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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 Increases Recurrence-Free Survival After Complete Resection of High-Risk Stage III Melanoma

In the phase III European Organisation for Research and Treatment of Cancer (EORTC) 18071 trial reported in The Lancet Oncology, Alexander M.M. Eggermont, MD, PhD, Director General of the Gustave Roussy Cancer Center in Villejuif, France, and colleagues found that adjuvant therapy with the immune...

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 ...

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...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia

The ASCO Post is pleased to present Hematology Expert Review, an occasional feature that includes a case report detailing a particular hematologic condition followed by questions. Answers to each question with expert commentary can be found in the sidebar. In this installment, we present the case...

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

Progress in the Treatment of Patients With EGFR-Mutated NSCLC

Approximately 10% to 15% of patients with advanced non–small cell lung (NSCLC) cancer have mutations in the epidermal growth factor receptor (EGFR) in tumor cells. Specific therapies to inhibit the activity of EGFR-mutated NSCLC have now been clearly shown to improve response rate and...

lung cancer

Early-Phase Studies Show Activity of Novel EGFR Inhibitors Rociletinib and AZD9291 in T790M-Positive NSCLC

Two early-phase studies have shown that the novel epidermal growth factor receptor (EGFR) inhibitors rociletinib and AZD9291 exhibit high activity in non–small cell lung cancer (NSCLC) patients with the EGFR T790M mutation who had progressed on prior EGFR inhibitor therapy.1,2 The T790M mutation...

issues in oncology

Precision Medicine Trials Bring Targeted Treatments to More Patients

At the 2015 ASCO Annual Meeting, both ASCO and the National Cancer Institute (NCI) unveiled details of new precision medicine trials that will greatly expand the number of patients with cancer who are benefiting from targeted agents. The trials will match a patient’s tumor molecular profile with an ...

Expert Point of View: Daniel G. Coit, MD

Daniel G. Coit, MD, of Memorial Sloan Kettering Cancer Center, New York, and Chair of the National Comprehensive Cancer Network (NCCN) Melanoma Guidelines Panel, discussed the findings reported by Lewin et al at the ASCO Annual Meeting. “This is a small retrospective study examining a prospective...

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 ...

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...

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,...

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: Noah Hahn, MD

Commenting on the pembrolizumab (Keytruda) phase Ib study, Noah Hahn, MD, of Johns Hopkins Sidney Kimmel Cancer Center, Baltimore, called the overall response rate of 28% with pembrolizumab “pretty impressive. Nearly two-thirds of patients had some response or tumor reduction, and overall survival...

bladder cancer

Immunotherapy Marches On, Making Headway in Advanced Urothelial Bladder Cancer

Two immunotherapy agents show promise in preliminary studies of advanced urothelial bladder cancer: the anti–PD-1 (programmed cell death protein 1) antibody pembrolizumab (Keytruda) and the anti–PD-L1 (programmed cell death ligand 1) antibody atezolizumab. Separate phase I studies of each drug...

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...

multiple myeloma

Carfilzomib/Dexamethasone Doubles Progression-Free Survival vs Bortezomib/Dexamethasone in Patients With Relapsed Multiple Myeloma

In the first head-to-head study comparing two proteasome inhibitors in relapsed multiple myeloma, carfilzomib (Kyprolis)/dexamethasone provided a doubling in progression-free survival, compared with bortezomib (Velcade)/dexamethasone.1 Results of the phase III ENDEAVOR trial of the two regimens in...

Expert Point of View: Jeremy Abramson, MD

Jeremy Abramson, MD, Clinical Director of the Center for Lymphoma at Massachusetts General Hospital, Boston, agrees that obinutuzumab is an advance over rituximab. Like rituximab, obinutuzumab targets CD-20, but rituximab does not directly induce cell death. Obinutuzumab is a type 2 antibody and...

hepatobiliary cancer

More Than One-Third of Those Diagnosed With Hepatocellular Carcinoma as Outpatients Have Diagnostic Delays of 3 or More Months

Nearly 20% of patients with hepatocellular carcinoma “wait more than 3 months from presentation to diagnosis, which can contribute to interval tumor growth,” Nishant Patel, MD, and colleagues concluded in the Journal of the National Comprehensive Cancer Network. They based their conclusions on a...

health-care policy

Medicare to Reimburse Doctors for End-of-Life Counseling

In a breakthrough proposal announced on July 8, the Centers for Medicare & Medicaid Services (CMS) plans to reimburse physicians for end-of-life counseling, a move that the oncology community has long been lobbying for. Arriving just as the presidential election cycle begins to heat up, the CMS ...

Mount Sinai Honors James F. Holland, MD, FASCO, on the Occasion of His 90th Birthday

On May 14, 2015, over 160 colleagues, family members, friends, and patients of James F. ­Holland, MD, FASCO, gathered in the Goldwurm Auditorium in the Icahn School of Medicine at Mount Sinai Hospital in New York to honor Dr. Holland for the contributions he has made during his remarkable career in ...

multiple myeloma

Daratumumab Expanded Access Program Open to Eligible U.S. Patients With Heavily Pretreated Multiple Myeloma

Janssen Biotech, Inc, announced the opening of a daratumumab expanded access program for eligible patients in the United States. Daratumumab is an investigational human anti-CD38 monoclonal antibody being evaluated in clinical trials as a treatment for patients with multiple myeloma. The...

issues in oncology

Cost vs Our Values in Cancer Care

An 80-year-old patient with metastatic prostate cancer asked me to discontinue his treatments, which were costing him more than $1,000 every 3 months. Although he had Medicare, he did not have secondary insurance. I told him that I would seek compassionate-care payment from the pharmaceutical...

palliative care

The Importance of Including Adolescents and Young Adults With Cancer in Their Advance Care Planning

Three years ago, a study of adolescents and young adults aged 16 to 28 with metastatic or recurrent cancer or HIV/AIDS compared the usefulness of two previously developed advance care planning guides—one prepared specifically for adolescents and young adults and one specifically for adults. The...

Charles Rubin, MD, Pediatric Cancer Specialist, Dies at 62

Charles M. Rubin, MD, Associate Professor of Pediatrics at the University of Chicago Medicine, a highly respected specialist in the care of children with cancer, died on July 17. He was 62. An authority on all aspects of pediatric cancers, Dr. Rubin had a particular interest in brain tumors and...

leukemia

A Lasting Legacy

When Emil J Freireich, MD, retires from the University of Texas MD Anderson Cancer Center on September 1, he will have spent 50 years at the institution and a total of 60 years in the pursuit of curing childhood leukemia as well as other cancers and in the educational development of young...

Blame

The following essay by Karen J. Krag, 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. It is easier ...

The Human Heart: Tales of Science and Mystery

BOOKMARK Title: The Man Who Touched His Own Heart: True Tales of Science, Surgery, and Mystery Author: Rob Dunn Publisher: Little, Brown and Company Publication date: February 3, 2015 Price: $27.00; hardcover, 384 pages No part of the human anatomy has been as mythologized, analogized, and...

issues in oncology

Past President of ASCO Takes on New Role at Memorial Sloan Kettering Cancer Center to Improve Patient Care and Public Health

In June, Memorial Sloan Kettering Cancer Center (Memorial) in New York announced it had appointed ­Clifford A. Hudis, MD, FACP, Chief of Breast Medicine Service, to a newly created position of Vice President for Government Relations and Chief Advocacy Officer. In addition to his new role, Dr. Hudis ...

breast cancer

Comparing Regimens Guides Therapeutic Decisions in Previously Treated Advanced Breast Cancer

Kaufman and colleagues recently reported findings of a phase III trial comparing eribulin ­(Halaven) vs capecitabine in patients with advanced breast cancer who had previously received anthracycline and taxane therapy,1 and a review of their study appears in this issue of The ASCO Post. Although...

breast cancer

No Survival Benefit for Eribulin vs Capecitabine in Advanced Breast Cancer

Eribulin (Halaven) currently is indicated in the United States for treatment of patients with metastatic breast cancer who previously received at least two chemotherapy regimens for metastatic disease and an anthracycline and a taxane in either the adjuvant or metastatic setting. Its approval was...

lung cancer

ODAC Discussion ‘Constructive’ About Necitumumab for Squamous NSCLC

The U.S. Food and Drug Administration’s (FDA) Oncologic Drugs Advisory Committee (ODAC) favored the approval of necitumumab in combination with gemcitabine and cisplatin for use in first-line treatment of patients with locally advanced or metastatic squamous non–small cell lung cancer (NSCLC). In...

prostate cancer

Magnetic Resonance Imaging/Ultrasound Fusion: A Promising Technology for Image-Guided Prostate Biopsy

An elegant study by Siddiqui et al1—reviewed in this issue of The ASCO Post—offers compelling evidence for the diagnostic utility of “targeted” prostate biopsy using multiparametric magnetic resonance imaging (MRI) data fused with ultrasound images. The technique involves first performing a...

prostate cancer

Magnetic Resonance Imaging/Ultrasound Fusion–Guided Biopsy Improves Detection of High-Risk Prostate Cancer

In a study reported in JAMA, M. Minhaj Siddiqui, MD, currently of the University of Maryland School of Medicine, and colleagues found that targeted magnetic resonance imaging (MRI)/ultrasound fusion–guided prostate biopsy increased diagnosis of high-risk prostate cancer and reduced detection of...

cost of care
hematologic malignancies

Study Shows Current Blood Cancer Drug Prices Are Not Justified

The costs associated with cancer drug prices have risen dramatically over the past 15 years, a trend concerning to many oncologists. In a new analysis, researchers at The University of Texas MD Anderson Cancer Center concluded the majority of existing treatments for hematologic cancers are...

cns cancers

Glioblastoma: Novel Immunotherapy Approaches Generate Responses and Excitement

Checkpoint inhibitors were major attention grabbers at the 2015 ASCO Annual Meeting, but studies suggested there are other encouraging means of harnessing the immune system in the treatment of glioblastoma. EGFRvIII-Targeted Vaccine David A. Reardon, MD, Clinical Director of the Center for...

issues in oncology

Value: What Do We Mean, Who Should Decide?

Oscar Wilde famously defined a cynic as “a man who knows the price of everything and the value of nothing.” I do not think that oncologists need to be as cynical as this, but it was very appropriate that a major theme of this year’s ASCO Annual Meeting was the concept of “value.” It is clear that...

colorectal cancer

Statin Use Not Associated With Reduced Mortality Among Patients With Primary Colorectal Cancer

Statin use was not associated with reduced mortality among patients diagnosed with primary colorectal cancer between 2003 and 2009 and followed for a median of 3.4 years in the Darmkrebs: Chancen der Verhütung durch Screening (DACHS) study, an ongoing population-based study of colorectal cancer in...

skin cancer

Expect Questions About Increased Risk of Melanoma From Consuming Grapefruits and Orange Juice

Could too much citrus cause skin cancer?” was the lead-in of an NBC News item about a study linking consumption of grapefruits and oranges to an increased risk of melanoma.1 “Citrus consumption and skin cancer: How real is the link?” was the question posed by a headline in The Washington Post.2...

skin cancer

Public Urged Not to Overreact to Study Finding Link Between Citrus Fruits and Melanoma Risk

A study finding a link between citrus consumption and increased risk of melanoma1 may provide food for thought about the findings and implications as well as whet the appetite for more evidence, but according to several experts commenting on the study, it does not mean you should stop eating citrus ...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia: Answers From Hematology Expert Review Questions

Question 1: What is the best first step in management of this patient? Correct Answer: C. Start plasma exchange. Expert Perspective Although distinguishing among thrombotic thrombocytopenic purpura, typical hemolytic uremic syndrome, and atypical hemolytic uremic syndrome (see Table 1 in the...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia: Questions

Hematology Expert Review is an occasional feature that includes a case report followed by questions, answers, and expert commentary. In the July 25 issue of The ASCO Post, part 1 of a case report was published and focused on diagnosis (see summary below). Here, in part 2, the management of this...

skin cancer

Sonidegib in Basal Cell Carcinoma

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 July 24, 2015, sonidegib (Odomzo) was approved for treatment...

issues in oncology

Johnson & Johnson Creates Independent Bioethics Panel to Evaluate Compassionate Drug Use Requests

In May 2015, Johnson & Johnson announced its partnership with New York University (NYU) School of Medicine in New York to create a first-of-its kind independent bioethics panel to review requests made to the company for compassionate use of an investigational drug and determine how the company...

geriatric oncology

Geriatric Oncology: A Geriatrician’s Perspective

“The management of older individuals, including older cancer patients, involves a wisdom developed over a lifetime, thanks to time-consuming listening and painstaking collection and interpretation of clinical details.” —Lodovico Balducci, MD It is not simple to be a geriatrician in a world of...

cns cancers

Improved Understanding of Glioma Tumor Biology

The management of patients with lower-grade gliomas is evolving. As evidenced by two recent publications in The New England Journal of Medicine,1,2 reviewed in this issue of The ASCO Post, there has been a substantial increase in our knowledge of the molecular characteristics of these neoplasms....

cns cancers

New Molecular Classifications of Gliomas Established

Two studies reported in The New England Journal of Medicine identified new molecular classifications of glioma that capture biologic and prognostic differences. The Cancer Genome Atlas Research Network identified three prognostically significant subtypes of lower-grade glioma that were identified...

breast cancer

The Conundrum of Estrogen-Receptor Signaling in HER2-Positive Breast Cancer

BOLERO-1—reviewed in this issue of The ASCO Post—is the next installment in a series of randomized trials evaluating the addition of everolimus (Afinitor) to standard therapy in metastatic breast cancer.1 The initial evaluation of everolimus in the HER2-positive metastatic setting looked extremely...

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