prevention, detection, and treatment. Disparate cancer outcomes continue to affect many populations in the United States and globally, including racial and ethnic minorities, populations with low income and education, and residents of rural areas or low socioeconomic neighborhoods, among others. Addressing cancer disparities requires approaches that are multilevel. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279959DOI Listing

Current Perspectives on Therapy for Chronic Lymphocytic Leukemia.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-10

Division of Hematology, Department of Internal Medicine, The Ohio State University Comprehensive Cancer Center, Columbus, OH.

Therapy for chronic lymphocytic leukemia has improved dramatically over the past decade with the introduction of new targeted therapies and a paradigm shift toward targeted therapies for the majority of patients. Better understanding of prognostic factors has helped tailor therapy for individual patients, and work continues to identify optimal therapy for each patient. When therapy is required, most patients will be treated with targeted therapies, either the Bruton tyrosine kinase (BTK) inhibitors ibrutinib or acalabrutinib or the BCL-2 inhibitor venetoclax in combination with obinutuzumab. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279099DOI Listing

Controversies in Rectal Cancer Treatment and Management.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-11

Instituto Angelita & Joaquim Gama, São Paulo, Brazil.

Incorporation of new treatment modalities has significantly increased the complexity of the treatment and management of rectal cancer, including perioperative therapy for local advanced disease and organ preservation for those with response to the preoperative treatment. This review may help practitioners better understand the rationale and selection. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279871DOI Listing

Therapeutic Targets and Opportunities in Endometrial Cancer: Update on Endocrine Therapy and Nonimmunotherapy Targeted Options.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-11

Section of Hematology-Oncology, Department of Medicine, The University of Chicago, Chicago, IL.

Worldwide, the incidence of endometrial cancer is increasing. Although the prognosis remains good for patients diagnosed with early-stage disease, for those diagnosed with recurrent or metastatic disease, options have been limited, and prognosis is short. Optimizing and identifying new well-tolerated treatments for women living with endometrial cancer is a top priority. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_280495DOI Listing

How Do We Align Health Services Research and Quality Improvement?

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-10

University of Alabama at Birmingham (UAB) Comprehensive Cancer Center, Birmingham, AL.

Quality improvement (QI) initiatives and health services research (HSR) are commonly used to target health care quality. These disciplines are increasingly important because of the movement toward value-based health care as alternative payment and care delivery models drive institutions and investigators to focus on reducing unnecessary health care use and improving care coordination. QI efforts frequently target medical error and/or efficiency of care through the Plan-Do-Study-Act methodology. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_281093DOI Listing

The Changing Landscape of Treatment in Acute Myeloid Leukemia.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-12

Center for International Blood and Marrow Transplant Research, Department of Medicine, Medical College of Wisconsin, Milwaukee, WI.

The treatment of acute myeloid leukemia is evolving, with increased understanding of molecular pathogenesis allowing better risk stratification and development of new therapies. Tests to identify and drugs to target specific molecular abnormalities are improving remission rates and prolonging survival in patients with high-risk disease. Allogeneic hematopoietic stem cell transplantation remains an important curative therapy, with advances in donor availability and approaches to reduce transplant-related mortality making it applicable in many more patients. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279129DOI Listing

Resource-Stratified Guideline-Based Cancer Care Should Be a Priority: Historical Context and Examples of Success.

Am Soc Clin Oncol Educ Book 2020 Mar;40:1-10

Division of Oncology, University of Washington, Seattle, WA.

Low- and middle-income countries (LMICs) are shouldering most of the burden of the rapidly increasing cancer incidence and mortality worldwide, and this situation is projected to worsen in coming decades. Studies estimate that more than one million deaths could be prevented annually if all patients received high-quality care, but most LMICs lack the resources and infrastructure to adopt U.S. Read More

View Article

Download full-text PDF

Source
http://dx.doi.org/10.1200/EDBK_279693DOI Listing