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issues in oncology

Prescribing of Off-Label Chemotherapy Is Common, and Most Off-Label Drug Use Meets NCCN Compendium Criteria  

Off-label prescribing of drugs remains common in oncology, but about two-thirds of off-label prescribing is consistent with the National Comprehensive Care Network (NCCN) compendium, according to a study1 reviewed at the Best of ASCO® ’13 meeting in Chicago by Monika K. Krzyzanowska, MD, MPH,...

Expert Point of View: Heather A. Wakelee, MD

Describing the PROSE study findings at the Best of ASCO meeting, Heather A. Wakelee, MD, Associate Professor of Medicine, Stanford University, Palo Alto, California, concluded, “The results of PROSE indicate that the 30% to 35% of patients classified as VeriStrat ‘poor’ have better survival with...

issues in oncology

A Great Privilege to Die Beneath an Open Sky 

It was 1:00 AM, and my beeping pager awakened me. When you’re a surgical oncologist, you know that a page from your chief resident at this hour of the morning usually means someone may need to go to the operating room. And, yes, it was the chief resident about a patient in crisis. Except in this...

issues in oncology

Paging Dr. Google: Practicing Oncology in the Era of Social Media and Telemedicine  

Over the past few decades, economic and political factors have reshaped oncology, especially in the community setting. To defray risk, we’ve seen a trend toward oncology practices partnering with hospitals or aggregating into larger networks. Moreover, the Internet and the advent of telemedicine...

breast cancer

Platinum Agents in Triple-Negative Breast Cancer: Encouraging New Data 

For the treatment of triple-negative breast cancer, there is renewed interest in investigating the role of platinum chemotherapy, according to Melinda L. Telli, MD, Assistant Professor of Medicine at Stanford University, Palo Alto. At the Best of ASCO meeting in Los Angeles, Dr. Telli reviewed the...

pancreatic cancer

High-Quality Diet May Reduce Risk 

Consuming a high-quality diet, consistent with the Dietary Guidelines for Americans 2005, may reduce the risk of pancreatic cancer, a dietary pattern analysis study found. “This finding contrasts with previous studies showing limited associations with specific foods or nutrients,” the authors...

prostate cancer

Shiftworkers Likely to Have Increased Risk  

A strong positive association with shiftwork and elevated prostate-specific antigen (PSA) level was found in an analysis of three National Health and Nutrition Examination Survey (NHANES) studies. “Our data support the notion that sleep or circadian disruption is associated with elevated PSA,...

multiple myeloma

Pomalidomide In Patients With Disease Progression Who Are Refractory to Bortezomib and Lenalidomide  

The second-generation immunomodulatory drug pomalidomide (Pomalyst) “has shown impressive results in patients with multiple myeloma who are refractory to lenalidomide [Revlimid] and bortezomib [Velcade],” according to a review of clinical data leading to the drug’s approval by the FDA. In February, ...

breast cancer

Mindfulness-Based Stress Reduction Therapy for Patients With Distress 

Mindfulness-based cancer recovery was shown to be superior to supportive-expressive group therapy “for decreasing symptoms of stress and also for improving overall quality of life and social support” among women who had stage I to III breast cancer and were assessed as experiencing distress,...

issues in oncology

What You Need to Know About E-Cigarettes 

“I’ve seen a lot of puzzled people,” Alexander V. Prokhorov, MD, PhD, said, referring to people who see others using electronic or e-cigarettes. That puzzlement can go beyond wondering why people are smoking in public places and whether they are breaking the law, or just being annoying, to...

health-care policy

Straight Talk: The Future of Medical and Health Research 

Nearly 200 scientists and stakeholders in the research community attended Research!America’s National Health Research Forum on September 12, at the Newseum’s Knight Conference Center in Washington, DC. Research!America’s President and CEO, Mary Woolley, opened the program. “The theme for this...

PCORI Board Approves $114 Million for Patient-Centered Outcomes Research

The Patient-Centered Outcomes Research Institute (PCORI) Board of Governors recently approved 71 awards, totaling more than $114 million over 3 years, to fund comparative clinical effectiveness research designed to answer questions most important to patients and those who care for them. The awards...

St. Jude Children's Hospital Appoints Larry Kun, MD, Clinical Director

St. Jude Children’s Research Hospital officials have named Larry Kun, MD, as Clinical Director and Executive Vice President. Dr. Kun will guide all aspects of clinical care and oversee clinical operations, clinical effectiveness practices and patient care quality programs for the 7,800 patients who ...

health-care policy

For 2 Decades, Nancy Davenport-Ennis Has Worked to Ensure Access to Health Care for All Patients Diagnosed With Life-Threatening Illness 

As a young girl, Nancy Davenport-Ennis remembers hearing her parents tell stories about families struggling to pay their health-care expenses following a diagnosis of a serious illness like cancer. But it wasn’t until 3 decades later when she was coping with her own diagnosis of breast cancer and...

SIDEBAR: About Donatori di Musica 

Created in 2009, Donatori di Musica is a nonprofit network of musicians, health-care professionals, volunteers, patients, and their families, who organize free concerts in oncology departments throughout Italy. Only established professional musicians are invited to perform, and since the program’s...

integrative oncology

Herb-Drug Interactions in Oncology  

Guest Editor Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering...

palliative care

Advances in Medical Oncology Over the Next Decade 

The next 10 years are expected to usher in unprecedented advances in oncology, including molecularly driven diagnostic and therapeutic developments, whole genome sequencing that results in true precision-based medicine, survivorship care plans that address long-term quality of life concerns, and...

lymphoma

Cancer Does Not Discriminate 

Looking back, my son Max’s fall as he was running after another little boy while playing baseball was such a blessing. Although he landed on his right arm, the fall didn’t seem severe enough to cause him to cry out in such excruciating pain. But after several hours of icing the bruise failed to...

cns cancers

Protecting Hippocampus During Whole-Brain Radiation Substantially Reduces Rate of Cognitive Decline 

Protecting the stem cells that reside in and around the hippocampus substantially reduces the rate of cognitive decline in patients during whole-brain radiotherapy without a significant risk of recurrence in that area of the brain, a new study shows. Results of the phase II clinical trial of...

prostate cancer

Fewer Weeks of Neoadjuvant Hormone Therapy Reduces Side Effects in Patients With Intermediate-Risk Prostate Cancer: RTOG 9910

A shorter course of androgen suppression therapy prior to radiation therapy, when compared to an extended course of androgen suppression therapy, yields comparable outcomes and fewer adverse effects for intermediate-risk prostate cancer patients, according to research presented recently at the 55th ...

prostate cancer

Long-Term Androgen Deprivation in Patients With Intermediate-Risk Prostate Cancer Does Not Improve Overall Survival

Men with advanced prostate cancer typically receive hormonal therapy to reduce the level of androgens in their bodies. Although hormone therapy alone will not cure prostate cancer, lowering androgen levels can reduce the size of prostate tumors or stall their growth. A secondary analysis of the...

prostate cancer

ALSYMPCA Trial: Updated Analysis of Survival With Radium-223 Treatment in Metastatic Prostate Cancer 

In a trial (ALSYMPCA trial) reported in The New England Journal of Medicine, Chris Parker, MD, from Royal Marsden Hospital in Surrey, UK, and colleagues compared the alpha emitter radium-223 dichloride (Xofigo) with best standard of care in men with castration-resistant prostate cancer and bone...

global cancer care

View From a Cancer Ward in Botswana 

Julie Livingston, PhD, MPH, is a Professor of History at Rutgers University. She is also an African historian with interdisciplinary training in public health and anthropology. Among other issues, her work considers the challenges of delivering oncology services in southern Africa, where there is a ...

global cancer care

Aftermath of the AIDS Pandemic: Cancer Care in Botswana  

The Republic of Botswana is slightly smaller than the state of Texas and with a population of just over 2 million people it is one of the world’s most sparsely populated countries. Botswana was among Africa’s poorest countries at the time it gained independence from the United Kingdom in 1966....

breast cancer

FDA Approves Neoadjuvant Pertuzumab for Early-Stage Breast Cancer

On September 30, 2013, the FDA granted accelerated approval to pertuzumab (Perjeta) in combination with trastuzumab (Herceptin) and docetaxel for patients with early-stage breast cancer in the neoadjuvant setting. Pertuzumab is the first FDA-approved drug for the neoadjuvant treatment of breast...

breast cancer

Alcohol Consumption Between Menarche and Pregnancy and Breast Cancer Risk: Factors in Risk Accumulation   

In a study recently published in the Journal of the National Cancer Institute and summarized in this issue of The ASCO Post, we found a relationship between alcohol intake between menarche and first pregnancy and risk for breast cancer. Placing this study in context can help us interpret the data...

breast cancer

Increased Alcohol Consumption Between Menarche and Pregnancy Increases Breast Cancer Risk  

Adult alcohol consumption during the previous year is related to breast cancer risk, and breast tissue is particularly susceptible to carcinogens between menarche and first full-term pregnancy. In a study reported in Journal of the National Cancer Institute, Ying Liu, MD, PhD, of Washington...

breast cancer

Accelerated Partial-Breast Irradiation Using 3D Conformal Radiation Therapy Causes More Adverse Events Compared With Whole-Breast Irradiation 

The RAPID trial compared accelerated partial-breast irradiation using three-dimensional (3D) conformal external-beam radiation therapy vs whole-breast irradiation in women with invasive or in situ breast cancer ≤ 3 cm. As reported by Ivo A. ­Olivotto, MD, FRCPC, of the British Columbia Cancer...

Association of Community Cancer Centers Honors Paul F. Engstrom, MD, With Annual Clinical Care Achievement Award

Paul F. Engstrom, MD, Acting Chairman of Medical Oncology and Senior Vice President of Extramural Research Programs at Fox Chase Cancer Center was recently honored by the Association of Community Cancer Centers (ACCC) at the organization’s 30th National Oncology Conference in Boston. Dr. Enstrom...

issues in oncology

Comparative Effectiveness Research: Its Time Has Arrived 

Reigning in the nation’s runaway medical costs was an underlying theme of President Obama’s health-care reform platform. Citing projects like The Dartmouth Atlas of Health Care, which documented large gaps in the quality, costs, and outcomes of health services around the country, the...

breast cancer

Germline Mutations and Breast Cancer Prognosis: Does the Cause Matter? 

Since the discovery of BRCA1 and BRCA2, investigators have sought to determine whether the presence of a germline mutation independently influences the outcome of a breast cancer diagnosed in a woman with an inherited mutation. The question is highly relevant to an unaffected woman with a mutation, ...

breast cancer

10-Year Breast Cancer Survival Similar Regardless of BRCA1 Mutation Status  

In a study reported in Journal of Clinical Oncology, Tomasz Huzarski, MD, PhD, of Pomeranian Medical University, Szczecin, Poland, and colleagues from the Polish Hereditary Breast Cancer Consortium assessed survival among women with early-onset breast cancer with and without BRCA1 mutation and...

SIDEBAR: Highlights From Fox Chase Cancer Center 

1945: Hugh J. Creech, PhD, begins his 31-year career at the Institute. Dr. Creech would become widely recognized for pioneering work in developing chemotherapy agents. 1959: Peter C. Nowell, MD, University of Pennsylvania School of Medicine, and his research fellow David A. Hungerford, Fox Chase...

New President and CEO of Fox Chase Cancer Center Reflects on Challenges and Opportunities Ahead 

On October 8, 1904, a group of Philadelphia physicians and businessmen who were concerned about the escalating incidence of cancer in the city signed a charter that established the American Oncologic Hospital, one of the nation’s first hospitals solely devoted to cancer care. Seven decades later—2...

issues in oncology

More Active Physician Intervention Needed to Keep Patients From Smoking  

More active support and interventions by physicians are required to get patients who still smoke to stop, according to two articles published online by the Journal of Oncology Practice (JOP),1,2 and to prevent school-aged children and adolescents from starting to use tobacco, according to a U.S....

lung cancer

Stereotactic Body Radiation Therapy Offers Near-Complete Tumor Control for Medically Inoperable Early-Stage NSCLC 

Patients with stage I non–small cell lung cancer (NSCLC) who are medically inoperable have an excellent chance at full local tumor control and long-term survival with stereotactic body radiation therapy. Hak Choy, MD, Professor and Chairman of the Department of Radiation Oncology at The University...

lung cancer

Ancient Chinese Military Tactics Might Help Win the War on Lung Cancer  

At the 14th International Lung Cancer Congress, held recently in Huntington Beach, California, Tony S.K. Mok, MD, Professor of Clinical Oncology at the Chinese University of Hong Kong, was the honored recipient of the Bonnie J. Addario Lung Cancer Foundation Award. The award was presented by Ms....

survivorship

Psychosocial Health in Long-Term Survivors of Childhood Cancer 

The study by Lund and colleagues discussed in this issue of The ASCO Post reinforces concerns about psychosocial health in long-term survivors of childhood cancer. Taking advantage of national registries, these investigators demonstrated that, when compared to the general population, survivors are...

survivorship

Study Shows Increased Risk of Mental Disorders in Childhood Cancer Survivors and Potential Increased Risk in Young Siblings  

Survivors of childhood cancer are at risk for long-term adverse physical and mental effects, but little is known about the effects of illness in siblings of these patients. In a study reported in The Lancet Oncology, Lasse Wegener Lund, MD, of the Danish Cancer Society Research Centre and...

gynecologic cancers

Challenging and Changing the Standard of Care for Cervical and Ovarian Cancers 

“It was a very exciting session this year, particularly for cervical cancers,” said Paul Haluska MD, PhD, of the Mayo Clinic, Rochester, Minnesota, in speaking of the 2013 ASCO Annual Meeting’s gynecologic oncology session and the abstracts highlighted recently at Best of ASCO in Chicago. In one...

colorectal cancer

Important Findings in Metastatic Colorectal Cancer Studies Address Treatment, Management Options

At the Best of ASCO Meeting in Los Angeles, Tony Reid, MD, PhD, Director of the Early Phase Clinical Research Program and Professor of Hematology/Oncology at the University of California, San Diego, reviewed important findings in metastatic colorectal cancer presented at the 2013 ASCO Annual...

breast cancer

FDA Grants Breakthrough Therapy Status to Entinostat for Advanced Breast Cancer

Syndax Pharmaceuticals Inc announced that the U.S. Food and Drug Administration (FDA) has designated entinostat as a Breakthrough Therapy for the treatment of locally recurrent or metastatic estrogen receptor (ER)-positive breast cancer when added to exemestane in postmenopausal women whose disease ...

prostate cancer

Telomere Length May Be a Prognostic Marker for Prostate Cancer

Cancer cells are known to have short telomeres, but just how short they are from cancer cell to cancer cell may be a determining factor in a prostate cancer patient’s prognosis, according to a study1 led by scientists at Johns Hopkins. “Doctors are looking for new ways to accurately predict...

issues in oncology

Applying Molecular Profiling to Clinical Practice: Promises and Challenges 

A “new kind of pathology,” with anatomy and histology being supplemented by molecular etiology, has been emerging over the past decade and promises better response rates among patients with cancer, as genomic alterations continue to be identified and treated with targeted therapies. “The list of...

pancreatic cancer

FDA Approves Nab-Paclitaxel for Late-Stage Pancreatic Cancer

The U.S. Food and Drug Administration (FDA) has expanded the approved uses of paclitaxel protein-bound particles for injectable suspension, albumin-bound (nab-paclitaxel, Abraxane) to treat patients with late-stage pancreatic cancer. “Patients with pancreatic cancer are often diagnosed after the...

breast cancer

Pathologic Complete Response as a Test Bed for Novel Therapies: Proceed—With Caution! 

Pathologic complete response as assessed surgically after neoadjuvant treatment is being touted by some researchers as a stand-alone endpoint justifying early drug approval for breast cancer. They argue that it provides a more efficient means of testing the value of agents that might be useful in...

breast cancer

Radiation Therapy Is Safe in the Management of Ductal Carcinoma In Situ: No Increase in Risk of Cardiovascular Disease 

Radiation therapy as part of the management of ductal carcinoma in situ (DCIS) did not increase the risk of cardiovascular disease 10 years after treatment, according to a large retrospective study presented at a press conference held just prior to the 2013 Breast Cancer Symposium.1 Longer...

Expert Point of View on ductal carcinoma in situ

In an e-mail interview, E. Shelley Hwang, MD, an expert who has coauthored several papers on ductal carcinoma in situ (DCIS), weighed in on the two abstracts about management of DCIS featured in this issue of The ASCO Post—one presented by Melissa L. Pilewskie, MD (perioperative MRI in DCIS, page...

Expert Point of View: Steven J. O’Day, MD

This is an important large retrospective single-institution study …[conducted in the context of a] tremendous increase in use of MRI for invasive and noninvasive breast cancer,” said Steven J. O’Day, MD, who moderated a presscast held just prior to the 2013 Breast Cancer Symposium. “The study...

breast cancer

Single-Institution Study Evaluates Routine Use of Perioperative MRI in Patients With Ductal Carcinoma In Situ 

Perioperative MRI for patients with ductal carcinoma in situ (DCIS) was not associated with a reduction in locoregional recurrence or contralateral breast cancer development in a large single-center study reported at the 2013 ASCO Breast Cancer Symposium. The study also was presented at a...

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