January 15, 2013 (View All Issues)
Adjuvant Tamoxifen for Women with ER-positive Breast Cancer: 10 Years Superior to 5 Years
Five years of tamoxifen has long been considered the standard of care as adjuvant therapy for women with estrogen receptor–positive breast cancer. However, extending tamoxifen treatment for 10 years reduced the risk of dying by 29% during the second decade after diagnosis compared with standard...
Are We Winning the War on Cancer?
On December 23, 1971, President Richard Nixon signed the U.S. National Cancer Act. This date is widely considered to mark the beginning of the so-called “War on Cancer,” although that phrase was introduced only later on. Over recent decades, journalists have from time to time questioned whether we...
Does Health-care Quality Translate to Value?
On March 23rd, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, enacting sweeping change in our health-care system. An underlying theme of the legislation is the realignment of our payment system so that it places value over volume of services. At ASCO’s first...
Last-minute ‘Fiscal Cliff’ Deal by Congress Again Averts Medicare Cuts to Physicians
A last-minute patch to the sustainable growth rate formula included in the “fiscal cliff” deal averted massive cuts to oncologists who care for and treat Medicare patients. “This end-of-year crisis management once again demonstrates the critical need for fundamental reform of the Medicare...
Pivotal Trial Shows Robust Activity of Ponatinib in Some Heavily Pretreated Leukemias
The pivotal phase II Ponatinib Ph+ ALL and CML Evaluation (PACE trial) found that 1 year of treatment with the novel investigational drug ponatinib achieved robust activity in heavily pretreated patients with chronic myeloid leukemia (CML) and Philadelphia chromosome–positive acute lymphoblastic...
National Comprehensive Cancer Network Appoints New CEO
The National Comprehensive Cancer Network (NCCN) recently appointed nationally regarded breast cancer expert Robert W. Carlson, MD, as its new CEO. Previously, Dr. Carlson was Professor of Medicine in the Division of Oncology and Medical Informatics, Stanford University Medical Center; he first...
FDA Approves Ponatinib to Treat CML and Philadelphia Chromosome–positive ALL
In December, the FDA granted accelerated approval to ponatinib (Iclusig) for the treatment of adult patients with chronic-, accelerated-, or blast-phase chronic myeloid leukemia (CML) that is resistant or intolerant to prior tyrosine kinase inhibitor therapy or Philadelphia chromosome–positive...
Overall Survival Benefit Achieved with Pomalidomide in Advanced Myeloma
Support for the oral immunomodulatory agent pomalidomide for multiple myeloma took a step forward when the phase III MM-003 trial showed a survival advantage in patients with advanced disease, in addition to a doubling in progression-free survival, when pomalidomide was given with low-dose...
Radiation Therapy for Patients with Invasive Breast Cancer: 3 Weeks Proves as Effective as 5 Weeks
Ten-year follow-up of the two-part UK Standardisation of Breast Radiotherapy Trials (START) supported the 5-year findings, demonstrating that a 3-week course of adjuvant radiation therapy is equivalent to a 5-week course of radiation for women with invasive breast cancer. The update was presented...
Oral Proteasome Inhibitor May Be a Game-changer in Myeloma
An investigational oral proteasome inhibitor currently known as MLN9708 could make the treatment of multiple myeloma much more convenient and possibly less neurotoxic, according to the results of a phase I/II study of treatment-naive multiple myeloma patients presented at the 54th Annual Meeting of ...
Umbilical Cord Blood Transplant: Two Units are No Better Than One in Children with Hematologic Malignancies
Use of two partially HLA-matched units of umbilical cord blood were not superior to a single unit if it contained an adequate number of hematopoietic stem cells, according to a randomized study by the Blood and Marrow Clinical Trials Network. Results were reported at the 54th Annual Meeting of the...
Excellent Preliminary Results for Ibrutinib in Chronic Lymphocytic Leukemia
Although still in preliminary testing with no phase III data, ibrutinib is poised to become an important new agent for patients with chronic lymphocytic leukemia (CLL). Two phase II trials reported at the 54th Annual Meeting of the American Society of Hematology (ASH) found that ibrutinib achieved...
Measuring and Improving Quality in Oncology Practices
The seed for ASCO’s Quality Oncology Practice Initiative (QOPI®) was planted a decade ago by Joseph Simone, MD, when he contemplated the feasibility of studying a volunteer group of oncologists to measure the quality of care they provide and share those results with their colleagues. Dr. Simone’s...
ASCO’s Approach to Health Information Technology and the Rapid-learning System
The slow, but inevitable evolution of electronic oncology health-care systems has already, at least conceptually, moved to the next generation of machines that not only store and process data, but also have the ability to provide real-time clinical decision support. At ASCO’s first Quality Care...
Developing Cancer Care Pathways for the New Environment
As community practices and the insurance industry seek cost-effective ways to adapt to the Patient Protection and Affordable Care Act, the evolving concept of cancer care pathways is emerging as a strategy that may help control oncology costs and add value to care. At ASCO’s recent Quality Care...
Tumor Grade Is Associated with Risk for Venous Thromboembolism
Recent data suggest that risk for venous thromboembolism is associated with biologic aggressiveness of cancer. Findings in the Vienna Cancer and Thrombosis Study, recently reported by Ahlbrecht and colleagues in Journal of Clinical Oncology, indicate that patients with higher-grade tumors are at...
Fixed-dose Apixaban Reduces Risk of Recurrent Venous Thromboembolism
Venous thromboembolism is a frequent problem in cancer patients, and approximately 20% of all patients who develop the disease have a recurrence. Extending treatment with two fixed doses of the investigational agent apixaban, a factor Xa inhibitor without laboratory monitoring, may provide a...
Omacetaxine for Chronic or Accelerated Phase CML Patients with Resistance/Intolerance to Tyrosine Kinase Inhibitors
In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.
Indication
On October 26, 2012, the FDA granted accelerated...
Faster Rituximab Infusion for Previously Untreated Follicular Non-Hodgkin and Diffuse Large B-cell Lymphomas
On October 19, 2012, FDA approved a 90-minute infusion for rituximab (Rituxan) starting at cycle 2 for patients with previously untreated follicular non-Hodgkin or diffuse large B-cell lymphoma who do not experience a grade 3 or 4 infusion-related reaction during cycle 1.1 Patients with clinically...
Management of Brain Metastases
Pearls in Neuro-oncology is guest edited by Tracy Batchelor, MD, Director, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, and Professor of Neurology, Harvard Medical School, Boston. The series is intended to provide the practicing oncologist with guidance in managing...
Peter P. Yu, MD, Elected ASCO President, 2014–2015, Others Named to ASCO Board
Peter P. Yu, MD, has been elected President of ASCO for a 1-year term beginning in June 2014. He will take office as President-Elect during the ASCO Annual Meeting in Chicago in June 2013. Additionally, three new members were elected to the ASCO Board of Directors, and three new members were...
Accountable Care Organizations: The New Normal?
The accountable care organization was introduced into our lexicon during a public meeting of the Medicare Payment Advisory Commission in 2006, and the term became ubiquitous when it was specified in the Patient Protection and Affordable Care Act of 2010. After the November 6 election, accountable...
Gene Profiling Directs Site-specific Therapy for Carcinoma of Unknown Primary Site
Patients with carcinoma of unknown primary site usually receive empiric therapy (eg, with taxane/platinum or gemcitabine/platinum regimens), resulting in a median overall survival of approximately 9 months. As reported recently in Journal of Clinical Oncology, Hainsworth and colleagues have shown...
New Drug Application Submitted for Radium-223 for the Treatment of Castration-resistant Prostate Cancer with Bone Metastases
Bayer HealthCare announced that the company has submitted a New Drug Application to the FDA seeking approval for radium Ra 223 dichloride (radium-223), an investigational compound for the treatment of patients with castration-resistant prostate cancer with bone metastases.
“If approved, radium-223 ...
Elekta Receives FDA 510(k) Clearance for Clarity 4D Monitoring
Elekta has received 510(k) clearance from the FDA for its Clarity 4D Monitoring software, enabling U.S. medical centers to implement a new way of reducing the uncertainty caused by prostate motion during radiation treatment. Physicians will be able to monitor the motion of the prostate and...
FDA Expands Abiraterone’s Use for Late-stage Prostate Cancer
In December, the FDA approved an expanded indication for abiraterone acetate (Zytiga) in combination with prednisone for the treatment of patients with metastatic castration-resistant prostate cancer.
Trial Design
The approval was based on a trial randomly assigning patients with metastatic...
ASCO Top Five List Highlighted in IOM Workshop
As part of the Institute of Medicine’s (IOM) National Cancer Policy Forum workshop on delivering affordable cancer care in the 21st century, ASCO’s Top Five list was highlighted as an example of a way to improve quality of care for patients while reducing unnecessary costs.
Lowell Schnipper, MD,...
ASCO Secures Major Funding and Data License Agreements for CancerLinQ™
ASCO has secured $3 million in new funding and key data sharing arrangements to support the development of CancerLinQ™, a ground-breaking information technology initiative that aims to achieve higher quality, higher value cancer care with better outcomes for patients.
ASCO’s Conquer Cancer...
New ASCO Statement Outlines Agenda to Advance Cancer Survivorship Care
In response to the needs of a growing population of cancer survivors, ASCO has released a position statement, recently published online in the Journal of Clinical Oncology. Developed through the work of the ASCO Cancer Survivorship Committee, the statement outlines a comprehensive agenda for...
Call for Abstracts: 2013 ASCO Annual Meeting
Groundbreaking research in cancer care is the cornerstone of ASCO’s Annual Meeting, and the deadline for submitting abstracts to be considered for presentation or publication at this year’s Meeting is fast approaching.
The submission deadline is February 5 at 11:59 PM (EST). Late-Breaking...
Give Your Patients the Latest GI Research News
During the upcoming Gastrointestinal Cancers Symposium, to be held on January 24–26, direct your patients to www.cancer.net/gisymposium, where they can get research highlights from the 2013 Symposium. Also, your patients can download or listen to podcasts with ASCO experts explaining what this...
Community Research Forum Addresses Conundrums Common to Community Practices that Conduct Research
It is every research site’s biggest concern. The National Cancer Institute (NCI), the FDA, or drug company sponsors could arrive at any time to comb through a site’s documents related to a specific trial.
It’s called an audit, and it’s common.
And yet, not all sites that conduct research have...
ASCO Report Encourages Further Discussion to Improve REMS Development, Communication
The oncology community—including providers, patients, and industry—and the FDA should continue to work together to improve the agency’s Risk Evaluation and Mitigation Strategies (REMS) program, according to the report of the ASCO REMS Working Group published online by the Journal of Oncology...
Online Prostate Cancer Information Is Written at Reading Levels above Many Americans’ Literacy Skills
Although 61% of Americans are going online to access health information,1 many of them may not understand what they find there, including information about prostate cancer treatment options. According to a new study published in The Journal of Urology,2 as many as 90 million Americans have literacy ...
Lumpectomy Rates Inconsistent with Response Rates in Early Breast Cancer
Achieving a pathologic complete response to neoadjuvant chemotherapy does not always reduce the aggressiveness of breast cancer surgery, according to an analysis of the NeoALLTO trial presented at the 2012 European Society for Medical Oncology (ESMO) Congress in Vienna.1
Carmen Criscitiello, MD,...
French Investigators Prospectively Test Genomically Driven Treatment in Metastatic Breast Cancer
Whole-genome DNA analysis prospectively identified alterations in metastatic tumors that could be individually targeted with molecular agents, in a study presented at the 2012 European Society for Medical Oncology (ESMO) Congress by Fabrice André, MD, of Institut Gustave-Roussy, Villejuif, France.
...
Richard I. Fisher, MD, to Join Fox Chase Cancer Center and Temple University School of Medicine
On March 1, 2013, leading cancer center administrator and nationally recognized hematology/oncology expert Richard I. Fisher, MD, will assume leadership roles at Fox Chase Cancer Center, a member of the Temple University Health System, and Temple University School of Medicine, Philadelphia.
Teens and Young Adults with Cancer Want a Voice in End-of-life Care
A top the list of concerns of adolescents and young adults with a life-threatening cancer are these two considerations: being able to choose the kind of medical treatment they want (or do not want) and expressing their wishes to family and friends about how they want to be remembered, according to...
Never a Dull Moment: A Day in the Life of an Oncology Fellow
Oncology fellows represent the future of cancer care, bringing the best and brightest young doctors into a rigorous training environment that molds their future career paths. Due to an impending workforce shortage in cancer care, the public health-care demands placed on today’s oncology fellows...
President Obama Signs High-mortality Cancer Bill into Law
Just hours before the end of the 112th Congress, constitutional deadline for approval of a bill passed by that Congress, President Barack Obama signed into law the first legislation requiring comprehensive plans of research action for high-mortality cancers, with lung and pancreatic cancers given...
NCI Director Assesses Barriers to Faster Progress in Cancer Research
At a National Press Club media event in Washington, DC, on September 25, 2012, National Cancer Institute (NCI) Director Harold E. Varmus, MD, addressed a group of 75 reporters and officials. His discussion focused on impediments—biologic, economic, institutional, and cultural—to faster cancer...
Physician-Scientist Judah Folkman, MD, Faced Years of Skepticism Before His Theory of Angiogenesis Was Proven
That Moses Judah Folkman would buck tradition, breaking his family’s long line of rabbinical succession and pursuing a career in science and medicine instead, was evident from the time he was a young child. Born in Cleveland on February 24, 1933, the first child of Rabbi Jerome and Bessie Folkman,...
New Appointments at Cancer Centers Nationwide
Two new physicians have joined a growing team of cancer experts at Carolinas HealthCare System’s Levine Cancer Institute in Charlotte, North Carolina.
Joshua S. Hill, MD, surgical oncologist, joins Levine Cancer Institute after completing a fellowship in surgical oncology at The University of...
The Rise of the Vintage Readers Book Club
Providing care beyond medical treatment, the multidisciplinary field of psychosocial oncology addresses the psychological, social, and emotional health of the patient with cancer. On an occasional basis, The ASCO Post will explore the realm of psychosocial oncology with a column guest edited by...
I’m Not the Same Person I Was before Cancer
It’s not clear to me—and my doctors can’t say with any certainty—whether taking birth control pills for many years had anything to do with my getting breast cancer 3 years ago, at age 44. But the cancer growing in my left breast was diagnosed as stage I, estrogen receptor–positive. Although I never ...
Six Presidential Appointees Named to National Cancer Advisory Board
President Barack Obama recently announced his intent to nominate the following individuals to the National Cancer Advisory Board: David Christiani, MD; Judy E. Garber, MD; Liz Jaffee, MD; Beth Karlan, MD; Mack Roach III, MD; and Charles Sawyers, MD.
David Christiani, MS, MD, MPH, is the Elkan...
Oncology Meetings
January 2013
Breast-Gynecological International Cancer Congress
January 17-18 • Cairo, Egypt
For more information: www.bgicc.eg.net/
Highlights of ASH® San Diego, CA and Toronto, Canada
January 18-19 • San Diego, CA and Toronto, Ontario, Canada
For more information: www.hematology.org/meetings
ASCO CEO Discusses the Society’s Initiatives
Created in 1964,a the American Society of Clinical Oncology (ASCO) has become the world’s preeminent professional cancer organization, with more than 30,000 members in the United States and abroad, unified by its founders’ “common concern for the patient with cancer.” The ASCO Post recently spoke...
Green Tea
The use of dietary supplements by cancer patients has risen significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the...
Patients Treated for Colon Cancer Can Reduce Risk of Recurrence with Balanced Diet and Lower Carbohydrate Intake
In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field.
Patients who have received standard ...
Screening and Risk-reduction without Testing Positive for BRCA Mutation
Many women who do not test positive for a BRCA mutation undergo additional ovarian cancer screenings and risk-reducing procedures, despite limited data to determine the effectiveness of these interventions among an average-risk population. Results of an analysis of data from 1,077 women who were...
Analysis Suggests Screening Mammography Results in Substantial Overdiagnosis with Small Effect on Mortality
An analysis of Surveillance, Epidemiology, and End Results (SEER) data from 1976 through 2008 “suggests that whatever the mortality benefit, breast-cancer screening involved a substantial harm of excess detection of additional early-stage cancers that was not matched by a reduction in late-stage...
Volume-doubling Time May Help Distinguish Aggressive Cancer from Slow-growing Tumors
Changes in the size of lung tumors over time, as measured by volume-doubling times on low-dose computed tomography, can be used to distinguish aggressive lung cancer from slow-growing or indolent tumors and reduce overdiagnosis that could result in overtreatment and unnecessary morbidity. Results...
Chlorambucil, but Not Fludarabine, Confers Significant Benefit in Older Patients with CLL
Among patients aged 70 years and older with chronic lymphocytic leukemia (CLL), “front-line therapy with fludarabine does not improve outcomes” compared to chlorambucil (Leukeran), according to an analysis of patients enrolled in successive front-line Cancer and Leukemia Group B (CALGB) studies...
Four-plus Cups of Coffee Daily Linked to Lower Risk of Death from Oral/Pharyngeal Cancer
Consuming four or more cups per day of caffeinated coffee could almost halve the risk of dying from oral/pharyngeal cancer compared to drinking no coffee or drinking it only occasionally, researchers reported in the American Journal of Epidemiology. “A dose-related decline in relative risk was...
Persistent Survival Benefit in Patients with Untreated Disease Treated with Bortezomib Added to Melphalan and Prednisone
A final analysis of the phase III VISTA trial (Velcade as Initial Standard Therapy in Multiple Myeloma: Assessment with Melphalan and Prednisone) found a persistent significant benefit in overall survival with VMP (bortezomib, melphalan, prednisone) vs MP (melphalan, prednisone) in patients with...
