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Showing 1601 - 1650The ‘Silver Oncologic Tsunami’: Rise in Elderly Cancer Patients Brings New Challenges to Oncology Workforce
The “graying of America” poses increasing challenges for the cancer community in terms of rising numbers of cases of cancer and costs associated with geriatric care. The scope of this problem and potential solutions were explored by Andrew E. Chapman, DO, FACP, at the ASCO Quality Care Symposium in ...
Overutilization a Key Target in Efforts to Control Health-Care Costs
Overutilization of health-care interventions has become a prime target of efforts to rein in health-care costs. Overtreatment of cancer patients is associated with a number of common harms to the patient—not just financial harm to the health-care system. At the recent ASCO Quality Care Symposium in ...
IMPRESS Trial: Lung Cancer Progression on First-Line Tyrosine Kinase Inhibitor Indicates the Drug Should Be Stopped
The IMPRESS trial found no benefit for continuing treatment with the epidermal growth factor receptor (EFGR) tyrosine kinase inhibitor gefitinib (Iressa, discontinued in the United States) plus chemotherapy vs chemotherapy alone in patients with EGFR-mutated non–small cell lung cancer (NSCLC) who...
Expert Point of View: Deborah Schrag, MD, MPH
Formal discussant of the Quality Care Symposium presentation on the impact of tumor boards, Deborah Schrag, MD, MPH, Dana-Farber Cancer Institute, Boston, commended the authors for the collaborative use of data to improve quality of care. “For this study, Dr. Kehl and coauthors leveraged the...
Impact of Tumor Boards on Cancer Care
A large observational study suggested that weekly tumor board participation by oncologists improves survival in advanced lung and colorectal cancers, increases participation in clinical trials, and leads to greater use of guideline-based curative care for early non–small cell lung cancer. This is...
Tumor Board Participation Associated With Improved Survival in Stage IV Lung and Colorectal Cancers
A large, population-based, observational study suggests that participation in weekly tumor boards can improve outcomes in oncologic care. Specifically, oncologist participation in weekly tumor board meetings was associated with improved survival in patients with stage IV small cell lung cancer and...
Hormonal Therapy for Early Breast Cancer: Do We Learn From Past Mistakes?
Guidelines can be incorrect if they are not based on incontrovertible evidence. Such was the case with the National Cancer Institute (NCI) 1995 guidelines recommending 5 years of tamoxifen adjuvant therapy for stage I to III hormone receptor–positive breast cancer. With more definitive evidence,...
New Agents and Novel Targets for Multiple Myeloma
New therapies for multiple myeloma have dramatically improved life expectancy, but despite these advances, 5-year overall survival still remains below 50%. Investigators are in hot pursuit of new therapies that will extend remissions and improve survival. Thus far, monoclonal antibodies,...
Optimizing HER2 Therapy in Early and Advanced Breast Cancers
Trastuzumab (Herceptin) has been the cornerstone of therapy for HER2-positive tumors, which comprise about 20% of all breast tumors. Additional therapies targeted to other HER2 pathways or other targets to be used in combination with trastuzumab are being explored in both the adjuvant and...
Appetite-Enhancing Agent Helps Patients Treated for NSCLC Gain Weight and Lean Body Mass and Feel Better
People have an image of stage III or IV lung cancer patients getting chemotherapy or chemoradiation, and they look terrible; they are losing weight. The fact is, when they respond, they can gain weight,” according to Philip Bonomi, MD, MS. He is the lead author of a phase III study showing that the ...
Expert Point of View: Justin Gainor, MD
This is a very exciting time in lung cancer. Immunotherapy is extremely promising,” stated Justin Gainor, MD, a thoracic oncologist at Massachusetts General Hospital in Boston. The promise of immunotherapy extends to a broad patient population. Targeted treatments have transformed the lives of...
Lung Cancer: Next Frontier for Immunotherapy
Immune checkpoint inhibitors, particularly PD-1 (programmed cell death-1) and PD-L1 (programmed death-ligand 1) inhibitors, are being studied extensively in lung cancer. These agents, alone and in combination, appear to have the potential to change the management of non–small cell lung cancer...
Expert Point of View: Alan Venook, MD
During the discussion, Alan Venook, MD, of Helen Diller Comprehensive Cancer Center, University of California, San Francisco, raised the concern that nab-paclitaxel appears to be the platform of choice for clinical trials going forward. “I’m not sure if this is based on market or merit,” he...
Choice for Metastatic Pancreatic Cancer: FOLFIRINOX or Gemcitabine/Nab-Paclitaxel?
The choice between FOLFIRINOX (fluorouracil [5-FU], leucovorin, irinotecan, oxaliplatin) vs the combination of gemcitabine and nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) for first-line treatment of metastatic pancreatic cancer is not much of a contest, judging by a discussion of...
Expert Point of View: Ethan Basch, MD
Formal discussant of the patient-reported outcomes study by Smith et al presented at the Quality Care Symposium in Boston, Ethan Basch, MD, Director of the Cancer Outcomes Research Program at the University of North Carolina School of Medicine in Chapel Hill, praised the research for its important...
Study Reveals Gaps in Symptom Management
The Patient-Reported Outcomes Symptoms and Side-Effects Study demonstrated that many cancer patients treated in community cancer centers are not discussing their common symptoms like pain, fatigue, and emotional distress with their oncologists/health-care team or receiving advice about how to...
Expert Point of View: Deborah Schrag, MD, MPH
Formal discussant of this abstract, Deborah Schrag, MD, MPH, Dana-Farber Cancer Institute, praised this effort. “Dr. Stuver’s abstract provides ample evidence of overuse of intensive care at the end of life. Patients and their families do not want to be in the hospital or emergency department at...
Private Payer and Academic Center Data Capture Inappropriate Use of End-of-Life Care
Data sharing between a comprehensive cancer center and a private insurer appears to be a novel way to capture practice patterns that can point to potential quality improvements. A study that combined data from Dana-Farber Cancer Institute and Blue Cross Blue Shield of Massachusetts showed that some ...
Victory for Pediatric Regimens in Adolescents and Young Adults With ALL
Long in the works, early results of the U.S. Intergroup C10403 trial clearly showed that treating acute lymphoblastic leukemia (ALL) in adolescents and young adults using a pediatric-inspired regimen improves event-free survival and overall survival and should be the backbone for future studies in...
Expert Point of View: Catherine Bollard, MD
Blinatumomab is one of several approaches to harness the immune system, and these therapies will revolutionize the treatment of cancer, but we will have to balance the effects of ‘revving up’ the immune system with toxicity. Compared with CAR [chimeric antigen receptor] T cells [made from each...
Blinatumomab Achieves Complete Molecular Responses in Majority of B-Cell Leukemia Patients
Results from the international phase II BLAST study show that one cycle of blinatumomab (Blincyto) immunotherapy achieved complete minimal residual disease response in 78% of patients with acute lymphoblastic leukemia.1 Complete minimal residual disease response was achieved in 80% of patients...
Expert Point of View: Timothy Graubert, MD
These studies are interesting, with provocative and compelling findings,” said Timothy Graubert, MD, the Hagler Family Chair in Oncology and Director of the Hematologic Malignancy Program at Massachusetts General Hospital in Boston. “Bcl-2 proteins regulate cell survival or promote cell death....
Venetoclax Gaining Ground in Two Types of Leukemia
Venetoclax, formerly known as ABT-199, is moving forward into phase III development in acute myelogenous leukemia (AML) and chronic lymphocytic leukemia (CLL), based on encouraging data from separate phase Ib and II trials presented at the 56th Annual Meeting and Exposition of the American Society...
Breast Health Global Initiative Tackles Third-World Health Care
Benjamin O. Anderson, MD, is the Director of the Breast Health Global Initiative (BHGI) and surgical oncologist and Director of the Breast Health Clinic at the University of Washington in Seattle. The ASCO Post recently spoke with Dr. Anderson about the conceptual framework of the...
Ultrasonography Detects Mammographically Occult Invasive Cancers
Mammograms often miss occult breast cancers concealed in dense breasts. Women with dense breasts represent about 40% to 50% of women who undergo mammography screening. In some states and centers in the United States, women with dense breasts are routinely offered ultrasonography following a...
Expert Point of View: Lajos Pusztai, MD
Commenting on the GeparSepto study presented at the San Antonio Breast Cancer Symposium, Lajos Pusztai, MD, Yale University School of Medicine, New Haven, Connecticut, said, “This study, along with a smaller SWOG study, establishes nab-paclitaxel as a legitimate treatment option for triple-negative ...
Nab-Paclitaxel Boosts Pathologic Complete Response in High-Risk Breast Cancer
Nab-paclitaxel (Abraxane) achieved superior results compared with conventional solvent-based paclitaxel in patients with early-stage high-risk breast cancer in the large phase III GeparSepto trial from the German Breast Group (GBG).1 The study, presented at the 2014 San Antonio Breast Cancer...
Expert Point of View: Benjamin O. Anderson, MD
Commenting on this study, Benjamin O. Anderson, MD, Director of the Breast Health Clinic, Seattle Cancer Care Alliance, Washington, said: “This new analysis of the Oncotype DX DCIS assay strengthens the findings of earlier studies performed in more limited subgroups, validating that the assay...
Oncotype DX Ductal Carcinoma in Situ Score Reliably Predicts Tumor Recurrence
Ductal carcinoma in situ, which accounts for 30% of all newly diagnosed breast cancers, does not always evolve into a lesion with metastatic potential. Only a proportion of these cases will progress to invasive breast cancer, but up until recently, it has not been possible to identify reliably...
No Benefit for Adjuvant Capecitabine Monotherapy in Elderly Patients With Early-Stage Breast Cancer
Adjuvant therapy with capecitabine plus ibandronate failed to improve outcomes vs ibandronate alone in elderly patients with moderate-to-high-risk early-stage breast cancer in the ICE study—the largest study to date conducted in elderly women with breast cancer.1 “Capecitabine is frequently used in ...
Fulvestrant Surpasses Anastrozole in First-Line Treatment of Metastatic Breast Cancer
Fulvestrant (Faslodex) at a 500-mg dose was superior to anastrozole as first-line therapy for advanced hormone receptor–positive breast cancer in the phase II FIRST study.1 Overall survival and time to disease progression were significantly better with fulvestrant than with the current standard of...
Expert Point of View: Erin Hofstatter, MD
These data do not change what we already know: Chemoprevention is slam-dunk, hands-down effective in preventing breast cancer. The effects of 5 years of chemoprevention persist for 20 years. This is great because it [could potentially] reduce the numbers of women we need to treat,” said Erin...
Tamoxifen Prevention of Breast Cancer Extends More Than 16 Years
The benefits of tamoxifen as primary prevention of breast cancer are well established. The good news is that the benefits live on, with a protective effect that extends up to 22 years. At a median follow-up of 16 years, women treated with 5 years of tamoxifen enjoyed a 29% reduction in the risk of...
Expert Point of View: David Steensma, MD
Patients with Philadelphia chromosome–positive ALL have traditionally done poorly with conventional chemotherapy, but outcomes are improving in the era of tyrosine kinase inhibitors. This study reports the safety and efficacy with a combination of a targeted approach and low-intensity...
Nilotinib With Low-Intensity Chemotherapy Useful in Elderly Patients With Philadelphia Chromosome–Positive ALL
The addition of the tyrosine kinase inhibitor nilotinib (Tasigna) to standard low-intensity chemotherapy improved outcomes in elderly patients with newly diagnosed Philadelphia chromosome–positive acute lymphoblastic leukemia (ALL) and may represent a new approach to this group of patients, who are ...
Expert Point of View: Brad S. Kahl, MD
AETHERA is the first study to show a significant effect of a post-transplant strategy in patients at high risk of relapse after transplant,” said Brad S. Kahl, MD, Associate Professor at the University of Wisconsin School of Medicine and Public Health, Madison. “The question remains whether...
Post-Transplant Brentuximab Vedotin Improved Progression-Free Survival in Hodgkin Lymphoma Patients
In patients with Hodgkin lymphoma who are at risk for disease progression following autologous stem cell transplantation, early consolidation with brentuximab vedotin (Adcetris) post-transplant significantly improved progression-free survival compared with placebo in the phase III AETHERA trial.1...
Ovarian Suppression Plus Hormonal Therapy May Be Practice-Changing in Premenopausal Hormone Receptor–Positive Early-Stage Breast Cancer
Results of the large International Breast Cancer Study Group (IBCSG)-coordinated SOFT trial present a convincing argument for the addition of ovarian function suppression to adjuvant hormonal therapy to reduce the risk of tumor recurrence in younger women with hormone receptor–positive early-stage...
New Choosing Wisely List, Leukemia Quick-Takes From ASH
Nearly 5,000 scientific abstracts were presented at the 2014 American Society of Hematology (ASH) Annual Meeting and Exhibition in San Francisco. Along with our targeted coverage of the meeting’s key newsmakers, The ASCO Post provides you with these brief reports of other interesting...
Expert Point of View: Yoav Messinger, MD
These are phenomenal results,” stated Yoav Messinger, MD, a pediatric oncologist at Children’s Hospital and Clinics of Minnesota, Minneapolis, and moderator of the session where these findings were presented. “We knew inotuzumab was coming, but we didn’t know how great it could be. We are very...
Inotuzumab Ozogamicin Plus Low-Intensity Chemotherapy: A Winner in Older Patients With Leukemia
Inotuzumab ozogamicin combined with a low-intensity chemotherapy called mini-hyper-CVD achieved highly encouraging results in older patients with acute lymphoblastic leukemia (ALL) in a phase II study reported at the 56th Annual Meeting of the American Society of Hematology.1 After the...
Expert Point of View: Timothy Graubert, MD
"I’m certainly excited about the promise of CAR T cells for patients with lymphoid leukemia (ALL and CLL). It’s clear from the data presented and published that CAR T cells can induce remissions in patients refractory to multiple lines of therapy,” said Timothy Graubert, MD, Hagler Family Chair in...
CAR T Cells Impressive in Acute Lymphocytic Leukemia
As more experience is gained with the use of genetically engineered chimeric antigen receptor (CAR) T cells in patients with leukemia, the data continue to be highly encouraging. Three different groups using slightly different modifications of CAR T cells reported positive experiences in treating...
Shedding Light on the Mystery of Male Breast Cancer
Male breast cancer represents less than 1% of all breast cancers, which partially explains why so little is known about the disease. Two presentations at the 2014 San Antonio Breast Cancer Symposium focused on the characteristics of male breast cancer drawn from a large international registry and...
Expert Point of View: David Steensma, MD
These results are fantastic,” said David Steensma, MD, a hematologist-oncologist at Dana-Farber Cancer Institute and Harvard Medical School, Boston. “We have long wanted agents for AML [acute myelogenous leukemia] like we have for APL [acute promyelocytic leukemia], noncytotoxic chemotherapy...
High Hopes for AG-221 in Advanced Leukemia
Although the data are preliminary, single-agent AG-221 therapy targeted to the IDH2 (isocitrate dehydrogenase 2) mutation holds great promise as a nonchemotherapy approach to the treatment of advanced hematologic malignancies, including relapsed/refractory acute myelogenous leukemia (AML) and...
Expert Point of View: David Steensma, MD and Bob Löwenberg, MD
Commenting on this study, David Steensma, MD, of Dana-Farber Cancer Institute and Harvard Medical School in Boston, said that longer follow-up is needed, especially in light of the lack of overall survival benefit, which may have been due to salvage therapy. “Sorafenib clearly has activity in...
First Randomized Trial to Show Benefit of Tyrosine Kinase Inhibitor in Newly Diagnosed Acute Myeloid Leukemia
Sorafenib (Nexavar) added to chemotherapy improved event-free survival and relapse-free survival in younger patients with acute myeloid leukemia, according to results of the randomized, controlled phase II SORAML trial.1 However, no significant improvement in overall survival has been seen to ...
Expert Point of View: Richard Little, MD
The National Cancer Institute (NCI) sees a real need for additional study of treatment options for human immunodeficiency virus (HIV)-infected patients with malignancies. The results of this trial make us confident that exclusion from autologous transplant studies on the basis of HIV serostatus is...
HIV-Related Lymphoma Can Be Safely Treated With Transplant
Human immunodeficiency virus (HIV)-positive patients with relapsed/refractory lymphoma can safely undergo autologous hematopoietic cell transplantation, according to results of a phase II multicenter trial presented at the 56th American Society of Hematology (ASH) Annual Meeting and Exposition in...
