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solid tumors

I Am Not a Victim

Six years ago, at age 62, I was feeling in great shape. The year before, I had taken over custody of my 2- and 3-year-old great-grandchildren and decided to change the course of my career from motivational speaker to motivational coach to be home more often with the kids. It was during one of our...

Oncology Meetings

January 2013 3rd International Conference on Medical, Biological and Pharmaceutical SciencesJanuary 4-5 • Bali, Indonesia For more information: www.psrcentre.org Breast-Gynecological International Cancer CongressJanuary 17-18 • Cairo, Egypt For more information: www.bgicc.eg.net/ Highlights of ASH® ...

integrative oncology

Acupuncture: Does It Alleviate Symptoms Associated with Cancer Care?

A therapeutic modality of traditional Chinese medicine, acupuncture has been extensively investigated in Western medical settings. Its clinical use is increasingly common for the management of pain and other conditions. In the oncology setting, research demonstrates that acupuncture can...

Updates on Ruxolitinib from ASCO and ASH 2012, including Long-term Survival Data

Ruxolitinib (Jakafi), a novel, oral JAK1 and JAK2 inhibitor, was approved by the FDA on November 16, 2011 for patients with intermediate- or high-risk myelofibrosis. The approval was based on its efficacy in reducing spleen size and improving disease-related burdensome symptoms. In the brief In the ...

Lenalidomide Trial Negative in Metastatic Castration-resistant Prostate Cancer

Lenalidomide (Revlimid) failed to improve survival and increased toxicity when added to docetaxel and prednisone in men with chemotherapy-naive, progressive, metastatic castration-resistant prostate cancer in the phase III MAINSAIL trial reported at the 2012 ESMO Congress in Vienna. This study...

sarcoma

Expert Point of View: George Demetri, MD

Invited discussant of the abstract, George Demetri, MD, of Dana-Farber Cancer Institute and Harvard Medical School, Boston, noted that metastatic soft-tissue sarcomas present with variable clinical behaviors but are nearly always incurable with any approach. “Therefore, our intent is to palliate...

sarcoma

No Survival Advantage for Combination Chemotherapy in Advanced Soft-tissue Sarcoma  

The addition of aggressively dosed ifosfamide to doxorubicin in the treatment of advanced soft-tissue sarcomas significantly delayed disease progression but did not improve survival in the randomized phase III EORTC 62012 trial conducted by the Soft Tissue and Bone Sarcoma Group of the European...

skin cancer

Prevention and Treatment of Multikinase Inhibitor–induced Hand-Foot Syndrome

Multikinase inhibitors (sorafenib [Nexavar], sunitinib [Sutent], pazopanib [Votrient], axitinib [Inlyta], regorafenib [Stivarga]) block various proteins including vascular endothelial growth factor receptor (VEGFR) and platelet-derived growth factor receptor (PDGFR). They have been approved by...

gynecologic cancers

Combination Bevacizumab/Chemotherapy Improves Outcomes in Platinum-resistant Ovarian Cancer

The addition of bevacizumab (Avastin) to chemotherapy improved progression-free survival and response rates in patients with platinum-resistant recurrent ovarian cancer, according to an exploratory analysis of the phase III AURELIA trial. The combination of paclitaxel with bevacizumab achieved very ...

solid tumors
prostate cancer

Early Quality of Life Better with Proton-beam Therapy, but Late Effects Similar to Other Treatment Modalities for Prostate Cancer

Differing patterns of patient-reported quality of life for three-dimensional (3D) conformal radiotherapy, intensity-modulated radiation therapy, and proton-beam therapy were reported in a nonrandomized comparison of three modern cohorts of patients with prostate cancer. The study was presented at...

solid tumors
prostate cancer

Stereotactic Body Radiation Therapy Produces Impressive Results in Organ-confined Prostate Cancer

Stereotactic body radiation therapy (SBRT) delivered via the CyberKnife can achieve excellent outcomes with minimal toxicity in patients with prostate cancer. Importantly, this technique delivers therapeutic doses of radiation in four to five fractions, which reduces the number of clinic visits...

solid tumors
prostate cancer

Sildenafil Improves Overall Sexual Function in Men with Prostate Cancer Treated with Radiation

For the first time, a randomized controlled trial reported improved sexual function with 6 months of prophylactic sildenafil citrate before, during, and after radiation therapy in patients with prostate cancer.1 The paper was presented at the Plenary Session during the 54th Annual Meeting of the...

solid tumors
prostate cancer

Androgen-deprivation Therapy plus Radiation Proven as Standard of Care for High-risk Prostate Cancer

A combined-modality approach of androgen-deprivation therapy plus radiation therapy achieves a substantial survival benefit over androgen-deprivation therapy alone in patients with locally advanced prostate cancer according to final analysis of an intergroup randomized phase III study conducted by...

issues in oncology
cost of care
health-care policy

The Ethics of Rationing Cancer Care

Should cost be a consideration when deciding on treatment for patients with cancer, and if so, what kind of ethical dilemma does that pose for oncologists? With U.S. spending on oncology drugs expected to climb more than 20% annually over the next decade—reaching $173 billion by 2020, according to...

Clinical Cancer Advances 2012: ASCO’s Annual Report on Progress Against Cancer

Clinical research is continuously delivering new treatments that lengthen and improve the lives of patients with cancer. The abundance of advances reported in the past year illustrates our steady progress in cancer treatment and care. Clinical Cancer Advances 2012: ASCO’s Annual Report on Progress...

solid tumors
colorectal cancer

Finding Lynch Syndrome among Patients with Colorectal Cancer: Routine Tumor Testing Looks Best

Oncologists generally agree that screening patients with colorectal cancer for Lynch syndrome is a good thing. Patients who turn out to have the hereditary syndrome can inform their first-degree relatives, who in turn can undergo genetic testing. Those who have the characteristic mutations can take ...

issues in oncology

2012 In Review: Oncology Drugs/Indications Newly Approved by FDA

At press time, the FDA had granted approval for the following new agents and indications for cancer treatment in 2012. Cabozantinib (Cometriq) for the treatment of progressive metastatic medullary thyroid cancer. Cabozantinib is a small molecule that inhibits the activity of multiple tyrosine...

cns cancers

Revised Everolimus Dosing and New Safety/Efficacy Data for Approval in Subependymal Giant Cell Astrocytoma

On August 29, 2012, everolimus in a tablet for oral suspension form (Afinitor Disperz) was given accelerated approval for the treatment of pediatric and adult patients with tuberous sclerosis complex who have subependymal giant cell astrocytoma (SEGA) that requires therapeutic intervention but...

hematologic malignancies
leukemia

Liposomal Vincristine for Adult Patients with Relapsed/Refractory 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 In August 2012, vinCRIStine sulfate LIPOSOME injection...

breast cancer

Plenary Session Included Findings on Partial- vs Whole-breast Techniques and Patient Beliefs about Radiotherapy

When the dates were picked for the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO), no one could have anticipated that the meeting would coincide with Hurricane Sandy’s devastation of parts of the northeast. As the storm approached on Monday and Boston shut down its...

Surgical Resection for Colorectal Cancer Liver Metastases: Who, When, How?

Many patients with colorectal liver metastases can undergo surgical resection with curative intent. Who are these patients and how are they best managed? In an interview with The ASCO Post, Steven A. Curley, MD, Professor of Surgical Oncology at The University of Texas MD Anderson Cancer Center,...

Combination Therapy Not Better than Single-agent Bevacizumab for Advanced Renal Cell Carcinoma in BeST Trial

None of three combination therapies tested among patients with advanced renal cell carcinoma in the BeST trial came close to achieving the primary objective of a 67% improvement in median progression-free survival compared to single-agent bevacizumab (Avastin), Keith T. Flaherty, MD, reported at...

prostate cancer
issues in oncology

Medical and Behavioral Variables Have More Impact on Physical Functioning Than Finasteride Treatment

Taking finasteride over a 7-year period as part of the Prostate Cancer Prevention Trial (PCPT) “did not affect any of the three primary health-related quality-of-life domains—physical function, mental health, or vitality—either positively or negatively,” according to a study published in the...

issues in oncology
symptom management

Statin Use Associated with Reduced Cancer-related Mortality in Danish Study

Cancer-related mortality among patients in the Danish population receiving a diagnosis of cancer at age ≥ 40 years between 1995 and 2007 was significantly reduced in those who were receiving statin therapy at the time of diagnosis, according to an analysis reported by Nielsen and colleagues in The...

breast cancer

Expert Point of View: Meena S. Moran, MD

“Breast cancer in the geriatric population is a major health issue. Of the more than 230,000 new cases diagnosed annually, somewhere between 40% and 50% will occur in women 65 and over. Furthermore, the elderly population has been and will continue to increase exponentially over time,” stated Meena ...

breast cancer

Radiation Therapy Extends Survival in Elderly Women with Early Breast Cancer 

Chronologic age alone should not preclude use of radiation in elderly women with early breast cancer, suggest two studies presented at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO). Both studies showed a survival improvement in elderly women with early breast cancer ...

cns cancers
supportive care

Memantine Provides Modest Improvement in Cognition after Cranial Irradiation

Memantine, a drug used to treat Alzheimer’s disease, slowed cognitive decline in patients with brain cancer treated with whole-brain radiation therapy in a phase III trial reported at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO), held recently in Boston. Cognitive...

Current Perspectives on Triple-negative Breast Cancers

Triple-negative breast cancer—which lacks expression of the estrogen receptor, progesterone receptor, and HER2 oncogene—is a challenge for oncologists. The emergence of data showing strong heterogeneity for this subtype of breast cancer creates even more confusion regarding prognosis and...

Screening for Ovarian Cancer: A Gynecologic Oncologist’s Perspective

The recent U.S. Preventive Services Task Force (USPSTF) Reaffirmation Recommendation Statement concluded that in the population of asymptomatic women without known genetic mutations that increase risk for ovarian cancer, clinicians should not screen for ovarian cancer using transvaginal ultrasound...

hematologic malignancies

Bone Marrow Transplants Reduce Risk of Graft-vs-Host Disease Compared to Peripheral Blood

Patients who receive bone marrow transplants are significantly less likely to develop chronic graft-vs-host disease than those who receive peripheral blood stem cell transplants, according to a new, large randomized trial, the first of its kind with unrelated donors. Published recently in The New...

breast cancer

Analysis Suggests Screening Mammography Results in Substantial Overdiagnosis with Small Effect on Mortality

An analysis of Surveillance, Epidemiology, and End Results (SEER) data from 1976 through 2008 “suggests that whatever the mortality benefit, breast-cancer screening involved a substantial harm of excess detection of additional early-stage cancers that was not matched by a reduction in late-stage...

gynecologic cancers

Screening and Risk-reduction without Testing Positive for BRCA Mutation

Many women who do not test positive for a BRCA mutation undergo additional ovarian cancer screenings and risk-reducing procedures, despite limited data to determine the effectiveness of these interventions among an average-risk population. Results of an analysis of data from 1,077 women who were...

colorectal cancer

Patients Treated for Colon Cancer Can Reduce Risk of Recurrence with Balanced Diet and Lower Carbohydrate Intake 

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. Patients who have received standard...

integrative oncology

Green Tea

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...

Oncology Meetings

January 2013 Breast-Gynecological International Cancer CongressJanuary 17-18 • Cairo, EgyptFor more information: www.bgicc.eg.net/ Highlights of ASH® San Diego, CA and Toronto, CanadaJanuary 18-19 • San Diego, CA and Toronto, Ontario, CanadaFor more information: www.hematology.org/meetings...

breast cancer

I’m Not the Same Person I Was before Cancer

It’s not clear to me—and my doctors can’t say with any certainty—whether taking birth control pills for many years had anything to do with my getting breast cancer 3 years ago, at age 44. But the cancer growing in my left breast was diagnosed as stage I, estrogen receptor–positive. Although I never ...

Physician-Scientist Judah Folkman, MD, Faced Years of Skepticism Before His Theory of Angiogenesis Was Proven

That Moses Judah Folkman would buck tradition, breaking his family’s long line of rabbinical succession and pursuing a career in science and medicine instead, was evident from the time he was a young child. Born in Cleveland on February 24, 1933, the first child of Rabbi Jerome and Bessie Folkman,...

issues in oncology

Never a Dull Moment: A Day in the Life of an Oncology Fellow

Oncology fellows represent the future of cancer care, bringing the best and brightest young doctors into a rigorous training environment that molds their future career paths. Due to an impending workforce shortage in cancer care, the public health-care demands placed on today’s oncology fellows...

breast cancer

French Investigators Prospectively Test Genomically Driven Treatment in Metastatic Breast Cancer 

Whole-genome DNA analysis prospectively identified alterations in metastatic tumors that could be individually targeted with molecular agents, in a study presented at the 2012 European Society for Medical Oncology (ESMO) Congress by Fabrice André, MD, of Institut Gustave-Roussy, Villejuif, France....

breast cancer

Lumpectomy Rates Inconsistent with Response Rates in Early Breast Cancer

Achieving a pathologic complete response to neoadjuvant chemotherapy does not always reduce the aggressiveness of breast cancer surgery, according to an analysis of the NeoALLTO trial presented at the 2012 European Society for Medical Oncology (ESMO) Congress in Vienna.1 Carmen Criscitiello, MD, of ...

prostate cancer

Online Prostate Cancer Information Is Written at Reading Levels above Many Americans’ Literacy Skills

Although 61% of Americans are going online to access health information,1 many of them may not understand what they find there, including information about prostate cancer treatment options. According to a new study published in The Journal of Urology,2 as many as 90 million Americans have literacy ...

issues in oncology

ASCO Secures Major Funding and Data License Agreements for CancerLinQ™

ASCO has secured $3 million in new funding and key data sharing arrangements to support the development of CancerLinQ™, a ground-breaking information technology initiative that aims to achieve higher quality, higher value cancer care with better outcomes for patients. ASCO’s Conquer Cancer...

solid tumors

Gene Profiling Directs Site-specific Therapy for Carcinoma of Unknown Primary Site

Patients with carcinoma of unknown primary site usually receive empiric therapy (eg, with taxane/platinum or gemcitabine/platinum regimens), resulting in a median overall survival of approximately 9 months. As reported recently in Journal of Clinical Oncology, Hainsworth and colleagues have shown...

Peter P. Yu, MD, Elected ASCO President, 2014–2015, Others Named to ASCO Board

Peter P. Yu, MD, has been elected President of ASCO for a 1-year term beginning in June 2014. He will take office as President-Elect during the ASCO Annual Meeting in Chicago in June 2013. Additionally, three new members were elected to the ASCO Board of Directors, and three new members were...

cns cancers

Management of Brain Metastases

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...

lymphoma

Faster Rituximab Infusion for Previously Untreated Follicular Non-Hodgkin and Diffuse Large B-cell Lymphomas 

On October 19, 2012, FDA approved a 90-minute infusion for rituximab (Rituxan) starting at cycle 2 for patients with previously untreated follicular non-Hodgkin or diffuse large B-cell lymphoma who do not experience a grade 3 or 4 infusion-related reaction during cycle 1.1 Patients with clinically...

leukemia

Omacetaxine for Chronic or Accelerated Phase CML Patients with Resistance/Intolerance to Tyrosine Kinase Inhibitors

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 October 26, 2012, the FDA granted accelerated...

supportive care

Tumor Grade Is Associated with Risk for Venous Thromboembolism

Recent data suggest that risk for venous thromboembolism is associated with biologic aggressiveness of cancer. Findings in the Vienna Cancer and Thrombosis Study, recently reported by Ahlbrecht and colleagues in Journal of Clinical Oncology, indicate that patients with higher-grade tumors are at...

issues in oncology

ASCO’s Approach to Health Information Technology and the Rapid-learning System

The slow, but inevitable evolution of electronic oncology health-care systems has already, at least conceptually, moved to the next generation of machines that not only store and process data, but also have the ability to provide real-time clinical decision support. At ASCO’s first Quality Care...

Expert Point of View: Martin Dreyling, MD and Joshua Brody, MD

Martin Dreyling, MD, Professor at the University of Munich in Germany, said the most important lymphoma studies presented at the 2012 ASH Annual Meeting focused on ibrutinib, the first-in-class Bruton’s tyrosine kinase inhibitor. “Basic science has gone mainstream. We will see a revolution during...

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