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bladder cancer

Expert Point of View: Chemoradiation with Fluorouracil and Mitomycin Reduces Recurrence of Muscle-invasive Bladder Cancer

In an editorial accompanying the recently reported UK phase III Bladder Cancer 2001 (BC2001) trial, Shipley and Zietman, from Massachusetts General Hospital and Harvard Medical School, point out that this trial shows that “the addition of a very tolerable regimen of chemotherapy to radiotherapy...

bladder cancer

Chemoradiation with Fluorouracil and Mitomycin Reduces Recurrence of Muscle-invasive Bladder Cancer

Radiotherapy is an alternative to surgery in muscle-invasive bladder cancer, particularly in less-fit patients. However, it is associated with high rates of incomplete response or recurrence, with salvage surgery often being required. Although synchronous chemoradiotherapy has improved local...

lung cancer

American Lung Association Provides Guidance on Lung Cancer Screening

The American Lung Association has released new interim guidelines to assist physicians, patients, and the public in their discussions about lung cancer screening. Developed by the American Lung Association’s Lung Cancer Screening Committee chaired by Jonathan Samet, MD, MS, from the University of...

supportive care

New Research Shows Promise in Cachexia, a Persistent Clinical Challenge

In the late 1980s, researchers led by Alfred L. Goldberg, PhD, first isolated the large protein complexes now called 26S proteasomes, which are the sites where most cellular proteins are degraded back to amino acids. Protein degradation by the proteasome pathway is critical in regulating many...

Expert Point of View: More New Data Support Use of Daily Aspirin to Prevent Cancers

Is it time to recommend aspirin for cancer prevention? “It’s the question we are asking,” said Andrew T. Chan, MD, Massachusetts General Hospital and Harvard Medical School, who wrote a commentary accompanying three new studies in The Lancet and Lancet Oncology. The studies, by Peter M. Rothwell,...

colorectal cancer

More New Data Support Use of Daily Aspirin to Prevent Cancers

Three new studies have added data to the growing evidence that low-dose, daily aspirin helps prevent colorectal cancer and other malignancies and may be useful in preventing metastases as well.1-3 Coming on the heels of other recent studies, the results appear to strengthen the case for using...

breast cancer

Automated HER2 Immunohistochemical System Approved

Leica Biosystems, a division of Leica Microsystems, announced that it has received premarket approval from the FDA for its Bond Oracle HER2 IHC System, a semi-quantitative immunohistochemical assay to determine human epidermal growth factor receptor 2 oncoprotein status in formalin-fixed,...

lung cancer
prostate cancer
issues in oncology

JAMA Highlights New Comparative Effectiveness Studies

A recent press briefing moderated by Phil B. Fontanarosa, MD, MBA, Executive Editor, JAMA, presented new findings on comparative effectiveness research, and two of the studies discussed focused on cancer. Dr. Fontanarosa started by defining comparative effectiveness research, which gained...

Cancer.Net, ASCO’s Patient Education Website: Celebrating 10 Years of Trusted Cancer Education

“For 10 years, Cancer.Net has reflected the voice of the physician and given people with cancer and their loved ones the tools they need to actively participate in their cancer care. ASCO has used all the technological advances of the past decade to make information more accessible, interactive,...

ASCO Past President Highlights QOPI® Efforts to Improve Care in Michigan

ASCO’s Quality Oncology Practice Initiative (QOPI®) can be used to assess the quality of care in a statewide consortium of oncology practices and ultimately can lead to better care for patients with cancer, said ASCO Past President Douglas W. Blayney, MD, at a recent briefing on cancer care value...

ASCO Launches First Annual Quality Care Symposium November 30

So much health services research is underway in oncology that, rather than relegating it to just a portion of the Annual Meeting, ASCO has decided to launch a meeting devoted entirely to the emerging discipline. The first annual Quality Care Symposium will take place November 30 through December 1...

Conquer Cancer Foundation Board Member Tom Roberts Cites Need to Grow Research Capacity as Opportunity for Discovery Accelerates

Thomas G. Roberts, MD, dedicates a shelf in his home to memories of patients—photographs, notes, expressions of gratitude, traces of lives linked with his through cancer treatment. He looks at it every day, he says, and the memories inform his mission. “In oncology, you become part of people’s...

thyroid cancer

Vandetanib: New Drug for Unresectable 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 The oral kinase inhibitor vandetanib (Caprelsa) was...

lung cancer
issues in oncology

Analysis Suggests CT Screening Could Save Lives at Relatively Low Cost

Results of an actuarial analysis suggest that offering lung cancer screening with low-dose spiral computed tomography (CT) as a commercial insurance benefit to individuals who are 50 to 64 years old and have a smoking history of 30 pack-years or more could save lives at relatively low cost....

lung cancer

Expert Point of View: Biomarker Analysis of the TORCH Study: First-line Erlotinib Only in Patients with EGFR-positive Non–Small Cell Lung Cancer

Tetsuya Mitsudomi, MD, PhD, of Aichi Cancer Center Hospital in Nagoya, Japan, discussed the study presented by Tsao and colleagues1 and said that many previous trials have already shown that EGFR mutation is the most reliable predictive marker for treatment with EGFR tyrosine kinase inhibitors....

lung cancer

Biomarker Analysis of the TORCH Study: First-line Erlotinib Only in Patients with EGFR-positive Non–Small Cell Lung Cancer

Patients with advanced non–small cell lung cancer (NSCLC) should receive treatment with erlotinib (Tarceva) before receiving standard chemotherapy only if their tumor is known to harbor EGFR mutations, researchers reported at the 3rd European Lung Cancer Conference in Geneva, Switzerland.1 The...

lung cancer

Expert Point of View: New Genetic Signature May Help Identify Risk of Relapse in Patients with Completely Resected Early Non–Small Cell Lung Cancer

Commenting on the study, David Carbone, MD, PhD, of the Vanderbilt-Ingram Cancer Center, said that the Spanish group studied tumors from patients with completely resected stage I and II NSCLC for gene RNA expression profiles using 41,000 different probes. “Since over one-half of these patients...

SIDEBAR: Private/Public Health-care Divide Creates Disparity in Cancer Pain Treatment in South Africa

Approximately 15% of South Africa’s people have private health-care insurance and use private hospitals and clinics; another 10% also use private care paid out of pocket. However, the remaining 75% of South Africans use public health care, which is spread out over rural and urban areas. Although...

global cancer care
pain management
palliative care

Untreated Cancer Pain Remains a Significant Global Problem

“Physicians are afraid of morphine … Doctors [in Kenya] are so used to patients dying in pain … they think that this is how you must die. They are suspicious if you don’t die this way — [and feel] that you died prematurely.” —Human Rights Watch interview with Dr. John Weru of Nairobi Hospice,...

global cancer care

Cancer Care in India: Complex Challenges in a Populous Nation

With 1.22 billion people, India is the second most populous country in the world. Experts project that cancer incidence in India will increase by more than two-thirds over the next 20 years, to approximately 1.7 million new cases per year. Due to a range of economic and social issues, most of...

leukemia

Progress in Treating Chronic Lymphocytic Leukemia Has Led to Across-the-board Improvements in Survival

Four decades ago, Kanti R. Rai, MD, was determined to figure out why some of his patients with chronic lymphocytic leukemia (CLL) died within 2 years after their diagnosis, while others lived for 20 or even 30 years. At the time, Dr. Rai was a young scientist doing research in leukemia at...

breast cancer

Inhibition of SFRP2 Found to Inhibit Growth of Triple-negative Breast Tumors

Secreted frizzled related protein 2 (SFRP2), a protein that modulates the Wnt signaling pathway and is involved in embryonic development, has been thought to exert a tumor-suppressive effect via inhibition of β-catenin activation. However, researchers at the University of North Carolina at Chapel...

SIDEBAR: Learning from Advanced Disease

Current testing of immunotherapy approaches against cancer involves patients in whom standard therapies have failed. “That really puts us at a great disadvantage because a lot of the standard therapies are immunosuppressive, as is the tumor itself as it grows,” Olivera Finn, PhD, said at a press...

Immunotherapy Clinical Trials Show Benefits for Patients with Advanced Cancers

Immunotherapeutic approaches, including vaccines, a monoclonal antibody, and a combination of low-dose interleukin (IL)-2 (Proleukin) and retinoic acid, are showing some success in clinical trials investigating the prevention of breast cancer recurrence in women at high risk, the treatment of...

supportive care
symptom management

Managing Febrile Neutropenia: What Are the Best Antibiotic Regimens?

Management of patients with cancer who have fever and a low neutrophil count is one of the most common scenarios oncologists face today. “Physicians have to be keenly aware of the infection risks, diagnostic methods, and microbial therapies required for managing febrile neutropenic patients because ...

prostate cancer

Advances in Prostate Cancer Accompanied by Ongoing Debates

Scientific advances have markedly improved prostate cancer survival, but this clinical success story is not without its share of controversy. From screening through treatment, a growing array of options offer an admixture of promise and confusion for clinicians and patients. Moreover, today’s...

issues in oncology
health-care policy

Maintenance of Certification in Medical Oncology

It is said that time is perhaps the most treasured asset we have. If you are a practicing oncologist, everyone wants more and more of your time, and I’m not referring to patients. Rather, there is an increasing proliferation of folks who want to make sure we’re doing a good job, and they are...

SIDEBAR: Obese Children with Cancer May Be at Greater Risk for Cancer Recurrence

A study published in the Journal of Clinical Oncologyin 2008 found that obesity is an important contributing factor to chemotherapy resistance and rising relapse rates in children with leukemia.1 According to the study, obese children diagnosed with leukemia have a 50% higher chance of relapsing...

health-care policy

ASCO Issues New Guideline on Chemotherapy Dosing for Obese Patients

In April, ASCO released a new clinical practice guideline on the appropriate dosing of chemotherapy drugs given to obese adult patients with cancer. The result of an analysis by a panel of experts assembled by ASCO, the guideline calls for the use of a patient's actual body weight when calculating...

breast cancer

New Breast Biopsy System with Vacuum Technology Approved

Devicor Medical Products, Inc, announced that it has received 510(k) clearance from the FDA for the Mammotome elite Biopsy System, a tetherless single-insertion, multiple-sample, vacuum-assisted biopsy device featuring proprietary vacuum technology. Devicor also announced the commercial launch of...

leukemia

Pediatric ALL with Induction Failure Is Highly Heterogeneous with Varying Outcomes

While failure of remission-induction therapy is rare in children and adolescents with acute lymphoblastic leukemia (ALL), when it does occur it is highly adverse and heterogeneous, according to a study in The New England Journal of Medicine. “Patients who have T-cell leukemia appear to have a...

lymphoma

Panobinostat Produces Objective Responses in Patients Refractory to Autologous Transplant

Panobinostat produced objective responses in 27% and tumor reductions in 74% of 129 patients enrolled in “the largest, prospective, multicenter, international trial conducted in heavily pretreated patients” with Hodgkin lymphoma who relapsed or were refractory to autologous stem cell...

thyroid cancer

Low-dose Radioiodine as Effective as High-dose in Thyroid Ablation

Two studies in The New England Journal of Medicine found that low-dose radioiodine is as effective as a high-dose strategy in treating patients with thyroid cancer and that recombinant human thyrotropin (thyrotropin alfa [Thyrogen]) and thyroid hormone withdrawal had similar efficacy in preparing...

health-care policy

Physicians Need to Be Involved in Reducing Costs

I am so proud of ASCO for participating in the American Board of Internal Medicine Foundation’s Choosing Wisely campaign (see The ASCO Post, May 1, page 19; and page 75 of this issue). I am the Associate Medical Director for a 280-physician multispecialty group in the Hudson Valley of New York,...

palliative care

The Semantics of Palliative Care

The interview with Thomas J. Smith, MD (The ASCO Post, April 15, 2012), the lead author of the ASCO Palliative Care Provisional Clinical Opinion, was timely. However, it left many clinical terms and issues unclear. A significant percentage of modern medicine, including cancer care, is palliative....

symptom management

Surviving the Aftermath of Cancer

With medical information now just a click away, it’s difficult to imagine a time before the Internet existed, when finding answers to questions about serious diseases was nearly impossible. When I was diagnosed with liposarcoma 33 years ago, there was only one oncologist in my hometown of Tyler,...

pain management

Screening for Distress and Unmet Needs in Patients with Cancer

In the past decade, “screening for distress has been positioned as the sixth vital sign in cancer care, in addition to the first five, which are measurements of pulse, respiration, blood pressure, temperature, and pain,” according to a review article in the Journal of Clinical Oncology. Although...

pain management
palliative care

Pain Remains Prevalent and Often Inadequately Treated among Cancer Outpatients

“Pain is as prevalent in ambulatory oncology patients with common solid tumors as it was more than 20 years ago, despite the fact that opioid prescribing in the United States has increased more than 10-fold since 1990,” according to results of a study among 3,023 ambulatory patients with cancer...

integrative oncology

Acai Berry

The use of dietary supplements by patients with cancer 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...

SIDEBAR: Difference between Efficacy and Effectiveness

One of the reasons large population-based studies are important is based on the “difference between efficacy—does a treatment work in a highly controlled setting of a phase III randomized clinical trial—and effectiveness—does a treatment work in general practice,” according to Benjamin D. Smith,...

SIDEBAR: Expect Questions from Your Patients

“Our study provides critical interim companion data to awaited randomized trials and may help clinicians and patients quantify the risk-benefit ratio of brachytherapy compared with standard therapy,” Benjamin D. Smith, MD, said of a study comparing lumpectomy and either whole-breast irradiation or...

breast cancer

Will Study Showing Increased Complications Compared to Whole-breast Irradiation Put the Brakes on Brachytherapy?

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. Older women treated for invasive...

What You Need to Know About Glucarpidase Injection for Toxic Methotrexate Levels in Renal Impairment

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, glucarpidase injection (Voraxaze) was...

lymphoma

Newest Indication for Rituximab as Maintenance Treatment in Non‑Hodgkin Lymphoma

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 The CD20-directed monoclonal antibody rituximab...

health-care policy

ASCO Reexamines the Oncology Workforce Shortage

A study commissioned by ASCO in 2006 predicted a significant shortage of medical and gynecologic oncologists in the United States by 2020. As a result, the organization created the Workforce Implementation Group to develop recommendations to stem the projected workforce shortfall and ensure ongoing ...

colorectal cancer

New Drug Application Submitted for Regorafenib for the Treatment of Metastatic Colorectal Cancer

Bayer HealthCare announced that it has submitted a New Drug Application (NDA) to the FDA seeking approval for the oral multikinase inhibitor regorafenib for the treatment of patients with metastatic colorectal cancer. The submission is based on the results of the pivotal, global phase III CORRECT...

prostate cancer

Denosumab Delays Time to First Bone Metastasis in Men with Castration-resistant Prostate Cancer

Denosumab (Xgeva) significantly delayed time to first bone metastases among men with nonmetastatic castration-resistant prostate cancer enrolled in a phase III randomized, placebo-controlled trial. The time to first bone metastasis was 33.2 months among the 716 patients randomly assigned to receive ...

FDA-led Research Team Discovers Autoimmune Mechanism for Drug-induced Adverse Reactions

A team of researchers led by the FDA has discovered a new mechanism for identifying and understanding drug-related autoimmune reactions. In an article available online in the journal AIDS, the team reported that in certain at-risk patients, the anti-HIV drug abacavir (Ziagen) causes the immune...

SIDEBAR: Photodynamic Therapy for Cancer

Photodynamic therapy is a two-step treatment that includes a photosensitizing agent and a light source. In the first step, the photosensitizing agent (porfimer sodium) is injected into the bloodstream and absorbed by all cells. Over 24 to 48 hours, the drug is concentrated in cancer cells. In the...

International Photodynamic Medicine Symposium: Shedding New Light on an Old Therapy

This past May, a collaborative think tank of researchers was convened at The Ohio State University, Columbus, to share their expertise in a somewhat older treatment that is reemerging on many fronts: photodynamic therapy. Participants from the United States, Great Britain, and Japan took part in...

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