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lung cancer

Bevacizumab Plus Standard Chemotherapy Improves Survival in Mesothelioma

The standard of care for malignant pleural mesothelioma may be poised for change, judging by results from a study by the French Cooperative Thoracic Intergroup. The addition of bevacizumab (Avastin) in the first-line setting to the current standard of care, pemetrexed (Alimta)/cisplatin, improved...

symptom management

Managing High-Risk Patients With Febrile Neutropenia

Febrile neutropenia is of particular concern in high-risk patients who have undergone stem cell transplant, according to William J. Hogan, MB, BCh, Assistant Professor of Medicine at the Mayo Clinic in Rochester, Minnesota. Dr. Hogan delivered an update on febrile neutropenia management in this...

symptom management

Rolapitant for Prevention of Delayed Chemotherapy-Induced Nausea and Vomiting

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. On September 2, 2015, rolapitant (Varubi) was approved for use in...

head and neck cancer

HPV-Positive Head and Neck Cancer: When Can Chemotherapy Be Omitted?

Are there patients with locally advanced squamous cell carcinoma of the head and neck associated with human papillomavirus (HPV) for whom chemotherapy can be omitted? Experts debated this question at the 2015 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia,...

lymphoma

Mantle Cell Lymphoma: Is Transplantation Still Necessary?

Autologous stem cell transplantation has played a critical role in the treatment of mantle cell lymphoma, but in the age of novel treatments, is it always warranted? Two experts in the field explored the question at the 2015 Debates and Didactics in Hematology and Oncology Conference sponsored by...

lymphoma

Double-Hit Lymphoma: Many Treatment Strategies, No Standard of Care

"Double-hit lymphoma” represents a challenging malignancy without a standard-of-care treatment, although outcomes for some patients are better than was once believed, according to Jonathon B. ­Cohen, MD, Assistant Professor of Hematology and Medical Oncology at Emory University, Atlanta. Dr. Cohen...

cost of care

Making Their Voices Heard: 118 Oncologists Speak Out About Stemming the High Cost of Cancer Drugs

In a bold move to shed light on the ramifications of the ever-increasing cost of cancer drugs for patients with cancer and for the health-care system, 118 prominent oncologists came together to write a commentary in Mayo Clinic Proceedings detailing their concerns.1 To learn more about these...

issues in oncology

Our Children’s Future Is Our Responsibility

Cancer prevention is a child-care issue. With many of cancer’s instigators planting their seeds during childhood, we—as a profession and as a nation—must seize this important window of opportunity to protect the health and well-being of future generations. Current estimates suggest that up to...

breast cancer

Diagnosis of Additional Small Cancers Suggests Screening Mammography Leads to Overdiagnosis

A study of screening mammography across U.S. counties found that “the clearest result of mammography screening is the diagnosis of additional small cancers” but without a “concomitant decline in the detection of larger cancers, which might explain the absence of any significant difference in the...

Scotty’s Gift

The following essay by Emil J. Freireich, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. I learned...

A Practical Guide to Surviving Breast Cancer and Its Treatments

BOOKMARK Title: Bald Is Better With Earrings: A Survivor’s Guide to Getting Through Breast CancerAuthor: Andrea HuttonPublisher: Harper CollinsPublication date: July 7, 2015Price: $17.99; paperback, 224 pages There are a plethora of books written by breast cancer survivors, and there are sure to...

solid tumors

Extraordinary Medical Advances and the Conundrum They Pose

BOOKMARK Title: Ordinary Medicine: Extraordinary Treatments, Longer Lives, and Where to Draw the LineAuthor: Sharon R. KaufmanPublisher: Duke University PressPublication date: May 29, 2015Price: $26.95 paperback, 336 pages Medicine has changed radically over the past 15 years. Who doesn’t welcome...

breast cancer

Varied Reactions to Study Finding That Preventing Ipsilateral Recurrence Did Not Prevent Death From Breast Cancer

Women diagnosed with ductal carcinoma in situ have a low risk of dying of breast cancer, according to an observational study looking at data from 108,196 women diagnosed with ductal carcinoma in situ between 1988 and 2011.1 The breast cancer–specific mortality rate for these women was 1.1% at 10...

NIH Awards Nearly $35 Million to Research Natural Products

Five research centers will focus on the safety of natural products, how they work within the body, and the development of cutting-edge research technologies. The centers, jointly funded by the National Institutes of Health’s Office of Dietary Supplements (ODS) and the National Center for...

issues in oncology

A Cancer Care Model for Rural Areas

Rural cancer patients have long had to adjust to difficult geographic and financial barriers to access high-quality cancer care. These problems are exacerbated by today’s fiscal challenges, which have disrupted many of the small community practices that once served rural communities. In 2006, the...

pain management

Improving Management of Cancer-Related Pain

Despite multiple guidelines from national and international organizations,1,2 the quality of current cancer pain management remains inadequate. The World Health Organization’s three-step analgesic dosing ladder forms the foundation of these guidelines.3 Yet, as noted by William S. Rosenberg, MD,...

pain management

The Need for a Multidisciplinary Approach to Combating Cancer-Related Pain

The statistics are staggering. Despite the development of novel analgesics and the increasing awareness of the importance of adequately controlling pain from cancer or its treatment, up to 50% of patients undergoing treatment and between 70% and 90% of patients with advanced disease experience some ...

global cancer care

Cancer: Increasing Awareness and Addressing This Lethal Disease on the Global Stage

The ASCO Post is pleased to introduce this special focus on the worldwide cancer burden, beginning in this issue with a close look at the cancer incidence and mortality rates in the United States. The aim of this special feature is to highlight the global cancer burden for various countries of the...

cost of care
health-care policy

ASCO Asks CMS to Revisit Its Payment Policy to Support Optimal Cancer Care

ASCO has called on the Centers for Medicare & Medicaid Services (CMS) to reconsider revisions to payment policies that could be administratively burdensome to oncology practices and result in reimbursement that inadequately supports optimal cancer patient care. In a comment letter to CMS on...

Journal of Oncology Practice to Expand in 2016: New Section Dedicated to Practical, Authoritative Clinical Reviews

In early 2016, readers of Journal of Oncology Practice (JOP) will be greeted with an expanded journal, featuring a new section of succinct, focused, practical clinical reviews authored by expert opinion leaders in oncology. These reviews are designed to provide busy, full-time clinicians with...

issues in oncology

Focus on Geriatric Oncology: ASCO Prepares for an Aging Nation

The United States—and much of the world—is experiencing unprecedented demographic shifts in the population of older people, defined as people age 65 and over. In 2012, the population of older people in the United States reached a never-before seen height of 43.1 million, a number that will more...

prostate cancer

Docetaxel Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer

Sweeney et al reported on the results of a seminal phase III trial (E3805) of chemohormonal therapy vs androgen-deprivation therapy in metastatic hormone-sensitive prostate cancer in a recent issue of The New England Journal of Medicine,1 and the study is summarized in this issue of The ASCO Post....

breast cancer

Male Breast Cancer: An Understudied Disease and Clinical Challenge

Male breast cancer is an uncommon disease, although the incidence has increased over the past couple of decades. As with many other “orphan” diseases, male breast cancer is understudied, especially in randomized controlled trials. Although it shares similarities with female breast cancer, some...

breast cancer

Adjuvant Treatment of Early-Stage Breast Cancer: Meta-analyses Provide More Clarity

The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) continues its practice of being a lighthouse, shedding its beacon of light on the vast ocean of breast cancer research through the publication of two large, individual patient level–data meta-analyses on the management of women with...

issues in oncology

Bridging the Gap Between Pediatric and Adult Oncology Care

According to the National Cancer Institute (NCI), about 70,000 adolescents and young adults—defined by the NCI as those in the 15- to 39-year-old range—are diagnosed with cancer each year in the United States, about six times the number of cases diagnosed in children aged 0 to 14.1 And, although...

colorectal cancer

FDA Approves New Oral Medication for the Treatment of Refractory Metastatic Colorectal Cancer

The U.S. Food and Drug Administration (FDA) has approved trifluridine/tipiracil (Lonsurf) for patients with metastatic colorectal cancer who have been previously treated with chemotherapy and biologic therapy and are no longer responding to treatment. Mechanism of Action The new oral agent is a...

Clinical Implications of Survivorship Study Findings

Based on study findings presented at the 2015 ASCO Annual Meeting, Arif Kamal, MD, MHS, of Duke University, Durham, North Carolina, listed six points for clinicians to consider that could change practice now or in the near future for cancer survivors. “Drugs for cancer cachexia are on their...

supportive care
survivorship

Patient and Survivor Care Studies Yield Useful Results to Improve Quality of Life

Recent studies have yielded useful results that clinicians can put into practice, some right now, to help improve the quality of life for patients with cancer. Concerns addressed included cachexia, pain, “chemobrain,” and fertility preservation. At the Best of ASCO®/Chicago meeting, Arif ­Kamal,...

Expert Point of View: Solange Peters, MD, PhD

Solange Peters, MD, PhD, of the Lausanne University Hospital, Switzerland, put these updates in context of what is known about programmed cell death protein 1 (PD-1) antibodies in non–small cell lung cancer (NSCLC), concluding that nivolumab (Opdivo) is “one of the best options” for...

lung cancer

Lung Cancer Rates Doubling Among Nonsmokers

Lung cancer is becoming an equal-opportunity malignancy—with rates rising among never-smokers, especially females, according to studies presented at the 16th World Conference on Lung Cancer in Denver. British investigators reported that in one large tertiary medical center, the proportion of...

lung cancer

AZD9291 Updates Encouraging for Treatment-Resistant NSCLC

At the 16th World Conference on Lung Cancer, several studies showed consistent activity with the investigational third-generation inhibitor AZD9291 in patients with advanced non–small cell lung cancer (NSCLC) that is resistant to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors....

breast cancer

Ductal Carcinoma in Situ: Where We Have Been and Where We Can Be

Ductal carcinoma in situ has been a recent topic of debate in the news because of a recent article by Narod et al1 and an accompanying editorial2 about the study in JAMA Oncology. This study, summarized in this issue of The ASCO Post, chronicled the long-term outcomes for women diagnosed with...

issues in oncology

NCCN Turns 20: Value-Based Care Has Arrived

Twenty years ago, the National Comprehensive Cancer Network (NCCN) began as a cooperative effort of 12 prestigious cancer centers, working to define and promote national guidelines for the care of patients with cancer. A major goal was to encourage uniformity in the management of malignant...

Expert Point of View: Robert Pirker, MD

Robert Pirker, MD, Professor of Medicine and Program Director for Lung Cancer at the Medical University of Vienna, Austria, discussed the findings at the “Top Abstracts” session of the 16th World Conference on Lung Cancer. Based on these results and the findings of similar studies, Dr. Pirker...

lung cancer

EGFR Gene Copy Number as Biomarker for Antibody Treatment in Squamous Cell NSCLC

Two studies presented at the 16th World Conference on Lung Cancer suggest that high expression of the epidermal growth factor receptor (EGFR), or gene copy number, may indicate potential benefit from EGFR antibodies in squamous cell non–small cell lung cancer (NSCLC). The studies were presented by...

What Do You Say When She Is No Longer Living With Cancer?

The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

lung cancer

Patients Whose Treatment Included Bevacizumab Were More Likely to Experience Toxicity but Less Likely to Be Hospitalized

A study among patients with advanced non–small cell lung cancer (NSCLC) treated with carboplatin-paclitaxel or carboplatin-paclitaxel-bevacizumab (Avastin) found that those receiving the triplet were more likely to experience a toxicity event but less likely to be hospitalized within 180 days after ...

Expect Questions From Patients About Daily Aspirin to Prevent Colorectal Cancer

Updating previous recommendations, the U.S. Preventive Services Task Force now recommends low-dose aspirin for the primary prevention of colorectal cancer among most adults age 50 to 59. This a draft recommendation, but it has generated major media coverage noting that this is the first time the...

colorectal cancer
issues in oncology

Important Caveats to Consider Concerning Low-Dose Daily Aspirin for the Primary Prevention of Colorectal Cancer

The use of low-dose aspirin by most adults aged 50 to 59 for the primary prevention of colorectal cancer is now included in the U.S. Preventive Services Task Force (USPSTF) updated draft recommendation statement, “Aspirin to Prevent Cardiovascular Disease and Cancer.”1 The release of the statement...

Patient Guides Available Through ASCO University Bookstore

ASCO Answers: 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...

solid tumors

A Snapshot of Early Immunotherapy

Over the past several years, immunotherapy has had a renaissance of sorts, emerging as one of the most active areas in cancer research. For instance, we have seen the therapeutic promise of disrupting the programmed cell death protein 1 (PD-1) and its ligand (PD-L1) immune checkpoints in cancer,...

lymphoma

Answers: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

Question 1: What is the most likely diagnosis for this patient? Correct Answer: B. Primary central nervous system lymphoma. Expert Perspective In an immunocompetent host, the differential diagnosis of isolated or multiple brain lesion(s) includes autoimmune etiologies such as neurosarcoidosis,...

hematologic malignancies

Early Research of David G. Nathan, MD, Ushered in the Field of Pediatric Hematology

When David G. Nathan, MD, was admitted to Harvard University in 1947, he had every intention of becoming an English professor. It was only his lack of writing talent that dissuaded him from a life in the classroom and propelled him into a medical career that has spanned more than 5 decades and has...

Confessions of a Neurosurgeon

BookmarkTitle: Do No Harm: Stories of Life, Death, and Brain SurgeryAuthor:  Henry Marsh, CBE, FRCSPublisher: Thomas Dunne BooksPublication date: May 26, 2015Price: $25.99, hardcover; 288 pages “I often have to cut into the brain and it is something I hate doing. With a pair of diathermy forceps I ...

pain management

Pain, Still Undertreated and Misunderstood

Bookmark Title: A Nation in Pain: Healing Our Biggest Health ProblemAuthor:  Judy ForemanPublisher: Oxford University PressPublication date: May 1, 2015Price: $19.95, paperback; 464 pages The subject of pain has been written about extensively, from the intriguing sociopolitical history of opium to...

Glimpses of the Human Condition Through Lively, Medically Themed Short Stories

BookmarkTitle: A View From the Inside: A Collection of Medically Oriented Short StoriesAuthor: Augustine L. Perrotta, DOPublisher: Keith Publications, LLCPublication date: March 31, 2015Price: $14.95, paperback; 246 pages The field of medicine, ripe with dramatic tension, offers an endless array...

colorectal cancer

Trifluridine/Tipiracil in Previously Treated Metastatic Colorectal Cancer

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. On September 22, 2015, trifluridine/tipiracil (Lonsurf) was...

gynecologic cancers

Bevacizumab in Ovarian Cancer: Results of ICON7

Based on preclinical (in vitro and in vivo) data, there is a strong biologic rationale for the addition of an antiangiogenic drug strategy in the treatment of epithelial ovarian cancer.1 Single-agent trials have confirmed both the biologic and clinical activity of bevacizumab (Avastin) in the...

lung cancer

FDA Grants Accelerated Approval to Pembrolizumab for Advanced NSCLC

The U.S. Food and Drug Administration (FDA) has granted accelerated approval for pembrolizumab (Keytruda) to treat patients with metastatic non–small cell lung cancer (NSCLC) whose disease has progressed after other treatments and with tumors that express programmed cell death-ligand 1 (PD-L1)....

lung cancer

FDA Approves Use of Nivolumab in Metastatic Nonsquamous Lung Cancer

The U.S. Food and Drug Administration (FDA) has approved nivolumab (Opdivo) to treat patients with metastatic nonsquamous non–small cell lung cancer (NSCLC) whose disease progressed during or after platinum-based chemotherapy. Nivolumab is a monoclonal antibody that that blocks the PD-1/PD-L1...

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