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lung cancer

Study Reports ‘Strong and Consistent Relation’ between Exposure to Diesel Exhaust and Risk of Dying of Lung Cancer

A nested case-control study of 198 lung cancer deaths among a cohort of 12,315 mine workers “showed a strong and consistent relation between quantitative exposure to diesel exhaust and increased risk of dying of lung cancer,” researchers reported in the Journal of the National Cancer Institute.1...

issues in oncology
supportive care

New Assessment Tools in Development to Guide Care for Older Patients

More than 1,400 people from 62 countries attended the 2012 Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) International Symposium on Supportive Care in Cancer, held in New York last June. One of the featured sessions, which was jointly...

A Physician, Who Is Also a Cancer Patient, Talks about Medical Errors

In a whispered but resolute voice, Itzhak Brook, MD, MSc, led off his presentation at the 2012 ASCO Annual Meeting1  by telling the audience his voice is weak because he doesn’t have vocal cords. He spoke with the aid of a tracheoesophageal voice prosthesis. “I have practiced medicine for more than ...

supportive care

Supportive Care Experts Explore 30 Years of Progress in the Field

Thirty years ago, when the first supportive care meeting as a forerunner of the Multinational Association of Supportive Care in Cancer (MASCC) Symposium was held in New York, supportive care was largely ignored, with little discussion at major cancer meetings, which focused primarily on...

breast cancer

Older Chemotherapy Studies in Breast Cancer Coming of Age

Results of several long-running chemotherapy trials were reported at the 2012 ASCO Annual Meeting breast cancer oral session, reported in brief here. NSABP B-38 The final analysis of the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-38 trial showed that the addition of gemcitabine...

Expert Point of View: Eun-Sil Shelley Hwang, MD, MPH

Eun-Sil Shelley Hwang, MD, MPH, of Duke University Medical Center, Durham, North Carolina, who discussed both papers on ductal carcinoma in situ at the ASCO Annual Meeting, noted that better risk stratification and treatments are substantially changing the outlook for DCIS. “We are getting close to ...

breast cancer

Improving Outcomes and Prediction in Ductal Carcinoma in Situ

Risk stratification and outcomes can be improved for women with ductal carcinoma in situ (DCIS), according to two studies presented at the 2012 ASCO Annual Meeting. RTOG 9804 Findings from the Radiation Therapy Oncology Group (RTOG) 9804 trial suggested that even for DCIS patients whose prognosis...

Trailblazer in Argentinean Oncology Remains Optimistic about War on Cancer

Eduardo Cazap, MD, PhD, is founder and first President of the Latin American and Caribbean Society of Medical Oncology (SLACOM). In 2008, he was elected to a 2-year term as President of the International Union against Cancer (UICC). The ASCO Post recently spoke with Dr. Cazap about his roots in...

breast cancer

Lapatinib Shows Value Similar to Trastuzumab in Neoadjuvant Regimens for Breast Cancer, but with Greater Toxicity

Lapatinib (Tykerb) proved valuable as a component of neoadjuvant chemotherapy for HER2-positive operable breast cancer in the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-41 trial presented at the 2012 ASCO Annual Meeting by Andre Robidoux, MD, of the NSABP and the University of...

lung cancer

No Improvement in Overall Survival, Worse Toxicity with Motesanib Added to Chemotherapy in Non–Small Cell Lung Cancer

Two trials (E4599 and AVAiL) have suggested a benefit to adding the anti–vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (Avastin) to chemotherapy in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Bevacizumab acts by binding directly to circulating...

gynecologic cancers

Adding Bevacizumab to Chemotherapy Improves Progression-free Survival in Platinum-sensitive Recurrent Ovarian Cancer

The addition of bevacizumab (Avastin) to gemcitabine and carboplatin, followed by bevacizumab until disease progression, resulted in significantly improved progression-free survival compared to gemcitabine and carboplatin plus placebo among women with platinum-sensitive recurrent ovarian, primary...

cns cancers

Understanding and Managing Pseudoprogression in Glioblastoma Patients

Pearls in Neuro-oncology is guest edited by Tracy Batchelor, MD, Director, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, and Professor of Neurology, Harvard Medical School, Boston. The series is intended to provide the practicing oncologist with guidance in managing...

prostate cancer

Enzalutamide Gets Priority Review for Castrate-resistant Prostate Cancer

Medivation, Inc, and Astellas Pharma, Inc, announced that the FDA has accepted for filing the New Drug Application (NDA) for enzalutamide (formerly MDV3100) for the potential treatment of men with castration-resistant prostate cancer previously treated with docetaxel-based chemotherapy and granted...

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...

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...

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 ...

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...

Kidney Transplant Recipients Switching to Sirolimus Had Lower Risk of Secondary Squamous Cell Carcinomas

Kidney transplant recipients with at least one previous cutaneous squamous cell carcinoma decreased their risk of developing new cutaneous squamous cell carcinomas by switching from calcineurin inhibitors (cyclosporine or tacrolimus) to sirolimus (Rapamune) in a multicenter phase III study. New...

breast cancer

Taxane-induced Neuropathy Does Not Correlate with Improved Outcomes in Operable Breast Cancer

An analysis of 4,554 patients who received adjuvant weekly paclitaxel and other taxane-based regimens in the E1199 trial “demonstrated that taxane-induced peripheral neuropathy does not correlate with improved outcomes in patients with operable breast cancer,” investigators reported in the Journal...

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. ...

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...

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 ...

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,...

Meetings Calendar

September 1st Multidisciplinary Symposium: Molecular Oncology: From Laboratory Bench to MedicineSeptember 17-22 • Kyiv, Ukraine For more information: http://rmd.org.ua/en Cancer Vaccines: Advances in Design, Therapy and EfficacySeptember 19-20 • London, United Kingdom For more information:...

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...

High-cost Imaging Used Frequently in Elderly with Stage IV Cancer

Patients with stage IV breast, colorectal, lung, and prostate cancers undergo frequent high-cost imaging procedures throughout the continuum of their care, and rates of imaging have steadily increased, according to an analysis of claims from the Surveillance, Epidemiology, and End Results...

colorectal cancer

Cetuximab Dose Escalation May Increase Responses among Patients with Mild or No Initial Skin Reactions

Escalating the dose of cetuximab (Erbitux) among patients with metastatic colorectal cancer who developed no or mild skin reactions on standard-dose cetuximab plus irinotecan “seemed to lead to an increase in response rate” as well as in the disease-control rate, according to a phase I/II study...

prostate cancer

Enzalutamide Significantly Prolonged Survival in Men with Castrate-resistant Metastatic Prostate Cancer

“Enzalutamide significantly prolonged the survival of men with metastatic castration-resistant prostate cancer after chemotherapy” in an international phase III, double-blind, placebo-controlled trial, investigators reported in The New England Journal of Medicine. Median overall survival, the...

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...

SIDEBAR: Expect Questions from Parents

Results of a study finding that exposure to radiation from multiple CT scans in childhood can triple the risk of leukemia and brain tumors may cause some parents to question the overall benefit of CT scans and to directly question physicians. “The three key questions that parents can ask are: (1)...

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...

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...

prostate cancer

FDA Approves New Drug for Late-stage Prostate Cancer

The FDA has approved enzalutamide (Xtandi) to treat men with metastatic castration-resistant prostate cancer that has spread or recurred, even with medical or surgical therapy to minimize testosterone. Approved for patients with prostate cancer previously treated with docetaxel, enzalutamide was...

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...

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,...

Metastasis Promoted by Cleaving and Inhibiting Proapoptotic Effect of von Willebrand Factor

Mochizuki and colleagues from Keio University in Tokyo, the Chemo-Sero-Therapeutic Research Institute in Kumamoto, and RIKEN in Saitama have shown that von Willebrand factor has proapoptotic effects and that a disintegrin and metalloproteinase 28 (ADAM28) promotes metastasis by cleaving and...

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....

hematologic malignancies
multiple myeloma

Is There a Role for Metronomic Chemotherapy in Patients with Highly Refractory Multiple Myeloma?

Metronomic chemotherapy using a multidrug regimen appears beneficial and fairly well tolerated in patients with multiple myeloma that is highly refractory to previous treatments, investigators from the Myeloma Institute for Research and Therapy in Little Rock, Arkansas, reported.1 Their results...

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

Physical Activity Benefits Breast Cancer Survivors, but Role in Reducing Breast Cancer Risk Is Less Clear

Breast cancer survivors who engage in moderate to high levels of physical activity have reduced mortality and improved quality of life, according to recent studies. In addition, exercise may play a role in lowering the risk of breast cancer. “Physical activity can hasten recovery from the immediate ...

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...

cns cancers

First Drug for Children with Rare Brain Tumor Approved

The FDA approved a new pediatric dosage form of everolimus (Afinitor Disperz) to treat the rare brain tumor called subependymal giant cell astrocytoma (SEGA). This is the first approved pediatric-specific dosage form developed for the treatment of a pediatric tumor. Afinitor Disperz is recommended...

Expert Point of View: Fritz H. Schröder, MD

I am happy to accept the invitation by The ASCO Post to comment on the recent, long-awaited publication of the PIVOT study (Wilt et al: N Engl J Med 367:203-213, 2012) and the accompanying editorial by Thompson and Tangen (N Engl J Med 367:270-271, 2012). The editorial both points out weaknesses of ...

Expert Point of View: Timothy Wilt, MD, MPH

PIVOT is the largest and longest randomized trial conducted in men with early-stage prostate cancer detected during the era of widespread PSA testing. The trial enrolled 731 men and followed them for up to 15 years after randomization. PIVOT results demonstrate that compared to observation, radical ...

lymphoma

Management of a Patient  with Systemic Anaplastic Large Cell Lymphoma following Failure of One or More Combination Regimens

Case Summary presented by Steven M. Horwitz, MD, Assistant Attending, Lymphoma Service, Memorial Sloan-Kettering Cancer Center, New York. This is a case of a 49-year-old woman who developed an enlarged right axillary lymph node. The woman had noticed some discomfort under her right arm, which she...

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