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Showing 12201 - 12250Pathologic Complete Response as a Test Bed for Novel Therapies: Proceed—With Caution!
Pathologic complete response as assessed surgically after neoadjuvant treatment is being touted by some researchers as a stand-alone endpoint justifying early drug approval for breast cancer. They argue that it provides a more efficient means of testing the value of agents that might be useful in...
Expert Point of View: Monica Morrow, MD
Monica Morrow, MD, the Anne Burnett Windfohr Chair of Clinical Oncology and Chief of the Breast Service, Department of Surgery, at Memorial Sloan-Kettering Cancer Center, New York, congratulated Christiane K. Kuhl, MD, and colleagues for “an innovative approach to making screening magnetic...
Could MRI Be a Better Breast Cancer Screening Tool Than Mammography?
German investigators reported at the 2013 Breast Cancer Symposium in San Francisco that an abridged magnetic resonance imaging (MRI) protocol can accurately detect cancers among women whose mammographic screenings were negative.1 MRI, therefore, may reveal the type of tumor that mammography...
Expert Point of View: Steven J. O’Day, MD
Steven J. O’Day, MD, Director of Clinical Research at the Beverly Hills Cancer Center and Adjunct Member of the John Wayne Cancer Institute in Los Angeles, said, “This is an important study. It allows us to feel comfortable with our aggressive approach to the management of DCIS.” Dr. O’Day...
Radiation Therapy Is Safe in the Management of Ductal Carcinoma In Situ: No Increase in Risk of Cardiovascular Disease
Radiation therapy as part of the management of ductal carcinoma in situ (DCIS) did not increase the risk of cardiovascular disease 10 years after treatment, according to a large retrospective study presented at a press conference held just prior to the 2013 Breast Cancer Symposium.1 Longer...
Expert Point of View on ductal carcinoma in situ
In an e-mail interview, E. Shelley Hwang, MD, an expert who has coauthored several papers on ductal carcinoma in situ (DCIS), weighed in on the two abstracts about management of DCIS featured in this issue of The ASCO Post—one presented by Melissa L. Pilewskie, MD (perioperative MRI in DCIS, page...
Expert Point of View: Steven J. O’Day, MD
This is an important large retrospective single-institution study …[conducted in the context of a] tremendous increase in use of MRI for invasive and noninvasive breast cancer,” said Steven J. O’Day, MD, who moderated a presscast held just prior to the 2013 Breast Cancer Symposium. “The study...
Single-Institution Study Evaluates Routine Use of Perioperative MRI in Patients With Ductal Carcinoma In Situ
Perioperative MRI for patients with ductal carcinoma in situ (DCIS) was not associated with a reduction in locoregional recurrence or contralateral breast cancer development in a large single-center study reported at the 2013 ASCO Breast Cancer Symposium. The study also was presented at a...
What Is on the Horizon in the Management of Breast Cancer?
In Keynote Lectures during the 2013 ASCO Breast Cancer Symposium, experts George Sledge, MD, and Monica Morrow, MD, offered their opinions and outlook on how the medical and surgical management of breast cancer may continue to evolve over the next 5 to 10 years.1 Dr. Sledge is Chief of Oncology at...
Trying to Improve Value in Cancer Care: An Experiment
One of the more significant problems in modern oncology practice is to provide increased value at a time when costs are spiraling upward, and new parameters of “success” are being introduced into the equation—most visibly, inside the Beltway in Washington, DC. Thus, oncologists will need to address ...
Breast Cancer Care in the Era of Accountable Care Organizations
Prepare for big changes ahead, Lawrence N. Shulman, MD, Senior Vice President for Medical Affairs at the Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Harvard Medical School in Boston, told oncologists at the 2013 Breast Cancer Symposium.1 One change is the emergence of...
Contemporary Studies Dispute Findings of Radiation-Induced Cardiotoxicity
At the 2013 Breast Cancer Symposium, studies suggested that with current radiotherapy techniques the mean radiation doses to the heart are much lower—and thus radiotherapy is presumably much safer—than findings suggested by an article published in The New England Journal of Medicine last spring.1...
Breast Cancer Radiotherapy and Cardiotoxicity: What Is the True Risk?
Evidence has long been accumulating that radiotherapy involving the heart can result in premature ischemic heart disease, but interest peaked last spring when a case control study published in The New England Journal of Medicine1 found an increased risk for cardiac-related deaths in breast cancer...
Front-Line Treatment Strategies to Achieve Long-Term Control of CLL Combined With Optimal Quality of Life
“The management of chronic lymphocytic leukemia (CLL) is undergoing profound changes. Several new drugs have been approved for CLL treatment (fludarabine, bendamustine [Treanda], and the monoclonal antibodies alemtuzumab [Campath], rituximab [Rituxan], and ofatumumab [Arzerra]), and many more drugs ...
Intralesional Cytokine Therapy in Cutaneous Melanoma: A Call for Clinical Trials
Cutaneous melanomas are mostly an immunogenic group of tumors, but they are also heterogeneous. Therefore, therapeutic specificity and autogenetic approaches are essential to secure beneficial results. The objective of sentinel lymph node biopsy, at the time of diagnosis, is to identify patients...
SIDEBAR: Expect Questions About Contralateral Prophylactic Mastectomy: Carefully Review Risks and Alternatives
Physicians were considered the most important source of information about contralateral prophylactic mastectomy in a survey of 123 women who were diagnosed with cancer in one breast and chose to have the contralateral procedure. While 80% of the women reported that they spoke with their physicians...
Better Risk Communication Strategies Needed to Ensure Decision to Have Contralateral Prophylactic Mastectomy Is Evidence-Based
Overestimating the risk that cancer in one breast will affect the other breast may cause many young women with breast cancer to choose contralateral prophylactic mastectomy even though most know it does not clearly improve survival. In a survey of 123 women who were diagnosed with cancer in one...
Claudia I. Henschke, PhD, MD, Took a Circuitous Route to Her Groundbreaking Work in Lung Cancer Screening
“Once you have tasted flight, you will forever walk the earth with your eyes turned skyward, for there you have been, and there you will always long to return.” —Leonardo da Vinci Lung cancer CT screening may have had no greater advocate than Claudia I. Henschke, PhD, MD. In the face of...
Lung Cancer Screening: Actionable Evidence
This recent paper in The New England Journal of Medicine outlines the details of the clinical outcomes with two incidence screens that were conducted as part of the National Lung Screening Trial (NLST).1 In the wake of the positive review of the U.S. Preventive Services Task Force (USPSTF) draft...
Low-Dose CT Screening Identifies More Early Lung Cancer but Has Lower Positive Predictive Value vs Radiography
Results of the two rounds of annual incidence screening with low-dose computed tomography (CT) vs radiography in the National Lung Screening Trial (NLST) were recently reported by Denise R. Aberle, MD, Professor of Radiology and Bioengineering at the University of California at Los Angeles and...
Nab-Paclitaxel in Metastatic Pancreas 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 September 6, paclitaxel protein-bound particles...
Having Breast Cancer Has Actually Been a Positive Experience
I know it sounds strange, but being diagnosed with cancer was one of the best things to have happened to me. I don’t mean to diminish the traumatic experience of hearing the words, “You have breast cancer.” That was over 11 years ago, and I’m still reeling from the diagnosis and its aftereffects....
Cabozantinib in Medullary Thyroid Cancer: A Landscape-Shaping New Treatment
Medullary thyroid cancer is derived from parafollicular C cells in the thyroid gland. The disease is sporadic in about 75% of cases and hereditary in the remaining 25%.1 Oncogenic mutations in the gene for tyrosine kinase receptor rearranged during transfection (RET) are driver genetic alterations...
AACR Cancer Progress Report 2013 Highlights Critical Importance of Biomedical Research
On September 17, the American Association for Cancer Research (AACR) presented highlights of its 2013 Cancer Progress Report1 at the National Press Club in Washington, DC. AACR Chief Executive Officer Margaret Foti, PhD, MD (hc), opened the program with a double-edged message, first citing the...
'Master Protocol' Could Revolutionalize Trials in Lung Cancer, and Eventually Other Cancers
Cancer advocates and clinical trialists, for some time, have been proposing a radical change to the laborious drug development process—that industry, academia, funding sources, and other stakeholders actually pool their brain power and financial means and work together, not separately, to develop...
A Look Ahead: How the FDA Is Adapting in the Era of Precision Medicine
Dubbed “Cancer Czar” by the media, Richard Pazdur, MD, Director of the U.S. Food and Drug Administration (FDA) Office of Hematology and Oncology Products, said he has the “best job in oncology, with a unique vantage point in cancer drug development.” An oncologist for more than 30 years—including...
ASCO President-Elect Candidate Julie M. Vose, MD, MBA, FASCO
Cost of Care and Federal Funding How can ASCO address the high cost of cancer care and diminishing federal resources for basic and translational research? We need to work with the Centers for Medicare & Medicaid Services, private insurers, and health-care systems to encourage evidence-based...
ASCO President-Elect Candidate Lynn M. Schuchter, MD, FASCO
Cost of Care and Federal Funding How can ASCO address the high cost of cancer care and diminishing federal resources for basic and translational research? In answer to the first part of this question, the rising cost of cancer care has certainly become a focus of national conversation given the...
International Cancer Corps Provides Valuable First-Time Volunteer Experience
Even as oncologists try to tackle the changing landscape of health care in the United States, many realize that both physicians and patients in this country are still in a better position than those fighting cancer abroad in low- and middle-income countries. In 2009, ASCO joined with Health...
SIDEBAR: IMWG Recommendations
The International Myeloma Working Group (IMWG) recommends intravenous zoledronic acid as first-line therapy and intravenous pamidronate as second-line therapy for all patients being treated for multiple myeloma, regardless of imaging findings.1 These drugs are given monthly for 2 years and can be...
Options for Management of Bone Health in Patients With Multiple Myeloma
Bone health is critical in patients with multiple myeloma, since up to 85% will suffer bone damage. Options for management include two FDA-approved bisphosphonates—pamidronate and zoledronic acid—and possibly the RANK-L inhibitor denosumab (Xgeva, investigational use). Importance of Supportive ...
New Strategies for Relapsed/Refractory Multiple Myeloma Explored
Although upfront therapy can achieve remission in multiple myeloma, most patients will ultimately relapse. Newer targeted therapies and genomic analysis are moving the management of relapsed/refractory multiple myeloma forward, according to Kenneth C. Anderson, MD, Director, Jerome Lipper Multiple...
The AVEX Trial
As reported in The Lancet Oncology by Cunningham and colleagues and reviewed in this issue of The ASCO Post, the AVEX trial was an open-label randomized phase III trial limited to patients over the age of 70 years with previously untreated, unresectable metastatic colorectal cancer who were not...
Aspirin Protects Against Colorectal Cancer Recurrence in PIK3CA-Mutant Tumors
At the 2013 European Cancer Congress, two investigative teams attempted to explain how aspirin may protect against colorectal cancer recurrences, with one study showing PIK3CA mutations associated with protection from aspirin, but not a COX-2 inhibitor, and the other study implicating HLA class I...
ESMO President Martine Piccart, MD, PhD, on the Importance of Diagnostics in Move From Stratified to Personalized Care
We are now living in an era of stratified oncology. The European Cancer Congress (ECC) 2013 held recently in Amsterdam provided many opportunities to attendees, including chance for discussions with basic and translational scientists, researchers, pathologists, and clinicians, as well as time for...
Program Co-Directors Highlight Abstracts of Interest for the Upcoming 2013 San Antonio Breast Cancer Symposium
The Co-Directors of the 2013 CTRC-AACR San Antonio Breast Cancer Symposium, which will be held December 10–14, 2013, have highlighted what they consider to be the most important abstracts to be presented at the Symposium. In a telebriefing in advance of the December meeting, C. Kent Osborne, MD,...
Expert Point of View: Steven J. O'Day, MD
This is a provocative and compelling study. I applaud Dr. Herman and his team. The take-home message was beautifully articulated,” said presscast moderator Steven J. O’Day, MD, Director of Clinical Research at the Beverly Hills Cancer Center and Adjunct Member of the John Wayne Cancer Institute in...
Women Undergoing Mammography Fail to Understand Breast Cancer Risk
More than 90% of women undergoing mammography screening could not give an accurate estimate of their personal risk of developing breast cancer, according to results of a large survey reported at the 2013 ASCO Breast Cancer Symposium and featured in a premeeting presscast. The survey showed that a...
Optimizing Anti-HER2 Treatment for Metastatic Breast Cancer in 2013
The good news about HER2-positive breast cancer is that recurrent disease is plummeting, owing to the impact of adjuvant trastuzumab [Herceptin]. Hopefully, first-line metastatic treatment is becoming a thing of the past,” said Harold Burstein, MD, PhD, of Dana-Farber Cancer Institute, Boston....
The Devastating Impact of Sequestration on Medical Research
The primacy of science and the overwhelming belief in medical research by the American people has sustained the research community and improved quality of life roughly since the turn of the 20th century. Almost without exception, the American people have voted for politicians who promise improved...
The Scientific Perils of Sequestration
We are just 7 months into the $1 trillion in automatic federal budget spending cuts known as sequestration, and the impact on scientists in all areas of research is already so great, some say its full effects may be irreversible. The ASCO Post recently interviewed ASCO President Clifford A. Hudis, ...
Expert Point of View: Paul Baas, MD, PhD
“It is very good to have a drug for patients who are smokers and former smokers. The antibody works in both adenocarcinoma and squamous cell carcinoma, and is already very active in phase I with very few side effects. This is such impressive data that [perhaps] we could leap directly to a phase III ...
FDA Approves Obinutuzumab for Chronic Lymphocytic Leukemia
The U.S. Food and Drug Administration (FDA) has approved obinutuzumab (Gazyva) for use in combination with chlorambucil (Leukeran) to treat patients with previously untreated chronic lymphocytic leukemia (CLL). Obinutuzumab is the first drug with Breakthrough Therapy designation to receive FDA...
COMMENTARY: Choosing Wisely: Good Care With Efficiency
Is more care better care? It is often said, by Americans, that the United States has the best care in the world. However, there are many population-based statistics that do not support that humble opinion. We certainly spend more money than any other nation by far. In fact, we may spend more money ...
ASCO's 2013 Top Five List in Oncology for Choosing Wisely Campaign
ASCO recognizes the importance of evidence-based cancer care and making wise choices in the diagnosis and management of patients with cancer. After careful consideration by experienced oncologists, ASCO annually highlights five categories of tests, procedures and/or treatments annually whose common ...
Patient Assistance Programs Provide Psychosocial but Not Practical Help
“Patients with breast cancer who connect to relevant patient assistance programs receive useful informational and psychosocial but not practical help,” concluded Nina A. Bickell, MD, MPH, of Mount Sinai School of Medicine in New York, and colleagues who conducted a randomized trial among 374 women...
The Power of Human Attachment
For those patients with cancer who may be single, widowed, separated, or divorced, those for whom a natural social support system may be weak, the role of the cancer support group should not be overlooked. In leading a previous trial of supportive-expressive group therapy as a key pathway to foster ...
SIDEBAR: Expect Questions About Support Systems for Unmarried Patients
The study finding that unmarried patients with cancer “are at significantly higher risk of presentation with metastatic cancer, undertreatment, and death resulting from their cancer,” generated a lot of comments from colleagues, family members, and patients, the study’s lead author Ayal A. Aizer,...
'Clear and Consistent Protective Effect of Marriage' Found in Patients With 10 Most Clinically Significant Cancers
A clear and consistent protective effect of marriage among patients harboring one of the 10 most clinically significant malignancies affecting Americans” was found in a study analyzing Surveillance, Epidemiology, and End Results (SEE) data for 734,889 patients diagnosed with lung, colorectal,...
Decoding Annie Parker: Hunting the Breast Cancer Gene
Based on true events, Decoding Annie Parker follows the parallel stories of two women obsessed with finding a genetic link to breast cancer. And from the film’s opening frame until the closing credits roll, the absorbing tale never allows your mind to wander. Attempting to Elude Fate One woman is...
