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issues in oncology

Expert Point of View: Eduardo Bruera, MD, FAAHPM

The study by Weeks and colleagues is an important one that shows quite unexpected results. There are three main possible reasons for the very low rate of accurate reporting by the patients: (1) Physicians are not communicating prognosis adequately. (2) Patients are unable to understand the...

issues in oncology

Most Patients Do Not Report that Cure Is Highly Unlikely with Chemotherapy for Advanced Cancer  

Chemotherapy for metastatic lung or colorectal cancer can provide palliation and modestly prolong life, but is not curative. In a study recently reported in The New England Journal of Medicine, Jane C. Weeks, MD, of Dana-Farber Cancer Insitute, and colleagues found that the majority of patients...

leukemia

Patients Receiving Higher-intensity Chemotherapy for ALL Are at Greater Risk for Cognitive Deficits, Researchers Report 

Omitting cranial irradiation from the treatment regimen for acute lymphoblastic leukemia (ALL) may help preserve global cognitive abilities. “Treatment with chemotherapy alone is not without risks,” however, noted researchers from St. Jude Children’s Research Hospital in Memphis. “The St. Jude...

health-care policy

Health Insurance Issues for Young Cancer Survivors

The latest addition to Cancer.Net’s video series for young adults, Moving Forward: Perspectives from Survivors and Doctors, deals with the health insurance issues young adult cancer survivors may face. This video series is a collaboration between Cancer.Net and LIVESTRONG. Each set of videos in the ...

breast cancer
lung cancer

ASCO Decision Aids Intersect Evidence-based Guidelines, Productive Patient Communication

Imagine this common clinical scenario: A 64-year-old woman presents with a new abnormality on a mammogram. A core needle biopsy and subsequent partial mastectomy reveal a 1.8-cm invasive ductal carcinoma. Sentinel lymph nodes are negative for cancer. The tumor is moderately differentiated and is...

issues in oncology

New England Journal of Medicine Article Reports Inferior Outcome in Using Alternative Treatments to Counter Mechlorethamine Shortage

ASCO Immediate Past President Michael P. Link, MD, recently coauthored a perspectives piece in The New England Journal of Medicine on the impact of drug shortages on children with cancer. The paper, “The Impact of Drug Shortages on Children with Cancer — The Example of Mechlorethamine,” describes...

breast cancer

Dune Medical Devices Receives FDA Approval for the MarginProbe System

Dune Medical Devices, Inc, announced that the FDA has granted Premarket Approval to the MarginProbe System, the company’s breakthrough intraoperative tissue assessment tool for early-stage breast cancer surgery. The technology significantly improves surgeons’ ability to intraoperatively identify...

breast cancer

Primary Endpoint Not Met for Eribulin vs Capecitabine in Breast Cancer 

While a global phase III trial failed to meet its primary endpoint in showing an overall or progression-free survival benefit for eribulin (Halavan) in metastatic breast cancer, a trend toward greater efficacy than capecitabine (Xeloda) was observed, researchers reported at the 2012 San Antonio...

breast cancer

Somatic HER2 Mutations That Drive Cancer Found in HER2-negative Breast Cancer 

A proportion of patients with breast cancer whose tumors test HER2-negative for gene amplification on fluorescence in situ hybridization or immunohistochemistry harbor HER2 mutations that are amenable to treatment with anti-HER2–targeted therapy, according to a gene-sequencing study presented at...

breast cancer

Key Pathways Identified in Triple-negative Breast Cancer 

Five key biologic pathways have become evident in triple-negative breast cancer tumors, and these pathways may be targetable with agents that are currently available or in development, results from an international genetic analysis revealed at the 2012 San Antonio Breast Cancer Symposium. Justin M. ...

cost of care

Cost of Cancer Drugs: What Price for What Benefit?

In 2011, national health-care spending in the United States was about $2.7 trillion, larger than the entire French national budget.1 U.S. national health-care spending is about 17% of the national gross domestic product. Total Medicare expenditures in 2011 were $549 million.2 In the debate about...

issues in oncology

Patient Expectations of Benefit in Early-phase Trials: Ethics Issues in Informed Consent 

It has been found that many patients in early-phase oncology trials believe their chance of benefit to be much higher than estimates derived from historical data.1-3 In a recently reported study in Journal of Clinical Oncology, Kevin P. Weinfurt, PhD, of Duke Clinical Research Institute, and...

Expert Point of View: Sagar Lonial, MD

Commenting on Dr. Palumbo’s presentation at the ASH meeting, Sagar Lonial, MD, Professor of Hematology and Medical Oncology at the Winship Cancer Center at Emory University, Atlanta, noted that while a survival benefit has been associated with maintenance lenalidomide (Revlimid) after transplant,...

multiple myeloma

Survival Benefit Achieved with Four Drugs plus Maintenance in Myeloma

An overall survival benefit in newly diagnosed multiple myeloma was attained with a four-drug induction regimen followed by a duet for maintenance in a study from the Italian GIMEMA network. Antonio Palumbo, MD, Chief of the Myeloma Unit at the University of Torino in Italy, reported the findings...

skin cancer

Tremelimumab Not Better Than Standard-of-care Chemotherapy in Patients with Advanced Melanoma 

Tremelimumab did not produce a statistically significant advantage in overall survival compared to first-line standard-of-care chemotherapy in a phase III randomized trial reported in the Journal of Clinical Oncology. At final analysis, median overall survival by intent to treat was 12.6 months...

SIDEBAR: Expect Questions from Patients with Diabetes and Cancer

Patients with diabetes and cancer need to know that some chemotherapy drugs and adjuvant agents may require modifications in how they manage their diabetes. For example, patients who are receiving steroids might have to further restrict their diet to keep blood sugar levels under control. “You...

issues in oncology

Keeping Diabetes under Control Is Critical to Good Outcomes for Patients Who Also Have Cancer 

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Cancer and diabetes can be comorbid...

Oncology Meetings

February Scripps Cancer Center’s 33rd Annual Clinical Hematology and Oncology ConferenceFebruary 16-19 • San Diego, CaliforniaFor more information:www.scripps.org/events/clinical-hematology-and-oncology-february-16-2013 2013 Translational Research Cancer Centers Consortium: The Power of Negative...

breast cancer

Betting Against the Odds 

I knew the two tumors in my left breast were cancerous even before I got the pathology results back on my biopsy. I could clearly see the tumors on the digital mammogram my doctor ordered, and when the radiologist pointed out that they had spikes radiating from the edges and that he was scheduling...

breast cancer

Researchers Develop Automated Breast Density Test Linked to Cancer Risk

Researchers at Moffitt Cancer Center in Tampa, Florida, and colleagues at the Mayo Clinic in Rochester, Minnesota, have developed a novel computer algorithm to quantify breast density based on analysis of a screening mammogram. Increased levels of mammographic breast density have been shown in...

integrative oncology

Turmeric 

The use of dietary supplements by cancer patients has risen significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the...

breast cancer

Subcutaneous Trastuzumab a Potential Alternative to Intravenous Administration in Breast Cancer 

Subcutaneous administration of trastuzumab might offer improvements in patient convenience and resource use compared with conventional intravenous administration (Herceptin). A new subcutaneous trastuzumab formulation containing a fixed dose of 600 mg and recombinant human hyaluronidase PH-20...

cost of care
health-care policy

The Doctor Who Championed Patient Navigation in Harlem 

After completing his residency at Memorial Sloan-Kettering Cancer Center, Harold P. Freeman, MD, arrived at Harlem Hospital Center in 1967, where the overwhelming majority of his patients presented with late-stage disease. That early experience with underserved patients would shape his career as...

solid tumors

Gene in Eye Melanomas Linked to Good Prognosis

Melanomas that develop in the eye often are fatal. Now, researchers at Washington University School of Medicine and the Siteman Cancer Center, St. Louis, Missouri, report they have identified a mutated gene in melanoma tumors of the eye that appears to predict a good outcome. The research was...

global cancer care

International Members Cite Networking, Enhanced Patient Care Among Benefits of ASCO Membership 

Thanks to the membership category ASCO designed for physicians in developing countries, Brazilian oncologist Milena Mak, MD, can greatly enhance the care she delivers in the very busy 580-bed Instituto do Cancer do Estado de Sao Paulo. And radiation oncologist Pooja Nandwani Patel, MD, can use the...

breast cancer

Research Roundup from San Antonio: New Data on Triple-negative, HER2-positive, Local, and Advanced Breast Cancer 

The 2012 San Antonio Breast Cancer Symposium featured more than 2,500 abstracts and lectures, including timely research in the field and discussions for scientists and clinicians alike. In addition to nearly two dozen in-depth reports from the meeting, The ASCO Post brings readers the following...

prostate cancer

Abiraterone in Patients with Metastatic Castration-resistant Prostate Cancer and No Prior Chemotherapy

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 December 10, 2012, abiraterone acetate (Zytiga)...

leukemia
lymphoma
multiple myeloma

ASH Highlights Included New Data in Myeloma, Lymphoma, and Leukemia, plus Studies of Mucositis and Graft-vs-Host Disease

The 54th Annual Meeting of the American Society of Hematology (ASH) featured about 5,000 abstracts, including oral sessions and posters, as well as named lectures and symposia. In addition to our regular news coverage from the meeting, below are capsule summaries of a few news highlights that we...

breast cancer
leukemia

Chemotherapy for Breast Cancer Carries a Small, but Concerning, Risk for Leukemia 

The risk for developing a secondary malignancy after chemotherapy for breast cancer is very small, but it is statistically significantly higher than for the general population, a review of the National Comprehensive Cancer Network (NCCN) database revealed in a study presented at the 2012 San...

Expert Point of View: Sarah B. Goldberg, MD, MPH

In a commentary accompanying reporting of the phase II study of the MEK inhibitor selumetinib by Dr. Pasi A. Jänne, MD, PhD, and colleagues, Sarah B. Goldberg, MD, MPH, Assistant Professor of Medicine, and colleagues at Yale Cancer Center, New Haven, Connecticut, noted that KRAS, a member of the...

Expert Point of View: William G. Woods, MD

Press conference moderator William G. Woods, MD, Pediatric Hematology/Oncology Director and the Daniel P. Amos Children’s Chair, Aflac Cancer and Blood Disorders Center, Children’s Healthcare of Atlanta, called the phase III FRALLE trial “an important confirmatory step regarding the front-line...

leukemia

Daunorubicin-free Induction Therapy for Standard-risk Childhood Acute Lymphoblastic Leukemia 

Omitting daunorubicin from induction therapy for children with standard-risk acute B-cell lymphoblastic leukemia (ALL) does not compromise survival and at the same time reduces the risk of associated toxicities, including myelosuppression and cardiac damage, according to results of the large phase...

leukemia

Expert Point of View: Farhad Ravandi, MD 

Over the past 2 decades, we have witnessed remarkable progress in the treatment of patients with acute promyelocytic leukemia (APL). The introduction of all-trans retinoic acid (ATRA) in the front-line therapy setting and arsenic trioxide in the relapse setting had already led to a significant...

leukemia

Chemotherapy-free Regimen Successful in Acute Promyelocytic Leukemia 

For the first time, a chemotherapy-free regimen was superior to conventional cytotoxic chemotherapy for the treatment of acute promyelocytic leukemia (APL). The combination of all-trans retinoic acid (ATRA) plus arsenic trioxide (Trisenox) achieved significantly superior overall survival compared...

leukemia

We Need Gemtuzumab Available Again to Treat AML

The word “revival” signifies a renewed use or acceptance after a period of inactivity; similarly, the word “resurrection” refers to the concept of an entity coming back to life after death. In the past year, these terms have been used frequently by us (and others) in articles calling for the return ...

Expert Point of View: Philip Agop Philip, MD and Alan P. Venook, MD

Philip Agop Philip, MD, Head of the Multidisciplinary Team for Gastrointestinal and Neuroendocrine Oncology and Neuroendocrine at Karmanos Cancer Institute at Wayne State University, Detroit, was the formal discussant of the paper at the Gastrointestinal Cancers Symposium. He said the positive...

Oncology Meetings

March Hematology and Medical Oncology Board Review: Contemporary Practice from Memorial Sloan-Kettering Cancer CenterMarch 1-5, 2013 • New York, New YorkFor more information: www.mskcc.org/hemoncreviewcourse International Congress on Targeted Anticancer TherapiesMarch 4-6 • Paris, FranceFor more...

skin cancer

Vemurafenib-resistant BRAF-mutant Melanoma

Mutational activation of BRAF is the most prevalent genetic alteration in melanoma, with ≥ 50% of tumors expressing the BRAF(V600E) oncoprotein. Vemurafenib (Zelboraf) produces tumor regression and improved survival in patients with late-stage BRAF-mutated melanoma. However, most patients relapse...

lymphoma

Solving a 30-year Mystery

When I began experiencing severe neck and back pain about 9 years ago, I had no idea it could be a late side effect from the radiation therapy I had received 31 years ago to treat my Hodgkin lymphoma. And none of the doctors I’ve seen over the past decade have been able to make the connection...

colorectal cancer

Genetics, Mathematics, and Colorectal Cancer 

Two recent study reports in colorectal cancer explored new data on genetic precursors to the disease and outcome predictors once treatment is initiated. New Genetic Links to Colorectal Cancer Are Identified Investigators from Vanderbilt-Ingram Cancer Center, Nashville, and colleagues in China,...

lung cancer

SIDEBAR: Beta-adrenergic Signaling Pathway

The take-home message from this study is that in this large group of patients, we have found that beta-blocker intake during radiation therapy for non–small cell lung cancer (NSCLC) is associated with improved survival and reduced rates of tumor spread, even when controlling for a large number of...

lung cancer

Use of Beta-blockers Associated with Improved Survival in Patients with NSCLC Receiving Definitive Radiation Therapy 

As reported recently in Annals of Oncology, a retrospective study by Wang and colleagues showed that use of beta-adrenergic receptor antagonists (beta-blockers), typically used in treatment of hypertension and heart disease, was associated with significantly improved distant metastasis–free...

leukemia
lymphoma
multiple myeloma

More Brief Reports from ASH, Including New Data in Leukemia, Lymphoma, and Myelodysplastic Syndrome

At the 54th Annual Meeting of the American Society of Hematology (ASH), held in Atlanta, nearly 5,000 abstracts were presented in oral sessions and posters. As part of our ongoing comprehensive coverage from the meeting, here are several more studies of note. New Targets in Acute Myeloid Leukemia...

Expert Point of View: David J. Kuter, MD, PhD

David J. Kuter, MD, PhD, Professor of Medicine, Harvard Medical School, and Director of the Center for Hematology at Massachusetts General Hospital, Boston, commented on the findings for The ASCO Post. “TOPPS is a good attempt to address whether transfusions are helpful as prophylaxis in patients...

Make a Lasting Difference: Choose the Giving Option that Works for You

If you are like the many supporters of the Conquer Cancer Foundation, you may have reached a point where you would welcome the opportunity to influence not only the future ownership of your possessions, but the meaning that others assign to your life. One way to accomplish this is by considering...

breast cancer

Dose-dense Chemotherapy in Breast Cancer: Epirubicin-based Regimens Studied in German and UK Trials

In the treatment of early breast cancer, dose-dense regimens (given every 2 weeks) have proven superior to conventionally dosed chemotherapy (given every 3 weeks), but data on long-term survival are lacking. Two studies presented at the San Antonio Breast Cancer Symposium evaluated the benefit of...

Expert Point of View: Axel Grothey, MD and Eric Van Cutsem, MD, PhD

Two gastrointestinal cancer experts commented on the findings in interviews with The ASCO Post. Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, noted, “The PEAK and SPIRITT trial were decently designed, decently powered randomized phase II trials, and the results...

colorectal cancer

Outcomes Comparable for Panitumumab and Bevacizumab in Metastatic Colorectal Cancer 

In patients with KRAS wild-type metastatic colorectal cancer, outcomes were comparable whether patients received the epidermal growth factor receptor (EGFR) inhibitor panitumumab (Vectibix) or the vascular endothelial growth factor (VEGF) inhibitor bevacizumab (Avastin). This was shown both in the...

issues in oncology

On Radiation and Cancer Risk

We owe our life to radiation. The universe was created in a thermonuclear explosion, and continued existence of life on Earth depends on plants using chlorophyll to capture light energy emitted by the sun (and exploding supernovas) and converting it into chemical energy, with the subsequent...

cost of care
survivorship

Study Finds Young Cancer Survivors Often Skip Checkups

Athough the majority of the more than 69,000 adolescents and young adults (AYAs) diagnosed with cancer each year will survive their disease, many of them will experience interruptions in their education and a derailment in their career tract, curtailing their lifetime earning potential and reducing ...

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