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health-care policy

Proposed 2015 Medicare Physician Fee Schedule and Hospital Outpatient Prospective Payment System Rules Released

On July 3, 2014, the Centers for Medicare & Medicaid Services (CMS) released its proposed rules for the Medicare Physician Fee Schedule and the Hospital Outpatient Prospective Payment System for 2015. The Medicare Physician Fee Schedule rule, which is titled “Medicare Program: Revisions to...

issues in oncology

Our First Charge: Fostering the Next Generation of Oncologists and Cancer Researchers

Gary H. Lyman, MD, MPH, FASCO, is Co-Director of the Hutchinson Institute for Cancer Outcomes Research, a Full Member of the Divisions of Public Health Sciences and Clinical Research at the Fred Hutchinson Cancer Research Center, and Professor of Medicine, Public Health, and Pharmacy at the...

survivorship

More Collaboration Needed Between Oncologists and Primary Care Physicians

One of the most important cancer survivorship issues is the transition from oncologist to the primary care setting. With a growing population of cancer survivors, patients need to feel secure about their primary care provider having the tools to address their special needs. To shed light on this...

breast cancer

Patience Remains a Virtue: The Ongoing Quest to Optimize Adjuvant Endocrine Therapy in Breast Cancer

The most recent ASCO Clinical Practice Guideline update—summarized in this issue of The ASCO Post—represents the latest chapter in the ongoing evolution of adjuvant endocrine therapy for hormone-sensitive breast cancer.1 Rather than including a comprehensive review of the 2010 guidelines, this...

solid tumors

The Evolving Role of Surgery in Germ Cell Tumors

Over the past several decades, the role of postchemotherapy surgery for advanced testicular cancer has evolved with regard to patient selection, surgical planning, lymph node dissection, and surgical technique. To add clarity to this complex clinical setting, The ASCO Post recently spoke with...

prostate cancer

College of American Pathologists Publishes Recommendations for Prostate Cancer Active Surveillance

Recommendations from the United States Preventive Services Task Force and randomized trials have drawn attention to overtreatment of localized, low-risk prostate cancer. PSA screening and changing consensus on PSA testing practices are among the many factors that contribute to the overdiagnosis and ...

prostate cancer

Enzalutamide and the Landscape of Castration-Resistant Prostate Cancer: Integrating New Indications With Existing Agents

The androgen receptor axis is a validated target for the treatment of castration-resistant prostate cancer. Several perturbations in this pathway are postulated to lead to androgen-independent growth, including androgen receptor mutation and amplification as well as the autocrine production of...

gastroesophageal cancer

EGFR as a Therapeutic Target for Gastroesophageal Cancer—or Is It Really?

The epidermal growth factor receptor (EGFR) gene is often amplified and its protein overexpressed in upper gastrointestinal cancers—and overexpression has prognostic value. With the advent of monoclonal antibodies and tyrosine kinase inhibitors against EGFR, we have witnessed a rash of randomized...

supportive care

Supportive Care in Pediatric Patients With Cancer: Recent Developments in Treating Febrile Neutropenia

Recent developments in supportive care for children with cancer can be broken down into three categories: doing the simple things well, applying evidence-based medicine to daily practice, and extending the benefits to everyone, according to Scott C. Howard, MD, of St. Jude Children’s Research...

supportive care

NEPA for Chemotherapy-Induced Nausea and Vomiting: Key Endpoints and Additional Analyses Show Strong Efficacy

For the prevention of chemotherapy-induced nausea and vomiting, NEPA, a novel combination of a neurokinin-1 (NK1) receptor antagonist and the 5-HT3 receptor antagonist palonosetron (Aloxi), has been studied in three pivotal trials that were recently published in the Annals of Oncology.1-3 Further...

head and neck cancer
supportive care

Mucositis Remains a Challenge in Head and Neck Cancer

Chemoradiotherapy for head and neck cancer requires intensive supportive care by a knowledgeable and proactive multidisciplinary team, according to Avraham Eisbruch, MD, Professor of Radiation Oncology at the University of Michigan, Ann Arbor. “Aggressive chemoradiotherapy has improved the cure...

breast cancer

Tackling the Heterogeneity of Triple-Negative Breast Cancer

Triple-negative breast cancer is now recognized as a very complex subtype for which one treatment will not be applicable to all, according to Mohammad Jahanzeb, MD, Professor of Clinical Medicine at the University of Miami and Director of the UM Sylvester Deerfield Campus, who gave an update on...

lymphoma

Rational Strategies Are Advancing Combination Lymphoma Therapies

Rational strategies informed by knowledge of a drug’s molecular mechanisms are helping to bring new combinations of lymphoma therapies to the clinic, according to Anas Younes, MD, Chief of the Lymphoma Service at Memorial Sloan Kettering Cancer Center in New York. The Challenge of Too Many Drugs...

issues in oncology

Precision Medicine: Precisely Where Are We Really?

Having attended ASCO Annual Meetings for almost 40 years, I believe that this year’s 50th anniversary celebration was one of the best ever. In many of the presentations and discussions, I experienced a sense of reality about the true state of cancer management that in previous years has sometimes...

lung cancer
sarcoma
head and neck cancer
kidney cancer

New Research Presented in Wilms Tumor, Pediatric Sarcoma, Head and Neck Cancer, and Non–Small Cell Lung Cancer

In the past few months, numerous presentations from this year’s ASCO Annual Meeting have been covered in depth in the pages of The ASCO Post and online at ASCOPost.com. The brief summaries below capture additional important highlights that have not been covered thus far. We hope you will find them...

Expert Point of View: Federico Cappuzzo, MD

Federico Cappuzzo, MD, Director of the Medical Oncology Department at Istituto Toscano Tumori, Ospedale Civile, Livorno, Italy, pointed out that the abstracts presented by Spigel et al and Camidge et al at the ASCO Annual Meeting explored the same target but with different results. The first...

lung cancer

Mixed Results for Targeting MET in Non–Small Cell Lung Cancer

Two different abstracts explored the potential for MET as a therapeutic target in patients with metastatic non–small cell lung cancer (NSCLC), with different results. A phase III study found that onartuzumab, an antibody that targets the MET receptor, combined with erlotinib (Tarceva) was not as...

Expert Point of View: Melinda L. Telli, MD

The potential of individualizing systemic treatment based on BRCA1/2 status has not yet been realized. BRCA1/2 germline status currently does not factor into systemic therapy decisions,” said Melinda L. Telli, MD, of Standard University School of Medicine, Palo Alto, California, who discussed the...

Expert Point of View: Lauren C. Harshman, MD

In her discussion of the renal cell carcinoma studies at the ASCO Annual Meeting, Lauren C. Harshman, MD, Assistant Professor of Medical Oncology at Dana-Farber Cancer Institute, Boston, suggested, “Given the plateau in efficacy with current treatments, there is space and need for agents with new...

issues in oncology

Who Will Care for Patients With Cancer?

The workforce numbers show a disturbing trend. According to a recent study by ASCO, by 2025, overall demand for oncology services is projected to grow by 40%, but physician supply is predicted to increase by only 25%, generating a shortage of 2,258 oncologists providing full-time equivalent...

health-care policy

Does the United States Have the Best Health-Care System in the World?

Many concerns were raised and dire speculations predicted during the further implementation of the Affordable Care Act this year. So far, the trickling news is good: An estimated total of 20 million people gained coverage under the new law as of May 1,1 about 6 million enrolled in the law’s...

leukemia
lymphoma

Recent FDA Drug Approvals Foster Growing Treatment Armamentarium for Chronic Lymphocytic Leukemia and Rare B-Cell Lymphomas

Recent approvals announced by the U.S. Food and Drug Administration (FDA) have led to increased treatment options for managing several difficult-to-treat hematologic B-cell cancers. The newly approved drugs and/or their indications include the oral PI3K delta inhibitor idelalisib (Zydelig) for the...

Jesse L. Steinfeld, MD, Past Surgeon General, ASCO President, Dies at 87

The 1964 Surgeon General’s Report on Smoking and Health started a culture change in the way Americans viewed tobacco and their health, and has saved countless million of lives. But the 1964 Report remained scientifically ambiguous on certain vital issues, such as the effect smoking had on the...

lymphoma

First Prospective Study of Rare Lymphoma Shows Promising but Inconclusive Results With DA-EPOCH-R

Presenting “the first prospective study” of mediastinal gray zone lymphoma, researchers from the National Cancer Institute reported that DA-EPOCH-R (infusional dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine, prednisone, and rituximab (Rituxan) and filgrastim (Neupogen)...

skin cancer

Simple Bedside Assessment of Pain and Itch Is Valuable Tool for the Evaluation of Suspicious Skin Lesions

A prospective, clinicopathologic study involving 268 patients with biopsy-proven basal cell carcinoma, squamous cell carcinoma, malignant melanoma, or melanoma in situ “revealed that pain is associated with histologic features that involve deeper dermal processes in [squamous cell carcinoma]...

colorectal cancer

Patient, Tumor Characteristics Associated With BRAF and KRAS Mutations

KRAS and BRAF V600E mutations were nearly mutually exclusive and associated with specific patient and tumor characteristics, such as age and smoking status, according to an analysis of data from the N0147 phase III trial for stage III colon cancer. Primary tumors were assessed for KRAS and BRAF...

Prolonged TV Viewing, Other Sedentary Behaviors Linked to Increased Risk of Particular Cancers

“Prolonged TV viewing and time spent in other sedentary pursuits is associated with increased risks of certain types of cancer,” concluded a meta-analysis of data from 43 observational studies including more than 4 million people and 68,936 cancer cases. A positive association with overall...

Dysregulated Cell-Cycle Progression and Akt Hyperactivation in Cancer

Akt plays important roles in cell proliferation, survival, and metabolism. Akt hyperactivation contributes to tumorigenesis and is associated with poor prognosis and resistance to chemotherapy and radiotherapy. It is known that activation of Akt results from phosphorylation at S473 and T308, but it ...

Fusion Protein Improves Dendritic Cell Penetration, Raising Prospect of Efficient Cancer Vaccine

Immunotherapy with dendritic cells in combination with cytotoxic chemotherapy may eliminate minimal disease burden by generating cytotoxic T lymphocytes (CTLs). Improving the cytosolic bioavailability of tumor-specific antigens to improve access to HLA class I molecules would result in better...

breast cancer

Postmenopausal Breast Cancer Risk Decreases Rapidly After Starting Regular Physical Activity

Postmenopausal women who in the past 4 years had undertaken regular physical activity equivalent to at least 4 hours of walking per week had a lower risk for invasive breast cancer compared with women who exercised less during those 4 years, according to data published recently in Cancer...

breast cancer

Expect Questions and Perhaps Unrealistic Expectations

A recent study reporting the absolute 20-year survival benefit from contralateral prophylactic mastectomy was less than 1% for women with stage I and II breast cancer without BRCA mutations runs counter to common perceptions about the risk of contralateral breast cancer among these women and the...

breast cancer

Survival Benefit of Contralateral Prophylactic Mastectomy Less Than 1% at 20 Years, but Numbers of Procedures Have Increased

For women with stage I and II breast cancer without BRCA mutations, the absolute 20-year survival benefit from contralateral prophylactic mastectomy was less than 1%, regardless of age, estrogen receptor status, and cancer stage, according to a decision analysis study using a Markov model to...

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...

survivorship

Cancer Has Given Me Courage

In 1986, I was pregnant with my third child and excited to be interviewing for a job on the assembly line at a General Motors plant near my home in Brodhead, Wisconsin. Hiring requirements included a physical examination and a chest x-ray, which was done by my obstetrician to avoid any radiation...

prostate cancer

September Is Prostate Cancer Awareness Month

In recognition of September as Prostate Cancer Awareness Month, The ASCO Post is pleased to share the following reminders, adapted in part from the American Cancer Society: Prostate cancer is the second most common cancer among men, behind skin cancer, and it affects one in seven men in his...

issues in oncology

NIH Awards Two New Grants to Explore the Understanding of Genomics Research in Africa

Two grants totaling more than $300,000 will support studies on genomic literacy among Africans as it relates to research conducted in Africa by African investigators. The 3-year grants are part of the Human Heredity and Health in Africa (H3Africa) program, funded by the National Institutes of...

gynecologic cancers
global cancer care

Gynecologic Cancer Care: Collaboration With Resource-Challenged Ethiopia

Over the past 40 years, largely because of universal Pap screening, cervical cancer deaths have been drastically reduced in the United States and other wealthy industrialized countries. However, cervical cancer is still a leading cause of cancer death among women in resource-challenged areas of the ...

How Pharmaceutical Companies Are Partnering With Patient Advocates to Ensure Access to Oncology Care

Thomas P. Sellers, MPA, has been a tireless advocate for patients’ rights for more than 20 years. A 15-year prostate cancer survivor and only child, Mr. Sellers said it was his mother’s death from lung cancer when she was 51, followed by the death of his father from glioblastoma multiforme that led ...

A New Book Explores an Old Subject: Aging

Title: Lighter as We Go: Virtues, Character Strengths, and AgingAuthors: Mindy Greenstein, PhD, and Jimmie Holland, MDPublisher: Oxford University Press Publication date: September 2014Price: $27.95; Hardcover, 320 pages   Death is the universal experience shared by Earth’s 7 billion or so...

issues in oncology

Identifying Impending Death Helps Patients and Caregivers

Significant weight loss, cachexia, and being bedbound signal that a cancer patient is dying. However, identifying the specific signs that give physicians the ability to predict death is not well described in the literature. To better understand why predicting death is an important part of the care...

leukemia

Program Offers Unique Intervention for Acute Promyelocytic Leukemia

If Anand P. Jillella, MD, has his way, no future patient with acute promyelocytic leukemia (APL) will experience a delay in treatment or lack for an expert consult—and few, if any, will die of this condition. Mortality from APL is much higher than most oncologists think, especially during the first ...

lung cancer

Phase III Trial of Figitumumab Plus Chemotherapy in Advanced NSCLC Stopped Early for Futility and Increased Harm

In the first phase III trial assessing the combination of an insulin-like growth factor 1 receptor (IGF-1R) inhibitor with chemotherapy as first-line treatment for advanced nonadenocarcinoma non–small cell lung cancer (NSCLC), the addition of the fully human immunoglobulin G2 monoclonal antibody...

gynecologic cancers

Bevacizumab in Persistent, Recurrent, or Metastatic Cervical Cancer

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 August 14, 2014, bevacizumab (Avastin) was approved for the...

A World Free From the Fear of Cancer—Is It Possible?

By every definition, ASCO’s 50th Annual Meeting was a huge success. The halls were buzzing as nearly 35,000 attendees shared excitement about cancer research.   This was a banner year for federally funded clinical trials—all four of the abstracts selected for ASCO’s Plenary Session were backed by...

#WeConquerCancer: Creative Fundraisers From Committed Conquerors

Conquer Cancer Foundation donors are a consistently creative bunch when it comes to encouraging others to help conquer cancer: Tyler invited his friends and family to a charity spin class; elementary school students in Malibu, California, sold bracelets in honor of their principal; Steve competed...

A Conversation With Lidia Schapira, MD, the New JCO Art of Oncology Editor

The popular Art of Oncology (AOO) section of the Journal of Clinical Oncology (JCO) brings a human perspective to the art and science of practicing oncology. Lidia Schapira, MD, FASCO, Assistant Professor at Harvard Medical School and Massachusetts General Hospital, became the Art of Oncology...

A Cautionary Note on Radiotherapy

Clinicians should use radiotherapy very judiciously in the treatment of mediastinal lymphomas, especially in young patients, recommended Wyndham H. Wilson, MD, PhD, Chief of the Hematological Malignancies Therapeutics Section, Metabolism Branch, Cancer Research Center, of the National Cancer...

lymphoma

Best Way to Treat Mediastinal Lymphomas Is Still Unclear

A variety of treatment options used today can achieve good outcomes in patients with mediastinal lymphomas, according to James O. ­Armitage, MD, the Joe Shapiro Professor of Medicine at the University of Nebraska Medical Center in Omaha. He discussed some of the current evidence helping to refine...

leukemia

Advances in Hematopoietic Cell Transplant for Pediatric AML Reduce Toxicity and Expand Access, but Relapse Remains a Problem

Advances in allogeneic hematopoietic cell transplantation for children with acute myeloid leukemia (AML) have resulted in less toxic pretransplant conditioning regimens and expanded access to transplantation, but post-treatment leukemic relapse remains a big problem. The progress and continuing...

multiple myeloma

Bortezomib Retreatment in Multiple Myeloma

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 August 8, 2014, the approved use of bortezomib (Velcade) in...

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