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lung cancer

Biomarker Analysis of the TORCH Study: First-line Erlotinib Only in Patients with EGFR-positive Non–Small Cell Lung Cancer

Patients with advanced non–small cell lung cancer (NSCLC) should receive treatment with erlotinib (Tarceva) before receiving standard chemotherapy only if their tumor is known to harbor EGFR mutations, researchers reported at the 3rd European Lung Cancer Conference in Geneva, Switzerland.1 The...

lung cancer

Study Reports on New Potential Biomarker of Response in Lung Cancer Chemoprevention Studies

MiRNAs, negative post-transcriptional regulators of gene expression, are involved in bronchial carcinogenesis from the very early steps of this process. Endobronchial histology is currently considered as the best intermediate endpoint for chemoprevention studies. However, no intermediate biomarker...

lung cancer

Expert Point of View: New Genetic Signature May Help Identify Risk of Relapse in Patients with Completely Resected Early Non–Small Cell Lung Cancer

Commenting on the study, David Carbone, MD, PhD, of the Vanderbilt-Ingram Cancer Center, said that the Spanish group studied tumors from patients with completely resected stage I and II NSCLC for gene RNA expression profiles using 41,000 different probes. “Since over one-half of these patients...

lung cancer

New Genetic Signature May Help Identify Risk of Relapse in Patients with Completely Resected Early Non–Small Cell Lung Cancer

A new genetic signature identified by Spanish researchers may provide robust and objective information about which patients with completely resected early stage non-small cell lung cancer are at low or high risk of relapse following surgery, according to Florentino Hernando, MD, who presented the...

SIDEBAR: Private/Public Health-care Divide Creates Disparity in Cancer Pain Treatment in South Africa

Approximately 15% of South Africa’s people have private health-care insurance and use private hospitals and clinics; another 10% also use private care paid out of pocket. However, the remaining 75% of South Africans use public health care, which is spread out over rural and urban areas. Although...

global cancer care
pain management
palliative care

Untreated Cancer Pain Remains a Significant Global Problem

“Physicians are afraid of morphine … Doctors [in Kenya] are so used to patients dying in pain … they think that this is how you must die. They are suspicious if you don’t die this way — [and feel] that you died prematurely.” —Human Rights Watch interview with Dr. John Weru of Nairobi Hospice,...

global cancer care

Cancer Care in India: Complex Challenges in a Populous Nation

With 1.22 billion people, India is the second most populous country in the world. Experts project that cancer incidence in India will increase by more than two-thirds over the next 20 years, to approximately 1.7 million new cases per year. Due to a range of economic and social issues, most of...

leukemia

Study Shows Steady Increases in Survival for Children with ALL

A study by the Children’s Oncology Group (COG) reported that 5-year survival for acute lymphoblastic leukemia (ALL) among children treated through COG clinical trials increased from 83.7% during the period 1990-1994 to 90.4% in the period 2000-2005. The improvements in survival were observed among...

leukemia

Progress in Treating Chronic Lymphocytic Leukemia Has Led to Across-the-board Improvements in Survival

Four decades ago, Kanti R. Rai, MD, was determined to figure out why some of his patients with chronic lymphocytic leukemia (CLL) died within 2 years after their diagnosis, while others lived for 20 or even 30 years. At the time, Dr. Rai was a young scientist doing research in leukemia at...

hepatobiliary cancer

Regional Infusion of Designer T Cells to Treat Intrahepatic Metastases

Designer T cells are modified from normal T cells to express specific immune receptors that allow them, via antibody-directed recognition or other mechanisms, to kill malignant cells bearing particular antigens. The Surgical Immunotherapy Lab at the Roger Williams Medical Center, Providence, Rhode...

SIDEBAR: Learning from Advanced Disease

Current testing of immunotherapy approaches against cancer involves patients in whom standard therapies have failed. “That really puts us at a great disadvantage because a lot of the standard therapies are immunosuppressive, as is the tumor itself as it grows,” Olivera Finn, PhD, said at a press...

Immunotherapy Clinical Trials Show Benefits for Patients with Advanced Cancers

Immunotherapeutic approaches, including vaccines, a monoclonal antibody, and a combination of low-dose interleukin (IL)-2 (Proleukin) and retinoic acid, are showing some success in clinical trials investigating the prevention of breast cancer recurrence in women at high risk, the treatment of...

supportive care
symptom management

Managing Febrile Neutropenia: What Are the Best Antibiotic Regimens?

Management of patients with cancer who have fever and a low neutrophil count is one of the most common scenarios oncologists face today. “Physicians have to be keenly aware of the infection risks, diagnostic methods, and microbial therapies required for managing febrile neutropenic patients because ...

sarcoma

FDA Approves Pazopanib for Advanced Soft-tissue Sarcoma

The FDA has approved pazopanib (Votrient) to treat patients with advanced soft-tissue sarcoma who have previously received chemotherapy. Pazopanib is an oral agent that works by interfering with angiogenesis. Soft-tissue sarcoma occurs in about 10,000 cases annually in the United States. More than ...

prostate cancer

Advances in Prostate Cancer Accompanied by Ongoing Debates

Scientific advances have markedly improved prostate cancer survival, but this clinical success story is not without its share of controversy. From screening through treatment, a growing array of options offer an admixture of promise and confusion for clinicians and patients. Moreover, today’s...

issues in oncology
health-care policy

Maintenance of Certification in Medical Oncology

It is said that time is perhaps the most treasured asset we have. If you are a practicing oncologist, everyone wants more and more of your time, and I’m not referring to patients. Rather, there is an increasing proliferation of folks who want to make sure we’re doing a good job, and they are...

health-care policy

ASCO Issues New Guideline on Chemotherapy Dosing for Obese Patients

In April, ASCO released a new clinical practice guideline on the appropriate dosing of chemotherapy drugs given to obese adult patients with cancer. The result of an analysis by a panel of experts assembled by ASCO, the guideline calls for the use of a patient's actual body weight when calculating...

gynecologic cancers

Scoring System Based on DNA Repair Pathways Predicts Outcomes and Response to Platinum Therapy

A potentially important tool to identify patients with advanced-stage ovarian cancer likely to benefit from platinum-based chemotherapy and redirect those with poor predicted outcomes to alternative treatments was developed using gene-expression data and validated in two independent datasets. While ...

thyroid cancer

Low-dose Radioiodine as Effective as High-dose in Thyroid Ablation

Two studies in The New England Journal of Medicine found that low-dose radioiodine is as effective as a high-dose strategy in treating patients with thyroid cancer and that recombinant human thyrotropin (thyrotropin alfa [Thyrogen]) and thyroid hormone withdrawal had similar efficacy in preparing...

Regional Disparities in Cancer Mortality

I was interested to see an article about the continuing declines in cancer death rates featured in the April 15 issue of The ASCO Post (page 94), as I have just published a paper on breast cancer mortality rates.1 Although overall breast cancer mortality rates have decreased significantly, a much...

health-care policy

Physicians Need to Be Involved in Reducing Costs

I am so proud of ASCO for participating in the American Board of Internal Medicine Foundation’s Choosing Wisely campaign (see The ASCO Post, May 1, page 19; and page 75 of this issue). I am the Associate Medical Director for a 280-physician multispecialty group in the Hudson Valley of New York,...

palliative care

The Semantics of Palliative Care

The interview with Thomas J. Smith, MD (The ASCO Post, April 15, 2012), the lead author of the ASCO Palliative Care Provisional Clinical Opinion, was timely. However, it left many clinical terms and issues unclear. A significant percentage of modern medicine, including cancer care, is palliative....

issues in oncology

Complex Relationship between Metformin and BRAF-mutant Tumors

The antidiabetic drug metformin appears to lower cancer risk in diabetic patients and has shown antitumor activity in preclinical studies. Suppression of mTOR signaling via AMP kinase (AMPK)-dependent TOR complex 1 (TORC1) inhibition is one of the proposed mechanisms by which metformin appears to...

symptom management

Surviving the Aftermath of Cancer

With medical information now just a click away, it’s difficult to imagine a time before the Internet existed, when finding answers to questions about serious diseases was nearly impossible. When I was diagnosed with liposarcoma 33 years ago, there was only one oncologist in my hometown of Tyler,...

pain management

Screening for Distress and Unmet Needs in Patients with Cancer

In the past decade, “screening for distress has been positioned as the sixth vital sign in cancer care, in addition to the first five, which are measurements of pulse, respiration, blood pressure, temperature, and pain,” according to a review article in the Journal of Clinical Oncology. Although...

integrative oncology

Acai Berry

The use of dietary supplements by patients with cancer has risen significantly over the past 2 decades 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...

breast cancer
issues in oncology
supportive care
palliative care

Studies Report Findings in Patient-centered Care

New studies highlighting findings that will lead to improvements in the patient experience and identifying potential risks for development of cancers in the future were reported at a press briefing held during the 2012 ASCO Annual Meeting in Chicago. “In this era of sophisticated research advances, ...

SIDEBAR: Difference between Efficacy and Effectiveness

One of the reasons large population-based studies are important is based on the “difference between efficacy—does a treatment work in a highly controlled setting of a phase III randomized clinical trial—and effectiveness—does a treatment work in general practice,” according to Benjamin D. Smith,...

SIDEBAR: Expect Questions from Your Patients

“Our study provides critical interim companion data to awaited randomized trials and may help clinicians and patients quantify the risk-benefit ratio of brachytherapy compared with standard therapy,” Benjamin D. Smith, MD, said of a study comparing lumpectomy and either whole-breast irradiation or...

breast cancer

Will Study Showing Increased Complications Compared to Whole-breast Irradiation Put the Brakes on Brachytherapy?

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. Older women treated for invasive...

What You Need to Know About Glucarpidase Injection for Toxic Methotrexate Levels in Renal Impairment

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. Indication In January 2012, glucarpidase injection (Voraxaze) was...

Choosing Wisely® Campaign

ASCO recently published a detailed review of the “Top Five” opportunities to improve the quality and value of cancer care by curbing use of common tests and treatments that are not supported by clinical evidence. Published in the Journal of Clinical Oncology,1 the article coincided with the...

health-care policy

ASCO Reexamines the Oncology Workforce Shortage

A study commissioned by ASCO in 2006 predicted a significant shortage of medical and gynecologic oncologists in the United States by 2020. As a result, the organization created the Workforce Implementation Group to develop recommendations to stem the projected workforce shortfall and ensure ongoing ...

prostate cancer

Denosumab Delays Time to First Bone Metastasis in Men with Castration-resistant Prostate Cancer

Denosumab (Xgeva) significantly delayed time to first bone metastases among men with nonmetastatic castration-resistant prostate cancer enrolled in a phase III randomized, placebo-controlled trial. The time to first bone metastasis was 33.2 months among the 716 patients randomly assigned to receive ...

FDA-led Research Team Discovers Autoimmune Mechanism for Drug-induced Adverse Reactions

A team of researchers led by the FDA has discovered a new mechanism for identifying and understanding drug-related autoimmune reactions. In an article available online in the journal AIDS, the team reported that in certain at-risk patients, the anti-HIV drug abacavir (Ziagen) causes the immune...

SIDEBAR: Photodynamic Therapy for Cancer

Photodynamic therapy is a two-step treatment that includes a photosensitizing agent and a light source. In the first step, the photosensitizing agent (porfimer sodium) is injected into the bloodstream and absorbed by all cells. Over 24 to 48 hours, the drug is concentrated in cancer cells. In the...

International Photodynamic Medicine Symposium: Shedding New Light on an Old Therapy

This past May, a collaborative think tank of researchers was convened at The Ohio State University, Columbus, to share their expertise in a somewhat older treatment that is reemerging on many fronts: photodynamic therapy. Participants from the United States, Great Britain, and Japan took part in...

Egidio Del Fabbro Named Program Director of Palliative Care at Virginia Commonwealth University Massey Cancer Center

Egidio Del Fabbro, MD, has been named program director of palliative care at Virginia Commonwealth University (VCU) Massey Cancer Center, effective May 1, 2012. A nationally recognized expert in palliative care, Dr. Del Fabbro comes to VCU Massey from The University of Texas MD Anderson Cancer...

gastrointestinal cancer

Strong Biomarker Candidates for Predicting Clinical Response to Bevacizumab

Plasma vascular endothelial growth factor A (VEGF-A) and tumor neuropilin-1 “are strong biomarker candidates for predicting clinical outcome in patients with advanced gastric cancer” after treatment with bevacizumab (Avastin). This was the conclusion of a mandatory biomarker program following up on ...

SIDEBAR: Success of the Multiple Myeloma Research Consortium

Since its founding in 2004, the Multiple Myeloma Research Consortium (MMRC) has grown from a handful of member institutions to 16 such academic centers and has launched 38 phase I and phase II clinical trials. Six of the drugs studied in those investigations are currently in phase III trials. And...

hematologic malignancies
multiple myeloma

Multiple Myeloma Research Foundation Initiatives Are Leading to More Effective Targeted Treatment

In 1996, at just 37, the last thing Kathy Giusti expected to hear was that she had the fatal blood cancer multiple myeloma. An executive at Searle Pharmaceuticals and the mother of an 18-month-old daughter, Giusti was told she probably had 3 years to live. At the time, treatments for the disease...

ASCO Participates in Two FDA Meetings on Improving Clinical Trials

ASCO recently took part in two public meetings at the U.S. Food and Drug Administration (FDA) that had the broad goal of improving clinical trials and, ultimately, treatment for cancer patients. Then ASCO President Michael P. Link, MD, served as a panelist on a workshop sponsored by FDA and ASCO,...

Markers in Cancer 2012, to be Held October 11–13, Will Seek to Move the Field of Biomarkers to the Next Phase

There are hundreds and hundreds of papers published on biomarkers in cancer each year, but very few make it over the hurdles necessary to be used in actual patient care, said James L. Abbruzzese, MD, Chair of the Department of Gastrointestinal Medical Oncology at the University of Texas MD Anderson ...

Full Membership: What It Means, What It Offers, and Why It’s Essential

As part of our series explaining the benefits of ASCO’s various membership categories, in this issue we focus on the Full Membership Category Involvement in ASCO—the largest and most inclusive professional organization in oncology—allows those involved in cancer care to chart the very course of the ...

Best of ASCO® Meetings Deliver Top Annual Meeting Abstracts and Select Educational Sessions in an Intimate Setting

If you have to miss the Annual Meeting this year, don’t worry. ASCO also offers Best of ASCO Meetings, which feature 2 days of presentations on the top scientific abstracts from the Annual Meeting, complemented by select education sessions. “The Best of ASCO Meeting provides an opportunity for...

lung cancer

Study Validates Prognostic Role of Tumor Lymphocytic Infiltration in Resectable Non–Small Cell Lung Cancer

The benefit from platinum-based adjuvant chemotherapy in non–small cell lung cancer (NSCLC) was demonstrated in four randomized trials (International Adjuvant Lung Cancer Trial [IALT], Canadian JBR.10 trial, Cancer and Leukemia Group B [­CALGB] 9633 trial, and Adjuvant Navelbine International...

issues in oncology
survivorship

Cancer Survivors Stand Up, Give Thanks, and Give Back

“I have me back,” is how breast cancer survivor Jeanette Daniel of Memphis described her life after being treated on a clinical trial at Vanderbilt-Ingram Cancer Center in Nashville. Being conducted by the Stand Up To Cancer P13K Dream Team, whose leader discovered the PI3K pathway, the trial...

survivorship

Risk Stratification and Targeted Therapy, Abetted by Collaboration, Improve Outcomes for Children with Cancer

Outcomes for children with cancer have “improved over the course of the years incrementally, mostly not from the development of new drugs, because virtually all the drugs that we use now in leukemia were available in the 1970s. It is really through better understanding of the heterogeneity of the...

breast cancer

Epidemiology, Diagnosis, and Treatment of Breast Cancer Explored at the American Society of Breast Surgeons Meeting

Over 1,300 breast surgeons attended the 13th Annual Meeting of the American Society of Breast Surgeons, held May 2–6 in Phoenix. Presentations included investigations on recurrence after lumpectomy, gender differences in breast cancer, and the potential role of infrared thermography in diagnosing...

breast cancer

Postsurgical Local Breast Cancer Therapies Compared in Two Large Studies

A study presented at the 13th Annual Meeting of the American Society of Breast Surgeons suggested that accelerated partial-breast irradiation (APBI) using brachytherapy might control the tumor bed better than whole-breast irradiation (WBI), while another study suggested that radiofrequency ablation ...

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