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integrative oncology

Getting Results: How Oncologists and Pathologists Can Work Together to Facilitate Molecular Testing

Advances in molecular testing mean that highly specific information can be detailed about the molecular characteristics of a patient’s tumor, as well as indications of potential responsiveness to targeted therapy. But getting those detailed results from the pathologists can be a challenge to many...

solid tumors

The Evolving Role of Surgery in Germ Cell Tumors

Over the past several decades, the role of postchemotherapy surgery for advanced testicular cancer has evolved with regard to patient selection, surgical planning, lymph node dissection, and surgical technique. To add clarity to this complex clinical setting, The ASCO Post recently spoke with...

gastroesophageal cancer
palliative care

No Overall Survival Improvement but Some Palliative Benefit With Gefitinib in Esophageal Cancer Progressing Postchemotherapy

In what may be the first randomized trial of systemic therapy in this setting, Susan J. Dutton, MSc, of University of Oxford, United Kingdom, and colleagues evaluated the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor gefitinib vs placebo in patients with esophageal cancer...

lymphoma

First Prospective Study of Rare Lymphoma Shows Promising but Inconclusive Results With DA-EPOCH-R

Presenting “the first prospective study” of mediastinal gray zone lymphoma, researchers from the National Cancer Institute reported that DA-EPOCH-R (infusional dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine, prednisone, and rituximab (Rituxan) and filgrastim (Neupogen)...

Royal Society Presents 2014 Royal Medal to Tony Hunter, PhD, FRS, Salk Professor

Tony Hunter, PhD, FRS, has been awarded the 2014 Royal Medal for Biological Sciences by the Royal Society, an international fellowship of scientists based in the United Kingdom. The award recognizes Dr. Hunter, Director of Salk Institute Cancer Center in San Diego, for his contributions to the...

survivorship

Cancer Has Given Me Courage

In 1986, I was pregnant with my third child and excited to be interviewing for a job on the assembly line at a General Motors plant near my home in Brodhead, Wisconsin. Hiring requirements included a physical examination and a chest x-ray, which was done by my obstetrician to avoid any radiation...

kidney cancer

Ongoing Clinical Trials Actively Recruiting Patients With Kidney Cancer

The information in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with kidney cancer. The list includes a pilot study and observational, randomized, and nonrandomized phase II and phase III studies evaluating new therapies, combination therapies,...

lung cancer

Lung Screening–Detected Abnormalities Other Than Cancer Result in Smoking Cessation: National Lung Screening Trial Analysis

In a study reported in the Journal of the National Cancer Institute, Martin C. Tammemägi, PhD, of Brock University, Ontario, and colleagues assessed smoking cessation rates among participants undergoing chest x-ray or computed tomography (CT) screening for lung cancer in the National Lung Screening ...

issues in oncology

Quest for Targeted Therapeutic ‘Cocktails’ Hits Roadblocks

The use of cutting-edge technology and bioinformatics to inform clinical decision-making in oncology is still a ways off, according to Mark Pegram, MD, the Susy Yuan-Huey Hung Professor of Oncology and Director of the Stanford Breast Oncology Program, Stanford University, Palo Alto, California. At...

lymphoma

International Group Updates Recommendations on Managing Lymphoma

An international multidisciplinary group of experts has updated their recommendations for staging and treatment response assessment in patients with Hodgkin and non-Hodgkin lymphomas. Bruce D. Cheson, MD, Professor of Medicine, Deputy Chief of Hematology-Oncology, and Head of Hematology at the...

bladder cancer

No Difference in Complication Rates or Hospital Stay With  Robot-Assisted vs Open-Surgery Cystectomy in Bladder Cancer

Retrospective analyses indicate that robot-assisted laparoscopic surgery for radical cystectomy in patients with bladder cancer is associated with reduced risk of complications and shorter hospital stay compared with open surgery. In a small single-institution randomized trial reported in a letter...

issues in oncology
health-care policy

9/11 and Cancer: What Do We Know?

On September 11, 2001, the devastating terrorist attack that destroyed the World Trade Center left in its wake a unique toxic site in both mass and quantity of hazardous materials. It took 9 months to remove approximately 2 million tons of wreckage from Ground Zero, during which thousands of...

sarcoma

Social Media Is Helping Me Cope With Cancer

Despite a diagnosis in August 2013 of stage III high-grade spindle cell sarcoma and subsequent disease recurrence, I’m mindful of how fortunate I am that my cancer was found before widespread metastases could take hold, making treatment futile. It was just happenstance, 2 months before, on a long...

lymphoma

Exciting Highlights in Several Types of Lymphoma Presented at Best of ASCO

Antibody-drug conjugates are being tested against several types of lymphomas and for some of these agents, “activity is quite impressive,” Andrew M. Evens, DO, MSc, reported at the recent Best of ASCO meeting in Chicago. Dr. Evens, Professor of Medicine, Chief, Division of Hematology/Oncology, and...

Expert Point of View: Florian Scotté, MD, PhD

The study was well performed and was a good representative sample of patients with cachexia,” said formal discussant Florian Scotté, MD, PhD, a medical oncologist in the Department of Oncology at the Georges Pompidou European Hospital, Paris, regarding the study presented by Temel et al at the ESMO ...

lung cancer
palliative care

Novel Oral Agent Treats Cachexia in Patients With Non–Small Cell Lung Cancer

For the first time, studies show that a drug is effective in treating several domains of cancer-related cachexia. Oral anamorelin increased lean body mass, achieved weight gain, and improved quality of life in patients with cancer-related cachexia in two pivotal phase III studies presented together ...

breast cancer

High-Risk Benign Breast Lesions: Some Patients Can Avoid Surgery

High-risk atypical benign breast lesions are upgraded to cancer in more than 15% of patients, but the routine excision of such lesions is probably unnecessary. At the 2014 Breast Cancer Symposium in San Francisco, researchers presented information that could guide the selection of patients who...

issues in oncology

A Father and Son’s Journey Through Medicine

BOOKMARK Title: The Good Doctor: A Father, a Son, and the Evolution of Medical EthicsAuthor: Barron H. Lerner, MDPublisher: Beacon PressPublication date: May 13, 2014Price: $25.95; hardcover, 240 pages   One morning in 1996, an infectious disease specialist was making rounds when he and his team...

lung cancer

X-Ray of Metastatic Carcinoma of the Lungs, Washington, DC, 1924

One hundred years ago, primary lung cancer was considered a rarity, with only a few hundred cases acknowledged in the world literature. Until the middle of the 1920s, medical textbooks by noted authors continued to label the disease “rare,” although metastatic lung disease was recognized and...

David G. Nathan, MD, Wins Lifetime Impact Award at Boston Children’s Hospital Innovation Summit

David G. Nathan, MD, President Emeritus of Dana-Farber Cancer Institute and Physician-in-Chief Emeritus of Boston Children’s Hospital, was recently honored as the inaugural recipient of the Boston Children’s Hospital Lifetime Impact Award at the Hospital’s second Annual Global Pediatric Innovation...

breast cancer

Noteworthy Abstracts From the Breast Cancer Symposium Include Studies of Novel Therapies and of the Impact of Disease Subtypes on Outcomes

More than 150 oral and poster presentations were featured at the 2014 Breast Cancer Symposium, held September 4–6 in San Francisco. The multidisciplinary meeting is sponsored by ASCO, the American Society of Breast Disease, American Society of Breast Surgeons, American Society for Radiation...

cost of care

Overutilization a Key Target in Efforts to Control Health-Care Costs

Overutilization of health-care interventions has become a prime target of efforts to rein in health-care costs. Overtreatment of cancer patients is associated with a number of common harms to the patient—not just financial harm to the health-care system. At the recent ASCO Quality Care Symposium in ...

Hyperthermia Reduces Gemcitabine Resistance

Removal of incorporated gemcitabine by DNA repair mechanisms may contribute to resistance to the agent in solid tumors. In a study reported in Journal of the National Cancer Institute, Raoof and colleagues found that radiofrequency-induced hyperthermia blocked repair of gemcitabine-stalled...

issues in oncology
thyroid cancer

South Korean Study Sparks Warnings About the Hazards of Overscreening

An “epidemic of diagnosis” of thyroid cancer is occurring in South Korea and “absolutely could happen here,” according to H. Gilbert Welch, MD, MPH, Professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire. Dr. Welch is coauthor of an article...

Preoperative Rodent Cancer: Patient of Charles Moore, MD, Albumen Print, London, 1864

A disease more repulsive and distressing can hardly be conceived than a Rodent Cancer of the face. Commencing in some trifling manner in the skin, and then sometimes producing so little irritation as scarcely to attract notice, it spreads abroad in all directions with a slow but unswerving advance. ...

solid tumors

Predicting Immunogenic Tumor Neoantigens With Combined Mass Spectrometry and Exome Sequencing

Peptides containing tumor somatic mutations are potentially immunogenic if presented on major histocompatibility complex class I molecules (MHC-I), and it has been shown that such mutant peptides act as T-cell epitopes.  In a study reported in Nature, Yadav and colleagues developed an approach...

Expect Questions About Cancer Cachexia From Patients and Family Members

Cachexia is estimated to be the immediate cause of death in 20% to 40% of cancer patients,” and by the time of diagnosis, “60% of patients with lung cancer have already experienced a significant weight loss, according to the National Cancer Institute.1 “All of us who have treated these patients...

supportive care
lung cancer
symptom management

Appetite-Enhancing Agent Helps Patients Treated for NSCLC Gain Weight and Lean Body Mass and Feel Better

People have an image of stage III or IV lung cancer patients getting chemotherapy or chemoradiation, and they look terrible; they are losing weight. The fact is, when they respond, they can gain weight,” according to Philip Bonomi, MD, MS. He is the lead author of a phase III study showing that the ...

health-care policy

Policy Issues in Molecularly Targeted Therapy: The Science, the Money, the Applications

In the past decade, much new knowledge about the molecular underpinnings of cancer has accumulated, and the array of molecular aberrations in each individual tumor can be assessed through genomic sequencing and other tests. The rationale for and feasibility of developing molecularly targeted...

breast cancer

Mammographic Density Is Highly Heritable, Possibly Explaining the Familial Aggregation of Breast Cancer

Using a fully automated method to ascertain volumetric mammographic density, a study conducted by the Karolinska Mammography (KARMA) project for risk prediction of breast cancer in Sweden confirmed the high heritability of mammographic density, although estimates were weaker for absolute than for...

colorectal cancer

AJCC Cancer Staging System Is Most Accurate Measuring Response to Chemoradiation in Locally Advanced Rectal Cancer

When classifying response to chemoradiation among patients with locally advanced rectal cancer, the American Joint Committee on Cancer (AJCC) Cancer Staging Manual (7th edition) system “is most accurate and should be adopted as the standard,” Attaphorn Trakarnsanga, MD, and colleagues at Memorial...

leukemia

Victory for Pediatric Regimens in Adolescents and Young Adults With ALL

Long in the works, early results of the U.S. Intergroup C10403 trial clearly showed that treating acute lymphoblastic leukemia (ALL) in adolescents and young adults using a pediatric-inspired regimen improves event-free survival and overall survival and should be the backbone for future studies in...

gastroesophageal cancer

High Genetic Propensity to Obesity Raises Risk of Esophageal Adenocarcinoma

“People with a high genetic propensity to obesity have higher risks of esophageal metaplasia and neoplasia than people with a low genetic propensity,” according to analyses of data from the Barrett’s and Esophageal Adenocarcinoma Genetic Susceptibility Study. “These analyses provide the strongest...

breast cancer

Mammographically Dense Breasts Highly Prevalent Among American Women

A study on the prevalence of mammographically dense breasts in the United States “estimated that approximately 43% of women aged 40 to 74 years have heterogeneously or extremely dense breasts, corresponding to approximately 27.6 million U.S. women,” researchers reported in the Journal of the...

gastrointestinal cancer

Minimally Invasive Techniques Used to Address Small GIST Lesions

Surgeons at the cutting edge are offering minimally invasive resection to patients with small gastrointestinal stromal tumors (GISTs) deemed to be low-risk, according to panelists at a session of the American College of Surgeons 2014 Clinical Congress in San Francisco. “We are seeing more small...

breast cancer

Atypical Hyperplasia as a Predictor of Future Breast Cancer: Focus on Chemoprevention and Screening

Atypical hyperplasia of the breast has “special importance as a predictor of future breast cancer,” according to a special report in The New England Journal of Medicine.1 That special importance is based on the high incidence of atypical hyperplasia—found in around 10% of the 1 million breast...

breast cancer
colorectal cancer
hepatobiliary cancer
lung cancer

Twenty Years After a Diagnosis …  and Counting

In 1995, I was diagnosed with advanced colorectal cancer and given little chance to live. The dire diagnosis came years after being assured by several physicians that the problem I was having with rectal bleeding and anemia was nothing more than the result of an internal hemorrhoid. Busy raising...

lymphoma

Tailoring Therapy for Diffuse Large B-Cell Lymphoma by Interim PET May Be Problematic

In a study that reflected clinical practice, treatment of diffuse large B-cell lymphoma based on the results of interim positron-emission tomography (PET) was feasible; however, switching PET-positive patients to an alternative treatment still resulted in inferior treatment outcomes, and the...

survivorship
gynecologic cancers

Cancer Was My Wake-Up Call to a Healthier Life

I come from strong physical stock and inherited a sort of “tough it out mentality” when it comes to coping with the usual aches and pains that creep up as you age. So by the time I realized that my legs had become so swollen and my breathing so labored it was difficult for me to walk, I could...

Conquer Cancer Foundation Researcher Spotlight

James D. Murphy, MD, MS, Assistant Professor in the Department of Radiation Medicine at the University of California, San Diego, received a 2012 Conquer Cancer Foundation (CCF) of ASCO Young Investigator Award for his research focusing on access to the delivery of palliative radiation therapy. Dr....

hematologic malignancies

Clonal Hematopoiesis With Somatic Mutations Increases Risk of Hematologic Cancer, Mortality, and Cardiovascular Disease

In two studies recently reported in The New England Journal of Medicine,1,2 whole-exome sequencing of DNA from peripheral blood cells of individuals unselected for hematologic phenotype showed that clonal hematopoiesis with somatic mutations is increasingly common with increasing age and is...

cns cancers

Having Cancer So Early in Life Gave Me Purpose

I had every classic brain tumor symptom in the book—severe headaches, dizziness, morning nausea—which plagued me for 16 years, starting when I was 8. In college, if I allowed myself to sleep more than 4 hours a night, the morning headaches, which were centered on the top of my head, were so severe, ...

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...

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,...

Owen N. Witte, MD, Recognized With AACR G.H.A. Clowes Memorial Award

The American Association for Cancer Research (AACR) honored Owen N. Witte, MD, Founding Director of the Eli & Edythe Broad Center of Regenerative Medicine & Stem Cell Research, and Distinguished Professor of Microbiology, Immunology, and Molecular Genetics at the University of California,...

colorectal cancer

Evidence of Recurrence-Free, Disease-Free, and Overall Survival Benefit of Aspirin and COX‑2 Inhibitor Use in Stage III Colon Cancer

In an analysis from the Cancer and Leukemia Group B (CALGB) 89803 adjuvant trial reported in the Journal of the National Cancer Institute, Kimmie Ng, MD, MPH, of Dana-Farber Cancer Institute, Boston, and colleagues found consistent trends suggesting benefit of aspirin use and cyclo-oxygenase-2...

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...

issues in oncology

The Paradox of Positive Thinking

The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

skin cancer

Pembrolizumab vs Ipilimumab: Good vs Better

The treatment landscape for metastatic melanoma has recently undergone a remarkable transformation. Prior to 2011, clinicians and patients were presented with difficult decisions between therapies without proven survival benefit. Now, similarly difficult but much more hopeful choices are posed...

skin cancer
breast cancer
multiple myeloma
leukemia
colorectal cancer
prostate cancer
pancreatic cancer

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2015 Updates

For 2 decades, the NCCN Guidelines® have been recognized as the standard of cancer care in the United States, combining evidence, experience, and choice, so that multidisciplinary cancer treatment teams—including patients—are empowered to make informed decisions about cancer care,” said Robert W....

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