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leukemia

FDA Approves Ponatinib to Treat CML and Philadelphia Chromosome–positive ALL

In December, the FDA granted accelerated approval to ponatinib (Iclusig) for the treatment of adult patients with chronic-, accelerated-, or blast-phase chronic myeloid leukemia (CML) that is resistant or intolerant to prior tyrosine kinase inhibitor therapy or Philadelphia chromosome–positive...

issues in oncology

National Comprehensive Cancer Network Appoints New CEO

The National Comprehensive Cancer Network (NCCN) recently appointed nationally regarded breast cancer expert Robert W. Carlson, MD, as its new CEO. Previously, Dr. Carlson was Professor of Medicine in the Division of Oncology and Medical Informatics, Stanford University Medical Center; he first...

health-care policy
legislation

Last-minute ‘Fiscal Cliff’ Deal by Congress Again Averts Medicare Cuts to Physicians

A last-minute patch to the sustainable growth rate formula included in the “fiscal cliff” deal averted massive cuts to oncologists who care for and treat Medicare patients. “This end-of-year crisis management once again demonstrates the critical need for fundamental reform of the Medicare...

health-care policy

Does Health-care Quality Translate to Value?

On March 23rd, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, enacting sweeping change in our health-care system. An underlying theme of the legislation is the realignment of our payment system so that it places value over volume of services. At ASCO’s first...

issues in oncology

Are We Winning the War on Cancer?

On December 23, 1971, President Richard Nixon signed the U.S. National Cancer Act. This date is widely considered to mark the beginning of the so-called “War on Cancer,” although that phrase was introduced only later on. Over recent decades, journalists have from time to time questioned whether we...

Expert Point of View: Peter Ravdin, MD and Sandra M. Swain, MD, FACP

Putting these results in perspective, Peter Ravdin, MD, moderator of a San Antonio Breast Cancer Symposium press conference where ATLAS findings were discussed, said that in the United States, there is currently a different strategy for pre- and postmenopausal women. Tamoxifen is used as primary...

cost of care
health-care policy

More Thoughts on Rationing Cancer Care

I read the article about “The Ethics of Rationing Cancer Care” with interest (The ASCO Post, Dec 15, 2012). The issue of rationing (or rational) care has likely been debated since Hippocrates. Yet the topic has become a focus of acute interest with the current fiscal crises facing countries around...

lung cancer
issues in oncology

E-mail Reminders to Providers May Improve Documentation of Code Status in Patients with Advanced Disease 

E-mail reminders to providers at the start of each new chemotherapy regimen may improve the rate and timing of code status documentation for patients with advanced lung cancer, according to a study in the Journal of Clinical Oncology. Jennifer S. Temel, MD, and colleagues from Massachusetts General ...

prostate cancer

No Difference in Toxicity with Proton Radiotherapy vs Less Costly Intensity-modulated Radiotherapy 

A national sample of Medicare beneficiaries treated for prostate cancer with intensity-modulated radiation therapy or proton radiotherapy found that proton radiotherapy “was rare and expensive and associated with only a modest and transient reduction in genitourinary toxicity,” reported James B....

breast cancer

Adding Temsirolimus to Letrozole Did Not Improve Survival but Might Benefit Patients under 65

Adding temsirolimus (Torisel) to letrozole did not improve progression-free survival in patients with aromatase inhibitor–naive, estrogen receptor (ER)-positive advanced breast cancer, but exploratory analysis indicated the combination could benefit postmenopausal patients ≤ 65. In their Journal of ...

breast cancer

Younger Patients with Family History of Breast Cancer at Similar Risk of Bilateral Disease as Those with BRCA Mutations 

Women who are diagnosed with breast cancer before age 55 and have a first-degree family history of bilateral disease have risks of contralateral breast cancer similar to women with deleterious mutations of BRCA1 and BRCA2, according to a study recently published in the Journal of Clinical Oncology, ...

SIDEBAR: Expect Questions from Patients

Results from the Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) study “will have a follow-on effect of being able to guide physicians about the advantages of longer than 5 years of therapy for the premenopausal woman,” said V. Craig Jordan, OBE, PhD, DSc, Scientific Director at the Lombardi...

breast cancer

'Practice-changing' ATLAS Study Supports 10 vs 5 Years of Tamoxifen Therapy in Women with Breast Cancer

"Practice-changing" is the term several physicians and researchers used when asked by the media to describe the results of a study showing that extending tamoxifen therapy from 5 to 10 years for women with estrogen receptor (ER)-positive breast cancer further reduced recurrence and mortality....

kidney cancer

Social Media Is Helping My Brother Fight Kidney Cancer 

My brother, Rick Thomas, is a great guy. I’m not just saying that because he’s my brother. He’s funny, warm, and kind to everyone he meets. He became a commercial airline pilot for American Airlines after flying C-5s in the Air Force for 12 years and has always been a responsible person and a...

leukemia
breast cancer

Oncology Trailblazer James F. Holland, MD, Recalls a Time of Unbridled Scientific Excitement 

James F. Holland, MD, began his journey into oncology when it was still a nascent discipline, working alongside groundbreaking pioneers in the field such as Drs. Emil “Tom” Frei and C. Gordon Zubrod. Dr. Holland recently shared a glimpse of his role in oncology’s formative years with The ASCO Post. ...

issues in oncology

Expert Point of View: Eduardo Bruera, MD, FAAHPM

The study by Weeks and colleagues is an important one that shows quite unexpected results. There are three main possible reasons for the very low rate of accurate reporting by the patients: (1) Physicians are not communicating prognosis adequately. (2) Patients are unable to understand the...

issues in oncology

Most Patients Do Not Report that Cure Is Highly Unlikely with Chemotherapy for Advanced Cancer  

Chemotherapy for metastatic lung or colorectal cancer can provide palliation and modestly prolong life, but is not curative. In a study recently reported in The New England Journal of Medicine, Jane C. Weeks, MD, of Dana-Farber Cancer Insitute, and colleagues found that the majority of patients...

thyroid cancer

Cabozantinib in Metastatic Medullary Thyroid 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 On November 29, 2012, cabozantinib (Cometriq) was...

The Conquer Cancer Foundation Announces Its Sustaining Donor Program

You can help the Conquer Cancer Foundation fulfill its mission of creating a world free from the fear of cancer when you make a monthly gift today. When you become a sustaining donor to the Foundation, your monthly gift will provide a reliable stream of support that is so vital to ensuring that the ...

ASCO's CancerProgress.Net: Where We've Come From, Where We Are, and Where We're Going 

The British science historian James Burke once wrote, “If you don’t know where you’ve come from, you don’t know where you are.” To tell the story of where we are in the treatment of people with cancer and how we got there, ASCO launched an ambitious history project in 2011 with a new website,...

breast cancer
lung cancer

ASCO Decision Aids Intersect Evidence-based Guidelines, Productive Patient Communication

Imagine this common clinical scenario: A 64-year-old woman presents with a new abnormality on a mammogram. A core needle biopsy and subsequent partial mastectomy reveal a 1.8-cm invasive ductal carcinoma. Sentinel lymph nodes are negative for cancer. The tumor is moderately differentiated and is...

issues in oncology

New England Journal of Medicine Article Reports Inferior Outcome in Using Alternative Treatments to Counter Mechlorethamine Shortage

ASCO Immediate Past President Michael P. Link, MD, recently coauthored a perspectives piece in The New England Journal of Medicine on the impact of drug shortages on children with cancer. The paper, “The Impact of Drug Shortages on Children with Cancer — The Example of Mechlorethamine,” describes...

prostate cancer

Postoperative Radiation Therapy Extends Progression-free Survival in Men with High-risk Prostate Cancer

Postoperative irradiation significantly improves biochemical progression-free survival and local control compared with a “wait-and-see” approach in men with high-risk prostate cancer, according to more than a decade of long-term follow-up in the European Organisation for Research and Treatment of...

lymphoma

PET-negative Scan after Short-course Chemotherapy Identifies Early Hodgkin Lymphoma Patients Who Can Forgo Radiation

Positron-emission tomography (PET)-directed therapy is promising for early-stage Hodgkin lymphoma, according to results of the UK NCRI RAPID trial presented at the 54th Annual Meeting of the American Society of Hematology (ASH).1 The use of PET scan enabled the identification of a population of...

breast cancer

Dune Medical Devices Receives FDA Approval for the MarginProbe System

Dune Medical Devices, Inc, announced that the FDA has granted Premarket Approval to the MarginProbe System, the company’s breakthrough intraoperative tissue assessment tool for early-stage breast cancer surgery. The technology significantly improves surgeons’ ability to intraoperatively identify...

Expert Point of View: Lisa Carey, MD

Lisa Carey, MD, Preyer Distinguished Professor in Breast Cancer Research at the University of North Carolina, Chapel Hill, said the study should not be interpreted as negative for eribulin. “Most of the patients in this study were being treated second-line. EMBRACE was a totally different...

breast cancer

Primary Endpoint Not Met for Eribulin vs Capecitabine in Breast Cancer 

While a global phase III trial failed to meet its primary endpoint in showing an overall or progression-free survival benefit for eribulin (Halavan) in metastatic breast cancer, a trend toward greater efficacy than capecitabine (Xeloda) was observed, researchers reported at the 2012 San Antonio...

Expert Point of View: Martin Dreyling, MD

Martin Dreyling, MD, Professor of Medicine at Ludwig Maximilians University in Munich and Coordinator of the European Mantle Cell Lymphoma Network, commented on the data emerging for ibrutinib in lymphoma. “Ibrutinib is the molecule of the year at ASH,” he told The ASCO Post. “With other molecular ...

lymphoma

Ibrutinib in Mantle Cell Lymphoma Yields 'Unprecedented' Response Rates 

The investigational agent ibrutinib demonstrated “unprecedented” single-agent activity in relapsed or refractory mantle cell lymphoma, according to the lead author of an international phase II study reported at the Annual Meeting of the American Society of Hematology (ASH).1 Durable Responses “The...

breast cancer

Somatic HER2 Mutations That Drive Cancer Found in HER2-negative Breast Cancer 

A proportion of patients with breast cancer whose tumors test HER2-negative for gene amplification on fluorescence in situ hybridization or immunohistochemistry harbor HER2 mutations that are amenable to treatment with anti-HER2–targeted therapy, according to a gene-sequencing study presented at...

breast cancer

Key Pathways Identified in Triple-negative Breast Cancer 

Five key biologic pathways have become evident in triple-negative breast cancer tumors, and these pathways may be targetable with agents that are currently available or in development, results from an international genetic analysis revealed at the 2012 San Antonio Breast Cancer Symposium. Justin M. ...

lung cancer

ACS Releases Lung Cancer Screening Guidelines

As reported online in CA: A Cancer Journal for Clinicians,1 based on results from the National Lung Screening Trial (NLST) sponsored by the National Cancer Institute (NCI), the American Cancer Society (ACS) has released lung cancer screening guidelines recommending that select clinicians should...

cost of care

Cost of Cancer Drugs: What Price for What Benefit?

In 2011, national health-care spending in the United States was about $2.7 trillion, larger than the entire French national budget.1 U.S. national health-care spending is about 17% of the national gross domestic product. Total Medicare expenditures in 2011 were $549 million.2 In the debate about...

issues in oncology

Expert Point of View: Kevin P. Weinfurt, PhD

Our work suggests three specific recommendations for researchers and care providers who are discussing with patients the possibility of enrolling in a phase I clinical trial. First, we should always communicate the likelihood of benefit in terms of the number of participants expected to derive...

issues in oncology

Patient Expectations of Benefit in Early-phase Trials: Ethics Issues in Informed Consent 

It has been found that many patients in early-phase oncology trials believe their chance of benefit to be much higher than estimates derived from historical data.1-3 In a recently reported study in Journal of Clinical Oncology, Kevin P. Weinfurt, PhD, of Duke Clinical Research Institute, and...

Expert Point of View: Sagar Lonial, MD

Commenting on Dr. Palumbo’s presentation at the ASH meeting, Sagar Lonial, MD, Professor of Hematology and Medical Oncology at the Winship Cancer Center at Emory University, Atlanta, noted that while a survival benefit has been associated with maintenance lenalidomide (Revlimid) after transplant,...

multiple myeloma

Survival Benefit Achieved with Four Drugs plus Maintenance in Myeloma

An overall survival benefit in newly diagnosed multiple myeloma was attained with a four-drug induction regimen followed by a duet for maintenance in a study from the Italian GIMEMA network. Antonio Palumbo, MD, Chief of the Myeloma Unit at the University of Torino in Italy, reported the findings...

issues in oncology

Failure to Screen Patients for Hepatitis B Virus Could Result in Fatal Complications 

Although hepatitis B virus (HBV) reactivation is a potentially fatal complication of chemotherapy, “provided that HBV carriers are recognized, HBV reactivation can be largely prevented through the administration of oral antinucleoside analogs,” researchers at the University of Toronto noted in an...

cns cancers

Surgery of Primary Tumor Site Has No Impact on Local Control and Outcome in Patients ≥ 18 Months with Stage IV Disease 

“In intensively treated patients with stage IV neuroblastoma age 18 months or older at diagnosis, surgery of the primary tumor site has no impact on local control rate and outcome,” according to findings from the German prospective clinical trial NB97. “The results of the study,” the researchers...

colorectal cancer

Even at NCCN Institutions, a 'Sizable Minority' of Patients with Rectal Cancer Are Not Treated per NCCN Guidelines 

Even at the eight cancer centers participating in the National Comprehensive Cancer Network (NCCN) Colorectal Cancer Outcomes project, a “sizable minority” of patients with stage II/III rectal cancer treated with curative intent neoadjuvant chemoradiotherapy did not complete postoperative...

SIDEBAR: Shout-out to Policymakers on Diabetes Education

“If we could just give a shout-out to policymakers to understand that in the long term,” when patients who have diabetes and cancer receive adequate diabetes education, “we are cutting our length of stay, we are decreasing hospital costs, we are decreasing readmission rates,” June McKoy, MD, MPH,...

SIDEBAR: Expect Questions from Patients with Diabetes and Cancer

Patients with diabetes and cancer need to know that some chemotherapy drugs and adjuvant agents may require modifications in how they manage their diabetes. For example, patients who are receiving steroids might have to further restrict their diet to keep blood sugar levels under control. “You...

issues in oncology

Keeping Diabetes under Control Is Critical to Good Outcomes for Patients Who Also Have Cancer 

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. Cancer and diabetes can be comorbid...

University of Michigan Cancer Center Names Kathleen Cooney, MD, to Head Clinical Operations

The University of Michigan (U-M) Comprehensive Cancer Center in Ann Arbor has named Kathleen Cooney, MD, as Deputy Director for Clinical Services.  Dr. Cooney is Frances and Victor Ginsberg Professor of Hematology/Oncology and Chief of the Division of Hematology/Oncology at the U-M Medical School...

breast cancer

Betting Against the Odds 

I knew the two tumors in my left breast were cancerous even before I got the pathology results back on my biopsy. I could clearly see the tumors on the digital mammogram my doctor ordered, and when the radiologist pointed out that they had spikes radiating from the edges and that he was scheduling...

breast cancer

Researchers Develop Automated Breast Density Test Linked to Cancer Risk

Researchers at Moffitt Cancer Center in Tampa, Florida, and colleagues at the Mayo Clinic in Rochester, Minnesota, have developed a novel computer algorithm to quantify breast density based on analysis of a screening mammogram. Increased levels of mammographic breast density have been shown in...

palliative care

Important Messages about Palliative Care and Hospice at the Heart of New End-of-life Memoir 

The illness memoir’s appeal proves enduring in a very crowded genre, perhaps because illness is a tie that binds us all. As Susan Sontag wrote in her classic work, Illness as a Metaphor, “Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in...

David A. Karnofsky's Early Contributions to Cancer Research Helped Establish Oncology as a Medical Discipline 

For nearly 30 years, from the time he was a young resident at the Collis P. Huntington Memorial Hospital for Cancer Research of Harvard University, until his death from lung cancer on August 31, 1969, David A. Karnofsky, MD, dedicated himself to the pursuit of scientific excellence and the...

integrative oncology

Turmeric 

The use of dietary supplements by cancer patients has risen significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the...

leukemia

Ponatinib in Chronic Myeloid Leukemia and Philadelphia Chromosome–positive Acute Lymphoblastic Leukemia 

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 On December 14, 2012, ponatinib (Iclusig) was granted...

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