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issues in oncology

Study Finds Poor Understanding of Illness in Patients With Advanced Cancer

Few patients with advanced cancer and a short life expectancy have an accurate understanding of their illness, according to a study reported in the Journal of Clinical Oncology by Andrew S. Epstein, MD, of the Memorial Sloan Kettering Cancer Center, New York, and colleagues. The study involved 178...

breast cancer

Mindfulness-Based Stress-Reduction Program May Reduce Psychological and Physical Symptoms in Breast Cancer Survivors

A mindfulness-based stress-reduction program for breast cancer survivors was associated with psychological and physical symptom benefits during and at 6 weeks after intervention, according to a randomized trial reported in the Journal of Clinical Oncology by Cecile A. Lengacher, RN, PhD, of the...

University of Kansas School of Medicine Names Allen M. Chen, MD, Department of Radiation Oncology Chair

Allen M. Chen, MD, has been appointed the new Joe and Jean Brandmeyer Chair of the Department of Radiation Oncology at the University of Kansas School of Medicine. He will join the faculty on October 1, 2016. Dr. Chen will succeed Terry Tsue, MD, the Douglas A. Girod, MD, Endowed Professor of Head ...

Rajesh K. Garg, MD, JD, Named President, CEO of CTCA

Rajesh K. Garg, MD, JD, is now President and CEO of Cancer Treatment Centers of America Global, Inc (CTCA). The announcement was made by CTCA earlier this spring. Dr. Garg, who started this new position on June 20, 2016, will also serve as a member of the company’s national Board of Directors. Dr. ...

The Healing Power of Words

Feminist literary scholar Susan Gubar was diagnosed with advanced ovarian cancer in November 2008. She then began her emigration “from the world of the healthy to the domain of the ill,” she wrote in her acclaimed book, Memoir of a Debulked Woman: Enduring Ovarian Cancer. In her memoir, she...

An Epic Medical Story by an Old-Style Doctor on the Front Lines of Care

The U.S. health-care system is a $3 trillion behemoth of dizzying complexity. Government oversight, ever-changing regulations, mountains of paperwork, electronic health records, initiative after initiative, and so forth, all of which has reshaped the delivery of care, for the good and bad. But...

FDA Advances Precision Medicine Initiative by Issuing Draft Guidances on Next-Generation Sequencing–Based Tests

In support of the President’s Precision Medicine Initiative, on July 6, the U.S. Food and Drug Administration (FDA) issued two draft guidances. When finalized, they will provide a flexible and streamlined approach to the oversight of tests that detect medically important differences in a person’s...

Fentanyl Nasal Spray Now Available at a Dose of 300 µg for Treatment of Breakthrough Cancer Pain

Fentanyl (Lazanda) nasal spray, a schedule II narcotic, is now available at a 300-µg dose to treat breakthrough cancer pain, offering physicians another titration option for dosing flexibility. The new strength can help physicians more easily and accurately target the appropriate dose for patients, ...

colorectal cancer

New ASTRO Clinical Practice Statement Updates Treatment Standard for Rectal Cancer

The American Society for Radiation Oncology (ASTRO) recently issued a new clinical practice statement, “Appropriate Customization of Radiation Therapy for Stage II and III Rectal Cancer: An ASTRO Clinical Practice Statement Using the RAND/UCLA Appropriateness Method.” An executive...

issues in oncology

As Low-Dose CT Screening Moves Into the Clinic, Implementation Issues Move Up on the Agenda

Low-dose computed tomography (CT) screening for lung cancer in high-risk groups is moving into the clinic in the wake of its approval by the U.S. Centers for Medicaid & Medicare Services. That does not mean, however, the discussion is over. As low-dose CT moves from research to everyday...

lung cancer

Lung Cancer Screening: Beneficial for Certain Populations but Not Without Controversy

The National Cancer Policy Forum of the National Academies of Sciences took up the issue of lung cancer screening at its mid-June workshop. Greta Massetti, PhD, Associate Director for Science, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC), and chair of ...

pancreatic cancer

ASCO Guideline on Metastatic Pancreatic Cancer

As reported in the Journal of Clinical Oncology by Davendra P.S. Sohal, MD, MPH, of Cleveland Clinic, and colleagues, ASCO has released a clinical practice guideline on the treatment of patients with metastatic pancreatic cancer.1 Recommendations are based on an expert panel systematic review of...

pancreatic cancer

ASCO Guideline on Treatment of Locally Advanced, Unresectable Pancreatic Cancer

As reported by Edward P. Balaban, DO, FASCO, of Penn State Hershey Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on the treatment of locally advanced, unresectable pancreatic cancer.1 The recommendations are based on expert...

pancreatic cancer

ASCO 2016 Guidelines for the Treatment of Pancreatic Cancer: Why Another Guideline?

The 5-year survival rate of those diagnosed with pancreatic cancer remains stubbornly fixed around 5%. Even in the 20% of cases in which surgical resection is undertaken for curative intent, the 5-year survival rate after surgery is 20% to 30%. As we make progress in other cancers with decreasing...

gynecologic cancers

Pap Smear Screenings May Help Prevent Cervical Cancer in Women Over 65

A new study from the University of Illinois confirms a link between Papanicolaou (Pap) smear screenings and a lower risk of developing cervical cancer in women over age 65. However, most American health guidelines discourage women in that age range from receiving screenings unless they have...

pancreatic cancer

ASCO Guideline on Potentially Curable Pancreatic Cancer

As reported in the Journal of Clinical Oncology by Alok A. Khorana, MD, of Cleveland Clinic, and colleagues, ASCO has released a clinical practice guideline on the treatment of potentially curable pancreatic cancer.1 The recommendations are based on an expert panel systematic review of the...

breast cancer

ASCO Guideline on Endocrine Therapy for Metastatic Breast Cancer: Reaffirming Principles for Making Treatment Decisions

The role of endocrine therapy for hormone receptor–positive metastatic breast cancer is well established, and clinicians are strongly encouraged to consider one of several therapeutic options for the majority of patients who present with metastatic disease. The recent ASCO guideline on this topic, ...

breast cancer

ASCO Guideline on Endocrine Therapy for Hormone Receptor–Positive Metastatic Breast Cancer

As reported by Hope S. Rugo, MD, of the University of California San Francisco Comprehensive Cancer Center, and colleagues in the Journal of Clinical Oncology, ASCO has released a clinical practice guideline on endocrine therapy for hormone receptor–positive metastatic breast cancer.1 The...

issues in oncology

Discovery of Fragment Length of Circulating Tumor DNA Might Increase Liquid Biopsy Sensitivity

The liquid biopsy may be a welcome reprieve from typical biopsies. The minimally invasive test could reduce the need for the sometimes painful and risky procedures involved in sampling tumors, particularly those that reside deep within the body. However, thus far, the utility of the test has been...

lymphoma

Five-Year Survival Data: Brentuximab Vedotin May Be Curative in Some Patients With Hodgkin Lymphoma

Five-year survival data published by Chen et al in Blood suggest that the targeted therapy brentuximab vedotin (Adcetris) may be curative in some patients with Hodgkin lymphoma whose disease has persisted despite receiving previous therapies. This multinational phase II study examined brentuximab...

survivorship

Endocrine Abnormalities Increase Over Time in Aging Survivors of Childhood Cancer

The cumulative incidence of endocrinopathies steadily increased over time in aging survivors of childhood cancers, according to an analysis of data from the Childhood Cancer Survivor Study reported by Mostoufi-Moab et al in the Journal of Clinical Oncology. Study Details The study included...

issues in oncology
health-care policy

Road to Successful Use of Real-World Evidence for Drug Development Is Long and Rocky

Friends of Cancer Research (Friends) has been a leader in the push for better and faster cancer drug development. Now it is tackling the use of real-world evidence in clinical trials. This is the report of a meeting on the subject that took place on June 16 in Washington, DC.1 Real-world evidence...

breast cancer
solid tumors

Study Finds Wide Variation in Breast Density Assessments Among Radiologists

A large observational study examining the variation in breast density assessment among radiologists in clinical practice has found a wide variation—from 6.3% to 84.5%—in the percentage of mammograms rated as showing dense breasts, which persisted after adjusting for patient...

breast cancer

The Metastatic Breast Cancer Project: Direct-to-Patient Research Initiative

A nationwide project is enlisting patients with breast cancer to share their tumor samples and clinical information. Launched in October 2015, the Metastatic Breast Cancer (MBC) Project has enrolled more than 2,000 patients from all 50 states and is yielding information that will be shared with...

breast cancer
issues in oncology
genomics/genetics

Using Social Media to Accelerate Genomic Research

The success of using social media to push forward causes for social good was a driving factor in the launch this past October of the Metastatic Breast Cancer Project (MBC project), which aims to accelerate the understanding of what makes patients with metastatic breast cancer genetically unique....

Sarah S. Donaldson, MD, FASCO, Honored With Inaugural Women Who Conquer Cancer Mentorship Award

Sarah S. Donaldson, MD, FASCO, of Stanford University School of Medicine and Lucile Packard Children’s Hospital, is the recipient of the Inaugural Women Who Conquer Cancer Mentorship Award. Throughout her decades-long career, Dr. Donaldson has mentored countless trainees and young oncologists,...

breast cancer

Quick Takes on Promising New Approaches to Treating Breast Cancer

At the 2016 ASCO Annual Meeting, researchers reported encouraging results for several new drugs and treatment strategies for breast cancer. The ASCO Post brings you brief summaries of a select few. Abemaciclib Trial The cyclin-dependent kinase 4/6 (CDK4/6) inhibitor abemaciclib produced responses...

HHS Announces Physician Groups Selected for Initiative Promoting Better Cancer Care

The U.S. Department of Health and Human Services (HHS) has announced that it has selected nearly 200 physician group practices and 17 health insurance companies to participate in a care delivery model that supports and encourages higher quality and more coordinated cancer care. The Medicare arm of...

Brachytherapy Pioneer Haakon Ragde, MD, Chosen as ASTRO 2016 Honorary Member

The American Society for Radiation Oncology (ASTRO) has selected Haakon Ragde, MD, as its 2016 Honorary Member, the highest honor ASTRO confers on distinguished cancer researchers, scientists, and leaders in disciplines other than radiation oncology, radiobiology, or radiation physics. Dr. Ragde...

American Cancer Society Endorses HPV Vaccine Recommendations From CDC ACIP

The American Cancer Society (ACS) has endorsed human papillomavirus (HPV) vaccination recommendations from the Centers for Disease Control and Prevention’s (CDC) Advisory Committee on Immunization Practices (ACIP), the principal source of guidance on U.S. immunization policy. The ACS's...

hematologic malignancies
leukemia
lymphoma
multiple myeloma

Selected Hematology Abstracts From the 2016 ASCO Annual Meeting

Here are several abstracts selected from the proceedings of the 2016 ASCO Annual Meeting, focusing on clinical trials on therapeutics in different types of leukemia, multiple myeloma, follicular lymphoma, and central nervous system (CNS) lymphoma. For full details of these study abstracts, visit...

Expert Point of View: Patricia A. Ganz, MD & Gregory A. Masters, MD

“This is a tremendous advance. If we had a drug that could achieve these results we would rush to use it. This is also personalized medicine that alerts the health-care team when symptoms need addressing. And it is very important that using the app led to appropriate use of scans and tests, which...

lung cancer

App Triggers Earlier Detection of Relapse, May Help Improve Survival of Patients With Lung Cancer

Web-based applications have invaded mainstream culture and grabbed the attention of multitudes of people around the world. According to a study presented at the 2016 ASCO Annual Meeting, an app may also contribute to extending the lives of people with cancer and, at the same time, reduce...

gynecologic cancers

Benefit Strongly Suggested With Hormonal Maintenance in Low-Grade Serous Carcinoma

In patients with low-grade serous carcinoma, maintenance hormonal therapy reduced the risk of recurrence by 77%, compared with surveillance, in a retrospective cohort from The University of Texas MD Anderson Cancer Center. The study was reported by David Marc Gershenson, MD, at the 2016 ASCO...

breast cancer

PHEREXA: Benefit for Second-Line Pertuzumab Questionable

In the second-line metastatic breast cancer setting, the addition of pertuzumab (Perjeta) to trastuzumab (Herceptin)/capecitabine did not significantly improve progression-free survival, results of the phase III ­PHEREXA trial showed.1 This is the first randomized trial to evaluate the efficacy of ...

skin cancer

Studies Suggest Bright Future for Combination Immunotherapy in Advanced Melanoma, but Questions Remain

Two studies presented at the 2016 ASCO Annual Meeting focused on the use of combination immunotherapy in the treatment of patients with advanced melanoma. Updated results from the phase III CheckMate 067 trial centered on the combination of nivolumab (Opdivo) plus ipilimu­mab (Yervoy) compared...

health-care policy
legislation

CMS Proposal for Part B Drug Payment: A Poorly Conceived Experiment

On March 11, 2016, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule in the Federal Register to test a change in reimbursement for Part B drugs.1 The first phase involves changing the 6% add-on to the average sales price (ASP) used to make drug payments under Part B to...

hematologic malignancies
lymphoma

CNS-IPI for CNS Relapse in Diffuse Large B-Cell Lymphoma

As reported in the Journal of Clinical Oncology, Schmitz et al have developed and validated a risk score for CNS relapse—the Central Nervous System International Prognostic Index (CNS-IPI)—in patients with diffuse large B-cell lymphoma (DLBCL) treated with R-CHOP (rituximab [Rituxan]...

health-care policy
cost of care
issues in oncology

Charting a New Course at the FDA

In February, after serving for a year as the U.S. Food and Drug Administration’s (FDA’s) Deputy Commissioner for Medical Products and Tobacco, Robert M. Califf, MD, MACC, was named the agency’s Commissioner of Food and Drugs. Prior to his appointment at the FDA, Dr. Califf was the Donald F....

breast cancer

Results of Two Practice-Changing Breast Cancer Trials Upheld

Results of two pivotal breast cancer trials reported at the 2016 ASCO Annual Meeting confirmed the practice-changing findings that resulted from earlier findings. PALOMA-2 The phase III PALOMA-2 trial confirmed results from the smaller, open-label phase II PALOMA-1 trial that led to the U.S. Food...

breast cancer

Stress and Adverse Life Events Unlikely to Cause Breast Cancer

Day-to-day psychological stress and adverse life events are unlikely to increase a woman’s risk of developing breast cancer, according to a new prospective study published by Schoemaker et al in Breast Cancer Research. Women with breast cancer often consider stress as a likely cause of their ...

lung cancer
cost of care
global cancer care

Swiss Study Examines Cost-Effectiveness of Nivolumab vs Docetaxel in Advanced Nonsquamous NSCLC

Nivolumab, a checkpoint inhibitor approved for patients with squamous and nonsquamous non–small cell lung cancer (NSCLC) in 2015, is not cost-effective when compared to treatment with docetaxel, chemotherapy medication. However, a Swiss analysis showed the cost-effectiveness of nivolumab is...

issues in oncology

Patient-Oncologist Difference of Opinion About Advanced Cancer Prognosis Is Common, Study Shows

Misunderstandings about prognosis between patients with advanced cancer and their doctors was common, according to a study by Gramling et al in JAMA Oncology—and the vast majority of patients didn't know that their doctors held different opinions about how long they might live. “We've...

prostate cancer

Early Evidence of Anti–PD-1 Activity in Enzalutamide-Resistant Prostate Cancer

Restoring tumor-specific immunity is a treatment strategy that works well in melanoma and lung cancer patients. Now a new study out of the Oregon Health & Science University (OSHU) Knight Cancer Institute is reviving hope that the approach also may help men with life-threatening prostate...

leukemia

Juno Therapeutics to Resume JCAR015 Phase II ROCKET Trial After FDA Clinical Hold

Juno Therapeutics, Inc, announced on July 12, 2016, that the U.S. Food and Drug Administration (FDA) has removed the clinical hold on the phase II clinical trial of JCAR015 (known as the ROCKET trial) in adult patients with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL). Under the ...

gynecologic cancers

Opportunistic Salpingectomy for Ovarian Cancer Prevention Adopted Without Adverse Surgical Outcomes

A surgical procedure recommended to reduce the future risk of ovarian cancer has been successfully implemented throughout Kaiser Permanente in Northern California without a change in surgical outcomes, according to research published by Garcia et al in Obstetrics & Gynecology. Previous...

hematologic malignancies
multiple myeloma

Long-Term Benefit of Lenalidomide/Dexamethasone Reported in High-Risk Smoldering Multiple Myeloma

As reported by Mateos et al in The Lancet Oncology, long-term follow-up in the phase III QuiRedex trial indicates continued benefit of lenalidomide (Revlimid)/dexamethasone vs observation in preventing disease progression in patients with high-risk smoldering multiple myeloma. Study Details In...

Internationally Renowned Geneticist, Alfred George Knudson, MD, PhD, Dies

Considered a visionary in cancer research, Alfred George Knudson, MD, PhD, was internationally recognized for his “two-hit theory” of cancer causation, which explained the relationship between hereditary and nonhereditary cancer types, predicting the existence of tumor-suppressor genes. ...

breast cancer

Better 10-Year Survival Reported With Breast-Conserving Surgery and Radiotherapy vs Mastectomy in Early Breast Cancer

In a Dutch population-based study reported in The Lancet Oncology, van Maaren et al found that breast-conserving surgery plus radiotherapy was associated with improved 10-year survival vs mastectomy in women with early breast cancer. Study Details The study included data from 37,207 women from...

breast cancer

New Analysis Evaluates Predictors of Persistent Pain After Breast Cancer Surgery

An analysis led by McMaster University researchers has found that women who undergo armpit lymph node surgery for breast cancer are much more likely to develop chronic pain. Wang et al published their review of studies exploring risk factors for developing chronic pain after breast cancer...

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