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Emil 'Tom' Frei III, MD 1924–2013

The pages of medical history are dog-eared with breakthroughs that have transformed medicine and saved lives. One of those dog-eared pages belongs to Emil Frei III, MD, known to his colleagues and friends as Tom. In the dawn of oncology, Dr. Frei, along with his associate, Emil Freireich, MD, did...

hematologic malignancies
leukemia
issues in oncology

'Matriarch of Modern Cancer Genetics,' Janet D. Rowley, MD, Helped Propel the Field of Molecular Oncology 

Even as a child, Janet D. Rowley, MD, found the intellectual order and logic of science appealing. Born on April 5, 1925, in New York, Dr. Rowley’s parents, Hurford and Ethel Ballantyne Davison, moved the family to Chicago 2 years later. Both educators, the Davisons encouraged their only child in...

issues in oncology

Strength of Patient-Oncologist Alliance Linked to Willingness to Adhere to Treatment in Young Adults 

Among young adults with advanced cancer, developing a strong alliance with their oncologist was associated with greater perceived social support, a greater willingness to adhere to treatment, and greater adherence to oral medication, according to results of a study published in the Journal of...

breast cancer

DCIS Score Quantifies Risk of Recurrence after Excision

The ductal carcinoma in situ (DCIS) Score, a multigene expression assay, quantifies the risk of local recurrence and invasive local recurrence for women with DCIS treated with surgical excision, researchers reported in the Journal of the National Cancer Institute. “The DCIS Score can aid clinical...

breast cancer

No Added Benefit from Radiotherapy after Lumpectomy/Tamoxifen in Older Women 

Long-term follow-up of Cancer and Leukemia Group B (CALGB) 9343 “confirms and extends the earlier report that in women age ≥ 70 years with clinical stage I, [estrogen receptor (ER)]-positive breast cancer treated with lumpectomy followed by tamoxifen, irradiation adds no significant benefit in...

breast cancer
issues in oncology

Chemotherapy-induced Peripheral Neuropathy Results in Dose Limiting and Less Chemotherapy Overall

Chemotherapy-induced peripheral neuropathy events resulted in limiting the dosing of chemotherapy in a significant proportion of women with nonmetastatic breast cancer being treated with paclitaxel, and those who had their dose reduced or discontinued received significantly less cumulative drug,...

colorectal cancer

Liver-first Approach to Colorectal Cancer with Synchronous Hepatic Metastases

“The liver-first approach for patients with colorectal cancer with synchronous liver metastases is possible but is associated with a wide range of survival outcomes, despite protocol similarities between studies,” according to a review of four cohort studies identified by a literature search. “All...

SIDEBAR: Expect Questions about Preventive Double Mastectomies  

For women who are considering prophylactic bilateral mastectomies, “I strongly encourage genetic testing, Todd M. Tuttle, MD, MS, said in an interview with The ASCO Post about the increased interest in preventive double mastectomy following Angelina Jolie’s disclosure that she had the procedure to...

breast cancer

Angelina Jolie's Disclosure of Prophylactic Bilateral Mastectomy: A Positive Example for Women with BRCA Mutations? 

Angelina Jolie, in a New York Times article entitled “My Medical Choice,”1 disclosed that having a BRCA1 mutation and an estimated 87% risk of breast cancer, “I decided to be proactive and minimize the risk as much I could. I made a decision to have a preventive double mastectomy.” She was writing...

breast cancer

Epigenome-wide Study of DNA Methylation in Breast Cancer Using Prospectively Collected Samples 

Available data suggest that DNA methylation in blood is a potential epigenetic marker of cancer risk, but this has not been evaluated on a genome-wide scale in prospective studies of breast cancer. Xu and colleagues measured DNA methylation at 27,578 CpG sites (ie, DNA regions where cytosine and...

colorectal cancer

Serum miR-21 as Diagnostic and Prognostic Biomarker in Colorectal Cancer 

The oncogenic microRNAs miR-21and miR-31 negatively regulate tumor-suppressor genes. Toiyama and colleagues conducted a series of studies to assess their potential as serum biomarkers in colorectal cancer. Screening in medium from two colorectal cancer cell lines and serum analysis in 12 patients...

pancreatic cancer

Elevated Serum miR-1290 May Distinguish Early Pancreatic Cancer  

In studies to identify circulating microRNA levels that could distinguish low-stage pancreatic cancer from healthy and disease controls, Li and colleagues, measured 735 microRNAs in pancreatic cancer case and control sera and selected 18 microRNA candidates for validation in an independent set of...

lung cancer

Circulating Tumor Cells with ALK Rearrangement in ALK-positive NSCLC 

The diagnostic test for ALK rearrangement in non–small cell lung cancer (NSCLC) for crizotinib (Xalkori) treatment currently uses biopsy or fine-needle aspiration. Pailler and colleagues assessed whether ALK rearrangement could be detected using circulating tumor cells. They analyzed circulating...

lymphoma

FDA Approves Lenalidomide for Relapsed/Refractory Mantle Cell Lymphoma

The U.S. Food and Drug Administration has approved lenalidomide (Revlimid) for the treatment of patients with mantle cell lymphoma whose disease has relapsed or progressed after two prior therapies, one of which included bortezomib (Velcade). Clinical Trial The approval was based on the results of...

colorectal cancer

Living Without Fear 

Even before I had a colonoscopy to determine the cause of abdominal pains I had been having, I instinctively knew that the news wouldn’t be good. A colonoscopy and subsequent pathology report confirmed stage IIIC colorectal cancer. Because I was just 47 years old at the time of my diagnosis and had ...

skin cancer

Trametinib in Unresectable or Metastatic Melanoma with BRAF V600E or BRAF V600K Mutation

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 May 29, 2013, trametinib (Mekinist) was approved by...

integrative oncology

Vitamin D and Cancer: A Uniform Dose Is Unlikely to Fit All Patients 

Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center...

skin cancer

Dabrafenib for Unresectable or Metastatic Melanoma with BRAF V600E Mutation 

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 May 29, 2013, dabrafenib (Tafinlar) was approved for ...

supportive care

Treating Both the Physical and Psychological Symptoms of Cancer 

A growing number of people with cancer are being treated on an outpatient basis. At the Herbert Irving Comprehensive Cancer Center of New York-Presbyterian Hospital/Columbia University Medical Center in New York, to ensure that the psychosocial and psychiatric needs of these patients were being...

leukemia

Identification of Oncogenic Mutations in Chronic Neutrophilic Leukemia and Atypical Chronic Myeloid Leukemia 

Among the hematologic cancers for which molecular causes remain unclear are chronic neutrophilic leukemia and atypical (BCR-ABL1–negative) chronic myeloid leukemia. Both disorders currently are diagnosed on the basis of neoplastic expansion of granulocytic cells and exclusion of genetic factors...

colorectal cancer

Similar Short-term Outcomes with Laparoscopic vs Open Surgery for Rectal Cancer 

As recently reported in Lancet Oncology by Martijn H.G.M. van der Pas, MD, of VU University Medical Center, Amsterdam, and colleagues, the phase III COLOR II trial has shown that laparoscopic surgery can produce similar safety outcomes, resection margins, and completeness of resection compared with ...

lung cancer

No Survival Benefit of ERCC1 and RRM1 Expression-based Chemotherapy in Patients with Advanced NSCLC 

A trial reported by Gerold Bepler, MD, PhD, of Karmanos Cancer Institute, Detroit, and colleagues in Journal of Clinical Oncology assessed whether chemotherapy selected on the basis of in situ ERCC1 and RRM1 protein levels could improve outcomes in patients with advanced non–small cell lung cancer...

In Memoriam: ASCO Remembers Founding Member Jane Cooke Wright, MD

Earlier this year, ASCO and the oncology community at large lost a true pioneer, mentor, and renowned researcher. It is with great sadness that we mark the passing of Jane Cooke Wright, MD, one of seven founding members of ASCO—the only woman among the founders—and the Society’s first...

issues in oncology

Reducing Unnecessary and High-dose Pediatric CT Scans Could Cut Future Cancers by More than Half

A study examining trends in x-ray computed tomography (CT) use in children in the United States has found that reducing unnecessary scans and lowering the doses for the highest-dose scans could lower the overall lifetime risk of future imaging-related cancers by 62%. The research was published...

lung cancer

Study Shows High Concordance of Recurrent Somatic Alterations in Primary and Matched Metastatic NSCLC

In a study reported in Journal of Clinical Oncology, Stéphane Vignot, MD, of Institut National de la Santé et de la Recherche Medicale (INSERM) Unit 981, Paris, and Gustave Roussy Institute, Villejuif, France, and colleagues used next-generation sequencing to identify somatic alterations in...

lung cancer

KRAS Status Not Associated with Survival in Pooled Adjuvant Therapy Trials in Early-stage Lung Cancer 

KRAS mutations have been reported in approximately 30% of lung adenocarcinomas. They occur most frequently in codons 12 and 13 in non–small cell lung cancer (NSCLC), and are most common in cancer in smokers and in nonsquamous NSCLC. Some data suggest that KRAS mutation is associated with poorer...

ASTRO to Award Society's Highest Honor to Three Physicians and Researchers

The American Society for Radiation Oncology (ASTRO) will award Amato J. Giaccia, PhD, Radhe Mohan, PhD, FASTRO, and Prabhakar Tripuraneni, MD, FASTRO, with the Society’s highest honor—the ASTRO Gold Medal. The 2013 awardees will receive the ASTRO Gold Medal during the society’s 55th Annual Meeting...

lymphoma

Radiation-sparing Dose-adjusted EPOCH-Rituximab for Primary Mediastinal B-cell Lymphoma 

Tumor control is frequently not achieved with standard immunochemotherapy in patients with primary mediastinal B-cell lymphoma, requiring consolidation with mediastinal radiotherapy. However, radiotherapy is associated with serious late adverse effects and is still associated with disease...

gynecologic cancers

Pazopanib Maintenance Therapy Extends Progression‑free Survival in Patients with Ovarian Cancer 

Maintenance therapy with the targeted therapy pazopanib (Votrient) extended progression-free survival in women with ovarian cancer who were disease-free following initial treatment with surgery and chemotherapy, according to results of a phase III trial presented at the 49th Annual Meeting of...

breast cancer

Axillary Radiotherapy: New Standard of Care in Node-positive Breast Cancer? 

Radiotherapy to the axilla may replace axillary lymph node dissection for local tumor control in selected patients with sentinel node–positive breast cancer, sparing many patients lymphedema, according to the final results of the European Organisation for Research and Treatment of Cancer (EORTC)...

breast cancer

Study Confirms 10 Years of Adjuvant Tamoxifen Is Superior to 5 Years 

The landmark aTTom study showed that 10 years of adjuvant tamoxifen is superior to 5 years of tamoxifen in reducing the risk of breast cancer recurrence or death but that the full survival benefits of extended treatment do not emerge until after the 10 years of treatment. These findings, which were ...

Expert Point of View: Lynn Mara Schuchter, MD and Michael A. Davies, MD, PhD

Lynn Mara Schuchter, MD, the C. Willard Robinson Professor of Hematology-Oncology and Program Leader of the Melanoma Program at Abramson Cancer Center of the University of Pennsylvania, Philadelphia, commented at a press briefing that the study “will ultimately be practice-changing.” She noted,...

skin cancer

MEK Inhibitor Improves Outcomes in Metastatic Uveal Melanoma 

For the first time, a drug has proven effective in the treatment of uveal (ocular) melanoma that has metastasized, according to a randomized multicenter phase II study presented at the 2013 ASCO Annual Meeting.1 “This study is the first to demonstrate an improved clinical outcome with any systemic...

gynecologic cancers
global cancer care

Simple Rapid Vinegar Test Cuts Cervical Cancer Death Rates by One-third in Rural India 

In the era of personalized medicine for cancer care, it was both surprising and encouraging to hear about a simple low-tech intervention delivered by women in the community that cut the rate of death from cervical cancer in India by about one-third. The intervention, a simple visual inspection...

Expert Point of View: Gottfried Konecny, MD

Formal discussant Gottfried Konecny, MD, Associate Professor of Medicine, David Geffen School of Medicine at UCLA, also viewed the study as a game changer. He cited the strengths of the study, including its design, randomization with stratification, P values adjusted for multiple testing, and the...

lymphoma

It’s Déjà Vu All Over Again

Yogi Berra offered the comment “It’s déjà vu all over again” when he witnessed Mickey Mantle and Roger Maris repeatedly hitting back-to-back home runs in the early 1960s. His pithy remark neatly summarizes my reaction when I read the article, “Dose-Adjusted EPOCH-Rituximab Therapy in Primary...

skin cancer

GM-CSF Boosts Survival Benefit of Ipilimumab in Metastatic Melanoma 

For metastatic melanoma, the activity of ipilimumab can be boosted by the addition of granulocyte-macrophage colony-stimulating factor (GM-CSF, Leukine), according to a phase II study that found the combination improved overall survival, vs ipilimumab alone. The results were presented at the 2013...

lymphoma

Plasma Epstein-Barr Virus DNA a Potential Marker for Treatment Response in Advanced Hodgkin Lymphoma 

Plasma Epstein-Barr Virus (EBV) DNA has prognostic significance in Hodgkin lymphoma, both prior to therapy and at 6 months of follow-up, according to results of a study published in Blood. “Plasma EBV-DNA positivity at month 6 is associated with particularly poor outcomes and may serve as an...

prostate cancer

Replacing Animal Fat with Vegetable Fat May Reduce Mortality Risk in Men with Nonmetastatic Disease

“Among men with nonmetastatic prostate cancer, replacing carbohydrates and animal fat with vegetable fat may reduce the risk of all-cause mortality,” according to a prospective study of 4,577 men with nonmetastatic prostate cancer in the Health Professionals Follow-up Study. Vegetable fat intake...

breast cancer

Cognitive Complaints after Breast Cancer Treatment and Neuropsychological Testing

About one in five patients who had completed primary breast cancer treatments but had not started endocrine therapy “had elevated memory and/or executive function complaints that were statistically significantly associated with domain-specific” neuropsychological test performances and depressive...

gynecologic cancers

Driven by the Past 

When I was 9 years old, a bout of nausea, vomiting, and abdominal pain sent me to the emergency room. The physicians diagnosed appendicitis and rushed me to the operating room. But what the surgeon found instead was a 10-cm-wide, grade 2, immature teratoma. In 1968, treatment for malignant ovarian...

skin cancer

'Spectacular' Results with Immunotherapies in Melanoma Galvanize the Oncology Community 

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Much of the news about immunotherapy ...

cns cancers

Molecular Imaging Improves Care in Pediatric Glioma

The amino acid imaging agent, O-(2-[18F]-fluoroethyl)-L-tyrosine (F-18 FET), may improve upon standard magnetic resonance imaging (MRI) and its diagnostic benefit for imaging pediatric gliomas when conventional MRI is not sufficient, said researchers at the Society of Nuclear Medicine and Molecular ...

kidney cancer

Results of AXIS Trial Indicate a Significant Improvement over Historical Survival Data in Renal Cell Carcinoma 

The phase III open-label AXIS trial comparing axitinib (Inlyta) vs sorafenib (Nexavar) as second-line treatment for metastatic renal cell carcinoma has shown a significant difference in median progression-free survival (8.3 months in the axitinib group vs 5.7 months in the sorafenib group; hazard...

gastrointestinal cancer

SEER Analysis Shows Increased Survival with Surgery and Radiation Therapy in Metastatic Gastric Cancer 

A Surveillance, Epidemiology, and End Results (SEER) database analysis reported by Ravi Shridhar, MD, PhD, and colleagues in Cancer indicates that patients receiving surgery and radiation therapy for metastatic gastric cancer have prolonged survival compared with those receiving either alone or...

gynecologic cancers

Integrated Genomic Characterization of Endometrial Carcinomas Suggests New Classification Scheme 

As recently reported in Nature, investigators in The Cancer Genome Atlas Research Network performed an integrated genomic, transcriptomic, and proteomic characterization of 373 endometrial carcinomas, including 307 endometrioid and 66 serous or mixed histology cases, using array- and...

issues in oncology

Study Shows HPV Vaccine Reduced Rate of Infection in Teenage Girls by 56% 

A new government study investigating the prevalence of human papillomavirus (HPV) infections in females aged 14 to 59 before and after the introduction in 2006 of the HPV vaccine found that the rate of the HPV infection dropped by 56%, decreasing from 11.5% in 2006 to 5.1% in 2010 among female...

lung cancer

Erlotinib in First-line Treatment of Metastatic NSCLC with EGFR Exon 19 Deletion or Exon 21 (L858R) Substitution 

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 May 14, 2013, erlotinib (Tarceva) was approved for...

solid tumors

FDA Approves Denosumab to Treat Giant Cell Tumor of the Bone

The U.S. Food and Drug Administration (FDA) has expanded the approved use of denosumab (Xgeva) to treat adults and some adolescents with giant cell tumor of the bone, a rare and usually noncancerous tumor. Denosumab, which was granted orphan product designation, was reviewed under the FDA’s...

SIDEBAR: Notes from the Lead Investigator 

We conducted this study to clarify a hypothesis that had been generated from preclinical work and small clinical datasets. One additional background point that should be made is that although not all previously reported small datasets had demonstrated a relationship between PTEN expression and...

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