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Showing 12401 - 12450IOM Report Illuminates U.S. Cancer Care Crisis and Offers Framework for Change
In September, the Institute of Medicine (IOM) of the National Academies issued its report, Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis,1 published more than a decade after its first study on the quality of cancer care in the United States. The authors of the...
Ipilimumab Conveys Long-Term Survival Benefit in Pooled Analysis of Metastatic Melanoma Patients
In the treatment of metastatic or locally advanced unresectable melanoma, the anti–CTLA-4 monoclonal antibody ipilimumab (Yervoy) conveys long-term survival benefits, with some patients alive out to 10 years, according to the largest survival analysis of the immunomodulating agent, presented at the ...
One in Three American Adults Do Not Comply With Screening Guidelines for Colorectal Cancer
The percentage of American adults aged 50 to 75 who are up-to-date with recommended screening for colorectal cancer “increased from 54% in 2002 to 65% in 2010, primarily driven by increased use of colonoscopy,” according to data from the 2012 Behavioral Risk Factor Surveillance System survey....
SIDEBAR: Expect Questions From Your Patients
Risk-reducing salpingo-oophorectomy “is an important strategy for reducing both breast and gynecologic cancer risk for women with BRCA1 or BRCA2 mutations and is proven to improve life expectancy,” Noah D. Kauff, MD, told The ASCO Post. Questions persist, however, about whether women undergoing...
'Reasonable but Not Required' for Women With BRCA Mutations to Have Hysterectomy Concurrent With Salpingo-Oophorectomy
For women with BRCA1 or BRCA2 mutations who choose to have salpingo-oophorectomy to reduce their risks of ovarian and breast cancer, also choosing to have a hysterectomy is “reasonable but not required,” noted Noah D. Kauff, MD, Director of the Ovarian Cancer Screening and Prevention Program and...
Evaluation of Breast Cancer MRI Screening Strategies
Recent years have witnessed much heated debate about the benefits of breast cancer screening and optimal screening strategies. Unlike with mammography, no randomized data are available to determine whether screening with magnetic resonance imaging (MRI) reduces mortality from breast cancer....
Expert Point of View: Daniel Zips, MD
Formal discussant of the Danish Head and Neck Cancer Group (DAHANCA) 19 trial at the European Cancer Congress, Daniel Zips, MD, University Hospital for Radiation Oncology, Tübingen, Germany, said that the DAHANCA trial program is impressive and conducted with stringent quality assurance....
Novel EGFR Inhibitor Added to Radiotherapy Fails to Improve Outcomes in Head and Neck Cancer
The addition of zalutumumab, an investigational epidermal growth factor receptor (EGFR) inhibitor, to primary chemoradiotherapy did not increase locoregional control or improve survival at 3 years in patients with squamous cell carcinoma of the head and neck compared with chemoradiotherapy alone,...
Spanning a Spectrum of Issues Related to Head and Neck Cancers
Five recent articles in JAMA Otolaryngology–Head & Neck Surgery1-5 span a spectrum of issues related to head and neck cancers. These include risk factors, concentration of care to teaching hospitals, avoiding venous thromboembolism, and encouraging patients to eat and do swallowing exercises to ...
Oncology Meetings
December Sixth AACR International Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically UnderservedDecember 6-9 • Atlanta, GeorgiaFor more information: www.aacr.org 55th ASH Annual MeetingDecember 7-10 • New Orleans, LouisianaFor more information:...
Expert Point of View: Monica Morrow, MD, and Chau T. Dang, MD
In an editorial accompanying the article by Boughey et al, Monica Morrow, MD, and Chau T. Dang, MD, of Memorial Sloan-Kettering Cancer Center, New York, question whether sentinel lymph node biopsy can be considered a part of standard management in patients with initial clinically node-positive...
Alliance Trial Evaluates Sentinel Node Surgery After Neoadjuvant Chemotherapy for Node-Positive cN1 Breast Cancer
Sentinel lymph node surgery provides reliable nodal staging information and is associated with less morbidity than axillary lymph node dissection in patients with clinically node-negative (cN0) breast cancer. The American College of Surgeons Oncology Group (ACOSOG) Z1071 (Alliance) trial examined...
Where Is Adjuvant Bisphosphonate Therapy Now?
The adjuvant use of bisphosphonates in breast cancer continues to yield seemingly contradictory data despite a sound biologic basis and smaller pilot studies suggesting that dampening bone turnover with bisphosphonates can lessen the bone reservoir of micrometastases.1,2 Early adjuvant trials with...
No Survival Benefit of Adjuvant Ibandronate in High-Risk Early Breast Cancer: Potential Activity in Low-Estrogen Patients
The effect of bisphosphonate treatment in early breast cancer is controversial, with some data indicating survival benefit in the adjuvant setting. In a study reported in the Journal of Clinical Oncology (German Adjuvant Intergroup Node-Positive Study, GAIN), Gunter von Minckwitz, MD, PhD, Chairman ...
German Analysis in Diffuse Large B-Cell Lymphoma: Hypothesis-Generating Rather Than Definitive?
In their retrospective analysis of German High-Grade Non-Hodgkin Lymphoma Study Group trials reported in the Journal of Clinical Oncology and reviewed in this issue of The ASCO Post, Held and colleagues assessed the effects of rituximab (Rituxan) and radiotherapy in patients with aggressive B-cell...
Rituximab Does Not Improve Outcome in B-Cell Lymphoma With Skeletal Involvement, but Radiotherapy Benefit Found
In a retrospective analysis of German High-Grade Non-Hodgkin Lymphoma Study Group trials reported in the Journal of Clinical Oncology, Gerhard Held, MD, of Saarland University Medical School in Homburg, and colleagues assessed the impact of rituximab (Rituxan) and radiotherapy on outcome in...
Obinutuzumab in Previously Untreated Chronic Lymphocytic 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 On November 1, 2013, obinutuzumab (Gazyva) was approved...
More Than 200 Practices Now QOPI® Certified for Delivering High-Quality Cancer Care
ASCO and its affiliate, the Quality Oncology Practice Initiative (QOPI®) Certification Program (QCP™), have announced that more than 200 practices have received certification. Since its start in 2010, the QOPI Certification Program has evaluated individual outpatient oncology practice performance...
Improving Fertility Options for Patients With Cancer
Seven years ago, Teresa K. Woodruff, PhD, coined the term “oncofertility” to describe the melding of two medical specialties, oncology and reproductive endocrinology, with the goal of maximizing the reproductive potential of patients with cancer. Today, with Dr. Woodruff’s establishment of the...
Gastric Cancer: Time to Revisit Angiogenesis
Progress in the treatment of gastric cancer has lagged behind advances in other solid tumor malignancies. A modest but clear survival benefit with the use of adjuvant therapy combined with surgery has been achieved, including the use of postoperative adjuvant chemotherapy as shown in large-scale...
Anti–VEGFR-2 Antibody Ramucirumab Prolongs Survival in Previously Treated Advanced Gastric or Gastroesophageal Cancer
Vascular endothelial growth factor (VEGF)– and VEGF receptor-2 (VEGFR-2)–mediated signaling and angiogenesis seem to have an important role in the pathogenesis of gastric cancer. In the phase III REGARD trial reported in Lancet, Charles S. Fuchs, MD, MPH, of Dana-Farber Cancer Institute, Boston,...
Has a New Standard of Care for Metastatic Pancreatic Cancer Been Established?
For a number of years following the approval of gemcitabine for advanced pancreatic cancer, one phase III clinical trial after the next failed to demonstrate a survival benefit of combination chemotherapy compared to gemcitabine alone. Even the one positive study from the mid-2000s—the PA.3 trial...
Addition of Nab-Paclitaxel to Gemcitabine Improves Survival in Previously Untreated Metastatic Pancreas Cancer
In a phase III trial reported in The New England Journal of Medicine, Daniel D. Von Hoff, MD, of Translational Genomics Research Institute in Phoenix, and colleagues assessed the addition of albumin-bound paclitaxel (nab-paclitaxel [Abraxane]) to gemcitabine in patients with previously untreated...
Long-Term CONKO-001 Results: Adjuvant Therapy Improves Survival
From 12% to 15% of the approximately 45,000 patients diagnosed with pancreas adenocarcinoma undergo a potentially curative resection each year in North America, translating into roughly 5,000 to 7,000 patients who are candidates for adjuvant therapy. About 80% of these patients will relapse and...
Standardized Approach Improves Palliative Care Services and Outcomes
Standardized criteria for initiating palliative care consultations can substantially improve the care of patients with advanced solid tumors, according to research from Mount Sinai School of Medicine, New York, led by Kerin Adelson, MD, Coordinator for Ambulatory Oncology Quality for the Tisch...
Two Studies Highlight Communication Challenges Facing Medical Oncology
In one study presented at ASCO’s second annual Quality Care Symposium in San Diego, patients receiving chemotherapy with palliative care intent were at high risk of side-effect–related hospitalization, which defeats the clinical purpose and adds preventable costs to health care.1 “There is an...
Cetuximab Confers Survival Benefit in All-RAS Wild-Type Colorectal Tumors
The FIRE-3 study compared the two epidermal growth factor receptor (EGFR) antibodies, on top of chemotherapy, in the first-line treatment of metastatic colorectal cancer. A preplanned analysis of KRAS wild-type patients without RAS mutations, ie, “all-RAS wild-type,” showed overall survival to be...
Time to Think Beyond KRAS in Metastatic Colorectal Cancer
Eric Van Cutsem, MD, PhD, Professor of Internal Medicine at the University of Leuven in Belgium, told attendees at the 2013 European Cancer Congress that in the management of metastatic colorectal cancer, it is time to expand KRAS testing to include more rare mutations. Until recently, KRAS status...
Expert Point of View: Eric Van Cutsem, MD, PhD
Eric Van Cutsem, MD, PhD, Professor of Internal Medicine at the University of Leuven in Belgium, the formal discussant of the late-breaking abstract, noted there is strong rationale for studying TP53 status in relation to rectal cancer outcomes, but he felt the findings of EXPERT-C could not yet be ...
In Operable Rectal Cancer, No Support Found for Adjuvant Chemotherapy
For patients with operable rectal cancer, there is no clear role for adjuvant chemotherapy, according to an analysis of the PROCTOR and SCRIPT trials from the Dutch Colorectal Cancer Group. The findings were presented by Anne J. Breugom, MD, of Leiden University Medical Center in the Netherlands,...
Metastatic Melanoma: Encouraging Data Keep Coming
Excitement continues to build in the metastatic melanoma arena, as novel agents keep upping the ante for efficacy. The following news from the 2013 European Cancer Congress has added to the buzz. New MEK Inhibitor In the phase IB BRIM7 study, cobimetinib, a novel MEK inhibitor, when combined with...
Early Evidence Supports Novel ALK Inhibitor in Patients with Non–Small Cell Lung Cancer With Brain Metastases
Identifying ALK rearrangements as a cancer target in patients with lung cancer led to the development and FDA approval of crizotinib (Xalkori) to treat ALK-positive non–small cell lung cancer (NSCLC). Several second-generation ALK inhibitors are in development, and these agents appear to work in...
Brentuximab and PET-Adapted Salvage May Eliminate Toxic Chemotherapy for Refractory Hodgkin Lymphoma
Relapsed and refractory transplant-eligible Hodgkin lymphoma patients who achieve complete responses after treatment with brentuximab vedotin (Adcetris) can often avoid more toxic salvage chemotherapy, according to investigators from Memorial Sloan-Kettering Cancer Center, New York....
SIDEBAR: Addition of Novel Agents May Improve Outcomes With ABVD
In North America, the standard front-line treatment for advanced Hodgkin lymphoma is ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine), but this regimen is not effective in all patient subsets. To improve upon the regimen’s efficacy, researchers are evaluating new combinations, said Stephen...
Brentuximab Vedotin Improves Response Rates to ABVD in Hodgkin Lymphoma
For the front-line treatment of advanced Hodgkin lymphoma, ABVD is a standard treatment, but not all patients have good outcomes with this regimen. The addition of brentuximab vedotin (Adcetris), or its substitution for bleomycin, produces high complete response rates but with a moderate increase...
Innovative Payment Models Needed to Sustain Quality Cancer Care
Nationally regarded health-care expert Lee N. Newcomer, MD, MHA, began his presentation at this year’s ASCO Quality Care Symposium with a rhetorical question. “Why are we talking about money when we’re gathered in San Diego for 2 days to discuss some wonderful ways to impact the quality of cancer...
Response-Guided Neoadjuvant Therapy for Breast Cancer: A Promising Model Warranting Additional Investigation
GeparTrio was an innovative phase III trial conducted by the German Breast Group, enrolling over 2,000 women with early breast cancer who were candidates for neoadjuvant chemotherapy. Patients with evidence of early response, defined as reduction in clinical tumor size by 50% or more, following two ...
GeparTrio Long-Term Data Show Response-Guided Neoadjuvant Therapy for Breast Cancer Improves Survival
In an exploratory analysis of long-term survival data from the GeparTrio trial reported in the Journal of Clinical Oncology, Gunter von Minckwitz, MD, PhD, of the German Breast Group in Neu-Isenburg and the University of Frankfurt, Germany, and colleagues found that response-guided neoadjuvant...
Using Life Expectancy, Not Age, to Make Cancer Screening Decisions Can Maximize Potential Benefits
Using life expectancy, rather than chronologic age, to inform decisions about whether to continue cancer screening for older persons can maximize the potential benefits of screening, while minimizing the harms, according to results of a population-based cohort study of 407,749 people over 66...
Three-Drug Regimen Produces High Response Rate in Relapsed/Refractory Myeloma
A phase II trial to evaluate the combination of bendamustine (Treanda) with bortezomib (Velcade) and dexamethasone in patients with relapsed/refractory multiple myeloma “showed a remarkable response rate of 60.9%,” and when minor responses were included, 75.9%,” researchers reported in Blood. “The...
SIDEBAR: Expect Questions From Patients
Not discussing the costs of medical interventions could result in “financial toxicity” for patients who have trouble paying out-of-pocket costs, as well as problems adhering to expensive treatment regimens. “The problem is perhaps starkest in cancer care, but it applies to all complex illness,”...
Disclosing Medical Costs Can Help Avoid 'Financial Toxicity'
High costs of cancer treatments can be an “undisclosed toxicity” that can harm a patient’s overall health and well-being, according to an article in The New England Journal of Medicine.1 High medical bills can not only cause stress and anxiety but may also compel patients to cut back on spending...
Dr. Weisenthal Replies
Dr. Mason states that I implied that Dr. Telli supports the routine application of chemosensitivity assays. I have no knowledge regarding Dr. Telli’s views on this subject, nor did I in any way attempt to represent her views, much less imply that she was supportive of anything relating to...
Oncology Meetings
January 2014 AACR-IASLC Joint Conference on the Molecular Origins of Lung CancerJanuary 6-9 • San Diego, CaliforniaFor more information: www.aacr.org 2014 Gastrointestinal Cancers SymposiumJanuary 16-18 • San Francisco, CaliforniaFor more information: www.gicasym.org 10th Annual Clinical...
Ibrutinib in Previously Treated Mantle Cell 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 On November 13, 2013, ibrutinib (Imbruvica) was granted...
Ginkgo biloba
The use of dietary supplements by patients with cancer has increased 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...
How to Measure the Impact of Dermatologic and Mucosal Adverse Events on Symptom Burden and Quality of Life
Targeted anticancer therapies like epidermal growth factor receptor (EGFR) inhibitors, multitargeted tyrosine kinase inhibitors (mTKIs), and mammalian target of rapamycin (mTOR) inhibitors frequently result in dermatologic adverse events and mucosal adverse events, or, taken together, mucocutaneous ...
National Cancer Policy Summit: Setting Priorities for the Next 3 Years
Welcome to the meeting we hold every 3 years to choose our next projects,” said John Mendelsohn, MD, Chair of the National Cancer Policy Forum and Director of the Khalifa Institute for Personalized Cancer Therapy at The University of Texas M.D. Anderson Cancer Center, Houston. “We have here a...
NCI-Led Scientists Develop Criteria for 'Omics' Tests Used in Clinical Investigations
High-throughput “omics” technologies that generate molecular profiles on tumor specimens are increasingly being incorporated into clinical trials, but some of these assays have not been well validated, leading many in the research community to question their fitness for use in patient-care...
Valganciclovir in Glioblastoma, Selection Bias, and Flawed Conclusions
As reviewed in this issue of The ASCO Post, Söderberg-Nauclér et al from the Karolinska Institute have written a provocative letter to The New England Journal of Medicine suggesting that long-term administration of valganciclovir (Valcyte), a drug that targets cytomegalovirus (CMV), improves...
