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Showing 11051 - 11100The Lawless and Uncertain World of Medicine
Bookmark Title: The Laws of Medicine: Field Notes From an Uncertain Science Author: Siddhartha Mukherjee Publisher: TED Books/Simon & Schuster Publication date: October 13, 2015 Price: $16.99; hardcover, 96 pages The Emperor of All Maladies, written by the Indian-born American oncologist...
How to Help Mentees Succeed
Although formal mentoring programs in medical education were not launched in the United States until the late 1990s,1 today they are regarded as playing an essential role in the career development of medical trainees and have been associated with improvements in research, teaching, and patient...
Acute Myeloid Leukemia in the Elderly: Trial Data Stir Hope for the Transplant Option
Older patients with acute myeloid leukemia (AML) have high relapse rates after induction chemotherapy, low survival rates, and fewer treatment options compared with younger patients. One of the options for both younger and older patients is hematopoietic cell transplantation, but relatively few...
ASCO Guides Members Through MACRA Implementation With a Robust Set of New Resources
The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), passed earlier this year, repealed the fundamentally flawed Sustainable Growth Rate formula and introduced significant changes in how Medicare will pay oncologists for the care they provide in the coming years. The new law will be...
The Promise of Immune Checkpoint Blockade in Cancer Therapy
The concept of using activation of the innate immune system and an inflammatory response against a bacterial component to instigate an antitumor response was studied in the 1960s, which led to the development of intravesical bacillus Calmette-Guérin, now used in the treatment of superficial bladder ...
A: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System
Question 1: Based on the rationale for the current “standard of care” for primary diffuse large B-cell lymphoma of the CNS, what is the optimal induction therapy? Correct Answer: C. A high-dose methotrexate–based regimen. Expert Perspective Untreated primary diffuse large B-cell lymphoma of the CNS ...
St. Jude Opens First Proton Therapy Center for Children
St. Jude Children’s Research Hospital has opened the St. Jude Red Frog Events Proton Therapy Center, the first proton therapy center in the world dedicated solely to children with cancer. Patients are now being treated at the center using precisely delivered, high-energy protons to kill or shrink...
Necitumumab in Metastatic Squamous Non–Small Cell Lung Cancer
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 November 24, 2015, necitumumab (Portrazza) was approved for use ...
ASCO Endorsement of ACCP Guideline on Treating SCLC: Moving Forward to Better Outcomes in Oncology
In the current climate of rising health-care costs, particularly in the field of oncology, clinical guidelines provide a crucial tool to guide practitioners in evidence-based care and to improve the quality and consistency of care.1 The ASCO review and endorsement of the American College of Chest...
Ductal Carcinoma in Situ and Relevant Endpoints for Omission of Standard Treatments: Are We There Yet?
The optimal management strategy for ductal carcinoma in situ has become increasingly controversial with respect to potential overdiagnosis and overtreatment. Much of the controversy for ductal carcinoma in situ stems from its exceptional breast cancer–specific survival, which approaches close to...
Surgical Excision Without Radiation Therapy in Women With Low-Risk Ductal Carcinoma in Situ
Lawrence J. Solin, MD, of Albert Einstein Healthcare Network, Philadelphia, and colleagues reported the 12-year results from the ECOG-ACRIN E5194 trial in the Journal of Clinical Oncology. Among women with ductal carcinoma in situ with low-risk clinical and pathologic characteristics, they found...
Minimally Invasive Surgery for Rectal Cancer: An Evolving Issue
Over 10 years ago, we welcomed a new approach to cancer surgery when the 2004 COST trial demonstrated the benefits of laparoscopic compared with open surgery for colon cancer. This randomized trial of 872 patients showed improved perioperative recovery with laparoscopic colectomy without...
Phase III Trials Fail to Show Noninferiority of Surgical Outcome for Laparoscopic vs Open Resection in Rectal Cancer
Two phase III trials, reported in JAMA by James Fleshman, MD, of Baylor University Medical Center, Dallas, and colleagues1 and Andrew R. Stevenson, MBBS, FRACS, of the University of Queensland, Brisbane, Australia, and colleagues,2 failed to show noninferiority of surgical outcome for laparoscopic...
ASTRO Launches Template to Help Radiation Oncologists Guide Cancer Survivors Through Ongoing Care
A new template published by the American Society for Radiation Oncology (ASTRO) standardizes and streamlines the creation of patient-focused plans for long-term cancer survivor care following radiation therapy. As the number of cancer patients and survivors in the United States continues to...
Clinical Trial System Badly in Need of Overhaul, Say Panelists at Friends-Brookings Conference
Cancer clinical trials in three distinct phases, as they have been conducted for decades, are probably no longer the best way to bring a drug or biologic agent to market. This was the consensus of three panels at the 8th Annual Conference on Clinical Cancer Research convened by Friends of Cancer...
Optimizing the Treatment of HIV-Associated Lymphoma
Non-Hodgkin lymphoma (NHL) associated with human immunodeficiency virus (HIV) infection generally can be treated the same as lymphoma in non–HIV-infected patients, with a few caveats, according to Lawrence D. Kaplan, MD, of the Helen Diller Family Comprehensive Cancer Center of the University of...
More, Earlier, and Better Goals-of-Care Conversations at the End of Life Are Feasible
An intervention called the Serious Illness Care Program helps clinicians to conduct more, earlier, and better conversations about goals of care with their seriously ill patients, according to Rachelle E. Bernacki, MD, MS, who presented the preliminary results of a study using this approach at the...
Promising Upfront Combination in Older Patients With Acute Lymphoblastic Leukemia
Frontline treatment with the antibody-drug conjugate inotuzumab ozogamicin plus deintensified chemotherapy is a promising option for older patients with Philadelphia chromosome–negative acute lymphoblastic leukemia (ALL). Phase II results suggest that this combination has the ability to improve...
Midostaurin: A New Standard of Care in Acute Myeloid Leukemia?
Upfront treatment with midostaurin added to standard chemotherapy improved survival compared with placebo plus chemotherapy in high-risk patients with acute myeloid leukemia (AML) characterized by FLT3 mutations. No new drugs have been approved for AML since 1990, and midostaurin is the first...
Ibrutinib Bests Standard of Care for Elderly Patients With CLL
First-line treatment with the Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) significantly reduced the risk of dying or disease progression compared with chlorambucil (Leukeran) in older treatment-naive patients with chronic lymphocytic leukemia (CLL) in the RESONATE-2 trial. At the time...
Expert Point of View: Virginia Kaklamani, MD
Press conference moderator Virginia Kaklamani, MD, commented on these results from the ABCSG-18 trial: “It’s pretty clear that 3 years of adjuvant denosumab not only reduced fracture risk but improved disease-free survival. It’s also pretty clear that adjuvant bisphosphonates improve disease-free...
Adjuvant Denosumab Improves Disease-Free Survival in Estrogen Receptor–Positive Postmenopausal Breast Cancer
There is good news about denosumab (Prolia). The primary analysis of the ABCSG-18 trial showed that adjuvant denosumab (given at low doses) reduces the risk of clinical fracture by 50% in postmenopausal women with early breast cancer who are taking an aromatase inhibitor.1 More good news is that...
Patients With Incomplete Response to Neoadjuvant Chemotherapy Benefit From Capecitabine
Treatment with capecitabine increased disease-free and overall survival in breast cancer patients with residual disease after neoadjuvant chemotherapy, according to a study reported by researchers from Japan and Korea at the 2015 San Antonio Breast Cancer Symposium.1 “It has been unclear whether...
A Shot to End Cancer: HPV Vaccination
As health-care providers, we have an obligation and a responsibility not only to care for our patients, but also to educate them—and the general public—about their cancer risk and ways to reduce or prevent it. We are living in the golden era of cancer prevention and treatment, made possible by...
Impressive Results With Daratumumab Plus Lenalidomide/Dexamethasone in Multiple Myeloma
The anti-CD38 monoclonal antibody daratumumab (Darzalex) took center stage among multiple myeloma studies presented at the 57th American Society of Hematology Annual Meeting and Exposition. In relapsed/refractory patients, daratumumab plus lenalidomide (Revlimid)/dexamethasone yielded an 81%...
New Study Suggests Benefits of Regular Mammography Extend to the Elderly
Breast cancer afflicts 1 in 8 women in their lifetime, and 1 in 25 die from this disease. Although a number of randomized trials have demonstrated the clear benefits of mammography screening in women up to age 74 on reducing mortality, data are sparse in women over age 74, especially among...
Tumor Tissue Specimens and Associated Analyses Appear to Be a Significant Barrier to Clinical Trial Enrollment
The requirement for tumor tissue specimens and associated analyses in order to participate in clinical trials appears to be a significant barrier to clinical trial enrollment and may delay treatment. Potential solutions to reducing or eliminating these barriers include routine tissue banking at...
Travel Distance Is Still a Barrier to Breast Reconstruction After Mastectomy
Long travel distances continue to be a significant obstacle to breast reconstruction after mastectomy for breast cancer, according to a study published by Abornoz et al in Plastic and Reconstructive Surgery. “While greater patient awareness and insurance coverage have contributed to greater...
Study Reports Improved Survival With Lapatinib and CapeOx in Asian and Younger Patients With HER2-Positive Advanced Gastroesophageal Adenocarcinoma
In a phase III trial (TRIO-013/LOGiC) reported in the Journal of Clinical Oncology, Hecht et al found that the addition of lapatinib (Tykerb) to capecitabine-oxaliplatin (CapeOx) in patients with previously untreated HER2-amplified advanced gastroesophageal adenocarcinoma did not improve overall...
James Foran, MD, on Clofarabine for AML: Clinical Trial Results of ECOG-ACRIN and ALFA/Clara
James Foran, MD, of the Mayo Clinic Cancer Center, discusses two key studies on clofarabine: as a single agent for induction and postremission therapy in newly diagnosed AML, and as the basis for consolidation in nonfavorable AML (Abstracts 217 and 218).
ESMO Asia 2015: Results From the KEYNOTE-010 Trial Show Pembrolizumab Benefit in Patients With NSCLC
More patients with advanced non–small cell lung cancer (NSCLC) could benefit from pembrolizumab (Keytruda), said Roy Herbst, MD, PhD, Chief of Medical Oncology at Yale Cancer Center and Smilow Cancer Hospital at Yale-New Haven. Dr. Herbst presented promising results from the pivotal phase...
ESMO Asia 2015: Immunotherapy and Targeted Therapy Provide New Options for Difficult-to-Treat Head and Neck Cancer
Novel strategies are being explored for difficult-to-treat and advanced head and neck cancer—the most heterogeneous group of malignancies that are generally associated with poor survival—and encouraging results have been presented in two trials at the first European Society for Medical...
FDA Expands Pembrolizumab Label to Include Approval in Initial Treatment of Unresectable or Metastatic Melanoma
On December 18, 2015, the U.S. Food and Drug Administration (FDA) expanded the pembrolizumab (Keytruda) label to include approval of the drug for the treatment of patients with unresectable or metastatic melanoma. This expansion now includes the initial treatment of patients with unresectable or...
Higher BMI Associated With Increased Risk of Breast Cancer–Related Lymphedema
Each year, about 1.38 million women worldwide are diagnosed with breast cancer. Advances in treatment have facilitated a 90% 5-year survival rate among those treated. Given the increased rate and length of survival following breast cancer, more and more survivors are facing a lifetime risk of...
New ‘Condensed’ Grading System Shown to Be Accurate for Predicting Prostate Cancer Outcomes
Using information gleaned from more than 20,000 men, researchers at Johns Hopkins have affirmed the value of their alternative system for assessing the likelihood of growth and spread of prostate cancer. The new grading system, they said, is not only easier to use and understand, but also more...
FDA Approves Alectinib for Advanced ALK-Positive NSCLC
The U.S. Food and Drug Administration (FDA) today granted accelerated approval to alectinib (Alecensa) for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC) who have had disease progression on or are intolerant to crizotinib (Xalkori). ...
Homologous Recombination Deficiency Diagnostic Test Helps Identify Patients With Breast Cancer Likely to Respond to Platinum-Based Therapy
Two studies evaluating the ability of myChoice HRD, a homologous recombination deficiency (HRD) test, to identify patients with breast cancer who are likely to respond to platinum-containing therapies have found that the test is effective in optimizing therapy selection for patients. The diagnostic ...
FDA Approves Uridine Triacetate for Emergency Treatment of Fluorouracil or Capecitabine Overdose
The U.S. Food and Drug Administration (FDA) today approved uridine triacetate (Vistogard) for the emergency treatment of adults and children who receive an overdose of the cancer treatment fluorouracil (5-FU) or capecitabine, or who develop certain severe or life-threatening toxicities within...
SABCS 2015: Ado-Trastuzumab Emtansine Improved Overall Survival for Heavily Pretreated Patients With HER2-Positive Breast Cancer
Among patients with HER2-positive, metastatic breast cancer that had progressed despite treatment with two or more forms of HER2-targeted therapy (trastuzumab [Herceptin] and lapatinib [Tykerb]), median overall survival was increased for those treated with ado-trastuzumab emtansine (aka T-DM1...
SABCS 2015: No Significant Difference in Recurrence Rates Among Women With Ductal Carcinoma in Situ Taking Anastrozole or Tamoxifen
Postmenopausal women with ductal carcinoma in situ (DCIS) had similar outcomes with disease recurrence whether they took tamoxifen or the aromatase inhibitor anastrozole for 5 years after surgery, but women in the two groups had different side effects, according to results from the phase III...
Repeating Abnormal PSA Tests Reduces Number of Unnecessary Biopsies
For more than 20 years, the prostate-specific antigen (PSA) test has been used to help screen for prostate cancer. However, in recent years, some task forces have called for this blood test to be abandoned because it leads to many unnecessary biopsies. Now, a new study from The Ottawa Hospital and...
SABCS 2015: Patients With Ductal Carcinoma in Situ Receiving Anastrozole Reported Symptoms Different From Those in Patients Receiving Tamoxifen
Analysis of patient-reported outcomes, a secondary endpoint of the phase III NSABP B-35 clinical trial, in which anastrozole and tamoxifen were compared in postmenopausal women with ductal carcinoma in situ (DCIS) who underwent lumpectomy plus radiotherapy, found that there were no differences in...
SABCS 2015: ESR1 Gene Mutations Are Associated With Worse Overall Survival in Metastatic ER-Positive Breast Cancer
A study by Chandarlapaty et al investigating whether mutations in the estrogen receptor are common in patients with advanced breast cancer and how they affect patient outcomes has found that the D538G and Y537S mutations in the estrogen receptor 1 (ESR1) gene are prevalent in patients with advanced ...
SABCS 2015: Mastectomy Plus Reconstruction Has Higher Complication Rates and Costs Than Lumpectomy Plus Radiation
Among the various guideline-concordant local therapy options available for women with early-stage breast cancer in the United States, mastectomy plus reconstruction had the highest complication rates and complication-related costs for both younger women with private insurance and older women on...
SABCS 2015: Women With Luminal A Breast Cancer Did Not Benefit From Adjuvant Chemotherapy in Phase III Trial
Premenopausal women whose invasive breast cancers were of the luminal A subtype had comparable 10-year disease-free survival rates, regardless of whether or not they received adjuvant chemotherapy, according to data from the phase III Dutch Breast Cancer Cooperative Group (DBCG77B) clinical trial...
Improved Overall Survival With Addition of Nanoliposomal Irinotecan to Fluorouracil/Leucovorin in Metastatic Pancreatic Cancer
In the phase III NAPOLI-1 trial reported in The Lancet, Wang-Gillam et al found that the addition of nanoliposomal irinotecan (Onivyde) to fluorouracil (5-FU) and folinic acid (leucovorin) resulted in improved overall survival in patients with metastatic pancreatic ductal cancer who had received...
ASH 2015: Updated Results of the Phase I/II GEN503 Study of Daratumumab in Multiple Myeloma
In a study update presented by Plesner et al at the 57th American Society of Hematology (ASH) Annual Meeting, daratumumab (Darzalex) was shown to be safe and effective in combination with lenalidomide (Revlimid) and dexamethasone in patients with relapsed/refractory multiple myeloma (Abstract 507). ...
ASH 2015: Young Adults With Acute Lymphoblastic Leukemia Have Encouraging Survival With Pediatric Chemotherapy Regimen
Using a pediatric chemotherapy regimen to treat young adults with acute lymphoblastic leukemia (ALL) significantly improved their outcomes compared to what has historically been achieved with “adult” treatment protocols, report Dana-Farber Cancer Institute scientists. Overall survival...
ASH 2015: High Response Rates, Long-Term Remissions in Relapsed/Refractory Pediatric ALL, Lymphomas After CTL019 Immunotherapy
Ninety-three percent of pediatric patients (55 of 59) with relapsed/refractory acute lymphoblastic leukemia (ALL) went into remission after receiving an investigational therapy made from their own immune cells, with continuous remissions of over 1 year in 18 patients and over 2 years in nine...
Depressed Head and Neck Cancer Patients 3.5 Times Less Likely to Survive, Have Higher Recurrence Risk
Depression is a significant predictor of 5-year survival and recurrence in head and neck cancer patients, according to a new study from The University of Texas MD Anderson Cancer Center. These findings, published by Shinn et al in Psychosomatic Medicine, represent one of the largest reported...
