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issues in oncology

Value: What Do We Mean, Who Should Decide?

Oscar Wilde famously defined a cynic as “a man who knows the price of everything and the value of nothing.” I do not think that oncologists need to be as cynical as this, but it was very appropriate that a major theme of this year’s ASCO Annual Meeting was the concept of “value.” It is clear that...

skin cancer

Public Urged Not to Overreact to Study Finding Link Between Citrus Fruits and Melanoma Risk

A study finding a link between citrus consumption and increased risk of melanoma1 may provide food for thought about the findings and implications as well as whet the appetite for more evidence, but according to several experts commenting on the study, it does not mean you should stop eating citrus ...

American University of Beirut Appoints Its 16th President, Fadlo R. Khuri, MD

The American University of Beirut (AUB) recently announced Fadlo R. Khuri, MD, as the 16th President of the University. Dr. Khuri is presently Professor and Chairman of the Department of Hematology and Medical Oncology, Emory University School of Medicine, and holds the Roberto C. Goizueta...

Pankaj Sharda, MD, Joins Fox Chase Cancer Center Department of Medicine

Pankaj Sharda, MD, has joined the Department of Medicine, Endocrinology Division at Fox Chase Cancer Center as an Attending Physician, where he will specialize in endocrinology, diabetes, and metabolism. “It is an honor to become part of such a prestigious and well-established organization as Fox...

ACCC Launches Immuno-Oncology Program for Community‐Based Cancer Care Providers

The Association of Community Cancer Centers (ACCC) has launched the Institute for Clinical Immuno-Oncology (ICLIO), a first-of-its-kind initiative aimed to facilitate the rapid adoption of immuno-oncology in the community cancer setting. To help with the rapid uptake of immuno-oncology at the...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia: Answers From Hematology Expert Review Questions

Question 1: What is the best first step in management of this patient? Correct Answer: C. Start plasma exchange. Expert Perspective Although distinguishing among thrombotic thrombocytopenic purpura, typical hemolytic uremic syndrome, and atypical hemolytic uremic syndrome (see Table 1 in the...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia: Questions

Hematology Expert Review is an occasional feature that includes a case report followed by questions, answers, and expert commentary. In the July 25 issue of The ASCO Post, part 1 of a case report was published and focused on diagnosis (see summary below). Here, in part 2, the management of this...

issues in oncology

Strengthening the Doctor-Patient Relationship: An Interview With Lidia Schapira, MD, FASCO

Earlier this summer, Lidia ­Schapira, MD, FASCO, a medical oncologist at Massachusetts General Hospital Cancer Center and Associate Professor of Medicine at Harvard Medical School, was named Editor-in-Chief of Cancer.Net, ASCO’s patient information website. Prior to taking on this role, Dr....

Conquer Cancer Foundation Donor Spotlight: Ludwig Cancer Research

Among the Conquer Cancer Foundation’s newest supporters, Ludwig Cancer Research is an international community of distinguished scientists dedicated to preventing and controlling cancer. Its emphasis on collaboration and long-term support has fostered its role as a leader in immunotherapy and other...

New Symposium Brings Together Oncologists and Primary Care Providers to Advance Survivorship Care and Research

With two-thirds of Americans now living at least 5 years after a cancer diagnosis, there are currently 14.5 million cancer survivors living in the United States. By 2024, that number is expected to increase by nearly 25%.1 Although the growing number of survivors is a welcome sign of progress, this ...

skin cancer

Sonidegib in Basal Cell Carcinoma

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 July 24, 2015, sonidegib (Odomzo) was approved for treatment...

issues in oncology

Johnson & Johnson Creates Independent Bioethics Panel to Evaluate Compassionate Drug Use Requests

In May 2015, Johnson & Johnson announced its partnership with New York University (NYU) School of Medicine in New York to create a first-of-its kind independent bioethics panel to review requests made to the company for compassionate use of an investigational drug and determine how the company...

geriatric oncology

Geriatric Oncology: A Geriatrician’s Perspective

“The management of older individuals, including older cancer patients, involves a wisdom developed over a lifetime, thanks to time-consuming listening and painstaking collection and interpretation of clinical details.” —Lodovico Balducci, MD It is not simple to be a geriatrician in a world of...

bladder cancer
prostate cancer
gynecologic cancers

Clinical Trials Actively Recruiting Patients With Genitourinary Cancers

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with genitourinary cancers—prostate, bladder, uterine, and testicular. The trials are investigating genetic biomarkers of cancer; proton beam therapy; allogeneic bone marrow...

cns cancers

Improved Understanding of Glioma Tumor Biology

The management of patients with lower-grade gliomas is evolving. As evidenced by two recent publications in The New England Journal of Medicine,1,2 reviewed in this issue of The ASCO Post, there has been a substantial increase in our knowledge of the molecular characteristics of these neoplasms....

breast cancer

The Conundrum of Estrogen-Receptor Signaling in HER2-Positive Breast Cancer

BOLERO-1—reviewed in this issue of The ASCO Post—is the next installment in a series of randomized trials evaluating the addition of everolimus (Afinitor) to standard therapy in metastatic breast cancer.1 The initial evaluation of everolimus in the HER2-positive metastatic setting looked extremely...

breast cancer

Adding Everolimus to First-Line Trastuzumab/Paclitaxel Does Not Increase Progression-Free Survival in HER2-Positive Metastatic Breast Cancer

In the phase III BOLERO-1 trial, reported in The Lancet Oncology, Sara A. Hurvitz, MD, of the University of California, Los Angeles, and colleagues found that the addition of the mTOR inhibitor everolimus (Afinitor) to trastuzumab (Herceptin)/paclitaxel did not significantly increase...

cost of care

Calculating the Value of Cancer Drugs

For nearly a decade, Peter B. Bach, MD, MAPP, Director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center in New York, has been a leading voice in sounding the alarm over the escalating cost of cancer drugs and in seeking a solution to the problem. In 2012, Dr....

multiple myeloma

Carfilzomib in Combination With Lenalidomide and Dexamethasone in Relapsed Multiple Myeloma

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 July 24, 2015, carfilzomib (Kyprolis) was approved for use in...

colorectal cancer

Learning to Refine the Use of Regorafenib to Best Advantage in Advanced Colorectal Cancer

In patients with advanced colorectal cancer who have been heavily treated with a sequence of chemotherapy regimens and/or targeted therapies, the goals of treatment on or off a clinical trial are readily definable. These patients and their managing teams are striving to extend the length of lives,...

supportive care
pain management
palliative care
symptom management

Managing Cancer Pain at the End of Life

Cancer-related pain does not exist in a vacuum. To effectively treat it, clinicians should understand the contributing factors. Proper assessment and management of cancer pain at the end of life can significantly alleviate patient suffering, according to Eduardo Bruera, MD, FAAHPM, Department Chair ...

head and neck cancer
supportive care
palliative care
symptom management

Dispelling the Myths Associated With Osteonecrosis of the Jaw

Osteonecrosis of the jaw associated with cancer treatment is frequently misunderstood, according to Cesar ­Augusto Migliorati, DDS, MS, PhD, who delivered an update on its proper recognition and management at the 2015 Multinational Association of Supportive Care in Cancer/International Society of...

cns cancers

Short Course of Radiotherapy May Be Adequate for Elderly and Frail Patients With Glioblastoma Multiforme

No difference in overall survival or progression-free survival was observed between elderly and/or frail patients undergoing short and standard courses of radiotherapy for glioblastoma multiforme, according to data presented by Elena Fidarova, MD, at the 2015 Multinational Association of Supportive ...

lung cancer

Gefitinib in EGFR-Mutant Metastatic NSCLC

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 July 13, 2015, gefitinib (Iressa) was approved for first-line ...

lung cancer

Immunotherapy Makes Inroads in Small Cell Lung Cancer

Early data on immunotherapy for small cell lung cancer (SCLC) have been encouraging. SCLC may catch up to non–small cell lung cancer (NSCLC), where immunotherapy is now standard of care, if these early data are borne out in phase III trials. Phase Ib and II studies of immunotherapy in SCLC were...

lung cancer

Moving Forward in Non–Small Cell Lung Cancer: Targeted Combinations and Immunotherapy

The newer targeted therapies and immunotherapies have proven to be a boon to the treatment of lung and other cancers, but how best to deploy those therapies remains a burning question. Another important focus of current research is the identification and validation of biomarkers for these...

health-care policy

‘Right to Try’ Laws: Helpful or Harmful?

Since 2014, “Right to Try” legislation has been sweeping the nation. Created to enable terminally ill patients to gain access to experimental drugs, biologics, and devices by sidestepping the approval process of the U.S. Food and Drug Administration (FDA), at press time, 22 states have enacted...

lung cancer

Immune Checkpoint Inhibitors: The Dawn of a New Era for Lung Cancer Therapy

The therapeutic paradigm for lung cancer has changed rapidly over the past few years toward individualized therapy. For certain subsets of patients, molecularly targeted agents have resulted in robust gains in overall survival and quality of life. However, for the majority of patients with...

breast cancer

Studies Explore New Avenues to Pursue in Metastatic Triple-Negative Breast Cancer

Two agents targeting novel pathways show promise in metastatic triple-negative breast cancer, according to separate studies presented at the 2015 ASCO Annual Meeting and reviewed at the Best of ASCO® meeting by Steven J. Isakoff, MD, PhD, of Massachusetts General Hospital, Boston. The first study...

James Welsh, MD, FACRO, Elected President of the American College of Radiation Oncology

Loyola University Medical Center radiation oncologist James Welsh, MD, FACRO, was recently elected president of the American College of Radiation Oncology (ACRO). Dr. Welsh, installed as president during ACRO’s Annual Meeting in Washington, DC, will serve a 2-year term as President. In 2017, Dr....

lymphoma

Increased Lifetime Risk of Cardiovascular Disease for Patients Treated for Hodgkin Lymphoma

Survivors of Hodgkin lymphoma treated as adolescents or adults are at increased risk of cardiovascular diseases throughout their lives, according to results of a retrospective cohort study of 2,524 Dutch patients followed for a median of 20 years. “Treating physicians and patients should be aware...

Expect Questions or Ask About Postmastectomy Pain

Since postmastectomy pain occurs in an estimated 20% to 40% of patients undergoing the procedure, physicians who treat these women can expect questions about the pain and how to deal with it. However, some patients may be reluctant to ask about it. “Sometimes, women don’t want to complain to their ...

breast cancer
pain management

Increased Interest in Simple Injection to Treat Women With Postmastectomy Pain

After presenting results of a study showing that injecting a standard analgesic combination into trigger points of pain along the inframammary fold relieved postmastectomy pain, Laura J. Esserman, MD, MBA, Director of the Carol Franc Buck Breast Care Center and Co-Leader of the Breast Oncology...

Unneccessary Complexity in Scientific Terminology?

In the highlighted quote in the article titled “Ado-Trastuzumab Emtansine Fails to Replace Standard of Care in First-Line Metastatic Breast Cancer,” which appeared in on page 3 of the July 10 issue of The ASCO Post, a most remarkable sentence was constructed: T-DM1 and T-DM1 plus pertuzumab...

ASCO and UICC Collaborate to Extend Reach of the Journal of Global Oncology

ASCO and the Union for International Cancer Control (UICC) announced their partnership to expand the reach of the Journal of Global Oncology (JGO), a new open-access journal that will focus on cancer care, research, and care delivery issues unique to countries and settings with limited health-care...

From Small-Town Mexico to Big Pharma, a Look at Opiates for Good and Bad

Bookmark Title: Dreamland: The True Tale of America’s Opiate Epidemic Author: Sam Quinones Publisher: Bloomsbury Press Publication date:  April 21, 2015 Price: $28.00; hardcover, 384 pages Despite growing awareness within the oncology community and the emergence of the palliative care...

To the One of the Many

(Using Shakespeare’s words to confront the plight of a Physician)   Give me that man That is not passion’s slave Give me that blanket that comforts and soothes For in my heart There was a fighting that would not let me sleep, Our indiscretion Sometimes serves us well. In those wakeful...

integrative oncology

Coriolus versicolor

The use of dietary supplements by patients with cancer has increased significantly over the past 20 years 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
survivorship

‘Share the Journey’ Mobile App Aims to Understand the Different Experiences of Breast Cancer Survivors

In March 2015, Sage Bionetworks and Apple released “Share the Journey: Mind, Body, and Wellness After Breast Cancer,” a patient-centered iPhone app that tracks five common consequences of breast cancer treatment, including fatigue, cognitive function, sleep disturbances, mood changes, and a...

breast cancer

I’m Living a Full and Happy Life With Stage IV Breast Cancer

After coping with breast cancer for more than a decade, it is difficult for me to put into words exactly how grateful I am to all the doctors, nurses, and researchers whose efforts have kept me alive for all these years. And not just alive, but thriving. A routine mammogram had discovered two...

A Cancer Handbook for Inquisitive Laypersons and Health-Care Professionals

Bookmark Title: The Cancer Solution: Taking Charge of Your Life With CancerAuthor: Jack C. Westman, MD, MSPublisher: Archway PublishingPublication date:  January 15, 2015Price: $20.00; paperback, 310 pages I was at a meeting in San Francisco in 1978 and received a call from my wife, Nancy:...

Never Say Never

The following essay by Grace Wang, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. D.K. came to me ...

Hypertrophic Tumor of the Forehead, Philadelphia, Circa 1870

Through the Lens of Oncology History: A Century of Progress The text and photographs on this page are excerpted from a four-volume series of books titled Oncology Tumors & Treatment: A Photographic History, by Stanley B. Burns, MD, FACS. The photos below are from the volume titled “The...

gynecologic cancers

How Carolyn D. Runowicz, MD, FASCO, Is Shaping the Future of Gynecologic Cancers

Carolyn D. Runowicz, MD, ­FASCO, has worn just about every hat in the field of oncology—clinician, professor, researcher, administrator, and even cancer survivor.  Currently the Executive Associate Dean for Academic Affairs and Professor in the Department of Obstetrics and Gynecology at the Herbert ...

The Flipped Classroom: Swapping the Traditional Lecture Hall for an Online Version

Despite enormous advances in modern medicine and the explosion of biomedical information over the past century, the way medical education is taught in the United States is stuck in a format that does not optimize learning, according to Charles Prober, MD, Senior Associate Dean for Medical Education ...

issues in oncology

Access to Cancer Medicines Not Uniform Across Europe

Access to cancer medicines—including some old standbys—is inconsistent across Europe, depriving many patients of treatments that are the standard of care elsewhere,1 according to Alexandru E. Eniu, MD, PhD, Chair of the European Society for Medical Oncology (ESMO) Emerging Countries Committee and...

skin cancer

COMBI-d Trial and the Need to Guide Progress in Melanoma Treatment

As reviewed in this issue of The ASCO Post, Long et al1 have reported the final overall survival analysis of the COMBI-d phase III trial comparing combination therapy with the BRAF inhibitor dabrafenib (Tafinlar) and the MEK inhibitor trametinib (Mekinist) to monotherapy with dabrafenib alone,...

This September, Triple Your Impact

At the 2015 ASCO Annual Meeting, the Conquer Cancer Foundation (CCF) launched The Campaign to Conquer Cancer—a comprehensive, $150 million fundraising campaign supporting breakthrough research and sharing vital knowledge with physicians, patients, and families. In support of The Campaign, CCF Board ...

ASCO Guidelines: A Collaborative Effort

The ASCO Guidelines Program has worked with other professional societies and guideline development organizations in an effort to expand the ASCO guideline portfolio and harmonize recommended care options across prominent guideline development groups. For ASCO, this effort began with a systematic...

Getting There From Here: What You Need to Know About Traveling to Cuba

In January 2015, the U.S. Department of the Treasury and the U.S. Department of Commerce announced changes related to the easing of sanctions on Cuba, which loosened some restrictions on travel for Americans, although some rules still apply. There are 12 legal categories of travel to Cuba,...

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