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Showing 1501 - 1550Erwinia chrysanthemi Asparaginase for Acute Lymphoblastic Leukemia in Patients with Hypersensitivity to E coli–derived Asparaginase
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 Erwinia chrysanthemi asparaginase (Erwinaze) was...
ASCO Advocates for Solutions to Oncology Drug Shortage Crisis
ASCO continues to call for three specific actions by Congress to help avert shortages of essential treatments for children and adults living with cancer. ASCO President Michael P. Link, MD, outlined the priorities in February at an FDA news briefing on the recent methotrexate and liposomal...
Surgeon General Releases New Report on Youth Smoking
The fight against tobacco use among young people was accelerated recently by Surgeon General Regina M. Benjamin, MD, MBA, with the release of the Surgeon General’s Report, Preventing Tobacco Use Among Youth and Young Adults. This report details the scope, health consequences, and influences that...
NCCN Announces New Guidelines for Adolescent and Young Adult Oncology
The National Comprehensive Cancer Network (NCCN) announced that it has issued new NCCN Clinical Practice Guidelines in Oncology for Adolescent and Young Adult (AYA) Oncology.1 Adolescent and young adult patients are defined in the guidelines as individuals 15 to 39 years of age at initial cancer...
ACCC Meeting Focuses on Affordable Care Act: Its Future, and What It Might Accomplish
The Association of Community Cancer Centers (ACCC) mid-March Annual Meeting devoted several sessions to the Patient Protection and Affordable Care Act: Will it still be here after the Supreme Court decides its fate? If so, how much of it will survive, and how will it affect oncology practice? In...
Quality of Life Is What’s Most Important to Me
For me, getting a cancer diagnosis has been more annoying than frightening. Mainly, I’m annoyed at myself for not taking care of an anal skin tag sooner. (I’d had it since birth.) The growth hadn’t been a problem until I got pregnant with my first child and it became temporarily engorged with...
Clinical Findings and Consequences of Distributing Counterfeit Drugs for Hematology and Oncology
As introduced in our report on page 1 of this issue, counterfeit pharmaceuticals are an increasingly important safety concern, and three of the most prominent drug-counterfeiting episodes in recent years have involved hematology/oncology products. Counterfeit Erythropoietin Helen B., a 61-year-old...
Younger Patients Treated with Systemic Carboplatin at Higher Risk of Ototoxicity
Patients younger than 6 months at the start of systemic carboplatin treatment for retinoblastoma have a significant risk of developing hearing loss, according to a study in the Journal of Clinical Oncology. A review of audiologic test results of 60 patients with retinoblastoma who received...
Update on Oncology Drug Shortage: Better for Now, But Permanent Solutions Must Address Underlying Issues
Over the past few years, drug shortages in the United States have been on the rise, involving hundreds of agents, many of which are lifesaving medications for patients with cancer. In recent months, the FDA has taken steps to alleviate some of the most critical oncology drug shortages. “We should...
Oncology Professionals and Leaders to be Honored at ASCO Annual Meeting
ASCO is recognizing researchers, patient advocates, and leaders of the global oncology community through its Special Awards Program at this year’s Annual Meeting in Chicago. Recipients of ASCO’s special awards collectively represent significant strides in cancer treatment and leadership in the...
FDA Reminds Public about Potential for Life-threatening Harm from Accidental Exposure to Fentanyl Patches
The FDA has issued a statement reminding patients, caregivers, and health-care professionals of the importance of appropriate storage, use, application, and disposal of fentanyl transdermal systems (including Duragesic and generic products) to prevent potential life-threatening harm from accidental ...
Untreated Cancer Pain Remains a Significant Global Problem
“Physicians are afraid of morphine … Doctors [in Kenya] are so used to patients dying in pain … they think that this is how you must die. They are suspicious if you don’t die this way — [and feel] that you died prematurely.” —Human Rights Watch interview with Dr. John Weru of Nairobi Hospice,...
Study Shows Steady Increases in Survival for Children with ALL
A study by the Children’s Oncology Group (COG) reported that 5-year survival for acute lymphoblastic leukemia (ALL) among children treated through COG clinical trials increased from 83.7% during the period 1990-1994 to 90.4% in the period 2000-2005. The improvements in survival were observed among...
Immunotherapy Clinical Trials Show Benefits for Patients with Advanced Cancers
Immunotherapeutic approaches, including vaccines, a monoclonal antibody, and a combination of low-dose interleukin (IL)-2 (Proleukin) and retinoic acid, are showing some success in clinical trials investigating the prevention of breast cancer recurrence in women at high risk, the treatment of...
SIDEBAR: Obese Children with Cancer May Be at Greater Risk for Cancer Recurrence
A study published in the Journal of Clinical Oncologyin 2008 found that obesity is an important contributing factor to chemotherapy resistance and rising relapse rates in children with leukemia.1 According to the study, obese children diagnosed with leukemia have a 50% higher chance of relapsing...
ASCO Issues New Guideline on Chemotherapy Dosing for Obese Patients
In April, ASCO released a new clinical practice guideline on the appropriate dosing of chemotherapy drugs given to obese adult patients with cancer. The result of an analysis by a panel of experts assembled by ASCO, the guideline calls for the use of a patient's actual body weight when calculating...
Pediatric ALL with Induction Failure Is Highly Heterogeneous with Varying Outcomes
While failure of remission-induction therapy is rare in children and adolescents with acute lymphoblastic leukemia (ALL), when it does occur it is highly adverse and heterogeneous, according to a study in The New England Journal of Medicine. “Patients who have T-cell leukemia appear to have a...
Low-dose Radioiodine as Effective as High-dose in Thyroid Ablation
Two studies in The New England Journal of Medicine found that low-dose radioiodine is as effective as a high-dose strategy in treating patients with thyroid cancer and that recombinant human thyrotropin (thyrotropin alfa [Thyrogen]) and thyroid hormone withdrawal had similar efficacy in preparing...
Surviving the Aftermath of Cancer
With medical information now just a click away, it’s difficult to imagine a time before the Internet existed, when finding answers to questions about serious diseases was nearly impossible. When I was diagnosed with liposarcoma 33 years ago, there was only one oncologist in my hometown of Tyler,...
ASCO Reexamines the Oncology Workforce Shortage
A study commissioned by ASCO in 2006 predicted a significant shortage of medical and gynecologic oncologists in the United States by 2020. As a result, the organization created the Workforce Implementation Group to develop recommendations to stem the projected workforce shortfall and ensure ongoing ...
Risk Stratification and Targeted Therapy, Abetted by Collaboration, Improve Outcomes for Children with Cancer
Outcomes for children with cancer have “improved over the course of the years incrementally, mostly not from the development of new drugs, because virtually all the drugs that we use now in leukemia were available in the 1970s. It is really through better understanding of the heterogeneity of the...
Can Whole-genome Sequencing Predict Cancer Risk and Improve Public Health?
If, as expected, the cost of whole-genome sequencing continues to drop, perhaps down to the $1,000 vicinity, it may become an alluring option for consumers who want to know about their risks for cancer and other diseases. But can genome sequencing really provide practical information about...
Crizotinib Yields Benefits in Aggressive Pediatric Tumors
The value of the targeted agent crizotinib (Xalkori) may not be restricted to the 5% of patients with non–small cell lung cancer who have abnormalities in the ALK gene. In a phase I study conducted by the Children’s Oncology Group consortium, crizotinib halted tumor growth and, in some cases,...
Dana-Farber Researcher’s Work with Partners in Health Brings Quality Cancer Care to Rwanda
Lawrence N. Shulman, MD, Chief Medical Officer at Dana-Farber Cancer Institute, grew up in New York City. A product of the public school system, Dr. Shulman entered Syracuse University as a history major, only to realize that studying the past, although important, wasn’t for him. “I wanted a field...
From Small-town House Calls to Bone Marrow Transplants, Nobel Laureate Continues Father’s Legacy
“I echo the sentiments of many previous Nobel laureates when I say that the success we celebrate today was made possible by the work of many others in this and in related fields.” So ended the Nobel Lecture by E. Donnall Thomas, MD, the famed investigator and 1990 Nobel Laureate in Physiology or...
Everolimus: New Indication in Renal Angiomyolipoma Associated with Tuberous Sclerosis Complex
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 April 2012, the kinase inhibitor everolimus...
Cancer Care in Rwanda: A Model of Creative Partnerships
While disparities in cancer care remain problematic in wealthy industrial nations like the United States, the challenges faced in poorer regions of the world are, by comparison, inestimable. Nationally regarded health-care expert Lawrence N. Shulman, MD, of Dana-Farber Cancer Institute, is part of...
Sarcoma Foundation of America Teams with Conquer Cancer Foundation to Fund Potentially Life-saving Research
When Matthew Alsante signed on to serve as Executive Director of the Sarcoma Foundation of America (SFA) 6 years ago, he had a visceral understanding of the importance of the organization’s work. Mr. Alsante had lost his father to lung cancer in 1999. “Right up until the last day of his life, if...
After a Decade of Decline in Smoking Rates, Progress Has Stalled
Approximately 20% of all Americans smoke, and 443,000 of them will die each year as a result. Tobacco use is the leading cause of preventable death in the United States and the greatest behavioral determinant of morbidity and mortality (6%–10% of U.S. health-care costs). Nearly 30% of all cancer...
ASCO Studies Point to Risks Associated with Treating Childhood Cancers
Risks associated with being a young cancer survivor were emphasized by two studies highlighted in press briefings at the 2012 ASCO Annual Meeting. Investigators from the Children’s Oncology Group (COG) reported that adolescents and young adults treated for high-risk B-precursor acute lymphoblastic ...
The Affordable Care Act Stands: Now What?
On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law—a hotly contested bill that enacted sweeping changes to the U.S. health-care system. The debate over the Affordable Care Act continued all the way to the Supreme Court, spearheaded by the case Florida...
Children with Favorable-risk Disease and Complete Response to Chemotherapy Have High Survival Rates without Radiotherapy
Among children with favorable-risk Hodgkin lymphoma, those who achieved a complete response after two cycles of chemotherapy and received no radiotherapy had high rates of survival similar to those who had a less complete response to chemotherapy and received radiotherapy, according to a study in...
‘Young and Strong’ Program Addresses Multiple Needs of Women in 40s and Younger Diagnosed with Breast Cancer
“Young and Strong” is an exportable model of a program developed at Dana-Farber Cancer Institute and Brigham and Women’s Hospital in Boston to address the significant challenges facing young women with breast cancer. The new model has been designed to “serve young women with breast cancer who are...
FDA Approves Colon-cleansing Drug for Prep Prior to Colonoscopy
The FDA has approved sodium picosulfate, magnesium oxide, and citric acid (Prepopik) to help cleanse the colon in adults preparing for colonoscopy, Ferring Pharmaceuticals announced. The new solution is a low-volume, dual-acting stimulant and osmotic laxative. The FDA approval is based on data from ...
Expert Point of View: James O. Armitage, MD
In an accompanying editorial entitled “Who Benefits From Surveillance Imaging?” James O. Armitage, MD, University of Nebraska Medical Center, Omaha, noted that data on surveillance imaging (CT or PET/CT) indicate a general absence of survival benefit in adults with lymphomas, while pointing out...
Study Shows Routine CT Surveillance Overused in Pediatric Hodgkin Lymphoma
The value of routine CT surveillance monitoring of pediatric patients for recurrence of Hodgkin lymphoma has been unclear. A study of CT surveillance recently reported by Stephan D. Voss, MD, PhD, and colleagues from the Children’s Oncology Group (COG) in the Journal of Clinical Oncology showed...
SIDEBAR: Dating among Adolescents and Young Adults with Cancer
How do you tell somebody you are dating that you have cancer or that you may not be able to have children? These are among the issues explored in “Dating and Disclosure for the Cancer Patient,” part of a new book, Sexuality and Cancer, scheduled for release in the fall by Springer, New York. “The...
SIDEBAR: Don’t Expect Questions: Be Proactive with Younger Patients
It is unrealistic to expect adolescents and young adults with cancer to initiate questions about disease-related or or treatment-related issues that are troubling them, according to Bradley Zebrack, PhD, MSW, MPH, Associate Professor of Social Work at the University of Michigan, Ann Arbor....
SIDEBAR: Unique Considerations for Radiation Exposure in Children
There are three “unique considerations” for radiation exposure in children, according to Radiation Risks and Pediatric Computed Tomography (CT): A Guide for Health Care Providers, an educational leaflet for health-care providers that was developed by the NCI: Children are considerably more...
SIDEBAR: Expect Questions from Parents
Results of a study finding that exposure to radiation from multiple CT scans in childhood can triple the risk of leukemia and brain tumors may cause some parents to question the overall benefit of CT scans and to directly question physicians. “The three key questions that parents can ask are: (1)...
CT Scans in Childhood Can Triple Risk of Leukemia and Brain Cancer Later in Life, Study Finds
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. Computed tomography scans with...
A Leading Light in Cancer Advances, Mary Lasker Used Wealth and Connections to Increase Funding for Medical Research
Born in Watertown, Wisconsin, in 1900, Mary Woodard Lasker was introduced to the ravages of cancer when she was just 3 or 4 years old and went with her mother to visit the family’s laundress, Mrs. Belter, who had just undergone surgery for breast cancer. On the way over to Mrs. Belter’s home, Ms....
First Drug for Children with Rare Brain Tumor Approved
The FDA approved a new pediatric dosage form of everolimus (Afinitor Disperz) to treat the rare brain tumor called subependymal giant cell astrocytoma (SEGA). This is the first approved pediatric-specific dosage form developed for the treatment of a pediatric tumor. Afinitor Disperz is recommended...
On Mentoring: Looking Back with Gratitude and Paying It Forward
Upon graduation from medical school, doctors are given a gift that lasts a lifetime—the gift of respect. That respect needs to be re-earned every day, but it is accompanied by other rewards that come with caring for people: the ability to gain another’s trust, to reverse illness that alters the...
Cancer Memoir Provides Inspiration for Those with Terminal Illness and Their Caregivers
“It almost always begins in darkness, my memory’s trip back to China where Terrence and I meet.” So begins Amanda Bennett’s moving new memoir, The Cost of Hope, the story of an intensely devoted marriage, cruelly shortened by the cancer that killed her husband. The word “darkness” in Ms. Bennett’s...
New Studies Explore Exposure to Cancer-causing Agents
Key studies on cancer epidemiology and prevention delivered both reassuring and not-so-reassuring findings on exposure to agents believed to be cancer-promoting. Kala Visvanathan, MD, MHS, of The Sidney Kimmel Cancer Center, Johns Hopkins School of Medicine and School of Public Health, Baltimore,...
Childhood Radiation Increases Breast Cancer Risk
The risk of developing breast cancer after receiving radiotherapy to the chest as a child are as high as those for BRCA1/2 mutation carriers, according to review of 1,268 cancer survivors and 4,570 female first-degree relatives of participants in the Women’s Environmental Cancer and Radiation...
Pediatric Pathologist Sidney Farber, MD: The ‘Father of Modern Chemotherapy’ and Cofounder of the Jimmy Fund
In June 3, 1948, The New England Journal of Medicine published a study by Sidney Farber, MD, showing that a synthetic compound, 4-aminopteroylglutamic acid (aminopterin), could induce remissions in seriously ill children with acute leukemia.1 Although the study was small—just 16 children—10 showed...
Viral Infection and Liver Cancer: A Global Health Crisis
It is estimated that at least 15% of all cancers worldwide can be attributed to infectious etiologies, mostly viral infections. At this year’s ASCO Annual Meeting, an intriguing session on virally induced cancers provided critical clues that could be of real practical value in advancing our battle...
On Mentoring: Looking Back with Gratitude and Paying It Forward
Upon graduation from medical school, doctors are given a gift that lasts a lifetime—the gift of respect. That respect needs to be re-earned every day, but it is accompanied by other rewards that come with caring for people: the ability to gain another’s trust, to reverse illness that alters the...
