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Expert Point of View: Andrés Cervantes, MD, PhD

During a special session at the European Society for Medical Oncology (ESMO) 2014 Congress, additional analyses from the FIRE-3 and Cancer and Leukemia Group B ­(CALGB)/SWOG 80405 trial were presented, and an expert panel was charged with putting the findings into context. Role of Subsequent...

colorectal cancer

All-RAS Testing in Metastatic Colorectal Cancer: Just the First Step

Now that clinicians know to “think beyond KRAS” in metastatic colorectal cancer—and test for all RAS mutations, not just those in exon 2—it seems this is still not sufficient for selecting the best drugs. At the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid, a proffered paper ...

issues in oncology

The Ohio State and Moffitt Collaborate on ORIEN: Using Big Data to Accelerate Trials With a Cancer Research ‘Expressway’

The Ohio State University Comprehensive Cancer Center and Moffitt Cancer Center have joined forces to create the Oncology Research Information Exchange Network (ORIEN), the largest collaboration of its kind designed to accelerate discoveries in cancer research. Members of this alliance of cancer...

issues in oncology

Young Adults With Cancer: Unique Issues Highlight Importance of Patient-Centered Care

Suleika Jaouad, a journalist, was 22 and had just gotten her first chance to cover a major news story—the revolution underway in Tunisia—when she was diagnosed with myelodysplastic syndrome that had evolved into acute myeloid leukemia (AML). Months into her treatment, she began to write again, but...

breast cancer

Noteworthy Abstracts From the Breast Cancer Symposium Include Studies of Novel Therapies and of the Impact of Disease Subtypes on Outcomes

More than 150 oral and poster presentations were featured at the 2014 Breast Cancer Symposium, held September 4–6 in San Francisco. The multidisciplinary meeting is sponsored by ASCO, the American Society of Breast Disease, American Society of Breast Surgeons, American Society for Radiation...

lymphoma

Targeted Therapies in Indolent Lymphoma: Challenging the Current Paradigm

The use of targeted therapies in indolent non-Hodgkin lymphoma (NHL) is a burgeoning area. New targeted therapies directed at the cell surface, intracellular pathways, and the microenvironment are being studied for relapsed indolent NHL. These treatments, if validated in large randomized trials,...

prostate cancer

ASCO Endorses AUA/ASTRO Guideline on Adjuvant and Salvage Radiotherapy After Prostatectomy

ASCO has issued an endorsement of the American Urological Association (AUA)/American Society for Radiation Oncology (ASTRO) guideline on the use of adjuvant and salvage radiotherapy after prostatectomy, which was based on a systematic review of medical literature. The ASCO endorsement was published ...

colorectal cancer

‘Incredible Changes’ in the Field of Colorectal Cancer

Over the past 50 years, there have been incredible changes in the field of colorectal cancer,” Emily K. Bergsland, MD, noted in opening the colorectal cancer session at the Best of ASCO meeting in Chicago. Dr. Bergsland is a gastrointestinal oncologist at the Helen Diller Family Comprehensive...

colorectal cancer

For Selected Patients With Metastatic Colorectal Cancer, Taking a Break From Combination Chemotherapy Might Be Appropriate and Appreciated

Two phase III studies presented at the Best of ASCO meeting in Chicago shed more light on the role of maintenance therapy in patients with metastatic colorectal cancer undergoing first-line treatment with oxaliplatin-based chemotherapy. The two studies compared maintenance therapy with bevacizumab...

breast cancer

Magee-Womens Hospital of UPMC Offers Test to Predict Possibility of Breast Cancer Recurrence

Magee-Womens Hospital of University of Pittsburgh is offering its patients the FDA-cleared breast cancer test assessing a woman’s risk of cancer recurrence by providing a risk category and numerical score. The hospital is the first in the tri-state area (Pennsylvania, Ohio, West Virginia) to offer...

sarcoma

Targeted Agents Making Inroads Against Sarcoma

Targeted agents have started to make inroads in sarcoma therapies, and gastrointestinal stromal tumor (GIST) is the poster child for this success,” Mark Agulnik, MD, stated in summarizing progress in GIST and other sarcomas at the Best of ASCO meeting in Chicago. Dr. Agulnik is Associate Professor, ...

cost of care

HHS Secretary Announces $840 Million Initiative to Improve Care, Lower Costs

Health and Human Services Secretary Sylvia M. Burwell has announced an initiative that will fund successful applicants who work directly with medical providers to rethink and redesign their practices, moving from systems driven by quantity of care to ones focused on patients’ health outcomes, and...

issues in oncology

Studies Address Impact of Social Factors on Cancer Treatment Disparities

New studies reported at ASCO’s 2014 Quality Care Symposium provided insight on the role social factors play in cancer treatment disparities, as well as effective approaches to improving the quality of care.   “The research presented [here] highlights how the conditions facing people living with...

cost of care

Financial Toxicity Potentially Harmful Treatment‑Related Effect

It turns out that in addition to treatment-related toxicity, cancer patients commonly experience “financial toxicity,” a phrase that is increasingly coming into parlance in the cancer community. Patients should be assessed for financial toxicity as early as possible following diagnosis so that they ...

issues in oncology

Choosing Wildly: A Patient’s Perspective on Overtreatment and Quality Care

Over the past decade, there has been growing concern in the oncology community about overdiagnosis and overtreatment of cancers that prove to be indolent and nonlethal, resulting in unnecessary and sometimes harmful procedures.  At this year’s ASCO Quality Care Symposium in Boston, this important...

issues in oncology

Why I Think Dr. Ezekiel Emanuel Is Wrong About Aging

The image of aging that Ezekiel Emanuel, MD, PhD, expresses in his essay, “Why I Hope to Die at 75,” in the October issue of The Atlantic,1 is bleak indeed and one that has contributed mightily to the negative views of aging imbedded in our society. But I refute his description of growing older as...

issues in oncology

Striving for Quality, Not Quantity, of Life

Advances in science and medicine have led to humans living longer than at any other time in history. According to a new report1 on mortality from the Centers for Disease Control and Prevention’s National Center for Health Statistics, life expectancy in the United States is at an all-time high of...

leukemia

The Next-to-Last Frontier in Managing Acute Promyelocytic Leukemia

The treatment of acute promyelocytic leukemia (APL) represents one of the major triumphs in the field of hematologic malignancies. With either the vitamin A derivative all-trans retinoic acid (ATRA) combined with anthracycline-based chemotherapy or ATRA plus arsenic trioxide (Trisenox),...

lung cancer

IMPRESS Trial: Lung Cancer Progression on First-Line Tyrosine Kinase Inhibitor Indicates the Drug Should Be Stopped

The IMPRESS trial found no benefit for continuing treatment with the epidermal growth factor receptor (EFGR) tyrosine kinase inhibitor gefitinib (Iressa, discontinued in the United States) plus chemotherapy vs chemotherapy alone in patients with EGFR-mutated non–small cell lung cancer (NSCLC) who...

lymphoma

Risk of Premature Menopause Raised by Some but Not All Hodgkin Lymphoma Therapies

An analysis of nonsurgical menopause risk among 2,127 women treated for Hodgkin lymphoma found that “risk of premature menopause increased more than 20-fold” after ovarian radiotherapy, alkylating chemotherapy other than dacarbazine, or BEAM (carmustine [BiCNU], etoposide, cytarabine, melphalan)...

lymphoma

Second-Line Gemcitabine the Preferred Option for Relapsed or Refractory Lymphoma

For patients with relapsed or refractory aggressive lymphoma in a National Cancer Institute of Canada clinical trial, second-line treatment with GDP (gemcitabine, dexamethasone, and cisplatin) was as effective as DHAP (dexamethasone, cytarabine, and cisplatin). Treatment with GDP “can be considered ...

gastroesophageal cancer

Customizing Surveillance Strategy in Patients With Esophageal Adenocarcinoma

A surveillance strategy for patients with esophageal adenocarcinoma treated with chemoradiation and surgery (trimodality therapy) can potentially be customized based on surgical pathology stage, according to an analysis of 518 patients with esophageal adenocarcinoma who underwent trimodality...

issues in oncology

Over 14 Million Major Medical Conditions in U.S. Adults Linked to Cigarette Smoking

At least 14 million major medical conditions among U.S. adults aged 35 years and older were attributed to cigarette smoking by a study estimating the disease burden of cigarette smoking, which, according to the study’s authors, “remains immense.” Among current and former smokers, prevalence ratios...

head and neck cancer
issues in oncology

mTOR Cotargeting Active in Cetuximab-Resistant Head/Neck Cancers With PIK3CA and RAS Mutations

In a study reported in Journal of the National Cancer Institute, Wang and colleagues found that adding an mTOR inhibitor to cetuximab (Erbitux) resulted in marked improvement in antitumor activity in squamous cell carcinomas of the head and neck expressing PIK3CA and RAS oncogenes. Cetuximab...

issues in oncology

NCCN Publishes 20th Annual Guidelines in NSCLC, Reflecting Advances in Screening, Diagnosis, Radiology, and Systemic Therapies

The National Comprehensive Cancer Network (NCCN) has published the 20th annual edition of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Non-Small Cell Lung Cancer (NSCLC), one of the eight original NCCN Guidelines published in November 1996. “Since the first NCCN...

Expect Questions From Patients

Screening for thyroid cancer should be discouraged to prevent an “epidemic of diagnosis”—like the one occurring in South Korea—from happening in the United States and other countries, according to the authors of an analysis of the South Korean screening program. That study was published in The New...

issues in oncology
thyroid cancer

South Korean Study Sparks Warnings About the Hazards of Overscreening

An “epidemic of diagnosis” of thyroid cancer is occurring in South Korea and “absolutely could happen here,” according to H. Gilbert Welch, MD, MPH, Professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire. Dr. Welch is coauthor of an article...

Fred Hutchinson Cancer Research Center Recruits D. Gary Gilliland, MD, PhD as New President and Director

Fred Hutchinson Cancer Research Center announced that it has named D. Gary Gilliland, MD, PhD, an expert in cancer genetics and precision medicine as its new President and Director. He will take the helm as the Center’s new leader on January 2. Dr. Gilliland comes to Fred Hutchinson from the...

lymphoma

Clinical Trials Actively Recruiting Patients With Hodgkin Lymphoma and Non-Hodgkin Lymphoma

The information contained in this Clinical Trials Resource Guide includes clinical studies actively recruiting people with Hodgkin lymphoma, non-Hodgkin lymphoma (NHL), including AIDS-related NHL, as well as studies that are also recruiting patients with multiple myeloma and mantle cell lymphoma....

pain management

FDA Approves Extended-Release, Single-Entity Hydrocodone Product With Abuse-Deterrent Properties

The U.S. Food and Drug Administration (FDA) today approved hydrocodone bitartrate (Hysingla ER), an extended-release opioid analgesic to treat pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative treatment options are inadequate. The product...

lung cancer

Beating the Odds

I know it sounds odd, but the past 10 years spent living with non–small cell lung cancer (NSCLC) have been very productive, wonderful years. It is not the life I had before my diagnosis, but it is the life I remember most clearly, and knowing how deadly this cancer is, I’m grateful for every day of ...

Fluoroscopy for Lung Disease, Boston, 1903

When Thomas Alva Edison, the Wizard of Menlo Park, heard of Roentgen’s discovery of the x-ray, he directed his research staff to create x-ray tubes and better screens on which to view the images. Edison owned America’s first industrial research laboratory and could easily supply the know-how,...

Bevacizumab Plus Chemotherapy in Platinum-Resistant Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal 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 November 14, 2014, bevacizumab (Avastin) in combination with...

lung cancer
issues in oncology

ASTRO Commends Medicare’s Proposed Decision to Cover Annual  Low-Dose CT Screening for High-Risk Lung Cancer Patients Aged 55–74

The American Society for Radiation Oncology (ASTRO) praised the November 11, 2014, decision proposal by the Centers for Medicare and Medicaid Services (CMS) to provide coverage for annual lung cancer screening via low-dose computed tomography (CT) screening for those at highest-risk for lung...

A Good Life, All the Way to the Very End

BOOKMARKTitle: Being MortalAuthor: Atul Gawande, MDPublisher: Metropolitan BooksPublication date: October 7, 2014Price: $26.00; hardcover, 304 pages   Mortality is the invisible observer in the oncology exam room. When people hear the three words, “You have cancer,” they see their world as they...

When Life Couldn’t Be Better

The following essay by Carolyn D. Runowicz, 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. Just...

skin cancer

Memorial Sloan Kettering Team Discovery Advances Understanding of Immunotherapy’s Successes—and Its Failures

A collaborative team of leaders in the field of cancer immunology from Memorial Sloan Kettering Cancer Center has made a key discovery that advances the understanding of why some patients respond to the CTLA-4 blocking antibody ipilimumab ­(Yervoy), an immunotherapy drug, while others do not. A...

Discussing Cessation of Medications Near the End of Life

Discussions with patients and families about stopping non–cancer-related medications near the end of life are thorny but necessary, according to Arif H. Kamal, MD, of Duke Cancer Institute, at the Best of ASCO meeting in Seattle. “What’s happening now is that a lot of hospices are having a...

survivorship

Major Strides Seen This Year in Survivorship Care

"This year was actually a boon for the patient and survivor care section,” Arif H. Kamal, MD, said at the Best of ASCO meeting in Seattle, where he reviewed the leading abstracts and gave some of his own perspective. “What you see is a lot of the limitations of research in the palliative care and...

ASH Awards New Bridge Grants to Help Alleviate Pain of Federal Funding Cuts

In November, the American Society of Hematology (ASH) announced the names of seven recipients of its Bridge Grant awards. These 1-year, $150,000 awards provide critical interim support for hematology research proposals that, despite earning high scores, could not be funded by the National...

supportive care
palliative care

Experts Stress the Need for Integrating Palliative Care Into Standard Oncology Care

The overriding consensus from the 2014 Palliative Care in Oncology Symposium: Patient-Centered Care Across the Cancer Continuum held in Boston was that achieving optimal high-quality cancer care requires both state-of-the-art cancer therapy and the integration of palliative care principles...

palliative care

Use of Hospice Care by Medicare Patients Associated With Lower Rate of Hospitalization, ICU Admission, Invasive Procedures, and Costs

Medicare patients with poor­prognosis cancers who received hospice care had significantly lower rates of hospitalization, intensive care unit (ICU) admissions and invasive procedures at the end of life, along with significantly lower health care expenditures during the last year of life, according...

palliative care

How the Earlier Introduction of Palliative Care Improves Quality of Life for Patients With Advanced Cancer

A 4-year study1 involving 461 patients with advanced stages of lung, gastrointestinal, genitourinary, breast, and gynecologic cancers has found that providing early outpatient palliative care vs standard oncology care alone improved quality of life and patient satisfaction. The study participants...

Helping Adolescents and Young Adults Cope With Cancer

Each year, about 70,000 adolescents and young adults (AYAs) are diagnosed with cancer in the United States, almost six times the number of cases diagnosed in children up to 14 years of age. While overall cancer survival rates continue to rise—according to the American Cancer Society, there are...

gynecologic cancers

Scientists Develop New Approach to Treating HPV-Related Cervical Cancer

Cidofovir, an antiviral drug that is well established as a treatment for infection of the retina in people with AIDS, has been shown to be effective in combination with chemoradiation in a phase I study of women with human papillomavirus (HPV)-related cervical cancer. The study results were...

cns cancers

Treating Brain Cancer in 2014

While primary malignant brain tumors account for only 2% of all adult cancers, these deadly neoplasms cause severe cancer-related disability; the 5-year survival rates for brain tumors rank third lowest among all cancers, with those for pancreas and lung cancers being first and second lowest,...

multiple myeloma

HDAC Inhibitors and Triple Therapy in Relapsed Myeloma

The use of histone deacetylase (HDAC) inhibitors as human cancer therapy has focused on the impact of these agents on epigenetic regulation and gene transcription. However, the use of HDAC inhibitors in myeloma may be working through a different mechanism. Specifically, HDAC6 is known to regulate...

multiple myeloma

Adding Pan-Deacetylase Inhibitor Panobinostat to Bortezomib and Dexamethasone Improves Progression-Free Survival in Relapsed Myeloma

In the phase III PANORAMA 1 trial reported in The Lancet Oncology, Jesus F. San-Miguel, MD, of Clinica Universidad de Navarra-CIMA, Pamplona, Spain, and colleagues found that adding the pan-deacetylase inhibitor panobinostat to bortezomib (Velcade) and dexamethasone improved progression-free...

gynecologic cancers

Cancer-Killing Virus Plus Chemotherapy Studied in Recurrent Ovarian Cancer

In 6 out of 10 cases, ovarian cancer is diagnosed when the disease is advanced and 5-year survival is only 27%. A new study suggests that a cancer-killing virus combined with a chemotherapy drug might safely and effectively treat advanced or recurrent forms of the disease. Researchers at The Ohio...

issues in oncology

Advancing ASCO’s Commitment to Quality to Ensure That Every Patient Receives the Highest Level of Cancer Care

On December 3, 2014, Robert S. Miller, MD, FACP, FASCO, will start his new position as Medical Director of ASCO’s Institute for Quality (iQ). Established in 2012 to oversee the development of clinical practice guidelines, the Quality Oncology Practice Initiative (QOPI), the QOPI Certification...

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