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head and neck cancer

Elective Neck Dissection Beats Watch and Wait Approach in Early Oral Cancer

Elective neck dissection of node-negative early-stage oral cancer at the time of primary surgery improves overall survival and disease-free survival compared with therapeutic neck dissection (ie, therapeutic neck dissection at the time of nodal relapse, or “watch and wait” approach), according to a ...

lung cancer

Date of Last Chemotherapy Is Not a Proxy for Deciding When to Stop Treating Metastatic NSCLC

“Patients, their families, and oncologists recognize the administration of chemotherapy near death as aggressive and poor-quality care,” William F. Pirl, MD, MPH, and colleagues from Massachusetts General Hospital, Boston, wrote in the Journal of Oncology Practice. “However, rates have been slowly...

issues in oncology

Significant Differences in Age at Diagnosis Between Blacks and Whites for Six Types of Cancer

Although blacks were diagnosed at a younger age than whites for nearly every cancer type, after adjustments for population structure shifted the comparisons toward older ages among blacks, only six statistically significant differences of 3 or more years remained, according to a study in the...

Expect and Encourage Questions About the Benefits and Harms of Cancer Screening

Issuing advice for high-value care in screening for five common cancers, the High Value Care Task Force of the American College of Physicians (ACP) stated: “The target audience for this paper is all clinicians. The target patient population is average-risk, asymptomatic patients.” “What we tried...

issues in oncology

Agreement on High-Value Screening for Five Common Cancers

Finding agreement on high-value cancer screening among organizations publishing screening guidelines, the American College of Physicians (ACP) issued advice listing the least-intensive screening strategies that all the organizations recommend—as well as strategies not recommended—for five common...

Noted Pediatric Oncologist, Robert J. Arceci, MD, PhD, Dies

Over the past 50 years, great strides have been made in diagnosis, treatment, and survival of childhood cancer. In the 1960s, the probability of survival for a child with cancer was less than 25%, whereas today it may exceed 80%. This incredible cancer success story has been made possible by the...

Clara D. Bloomfield, MD, FASCO: Never One to Back Down From a Challenge

Clara D. Bloomfield, MD, FASCO, always sat in the front row at school. She grew up during a rigidly paternalist period in American society, and her early feminist leanings were brushed aside as grade-school adventures. The medical school lecture room of the 1960s was a male-dominated culture, and...

integrative oncology

The Pediatric Fitness Program: A Mind-Body Approach

The fundamental challenge in treating children with cancer centers on how to help relieve their suffering while they undergo difficult care. Typically, they do not yet have adult coping skills, and even if they had some ability to cope, many of the issues they face during treatment are...

ASCO Members, Public Working Together to ‘Take Down’ Cancer

From Wrigley Field to McCormick Place, Chicago residents and visitors felt the energy surrounding the launch of The Campaign to Conquer Cancer during the ASCO 2015 Annual Meeting. The Conquer Cancer Foundation of the American Society of Clinical Oncology (CCF) threw out the ceremonial first pitch...

ASCO Releases Payment Reform Proposal to Support Higher Quality, More Affordable Cancer Care

ASCO has released a proposal to significantly improve the quality and affordability of care for cancer patients. Expanding on a payment model circulated last year, the ASCO proposal would fundamentally restructure the way oncologists are paid for cancer care in the United States, by providing...

ASCO QOPI® Certification Program Benefits Oncology Practices and Patients

Christa Braun-Inglis, MS, NP, has seen her last three practices certified through ASCO’s Quality Oncology Practice Initiative (QOPI®). Ms. Braun-Inglis, a nurse practitioner with Kaiser Hawaii Region, was not solely responsible for the designations, although she helped some of the practices become...

2015 Breast Cancer Symposium to Encourage Collaboration in Patient Care, Education, and Research

ASCO’s educational symposia have historically provided attendees with a forum for learning and discussion, demonstrating ASCO’s commitment to promoting a network of global oncology expertise. The 2015 Breast Cancer Symposium, to be held in San Francisco, California, from Friday, September 25, to...

lung cancer

Pembrolizumab in Advanced NSCLC: The Promise of Immune Checkpoint Inhibitors

Drugs targeting the immune-checkpoint pathways have shown promising activity in non–small cell lung cancer (NSCLC). In a recent article in The New England Journal of Medicine, Garon and colleagues reported the results of the KEYNOTE-001 clinical trial evaluating single-agent pembrolizumab...

lung cancer

PD-1 Inhibitor Pembrolizumab Active in Advanced NSCLC: Outcomes Better With Higher PD-L1 Expression

In the phase I KEYNOTE-001 trial reported in The New England Journal of Medicine,1 Edward B. Garon, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues found that the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda)...

breast cancer
issues in oncology

Assessing and Improving Imaging Interpretation in Breast Cancer Screening

The quality of mammography images has markedly improved over the past few decades. However, the quality of the interpretation of mammograms remains variable. That said, more than 38 million mammograms are performed annually in the United States. So said Diana Buist, PhD, Senior Scientific...

skin cancer

Oncolytic Immunotherapy in Melanoma: It’s Not All About PD-1

The benefit from immune-directed therapies in patients with advanced melanoma is not limited to the exploding field of checkpoint inhibitors. According to Robert Andtbacka, MD, Associate Professor of Surgical Oncology, at the Huntsman Cancer Institute at the University of Utah, Salt Lake City,...

cns cancers

Poliovirus for Glioblastoma Grabs National Attention

Researchers at The Preston Robert Tisch Brain Tumor Center at Duke University are being barraged by patients wishing to enroll in their clinical trial of an engineered poliovirus for recurrent glioblastoma. This comes as a result of a CBS 60 Minutes interview with lead researcher Matthias...

cost of care

Cost of Immunotherapy Projected to Top $1 Million per Patient per Year

If new immunotherapy combinations were administered to the half a million Americans dying of cancer each year, the nation’s price tag for treating them—for just 1 year—could top $174 billion, according to projections by Leonard Saltz, MD, Chief of Gastrointestinal Oncology and Chair of the Pharmacy ...

cns cancers

Investigators Update PVS-RIPO Data in Glioblastoma

At the 2015 ASCO Annual Meeting, Annick Desjardins, MD, Associate Professor of Neurology at Duke University Medical Center, presented a brief update on the ongoing study of oncolytic PVS-RIPO in glioblastoma, which now includes 24 patients.1 The median age of enrolled patients is 57, most have a...

hematologic malignancies

Pacritinib for Myelofibrosis: Effective in Patients With Thrombocytopenia

An emerging JAK inhibitor, pacritinib, appears not only effective in a broad population of patients with myelofibrosis but also among a subset with very low platelet counts, investigators from the global phase III PERSIST-1 trial reported at the 2015 ASCO Annual Meeting.1 “There is a huge unmet...

cost of care

UAB Study on Lay Navigation Program Shows Trend Toward Cost Savings

Researchers from the University of Alabama at Birmingham (UAB) presented preliminary findings of an observational study indicating a rapid decline in Medicare costs and patient resource utilization during implementation of a lay navigation program. The study was presented at this year’s ASCO Annual ...

Expert Point of View: Anees B. ­Chagpar, MD

“This is an important study. We’ve known for some time that the aromatase inhibitors tend to be better than tamoxifen for postmenopausal women with hormonally sensitive invasive breast cancer. The NSABP B-35 trial asked the same question in ductal carcinoma in situ. These data, which now follow...

breast cancer

Anastrozole and Tamoxifen: Both Options for Ductal Carcinoma in Situ

Anastrozole was found to be at least as safe and effective as tamoxifen in preventing breast cancer recurrence in women with ductal carcinoma in situ, in the large NSABP B-35/SWOG-35 study.1 Among all women in the trial, however, the 10-year breast cancer–free interval rates were higher in women...

Expert Point of View: Shanu Modi, MD

Study discussant Shanu Modi, MD, of Memorial Sloan Kettering Cancer Center, New York, commented, “Neither T-DM1 [Kadcyla] nor T-DM1 plus pertuzumab [Perjeta] proved to be superior to the old standard of care, taxane plus trastuzumab [Herceptin]. MARIANNE was a valiant trial, but THP (taxane,...

issues in oncology

How CancerLinQ™ Can Benefit People Living With Cancer

As a regular readers of The ASCO Post know, ASCO is developing an exciting new health information learning system called CancerLinQ™, which will exponentially enlarge our understanding of cancer therapy far beyond what we’ve achieved with our system of clinical trials. Cancer clinical trials have...

issues in oncology

Biosimilars: Questions Remain

Biosimilars are biologic drugs that are similar to an already established “reference” or “innovator” biologic drug product and can be manufactured when an original biologic drug product’s patent expires. Reference to the innovator product is an integral component of approval for a biosimilar. The...

survivorship

Survivors of Childhood Cancer Living Longer, Largely Due to Treatment Improvements

Survivors of childhood cancers can expect longer lives than their peers of 30 years ago. Improvements in the care of children with cancer have reduced the long-term mortality rate, according to an analysis of 34,000 participants in the Childhood Cancer Survivor Study.1 Cumulative all-cause late...

thyroid cancer

Thyroid Cancer Rarely Diagnosed in Those With Asymptomatic, Benign Nodules

A prospective, multicenter, observational study involving 992 consecutive patients with one to four asymptomatic, sonographically or cytologically benign thyroid nodules found that “the majority of nodules exhibited no significant size change during 5 years of follow-up or actually decreased in...

leukemia

Durable Responses at 3-Year Follow-up for CLL Patients Receiving Single-Agent Ibrutinib

At a median follow-up of 3 years, ibrutinib (Imbruvica) demonstrated continued activity with durable responses that improved in quality with extended treatment of patients with chronic lymphocytic leukemia (CLL). In addition, grade 3 toxicity and adverse events leading to treatment discontinuation...

Expect Questions About Preventing Melanoma

A recent report from the Centers for Disease Control and Prevention (CDC) stated that the incidence of melanoma “doubled between 1982 and 2011, but comprehensive skin cancer prevention programs could prevent 20% of new cases between 2020 and 2030.”1,2 That report should serve to increase interest...

skin cancer

Capitalizing on Increased Interest in Skin Cancer During Summer to Reeducate People About Sunscreens and ‘Smart Sun Strategies’

Amid the encouraging studies reported at the 2015 ASCO Annual Meeting about advances in the treatment of melanoma was a troubling finding about the incidence of melanoma increasing. An analysis of data from nine Surveillance, Epidemiology, and End Results (SEER) registries found that the incidence...

skin cancer

Adjuvant Ipilimumab in High-Risk Stage III Melanoma: Encouraging Study Results Yet Questions Remain

Ipilimumab (Yervoy) is a fully human monoclonal antibody that blocks the negative T-cell regulator cytotoxic T-lymphocyte antigen 4 (CTLA-4) and has improved overall survival for patients with unresectable or metastatic melanoma in two phase III studies.1,2 Based upon these results, ipilimumab was...

integrative oncology

American Ginseng

The use of dietary supplements by patients with cancer has increased significantly over the past 20 years despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the ...

issues in oncology

FDA’s Pregnancy Category Labeling

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, FDA supervisory toxicologist Todd Palmby, PhD, and pharmacologist Eias Zahalka, PhD, MBA, discuss the approach taken in the Office of ...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia

Question 1: In this case, what is the most appropriate next best test? Correct Answer: B. Peripheral blood smear examination. Expert Perspective In the appropriate clinical setting, information obtained from a carefully examined peripheral blood smear film is indispensable. The peripheral blood...

Laura van’t Veer, PhD, Receives European Inventor Award 2015

Laura van’t Veer, PhD, Co-leader of the University of California San Francisco Helen Diller Family Comprehensive Cancer Center (HDFCCC) Breast Oncology Program, and her team at the Netherlands Cancer Institute were awarded the European Inventor Award for the invention of a gene-based tissue test,...

gynecologic cancers
geriatric oncology

Gynecologic Cancer in the Older Patient: The Activities of the Elderly Working Group of NRG Oncology

Geriatrics for the Oncologist is guest edited by Stuart Lichtman, MD, FACP, FASCO, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Visit SIOG.org for more on geriatric oncology.   The elderly population in the United States is growing, and by the year...

lung cancer

ASCO Endorses ASTRO Guideline on Definitive and Adjuvant Radiotherapy in Locally Advanced NSCLC

As reported in the Journal of Clinical Oncology by Andrea Bezjak, MD, of Princess Margaret Cancer Center, Toronto, and colleagues,1 ASCO has recently endorsed the American Society for Radiation Oncology (ASTRO) evidence-based guideline on external-beam radiotherapy for patients with locally...

health-care policy
survivorship
legislation

NCCS Advocates for Legislation to Establish Medicare Service for Cancer Survivorship Care Planning

Some years after successful treatment of a childhood cancer, a 16-year-old survivor required surgery to replace both hip joints, which were damaged from therapy containing steroids. An x-ray of the teenager’s destroyed joints is a stark reminder of the serious health challenges faced by cancer...

skin cancer

PET/CT Detects Asymptomatic Melanoma Recurrences

In monitoring patients with melanoma at high risk for relapse, surveillance imaging with 18F-fluorodeoxyglucose–positron-emission tomography (FDG-PET)/computed tomography (CT) can detect asymptomatic metastases and thus facilitate early treatment, according to Australian investigators who presented ...

Expert Point of View: Wendy Stock, MD

Wendy Stock, MD, of the University of Chicago, was the formal discussant of these three studies presented at the 2015 ASCO Annual Meeting. Commenting on the first study on acute myeloid leukemia (AML) by Dr. Gerber and colleagues, she said, “This work can improve understanding of the leukemia stem...

leukemia
myelodysplastic syndromes

Advancing Classification and Risk Stratification for Leukemia and Myelodysplastic Syndromes

Refinements in the classification and risk stratification for leukemia and myelodysplastic syndromes were reported by three different investigators at the 2015 ASCO Annual Meeting. The first study showed that leukemia stem cell phenotypes are associated with outcomes in acute myeloid leukemia...

Expert Point of View: Martin J. van den Bent, MD

Commenting on the EF14 study was Martin J. van den Bent, MD, of The Brain Tumor Center at Erasmus MC Cancer Institute in Rotterdam, The Netherlands, who was reticent to predict that tumor treating fields will become a standard of care. He noted that 57% of patients are still alive; therefore, the...

Expert Point of View: Keith T. Flaherty, MD

Keith T. Flaherty, MD, Associate Professor of Medicine, Harvard Medical School, and Director of the Termeer Center for Targeted Therapy, Boston, was interviewed by The ASCO Post for his thoughts on the findings from Atreya and colleagues. He believes the study’s outcomes are sufficient for...

colorectal cancer

Triple Inhibition May Cripple BRAF-Mutated Colorectal Cancer

Triplet therapy that inhibits the BRAF, MEK, and EGFR pathways appears promising in BRAF-mutated colorectal cancer, a malignancy that typically does not respond to BRAF inhibition alone.1 At the 2015 ASCO Annual Meeting, Chloe Evelyn Atreya, MD, of the University of California, San Francisco,...

Expert Point of View: Kenneth Yu, MD, MSc

Kenneth Yu, MD, MSc, of Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, called investigational ­PEGPH20 “a very promising tumor microenvironment-targeted approach” that appears to be well tolerated. “The results are preliminary but there appears to be a biomarker ...

pancreatic cancer

Novel Enzyme Improves Outcomes in Subset of Patients With Pancreatic Cancer

Patients with stage IV pancreatic cancer who received a novel enzyme along with standard chemotherapy experienced a doubling in progression-free survival, compared to those given chemotherapy alone, in a study presented at the 2015 ASCO Annual Meeting.1 Response rates and median duration of...

Expert Point of View: Jeffrey L. Wolf, MD

Jeffrey L. Wolf, MD, Director of the Myeloma Program at the University of California, San Francisco, formally discussed the ENDEAVOR study at the ASCO Annual Meeting. He commented that the “doubling” in progression-free survival is “impressive” and said that “time will tell if this difference...

lung cancer

ASTRO Guidelines on Radiotherapy in Locally Advanced NSCLC: A Good Place to Start

ASCO’s endorsement of the American Society for Radiation Oncology (ASTRO) guidelines on the role of radiotherapy in locally advanced non–small cell lung cancer (NSCLC) is an important summary of the best evidence on the appropriate role and techniques for radiotherapy in this disease.1 These...

multiple myeloma

Collaborating Toward a Cure

We’ve seen how dramatically patients’ lives can change when they are matched with the right treatment at the right time in their disease course. Although this is still an exception and not the rule, we believe collaborative research approaches will make this kind of precision medicine a reality for ...

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