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breast cancer

Complexity of the Contralateral Prophylactic Mastectomy Decision

The powerful and important study by Kurian et al,1 reviewed in this issue of The ASCO Post, adds vital information to the discussion regarding use of contralateral prophylactic mastectomy among patients with unilateral breast cancer in the United States.2,3 Based upon data from the California...

breast cancer

Study Finds Significant Increase in Bilateral Mastectomy for Unilateral Breast Cancer Despite Lack of Survival Benefit

In an observational cohort study reported in JAMA, Allison W. Kurian, MD, MSc, Assistant Professor of Medicine and of Health Research and Policy at Stanford University School of Medicine, and colleagues assessed use of and mortality after bilateral mastectomy, breast-conserving surgery plus...

multiple myeloma

Treatment of Newly Diagnosed Multiple Myeloma With Lenalidomide Plus Low-Dose Dexamethasone

The FIRST trial—reported by Benboubker and colleagues in The New England Journal of Medicine and summarized in this issue of The ASCO Post (page 93)—is a landmark study.1 It is one of the largest randomized trials in multiple myeloma ever conducted. More importantly, it is a well-designed trial...

multiple myeloma

Continuous Lenalidomide/Dexamethasone Improves Progression-Free  Survival in Transplant-Ineligible Patients With Myeloma

In the phase III FIRST trial reported in The New England Journal of Medicine, Lotfi Benboubker, MD, Service d’Hématologie et Thérapie Cellulaire, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire (CHRU), Tours, France, and colleagues found that continuous lenalidomide (Revlimid) plus...

Expert Point of View: Hope S. Rugo, MD

Hope S. Rugo, MD, Professor of Medicine and Director of Breast Oncology and Clinical Trials Education at the University of California, San Francisco, Helen Diller Family Comprehensive Cancer Center, discussed the results of the RESILIENCE trial presented at the European Society for Medical Oncology ...

breast cancer

Studies Evaluate Maintenance Bevacizumab in Metastatic Breast Cancer

Although bevacizumab (Avastin) may no longer be an active player in metastatic breast cancer, phase III studies presented at this year’s European Society for Medical Oncology (ESMO) Congress reignited interest in the drug as part of maintenance therapy. The TANIA trial met its primary endpoint,...

lung cancer

Moving Forward With Biomarkers in Non–Small Cell Lung Cancer

The effort to identify new biomarkers for response and outcomes in lung cancer is advancing, according to studies presented at the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid. Immunohistochemical expression of folate receptor for vintafolide and thymidylate synthase for...

lung cancer

Emerging Drugs Effectively Tackle Non–Small Cell Lung Cancer Mutations

For advanced nonsquamous non–small cell lung cancer (NSCLC), targeting of the epidermal growth factor receptor (EGFR) mutation and the ALK abnormality has become an established strategy. Later-generation drugs in these categories are now showing efficacy in trials, including for the treatment of...

multiple myeloma

Single-Agent Carfilzomib, Compared to Corticosteroids Plus Cyclophosphamide, Fails to Improve Survival in Myeloma

Carfilzomib (Kyprolis), as a single agent, failed to improve survival in relapsed and refractory myeloma patients, as compared with a corticosteroid and optional cyclophosphamide, in the phase III FOCUS trial, presented at the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid.1...

gastrointestinal cancer

Pazopanib Improves Progression-Free Survival in Advanced Pretreated GIST

Patients with gastrointestinal stromal tumor (GIST) can achieve remission on tyrosine kinase inhibitors, but almost all of them eventually develop resistance to these agents. The ­PAZOGIST trial results suggest that pazopanib (Votrient)—a broad-spectrum tyrosine kinase inhibitor—may be an effective ...

colorectal cancer

QUASAR2 Final Analysis: Bevacizumab Still of No Value in Adjuvant Treatment of Colorectal Cancer

The final analysis of the international phase III QUASAR2 trial confirmed the lack of benefit for bevacizumab (Avastin) as part of the adjuvant treatment of colorectal cancer. “There is no role for bevacizumab in combination with capecitabine as adjuvant treatment for colorectal cancer,” said...

colorectal cancer

Phase III Study Confirms Regorafenib’s Survival Benefit in Metastatic Colorectal Cancer

The phase III CONCUR trial1 of regorafenib (Stivarga) monotherapy in Asian patients with previously treated metastatic colorectal cancer confirmed the overall survival benefit seen in the previous ­CORRECT trial,2 and in a planned subgroup analysis, suggesting the benefit is substantial in patients ...

Expert Point of View: Andrés Cervantes, MD, PhD

During a special session at the European Society for Medical Oncology (ESMO) 2014 Congress, additional analyses from the FIRE-3 and Cancer and Leukemia Group B ­(CALGB)/SWOG 80405 trial were presented, and an expert panel was charged with putting the findings into context. Role of Subsequent...

pain management

FDA Approves Labeling With Abuse-Deterrent Features for Extended-Release Opioid Analgesic

The U.S. Food and Drug Administration (FDA) has approved new labeling for morphine sulfate and naltrexone hydrochloride extended-release capsules. The drug, marketed as Embeda, is an opioid analgesic used to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment and ...

issues in oncology

The Ohio State and Moffitt Collaborate on ORIEN: Using Big Data to Accelerate Trials With a Cancer Research ‘Expressway’

The Ohio State University Comprehensive Cancer Center and Moffitt Cancer Center have joined forces to create the Oncology Research Information Exchange Network (ORIEN), the largest collaboration of its kind designed to accelerate discoveries in cancer research. Members of this alliance of cancer...

breast cancer

Noteworthy Abstracts From the Breast Cancer Symposium Include Studies of Novel Therapies and of the Impact of Disease Subtypes on Outcomes

More than 150 oral and poster presentations were featured at the 2014 Breast Cancer Symposium, held September 4–6 in San Francisco. The multidisciplinary meeting is sponsored by ASCO, the American Society of Breast Disease, American Society of Breast Surgeons, American Society for Radiation...

lymphoma

Targeted Therapies in Indolent Lymphoma: Challenging the Current Paradigm

The use of targeted therapies in indolent non-Hodgkin lymphoma (NHL) is a burgeoning area. New targeted therapies directed at the cell surface, intracellular pathways, and the microenvironment are being studied for relapsed indolent NHL. These treatments, if validated in large randomized trials,...

colorectal cancer

For Selected Patients With Metastatic Colorectal Cancer, Taking a Break From Combination Chemotherapy Might Be Appropriate and Appreciated

Two phase III studies presented at the Best of ASCO meeting in Chicago shed more light on the role of maintenance therapy in patients with metastatic colorectal cancer undergoing first-line treatment with oxaliplatin-based chemotherapy. The two studies compared maintenance therapy with bevacizumab...

issues in oncology

Past Drug Failures Help Create Cancer’s Next Successes

The Pharmaceutical Research and Manufacturers of America (PhRMA) has released a new report, “Researching Cancer Medicines: Setbacks and Stepping Stones,” which highlights the number of investigational cancer medicines that did not succeed in clinical trials and how these so-called failures are a...

sarcoma

Targeted Agents Making Inroads Against Sarcoma

Targeted agents have started to make inroads in sarcoma therapies, and gastrointestinal stromal tumor (GIST) is the poster child for this success,” Mark Agulnik, MD, stated in summarizing progress in GIST and other sarcomas at the Best of ASCO meeting in Chicago. Dr. Agulnik is Associate Professor, ...

issues in oncology

Studies Address Impact of Social Factors on Cancer Treatment Disparities

New studies reported at ASCO’s 2014 Quality Care Symposium provided insight on the role social factors play in cancer treatment disparities, as well as effective approaches to improving the quality of care.   “The research presented [here] highlights how the conditions facing people living with...

geriatric oncology

The ‘Silver Oncologic Tsunami’: Rise in Elderly Cancer Patients Brings New Challenges to Oncology Workforce

The “graying of America” poses increasing challenges for the cancer community in terms of rising numbers of cases of cancer and costs associated with geriatric care. The scope of this problem and potential solutions were explored by Andrew E. Chapman, DO, FACP, at the ASCO Quality Care Symposium in ...

cost of care

Overutilization a Key Target in Efforts to Control Health-Care Costs

Overutilization of health-care interventions has become a prime target of efforts to rein in health-care costs. Overtreatment of cancer patients is associated with a number of common harms to the patient—not just financial harm to the health-care system. At the recent ASCO Quality Care Symposium in ...

issues in oncology

Striving for Quality, Not Quantity, of Life

Advances in science and medicine have led to humans living longer than at any other time in history. According to a new report1 on mortality from the Centers for Disease Control and Prevention’s National Center for Health Statistics, life expectancy in the United States is at an all-time high of...

leukemia

The Next-to-Last Frontier in Managing Acute Promyelocytic Leukemia

The treatment of acute promyelocytic leukemia (APL) represents one of the major triumphs in the field of hematologic malignancies. With either the vitamin A derivative all-trans retinoic acid (ATRA) combined with anthracycline-based chemotherapy or ATRA plus arsenic trioxide (Trisenox),...

Raising Consciousness About Drug Costs: A Call to Action

As medical oncologists working in chemotherapy utilization management (Oncology Analytics, Inc), my colleagues and I find ourselves daily in the center of the drug-cost maelstrom. While it is encouraging to see that more attention is being paid in the popular and medical press to this...

pain management

Unique Barriers to Pain Control

I read with great interest your interview with Virginia LeBaron, PhD, APRN, about barriers to adequate pain control (“Despite Growing Awareness, the Global Crisis of Untreated Cancer Pain Persists,” The ASCO Post, October 15, 2014). Having served as the medical director of a hospice, I am...

gastroesophageal cancer

Customizing Surveillance Strategy in Patients With Esophageal Adenocarcinoma

A surveillance strategy for patients with esophageal adenocarcinoma treated with chemoradiation and surgery (trimodality therapy) can potentially be customized based on surgical pathology stage, according to an analysis of 518 patients with esophageal adenocarcinoma who underwent trimodality...

issues in oncology

Over 14 Million Major Medical Conditions in U.S. Adults Linked to Cigarette Smoking

At least 14 million major medical conditions among U.S. adults aged 35 years and older were attributed to cigarette smoking by a study estimating the disease burden of cigarette smoking, which, according to the study’s authors, “remains immense.” Among current and former smokers, prevalence ratios...

head and neck cancer
issues in oncology

mTOR Cotargeting Active in Cetuximab-Resistant Head/Neck Cancers With PIK3CA and RAS Mutations

In a study reported in Journal of the National Cancer Institute, Wang and colleagues found that adding an mTOR inhibitor to cetuximab (Erbitux) resulted in marked improvement in antitumor activity in squamous cell carcinomas of the head and neck expressing PIK3CA and RAS oncogenes. Cetuximab...

Hyperthermia Reduces Gemcitabine Resistance

Removal of incorporated gemcitabine by DNA repair mechanisms may contribute to resistance to the agent in solid tumors. In a study reported in Journal of the National Cancer Institute, Raoof and colleagues found that radiofrequency-induced hyperthermia blocked repair of gemcitabine-stalled...

issues in oncology

PRC2 Loss Amplifies RAS-Driven Transcription and Results in Sensitivity to Bromodomain Inhibition

PRC2 (polycomb repressive complex 2) has been shown to promote oncogenesis in many tumor types; however, loss of function mutations in PRC2 components has also been shown to occur in some hematopoietic malignancies, raising questions about the precise role of the complex in cancer. In a study...

Expect Questions From Patients

Screening for thyroid cancer should be discouraged to prevent an “epidemic of diagnosis”—like the one occurring in South Korea—from happening in the United States and other countries, according to the authors of an analysis of the South Korean screening program. That study was published in The New...

lymphoma

Clinical Trials Actively Recruiting Patients With Hodgkin Lymphoma and Non-Hodgkin Lymphoma

The information contained in this Clinical Trials Resource Guide includes clinical studies actively recruiting people with Hodgkin lymphoma, non-Hodgkin lymphoma (NHL), including AIDS-related NHL, as well as studies that are also recruiting patients with multiple myeloma and mantle cell lymphoma....

pain management

FDA Approves Extended-Release, Single-Entity Hydrocodone Product With Abuse-Deterrent Properties

The U.S. Food and Drug Administration (FDA) today approved hydrocodone bitartrate (Hysingla ER), an extended-release opioid analgesic to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. The product...

Patient Guides Available Through ASCO University Bookstore

ASCO Answers: Managing the Cost of Cancer Care explains the various costs associated with cancer treatment, including health-care coverage through the Affordable Care Act. It also provides a list of financial resources available to help offset expenses related to care and tips for organizing...

Preoperative Rodent Cancer: Patient of Charles Moore, MD, Albumen Print, London, 1864

A disease more repulsive and distressing can hardly be conceived than a Rodent Cancer of the face. Commencing in some trifling manner in the skin, and then sometimes producing so little irritation as scarcely to attract notice, it spreads abroad in all directions with a slow but unswerving advance. ...

Bevacizumab Plus Chemotherapy in Platinum-Resistant Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

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 November 14, 2014, bevacizumab (Avastin) in combination with...

2014 Oncology Meetings

DECEMBER Society of Urologic Oncology 15th Annual MeetingDecember 3-5 • Bethesda, Maryland For more information: http://suonet.org/meetings/2014/default.aspx UICC World Cancer CongressDecember 3-6 • Melbourne, AustraliaFor more information: www.worldcancercongress.org 1st Rome International Meeting ...

When Life Couldn’t Be Better

The following essay by Carolyn D. Runowicz, 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. Just...

skin cancer

Memorial Sloan Kettering Team Discovery Advances Understanding of Immunotherapy’s Successes—and Its Failures

A collaborative team of leaders in the field of cancer immunology from Memorial Sloan Kettering Cancer Center has made a key discovery that advances the understanding of why some patients respond to the CTLA-4 blocking antibody ipilimumab ­(Yervoy), an immunotherapy drug, while others do not. A...

Tapping Palliative Care’s Survival Benefit

A trial reported in 2010 found that adding palliative care to standard care at the time of lung cancer diagnosis prolonged overall survival by an average of about 2.6 months,1 Arif H. Kamal, MD, told attendees at the Best of ASCO meeting in Seattle. Dr. Kamal is Director of Quality and Outcomes at...

Discussing Cessation of Medications Near the End of Life

Discussions with patients and families about stopping non–cancer-related medications near the end of life are thorny but necessary, according to Arif H. Kamal, MD, of Duke Cancer Institute, at the Best of ASCO meeting in Seattle. “What’s happening now is that a lot of hospices are having a...

survivorship

Major Strides Seen This Year in Survivorship Care

"This year was actually a boon for the patient and survivor care section,” Arif H. Kamal, MD, said at the Best of ASCO meeting in Seattle, where he reviewed the leading abstracts and gave some of his own perspective. “What you see is a lot of the limitations of research in the palliative care and...

solid tumors
issues in oncology

Proteome-Scale Map of the Human Interactome Network Created

Researchers have produced a new largest-scale map of human protein interactions that will better enable scientists to trace how genetic changes lead to diseases ranging from cancer to Huntington’s disease. The expanded map, published in the journal Cell,1 is about 30% larger than the combination of ...

Helping Adolescents and Young Adults Cope With Cancer

Each year, about 70,000 adolescents and young adults (AYAs) are diagnosed with cancer in the United States, almost six times the number of cases diagnosed in children up to 14 years of age. While overall cancer survival rates continue to rise—according to the American Cancer Society, there are...

cns cancers

Treating Brain Cancer in 2014

While primary malignant brain tumors account for only 2% of all adult cancers, these deadly neoplasms cause severe cancer-related disability; the 5-year survival rates for brain tumors rank third lowest among all cancers, with those for pancreas and lung cancers being first and second lowest,...

multiple myeloma

HDAC Inhibitors and Triple Therapy in Relapsed Myeloma

The use of histone deacetylase (HDAC) inhibitors as human cancer therapy has focused on the impact of these agents on epigenetic regulation and gene transcription. However, the use of HDAC inhibitors in myeloma may be working through a different mechanism. Specifically, HDAC6 is known to regulate...

issues in oncology

Top 5 Features of ASCO’s Newly Redesigned Patient Education Website Highlighted

ASCO recently launched a new and redesigned version of Cancer.Net, its patient-facing website that includes timely, comprehensive, and oncologist-approved information. With support from the Conquer Cancer Foundation, Cancer.Net is able to bring the expertise and resources of ASCO to your patients...

issues in oncology

Focused Ultrasound, a Young Technology, Begins to Grow

In the United States, it’s been a good 2 years for focused ultrasound. The technology, which uses multiple, intersecting ultrasound beams to treat cancer and other diseases, completed its first successful U.S. phase III oncology trial—to alleviate the pain of bone metastases—and received approval...

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