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issues in oncology
health-care policy

As Conflicting Guidelines Evolve, Experts Continue to Debate the Merits of Cancer Screening

In the 1930s and 1940s, when the American Cancer Society [ACS] first brought forth the message that early cancer detection saves lives, it was a broad brushstroke and an appropriate message. The problem now is that new technology enables us to find [tumors that would never progress to invasive...

Expert Point of View: Grant McArthur, MB, BS, PhD

Grant McArthur, MB, BS, PhD, Head of the Cancer Therapeutics Program at the Peter MacCallum Cancer Centre in Melbourne, Australia, congratulated the investigators on a rapidly accrued, well-conducted, and ethical study that encouraged crossover to the active arm. He noted that regorafenib is an...

solid tumors

Striking Activity Shown for Regorafenib in Advanced GIST

Regorafenib, an orally administered investigational tyrosine kinase inhibitor that has shown activity in chemorefractory metastatic colorectal cancer, markedly delayed disease progression in patients with treatment-refractory metastatic gastrointestinal stromal tumor (GIST) in the phase III GRID...

thyroid cancer

Differentiated Thyroid Cancer: Who, When, and How to Treat?

Differentiated thyroid cancer—papillary, follicular, and Hürthle cell carcinomas—has historically been managed by endocrinologists, surgeons, and radiation oncologists, but recent progress in the field has led to greater involvement by medical oncologists, especially in the care of patients with...

supportive care
palliative care

Supportive Care Research Runs the Gamut from Genetic Markers of Treatment Side Effects to Neuropathic Pain Therapies

Attendees from around the world gathered for the Multinational Association for Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) International Symposium on Supportive Care in Cancer, held June 28–30 in New York. Below are highlights from the meeting, representing...

leukemia

Novel Agents Should Have Impact in Lymphocytic Leukemias

Agents with novel mechanisms of action may strongly impact outcomes in chronic lymphocytic leukemia (CLL) and acute lymphocytic leukemia (ALL), if data from early-phase studies presented at this year’s ASCO Annual Meeting are any indication. There is a clear unmet need for more effective therapies...

colorectal cancer

FDA Approves Colon-cleansing Drug for Prep Prior to Colonoscopy

The FDA has approved sodium picosulfate, magnesium oxide, and citric acid (Prepopik) to help cleanse the colon in adults preparing for colonoscopy, Ferring Pharmaceuticals announced. The new solution is a low-volume, dual-acting stimulant and osmotic laxative. The FDA approval is based on data from ...

hematologic malignancies

Biokine Therapeutics Awarded FDA Orphan Drug Designation for Mobilization of Stem Cells in Patients with Cancer

Biokine Therapeutics Ltd announced that it has received Orphan Drug designation from the FDA for BKT140, a highly selective chemokine receptor antagonist that induces mobilization of hematopoietic stem cells from bone marrow into peripheral blood for collection and subsequent transplantation in...

colorectal cancer

FDA Approves Ziv-aflibercept for Metastatic Colorectal Cancer

The FDA has approved ziv-aflibercept (Zaltrap) for use in combination with a FOLFIRI (leucovorin, fluorouracil, irinotecan) chemotherapy regimen to treat adults with colorectal cancer. Ziv-aflibercept is an angiogenesis inhibitor that inhibits the blood supply to tumors. It is intended for patients ...

health-care policy

Maintenance of Certification: One Size Should Not Fit All

After a conference call and having returned several phone calls, I again opened my ASCO Medical Oncology Self Evaluation Program (SEP) book hoping to steal an hour to reread the chapter on multiple myeloma, and begin digging deeper into head and neck cancer. It was March 2011, and my Maintenance of ...

prostate cancer
issues in oncology

Rethinking the Role of PSA Screening in Public Health

Population screening to identify preclinical disease is considered a central factor in the decades-long decrease in mortality seen in certain cancers. However, hope in the face of deadly disease can sometimes blind us to the scientific evidence. According to the recent U.S. Preventive Services Task ...

Expert Point of View: James O. Armitage, MD

In an accompanying editorial entitled “Who Benefits From Surveillance Imaging?” James O. Armitage, MD, University of Nebraska Medical Center, Omaha, noted that data on surveillance imaging (CT or PET/CT) indicate a general absence of survival benefit in adults with lymphomas, while pointing out...

lymphoma

Study Shows Routine CT Surveillance Overused in Pediatric Hodgkin Lymphoma

The value of routine CT surveillance monitoring of pediatric patients for recurrence of Hodgkin lymphoma has been unclear. A study of CT surveillance recently reported by Stephan D. Voss, MD, PhD, and colleagues from the Children’s Oncology Group (COG) in the Journal of Clinical Oncology showed...

SIDEBAR: Don’t Expect Questions: Be Proactive with Younger Patients

It is unrealistic to expect adolescents and young adults with cancer to initiate questions about disease-related or or treatment-related issues that are troubling them, according to Bradley Zebrack, PhD, MSW, MPH, Associate Professor of Social Work at the University of Michigan, Ann Arbor....

supportive care

Adolescent and Young Adult Patients Report Unmet Needs for Cancer Information and Psychosocial Support Services

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. Psychosocial care needs are not...

New Agents That Improve Efficacy Can Also Increase Morbidity and Treatment-related Mortality

Newly approved anticancer drugs that lead to improvements in efficacy can also lead to increased morbidity and treatment-related mortality, according to a study in the Journal of Clinical Oncology. The investigators conducted a meta-analysis of 38 randomized controlled trials evaluating agents...

Updated for 2012: Cancer in Older Adults

Tell your patients about Cancer in Older Adults, Cancer.Net’s newly updated booklet for older adults and their family and friends. The content of the booklet is adapted from the ASCO University Module, Cancer Care for Older Patients. It provides information on the physical and emotional changes...

It’s Time to Get Ready for New Medicare Reporting Requirements

As if you didn’t already have enough to worry about, now add this: If your practice doesn’t meet the requirements of the Physicians Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive, you don’t just miss out on the bonuses the programs offered as incentive in recent years....

Conquer Cancer Foundation $10K Challenge: Multiply Your Donation’s Impact in September

The Foundation proudly announces its first-ever Conquer Cancer Foundation $10K Challenge. In September, a portion of online gifts to the Conquer Cancer Foundation of the American Society of Clinical Oncology will be matched by the generous support of Ariad Pharmaceuticals®. The Conquer Cancer...

ASCO Expert Panel Concludes Evidence Supports Physician Discussion of PSA Testing for Men with Longer Life Expectancies

ASCO has issued a new evidence-based provisional clinical opinion (PCO) on the use of prostate-specific antigen (PSA) testing for prostate cancer screening. To facilitate informed decisions, ASCO also released a new, detailed decision aid to help men and their physicians understand the risks and...

The 2013 Gastrointestinal Cancers Symposium Will Observe the Meeting’s 10-Year Anniversary

A decade after its start in 2003 with a few hundred attendees, the Gastrointestinal Cancers Symposium now boasts more than 3,000 participants from all over the world. The next implementation marks the meeting’s 10th anniversary. The 3-day meeting—to be held January 24–26 in San Francisco—is...

hepatobiliary cancer

Coping with Liver Cancer

From the moment I had a partial hysterectomy in 2010, I started having unexplained bouts of nausea. My surgeon and even my primary care physician chalked it up to everything from the difficult 6-hour surgery I had just had to anxiety over a move I’d recently made from Connecticut to North Carolina. ...

global cancer care

Despite Challenges, Initiatives Bring Gradual Improvements to Cancer Care in Lebanon

Nagi S. El Saghir, MD, FACP, Professor of Clinical Medicine and Hematology-Oncology at the American University of Beirut, is the founding President of the Lebanese Society of Medical Oncology (LSMO). Dr. El Saghir has focused much of his research on the early detection, prevention, and treatment of ...

multiple myeloma

Carfilzomib: New Drug with Accelerated Approval for Multiple Myeloma

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 July 2012, carfilzomib (Kyprolis) was granted...

solid tumors
pancreatic cancer

Ongoing and Future Directions in Pancreatic Cancer Research

Margaret A. Tempero, MD, is a pioneer in pancreatic cancer treatment and research. She has long been a leader in the research and development of therapeutics for pancreatic ductal adenocarcinoma, particularly in studying investigational antibody-based therapies, developing the fixed-dose-rate...

leukemia

Liposomal Vincristine Approved in Acute Lymphoblastic Leukemia

The FDA has approved vincristine sulfate liposome injection (Marqibo) to treat adults with Philadelphia chromosome–negative acute lymphoblastic leukemia (ALL). Administered once a week, liposomal vincristine is approved for patients whose leukemia has relapsed two or more times, or whose leukemia...

The Problem of Monitoring Remission

How wonderful it is that we now have to concern ourselves with survivorship issues! The ever-increasing success of cancer therapy means that more and more patients can look to a life beyond cancer diagnosis and treatment. But living with cancer creates its own problems. While treatment often may be ...

The Science of Resilience: Exploring the Process of Grieving from a New Perspective

How human beings cope with bereavement, loss, extreme adversity, and life-threatening illness has dominated the research interests of George A. Bonanno, PhD, Professor of Clinical Psychology, Teachers College at Columbia University, New York, for more than 20 years. In his book, The Other Side of...

breast cancer

No Advantage to Longer Adjuvant Chemotherapy in Women with Early Breast Cancer: CALGB 40101 Trial

The ideal duration of adjuvant therapy for women with lower-risk primary breast cancer remains unknown. The National Surgical Adjuvant Breast and Bowel Project (NSABP) B-15 trial, reported more than 20 years ago, found no difference in outcomes between six cycles of cyclophosphamide, methotrexate,...

prostate cancer

Letter to the Editor: Dr. Ablin’s Reply

Given my explanation and widely publicized opinion on the improper use of the prostate-specific antigen (PSA) test for screening asymptomatic men for prostate cancer—most recently expressed in a feature article in The ASCO Post (August 15, 2012)—I was pleased to read that Drs. James Mohler and...

prostate cancer

Letter to the Editor: More Thoughts on PSA

An article that appeared in the August 15 issue of The ASCO Post (“Rethinking the Role of PSA Screening in Public Health”) contains false statements about the discovery of prostate-specific antigen (PSA) and its effectiveness as a test for early detection of prostate cancer. Contrary to what’s...

breast cancer

Being Well Informed Helped Me Cope with Breast Cancer

I had been putting off getting a screening mammogram for a few years. When I finally made an appointment in March 2011 and was told that I needed a follow-up sonogram because the test had picked up a suspicious-looking mass in my right breast, I knew I was in trouble. A biopsy of the tumor showed...

leukemia

CT Scans in Childhood Can Triple Risk of Leukemia and Brain Cancer Later in Life, Study Finds

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. Computed tomography scans with...

Researchers Awarded NCI Grants to Address ‘Provocative Questions’

Two scientists are among the first recipients of grants geared to answer “Provocative Questions” in cancer research, a new project funded by the National Cancer Institute (NCI), part of the National Institutes of Health (NIH).  Cynthia Sears, MD, and Peter Searson, PhD, both of Johns Hopkins, will...

supportive care

Getting the Right End-of-life Care: Coming to Terms with the Realities of Advanced Disease and Mortality

“Dying is at once a fact of life and a profound mystery.” That was the opening sentence of a 1997 Institute of Medicine report, Approaching Death: Improving Care at the End of Life, a much-needed jump-start in the national dialogue over identifying the barriers that impede the delivery of...

Ziv-aflibercept with FOLFIRI in Metastatic Colorectal Cancer

In August 2012, the antiangiogenic agent ziv-aflibercept (Zaltrap) was approved for use in combination with FOLFIRI (fluorouracil, leucovorin, irinotecan) for the treatment of metastatic colorectal cancer resistant to or progressing after an oxaliplatin-containing regimen.1,2 Approval was based on...

colorectal cancer

New Indication for Cetuximab plus FOLFIRI to Treat EGFR-positive, Wild-type KRAS Metastatic Colorectal 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. Indication In July 2012, cetuximab (Erbitux) was approved for use...

Inaugural Quality Care Symposium Will Detail How to Pioneer Successful Quality Initiatives in Your Practice

Over the past 10 years, Wilshire Oncology Medical Group of La Verne, California, has reengineered itself so that all processes—from front-desk operations at all eight locations to the 10 oncologists’ interactions with patients and payers—capture quality data that can be used for robust benchmarking ...

What the Latest Breast Cancer News Means For Patients

Direct your patients to www.cancer.net/breastsymposium to learn about the research highlighted at the 2012 Breast Cancer Symposium in the special online newsletter, Cancer Advances: News for Patients from the 2012 Breast Cancer Symposium. In addition, your patients can listen to a podcast of the...

All Oncology Care Practices Urged to ‘Be Counted’ in Groundbreaking Census

The National Oncology Census, sponsored by the American Society of Clinical Oncology (ASCO), represents the first-ever attempt to capture comprehensive, real-time data on the state of oncology practice in the United States. ASCO is urging all U.S. oncology practices—representing oncologists in...

Genitourinary Cancers Symposium Still Intimate Despite Record Growth

Despite its exponential growth since launching in 2007—from 1,450 attendees then to a record 2,530 last year—the Genitourinary (GU) Cancers Symposium remains an inviting meeting that feels small, accessible, and comfortable. And that’s the perfect blend for networking, said Jeff Michalski, MD,...

Evolutionary Pathways in BRCA1-associated Breast Tumors

BRCA1 germline mutations are associated with elevated risk of breast and ovarian cancers, and somatic loss of the wild-type BRCA1 allele has been thought to be a rate-limiting initiating step in tumor development. BRCA1-associated breast tumors acquire additional somatic alterations during...

A Leading Light in Cancer Advances, Mary Lasker Used Wealth and Connections to Increase Funding for Medical Research

Born in Watertown, Wisconsin, in 1900, Mary Woodard Lasker was introduced to the ravages of cancer when she was just 3 or 4 years old and went with her mother to visit the family’s laundress, Mrs. Belter, who had just undergone surgery for breast cancer. On the way over to Mrs. Belter’s home, Ms....

breast cancer

Lack of Sleep Found to Be Risk Factor for Aggressive Breast Cancers

Lack of sleep is linked to more aggressive breast cancers, according to new findings published in the August issue of Breast Cancer Research and Treatment by physician-scientists from University Hospitals Case Medical Center’s Seidman Cancer Center and Case Comprehensive Cancer Center at Case...

Expert Point of View: Sergio Giralt, MD

Sergio Giralt, MD, Chief of Adult Bone Marrow Transplant Service at Memorial Sloan-Kettering Cancer Center, New York, commented on the findings by Papanikolaou et al presented at the 2012 ASCO Annual Meeting. “To put this trial into context, in a recent study of 283 double-refractory multiple...

supportive care
palliative care

Dying Patients with Cancer Who Avoid Aggressive Care but Stay Connected with an Oncologist Have Better Quality of Life

Dying patients with cancer who avoided hospitalizations and life-prolonging measures, who worried less, prayed or meditated, were visited by a pastor, and maintained a therapeutic alliance with their oncologist had the highest quality of life at the end of life, according to a study recently...

breast cancer

EMILIA Study: T-DM1 Significantly Improves Overall Survival in HER2-positive Metastatic Breast Cancer

Updated results from the phase III EMILIA study showed that trastuzumab emtansine (T-DM1) significantly improved overall survival of people with HER2-positive metastatic breast cancer compared to the combination of lapatinib and capecitabine (Xeloda). The new data were reported in a press release...

Expert Point of View: Michael Krychman, MD

Like female cancer survivors, men experience high rates of sexual dysfunction following a cancer diagnosis and treatment, especially for prostate cancer, with as many as 90% of men reporting erectile dysfunction after radical prostatectomy and nearly as many suffering with the problem following...

breast cancer
supportive care

Sexual Dysfunction in Female Cancer Survivors Is Prevalent

Although medical experts put the proportion of female survivors facing some form of sexual dysfunction following a cancer diagnosis and treatment at nearly 100%, very few women raise sexual health concerns with their oncologist. In a study of 261 patients with gynecologic or breast cancer published ...

Anticancer Effect of Diabetes Drug Metformin

Retrospective analyses have indicated that the antidiabetic agent metformin may be associated with a quite substantial reduction in risk of cancers. There is evidence that the anticancer effects of metformin are related to inhibition of the growth of certain cancers via activation of AMP kinase...

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