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issues in oncology

Quest for Targeted Therapeutic ‘Cocktails’ Hits Roadblocks

The use of cutting-edge technology and bioinformatics to inform clinical decision-making in oncology is still a ways off, according to Mark Pegram, MD, the Susy Yuan-Huey Hung Professor of Oncology and Director of the Stanford Breast Oncology Program, Stanford University, Palo Alto, California. At...

multiple myeloma

Treating Multiple Myeloma in 2014

The field of multiple myeloma is rapidly changing, and the shifts that are occurring impact the management of these patients, from initial diagnosis through multiple relapses. At the 9th Annual New Orleans Summer Cancer Meeting, Sergio A. Giralt, MD, Chief of the Adult Bone Marrow Transplant...

gynecologic cancers

September Is Ovarian Cancer Awareness Month

In recognition of September as Ovarian Cancer Awareness month, David A. Fishman, MD, Director of the Mount Sinai Ovarian Cancer Risk Assessment Program and Professor and Fellowship Director in the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Medicine at...

lung cancer

Targeting KRAS Mutations in Lung Cancer: No Longer Impossible

The KRAS mutation has long been considered “undruggable,” but new approaches in drug development may change this. The end result could be effective new treatment options for KRAS-mutated non–small cell lung cancer (NSCLC), according to David R. Gandara, MD, who described the emerging findings at...

lymphoma

Jury Still Out on Interim PET for Response-Adapted Therapy in Hodgkin Lymphoma

Interim positron-emission tomography (PET) scans provide good prognostic information in patients with Hodgkin lymphoma, but more research is needed to determine whether patients benefit when the findings are used to alter treatment, according to Oliver Press, MD, PhD, Professor at the University of ...

lymphoma

International Group Updates Recommendations on Managing Lymphoma

An international multidisciplinary group of experts has updated their recommendations for staging and treatment response assessment in patients with Hodgkin and non-Hodgkin lymphomas. Bruce D. Cheson, MD, Professor of Medicine, Deputy Chief of Hematology-Oncology, and Head of Hematology at the...

issues in oncology

Oncology Practice: What Are the Factors Driving Change?

Clinical practice changes in response to new medical evidence, but not always immediately or all at once. So what else determines whether and how quickly practice changes in response to evidence, for instance, that a widely used drug is effective only in patients with a certain biomarker? In a new...

issues in oncology

My Priorities for the Year Ahead

I am honored and privileged to lead ASCO during its 51st year, a year that promises to bring both challenges and opportunities to our members and our patients. As the theme for my Presidential term, I’ve chosen Illumination and Innovation: Transforming Data Into Learning, because we are positioned...

lung cancer

Stereotactic Body Radiation Therapy an Effective Option for Early-Stage Lung Cancer Patients

Stereotactic body radiation therapy (SBRT) is safe and effective in early-stage non–small cell lung cancer (NSCLC), as it confers local control in 90% or more patients with T1 disease, according to Roy Decker, MD, PhD, Associate Professor in the Department of Therapeutic Radiology at Yale Cancer...

solid tumors

How Evolutionary Game Theory Is Offering Clues to Disrupt Cancer Cell Metabolism

Kenneth J. Pienta, MD, and his colleagues at Johns Hopkins Medicine in Baltimore are using the principles of evolutionary game theory to learn how cancer cells cooperate within a tumor to gather energy and metastasize. Game theory, the mathematic study of strategic decision-making that is commonly...

supportive care

Memorial Sloan Kettering Cancer Center Launches Meaning-Centered Psychotherapy Programs for Terminally Ill Patients, Cancer Survivors, and Caregivers

Although most major cancer centers in the United States offer support groups and individual counseling sessions to help patients with cancer cope with their disease and treatment, over the past decade Memorial Sloan Kettering Cancer Center in New York has broadened its psycho-oncology programs to...

lymphoma

Para-Aortic Lymph Node Radiation Raises Risk of Developing Diabetes Mellitus in Hodgkin Lymphoma Survivors

Radiation to the para-aortic lymph nodes, “leading to radiation exposure of the pancreas, is associated with a dose-dependent increased risk” of developing diabetes mellitus among long-term survivors of Hodgkin lymphoma (HL), according to a study by Frederika A. van Nimwegen, MSc, of the...

leukemia
lymphoma

Allogeneic Conditioning Regimen Reduces Myelosuppression, Graft-vs-Host Disease in Lymphocytic Leukemia/Lymphoma

The combination of bendamustine (Treanda), fludarabine, and rituximab (Rituxan), or BFR, was shown to be safe and effective conditioning for patients with relapsed chronic lymphocytic leukemia/lymphoma receiving allogeneic stem cell transplantation from related or unrelated donors. “Remarkably,...

colorectal cancer

Substantial Reductions in Surgical Site Infections After Colorectal Surgery With Bundling Approach

Use of a preventive surgical site infection bundle that spanned the phases or perioperative care “was associated with a substantial reduction in [surgical site infections] after colorectal surgery,” according to results of a retrospective study of 559 patients who underwent major elective...

lung cancer

No Survival Benefits With Erlotinib and Whole-Brain Radiotherapy for NSCLC With Multiple Brain Metastases

“To exploit the potential radiosensitizing properties, the direct effect on brain metastases, and systemic activity of erlotinib,” researchers from the United Kingdom tested concurrent erlotinib and whole-brain radiotherapy followed by maintenance erlotinib in patients with of non–small cell lung...

breast cancer

Most Women Who Choose Breast Reconstruction Are Satisfied With Decision-Making Process

Most patients who choose to have breast reconstruction following mastectomy are satisfied with the decision-making process. Reasons for not choosing reconstruction vary by race and include the desire to avoid additional surgery and fear of implants. These and other conclusions of an analysis of...

colorectal cancer

LCS6 Genotype Not Associated With KRAS Mutation Status or Outcome in Stage III Colon Cancer

A let-7 microRNA-complementary site (LCS6) polymorphism in the 3’UTR of KRAS has been shown to disrupt let-7 binding and upregulate KRAS expression. As reported in Clinical Cancer Research, Sha and colleagues found that LCS6 genotype was not associated with KRAS mutation status or disease-free...

leukemia

Tissue Microenvironment Affects Activity of PTEN in Leukemia

The tumor suppressor PTEN, which is underexpressed in many cancers, dephosphorylates phosphatidylinositol (3,4,5)-triphosphate and thus inhibits activity of phosphatidylinositol 3-kinases involved in growth factor and survival factor signaling through effectors such as Akt and mTOR. As reported in...

‘Everybody Has a Mutation or More’

While genome sequencing is not currently recommended or widely used because of its high cost and paucity of meaningful, actionable results, some patients wouldn’t want it even if it were free and useful, ­Theodora Ross, MD, PhD, Director of the Cancer Genetics Program at the University of Texas...

breast cancer

News of Mutations in PALB2 Gene Raising Risk of Breast Cancer Offers Opportunity to Explain Limits of Genetic Testing

The response among patients to news reports about mutations in a gene known as PALB2 raising the risk of breast cancer “has been predictable,” Theodora Ross, MD, PhD, wrote in The New York Times.1 As an example, Dr. Ross, Director of the Cancer Genetics Program at The University of Texas...

integrative oncology

The Role of Music Therapy in Cancer Care

Music therapy, an established adjuvant to standard cancer care, is offered in a growing number of cancer centers throughout the United States and internationally. Defined by the American Music Therapy Association (AMTA) as “the evidence-based use of music interventions to accomplish individual...

ASTRO Awards Seven Physicians a Total of $675,000 to Fund Radiation Oncology-Specific Studies

The American Society for Radiation Oncology (ASTRO) presented seven physicians a total of $675,000 in awards and grants to advance radiation oncology research. The awards will fund studies in radiation and cancer biology, radiation physics, translational research, outcomes/health services research, ...

I Work for You

The following essay by James O. Armitage, MD, is excerpted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was co-edited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and at thebigcasino.org.   The ...

Cancer Frontier: Bringing the New Sciences to an Old School

Cancer seems to have an endless supply of people who want to write about it. Why not? It’s an intriguing subject of life and death and struggle and hope, one that touches virtually every person of a certain age. However, the bookshelves are filled with cancer survivorship books, so to stand out, an ...

issues in oncology

Sequencing Analysis of Tumor DNA: Is It All in the Plasma?

Massively parallel sequencing analyses have demonstrated that most of the common malignancies display relatively complex repertoires of somatic genetic alterations, that the number of highly recurrent mutations is limited, and that a large number of genes is mutated in a small minority of tumors...

issues in oncology

Potential of Liquid Biopsies in Detecting Cancer and Establishing Prognosis

Tests in development to detect circulating tumor cells that escape from solid tumors and travel through the blood, spreading cancer to new sites, may serve as an alternative to conventional tissue biopsy for early cancer diagnosis and gene-expression analysis over the next decade. According to...

neuroendocrine tumors

FDA Grants Priority Review to Lanreotide Injection for Gastroenteropancreatic Neuroendocrine Tumors

The U.S. Food and Drug Administration (FDA) has accepted and granted priority review to Ipsen’s supplemental New Drug Application (sNDA) for the somatostatin analog lanreotide (Somatuline Depot) 120 mg injection in the treatment of gastroenteropancreatic neuroendocrine tumors. The FDA designates...

issues in oncology
global cancer care
health-care policy

Delivering Cancer Care in Low-Income Countries

In eealthy industrialized nations like the United States, escalating costs of cancer care have put the term “cost-effective care” on the forefront of health-care policy discussions. However, the cost issues we wrestle with in our $3 trillion health-care system are vague abstractions for much of the ...

issues in oncology

Using Electronic Health Records to Improve Communication With Patients

Clinicians may argue that electronic health records (EHRs) interfere with the patient-physician relationship, and patients may complain about “distracted doctors,” too busy with computer screens to make eye contact, but according to Thomas W. LeBlanc, MD, MA, of Duke University School of Medicine...

cns cancers

Gene Therapy Betters Chemotherapy Tolerance, Effectiveness in Small Glioblastoma Study

Using gene therapy and a combination of chemotherapy drugs, researchers at Fred Hutchinson Cancer Research Center have been able to enhance the tolerance and effectiveness of medications used in treating glioblastoma while also protecting healthy cells from their toxic effects. The report,...

Immunotherapy Research of James P. Allison, PhD,  Has Led to a Paradigm Shift in the Treatment of Cancer

James P. Allison, PhD, has been bucking the status quo since he was a teenager growing up in the small agricultural town of Alice, Texas, in the 1950s and 1960s. He first butted heads with authority figures when he was in high school and learned that his biology class had omitted the teaching of...

Expert Point of View: Karla Kerlikowske, MD

In an accompanying editorial,1 Karla Kerlikowske, MD, of the University of California, San Francisco, and colleagues point out that while the finding of Killelea et al that digital mammography screening was not associated with downstaging of disease may not be surprising, given the similar accuracy ...

breast cancer

Study Finds Increased Breast Cancer Screening Costs in Medicare Population but No Increase in Cancer Detection

In a study of the use of breast cancer screening modalities in the Medicare population reported in Journal of the National Cancer Institute, Brigid K. Killelea, MD, MPH, FACS, and colleagues at Yale University School of Medicine, Yale Cancer Center, and Yale–New Haven Hospital, New Haven,...

breast cancer

Breast Cancer Screening Using Tomosynthesis in Combination With Digital Mammography

In a study reported in JAMA and reviewed in this issue of The ASCO Post, Friedewald and colleagues1 showed that the addition of tomosynthesis to digital mammography2 resulted in a decrease in the screening recall rate3 and an increase in the cancer detection rate.4,5 This retrospective analysis of...

National Cancer Institute Launches the National Clinical Trials Network to Expedite Scientific Advances

In March, the National Cancer Institute (NCI) transformed its Cooperative Group Program into the National Clinical Trials Network (NCTN). Spurred by recommendations in the Institute of Medicine (IOM) 2010 report, A National Cancer Clinical Trials System for the 21st Century: Reinvigorating the NCI...

NIH Launches Human Safety Study of Ebola Vaccine Candidate

The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, has launched initial human testing of an investigational vaccine to prevent Ebola virus disease, according to a news release issued by NIH. The early-stage trial has begun initial human...

palliative care

Timing and Meaning of Do-Not-Resuscitate Orders in the Palliative Care Setting

Although a do-not-resuscitate (DNR) order does not mean “do not treat,” that is how it is often interpreted, according to a study examining the level of care oncology inpatients at a tertiary care hospital received.1 The study found that the interpretation of DNR orders among oncology nurses and...

bladder cancer

Complications No Different Between Open and Robot-Assisted Radical Cystectomy When Open Urinary Diversion Performed

We read the letter to the editor in the July 24, 2014, issue of The New England Journal of Medicine entitled, “A Randomized Trial of Robot-Assisted Laparoscopic Radical Cystectomy,” with great interest.1 Provocative Results In the letter, reviewed in this issue of The ASCO Post, Bochner and...

bladder cancer

No Difference in Complication Rates or Hospital Stay With  Robot-Assisted vs Open-Surgery Cystectomy in Bladder Cancer

Retrospective analyses indicate that robot-assisted laparoscopic surgery for radical cystectomy in patients with bladder cancer is associated with reduced risk of complications and shorter hospital stay compared with open surgery. In a small single-institution randomized trial reported in a letter...

breast cancer

PALB2 Study: Researchers and Patients Must 'Pal' for Progress

The recent publication by Antoniou et al on risk of breast cancer in PALB2 carriers,1 reviewed in this issue of The ASCO Post (page 47), is a contribution to the interesting history of the PALB2 gene, and an important milestone in the expansion of hereditary cancer susceptibility testing in the...

breast cancer

Study Quantifies Risk of Hereditary Breast Cancer in Carriers of PALB2 Mutations

In a study reported in The New England Journal of Medicine, Antonis C. Antoniou, PhD, Reader in Cancer Risk Prediction and Cancer Research UK Senior Cancer Research Fellow at the University of Cambridge, and colleagues identified lifetime risk of breast cancer in families with germline...

issues in oncology

Patient-Reported Outcomes in Hematology and Oncology Product Development

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, Virginia Kwitkowski, MS, RN, ACNP-BC, and Elektra Papadopoulos, MD, MPH, discuss FDA’s current approach to the review of study...

Researchers at University of Michigan Receive $2.3 Million Grant to Promote Safety, Reduce Exposure Risk, at Chemotherapy Infusion Sites

Researchers at the University of Michigan School of Nursing and Comprehensive Cancer Center have received a $2.3 million grant to study oncology nurses’ exposure to hazardous drugs, including identifying ways to reduce exposure. “There are significant acute and long-term side effects from hazardous ...

lung cancer

Lung Cancer Webinar Highlights Brain Metastases and Thoracic Radiotherapy

Postoperative radiation therapy, given after adjuvant chemotherapy, significantly increased overall survival in non–small cell lung cancer (NSCLC) compared to chemotherapy alone, according to a study reported at ASCO’s 2014 Annual Meeting.1 That study, an analysis of records in the National Cancer...

lung cancer

Optimal Chemoradiotherapy Dosing and Recurrence After Stereotactic Body Radiotherapy Explored in Lung Cancer Webinar

Cetuximab (Erbitux) added no survival benefit to chemoradiation in stage III non–small cell lung cancer (NSCLC), according to results reported in a Plenary Session of the 2013 World Conference on Lung Cancer in Sydney, Australia.1 It was the second surprise result from the Radiation Therapy...

gynecologic cancers

Angiogenesis in Ovarian Cancer: Are We Missing the Clinical Target?

Production of vascular endothelial growth factor (VEGF) is increased during normal ovulation, and can account for much of the reversible toxicity associated with ovarian hyperstimulation.1,2 We also have compelling data from multiple clinical trials to validate the importance of tumor-associated...

gynecologic cancers

Adding Antiangiopoietin Agent Trebananib to Paclitaxel Improves Progression-Free Survival in Recurrent Epithelial Ovarian Cancer

Trebananib inhibits angiogenesis by blocking the binding of angiopoietins 1 and 2 to the Tie2 receptor expressed on endothelial cells, a mechanism that differs from vascular endothelial growth factor (VEGF) inhibitors and that involves a different signaling pathway. In the phase III TRINOVA-1 trial ...

gynecologic cancers

Early Study Finds Olaparib Tablet Safe in Pretreated Ovarian Cancer Patients; More Effective in Those With BRCA Mutations

An oral tablet form of a poly-ADP ribose polymerase (PARP) inhibitor, olaparib, given in combination with chemotherapy, was safe in heavily pretreated patients with ovarian cancer, and patients with BRCA mutations may have a better response compared with those without a BRCA mutation, according to...

prostate cancer

PSA—It Just Keeps Getting Better, So Why Should It Stand Alone?

The updated results of the European Randomised Study of Screening for Prostate Cancer (ERSPC)—reported in The Lancet by Fritz H. Schröder, MD, of Erasmus University Medical Center, and colleagues1 and reviewed in this issue of The ASCO Post—show a continued decline, as predicted,2 in the number...

prostate cancer

European Researchers at 13-Year Follow-up: Increased Absolute Benefit of PSA Screening in Prostate Cancer Mortality, but Time for Population-Based Screening Has Not Arrived

The 13-year follow-up of the European Randomized Study of Screening for Prostate Cancer ­(ERSPC), reported by Fritz H. Schröder, MD, PhD, Professor Emeritus of Urology at Erasmus University Medical Center, Rotterdam, the Netherlands, and colleagues in The Lancet, showed that prostate-specific...

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