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Ambitious Call to Arms Seeks a Shift in Priorities to Eradicate Cancer

It has been more than 4 decades since our nation loaded its medical cannons and declared war on cancer, self-assured that money and American scientific resolve would lead to victory. But cancer has proved to be a humbling enemy. The war is now fought in targeted skirmishes; the weaponry is a...

The Practice of More than One Art

The positive healing effects of music can be traced as far back as ancient Greece and the belief that Apollo was God of medicine and music. In his book De Anima, Aristotle wrote that flute music could purify the soul. By the end of the 19th century, researchers were showing a correlation between...

Expert Point of View: Robert Jones, MD

“The data speak for themselves,” stated Robert Jones, MD, of the Beatson West of Scotland Cancer Center, Glasgow, UK, during discussion of the MAINSAIL trial at the 2012 ESMO Congress. The study raises some important questions, he continued: What are the implications for designing future trials?...

Karen E. Knudsen, PhD, Named New Editor-in-Chief of AACR Journal Molecular Cancer Research

The American Association for Cancer Research (AACR) recently announced that Karen E. Knudsen, PhD, Professor and Hilary Koprowski Chair in the Departments of Cancer Biology, Urology, and Radiation Oncology at Thomas Jefferson University in Philadelphia, and Deputy Director for Basic Science of the...

sarcoma

Expert Point of View: George Demetri, MD

Invited discussant of the abstract, George Demetri, MD, of Dana-Farber Cancer Institute and Harvard Medical School, Boston, noted that metastatic soft-tissue sarcomas present with variable clinical behaviors but are nearly always incurable with any approach. “Therefore, our intent is to palliate...

sarcoma

No Survival Advantage for Combination Chemotherapy in Advanced Soft-tissue Sarcoma  

The addition of aggressively dosed ifosfamide to doxorubicin in the treatment of advanced soft-tissue sarcomas significantly delayed disease progression but did not improve survival in the randomized phase III EORTC 62012 trial conducted by the Soft Tissue and Bone Sarcoma Group of the European...

Top 10 Most Viewed Articles on ASCOPost.com for 2012

Novel Multikinase Inhibitor Improves Survival in Metastatic Colorectal CancerBy Caroline HelwickThe novel tyrosine kinase inhibitor regorafenib, given as a single agent to patients with treatment-refractory metastatic colorectal cancer, significantly improved overall survival and delayed disease...

skin cancer

Prevention and Treatment of Multikinase Inhibitor–induced Hand-Foot Syndrome

Multikinase inhibitors (sorafenib [Nexavar], sunitinib [Sutent], pazopanib [Votrient], axitinib [Inlyta], regorafenib [Stivarga]) block various proteins including vascular endothelial growth factor receptor (VEGFR) and platelet-derived growth factor receptor (PDGFR). They have been approved by...

solid tumors
prostate cancer

Early Quality of Life Better with Proton-beam Therapy, but Late Effects Similar to Other Treatment Modalities for Prostate Cancer

Differing patterns of patient-reported quality of life for three-dimensional (3D) conformal radiotherapy, intensity-modulated radiation therapy, and proton-beam therapy were reported in a nonrandomized comparison of three modern cohorts of patients with prostate cancer. The study was presented at...

solid tumors
prostate cancer

Expert Point of View: Colleen Lawton, MD

“These were two nice presentations evaluating the ability of SBRT to control disease as well as toxicity. This is cutting-edge research. It is very exciting that we could treat prostate cancer patients with radiation inside of 2 to 2.5 weeks, and it is clearly cost-saving. We need longer follow-up...

solid tumors
prostate cancer

Stereotactic Body Radiation Therapy Produces Impressive Results in Organ-confined Prostate Cancer

Stereotactic body radiation therapy (SBRT) delivered via the CyberKnife can achieve excellent outcomes with minimal toxicity in patients with prostate cancer. Importantly, this technique delivers therapeutic doses of radiation in four to five fractions, which reduces the number of clinic visits...

solid tumors
prostate cancer

Expert Point of View: Thomas Pisansky, MD

Commenting on this paper, Thomas Pisansky, MD, the Mayo Clinic, Rochester, Minnesota, reminded listeners that about 50% of patients treated with external-beam radiation therapy and about 33% of those treated with brachytherapy already have erectile dysfunction prior to treatment. After radiation...

solid tumors
prostate cancer

Expert Point of View: Jason A. Efstathiou, MD, DPhil

Although these two trials reported at the ASTRO Annual Meeting are seemingly different, they both establish the value of radiation-based therapy in prostate cancer, demonstrating overall survival benefit and favorable toxicity profiles in high-risk, locally advanced, and castrate-resistant...

issues in oncology
cost of care
health-care policy

SIDEBAR: How Other Countries Are Controlling Oncology Costs

The refrain is familiar: The United States spends more on health care than any other industrialized country, but the investment does not correspond to superior care. A recent study by The Commonwealth Fund, a health-care policy research foundation, shows just how stark the contrast is. Instructive ...

issues in oncology
cost of care
health-care policy

The Ethics of Rationing Cancer Care

Should cost be a consideration when deciding on treatment for patients with cancer, and if so, what kind of ethical dilemma does that pose for oncologists? With U.S. spending on oncology drugs expected to climb more than 20% annually over the next decade—reaching $173 billion by 2020, according to...

ASCO Calls on Congress to Avoid Looming ‘Fiscal Cliff’

As Congress reconvenes for its lame duck session, ASCO calls on lawmakers to prevent devastating budget cuts to cancer care, research, and the drug review process citing the negative impact to millions of individuals who have cancer. The mandated cuts, known as “sequestration” under the Budget...

Research of Three Conquer Cancer Foundation Grantees Featured among Top Cancer Advances of the Year

Every year, the Conquer Cancer Foundation of the American Society of Clinical Oncology funds research grants that provide critical start-up funding for young physician-scientists, with the goal of enabling them to develop successful careers in cancer research so that they can bring new treatments...

Clinical Cancer Advances 2012: ASCO’s Annual Report on Progress Against Cancer

Clinical research is continuously delivering new treatments that lengthen and improve the lives of patients with cancer. The abundance of advances reported in the past year illustrates our steady progress in cancer treatment and care. Clinical Cancer Advances 2012: ASCO’s Annual Report on Progress...

Shaping the Future of Oncology: Envisioning Cancer Care in 2030

Over the course of the last year, the ASCO Board of Directors worked to identify “drivers of change” that will have the greatest impact on the oncology field over the next two decades. “We are on the verge of a new age of cancer care, in which emerging scientific, technical, and economic trends are ...

solid tumors
colorectal cancer

Finding Lynch Syndrome among Patients with Colorectal Cancer: Routine Tumor Testing Looks Best

Oncologists generally agree that screening patients with colorectal cancer for Lynch syndrome is a good thing. Patients who turn out to have the hereditary syndrome can inform their first-degree relatives, who in turn can undergo genetic testing. Those who have the characteristic mutations can take ...

Genetic Variation in Vitamin D Pathway Is Tied to Colorectal Cancer Risk among African Americans

African Americans’ risk of colorectal cancer varies according to whether they have certain genetic variants that affect vitamin D metabolism, according to a study presented at the Fifth American Association for Cancer Research (AACR) Conference on The Science of Cancer Health Disparities, held...

head and neck cancer

Expert Point of View: Paul Harari, MD

Formal discussant of this trial, Paul Harari, MD, University of Wisconsin School of Medicine and Public Health, Madison, commended the N09C6 investigators for conducting a randomized controlled phase III trial on symptom relief. “Most phase III trials are conducted to evaluate a new cancer...

issues in oncology

2012 In Review: Oncology Drugs/Indications Newly Approved by FDA

At press time, the FDA had granted approval for the following new agents and indications for cancer treatment in 2012. Cabozantinib (Cometriq) for the treatment of progressive metastatic medullary thyroid cancer. Cabozantinib is a small molecule that inhibits the activity of multiple tyrosine...

cns cancers

Revised Everolimus Dosing and New Safety/Efficacy Data for Approval in Subependymal Giant Cell Astrocytoma

On August 29, 2012, everolimus in a tablet for oral suspension form (Afinitor Disperz) was given accelerated approval for the treatment of pediatric and adult patients with tuberous sclerosis complex who have subependymal giant cell astrocytoma (SEGA) that requires therapeutic intervention but...

hematologic malignancies
leukemia

Liposomal Vincristine for Adult Patients with Relapsed/Refractory Acute Lymphoblastic Leukemia

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 August 2012, vinCRIStine sulfate LIPOSOME injection...

kidney cancer

IMA901 Granted Orphan Drug Designation by FDA

immatics biotechnologies GmbH announced that the cancer vaccine IMA901 has been granted orphan drug designation from the FDA for the treatment of renal cell carcinoma (RCC) in HLA-A*02 positive patients. The FDA grants orphan drug designation to novel drugs aimed at treating rare diseases or...

breast cancer

Molecular Breast Imaging an Option for Early Detection in High-risk Women

Molecular breast imaging, also known as breast-specific gamma imaging, was a key topic of discussion at the Radiological Society of North America (RSNA) Annual Meeting, held recently in Chicago. Molecular breast imaging can detect breast cancer missed by mammography, according to clinical data...

health-care policy

How Sequestration May Affect Cancer Research

Senator Sherrod Brown (D-Ohio) began his political career in 1974 as a state representative in Ohio. He served as Ohio’s Secretary of State between 1983 and 1991, went on to serve in the U.S. Congress from 1993 to 2006, and was elected to the Senate in 2006. A supporter of biomedical and cancer...

breast cancer

Fox Chase Researchers Find Most Medicare Patients Wait Weeks before Breast Cancer Surgery

Although patients may feel anxious waiting weeks from the time of their first doctor visit to evaluate their breast until they have breast cancer surgery, new findings from Fox Chase Cancer Center in Philadelphia show that these waits are typical in the United States. Results were published...

breast cancer

Plenary Session Included Findings on Partial- vs Whole-breast Techniques and Patient Beliefs about Radiotherapy

When the dates were picked for the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO), no one could have anticipated that the meeting would coincide with Hurricane Sandy’s devastation of parts of the northeast. As the storm approached on Monday and Boston shut down its...

Surgical Resection for Colorectal Cancer Liver Metastases: Who, When, How?

Many patients with colorectal liver metastases can undergo surgical resection with curative intent. Who are these patients and how are they best managed? In an interview with The ASCO Post, Steven A. Curley, MD, Professor of Surgical Oncology at The University of Texas MD Anderson Cancer Center,...

kidney cancer

What Combinations Should Be Tested? 

If the therapy combinations tested in the BeST trial don’t deserve to move on to phase III trials, what other combinations do show enough promise against renal cell carcinoma to merit being tested in phase III trials? “None at the present time,” maintained Bernard Escudier, MD, of the Institut...

Combination Therapy Not Better than Single-agent Bevacizumab for Advanced Renal Cell Carcinoma in BeST Trial

None of three combination therapies tested among patients with advanced renal cell carcinoma in the BeST trial came close to achieving the primary objective of a 67% improvement in median progression-free survival compared to single-agent bevacizumab (Avastin), Keith T. Flaherty, MD, reported at...

prostate cancer
issues in oncology

Medical and Behavioral Variables Have More Impact on Physical Functioning Than Finasteride Treatment

Taking finasteride over a 7-year period as part of the Prostate Cancer Prevention Trial (PCPT) “did not affect any of the three primary health-related quality-of-life domains—physical function, mental health, or vitality—either positively or negatively,” according to a study published in the...

cns cancers

Bevacizumab Added to Radiation and Chemotherapy Improved Progression-free Survival in Newly Diagnosed Glioblastoma

Recently announced results of the phase III AVAglio study showed that bevacizumab (Avastin) in combination with radiation and temozolomide chemotherapy increased progression-free survival (a co-primary endpoint) by 36% compared to radiation and temozolomide chemotherapy plus placebo (hazard ratio...

breast cancer

Expert Point of View: Meena S. Moran, MD

“Breast cancer in the geriatric population is a major health issue. Of the more than 230,000 new cases diagnosed annually, somewhere between 40% and 50% will occur in women 65 and over. Furthermore, the elderly population has been and will continue to increase exponentially over time,” stated Meena ...

cns cancers
supportive care

Expert Point of View: Vinai Gondi, MD

This memantine study is a critical first step in understanding and delaying cognitive deterioration in brain metastasis patients, noted formal discussant Vinai Gondi, MD, Associate Director of Research at the CDH Proton Center in Warrenville, Illinois, and Clinical Associate Professor at the...

cns cancers
supportive care

Memantine Provides Modest Improvement in Cognition after Cranial Irradiation

Memantine, a drug used to treat Alzheimer’s disease, slowed cognitive decline in patients with brain cancer treated with whole-brain radiation therapy in a phase III trial reported at the 54th Annual Meeting of the American Society for Radiation Oncology (ASTRO), held recently in Boston. Cognitive...

Gene-expression Profiles of Triple-negative Breast Cancers Differ between African American and Native African Women

Triple-negative breast cancers in African-American women and native African women have differing gene-expression profiles that may have implications for treatment, according to the first study to directly compare tumor gene expression between these populations. Results were reported at the Fifth...

Current Perspectives on Triple-negative Breast Cancers

Triple-negative breast cancer—which lacks expression of the estrogen receptor, progesterone receptor, and HER2 oncogene—is a challenge for oncologists. The emergence of data showing strong heterogeneity for this subtype of breast cancer creates even more confusion regarding prognosis and...

Screening for Ovarian Cancer: A Gynecologic Oncologist’s Perspective

The recent U.S. Preventive Services Task Force (USPSTF) Reaffirmation Recommendation Statement concluded that in the population of asymptomatic women without known genetic mutations that increase risk for ovarian cancer, clinicians should not screen for ovarian cancer using transvaginal ultrasound...

issues in oncology

SIDEBAR: How to Reduce Burnout

Although definitive solutions to preventing or overcoming burnout are still being researched, Michael P. Kosty, MD, a member of ASCO’s Workforce Advisory Group and Director of the Scripps Green Cancer Center, said taking regularly scheduled time off and pursuing outside interests may help. “It...

Recognizing and Managing Physician Burnout in Oncology

Although job burnout occurs in all professions, it is more common among physicians, according to a study published recently in Archives of Internal Medicine.1 Physicians on the front line of care, such as those working in emergency rooms or in family medicine, experience the highest rates of...

Expert Point of View: Frederick R. Appelbaum, MD

Commenting on the trial of bone marrow vs peripheral blood stem cell transplants, Frederick R. Appelbaum, MD, at the Fred Hutchinson Cancer Research Center, wrote that the results should change practice. But he added in his editorial, “it will be interesting to see whether it really does.”1...

hematologic malignancies

Bone Marrow Transplants Reduce Risk of Graft-vs-Host Disease Compared to Peripheral Blood

Patients who receive bone marrow transplants are significantly less likely to develop chronic graft-vs-host disease than those who receive peripheral blood stem cell transplants, according to a new, large randomized trial, the first of its kind with unrelated donors. Published recently in The New...

multiple myeloma

Persistent Survival Benefit in Patients with Untreated Disease Treated with Bortezomib Added to Melphalan and Prednisone

A final analysis of the phase III VISTA trial (Velcade as Initial Standard Therapy in Multiple Myeloma: Assessment with Melphalan and Prednisone) found a persistent significant benefit in overall survival with VMP (bortezomib, melphalan, prednisone) vs MP (melphalan, prednisone) in patients with...

leukemia

Chlorambucil, but Not Fludarabine, Confers Significant Benefit in Older Patients with CLL

Among patients aged 70 years and older with chronic lymphocytic leukemia (CLL), “front-line therapy with fludarabine does not improve outcomes” compared to chlorambucil (Leukeran), according to an analysis of patients enrolled in successive front-line Cancer and Leukemia Group B (CALGB) studies...

lung cancer

Volume-doubling Time May Help Distinguish Aggressive Cancer from Slow-growing Tumors

Changes in the size of lung tumors over time, as measured by volume-doubling times on low-dose computed tomography, can be used to distinguish aggressive lung cancer from slow-growing or indolent tumors and reduce overdiagnosis that could result in overtreatment and unnecessary morbidity. Results...

breast cancer

Analysis Suggests Screening Mammography Results in Substantial Overdiagnosis with Small Effect on Mortality

An analysis of Surveillance, Epidemiology, and End Results (SEER) data from 1976 through 2008 “suggests that whatever the mortality benefit, breast-cancer screening involved a substantial harm of excess detection of additional early-stage cancers that was not matched by a reduction in late-stage...

SIDEBAR: Expect Questions from Patients

A study finding that a diet high in total carbohydrates can increase the risk of cancer recurrence and mortality doesn’t mean that patients need to totally avoid carbohydrates, any more than previous findings about increased risk from a Western pattern diet means patients can’t eat any red meat....

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