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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...

Alexander Eggermont, MD, PhD, to Lead Gustave Roussy for 5 More Years

Alexander Eggermont, MD, PhD, the General Director of Gustave Roussy since 2010, has had his appointment at the Head of the Institute renewed by the French Minister of Health for 5 years, with this term beginning October 1, 2015. Success of 2010–2015 Period The 2010–2015 period was primarily one in ...

gynecologic cancers

Addition of Bevacizumab to Standard Chemotherapy Improves Overall Survival Only in High-Risk Ovarian Cancer

Final overall survival results of the phase III ICON7 trial reported in The Lancet Oncology by Amit M. Oza, MD, and colleagues indicate no significant improvement with the addition of bevacizumab (Avastin) to standard chemotherapy in women with newly diagnosed ovarian cancer.1 However, an overall...

lung cancer

Anti-EGFR Therapy in Squamous Cell Lung Carcinoma: Swimming With or Against the Tide?

Lung cancer is the most common, lethal, and costly cancer worldwide, accounting for at least 1.8 million new cases per year (12.9% of the total).1 Over the past decade, there has been a major shift in the treatment of non–small cell lung cancer (NSCLC), especially in adenocarcinoma, accompanied by...

cns cancers

FDA Approves Expanded Indication for Medical Device to Treat Newly Diagnosed Glioblastoma Multiforme

The U.S. Food and Drug Administration (FDA) has approved an expanded indication for the Optune tumor-treating fields device to treat patients with newly diagnosed glioblastoma multiforme. It is given along with the chemotherapy drug temozolomide following standard treatments that include surgery,...

lung cancer

Pembrolizumab in Previously Treated PD-L1–Positive Metastatic NSCLC

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 October 2, 2015, the U.S. Food and Drug Administration granted...

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)....

skin cancer

Nivolumab in Combination With Ipilimumab in BRAF V600 Wild-Type Unresectable or Metastatic Melanoma

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 30, 2015, the U.S. Food and Drug Administration...

Maternal Malignancy Treated During Pregnancy (125 Mothers)

The majority of women with cancer treated during pregnancy had a diagnosis of breast cancer (69 mothers, including 2 twin pregnancies [55%]) or a hematologic malignancy (20 mothers [16%], including 1 mother with acute lymphoid leukemia, 4 with acute myeloid leukemia, 1 with chronic myeloid...

issues in oncology

Maternal Cancer During Pregnancy Does Not Appear to Affect Cognitive or General Development in Early Childhood

In a study reported in The New England Journal of Medicine, Frederic Amant, MD, PhD, of University Hospitals Leuven, Belgium, and colleagues in the International Network on Cancer, Infertility, and Pregnancy found that cancer diagnosed during pregnancy did not appear to affect cognitive, cardiac,...

kidney cancer

Nivolumab and Cabozantinib Improve Outcomes vs Everolimus in Previously Treated Advanced Renal Cell Carcinoma

The CheckMate 025 trial, reported in The New England Journal of Medicine by Robert J. Motzer, MD, and colleagues, showed that treatment with the programmed cell death protein (PD-1) checkpoint inhibitor nivolumab (Opdivo) increased overall survival vs the mTOR inhibitor everolimus (Afinitor) in...

breast cancer

Endocrine Therapy Alone Linked to Low Risk of Breast Cancer Recurrence in Women With a Low-Risk Score on 21-Gene Assay

A prospective validation study of a 21-gene expression assay showed that treatment with endocrine therapy alone in women with hormone receptor–positive, HER2-negative breast cancer who had a low recurrence risk score resulted in low risk of recurrence. All patients included in the study were...

colorectal cancer

Many Patients Do Not Accurately Recall Important Colonoscopy Details as Time Lapses

As time lapses, many patients who have undergone a colonoscopy become less and less likely to recall when and where they last had the procedure performed, who the doctor was who performed it, whether polyps were found, and, if so, the number and size of those polyps, according to new study results...

Alternative Therapies: Knowledge Is Power, but Consider the Source

The use of dietary supplements and other complementary and “alternative” therapies 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 complementary therapies can be...

palliative care

Important Research in the Palliative Care of Patients With Cancer

The emphasis at this year’s Palliative Care in Oncology Symposium, held earlier this month in Boston, was on patient-centered care throughout the cancer continuum. The meeting attracted more than 650 attendees and included six general sessions featuring best practices in communication,...

issues in oncology

Delays in Drug Approval Are Deadly, Highlighting the Need for Improved Regulatory Efficiency

Researchers have determined just how many lives are lost when effective investigational drugs are not approved in a timely manner. These delays in the process of anticancer drug approvals result in thousands of premature deaths each year, according to an analysis presented at the 16th World...

lung cancer

Smoking Cessation Reduces Mortality in Lung Cancer Screening Population

Data from an analysis of lung cancer screening programs in Italy add further evidence that smoking cessation reduces mortality. Heavy smokers screened by low-dose computed tomography (CT) who stopped smoking before or during the screening period had a three- to fivefold reduction in mortality...

breast cancer

MRI Improves Breast Cancer Detection in Women at Average Risk

Magnetic resonance imaging (MRI) screening of women at average risk for breast cancer achieved a mean additional cancer yield of 15.8 cases per 1,000 women, greatly surpassing yields for supplemental digital breast tomosynthesis (1.25 per 1,000) or supplemental ultrasound (4.1 per 1,000). The...

breast cancer

Aromatase Inhibitors May Decrease Risk of Contralateral Breast Cancer in BRCA Mutation–Positive Patients

Given that BRCA1 and BRCA2 mutation carriers have an estimated 40% to 85% lifetime risk of breast cancer and an increased risk of developing contralateral breast cancer, risk reduction in this population remains essential. According to a study presented at the 2015 Breast Cancer Symposium, use of...

breast cancer

TAILORx: Chemotherapy Not Necessary for Women With a Low Recurrence Score

The long-awaited first results are in from the TAILORx study, showing that patients with early breast cancer considered at low risk for recurrence can forgo chemotherapy and be treated with endocrine therapy alone.1 “Women with axillary node-negative, estrogen receptor–positive, HER2-negative...

neuroendocrine tumors

Treatment Options Expanding for Neuroendocrine Tumors

Patients with advanced neuroendocrine tumors have two promising new treatment options, according to studies that earned spots in the Presidential Session of the 2015 European Cancer Congress, held recently in Vienna, Austria. The phase III studies evaluated the mTOR inhibitor everolimus (Afinitor)...

issues in oncology

Chemotherapy/Radiotherapy Safe in Second and Third Trimesters of Pregnancy

Children with in utero exposure to chemotherapy and/or radiation therapy during maternal treatment for cancer had no impairment in cognition, cardiac function, and general early childhood development, according to a study reported at the European Cancer Congress in Vienna, Austria, and published...

lung cancer

Atezolizumab Makes Inroads in Non–Small Cell Lung Cancer

The anti–PD-L1 (programmed cell death-ligand 1) antibody atezolizumab (formerly known as MPDL3280A) achieved encouraging outcomes in patients with non–small lung cancer (NSCLC) in two different trials: POPLAR1 and BIRCH.2 PD-L1 has emerged as a predictive biomarker for atezolizumab response in both ...

Expert Point of View: Cora N. Sternberg, MD, FACP

Cora N. Sternberg, MD, FACP, Chief of Medical Oncology at San Camillo Forlanini Hospital, Rome, Italy, discussed the implications of the METEOR trial. Everolimus (Afinitor) is considered standard second-line therapy, with a benchmark progression-free survival of 4.9 months in the RECORD-1 trial,...

kidney cancer

Phase III METEOR Trial Finds Cabozantinib Improves Progression-Free Survival vs Everolimus in Advanced Renal Cell Carcinoma

Cabozantinib (Cometriq) nearly doubled progression-free survival compared with standard everolimus (Afinitor) therapy in patients with advanced renal cell carcinoma, according to the phase III METEOR trial.1 Additionally, a preplanned interim analysis found an encouraging trend toward overall...

breast cancer
issues in oncology

Ovarian Suppression During Chemotherapy Preserves Fertility in Young Women With Breast Cancer

Several studies have addressed the risks and benefits of ovarian suppression during chemotherapy for breast cancer in women of childbearing age. A new meta-analysis of randomized trials found that it prevented premature ovarian failure and was associated with a higher number of pregnancies post...

kidney cancer

Nivolumab Produces Survival Benefit in Advanced Renal Cell Carcinoma

Patients with advanced renal cell carcinoma treated with nivolumab (Opdivo) were 27% less likely to die than those receiving everolimus (Afinitor), in a planned interim analysis of the open-label phase III CheckMate 025 trial.1 These positive results prompted an early termination of the study by...

skin cancer

FDA Approves First Oncolytic Viral Therapy in the United States

The U.S. Food and Drug Administration (FDA) has approved the biologics license application for talimogene laherparepvec (Imlygic), a genetically modified oncolytic viral therapy indicated for the local treatment of unresectable cutaneous, subcutaneous, and nodal lesions in patients with melanoma...

gynecologic cancers

ASCO Endorses ASTRO Guideline on Postoperative Radiation Therapy for Endometrial Cancer

As reported in the Journal of Clinical Oncology by Larissa A. Meyer, MD, MPH, and colleagues, ASCO has endorsed the recently published American Society for Radiation Oncology (ASTRO) guideline on postoperative radiation therapy for endometrial cancer.1 The ASCO clinical practice guideline...

breast cancer
leukemia

Shadowed by Cancer

Although genetic testing has not turned up any inherited mutations that might explain the number of cancers that have plagued my immediate family, over the past 15 years, I have lost my father, aunt, and sister to the disease. In 2001, my husband, Wayne, died of acute promyelocytic leukemia, and...

Equanimity

The following essay by S. Vincent Rajkumar, 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 was...

lymphoma

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

Question 1: What is next best step in the management of this patient? Correct Answer: C. Ophthalmoscopy/slit lamp examination. Expert Perspective Ophthalmic involvement should be sought by noninvasive procedures such as slit lamp examination and ophthalmoscopy and abnormal findings must be...

A Chemist Exposes Dangerous Chemicals

Bookmark Title: Pick Your Poison: How Our Mad Dash to Chemical Utopia Is Making Lab Rats of Us All Author:  Monona Rossol Publisher: John Wiley & Sons Publication date: October 2015 Price: E-book, 210 pages Monona Rossol is a chemist and “industrial hygienist” who is a frequent contributor to...

A Pandemic’s Story of Tragedy and Success

Bookmark Title: AIDS Between Science and Politics Author:  Peter Piot Publisher: Columbia University Press Publication date: May 2015 Price: $29.95; hardcover, 216 pages AIDS is a global phenomenon that recognizes neither national boundaries nor social strata. The AIDS pandemic was one of the...

The Future of ASCO: President-Elect Candidates Share Their Vision

S. Gail Eckhardt, MD, FASCO, is a tenured Professor at the University of Colorado School of Medicine, where she also holds the Stapp Harlow Chair in Cancer Research. She has been a faculty member at the institution since 1999 and was Division Head of Medical Oncology from 2006–2014. Currently, she...

lung cancer

Nivolumab in Metastatic NSCLC After Platinum Therapy

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 October 9, 2015, the anti–programmed cell death protein 1...

neuroendocrine tumors

Telotristat Etiprate Added to Standard Therapy for Carcinoid Syndrome Shows Clinical Benefit in Patients With Metastatic Neuroendocrine Tumors

The investigational drug telotristat etiprate was shown to have clinical benefit when added to somatostatin analog therapy for carcinoid syndrome not adequately controlled by long-acting somatostatin analog therapy, the current standard of care, in patients with metastatic neuroendocrine tumors....

skin cancer

Why Melanoma Rates Are Increasing in Adolescents and Young Adults, Especially Among Females

The incidence of melanoma among children, adolescents, and young adults has reached epidemic proportions, increasing more than 250% over the past 4 decades, with young females at highest risk for the deadly cancer, according to a study1 by researchers at Roswell Park Cancer Institute in Buffalo,...

breast cancer

Survival and Bevacizumab in Early Breast Cancer: Time to Reconsider?

In metastatic HER2-negative breast cancer, several trials have shown that the addition of the anti–vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (Avastin) to different chemotherapy regimens significantly improved response rates and progression-free survival by various...

palliative care

End-of-Life Clinical Decisions Still Need Conversations About Improving Care

In 2014, the Institute of Medicine report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life called for more conversations about improving care for those who are dying. Improving the care of the imminently dying is an important issue in the oncology...

issues in oncology

Study Finds Quality of Physician Recommendation to Parents Key to Encourage/Discourage HPV Vaccination of Adolescents

A nationwide online survey of 776 pediatricians and family physicians assessing the quality of their human papillomavirus (HPV) vaccine recommendations to parents has found that approximately 27% of respondents said they do not strongly endorse HPV vaccination; further, 26% and 39% of respondents...

breast cancer

Functional Subtyping With 80-Gene Assay Identifies Distinct Triple-Positive Subtypes in Breast Cancer Patients

Molecular categorization of tumors with immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) has become a critical component in the diagnosis and treatment of breast cancer, improving outcomes by assigning the most appropriate therapy to specific tumor pathways. According to a...

lung cancer

Antibody-Drug Conjugate Makes Strong Showing in Small Cell Lung Cancer

The antibody-drug conjugate rovalpituzumab tesirine has shown strong clinical activity as second- and third-line treatment for small cell lung cancer in a phase I/Ib multicenter study,1 especially in the subset with high expression of the delta-like protein 3 (DLL3), which the drug targets. This...

lung cancer

Combined EGFR and VEGF Inhibition Ameliorates the Impact of  the EGFR T790M Mutation in NSCLC

Treatment with erlotinib and bevacizumab (Avastin) may help overcome the poor prognosis associated with T790M mutations present at diagnosis in advanced non–small cell lung cancer (NSCLC), according to the results of the phase II BELIEF trial.1 At the 2015 European Cancer Congress, Rolf A. Stahel,...

solid tumors
bladder cancer
skin cancer

PD-1/PD-L1 Inhibitors Show Promise in Additional Tumor Types

While inhibitors of programmed cell death protein 1 (PD-1) or its ligand (PD-L1) are becoming established in melanoma, non–small cell lung cancer, and renal cell carcinoma, their efficacy is also being evaluated in numerous other tumor types, with promising results, according to studies presented...

skin cancer

Survival Benefit in Metastatic Melanoma Grows Larger in COMBI-v Update

Combined BRAF and MEK inhibition was superior to BRAF inhibition alone in unresectable metastatic melanoma, according to the updated survival analysis of the large randomized COMBI-v trial.1 These findings were reported at the 2015 European Cancer Congress recently held in Vienna, Austria....

Expert Point of View: Bertrand Tombal, MD, PhD

We have made major progress by moving docetaxel forward, and now the largest pool of patients who become hormone resistant have received local therapy and then progressed. We have a lot of drugs for castration-resistant prostate cancer, and we are studying them earlier in the course of disease, but ...

prostate cancer

Update on Clinical Trials in Metastatic Prostate Cancer

Despite the proliferation of new drugs to treat prostate cancer, further progress is proving somewhat elusive, according to three trials presented at the 2015 European Cancer Congress. One study had positive results with orteronel maintenance therapy in patients with metastatic castration-resistant ...

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