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Showing 1001 - 1050Expert Point of View: Bevacizumab Progression-free Survival Benefit Upheld in AVEREL Trial
Modest benefit reported from AVEREL1 triggered comments among trialists about the future of bevacizumab (Avastin) in breast cancer. “Although there’s controversy about the recent revoking of FDA approval of bevacizumab for metastatic breast cancer, I think there is a consensus in our disappointment ...
Nearly Identical Survival for Laparoscopy vs Laparatomy in Patients with Stage I/IIA Disease
Building on previously reported results that laparoscopic surgical management of uterine cancer is superior for short-term safety and length-of-stay endpoints, the Gynecologic Oncology Group reported small and lower than anticipated potential for increase risk of cancer recurrence with laparoscopy...
A Patient with Cancer Saw a Need and Left a Living Legacy
It is well documented that the rigors of delivering cancer care can unintentionally supersede valuable doctor-patient communication. Before he died in 1995, Kenneth B. Schwartz, a patient with cancer at Massachusetts General Hospital, recognized this phenomenon and founded the Kenneth B. Schwartz...
SIDEBAR: Expect Questions from Your Patients
The possibility of reexcision after breast-conservation surgery should be discussed with patients before the initial surgery, advised Laurence E. McCahill, MD, lead investigator of the JAMA study on reexcision following breast-conservation surgery, which showed wide variability in reexcision...
Cost of Cancer Therapy: The Elephant in the Room?
I am distressed by your coverage of innovative therapies, such as dual HER2 blockade (see The ASCO Post, January 1, 2012, and Supplement to February 15, 2012), without mentioning that these therapies will never be cost-effective given the current pricing of the agents involved. If we wish to...
SIDEBAR: Should ‘AYA’ Be an Oncology Subspecialty?
The lag in improvement in survival rates for adolescents and young adults (AYAs) with cancer and a greater awareness of the unique issues they face has prompted discussion about whether “AYA” should become a new oncology subspecialty.1 “Yes and no,” according to Archie Bleyer, MD. “I am going to...
Research Funding Key to Continued Progress in Cancer Care
American Association for Cancer Research (AACR) President and ASCO member Judy Garber, MD, MPH, recently spoke with The ASCO Post about the findings of AACR’s landmark Cancer Progress Report,1 In addition, she offered her perspective on the current and future state of cancer research. Project...
ASCO Launches Community Research Forum to Tackle Top Research Conundrums
Just how many research-focused staff members is it optimal to have when conducting clinical trials in a community-practice setting? To properly gauge that, should the practice look closely at how many studies it’s working on? The complexity of those studies? The number of patients enrolled? Some...
Expert Point of View: SELECT Trial Update: Vitamin E Fails to Prevent Prostate Cancer in Healthy Men, Appears to Increase Risk
According to Adam Kibel, MD, Urology Chair at Brigham and Women’s Hospital in Boston, it would appear to be logical that increasing the doses of vitamin E and selenium would decrease the risk of prostate cancer, since the preponderance of evidence demonstrates that these supplements do so. “The...
I Refuse to Let Cancer Win
My battle with cancer started with a simple sore throat in June 2005. Despite two rounds of an antibiotic to clear up the problem, within 2 months my throat hurt so much I couldn’t swallow, and a mysterious lump had suddenly appeared on my tongue. By the end of August, I was diagnosed with stage...
SIDEBAR: Expect Questions from Your Patients
“Our study provides critical interim companion data to awaited randomized trials and may help clinicians and patients quantify the risk-benefit ratio of brachytherapy compared with standard therapy,” Benjamin D. Smith, MD, said of a study comparing lumpectomy and either whole-breast irradiation or...
Cancer Survivors Stand Up, Give Thanks, and Give Back
“I have me back,” is how breast cancer survivor Jeanette Daniel of Memphis described her life after being treated on a clinical trial at Vanderbilt-Ingram Cancer Center in Nashville. Being conducted by the Stand Up To Cancer P13K Dream Team, whose leader discovered the PI3K pathway, the trial...
Postsurgical Local Breast Cancer Therapies Compared in Two Large Studies
A study presented at the 13th Annual Meeting of the American Society of Breast Surgeons suggested that accelerated partial-breast irradiation (APBI) using brachytherapy might control the tumor bed better than whole-breast irradiation (WBI), while another study suggested that radiofrequency ablation ...
Can Whole-genome Sequencing Predict Cancer Risk and Improve Public Health?
If, as expected, the cost of whole-genome sequencing continues to drop, perhaps down to the $1,000 vicinity, it may become an alluring option for consumers who want to know about their risks for cancer and other diseases. But can genome sequencing really provide practical information about...
Expert Point of View: T-DM1 Proves More Effective, Less Toxic Than Standard Treatment for Metastatic Breast Cancer
“Stated simply, T-DM1 really works in this patient population,” said Louis Weiner, MD, Director of the Georgetown-Lombardi Cancer Center in Washington, DC, and the invited discussant of the presentation. “It is an important new weapon in the therapeutic armamentarium for breast cancer.” While...
When It Comes to Scientific Exploration, Renowned Clinical Investigator Lets the Work Guide His Path
Internationally renowned clinical investigator Daniel D. Von Hoff, MD, FACP, attended grade school in a one-room schoolhouse on the rural outskirts of Oshkosh, Wisconsin. Polio was a scourge at the time, and Dr. Von Hoff recalled lining up with his skittish classmates to get the newly developed...
Trailblazing Oncologist Had Instrumental Role in France’s War on Cancer
David Khayat, MD, PhD, Chair of the Department of Medical Oncology at the Pitié-Salpêtrière Hospital in Paris, was inspired to become an oncologist by an episode that could have been ripped from the pages of one of his best-selling novels. At the age of 18, Dr. Khayat was the witness at his best...
From Small-town House Calls to Bone Marrow Transplants, Nobel Laureate Continues Father’s Legacy
“I echo the sentiments of many previous Nobel laureates when I say that the success we celebrate today was made possible by the work of many others in this and in related fields.” So ended the Nobel Lecture by E. Donnall Thomas, MD, the famed investigator and 1990 Nobel Laureate in Physiology or...
Too Soon to Know How Circulating Tumor Cells Might Be Used to Guide Treatment of Breast Cancer
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. “A simple blood test.” These were...
SIDEBAR: SWOG 9346 Conclusions Debated in Special Post-plenary Discussion
Based on the controversial nature of the SWOG 9346 findings, presented at the 2012 Annual Meeting Plenary Session, ASCO intiated a pilot program at the meeting for a “town hall” type of discussion, where attendees could voice their concerns and questions, and where presenter Maha Hussain, MD,...
Cancer Care in Rwanda: A Model of Creative Partnerships
While disparities in cancer care remain problematic in wealthy industrial nations like the United States, the challenges faced in poorer regions of the world are, by comparison, inestimable. Nationally regarded health-care expert Lawrence N. Shulman, MD, of Dana-Farber Cancer Institute, is part of...
After a Decade of Decline in Smoking Rates, Progress Has Stalled
Approximately 20% of all Americans smoke, and 443,000 of them will die each year as a result. Tobacco use is the leading cause of preventable death in the United States and the greatest behavioral determinant of morbidity and mortality (6%–10% of U.S. health-care costs). Nearly 30% of all cancer...
Expert Point of View: Benjamin J. Solomon, MBBS, PhD
“The LUX-Lung 3 study has been much awaited. It is the first study to use cisplatin/pemetrexed [Alimta], which we now recognize as the best comparator arm. The study was positive for afatinib. While the use of maintenance pemetrexed may have dented the hazard ratio, I doubt this would have impacted ...
Genomics vs Site of Cancer Origin as Basis for Treatment of Cancer Is ‘False Dichotomy’
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. Despite recent news reports...
Data Liquidity Coalition Takes Shape
A coalition to promote and implement data sharing in cancer by facilitating data ‘liquidity,’ first proposed in February at an Institute of Medicine (IOM) workshop, is taking shape with the formation of a steering committee and action plans that include a demonstration project. For several years,...
A Physician, Who Is Also a Cancer Patient, Talks about Medical Errors
In a whispered but resolute voice, Itzhak Brook, MD, MSc, led off his presentation at the 2012 ASCO Annual Meeting1 by telling the audience his voice is weak because he doesn’t have vocal cords. He spoke with the aid of a tracheoesophageal voice prosthesis. “I have practiced medicine for more than ...
Supportive Care Experts Explore 30 Years of Progress in the Field
Thirty years ago, when the first supportive care meeting as a forerunner of the Multinational Association of Supportive Care in Cancer (MASCC) Symposium was held in New York, supportive care was largely ignored, with little discussion at major cancer meetings, which focused primarily on...
As Conflicting Guidelines Evolve, Experts Continue to Debate the Merits of Cancer Screening
In the 1930s and 1940s, when the American Cancer Society [ACS] first brought forth the message that early cancer detection saves lives, it was a broad brushstroke and an appropriate message. The problem now is that new technology enables us to find [tumors that would never progress to invasive...
Expert Point of View: Bruno C. Medeiros, MD
Bruno C. Medeiros, MD, of Stanford University School of Medicine, Palo Alto, commented, “It’s clear to say that new treatment strategies are needed for adults with [acute lymphocytic leukemia (ALL)] to improve outcomes of relapsed disease and to prevent relapses to begin with.” He noted that while ...
Adolescent and Young Adult Patients Report Unmet Needs for Cancer Information and Psychosocial Support Services
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. Psychosocial care needs are not...
Coping with Liver Cancer
From the moment I had a partial hysterectomy in 2010, I started having unexplained bouts of nausea. My surgeon and even my primary care physician chalked it up to everything from the difficult 6-hour surgery I had just had to anxiety over a move I’d recently made from Connecticut to North Carolina. ...
Getting the Right End-of-life Care: Coming to Terms with the Realities of Advanced Disease and Mortality
“Dying is at once a fact of life and a profound mystery.” That was the opening sentence of a 1997 Institute of Medicine report, Approaching Death: Improving Care at the End of Life, a much-needed jump-start in the national dialogue over identifying the barriers that impede the delivery of...
Expert Point of View: Fritz H. Schröder, MD
I am happy to accept the invitation by The ASCO Post to comment on the recent, long-awaited publication of the PIVOT study (Wilt et al: N Engl J Med 367:203-213, 2012) and the accompanying editorial by Thompson and Tangen (N Engl J Med 367:270-271, 2012). The editorial both points out weaknesses of ...
Faculty Q&A Discussion: Anaplastic Large-cell Lymphoma
Dr. Armitage: For ALK-negative anaplastic large cell lymphoma, brentuximab vedotin is the best thing we have to deal with patients with recurrent disease, and who knows where it will end up in primary therapy. But if the patient is ALK-positive, there is a potential for crizotinib (Xalkori) to...
Faculty Q&A Discussion: Communicating with Patients
Dr. Armitage: As oncologists, we face many challenges. I think the most difficult is when you say to a patient with a disease everybody expects will be cured, and every patient expects to be cured, “It is not worth trying to do that. It is time to worry about keeping you as well as possible for as ...
Exciting New Agents Offer Further Treatment Options for Metastatic Melanoma
“This is a very exciting time in melanoma,” said Michael Sabel, MD, of the University of Michigan, Ann Arbor. “For years, we chugged along with few options for systemic therapy. Then in 2010 and 2011, we saw melanoma data presented at ASCO plenary sessions. At ASCO 2012, we expanded in these areas...
Which Rituximab-based Regimen Works Best in Non-Hodgkin Lymphoma?
The treatment of non-Hodgkin lymphoma (NHL) patients has been recently informed by several important studies, which were discussed at the Best of ASCO Boston meeting by Michael E. Williams, MD, of the University of Virginia Cancer Center in Charlottesville. Bendamustine Outperforms R-CHOP in NHL...
SIDEBAR: Should EGFR Tyrosine Kinase Inhibitors Be Continued Beyond Progression?
It is not yet clear if it is beneficial to continue first-line EGFR tyrosine kinase inhibitors in patients with EGFR-mutated lung cancer who experience progression and are started on chemotherapy, according to Dr. Horn. Two trials, one in Asia (looking at gefitinib [Iressa]) and one in North...
SIDEBAR: Is Vitamin D Supplementation Ready for Prime Time?
The VITAL study generated a host of questions about vitamin D among ASCO Annual Meeting attendees, including whether the study’s findings are ready for clinical application, according to Debra L. Barton, RN, PhD, of the Mayo Clinic, Rochester, Minnesota, speaking at the Best of ASCO San Diego...
2012 Is ‘Banner Year’ for Research on Symptom Management
The year 2012 was “a banner year for symptom management,” according to Debra L. Barton, RN, PhD, of the Mayo Clinic, Rochester, Minnesota, who presented data on patient and survivor care at the Best of ASCO San Diego meeting. “I have been doing symptom management for about 20 years, and it seems...
SIDEBAR: Expect Questions from Patients
A recently reported study finding that anticoagulants and particularly aspirin were associated with a reduced risk of prostate cancer–specific mortality1 has the potential to generate a lot of questions because of the large number of patients potentially affected. As the study’s corresponding...
Cancer Memoir Provides Inspiration for Those with Terminal Illness and Their Caregivers
“It almost always begins in darkness, my memory’s trip back to China where Terrence and I meet.” So begins Amanda Bennett’s moving new memoir, The Cost of Hope, the story of an intensely devoted marriage, cruelly shortened by the cancer that killed her husband. The word “darkness” in Ms. Bennett’s...
In DCIS, Radiotherapy Benefits ‘Good Risk’ Patients
Radiation therapy will improve outcomes for patients with ductal carcinoma in situ (DCIS), even if they are considered at low risk for recurrence, according to the Radiation Therapy Oncology Group (RTOG) 9804 trial.1 But the follow-up time is short, and the findings still leave some wiggle room,...
SIDEBAR: Treatment Decisions for Locally Advanced NSCLC Draw on 'Art of Medicine'
With treatment advances, there are now fewer absolutes in managing locally advanced NSCLC, according to Dr. Reckamp. “We are moving toward treating performance status 2 patients, and obviously, that is a heterogeneous group of people,” she elaborated. “For those who need a lot of care, you need to...
Progress, Slow but Sure, Seen for Current Lung Cancer Therapies
This year, we have some abstracts that help move things forward in lung cancer, maybe at a little bit slower pace than in previous years. But there are important points that we can learn from some of these abstracts,” commented Karen L. Reckamp, MD, of the City of Hope, who presented findings on...
SIDEBAR: From Small Centers to Academic Centers
The use of cytoreduction plus hyperthermic intraperitoneal chemotherapy (HIPEC) to treat carcinomatosis “came from the smaller centers,” noted Nita Ahuja, MD, Director of the Peritoneal Surface Malignancies Program at Johns Hopkins Medicine. “A lot of things in medicine come from academia and move...
Successful Use of Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy May Hinge on Prior Experience
A review of 60 consecutive patients with peritoneal carcinomatosis who underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC)—sometimes called “hot chemotherapy”—found 0% mortality and 33% morbidity, with “a significant reduction of grade III/IV morbidity,...
Noncolorectal GI Cancer Evidence Incorporated into Guidelines
The noncolorectal gastrointestinal cancer studies selected for this year’s Best of ASCO meetings include some whose results are being folded into practice guidelines or are good candidates for incorporation, according to Alexandria T. Phan, MD, Associate Professor at The University of Texas MD...
SIDEBAR: Don’t Expect Direct Questions from Patients about Pain
Just asking patients “Is there something else you want to address in the visit,” rather than “Is there anything else you want to address in the visit today,” dramatically reduced patients’ unmet concerns during a primary care visit, according to a 2007 study.1 That learning can be applied to...
Pain Remains Prevalent among Oncology Outpatients, with Odds of Undertreatment Twice as High among Minority Patients
In 1994, a landmark study of pain among oncology outpatients prompted a host of pain management initiatives.1 More than 18 years later, a recent study among more than 2,000 cancer outpatients has found that “one-third of the patients who had pain or used analgesics received inadequate treatment for ...
