The Society of Surgical Oncology (SSO) and American Society for Radiation Oncology (ASTRO) formed a multidisciplinary expert panel in 2013 to examine the relationship between surgical margin width and ipsilateral breast tumor recurrence and develop guidelines on margins for breast-conserving...
Although breast-conserving therapy has been a standard practice for more than 20 years, controversy still exists over what constitutes the appropriate margin of normal breast tissue around a tumor that minimizes local recurrence while maintaining a good cosmetic outcome. Surveys of surgeons1 and...
In the March 1, 2014, issue of The ASCO Post we talked with Francis S. Collins, MD, PhD, Director of the National Institutes of Health (NIH), about the future of biomedical research at the NIH during this time of constrained federal funding. We continue that conversation here with our interview of...
On March 11, ASCO released its first-ever comprehensive assessment of the daunting challenges facing America’s ability to continue to deliver high-quality care to all patients with cancer. ASCO President Clifford A. Hudis, MD, FACP, introduced the assessment at a Congressional news briefing in...
During the course of the 2014 Genitourinary Cancers Symposium, The ASCO Post had the opportunity to speak with several of the world’s leading authorities about the state of the art in screening, diagnosis, and treatment for prostate and kidney cancers. In this second installment of a two-part...
First-Line Therapy
Please describe current medical oncology approaches to first-line therapy for metastatic renal cell carcinoma.
The current first-line therapy for most patients with good- to intermediate-risk metastatic renal cell carcinoma is a vascular endothelial growth factor (VEGF)...
Cancer Immunotherapy
What is the role of immunotherapy in the treatment of metastatic renal cell carcinoma?
The harnessing of the immune system as an effective treatment for cancer was recently selected by the journal Science as the top scientific Breakthrough of the Year for 2013.1 With this...
A patient with advanced bladder cancer experienced a complete response for 14 months to the drug combination everolimus (Afinitor) and pazopanib (Votrient) in a phase I trial, and genomic profiling of his tumor revealed two alterations that may have caused this exceptional response, according to a...
Physicians at MedStar Georgetown University Hospital and Georgetown University Medical Center, Washington, DC, are studying the safety and effectiveness of prostate artery embolization in men with enlarged prostate glands and urinary obstruction. According to the National Institutes of Health,...
More data have emerged that discount the potential for benefit with epidermal growth factor receptor (EGFR) inhibitors in esophageal cancer. The latest comes from the RTOG 0436 randomized phase III trial in patients with nonoperable esophageal cancer, the results of which were presented at the 2014 ...
Emerging effective treatment options for salvage therapy in Hodgkin lymphoma were described by Anas Younes, MD, Chief of the Lymphoma Service at Memorial Sloan Kettering Cancer Center, New York, at the 2014 Highlights of ASH in North America meeting in Miami.
“This is an exciting time in Hodgkin...
The American Society of Hematology (ASH) recently announced the names of 15 researchers (see sidebar on page 15) who will receive interim support from the Society for hematology research proposals. These proposals earned high scores but could not be funded by the National Institutes of Health (NIH) ...
"Double-hit” lymphomas remain challenging tumors, and the best means of treatment remains somewhat elusive, according to studies presented at the 2013 American Society of Hematology (ASH) Annual Meeting in New Orleans, and experts who commented on these findings.
“We still don’t have a standard of ...
Webster K. Cavenee, PhD, was honored with the eighth annual American Association for Cancer Research (AACR) Margaret Foti Award for Leadership and Extraordinary Achievements in Cancer Research at the AACR Annual Meeting held recently in San Diego. Dr. Cavenee is Director of the Ludwig Institute for ...
As reported in BMJ by Anthony B. Miller, MD, Professor Emeritus at the Dalla Lana School of Public Health, University of Toronto, and colleagues, the 25-year follow-up of the Canadian National Breast Screening Study has shown no mortality benefit of annual mammography screening for breast cancer...
The recent report from the Canadian National Breast Screening Study (CNBSS)—published in BMJ and reviewed in this issue of The ASCO Post—concluded that annual mammography in women aged 40 to 59 does not result in a reduction in mortality from breast cancer beyond that of physical examination alone...
If a randomized, controlled trial of therapy for breast cancer was submitted for publication in which
1. The drug being tested was old and ineffective, and
2. prior to randomization, the women underwent a clinical breast examination and the study coordinators knew who had the largest cancers, and
...
Currently, one of the most challenging problems in oncology is to accurately predict whether neoplastic lesions detected by screening tests will progress. The focus on developing ever-more sensitive cancer screening tests has produced the clinical dilemma of overdiagnosis. Overdiagnosis occurs when ...
In the FACS trial, reported in JAMA, John N. Primrose, MD, FRCS, of University of Southampton, England, and colleagues compared outcomes with intensive follow-up with carcinoembryonic antigen (CEA) measurement, computed tomography (CT), both, or minimum follow-up after curative surgery for primary...
Colorectal cancer is a common malignancy that will impact 1.4 million individuals globally each year.1 Approximately 70% to 75% of patients will present with locally advanced disease. For patients with stage III colon cancer, adjuvant chemotherapy is commonly offered, whereas chemotherapy for those ...
Studies of complications of surgery or radiotherapy for prostate cancer generally focus on incontinence and erectile dysfunction. In a population-based cohort study reported in The Lancet Oncology, Robert Nam, MD, MSc, FRCS(C), Professor of Surgery, Sunnybrook Health Sciences Centre, University of...
Men with newly diagnosed localized prostate cancer face a decision between prostatectomy and radiotherapy, treatments deemed similarly effective but with well-established trade-offs in terms of treatment-related morbidity. Numerous clinical trials and other prospective studies, from both academic...
The recent study by Nam et al in The Lancet Oncology—reviewed in this issue of The ASCO Post—provides a fresh perspective on complications other than incontinence or erectile dysfunction that commonly arise after primary treatment of localized prostate cancer.1 The authors conducted a...
Last fall, Kirsten K. Ness, PhD, published her study1 on the prevalence of frailty as a sign of accelerated aging in adult survivors of childhood cancer, and the results are startling. Among the 1,922 participants in the study, the prevalence of prefrailty was 31.5% among women and 12.9% among men; ...
Preclinical models have suggested that cancer stem cells play a role in tumor recurrence and metastasis following adjuvant therapy, and Max S. Wicha, MD, and his research team are deciphering the mechanisms by which this might happen. A true understanding of cancer stem cells will have important...
In 2010, Jennifer S. Temel, MD, published her landmark study in The New England Journal of Medicine showing that the introduction of palliative care early after a diagnosis of metastatic non–small cell lung cancer, along with cancer therapy, not only provided patients with a better quality of life...
According to data from the Surveillance, Epidemiology, and End Results (SEER) program, rates for new cases of thyroid cancer in the United States have been rising on average 6.4% each year over the past 10 years, and death rates have been rising on average 0.9% each year over the same period.
The...
Use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among U.S. adolescents.” This was the conclusion of a cross-sectional analysis of survey data from a representative sample of middle and high school students who completed the National Youth Tobacco Survey (NYTS) ...
The American College of Radiology (ACR) recently issued a statement applauding steps to reign in medical imaging and radiation oncology self-referral included in the President’s fiscal year 2015 budget. However, prior authorization for imaging services, also included in the FY2015 budget, is...
Learning about the particulars of each cancer patient’s pain and treating each case uniquely is the key to keeping pain manageable. That is the goal of the Duffey Pain and Palliative Care Program at The Sidney Kimmel Comprehensive Cancer Center in Baltimore. The team consists of physicians, nurse...
Margaret Foti, PhD, MD (hc), CEO of the American Association for Cancer Research (AACR), welcomed about 150 congressional staffers to a March briefing in Washington, DC, with a plea for increased federal funding.
“Extraordinary progress is being made in cancer research today, as evidenced by the...
It is a challenge faced time and time again by oncologists: how to achieve the best possible outcomes for patients while simultaneously controlling costs, providing care that is both high quality and high value. Raj Mantena, RPh, the first individual to donate $1 million dollars to the Conquer...
The Society’s 2013 Policy for Relationships with Companies is scheduled to go into effect on April 22, with one large change to its original requirements. The policy will still require the full disclosure of all financial relationships by all authors; however, since announcing the new policy in...
Have you given any thought to the legacy you would like to leave? For many of you, your professional legacy will include the patients you have cared for, the research you have conducted, the students you have mentored, and the lives you have touched in the world of cancer care. You also have your...
Join oncology professionals from around the world for the 2014 ASCO Annual Meeting, which will be held May 30 through June 3 in Chicago. This year’s meeting will offer opportunities to learn about, debate, and discuss practice-changing advances in the field, and also highlight promising clinical...
ASCO has signed a joint letter to U.S. Department of Health and Human Services Secretary Kathleen Sebelius asking for clear and comprehensive guidance on the tobacco cessation benefit in the Affordable Care Act regulations.
In the letter, the organizations applaud the Department of Health and...
ASCO has joined 26 of the nation’s leading public health and medical organizations in signing a joint letter calling on drug stores and other retailers to end the sale of cigarettes and other tobacco products.
The open letter came just weeks after CVS Caremark announced it would stop selling...
On the Cancer.Net Blog, your patients can read about the various health professionals involved in their diagnosis, treatment, and survivorship and listen to podcasts with these professionals discussing their roles in caring for people with cancer. This month, the Cancer.Net Blog highlighted...
Ten projects that will enable nongovernment researchers to conduct clinical research at the National Institutes of Health (NIH) Clinical Center in Bethesda, Maryland, were announced recently. Through these 3-year, renewable awards of up to $500,000 per year, scientists from institutions across the...
On February 24, the Institute of Medicine National Cancer Policy Forum convened a workshop, “Contemporary Issues in Human Subjects Protection in Cancer Research,” in Washington, DC.
In his introduction to the workshop, Steven Piantadosi, MD, PhD, Director, Samuel Oschin Cancer Institute,...
Three of the 10 projects recently awarded grants by the National Institutes of Health (see page 73) focused on cancer research. These include the following:
Grant No. 1 U01 CA18303001
Title: Therapeutic Elimination of Stem Cells for Relapsed Pediatric AML
Extramural Investigators: Drs. Yang Liu, ...
Accidental extravasation of chemotherapy is a rare but feared complication of cancer treatment. Risk factors for extravasation include medication-related factors (such as the vesicant properties of the compound, or the volume, concentration, and duration of the infusion), patient-related factors...
Although cancer survival rates among pediatric and older adult patients continue to rise, survival rates for adolescents and young adults (AYAs), defined by the National Cancer Institute as those between the ages of 15 and 39, have remained stagnant for decades. In breast cancer especially, AYAs...
The USTAR Center for Genetic Discovery is partnering with California-based Omicia, Inc, to make analyzing a patient’s genome as routine as performing a blood test. The center, codirected by Mark Yandell, PhD, and Gabor Marth, DSc, was launched this month with $6 million from the University of Utah...
Mary Horowitz, MD, MS, the Robert A. Uihlein, Jr. Chair in Hematologic Research, Professor of Medicine and Chief of Hematology and Oncology at the Medical College of Wisconsin (MCW), was presented with the 2014 Lifetime Achievement Award by the American Society for Blood and Marrow Transplantation...
The Journal of Vascular and Interventional Radiology, the Society of Interventional Radiology’s (SIR) peer-reviewed scientific journal, together with SIR Foundation, recently presented a number of awards at SIR’s 39th Annual Scientific Meeting in San Diego.
Clinical Research
Eliseo Vano, PhD, an ...
In recognition of his dedication to cancer research and education, and for promoting the goals of cancer prevention, early detection, and quality cancer treatment, John Powderly II, MD, Certified Physician Investigator, President and Founder of Carolina BioOncology Institute, Huntersville, North...
Hagop Kantarjian, MD, Professor and Chair of Leukemia at The University of Texas MD Anderson Cancer Center, Houston, and Victor Fazio, MD, Chairman Emeritus, Digestive Disease Institute; Department of Colorectal Surgery, Cleveland Clinic, Rochester, were honored recently with the “Lifetime...
Pathologic complete response to neoadjuvant therapy has been proposed as a surrogate endpoint for long-term clinical benefit in breast cancer. The U.S. Food and Drug Administration (FDA) established the international Collaborative Trials in Neoadjuvant Breast Cancer (CTNeoBC) working group to...
The goal of effective adjuvant therapy is to increase overall survival. It has been suggested cynically that all we need to accomplish, actually, is to delay recurrence until after the time the patients die from another cause. However, patients want to hear from us that “it’s never coming back,”...
For decades, dedicated members of the oncology community have fought to increase the nation’s focus on lung cancer prevention and treatment. Although smoking cessation initiatives have reduced cigarette consumption, lung cancer 5-year survival has remained stagnant at 15%, lagging far below most...
Roche recently announced that William Pao, MD, PhD, Professor of Medicine and Head of the Hematology-Oncology Division at Vanderbilt University Medical Center, Nashville, will join Roche Pharma Research and Early Development (pRED) as Global Head of the Oncology Disease and Translational Area...
Shaw T. Chen, MD, PhD, has been appointed Executive Vice-President of Regulatory Affairs at Polaris Pharmaceuticals, a subsidiary of Polaris Group. Dr. Chen had previously been with the U.S. Food & Drug Administration (FDA) for over 26 years in new drug development. Most recently he served as...
Specialist bias, in which specialists recommend the therapy that they are capable of delivering, is thought to influence the treatment of patients with localized prostate cancer and to contribute to overtreatment of men with limited life expectancy,” Ayal A. Aizer, MD, MPH, and colleagues, from the ...
In 2011, the Multiple Myeloma Research Foundation (MMRF) announced the launch of CoMMpass (Relating Clinical Outcomes in Multiple Myeloma to Personal Assessment of Genetic Profile), a clinical study at the heart of its Personalized Medicine Initiative. CoMMpass will follow 1,000 newly diagnosed...
When I was diagnosed with multiple myeloma in 2008, at just 47, I was lucky. I was asymptomatic, my cancer was detected through a routine blood test, and I had the smoldering type, so I didn’t need immediate treatment. Plus, I knew that recent advances in more effective therapies were making it...
The members of the American Association for Cancer Research (AACR) have elected José Baselga, MD, PhD, Physician-in-Chief at Memorial Sloan Kettering Cancer Center in New York, as their President-Elect for 2014–2015. Dr. Baselga is an internationally recognized physician-scientist whose research...
INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this installment, Robert Dean, MBA, Director, and Michael Sauers, Deputy Director, of Division II in the FDA’s Office of Prescription Drug Promotion discuss the FDA’s Bad Ad program.
The ...
Francis S. Collins, MD, PhD, Director of the National Institutes of Health recently announced the appointment of Yvonne T. Maddox, PhD, as Acting Director of the National Institute on Minority Health and Health Disparities (NIMHHD). This follows the retirement Dr. John Ruffin, NIMHD’s previous...
APRIL
15th Annual Meeting of the American Society of Breast Surgeons
April 30-May 4 • Las Vegas, Nevada
For more information:
www.breastsurgeons.org/index.php
MAY
Oncology Nursing Society 39th Annual Congress
May 1-4 • Anaheim, California
For more information:
www.ons.org
Association for Value-Based ...
Patients with cancer who are struggling with sleep troubles, due in part to pain or side effects of treatment, can count on two behavioral interventions for relief—cognitive behavioral therapy for insomnia and mindfulness-based stress reduction—Penn Medicine researchers reported in a recent study...
Nearly 4,000 attendees, including more than 700 cancer survivors along with friends and family members, will gather in Chicago’s Grant Park for the Robert H. Lurie Comprehensive Cancer Center of Northwestern University’s Annual Cancer Survivors’ Celebration Walk & 5K Run. This year’s event will ...
In a study reported in the Journal of the National Cancer Institute, Carter and colleagues identified deregulated apoptotic components in acute myeloid leukemia (AML) stem/progenitor cells and investigated the effects of the novel inhibitor of apoptosis (IAP) protein antagonist and SMAC mimetic...
Clinical trials of antioxidants in cancer have yielded inconsistent results. In a study reported in Science Translational Medicine, Sayin and colleagues evaluated the effects of the antioxidants N-acetylcysteine and vitamin E in mouse models of BRAF- and KRAS-induced lung cancer. N-acetylcysteine...
Patients in the Radiation Therapy Oncology Group (RTOG) 9402 study with 1p/19q codeleted anaplastic oligodendroglial tumors had markedly prolonged overall survival after chemoradiotherapy (with procarbazine, lomustine, and vincristine) compared with radiation therapy alone. Some patients with...
Although recent findings indicate that targeting of inhibitory receptors on T cells can produce durable responses in some cancer patients despite the presence of advanced disease, the mechanisms controlling T-cell function in immunosuppressive tumors have not been well characterized. In a study...
The mechanism of action of lenalidomide (Revlimid) in multiple myeloma and other B-cell neoplasms remains largely uncharacterized. In a study reported in Science, Krönke and colleagues identified one of the effects of lenalidomide in this setting.
Use of quantitative proteomics showed that...
ADOLESCENT AND YOUNG ADULT CHILDHOOD CANCER SURVIVORS
Study Type: Randomized/interventional
Study Title: A Randomized Web-Based Physical Activity Intervention in Adolescent Survivors of Childhood Cancer
Study Sponsor and Collaborators: St. Jude Children’s Research Hospital
Purpose:...
Two champions of gender equality in medicine and research were recently honored by The University of Texas MD Anderson Cancer Center.
Laurie Glimcher, MD, the Stephen and Suzanne Weiss Dean of Weill Cornell Medical College and Provost for Medical Affairs of Cornell University since 2012, received...
Scientific name: Ganoderma lucidum
Common names: Ling zhi, lin zi, mushroom of immortality
Overview
A fungus, reishi mushroom is an important component of the traditional medical systems of China, Japan, Korea, and other Asian countries. It is used to increase energy, stimulate the immune...
Barrie Cassileth, PhD, Laurance S. Rockefeller Chair in Integrative Medicine and Chief, Integrative Medicine Service, at Memorial Sloan Kettering Cancer Center (MSKCC) in New York has published a new book called Survivorship: Living Well During and After Cancer. Dr. Cassileth provides readers with...
“It’s not a matter of if a child will be seriously poisoned or killed. It’s a matter of when.”
Lee Cantrell, PharmD, Director of the San Diego Division of the California Poison Control System and Professor of Clinical Pharmacy at the University of California, San Francisco, commenting on the...
Extended follow-up in the Scandinavian Prostate Cancer Group Study Number 4 (SPCG4), reported recently in The New England Journal of Medicine,1 found that men with early-stage prostate cancer, particularly those under 65 years old, who were treated with radical prostatectomy had increased survival...
The members of the American Association for Cancer Research (AACR) have elected five members to serve on the AACR Board of Directors for the 2014–2017 term and four members to serve on the Nominating Committee for the 2014–2016 term. They assumed their roles at the AACR Annual Meeting 2014, held in ...
The U.S. Preventive Services Task Force recently announced the appointments of Michael L. LeFevre, MD, MSPH, as Chair of the Task Force and Kirsten Bibbins-Domingo, PhD, MD, as Co-Vice Chair. Albert L. Siu, MD, MSPH, current Co-Vice Chair, will remain in his position. Dr. LeFevre and Dr....
City of Hope recently announced the appointment of two new chairs in the Department of Surgery and for the Board of Directors.
Yuman Fong, MD, has been named Chair of the Department of Surgery at City of Hope. Dr. Fong comes to City of Hope from Memorial Sloan Kettering Cancer Center in New York,...
Analysis of data from 20,560 women undergoing mastectomy for breast cancer found that breast reconstruction use “increased from 46% in 1998 to 63% in 2007 (P< .001), with increased use of implants and decreased use of autologous techniques over time (P < .001),” according to a report...
Patients with chronic myeloid leukemia (CML) in the chronic phase who are resistant or intolerant to imatinib (Gleevec) can experience long-term benefit with dasatinib (Sprycel), according to long-term results of a randomized phase III study. The CA180-034 study also found that early molecular and...
Receiving rituximab (Rituxan) with idelalisib, rather than rituximab with placebo, “significantly improved progression-free survival, response rate, and overall survival” among patients with relapsed chronic lymphocytic leukemia (CLL) who were less able to undergo chemotherapy because of clinically ...
Results from the BRIGHT study combined with long-term safety data from other studies suggest that bendamustine (Treanda) plus rituximab (Rituxan) “may be an important alternative treatment option” for the initial treatment of patients with low-grade non-Hodgkin lymphoma (NHL) and mantle cell...
Oncology is a demanding field that requires special qualities to care for very sick patients, many of whom will die prematurely of their disease. Research indicates that years of facing life-and-death decisions in the clinic can be associated with oncology burnout syndrome, which effects physician...
The American Society of Clinical Oncology (ASCO) is deeply frustrated by the failure of Congress to permanently repeal the flawed sustainable growth rate (SGR) formula used to set Medicare physician payments and passage of the 17th patch to the system.
ASCO and the entire physician community...