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supportive care
cost of care

Palliative Care Offers Greater Cost Savings for Cancer Patients With Multiple Chronic Conditions

Patients with incurable cancer and numerous other serious health conditions who consulted with a palliative care team within 2 days of hospitalization had significant savings in hospital costs, according to a new study led by researchers at the Icahn School of Medicine at Mount Sinai. Published by...

issues in oncology

Report to the Nation Finds Continuing Declines in Cancer Death Rates

Death rates from all cancers combined for men, women, and children continued to decline in the United States between 2004 and 2008, according to the Annual Report to the Nation on the Status of Cancer, 1975-2008. Overall cancer incidence rates among men decreased by an average of 0.6% per year...

issues in oncology

Options for Preserving Fertility Should Be Considered Early to Maximize the Likelihood of Success

Most cancer survivors prefer to have biologic offspring despite concerns about the possible effects of cancer treatment on the child, the child’s lifetime cancer risk, or their own longevity, according to an ASCO panel that developed guidelines on fertility preservation in patients with cancer.1...

gastrointestinal cancer

Salvage Chemotherapy plus Best Supportive Care in Advanced Gastric Cancer

Adding salvage chemotherapy to best supportive care was tolerated and improved overall survival among patients with advanced gastric cancer previously treated with both fluoropyrimidines and platinum, administered simultaneously or concurrently. The authors of the study report, published in the...

prostate cancer

Androgen Deprivation Therapy May Lead to Castration Resistance in Prostate Cancer

Although androgen-deprivation therapy is effective in inducing regression of androgen-dependent prostate cancer, relapse often occurs in an androgen-independent manner and is associated with poor prognosis. The mechanisms underlying castration resistance are not fully understood. Sung and...

Targeted Mutations in ATR Pathway and Implications for Combination Strategies

Many chemotherapy agents work by causing DNA strand breaks or accumulation of DNA replication intermediates. ATR (ataxia-telangiectasia mutated and Rad 3-related protein) is a potential target for combination drug strategies, because signaling of this protein in response to such altered DNA...

issues in oncology

ASCO’s Blueprint Sets Goals for Accelerating Cancer Progress

ASCO recently issued a report, Accelerating Progress Against Cancer: ASCO’s Blueprint for Transforming Clinical and Translational Cancer Research, which outlines the Society’s 10-year plan for improving cancer outcomes. Central to achieving that goal are three steps, including (1) therapy...

colorectal cancer

Cancer Does Not Have to Be a Death Sentence

When I found a large amount of blood on my toilet tissue just before Thanksgiving in 2010, I wasn’t too concerned. At just 45 years old, I was in excellent health, and other than the bloody stool I had no other symptoms signaling that something was seriously wrong. My primary care physician thought ...

lymphoma

New Data Guide Treatment for Rare Form of Hodgkin Lymphoma

Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) accounts for approximately 5% of Hodgkin lymphoma cases. It is distinguished from classic Hodgkin lymphoma by a variety of clinical and pathologic features, including expression of B-cell associated antigens such as CD20. Given that the...

leukemia

Erwinia chrysanthemi Asparaginase for Acute Lymphoblastic Leukemia in Patients with Hypersensitivity to E coli–derived Asparaginase

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. Indication Erwinia chrysanthemi asparaginase (Erwinaze) was...

issues in oncology

FDA Commissioner Statement: Surgeon General’s Report on Youth Smoking

The recent report on “Preventing Tobacco Use Among Youth and Young Adults” by the Surgeon General not only documents the devastating consequences of tobacco use for our nation’s youth, but also represents a clarion call for bold action at every level of government to implement proven strategies to...

supportive care

Update on Novel Anticoagulants: Dabigatran Etexilate

Efficacy and safety of traditional anticoagulants (eg, vitamin K antagonists) are well recognized, given their long-standing use in clinical practice. However, the novel anticoagulants have several potential advantages over the vitamin K antagonists. Even so, in light of their recent introduction...

leukemia

Treating Acute Promyelocytic Leukemia without Chemotherapy

Throughout the course of medical history, we have witnessed innovations that have initially been met with skepticism but have later revolutionized our management of patients with specific disorders. The recent history of oncology drug development is full of instances where a drug that was...

breast cancer

SIDEBAR: International Study Confirms ACOSOG Z0011

Preliminary findings of the International Breast Cancer Study Group (IBCSG) 23-01 trial1 show no benefit for axillary lymph node dissection in patients with only minimally involved sentinel nodes, thereby supporting the results of the American College of Surgeons Oncology Group (ACOSOG) Z0011...

breast cancer

Advances in Axillary Surgery for Patients with Breast Cancer

Results from the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial, which found no benefit for completion axillary nodal dissection in patients with breast cancer involving one to two positive sentinel nodes,1 have led to changes in breast cancer management, though points of...

Expert Point of View: New Biomarker Predicts Survival in Advanced Prostate Cancer

“The Bone Scan Index (BSI) is a very important new quantitative imaging biomarker to help us better assess patients with metastatic prostate cancer in a robust and reproducible way, particularly those with bone-dominant disease,” said Lawrence Schwartz, MD, Chair of the Department of Radiology at...

prostate cancer

New Biomarker Predicts Survival in Advanced Prostate Cancer

Researchers at Memorial Sloan-Kettering Cancer Center have developed the Bone Scan Index (BSI), which is the first quantitative imaging response biomarker that can assess response to treatment and prognosticates for survival in men with metastatic castration-resistant prostate cancer. Based on Bone ...

issues in oncology

2012 Annual Meeting to Highlight NCI’s ‘Provocative Questions’ and Offer First-ever Pre–Annual Meeting Seminars

As this year’s ASCO Annual Meeting was being planned, the NCI was developing and releasing its “Provocative Questions” project—an effort to stimulate the cancer community to ask itself 24 key questions in order to advance the treatment of cancer and provide better care. It quickly became clear to...

breast cancer

2012 Breast Cancer Symposium to Expand Tumor Board Session, Add ‘Meet the Professors’ Session

The days of attending the Breast Cancer Symposium, just quietly listening to useful lectures, and then going home are over. In recent years, the meeting’s sponsors and planners have worked to make the 3-day gathering far more interactive and as intimate as a meeting with 1,500 attendees can be....

SIDEBAR: Lessons Learned from caBIG

The Cancer Biomedical Informatics Grid (caBIG) is an NCI program that was launched in 2004 in reaction to a “health information tsunami,” said Daniel R. Masys, MD, Chair of the caBIG Oversight Committee and Affiliate Professor in the Department of Biomedical Informatics and Medical Education,...

issues in oncology

Cancer Informatics: A Future Necessity, but Challenges Abound

The National Cancer Policy Forum of the Institute of Medicine (IOM) recently convened a workshop on cancer informatics to examine and discuss needs and challenges facing biomedical researchers, which will in turn affect the way oncology is practiced in the future. “This is a time of huge scientific ...

palliative care

Summary of ASCO Provisional Clinical Opinion on Palliative Care

The ASCO provisional clinical opinion on palliative care recently published1 was based largely on data from seven published randomized controlled trials, including a phase III lung cancer trial by Temel and colleagues, which was the trigger for the new recommendations.2 The trial’s principal...

lung cancer

An Expert Shares Insight into the Future of Lung Cancer Treatment

Despite growing national focus on early detection, prevention, and new molecular-based treatments, lung cancer persistently remains the number 1 cause of cancer death for men and women in the United States. The ASCO Post spoke to lung cancer specialist Paul A. Bunn, Jr, MD, Executive Director,...

issues in oncology

Radiation Oncologists Are Discussing Infertility Risks with Young Patients

More than 80% of radiation oncologists discuss the impact of cancer treatments on fertility with their patients of childbearing age. This can lead to improved quality of life for young patients with cancer, according to a study in Practical Radiation Oncology.1 In the past, the clinical focus for...

issues in oncology

NCCN Announces New Guidelines for Adolescent and Young Adult Oncology

The National Comprehensive Cancer Network (NCCN) announced that it has issued new NCCN Clinical Practice Guidelines in Oncology for Adolescent and Young Adult (AYA) Oncology.1 Adolescent and young adult patients are defined in the guidelines as individuals 15 to 39 years of age at initial cancer...

Expert Point of View: SELECT Trial Update: Vitamin E Fails to Prevent Prostate Cancer in Healthy Men, Appears to Increase Risk

According to Adam Kibel, MD, Urology Chair at Brigham and Women’s Hospital in Boston, it would appear to be logical that increasing the doses of vitamin E and selenium would decrease the risk of prostate cancer, since the preponderance of evidence demonstrates that these supplements do so. “The...

prostate cancer

SELECT Trial Update: Vitamin E Fails to Prevent Prostate Cancer in Healthy Men, Appears to Increase Risk

Supplements touted as preventing prostate cancer may turn out to be dangerous, as is evident from updated results of the largest long-term prevention trial, called the Selenium and Vitamin E Cancer Prevention Trial (SELECT). Final analysis of SELECT showed that, compared to placebo, vitamin E alone ...

Expert Point of View: Short-term Hormone Therapy Did Not Increase Risk of Cardiovascular Death in Men with Localized Prostate Cancer, RTOG 94-08 Trial Finds

Oliver Sartor, MD, Medical Director of Tulane Cancer Center, New Orleans, said that in his opinion, RTOG 94-08 had some flaws because outdated radiotherapy doses were employed. “The utility of hormone therapy is questionable with today’s doses,” Dr. Sartor said. “Using standard radiation doses at...

Expert Point of View: Study Shows Concurrent Chemoradiation Therapy to be a Viable Strategy for Muscle-invasive Bladder Cancer

According to Seth P. Lerner, MD, Professor in the Scott Department of Urology at Baylor College of Medicine, Houston, and Co-chair of the session at the Genitourinary Cancers Symposium where the study by Mak and colleagues was presented, the data clearly demonstrate proof of principle that the...

George Kovach, MD, Named as President of the Association of Community Cancer Centers

George Kovach, MD, became President of the Association of Community Cancer Centers (ACCC) at its 38th Annual National Meeting in March 2012. Dr. Kovach is the medical director of the Genesis Cancer Center, Davenport, Iowa, and one of the founding members of the Iowa Oncology Society (IOS). “I am...

Expert Point of View: Controlled Study Links ‘Chemobrain’ to Longitudinal Changes in Brain

Commenting on the study by Deprez et al, Patricia Ganz, MD, noted the importance of the finding for clinicians. “This study tells us that self-reported complaints mapped onto the neuropsychologic tasks; this has not been shown very often,” said Dr. Ganz, who is Director of the Division of Cancer...

gastrointestinal cancer

Survival Analysis by Gastric Cancer Subtypes in AVAGAST Phase III Trial

Subset analysis of the AVAGAST trial, which evaluated the benefit of bevacizumab (Avastin) in advanced gastric cancer, has demonstrated distinct differences in outcomes according to disease subtype, reported Manish A. Shah, MD, of Weill Cornell Medical College and New York Presbyterian Hospital, at ...

gastrointestinal cancer

Targeting KRAS in GI Cancers: The Hunt for the Holy Grail in Cancer Research

The RAS oncogenes are the most frequently mutated class of oncogenes in human cancers, and this has prompted a search for Ras inhibitors to effectively treat tumors with these mutations. Despite intensive efforts, however, none has materialized clinically because K-Ras is proving to be a very...

palliative care

ASCO Releases Palliative Care Provisional Clinical Opinion

ASCO has released a provisional clinical opinion (PCO) addressing the integration of palliative care services into standard oncology care.1 The ASCO Post recently spoke with one of the PCO’s lead authors, Thomas J. Smith, MD, Director of Palliative Care for Johns Hopkins Medicine and the Johns...

issues in oncology

‘We Need an Index of Biologic Aging’

As a retired elderly (soon to be 83-year-old) oncologist, I read the recent article on the subject of geriatric oncology, in the March 15 issue of The ASCO Post, with great interest ("Moving the Field of Geriatric Oncology Forward," by Stuart M. Lichtman, MD, FACP, FASCO.) This was particularly so...

health-care policy

ACCC Meeting Focuses on Affordable Care Act: Its Future, and What It Might Accomplish

The Association of Community Cancer Centers (ACCC) mid-March Annual Meeting devoted several sessions to the Patient Protection and Affordable Care Act: Will it still be here after the Supreme Court decides its fate? If so, how much of it will survive, and how will it affect oncology practice? In...

issues in oncology

Our Patients, Our Teachers

There is no greater professional satisfaction than the knowledge that you have cared for a patient and the care brought an improvement in the patient's health.  Regardless of the level of appreciation, whether the patient is cured or not, and even if the patient's sense of well-being may be...

colorectal cancer

Adding Cetuximab to Adjuvant Therapy with Modified FOLFOX6 Does Not Improve Survival

Adding cetuximab (Erbitux) to adjuvant treatment with mFOLFOX6, the modified sixth version of FOLFOX (leucovorin, fluorouracil, oxaliplatin) did not improve disease-free survival among patients with resected stage III colon cancer, even those with wild-type KRAS, according to a phase III study in...

lung cancer

Nearly 800,000 Lung Cancer Deaths Averted during 1975–2000 Due to Decline in Smoking Rates

The cumulative impact of changes in smoking behavior that started in the mid-1950s averted approximately 795,851 U.S. lung cancer deaths, 552,574 among men and 243,277 among women from 1975 to 2000, according to a report in the Journal of the National Cancer Institute. The researchers also...

colorectal cancer

Quality of Life Is What’s Most Important to Me

For me, getting a cancer diagnosis has been more annoying than frightening. Mainly, I’m annoyed at myself for not taking care of an anal skin tag sooner. (I’d had it since birth.) The growth hadn’t been a problem until I got pregnant with my first child and it became temporarily engorged with...

SIDEBAR: Expect Questions from Your Patients: Cervical Cancer Screening Guidelines

Changes in the cervical cancer screening guidelines, as recommended by the U.S. Preventive Services Task Force (USPSTF), mainly concern longer intervals between screening tests and recommended ages when women should start and stop being screened. USPSTF Co-Vice Chair Michael L. LeFevre, MD, MSPH,...

SIDEBAR: Women Who Received HPV Vaccine Still Need Cervical Cancer Screening

The updated cervical cancer screening guidelines from the the U.S. Preventive Services Task Force (USPSTF) note that women who receive the HPV vaccine still need to be screened for cervical cancer because the vaccine does not protect against all strains of HPV that can cause cervical cancer. “The...

SIDEBAR: Could HPV Testing Be Used Alone?

“In the United States, there are no recommendations currently for HPV screening alone as a primary screening test for cervical cancer,” Michael L. LeFevre, MD, MSPH, Co-Vice Chair of the U.S. Preventive Services Task Force (USPSTF) told The ASCO Post. “Cytology picks up very few cases of...

gynecologic cancers
issues in oncology

New Guidelines Recommend Less Frequent Screening for Cervical Cancer, but That Doesn’t Mean Screening Is Less Important

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. In March 2012, the U.S. Preventive...

solid tumors

Using Imatinib for Adjuvant Treatment after Resection of Kit (CD117)-positive Gastrointestinal Stromal Tumors

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. Indication In January 2012, imatinib mesylate (Gleevec) was granted ...

breast cancer

PEDF Has Cytotoxic Effect on Breast Cancer Cells and Neuron-protective Effect

The cytokine pigment epithelium–derived factor (PEDF) is downregulated in brain metastases of breast cancer by approximately 14-fold compared with primary breast tumors, suggesting that promoting its expression might inhibit metastatic spread. Normal breast epithelial cells express high levels of...

Constructing a Top Five List in Oncology

The American Society of Clinical Oncology has joined the American Board of Internal Medicine (ABIM) Foundation and eight other medical specialty societies to take a collective stand in improving patient care and addressing rising health-care costs. As part of the ABIM Foundation’s Choosing Wisely®...

solid tumors

FDA Approves Investigational New Drug Application for Clinical Testing of Oncology Drug Candidate ME-344

Marshall Edwards, Inc, an oncology company focused on the clinical development of novel therapeutics targeting cancer metabolism, announced that it has received approval from the FDA of its Investigational New Drug (IND) application for ME-344, the Company’s lead mitochondrial inhibitor. The...

issues in oncology

Clinical Findings and Consequences of Distributing Counterfeit Drugs for Hematology and Oncology

As introduced in our report on page 1 of this issue, counterfeit pharmaceuticals are an increasingly important safety concern, and three of the most prominent drug-counterfeiting episodes in recent years have involved hematology/oncology products. Counterfeit Erythropoietin Helen B., a 61-year-old...

colorectal cancer

Expert Point of View: ColoPrint Gene Assay Can Guide Treatment Decisions in Stage II Colon Cancer

Axel Grothey, MD, of the Mayo Clinic, Rochester, Minnesota, told The ASCO Post that he finds the data “intriguing” and that the study exemplifies the value of developing molecular signatures for use in colon cancer. “It identifies patients with an excellent prognosis, who perhaps should not be...

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