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issues in oncology

Expert Panels Offer Five Proposals to Address Challenges in Regulating, Implementing Next-Generation Sequencing

At the third annual Blueprint for Drug/Diagnostic Co-Development forum, cohosted by Friends of Cancer Research in Washington, DC, and the Alexandria Center for Life Science in New York, two panels tackled considerations in simultaneous development of drugs and companion diagnostics. Friends of...

lung cancer
cost of care

Dartmouth Study Finds Lung Cancer Screening With Low-Dose CT Could Be Cost-Effective

Dartmouth researchers say lung cancer computed tomographic (CT) screening in the National Lung Screening Trial (NLST) meets a commonly accepted standard for cost-effectiveness as reported recently in The New England Journal of Medicine.1 The screening test uses annual low-dose CT scans to spot lung ...

palliative care

Dying in America: Ensuring High-Quality Care at the End of Life

In September, the Institute of Medicine (IOM) released its report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. The report argues that the U.S. health-care system subjects patients to too many—and often futile—interventions near the end of life, often ...

survivorship

Addressing Patients’ Sexual Dysfunction Throughout Survivorship

Studies show that all cancers and related treatments have the potential to affect sexuality and sexual function. Surgery, chemotherapy, hormonal therapy, bone marrow transplantation, and radiation therapy can physically impact sexual health in myriad ways, including vaginal dryness, dyspareunia,...

pancreatic cancer

Pancreatic Cancer in 2014

Adenocarcinoma of the pancreas is the fourth leading cause of cancer death in men and women in the United States. This year, about 46,000 people in this country will be diagnosed with pancreatic cancer, and more than 39,000 will die of the disease. The ASCO Post recently spoke with Margaret A....

supportive care

Fixed-Combination Netupitant/Palonosetron for Prevention of Chemotherapy-Induced Nausea and Vomiting

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 October 10, 2014, oral fixed-combination netupitant and...

pancreatic cancer

Study Sheds Light on Factors That May Contribute to Pancreatic Cancer

New research that provides a better understanding of pancreatic cancer may help identify individuals at increased risk. The findings were recently published early online in Cancer.1 Pancreatic cancer is usually detected at a very late stage and has a 5-year survival rate of less than 5%. Strategies ...

hematologic malignancies
solid tumors
issues in oncology

Top 10 Myths About FDA’s Office of Hematology and Oncology Products

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, FDA oncologists Gideon Blumenthal, MD, and Tatiana Prowell, MD, discuss 10 common myths about FDA’s Office of Hematology and Oncology ...

lymphoma

Bortezomib in Previously Untreated Mantle Cell Lymphoma

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 October 9, 2014, bortezomib (Velcade) was granted approval for ...

skin cancer
cost of care

U.S. Skin Cancer Costs Rise From 2002 Through 2011

The costs associated with skin cancer increased five times as fast as treatments for other cancers between 2002 and 2011, according to a Centers for Disease Control and Prevention (CDC) study published online in the American Journal of Preventive Medicine.1 The average annual cost for skin cancer...

gynecologic cancers

Maintenance Therapy in Ovarian Cancer: What’s at Stake?

Maintenance therapy in ovarian cancer refers to a cohort of women achieving response to initial adjuvant chemotherapy who then go on to additional therapy in the hopes of extending time to recurrence or inducing a lasting remission. The concept is not new and retains its scientific and clinical...

breast cancer

Complexity of the Contralateral Prophylactic Mastectomy Decision

The powerful and important study by Kurian et al,1 reviewed in this issue of The ASCO Post, adds vital information to the discussion regarding use of contralateral prophylactic mastectomy among patients with unilateral breast cancer in the United States.2,3 Based upon data from the California...

multiple myeloma

Treatment of Newly Diagnosed Multiple Myeloma With Lenalidomide Plus Low-Dose Dexamethasone

The FIRST trial—reported by Benboubker and colleagues in The New England Journal of Medicine and summarized in this issue of The ASCO Post (page 93)—is a landmark study.1 It is one of the largest randomized trials in multiple myeloma ever conducted. More importantly, it is a well-designed trial...

Commentary: Screening Young Adults for Nonhereditary Colorectal Cancer

In a related commentary, ­Kiran K. Turaga, MD, MPH, of the Medical College of Wisconsin, Milwaukee, writes: “In the setting of these congratulatory reports of a successful public health screening program, this report from Bailey et al is rather unsettling.” “Nevertheless, assuming that this...

ASTRO Initiatives Aimed at Practice Improvement

At the opening press conference of the 56th Annual Meeting of the American Society for Radiation Oncology (ASTRO), 2014 President Bruce G. Haffty, MD, FASTRO, Professor and Chairman of the Department of Radiation Oncology at Rutgers–Robert Wood Johnson Medical School and Associate Director at the...

David G. Nathan, MD, Wins Lifetime Impact Award at Boston Children’s Hospital Innovation Summit

David G. Nathan, MD, President Emeritus of Dana-Farber Cancer Institute and Physician-in-Chief Emeritus of Boston Children’s Hospital, was recently honored as the inaugural recipient of the Boston Children’s Hospital Lifetime Impact Award at the Hospital’s second Annual Global Pediatric Innovation...

Clinical Trials Participation Awards Recognize Community-Based Practice Dedicated to Research

Since 2003, the Conquer Cancer Foundation of ASCO has recognized more than 100 high-quality, community-based clinical research sites through the Clinical Trial Participation Award (CTPA). The program has been generously supported by the Coalition of Cancer Cooperative Groups for the past decade....

Interviews With Candidates for 2015-2016 ASCO President-Elect

The ASCO Nominating Committee has selected Daniel F. Hayes, MD, FASCO, and Patrick J. Loehrer, Sr, MD, FASCO, as candidates for the position of 2015-2016 President-Elect (2016-2017 President). In the abridged interviews below, the candidates discuss their vision for the Society and their leadership ...

breast cancer

Patient-Reported Data Indicate that Radiation Therapy Does Not Increase Risk of Lymphedema in Patients With Node-Negative Breast Cancer

A secondary analysis of the National Surgical Adjuvant Breast and Bowel Project B-32 trial1 indicates that radiation therapy does not increase the incidence of lymphedema in patients with node-negative breast cancer, according to research presented at the American Society for Radiation Oncology’s...

Expert Point of View: Hope S. Rugo, MD

Hope S. Rugo, MD, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education at the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discussed the results of the RESILIENCE trial presented at the European Society for Medical Oncology ...

Expert Point of View: Hope S. Rugo, MD

Hope S. Rugo, MD, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education for the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discussed the two studies on maintenance bevacizumab (Avastin) for metastatic breast cancer...

lung cancer

Emerging Drugs Effectively Tackle Non–Small Cell Lung Cancer Mutations

For advanced nonsquamous non–small cell lung cancer (NSCLC), targeting of the epidermal growth factor receptor (EGFR) mutation and the ALK abnormality has become an established strategy. Later-generation drugs in these categories are now showing efficacy in trials, including for the treatment of...

Expert Point of View: Stefan Sleijfer, MD, PhD

Formal discussant of the PAZOGIST trial at the European Society for Medical Oncology (ESMO) 2014 Congress, Stefan Sleijfer, MD, PhD, of Erasmus MC Cancer Institute, Rotterdam, the Netherlands, said “The title of my talk is ‘Small Molecules: Greater Success,’ and we are not yet there.” He agreed...

prostate cancer

Genomic Score Predicts Aggressiveness of Prostate Cancer in Biopsy Specimens

A prospectively designed study establishes the17-gene Oncotype DX prostate cancer test as a robust and independent predictor of the aggressiveness of prostate cancer based on a patient’s diagnostic specimen. Tumor aggressiveness, as measured by the test’s Genomic Prostate Score, was similar in...

Expert Point of View: Alexandria Phan, MD

Formal discussant of the RADIANT-3 trial at the European Society for Medical Oncology (ESMO) Congress, Alexandria Phan, MD, of Houston Methodist Cancer Center, agreed that the crossover to open-label everolimus (Afinitor) by placebo patients probably muddied the waters in the survival estimate....

neuroendocrine tumors

Clinically Relevant Survival Benefit Seen for Everolimus in Pancreatic Neuroendocrine Tumors

Final results from the RADIANT-3 trial showed a 6-month difference in overall survival favoring everolimus (Afinitor) plus best supportive care over placebo plus best supportive care in patients with well-differentiated advanced and progressive pancreatic neuroendocrine tumors.1 Although the...

colorectal cancer

Phase III Study Confirms Regorafenib’s Survival Benefit in Metastatic Colorectal Cancer

The phase III CONCUR trial1 of regorafenib (Stivarga) monotherapy in Asian patients with previously treated metastatic colorectal cancer confirmed the overall survival benefit seen in the previous ­CORRECT trial,2 and in a planned subgroup analysis, suggesting the benefit is substantial in patients ...

colorectal cancer

European Studies Explore Maintenance Strategies for Metastatic Colorectal Cancer

Studies presented at the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid added insight regarding maintenance therapy in metastatic colorectal cancer, an area lacking a clear recommended strategy following first-line regimens. Two phase III trials found benefit for bevacizumab...

Expert Point of View: Andrés Cervantes, MD, PhD

During a special session at the European Society for Medical Oncology (ESMO) 2014 Congress, additional analyses from the FIRE-3 and Cancer and Leukemia Group B ­(CALGB)/SWOG 80405 trial were presented, and an expert panel was charged with putting the findings into context. Role of Subsequent...

colorectal cancer

All-RAS Testing in Metastatic Colorectal Cancer: Just the First Step

Now that clinicians know to “think beyond KRAS” in metastatic colorectal cancer—and test for all RAS mutations, not just those in exon 2—it seems this is still not sufficient for selecting the best drugs. At the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid, a proffered paper ...

pain management

FDA Approves Labeling With Abuse-Deterrent Features for Extended-Release Opioid Analgesic

The U.S. Food and Drug Administration (FDA) has approved new labeling for morphine sulfate and naltrexone hydrochloride extended-release capsules. The drug, marketed as Embeda, is an opioid analgesic used to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment and ...

issues in oncology

The Ohio State and Moffitt Collaborate on ORIEN: Using Big Data to Accelerate Trials With a Cancer Research ‘Expressway’

The Ohio State University Comprehensive Cancer Center and Moffitt Cancer Center have joined forces to create the Oncology Research Information Exchange Network (ORIEN), the largest collaboration of its kind designed to accelerate discoveries in cancer research. Members of this alliance of cancer...

issues in oncology
cost of care

Tackling the Complexity of Cancer: Finding Common Ground on Value and Progress

To kick off the second national Turning the Tide Against Cancer conference, sponsored by the American Association for Cancer Research, Personalized Medicine Coalition (PMC), and Feinstein Kean Healthcare, Edward Abrahams, PhD, President of PMC, noted that U.S. health-care costs are unsustainable...

issues in oncology

Young Adults With Cancer: Unique Issues Highlight Importance of Patient-Centered Care

Suleika Jaouad, a journalist, was 22 and had just gotten her first chance to cover a major news story—the revolution underway in Tunisia—when she was diagnosed with myelodysplastic syndrome that had evolved into acute myeloid leukemia (AML). Months into her treatment, she began to write again, but...

breast cancer

Noteworthy Abstracts From the Breast Cancer Symposium Include Studies of Novel Therapies and of the Impact of Disease Subtypes on Outcomes

More than 150 oral and poster presentations were featured at the 2014 Breast Cancer Symposium, held September 4–6 in San Francisco. The multidisciplinary meeting is sponsored by ASCO, the American Society of Breast Disease, American Society of Breast Surgeons, American Society for Radiation...

Expert Point of View: Andrew D. Zelenetz, MD, PhD, and Jennifer R. Brown, MD, PhD

Up until now, our paradigm—particularly in indolent lymphoma—has been episodic treatment, remission, and retreatment at emergence of symptoms. Very frequently, we can show that you can defer therapy in asymptomatic patients until relapse,” explained Andrew D. Zelenetz, MD, PhD, Vice Chair of the...

lymphoma

Targeted Therapies in Indolent Lymphoma: Challenging the Current Paradigm

The use of targeted therapies in indolent non-Hodgkin lymphoma (NHL) is a burgeoning area. New targeted therapies directed at the cell surface, intracellular pathways, and the microenvironment are being studied for relapsed indolent NHL. These treatments, if validated in large randomized trials,...

colorectal cancer

‘Incredible Changes’ in the Field of Colorectal Cancer

Over the past 50 years, there have been incredible changes in the field of colorectal cancer,” Emily K. Bergsland, MD, noted in opening the colorectal cancer session at the Best of ASCO meeting in Chicago. Dr. Bergsland is a gastrointestinal oncologist at the Helen Diller Family Comprehensive...

colorectal cancer

For Selected Patients With Metastatic Colorectal Cancer, Taking a Break From Combination Chemotherapy Might Be Appropriate and Appreciated

Two phase III studies presented at the Best of ASCO meeting in Chicago shed more light on the role of maintenance therapy in patients with metastatic colorectal cancer undergoing first-line treatment with oxaliplatin-based chemotherapy. The two studies compared maintenance therapy with bevacizumab...

issues in oncology

Past Drug Failures Help Create Cancer’s Next Successes

The Pharmaceutical Research and Manufacturers of America (PhRMA) has released a new report, “Researching Cancer Medicines: Setbacks and Stepping Stones,” which highlights the number of investigational cancer medicines that did not succeed in clinical trials and how these so-called failures are a...

breast cancer

Magee-Womens Hospital of UPMC Offers Test to Predict Possibility of Breast Cancer Recurrence

Magee-Womens Hospital of University of Pittsburgh is offering its patients the FDA-cleared breast cancer test assessing a woman’s risk of cancer recurrence by providing a risk category and numerical score. The hospital is the first in the tri-state area (Pennsylvania, Ohio, West Virginia) to offer...

sarcoma

Targeted Agents Making Inroads Against Sarcoma

Targeted agents have started to make inroads in sarcoma therapies, and gastrointestinal stromal tumor (GIST) is the poster child for this success,” Mark Agulnik, MD, stated in summarizing progress in GIST and other sarcomas at the Best of ASCO meeting in Chicago. Dr. Agulnik is Associate Professor, ...

cost of care

HHS Secretary Announces $840 Million Initiative to Improve Care, Lower Costs

Health and Human Services Secretary Sylvia M. Burwell has announced an initiative that will fund successful applicants who work directly with medical providers to rethink and redesign their practices, moving from systems driven by quantity of care to ones focused on patients’ health outcomes, and...

cost of care

Financial Toxicity Potentially Harmful Treatment‑Related Effect

It turns out that in addition to treatment-related toxicity, cancer patients commonly experience “financial toxicity,” a phrase that is increasingly coming into parlance in the cancer community. Patients should be assessed for financial toxicity as early as possible following diagnosis so that they ...

geriatric oncology

The ‘Silver Oncologic Tsunami’: Rise in Elderly Cancer Patients Brings New Challenges to Oncology Workforce

The “graying of America” poses increasing challenges for the cancer community in terms of rising numbers of cases of cancer and costs associated with geriatric care. The scope of this problem and potential solutions were explored by Andrew E. Chapman, DO, FACP, at the ASCO Quality Care Symposium in ...

issues in oncology

Choosing Wildly: A Patient’s Perspective on Overtreatment and Quality Care

Over the past decade, there has been growing concern in the oncology community about overdiagnosis and overtreatment of cancers that prove to be indolent and nonlethal, resulting in unnecessary and sometimes harmful procedures.  At this year’s ASCO Quality Care Symposium in Boston, this important...

cost of care

Overutilization a Key Target in Efforts to Control Health-Care Costs

Overutilization of health-care interventions has become a prime target of efforts to rein in health-care costs. Overtreatment of cancer patients is associated with a number of common harms to the patient—not just financial harm to the health-care system. At the recent ASCO Quality Care Symposium in ...

issues in oncology

Why I Think Dr. Ezekiel Emanuel Is Wrong About Aging

The image of aging that Ezekiel Emanuel, MD, PhD, expresses in his essay, “Why I Hope to Die at 75,” in the October issue of The Atlantic,1 is bleak indeed and one that has contributed mightily to the negative views of aging imbedded in our society. But I refute his description of growing older as...

issues in oncology

Striving for Quality, Not Quantity, of Life

Advances in science and medicine have led to humans living longer than at any other time in history. According to a new report1 on mortality from the Centers for Disease Control and Prevention’s National Center for Health Statistics, life expectancy in the United States is at an all-time high of...

leukemia

The Next-to-Last Frontier in Managing Acute Promyelocytic Leukemia

The treatment of acute promyelocytic leukemia (APL) represents one of the major triumphs in the field of hematologic malignancies. With either the vitamin A derivative all-trans retinoic acid (ATRA) combined with anthracycline-based chemotherapy or ATRA plus arsenic trioxide (Trisenox),...

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