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breast cancer

Study Confirms 10 Years of Adjuvant Tamoxifen Is Superior to 5 Years 

The landmark aTTom study showed that 10 years of adjuvant tamoxifen is superior to 5 years of tamoxifen in reducing the risk of breast cancer recurrence or death but that the full survival benefits of extended treatment do not emerge until after the 10 years of treatment. These findings, which were ...

Expert Point of View: Lynn Mara Schuchter, MD and Michael A. Davies, MD, PhD

Lynn Mara Schuchter, MD, the C. Willard Robinson Professor of Hematology-Oncology and Program Leader of the Melanoma Program at Abramson Cancer Center of the University of Pennsylvania, Philadelphia, commented at a press briefing that the study “will ultimately be practice-changing.” She noted,...

Expert Point of View: Ezra Cohen, MD

“These patients finally have options,” commented the DECISION trial’s discussant at the ASCO Plenary Session, Ezra Cohen, MD, Associate Professor of Medicine and Associate Director for Education at the University of Chicago Comprehensive Cancer Center. He further noted that differentiated thyroid...

thyroid cancer

Sorafenib Halts Disease Progression in Metastatic Differentiated Thyroid Cancer  

For the first time in decades, a drug has halted disease progression in treatment-resistant differentiated thyroid cancer, according to the results of a phase III study presented at the 2013 ASCO Annual Meeting.1 No new drugs have been approved for differentiated thyroid cancer in 40 years, but...

gynecologic cancers
global cancer care

Simple Rapid Vinegar Test Cuts Cervical Cancer Death Rates by One-third in Rural India 

In the era of personalized medicine for cancer care, it was both surprising and encouraging to hear about a simple low-tech intervention delivered by women in the community that cut the rate of death from cervical cancer in India by about one-third. The intervention, a simple visual inspection...

Expert Point of View: Gottfried Konecny, MD

Formal discussant Gottfried Konecny, MD, Associate Professor of Medicine, David Geffen School of Medicine at UCLA, also viewed the study as a game changer. He cited the strengths of the study, including its design, randomization with stratification, P values adjusted for multiple testing, and the...

gynecologic cancers

Practice-changing Study Shows Survival Benefit for Antiangiogenesis in Advanced Cervical Cancer 

The addition of bevacizumab (Avastin) to chemotherapy prolongs overall survival in women with metastatic cervical cancer compared with chemotherapy alone, according to the results of a randomized phase III study presented at the Plenary Session of the ASCO Annual Meeting.1 Women on the...

lymphoma

It’s Déjà Vu All Over Again

Yogi Berra offered the comment “It’s déjà vu all over again” when he witnessed Mickey Mantle and Roger Maris repeatedly hitting back-to-back home runs in the early 1960s. His pithy remark neatly summarizes my reaction when I read the article, “Dose-Adjusted EPOCH-Rituximab Therapy in Primary...

issues in oncology

Financial Revamping of Medical Education 

The American medical education system was in a state of crisis in 1910 when Abraham Flexner published his treatise, Report on Medical Education in the United States and Canada (Carnegie Foundation Bulletin Number Four).1 A century later, we face another crisis in medical education—not in terms of...

SIDEBAR: GM-CSF plus Ipilimumab: Ready to Use in the Clinic?

Lynn Mara Schuchter, MD, the C. Willard Robinson Professor of Hematology-Oncology and Program Leader of the Melanoma Program at Abramson Cancer Center of the University of Pennsylvania, Philadelphia, commented on the wealth of promising agents now dotting the formerly barren landscape for...

skin cancer

GM-CSF Boosts Survival Benefit of Ipilimumab in Metastatic Melanoma 

For metastatic melanoma, the activity of ipilimumab can be boosted by the addition of granulocyte-macrophage colony-stimulating factor (GM-CSF, Leukine), according to a phase II study that found the combination improved overall survival, vs ipilimumab alone. The results were presented at the 2013...

lymphoma

Plasma Epstein-Barr Virus DNA a Potential Marker for Treatment Response in Advanced Hodgkin Lymphoma 

Plasma Epstein-Barr Virus (EBV) DNA has prognostic significance in Hodgkin lymphoma, both prior to therapy and at 6 months of follow-up, according to results of a study published in Blood. “Plasma EBV-DNA positivity at month 6 is associated with particularly poor outcomes and may serve as an...

prostate cancer

Replacing Animal Fat with Vegetable Fat May Reduce Mortality Risk in Men with Nonmetastatic Disease

“Among men with nonmetastatic prostate cancer, replacing carbohydrates and animal fat with vegetable fat may reduce the risk of all-cause mortality,” according to a prospective study of 4,577 men with nonmetastatic prostate cancer in the Health Professionals Follow-up Study. Vegetable fat intake...

breast cancer

Cognitive Complaints after Breast Cancer Treatment and Neuropsychological Testing

About one in five patients who had completed primary breast cancer treatments but had not started endocrine therapy “had elevated memory and/or executive function complaints that were statistically significantly associated with domain-specific” neuropsychological test performances and depressive...

breast cancer

Survival Benefits of DCIS Management Strategies Compared 

Overall survival benefits of six management strategies for ductal carcinoma in situ (DCIS) are within 1 year of each other, according to a disease simulation model integrating empirical data from published literature and quantifying the tradeoffs among the different management strategies with...

integrative oncology

Shiitake Mushroom 

The use of dietary supplements by patients with cancer has increased 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...

gynecologic cancers

Driven by the Past 

When I was 9 years old, a bout of nausea, vomiting, and abdominal pain sent me to the emergency room. The physicians diagnosed appendicitis and rushed me to the operating room. But what the surgeon found instead was a 10-cm-wide, grade 2, immature teratoma. In 1968, treatment for malignant ovarian...

SIDEBAR: Expect Questions about Programmed Death Receptors 

In today’s high-tech, sci-fi–loving culture, “programmed death receptor” seems like a term apt to stir up public interest, particularly when those receptors are being “targeted” by “agents.” In this case, however, the agents are antibodies that target programmed death 1 (PD-1) receptor and disable...

skin cancer

'Spectacular' Results with Immunotherapies in Melanoma Galvanize the Oncology Community 

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. Much of the news about immunotherapy ...

issues in oncology

Focus on the Society of Rhode Island Clinical Oncologists 

Founded in 1994, just 1 year after ASCO launched the State/Regional Affiliate Program, the Society of Rhode Island Clinical Oncologists is one of ASCO’s oldest state affiliates. Like many other ASCO affiliates, the Providence-based group is facing a myriad of challenges, including ensuring...

issues in oncology

Big Ten Universities Join Together in Cancer Research Consortium

Leaders from cancer centers affiliated with the “Big Ten” universities joined together in launching the Big Ten Cancer Research Consortium on June 1 in Chicago. The group is uniting to transform cancer research through collaborative oncology trials that leverage the scientific and clinical...

health-care policy
legislation

Accountable Care Organizations May Be at Risk for New Medical Liabilities 

The promotion of accountable care organizations, a crucial element in the Affordable Care Act, may result in liability risks, said H. Benjamin Harvey, MD, JD, a radiologist in the Department of Radiology at Massachusetts General Hospital, and I. Glenn Cohen, JD, Assistant Professor of Law at...

cns cancers

Molecular Imaging Improves Care in Pediatric Glioma

The amino acid imaging agent, O-(2-[18F]-fluoroethyl)-L-tyrosine (F-18 FET), may improve upon standard magnetic resonance imaging (MRI) and its diagnostic benefit for imaging pediatric gliomas when conventional MRI is not sufficient, said researchers at the Society of Nuclear Medicine and Molecular ...

gastrointestinal cancer

SEER Analysis Shows Increased Survival with Surgery and Radiation Therapy in Metastatic Gastric Cancer 

A Surveillance, Epidemiology, and End Results (SEER) database analysis reported by Ravi Shridhar, MD, PhD, and colleagues in Cancer indicates that patients receiving surgery and radiation therapy for metastatic gastric cancer have prolonged survival compared with those receiving either alone or...

gynecologic cancers

Learning to Negotiate the Genomic Complexities of Cancer

The Cancer Genome Atlas (TCGA) Research Network recently reported the results of an integrated analysis of the genomic features of 373 endometrial carcinomas.1 This report joins previously published results of similar analyses in ovarian, breast, and colorectal cancers, squamous cell carcinoma of...

gynecologic cancers

Integrated Genomic Characterization of Endometrial Carcinomas Suggests New Classification Scheme 

As recently reported in Nature, investigators in The Cancer Genome Atlas Research Network performed an integrated genomic, transcriptomic, and proteomic characterization of 373 endometrial carcinomas, including 307 endometrioid and 66 serous or mixed histology cases, using array- and...

SIDEBAR: HPV Vaccine Reduces HPV Infection Rate in Girls  

A study from the Centers for Disease Control and Prevention (CDC) looking at the prevalence of HPV infections in girls before and after the introduction of the HPV vaccine in 2006 found a significant reduction of 56% in infections among female teenagers aged 14 to 19. About 79 million Americans,...

issues in oncology

Study Shows HPV Vaccine Reduced Rate of Infection in Teenage Girls by 56% 

A new government study investigating the prevalence of human papillomavirus (HPV) infections in females aged 14 to 59 before and after the introduction in 2006 of the HPV vaccine found that the rate of the HPV infection dropped by 56%, decreasing from 11.5% in 2006 to 5.1% in 2010 among female...

lung cancer

Erlotinib in First-line Treatment of Metastatic NSCLC with EGFR Exon 19 Deletion or Exon 21 (L858R) Substitution 

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 On May 14, 2013, erlotinib (Tarceva) was approved for...

solid tumors

FDA Approves Denosumab to Treat Giant Cell Tumor of the Bone

The U.S. Food and Drug Administration (FDA) has expanded the approved use of denosumab (Xgeva) to treat adults and some adolescents with giant cell tumor of the bone, a rare and usually noncancerous tumor. Denosumab, which was granted orphan product designation, was reviewed under the FDA’s...

SIDEBAR: Notes from the Lead Investigator 

We conducted this study to clarify a hypothesis that had been generated from preclinical work and small clinical datasets. One additional background point that should be made is that although not all previously reported small datasets had demonstrated a relationship between PTEN expression and...

breast cancer

Outcomes with Adjuvant Trastuzumab in HER2-positive Breast Cancer Not Affected by PTEN Status 

PTEN is a negative regulator of PI3K/AKT signaling. PI3K/AKT signaling can be activated by HER2, and it has been hypothesized that alteration in this pathway may affect sensitivity to trastuzumab (Herceptin). Preclinical data and some of the limited available clinical data suggest that loss or...

Expert Point of View: Marc Lippman, MD and C. Kent Osborne, MD

An editorial by Marc Lippman, MD, Leonard M. Miller School of Medicine, University of Miami, and C. Kent Osborne, MD, Breast Center, Baylor College of Medicine, Houston,1 accompanied the study by Dawson and colleagues. These authors commented that the study’s key findings—that variation in the...

breast cancer

Measurement of Circulating Tumor DNA Shows Promise in Monitoring Metastatic Breast Cancer 

Management of metastatic breast cancer requires monitoring of tumor burden to assess response to treatment, and there is a need for biomarkers that can measure tumor burden with high sensitivity and specificity. Assays measuring serum cancer antigen (CA) 15-3 and circulating tumor cells have been...

skin cancer

Melanomas Induced by BRAF Inhibitors 

Dermatologic Events in Oncology is guest edited by Mario E. Lacouture, MD, an Associate Member in the Division of Dermatology, Department of Medicine, at Memorial Sloan-Kettering Cancer Center, New York. He is a board-certified dermatologist with a special interest in dermatologic conditions that...

global cancer care

New International Innovation Grant Directly Supports Research Projects in Developing Countries

The Conquer Cancer Foundation and ASCO International have just launched a new research funding opportunity, the Conquer Cancer Foundation of ASCO International Innovation Grant, which directly supports research being conducted by investigators in low- and middle-income countries. Advancing Cancer...

prostate cancer

Radium-223 Dichloride for Castration-resistant Prostate Cancer with Symptomatic Bone Metastases 

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 On May 15, 2013, radium Ra 223 dichloride (Xofigo) was...

leukemia

Molecular Landscaping of Acute Myeloid Leukemia: Are We Relearning the Past or Informing the Future?

Acute myeloid leukemia (AML) is a clinically and molecularly heterogeneous disease.1 This concept has been supported by more than 4 decades of studies showing distinct outcomes of subsets of patients that differ in age, disease type (primary vs secondary vs therapy-related), and cytogenetic and...

breast cancer

Study Reports 25% of Women Don't Complete Recommended Breast Cancer Treatment

One-quarter of women who should take hormone-blocking therapies as part of their breast cancer treatment either do not start or do not complete the 5-year course, according to a new study led by University of Michigan Comprehensive Cancer Center researchers. For many women with hormone...

supportive care

Venous Thromboembolism in Patients with Cancer: Real-world Challenges for the Practicing Oncologist 

The close association between cancer and thrombosis has been recognized now for more than 150 years.1 Not only is it now known that patients with cancer are at substantially increased risk of developing venous thromboembolism, even prior to the diagnosis of cancer, but the association between...

supportive care

Updated ASCO Clinical Practice Guideline for Venous Thromboembolism Prophylaxis and Treatment 

ASCO has released a new evidence-based clinical practice guideline for venous thromboembolism prophylaxis and treatment, updating the 2007 practice guideline.1 The update is based on a systematic review of literature published from December 2007 to December 2012. An Update Committee reviewed...

Expert Point of View: Richard Goldberg, MD

The FIRE-3 investigators did not report the use of salvage treatments, and this may be confounding the results, according to Richard Goldberg, MD, who discussed the paper at an ASCO press briefing. Dr. Goldberg is Professor of Medicine at The Ohio State University, Columbus. “The study shows a...

colorectal cancer

Best First-line Treatment for Advanced Colorectal Cancer Remains Unclear 

In patients with advanced colorectal cancer, it remains unclear which biologic agent added to standard chemotherapy is best, even after a head-to-head comparison of two commonly used agents. In the phase III FIRE-3 trial, conducted by the German AIO CRC Study Group, the addition of cetuximab...

Expert Point of View: Prolaris

Scott Tomlins, MD, PhD, a pathologist at the University of Michigan, Ann Arbor, was cautiously optimistic about this new test. “Whenever you introduce a new biomarker, you need to demonstrate its ability to impact clinical decision-making, and it needs to improve on what we currently have,” he...

Expert Point of View: Oncotype DX

“Prostate cancer is a heterogeneous disease and has not yet benefitted from personalized medicine discoveries. Anything that gets us closer to personalized medicine [for prostate cancer] is a plus,” said Michael J. Morris, MD, a medical oncologist at Memorial Sloan-Kettering Cancer Center, New...

prostate cancer

Two New Genetic Tests Offer Progress in Personalized Medicine for Newly Diagnosed Prostate Cancer 

At least 12 different genetic tests for prostate cancer are under development. The two tests currently available are Oncotype DX (Genomic Health, Redwood City, California) and Prolaris (Myriad Genetic Laboratories, Salt Lake City). Both tests can identify which low-risk patients are “truly” at low...

Expert Point of View: Priya Rastogi, MD

Priya Rastogi, MD, Associate Professor of Medicine at the University of Pittsburgh Medical Center, discussed the findings at the session. She noted that previous studies have also shown higher pathologic complete response rates among HER2-enriched patients who were hormone receptor–negative, and...

breast cancer

Benefit for Dual HER2 Targeting in Neoadjuvant Breast Cancer Regimen Restricted to Subset of Patients 

As a neoadjuvant regimen for HER2-positive early breast cancer, the use of two HER2-directed agents was no more effective than trastuzumab (Herceptin) alone in producing pathologic complete responses, although one subset of patients did benefit from this approach, according to the results of the...

Expert Point of View: Stephen R.D. Johnston, MA, MD, PhD

The results of the next-generation sequencing analysis of the BOLERO-2 samples showed that specific activating PIK3CA mutations are not in themselves predictive of clinical benefit from mTOR inhibitors, possibly because there are other ways to activate mTOR independently of PI3K. “It is probably...

issues in oncology

ASCO Will Change with the Times 

At the 2013 ASCO Annual Meeting, The ASCO Post caught up with new President Clifford A. Hudis, MD, Chief of the Breast Cancer Medicine Service at Memorial Sloan-Kettering Cancer Center, New York, for a glimpse of his plans for ASCO in the coming year, and his thoughts on being elected ASCO...

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