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issues in oncology
health-care policy

Health-Care Fraud and Abuse: Implications for Oncology

Health-care fraud is a long-standing problem in the United States, accounting for $75 billion in government expenses per year,1 while total spending on government health-care programs is over $1 trillion. Two decades ago, the Department of Justice increased its efforts to combat health-care fraud....

Expert Point of View: Charles Ryan, MD

ASCO Expert and GU News Planning Team Member, Charles Ryan, MD, of the University of California, San Franciso, Helen Diller Family Comprehensive Cancer Center, said the results presented by Singh et al at the 2015 Genitourinary Cancers Symposium were “encouraging” and that it makes sense to exploit ...

prostate cancer

Intensified Immunotherapy Encouraging in Chemotherapy-Naive Metastatic Prostate Cancer

Emerging evidence suggests that immunotherapy may play an important role in treating prostate cancer. In particular, preliminary results have shown that combining a new vaccine with ipilimumab ­(Yervoy) boosts overall survival in men with castration-resistant prostate cancer.1 A study comparing...

lymphoma

Radiotherapy in Good-Prognosis DLBCL

I was disturbed by the article on “Radiotherapy in Good-Prognosis ­DLBCL” published recently in The ASCO Post.1 As a practicing radiation oncologist for 30 years, I have seen the evolution of radiation techniques (and philosophy) for non-Hodgkin lymphoma progress from regional—or even...

prostate cancer

Targeted MR/Ultrasound Fusion–Guided Biopsy Increased Detection of  High-Risk Prostate Cancer

Among men undergoing biopsy for suspected prostate cancer, targeted magnetic resonance (MR)/ultrasound fusion–guided biopsy was associated with an increased rate of detection of high-risk prostate cancer and a decreased rate of detection of low-risk prostate cancer than was standard...

breast cancer

Are Physicians Choosing Wisely When Imaging for Distant Metastases in Early-Stage Breast Cancer?

Patients with early-stage breast cancer still undergo imaging for distant metastases despite evidence-based local, national, and international guidelines—and a recommendation from ASCO—to avoid such imaging, according to a retrospective review of staging imaging for distant metastases in patients...

colorectal cancer

Don’t Disregard Questions About Possible Symptoms of Colorectal Cancer Just Because the Patient Is ‘Too Young’

While colorectal cancer predominantly occurs in people over 50 years old, rates are increasing among younger patients. It is important for physicians not to ignore symptoms in patients who are young, “simply because they are young,” Jason A. Zell, DO, MPH, told The ASCO Post. Dr. Zell is the...

colorectal cancer

Colorectal Cancer Is Significantly Increasing Among Younger Adults and Being Diagnosed at Later Stages

A growing body of literature indicates that the incidence of colorectal cancer is rising among people under age 50, according to Jason A. Zell, DO, MPH. Dr. Zell is the corresponding author of one of the two recent studies finding significant increases in colorectal cancer among adults aged 20 to...

sarcoma

Shining a Spotlight on Epithelioid Hemangioendothelioma

In the winter of 2013, my son, Dmitriy, now 26, had a cough that wouldn’t go away. After several rounds of antibiotics failed to halt the persistent problem, a pulmonologist we consulted ordered a chest x-ray, which showed a large tumor lodged between Dmitriy’s lungs. Although the doctor said the...

colorectal cancer

Refining the ‘Right Patient, Right Drug’ Pairing in Cancer Care: RAS Profiling in Metastatic Colorectal Cancer

In an important post hoc analysis (reviewed in this issue of The ASCO Post), Van Cutsem and colleagues have further refined our knowledge of who are the “right” patients with metastatic colorectal cancer to receive treatment with cetuximab (Erbitux).1 This refinement was accomplished through the...

issues in oncology
palliative care

Why Just Having ‘Good’ Communication Skills Is Not Enough for Talking With Seriously Ill Patients

In the Institute of Medicine’s 2014 report Dying in America,1 the report’s authors found that while frequent clinician-patient conversations about end-of-life care, goals, and preferences are necessary to avoid unwanted treatment, most patients do not have those conversations with their physicians. ...

lung cancer

Nivolumab in Metastatic Squamous Non–Small Cell Lung Cancer After Platinum Therapy

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 March 4, 2015, the anti–programmed cell death protein 1 (PD-1) ...

supportive care

FDA Approves Isavuconazonium Sulfate for the Treatment of Invasive Aspergillosis and Invasive Mucormycosis

The U.S. Food and Drug Administration (FDA) has approved Astellas’ New Drug Application for the use of isavuconazonium sulfate (Cresemba), the prodrug for isavuconazole, for patients 18 years of age and older in the treatment of invasive aspergillosis and invasive mucormycosis (also known as...

multiple myeloma

The ASPIRE Trial of Carfilzomib in Relapsed Myeloma: A Major Step Forward

Currently in myeloma, there are at least five new agents that are either approved or in the late-stage of development with impending approval. Major questions in the field relate to how we, as clinicians, will use these new agents and where they will fit in the overall treatment schema. The phase...

multiple myeloma

Increased Progression-Free Survival With Addition of Carfilzomib to Lenalidomide/Dexamethasone in Relapsed Multiple Myeloma

In a planned interim analysis of the phase III ASPIRE trial reported in The New England Journal of Medicine, A. Keith Stewart, MB, ChB, of the Mayo Clinic, Scottsdale, Arizona, and colleagues found that the addition of the proteasome inhibitor carfilzomib (Kyprolis) to lenalidomide...

gastrointestinal cancer

The Emerging Role of Radiation Therapy in Gastrointestinal Cancers

The use of radiation therapy in the treatment of gastrointestinal cancer has evolved over the past several decades, in a gradual, stepwise fashion. Since most gastrointestinal cancers are diagnosed at a locally advanced stage, coupled with the inherent sensitivity of most parts of the...

St. Jude Children’s Research Hospital Appoints Chair of Department of Radiation Oncology

St. Jude Children’s Research Hospital has named Thomas E. Merchant, DO, PhD, as Chair of the Department of Radiation Oncology. Dr. Merchant will hold the Baddia J. Rashid Endowed Chair in Radiation Oncology. “Dr. Merchant is a proven leader in pediatric radiotherapy and will be instrumental in...

solid tumors

Current Progress Against Cancer and What Lies Ahead in the Next Decade

In January, ASCO released its report, Clinical Cancer Advances 2015: An Annual Report on Progress Against Cancer,1 which details research advances over the past decade that have led to longer survival and better quality of life for the more than half-a-million people diagnosed with cancer each...

bladder cancer

Adjuvant Chemotherapy and Overall Survival in Muscle-Invasive Bladder Cancer: Still Climbing the Mountain

Muscle-invasive bladder cancer can be a lethal disease despite curative intent local therapy, with 5-year survival that can be as low as 30% based on the extent of T status and/or lymph node involvement. The use of neoadjuvant chemotherapy with MVAC (methotrexate, vinblastine, doxorubicin, and...

bladder cancer

No Overall Survival Difference for Immediate vs Deferred Chemotherapy After Radical Cystectomy in Muscle-Invasive Bladder Cancer

In the European Organisation for Research and Treatment of Cancer (EORTC) 30994 trial, a phase III intergroup study reported in The Lancet Oncology,1 Cora N. Sternberg, MD, FACP, Chief of Medical Oncology at San Camillo and Forlanini Hospitals, Rome, and colleagues found no overall survival...

breast cancer

Breast Cancer Management in Review

Anyone who has attended the major oncology meetings knows that research from clinical trials in breast cancer often dominates the stage, with countless abstracts featuring new and updated results. To help the readers of The ASCO Post stay up to date with the latest discoveries and findings...

lung cancer

Results of RTOG 0617 Reconsidered

Radiation Therapy Oncology Group (RTOG) 0617 was a study initially designed to address an important issue in radiation oncology regarding the treatment of stage III non–small cell lung cancer (NSCLC): Are outcomes improved with high-dose as opposed to standard-dose thoracic radiation therapy? The...

lung cancer

No Benefit of High- vs Standard-Dose Radiotherapy or Addition of Cetuximab to Chemoradiation in Stage IIIA/IIIB NSCLC

As reported in The Lancet Oncology by Jeffrey D. Bradley, MD, of Washington University, and colleagues, the phase III Radiation Therapy Oncology Group 0617 trial showed no survival benefit of high- vs standard-dose radiotherapy or addition of cetuximab (Erbitux) to concurrent...

prostate cancer

Evidence Mounts for Clinical Utility of AR-V7 in Treatment Selection for Advanced Prostate Cancer

The search is on in prostate cancer to identify predictive and prognostic biologic and genomic markers that go beyond traditional ones. Several groups are working in this area. One marker that has received much attention is a splice abnormality in the androgen receptor (AR) called AR-V7. Two...

prostate cancer

Androgen-Deprivation Therapy Added to Radiation Therapy Improves Disease Control in Intermediate-Risk Prostate Cancer

The addition of 6 months of androgen-deprivation therapy to radiation therapy as primary therapy for intermediate-risk prostate cancer improved biochemical control and disease-free survival but did not translate to an improvement in overall survival, in a phase III trial reported at the 2015...

breast cancer
issues in oncology

Should Oncologists Be Ordering Breast Cancer Gene Panels?

Two oncologic surgeons squared off at the 32nd Miami Breast Cancer Conference to debate whether breast cancer genetic susceptibility panel testing is ready for routine use in the clinic. J. Michael Dixon, MD, Professor of Surgery and Consultant Surgeon at the Edinburgh Breast Unit in the United...

breast cancer

Immune Gene Profile Strongly Associated With Benefit of Adjuvant Trastuzumab in HER2-Positive Breast Cancer

In a study reported in the Journal of Clinical Oncology, Edith A. Perez, MD, of the Mayo Clinic, Jacksonville, and colleagues found that an immune function gene profile was associated with significantly improved relapse-free survival among patients with early-stage HER2-positive breast cancer who...

kidney cancer

No Survival Benefit From Adjuvant Sorafenib or Sunitinib in Kidney Cancer

Adjuvant therapy with sorafenib (Nexavar) or sunitinib (Sutent) failed to make any inroads in improving disease-free survival in patients with locally advanced kidney cancer in the randomized, placebo-controlled, multicenter, phase III Adjuvant Sorafenib and Sunitinib for Unfavorable Renal...

lymphoma

Objective Response Rate of 44% Among Patients With Relapsed/Refractory DLBCL Receiving Brentuximab Vedotin

A phase II, open-label study evaluating the efficacy of brentuximab vedotin (Adcetris), an anti-CD antibody-drug conjugate, found that among 48 evaluable patients with CD30-positive diffuse large B-cell lymphoma (DLBCL), 21 (44%) had objective responses. These responses included 8 patients (17%)...

gastroesophageal cancer

Too Young to Have Cancer

The first inkling I had that something could be seriously wrong occurred just over a year ago, when I was suddenly inflicted with such severe heartburn it kept me awake at night. Prescriptions from my doctor for ranitidine (Zantac) and meloxicam (Mobic) not only failed to tamp down the fiery pain,...

multiple myeloma

FDA Grants Priority Review to Carfilzomib Supplemental New Drug Application for Relapsed Multiple Myeloma

The U.S. Food and Drug Administration (FDA) has accepted Amgen’s supplemental New Drug Application (sNDA) for carfilzomib (Kyprolis) injection for the treatment of patients with relapsed multiple myeloma who have received at least one prior therapy. The sNDA is designed to support the conversion of ...

gynecologic cancers

FDA Grants Breakthrough Therapy Designation to Rucaparib in Advanced Ovarian Cancer With BRCA Mutations

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to Clovis Oncology’s investigational agent rucaparib as monotherapy treatment of advanced ovarian cancer in patients who have received at least two lines of prior platinum-containing therapy, with ­BRCA-mutated ...

sarcoma

Persistence of HER2-Specific CAR T Cells in HER2-Positive Sarcoma

In a phase I/II study reported in the Journal of Clinical Oncology,1 Nabil Ahmed, MD, MSc, of Baylor College of Medicine, Houston, and colleagues, found that infusion of T cells expressing HER2-specific chimeric antigen receptor (CAR) with a CD28.ζ signaling domain (HER2-CAR T cells) could produce...

breast cancer
survivorship

Breast Cancer Management in Review

With the field of breast oncology as complex as ever, a brief update of the latest findings impacting breast cancer treatment seems timely. To that end, I have assembled highlights from a collection of newsworthy studies featured over the past year and into early 2015. Part 1 of this review, which...

colorectal cancer

Overweight Girls Face Increased Risk of Colorectal Cancer Later in Life

Girls who are overweight as young children and teens may face increased risk for colorectal cancer decades later, regardless of what they weigh as adults, suggests a new study published by Xuehong Zhang, MD, ScD, Instructor at Harvard Medical School, and colleagues in Cancer Epidemiology,...

gynecologic cancers

Complete Regression of Metastatic Cervical Cancer Is Observed After Treatment With HPV-Targeted Tumor-Infiltrating T Cells

As reported in the Journal of Clinical Oncology,1 researchers at the National Cancer Institute observed complete regression of metastatic cervical tumors in two patients following a single infusion of human papillomavirus (HPV)-targeted tumor-infiltrating T cells. In the protocol, nine patients...

breast cancer

Analysis Shows No Link Between Aromatase Inhibitor–Related Musculoskeletal/Vasomotor Symptoms and Relapse-Free Survival

Retrospective analyses of the ATAC, TEAM, and BIG 1-98 adjuvant endocrine therapy trials in breast cancer have suggested that treatment-emergent endocrine symptoms may be associated with superior survival outcomes. In a study reported in the Journal of Clinical Oncology, Vered Stearns, MD,...

issues in oncology

Remembering Dr. Jane Weeks’ Pioneering Work and NCCN’s Outcomes Research Initiative

Jane Carrie Weeks, MD, MSc, a prominent researcher at Dana-Farber Cancer Center, died of cancer on September 10, 2013, at the age of 61. At the time of her death, Dr. Weeks was Professor of Medicine at Harvard Medical School, Professor of Health Policy and Management at the Harvard School of Public ...

issues in oncology

20 Years of NCCN: The Best Is Yet to Come

As the National Comprehensive Cancer Network (NCCN) celebrates its 20th year, The ASCO Post asked its Chief Executive Officer, Robert W. Carlson, MD, to reflect on the organization’s accomplishments, mission, and future and on the role he may have played in its success.  The Early Years You became...

issues in oncology
global cancer care

Noncommunicable Diseases Are the Leading Cause of Death in Low- and Middle-Income Countries

The greatest health threat to people living in low- and middle-income countries is no longer infectious diseases like HIV/AIDS, which has seen a 33% decline in the global rate of new infections since 2001.1 It is the rise of noncommunicable diseases (including cancer, cardiovascular disease, and...

pancreatic cancer

Heal Thy Patient … Reflections on the Human Side of Medicine

Dr. Are extended to me the opportunity to make additional comments about his article. I am the husband of the most wonderful Mrs. X he discusses. As always, Dr. Are’s comments are very kind and generous. Three Roles Based on my experience and observations, I would like to mention three roles a...

breast cancer
issues in oncology

PRIME II and the Omission of Radiation Therapy in Low-Risk, Elderly Patients Undergoing Breast Conservation: The Time Has Come

Despite the high prevalence of breast cancer worldwide, it is important to recognize that > 40% of all cases occur in women aged 65 years or older in both the United States and the United Kingdom.1,2 Breast cancers in older patients are more often associated with indolent features and with...

integrative oncology
palliative care

Escalation of Oncology Services at End of Life May Be Moderated by Coordinated Care

“Use of oncology-related services is increasingly scrutinized, yet precisely which services are actually rendered to patients, particularly at the end of life, is unknown,” noted an article in the Journal of Oncology Practice. To address this knowledge gap, Eijean Wu, MD, of the Los Angeles County...

cns cancers

Clinical Trials Actively Recruiting Patients With Neuroblastoma

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with newly diagnosed or relapsed or refractory neuroblastoma. The studies include pilot, observational, phase I, phase II, and phase III trials investigating single-agent and...

breast cancer

Cancer Has Left an Indelible Mark on Me

Even though today I’m cancer-free, the experience of getting a cancer diagnosis and going through treatment leaves an indelible mark on your psyche—as well as your body—that time doesn’t erase. Once you have cancer, you become a cancer survivor, and that status doesn’t change. I’ve known many...

Maintenance of Certification Activities: Earn Points at the ASCO Annual Meeting

The 2015 ASCO Annual Meeting will feature three activities to help attendees earn American Board of Internal Medicine (ABIM) Maintenance of Certification (MOC) points while onsite. Annual Meeting Practice-Centered Session MOC Self-Assessment Activity This activity is designed for attendees who want ...

issues in oncology
breast cancer

Informing Decision-Making About Mammography Screening

Overdiagnosis associated with breast cancer screening has been the subject of much attention in recent years. The notion that cancer screening—largely believed to be beneficial—could actually be harmful is simultaneously fascinating and difficult to believe. With the publication of multiple studies ...

breast cancer
issues in oncology

Impact of Informed Decision-Making on Breast Cancer Screening

In a study reported in Lancet, Jolyn Hersch, MApplSc, of the University of Sydney, and colleagues found that use of a decision aid containing information on overdetection in breast cancer screening was associated with an increased rate of informed choice regarding screening, a reduced rate of...

lymphoma

Brentuximab Vedotin After Autologous Stem Cell Transplantation in High-Risk Hodgkin Lymphoma: Implications of the AETHERA Trial

Hodgkin lymphoma is generally thought to be a malignancy with a favorable prognosis. Overall, approximately 80% of patients will have durable, long-term remissions with initial chemotherapy. Some patients, however, demonstrate evidence of disease progression, and these patients usually receive...

lymphoma

Improved Progression-Free Survival With Brentuximab Vedotin After Transplantation in Hodgkin Lymphoma Patients

In the phase III AETHERA trial reported in The Lancet, Craig H. Moskowitz, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that brentuximab vedotin (Adcetris) consolidation therapy after autologous stem cell transplantation prolonged progression-free survival by 18 months vs...

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