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issues in oncology

Cancer Informatics: A Future Necessity, but Challenges Abound

The National Cancer Policy Forum of the Institute of Medicine (IOM) recently convened a workshop on cancer informatics to examine and discuss needs and challenges facing biomedical researchers, which will in turn affect the way oncology is practiced in the future. “This is a time of huge scientific ...

palliative care

Summary of ASCO Provisional Clinical Opinion on Palliative Care

The ASCO provisional clinical opinion on palliative care recently published1 was based largely on data from seven published randomized controlled trials, including a phase III lung cancer trial by Temel and colleagues, which was the trigger for the new recommendations.2 The trial’s principal...

lung cancer

Not All KRAS Mutations Are Alike in Non–Small Cell Lung Cancer

Mutations in the KRAS oncogene play a critical role in cancer cell growth and resistance to treatment. In colorectal cancer, the presence of any mutant amino acid substitution in the K-Ras protein predicts a poorer response to targeted therapy. In non–small cell lung cancer (NSCLC), however, there...

lung cancer

An Expert Shares Insight into the Future of Lung Cancer Treatment

Despite growing national focus on early detection, prevention, and new molecular-based treatments, lung cancer persistently remains the number 1 cause of cancer death for men and women in the United States. The ASCO Post spoke to lung cancer specialist Paul A. Bunn, Jr, MD, Executive Director,...

SIDEBAR: Major Conclusions of the Surgeon General’s Report on Youth Tobacco Use

Cigarette smoking by youth and young adults has immediate adverse health consequences, including addiction, and accelerates the development of chronic diseases across the full life course. Prevention efforts must focus on both adolescents and young adults because among adults who become daily...

issues in oncology

Radiation Oncologists Are Discussing Infertility Risks with Young Patients

More than 80% of radiation oncologists discuss the impact of cancer treatments on fertility with their patients of childbearing age. This can lead to improved quality of life for young patients with cancer, according to a study in Practical Radiation Oncology.1 In the past, the clinical focus for...

prostate cancer

SELECT Trial Update: Vitamin E Fails to Prevent Prostate Cancer in Healthy Men, Appears to Increase Risk

Supplements touted as preventing prostate cancer may turn out to be dangerous, as is evident from updated results of the largest long-term prevention trial, called the Selenium and Vitamin E Cancer Prevention Trial (SELECT). Final analysis of SELECT showed that, compared to placebo, vitamin E alone ...

Expert Point of View: Short-term Hormone Therapy Did Not Increase Risk of Cardiovascular Death in Men with Localized Prostate Cancer, RTOG 94-08 Trial Finds

Oliver Sartor, MD, Medical Director of Tulane Cancer Center, New Orleans, said that in his opinion, RTOG 94-08 had some flaws because outdated radiotherapy doses were employed. “The utility of hormone therapy is questionable with today’s doses,” Dr. Sartor said. “Using standard radiation doses at...

prostate cancer

Short-term Hormone Therapy Did Not Increase Risk of Cardiovascular Death in Men with Localized Prostate Cancer, RTOG 94-08 Trial Finds

Short-term androgen deprivation therapy does not appear to increase cardiovascular mortality in men with clinically localized prostate cancer, according to a post hoc analysis of a large Radiation Therapy Oncology Group (RTOG)-sponsored clinical trial.1 “Our study analyzes data from a large...

Expert Point of View: Study Shows Concurrent Chemoradiation Therapy to be a Viable Strategy for Muscle-invasive Bladder Cancer

According to Seth P. Lerner, MD, Professor in the Scott Department of Urology at Baylor College of Medicine, Houston, and Co-chair of the session at the Genitourinary Cancers Symposium where the study by Mak and colleagues was presented, the data clearly demonstrate proof of principle that the...

bladder cancer

Study Shows Concurrent Chemoradiation Therapy to be a Viable Strategy for Muscle-invasive Bladder Cancer

Combined-modality therapy provides a bladder-sparing alternative to radical cystectomy with comparable outcomes in patients with muscle-invasive bladder cancer, according to a pooled analysis of six Radiation Therapy Oncology Group (RTOG) trials.1 The study included 468 patients and showed that...

George Kovach, MD, Named as President of the Association of Community Cancer Centers

George Kovach, MD, became President of the Association of Community Cancer Centers (ACCC) at its 38th Annual National Meeting in March 2012. Dr. Kovach is the medical director of the Genesis Cancer Center, Davenport, Iowa, and one of the founding members of the Iowa Oncology Society (IOS). “I am...

Expert Point of View: Controlled Study Links ‘Chemobrain’ to Longitudinal Changes in Brain

Commenting on the study by Deprez et al, Patricia Ganz, MD, noted the importance of the finding for clinicians. “This study tells us that self-reported complaints mapped onto the neuropsychologic tasks; this has not been shown very often,” said Dr. Ganz, who is Director of the Division of Cancer...

survivorship

Controlled Study Links ‘Chemobrain’ to Longitudinal Changes in Brain

The phenomenon called “chemobrain”—impaired cognitive functioning following chemotherapy—correlates with longitudinal changes in the brain’s white matter, according a recent study in the Journal of Clinical Oncology.1 Structural changes in the white matter, measured by magnetic resonance diffusion...

gastrointestinal cancer

Targeting KRAS in GI Cancers: The Hunt for the Holy Grail in Cancer Research

The RAS oncogenes are the most frequently mutated class of oncogenes in human cancers, and this has prompted a search for Ras inhibitors to effectively treat tumors with these mutations. Despite intensive efforts, however, none has materialized clinically because K-Ras is proving to be a very...

palliative care

ASCO Releases Palliative Care Provisional Clinical Opinion

ASCO has released a provisional clinical opinion (PCO) addressing the integration of palliative care services into standard oncology care.1 The ASCO Post recently spoke with one of the PCO’s lead authors, Thomas J. Smith, MD, Director of Palliative Care for Johns Hopkins Medicine and the Johns...

issues in oncology

‘We Need an Index of Biologic Aging’

As a retired elderly (soon to be 83-year-old) oncologist, I read the recent article on the subject of geriatric oncology, in the March 15 issue of The ASCO Post, with great interest ("Moving the Field of Geriatric Oncology Forward," by Stuart M. Lichtman, MD, FACP, FASCO.) This was particularly so...

health-care policy

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...

issues in oncology

Our Patients, Our Teachers

There is no greater professional satisfaction than the knowledge that you have cared for a patient and the care brought an improvement in the patient's health.  Regardless of the level of appreciation, whether the patient is cured or not, and even if the patient's sense of well-being may be...

breast cancer

Neoadjuvant Aromatase Inhibitor Therapy Converts Many Patients to Candidates for Breast-conserving Surgery

The American College of Surgeons Oncology Group (ACOSOG) Z1031 trial examined the effect of neoadjuvant aromatase inhibitor therapy on clinical response and breast-conservation rates in postmenopausal women with estrogen receptor (ER)-rich stage II or III breast cancer. An update of the surgical...

lung cancer

Nearly 800,000 Lung Cancer Deaths Averted during 1975–2000 Due to Decline in Smoking Rates

The cumulative impact of changes in smoking behavior that started in the mid-1950s averted approximately 795,851 U.S. lung cancer deaths, 552,574 among men and 243,277 among women from 1975 to 2000, according to a report in the Journal of the National Cancer Institute. The researchers also...

SIDEBAR: Expect Questions from Your Patients: Cervical Cancer Screening Guidelines

Changes in the cervical cancer screening guidelines, as recommended by the U.S. Preventive Services Task Force (USPSTF), mainly concern longer intervals between screening tests and recommended ages when women should start and stop being screened. USPSTF Co-Vice Chair Michael L. LeFevre, MD, MSPH,...

SIDEBAR: Women Who Received HPV Vaccine Still Need Cervical Cancer Screening

The updated cervical cancer screening guidelines from the the U.S. Preventive Services Task Force (USPSTF) note that women who receive the HPV vaccine still need to be screened for cervical cancer because the vaccine does not protect against all strains of HPV that can cause cervical cancer. “The...

SIDEBAR: Could HPV Testing Be Used Alone?

“In the United States, there are no recommendations currently for HPV screening alone as a primary screening test for cervical cancer,” Michael L. LeFevre, MD, MSPH, Co-Vice Chair of the U.S. Preventive Services Task Force (USPSTF) told The ASCO Post. “Cytology picks up very few cases of...

gynecologic cancers
issues in oncology

New Guidelines Recommend Less Frequent Screening for Cervical Cancer, but That Doesn’t Mean Screening Is Less Important

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. In March 2012, the U.S. Preventive...

issues in oncology

Changing the Course of Human Health through Bold Pursuits in Science

The synergy between industry, academic research, and regulatory bodies will play an increasingly important role in ensuring the future of a robust cancer drug pipeline. To gain insight on oncologic development trends, The ASCO Post recently spoke with Jean Pierre Bizzari, MD, Head of Global...

Institute of Medicine Report on Omics-based Testing Bolsters ASCO’s Blueprint for Transforming Cancer Research

A recent report by the Institute of Medicine (IOM) addresses elements that ASCO has stated are necessary for transforming the therapeutic development and clinical trial processes. In March, the IOM released the report “Evolution of Translational Omics: Lessons Learned and the Path Forward,” which...

Constructing a Top Five List in Oncology

The American Society of Clinical Oncology has joined the American Board of Internal Medicine (ABIM) Foundation and eight other medical specialty societies to take a collective stand in improving patient care and addressing rising health-care costs. As part of the ABIM Foundation’s Choosing Wisely®...

ASCO Guidelines Support Weight-based Chemotherapy Dosing

The American Society of Clinical Oncology supports research showing that it’s safe and effective for people with cancer—especially those who are obese—to receive higher chemotherapy doses based not on estimates but on their actual weight. Direct your patients to ASCO’s guidelines on weight-based...

issues in oncology

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...

colorectal cancer

Expert Point of View: ColoPrint Gene Assay Can Guide Treatment Decisions in Stage II Colon Cancer

Axel Grothey, MD, of the Mayo Clinic, Rochester, Minnesota, told The ASCO Post that he finds the data “intriguing” and that the study exemplifies the value of developing molecular signatures for use in colon cancer. “It identifies patients with an excellent prognosis, who perhaps should not be...

colorectal cancer

ColoPrint Gene Assay Can Guide Treatment Decisions in Stage II Colon Cancer

ColoPrint, an 18-gene expression profile assay for patients with early-stage colon cancer, accurately stratifies patients by recurrence risk and identifies a subset who can be adequately treated by surgery alone, investigators reported at the 2012 Gastrointestinal Cancers Symposium.1 According to...

multiple myeloma

Novel Agents and Genomic Sequencing Show Promise in Improving Multiple Myeloma Management

For over 30 years, 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 Institute in Boston, has focused his translational research on B-cell ...

breast cancer
kidney cancer
lung cancer
skin cancer
leukemia
lymphoma
issues in oncology

NCCN Clinical Practice Guidelines: Important Updates for 2012

The National Comprehensive Cancer Network (NCCN) Clinical Practice Guidelines in Oncology have become the most widely used guidelines in oncology practice. The Guidelines cover 97% of all patients with cancer and are continually updated by expert panels. The 2012 Guidelines include some completely...

issues in oncology

Caveat Oncologist: Counterfeit Pharmaceuticals

In 2002, Tim F., a 17-year-old liver transplant patient, received 40,000 units of erythropoietin weekly, beginning immediately after his transplantation procedure.1 His family had purchased the product from the local CVS Pharmacy, upon his discharge from a Manhattan hospital. After each injection,...

colorectal cancer

Expert Point of View: Novel Multikinase Inhibitor Improves Survival in Metastatic Colorectal Cancer

The results of the CORRECT trial created some degree of “buzz” at the 2012 Gastrointestinal Cancers Symposium, with experts predicting that regorafenib will become FDA-approved and have strong clinical utility. While numerically, the benefit appeared small, “There is a real difference with this...

colorectal cancer

Novel Multikinase Inhibitor Improves Survival in Metastatic Colorectal Cancer

The novel tyrosine kinase inhibitor regorafenib, given as a single agent to patients with treatment-refractory metastatic colorectal cancer, significantly improved overall survival and delayed disease progression in an international phase III trial presented at the 2012 Gastrointestinal Cancers...

head and neck cancer

I Refuse to Let Cancer Win

My battle with cancer started with a simple sore throat in June 2005. Despite two rounds of an antibiotic to clear up the problem, within 2 months my throat hurt so much I couldn’t swallow, and a mysterious lump had suddenly appeared on my tongue. By the end of August, I was diagnosed with stage...

kidney cancer

Partial Nephrectomy Can Optimize Survival in Patients with Early-stage Disease

Following recent clinical trial data from the European Organisation for Research and Treatment (EORTC) showing a survival benefit for patients with small kidney cancers treated with radical vs partial nephrectomy, an analysis using linked Surveillance, Epidemiology and End Results (SEER) and...

leukemia

Integrated Genetic Profiling Can Identify Predictors of Outcome and Improve Risk Stratification in AML Patients

A mutational analysis of 18 genes in 398 patients with acute myeloid leukemia (AML) found at least one somatic alteration in 97.3% of the patients and identified genetic predictors of outcome that improved risk stratification among patients with AML, independent of age, white-cell count, induction...

head and neck cancer

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...

breast cancer

Women Treated with Breast-conserving Surgery More Likely to Have Diagnostic and Invasive Procedures over Time

Women with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery “continue to have diagnostic and invasive breast procedures in the conserved breast over an extended period,” according to a study reported in the Journal of the National Cancer Institute. “The estimated 10-year...

breast cancer

Concepts about Effects of Menopausal Hormone Therapy on Breast Cancer Continue to Change

In 2002, it was thought that menopausal hormone therapy using estrogen alone increases breast cancer risk, although not as quickly as combined estrogen plus progestin. Current thinking about estrogen alone is that it reduces breast cancer risk. This is just one example of changing concepts about...

lymphoma

Two Cycles of Chemotherapy plus Involved-field Radiation Improves Tumor Control in Early Unfavorable Disease

Final analysis of the German Hodgkin Study Group (GHSG) HD14 trial concluded that intensified chemotherapy with two cycles of escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine [Matulane], and prednisone) followed by two cycles of ABVD (doxorubicin,...

issues in oncology
health-care policy

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...

Fellows of the American Society of Clinical Oncology: 2012 Recipients Will be Honored at ASCO Annual Meeting

Formerly called the ASCO Statesman Award, which launched in 2007, the new distinction of Fellow of the American Society of Clinical Oncology (FASCO) is designed to honor ASCO’s most active volunteer members. “The FASCO status represents recognition for the most dedicated volunteer members inside...

issues in oncology

Novel Initiative to Address Oncology Drug Crisis

Much has been written about the oncology drug shortage crisis in the United States. In the spirit of being part of the solution to that problem, a group of oncologists has formed the Citizen’s Oncology Foundation (COF). The goal of the start-up not-for-profit association is two-pronged: to find...

lung cancer
geriatric oncology

Canadian Registry Study of Adjuvant Therapy for NSCLC Shows Increased Use in Elderly Patients and Improved Survival

Cisplatin-based adjuvant therapy is recommended for patients with resected stage II–IIIA non–small cell lung cancer (NSCLC). There have been no trials of adjuvant therapy in elderly patients with NSCLC, who constitute a large part of the NSCLC population. A number of analyses indicate that older...

geriatric oncology

Geriatric Oncologists: A Small but Passionate Group

Although age is the major risk factor for developing cancer, geriatric oncology is still a relatively new discipline within the oncology community. To gain insight into this evolving component of cancer care, The ASCO Post recently spoke with a leader in the field, Stuart M. Lichtman, MD, FACP,...

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