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issues in oncology

The Author Replies

I read with interest the note from Jeff Boyd, PhD, Senior Vice-President for Molecular Medicine at Fox Chase Cancer Center, calling into question my recent commentary about the high costs of partly validated testing in the domain of molecular medicine. One of the oldest tricks in the book is to...

issues in oncology

Cancer Genes and Molecular Medicine: More Education Needed

I read with interest and concern the Perspective piece, “Cancer Genes, Promiscuity, and the National Debt,” which appeared on page 1 of the February 1st issue of The ASCO Post. The underlying premise of this wide-ranging and provocative article would appear to be that in a rush to implement...

thyroid cancer

‘Epidemic of Diagnosis’ of Thyroid Cancer Is Most Acute for Women

The epidemiology of the increased incidence of thyroid cancer, which has nearly tripled since 1975, “suggests that it is not an epidemic of disease but rather an epidemic of diagnosis,” Louise Davies, MD, MS, and H. Gilbert Welch, MD, MPH, concluded after analyzing trends in patients diagnosed with ...

skin cancer
cost of care

Dermatologists Defend Mohs Surgery as Effective and Cost-Efficient With Low Rate of Recurrence

The headline, “Patients’ Costs Skyrocket, Specialists’ Incomes Soar,” aptly encapsulates the theme of a recent article in The New York Times,1 part of a series entitled, “Paying Till It Hurts.” “Oncologists benefit from the ability to mark up (and profit from) each dose of chemotherapy they...

issues in oncology

Focus on the Virginia Association of Hematologists and Oncologists

The state of Virginia encompasses a vast area of 40,000 square miles and is divided into five regions: the Atlantic Coastal Plain, the Piedmont, the Blue Ridge, the Appalachian Ridge and Valley Region, and the Appalachian Plateau. The diverse geography of the state creates unique challenges for...

gynecologic cancers

Cancer Has Allowed Me to Put My Goals First

Despite my family history of cancer—my father had colorectal cancer, his father had gallbladder cancer, and my father’s mother died of what was believed to be uterine cancer—when I complained to my gynecologist about postmenopausal bleeding in the spring of 2011, I was told not to worry about it....

supportive care

Music Therapy Yields Positive Effects on Coping Skills, Social Integration, and Family Environment for Young Patients With Cancer

A collaborative multisite study has found that teens and young adults undergoing stem cell transplantation as part of cancer treatment gain coping skills and resilience-related outcomes when participating with a board-certified music therapist in a therapeutic music protocol that includes writing...

breast cancer
cns cancers

How to Approach the Problem of CNS Metastasis in HER2-Positive Patients

Central nervous system (CNS) metastasis is a pervasive problem in the setting of HER2-positive breast cancer. While some patients can be managed easily, others are challenging, said Eric P. Winer, MD, Chief of the Division of Women’s Cancers and the Thompson Senior Investigator for Breast Cancer...

integrative oncology

The Ketogenic Diet in Cancer Control

Ketogenic (or very-low-carbohydrate) diets have been employed since the 1920s as nonpharmacologic therapies for epilepsy and, in some instances, have obviated the need for medication for that disease. Since the 1960s, the ketogenic diet has become better known as a means of managing obesity. This...

neuroendocrine tumors

Radiopharmaceutical Receives Orphan Drug Designation

The radiopharmaceutical gallium-68 dotatate has been given orphan drug designation by the U.S. Food and Drug Administration and the European Medicines Agency for use as a diagnostic agent for the management of gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Gallium-68 dotatate is owned by...

issues in oncology

Telemedicine: Efficiency in Cancer Screening and Outreach

As defined by the U.S. Health Resources and Services Administration teleheath is “the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration.” It has ...

breast cancer

SSO/ASTRO Release Consensus Guideline on Breast Cancer Treatment

The Society of Surgical Oncology (SSO) has announced the availability of a comprehensive consensus guideline for physicians treating breast cancer developed to help reduce health-care costs and improve the course of treatment. Developed in conjunction with the American Society of Radiation Oncology ...

solid tumors
issues in oncology

How Decoding the Genomes of Exceptional Responders Is Leading to More Effective Treatment for All Patients With Cancer

In 2012, David B. Solit, MD, Geoffrey Beene Chair and Director of the Center for Molecular Oncology at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, and his colleagues published the results of a phase II study1 of 45 patients with advanced bladder cancer. The purpose of the clinical...

palliative care

St. Jude Children’s Research Hospital Committee Identifies Eight Palliative Care Priorities in Pediatric Oncology

About 2½ years ago, St. Jude Children’s Research Hospital in Memphis conducted a series of focus groups to better understand the palliative care priorities of bereaved parents. Their findings were never intended to be generalized, but rather to be used to formulate a strategic plan for an...

breast cancer
health-care policy

Affordable Care Act to Cover Chemoprevention for Women at High Risk for Breast Cancer

On January 9, 2014, Kathleen Sebelius, Secretary of the Department of Health and Human Services, announced that under the Patient Protection and Affordable Care Act, women at increased risk of breast cancer will be entitled to preventive medications without incurring out-of-pocket costs (with the...

health-care policy

ASCO Addresses Changes in Medicare for 2014

Medicare patients make up 61% of new cancer cases in the United States, and as the population ages, that proportion is expected to rise to 70% by 2030. Over the past decade, the oncology community has been financially challenged by alterations in the Medicare payment system. To address the changes...

leukemia

Ibrutinib for Previously Treated Chronic Lymphocytic Leukemia

On February 12, 2014, ibrutinib (Imbruvica) was granted accelerated approval for the treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one prior therapy.1,2 Ibrutinib previously received accelerated approval for the treatment of patients with mantle cell...

breast cancer

Impact of Delayed Initiation of Adjuvant Chemotherapy for Breast Cancer Varies by Tumor Subtype

The optimal time interval between surgery and initiation of adjuvant chemotherapy for early-stage breast cancer is not well established. Although most physicians aim to initiate adjuvant chemotherapy within a few weeks of surgery, clinical factors may cause delay. The influence of delay on relapse...

CD137 Identifies and Enriches for Tumor-Reactive T Cells

In a study reported in Clinical Cancer Research, Ye and colleagues showed that CD137 can be used to identify tumor-reactive T cells and to enrich for tumor-infiltrating lymphocytes and tumor-associated lymphocytes for use in adoptive immunotherapy. In the study, tumor-infiltrating lymphocytes from...

solid tumors

Antitumor Immunity Affected by Standard Lab Mouse Housing Temperature

In a study reported in Proceedings of the National Academy of Sciences USA, Kokolusa and colleagues showed that fundamental aspects of antitumor immunity are significantly affected by ambient housing temperature for lab mice. Standard ambient temperature in research facility lab mice housing is...

cns cancers

Dual PI3K/mTOR Inhibitor Effective as Radiosensitizer for Glioblastoma

In a study reported in Clinical Cancer Research, del Alcazar and colleagues assessed the effects of the dual PI3K/mTOR inhibitor NVP-BEZ235 as a radiosensitizer in glioblastoma. No DNA double-strand break repair inhibitors have been successful in treating glioblastoma. However, in prior studies in...

breast cancer

National Program to Screen Ashkenazi Women in Israel for BRCA Mutations Is Being Explored

Citing a World Health Organization report that lists Israel as having one of the highest rates of breast cancer in the world, The New York Times reported on a proposed screening program to identify women with BRCA1 and BRCA2 mutations.1 “A number of influential geneticists and cancer doctors from...

issues in oncology

Stay Up-to-Date on New Patient Materials From Cancer.Net

Encourage your patients to use social media to stay-up-to-date with the new resources available on Cancer.Net. It is easier than ever for patients to get the latest cancer information on their computer or mobile device by subscribing to the Cancer.Net Blog at www.cancer.net/blog, or on...

issues in oncology

ASCO’s Membership Grows to Nearly 35,000

ASCO has much to celebrate this year—namely, the Society’s 50th Anniversary. This occasion brings with it many other notable milestones. 2014 is a prime time to reflect on the remarkable growth of ASCO, from seven founders and 51 physicians at its first Annual Meeting to nearly 35,000 members...

breast cancer

Support from 1999 Career Development Award Launched Dr. Kornelia Polyak’s Quest to Advance Understanding of DCIS of the Breast

In 1999, Kornelia Polyak, MD, PhD, of the Dana-Farber Cancer Institute, received a Career Development Award from the Conquer Cancer Foundation for her project, “Isolation of Tumor Suppressor Genes Inactivated in DCIS of the Breast.” “The Career Development Award got me started,” she said. “When...

issues in oncology

Charting the Successes: CancerProgress.Net Chronicles More Than 50 Years of ASCO and Progress Against Cancer

On this historic year, as ASCO proudly commemorates its 50th anniversary and decades of evolutionary change and growth, it also celebrates the significant progress that has been made against cancer throughout history. ASCO’s anniversary website, CancerProgress.Net, chronicles these achievements and ...

skin cancer

Staging of Cutaneous Squamous Cell Carcinoma

Neoplasms originating from skin keratinocytes are increasing in frequency in the United States and include a spectrum of diseases culminating in the development of invasive cutaneous squamous cell carcinoma. Although most cases of cutaneous squamous cell carcinoma can be treated conservatively with ...

cost of care

Who Pays for Noncompliance? The Hidden Costs of Our Current System

The development of novel targeted therapies that capitalize on our growing understanding of the molecular underpinnings and vulnerabilities of specific malignancies has to rank among the most important advances we have seen in the 50 years since the American Society of Clinical Oncology was...

leukemia
cost of care

Higher Copayment Associated With Greater Discontinuation of and Nonadherence to Tyrosine Kinase Inhibitor Treatment in CML

The availability of the tyrosine kinase inhibitor imatinib (Gleevec) has dramatically increased survival in chronic myeloid leukemia (CML). Nonadherence to therapy with imatinib and other tyrosine kinase inhibitors is associated with disease progression and treatment resistance. In a study reported ...

prostate cancer
skin cancer

Melanoma and Prostate Cancer: Two Sides of One Coin?

In a recent study, reviewed in this issue of The ASCO Post, Li et al present data from two long- term prospective studies—the Physicians Health Study (PHS, from 1982 to 1998), and the Health Professionals’ Follow-up Study (HPFS, from 1986 to 2010)—both of which suggest a strong association between...

prostate cancer
skin cancer

History of Prostate Cancer Increases Risk of Melanoma in White Men

History of severe acne, which is a surrogate for high androgen activity, has been associated with increased risk of prostate cancer, and recent data suggest that severe teenage acne is a risk factor for melanoma. Such findings suggest a role of androgens in etiology for both prostate cancer and...

SIDEBAR: Meet the Panel

Laura Zitella, MS, RN, ACNP-BC, AOCN®, moderator: Lead Advanced Practice Provider, Inpatient Hematology/Oncology, Stanford University Medical Center, Stanford, California, and Clinical Assistant Professor, ­Department of Physiological Nursing, University of California, San Francisco Jeannine M....

issues in oncology

Advanced Practitioners in Oncology: Diverse Experiences, Shared Challenges

The professional paths of advanced practitioners (APs) in oncology are as varied as the locations in which they work. The first annual JADPRO Live 2014 educational symposium was held in St. Petersburg, Florida, and hosted by JADPRO, the Journal of the Advanced Practitioner in Oncology. A...

Expert Point of View: Anas Younes, MD

Anas Younes, MD, Chief of the Lymphoma Service at Memorial Sloan-Kettering Cancer Center in New York, told The ASCO Post, “Of the 800 or so ALK-positive anaplastic large-cell lymphoma patients in the United States, 70% to 80% are cured by CHOP [cyclophosphamide, doxorubicin, vincristine,...

leukemia

Gemtuzumab Ozogamicin Reduces Relapse, Improves Event-Free Survival in Pediatric AML

The monoclonal antibody gemtuzumab ozogamicin (Mylotarg) improved event-free survival and reduced the risk of relapse in children with acute myeloid leukemia (AML) in a study from the Children’s Oncology Group, presented at the 55th American Society of Hematology (ASH) Annual Meeting and Exposition ...

Expert Point of View: Jennifer R. Brown, MD, PhD

Idelalisib is being studied in three ongoing registration trials. [Study 116] was stopped early after idelalisib/rituximab demonstrated high efficacy in relapsed chronic lymphocytic leukemia [CLL],” said Jennifer R. Brown, MD, PhD, Director of the CLL Center at Dana-Farber Cancer Institute, Boston. ...

leukemia

Idelalisib Plus Rituximab in Heavily Pretreated Relapsed CLL: ‘Dawn of a New Age’?

Idelalisib plus rituximab (Rituxan) improved progression-free survival, overall response rates, and overall survival compared with rituximab alone in heavily pretreated patients with relapsed chronic lymphocytic leukemia (CLL). Moreover, the combination provided effective, durable disease control...

lymphoma

Promising Results Demonstrated for Brentuximab Vedotin in Cutaneous T-Cell Lymphoma

Phase II results suggest that brentuximab vedotin (Adcetris) has encouraging activity in CD30-positive cutaneous T-cell lymphomas and lymphoproliferative disorders, including mycosis fungoides, the most common type of cutaneous T-cell lymphoma. High levels of responses were achieved in a 48-patient ...

breast cancer

Zoledronic Acid Fails to Benefit Women With Chemoresistant Breast Cancer

Zoledronic acid does not improve outcomes in patients with early breast cancer who do not have a full response to neoadjuvant anthracycline/taxane–based chemotherapy, according to results of the Neo-Adjuvant Trial Add-On (NATAN) study presented at the 2013 San Antonio Breast Cancer Symposium.1 A...

breast cancer

Adding Bevacizumab to Adjuvant Chemotherapy/Trastuzumab Fails to Improve Survival in HER2-Positive Breast Cancer

The addition of bevacizumab (Avastin) to adjuvant chemotherapy did not improve invasive disease-free survival or overall survival in patients with high-risk HER2-positive breast cancer in the large randomized phase III BETH trial. Although not specifically designed to answer this question, BETH...

leukemia

Minimal Residual Disease Before and After Transplant: What Does It Mean?

In patients with acute leukemia, outcomes after hematopoietic stem cell transplantation are negatively impacted by the presence of minimal residual disease. However, transplant can prolong survival in patients with minimal residual disease after consolidation, according to two studies presented at...

SIDEBAR: Colorectal Cancer Survivors’ Comments on Strategies to Regulate Bowel Function

Avoiding Foods I don’t eat beans, I don’t eat onions. I’m kind of careful on greens because they just don’t digest well. I don’t eat as many salads. I couldn’t because they went right through. Behavioral Adjustments You learn, over the years, what you can and can’t do. And you can’t overeat....

colorectal cancer
survivorship

Colorectal Cancer Survivors Face Challenges With Bowel Regulation

The fight against colorectal cancer leaves many survivors with battle wounds, according to studies that show a high incidence of assorted morbidities that can affect quality of life. Clinicians, in fact, may be unaware of the struggles with bowel function that occur during survivorship, researchers ...

colorectal cancer

Outcomes in Metastatic Colorectal Cancer: Studies Examine Relative Merits, Cost-Effectiveness

Targeted biologic agents have improved long-term outcomes in metastatic colorectal cancer, but debate continues as to their relative efficacy and proper sequencing. At the 2014 Gastrointestinal Cancers Symposium, a number of studies attempted to answer these questions by interrogating the clinical...

colorectal cancer

More Support for ‘All-RAS’ Testing in Metastatic Colorectal Cancer

Multiple studies reported at the 2014 Gastrointestinal Cancers Symposium add further support for widening the genetic analysis of colorectal cancer tumors. In fact, experts predict that more extensive genetic testing for RAS gene mutations (in KRAS and NRAS) beyond the routine analysis of KRAS exon ...

colorectal cancer

Colorectal Cancer Screening: Quality Measures Should Focus on Patient Benefit Over Age Alone, Study Reports

Screening for colorectal cancer based on age alone may contribute to both underuse and overuse of colonoscopy, sigmoidoscopy, and fecal occult blood testing among older people, according to a study by investigators at the University of Michigan and the Veterans Affairs Center for Clinical...

Expert Point of View: Thomas W. Flaig, MD

This study has the potential to expand the number of patients who can benefit from organ-sparing therapy,” said Thomas W. Flaig, MD, Associate Professor in the Division of Medical Oncology at the University of Colorado Denver, commenting on the pooled analysis of RTOG 9906 and 0233 presented at the ...

bladder cancer

Fine-Tuning Bladder-Preservation Trimodality Therapy for Patients With Muscle-Invasive Bladder Cancer

Organ preservation is a hallmark of progress in the world of cancer management. For patients with muscle-invasive bladder cancer, the bladder-sparing approach is a well-established alternative to radical cystectomy. Patients undergo cystoscopic evaluation between the induction and consolidation...

prostate cancer

Role of Immunotherapy Explored in Metastatic Castration-Resistant Prostate Cancer

Ipilimumab (Yervoy) failed to meet the primary endpoint of improving overall survival in the randomized, phase III CA184-043 trial. However, the immunotherapy did improve progression-free survival and prostate-specific antigen (PSA) response compared with placebo in postdocetaxel metastatic...

health-care policy

The Evolution of U.S. Cooperative Group Trials: Publicly Funded Cancer Research at a Crossroads

Over the past 5 decades, National Cancer Institute (NCI) Clinical Trials Cooperative Groups have played an enormous role in the fight against cancer, tackling a broad social agenda, including cancer prevention, quality-of-life issues for patients with cancer, and comparison of benefits among...

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