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lymphoma

FDA Approves Ibrutinib for Mantle Cell Lymphoma

The U.S. Food and Drug Administration has approved ibrutinib (Imbruvica) to treat patients with mantle cell lymphoma, a rare and aggressive form of non-Hodgkin lymphoma representing about 6% of all non-Hodgkin lymphoma cases in the United States. By the time mantle cell lymphoma is diagnosed, it...

Expert Point of View: Frances A. Shepherd, MD, FRCPC

Formal discussant of the AP26113 trial at the European Cancer Congress, Frances A. Shepherd, MD, FRCPC, Professor at the University of Toronto Faculty of Medicine and Scott Taylor Chair in Lung Cancer Research at the Princess Margaret Cancer Centre, Toronto, Canada, explained that ALK...

lung cancer

Early Evidence Supports Novel ALK Inhibitor in Patients with Non–Small Cell Lung Cancer With Brain Metastases 

Identifying ALK rearrangements as a cancer target in patients with lung cancer led to the development and FDA approval of crizotinib (Xalkori) to treat ALK-positive non–small cell lung cancer (NSCLC). Several second-generation ALK inhibitors are in development, and these agents appear to work in...

SIDEBAR: Addition of Novel Agents May Improve Outcomes With ABVD

In North America, the standard front-line treatment for advanced Hodgkin lymphoma is ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine), but this regimen is not effective in all patient subsets. To improve upon the regimen’s efficacy, researchers are evaluating new combinations, said Stephen...

lymphoma

Brentuximab Vedotin Improves Response Rates to ABVD in Hodgkin Lymphoma

For the front-line treatment of advanced Hodgkin lymphoma, ABVD is a standard treatment, but not all patients have good outcomes with this regimen. The addition of brentuximab vedotin (Adcetris), or its substitution for bleomycin, produces high complete response rates but with a moderate increase...

multiple myeloma

What Does ‘Myeloma’ Mean?

Over the centuries it has become clear that, as physicians, what we say and how we say it can have a major impact on those who seek our help. Our pronouncement that a patient is in remission or harbors a serious illness carries with it a large number of spoken and unspoken implications. So when we...

health-care policy
cost of care

Innovative Payment Models Needed to Sustain Quality Cancer Care  

Nationally regarded health-care expert Lee N. Newcomer, MD, MHA, began his presentation at this year’s ASCO Quality Care Symposium with a rhetorical question. “Why are we talking about money when we’re gathered in San Diego for 2 days to discuss some wonderful ways to impact the quality of cancer...

breast cancer

Response-Guided Neoadjuvant Therapy for Breast Cancer: A Promising Model Warranting Additional Investigation 

GeparTrio was an innovative phase III trial conducted by the German Breast Group, enrolling over 2,000 women with early breast cancer who were candidates for neoadjuvant chemotherapy. Patients with evidence of early response, defined as reduction in clinical tumor size by 50% or more, following two ...

Peter Jacobs, MD, Storied South African Hematology Pioneer, Dies 

“We make a living by what we get. We make a life by what we give.” —Winston S. Churchill The remarkable medical career of Peter Jacobs, MD, in large part, traces the oncologic history of South Africa. During the decades of political and social unrest that engulfed his native land, Dr. Jacobs...

issues in oncology
survivorship

Oncologists Need to Inform Primary Care Physicians About Late and Long-Term Effects of Chemotherapy

A nationally representative survey of 1,130 oncologists and 1,072 primary care physicians found that primary care physicians had limited awareness of late or long-term effects of chemotherapy agents. This was attributed to primary care physicians not typically encountering chemotherapy agents...

geriatric oncology

Using Life Expectancy, Not Age, to Make Cancer Screening Decisions Can Maximize Potential Benefits

Using life expectancy, rather than chronologic age, to inform decisions about whether to continue cancer screening for older persons can maximize the potential benefits of screening, while minimizing the harms, according to results of a population-based cohort study of 407,749 people over 66...

gastrointestinal cancer

Disease-Free Survival Is Acceptable Surrogate for Overall Survival in Trials of Adjuvant Chemotherapy

Disease-free survival is an acceptable surrogate for overall survival in trials of cytotoxic agents for gastric cancer in the adjuvant setting, the GASTRIC group concluded after conducting a meta-analysis of data from 3,288 individual patients enrolled in 14 randomized clinical trials. The trials...

SIDEBAR: Expect Questions From Patients 

Not discussing the costs of medical interventions could result in “financial toxicity” for patients who have trouble paying out-of-pocket costs, as well as problems adhering to expensive treatment regimens. “The problem is perhaps starkest in cancer care, but it applies to all complex illness,”...

cost of care

Disclosing Medical Costs Can Help Avoid 'Financial Toxicity'

High costs of cancer treatments can be an “undisclosed toxicity” that can harm a patient’s overall health and well-being, according to an article in The New England Journal of Medicine.1 High medical bills can not only cause stress and anxiety but may also compel patients to cut back on spending...

issues in oncology

Focus on the Massachusetts Society of Clinical Oncologists

The Massachusetts Society of Clinical Oncologists (MSCO) is among the oldest and largest of ASCO’s State Affiliates. Based in the same building as the Massachusetts Medical Society in Waltham, MSCO was founded in 1985 and has a growing membership of 160 members, including medical, surgical, and...

Dr. Weisenthal Replies

Dr. Mason states that I implied that Dr. Telli supports the routine application of chemosensitivity assays. I have no knowledge regarding Dr. Telli’s views on this subject, nor did I in any way attempt to represent her views, much less imply that she was supportive of anything relating to...

kidney cancer

Cancer Has Given Me a Greater Appreciation for Life

I’ve been blessed with good health for most of my life, and I was careful to keep it that way. I don’t smoke, I eat a healthy diet, and I maintain a healthy weight. I also was fortunate to be born with pretty good genes and have no family history of cancer. In fact, except for an occasional...

lymphoma

Ibrutinib in Previously Treated Mantle Cell Lymphoma

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 November 13, 2013, ibrutinib (Imbruvica) was granted...

integrative oncology

Society for Integrative Oncology Is Helping to Advance Evidence-Based, Comprehensive Integrative Health Care

Heather Greenlee, ND, PhD, was named President of the Society for Integrative Oncology (SIO) at the organization’s 10th International Conference in October. Dr. Greenlee is Assistant Professor in the Department of Epidemiology at the Mailman School of Public Health at Columbia University in New...

integrative oncology

Highlights From the 10th International Conference of the Society for Integrative Oncology 

The 10th International Conference of the Society for Integrative Oncology (SIO) was held recently in Vancouver, British Columbia, Canada, and attracted over 300 oncologists and internal medicine physicians, researchers, nurses, integrative medicine practitioners, cancer survivors, and patient...

health-care policy

National Cancer Policy Summit: Setting Priorities for the Next 3 Years

Welcome to the meeting we hold every 3 years to choose our next projects,” said John Mendelsohn, MD, Chair of the National Cancer Policy Forum and Director of the Khalifa Institute for Personalized Cancer Therapy at The University of Texas M.D. Anderson Cancer Center, Houston. “We have here a...

issues in oncology

Patient-Reported Outcomes, a Central Component to Value and Rapid-Learning Systems

With the passage of the Patient Protection and Affordable Care Act in 2010, value became the operative word in assessing the success of health care, from outcomes to cost. To drive more value, the Affordable Care Act seeks to implement initiatives such as comparative effectiveness research that...

American Association for Advancement of Science Elects New Fellows

The American Association for the Advancement of Science (AAAS) has identified 388 individuals who have been named AAAS Fellows. These individuals have been recognized by their peers for their efforts to advance science or its applications. The new AAAS Fellows, whose names were published in the...

issues in oncology

Oncology Drug Dosing: Can an Optimal Dose Be Fine-Tuned for Each Patient?

ASCO Chief Medical Officer Richard L. Schilsky, MD, and other oncology drug experts presented a panel on drug dosing at a recent meeting, cosponsored by the Friends of Cancer Research and the Brookings Institution, in Washington, DC.1 The presentations made it clear that issues surrounding drug...

issues in oncology

ASCO’s Innovative Quality Improvement Programs Highlighted at Symposium

Several presentations at the 2013 Quality Care Symposium demonstrated the current and potential impact of ASCO’s initiatives to achieve higher-quality cancer care with better outcomes for patients. Key presentations at the conference centered on the development of ASCO’s ground-breaking “big data”...

A New Gift to Add to Your List—One to Conquer Cancer

Conquering cancer requires the commitment, talent, and resources of all members of our community. It requires the innovation of researchers and the insight of clinicians, the courage of our worldwide community of patients and survivors, and it requires the generosity of everyone who believes in a...

issues in oncology

Conquer Cancer Foundation–Funded Research Identified Among Top Cancer Advances of 2013

The recently released Clinical Cancer Advances 2013: ASCO’s Annual Report on Progress Against Cancer, highlights the most impactful advances in clinical cancer research of the year, and this year’s report identifies two studies that were funded by the Conquer Cancer Foundation. Advances in Targeted ...

cost of care

Newly Updated: Managing the Cost of Cancer Care

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 financial paperwork. ...

issues in oncology

Clinical Cancer Advances 2013: ASCO's Annual Report on Progress Against Cancer

The Society has recently published Clinical Cancer Advances 2013: ASCO’s Annual Report on Progress Against Cancer, a comprehensive review of progress in clinical cancer research that has come to fruition in 2013. The report highlights advances across the entire continuum of cancer care, from...

issues in oncology

NCI-Led Scientists Develop Criteria for 'Omics' Tests Used in Clinical Investigations

High-throughput “omics” technologies that generate molecular profiles on tumor specimens are increasingly being incorporated into clinical trials, but some of these assays have not been well validated, leading many in the research community to question their fitness for use in patient-care...

lung cancer

No Apparent Benefit of Adjuvant Gefitinib in Resected NSCLC in Prematurely Closed Trial

As reported in Journal of Clinical Oncology by Glenwood D. Goss, MD, of the Ottawa Hospital Cancer Center, and colleagues, the prematurely closed NCIC CTG BR19 study showed no apparent survival benefit of adjuvant gefitinib (Iressa, withdrawn from U.S. market) vs placebo in patients with completely ...

prostate cancer

Correctly Assessing Pain Progression and Quality-of-Life Deterioration in Metastatic Castration-Resistant Prostate Cancer

The therapeutic landscape for the treatment of castration-resistant prostate cancer has changed dramatically in the past 4 years, as five new agents affecting different aspects of the malignant process were proven to prolong life. The results are a great benefit to patients, but at the same time...

prostate cancer

Adding Abiraterone to Prednisone Significantly Prolongs Time to Pain Progression in Chemotherapy-Naive Men With Metastatic Castration-Resistant Prostate Cancer

An interim analysis of the COU-AA-302 phase III trial in asymptomatic or mildly symptomatic chemotherapy-naive men with metastatic castration-resistant prostate cancer showed that the addition of abiraterone (Zytiga) to prednisone significantly delayed radiographic progression and improved overall...

breast cancer

Similar High Complete Response Rate With Neoadjuvant Trastuzumab, Lapatinib, and Combined Therapy in HER2-Positive Breast Cancer

In a phase III trial (NSABP B-41) performed to assess the potential benefit of neoadjuvant dual HER2 blockade in HER2-positive breast cancer, André Robidoux, MD, of Centre Hospitalier de l’Université de Montréal, and colleagues in the National Surgical Adjuvant Breast and Bowel Project (NSABP)...

breast cancer

Long-Term Follow-up of the HERA Trial Shows No Benefit of 2 Years vs 1 Year of Trastuzumab in Early Breast Cancer 

As reported in The Lancet by Aron Goldhirsch, MD, of the European Institute of Oncology in Milan, Italy, and colleagues from the Breast International Group (BIG), the comparison of 1 vs 2 years of trastuzumab (Herceptin) in patients with HER2-positive early breast cancer in the phase III HERA trial ...

breast cancer

Breast Cancer Vaccines for Primary Prevention Move Toward Clinical Use

The first candidate vaccine to prevent recurrence of breast cancer entered clinical trials about 8 years ago, and since then, the idea of a vaccine for secondary prevention has gained traction; more such vaccines are now in development. But this fall, it was vaccines for primary prevention that had ...

issues in oncology

Centers in Massachusetts Collaborate in Joint Center for Cancer Precision Medicine 

The Joint Center for Cancer Precision Medicine, a collaborative initiative among Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Boston Children’s Hospital, and the Broad Institute of MIT and Harvard, has been established to create “precision medicine treatment pathways” for patients...

Expert Point of View: Kenneth C. Anderson, MD

Commenting on the evidence for treating precursor myeloma in the study by Mateos et al,1 Kenneth C. Anderson, MD, Kraft Family Professor of Medicine at Harvard Medical School and Director of the Jerome Lipper Multiple Myeloma Center and LeBow Institute for Myeloma Therapeutics at Dana-Farber Cancer ...

multiple myeloma

Treating Earlier to Avoid Progression to Multiple Myeloma 

With an expanded list of drugs to treat multiple myeloma, experts are interested in whether treating precursor diseases to multiple myeloma can prevent progression to full-blown myeloma. In addition, new drugs are entering the armamentarium for treating multiple myeloma, noted Ruben Niesvizky, MD,...

Expert Point of View: Sibylle Loibl, MD

Sibylle Loibl, MD, of the German Breast Group and the Klinikum Offenbach in Germany, discussed the NeoALTTO findings at the European Cancer Congress, noting that this trial is one of several studies that all point to one conclusion: Pathologic complete response rates are lower in HER2-positive...

breast cancer

PIK3CA-Mutant Tumors Not Likely to Respond to Neoadjuvant HER2 Blockade

In early breast cancer patients receiving anti-HER2 therapy in the NeoALTTO trial, mutations in PIK3CA were associated with lower rates of pathologic complete response, according to a study reported at the 2013 European Cancer Congress by José Baselga, MD, Physician-in-Chief at Memorial...

issues in oncology
global cancer care

Global Oncology 2013: Disparities in Cancer Care 

While much progress has been made against cancer over the last century, a new report1 presented at the 2013 European Cancer Congress brings together evidence that not every patient benefits from it, nor even has the opportunity to benefit. The economics of cancer are daunting and the current model...

Expert Point of View: Elzbieta Senkus-Konefka, MD, PhD

Elzbieta Senkus-Konefka, MD, PhD, of the Medical University of Gdansk, Poland, the formal discussant of the paper at the European Cancer Congress, took exception with the authors’ conclusion that radiotherapy may not be effective in all subtypes. “I don’t agree that luminal B and HER2-enriched...

lymphoma

S9704 Trial: Autologous Transplantation as Consolidation in Aggressive Lymphoma

Autologous bone marrow or stem cell transplantation has had an important role in the treatment of aggressive lymphoma for several decades. The important results of the PARMA study1 demonstrated that patients in first relapse who remained chemosensitive had improved progression-free and overall...

lymphoma

Autologous Transplantation as Consolidation Improves Progression-Free Survival in Aggressive Non-Hodgkin Lymphoma

The strategy of autologous stem-cell transplantation as consolidation in high-intermediate– or high-risk diffuse aggressive non-Hodgkin lymphoma (NHL) has not been specifically examined in the rituximab (Rituxan) era. In the phase III Southwest Oncology Group (SWOG)-led intergroup 9704 trial...

issues in oncology

Consent Is Informed and Shared, But Is It Compassionate?

A 72-year-old, obese male patient and a poor operative candidate is diagnosed with esophageal carcinoma. He has multiple comorbidities and a past history of colon carcinoma. His staging workup, which included a colonoscopy, revealed recurrent colon carcinoma. Thus, we have a patient who we...

SIDEBAR: Shared Decisions: What Should We Expect?

There is growing interest by patients, policymakers, and clinicians in shared decision-making as a means to include patients in health decisions and translate patient evidence into clinical practice. Conceptually, sharing of information seems like a natural interplay between doctors and their...

Expert Point of View: Howard Hochster, MD

Addressing a presentation by Scott Kopetz, MD, PhD, at the 2013 Chemotherapy Foundation, Howard Hochster, MD, Yale University Cancer Center, New Haven, Connecticut, said he agrees with Dr. Kopetz about the need for expanded RAS testing. “Now we have two studies suggesting that tumors with all the...

issues in oncology

African Americans Report Receiving Few Positive Recommendations by Physicians About Joining Clinical Trial 

A study among African American patients with cancer who had declined to participate in a therapeutic clinical trial found that few patients reported receiving a positive recommendation from their physician to participate in the trial. “Patients gave multiple refusal reasons,” researchers led by...

lymphoma

Increased Ultraviolet Radiation Exposure May Protect Against HL, Particularly in Those With EBV-Positive Disease

Increased exposure to ultraviolet radiation may offer protection against Hodgkin lymphoma (HL), particularly against Epstein-Barr virus (EBV)-positive HL, according to a pooled analysis of studies involving 1,320 HL patients and 6.381 controls.  “Our pooled analysis of 7,701 participants from 4...

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