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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...

lung cancer

FDG-PET Falls Short for Diagnosis of Non–Small Cell Lung Cancer

The ability to make a diagnosis of non–small cell lung cancer (NSCLC) with FDG-PET varies widely among centers, and this imaging modality performed more poorly in community and academic centers than in published studies.1 A secondary analysis of the prospective American College of Surgeons Oncology ...

solid tumors
kidney cancer

Patient Preference Studied in Treatment Selection for Renal Cell Carcinoma

More attention is being paid to the importance of patient preference as a factor in treatment selection. An innovative randomized, double-blind study in patients with metastatic kidney cancer demonstrates that quality of life and side effects drive patient preference.1 Results also suggest that...

Expert Point of View: Eun-Sil Shelley Hwang, MD, MPH

Eun-Sil Shelley Hwang, MD, MPH, of Duke University Medical Center, Durham, North Carolina, who discussed both papers on ductal carcinoma in situ at the ASCO Annual Meeting, noted that better risk stratification and treatments are substantially changing the outlook for DCIS. “We are getting close to ...

Trailblazer in Argentinean Oncology Remains Optimistic about War on Cancer

Eduardo Cazap, MD, PhD, is founder and first President of the Latin American and Caribbean Society of Medical Oncology (SLACOM). In 2008, he was elected to a 2-year term as President of the International Union against Cancer (UICC). The ASCO Post recently spoke with Dr. Cazap about his roots in...

Expert Point of View: Gunter von Minckwitz, MD, PhD

Gunter von Minckwitz, MD, PhD, of the German Breast Group and the University of Frankfurt, discussed the findings of the NSABP B-41 trial. He observed that lapatinib was not more effective than trastuzumab, which is in line with increasing evidence in various breast cancer settings showing greater...

breast cancer

Lapatinib Shows Value Similar to Trastuzumab in Neoadjuvant Regimens for Breast Cancer, but with Greater Toxicity

Lapatinib (Tykerb) proved valuable as a component of neoadjuvant chemotherapy for HER2-positive operable breast cancer in the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-41 trial presented at the 2012 ASCO Annual Meeting by Andre Robidoux, MD, of the NSABP and the University of...

ASCO Responds to Supreme Court Ruling on Health-care Law

When the Supreme Court upheld the Patient Protection and Affordable Care Act on June 28, ASCO released a statement by ASCO President Sandra M. Swain, MD, Medical Director of the Washington Cancer Institute at MedStar Washington Hospital Center. Critically Important Provisions In the statement, Dr....

ASCO University’s e-Seminars Offer a Stimulating Way to Stay on Top of Trends as Well as Meeting Highlights

Did you miss one of the symposia this year and need to quickly catch up on the highlights in small, digestible portions? No problem. ASCO University’s e-Seminar series now has you covered. Or, is there a new journal article that everyone’s talking about, and you need guidance on how to interpret...

lung cancer

No Improvement in Overall Survival, Worse Toxicity with Motesanib Added to Chemotherapy in Non–Small Cell Lung Cancer

Two trials (E4599 and AVAiL) have suggested a benefit to adding the anti–vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (Avastin) to chemotherapy in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Bevacizumab acts by binding directly to circulating...

gynecologic cancers

Adding Bevacizumab to Chemotherapy Improves Progression-free Survival in Platinum-sensitive Recurrent Ovarian Cancer

The addition of bevacizumab (Avastin) to gemcitabine and carboplatin, followed by bevacizumab until disease progression, resulted in significantly improved progression-free survival compared to gemcitabine and carboplatin plus placebo among women with platinum-sensitive recurrent ovarian, primary...

cns cancers

Understanding and Managing Pseudoprogression in Glioblastoma Patients

Pearls in Neuro-oncology is guest edited by Tracy Batchelor, MD, Director, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, and Professor of Neurology, Harvard Medical School, Boston. The series is intended to provide the practicing oncologist with guidance in managing...

solid tumors
prostate cancer

Radiotracer Targeting of Free Prostate-specific Antigen

Serum levels of prostate-specific antigen (PSA) are widely used as a biomarker for prostate cancer, although they often do not distinguish between normal tissue and cancer and do not always accurately reflect clinical outcome. In order to overcome the fact that the small proportion of...

breast cancer

Everolimus Approved for Advanced Breast Cancer

The FDA has approved everolimus tablets (Afinitor) for use in combination with exemestane to treat postmenopausal women with advanced hormone receptor–positive, HER2-negative breast cancer after failure of treatment with letrozole or anastrozole. The approval was based on a randomized,...

issues in oncology
health-care policy

As Conflicting Guidelines Evolve, Experts Continue to Debate the Merits of Cancer Screening

In the 1930s and 1940s, when the American Cancer Society [ACS] first brought forth the message that early cancer detection saves lives, it was a broad brushstroke and an appropriate message. The problem now is that new technology enables us to find [tumors that would never progress to invasive...

solid tumors

Striking Activity Shown for Regorafenib in Advanced GIST

Regorafenib, an orally administered investigational tyrosine kinase inhibitor that has shown activity in chemorefractory metastatic colorectal cancer, markedly delayed disease progression in patients with treatment-refractory metastatic gastrointestinal stromal tumor (GIST) in the phase III GRID...

thyroid cancer

Differentiated Thyroid Cancer: Who, When, and How to Treat?

Differentiated thyroid cancer—papillary, follicular, and Hürthle cell carcinomas—has historically been managed by endocrinologists, surgeons, and radiation oncologists, but recent progress in the field has led to greater involvement by medical oncologists, especially in the care of patients with...

supportive care
palliative care

Supportive Care Research Runs the Gamut from Genetic Markers of Treatment Side Effects to Neuropathic Pain Therapies

Attendees from around the world gathered for the Multinational Association for Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) International Symposium on Supportive Care in Cancer, held June 28–30 in New York. Below are highlights from the meeting, representing...

Expert Point of View: Constantine S. Tam, MBBS, MD

The findings in chronic lymphocytic leukemia (CLL) were discussed by Constantine S. Tam, MBBS, MD, of St. Vincent’s Hospital in Melbourne, Australia, who observed, “There is a long list of novel agents in CLL. I think some of the most promising are those targeting the B-cell receptor pathway. This...

colorectal cancer

FDA Approves Colon-cleansing Drug for Prep Prior to Colonoscopy

The FDA has approved sodium picosulfate, magnesium oxide, and citric acid (Prepopik) to help cleanse the colon in adults preparing for colonoscopy, Ferring Pharmaceuticals announced. The new solution is a low-volume, dual-acting stimulant and osmotic laxative. The FDA approval is based on data from ...

health-care policy

Maintenance of Certification: One Size Should Not Fit All

After a conference call and having returned several phone calls, I again opened my ASCO Medical Oncology Self Evaluation Program (SEP) book hoping to steal an hour to reread the chapter on multiple myeloma, and begin digging deeper into head and neck cancer. It was March 2011, and my Maintenance of ...

prostate cancer
issues in oncology

Rethinking the Role of PSA Screening in Public Health

Population screening to identify preclinical disease is considered a central factor in the decades-long decrease in mortality seen in certain cancers. However, hope in the face of deadly disease can sometimes blind us to the scientific evidence. According to the recent U.S. Preventive Services Task ...

Expert Point of View: James O. Armitage, MD

In an accompanying editorial entitled “Who Benefits From Surveillance Imaging?” James O. Armitage, MD, University of Nebraska Medical Center, Omaha, noted that data on surveillance imaging (CT or PET/CT) indicate a general absence of survival benefit in adults with lymphomas, while pointing out...

lymphoma

Study Shows Routine CT Surveillance Overused in Pediatric Hodgkin Lymphoma

The value of routine CT surveillance monitoring of pediatric patients for recurrence of Hodgkin lymphoma has been unclear. A study of CT surveillance recently reported by Stephan D. Voss, MD, PhD, and colleagues from the Children’s Oncology Group (COG) in the Journal of Clinical Oncology showed...

SIDEBAR: Dating among Adolescents and Young Adults with Cancer

How do you tell somebody you are dating that you have cancer or that you may not be able to have children? These are among the issues explored in “Dating and Disclosure for the Cancer Patient,” part of a new book, Sexuality and Cancer, scheduled for release in the fall by Springer, New York. “The...

SIDEBAR: Don’t Expect Questions: Be Proactive with Younger Patients

It is unrealistic to expect adolescents and young adults with cancer to initiate questions about disease-related or or treatment-related issues that are troubling them, according to Bradley Zebrack, PhD, MSW, MPH, Associate Professor of Social Work at the University of Michigan, Ann Arbor....

supportive care

Adolescent and Young Adult Patients Report Unmet Needs for Cancer Information and Psychosocial Support Services

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. Psychosocial care needs are not...

breast cancer

Taxane-induced Neuropathy Does Not Correlate with Improved Outcomes in Operable Breast Cancer

An analysis of 4,554 patients who received adjuvant weekly paclitaxel and other taxane-based regimens in the E1199 trial “demonstrated that taxane-induced peripheral neuropathy does not correlate with improved outcomes in patients with operable breast cancer,” investigators reported in the Journal...

New Agents That Improve Efficacy Can Also Increase Morbidity and Treatment-related Mortality

Newly approved anticancer drugs that lead to improvements in efficacy can also lead to increased morbidity and treatment-related mortality, according to a study in the Journal of Clinical Oncology. The investigators conducted a meta-analysis of 38 randomized controlled trials evaluating agents...

It’s Time to Get Ready for New Medicare Reporting Requirements

As if you didn’t already have enough to worry about, now add this: If your practice doesn’t meet the requirements of the Physicians Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive, you don’t just miss out on the bonuses the programs offered as incentive in recent years....

ASCO Expert Panel Concludes Evidence Supports Physician Discussion of PSA Testing for Men with Longer Life Expectancies

ASCO has issued a new evidence-based provisional clinical opinion (PCO) on the use of prostate-specific antigen (PSA) testing for prostate cancer screening. To facilitate informed decisions, ASCO also released a new, detailed decision aid to help men and their physicians understand the risks and...

cns cancers

Chemotherapy plus Radiation Improved Progression-free Survival in Adults with Low-grade Glioma

Adult patients with supratentorial low-grade glioma who received chemotherapy with PCV (procarbazine [Matulane], lomustine [CeeNu], and vincristine) in addition to radiation therapy had improved progression-free survival but not overall survival compared to patients receiving radiotherapy alone,...

hepatobiliary cancer

Coping with Liver Cancer

From the moment I had a partial hysterectomy in 2010, I started having unexplained bouts of nausea. My surgeon and even my primary care physician chalked it up to everything from the difficult 6-hour surgery I had just had to anxiety over a move I’d recently made from Connecticut to North Carolina. ...

global cancer care

Despite Challenges, Initiatives Bring Gradual Improvements to Cancer Care in Lebanon

Nagi S. El Saghir, MD, FACP, Professor of Clinical Medicine and Hematology-Oncology at the American University of Beirut, is the founding President of the Lebanese Society of Medical Oncology (LSMO). Dr. El Saghir has focused much of his research on the early detection, prevention, and treatment of ...

solid tumors
pancreatic cancer

Ongoing and Future Directions in Pancreatic Cancer Research

Margaret A. Tempero, MD, is a pioneer in pancreatic cancer treatment and research. She has long been a leader in the research and development of therapeutics for pancreatic ductal adenocarcinoma, particularly in studying investigational antibody-based therapies, developing the fixed-dose-rate...

The Problem of Monitoring Remission

How wonderful it is that we now have to concern ourselves with survivorship issues! The ever-increasing success of cancer therapy means that more and more patients can look to a life beyond cancer diagnosis and treatment. But living with cancer creates its own problems. While treatment often may be ...

The Science of Resilience: Exploring the Process of Grieving from a New Perspective

How human beings cope with bereavement, loss, extreme adversity, and life-threatening illness has dominated the research interests of George A. Bonanno, PhD, Professor of Clinical Psychology, Teachers College at Columbia University, New York, for more than 20 years. In his book, The Other Side of...

breast cancer

No Advantage to Longer Adjuvant Chemotherapy in Women with Early Breast Cancer: CALGB 40101 Trial

The ideal duration of adjuvant therapy for women with lower-risk primary breast cancer remains unknown. The National Surgical Adjuvant Breast and Bowel Project (NSABP) B-15 trial, reported more than 20 years ago, found no difference in outcomes between six cycles of cyclophosphamide, methotrexate,...

prostate cancer

Letter to the Editor: Dr. Ablin’s Reply

Given my explanation and widely publicized opinion on the improper use of the prostate-specific antigen (PSA) test for screening asymptomatic men for prostate cancer—most recently expressed in a feature article in The ASCO Post (August 15, 2012)—I was pleased to read that Drs. James Mohler and...

prostate cancer

Letter to the Editor: More Thoughts on PSA

An article that appeared in the August 15 issue of The ASCO Post (“Rethinking the Role of PSA Screening in Public Health”) contains false statements about the discovery of prostate-specific antigen (PSA) and its effectiveness as a test for early detection of prostate cancer. Contrary to what’s...

High-cost Imaging Used Frequently in Elderly with Stage IV Cancer

Patients with stage IV breast, colorectal, lung, and prostate cancers undergo frequent high-cost imaging procedures throughout the continuum of their care, and rates of imaging have steadily increased, according to an analysis of claims from the Surveillance, Epidemiology, and End Results...

colorectal cancer

Patients with Unresectable Metastases Can Be Spared Noncurative Resection of Intact Primary Tumor

Patients with surgically unresectable metastatic colon cancer and an asymptomatic intact primary tumor can be spared initial noncurative resection of their intact primary tumor, National Surgical Adjuvant Breast and Bowel Project (NSABP) C-10 trial investigators reported in the Journal of Clinical...

colorectal cancer

Cetuximab Dose Escalation May Increase Responses among Patients with Mild or No Initial Skin Reactions

Escalating the dose of cetuximab (Erbitux) among patients with metastatic colorectal cancer who developed no or mild skin reactions on standard-dose cetuximab plus irinotecan “seemed to lead to an increase in response rate” as well as in the disease-control rate, according to a phase I/II study...

prostate cancer

Enzalutamide Significantly Prolonged Survival in Men with Castrate-resistant Metastatic Prostate Cancer

“Enzalutamide significantly prolonged the survival of men with metastatic castration-resistant prostate cancer after chemotherapy” in an international phase III, double-blind, placebo-controlled trial, investigators reported in The New England Journal of Medicine. Median overall survival, the...

breast cancer

Being Well Informed Helped Me Cope with Breast Cancer

I had been putting off getting a screening mammogram for a few years. When I finally made an appointment in March 2011 and was told that I needed a follow-up sonogram because the test had picked up a suspicious-looking mass in my right breast, I knew I was in trouble. A biopsy of the tumor showed...

SIDEBAR: Unique Considerations for Radiation Exposure in Children

There are three “unique considerations” for radiation exposure in children, according to Radiation Risks and Pediatric Computed Tomography (CT): A Guide for Health Care Providers, an educational leaflet for health-care providers that was developed by the NCI: Children are considerably more...

SIDEBAR: Expect Questions from Parents

Results of a study finding that exposure to radiation from multiple CT scans in childhood can triple the risk of leukemia and brain tumors may cause some parents to question the overall benefit of CT scans and to directly question physicians. “The three key questions that parents can ask are: (1)...

leukemia

CT Scans in Childhood Can Triple Risk of Leukemia and Brain Cancer Later in Life, Study Finds

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. Computed tomography scans with...

supportive care

Getting the Right End-of-life Care: Coming to Terms with the Realities of Advanced Disease and Mortality

“Dying is at once a fact of life and a profound mystery.” That was the opening sentence of a 1997 Institute of Medicine report, Approaching Death: Improving Care at the End of Life, a much-needed jump-start in the national dialogue over identifying the barriers that impede the delivery of...

Ziv-aflibercept with FOLFIRI in Metastatic Colorectal Cancer

In August 2012, the antiangiogenic agent ziv-aflibercept (Zaltrap) was approved for use in combination with FOLFIRI (fluorouracil, leucovorin, irinotecan) for the treatment of metastatic colorectal cancer resistant to or progressing after an oxaliplatin-containing regimen.1,2 Approval was based on...

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