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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...

breast cancer

What Is on the Horizon in the Management of Breast Cancer? 

In Keynote Lectures during the 2013 ASCO Breast Cancer Symposium, experts George Sledge, MD, and Monica Morrow, MD, offered their opinions and outlook on how the medical and surgical management of breast cancer may continue to evolve over the next 5 to 10 years.1 Dr. Sledge is Chief of Oncology at...

health-care policy

Trying to Improve Value in Cancer Care: An Experiment

One of the more significant problems in modern oncology practice is to provide increased value at a time when costs are spiraling upward, and new parameters of “success” are being introduced into the equation—most visibly, inside the Beltway in Washington, DC. Thus, oncologists will need to address ...

breast cancer
issues in oncology

Breast Cancer Care in the Era of Accountable Care Organizations

Prepare for big changes ahead, Lawrence N. Shulman, MD, Senior Vice President for Medical Affairs at the Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Harvard Medical School in Boston, told oncologists at the 2013 Breast Cancer Symposium.1 One change is the emergence of...

issues in oncology

Contemporary Studies Dispute Findings of Radiation-Induced Cardiotoxicity  

At the 2013 Breast Cancer Symposium, studies suggested that with current radiotherapy techniques the mean radiation doses to the heart are much lower—and thus radiotherapy is presumably much safer—than findings suggested by an article published in The New England Journal of Medicine last spring.1...

breast cancer

Breast Cancer Radiotherapy and Cardiotoxicity: What Is the True Risk?  

Evidence has long been accumulating that radiotherapy involving the heart can result in premature ischemic heart disease, but interest peaked last spring when a case control study published in The New England Journal of Medicine1 found an increased risk for cardiac-related deaths in breast cancer...

leukemia

Front-Line Treatment Strategies to Achieve Long-Term Control of CLL Combined With Optimal Quality of Life 

“The management of chronic lymphocytic leukemia (CLL) is undergoing profound changes. Several new drugs have been approved for CLL treatment (fludarabine, bendamustine [Treanda], and the monoclonal antibodies alemtuzumab [Campath], rituximab [Rituxan], and ofatumumab [Arzerra]), and many more drugs ...

breast cancer

Calcium Channel Blockers Linked to Increased Risk of Lobular/Ductal Breast Cancer  

Women who are currently using calcium channel blockers and have been doing so for 10 or more years are at increased risk of the two most common histologic types of breast cancer, invasive ductal carcinoma and invasive lobular carcinoma, according to a population-based case control study. “While...

skin cancer

Intralesional Cytokine Therapy in Cutaneous Melanoma: A Call for Clinical Trials

Cutaneous melanomas are mostly an immunogenic group of tumors, but they are also heterogeneous. Therefore, therapeutic specificity and autogenetic approaches are essential to secure beneficial results. The objective of sentinel lymph node biopsy, at the time of diagnosis, is to identify patients...

SIDEBAR: Expect Questions About Contralateral Prophylactic Mastectomy: Carefully Review Risks and Alternatives

Physicians were considered the most important source of information about contralateral prophylactic mastectomy in a survey of 123 women who were diagnosed with cancer in one breast and chose to have the contralateral procedure. While 80% of the women reported that they spoke with their physicians...

breast cancer

Better Risk Communication Strategies Needed to Ensure Decision to Have Contralateral Prophylactic Mastectomy Is Evidence-Based 

Overestimating the risk that cancer in one breast will affect the other breast may cause many young women with breast cancer to choose contralateral prophylactic mastectomy even though most know it does not clearly improve survival. In a survey of 123 women who were diagnosed with cancer in one...

Shades of Autumn

days getting shorter the unopened rose buds … Fall color viewinghere and therethe sky … leaves leaves …not one lefton our maple seasonal affective disorderpumpkin festivallifts my mood Jyothirmai Gubili is an editor with the Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center in ...

lung cancer

Claudia I. Henschke, PhD, MD, Took a Circuitous Route to Her Groundbreaking Work in Lung Cancer Screening 

“Once you have tasted flight, you will forever walk the earth with your eyes turned skyward, for there you have been, and there you will always long to return.”  —Leonardo da Vinci Lung cancer CT screening may have had no greater advocate than Claudia I. Henschke, PhD, MD. In the face of...

lung cancer

Lung Cancer Screening: Actionable Evidence 

This recent paper in The New England Journal of Medicine outlines the details of the clinical outcomes with two incidence screens that were conducted as part of the National Lung Screening Trial (NLST).1 In the wake of the positive review of the U.S. Preventive Services Task Force (USPSTF) draft...

lung cancer

Low-Dose CT Screening Identifies More Early Lung Cancer but Has Lower Positive Predictive Value vs Radiography  

Results of the two rounds of annual incidence screening with low-dose computed tomography (CT) vs radiography in the National Lung Screening Trial (NLST) were recently reported by Denise R. Aberle, MD, Professor of Radiology and Bioengineering at the University of California at Los Angeles and...

Innovation Impact Awards Support Efforts to Advance Blood Cancer Research Priorities and Lung Cancer Screening Adoption

Celgene Corporation recently announced the two recipients of Celgene’s inaugural Innovation Impact Awards: The Aplastic Anemia & Myelodysplastic Syndromes International Foundation (AA&MDSIF) and the Lung Cancer Alliance. The Innovation Impact Awards program recognizes effective, innovative, ...

pancreatic cancer

Nab-Paclitaxel in Metastatic Pancreas 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. Indication On September 6, paclitaxel protein-bound particles...

thyroid cancer

Cabozantinib in Medullary Thyroid Cancer: A Landscape-Shaping New Treatment 

Medullary thyroid cancer is derived from parafollicular C cells in the thyroid gland. The disease is sporadic in about 75% of cases and hereditary in the remaining 25%.1 Oncogenic mutations in the gene for tyrosine kinase receptor rearranged during transfection (RET) are driver genetic alterations...

thyroid cancer

Cabozantinib Improves Disease-Free Survival in Progressive Medullary Thyroid Cancer 

Cabozantinib (Cometriq) is an inhibitor of hepatocyte growth factor receptor (MET), vascular endothelial growth factor receptor 2 (VEGFR2), and rearranged during transfection (RET) tyrosine kinases. In a phase III trial reported in Journal of Clinical Oncology, Rossella Elisei, MD, of University of ...

survivorship

Modifiable Risk Factors Potentiate Therapy-Associated Risk for Major Cardiac Events in Adult Survivors of Childhood Cancer 

In a study reported in the Journal of Clinical Oncology, Gregory T. Armstrong, MD, of St. Jude Children’s Research Hospital in Memphis, and colleagues assessed the frequency of major cardiac events and cardiovascular risk factors among adult survivors of childhood cancer and their siblings.1 They...

health-care policy

AACR Cancer Progress Report 2013 Highlights Critical Importance of Biomedical Research 

On September 17, the American Association for Cancer Research (AACR) presented highlights of its 2013 Cancer Progress Report1 at the National Press Club in Washington, DC. AACR Chief Executive Officer Margaret Foti, PhD, MD (hc), opened the program with a double-edged message, first citing the...

lung cancer

'Master Protocol' Could Revolutionalize Trials in  Lung Cancer, and Eventually Other Cancers 

Cancer advocates and clinical trialists, for some time, have been proposing a radical change to the laborious drug development process—that industry, academia, funding sources, and other stakeholders actually pool their brain power and financial means and work together, not separately, to develop...

issues in oncology
legislation

A Look Ahead: How the FDA Is Adapting in the Era of Precision Medicine  

Dubbed “Cancer Czar” by the media, Richard Pazdur, MD, Director of the U.S. Food and Drug Administration (FDA) Office of Hematology and Oncology Products, said he has the “best job in oncology, with a unique vantage point in cancer drug development.” An oncologist for more than 30 years—including...

ASCO President-Elect Candidate Julie M. Vose, MD, MBA, FASCO

Cost of Care and Federal Funding How can ASCO address the high cost of cancer care and diminishing federal resources for basic and translational research? We need to work with the Centers for Medicare & Medicaid Services, private insurers, and health-care systems to encourage evidence-based...

ASCO President-Elect Candidate Lynn M. Schuchter, MD, FASCO

Cost of Care and Federal Funding How can ASCO address the high cost of cancer care and diminishing federal resources for basic and translational research? In answer to the first part of this question, the rising cost of cancer care has certainly become a focus of national conversation given the...

pain management

FDA Announces Class-Wide Safety Labeling Changes for Long-Acting Opioid Analgesics to Combat Abuse

The U.S. Food and Drug Administration (FDA) announced class-wide safety labeling changes and new postmarketing study requirements for all extended-release and long-acting opioid analgesics intended to treat pain. “The FDA is invoking its authority to require safety labeling changes and postmarket...

ASCO Develops Educational Article Series on Research Funding 

During this and the coming year, ASCO is ramping up its advocacy efforts in calling for increased federal funding to support clinical cancer trials. As part of an extensive effort to educate and mobilize its membership to call for a renewed national investment in federally funded cancer research,...

global cancer care

International Cancer Corps Provides Valuable First-Time Volunteer Experience 

Even as oncologists try to tackle the changing landscape of health care in the United States, many realize that both physicians and patients in this country are still in a better position than those fighting cancer abroad in low- and middle-income countries. In 2009, ASCO joined with Health...

SIDEBAR: IMWG Recommendations 

The International Myeloma Working Group (IMWG) recommends intravenous zoledronic acid as first-line therapy and intravenous pamidronate as second-line therapy for all patients being treated for multiple myeloma, regardless of imaging findings.1 These drugs are given monthly for 2 years and can be...

multiple myeloma

Options for Management of Bone Health in Patients With Multiple Myeloma 

Bone health is critical in patients with multiple myeloma, since up to 85% will suffer bone damage. Options for management include two FDA-approved bisphosphonates—pamidronate and zoledronic acid—and possibly the RANK-L inhibitor denosumab (Xgeva, investigational use). Importance of Supportive ...

hematologic malignancies

Take-Home Messages From the NCCN Hematologic Malignancies Conference 

As the National Comprehensive Cancer Network (NCCN) 8th Annual Congress: Hematologic Malignancies was drawing to a close, The ASCO Post spoke with Andrew D. Zelenetz, MD, PhD, about the themes of the meeting and the take-home messages for attendees and for our readers. Dr. Zelenetz is Vice Chair...

multiple myeloma

New Strategies for Relapsed/Refractory Multiple Myeloma Explored 

Although upfront therapy can achieve remission in multiple myeloma, most patients will ultimately relapse. Newer targeted therapies and genomic analysis are moving the management of relapsed/refractory multiple myeloma forward, according to Kenneth C. Anderson, MD, Director, Jerome Lipper Multiple...

colorectal cancer

The AVEX Trial

As reported in The Lancet Oncology by Cunningham and colleagues and reviewed in this issue of The ASCO Post, the AVEX trial was an open-label randomized phase III trial limited to patients over the age of 70 years with previously untreated, unresectable metastatic colorectal cancer who were not...

colorectal cancer

Bevacizumab/Capecitabine Improves Progression-Free Survival in Older Patients With Treatment-Naive Metastatic Colorectal Cancer 

Elderly patients are often underrepresented in clinical trials of metastatic colorectal cancer. In the phase III AVEX trial reported in The Lancet ­Oncology,1 David Cunningham, MD, of Royal Marsden Hospital in London and colleagues assessed the addition of bevacizumab (Avastin) to capecitabine in...

Expert Point of View: Josep Tabernero, MD, PhD and Eric Van Cutsem, MD, PhD

At the European Cancer Congress (ECC), Josep Tabernero, MD, PhD, Head of the Medical Oncology Department at Vall d’Hebron University in Barcelona, Spain, noted that the ASPECCT study asks a “reasonable question about the efficacy and safety of the two clinically approved anti-EGFR antibodies” and...

colorectal cancer

Panitumumab vs Cetuximab in Chemorefractory Colorectal Cancer: Survival Benefits Comparable  

For the treatment of wild-type KRAS metastatic colorectal cancer in previously treated patients, a head-to-head comparison of the two antibodies—cetuximab (Erbitux) and panitumumab (Vectibix)—that target the epidermal growth factor receptor (EGFR) concluded that they convey similar overall survival ...

Expert Point of View: Alberto Sobrero, MD

Alberto Sobrero, MD, who discussed the VICTOR trial at the European Cancer Congress, said that at this point, adjuvant trials may be unethical, if the findings of multiple observational studies are to be trusted. Apparently, Dr. Sobrero is a believer: He introduced his remarks at the ECC session by ...

colorectal cancer

Aspirin Protects Against Colorectal Cancer Recurrence in PIK3CA-Mutant Tumors 

At the 2013 European Cancer Congress, two investigative teams attempted to explain how aspirin may protect against colorectal cancer recurrences, with one study showing PIK3CA mutations associated with protection from aspirin, but not a COX-2 inhibitor, and the other study implicating HLA class I...

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

This is a provocative and compelling study. I applaud Dr. Herman and his team. The take-home message was beautifully articulated,” said presscast moderator Steven J. O’Day, MD, Director of Clinical Research at the Beverly Hills Cancer Center and Adjunct Member of the John Wayne Cancer Institute in...

breast cancer

Women Undergoing Mammography Fail to Understand Breast Cancer Risk 

More than 90% of women undergoing mammography screening could not give an accurate estimate of their personal risk of developing breast cancer, according to results of a large survey reported at the 2013 ASCO Breast Cancer Symposium and featured in a premeeting presscast. The survey showed that a...

breast cancer

Optimizing Anti-HER2 Treatment for Metastatic Breast Cancer in 2013 

The good news about HER2-positive breast cancer is that recurrent disease is plummeting, owing to the impact of adjuvant trastuzumab [Herceptin]. Hopefully, first-line metastatic treatment is becoming a thing of the past,” said Harold Burstein, MD, PhD, of Dana-Farber Cancer Institute, Boston....

legislation

The Devastating Impact of Sequestration on Medical Research

The primacy of science and the overwhelming belief in medical research by the American people has sustained the research community and improved quality of life roughly since the turn of the 20th century. Almost without exception, the American people have voted for politicians who promise improved...

health-care policy
legislation

The Scientific Perils of Sequestration 

We are just 7 months into the $1 trillion in automatic federal budget spending cuts known as sequestration, and the impact on scientists in all areas of research is already so great, some say its full effects may be irreversible. The ASCO Post recently interviewed ASCO President Clifford A. Hudis, ...

lung cancer

Novel Anti–PD-L1 Antibody Produces Durable Responses in Metastatic NSCLC, Smokers Included  

The engineered monoclonal antibody MPDL3280A achieved encouraging and durable responses in a phase I study in metastatic non–small cell lung cancer (NSCLC) in both smokers and nonsmokers, as well as in cancers of squamous and adenocarcinoma histology. Responses were more robust in smokers than...

COMMENTARY: Choosing Wisely: Good Care With Efficiency

Is more care better care? It is often said, by Americans, that the United States has the best care in the world. However, there are many population-based statistics that do not support that humble opinion. We certainly spend more money than any other nation by far. In fact, we may spend more money ...

issues in oncology

ASCO's 2013 Top Five List in Oncology for Choosing Wisely Campaign

ASCO recognizes the importance of evidence-based cancer care and making wise choices in the diagnosis and management of patients with cancer. After careful consideration by experienced oncologists, ASCO annually highlights five categories of tests, procedures and/or treatments annually whose common ...

breast cancer

Patient Assistance Programs Provide Psychosocial but Not Practical Help

“Patients with breast cancer who connect to relevant patient assistance programs receive useful informational and psychosocial but not practical help,” concluded Nina A. Bickell, MD, MPH, of Mount Sinai School of Medicine in New York, and colleagues who conducted a randomized trial among 374 women...

breast cancer

Impact of Hormone Replacement Therapy on Breast Cancer Risk Varies by Race, Weight, and Breast Density

The impact of hormone replacement therapy on breast cancer risk varies according to the patient’s to race/ethnicity, body mass index, and breast density. An analysis of 1,642,824 screening mammograms with 9,300 breast cancer cases in postmenopausal women aged 45 years or older found that hormone...

breast cancer

Variations in Risk Factors Suggest Distinct Etiology for Inflammatory Breast Cancer

“Varying risk factor associations between inflammatory and noninflammatory breast cancer suggest a distinct etiology for [inflammatory] breast cancer,” according to a study in the Journal of the National Cancer Institute. High body mass index was shown to increase risk of inflammatory breast cancer ...

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