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Contralateral Breast Cancer Risk Is Highly Overestimated

Breast cancer is highly unlikely to develop in the contralateral breast of women treated for primary breast cancer, yet many women continue to fear it and undergo prophylactic mastectomies. “Regardless, the perceived risk of developing and dying from a contralateral breast cancer is highly...

Trastuzumab Emtansine Improves Survival vs Capecitabine plus Lapatinib in Second-line HER2-positive Breast Cancer

Trastuzumab emtansine (T-DM1) is an antibody-drug conjugate composed of trastuzumab bound to the cytotoxic microtubule inhibitor emtansine (DM1, derivative of maytansine) by a stable linker. Trastuzumab targets the conjugate to HER2 receptors, and the linker releases the cytotoxic agent when the...

No Survival Benefit for Oxaliplatin Added to Adjuvant Therapy in Stage II or Elderly Patients with Colon Cancer

Oxaliplatin plus fluorouracil (5-FU)/leucovorin or capecitabine (Xeloda) is a standard of care in adjuvant therapy for stage III colorectal cancer. There is ongoing debate about whether any adjuvant therapy is of benefit in patients with stage II disease, and it is not routinely recommended in this ...

SIDEBAR: Mammography Study Stokes Overdiagnosis Debate

Overdiagnosis and the harms associated with unnecessary procedures is becoming a vibrant subject in today’s health-care dialogue, with serious implications for providers and patients alike. A new study from the Norwegian Screening Program concluded that 15% to 25% of breast cancers identified on...

Seeking Solutions to the Dilemmas of Overdiagnosis and Overtreatment

Widespread use of screening technologies has markedly increased early detection rates of cancer, saving countless lives. However, while screening technologies have remarkable sensitivity, their  inability to identify which tumors will progress and which will not has created the phenomenon of...

Updated Results from T-DM1 and Regorafenib Trials, plus Other Highlights from ESMO 2012

The 35th European Society for Medical Oncology (ESMO) Congress in Vienna broke all records for attendance, with about 16,000 attendees from all over the world. Some sessions were standing room only, including the Presidential Symposia, the ESMO-ASCO Joint Symposium on genomics in breast cancer, and ...

Defining a Cure for Chronic Myeloid Leukemia and Strategies to Achieve this Goal

In chronic myeloid leukemia (CML), continued long-term therapy that prevents both progression to accelerated-phase disease and the emergence of resistance may be thought of as an “operational” or “functional” cure. However, long-term disease control without the requirement for continuous treatment...

Managing Treatment Failure in Chronic Myeloid Leukemia

As John Goldman, DM, FRCP, FRCPath, FMedSci, discussed earlier, a substantial minority of patients with chronic myeloid leukemia (CML) experience treatment failure. Jorge Cortes, MD, of The University of Texas MD Anderson Cancer Center, introduced this session with two patient cases to illustrate...

Defining and Recognizing the Causes of Imatinib Resistance and the Importance of Adherence

Imatinib (Gleevec) is a highly effective therapy for the majority of patients with chronic myeloid leukemia (CML). In the IRIS study, only 30% of patients could be considered to have failed imatinib treatment after 6 years.1 However, these 30% of patients are a substantial minority. John Goldman,...

Beyond Molecular Monitoring: Cytogenetic Testing and Mutational Analysis in Chronic Myeloid Leukemia

Cytogenetic analysis remains an important component of patient monitoring until a complete cytogenetic response is achieved. In addition, the ability of conventional cytogenetics to identify additional chromosomal abnormalities not detected by fluorescence in situ hybridization is noteworthy. Jorge ...

Treatment Goals, Molecular Monitoring, and the Role and Use of Guideline Recommendations

The importance of achieving a certain level of response with imatinib (Gleevec) by 3 months in patients with chronic myeloid leukemia (CML) had previously been established in the IRIS (International Randomized Study of Interferon and STI571) trial.1 Analysis of data from this trial showed that...

Past ASCO President, John Ridgway Durant, MD, Dies at 82

John Ridgway Durant, MD, ASCO’s 20th President, was born on July 29th, 1930, and died on October 28th, 2012. Dates that mark a person’s birth and passing are made all the more significant by how that person filled the days that link the two milestones. Dr. Durant will be remembered fondly as a man...

prostate cancer
issues in oncology

Role of Glutamate and Effect of Its Blockade in Prostate Cancer

Glutamate plays a role in oncogenic metabolic and signaling pathways. In a recently reported study, Koochekpour and colleagues from the Roswell Park Cancer Institute in Buffalo, NY, investigated potential correlations of glutamate levels with prostate cancer in patients with primary or...

hepatobiliary cancer

Lower Risk of Recurrence in Patients with HBV-related Liver Cancer Receiving Nucleoside Analogs

Patients with hepatitis B virus (HBV)-related hepatocellular carcinoma who received nucleoside analogs after curative liver resection had an associated lower risk of hepatocellular carcinoma in a nationwide cohort study using data from the Taiwan National Health Research Data Base. The study was...

sarcoma

Interval-compressed Chemotherapy More Effective with No Increase in Toxicity

A randomized controlled trial among patients with newly diagnosed localized Ewing sarcoma found that “chemotherapy administered every 2 weeks is more effective than chemotherapy administered every 3 weeks, with no increase in toxicity,” investigators from the Children’s Oncology Group reported in...

breast cancer

Small Increase in Cardiac Events for Trastuzumab plus Anthracycline in HER2-positive Disease

A 7-year follow-up of the phase III National Surgical Adjuvant Breast and Bowel Project (NSABP) protocol B-31 found that the cumulative difference in the rate of cardiac events was 3.1% between patients with HER2-positive, node-positive breast cancer who received trastuzumab (Herceptin) in addition ...

cns cancers

Early Surgical Treatment of Low-grade Glioma Improves Survival vs Watchful Waiting

In a comparison of surgical treatment strategies for low-grade gliomas, patients in Norway treated at a hospital that generally favored early surgical resection had better overall survival than patients treated at a hospital that favored diagnostic biopsy and watchful waiting, according to a study...

MSKCC’s Decision Not to Purchase New Cancer Drug Sparks Editorial and Unprecedented Actions

“At Memorial Sloan-Kettering Cancer Center, we recently made a decision that should have been a no-brainer: we are not going to give a phenomenally expensive new cancer drug to our patients.” That was the opening sentence of a New York Times op-ed piece written by three physicians from Memorial...

solid tumors

I Am Not a Victim

Six years ago, at age 62, I was feeling in great shape. The year before, I had taken over custody of my 2- and 3-year-old great-grandchildren and decided to change the course of my career from motivational speaker to motivational coach to be home more often with the kids. It was during one of our...

Dr. Jimmie C. Holland’s Research Has Long Underscored the Importance of Caring for the Whole Patient

Although internationally recognized today as the founder of the subspeciality of psycho-oncology, the field of psychiatry held no interest for Jimmie C. Holland, MD, when she entered Baylor College of Medicine in Houston, Texas, in the mid-1940s. Born in 1928 at the dawn of the Great Depression,...

integrative oncology

Acupuncture: Does It Alleviate Symptoms Associated with Cancer Care?

A therapeutic modality of traditional Chinese medicine, acupuncture has been extensively investigated in Western medical settings. Its clinical use is increasingly common for the management of pain and other conditions. In the oncology setting, research demonstrates that acupuncture can...

The ‘True’ History of the Discovery of Prostate-specific Antigen

I am frequently asked about the “true” history of prostate-specific antigen (PSA). As PSA has become more important, a controversy about its discovery has increased. I lived through much of this history and have known many of the “players.” Here are the relevant facts, as I believe them to be ...

Updates on Ruxolitinib from ASCO and ASH 2012, including Long-term Survival Data

Ruxolitinib (Jakafi), a novel, oral JAK1 and JAK2 inhibitor, was approved by the FDA on November 16, 2011 for patients with intermediate- or high-risk myelofibrosis. The approval was based on its efficacy in reducing spleen size and improving disease-related burdensome symptoms. In the brief In the ...

Ambitious Call to Arms Seeks a Shift in Priorities to Eradicate Cancer

It has been more than 4 decades since our nation loaded its medical cannons and declared war on cancer, self-assured that money and American scientific resolve would lead to victory. But cancer has proved to be a humbling enemy. The war is now fought in targeted skirmishes; the weaponry is a...

The Practice of More than One Art

The positive healing effects of music can be traced as far back as ancient Greece and the belief that Apollo was God of medicine and music. In his book De Anima, Aristotle wrote that flute music could purify the soul. By the end of the 19th century, researchers were showing a correlation between...

sarcoma

No Survival Advantage for Combination Chemotherapy in Advanced Soft-tissue Sarcoma  

The addition of aggressively dosed ifosfamide to doxorubicin in the treatment of advanced soft-tissue sarcomas significantly delayed disease progression but did not improve survival in the randomized phase III EORTC 62012 trial conducted by the Soft Tissue and Bone Sarcoma Group of the European...

Top 10 Most Viewed Articles on ASCOPost.com for 2012

Novel Multikinase Inhibitor Improves Survival in Metastatic Colorectal CancerBy Caroline HelwickThe novel tyrosine kinase inhibitor regorafenib, given as a single agent to patients with treatment-refractory metastatic colorectal cancer, significantly improved overall survival and delayed disease...

gynecologic cancers

Combination Bevacizumab/Chemotherapy Improves Outcomes in Platinum-resistant Ovarian Cancer

The addition of bevacizumab (Avastin) to chemotherapy improved progression-free survival and response rates in patients with platinum-resistant recurrent ovarian cancer, according to an exploratory analysis of the phase III AURELIA trial. The combination of paclitaxel with bevacizumab achieved very ...

solid tumors
prostate cancer

Stereotactic Body Radiation Therapy Produces Impressive Results in Organ-confined Prostate Cancer

Stereotactic body radiation therapy (SBRT) delivered via the CyberKnife can achieve excellent outcomes with minimal toxicity in patients with prostate cancer. Importantly, this technique delivers therapeutic doses of radiation in four to five fractions, which reduces the number of clinic visits...

solid tumors
prostate cancer

Sildenafil Improves Overall Sexual Function in Men with Prostate Cancer Treated with Radiation

For the first time, a randomized controlled trial reported improved sexual function with 6 months of prophylactic sildenafil citrate before, during, and after radiation therapy in patients with prostate cancer.1 The paper was presented at the Plenary Session during the 54th Annual Meeting of the...

solid tumors
prostate cancer

Androgen-deprivation Therapy plus Radiation Proven as Standard of Care for High-risk Prostate Cancer

A combined-modality approach of androgen-deprivation therapy plus radiation therapy achieves a substantial survival benefit over androgen-deprivation therapy alone in patients with locally advanced prostate cancer according to final analysis of an intergroup randomized phase III study conducted by...

issues in oncology
cost of care
health-care policy

SIDEBAR: How Other Countries Are Controlling Oncology Costs

The refrain is familiar: The United States spends more on health care than any other industrialized country, but the investment does not correspond to superior care. A recent study by The Commonwealth Fund, a health-care policy research foundation, shows just how stark the contrast is. Instructive ...

issues in oncology
cost of care
health-care policy

The Ethics of Rationing Cancer Care

Should cost be a consideration when deciding on treatment for patients with cancer, and if so, what kind of ethical dilemma does that pose for oncologists? With U.S. spending on oncology drugs expected to climb more than 20% annually over the next decade—reaching $173 billion by 2020, according to...

Research of Three Conquer Cancer Foundation Grantees Featured among Top Cancer Advances of the Year

Every year, the Conquer Cancer Foundation of the American Society of Clinical Oncology funds research grants that provide critical start-up funding for young physician-scientists, with the goal of enabling them to develop successful careers in cancer research so that they can bring new treatments...

solid tumors
colorectal cancer

Finding Lynch Syndrome among Patients with Colorectal Cancer: Routine Tumor Testing Looks Best

Oncologists generally agree that screening patients with colorectal cancer for Lynch syndrome is a good thing. Patients who turn out to have the hereditary syndrome can inform their first-degree relatives, who in turn can undergo genetic testing. Those who have the characteristic mutations can take ...

Genetic Variation in Vitamin D Pathway Is Tied to Colorectal Cancer Risk among African Americans

African Americans’ risk of colorectal cancer varies according to whether they have certain genetic variants that affect vitamin D metabolism, according to a study presented at the Fifth American Association for Cancer Research (AACR) Conference on The Science of Cancer Health Disparities, held...

head and neck cancer

Oral Rinse Doxepin Relieves Painful Mucositis in Head and Neck Cancer

Doxepin oral rinse significantly improved oral mucositis in patients treated with radiation therapy for head and neck cancer according to results of a phase III trial presented at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO) in Boston. However, the improvement was...

issues in oncology

Significant Reduction in Cancer Risk Seen with Daily Multivitamin Use in Middle-aged and Older Men

Large-scale trials over the past several years have shown a general lack of effect of single vitamins or small numbers of vitamins given at high doses in preventing cancer. However, as recently reported in JAMA by Gaziano and colleagues, the Physicians’ Health Study II has found a modest but...

issues in oncology

2012 In Review: Oncology Drugs/Indications Newly Approved by FDA

At press time, the FDA had granted approval for the following new agents and indications for cancer treatment in 2012. Cabozantinib (Cometriq) for the treatment of progressive metastatic medullary thyroid cancer. Cabozantinib is a small molecule that inhibits the activity of multiple tyrosine...

cns cancers

Revised Everolimus Dosing and New Safety/Efficacy Data for Approval in Subependymal Giant Cell Astrocytoma

On August 29, 2012, everolimus in a tablet for oral suspension form (Afinitor Disperz) was given accelerated approval for the treatment of pediatric and adult patients with tuberous sclerosis complex who have subependymal giant cell astrocytoma (SEGA) that requires therapeutic intervention but...

hematologic malignancies
leukemia

Liposomal Vincristine for Adult Patients with Relapsed/Refractory Acute Lymphoblastic 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 In August 2012, vinCRIStine sulfate LIPOSOME injection...

kidney cancer

IMA901 Granted Orphan Drug Designation by FDA

immatics biotechnologies GmbH announced that the cancer vaccine IMA901 has been granted orphan drug designation from the FDA for the treatment of renal cell carcinoma (RCC) in HLA-A*02 positive patients. The FDA grants orphan drug designation to novel drugs aimed at treating rare diseases or...

breast cancer

FDA Grants Fast Track Designation to Etirinotecan Pegol for the Treatment of Metastatic Breast Cancer

Nektar Therapeutics announced that the FDA has designated etirinotecan pegol (NKTR-102) as a Fast Track development program for the treatment of patients with locally recurrent or metastatic breast cancer progressing after treatment with an anthracycline, a taxane, and capecitabine (ATC)....

breast cancer

Molecular Breast Imaging an Option for Early Detection in High-risk Women

Molecular breast imaging, also known as breast-specific gamma imaging, was a key topic of discussion at the Radiological Society of North America (RSNA) Annual Meeting, held recently in Chicago. Molecular breast imaging can detect breast cancer missed by mammography, according to clinical data...

lung cancer

Effects of LKB1 Mutation and mTOR Inhibition on IGFR1 Pathway in Non-small Cell Lung Cancer

LKB1 is a serine/threonine kinase that has been found to be mutated in approximately 20% to 30% of patients with non–small cell lung cancer (NSCLC). LKB1 acts as a tumor suppressor by activating AMPK, and loss of LKB1 by point mutation or deletion suppresses AMPK, leading to increased mTOR...

breast cancer

Fox Chase Researchers Find Most Medicare Patients Wait Weeks before Breast Cancer Surgery

Although patients may feel anxious waiting weeks from the time of their first doctor visit to evaluate their breast until they have breast cancer surgery, new findings from Fox Chase Cancer Center in Philadelphia show that these waits are typical in the United States. Results were published...

breast cancer

Plenary Session Included Findings on Partial- vs Whole-breast Techniques and Patient Beliefs about Radiotherapy

When the dates were picked for the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO), no one could have anticipated that the meeting would coincide with Hurricane Sandy’s devastation of parts of the northeast. As the storm approached on Monday and Boston shut down its...

Surgical Resection for Colorectal Cancer Liver Metastases: Who, When, How?

Many patients with colorectal liver metastases can undergo surgical resection with curative intent. Who are these patients and how are they best managed? In an interview with The ASCO Post, Steven A. Curley, MD, Professor of Surgical Oncology at The University of Texas MD Anderson Cancer Center,...

Combination Therapy Not Better than Single-agent Bevacizumab for Advanced Renal Cell Carcinoma in BeST Trial

None of three combination therapies tested among patients with advanced renal cell carcinoma in the BeST trial came close to achieving the primary objective of a 67% improvement in median progression-free survival compared to single-agent bevacizumab (Avastin), Keith T. Flaherty, MD, reported at...

prostate cancer
issues in oncology

Medical and Behavioral Variables Have More Impact on Physical Functioning Than Finasteride Treatment

Taking finasteride over a 7-year period as part of the Prostate Cancer Prevention Trial (PCPT) “did not affect any of the three primary health-related quality-of-life domains—physical function, mental health, or vitality—either positively or negatively,” according to a study published in the...

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