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Showing 10001 - 10050Overdiagnosis of Breast Cancer: New Research Directions
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 ...
The Canadian National Breast Screening Trial Had So Many Flaws That Its Results Should Not Be Used to Guide Screening Recommendations
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...
Flaws in CNBSS Are Vast, Impact on Screening Recommendations Is Nil
The recent report from the Canadian National Breast Screening Study (CNBSS)—published in BMJ and reviewed in The ASCO Post, early release online—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...
No Mortality Benefit of Breast Cancer Mammography Screening in 25-Year Follow-up of Canadian National Breast Screening Study
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...
Encouraging Early Results With Novel Agents in CLL
Two novel agents have shown promising activity in chronic lymphocytic leukemia (CLL), including poor-risk patients: the Bcl-2 inhibitor ABT-199 and the small-molecule PI3K inhibitor IPI-145. Both drugs achieved excellent response rates in heavily pretreated relapsed/refractory patients including...
First-Line Obinutuzumab/Chlorambucil Improves Outcomes Over Rituximab/Chlorambucil in Older CLL Patients With Comorbidities
Obinutuzumab (Gazyva) plus chloramubucil outperformed rituximab (Rituxan) plus chlorambucil (Leukeran) as first-line therapy in older patients with chronic lymphocytic leukemia (CLL) and comorbidities in the large CLL 11 trial. Final results showed that obinutuzumab/chloramubucil improved overall...
Haploidentical Stem Cell Transplantation Producing Good Outcomes, Expanding Transplant Pool
HLA-haploidentical hematopoietic stem cell transplantation can be performed safely, yield good outcomes, and greatly expand the number of patients with hematologic malignancies who can be treated with stem cell transplant, studies presented at the 2013 American Society of Hematology (ASH) Annual...
Amplifying the Signal: Foundation Donor Takes His Advocacy Into the Twittersphere
Michael A. Thompson, MD, PhD, a Medical Oncologist for Aurora Cancer Care and the Medical Director of Early Cancer Research at Aurora Health Care in Wisconsin, has become something of an expert on the Conquer Cancer Foundation. It began in 2006, when he received a Conquer Cancer Foundation of ASCO...
HER2-Positive Breast Cancer Patients With Small Tumors Benefit From Low-Toxicity Regimen
There may be a benefit for treating small HER2-positive tumors—a breast cancer subset for whom treatment recommendations have not been established but for whom there is still risk of recurrence—and this can be done with little toxicity, according to a multicenter study presented at the 2013 San...
GI Symposium Presentations Include Important Updates in Treatment and Prognosis of Pancreatic and Colorectal Cancers
More than 650 studies were presented at the 2014 Gastrointestinal Cancers Symposium, which attracted a multidisciplinary group of more than 3,500 medical, surgical, and radiation oncologists and gastroenterologists. The following briefs highlight a handful of noteworthy studies from the meeting....
Biomarker-Defined Subgroup Benefits From Novel Approach to Advanced Hepatocellular Carcinoma
Promising efficacy in advanced hepatocellular carcinoma patients was reported for a novel transforming growth factor–beta receptor type 1 (TGF-β1) kinase inhibitor, LY2157299 monohydrate, at the 2014 Gastrointestinal Cancers Symposium in San Francisco.1 In particular, patients with moderate to...
Irinotecan Drug-Eluting Beads Improve Outcomes in Colorectal Cancer Patients With Liver Metastases
Irinotecan drug-eluting beads (DEBIRI) given simultaneously with FOLFOX (leucovorin, fluorouracil, oxaliplatin) and bevacizumab (Avastin) in patients with unresectable colorectal liver metastasis improved response rates, increased resectability, and prolonged hepatic progression–free survival in a...
Long-Term Safety Data on Radium-223 in Prostate Cancer Reassuring
Long-term follow-up of the ALSYMPCA trial showed that radium Ra 223 dichloride (Xofigo) is extremely safe and active in men with castration-resistant prostate cancer and bone metastases. A snapshot of safety data from about 1.5 years after patients’ final radium-223 injection shows minimal...
Sequencing Sorafenib and Sunitinib in Either Order Does Not Affect Survival in Metastatic Renal Cell Carcinoma
The explosion of new therapies for metastatic renal cell carcinoma is a welcome advance, but studies have not yet defined optimal sequencing of the newer therapies. According to the phase III SWITCH trial, it matters little whether therapy for metastatic renal cell carcinoma begins with sorafenib...
Expert Point of View: Daniel J. Canter, MD
“Cytoreductive nephrectomy is routinely used in metastatic renal cell carcinoma, but its use is not as firmly established in the targeted therapy era. And its use is not without risk,” said formal discussant of the International Metastatatic Renal Cell Carcinoma Database Consortium (IMDC) trial,...
Cytoreductive Nephrectomy Improves Survival in Metastatic Renal Cell Carcinoma Patients With Longer Life Expectancy
Prior to the advent of targeted therapy, cytoreductive nephrectomy was associated with a 6-month improvement in overall survival in patients with metastatic renal cell carcinoma. With new and better targeted therapies for the disease, the appropriate use of cytoreductive nephrectomy has been...
PREVAIL Trial Shows Enzalutamide to Be a Promising Option for Metastatic Castration-Resistant Prostate Cancer
Encouraging results of the large phase III PREVAIL trial represent another positive milestone for men with metastatic castration-resistant prostate cancer. Enzalutamide (Xtandi) improved overall survival by 29% and reduced the risk of radiographic progression of disease by 81% in men who had not...
Task Force Recommends Against Beta-Carotene or Vitamin E Supplements for Primary Cancer Prevention
The U.S. Preventive Services Task Force (USPSTF) recommends against the use of beta-carotene or vitamin E supplementation for the primary prevention of cancer or cardiovascular disease, according to an updated recommendation statement published in the Annals of Internal Medicine. “The USPSTF found...
For Metastatic Colorectal Cancer, Bevacizumab Is More Commonly Included Than Anti-EGFR Antibody Therapies
Analysis of a large cohort of patients with metastatic colorectal cancer who received chemotherapy at academic, private, and community-based oncology practices using the same chemotherapy order entry system showed that “bevacizumab has been more consistently integrated into treatment regimens than...
Dermatologists Defend Mohs Surgery as Effective and Cost-Efficient With Low Rate of Recurrence
The headline, “Patients’ Costs Skyrocket, Specialists’ Incomes Soar,” aptly encapsulates the theme of a recent article in The New York Times,1 part of a series entitled, “Paying Till It Hurts.” “Oncologists benefit from the ability to mark up (and profit from) each dose of chemotherapy they...
Ongoing Clinical Trials Actively Recruiting Patients With Gastrointestinal Cancers
This Clinical Trials Resource Guide is meant to increase awareness of currently recruiting NCI- or academic institution–sponsored clinical studies for your patients with gastrointestinal cancers. All of the studies are listed on the National Institutes of Health website at ClinicalTrials.gov, and...
Focus on the Virginia Association of Hematologists and Oncologists
The state of Virginia encompasses a vast area of 40,000 square miles and is divided into five regions: the Atlantic Coastal Plain, the Piedmont, the Blue Ridge, the Appalachian Ridge and Valley Region, and the Appalachian Plateau. The diverse geography of the state creates unique challenges for...
The Ketogenic Diet in Cancer Control
Ketogenic (or very-low-carbohydrate) diets have been employed since the 1920s as nonpharmacologic therapies for epilepsy and, in some instances, have obviated the need for medication for that disease. Since the 1960s, the ketogenic diet has become better known as a means of managing obesity. This...
Telemedicine: Efficiency in Cancer Screening and Outreach
As defined by the U.S. Health Resources and Services Administration teleheath is “the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration.” It has ...
Telephone Education and Counseling Effective in Programs Targeting Familial/Genetic Cancer Risk Screening
Two studies recently reported in the Journal of Clinical Oncology indicate that telephone-based education or counseling initiatives can be successful in educating individuals at familial or genetic risk of cancer and in inducing these at-risk individuals to undergo recommended screening. In the...
How Decoding the Genomes of Exceptional Responders Is Leading to More Effective Treatment for All Patients With Cancer
In 2012, David B. Solit, MD, Geoffrey Beene Chair and Director of the Center for Molecular Oncology at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, and his colleagues published the results of a phase II study1 of 45 patients with advanced bladder cancer. The purpose of the clinical...
ASCO Addresses Changes in Medicare for 2014
Medicare patients make up 61% of new cancer cases in the United States, and as the population ages, that proportion is expected to rise to 70% by 2030. Over the past decade, the oncology community has been financially challenged by alterations in the Medicare payment system. To address the changes...
Impact of Delayed Initiation of Adjuvant Chemotherapy for Breast Cancer Varies by Tumor Subtype
The optimal time interval between surgery and initiation of adjuvant chemotherapy for early-stage breast cancer is not well established. Although most physicians aim to initiate adjuvant chemotherapy within a few weeks of surgery, clinical factors may cause delay. The influence of delay on relapse...
Delayed Adjuvant Chemotherapy Associated With Poorer Overall Survival in Breast Cancer
In a study reported in the Journal of Clinical Oncology, de Melo Gagliato et al from The University of Texas MD Anderson Cancer Center, Houston, assessed the association between time to adjuvant chemotherapy and survival in breast cancer patients.1 They found that delay of therapy is associated...
Dual PI3K/mTOR Inhibitor Effective as Radiosensitizer for Glioblastoma
In a study reported in Clinical Cancer Research, del Alcazar and colleagues assessed the effects of the dual PI3K/mTOR inhibitor NVP-BEZ235 as a radiosensitizer in glioblastoma. No DNA double-strand break repair inhibitors have been successful in treating glioblastoma. However, in prior studies in...
Staging of Cutaneous Squamous Cell Carcinoma
Neoplasms originating from skin keratinocytes are increasing in frequency in the United States and include a spectrum of diseases culminating in the development of invasive cutaneous squamous cell carcinoma. Although most cases of cutaneous squamous cell carcinoma can be treated conservatively with ...
Brigham and Women’s Hospital Tumor Staging for Cutaneous Squamous Cell Carcinoma Outperforms AJCC and UICC Staging
In a study reported in the Journal of Clinical Oncology, Pritesh S. Karia, MPH, and Chrysalyne D. Schmults, MD, MSCE, of Brigham and Women’s Hospital, Boston, and colleagues compared Brigham and Women’s Hospital, American Joint Committee on Cancer (AJCC), and International Union Against Cancer...
Melanoma and Prostate Cancer: Two Sides of One Coin?
In a recent study, reviewed in this issue of The ASCO Post, Li et al present data from two long- term prospective studies—the Physicians Health Study (PHS, from 1982 to 1998), and the Health Professionals’ Follow-up Study (HPFS, from 1986 to 2010)—both of which suggest a strong association between...
History of Prostate Cancer Increases Risk of Melanoma in White Men
History of severe acne, which is a surrogate for high androgen activity, has been associated with increased risk of prostate cancer, and recent data suggest that severe teenage acne is a risk factor for melanoma. Such findings suggest a role of androgens in etiology for both prostate cancer and...
Advanced Practitioners in Oncology: Diverse Experiences, Shared Challenges
The professional paths of advanced practitioners (APs) in oncology are as varied as the locations in which they work. The first annual JADPRO Live 2014 educational symposium was held in St. Petersburg, Florida, and hosted by JADPRO, the Journal of the Advanced Practitioner in Oncology. A...
Omacetaxine Mepesuccinate Receives Full FDA Approval for CML
The U.S. Food and Drug Administration (FDA) has granted full approval to omacetaxine mepesuccinate (Synribo) for injection. The full approval was based on the final analysis of two phase II trials that evaluated the efficacy and tolerability data of omacetaxine. The agent received an accelerated...
Crizotinib Proves Effective in ALK-Positive Lymphoma
Crizotinib (Xalkori) produced promising results in patients with ALK-positive lymphoma in two small studies presented at the 2013 American Society of Hematology (ASH) Annual Meeting. Crizotinib exerted potent antitumor activity in advanced ALK-positive lymphoma and achieved durable responses in...
Gemtuzumab Ozogamicin Reduces Relapse, Improves Event-Free Survival in Pediatric AML
The monoclonal antibody gemtuzumab ozogamicin (Mylotarg) improved event-free survival and reduced the risk of relapse in children with acute myeloid leukemia (AML) in a study from the Children’s Oncology Group, presented at the 55th American Society of Hematology (ASH) Annual Meeting and Exposition ...
Idelalisib Achieves High Response Rates in ‘Double-Refractory’ Indolent NHL
In patients with indolent B-cell non-Hodgkin lymphoma (NHL) refractory to both rituximab (Rituxan) and an alkylating agent, monotherapy with the selective oral PI3K-delta inhibitor idelalisib produced a high response rate, with responses persisting for 1 year in the average patient, according to...
Idelalisib Plus Rituximab in Heavily Pretreated Relapsed CLL: ‘Dawn of a New Age’?
Idelalisib plus rituximab (Rituxan) improved progression-free survival, overall response rates, and overall survival compared with rituximab alone in heavily pretreated patients with relapsed chronic lymphocytic leukemia (CLL). Moreover, the combination provided effective, durable disease control...
Promising Results Demonstrated for Brentuximab Vedotin in Cutaneous T-Cell Lymphoma
Phase II results suggest that brentuximab vedotin (Adcetris) has encouraging activity in CD30-positive cutaneous T-cell lymphomas and lymphoproliferative disorders, including mycosis fungoides, the most common type of cutaneous T-cell lymphoma. High levels of responses were achieved in a 48-patient ...
Zoledronic Acid Fails to Benefit Women With Chemoresistant Breast Cancer
Zoledronic acid does not improve outcomes in patients with early breast cancer who do not have a full response to neoadjuvant anthracycline/taxane–based chemotherapy, according to results of the Neo-Adjuvant Trial Add-On (NATAN) study presented at the 2013 San Antonio Breast Cancer Symposium.1 A...
Adding Bevacizumab to Adjuvant Chemotherapy/Trastuzumab Fails to Improve Survival in HER2-Positive Breast Cancer
The addition of bevacizumab (Avastin) to adjuvant chemotherapy did not improve invasive disease-free survival or overall survival in patients with high-risk HER2-positive breast cancer in the large randomized phase III BETH trial. Although not specifically designed to answer this question, BETH...
Immune Modulation May Aid Some Breast Cancer Subtypes
There may be an immunogenic phenotype in breast cancer that could benefit from immune modulation as part of treatment, according to results from studies that correlated high levels of tumor-infiltrating lymphocytes with both pathologic complete responses and long-term outcomes. Studies presented at ...
Novel Therapies May Help Wipe Out Residual Acute Lymphoblastic Leukemia
Minimal residual disease after induction and consolidation for the treatment of acute leukemia might be eradicated by novel therapies, thus obviating the need for stem cell transplantation. That is the prediction of Matthew J. Wieduwilt, MD, PhD, Assistant Clinical Professor of Medicine at the...
Minimal Residual Disease Before and After Transplant: What Does It Mean?
In patients with acute leukemia, outcomes after hematopoietic stem cell transplantation are negatively impacted by the presence of minimal residual disease. However, transplant can prolong survival in patients with minimal residual disease after consolidation, according to two studies presented at...
For Progressive Neuroendocrine Tumors, Clinical Benefit Is High With Capecitabine Plus Temozolomide
In an interim analysis of a phase II trial, 97% of patients with progressive metastatic neuroendocrine tumors achieved clinical benefit with the combination of capecitabine and temozolomide (CAPTEM). The results were reported at the 2014 Gastrointestinal Cancers Symposium by Robert L. Fine, MD,...
Outcomes in Metastatic Colorectal Cancer: Studies Examine Relative Merits, Cost-Effectiveness
Targeted biologic agents have improved long-term outcomes in metastatic colorectal cancer, but debate continues as to their relative efficacy and proper sequencing. At the 2014 Gastrointestinal Cancers Symposium, a number of studies attempted to answer these questions by interrogating the clinical...
More Support for ‘All-RAS’ Testing in Metastatic Colorectal Cancer
Multiple studies reported at the 2014 Gastrointestinal Cancers Symposium add further support for widening the genetic analysis of colorectal cancer tumors. In fact, experts predict that more extensive genetic testing for RAS gene mutations (in KRAS and NRAS) beyond the routine analysis of KRAS exon ...
Fine-Tuning Bladder-Preservation Trimodality Therapy for Patients With Muscle-Invasive Bladder Cancer
Organ preservation is a hallmark of progress in the world of cancer management. For patients with muscle-invasive bladder cancer, the bladder-sparing approach is a well-established alternative to radical cystectomy. Patients undergo cystoscopic evaluation between the induction and consolidation...
