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issues in oncology

FDA Hears Proposals on Codevelopment of Companion Diagnostics for Breakthrough Therapies

A companion diagnostic developed for use with a drug that has received Breakthrough Therapy designation from the U.S. Food and Drug Administration (FDA) should automatically be eligible for priority review, according to an expert panel that presented this proposal and four others to the FDA in...

issues in oncology

Focus on the Texas Society of Clinical Oncology

The second largest state in the nation (after Alaska), Texas covers a total area of 268,581 square miles and has a diverse population of over 26 million people. In 1987, the Texas Society of Medical Oncology, now the Texas Society of Clinical Oncology (TxSCO), was formed to address the oncology...

supportive care

Yoga to Manage Sleep Disruption in Cancer Survivors: A Low-Risk Intervention With High Potential for Benefit

Impaired sleep quality is a concerning problem for many patients with cancer, and pharmacologic treatments come with many negative effects. Several small studies indicate that yoga improves persistent fatigue, sleep disturbance, anxiety, and quality of life, in addition to reducing the need for...

supportive care

Yoga Improves Sleep Quality in Patients With Cancer Suffering From Sleep Disruption

It is estimated that 30% to 90% of patients with cancer experience impairment of sleep quality post-treatment, and such impairment can be severe enough to increase morbidity and mortality. Preliminary evidence indicates that yoga may improve sleep in cancer patients. In a study reported in the...

Oncology Meetings

November Academy of Oncology Nurse Navigators 4th Annual Navigation and Survivorship Conference November 14-17 • Memphis, Tennessee For more information: aonnonline.org/conference Iowa Oncology Society Fall Membership ConferenceNovember 15 • West Des Moines, IowaFor more information:...

pancreatic cancer

Fatty Acid Network Exerts Growth Inhibitory Effects in Pancreatic Cancer

In a study reported in Clinical Cancer Research, Zhang and colleagues used integrated metabolomics and transcriptomics to investigate gene-metabolic networks and identify metabolic pathways that are perturbed in pancreatic ductal adenocarcinoma.  A global metabolite profiling analysis was performed ...

breast cancer

Evidence-Based Opportunity to Personalize Breast Cancer Risk: The Data Are Building

The worldwide data from prospective studies of the relationship between levels of endogenous sex hormones and breast cancer risk in postmenopausal women show multiple and complex relationships.1 Nine prospective studies (different from those reported here) of women not taking exogenous sex hormones ...

issues in oncology

High-Dose Spinal Stereotactic Body Radiotherapy Associated With Increased Risk of Vertebral Compression Fracture

As reviewed in this issue of The ASCO Post, Sahgal et al reported a multi-institutional analysis aimed at clarifying the risk of developing either new or progressive vertebral body compression fractures following high-dose spinal stereotactic body radiation therapy. In the period studied, they...

issues in oncology

Vertebral Compression Fracture Risk Increased After Spinal Stereotactic Body Radiotherapy 

In a study reported in Journal of Clinical Oncology, Arjun Sahgal, MD, of Princess Margaret Cancer Centre in Toronto, and colleagues evaluated the occurrence of vertebral compression fractures in patients undergoing spinal stereotactic body radiotherapy.1 Vertebral compression fractures occurred in ...

lymphoma

Two Patients in One, Mom and Baby: Managing Coincident Pregnancy and Lymphoma

The news that she is both pregnant and has been found to have a potentially lethal malignancy is one of the most emotionally wrenching events any young woman ever faces. Understandably, the patient, her partner, their families, and even their caregivers find this experience fraught with anxiety and ...

palliative care

Illness Is Personal!

For clinicians and health service researchers striving to improve care for people living with life-threatening conditions, September was a sobering month. The Dartmouth Atlas group released a brief report on Trends in Cancer Care Near the End of Life1 showing that while the proportion of patients...

breast cancer

Breast Cancer Index Assay Prognostic for Distant Recurrence in Estrogen Receptor–Positive, Node-Negative Breast Cancer

In a study reported in The Lancet Oncology, Dennis C. Sgroi, MD, of Massachusetts General Hospital, and colleagues compared the ability of the breast-cancer index (BCI) assay, 21-gene recurrence score (Oncotype DX), and an immunohistochemical prognostic model (IHC4) to predict early and late...

ASCO Resources for Transitioning to ICD-10

ASCO has developed resources to educate and assist oncology practices in transitioning to the Center for Medicare and Medicaid Services (CMS) 10th Edition of its International Classification of Diseases (ICD-10) coding system. Practices are encouraged to prepare for the transition before the...

ASCO Reconfirms Commitment to Choosing Wisely® Campaign 

In collaboration with the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely® campaign, ASCO recently released a second “Top Five” opportunities list of common practices or procedures in oncology whose clinical value is not supported by available evidence and if eliminated, can ...

issues in oncology

FDA Announces Strategic Plan to Prevent Drug Shortages

The U.S. Food and Drug Administration (FDA) is taking two actions to further enhance the agency’s ongoing efforts to prevent and resolve drug shortages. The FDA has released a strategic plan called for in the Food and Drug Administration Safety and Innovation Act (FDASIA) of 2012 to improve the...

prostate cancer

Finasteride for Prostate Cancer Prevention: Long-Term Results Disappointing but Reassuring

All medical care should seek to achieve one or more of three goals: to relieve suffering, to prevent future suffering, or to prolong life. Care for cancer is no exception, and minimizing suffering from cancer and prolonging life has primarily resulted from advances in treatment. Although there are...

prostate cancer

No Difference in Long-Term Survival With Finasteride or Placebo in the Prostate Cancer Prevention Trial 

In the Prostate Cancer Prevention Trial (PCPT), initially reported in 2003, finasteride significantly reduced the risk of prostate cancer by 24.8% but was associated with a relative 26.9% increase in risk of high-grade disease compared with placebo. In a study reported in The New England Journal of ...

issues in oncology

Technologic Innovations Are Likely to Transform Oncology Care

Oncology and medicine as a whole are likely to benefit from a variety of technologic innovations recently showcased at the third annual The Atlantic Meets the Pacific symposium, according to Peter P. Yu, MD, President-Elect of the American Society of Clinical Oncology, and medical oncologist and...

SIDEBAR: Brian J. Druker, MD, Discusses Ponatinib

In an interview with The ASCO Post following FDA’s recommendation that sales of ponatinib (Iclusig) be suspended, (see here) Brian J. Druker, MD, Director of Oregon Health & Science University Knight Cancer Institute and JELD-WEN Chair of Leukemia Research, had concerns about obtaining the drug ...

hepatobiliary cancer

Brivanib Fails to Live Up to the Promise of Early Studies

Hepatocellular carcinoma is a devastating disease worldwide. Although advances in liver transplantation, surgery, and locoregional therapies have made tumor control or even cure possible for a minority of patients, the majority of patients diagnosed with hepatocellular carcinoma will develop...

hepatobiliary cancer

Brivanib Studied in First- and Second-Line Therapy for Advanced Hepatocellular Carcinoma 

The investigational drug brivanib is a dual inhibitor of vascular endothelial growth factor and fibroblast growth factor signaling, both implicated in hepatocellular carcinoma. The agent was recently evaluated in two phase III trials, one comparing first-line brivanib with sorafenib (Nexavar) in...

lung cancer

Oncogene Addiction and the Rationale for Molecular Targeted Therapy in Lung Cancer

Over the past decade, Fadlo R. Khuri, MD, Professor and Roberto C. Goizueta Distinguished Chair of Hematology and Medical Oncology, and Deputy Director of the Winship Cancer Institute of Emory University, Atlanta, has focused his research and clinical career on investigating novel approaches in the ...

leukemia

Sale of Ponatinib Suspended Due to Risk of Life-Threatening Blood Clots

The U.S. Food and Drug Administration (FDA) has asked the manufacturer of the tyrosine kinase inhibitor ponatinib (Iclusig) to suspend marketing and sales of the drug because of the risk of life-threatening blood clots and severe narrowing of blood vessels. Ariad Pharmaceuticals has agreed to...

gynecologic cancers

One Dose of HPV 16/18 Vaccine Produces Durable Response, Study Finds

Results from the Costa Rica HPV 16/18 Vaccine Trial indicate that 4-year efficacy against 12-month HPV 16/18 persistent infection was similarly high among women who received one, two, or the recommended three doses of the bivalent HPV16/18 L1 virus-like particle vaccine (Cervarix). The findings...

colorectal cancer

In Mismatch Repair–Deficient Colon Cancer, Side Matters

In general, we have come to think of mismatch repair–deficient colon cancer as having a more favorable prognosis, being less likely to metastasize to regional nodes or distant sites, and being resistant to fluoropyrimidines. Much of our data, however, come from trials combining stage II and III...

colorectal cancer

Impact of Deficient DNA Mismatch Repair on Disease-Free Survival in Stage III Colon Cancer 

In an analysis reported in the Journal of Clinical Oncology, Frank A. Sinicrope, MD, of the Mayo Clinic and North Central Cancer Treatment Group (NCCTG), and colleagues investigated the association of deficient DNA mismatch repair with prognosis in patients with stage III colon cancer treated with...

breast cancer
head and neck cancer
kidney cancer
lung cancer

Important News Briefs: New Data Reported in Breast, Renal Cell, Head and Neck, and Lung Cancer

The 2013 European Cancer Congress (ECC), held September 27 to October 1 in Amsterdam, was jointly sponsored by the European Society of Medical Oncology, the European Cancer Organization, and the European Society of Radiation Oncology. With the Congress theme being “Reinforcing Multidisciplinarity,” ...

Expert Point of View: Rebecca Kristeleit, MD

Formal discussant of the AURELIA and ICON7 presentations, Rebecca Kristeleit, MD, University College London Hospital, London, said that a consistent message in both trials was the benefit of bevacizumab (Avastin) in high-risk disease. “Angiogenesis seems to be a particular driver of advanced...

Expert Point of View: Cora N. Sternberg, MD

Press conference moderator Cora N. Sternberg, MD, Chief of Medical Oncology at San Camillo and Forlanini Hospitals, Rome, called the 2- to 3-month improvement in overall survival “worthwhile, and clinically meaningful.” She said this should be viewed in the context of manageable toxicity....

breast cancer

Strong Showing for Ado-Trastuzumab Emtansine in Advanced HER2-Positive Heavily Pretreated Breast Cancer

Results of the phase III TH3RESA trial show that the antibody-conjugate ado-trastuzumab emtansine (Kadcyla), formerly known as T-DM1, extends progression-free survival in women with advanced HER2-positive breast cancer that progressed on two or more previous HER2-directed therapies including...

lymphoma

Standardizing the Interpretation of PET Scans: An INR Equivalent

Since its introduction, the positron-emission tomography (PET) scan has shown great potential to improve our ability to care for patients with lymphoma. By demonstrating which masses seen on a computed tomography (CT) scan represent viable tumor, and by identifying viable tumor in places that were...

health-care policy

IOM Report Illuminates U.S. Cancer Care Crisis and Offers Framework for Change

In September, the Institute of Medicine (IOM) of the National Academies issued its report, Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis,1 published more than a decade after its first study on the quality of cancer care in the United States. The authors of the...

gynecologic cancers

Impact of Pelvic Radiotherapy and Lymphadenectomy on Endometrial Cancer Mortality 

Analysis of data from 58,172 patients identified from Surveillance, Epidemiology, and End Results (SEER) registries as having stage I or II endometrial adenocarcinoma found that pelvic radiotherapy and lymphadenectomy were associated with statistically significantly reduced noncancer mortality,...

breast cancer

Nodal Status and Tumor Size Predicted Late Recurrences of ER-Positive Breast Cancer in Postmenopausal Women 

Only nodal status and tumor size provided statistically significant prognostic information for predicting recurrences 5 to 10 years after diagnosis for postmenopausal women with early estrogen receptor–positive breast cancer enrolled in the monotherapy arms of the ATAC (Arimidex, Tamoxifen, Alone...

cost of care
legislation

ASH as Part of 'NDD United' Releases Report on Effects of Sequestration 

A new report recently released and supported by the American Society of Hematology (ASH) details the crippling effects of sequestration on programs that rely on discretionary federal funding, including the National Institutes of Health (NIH). In “Faces of Austerity: How Budget Cuts Have Made Us...

SIDEBAR: Expect Questions From Your Patients 

Risk-reducing salpingo-oophorectomy “is an important strategy for reducing both breast and gynecologic cancer risk for women with BRCA1 or BRCA2 mutations and is proven to improve life expectancy,” Noah D. Kauff, MD, told The ASCO Post. Questions persist, however, about whether women undergoing...

gynecologic cancers
breast cancer

'Reasonable but Not Required' for Women With BRCA Mutations to Have Hysterectomy Concurrent With Salpingo-Oophorectomy 

For women with BRCA1 or BRCA2 mutations who choose to have salpingo-oophorectomy to reduce their risks of ovarian and breast cancer, also choosing to have a hysterectomy is “reasonable but not required,” noted Noah D. Kauff, MD, Director of the Ovarian Cancer Screening and Prevention Program and...

breast cancer
cost of care

Cost-Effectiveness of MRI Screening for Women With Familial Risk of Breast Cancer in the Netherlands 

Annual screening for breast cancer with magnetic resonance imaging (MRI) has been found to be cost-effective in women aged 30 to 60 years who are BRCA1 or BRCA2 carriers or who have a 50% chance of being a carrier, and such screening is recommended in these women by many authorities. It is unclear...

multiple myeloma

Phospho-cMET Inhibition in Multiple Myeloma

In a study reported in Clinical Cancer Research, Moschetta and colleagues characterized the involvement of the cMet oncogene in drug resistance and the activity of a novel selective inhibitor of cMET/phospho-cMET (SU11274) in multiple myeloma cells sensitive (RPMI-8226 and MM.1S) and resistant (R5...

head and neck cancer

Spanning a Spectrum of Issues Related to Head and Neck Cancers

Five recent articles in JAMA Otolaryngology–Head & Neck Surgery1-5 span a spectrum of issues related to head and neck cancers. These include risk factors, concentration of care to teaching hospitals, avoiding venous thromboembolism, and encouraging patients to eat and do swallowing exercises to ...

Oncology Meetings

December Sixth AACR International Conference on The Science of Cancer Health Disparities in Racial/Ethnic Minorities and the Medically UnderservedDecember 6-9 • Atlanta, GeorgiaFor more information: www.aacr.org 55th ASH Annual MeetingDecember 7-10 • New Orleans, LouisianaFor more information:...

Expert Point of View: Monica Morrow, MD, and Chau T. Dang, MD

In an editorial accompanying the article by Boughey et al, Monica Morrow, MD, and Chau T. Dang, MD, of Memorial Sloan-Kettering Cancer Center, New York, question whether sentinel lymph node biopsy can be considered a part of standard management in patients with initial clinically node-positive...

survivorship
palliative care

Living With Cancer: The Role of Palliative Care in Long-Term Survivorship Care

According to data from the Surveillance, Epidemiology, and End Results Program (SEER) and the U.S. Census Bureau registries,1 there are currently about 13.7 million cancer survivors in the United States, and that number is projected to grow to 18 million by 2022. In addition, 64% of this population ...

skin cancer

Ocular Melanoma Research Fellowship Opportunity Announced

The American Association for Cancer Research (AACR) and the Ocular Melanoma Foundation (OMF) are pleased to announce a new partnership to provide a grant opportunity for researchers focused on ocular melanoma, which is diagnosed in approximately 2,000 adults in the United States each year....

breast cancer

Where Is Adjuvant Bisphosphonate Therapy Now? 

The adjuvant use of bisphosphonates in breast cancer continues to yield seemingly contradictory data despite a sound biologic basis and smaller pilot studies suggesting that dampening bone turnover with bisphosphonates can lessen the bone reservoir of micrometastases.1,2 Early adjuvant trials with...

breast cancer

No Survival Benefit of Adjuvant Ibandronate in High-Risk Early Breast Cancer: Potential Activity in Low-Estrogen Patients 

The effect of bisphosphonate treatment in early breast cancer is controversial, with some data indicating survival benefit in the adjuvant setting. In a study reported in the Journal of Clinical Oncology (German Adjuvant Intergroup Node-Positive Study, GAIN), Gunter von Minckwitz, MD, PhD, Chairman ...

lymphoma

German Analysis in Diffuse Large B-Cell Lymphoma: Hypothesis-Generating Rather Than Definitive?

In their retrospective analysis of German High-Grade Non-Hodgkin Lymphoma Study Group trials reported in the Journal of Clinical Oncology and reviewed in this issue of The ASCO Post, Held and colleagues assessed the effects of rituximab (Rituxan) and radiotherapy in patients with aggressive B-cell...

breast cancer

With Genetic Discoveries, Breast Cancer Complexity Grows

Oncologists are getting a handle on BRCA1/2 in breast cancer, becoming more adept at treating and counseling patients with these mutations. But the BRCA mutation is only one example of a host of genetic variations that can increase breast cancer risk, according to James M. Ford, MD, Associate...

leukemia

Obinutuzumab in Previously Untreated Chronic Lymphocytic Leukemia

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 November 1, 2013, obinutuzumab (Gazyva) was approved...

issues in oncology

Sunshine Act Reporting: ASCO Encourages Members to Get Prepared, Stay Educated 

On August 1 of this year, requirements of the Physician Payments Sunshine Act, or Open Payments, went into effect. The legislation, passed as part of the Patient Protection and Affordable Care Act, was designed to create greater transparency around financial relationships between physicians,...

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