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issues in oncology

My Priorities for the Year Ahead

I am honored and privileged to lead ASCO during its 51st year, a year that promises to bring both challenges and opportunities to our members and our patients. As the theme for my Presidential term, I’ve chosen Illumination and Innovation: Transforming Data Into Learning, because we are positioned...

lung cancer

Stereotactic Body Radiation Therapy an Effective Option for Early-Stage Lung Cancer Patients

Stereotactic body radiation therapy (SBRT) is safe and effective in early-stage non–small cell lung cancer (NSCLC), as it confers local control in 90% or more patients with T1 disease, according to Roy Decker, MD, PhD, Associate Professor in the Department of Therapeutic Radiology at Yale Cancer...

John H. Saiki, MD, SWOG Investigator, Dies at 77

John “Jack” Harris Saiki, MD, Professor Emeritus at the University of New Mexico Department of Medicine, Hematology/Oncology Division, lived the history of modern day oncology with a career spanning 44 years. In the early days of his career, with the support of a grant from the federally funded New ...

solid tumors

How Evolutionary Game Theory Is Offering Clues to Disrupt Cancer Cell Metabolism

Kenneth J. Pienta, MD, and his colleagues at Johns Hopkins Medicine in Baltimore are using the principles of evolutionary game theory to learn how cancer cells cooperate within a tumor to gather energy and metastasize. Game theory, the mathematic study of strategic decision-making that is commonly...

supportive care

Memorial Sloan Kettering Cancer Center Launches Meaning-Centered Psychotherapy Programs for Terminally Ill Patients, Cancer Survivors, and Caregivers

Although most major cancer centers in the United States offer support groups and individual counseling sessions to help patients with cancer cope with their disease and treatment, over the past decade Memorial Sloan Kettering Cancer Center in New York has broadened its psycho-oncology programs to...

leukemia
lymphoma

Allogeneic Conditioning Regimen Reduces Myelosuppression, Graft-vs-Host Disease in Lymphocytic Leukemia/Lymphoma

The combination of bendamustine (Treanda), fludarabine, and rituximab (Rituxan), or BFR, was shown to be safe and effective conditioning for patients with relapsed chronic lymphocytic leukemia/lymphoma receiving allogeneic stem cell transplantation from related or unrelated donors. “Remarkably,...

colorectal cancer

Substantial Reductions in Surgical Site Infections After Colorectal Surgery With Bundling Approach

Use of a preventive surgical site infection bundle that spanned the phases or perioperative care “was associated with a substantial reduction in [surgical site infections] after colorectal surgery,” according to results of a retrospective study of 559 patients who underwent major elective...

breast cancer

Most Women Who Choose Breast Reconstruction Are Satisfied With Decision-Making Process

Most patients who choose to have breast reconstruction following mastectomy are satisfied with the decision-making process. Reasons for not choosing reconstruction vary by race and include the desire to avoid additional surgery and fear of implants. These and other conclusions of an analysis of...

breast cancer
gastroesophageal cancer

TRIM44 Amplification in Esophagogastric, Breast Tumors May Be Marker for mTOR Inhibitor Therapy

TRIM44 family overexpression is associated with carcinogenesis, and TRIM44 has been identified as a prognostic gene. In a study reported in Journal of the National Cancer Institute, Ong and colleagues attempted to identify therapeutic strategies for patients with TRIM44 overexpression. Genomic and...

‘Everybody Has a Mutation or More’

While genome sequencing is not currently recommended or widely used because of its high cost and paucity of meaningful, actionable results, some patients wouldn’t want it even if it were free and useful, ­Theodora Ross, MD, PhD, Director of the Cancer Genetics Program at the University of Texas...

Expect Questions From Patients

Conscientious doctors are unlikely to say yes to a patient’s request for full genome sequencing,” Theodora Ross, MD, PhD, wrote in The New York Times.1 Dr. Ross, Director of the Cancer Genetics Program at the University of Texas Southwestern Medical Center in Dallas, was writing about the current...

breast cancer

News of Mutations in PALB2 Gene Raising Risk of Breast Cancer Offers Opportunity to Explain Limits of Genetic Testing

The response among patients to news reports about mutations in a gene known as PALB2 raising the risk of breast cancer “has been predictable,” Theodora Ross, MD, PhD, wrote in The New York Times.1 As an example, Dr. Ross, Director of the Cancer Genetics Program at The University of Texas...

Patient Guides Available Through ASCO University Bookstore

ASCO Answers: Managing the Cost of Cancer Care explains the various costs associated with cancer treatment, including health-care coverage through the Affordable Care Act. It also provides a list of financial resources available to help offset expenses related to care and tips for organizing...

breast cancer
survivorship

Breast Cancer Has Led Me to Careers in Activism and Filmmaking

The last thing I expected to find when I returned home after a summer vacation celebrating my 50th birthday was a letter from my gynecologist saying the routine mammogram I had before I left found suspicious-looking calcifications in my right breast and that I should see a surgeon right away. Being ...

ASTRO Honors Jasan Zimmerman With 2014 Survivor Circle Award

The American Society for Radiation Oncology (ASTRO) presented the 2014 Survivor Circle Award to San Francisco Bay Area resident and cancer survivor Jasan Zimmerman during ASTRO’s 56th Annual Meeting held recently in San Francisco. The Survivor Circle Award recognizes a cancer survivor who lives in...

integrative oncology

The Role of Music Therapy in Cancer Care

Music therapy, an established adjuvant to standard cancer care, is offered in a growing number of cancer centers throughout the United States and internationally. Defined by the American Music Therapy Association (AMTA) as “the evidence-based use of music interventions to accomplish individual...

I Work for You

The following essay by James O. Armitage, MD, is excerpted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was co-edited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and at thebigcasino.org.   The ...

Cancer Frontier: Bringing the New Sciences to an Old School

Cancer seems to have an endless supply of people who want to write about it. Why not? It’s an intriguing subject of life and death and struggle and hope, one that touches virtually every person of a certain age. However, the bookshelves are filled with cancer survivorship books, so to stand out, an ...

issues in oncology

Sequencing Analysis of Tumor DNA: Is It All in the Plasma?

Massively parallel sequencing analyses have demonstrated that most of the common malignancies display relatively complex repertoires of somatic genetic alterations, that the number of highly recurrent mutations is limited, and that a large number of genes is mutated in a small minority of tumors...

issues in oncology

Potential of Liquid Biopsies in Detecting Cancer and Establishing Prognosis

Tests in development to detect circulating tumor cells that escape from solid tumors and travel through the blood, spreading cancer to new sites, may serve as an alternative to conventional tissue biopsy for early cancer diagnosis and gene-expression analysis over the next decade. According to...

Prioritizing Cancer Care

In Rwanda, there is basically no chemotherapy available through government purchasing. The Partners in Health/Dana-Farber partnership supplies all the standard-of-care chemotherapy regimens for the cancer patients at the Butaro Cancer Center of Excellence, explained Lawrence N. Shulman, MD, Chief...

issues in oncology
global cancer care
health-care policy

Delivering Cancer Care in Low-Income Countries

In eealthy industrialized nations like the United States, escalating costs of cancer care have put the term “cost-effective care” on the forefront of health-care policy discussions. However, the cost issues we wrestle with in our $3 trillion health-care system are vague abstractions for much of the ...

issues in oncology

Using Electronic Health Records to Improve Communication With Patients

Clinicians may argue that electronic health records (EHRs) interfere with the patient-physician relationship, and patients may complain about “distracted doctors,” too busy with computer screens to make eye contact, but according to Thomas W. LeBlanc, MD, MA, of Duke University School of Medicine...

Moffitt Appoints Louis B. Harrison, MD, New Chair, Radiation Oncology

Louis B. Harrison, MD, has joined Moffitt Cancer Center in Tampa as Chair of the Department of Radiation Oncology, and Senior Member. Moffitt’s Radiation Oncology program includes faculty of cancer specialists who provide comprehensive cancer care for tumors at all anatomical locations, as well as...

Immunotherapy Research of James P. Allison, PhD,  Has Led to a Paradigm Shift in the Treatment of Cancer

James P. Allison, PhD, has been bucking the status quo since he was a teenager growing up in the small agricultural town of Alice, Texas, in the 1950s and 1960s. He first butted heads with authority figures when he was in high school and learned that his biology class had omitted the teaching of...

breast cancer

Breast Cancer Screening Using Tomosynthesis in Combination With Digital Mammography

In a study reported in JAMA and reviewed in this issue of The ASCO Post, Friedewald and colleagues1 showed that the addition of tomosynthesis to digital mammography2 resulted in a decrease in the screening recall rate3 and an increase in the cancer detection rate.4,5 This retrospective analysis of...

National Cancer Institute Launches the National Clinical Trials Network to Expedite Scientific Advances

In March, the National Cancer Institute (NCI) transformed its Cooperative Group Program into the National Clinical Trials Network (NCTN). Spurred by recommendations in the Institute of Medicine (IOM) 2010 report, A National Cancer Clinical Trials System for the 21st Century: Reinvigorating the NCI...

NIH Launches Human Safety Study of Ebola Vaccine Candidate

The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, has launched initial human testing of an investigational vaccine to prevent Ebola virus disease, according to a news release issued by NIH. The early-stage trial has begun initial human...

palliative care

Timing and Meaning of Do-Not-Resuscitate Orders in the Palliative Care Setting

Although a do-not-resuscitate (DNR) order does not mean “do not treat,” that is how it is often interpreted, according to a study examining the level of care oncology inpatients at a tertiary care hospital received.1 The study found that the interpretation of DNR orders among oncology nurses and...

A Vision That Endured: Celebrating ASCO’s Founders

As 2014 marks the 50th Anniversary of the founding of the American Society of Clinical Oncology (ASCO), it seems only appropriate to highlight the founders of the Society and the vision they shared for its future. The 1960s were the early days of the use of chemotherapy for the treatment of cancer, ...

Issue Highlights

Career and Training Transitioning From Fellowship to Career: Expectations vs Reality Start Expanding Your Oncology Network Today: Five Tips to Get You Networking Mentoring for New Community Physicians: The Toledo Clinic Experience Don’t Call Your Program Director “Dude”… and Other Tips for...

issues in oncology

ASCO Launches New Publication for Oncology Trainees and Early-Career Professionals

In February 2014, ASCO launched a new member publication, ASCO Connection: Trainee & Early-Career Oncologists. This quarterly magazine-style publication is dedicated to topics of interest to medical students, interns, residents, fellows, and junior faculty. All ASCO Student/Non-Oncology...

bladder cancer

Complications No Different Between Open and Robot-Assisted Radical Cystectomy When Open Urinary Diversion Performed

We read the letter to the editor in the July 24, 2014, issue of The New England Journal of Medicine entitled, “A Randomized Trial of Robot-Assisted Laparoscopic Radical Cystectomy,” with great interest.1 Provocative Results In the letter, reviewed in this issue of The ASCO Post, Bochner and...

breast cancer

PALB2 Study: Researchers and Patients Must 'Pal' for Progress

The recent publication by Antoniou et al on risk of breast cancer in PALB2 carriers,1 reviewed in this issue of The ASCO Post (page 47), is a contribution to the interesting history of the PALB2 gene, and an important milestone in the expansion of hereditary cancer susceptibility testing in the...

breast cancer

Study Quantifies Risk of Hereditary Breast Cancer in Carriers of PALB2 Mutations

In a study reported in The New England Journal of Medicine, Antonis C. Antoniou, PhD, Reader in Cancer Risk Prediction and Cancer Research UK Senior Cancer Research Fellow at the University of Cambridge, and colleagues identified lifetime risk of breast cancer in families with germline...

issues in oncology

Patient-Reported Outcomes in Hematology and Oncology Product Development

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, Virginia Kwitkowski, MS, RN, ACNP-BC, and Elektra Papadopoulos, MD, MPH, discuss FDA’s current approach to the review of study...

lung cancer

Optimal Chemoradiotherapy Dosing and Recurrence After Stereotactic Body Radiotherapy Explored in Lung Cancer Webinar

Cetuximab (Erbitux) added no survival benefit to chemoradiation in stage III non–small cell lung cancer (NSCLC), according to results reported in a Plenary Session of the 2013 World Conference on Lung Cancer in Sydney, Australia.1 It was the second surprise result from the Radiation Therapy...

gynecologic cancers

Angiogenesis in Ovarian Cancer: Are We Missing the Clinical Target?

Production of vascular endothelial growth factor (VEGF) is increased during normal ovulation, and can account for much of the reversible toxicity associated with ovarian hyperstimulation.1,2 We also have compelling data from multiple clinical trials to validate the importance of tumor-associated...

prostate cancer

PSA—It Just Keeps Getting Better, So Why Should It Stand Alone?

The updated results of the European Randomised Study of Screening for Prostate Cancer (ERSPC)—reported in The Lancet by Fritz H. Schröder, MD, of Erasmus University Medical Center, and colleagues1 and reviewed in this issue of The ASCO Post—show a continued decline, as predicted,2 in the number...

hematologic malignancies

‘Paradigm-Shifting’ Results in Treatment of Hematologic Disorders

The three leukemia/lymphoma studies selected from the many 2014 ASCO Annual Meeting abstracts for presentation at the recent Best of ASCO meeting in Chicago “are really paradigm-shifting,” noted Lucy A. Godley, MD, PhD, of the University of Chicago. These studies, she said, “give great promise for...

What Constitutes High-Volume/Extensive Disease?

"I'm not sure what extensive disease really is, but in some patients, when you see it, you really recognize it. In other patients, it’s not 100% clear,” Dr. Yu commented (Fig. 1). Some patients with multiple medium or large lesions in bone would clearly meet the definition used in the CHAARTED...

Pros and Cons of Early Chemohormonal Therapy

There is considerable debate about moving chemohormonal therapy to an earlier point in the treatment of prostate cancer, at the time of initial diagnosis of metastases, according to Dr. Yu. In the pro column, “You might hit those de novo testosterone-independent clones if they exist.” Additionally, ...

When Should Chemotherapy Be Used in Metastatic Prostate Cancer?

Questions abound when it comes to the optimal timing and sequencing of chemotherapy in metastatic prostate cancer, according to Dr. Yu. For example, arguments could be made both for using it earlier, while disease is still hormone-sensitive, or later, after hormonal resistance emerges. “For...

prostate cancer

Studies Help Refine Management of Prostate Cancer

Several studies reported at this year’s ASCO Annual Meeting address gray areas in the management of prostate cancer, according to Evan Y. Yu, MD, Associate Professor at the University of Washington and the Seattle Cancer Care Alliance. “In prostate cancer, probably the most excitement has happened...

gynecologic cancers

In Managing Ovarian Cancer, Precision Medicine Is a Work in Progress

Precision medicine in the management of ovarian cancer “is a work in progress, to be sure,” Steven B. Newman, MD, noted in wrapping up the session on gynecologic cancer at the recent Best of ASCO meeting in Chicago. “A list of different histologic types of ovarian cancer and potential targets are...

breast cancer

Disparities Persist in Early-Stage Breast Cancer Treatment, MD Anderson Study Finds

Despite its acceptance as standard of care for early-stage breast cancer almost 25 years ago, barriers still exist that preclude patients from receiving breast-conserving therapy, with some patients still opting for a mastectomy, according to research from The University of Texas MD Anderson Cancer ...

lung cancer

In Advanced Lung Cancer, Targeted Combinations Are Still Works in Progress

For the treatment of advanced non–small cell lung cancer (NSCLC), combinations of targeted agents are of great research interest but have not yet been shown to improve outcomes. Single-agent treatment with tyrosine kinase inhibitors, therefore, remains the standard of care for patients with...

Important Resources

Persons whose illnesses are related to exposure to the World Trade Center disaster may be eligible for medical services or monetary compensation under two Federal programs. The World Trade Center (WTC) Health Program provides medical monitoring and treatment for responders at the World Trade...

issues in oncology
health-care policy

9/11 and Cancer: What Do We Know?

On September 11, 2001, the devastating terrorist attack that destroyed the World Trade Center left in its wake a unique toxic site in both mass and quantity of hazardous materials. It took 9 months to remove approximately 2 million tons of wreckage from Ground Zero, during which thousands of...

issues in oncology

Will Oncologists Be the First to Cure Heart Disease?

Oncologists love jargon—a language peculiar to a particular trade, profession, or group that facilitates communication among members. Our day-to-day communications, medical notes, and journal reports are filled with this type of jargon. Other definitions of jargon are less flattering, including...

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