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issues in oncology

Outcome Measures in Quality and Identifying High-Quality Practice

At this year’s ASCO Quality Care Symposium, Craig Earle, MD, MSc, of the Ontario Institute for Cancer Research, used Donabedian’s Triad—structure, process, and outcome—to set the stage for his presentation on the science of quality. “The theory behind Donabedian’s Triad is that structure...

breast cancer

A Business Professor and Husband Turns Breast Cancer Researcher

In more than 25 years of viewing posters at oncology meetings, I’ve met researchers from virtually all professional walks of life, but it was not until the 2016 Miami Breast Cancer Conference, that the author’s affiliation turned my head: It was a business school. “Utilizing Metastatic Tumor...

breast cancer

Metastatic Breast Cancer With Discordant Tumors: Small Study Reports Treatment by Primary Status May Improve Survival

In a small retrospective series, patients with metastatic breast cancer treated according to the receptor status of the primary tumor, not the metastatic one, had significantly longer median overall survival. The study was reported at the 2016 Miami Breast Cancer Conference by T. Allen Pannell, Jr, ...

breast cancer

Breast Cancer Vaccines Moving Forward at a Fast Clip

Vaccines for both secondary and primary prevention of breast cancer are showing potential in clinical trials, according to Elizabeth A. Mittendorf, MD, PhD, who is leading much of the vaccine research at the University of Texas MD Anderson Cancer Center, Houston. Vaccine platforms being explored...

issues in oncology

Computer-Assisted Decision Support in Medical Oncology: We Need It Now

Today’s medical oncologist is increasingly challenged to stay current with the latest developments in cancer treatment. I have been fortunate to speak with many oncologists over the past quarter-century on how professional life has evolved since the 1990s. These conversations have left me with a...

prostate cancer

Throwing Out the Baby With the Bathwater: A Critical Appraisal of the USPSTF Recommendation Against Screening for Prostate Cancer

In 2012, the U.S. Preventive Services Task Force (USPSTF) issued a recommendation against routine screening for prostate cancer.1,2 The grade D recommendation was considered controversial at the time, and remains so now, because many stakeholders have weighed the same body of evidence and come to...

cns cancers

Glioblastoma Multiforme With Mismatch Repair Deficiency May Be Target for Immune Checkpoint Inhibition

Glioblastoma multiforme resulting from germline biallelic mismatch repair deficiency was characterized by hypermutation and elevated neoantigen load—characteristics associated with response to immune checkpoint inhibitors in other settings—according to a study reported in the Journal of ...

breast cancer

Ultrasound Screening for Breast Cancer May Be Linked to Increased Detection of Invasive Tumors but More False-Positive Results

As reported in the Journal of the National Cancer Institute by Berg et al, an analysis from the American College of Radiology Imaging Network (ACRIN) 6666 study indicates that use of ultrasound in primary screening for breast cancer resulted in increased detection of invasive cancers but more...

survivorship

ENDO 2016: Engineered Ovary Implant Restores Fertility in Mice

Northwestern University scientists used a three-dimensional (3D) printer to create a prosthetic ovary—an implant that allowed mice that had their ovaries surgically removed to bear live young. The results were presented by Laronda et al on Saturday, April 2, at the Endocrine Society's Annual...

breast cancer

ENDO 2016: BPA Changes Fetal Development of the Mammary Gland, Can Raise Breast Cancer Risk

A new culture system that tests the role of chemical exposure on the developing mammary gland has found that bisphenol A (BPA) directly affects the mammary gland of mouse embryos. The study results, presented by Speroni et al Friday, April 1, at the Endocrine Society's Annual Meeting in Boston...

issues in oncology

TP53 Gene Variant S47 May Contribute to Increased Cancer Risk in People of African Descent

For years, clinical data have shown that African Americans have a higher death rate and shorter period of survival among patients with commonly diagnosed cancers. While studies have focused on whether socioeconomic factors contribute to these statistics, researchers have been diligently trying to...

breast cancer

ASCO Endorses Cancer Care Ontario Recommendations on Decision-Making in Adjuvant Systemic Therapy for Early-Stage, Operable Breast Cancer

As reported in the Journal of Clinical Oncology by N. Lynn Henry, MD, PhD, of the University of Michigan Comprehensive Cancer Center, and colleagues, ASCO has endorsed Cancer Care Ontario (CCO) guideline recommendations on the role of patient and disease factors in decisions on adjuvant systemic...

prostate cancer

Lower Vitamin D Levels Associated With Adverse Pathology at Prostatectomy in Men With Localized Prostate Cancer

In a study reported in the Journal of Clinical Oncology, Nyame et al found that lower serum 25-hydroxyvitamin D (25-OH D) levels were associated with an increased likelihood of adverse pathology at radical prostatectomy in men with localized prostate cancer. Study Details The cross-sectional...

breast cancer

Increased Frequency of BRCA Mutation Testing in Young Women With Breast Cancer

Rosenberg et al found that the proportion of women diagnosed with breast cancer at age ≤ 40 years who have undergone BRCA1 and BRCA2 testing has increased during recent years. These findings, which were reported in JAMA Oncology, were part of the ongoing prospective Helping Ourselves, Helping...

bladder cancer

Study Finds Adaptive Image-Guided Radiation Therapy for Bladder Preservation Clinically Feasible in Urinary Bladder Cancer

A prospective study examining a trimodality treatment approach in localized bladder cancer cases using adaptive image-guided, intensity-modulated radiation therapy found that the bladder preservation rate at 3 years was 83%. These findings were published by Murthy et al in the International Journal ...

colorectal cancer

Endoscopic Mucosal Resection Is an Alternative to Surgery in Most Patients With Complex Colon Polyps

Using the latest advances in endoscopic resection techniques, more than 75% of patients with complex colon polyps could avoid surgery for their polyp removal, according to new research from The University of Texas MD Anderson Cancer Center. The findings, published by Raju et al in Gastrointestinal ...

breast cancer

Danish Study Shows Increased Risk for Cancers in Addition to Breast Cancer in CHEK2 Mutation Heterozygotes

In a study reported in the Journal of Clinical Oncology, Näslund-Koch et al found an increased risk for cancers in addition to breast cancer in individuals heterozygous for the CHEK2*1100delC germline mutation associated with an increased breast cancer risk. CHEK2 is a cell-cycle checkpoint...

bladder cancer

ASCO Endorses European Association of Urology Guideline on Muscle-Invasive and Metastatic Bladder Cancer

As reported in the Journal of Clinical Oncology by Matthew I. Milowsky, MD, of the University of North Carolina Lineberger Comprehensive Cancer Center, and colleagues, ASCO has endorsed the European Association of Urology clinical practice guideline on muscle-invasive and metastatic bladder cancer. ...

issues in oncology

PET Probe [18F]CFA Detects Deoxycytidine Kinase Activity, May Lead to New Ways to Improve Response to Treatment

A promising new discovery by University of California, Los Angeles (UCLA) scientists could lead to a new method of identifying cancer patients whose disease expresses high levels of an enzyme and who are more likely to respond to particular treatments. Their findings were published by Kim et al in...

breast cancer

Therapeutic Combinations May Prevent Resistance to CDK4/6 Inhibition in Estrogen Receptor–Positive Breast Cancer

In preclinical studies, breast cancer cells became resistant to therapeutics targeting CDK4/6, such as palbociclib (Ibrance), in multiple ways. According to the research published by Herrera-Abreu et al in Cancer Research, different combinations of therapeutics might prevent and overcome the...

pancreatic cancer

Meta-analysis of Gene-Expression Datasets Identifies Novel Five-Gene Pancreatic Cancer Classifier

Pancreatic cancer is often diagnosed at a late stage, when curative treatment is no longer possible. A team led by investigators at Beth Israel Deaconess Medical Center (BIDMC) identified and validated an accurate five-gene classifier for discriminating early pancreatic cancer from nonmalignant...

survivorship

Survivors of Adolescent and Young Adult Cancer May Be at Increased Risk of Cardiovascular Disease

Survivors of adolescent and young adult cancer were at a greater than twofold increased risk for cardiovascular disease than their counterparts without cancer, according to a study reported in the Journal of Clinical Oncology by Chao et al. Study Details The study involved data from a...

hematologic malignancies
lymphoma

Italian Study Suggests Benefit of Interim PET Response–Adapted Therapy in High-Risk Advanced Hodgkin Lymphoma

The phase II portion of the Italian HD0801 study suggests that treatment based on positron-emission tomography (PET) performed early in first-line therapy for advanced Hodgkin lymphoma may improve outcome in patients at risk of first-line treatment failure. Zinzani et al reported their findings in...

breast cancer

ASCO Guideline on Use of Biomarkers to Guide Decisions on Adjuvant Systemic Therapy in Women With Early-Stage Invasive Breast Cancer

As reported in the Journal of Clinical Oncology by Harris et al, ASCO released a clinical practice guideline on the use of biomarkers in addition to estrogen receptor/progesterone receptor and HER2 status to guide decisions on adjuvant systemic therapy in women with early-stage invasive breast...

survivorship

Low-Magnitude, High-Frequency Mechanical Stimulation May Improve Bone Mineral Density in Young Childhood Cancer Survivors

In a small trial reported in JAMA Oncology, Mogil et al found that low-magnitude, high-frequency mechanical stimulation improved the whole-body bone mineral density score in childhood cancer survivors with low bone mineral density. Study Details In the double-blind trial, 65 survivors of...

leukemia

Minimal Residual Disease in AML: Worth Looking?

As summarized in this issue of The ASCO Post, Ivey and colleagues demonstrated that assessing for NPM1-mutated gene transcripts by reverse-transcriptase quantitative polymerase chain reaction assay is a feasible approach for measuring minimal residual disease after acute myeloid leukemia (AML)...

issues in oncology

Quality Improvement Projects Aim at Reducing Errors in Prescribing IV and Oral Chemotherapy

Two quality improvement projects described in the Journal of Oncology Practice resulted in reduced errors in prescribing intravenous (IV) and oral chemotherapy. A project at the University of Texas Medical Branch in Galveston outpatient infusion centers first identified 15 different types of...

colorectal cancer

Patients Diagnosed With Stage I to III Rectal Cancer at Younger Age Have Increased Risk for Positive Lymph Nodes

Patients diagnosed with stage I to III rectal cancer at a younger age are at increased risk of having positive lymph nodes, according to an analysis of data published in the Journal of the National Cancer Institute. “This finding merits further investigation and may ultimately impact treatment...

skin cancer

Long Noncoding RNA SAMMSON Linked to Malignant Melanoma

In collaboration with researchers from Ghent University, Vlaams Instituut voor Biotechnologie (VIB) scientists from the University of Leuven have revealed a remarkable link between malignant melanoma and a noncoding RNA gene called SAMMSON. The SAMMSON gene is specifically expressed in human...

solid tumors
prostate cancer

Survival Differs With Metastatic Site in Castration-Resistant Prostate Cancer

Overall survival differed according to the site of metastases in men with castration-resistant prostate cancer, according to a meta-analysis reported in the Journal of Clinical Oncology by Halabi et al. Study Details The study involved data from 8,820 men who received docetaxel chemotherapy in...

solid tumors
kidney cancer

Study Finds Apitolisib Less Effective Than Everolimus in Metastatic Renal Cell Carcinoma

As reported in the Journal of Clinical Oncology by Powles et al, the dual PI3K/mTOR inhibitor apitolisib was inferior to the mTOR inhibitor everolimus (Afinitor) in progression-free survival in a phase II trial in patients with metastatic clear cell renal cell carcinoma progressing on or after...

skin cancer

Study Explores Genomic and Transcriptomic Features of Anti–PD-1 Resistance in Advanced Melanoma

Immunotherapy using anti­–programmed cell death 1 (PD-1) antibodies has revolutionized the treatment of advanced melanoma and a growing list of other cancers. But 60% to 70% of melanoma tumors are resistant to anti–PD-1 antibodies, and there is an urgent need to understand how to...

skin cancer

Assessment of Survival Impact of Atypical Responses With Pembrolizumab Treatment in Advanced Melanoma

As reported by Hodi et al in the Journal of Clinical Oncology, use of conventional Response Evaluation Criteria in Solid Tumors (RECIST) to assess response may have underestimated the benefit of treatment with the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda) in the...

health-care policy

ASCO Issues Report on State of Cancer Care in America: 2016

The State of Cancer Care in America: 2016, published online in the Journal of Oncology Practice1 and presented earlier this month at a Congressional briefing in Washington, DC, is ASCO’s third annual assessment of national trends in cancer care delivery. The report highlights many promising cancer...

breast cancer

I Never Forget I Have Cancer

I have a history of fibrocystic breasts, which required biopsies to make certain the cysts were benign, and for years they were. But in 2009, my mammogram screening picked up a suspicious lump in my right breast, which turned out to be stage III estrogen receptor–positive/progesterone...

Expect Questions and Heightened Interest About Bilateral Mastectomy

Recently released data from the Agency for Healthcare Research and Quality (AHRQ) showed that the rate of mastectomies increased between 2005 and 2013, with much of that increase attributed to bilateral mastectomies among women with early-stage cancer in one breast opting for bilateral...

breast cancer

The Perplexing Increase in Bilateral Mastectomies

The increased rate of bilateral mastectomies, as shown in recently released data from the Agency for Healthcare Research and Quality (AHRQ), is “perplexing,” Ismail Jatoi, MD, PhD, told The ASCO Post. “We are seeing more and more women with unilateral breast cancer opt for bilateral mastectomy,...

A Hard Look at the Connection Between Germs and Mental Illness

The relationship between disease and microbes was first proposed in the 17th century, but the basic standards for proving that infection causes disease were not laid down until 1883, when the German bacteriologists Robert Koch and Friedrich Loeffler provided the first evidence of the processes...

A Doctor’s Prescription for a Long Life

Longevity is a common goal among humans. And like all things human, it is not distributed equally. According to world health data, Japan is number one on the longevity list; its 130 million citizens have a life expectancy of about 84.74 years. The sub-Saharan country of Chad is number 224, having ...

A Gene Hunter’s Advice on How to Take Control of Your Genetic Inheritance

Since the late 1970s, researchers have identified several gene mutations that are implicated in cancer. Many of these mutations are acquired during our lifetime, but, as we know, some are inherited in families. Identifying heritable cancer-causing genetic mutations is a double-edged sword,...

2016 Oncology Meetings

MARCH 2016 Methods in Clinical Research Workshop for Minority PhysiciansMarch 17-20 • Fort Lauderdale, FloridaFor more information:https://www.roswellpark.edu/education/diversity-clinical-research-workshop The 16th Multidisciplinary Management of Cancers: A Case-Based ApproachMarch 18-20 • Napa,...

integrative oncology

Benefiting From Mind-Body Therapy

My diagnosis of early-stage breast cancer at age 35 was a shock, also because I come from a family with no history of cancer. In disbelief, I was literally speechless—I lost my voice completely for several days. I grew up in the former Soviet Union and then in the newly independent Kyrgyzstan. My...

Expert Point of View: Carlos Arteaga, MD

Carlos Arteaga, MD, of Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, said, “Breast-conserving therapy is the right thing to do. This study will not change current practice guidelines. Mastectomy is generally reserved for larger tumors and those with multifocal disease. The study just...

pancreatic cancer

‘Know Your Tumor’ Program Aids Patients With Pancreatic Cancer

Patients with pancreatic cancer can obtain molecular tumor profiling through the Pancreatic Cancer Action Network’s Know Your TumorSM precision medicine initiative, a partnership with Perthera, a personalized medicine service company that facilitates the multi-omic profiling and generates the...

colorectal cancer

Studies Evaluate Bevacizumab-Containing Regimens in Metastatic Colorectal Cancer

Two trials reported at the 2016 Gastrointestinal Cancers Symposium evaluated bevacizumab (Avastin)-containing regimens in the first-line treatment of metastatic colorectal cancer and supported some, but not all, previous findings. The STEAM trial found some numerical differences but no...

prostate cancer

Biomarkers in Prostate Cancer: PARP Inhibitors and Defects in DNA Repair

New data on molecular biomarkers in advanced prostate cancer are accumulating at a fast pace. The studies in this area can now be broadly grouped in two distinct areas—those that broadly relate to androgen signaling and those that relate to DNA-repair pathways. The Androgen-Signaling Pathway With...

breast cancer

Introduction of New Diagnostic Devices in Oncology: New Is Not Necessarily Better

“New!” “Improved!” “Throw out that old [fill in the blank] and go buy a new [fill in the blank]!” Sound familiar? The key to marketing is to convince customers that they need a product without which they had previously been quite happy. All too often, this strategy is accompanied by a caveat emptor ...

breast cancer

Potential Overdiagnosis of Contralateral Breast Cancer With Preoperative Breast MRI in Older Women With Breast Cancer

In an analysis of the Surveillance, Epidemiology, and End Results (SEER)-Medicare database reported in the Journal of Clinical Oncology, Shi-Yi Wang, MD, PhD, of Yale School of Public Health, and colleagues found that the use of preoperative magnetic resonance imaging (MRI) was associated with...

supportive care

How Rehabilitation Services Provide Benefit for Patients With Spinal Metastases

The benefits of rehabilitation in traumatic spinal injuries are well established. Recently, studies have shown similarly positive results in cancer-related spinal injuries, indicating that rehabilitation can play a complementary role in the care management of this patient population....

solid tumors

Modified CAR T Cells Overcome Immune Suppression, Effective Against Solid Tumors in Preclinical Models

Adding a genetically engineered “switch receptor” to second-generation CAR T cells blocked PD-1–mediated immune suppression, and made the immunotherapy effective against solid tumors in preclinical models, according to a study published by Liu et al in Cancer Research....

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