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hematologic malignancies

Expert Point of View: Claire Dearden, MD

Patients are very excited about this new, well tolerated drug for chronic lymphocytic leukemia (CLL). Ibrutinib is available orally and is not chemotherapy. It produces excellent responses. This is particularly important for elderly [ie, age 65 and older] patients who are not always fit enough to...

multiple myeloma

Oral Proteasome Inhibitor May Be a Game-changer in Myeloma

An investigational oral proteasome inhibitor currently known as MLN9708 could make the treatment of multiple myeloma much more convenient and possibly less neurotoxic, according to the results of a phase I/II study of treatment-naive multiple myeloma patients presented at the 54th Annual Meeting of ...

breast cancer

Radiation Therapy for Patients with Invasive Breast Cancer: 3 Weeks Proves as Effective as 5 Weeks

Ten-year follow-up of the two-part UK Standardisation of Breast Radiotherapy Trials (START) supported the 5-year findings, demonstrating that a 3-week course of adjuvant radiation therapy is equivalent to a 5-week course of radiation for women with invasive breast cancer. The update was presented...

multiple myeloma

Overall Survival Benefit Achieved with Pomalidomide in Advanced Myeloma

Support for the oral immunomodulatory agent pomalidomide for multiple myeloma took a step forward when the phase III MM-003 trial showed a survival advantage in patients with advanced disease, in addition to a doubling in progression-free survival, when pomalidomide was given with low-dose...

leukemia

FDA Approves Ponatinib to Treat CML and Philadelphia Chromosome–positive ALL

In December, the FDA granted accelerated approval to ponatinib (Iclusig) for the treatment of adult patients with chronic-, accelerated-, or blast-phase chronic myeloid leukemia (CML) that is resistant or intolerant to prior tyrosine kinase inhibitor therapy or Philadelphia chromosome–positive...

hematologic malignancies
leukemia

Pivotal Trial Shows Robust Activity of Ponatinib in Some Heavily Pretreated Leukemias

The pivotal phase II Ponatinib Ph+ ALL and CML Evaluation (PACE trial) found that 1 year of treatment with the novel investigational drug ponatinib achieved robust activity in heavily pretreated patients with chronic myeloid leukemia (CML) and Philadelphia chromosome–positive acute lymphoblastic...

health-care policy
legislation

Last-minute ‘Fiscal Cliff’ Deal by Congress Again Averts Medicare Cuts to Physicians

A last-minute patch to the sustainable growth rate formula included in the “fiscal cliff” deal averted massive cuts to oncologists who care for and treat Medicare patients. “This end-of-year crisis management once again demonstrates the critical need for fundamental reform of the Medicare...

health-care policy

Does Health-care Quality Translate to Value?

On March 23rd, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, enacting sweeping change in our health-care system. An underlying theme of the legislation is the realignment of our payment system so that it places value over volume of services. At ASCO’s first...

issues in oncology

Are We Winning the War on Cancer?

On December 23, 1971, President Richard Nixon signed the U.S. National Cancer Act. This date is widely considered to mark the beginning of the so-called “War on Cancer,” although that phrase was introduced only later on. Over recent decades, journalists have from time to time questioned whether we...

Expert Point of View: Peter Ravdin, MD and Sandra M. Swain, MD, FACP

Putting these results in perspective, Peter Ravdin, MD, moderator of a San Antonio Breast Cancer Symposium press conference where ATLAS findings were discussed, said that in the United States, there is currently a different strategy for pre- and postmenopausal women. Tamoxifen is used as primary...

breast cancer

Adjuvant Tamoxifen for Women with ER-positive Breast Cancer: 10 Years Superior to 5 Years

Five years of tamoxifen has long been considered the standard of care as adjuvant therapy for women with estrogen receptor–positive breast cancer. However, extending tamoxifen treatment for 10 years reduced the risk of dying by 29% during the second decade after diagnosis compared with standard...

lung cancer
issues in oncology

E-mail Reminders to Providers May Improve Documentation of Code Status in Patients with Advanced Disease 

E-mail reminders to providers at the start of each new chemotherapy regimen may improve the rate and timing of code status documentation for patients with advanced lung cancer, according to a study in the Journal of Clinical Oncology. Jennifer S. Temel, MD, and colleagues from Massachusetts General ...

prostate cancer

No Difference in Toxicity with Proton Radiotherapy vs Less Costly Intensity-modulated Radiotherapy 

A national sample of Medicare beneficiaries treated for prostate cancer with intensity-modulated radiation therapy or proton radiotherapy found that proton radiotherapy “was rare and expensive and associated with only a modest and transient reduction in genitourinary toxicity,” reported James B....

breast cancer

Adding Temsirolimus to Letrozole Did Not Improve Survival but Might Benefit Patients under 65

Adding temsirolimus (Torisel) to letrozole did not improve progression-free survival in patients with aromatase inhibitor–naive, estrogen receptor (ER)-positive advanced breast cancer, but exploratory analysis indicated the combination could benefit postmenopausal patients ≤ 65. In their Journal of ...

breast cancer

Younger Patients with Family History of Breast Cancer at Similar Risk of Bilateral Disease as Those with BRCA Mutations 

Women who are diagnosed with breast cancer before age 55 and have a first-degree family history of bilateral disease have risks of contralateral breast cancer similar to women with deleterious mutations of BRCA1 and BRCA2, according to a study recently published in the Journal of Clinical Oncology, ...

SIDEBAR: Expect Questions from Patients

Results from the Adjuvant Tamoxifen: Longer Against Shorter (ATLAS) study “will have a follow-on effect of being able to guide physicians about the advantages of longer than 5 years of therapy for the premenopausal woman,” said V. Craig Jordan, OBE, PhD, DSc, Scientific Director at the Lombardi...

breast cancer

'Practice-changing' ATLAS Study Supports 10 vs 5 Years of Tamoxifen Therapy in Women with Breast Cancer

"Practice-changing" is the term several physicians and researchers used when asked by the media to describe the results of a study showing that extending tamoxifen therapy from 5 to 10 years for women with estrogen receptor (ER)-positive breast cancer further reduced recurrence and mortality....

gynecologic cancers

Internationally Renowned Gynecologic Cancer Researcher Joins Ohio State

Internationally renowned uterine cancer researcher and geneticist Paul Goodfellow, MD, PhD, will lead a new team of three researchers devoted to gynecologic oncology research at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research...

leukemia
breast cancer

Oncology Trailblazer James F. Holland, MD, Recalls a Time of Unbridled Scientific Excitement 

James F. Holland, MD, began his journey into oncology when it was still a nascent discipline, working alongside groundbreaking pioneers in the field such as Drs. Emil “Tom” Frei and C. Gordon Zubrod. Dr. Holland recently shared a glimpse of his role in oncology’s formative years with The ASCO Post. ...

issues in oncology

Most Patients Do Not Report that Cure Is Highly Unlikely with Chemotherapy for Advanced Cancer  

Chemotherapy for metastatic lung or colorectal cancer can provide palliation and modestly prolong life, but is not curative. In a study recently reported in The New England Journal of Medicine, Jane C. Weeks, MD, of Dana-Farber Cancer Insitute, and colleagues found that the majority of patients...

supportive care

Cisplatin Linked to Significantly Increased Risk of Venous Thromboembolism

Patients with advanced solid tumors treated with cisplatin-based chemotherapy had a significantly increased risk of venous thromboembolic events, according to a meta-analysis of 38 randomized phase II and III trials evaluating cisplatin-based vs non–cisplatin-based chemotherapy. The trials involved ...

leukemia

Patients Receiving Higher-intensity Chemotherapy for ALL Are at Greater Risk for Cognitive Deficits, Researchers Report 

Omitting cranial irradiation from the treatment regimen for acute lymphoblastic leukemia (ALL) may help preserve global cognitive abilities. “Treatment with chemotherapy alone is not without risks,” however, noted researchers from St. Jude Children’s Research Hospital in Memphis. “The St. Jude...

ASCO's CancerProgress.Net: Where We've Come From, Where We Are, and Where We're Going 

The British science historian James Burke once wrote, “If you don’t know where you’ve come from, you don’t know where you are.” To tell the story of where we are in the treatment of people with cancer and how we got there, ASCO launched an ambitious history project in 2011 with a new website,...

breast cancer
lung cancer

ASCO Decision Aids Intersect Evidence-based Guidelines, Productive Patient Communication

Imagine this common clinical scenario: A 64-year-old woman presents with a new abnormality on a mammogram. A core needle biopsy and subsequent partial mastectomy reveal a 1.8-cm invasive ductal carcinoma. Sentinel lymph nodes are negative for cancer. The tumor is moderately differentiated and is...

issues in oncology

New England Journal of Medicine Article Reports Inferior Outcome in Using Alternative Treatments to Counter Mechlorethamine Shortage

ASCO Immediate Past President Michael P. Link, MD, recently coauthored a perspectives piece in The New England Journal of Medicine on the impact of drug shortages on children with cancer. The paper, “The Impact of Drug Shortages on Children with Cancer — The Example of Mechlorethamine,” describes...

Coalition of Cancer Cooperative Groups Celebrates 10 Years of Clinical Trial Participation Awards

For any community practice, participation in a clinical trial can be a time-consuming, intense commitment. But this commitment is integral to the advancement of new methods and therapies, which is why the Coalition of Cancer Cooperative Groups has exactly one mission: increasing clinical trial...

prostate cancer

Postoperative Radiation Therapy Extends Progression-free Survival in Men with High-risk Prostate Cancer

Postoperative irradiation significantly improves biochemical progression-free survival and local control compared with a “wait-and-see” approach in men with high-risk prostate cancer, according to more than a decade of long-term follow-up in the European Organisation for Research and Treatment of...

Samuel M. Silver, Elected as a Master of ACP

Samuel M. Silver, MD, PhD, has been elected as a Master of the American College of Physicians (ACP). Mastership is conferred upon a select number of candidates following election by ACP’s Awards Committee and Board of Regents. Dr. Silver is Assistant Dean for Research and Professor of Internal...

Pediatric Cancer Foundation Names Four Recipients of 2012 Award, Each to Receive Grant for Research 

Alex’s Lemonade Stand Foundation, a nonprofit group dedicated to finding cures for all children with cancer, has named four researchers 2012 recipients of the “A” Award. Christopher Vakoc, MD, PhD, of Cold Spring Harbor Laboratory; Roland Walter, MD, PhD, of the Fred Hutchinson Cancer Research...

lymphoma

PET-negative Scan after Short-course Chemotherapy Identifies Early Hodgkin Lymphoma Patients Who Can Forgo Radiation

Positron-emission tomography (PET)-directed therapy is promising for early-stage Hodgkin lymphoma, according to results of the UK NCRI RAPID trial presented at the 54th Annual Meeting of the American Society of Hematology (ASH).1 The use of PET scan enabled the identification of a population of...

breast cancer

Dune Medical Devices Receives FDA Approval for the MarginProbe System

Dune Medical Devices, Inc, announced that the FDA has granted Premarket Approval to the MarginProbe System, the company’s breakthrough intraoperative tissue assessment tool for early-stage breast cancer surgery. The technology significantly improves surgeons’ ability to intraoperatively identify...

SIDEBAR: Treating Earlier with Eribulin

Eribulin is also being evaluated for use earlier in patients with breast cancer, in both the metastatic and adjuvant settings, in three studies described at the San Antonio meeting. In a phase II study of eribulin as first-line treatment for locally recurrent or metastatic HER2-negative breast...

breast cancer

Primary Endpoint Not Met for Eribulin vs Capecitabine in Breast Cancer 

While a global phase III trial failed to meet its primary endpoint in showing an overall or progression-free survival benefit for eribulin (Halavan) in metastatic breast cancer, a trend toward greater efficacy than capecitabine (Xeloda) was observed, researchers reported at the 2012 San Antonio...

Expert Point of View: Amir T. Fathi, MD

For years, adults with acute lymphoblastic leukemia (ALL) have been treated with intensive, multiagent, cytotoxic chemotherapy involving multiple rounds of treatment, derived from regimens that are highly effective in children. Although the survival of children with ALL hovers around 90%, less than ...

breast cancer

Somatic HER2 Mutations That Drive Cancer Found in HER2-negative Breast Cancer 

A proportion of patients with breast cancer whose tumors test HER2-negative for gene amplification on fluorescence in situ hybridization or immunohistochemistry harbor HER2 mutations that are amenable to treatment with anti-HER2–targeted therapy, according to a gene-sequencing study presented at...

Expert Point of View: Sandra M. Swain, MD, FACP, and Lisa Carey, MD

Sandra M. Swain, MD, FACP, Medical Director, Washington Cancer Institute, MedStar Washington Hospital Center, Washington, DC, who moderated the session, said these interesting observations must now be validated in preclinical models of triple-negative tumors, and then tested in patients. “Residual...

lung cancer

ACS Releases Lung Cancer Screening Guidelines

As reported online in CA: A Cancer Journal for Clinicians,1 based on results from the National Lung Screening Trial (NLST) sponsored by the National Cancer Institute (NCI), the American Cancer Society (ACS) has released lung cancer screening guidelines recommending that select clinicians should...

cost of care

Cost of Cancer Drugs: What Price for What Benefit?

In 2011, national health-care spending in the United States was about $2.7 trillion, larger than the entire French national budget.1 U.S. national health-care spending is about 17% of the national gross domestic product. Total Medicare expenditures in 2011 were $549 million.2 In the debate about...

issues in oncology

Expert Point of View: Neal J. Meropol, MD

A critical component of informed consent is an understanding of the potential risks and benefits of investigational treatments. In the context of early-phase oncology trials, concern has been raised about whether this understanding is adequate, since patients tend to express high expectations about ...

issues in oncology

Expert Point of View: Kevin P. Weinfurt, PhD

Our work suggests three specific recommendations for researchers and care providers who are discussing with patients the possibility of enrolling in a phase I clinical trial. First, we should always communicate the likelihood of benefit in terms of the number of participants expected to derive...

issues in oncology

Patient Expectations of Benefit in Early-phase Trials: Ethics Issues in Informed Consent 

It has been found that many patients in early-phase oncology trials believe their chance of benefit to be much higher than estimates derived from historical data.1-3 In a recently reported study in Journal of Clinical Oncology, Kevin P. Weinfurt, PhD, of Duke Clinical Research Institute, and...

multiple myeloma

Survival Benefit Achieved with Four Drugs plus Maintenance in Myeloma

An overall survival benefit in newly diagnosed multiple myeloma was attained with a four-drug induction regimen followed by a duet for maintenance in a study from the Italian GIMEMA network. Antonio Palumbo, MD, Chief of the Myeloma Unit at the University of Torino in Italy, reported the findings...

skin cancer

Tremelimumab Not Better Than Standard-of-care Chemotherapy in Patients with Advanced Melanoma 

Tremelimumab did not produce a statistically significant advantage in overall survival compared to first-line standard-of-care chemotherapy in a phase III randomized trial reported in the Journal of Clinical Oncology. At final analysis, median overall survival by intent to treat was 12.6 months...

cns cancers

Surgery of Primary Tumor Site Has No Impact on Local Control and Outcome in Patients ≥ 18 Months with Stage IV Disease 

“In intensively treated patients with stage IV neuroblastoma age 18 months or older at diagnosis, surgery of the primary tumor site has no impact on local control rate and outcome,” according to findings from the German prospective clinical trial NB97. “The results of the study,” the researchers...

SIDEBAR: Shout-out to Policymakers on Diabetes Education

“If we could just give a shout-out to policymakers to understand that in the long term,” when patients who have diabetes and cancer receive adequate diabetes education, “we are cutting our length of stay, we are decreasing hospital costs, we are decreasing readmission rates,” June McKoy, MD, MPH,...

SIDEBAR: Expect Questions from Patients with Diabetes and Cancer

Patients with diabetes and cancer need to know that some chemotherapy drugs and adjuvant agents may require modifications in how they manage their diabetes. For example, patients who are receiving steroids might have to further restrict their diet to keep blood sugar levels under control. “You...

issues in oncology

Keeping Diabetes under Control Is Critical to Good Outcomes for Patients Who Also Have 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. Cancer and diabetes can be comorbid...

breast cancer

Researchers Develop Automated Breast Density Test Linked to Cancer Risk

Researchers at Moffitt Cancer Center in Tampa, Florida, and colleagues at the Mayo Clinic in Rochester, Minnesota, have developed a novel computer algorithm to quantify breast density based on analysis of a screening mammogram. Increased levels of mammographic breast density have been shown in...

palliative care

Important Messages about Palliative Care and Hospice at the Heart of New End-of-life Memoir 

The illness memoir’s appeal proves enduring in a very crowded genre, perhaps because illness is a tie that binds us all. As Susan Sontag wrote in her classic work, Illness as a Metaphor, “Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in...

David A. Karnofsky's Early Contributions to Cancer Research Helped Establish Oncology as a Medical Discipline 

For nearly 30 years, from the time he was a young resident at the Collis P. Huntington Memorial Hospital for Cancer Research of Harvard University, until his death from lung cancer on August 31, 1969, David A. Karnofsky, MD, dedicated himself to the pursuit of scientific excellence and the...

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