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palliative care

The Importance of Including Adolescents and Young Adults With Cancer in Their Advance Care Planning

Three years ago, a study of adolescents and young adults aged 16 to 28 with metastatic or recurrent cancer or HIV/AIDS compared the usefulness of two previously developed advance care planning guides—one prepared specifically for adolescents and young adults and one specifically for adults. The...

leukemia

A Lasting Legacy

When Emil J Freireich, MD, retires from the University of Texas MD Anderson Cancer Center on September 1, he will have spent 50 years at the institution and a total of 60 years in the pursuit of curing childhood leukemia as well as other cancers and in the educational development of young...

The Human Heart: Tales of Science and Mystery

BOOKMARK Title: The Man Who Touched His Own Heart: True Tales of Science, Surgery, and Mystery Author: Rob Dunn Publisher: Little, Brown and Company Publication date: February 3, 2015 Price: $27.00; hardcover, 384 pages No part of the human anatomy has been as mythologized, analogized, and...

An Oncologist’s Memoir

BOOKMARK Title: Megalies: A Memoir Author: Lodovico Balducci, MD Publisher: Resource Publications Publication date: February 28, 2014 Price: $33.00; hardcover, 304 pages Reading a good book produces various sensory responses; a skilled author exerts his or her narrative power on each page,...

issues in oncology
palliative care

Using Gene Analytics to Identify Patients at Risk for Treatment Toxicity

Genomic applications are now an accepted part of oncologic science and practice. Differences in gene expression have been used to understand and predict tumor behaviors and response to treatment. And now it seems likely that genomics may also play a pivotal role in guiding treatment preferences by...

breast cancer

Comparing Regimens Guides Therapeutic Decisions in Previously Treated Advanced Breast Cancer

Kaufman and colleagues recently reported findings of a phase III trial comparing eribulin ­(Halaven) vs capecitabine in patients with advanced breast cancer who had previously received anthracycline and taxane therapy,1 and a review of their study appears in this issue of The ASCO Post. Although...

breast cancer

No Survival Benefit for Eribulin vs Capecitabine in Advanced Breast Cancer

Eribulin (Halaven) currently is indicated in the United States for treatment of patients with metastatic breast cancer who previously received at least two chemotherapy regimens for metastatic disease and an anthracycline and a taxane in either the adjuvant or metastatic setting. Its approval was...

lung cancer

ODAC Discussion ‘Constructive’ About Necitumumab for Squamous NSCLC

The U.S. Food and Drug Administration’s (FDA) Oncologic Drugs Advisory Committee (ODAC) favored the approval of necitumumab in combination with gemcitabine and cisplatin for use in first-line treatment of patients with locally advanced or metastatic squamous non–small cell lung cancer (NSCLC). In...

issues in oncology

Is Proton-Beam Therapy Facing a Difficult Future?

Health-care experts are questioning whether proton-beam therapy is on the verge of an economic bubble—ie, a rapid surge in growth for the industry beyond its intrinsic value, inevitably leading to a drastic drop in earnings for proton centers when the “bubble bursts.” A proton-beam facility can...

issues in oncology

Value: What Do We Mean, Who Should Decide?

Oscar Wilde famously defined a cynic as “a man who knows the price of everything and the value of nothing.” I do not think that oncologists need to be as cynical as this, but it was very appropriate that a major theme of this year’s ASCO Annual Meeting was the concept of “value.” It is clear that...

Expert Point of View: Peter B. Bach, MD, MAPP, and Leonard Saltz, MD

Peter B. Bach, MD, MAPP, Director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center (Memorial), New York, discussed Dr. Schrag’s study at the ASCO Health Services Research and Quality of Care session. “Dr. Schrag’s analysis could have been ‘back of the...

colorectal cancer

Bevacizumab More Cost-Effective Than Cetuximab in Metastatic Colorectal Cancer

The landmark CALGB/SWOG 80405 trial concluded that bevacizumab (Avastin) and cetuximab (Erbitux) provide comparable benefit in the treatment of metastatic colorectal cancer. However, in terms of cost, bevacizumab was recently declared the winner. In an economic analysis presented at the 2015 ASCO...

skin cancer

Public Urged Not to Overreact to Study Finding Link Between Citrus Fruits and Melanoma Risk

A study finding a link between citrus consumption and increased risk of melanoma1 may provide food for thought about the findings and implications as well as whet the appetite for more evidence, but according to several experts commenting on the study, it does not mean you should stop eating citrus ...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia: Questions

Hematology Expert Review is an occasional feature that includes a case report followed by questions, answers, and expert commentary. In the July 25 issue of The ASCO Post, part 1 of a case report was published and focused on diagnosis (see summary below). Here, in part 2, the management of this...

Conquer Cancer Foundation Donor Spotlight: Ludwig Cancer Research

Among the Conquer Cancer Foundation’s newest supporters, Ludwig Cancer Research is an international community of distinguished scientists dedicated to preventing and controlling cancer. Its emphasis on collaboration and long-term support has fostered its role as a leader in immunotherapy and other...

health-care policy

Physician Fee Schedule: A Closer Look

The Centers for Medicare & Medicaid Services (CMS) issued the Notice of Proposed Rulemaking for the 2016 Physician Fee Schedule on July 15. Among other changes, CMS proposes new codes and payment levels for Advance Care Planning; requests comments for future implementation of the Medicare...

New Symposium Brings Together Oncologists and Primary Care Providers to Advance Survivorship Care and Research

With two-thirds of Americans now living at least 5 years after a cancer diagnosis, there are currently 14.5 million cancer survivors living in the United States. By 2024, that number is expected to increase by nearly 25%.1 Although the growing number of survivors is a welcome sign of progress, this ...

skin cancer

Sonidegib in Basal Cell Carcinoma

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. On July 24, 2015, sonidegib (Odomzo) was approved for treatment...

issues in oncology

Johnson & Johnson Creates Independent Bioethics Panel to Evaluate Compassionate Drug Use Requests

In May 2015, Johnson & Johnson announced its partnership with New York University (NYU) School of Medicine in New York to create a first-of-its kind independent bioethics panel to review requests made to the company for compassionate use of an investigational drug and determine how the company...

cns cancers

Improved Understanding of Glioma Tumor Biology

The management of patients with lower-grade gliomas is evolving. As evidenced by two recent publications in The New England Journal of Medicine,1,2 reviewed in this issue of The ASCO Post, there has been a substantial increase in our knowledge of the molecular characteristics of these neoplasms....

cns cancers

New Molecular Classifications of Gliomas Established

Two studies reported in The New England Journal of Medicine identified new molecular classifications of glioma that capture biologic and prognostic differences. The Cancer Genome Atlas Research Network identified three prognostically significant subtypes of lower-grade glioma that were identified...

breast cancer

The Conundrum of Estrogen-Receptor Signaling in HER2-Positive Breast Cancer

BOLERO-1—reviewed in this issue of The ASCO Post—is the next installment in a series of randomized trials evaluating the addition of everolimus (Afinitor) to standard therapy in metastatic breast cancer.1 The initial evaluation of everolimus in the HER2-positive metastatic setting looked extremely...

breast cancer

Adding Everolimus to First-Line Trastuzumab/Paclitaxel Does Not Increase Progression-Free Survival in HER2-Positive Metastatic Breast Cancer

In the phase III BOLERO-1 trial, reported in The Lancet Oncology, Sara A. Hurvitz, MD, of the University of California, Los Angeles, and colleagues found that the addition of the mTOR inhibitor everolimus (Afinitor) to trastuzumab (Herceptin)/paclitaxel did not significantly increase...

multiple myeloma

Carfilzomib in Combination With Lenalidomide and Dexamethasone in Relapsed Multiple Myeloma

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.   On July 24, 2015, carfilzomib (Kyprolis) was approved for use in...

colorectal cancer

Learning to Refine the Use of Regorafenib to Best Advantage in Advanced Colorectal Cancer

In patients with advanced colorectal cancer who have been heavily treated with a sequence of chemotherapy regimens and/or targeted therapies, the goals of treatment on or off a clinical trial are readily definable. These patients and their managing teams are striving to extend the length of lives,...

colorectal cancer

Regorafenib Improves Overall Survival in Asian Patients  With Previously Treated Metastatic Colorectal Cancer

In a phase III trial (CONCUR) reported in The Lancet Oncology, Jin Li, MD, and colleagues found that the multikinase inhibitor regorafenib (Stivarga) improved overall survival vs placebo in Asian patients with previously treated metastatic colorectal cancer.1 Regorafenib is approved in the United...

skin cancer

FDA Approves Sonidegib for Locally Advanced Basal Cell Carcinoma

The U.S. Food and Drug Administration (FDA) approved sonidegib (Odomzo) for the treatment of patients with locally advanced basal cell carcinoma that has recurred following surgery or radiation therapy or those who are not candidates for surgery or radiation therapy. The approval was based on...

supportive care
pain management
palliative care
symptom management

Managing Cancer Pain at the End of Life

Cancer-related pain does not exist in a vacuum. To effectively treat it, clinicians should understand the contributing factors. Proper assessment and management of cancer pain at the end of life can significantly alleviate patient suffering, according to Eduardo Bruera, MD, FAAHPM, Department Chair ...

cns cancers

Short Course of Radiotherapy May Be Adequate for Elderly and Frail Patients With Glioblastoma Multiforme

No difference in overall survival or progression-free survival was observed between elderly and/or frail patients undergoing short and standard courses of radiotherapy for glioblastoma multiforme, according to data presented by Elena Fidarova, MD, at the 2015 Multinational Association of Supportive ...

kidney cancer

FDA Grants Breakthrough Therapy Designation to Lenvatinib for Metastatic Renal Cell Carcinoma

The U.S. Food and Drug Administration (FDA) granted lenvatinib (Lenvima) Breakthrough Therapy designation for investigational use in patients with advanced or metastatic renal cell carcinoma who were previously treated with a vascular endothelial growth factor (VEGF)-targeted therapy. Lenvatinib...

multiple myeloma

FDA Approves Carfilzomib Combination for Patients With Relapsed Multiple Myeloma

The U.S. Food and Drug Administration (FDA) approved carfilzomib (Kyprolis) in combination with lenalidomide (Revlimid) and dexamethasone for the treatment of patients with relapsed multiple myeloma who have received one to three prior lines of therapy. In the United States, there are nearly...

lung cancer

Immunotherapy Makes Inroads in Small Cell Lung Cancer

Early data on immunotherapy for small cell lung cancer (SCLC) have been encouraging. SCLC may catch up to non–small cell lung cancer (NSCLC), where immunotherapy is now standard of care, if these early data are borne out in phase III trials. Phase Ib and II studies of immunotherapy in SCLC were...

breast cancer

Studies Explore New Avenues to Pursue in Metastatic Triple-Negative Breast Cancer

Two agents targeting novel pathways show promise in metastatic triple-negative breast cancer, according to separate studies presented at the 2015 ASCO Annual Meeting and reviewed at the Best of ASCO® meeting by Steven J. Isakoff, MD, PhD, of Massachusetts General Hospital, Boston. The first study...

lymphoma

Increased Lifetime Risk of Cardiovascular Disease for Patients Treated for Hodgkin Lymphoma

Survivors of Hodgkin lymphoma treated as adolescents or adults are at increased risk of cardiovascular diseases throughout their lives, according to results of a retrospective cohort study of 2,524 Dutch patients followed for a median of 20 years. “Treating physicians and patients should be aware...

thyroid cancer

Clinical Trials Actively Recruiting Patients With Thyroid Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with thyroid cancer. The trials are investigating novel drug combinations; the effects of radioiodine; blood cell modification; biomarker-targeted therapies; and the effects...

breast cancer
pain management

Increased Interest in Simple Injection to Treat Women With Postmastectomy Pain

After presenting results of a study showing that injecting a standard analgesic combination into trigger points of pain along the inframammary fold relieved postmastectomy pain, Laura J. Esserman, MD, MBA, Director of the Carol Franc Buck Breast Care Center and Co-Leader of the Breast Oncology...

ASCO and UICC Collaborate to Extend Reach of the Journal of Global Oncology

ASCO and the Union for International Cancer Control (UICC) announced their partnership to expand the reach of the Journal of Global Oncology (JGO), a new open-access journal that will focus on cancer care, research, and care delivery issues unique to countries and settings with limited health-care...

Chris Marshall, FRS, FMedSci, Dies at 66 of Colorectal Cancer

Chris Marshall, FRS, FMedSci, a rigorous scientist with a lasting legacy of game-changing discoveries in cancer research and generous support for his younger colleagues, has died at 66. The cause of death was colorectal cancer. Professor Marshall was the Head of the Division for Cancer Biology at...

Breast Surgeon Carolyn Mary Kaelin, MD, MPH, FACS, Dies at 54

Carolyn Mary Kaelin, MD, MPH, FACS, died on July 28 at the age of 54. A gifted and compassionate breast cancer surgeon, Dr. Kaelin was a surgical oncologist in the Women’s Cancers Program at Dana-Farber Cancer Center and Director of the Breast Clinic at Brigham and Women’s Hospital. Dr. Kaelin...

breast cancer

I’m Living a Full and Happy Life With Stage IV Breast Cancer

After coping with breast cancer for more than a decade, it is difficult for me to put into words exactly how grateful I am to all the doctors, nurses, and researchers whose efforts have kept me alive for all these years. And not just alive, but thriving. A routine mammogram had discovered two...

Never Say Never

The following essay by Grace Wang, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. D.K. came to me ...

gynecologic cancers

How Carolyn D. Runowicz, MD, FASCO, Is Shaping the Future of Gynecologic Cancers

Carolyn D. Runowicz, MD, ­FASCO, has worn just about every hat in the field of oncology—clinician, professor, researcher, administrator, and even cancer survivor.  Currently the Executive Associate Dean for Academic Affairs and Professor in the Department of Obstetrics and Gynecology at the Herbert ...

The Flipped Classroom: Swapping the Traditional Lecture Hall for an Online Version

Despite enormous advances in modern medicine and the explosion of biomedical information over the past century, the way medical education is taught in the United States is stuck in a format that does not optimize learning, according to Charles Prober, MD, Senior Associate Dean for Medical Education ...

skin cancer

COMBI-d Trial and the Need to Guide Progress in Melanoma Treatment

As reviewed in this issue of The ASCO Post, Long et al1 have reported the final overall survival analysis of the COMBI-d phase III trial comparing combination therapy with the BRAF inhibitor dabrafenib (Tafinlar) and the MEK inhibitor trametinib (Mekinist) to monotherapy with dabrafenib alone,...

This September, Triple Your Impact

At the 2015 ASCO Annual Meeting, the Conquer Cancer Foundation (CCF) launched The Campaign to Conquer Cancer—a comprehensive, $150 million fundraising campaign supporting breakthrough research and sharing vital knowledge with physicians, patients, and families. In support of The Campaign, CCF Board ...

Conquer Cancer Foundation Young Investigator Award Applications Now Open

The Conquer Cancer Foundation’s Young Investigator Award (YIA) provides research funding to promising physicians to support the transition from final years of training to faculty appointment and to encourage and promote quality research in clinical oncology. The online application for 2016 YIAs is...

ASCO Guidelines: A Collaborative Effort

The ASCO Guidelines Program has worked with other professional societies and guideline development organizations in an effort to expand the ASCO guideline portfolio and harmonize recommended care options across prominent guideline development groups. For ASCO, this effort began with a systematic...

lung cancer

Roswell Park Cancer Institute Partners With Cuban Scientists to Develop Lung Cancer Vaccine

Just 4 months after President Barack Obama’s announcement in December 2014 that there would be an easing of the trade embargo between the United States and Cuba, a deal was struck between Roswell Park Cancer Institute in Buffalo, New York, and the Center for Molecular Immunology (CIM) in Havana,...

solid tumors

State-of-the-Art Management of Germ Cell Tumors Produces High Cure Rates

Pasquale W. Benedetto, MD, the Leonard M. Miller Professor of Medicine at the University of Miami/Sylvester Comprehensive Cancer Center, recently spoke at the 2015 New Orleans Summer Cancer Meeting about his approach to diagnosing and treating germ cell tumors in men.1 The ASCO Post was there to...

breast cancer

Genetic Testing in Breast Cancer Offers Much Information but Poses Challenges in Interpretation

For breast cancer patients with robust family histories, medical oncologists should be testing not only for BRCA1/2 mutations, but also for large duplications and deletions as well as for PALB2 mutations. “These [findings] have proven utility in testing breast cancer patients,” said Louise E....

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