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issues in oncology

Cancer Research Funding Still Tight—and Getting Tighter

Margaret Foti, PhD, MD (hc), CEO of the American Association for Cancer Research (AACR), welcomed about 150 congressional staffers to a March briefing in Washington, DC, with a plea for increased federal funding. “Extraordinary progress is being made in cancer research today, as evidenced by the...

pain management

Individualized Care Key to Cancer Pain Management at Sidney Kimmel Comprehensive Cancer Center

Learning about the particulars of each cancer patient’s pain and treating each case uniquely is the key to keeping pain manageable. That is the goal of the Duffey Pain and Palliative Care Program at The Sidney Kimmel Comprehensive Cancer Center in Baltimore. The team consists of physicians, nurse...

cost of care
health-care policy

American College of Radiology Issues Statement on Budgetary Efforts to Curtail Imaging and Radiation Oncology Self-Referral

The American College of Radiology (ACR) recently issued a statement applauding steps to reign in medical imaging and radiation oncology self-referral included in the President’s fiscal year 2015 budget. However, prior authorization for imaging services, also included in the FY2015 budget, is...

thyroid cancer

Thyroid Cancer On the Rise: Is It Clinically Meaningful?

According to data from the Surveillance, Epidemiology, and End Results (SEER) program, rates for new cases of thyroid cancer in the United States have been rising on average 6.4% each year over the past 10 years, and death rates have been rising on average 0.9% each year over the same period. The...

palliative care

Overcoming Physician Bias in Recommending Palliative Care

In 2010, Jennifer S. Temel, MD, published her landmark study in The New England Journal of Medicine showing that the introduction of palliative care early after a diagnosis of metastatic non–small cell lung cancer, along with cancer therapy, not only provided patients with a better quality of life...

breast cancer

Targeting Cancer Stem Cells in Breast Cancer: A Potential Clinical Strategy

Preclinical models have suggested that cancer stem cells play a role in tumor recurrence and metastasis following adjuvant therapy, and Max S. Wicha, MD, and his research team are deciphering the mechanisms by which this might happen. A true understanding of cancer stem cells will have important...

survivorship

Detecting Accelerated Aging in Adult Survivors of Childhood Cancer

Last fall, Kirsten K. Ness, PhD, published her study1 on the prevalence of frailty as a sign of accelerated aging in adult survivors of childhood cancer, and the results are startling. Among the 1,922 participants in the study, the prevalence of prefrailty was 31.5% among women and 12.9% among men; ...

prostate cancer

Prostatectomy vs Radiotherapy: A Study for Cautious Interpretation

Men with newly diagnosed localized prostate cancer face a decision between prostatectomy and radiotherapy, treatments deemed similarly effective but with well-established trade-offs in terms of treatment-related morbidity. Numerous clinical trials and other prospective studies, from both academic...

colorectal cancer

Will Colorectal Cancer Surveillance Change Based on the Results of the FACS Trial?

Colorectal cancer is a common malignancy that will impact 1.4 million individuals globally each year.1 Approximately 70% to 75% of patients will present with locally advanced disease. For patients with stage III colon cancer, adjuvant chemotherapy is commonly offered, whereas chemotherapy for those ...

colorectal cancer

FACS Trial: Intensive Follow-up Increases Surgical Treatment of Recurrence With Curative Intent in Colorectal Cancer

In the FACS trial, reported in JAMA, John N. Primrose, MD, FRCS, of University of Southampton, England, and colleagues compared outcomes with intensive follow-up with carcinoembryonic antigen (CEA) measurement, computed tomography (CT), both, or minimum follow-up after curative surgery for primary...

breast cancer

Overdiagnosis of Breast Cancer: New Research Directions

Currently, one of the most challenging problems in oncology is to accurately predict whether neoplastic lesions detected by screening tests will progress. The focus on developing ever-more sensitive cancer screening tests has produced the clinical dilemma of overdiagnosis. Overdiagnosis occurs when ...

breast cancer

The Canadian National Breast Screening Trial Had So Many Flaws That Its Results Should Not Be Used to Guide Screening Recommendations

If a randomized, controlled trial of therapy for breast cancer was submitted for publication in which 1. The drug being tested was old and ineffective, and 2. prior to randomization, the women underwent a clinical breast examination and the study coordinators knew who had the largest cancers, and...

breast cancer

Flaws in CNBSS Are Vast, Impact on Screening Recommendations Is Nil

The recent report from the Canadian National Breast Screening Study (CNBSS)—published in BMJ and reviewed in this issue of The ASCO Post—concluded that annual mammography in women aged 40 to 59 does not result in a reduction in mortality from breast cancer beyond that of physical examination alone...

lymphoma

‘Double-Hit’ Lymphomas a Challenge for the Oncologist

"Double-hit” lymphomas remain challenging tumors, and the best means of treatment remains somewhat elusive, according to studies presented at the 2013 American Society of Hematology (ASH) Annual Meeting in New Orleans, and experts who commented on these findings. “We still don’t have a standard of...

hematologic malignancies

ASH Awards Bridge Grants to 15 Investigators

The American Society of Hematology (ASH) recently announced the names of 15 researchers (see sidebar on page 15) who will receive interim support from the Society for hematology research proposals. These proposals earned high scores but could not be funded by the National Institutes of Health (NIH) ...

lymphoma

Better Options Emerging for Salvage Therapy in Hodgkin Lymphoma

Emerging effective treatment options for salvage therapy in Hodgkin lymphoma were described by Anas Younes, MD, Chief of the Lymphoma Service at Memorial Sloan Kettering Cancer Center, New York, at the 2014 Highlights of ASH in North America meeting in Miami. “This is an exciting time in Hodgkin...

gastroesophageal cancer

Cetuximab Fails to Improve Survival in Nonoperable Esophageal Cancer

More data have emerged that discount the potential for benefit with epidermal growth factor receptor (EGFR) inhibitors in esophageal cancer. The latest comes from the RTOG 0436 randomized phase III trial in patients with nonoperable esophageal cancer, the results of which were presented at the 2014 ...

prostate cancer

Georgetown Researchers Study Nonsurgical, Minimally Invasive Approach to Benign Prostatic Hyperplasia

Physicians at MedStar Georgetown University Hospital and Georgetown University Medical Center, Washington, DC, are studying the safety and effectiveness of prostate artery embolization in men with enlarged prostate glands and urinary obstruction. According to the National Institutes of Health,...

bladder cancer

Bladder Cancer Patient With Rare Genetic Mutations Shows Exceptional Response to Everolimus/Pazopanib Combination

A patient with advanced bladder cancer experienced a complete response for 14 months to the drug combination everolimus (Afinitor) and pazopanib (Votrient) in a phase I trial, and genomic profiling of his tumor revealed two alterations that may have caused this exceptional response, according to a...

kidney cancer

A Conversation With Arie Belldegrun, MD, FACS, and Allan Pantuck, MD, MS, FACS

Cancer Immunotherapy What is the role of immunotherapy in the treatment of metastatic renal cell carcinoma? The harnessing of the immune system as an effective treatment for cancer was recently selected by the journal Science as the top scientific Breakthrough of the Year for 2013.1 With this...

kidney cancer

A Conversation With David I. Quinn, MBBS, PhD, FRACP

First-Line Therapy Please describe current medical oncology approaches to first-line therapy for metastatic renal cell carcinoma. The current first-line therapy for most patients with good- to intermediate-risk metastatic renal cell carcinoma is a vascular endothelial growth factor (VEGF) receptor...

health-care policy

ASCO Releases Its First-Ever Report on the State of Cancer Care in America

On March 11, ASCO released its first-ever comprehensive assessment of the daunting challenges facing America’s ability to continue to deliver high-quality care to all patients with cancer. ASCO President Clifford A. Hudis, MD, FACP, introduced the assessment at a Congressional news briefing in...

health-care policy

The Outlook on Cancer Research in This Era of Leaner Federal Funding

In the March 1, 2014, issue of The ASCO Post we talked with Francis S. Collins, MD, PhD, Director of the National Institutes of Health (NIH), about the future of biomedical research at the NIH during this time of constrained federal funding. We continue that conversation here with our interview of...

breast cancer

SSO-ASTRO Margin Guideline: Why Now and What Does It Mean?

Although breast-conserving therapy has been a standard practice for more than 20 years, controversy still exists over what constitutes the appropriate margin of normal breast tissue around a tumor that minimizes local recurrence while maintaining a good cosmetic outcome. Surveys of surgeons1 and...

Bringing the Humanistic Approach to Palliative Care: From Diagnosis and Throughout Disease Course

For much of her career in oncology, Teresa A. Gilewski, MD, has sought to bridge the science of medicine with the humanistic aspect of care. She has created the Art of Medicine lecture series at Memorial Sloan Kettering Cancer Center in New York, where she is a medical oncologist on the Breast...

American Psychosocial Oncology Society Launches Psychosocial Distress Program

In February, the American Psychosocial Oncology Society (APOS) held its 11th Annual Conference in Tampa, Florida, and it marked a number of firsts. With over 500 registrants and more than 300 abstracts presented over the 3-day program, this was the largest APOS event to date. The theme of this...

Expert Point of View: Joyce F. Liu, MD, MPH, of Dana-Farber Cancer Institute, and Stephen A. Cannistra, MD

In an editorial accompanying publication of the AURELIA study results, Joyce F. Liu, MD, MPH, of Dana-Farber Cancer Institute, and Stephen A. Cannistra, MD, of Beth Israel Deaconess Medical Center, Boston, considered the implications of the benefits observed in the trial and limitations in...

ASCO Rolls Out Support for Changes in Maintenance of Certification Requirements

Big changes came to the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program requirements in 2014. As of January 1, all diplomates, including “grandfathers” (or those certified before 1990 who are “board-certified for life”), must actively participate in MOC...

Help Your Patients Learn About Collecting Family Cancer History

Based on ASCO’s recent recommendations, Cancer.Net has provided your patients with an article and an infographic on the importance of collecting family cancer history, what information to collect, what it can mean, and when and with whom to share this information. Direct your patients to...

Enhance Your ASCO Annual Meeting Experience With Attendee Resources

At the end of the month, more than 25,000 oncology professionals from around the world will meet in Chicago for the 2014 ASCO Annual Meeting. Will you be joining this global community? As you’re beginning to consider what to pack for your trip, keep in mind that you have a host of electronic...

We Need Your Vote: History’s Top 5 Cancer Research Achievements

Throughout the year, we are celebrating not only ASCO’s 50th anniversary, but also the tremendous progress achieved against cancer in the last 50 years. Thanks to the dedication and contributions of patients and researchers, and our nation’s long-standing commitment to funding clinical research,...

Conquering Colorectal Cancer With Sanjay Goel, MD, the 2010 Advanced Clinical Research Award in Colorectal Cancer Recipient

Colorectal cancer is the third most common cancer diagnosed in both men and women in the United States, and about 1 in 20 individuals will develop colorectal cancer in their lifetime. The good news is that improvements in screening, earlier detection, and treatments are all leading to improved...

gynecologic cancers

Preliminary Study Suggests Veliparib May Be Effective in Resistant, BRCA-Mutated Ovarian Cancers

Veliparib, an oral poly(ADP-ribose) polymerase (PARP) inhibitor, appears to be of value in treating women with BRCA-mutated gynecologic cancers that are resistant to other therapies. These preliminary findings of a phase II study support the concept that BRCA-associated ovarian cancers are...

gynecologic cancers

Bariatric Surgery Reduces Risk of Uterine Cancer in Obese Women

Bariatric surgery for weight loss appears to protect obese women from developing uterine cancer, according to a large retrospective study presented at the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer, held March 22–25 in Tampa, Florida. The study found that obese women who ...

gynecologic cancers

High-Risk Uterine Cancers Found in BRCA1 Mutation Carriers Who Had Preventive Oophorectomy but Not Hysterectomy

Prophylactic surgery to remove the ovaries and fallopian tubes is advised for women who carry BRCA mutations to reduce the risk of breast and ovarian cancer. This procedure, referred to as risk-reducing salpingo-oophorectomy, typically does not require a hysterectomy. However, a new study presented ...

Expert Point of View: William Cliby, MD

When asked to comment on the study presented by Lin et al at the Annual Meeting on Women’s Cancer, William Cliby, MD, Chair, Division of Surgery, The Mayo Clinic, Rochester, Minnesota, said, “This study is important because of its size and the utilization of the National Cancer Data Base—the...

NCCN Receives $2 Million in Research Funding to Study Nintedanib in Colorectal and Lung Cancers

The National Comprehensive Cancer Network® (NCCN®) Oncology Research Program (ORP) has announced it has been awarded a $2 million grant from Boehringer Ingelheim Pharmaceuticals, Inc. to develop a program to scientifically evaluate and define the safety and clinical effectiveness of the...

SIDEBAR: Should You Treat Smoldering Multiple Myeloma?

A recent article in The New England Journal of Medicine has provoked conversation about the management of smoldering multiple myeloma.1 At the recent National Comprehensive Cancer Network (NCCN) Annual Conference, Kenneth C. Anderson, MD, of Dana-Farber Cancer Institute, Boston, shared his thoughts ...

multiple myeloma

Promising Compounds in Development for Multiple Myeloma

The term “novel agents” has been used for the past decade to describe proteasome inhibitors and immunomodulatory drugs that are now conventionally used for multiple myeloma. However, even newer agents in development will be considered truly novel when they hit the market, as they represent new...

SSO Awarded ACCME’S Highest Accreditation Status

The Accreditation Council for Continuing Medical Education® (ACCME) recently awarded the Society of Surgical Oncology (SSO) the designation of Accreditation with Commendation. Accreditation with Commendation is ACCME’s highest accreditation award status and extends SSO’s reaccreditation period from ...

sarcoma

Surgery Plus Radiation Offers Mixed Results in Soft-Tissue Sarcoma

Adjuvant radiation following surgery for soft-tissue sarcomas of the extremities did not lead to a survival benefit and seemed to be associated with some degree of long-term limb complications, according to a presentation at the 2014 Society of Surgical Oncology (SSO) Cancer Symposium in Phoenix.1...

skin cancer

Patients With Thin Melanoma Benefit From Sentinel Lymph Node Biopsy

Sentinel node status is “the most powerful predictor” of melanoma-specific survival in patients with thin melanoma, according to a presentation at the 2014 Society of Surgical Oncology (SSO) Cancer Symposium in Phoenix.1 As a result, sentinel lymph node biopsy should be considered in patients with...

Expert Point of View: Mario Sznol, MD

Mario Sznol, MD, of Yale Cancer Center, New Haven, Connecticut, was formal discussant of the MK-3475 presentations at the American Association for Cancer Research (AACR) Annual Meeting. He alluded to all the factors that complicate assays of PD-L1: the disparate nature of the assays themselves, the ...

skin cancer

PD-L1 Studied as Biomarker for Anti–PD-1 Immunotherapy

The anti–PD-1 inhibitor MK-3475 (formerly lambrolizumab) is in late-stage trials for advanced melanoma and is also being studied in other malignancies, including non–small cell lung cancer (NSCLC). An important aspect of Merck’s development program for MK-3475, as well as for other anti–PD-1 agents ...

Expert Point of View: Gary Schwartz, MD

Formal discussant of the LY2835219 trial reported at the American Association for Cancer Research Annual Meeting, Gary Schwartz, MD, of Columbia University School of Medicine, New York, said the drug had “dramatic effects” in estrogen receptor–positive patients. “This drug is highly active in...

issues in oncology

ASCO Speaks Out on Release of Medicare Physician Payment Data

The American Society of Clinical Oncology (ASCO) is deeply concerned about [the recent] release of Medicare physician payment data. ASCO is committed to the delivery of high-quality, high-value care for all people with cancer in the United States. This data release solely focuses attention on the...

multiple myeloma

Maintenance Therapy in Multiple Myeloma

In 2012, three randomized placebo-controlled trials reported a significant prolongation of progression-free survival with lenalidomide (Revlimid) as maintenance therapy for multiple myeloma.1-3 Two of these trials tested lenalidomide maintenance after stem cell transplantation, and one investigated ...

Case Studies: Collaborative Practice in Action

The panel presented two case studies—one on high-dose methotrexate toxicity and one on 5-FU toxicity—as a platform for discussion of considerations, challenges, and interconnected roles of oncologists, nurse practitioners, physician assistants, and clinical pharmacists in safely managing patients...

Collaborative Exchange: The Expanded Access Program and Uridine Triacetate

The panel discussed the various aspects of obtaining a drug such as uridine triacetate through the expanded access program. Ms. Vogel: The expanded access program allows companies to provide patients access to their medicines while the drugs are still in preapproval process, but it is strictly...

Learning More About Expanded Access Programs

The FDA and ASCO have collaborated to create an educational webinar to explain expanded access programs and to clarify the process to access investigational drugs outside a clinical trial. Although it is primarily intended for physicians, the webinar provides valuable information to anyone...

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