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Karnofsky Award Winner Honors Mentors through Gift to Conquer Cancer Foundation

Kanti R. Rai, MD, and his wife Susan have been loyal donors to the Conquer Cancer Foundation for the past 9 years, but in 2012, a momentous occasion in his career inspired Dr. Rai to make a unique gift. A Moment of Reflection In the spring of 2012, Dr. Rai, an internationally recognized expert on ...

skin cancer

Vismodegib: Novel Agent for Treating Advanced Basal Cell Carcinoma

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 In January 2012, vismodegib (Erivedge) was approved...

breast cancer

SIDEBAR: Dealing with the Toxicity of Everolimus/Exemestane

While packing a punch in terms of clinical benefit, everolimus plus exemestane can also be a tough pill to swallow for many patients. The management of the potential toxicities associated with this new regimen was addressed at the 2012 Breast Cancer Symposium by Matthew J. Ellis, MB, PhD, of...

breast cancer

Will mTOR Inhibitors Change the Treatment of Endocrine-sensitive HER2-negative Breast Cancer?

For the treatment of endocrine-sensitive metastatic breast cancer, the combination of an mTOR inhibitor and an endocrine agent represents a promising new option. At the 2012 Breast Cancer Symposium, the 18-month update of BOLERO-2, which tested therapy with everolimus (Afinitor) plus exemestane,...

lung cancer
issues in oncology

SIDEBAR: Dacomitinib: Better in Whom? Better in What?

Drug development is a highly competitive business. A new drug must be proven to be better than the standard one before it can be registered for public use. Starting with preclinical data, there should be evidence of lower 50% inhibitory concentrations in selective cell lines or a broader spectrum...

lung cancer
issues in oncology

Phase II Study Suggests Advantage of Irreversible Pan-HER Inhibition in Advanced NSCLC

Dacomitinib is a new tyrosine kinase inhibitor that forms irreversible covalent bonds with the ATP domain of each of the three kinase-active members of the HER family—EGFR/HER1, HER2, and HER4. Agents such as erlotinib (Tarceva) and gefitinib (Iressa), which are of proven benefit in advanced...

leukemia

Challenges Persist in Treatment of Elderly Patients with CLL, but Novel Agents Hold Promise for Future Strategies

Chronic lymphocytic leukemia (CLL) is mainly a disease of the elderly, and the lack of a standard regimen for elderly patients has been a major challenge. The myelosuppressive regimens used to treat younger patients are not well tolerated by the elderly. However, some newer approaches currently...

breast cancer

Expert Point of View: Sandra M. Swain, MD

Commenting on the PHARE trial and HERA update presented at ESMO, ASCO President Sandra M. Swain, MD, of Washington Hospital Center’s Washington Cancer Institute, said “Today we have seen that 12 months of trastuzumab is better than 6 months, and 12 months is the same as 2 years of treatment, so...

issues in oncology

Challenging Times: A Day in the Life of a Community Oncologist

Community oncologists man the front line of cancer care, treating upward of 85% of our nation’s patients. Over the past 2 decades, regulatory and economic changes have left many practices in a state of flux and uncertainty, some struggling to keep their doors open. To shed light on the community...

Ignoring Level 1 Evidence in Invasive Bladder Cancer: Is Ignorance Bliss?

I’ve been part of the uro-oncology community for more than 30 years and have been proud to be involved in a good number of well-powered, enthusiastically subscribed randomized clinical trials. These have dated back to a time before randomization was necessarily the fashion. I have had the pleasure...

2012-2013 Oncology Meetings

November 2012 AACR-NCI-EORTC Molecular Targets and Cancer TherapeuticsNovember 12-16 • San Francisco, California For more information: www.aacr.org Connective Tissue Oncology Society 17th Annual MeetingNovember 14-17 • Prague, Czech Republic For more information: www.ctos.org Controversies in the...

Letter to the Editor: Origins of PSA Testing: The Conversation Continues

As Drs. James Mohler and Donald Trump noted in their September 15 letter to The ASCO Post (“More Thoughts on PSA,” 3[14]:2, 2012), Richard Ablin, PhD, discovered a “prostate-specific antigen” of unknown properties, but his PSA is not the antigen in the PSA test we know today. Since Dr. Ablin has...

Impaired Plasmacytoid Dendritic Cell IFN-α Production May Contribute to Breast Cancer Progression

Infiltration and dysfunction of immune cells has been observed in numerous cancers. After finding that plasmacytoid dendritic cells (pDC) in primary breast tumors correlated with unfavorable prognosis, Sisirak and colleagues from INSERM (Institut National de la Santé et de la Recherche Médicale)...

Strong Association Increasingly Recognized Between Obesity and Cancer Incidence/Poor Prognosis

The rise in obesity in the United States coincides with greater recognition of the role of obesity in cancer and other diseases.1 While decades of research have indicated a strong association between obesity and cancer, “several forces have made that association increasingly recognized,” according...

The Nuts and Bolts of Getting into an Oncology Fellowship

Oncology continues to be one of the most sought-after specialties. Because of a shortage of oncologists and the accelerating pace of developments in the diagnosis and treatment of cancer, oncology has become an increasingly competitive field. Accreditation Council for Graduate Medical Education...

Effects of LKB1 Mutation and mTOR Inhibition on IGFR1 Pathway in NSCLC

LKB1 is a serine/threonine kinase that has been found to be mutated in approximately 20% to 30% of patients with non–small cell lung cancer (NSCLC). LKB1 acts as a tumor suppressor by activating AMPK, and loss of LKB1 by point mutation or deletion suppresses AMPK, leading to increased mTOR...

Explaining Research to Patients

Everyone understands the need for medical research, especially regarding cancer. However, only a minority of the public understand what is actually involved in taking part in a clinical trial. As professionals, we are responsible for designing relevant studies, for their conduct and analysis, and...

lung cancer

Sorafenib Fails to Improve Survival as Third- or Fourth-line Treatment of Advanced Non–Small Cell Lung Cancer

Third- or fourth-line therapy with sorafenib (Nexavar) failed to extend overall survival in patients with advanced non–small cell lung cancer (NSCLC), according to the main results of the phase III MISSION trial. However, a post hoc biomarker analysis of MISSION suggested that patients with...

Risk Reduction for Patients with Multiple Primary Cancers

The number of patients with multiple primary cancers is increasing so that second malignant neoplasms now represent approximately 16%, or 1 in 6 cancers reported to the Surveillance, Epidemiology, and End Results (SEER) Program. While some second malignant neoplasms are treatment-related, others...

Intermittent Androgen Suppression in Prostate Cancer Noninferior to Continuous Suppression, Associated with Some QOL Benefit

A recently reported National Cancer Institute of Canada (NCIC) Clinical Trials Group study, reported by Crook and colleagues in The New England Journal of Medicine, showed that intermittent androgen suppression was associated with noninferior overall survival when compared with continuous...

Options Shifting for First-line Treatment of Renal Cell Carcinoma

Trials with pazopanib (Votrient) have “provided significant efficacy, toxicity, and tolerability data for pazopanib to be established as a first-line standard of care” for renal cell carcinoma,” Tim Eisen, PhD, of the University of Cambridge, United Kingdom, stated at the 11th International Kidney...

Stereotactic Radiosurgery May Offer Therapeutic Option for Patients with Primary Renal Cancer, Early Study Indicates

Stereotactic radiosurgery may hold potential as a therapeutic option for patients with localized primary renal cancer who are considered poor surgical candidates and who do not have a prior history of pelvic or abdominal radiation, according to data from a safety and toxicity study recently...

SIDEBAR: Support Underfunded Areas of Research

The Conquer Cancer Foundation funds research focused on finding new therapeutics to conquer cancer and is also committed to funding research that other organizations may not, such as in palliative care, rare cancers, pediatric cancers, and high-risk areas. With donations from supporters like you,...

Albumin-bound Paclitaxel in First-line Treatment of Advanced NSCLC

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 October 11, 2012, paclitaxel protein-bound particles...

Nab-paclitaxel vs Solvent-based Paclitaxel in First-line Treatment of Advanced Non–Small Cell Lung Cancer: Final Results

Nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) is a solvent-free paclitaxel formulation intended to reduce solvent-related adverse reactions and improve tumor penetration via the physiologic transport properties of albumin. The final results of a phase III trial comparing nab-paclitaxel and ...

Adjuvant Chemotherapy for Breast Cancer Predicted by Disease, Age, and Insurance Type, but Not by Race

Breast cancer mortality has been found to be higher among black and Hispanic women than among white women, with the differences in outcome being attributed in part to more advanced disease stage and greater frequency of unfavorable tumor biology among black and Hispanic women. Studies to date have...

Novel Agents for Breast Cancer and Prostate Cancer Impressive in Early Trials

Several sessions at the 2012 European Society for Medical Oncology (ESMO) Congress in Vienna focused on novel targeted therapies in various stages of development. Summarized here are data on two promising drugs for breast cancer and two for prostate cancer. E-3810 in Breast Cancer Two experimental...

Highlights From the Ninth International Conference of the Society for Integrative Oncology

The theme of this year’s International Conference of the Society for Integrative Oncology (SIO) was “Honoring Diversity in Cancer Prevention and Control.” The conference was held October 8–10, 2012, in Albuquerque, New Mexico, and examined such varied topics as health-care disparities, novel...

Integrative Medicine Showing Benefits in Cancer Management

Donald I. Abrams, MD, Chief of Hematology-Oncology at San Francisco General Hospital and Integrative Oncologist at the University of California, San Francisco, Osher Center for Integrative Medicine, has been investigating and incorporating integrative medicine approaches in his clinical treatment...

Contralateral Breast Cancer Risk Is Highly Overestimated

Breast cancer is highly unlikely to develop in the contralateral breast of women treated for primary breast cancer, yet many women continue to fear it and undergo prophylactic mastectomies. “Regardless, the perceived risk of developing and dying from a contralateral breast cancer is highly...

SIDEBAR: Mammography Study Stokes Overdiagnosis Debate

Overdiagnosis and the harms associated with unnecessary procedures is becoming a vibrant subject in today’s health-care dialogue, with serious implications for providers and patients alike. A new study from the Norwegian Screening Program concluded that 15% to 25% of breast cancers identified on...

Updated Results from T-DM1 and Regorafenib Trials, plus Other Highlights from ESMO 2012

The 35th European Society for Medical Oncology (ESMO) Congress in Vienna broke all records for attendance, with about 16,000 attendees from all over the world. Some sessions were standing room only, including the Presidential Symposia, the ESMO-ASCO Joint Symposium on genomics in breast cancer, and ...

Defining a Cure for Chronic Myeloid Leukemia and Strategies to Achieve this Goal

In chronic myeloid leukemia (CML), continued long-term therapy that prevents both progression to accelerated-phase disease and the emergence of resistance may be thought of as an “operational” or “functional” cure. However, long-term disease control without the requirement for continuous treatment...

Managing Treatment Failure in Chronic Myeloid Leukemia

As John Goldman, DM, FRCP, FRCPath, FMedSci, discussed earlier, a substantial minority of patients with chronic myeloid leukemia (CML) experience treatment failure. Jorge Cortes, MD, of The University of Texas MD Anderson Cancer Center, introduced this session with two patient cases to illustrate...

Defining and Recognizing the Causes of Imatinib Resistance and the Importance of Adherence

Imatinib (Gleevec) is a highly effective therapy for the majority of patients with chronic myeloid leukemia (CML). In the IRIS study, only 30% of patients could be considered to have failed imatinib treatment after 6 years.1 However, these 30% of patients are a substantial minority. John Goldman,...

Beyond Molecular Monitoring: Cytogenetic Testing and Mutational Analysis in Chronic Myeloid Leukemia

Cytogenetic analysis remains an important component of patient monitoring until a complete cytogenetic response is achieved. In addition, the ability of conventional cytogenetics to identify additional chromosomal abnormalities not detected by fluorescence in situ hybridization is noteworthy. Jorge ...

CE Activity Instructions

*Corresponding author, MediCom Worldwide, Inc, 101 Washington Street, Morrisville, PA 19067, e-mail: gtombler@medicaled.com Activity Release Date: November 15, 2012Period of Validity: November 15, 2013 Program Overview This activity presents highlights from a satellite symposium held in...

prostate cancer
issues in oncology

Role of Glutamate and Effect of Its Blockade in Prostate Cancer

Glutamate plays a role in oncogenic metabolic and signaling pathways. In a recently reported study, Koochekpour and colleagues from the Roswell Park Cancer Institute in Buffalo, NY, investigated potential correlations of glutamate levels with prostate cancer in patients with primary or...

hepatobiliary cancer

Lower Risk of Recurrence in Patients with HBV-related Liver Cancer Receiving Nucleoside Analogs

Patients with hepatitis B virus (HBV)-related hepatocellular carcinoma who received nucleoside analogs after curative liver resection had an associated lower risk of hepatocellular carcinoma in a nationwide cohort study using data from the Taiwan National Health Research Data Base. The study was...

breast cancer

Small Increase in Cardiac Events for Trastuzumab plus Anthracycline in HER2-positive Disease

A 7-year follow-up of the phase III National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol B-31 found that the cumulative difference in the rate of cardiac events was 3.1% between patients with HER2-positive, node-positive breast cancer who received trastuzumab (Herceptin) in addition ...

SIDEBAR: Expect Questions and Respond with Reasoned Explanations

“Soaring spending has presented the medical community with a new obligation. When choosing treatments for a patient, we have to consider the financial strains they may cause alongside the benefits they might deliver,” three physicians from Memorial Sloan-Kettering Cancer Center (MSKCC) in New York...

MSKCC’s Decision Not to Purchase New Cancer Drug Sparks Editorial and Unprecedented Actions

“At Memorial Sloan-Kettering Cancer Center, we recently made a decision that should have been a no-brainer: we are not going to give a phenomenally expensive new cancer drug to our patients.” That was the opening sentence of a New York Times op-ed piece written by three physicians from Memorial...

solid tumors

I Am Not a Victim

Six years ago, at age 62, I was feeling in great shape. The year before, I had taken over custody of my 2- and 3-year-old great-grandchildren and decided to change the course of my career from motivational speaker to motivational coach to be home more often with the kids. It was during one of our...

Oncology Meetings

January 2013 3rd International Conference on Medical, Biological and Pharmaceutical SciencesJanuary 4-5 • Bali, Indonesia For more information: www.psrcentre.org Breast-Gynecological International Cancer CongressJanuary 17-18 • Cairo, Egypt For more information: www.bgicc.eg.net/ Highlights of ASH® ...

integrative oncology

Acupuncture: Does It Alleviate Symptoms Associated with Cancer Care?

A therapeutic modality of traditional Chinese medicine, acupuncture has been extensively investigated in Western medical settings. Its clinical use is increasingly common for the management of pain and other conditions. In the oncology setting, research demonstrates that acupuncture can...

Health-care Crisis Reconsidered

As an oncologist in private practice, I usually read with great interest the many articles in The ASCO Post on issues regarding the politics of oncology practice. These articles deal with the major topics of the day, ranging from the high cost of oncologic care to shortages of generic drugs, to...

Top 10 Most Viewed Articles on ASCOPost.com for 2012

Novel Multikinase Inhibitor Improves Survival in Metastatic Colorectal CancerBy Caroline HelwickThe novel tyrosine kinase inhibitor regorafenib, given as a single agent to patients with treatment-refractory metastatic colorectal cancer, significantly improved overall survival and delayed disease...

skin cancer

Prevention and Treatment of Multikinase Inhibitor–induced Hand-Foot Syndrome

Multikinase inhibitors (sorafenib [Nexavar], sunitinib [Sutent], pazopanib [Votrient], axitinib [Inlyta], regorafenib [Stivarga]) block various proteins including vascular endothelial growth factor receptor (VEGFR) and platelet-derived growth factor receptor (PDGFR). They have been approved by...

solid tumors
prostate cancer

Expert Point of View: Jeffrey Bradley, MD

Commenting on both radiotherapy studies and the use of proton-beam therapy in general, Jeffrey Bradley, MD, of Washington University in St Louis, agreed with both presenters that a randomized prospective trial is needed to justify the use of proton-beam therapy in prostate cancer. Washington...

solid tumors
prostate cancer

Early Quality of Life Better with Proton-beam Therapy, but Late Effects Similar to Other Treatment Modalities for Prostate Cancer

Differing patterns of patient-reported quality of life for three-dimensional (3D) conformal radiotherapy, intensity-modulated radiation therapy, and proton-beam therapy were reported in a nonrandomized comparison of three modern cohorts of patients with prostate cancer. The study was presented at...

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