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solid tumors

Identification of Novel Mechanism for Suppression of Antitumor Immunity

The efficacy of cancer immunotherapy has been limited, likely reflecting in large part the incomplete understanding of the complex interactions between tumors and the immune microenvironment. A study presented at the 2012 ASCO Annual Meeting helps clarify some of these interactions. Changes in...

breast cancer

My Breast Cancer Had Been Coming for Years

I’ve never had a normal mammogram screening. There was always something suspicious the test picked up: macrocalcifications in one breast 1 year and a cyst in the other breast the next year. Over a period of 3 years, I had six tissue biopsies, all benign for cancer. So when I flunked another...

breast cancer
integrative oncology

Soy Phytoestrogens and Breast Cancer: An Enduring Dilemma

The impact of soy consumption on breast cancer diagnosis and outcome has remained of concern to clinicians and researchers for the past 20 years. Although studied extensively in epidemiologic studies as well as lab and animal research, no medical consensus on soy’s effects has emerged. Many studies ...

Expert Point of View: Samuel A. Wells, MD

This study follows earlier phase I and II trials showing remarkable responses in patients with advanced medullary thyroid carcinoma, some of whom had progressed on prior tyrosine kinase inhibitor therapy, explained formal discussant of this trial, Samuel A. Wells, MD, of the Center for Cancer...

thyroid cancer

Cabozantinib Prolongs Progression-free Survival in Advanced Medullary Thyroid Cancer

Cabozantinib prolonged progression-free survival in patients with unresectable, locally advanced, or metastatic medullary thyroid cancer with documented disease progression in the phase III EXAM trial. Based on these results, Exelixis submitted a New Drug Application to the FDA in May 2012. The...

solid tumors

Two Single Nucleotide Polymorphisms Associated with Risk for Paclitaxel-related Peripheral Neuropathy

Peripheral neuropathy is the most common severe toxicity in patients receiving paclitaxel, and mutations in genes affecting drug metabolism, distribution, and elimination are likely to modulate risk for such neurotoxicity. In a recent study, Daniel Hertz, PharmD, and colleagues from the University...

solid tumors

Alterations in PTEN Insufficient to Predict Sensitivity to Drugs Targeting PI3K/mTOR Pathway

PTEN acts as a tumor-suppressor gene through the action of its phosphatase protein product, which participates in regulation of the cell cycle to prevent too-rapid cell growth and division. Loss of PTEN function has been shown to increase PI3K/mTOR signaling, and preclinical data suggest that PTEN...

breast cancer

New Study Examines Racial Disparities in Breast Cancer Mortality

According to the first national study looking at racial disparity in breast cancer mortality rates at the city level in the United States, societal factors—especially poverty and residential segregation—are resulting in the unnecessary deaths of five black women every day—more than 1,700 deaths a...

global cancer care
health-care policy

Cancer Care in Rwanda: A Model of Creative Partnerships

While disparities in cancer care remain problematic in wealthy industrial nations like the United States, the challenges faced in poorer regions of the world are, by comparison, inestimable. Nationally regarded health-care expert Lawrence N. Shulman, MD, of Dana-Farber Cancer Institute, is part of...

Sarcoma Foundation of America Teams with Conquer Cancer Foundation to Fund Potentially Life-saving Research

When Matthew Alsante signed on to serve as Executive Director of the Sarcoma Foundation of America (SFA) 6 years ago, he had a visceral understanding of the importance of the organization’s work. Mr. Alsante had lost his father to lung cancer in 1999. “Right up until the last day of his life, if...

YIA and CDA: Abbreviations of Great Importance to Continued Progress in Cancer Research

Behind the scenes researchers—who are well acquainted with the human cost of cancer and see the vast scientific and clinical opportunities for conquering it—are working to unlock the secrets of cancer in its many forms. Some are well established in their careers and have been conducting studies for ...

ASCO Bookstore Revamped

ASCO has redesigned its online bookstore. Now visitors can enjoy a streamlined environment powered by Amazon, allowing them to search in just about any way they want to: newest to oldest, most popular, by disease type, by professional interest, and the list goes on. The new bookstore platform,...

ASCO Launches Oncology Practice Census

How many oncologists are in private practice and how many are employed by hospitals and academic medical centers in the United States? No one knows the answer for sure, but ASCO is undertaking an ambitious national effort to determine where oncologists are practicing these days. Online Survey...

lung cancer
issues in oncology

After a Decade of Decline in Smoking Rates, Progress Has Stalled

Approximately 20% of all Americans smoke, and 443,000 of them will die each year as a result. Tobacco use is the leading cause of preventable death in the United States and the greatest behavioral determinant of morbidity and mortality (6%–10% of U.S. health-care costs). Nearly 30% of all cancer...

leukemia

Prognostic Value of Integrated Cytogenetic and Mutational Risk Classification in Acute Myeloid Leukemia

Jay P. Patel, BS, and colleagues from Memorial Sloan-Kettering Cancer Center in New York recently performed mutational analysis of 18 genes in a subgroup of newly diagnosed acute myeloid leukemia (AML) patients who had been randomized to receive cytarabine plus high-dose or standard-dose...

leukemia

Updated Findings Further Define Role of Tyrosine Kinase Inhibitors in CML

With three available tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia (CML), attention has turned from the ability to achieve a sustained response to the possibility of “curing” patients. Updates of pivotal trials presented at ASCO may help define the role of the tyrosine...

leukemia

PACE Trial Update: Ponatinib Produces High Response Rates in CML

The third-generation tyrosine kinase inhibitor ponatinib showed robust efficacy in the 10-month follow-up of the phase II PACE trial (Ponatinib Ph+ALL and CML Evaluation), which is evaluating ponatinib in treatment-refractory chronic myeloid leukemia (CML)1 At the 2012 ASCO Annual Meeting, Jorge E. ...

issues in oncology

New Study on Communicating Bad News, from the Patient’s Perspective

There is limited evidence in the literature about how oncologists should discuss bad or serious news with their patients. A recent study sought to understand what patients with cancer value when their doctors communicate news of recurrence.1 The ASCO Post spoke with the study’s lead author, Anthony ...

colorectal cancer

Increased Adjuvant Therapy Use and Improved Survival in Dutch Elderly Patients with Stage III Colon Cancer: A Direct Correlation?

A survival benefit of adjuvant chemotherapy has been reported for select elderly patients with stage III colon cancer, but many elderly patients are not candidates for or are not given adjuvant therapy due to comorbidities and fear of toxicity. In a recent Annals of Oncology article, van...

breast cancer
lymphoma
survivorship

ASCO Studies Point to Risks Associated with Treating Childhood Cancers

Risks associated with being a young cancer survivor were emphasized by two studies highlighted in press briefings at the 2012 ASCO Annual Meeting. Investigators from the Children’s Oncology Group (COG) reported that adolescents and young adults  treated for high-risk B-precursor acute lymphoblastic ...

2013 Certifying Examination in Pediatric Hematology-Oncology

The American Board of Pediatrics has announced that the upcoming 2013 Pediatric Hematology-Oncology Certifying Examination will be held on April 16, 2013. Registration and other information is provided below. Examination Date: April 16, 2013 Registration for first-time applicants: August 1, 2012,...

lung cancer

First-line Afatinib Superior to Standard Chemotherapy in Advanced EGFR-mutated Non–Small Cell Lung Cancer

First-line therapy with the investigational oral agent afatinib improved progression-free survival compared with standard chemotherapy (pemetrexed (Alimta)/cisplatin) in patients with advanced non–small cell lung cancer (NSCLC) harboring an EGFR mutation. Afatinib improved progression-free survival ...

Expert Point of View: Landscape for Treatment of Metastatic Melanoma Is Expanding

At an Annual Meeting press conference, ASCO spokesperson Sylvia Adams, MD, said, “BREAK-3 confirms that BRAF targeting is effective in metastatic melanoma. The tumor shrinkage seen with dabrafenib is similar to results observed for the FDA-approved drug vemurafenib, with fewer side effects. We will ...

skin cancer

Landscape for Treatment of Metastatic Melanoma Is Expanding

Metastatic melanoma was long considered untreatable and incurable. The FDA approval of ipilimumab (Yervoy) and vemurafenib (Zelboraf) ushered in a new era for this disease, and now additional treatment options are in late stages of clinical development. Dabrafenib, a novel oral BRAF inhibitor, and...

lung cancer

Lung Cancer Death Rates Increase among White Women in Some States

A new study comparing lung cancer death rates among women by year of birth shows dramatic differences in trends between states, likely reflecting the success or failure of tobacco control efforts. The study, published early online in the Journal of Clinical Oncology,1 finds that while lung cancer...

Reflections from the Old World

A few years ago, I was a key witness for a patent dispute at a trial in Delaware. Acting for the complainant, I was briefed that the opening gambit of the opposition lawyer would be to discredit my CV and, therefore, the value of my testimony. “So you are a full Professor at the University of...

health-care policy

Three Experts Weigh In on the Health-care Reform Legislation

In light of the Supreme Court ruling, The ASCO Post asked three nationally regarded experts about how the Affordable Care Act will affect the practice of oncology. Ezekiel J. Emanuel, MD, PhD, Professor and Vice Provost for Global Initiatives, University of Pennsylvania: This is an overwhelmingly...

health-care policy

The Affordable Care Act Stands: Now What?

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law—a hotly contested bill that enacted sweeping changes to the U.S. health-care system. The debate over the Affordable Care Act continued all the way to the Supreme Court, spearheaded by the case Florida...

Expert Point of View: TAILOR

Formal discussant of the TAILOR trial, Benjamin J. Solomon, MBBS, PhD, of the Peter MacCallum Cancer Centre, East Melbourne, Australia, noted that the study asks an important question about the benefit of an EGFR inhibitor in patients with wild-type EGFR. The progression-free survival reported in...

Expert Point of View: PARAMOUNT

Formal discussant Gregory Peter Kalemkerian, MD, of the University of Michigan Comprehensive Cancer Center, Ann Arbor, questioned whether all patients need maintenance therapy, since some patients on placebo lived as long as those on pemetrexed maintenance, and quality of life, as reported...

lung cancer

Second-line Treatments Tested in Patients with Non-Small Cell Lung Cancer

Results of two late-breaking phase III trials presented at 2012 ASCO Annual Meeting add to the evolving understanding of how best to treat non–small cell lung cancer (NSCLC). The TAILOR trial suggested the benefit of chemotherapy over EGFR-targeted therapy as second-line treatment of patients with...

Conquer Cancer Foundation Honors Oncology Professionals forHigh-quality Research in Breast Cancer

The Conquer Cancer Foundation of ASCO recently announced the recipients of its 2012 Breast Cancer Symposium Merit Awards, which recognize leading oncology professionals for their work in the area of breast cancer research. This year, the Foundation honors 16 individuals for their research in the...

cns cancers

Bevacizumab/Temozolomide Combination Safe and Active against Advanced Neuroendocrine Tumors

The combination of bevacizumab (Avastin) and temozolomide can be safely administered together in patients with advanced neuroendocrine tumors, and “the combination regimen appears promising for patients with pancreatic [neuroendocrine tumors],” according to results of a phase II study reported in...

lymphoma

Children with Favorable-risk Disease and Complete Response to Chemotherapy Have High Survival Rates without Radiotherapy

Among children with favorable-risk Hodgkin lymphoma, those who achieved a complete response after two cycles of chemotherapy and received no radiotherapy had high rates of survival similar to those who had a less complete response to chemotherapy and received radiotherapy, according to a study in...

SIDEBAR: Expect Questions from Your Patients

For now, genomic sequencing seems to have a greater presence in the news than in the clinic. What can physicians tell their patients who ask about genetic testing to identify mutations driving cancer growth?  “The real answer is that when you get down to it, genomics is like any other test,”...

Genomics vs Site of Cancer Origin as Basis for Treatment of Cancer Is ‘False Dichotomy’

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. Despite recent news reports...

integrative oncology

Astragalus

The use of dietary supplements by cancer patients 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

Pertuzumab: New Drug for HER2-positive Metastatic Breast 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. Indication In June 2012, pertuzumab (Perjeta) was approved for use...

issues in oncology

Symposium Focuses on Policy Issues in Personalized Cancer Care

“What is the biggest barrier to progress in personalized medicine?” asked moderator Anna Barker, PhD, leading a panel discussion at a recent meeting convened by the Washington-based advocacy group, the Personalized Medicine Coalition, with the American Association for Cancer Research and Feinstein...

SIDEBAR: Coalition Activities

The new Data Liquidity Coalition has identified five activity tracks. Marcia Kean, MBA, a leader of the coalition steering committee, described the tracks: 1. Intellectual Capital is a set of activities that would seek to identify and illuminate some of the key issues in the space, such as the...

issues in oncology

Data Liquidity Coalition Takes Shape

A coalition to promote and implement data sharing in cancer by facilitating data ‘liquidity,’ first proposed in February at an Institute of Medicine (IOM) workshop, is taking shape with the formation of a steering committee and action plans that include a demonstration project. For several years,...

lung cancer

Response Rate Is Significantly Improved with Nab- vs Solvent-based Paclitaxel plus Carboplatin in Advanced NSCLC

Final results of a phase III trial found nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) plus carboplatin as first-line therapy in patients with advanced non–small cell lung cancer (NSCLC) resulted in a significantly improved overall response rate vs conventional solvent-based paclitaxel...

lung cancer

Study Reports ‘Strong and Consistent Relation’ between Exposure to Diesel Exhaust and Risk of Dying of Lung Cancer

A nested case-control study of 198 lung cancer deaths among a cohort of 12,315 mine workers “showed a strong and consistent relation between quantitative exposure to diesel exhaust and increased risk of dying of lung cancer,” researchers reported in the Journal of the National Cancer Institute.1...

issues in oncology

Information Service Provides Innovative Resource for Patients and Providers

Jennifer Levin Carter, MD, MPH is Founder and President of N-of-One. A board-certified internist and entrepreneur, she has more than 20 years of experience evaluating existing and emerging markets, new medical technologies, and early-stage companies in the health-care field. Formerly, Dr. Carter...

issues in oncology
supportive care

New Assessment Tools in Development to Guide Care for Older Patients

More than 1,400 people from 62 countries attended the 2012 Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) International Symposium on Supportive Care in Cancer, held in New York last June. One of the featured sessions, which was jointly...

A Physician, Who Is Also a Cancer Patient, Talks about Medical Errors

In a whispered but resolute voice, Itzhak Brook, MD, MSc, led off his presentation at the 2012 ASCO Annual Meeting1  by telling the audience his voice is weak because he doesn’t have vocal cords. He spoke with the aid of a tracheoesophageal voice prosthesis. “I have practiced medicine for more than ...

supportive care

Supportive Care Experts Explore 30 Years of Progress in the Field

Thirty years ago, when the first supportive care meeting as a forerunner of the Multinational Association of Supportive Care in Cancer (MASCC) Symposium was held in New York, supportive care was largely ignored, with little discussion at major cancer meetings, which focused primarily on...

breast cancer

Older Chemotherapy Studies in Breast Cancer Coming of Age

Results of several long-running chemotherapy trials were reported at the 2012 ASCO Annual Meeting breast cancer oral session, reported in brief here. NSABP B-38 The final analysis of the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-38 trial showed that the addition of gemcitabine...

issues in oncology

Taking Family History and Referral to Genetic Counseling Could Be Improved, Survey Finds

Obtaining a thorough family history of cancer should be a key component in evaluating patients and deciding whether to refer those at increased risk of either primary or second cancers for genetic counseling and testing. Many community oncology practices comply with this practice, but there is room ...

supportive care

Antidepressant Drug Has ‘Clinically Meaningful’ Effect on Chemotherapy-induced Painful Neuropathy

The oral antidepressant duloxetine (Cymbalta) at 60 mg/d improved chemotherapy-induced painful neuropathy in a randomized, double-blind, placebo-controlled, phase III trial.1 Overall, 59% of patients treated with duloxetine experienced some pain relief, 33% reported at least a 30% decrease in pain, ...

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