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lung cancer

U.S. Preventive Services Task Force Recommends CT Screening for Lung Cancer in High-risk Individuals

The U.S. Preventive Services Task Force recently posted its final evidence report and draft recommendation statement on screening for lung cancer. The Task Force is providing an opportunity for public comment on this draft recommendation statement until August 26. All public comments will be...

Expert Point of View: ­Jonathan S. Berek, MD 

The CHORUS trial had similar results to the previous European Organisation for Research and Treatment of Cancer (EORTC) 55971 study, showing noninferiority for primary debulking surgery followed by chemotherapy vs neoadjuvant chemotherapy followed by surgery and additional chemotherapy, said formal ...

gynecologic cancers

Neoadjuvant Chemotherapy and Interval Debulking May Be Appropriate for Some Patients With Poor Performance Status Advanced Ovarian Cancer 

Patients with newly diagnosed advanced ovarian cancer—especially patients with poor performance status—appear to derive benefits from neoadjuvant chemotherapy followed by surgery vs primary surgery followed by chemotherapy, according to results of the Medical Research Council (MRC) CHORUS trial. In ...

Expert Point of View: ­Jonathan S. Berek, MD

Weekly vs every-3-week therapy is a somewhat controversial area in ovarian cancer, said formal discussant of the MITO-7 trial, ­Jonathan S. Berek, MD, Director of the Stanford Women’s Cancer Center, Palo Alto, California. “[Japan Clinical Oncology Group (JCOG)]-16 showed a survival advantage for...

Expert Point of View: Judy Garber, MD, MPH

Judy Garber, MD, MPH, Professor of Medicine at Harvard Medical School and Director of the Cancer Risk and Prevention Center at Dana-Farber Cancer Institute, Boston, was the formal discussant of the GeparSixto paper. The rationale for studying platinum in triple-negative breast cancer is clear: The...

breast cancer

GeparSixto Study Finds Benefit for Neoadjuvant Carboplatin in Triple-negative Breast Cancer 

In patients with triple-negative breast cancer, the addition of carboplatin significantly improved the rate of pathologic complete response after neoadjuvant chemotherapy in a study by the German Breast Group (GBG)/Gynecologic Oncology Working Group–Breast (AGO-B) reported at the 2013 ASCO Annual...

issues in oncology

Molecular Tests and Precision Medicine: Not So Fast Now!

The era of the application of genomic, proteomic, and a host of other “omic” analyses to guide decision-making in the therapeutic selection of drugs and biologics is now a key part of cancer care. Medical practice is working to keep up with the scientific advances, evaluate them, and add a variety...

cost of care

Oncologists Speak Out Against the High Cost of Cancer Drugs 

That the United States spends twice as much on health care than other industrialized countries—about $2.8 trillion in 2012—without reaping appreciably better outcomes1 is not news. The topic has been dissected on the front pages of leading newspapers for years and was the subject of the entire...

breast cancer

Nodal Metastases More Likely if Tumors Have Breast Cancer Stem and Progenitor Cells With PI3K/Akt Signaling Defects 

Patients with breast tumors in which breast cancer stem and progenitor cells have a genetic abnormality of the PI3K/Akt signaling pathway are more likely to have lymph node metastases, according to a study in JAMA Surgery. “These oncogenic defects may be missed by gross molecular testing of the...

lung cancer

Role of Erlotinib in EGFR Wild-Type Lung Cancer 

I welcomed Matthew Stenger’s Journal Spotlight on the TAILOR trial in the August 15 issue of The ASCO Post (“Docetaxel Superior to Erlotinib in Second-Line Treatment of Advanced Non–Small Cell Lung Cancer With Wild-Type EGFR”). The trial was recently published online in Lancet Oncology,1 and...

Expect Questions From Patients About Active Surveillance 

While National Comprehensive Cancer Network (NCCN) practice guidelines for prostate cancer advise that active surveillance is usually appropriate for men with very low-risk prostate cancer and a life expectancy ≤ 20 years, a Johns Hopkins study suggests that outcomes for African American men...

prostate cancer

Active Surveillance of Very Low-Risk Prostate Cancer Might Not Be Suitable Option for African American Men 

African American men with prostate cancer that meets current criteria for very low-risk disease might actually be harboring larger and more aggressive tumors that make active surveillance a less viable option, according to the results of a study published online in the Journal of Clinical Oncology1 ...

integrative oncology

Ginseng 

Guest Editor Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering...

issues in oncology

Family Members of Children With Cancer Are Also at Risk for the Disease 

Parents and siblings of children with cancer have between a two- and four-times increased risk of developing cancer than first-degree relatives with no childhood cancer patients, according to a study published in the International Journal of Cancer.1 The study, led by Joshua Schiffman, MD, Medical...

ASCO University® Appoints First Editor-in-Chief

ASCO has appointed Daniel G. Haller, MD, as the first Editor-in-Chief of ASCO University®, an eLearning center designed to serve as the educational home for physicians, nurses, advanced practice providers, and patient educators at every stage of their careers. As head of the editorial board, Dr....

issues in oncology
legislation

Legislative Endorsement Update From ASCO 

ASCO recently announced its endorsement of the Tobacco Tax Equity Act of 2014 (S. 194), which would close tax loopholes that allow tobacco companies to avoid the federal cigarette tax by making taxes on pipe tobacco equivalent to cigarette tobacco. “Raising tobacco taxes is one of the most...

Conquer Cancer Foundation Donor and ASCO Member Denis Hammond, MD: Spreading the Word to Help Conquer Cancer

Oncology care professionals answer hundreds of questions from patients and their families every day. Over the course of months and years doctors and nurses address everything from medical questions about drug regimens and side effects, to personal questions about how cancer may affect work or...

integrative oncology

Ginseng in the Spotlight 

I read the study by Barton and colleagues in Journal of the National Cancer Institute with great interest. Ginseng seems potentially to be one treatment for cancer-related fatigue, a poorly understood but debilitating symptom that patients experience during and after treatment.1 I am impressed that ...

integrative oncology

American Ginseng Improves Cancer-Related Fatigue 

In a collaborative phase III trial of the North Central Cancer Treatment Group and Mayo Clinic (N07C2) reported in Journal of the National Cancer Institute by Debra L. Barton, RN, PhD, AOCN, FAAN, of the Mayo Clinic and colleagues, patients with cancer-related fatigue were treated with Wisconsin...

issues in oncology

ASCO Examines the Future of Cancer Care Over the Next 2 Decades 

While the many scientific advances over the past 50 years have led to improved outcomes for millions of patients with cancer—increasing the number of survivors from just 3 million in the 1970s to nearly 14 million today—the next 20 years promise to bring even greater opportunities to improve the...

lymphoma
multiple myeloma

Dr. Julie Vose Finds the Best of Both Worlds—Patient Care and Cutting-Edge Research—in Academic Medicine 

Julie M. Vose, MD, MBA, is the Neumann M. and Mildred E. Harris Professor and Chief of the Division of Hematology/Oncology at the University of Nebraska Medical Center. She grew up in Mitchell, South Dakota, a small town nestled on the banks of the James River. Mitchell is home to the Corn Palace,...

prostate cancer

Study Suggests Low-Grade Prostate Cancers May Not Progress Over Time 

Data analyzed from a large cohort study of men diagnosed with prostate cancer found that prostate cancer aggressiveness may be established when the tumor is formed and not changed over time. The researchers of the study, Kathryn L. Penney, ScD, Instructor in the Department of Medicine at Harvard...

skin cancer

Enhanced Treatment, Surveillance Needed for Patients With BRAF-Mutant Melanoma to Prevent Secondary Cancers

Researchers at Moffitt Cancer Center suggest secondary cancers seen in melanoma patients who are being treated for a BRAF gene mutation may require new strategies, such as enhanced surveillance and combining BRAF inhibitor therapy with other inhibitors, especially as they become more widely used....

issues in oncology

Integrating Genomic Sequencing Into Clinical Care  

Although the price of next-generation genomic sequencing is coming way down, making it available to more people interested in determining their risk for disease, figuring out how to interpret the results and applying that information in the routine medical care of individual patients remains a...

survivorship

Fertility Rates in Childhood Cancer Survivors Suggest Strategies for Follow-up Care 

Childhood cancer survivors with clinical infertility have a good chance of achieving pregnancy, according to new findings from the Childhood Cancer Survivor Study (CCSS). Study Background As a group, women who survive childhood cancer are known to have lower fertility rates. This study, however,...

FDA Approves First Rapid Diagnostic Test to Detect Both HIV-1 Antigen and HIV-1/2 Antibodies

The U.S. Food and Drug Administration (FDA) approved the first rapid human immunodeficiency virus (HIV) test for the simultaneous detection of HIV-1 p24 antigen as well as antibodies to both HIV-1 and HIV-2 in human serum, plasma, and venous or fingerstick whole blood specimens. Approved for use as ...

lung cancer

Non–Small Cell Lung Cancer Maintenance Therapy: None, Single Agent, Multiple Agents? 

Barlesi et al have reported results of a randomized trial comparing bevacizumab (Avastin) vs pemetrexed (Alimta)/bevacizumab as maintenance therapy in patients with stage IV nonsquamous cell non–small cell lung cancer (NSCLC). It is important to consider their observations in relation to data from...

lung cancer

Pattern in Lung Cancer Pathology May Predict Recurrence After Surgery 

A new study by thoracic surgeons and pathologists at Memorial Sloan-Kettering Cancer Center shows that a specific pattern found in the tumor pathology of some lung cancer patients is a strong predictor of recurrence. Knowing that this feature exists in a tumor’s pathology could be an important...

lung cancer

Pemetrexed Maintenance in PARAMOUNT: Continuation Proves to Be a Strong Option for Advanced NSCLC, Although Not a Mandate 

The PARAMOUNT trial1 represents an important landmark study of continuation maintenance therapy with pemetrexed (Alimta). While maintenance therapy gained a toehold in routine management of advanced non–small cell lung cancer (NSCLC) several years ago, the first trials that demonstrated a...

lymphoma

Can Obinutuzumab Benefit Patients With Rituximab-Refractory Non-Hodgkin Lymphoma? 

Obinutuzumab is a glycoengineered type II antibody that differs from type I anti-CD20 antibodies by being associated with actin reorganization and adhesion followed by direct cell death.1 Obinutuzumab has been glycoengineered by reduction in fucose content of the Fc region, which increases its...

lymphoma

Molecular Profiling Improves Classification of Nodal Peripheral T-Cell Lymphomas 

One of the primary obstacles we face in caring for patients with peripheral T-cell lymphomas is a too often inadequate response to chemotherapy with low rates of progression-free and overall survival.1 And while more intensive treatment programs and the availability of novel agents give a greater...

skin cancer

Merkel Cell Carcinoma: Hints of Immune Mediation May Enhance Treatment Options 

Merkel cell carcinoma is a rare but aggressive skin cancer with poor outcomes and suboptimal therapeutic options. With a 46% mortality rate, it is three times more lethal than melanoma, and its reported incidence is rising. “Merkel cell carcinoma is a nasty cancer and we have zero FDA-approved...

gynecologic cancers

Olaparib Shows Robust Progression-Free Survival Benefit in Patients With BRCA Mutations 

Maintenance therapy with olaparib extended progression-free survival and the time to disease progression after a second subsequent therapy in patients with platinum-sensitive relapsed serous ovarian cancer and a BRCA mutation, according to an updated analysis of Study 19 presented at the 2013 ASCO...

lung cancer

Researchers Identify Gene Variations in Lung Cancer Patients That May Help Predict an Individual's Treatment Response

Researchers at the Moffitt Cancer Center have identified four inherited genetic variants in patients with non–small cell lung cancer that can help predict survival and treatment response. Their findings, published in Carcinogenesis,1 could help lead to more personalized treatment options and...

lung cancer

Paul A. Bunn, Jr, MD, Offers Insights About a Hopeful Era in Lung Cancer Treatment 

The treatment of non–small cell lung cancer (NSCLC) is rapidly evolving as molecular targets are being refined and targeted drugs are designed to combat acquired resistance. In his State of the Art Lecture at the 14th International Lung Cancer Congress, Dr. Bunn, Professor of Medicine and the James ...

lung cancer

Will Funding for Lung Cancer Ever Improve?

Lung cancer is the most common cause of cancer-related death in the world. In the United States alone, an estimated 228,190 new cases of lung cancer and 159,480 deaths from lung cancer will occur in 2013. These are alarming statistics when compared to the next four common causes of cancer-related...

issues in oncology

Access to and Appropriate Use of Oncology Drugs Called Into Question by ASCO Studies 

Studies presented at this year’s ASCO Annual Meeting suggest that despite the wealth of amazing oncolytics on the market, drug shortages persist, drug substitutions are common, off-label use of drugs occurs frequently, and patients find their costs burdensome. Drug Shortage Persists The shortage of ...

skin cancer

Addressing the Key Clinical Questions in Advanced Melanoma 

At the 3rd Annual World Cutaneous Malignancies Congress, in La Jolla, California, Steven J. O’Day, MD, Director of Clinical Research at the Beverly Hills Cancer Center and Adjunct Member of the John Wayne Cancer Institute, Los Angeles, addressed what he labeled the “key clinical questions” about...

leukemia

Cord Blood Transplantation Benefits Some Children With Juvenile Myelomonocytic Leukemia 

A retrospective analysis of 110 patients with juvenile myelomonocytic leukemia found that single-unit, unrelated donor umbilical cord blood transplantation resulted in a 5-year disease-free survival rate of 44%. “Our data document that a significant proportion of children with this disease,...

thyroid cancer

More Prudent Interpretation of Thyroid Ultrasound Could Reduce Unnecessary Biopsies 

Thyroid ultrasound imaging could be used to identify patients who have a low risk of thyroid cancer for whom biopsy could be deferred, according to a retrospective case-control study reported in JAMA Internal Medicine. Reviewing 11,618 thyroid ultrasound imaging examinations from 8,806 patients...

skin cancer

Indoor Tanning Common Among Young White Females Despite Skin Cancer Risk 

Indoor tanning, defined as using a tanning booth, sun bed, or sunlamp, is common among non-Hispanic white female high school students and young adults, despite risks of melanoma and nonmelanoma skin cancer, according to a study published online by JAMA Internal Medicine.  Using data from the 2011...

skin cancer

Low Risk of Transformation to Melanoma for Biopsy-Diagnosed Mildly or Moderately Dysplastic Nevi 

The risk of transformation to melanoma appears very low for biopsy-diagnosed mildly or moderately dysplastic nevi, and routine surgical excision of nevi with a positive biopsy margin may not be indicated. Patients with biopsy-diagnosed moderately-to-severely and severely atypical nevi, however,...

leukemia

FDA on CLL Drug Approval and Expanded Access

The ASCO Post article, “Ibrutinib CLL Trial: Where is the Equipoise?” published in May 2013, inaccurately conveyed that the Food and Drug Administration (FDA) requires an improvement in overall survival for chronic lymphocytic leukemia (CLL) drug approval and opposes allowing crossover in the...

leukemia

Pharmacyclics' Reply

We acknowledge the letters submitted to The ASCO Post from a patient advocate and a chronic lymphocytic leukemia (CLL) patient enrolled on the RESONATE study (PCYC-1112-CA). At Pharmacyclics, we are committed to adhering to high scientific and ethical standards as we strive to develop novel...

leukemia

Clinical Trials, Crossover, and Clinical Equipoise: An Advocate's Perspective

In a previous issue of The ASCO Post, Dr. Susan O’Brien wrote, “It is my understanding that the FDA strongly opposed allowing crossover [in the RESONATE trial]. I presume that is because the FDA also wants to see if there is a survival advantage.”1 The lack of crossover seems a valid concern to me...

leukemia

Clinical Trials, Crossover, and Clinical Equipoise: A Patient's Perspective

I am writing with regard to two articles on the ethical imperative of clinical equipoise written by Susan O’Brien, MD, and Stephen J. Schuster, MD, and published recently in The ASCO Post.1,2 I was a victim of Pharmacyclics’ policies during one of their randomized ibrutinib trials (PCI-32765)...

SIDEBAR: Expect Questions From Your Patients 

Physicians and patients should engage in open discussion” about the complex issues of cancer screening, overdiagnosis, and overtreatment, according to a report from the chairs of a National Cancer Institute working group tasked with developing a strategy to improve the current approach to cancer...

issues in oncology

Tackling Overdiagnosis and Overtreatment, by Words and by Deeds  

The complexity of the pathologic condition called cancer,” according to a Viewpoint article in the Journal of the American Medical Association,1 “complicates the goal of early diagnosis.” Failure to recognize that cancers are heterogeneous, and that not all progress to metastases and death, can...

Prominent Surgeon and Teacher LaSalle D. Leffall, Jr, MD, Promotes Hard Work and Education to Overcome Boundaries 

Reminiscing about his 65 years in medicine, LaSalle Doheny Leffall, Jr, MD, FACS, cites three events in his early childhood that would ultimately lead him to his position today as the Charles R. Drew Professor of Surgery at Howard University College of Medicine in Washington, DC. First, he was...

issues in oncology

The Oncologist as Author: On Guiding Patients Through Cancer 

When Tumor Is the Rumor and Cancer Is the Answer is the guidebook to cancer that Kevin P. Ryan, MD, FACP, COL, USAF (ret) wished his patients had during his 30 years of practicing oncology. The book, recently published by AuthorHouse, is an authoritative, inspiring, and even philosophical guide for ...

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