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ASCO’s International Cancer Corps Launches Initiatives in Ethiopia and Vietnam

Imagine just four oncologists attempting to provide care for a population of 82 million people living in a country covering twice the territory of Texas. That’s the state of cancer care in Ethiopia. And imagine a country of more than 90 million people—more than twice the population of...

issues in oncology

FDA Issues Guidance for Diagnostic Tests Used with Targeted Therapies

The FDA issued a new draft guidance to facilitate the development and review of “companion diagnostics”—tests used to help health-care professionals determine whether a patient with a particular disease or condition should receive a particular drug therapy or how much of the drug to give. The draft ...

gynecologic cancers

Bevacizumab Makes Inroads against Ovarian Cancer

Bevacizumab (Avastin) administered with chemotherapy and continued after chemotherapy improves outcomes in ovarian cancer, according to two multicenter, randomized, double-blind phase III investigations presented at the 2011 ASCO Annual Meeting. The first study, ICON7, incorporated bevacizumab as...

multiple myeloma

Second Primary Malignancies Explored in Multiple Myeloma

Three randomized controlled trials presented at the 2010 Annual Meeting of the American Society of Hematology (ASH) suggested that treating multiple myeloma with lenalidomide (Revlimid) increased the risk of second primary malignancies; of particular concern is transformation to acute myeloid...

cost of care
health-care policy

Rising Costs of Cancer Care: It's More Than Drugs

All parties—the government, payers, and consumers—agree that, left unchecked, rising health-care costs will eventually hamstring vital portions of our delivery system. For example, Medicare, which covers more than 50% of the nation’s patients with cancer, is marching headlong toward insolvency....

lung cancer

A Clinician Weighs In on the National Lung Screening Trial

The results of the National Lung Screening Trial (NLST) will have important implications for practicing oncologists if low-dose helical CT screening is used routinely in the clinic. First, we will begin to find many more small tumors than we do now. This will pose new sets of questions for...

lung cancer

A Landmark Lung Screening Trial: What Does It Mean for Clinicians and Their Patients?

The NCI-funded National Lung Screening Trial (NLST), published recently in The New England Journal of Medicine,1 was heralded as a landmark study in lung cancer detection. This study is the first comprehensive clinical trial to find that screening high-risk individuals with low-dose CT reduces lung ...

prostate cancer

Androgen Deprivation Therapy plus Radiotherapy Increases Survival in Men with Localized Prostate Cancer

The addition of short-term androgen deprivation therapy to radiotherapy for men with stage T1b, T1c, T2a, or T2b prostate adenocarcinoma and a prostate-specific antigen (PSA) level of 20 ng/mL or less “conferred a modest but significant increase in the 10-year rate of overall survival, from 57 to...

SIDEBAR: NY State Law Mandates Discussion on End-of-life Care

Earlier this year, the New York State legislature passed a law requiring physicians and nurse practitioners to talk to patients with an expected survival of less than 6 months about their options, including hospice care and aggressive vs palliative treatment, although patients can refuse to discuss ...

issues in oncology

‘Unrealistic Optimism’ Poses Ethical Challenges, May Affect Informed Consent Process

Does a patient’s optimistic expectation of reaping a health benefit from participating in phase I and phase II oncology studies, even when he understands that these early trials are not designed to provide direct therapeutic benefit, compromise the informed consent process? And, does that...

bladder cancer

Updated Drug Label Approved for Pioglitazone after Safety Review

The FDA recently approved updated drug labels for pioglitazone (Actos) and other pioglitazone-containing medicines (in combination with metformin, Actoplus Met and Actoplus Met XR; and with glimepiride, Duetact) to include safety information that the use of pioglitazone for more than 1 year may be...

supportive care
symptom management

Experts Address Cancer-related Distress—the ‘Sixth Vital Sign’

More research is needed to investigate the effects of screening and treatment for distress in cancer care, according to a recent issue of the international journal Psycho‑Oncology. This special edition of the journal includes a review of screening for distress and depression over 40 years in cancer ...

global cancer care
health-care policy

Cancer Care in the UK: A Conversation with Chris Parker, MD

In the contentious debate over rising health-care spending, the cancer care policies of the British National Health Service (NHS) are often cited by U.S. policymakers as an example of how health-care rationing denies patients life-prolonging treatments based on costs. The ASCO Post recently spoke...

issues in oncology

Research in Combining Targeted Agents Faces Numerous Challenges

If the clinical trials endeavor in oncology is falling short of its goals and if targeted agents have not kept their promise, can a new approach to drug development provide a solution? Very possibly, said John Hohneker, MD, Chair of the Workshop Planning Committee for the conference, “Facilitating...

head and neck cancer

Circulating Tumor Cell Assay Shows Potential for Predicting Prognosis in Head and Neck Carcinoma

According to the NCI, an estimated 49,260 new cases of oral cavity, pharyngeal, and laryngeal cancers occurred in the United States in 2010, and approximately 11,480 deaths were attributed to these cases. It is estimated that 95% or more of these cases are squamous cell carcinomas. Currently, the...

ASCO Examines Impact of Health-care Reform on Cancer Care Disparities

In a new policy statement, ASCO outlines specific provisions of the 2010 Patient Protection and Affordable Care Act that have the potential to reduce cancer care disparities. ASCO’s statement makes recommendations to ensure that such provisions are carried out effectively, and urges additional...

UN Summit to Focus on Noncommunicable Diseases This Month

For the second time since its inception 65 years ago, the United Nations General Assembly is holding a “High-level Meeting” that will focus on health. During the September 19–20 meeting, world leaders will shine a spotlight on the devastation that noncommunicable diseases are causing and have...

ASCO Connection Adds New Columnists, Launches Group Creation Option

ASCO’s professional networking site, ASCOconnection.org, continues to build depth in areas of interest to the oncology community, adding as its newest commentator ASCO President Michael P. Link, MD, the Lydia J. Lee Professor in Pediatric Oncology at Stanford University School of Medicine, as well...

breast cancer
symptom management

A Conversation with Constance M. Chen, MD, MPH

Although incidence data vary widely, breast cancer–related lymphedema may affect as many  as 54% of the 2.3 million survivors of breast cancer in the United States. The condition is often disabling and can result in both long-term devastating physical consequences for survivors, including the loss...

issues in oncology
health-care policy

Congressional Hearing Highlights Oncology Drug Shortages

Some oncology drugs are in such short supply that the situation is now critical, with almost 200 drugs affected—triple that of 2003. This was the background described by speakers at a July 2011 congressional briefing sponsored by the Association of Community Cancer Centers (ACCC), ASCO, and other...

breast cancer

Genomic Researchers Identify Weak Points in Breast Cancer Cells

A large-scale project in genetic profiling has identified weak points in breast tumor cells that not only represent potentially new “druggable” targets but could lead to an entirely new classification of all cancers. The findings were recently reported in Cancer Discovery, a journal of the American ...

issues in oncology

A Conversation with Samuel Silver, MD, PhD

Over the past 2 decades, significant therapeutic advances have led to greater survival rates and quality of life for patients with cancer. During the same period there has been a transformation in the way oncology services are both perceived and delivered. In a recent conversation with The ASCO...

issues in oncology
health-care policy

Fixing the Drug Shortage: It’s About Time

I have spent the past 30 years trying to improve the results of treatment for advanced cancer. I had the privilege of working with Sir Michael Peckham when the late Professor Tim McElwain and he were evolving variants of the PVB (cisplatin, vinblastine, bleomycin) and PEB (cisplatin, etoposide,...

Expert Point of View: World Conference on Lung Cancer

The EURTAC study provides additional evidence of the efficacy of the oral EGFR inhibitors in the first-line treatment of patients with mutated EGFR—and, importantly, in Western patients, rather than Asians, for whom data are more abundant. “The findings speak to the fact that all patients with...

lung cancer

World Conference on Lung Cancer: Personalized Approaches to Treatment

The 14th World Conference on Lung Cancer hosted more than 7,000 attendees in Amsterdam recently, with the theme “Better Care through Personalized Medical Approaches.” The following are brief summaries of key data presented at the conference, with perspective provided by Roy S. Herbst, MD, PhD, of...

breast cancer

Patients with HER2-positive Breast Cancer Benefit from Trastuzumab plus Chemotherapy

Adding trastuzumab (Herceptin) to standard anthracycline/taxane–based chemotherapy continued to produce disease-free and overall survival benefits in patients with HER2-positive breast cancer enrolled in the North Central Cancer Treatment Group (NCCTG) N9831 and the National Surgical Adjuvant...

prostate cancer

Androgen Deprivation plus Radiotherapy Increases Survival in Men with Localized Prostate Cancer

Adding short-term androgen-deprivation therapy to radiotherapy “conferred a modest but significant increase in the 10-year rate of overall survival, from 57% to 62%,” in men with localized prostate cancer enrolled in Radiation Therapy Oncology Group (RTOG) trial 94-08. “This increase was...

prostate cancer

Long-term Data Show Benefit of Degarelix Beyond 3 Years in Advanced Hormone-dependent Prostate Cancer

Degarelix (Firmagon) is effective and well tolerated beyond 3 years in patients with advanced prostate cancer, according to a recent study published in The Journal of Urology.1 The new study (CS21A) extends the conclusions of the pivotal phase III study (CS21) in which the risk of prostate-specific ...

SIDEBAR: Expect Questions from Your Patients

Women who have already undergone mastectomy and chemotherapy may question why additional breast cancer treatment is needed. Benjamin D. Smith, MD, of MD Anderson Cancer Center in Houston said that he frequently has patients referred to him who initially express their preference to avoid radiation...

breast cancer

Many Women Treated for High-risk Breast Cancer Do Not Receive Recommended Postmastectomy Radiation Therapy

Despite major studies showing that postmastectomy radiation therapy improves survival for women with high-risk breast cancer and evidence-based guidelines supporting the use of postmastectomy radiotherapy, 45% of these patients do not receive such treatment, according to an analysis of data from...

lymphoma
global cancer care

Treating Cancer in Japan: A Conversation with Kensei Tobinai, MD

In this installment of Oncology Worldwide, internationally regarded lymphoma expert and cancer survivor, Kensei Tobinai, MD, Chief, National Cancer Center Hospital, Tokyo, sheds light on the Japanese oncology experience. Medical Education What was the medical school experience in Japan like? When...

integrative oncology

Integrative Oncology Modalities Supported by Varying Levels of Evidence, but More Research Needed Overall

Over the past couple of decades, unregulated nonstandard oncology approaches have gained growing popularity among cancer patients. The relatively new field of integrative oncology was established to promote a more holistic and multidisciplinary approach to cancer care and to encourage scientific...

leukemia

FDA Clears Genetic FISH Panel for Leukemia Patient Prognosis

Abbott announced it has received 510k clearance from the FDA for a new in vitro diagnostic test to aid in determining the prognosis of patients with chronic lymphocytic leukemia (CLL). Abbott’s Vysis CLL FISH Probe Kit is the first FDA-cleared CLL test to aid in prognosis. The test detects genetic...

New ASCO in Action Website

For the past 2 years, ASCO members and others who have looked to ASCO for insight on policy issues have turned to the ASCO in Action section of the Society’s website for up-to-date information. Now, ASCO has launched a whole new website devoted entirely to policy issues and ASCO’s specific efforts...

ASCO’s International Clinical Trials Workshop Educates Nascent Researchers on the Inner Workings of Clinical Trials

Pharmaceutical companies are increasingly conducting drug development research outside of the United States, Western Europe, and Japan. Attracted to the perceived lower costs, easier patient recruitment, and market potential, drug developers are now conducting more phase III clinical trials in...

ASCO’s Immediate Past President Helps Build Future of Cancer Research and Care by Supporting Conquer Cancer Foundation

George W. Sledge, Jr, MD, has been treating patients with breast cancer, and pursuing research in the field, for more than 30 years—the last few electrified by a rapid proliferation of knowledge. “We have so much to offer our patients today,” says Dr. Sledge, who serves as Ballve-Lantero Professor...

issues in oncology
health-care policy

Developing Targeted-agent Combinations: Business and Regulatory Issues, and Legal Obstacles

The Institute of Medicine’s National Cancer Policy Forum recently convened a public workshop, “Facilitating Collaborations to Develop Combination Investigational Cancer Therapies,” to address the promises and challenges involved in the development of combination oncologic drug therapies. In the...

issues in oncology
health-care policy

Oncology Drug Shortage: An Unintended Consequence of the Medicare Modernization Act and Free-market Forces?

Oncology has a drug shortage problem, and the FDA says that it is getting worse. Drug shortages are not a new phenomenon, but over the past few years we have seen a rapidly growing number of shortfalls that are limiting providers’ ability to care for their patients. In 2004, the FDA reported 58...

health-care policy

A Conversation with Monica Morrow, MD, FACS

Over the past 15 years, practice guidelines have become an accepted tool to help physicians optimize patient care by offering informed assessment of the benefits and potential harms associated with various care options. However, a plethora of new guidelines have entered the market, many of which...

skin cancer

Using the New Melanoma Drugs in the Clinic

With two effective new treatments for advanced melanoma, the question has become how to best use them and how to manage their toxicities.  Vemurafenib (Zelboraf) and ipilimumab (Yervoy)1 have different pharmacokinetics, which lend themselves to different patient types. Omid Hamid, MD, of The...

skin cancer

Novel BRAF Inhibitor Receives FDA Approval in Metastatic Melanoma

Vemurafenib (Zelboraf) received FDA approval on August 17, 2011, for treatment of metastatic or unresectable melanoma, based on the results of the phase III BRIM3 trial.1 BRIM3 compared vemurafenib to dacarbazine in 675 untreated patients with the BRAF V600E mutation. Vemurafenib targets the...

issues in oncology

We Can Conduct Clinical Trials of Protons

A great deal has been written about proton therapy, with a good deal of heat and only a modest amount of light. I would like to comment on an aspect of the proton vs photon controversy that I believe has not been adequately addressed: Should we run clinical trials that would allow us to prove that...

cost of care
palliative care
health-care policy

Palliative Care, Quality of Life, and Cost

More than half of our nation’s patients with cancer are Medicare beneficiaries, making the entitlement program ground zero in the heated debate on health-care spending. Total Medicare expenditures attributable to beneficiaries in their last year of life runs upward of 30%; this statistic serves as...

lymphoma

FDA Approves Brentuximab Vedotin in Two Lymphoma Indications

The antibody-drug conjugate brentuximab vedotin (Adcetris) was granted accelerated approval on August 19 for the treatment of relapsed or refractory Hodgkin lymphoma and systemic anaplastic large cell lymphoma. Brentuximab vedotin is the first new drug to be approved in Hodgkin lymphoma in more...

breast cancer
legislation

Giving Women a Fighting Chance When They Have Breast Cancer

I knew there was a chance I could get breast cancer, I just never thought it would really happen to me. I am one of 2.5 million breast cancer survivors living in our country today. Just weeks after getting a clean mammogram and my 41st birthday, I felt a lump in my breast. As a young and otherwise...

Susan G. Komen for the Cure® Announces 2011 Brinker Award Winners for Scientific Distinction

Armando Giuliano, MD, and Carlos Arteaga, MD, are being honored as this year’s winners of the Susan G. Komen for the Cure® Brinker Awards for Scientific Distinction in basic science and clinical research. The awards will be presented on December 7 at the 34th Annual San Antonio Breast Cancer...

breast cancer

LETTER TO THE EDITOR: Treating Cancer or Fear?

I read the article by Deb Stewart, “Acting on Fear” (The ASCO Post, August 15, 2011, page 1) with interest, disappointment, and empathy. “Acting on fear” in cancer treatment generally, and particularly in breast cancer, is not uncommon. Hence, I was most interested in the article’s major thrust, as ...

issues in oncology

Cancer Information on Wikipedia as Accurate as on PDQ but Harder to Understand

A comparison of cancer information on Wikipedia and the patient version of information on the NCI’s Physician Data Query (PDQ) “found that although Wikipedia had similar accuracy and depth to the PDQ, the written style was more complex and thus might be less understandable to patients.” According...

colorectal cancer

‘Hot Chemotherapy’ Generates Heated Debate about Its Use with Cytoreductive Surgery to Manage Peritoneal Metastases

"Hot chemotherapy” has become the common term for hyperthermic intraperitoneal chemotherapy (HIPEC), which together with cytoreductive surgery is being used by some surgeons to treat patients with carcinomatosis from colorectal cancer. While HIPEC is not considered the most important component of...

FDA Announces Changes in Drug Center’s Oncology Office

The FDA recently announced organizational changes within the office responsible for reviewing all drug and biologic applications for cancer therapies. The Center for Drug Evaluation and Research’s (CDER) Office of Oncology Drug Products has been reorganized and renamed the Office of Hematology and...

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