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lung cancer

Time to Reconsider Treatment Paradigm for Elderly Patients with Advanced Non–Small Cell Lung Cancer?

Significantly longer median overall survival among elderly patients with advanced non–small cell lung cancer (NSCLC) receiving doublet chemotherapy rather than monotherapy yielded a 36% reduction in mortality risk in a phase III randomized trial. “We saw a survival benefit with doublet chemotherapy ...

cost of care

New Technologies Are Driving Up Costs: Are They Worth the Price?

Expensive new cancer therapies and technologies are alluring for both physicians and their patients. Prostate cancer, because of the sheer volume of cases and the variability of treatment options, serves as a dynamic disease model in the ongoing debate over how to curb spending and maintain...

ASCO Symposium Helps Practices Leverage Health IT, Understand EHR Policy Changes

To help community oncology practices and large institutions navigate recent health-care policy changes and leverage health information technology (HIT) to improve the quality of care, ASCO will hold the 2011 HIT/EHR Symposium at the Westin Peachtree Plaza in Atlanta on November 4–5. “This symposium ...

GI Symposium Helps Oncologists Stay Abreast of Fast-moving Research

Gastrointestinal cancers are a key therapeutic area in research, and science is moving forward in that arena at a fast clip. But how are those who focus on gastrointestinal malignancies in the clinic supposed to stay on top of it all? One great way is to attend the annual Gastrointestinal Cancers...

Susan Halabi, PhD, Is Helping to Fund Future of Cancer Research

Susan Halabi, PhD, thinks in terms of probabilities. Based at Duke University School of Medicine, where she is an Associate Professor of Biostatistics and Bioinformatics, Dr. Halabi specializes in the design and analysis of clinical trials, statistical analysis of biomarker and microarray data, and ...

issues in oncology
cost of care

A Conversation with Richard J. Gilbertson, MD, PhD

St. Jude Children’s Research Hospital, Memphis, the country’s first and only NCI-designated Comprehensive Cancer Center devoted solely to children, recently appointed internationally regarded pediatric brain tumor researcher, Richard J. Gilbertson, MD, PhD, as its new Cancer Center Director. In a...

health-care policy

AACR Issues Landmark Report on Cancer Progress

At a recent press conference in Washington, DC, the American Association for Cancer Research (AACR) assembled luminaries from the cancer research and care communities to discuss the salient points of the association’s newly released progress report on the current and future state of cancer research ...

breast cancer

T-DM1: Antibody Drug Conjugate Outperforms Standard Anti‑HER2 Therapy in Metastatic HER2-positive Breast Cancer

The investigational antibody-drug conjugate T-DM1 improved progression-free survival over standard chemotherapy with docetaxel plus trastuzumab (Herceptin) when given as first-line treatment of HER2-positive metastatic breast cancer, according to an open-label phase II study reported at the 2011...

survivorship

Helping Cancer Survivors Return to Work

For many of the 12 million cancer survivors throughout the United States, remaining in the workforce is an important expectation that requires the support and attention of the oncology community. And while continuing employment can be critically important for economic reasons (especially in the...

issues in oncology

Do We Need the USPSTF?

Like most of the folks reading this commentary, I’m a taxpayer. Although I sometimes become impatient with the strategic games on Capitol Hill, I basically appreciate that government helps many things to work, and some of them even work well. However, there are aspects of government function that...

lung cancer

NSCLC Studies: Bevacizumab/Pemetrexed Maintenance Improves Survival, KRAS Status Has No Impact on Outcomes with Sorafenib

Maintenance therapy with bevacizumab (Avastin) plus pemetrexed (Alimta) showed a modest improvement in progression-free survival vs bevacizumab alone in patients with advanced non–small cell lung cancer (NSCLC), according to the final analysis of the AVAPERL study. In a separate study, selecting...

breast cancer

Everolimus Overcomes Resistance to Hormonal Therapy in Advanced Breast Cancer

Adding everolimus (Afinitor) to exemestane in postmenopausal women with advanced breast cancer resistant to aromatase inhibitors significantly improved outcomes, according to the phase III BOLERO-2 trial reported at the 2011 European Multidisciplinary Cancer Congress, held September 23–27 in...

breast cancer

FDA Commissioner Announces Decision on Bevacizumab

On November 18, FDA Commissioner Margaret A. Hamburg, MD, said she is revoking the agency’s approval of the breast cancer indication for bevacizumab (Avastin) after concluding that the drug has not been shown to be safe and effective for that use. Bevacizumab will still remain on the market as an...

health-care policy

ASCO Supports the United Nations Political Declaration on Noncommunicable Diseases

In September, government leaders from around the world as well as representatives from civil society, the private sector and academia gathered at the United Nations in New York for the first-ever summit on the growing economic and human crisis posed by noncommunicable diseases (NCDs), especially in ...

breast cancer

Fewer False-positives, Small Increased Risk of Late Diagnosis with Biennial Mammography

Screening mammography every other year reduced false-positive recalls by about one-third compared to annual screening, but was associated with a small increase in the probability of late-stage cancer diagnosis, according to a study funded by the NCI and published in Annals of Internal Medicine. To...

colorectal cancer

Should Age at Initial Screening Colonoscopy Be Younger for Men?

A study to investigate the most appropriate age for initial screening colonoscopy to improve detection of adenomas, advanced adenomas, and colorectal cancer, and lower colorectal cancer mortality found that the most appropriate age might be different for men and women. “In our study, analysis of...

breast cancer

Adjuvant Trastuzumab in Nonanthracycline Regimen Studied

One of four large, randomized trials to evaluate adjuvant trastuzumab (Herceptin) in early-stage HER2-positive breast cancer—and the only study to include a nonanthracycline chemotherapy regimen—found that regimen had similar efficacy to anthracycline-containing regimens, but with lower rates of...

SIDEBAR: Expect Questions from Your Patients

Young women with early-stage breast cancer “should be counseled appropriately regarding their treatment options, and should not choose a mastectomy based on the assumption of improved survival,” maintained investigators presenting a retrospective study at the 2011 Breast Cancer Symposium. Their...

breast cancer

Challenging Perceptions about Treatment Options for Younger Women with Early-stage Breast Cancer

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. “There is a perception out there...

cost of care
issues in oncology

A Conversation with Craig B. Thompson, MD

In November 2010, Craig B. Thompson, MD, was named President and CEO of Memorial Sloan-Kettering Cancer Center (MSK) in New York, succeeding Harold Varmus, MD, who is now Director of the NCI. A cancer clinician and researcher, before coming to Memorial Sloan-Kettering Dr. Thompson was Director of...

Expert Point of View: ‘Breakthrough’ Approach to Advanced Basal Cell Carcinoma via Inhibition of Hedgehog Pathway

“Vismodegib is a breakthrough for advanced basal cell carcinoma. These responses were convincing and spectacular, with a clinical benefit in more than 80% of patients and progression-free survival of 10 months,” said Caroline Robert, MD, Institut Gustav Roussy, Villejuif Paris-Sud, France, who was...

lung cancer

Improved Survival with Concurrent Chemotherapy plus Radiotherapy for Patients with Stage III Non–Small Cell Lung Cancer

Five-year survival was statistically significantly higher for patients with stage III non–small cell lung cancer (NSCLC) who received concurrent rather than sequential cisplatin-based chemotherapy combined with thoracic radiotherapy, according to the phase III Radiation Therapy Oncology Group...

Expert Point of View: Lessening Patients’ Suffering at the End of Life

In her interview with The ASCO Post, Judith Redwing Keyssar, RN, sheds light on easing the suffering of patients facing the end of life. Although what she says is appropriate for patients who are clearly dying, I would emphasize that palliative care is also pertinent to patients who are not...

palliative care

A Conversation with Judith Redwing Keyssar, RN

The number of patients seeking hospice and palliative care has grown significantly since 1974, when the NCI funded the first hospice facility in Branford, Connecticut. Nevertheless, according to the National Center for Health Statistics, 85% of Americans still die in hospitals or nursing homes....

head and neck cancer

FDA Approves Cetuximab to Treat Metastatic Head and Neck Cancer

On November 7, the FDA approved cetuximab (Erbitux) in combination with platinum-based therapy plus fluorouracil (5-FU) for the first-line treatment of patients with recurrent locoregional disease and/or metastatic squamous cell carcinoma of the head and neck. The approval was based primarily on...

geriatric oncology

Geriatric Oncology, a Much Needed Discipline for Future Cancer Care

The U.S. health-care system, with its rapidly aging population, faces a multitude of difficult clinical and financial challenges in caring for its burgeoning population of older patients with cancer. Moreover, age-related social and medical issues among older patients need to be addressed by a...

Expert Point of View: Chemotherapy Generally Safe in Pregnancy

Chemotherapy delivered in the first trimester is associated with a 10% to 30% risk of abortion and 10% to 25% risk of malformations. Therefore, it should be postponed until the second or third trimester, when most regimens appear to be safe, according to Nicholas Pavlidis, MD, of the University of...

issues in oncology

Chemotherapy Generally Safe in Pregnancy

The diagnosis of cancer in a pregnant woman causes concerns for both the mother and her unborn child. But studies suggest that most chemotherapy regimens can be delivered with reasonable safety after the first trimester. Cancer is diagnosed in about 1 per 1,000 to 2,000 pregnancies, mostly breast...

skin cancer

Investigators Unlocking the Mysteries of Merkel Cell Carcinoma

Researchers at the University of Pittsburgh Cancer Institute have documented the molecular activity through which the Merkel cell polyomavirus contributes to 80% of cases of Merkel cell carcinoma—a finding that holds promise for future therapies. The researchers are now working on testing more than ...

American Society of Hematology Recognizes Christoph Klein, MD, PhD, with William Dameshek Prize

The American Society of Hematology (ASH) will honor ­Christoph Klein, MD, PhD, of Children’s Hospital, Ludwig-Maximilians University in Munich, Germany, with the 2011 William Dameshek Prize, at the upcoming Annual Meeting in San Diego. Dr. Klein is being recognized by ASH for his many...

issues in oncology

Biosimilars in Cancer Treatment: What Should the Oncology Community Expect?

Alternative versions of biologic agents, ie, “biosimilars,” will presumably be getting the green light by the FDA, giving oncologists more choices for treatments that come at lower costs to patients and society. The FDA plans to issue its guidance on biosimilars by the end of this year, paving the...

breast cancer

Tamoxifen vs Surgery Study Shows Older Patients with Breast Cancer Can Achieve a ‘Personal Cure’

A truly final review—when all the patients in the trial have died and the cause of death is known for each—of a randomized trial comparing tamoxifen to surgery in patients over the age of 70 with operable breast cancer found no differences in the survival rates or deaths attributable to breast...

Expert Point of View: Hypofractionated Radiotherapy Effectively Controls High-risk Prostate Cancer

The take-home message of the study findings from the Fox Chase trial reported at the 53rd ASTRO Annual Meeting plenary session supports the use of hypofractionated intensity-modulated radiotherapy as a more convenient and cost-effective alternative than conventional IMRT, according to formal...

prostate cancer

Hypofractionated Radiotherapy Effectively Controls High-risk Prostate Cancer

The use of hypofractionated intensity-modulated radiotherapy (IMRT) appears to be a reasonable option for men with intermediate- to high-risk prostate cancer,1 reported Alan Pollack, MD, Chairman of Radiation Oncology at the University of Miami Miller School of Medicine in Miami and lead...

ASCO in Action Online: Your Source for Policy News and Information

The recently enhanced ASCO in Action site ascoaction.asco.org is a one-stop source for the latest policy news related to quality cancer care and research. Whether it is information about legislation that affects cancer patients or oncology practices, easy links to ASCO’s recent policy positions,...

Oncology’s Only Benchmark Report, National Practice Benchmark, Is Now a Yearly JOP Supplement

Would it surprise you to learn that 40% of your peers in oncology who responded to a survey last year have a certified electronic medical record system in place? Or that 86% of them are in physician-owned practices? Or that the average number of full-time equivalent hematology/oncology physicians...

Global Trials: Do Benefits Outweigh Pitfalls?

Global clinical trials have many advantages and are essential in many disease settings, but there are also challenges that confront global industry-sponsored research, said Sandra Horning, MD, Senior Vice President and Global Head of Clinical Development in Hematology/Oncology for Genentech (Table...

colorectal cancer

Despite Challenges, Combined-modality Therapy Warranted for Locally Recurrent Colorectal Cancer

Encouraging outcomes have been achieved with a combined-modality treatment approach for patients with locally recurrent colorectal cancer in both curative and palliative settings, although room for improvement remains. During a session presented at the American Society for Radiation Oncology...

prostate cancer

Fewer Rectal Side Effects with IMRT than with 3D-CRT for Prostate Cancer

The use of intensity-modulated radiation therapy (IMRT) is associated with fewer acute and late toxic effects than is three-dimensional conformal radiation therapy (3D-CRT) in men with localized prostate cancer, according to preliminary analysis of the Radiation Therapy Oncology Group (RTOG) 0126...

hematologic malignancies
leukemia
lymphoma
multiple myeloma

NCCN Meeting Addresses Issues in Hematologic Malignancies

The National Comprehensive Cancer Network (NCCN) 6th Annual Congress on Hematologic Malignancies, held recently in New York, included reviews of the management of hematologic diseases as well as discussions of outstanding issues in the field. The following is a synopsis of some of the important...

Expert Point of View: Novel HDAC Inhibitor May Restore Estrogen Sensitivity in Breast Cancer

Joyce O’Shaughnessy, MD, of Baylor Sammons Cancer Center in Dallas, who moderated the symposium where the results were presented, called the use of entinostat in advanced estrogen receptor–positive breast cancer “very, very promising.” She added, “I agree that it’s time for a phase III trial of...

breast cancer

Novel HDAC Inhibitor May Restore Estrogen Sensitivity in Breast Cancer

The addition of the investigational histone deacetylase (HDAC) inhibitor entinostat significantly delayed breast cancer progression and showed a trend for a survival benefit in the phase II ENCORE 301 study. The study was conducted in women with advanced estrogen receptor–positive breast cancer...

issues in oncology

Chemotherapy Drug Shortages: A Preventable Human Disaster

The issue of chemotherapy drug shortages continues with no end in sight. Many heartfelt human interest stories have been told on television, in newspapers, and even to Congress, but the bottom line is that little, if any, action has been taken. Uniquely American Problem News of the generic...

issues in oncology

Important Lessons for Oncology from the Front Lines of the AIDS Pandemic

On June 5, 1981, the CDC issued a warning about a rare type of pneumonia discovered among a small group of young gay men in Los Angeles, later determined to be AIDS-related, ushering in the HIV/AIDS epidemic. Early on, AIDS-related malignancies brought the oncology community into this formidable...

Expert Point of View: Aflibercept Improves Overall Survival in Patients with Metastatic Colorectal Cancer

David Kerr, MD, of the University of Oxford, United Kingdom, who is also President of the European Society of Medical Oncology, formally discussed the study, which he called “well designed and well conducted.” He applauded the investigators for performing a preplanned subgroup analysis with a...

colorectal cancer

Aflibercept Improves Overall Survival in Patients with Metastatic Colorectal Cancer

The novel fusion protein aflibercept added to standard chemotherapy led to an overall survival benefit in a global phase III trial of second-line metastatic colorectal cancer, reported at the 2011 European Multidisciplinary Cancer Congress in Stockholm.1 “Adding aflibercept to FOLFIRI [leucovorin,...

symptom management

Neural Stem Cell Transplantation May Improve Cognitive Function in Brain Cancer

The potentially devastating long-term consequences on cognitive function in patients with brain cancer following cranial irradiation led Charles L. Limoli, PhD, Professor of Radiation Oncology, University of California, Irvine, to study neural stem cell transplantation and how the procedure may...

SIDEBAR: Expect Questions from Your Patients

Patients concerned about an increased risk of cancer among recipients of organ transplantation need to know that “in the great majority of cases, patients don’t get cancer,” according to Eric Engels, MD, MPH, lead author of the Transplant Cancer Match Study report and Senior Investigator, Division...

issues in oncology
solid tumors
hematologic malignancies

Solid Organ Transplant Recipients Have Increased Risk for Broad Range of Malignancies

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. The Transplant Cancer Match Study, a ...

breast cancer
survivorship

Significant Neurologic and Executive Function Impairment among Breast Cancer Survivors

Women who survive breast cancer show significant neurologic impairment, with outcomes appearing to be significantly poorer for those treated with chemotherapy, according to a report in the Archives of Neurology. Investigators at Stanford University School of Medicine in California conducted an...

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