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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...

prostate cancer

Long-Term Complications of Prostate Cancer Treatment May Have Been Underappreciated

The recent study by Nam et al in The Lancet Oncology—reviewed in this issue of The ASCO Post—provides a fresh perspective on complications other than incontinence or erectile dysfunction that commonly arise after primary treatment of localized prostate cancer.1 The authors conducted a...

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...

prostate cancer

Complications Other Than Incontinence or Erectile Dysfunction After Prostatectomy or Radiotherapy for Prostate Cancer

Studies of complications of surgery or radiotherapy for prostate cancer generally focus on incontinence and erectile dysfunction. In a population-based cohort study reported in The Lancet Oncology, Robert Nam, MD, MSc, FRCS(C), Professor of Surgery, Sunnybrook Health Sciences Centre, University of...

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

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...

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...

lymphoma

Brentuximab Vedotin Shows Antitumor Activity in Patients With Relapsed Peripheral T-Cell Lymphoma

In a phase II study, the 34 evaluable patients with peripheral T-cell lymphomas who received brentuximab vedotin (Adcetris) had an overall response rate of 41%, including an overall response rate of 54% among the 13 patients with angioimmunoblastic T-cell lymphoma. The median progression-free...

breast cancer

Exemestane to Reduce Invasive Breast Cancer Risk Has Small Negative Impact on Quality of Life

Detailed quality-of-life data from the National Cancer Institute of Canada Clinical Trials Group (NCIC CTG) Mammary Prevention 3 (MAP.3) trial showed that exemestane given for the prevention of breast cancer “has limited negative impact on menopause-specific and health-related [quality of life] in...

2014 Oncology Meetings

MAY Association for Value-Based Cancer Care – 4th Annual ConferenceMay 6-9 • Los Angeles, CaliforniaFor more information: http://avbcconline.org/ Accelerating Anticancer Agent Development and Validation WorkshopMay 7-9 • Bethesda, MarylandFor more information: www.acceleratingworkshop.org/ Current...

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...

gynecologic cancers

AURELIA Trial: Adding Bevacizumab to Chemotherapy Improves Outcomes in Platinum-Resistant Recurrent Ovarian Cancer

Single-agent chemotherapy is standard in platinum-resistant ovarian cancer. In the open-label phase III AURELIA trial reported in the Journal of Clinical Oncology, Eric Pujade-Lauraine, MD, PhD, of Université Paris Descartes, and colleagues found that the addition of bevacizumab (Avastin) to...

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

Gynecologic Cancer Treatment at High-Volume Centers May Be Lifesaving

Women with gynecologic cancers who are treated at hospitals that frequently manage these conditions appear to live significantly longer than those who receive their care at lower-volume centers, according to a large study presented at the Society of Gynecologic Oncology (SGO) Annual Meeting on...

leukemia

FDA Approves Ofatumumab for Previously Untreated Chronic Lymphocytic Leukemia

The U.S. Food and Drug Administration (FDA) has approved ofatumumab (Arzerra) injection in combination with chlorambucil (Leukeran) for the treatment of previously untreated patients with chronic lymphocytic leukemia (CLL), for whom fludarabine-based therapy is considered inappropriate. The...

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...

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...

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 ...

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 ...

breast cancer

PALOMA-1 Trial Finds Palbociclib/Letrozole Doubles Progression-Free Survival in Metastatic Breast Cancer

First-line treatment with the combination of palbociclib plus letrozole extended progression-free survival by approximately 50% in patients with metastatic estrogen receptor–positive, HER2-negative breast cancer, according to final results of the PALOMA-1 trial, a randomized phase II study...

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...

Collaborative Exchange: Timing of Uridine Triacetate

The challenge of deciding when to administer uridine triacetate was explored by the panel. Dr. Schwartzberg: I assume uridine triacetate would work more effectively if given very early; otherwise we would see the same kind of downstream toxicity we see with methotrexate. Dr. Campen: Exactly, but...

Questions Answered About Uridine Triacetate

Q. What is uridine triacetate? A. It is an investigational, orally active prodrug of uridine currently under development as an antidote to overexposure of fluorouracil (5-FU). Although not yet approved by the U.S. Food and Drug Administration, it has been shown to be effective in treating patients...

breast cancer

Adjuvant Chemotherapy Accelerates Pace of Physiologic Aging in Women Treated for Breast Cancer

“Adjuvant chemotherapy for breast cancer is gerontogenic,” accelerating the pace of physiologic aging, according to an analysis of blood and clinical data from 33 women with stage I to III breast cancer. “We have shown that cytotoxic chemotherapy potently induces the expression of markers of...

prostate cancer

Tadalafil Did Not Prevent Erectile Dysfunction Among Men Receiving Radiotherapy

Daily use of tadalafil (Cialis) did not improve erectile function compared to placebo or prevent erectile dysfunction among men undergoing radiotherapy for prostate cancer, according to results of a stratified, placebo-controlled, double-blind, parallel-group study with 1:1 randomization at 76...

issues in oncology

Breaking Bad News Badly Can Add to Upset

When the prognosis is poor, breaking the bad news badly can exacerbate the distress experienced by cancer patients and their families. A lack of sensitivity to patient and family emotions and not being attuned to how individual patients would prefer to be informed about their prognoses can result...

pancreatic cancer

Learning to Live in the Moment

I’ve been health conscious all my life. I have never smoked, I eat a healthy diet, and I have maintained a near-daily exercise routine since I was 20. I’m also steadfast about keeping yearly medical checkups and screenings. So when I felt a sharp, lightning-bolt of pain that went from the top of my ...

ASCO Cofounder Jane Cooke Wright, MD, Defied Racial/Gender Barriers and Helped Usher in the Modern Age of Chemotherapy

When Jane Cooke Wright, MD, met with six other oncologists at the Edgewater Beach Hotel in Chicago on April 9, 1964, to discuss the creation of American Society of Clinical Oncology, the first medical society dedicated to bringing patient-oriented issues to clinical oncology, the Civil Rights Act...

Collaborating to Conquer Cancer

Serving as ASCO’s President was one of the most exciting years of my professional career. Although that year presented a number of challenges, it also marked a number of accomplishments, including a record number of new ASCO members, which then reached more than 30,000 in 122 countries (today,...

Celebrating ASCO's History, 1964-2014

The last 50 years have been marked by significant advances in cancer research and in more effective therapy for patients. Once viewed as a largely untreatable, fatal disease, today a number of cancers are being converted into chronic diseases that can be managed for long periods of time. The result ...

2014 Oncology Meetings

MAY ASPHO’s 27th Annual MeetingMay 14-17 • Chicago, Illinois For more information: www.aspho.org Oral Oncology: Oncologic Dentistry and Maxillofacial Prosthetics SymposiumMay 15-17 • Houston, TexasFor more information: www.mdanderson.org/conferences 2014 State of the Art Radiation Therapy:...

global cancer care

A Vision of Independent Clinical Research in South America

Clinical research is vital for the development and improvement of methods designed to prevent and treat cancer. The majority of clinical trials take place in the developed world through sponsored pharmaceutical research companies.1 The corresponding lack of research in developing countries results...

gastroesophageal cancer

Ramucirumab for Advanced or Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma

On April 21, 2014, ramucirumab (Cyramza) was approved for use as a single agent in the treatment of patients with advanced or metastatic gastric or gastroesophageal junction adenocarcinoma with disease progression on or after prior treatment with fluoropyrimidine- or platinum-containing...

Connecting to ASCO Through the State Affiliate Council

ASCO’s State Affiliate Council is composed of the State Society Presidents and/or designated physician Council Representatives as well as the Executive Directors of each state and/or regional oncology society. The Council convened in late February to address the most relevant issues affecting...

leukemia

Ofatumumab Plus Chlorambucil for Previously Untreated CLL in Patients Not Treatable With Fludarabine-Based Regimens

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. On April 17, 2014, ofatumumab (Arzerra) received regular approval...

survivorship
global cancer care

Improving Quality of Life in Cancer Survivors

The number of cancer survivors has been steadily increasing in recent years. According to the Ministry of Health National Cancer Registry, in 2010 there were 254,000 cancer survivors in Israel (3.3% of the population) compared with 15,700 (0.4% of the population, P < .005) in 1975.1 Forty years...

survivorship

Elevated Morbidity/Mortality Risks for Childhood Cancer Survivors Further Increase After Fourth Decade

An analysis of the first generation of childhood cancer survivors, who are now aging into their fourth and fifth decades, shows further increases in the survivors’ morbidity and mortality risks. “By age 50 years, more than half of survivors have experienced a severe, disabling, or life-threatening...

gynecologic cancers

Ongoing Clinical Trials Actively Recruiting Patients With Ovarian or Cervical Cancers

The information contained in this Clinical Trials Resource Guide includes details of actively recruiting clinical studies of patients with gynecologic and breast cancers. It also includes the Family Caregiver Palliative Care Intervention study, which is investigating interventions to support...

integrative oncology

Thirty Years of Effort Has Led to the Mainstreaming of Integrative Medicine in Oncology Care

When Barrie R. Cassileth, MS, PhD, began researching complementary medicine and its potential for use in oncology care over 30 years ago, not much was known about the importance of complementary therapies for the well-being of patients with cancer. She chose to conduct her doctoral dissertation...

thyroid cancer

Increased Incidence of Thyroid Cancer: An Epidemic of Diagnosis?

In a study reported in JAMA Otolaryngology Head & Neck Surgery,1 Davies and Welch found that the incidence of thyroid cancer has nearly tripled since 1975. However, the increase appears to represent an “epidemic of diagnosis” and to almost exclusively represent increased diagnosis of papillary...

cns cancers

Surgical Resection of Newly Diagnosed Glioblastoma: What Is the Standard of Care?

The neurosurgeon is often the gateway provider when patients present with what on magnetic resonance imaging (MRI) appears to be a new glioblastoma. Because histology-based diagnosis is a prerequisite for initiating standard therapy with radiation and chemotherapy, the first question that the...

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