We think of the compilation of The Cancer Letter’s most-read stories as an end-of-year snapshot of oncology’s priorities.
Since 2019, we have been mining our analytics to give you a glimpse into what you and your colleagues were thinking about over the course of that year:
- In 2019, the Chernobyl HBO miniseries, minimally invasive surgery, and real-world evidence held our attention.
- In 2020, the field reacted to a world on fire, as coverage of COVID-19, a tumultuous election, George Floyd, and equity topped the list.
- In 2021, coverage of sexism and sexual misconduct in academic medicine ricocheted throughout oncology and landed on the desks of federal lawmakers.
- In 2022, The Cancer Letter captured oncology’s response to the war in Ukraine, the overturning of Roe v. Wade, and turnover in oncology leadership.
What captured your attention in 2023?
In November, NYU suspended Benjamin Neel following his activity on social media that included reposts of political cartoons and other materials that were critical of protesters against Israel’s strikes on Gaza and that included caricatures critics described as “anti-Arab.”
A cisplatin and carboplatin shortage prompted drug rationing, and left oncologists questioning whether they would have enough to treat the next patient. “Discussions in the oncology community have focused on the proposal that the government contract with manufacturers to produce a ‘buffer stockpile’ of ‘essential’ oncology drugs,” Richard Pazdur, director of the FDA Oncology Center of Excellence and acting director of the Office of Oncologic Diseases, said to The Cancer Letter.
At a time when cancer centers are focused on reducing disparities, patients, providers, advocates, and legal experts expressed outrage and concern at the 500+ legislative proposals in 49 states that target trans people—predominantly youths. “Any action, even broadly, that erodes anti-discrimination protections, has the potential to exacerbate those existing disparities and worsen a community’s access to services,” Clifford Hudis, CEO of the American Society of Clinical Oncology, said to The Cancer Letter.
Five of The Cancer Letter’s top 25 most-read stories this year are obituaries. C. David Allis, Susan Love, William Blackstock, Franklyn Prendergast, and Mohammed Dabbour are remembered by friends, colleagues, and loved ones.
In 2023, The Cancer Letter published obituaries commemorating 13 people in oncology. In recent weeks, Worta McCaskill-Stevens and Michelle Rudek were memorialized by colleagues and friends, and an obituary for Cullen Taniguchi appears in this issue.
As we ring in the New Year—and The Cancer Letter’s 50th anniversary—we invite you to revisit some of our most-read stories of 2023. This list is compiled based on The Cancer Letter‘s web analytics:
1
Suspensions, public outrage ensue as tensions over Middle East sweep through oncology
NYU Cancer Center Director Benjamin Neel suspended over social media posts
Benjamin G. Neel, a widely respected cancer biologist with a considerable social media presence, was suspended from his job as director of the New York University Perlmutter Cancer Center following complaints over his retweets of political cartoons and other materials that were critical of protesters against Israel’s strikes on Gaza and that included caricatures critics described as “anti-Arab.”
Neel, a cancer biologist whose work focuses on cell signaling and who has run the cancer center since 2014, was voted into the National Academy of Sciences a year ago. Neel is the highest-ranking cancer physician-scientist to face suspension as a result of posting social media content about the volatile situation in the Middle East.
His suspension was announced on Nov. 1, four days after NYU suspended a resident named Zaki Masoud for an analogous infraction.
Related:
- Former Perlmutter Cancer Center director Benjamin Neel sues NYU over termination (The Cancer Letter, Nov. 17, 2023)
- Alec Kimmelman named director of Perlmutter Cancer Center, quickly replacing ousted Benjamin Neel (The Cancer Letter, Dec. 1, 2023)
2
How Beth Carner went from six weeks left to live with stage 4 colon cancer to complete remission
At 25, Elizabeth Carner was diagnosed with stage 4 colon cancer.
“I mean, the first thing that went through my head was just looking at mom and dad, and it’s just like, OK, well, where did all the other stages go? Because we literally went from my colonoscopy as being OK to everything’s not OK,” Carner, now 33, said to Deborah Doroshow, an oncologist at the Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai.
At the time, Carner, who studied theater and stage management as an undergraduate, had a coveted job at an equity theater, Cincinnati Playhouse in the Park. She hadn’t thought much of her recent weight loss before the diagnosis—going from 175 to around 150—chalking it up to the hustle of theater life.
Then, one day, Carner fainted at work.
3
UCSD’s Comprehensive Cancer Center designation is in trouble; director Califano steps down amid turmoil
The Moores Cancer Center at UC San Diego Health is in imminent danger of losing its Comprehensive designation, and members of the center’s External Advisory Board are urging the leadership of the parent institution to act fast.
For starters, amid the turmoil and with the NCI designation deadline approaching, the center must recruit a new director.
On May 26, the cancer center’s faculty and staff were stunned to learn that Joseph A. Califano III is stepping down after six-and-a-half months as director, setting what appears to be a record for brevity of service by any center director in the 50-year history of the NCI Cancer Centers Program.
Editor’s note: This story is part of a series.
4
Richard Pazdur discusses root causes of cisplatin and carboplatin shortage and what can be done to alleviate it
Today’s critical shortage of cisplatin and carboplatin occurred because manufacturers failed to invest in enhancing production capacity, Richard Pazdur, director of the FDA Oncology Center of Excellence and acting director of the Office of Oncologic Diseases, said to The Cancer Letter.
In a wide-ranging interview, Pazdur addressed the immediate problem of shortages of platinum-based drugs as well as the underlying causes of shortages that have been plaguing oncology for over a decade.
The shortage of platinum-based drugs is causing oncologists all over the U.S. to ration the drugs that are used to treat as many as 500,000 new cancer patients per year. As cisplatin and carboplatin are being rationed at clinics nationwide, this often means that only patients who stand a chance of being cured are prioritized to receive these off-patent, inexpensive treatments.
Related:
- “Historic” cisplatin shortage leaves oncologists guessing whether they will have enough to treat the next patient (The Cancer Letter, April 7, 2023)
- Cisplatin, carboplatin shortage prompts rationing of lifesaving drugs—patients will die (The Cancer Letter, May 26, 2023)
- ASCO’s Julie Gralow: At least 100,000 (and up to 500,000) cancer patients affected by cisplatin, carboplatin shortage (The Cancer Letter, May 26, 2023)
5
More than 500 bills restricting trans medical care threaten LGBTQ+ people with cancer
More than 500 legislative proposals in 49 states are targeting trans people—predominantly youths—prompting fear among patients, healthcare providers, advocates, and legal experts that trans and gender nonconforming patients will be excluded from care.
According to translegislation.com, a legislation tracker, 80 such state bills have been signed into law.
Studies show that transgender and gender nonconforming patients are reluctant to seek cancer care. And now, nearly identically worded pieces of legislation churned out by Alliance Defending Freedom, the Family Research Council, the Liberty Counsel, the American Principles Project, and other extreme right groups, threaten to deepen health disparities among these patients.
6
Prominent GI oncologist Axel Grothey was forced out of Mayo Clinic for unethical sexual relationships with women he mentored
Three reprimands later, he retains leadership—and mentorship—positions
The aftermath of sexual misconduct at premier medical institutions rarely leaves visible traces: HR is brought in, confidentiality invoked, deals made. The case of Axel Grothey’s exit from Mayo Clinic is a notable exception.
Last year, the prominent gastrointestinal oncologist was reprimanded by medical licensure boards in three states for engaging in unethical sexual relationships with an oncology fellow and a faculty colleague at Mayo Clinic Rochester, his longtime place of employment.
Three reprimands notwithstanding, Grothey has kept his appointment as co-chair of the NCI National Clinical Trials Network’s Gastrointestinal Steering Committee, an influential group that reviews ideas for clinical trials and helps determine the priorities in federally funded clinical research in GI oncology.
Editor’s note: This story is part of a series.
7
The unKOOL, unfiltered history of menthol cigarettes
Quick, what color is menthol?
No, it’s not green. That’s the color of the KOOL, Newport, or Salem cigarette pack. Get it? Green is cool. Red is hot.
Menthol, a component of peppermint oil, is a colorless topical pain reliever like Novocain that the dentist uses to numb a tooth.
The idea of adding menthol to reduce smoking’s harshness on the throat came to Lloyd “Spud” Hughes in the 1920s, after he’d stored his cigarettes in an old tin of menthol crystals that his mother insisted that he inhale for his asthma.
He patented the process in 1924, and three years later, the Axton-Fisher Tobacco Company acquired the patent and began manufacturing “Spud Menthol Cooled Cigarettes.”
Today, as the Biden administration targets mentholated cigarettes, it behooves us to review the history of the tobacco industry’s marketing campaigns that target Black Americans.
8
Gynecology’s deadly surprise: Cancers are frequently missed prior to routine procedures
As they reach for surgical tools, gynecologists vastly underestimate the probability that their patients have undiagnosed uterine cancers, a study by Yale University researchers found.
Their paper, published in Obstetrics & Gynecology last month, is immediately relevant in the clinic, because a suspicion that cancer may be present dictates the choice of surgical techniques employed in gynecological procedures that are performed in about 650,000 women every year in the United States.
The newly calculated prevalence rates, based on analysis of data from 26,444 cases in the 2014-2015 American College of Surgeons National Surgical Quality Improvement Program, are staggering:
- One in 20 women over age 55 were subjected to surgery for benign indications, but were later found to have malignancies in the main body of the uterus. Nearly one in 10 women over age 55 who underwent total abdominal hysterectomies had hidden corpus uteri cancer.
- Overall, prevalence of cancers undetected at the initiation of hysterectomies was almost as high as one in 70. For women who underwent total laparoscopic or laparoscopic-assisted vaginal hysterectomies, the estimated prevalence rose to nearly one in 50.
Editor’s note: This story is part of a series.
9
C. David Allis, pioneer of chromatin biology and epigenetics, dies at 71
When you hear the words “world famous scientist,” “devoted parent and husband,” “enthusiastic mentor,” and “committed friend,” who comes to mind? I, like many others across the world, think of Dr. C. David Allis. David, a prolific scientist, with over 400 publications and more than 100,000 citations, made many discoveries that have shaped our understanding about how genes are regulated and made a full circle bench-to-bedside impact.
He spent his career addressing concepts that resulted in new principles and understanding in areas that desperately needed answers. The numerous trainees he mentored are now leading laboratories at the most prestigious universities and medical schools across the world, and they too are making breakthroughs and flourishing as mentors, just as he taught them. At this time, I am privileged to join many throughout the globe who are remembering, thanking, and honoring him.
10
San Antonio Breast Cancer Symposium 2022 tackled big obstacles, recommended solutions for breast cancer progress
To provide a roadmap for accelerating progress against breast cancer over the next 10 years, an expert panel was convened at the 2022 San Antonio Breast Cancer Symposium to identify the biggest obstacles hindering our ability to cure breast cancer and to propose transformative solutions to address these obstacles.
While the last few decades have witnessed remarkable progress against breast cancer, it remains the most common type of cancer diagnosed in women and is the second most deadly, after lung cancer. According to the 2023 estimates, there were more than 297,000 new cases of invasive breast cancer diagnosed among U.S. women, and more than 43,000 deaths from the disease.
The advances against breast cancer have mainly been the result of early detection by screening mammography, the investment in research leading to the identification of breast cancer molecular subtypes, and the success of randomized clinical trials resulting in improved treatments and reduction in metastatic recurrences with adjuvant and, increasingly, neoadjuvant therapy.
As a result, over the past three decades, breast cancer related deaths have declined consistently in the U.S., decreasing by 43% from 1989 to 2020, translating into nearly 460,000 breast cancer deaths avoided. As a result, as of January 2022, there were more than 4 million women with a history of breast cancer living in the U.S.
11
Susan Love, a transformative leader in breast cancer movement, dies at 75
She intuitively understood the right thing to do—and then just did it
In May 1991, I sat in a law firm conference room in Washington, DC, listening to a pitch from a small group of women who had the idea to launch a political advocacy movement around breast cancer. One of those women was Dr. Susan Love. The person next to me nudged me with her elbow and whispered, “She is famous. She wrote this unbelievable book.”
Though I had received a breast cancer diagnosis just four years earlier, I knew very little about the issue or the players—I just knew I wanted to do something about it. And it was very clear to me that day that Susan Love had the vision and the balls to make something big happen.
That was my introduction to Sue, and what was to become the National Breast Cancer Coalition (NBCC). For more than 30 years, I had the privilege of working with Susan to grow NBCC into a strong, powerful movement. But in May 1991, no one knew who NBCC was. The fact that Dr. Susan Love was part of NBCC’s launch gave it credibility among many and instilled fear in some.
Related:
- Susan Love on breast cancer activism in the 1990s (Interview with the Cancer History Project)
12
Chernobyl: a 35 year follow up on long-term health effects
In the early morning of April 30, 35 years ago, I was awakened by a call from Anatoly Dobrynin, a long-time Soviet Ambassador to the United States.
He said General Secretary Mikhail Gorbachev wanted me to come to the Soviet Union to help treat victims of the Chernobyl nuclear power facility accident. I had cabled Gorbachev a few days earlier, offering my assistance.
Related:
- Chernobyl, the HBO miniseries: Fact and fiction (The Cancer Letter, four-part series)
13
ODAC clears a path for dostarlimab, a drug that may “beat the reaper” in locally advanced rectal cancer
Cancer specialists like me, whether they are medical, surgical, or radiation oncologists spend our lives treating life threatening disease. We generally have a serious and professional demeanor reflective of the world that we choose to inhabit and the circumstances facing our patients that entrust us with their care.
Employees of FDA are charged with regulatory authority regarding drugs used by oncologists and other medical practitioners. They understand that their task requires them to make dispassionate judgments based upon a record of historical precedent, expert advice, and validated endpoints to both protect patients and facilitate their access to new discoveries. Those FDA employees are generally known for their equanimity and diplomacy.
14
Cisplatin, carboplatin shortage prompts rationing of lifesaving drugs—patients will die
Thousands of cancer patients across the U.S. are getting bewildering news from their oncologists:
Proven curative regimens containing platinum-based drugs—cisplatin and carboplatin—have become largely unavailable because of a nationwide drug shortage. The institutions that have some supplies of cisplatin and carboplatin are setting up algorithms for rationing their dwindling stocks, which usually means giving top priority to patients treated with curative intent and denying standard-of-care treatment to patients who cannot be cured but who can still benefit from these drugs.
Cisplatin and carboplatin are old, generic drugs. Cisplatin was first described in medical literature in 1844. Both cisplatin and carboplatin have been widely used since the 1970s. Since platinum drugs are thoroughly studied and are a staple in oncology, this means they are often present in regimens on both the experimental and control arms of clinical trials.
Related:
- Richard Pazdur discusses root causes of cisplatin and carboplatin shortage and what can be done to alleviate it (The Cancer Letter, May 30, 2023)
- “Historic” cisplatin shortage leaves oncologists guessing whether they will have enough to treat the next patient (The Cancer Letter, April 7, 2023)
- ASCO’s Julie Gralow: At least 100,000 (and up to 500,000) cancer patients affected by cisplatin, carboplatin shortage (The Cancer Letter, May 26, 2023)
15
Wake Forest’s pioneering radiation oncologist William Blackstock dies at 60
The effort to defeat cancer is a visceral need for each of us, fueled by the memories of the myriad of special individuals we cared for who passed from this earth due to this terrible disease.
Indeed, the inescapable impact of cancer was felt deeply this week across North Carolina and the cancer world as William Blackstock, MD, died from his long battle with prostate cancer.
William died on June 18. He was 60.
16
Mount Sinai oncologist Krystal Cascetta, 40, and her infant daughter die in Somers, NY, home
Krystal P. Cascetta, a 40-year-old New York City oncologist, and her 4-month-old infant daughter were found dead at a home in Somers, NY, Aug. 5 in what police describe as a possible murder-suicide.
17
ODAC Confidential: The seven deadly sins sponsors commit again and again at FDA presentations
Over and over again, I’ve seen the same missteps, clumsy excuses, and faulty logic during sponsor presentations to the FDA Oncologic Drugs Advisory Committee, repeated as if part of a tragic, regulatory update to the movie Groundhog Day.
For five years, I served as a member of ODAC, and was even privileged enough to chair the committee for two of those years. To my knowledge, there is no exit interview of ODAC members in which we are asked to recount what “mistakes were made” during those pharma presentations to the agency.
Yet, the transgressions that occur as sponsors present trial data to FDA and ODAC are common–and recurring.
18
Mayo’s Franklyn Prendergast dies at 78
On Oct. 12, 2023, the world lost a brilliant mind, a dedicated physician and an extraordinary individual.
Dr. Franklyn Prendergast’s life and career were marked by an unwavering commitment to the field of medicine and a relentless pursuit of knowledge. His legacy, which spans decades of groundbreaking research and institutional leadership, continues to inspire and influence the future of healthcare and scientific exploration.
19
Bertagnolli raises paylines, creates Clinical Trials Innovation Unit, and announces National Cancer Plan
NCI is increasing the R01 payline to the 12th percentile in fiscal year 2023, up from the 11th percentile in FY22—bringing the institute’s payline to a level not seen since 2010.
“The last time that the RPG payline was 12% or higher was in 2010. So, we are now at a 13-year high,” NCI Director Monica Bertagnolli said Feb. 9, addressing members of the National Cancer Advisory Board in a virtual meeting. “Not as high as we want, but a 13-year high in our ability to fund these very important grants. We also raised the payline for early-stage investigators to the 17th percentile, up 1%.
“Together, these payline increases as well as some others will fund more than 100 additional R01 and ESI awards than last year.”
The bump-up is a continuation of former NCI Director Ned Sharpless’s efforts to reach 15% by 2025, from 8% in 2019 (The Cancer Letter, Sept. 4, 2020). Alas, there is a tradeoff.
20
Jedd Wolchok: Weill Cornell’s path to NCI designation runs through Brooklyn and Queens
Some job relocations are less cumbersome than others.
When Jedd Wolchok left Memorial Sloan Kettering Cancer Center after more than a quarter century, he crossed East 68th Street to Weill Cornell campus, where he is now the director of the Sandra and Edward Meyer Cancer Center.
Wolchok, former chief of the Immuno-Oncology Service and the Lloyd J. Old/Virginia and Daniel K. Ludwig Chair in Clinical Investigation at MSK, who started the Weill Cornell job Sept. 12, 2022, didn’t even have to change his academic affiliation. He has been a Weill Cornell Medicine faculty member throughout his time at MSK.
“I had the great privilege of working for 26 years at Memorial Sloan Kettering, and really could not be more grateful for the time and opportunities that I had there to really see a wholesale change in the way that immunotherapy is perceived, and to really be supported by amazing colleagues,” Wolchok said to The Cancer Letter.
21
Betty Ford and the press conference that changed oncology
An NCI press conference is rarely a tabloid affair—except on Sept. 30, 1974. What was anticipated to be a dry occasion shifted when Betty Ford, wife of President Gerald Ford, underwent a radical mastectomy Sept. 28.
The Cancer Letter was there: “Breast Cancer Report To The Profession Suddenly Is a Report To The Nation; Treatment Progress Noted,” was the Oct. 7, 1974 issue’s lead story.
Nathaniel Berlin, then director of NCI’s Division of Biology & Diagnosis and chairman of the Breast Cancer Task Force, had been concerned the breast cancer report would receive limited public attention. Instead, he got a media circus—leading to fears of publishing the findings prematurely.
Related:
- Cancer History Project Panel: How Betty Ford’s and Nancy Reagan’s breast cancer diagnoses changed attitudes to cancer (The Cancer Letter, March 10, 2023)
- Women’s History Month: Breast cancer in the White House (The Cancer Letter, March 3, 2023)
22
What Ruben Mesa is thinking as he steps into one of the most-watched jobs in cancer
Ruben A. Mesa is going into the new year with a massive new challenge: bring together the programs and cultures of an academic cancer center and a hybrid cancer center—and convincing NCI that the new organization should keep its elite designation.
In December, Mesa was named president and executive director of the cancer service line of Atrium Health, a job that places him at the helm of both Atrium Health Levine Cancer Institute in Charlotte, NC, and Atrium Health Wake Forest Baptist Comprehensive Cancer Center in Winston-Salem. Mesa was also named vice dean for cancer programs at Wake Forest University School of Medicine.
Last year, NCI truncated the five-year Cancer Center Support Grant held by Wake Forest Baptist as that institution was undergoing a bumpy transition of leadership—in the midst of its integration with Levine.
Related:
- Wake Forest’s entire EAB resigns in protest as director Boris Pasche is fired (The Cancer Letter, Feb. 25, 2022)
- Wake Forest CCSG cut from 5 years to 3 as center changes leadership, administrative structure (The Cancer Letter, May 27, 2022)
23
Should you eat a kielbasa tonight?
Six experts weigh evidence on papers debunking nutritional guidelines on red and processed meat
We asked six experts in disease prevention, nutrition, and guidelinemaking to discuss the just-published recommendations that disagree with the dietary guidelines promulgated by mainstream health organizations.
The paper, published in Annals of Internal Medicine said there is little evidence of increased risk of cancer, heart disease, and other harm from eating red meat and processed meat.
Related:
- Don’t put red, processed meat back on the menu: Cancer and dietary experts dispute controversial directive (The Cancer Letter, Oct. 4, 2019)
- Guyatt: Existing dietary guidelines for red and processed meat are based on slim evidence and are paternalistic (The Cancer Letter, Oct. 4, 2019)
- Scientists spar over COIs, methodology of Annals guideline on red, processed meat (The Cancer Letter, Oct. 11, 2019)
- Laine: Annals wouldn’t have published studies on red, processed meat “if we thought it was bad science” (The Cancer Letter, Oct. 11, 2019)
- AICR’s Brockton: Annals studies on red, processed meat don’t change facts on health outcomes; also, funding is “murky” (The Cancer Letter, Oct. 11, 2019)
- Annals corrects NutriRECS red, processed meat papers to reflect industry-related funding from Texas A&M AgriLife (The Cancer Letter, Jan. 10, 2020)
24
Mohammed Dabbour, cancer pathologist, killed in Gaza
On Oct. 13, 2023, the world mourned the loss of Dr. Mohammed Dabbour, an exceptionally kind and dedicated individual with aspirations. I was deeply saddened to learn about the tragic passing of a colleague, along with several members of his family, including his son and father.
This heartrending event, resulting from the Israeli military’s airstrikes in Gaza, claimed the life of an extraordinary soul.
25
Lowy: “Our patients are counting on us, and we must not let them down”
NCI Frederick lab takes aim at Covid-19
NCI’s Frederick National Laboratory for Cancer Research has launched three initiatives focused on SARS-CoV-2:
- Identifying genetic determinants of SARS-CoV-2 susceptibility and outcomes at the Cancer Genomics Research Laboratory,
- Testing and validating serologic assays for SARS-CoV-2 in the Serology laboratory of the Vaccine, Immunity, and Cancer Program, and
- High-throughput screening for small molecule inhibitors of SARS-CoV-2 proteins, with technology developed by the RAS Initiative.
“We think that it was built for a situation like this, where speed, flexibility, and expertise are critical to addressing such a deadly public health threat,” Douglas Lowy, NCI principal deputy director, said April 9 in an emergency virtual meeting of the NCI Board of Scientific Advisors and the National Cancer Advisory Board.
