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health-care policy
issues in oncology

Evolving Tools for Clinical Decision-Making

Value in cancer care—and how to define it—is a hot topic. There is general agreement that it is some measure of benefit vs cost, but “should the focus be on providing value to patients at a population level or at an individual level?” asked Alan Balch, PhD, CEO of the Patient Advocate Foundation,...

Expert Point of View: Elizabeth Plimack, MD

The Egyptian study presented by Brian Baumann, MD, of the University of Pennsylvania, Philadelphia, was a “valiant effort” to determine whether sequential adjuvant chemotherapy added to adjuvant radiation would improve disease-free survival, said formal discussant of this trial Elizabeth Plimack,...

bladder cancer

Adjuvant Chemoradiotherapy in Locally Advanced Bladder Cancer: Hint of Benefit That Needs Confirmation

Adjuvant sequential chemotherapy plus radiation therapy and adjuvant radiation therapy alone significantly improved local tumor control compared with adjuvant chemotherapy alone in locally advanced bladder cancer but the improvement in disease-free survival (3-year disease-free survival of 68% vs...

prostate cancer

Active Holistic Surveillance May Prevent Unnecessary Biopsies in Low- and Low/Intermediate-Risk Prostate Cancer

The use of prostate-specific antigen (PSA) screening has led to a dramatic rise in the number of men diagnosed with low-grade prostate cancer. Active surveillance is recommended to manage patients with favorable-risk, low-grade prostate cancer, with the goal of avoiding overtreatment of these...

Expert Point of View: Oliver Sartor, MD

“This platform has no selection bias. Phlebotomy samples are drawn at key decision points. We begin to see that heterogeneity of circulating tumor cells predicted for shorter progression and survival times with selected androgen receptor–directed therapies. We need to study this prospectively,”...

prostate cancer

New Technology to Characterize Circulating Tumor Cells Suggests Better Treatment Decision-Making in Prostate Cancer

An early study showed that an experimental blood test (ie, “liquid biopsy”) that characterizes the phenotype and genomic characteristics of circulating tumor cells appears to have utility in personalizing treatment decisions for individual men with advanced prostate cancer.1 The assay—developed and ...

survivorship

Study Finds Abnormal Insulin and Glucose Dynamics in Childhood Survivors Treated With Abdominal Radiation

An ongoing pilot study, designed to assess dynamic indices of insulin and glucose homeostasis in childhood cancer survivors exposed to abdominal radiation, has found a variety of derangements in glucose and insulin homeostasis in this cohort.1 According to an analysis presented at the 2016 Cancer...

Expert Point of View: Kathryn Schmitz, PhD, MPH

Discussant Kathryn Schmitz, PhD, MPH, Professor of Epidemiology at the Perelman School of Medicine, University of Pennsylvania, lauded the researchers’ successful intervention in what can be a challenging setting. “Dr. Yung presented evidence that it is feasible to conduct an evidence-based,...

survivorship

Clinic-Based Weight-Loss Intervention Successful in Cancer Survivors

A randomized clinical trial examining the effect of a 15-week healthy living program on weight loss in cancer survivors showed a 5.3% decrease in baseline body weight in those participating in the program.1 “Cancer survivors randomized to a 15-week clinic-based weight-loss intervention lost an...

Expert Point of View: Chunkit Fung, MD, MSCE

Moderator of the session Chunkit Fung, MD, MSCE, Assistant Professor at the Wilmot Cancer Center, University of Rochester, New York, said that the analysis shows the cost-effectiveness of performing yearly physical examinations. “In addition to the cost savings,” Dr. Fung observed, “clinicians need ...

survivorship

Bridging the Medical Gap in Long-Term Cancer Survivorship Care

Although more people than ever before are surviving cancer—there are currently 14.5 million cancer survivors, and that number is expected to climb to 19 million by 20241—they often experience long-lasting physical, emotional, and financial concerns related to the disease. To address the unmet...

Expert Point of View: Daniel V.T. Catenacci, MD

In his discussion of the presentation, Daniel V.T. Catenacci, MD, Assistant Professor of Medicine at the University of Chicago, said that conclusions cannot be drawn from the results of NEOSCOPE, which is underpowered to show differences. “On the surface, we see an improvement in the CarPacRT...

gastrointestinal cancer

Radiotherapy for Rectal Cancer: Study Reports No Risk for Subsequent Pelvic Tumors

Second malignancies were not more common among patients who underwent radiotherapy for rectal cancer. In fact, radiotherapy appeared to offer some degree of protection against subsequent cancers, according to the findings of a study from the Netherlands reported at the 2016 Gastrointestinal Cancers ...

Expert Point of View: Claus Rödel, MD

Claus Rödel, MD, of the Department of Radiotherapy, University of Frankfurt, Germany, discussed the study at the 2016 Gastrointestinal Cancers Symposium. “The main strength of the Polish II study is clearly its innovative design,” he said. “It sequentially combines effective local radiotherapy and...

colorectal cancer

Shorter Radiation Course May Benefit Patients With Locally Advanced Rectal Cancer

As neoadjuvant treatment for locally advanced rectal cancer, a shorter course of radiation therapy followed by chemotherapy may be as good as, or better than, standard chemoradiotherapy, according to a study from the Polish Colorectal Study Group presented at the 2016 Gastrointestinal Cancers...

Expert Point of View: Bertram Wiedenmann, MD, PhD and Markus Moehler, MD, PhD

Commenting on the programmed cell death protein 1 (PD-1)/PD-1 ligand (PD-L1) antibodies in tumors with mismatch repair deficiency, Bertram Wiedenmann, MD, PhD, Professor of Internal Medicine and Gastroenterology, Universitätsmedizin Berlin, Germany, suggested, “The efficacy of pembrolizumab...

cost of care

Cost in the Context of Value for Cancer Medicines

Bringing new cancer therapies through the discovery and development process entails considerable risk and many years of study. It also requires substantial investment and incentives from the public and private sectors to fuel future investment and discovery. A system that rewards advances in cancer ...

leukemia
issues in oncology

Inherited Genetic Variations That Lead to Severe Drug Toxicity in Pediatric Leukemia Discovered

An international research team has determined how inherited gene variations lead to severe drug toxicity that may threaten chances for a cure in children with leukemia. St. Jude Children’s Research Hospital scientists led the study, results of which set the stage to expand the use of a...

gastrointestinal cancer

Anti–PD-1/PD-L1 Antibodies Make Strong Showing in Gastrointestinal Cancers

Although the results may not yet be as impressive as those seen in melanoma, lung, and kidney cancers, monoclonal antibodies targeting the programmed cell death protein 1 (PD-1) are producing responses, with some durability, in gastrointestinal cancers, according to studies presented at the 2016...

colorectal cancer
issues in oncology
issues in oncology

Updated Guidelines Recommend That Patients With Colorectal Cancer Undergo Colonoscopy After Cancer Resection

According to new recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer published by Kahi et al in Gastroenterology, postoperative colonoscopy is associated with improved overall survival for colorectal cancer patients. Therefore, it is critically important that colorectal...

survivorship

Norwegian Male Cancer Survivors Less Likely to Reproduce

A study of all Norwegian men born between 1965 and 1985 showed that male cancer survivors are less likely to have children than those without a cancer diagnosis. “These findings are important for male cancer survivors, seeing as we can identify groups at risk of having reproduction...

breast cancer
pancreatic cancer

Study Finds Mechanism by Which Obesity Promotes Pancreatic and Breast Cancers

Massachusetts General Hospital (MGH) investigators may have uncovered a novel mechanism behind the ability of obesity to promote cancer progression. In their report published by Incio et al in Clinical Cancer Research, the research team describes finding an association between obesity and an...

breast cancer
issues in oncology

Gene Previously Observed Only in Brain Is Important Driver of Metastatic Breast Cancer

When breast cancer becomes metastatic, patient survival is drastically reduced, prompting the need to explore the genes that may cause tumor cells to metastasize. Now, scientists from The Wistar Institute have shown that a gene that was once thought only to be found in the brain is also expressed...

leukemia
lymphoma

Younger T Cells May Improve Immunotherapy for Pediatric Cancer

Pediatric oncologists from The Children’s Hospital of Philadelphia (CHOP) have investigated techniques to improve and broaden a novel personalized cell therapy to treat children with cancer. The researchers say that a patient’s outcome may be improved if clinicians select specific...

prostate cancer

Study Finds Enzalutamide Increases Progression-Free Survival vs Bicalutamide in Metastatic Prostate Cancer

Use of the androgen receptor–inhibitor enzalutamide (Xtandi) more than doubled progression-free survival vs the nonsteroidal antiandrogen bicalutamide in patients with metastatic prostate cancer progressing on androgen-deprivation therapy, according to the randomized phase II TERRAIN trial...

breast cancer
survivorship

ACS/ASCO Breast Cancer Survivorship Care Guideline

The American Cancer Society (ACS) and ASCO have issued a Breast Cancer Survivorship Care guideline, published jointly in the Journal of Clinical Oncology and CA: A Cancer Journal for Clinicians. The guideline recommendations were formulated by a multidisciplinary expert work group and are based on...

hepatobiliary cancer

Nanoparticle Therapy That Uses LDL and Fish Oil Kills Liver Cancer Cells

An experimental nanoparticle therapy that combines low-density lipoproteins (LDL) and fish oil preferentially kills primary liver cancer cells without harming healthy cells, UT Southwestern Medical Center researchers report. The study was published by Wen et al in Gastroenterology. “This...

pancreatic cancer
issues in oncology

Preclinical Device Hits Pancreatic Tumors With Drug Cocktail, Sparing the Body

A highly lethal cancer sometimes requires large doses of highly toxic drugs. However, a blitzkrieg approach can be unfeasible for some patients due to severe side effects. Now a team of researchers at the University of North Carolina at Chapel Hill has found that an implantable device can deliver a ...

Study Finds Time Lag Between Positive Fecal Blood Test and Follow-up Colonoscopy

Annual testing for blood in the stool using high-sensitivity guaiac fecal occult blood tests or fecal immunochemical tests is one of several recommended colorectal cancer screening strategies for adults 50 to 70 years old. However, although a positive finding requires a follow-up colonoscopy to...

issues in oncology
head and neck cancer

Possible Marker for Recurring HPV-Linked Oropharyngeal Cancers

A retrospective analysis of human papillomavirus (HPV) antibodies in patients treated for oropharyngeal cancers linked to HPV infection suggests at least one of the antibodies could be useful in identifying those at risk for a recurrence of the cancer, said scientists at The Johns Hopkins...

lung cancer

Alectinib in ALK-Positive Metastatic NSCLC After Crizotinib

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 December 11, 2015, alectinib (Alecensa) was granted...

Richard ‘Buz’ Cooper, MD, Noted Health Policy Expert, Dies at 79

Addressing disparities of cancer care that result in poorer outcomes among certain populations remains a persistent challenge in the oncology community and in the health-care system at large. It is, to a large degree, a medical story of haves and have-nots. Richard “Buz” Cooper, MD, a preeminent...

kidney cancer
kidney cancer

Removal of Complex Renal Tumors Performed Safely by Robotic Surgery in Selected Patients

Renal cell carcinoma can sometimes spread to the inferior vena cava, posing a threat to the heart and brain. Robotic nephrectomy for inferior vena cava tumor thrombus has favorable outcomes in selected patients compared with open surgery, which can have a high rate of complications, reported Abaza...

Patient Guides Available Through ASCO University Bookstore

ASCO Answers: Managing the Cost of Cancer Care explains the various costs associated with cancer treatment, including health-care coverage through the Affordable Care Act. It also provides a list of financial resources available to help offset expenses related to care and tips for organizing...

cns cancers

A Brain Tumor Diagnosis Has Taken My Life in New Directions

The first sign that I could have a life-threatening illness was a bout of severe dizziness, which sent me first to a general practitioner for a physical examination and then to an ear specialist for more tests. At just 24 and in excellent health, the sudden onset of dizziness didn’t initially set...

Certainty

The following essay by William N. Harwin, 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.   My wife...

James K.V. Willson, MD, Named Chief Scientific Officer of CPRIT

James K.V. Willson, MD, Associate Dean of Oncology Programs and Professor and Director of the Harold C. ­Simmons Comprehensive Cancer Center at University of Texas (UT) Southwestern Medical Center, has been named Chief Scientific Officer of the Cancer Prevention and Research Institute of Texas...

New AJCC Precision Medicine Guidelines Aimed at Improving Personalized Cancer Treatment Plans for Patients

A committee of national experts, led by a Cleveland Clinic researcher, has established first-of-its-kind guidelines to promote more accurate and individualized cancer predictions, guiding more precise treatment and leading to improved patient survival rates and outcomes. These guidelines were...

Misconstrued Review

I’ve been a member of ASCO for longer than I can remember. I read most breast cancer–related articles in The ASCO Post and find them helpful, particularly the reports of as-yet-unpublished papers from meetings. So, it is with great disappointment that, in the November 10, 2015, issue, I read a...

issues in oncology

Vice President Joe Biden Discusses Big Data in Cancer Research at World Economic Forum

On January 19, 2016, Vice President Joe Biden discussed big data as one of the “major undertakings” designed to advance the pace of progress in the fight against cancer as part of his new “moonshot” initiative at the World Economic Forum in Davos Klosters, Switzerland. Mr. Biden presided over a...

skin cancer

Expanded Approval of Pembrolizumab in Unresectable or Metastatic Melanoma

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 December 18, 2015, approval of the programmed cell death...

A Famous French Oncologist’s Gastronomic Advice for Reducing Cancer Risk

BookmarkTitle: The Anti-cancer Diet: Reduce Cancer Risk Through the Foods You EatAuthors:  David Khayat, MDPublisher: W.W. Norton & CompanyPublication date: April 2015Price: $26.95; hardcover, 288 pages   In 2002, David Khayat, MD, was in Turkey on holiday with friends when he received a call...

Fear’s Many Deleterious Consequences

Bookmark Title: The Fear Cure: Cultivating Courage as Medicine for the Body, Mind, and Soul Author: Lissa Rankin, MD Publisher: Hay House, Inc Publication date: February 23, 2015 Price: $25.99; hardcover, 336 pages   Fear is a healthy survival mechanism, a fight-or-flight response designed to put...

A Pioneering Oncologist’s Roadmap Forward

Bookmark Title: The Death of Cancer: After Fifty Years on the Front Lines of Medicine, a Pioneering Oncologist Reveals Why the War on Cancer Is Winnable—and How We Can Get There Authors: Vincent T. DeVita, Jr, MD, and Elizabeth DeVita-Raeburn Publisher: Farrar, Straus and Giroux Publication date:...

breast cancer

Looking at the Real-World Effects of Genetic Testing

According to the most recent estimates, 55% to 65% of women who inherit the BRCA1 mutation and about 45% of women who inherit the BRCA2 mutation will develop breast cancer by the time they are 70 years old. There is also a substantial increase in the probability of developing ovarian cancers in...

Expert Point of View: Sergio A. Giralt, MD

Sergio A. Giralt, MD, Chief of the Adult Bone Marrow Transplant Service at Memorial Sloan Kettering Cancer Center, New York, told The ASCO Post that defibrotide could be helpful in high-risk patients and applauded the investigators for completing the trial to prove it. “Veno-occlusive...

Defibrotide Under Review for Transplant-Related Complication

A potentially fatal complication of hematopoietic stem cell transplantation may be reversed with the use of a novel drug currently under priority review at the U.S. Food and Drug Administration (FDA). Hepatic veno-occlusive disease/sinusoidal obstruction syndrome is usually a serious complication...

symptom management

How Cancer and Its Treatments Affect Cognitive Function

Although chemotherapy is often cited as the main culprit for diminishing cognitive function in patients with cancer, ushering the term “chemobrain” into the vernacular, research by Tim A. Ahles, PhD, and his colleagues is showing that multiple factors may contribute to the condition.1 Using breast...

leukemia

Bone Loss Associated With Leukemia Therapy Occurs Sooner Than Previously Thought

Investigators at Children’s Hospital Los Angeles (CHLA) have found that significant bone loss occurs during the first month of chemotherapy for acute lymphoblastic leukemia (ALL), which is far earlier than previously assumed. Results of the study were published by Orgel et al in the...

issues in oncology

World Cancer Day 2016: We Can. I Can.

Cancer will kill more than 8 million people worldwide this year, which is equivalent to the entire population of New York. Half of these will be people of working age (30–69 years old). It has been estimated that the cost implications on world economies caused by cancer and the other...

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