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Showing 1901 - 1950How Rehabilitation Services Provide Benefit for Patients With Spinal Metastases
The benefits of rehabilitation in traumatic spinal injuries are well established. Recently, studies have shown similarly positive results in cancer-related spinal injuries, indicating that rehabilitation can play a complementary role in the care management of this patient population....
Closing the Clinical Trial Gap for Adolescents and Young Adults With Cancer
Although overall survival rates for patients with cancer continue to soar—with 14.5 million cancer survivors today1—most of that gain is among pediatric and older adult patients. For adolescents and young adults with cancer—defined by the National Cancer Institute (NCI) as those in the 15- to...
Geriatric Assessment of Transplant-Ineligible Older Adults With Multiple Myeloma: A Novel Approach in the Era of Novel Agents
Myeloma is a disease of aging, with a median age at diagnosis in the United States of 69 years.1 As the population ages, forecasts estimate that, within 20 years, 3 of every 4 people diagnosed with multiple myeloma in the United States will be between the ages of 64 and 84 years.2 In anticipation...
Palbociclib Combined With Fulvestrant in Advanced Breast Cancer Progressing After Endocrine Therapy
On February 19, 2016, palbociclib (Ibrance) was approved for use in combination with fulvestrant (Faslodex) for treatment of hormone receptor–positive, HER2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy.1,2 In February 2015, palbociclib in...
Cancer Survivorship Research: Learning From the Past to Improve Future Outcomes
Soon after effective therapies for some childhood malignancies were first identified, early leaders in our field had concerns about what would happen to surviving patients as they aged. In 1975, Giulio D’Angio, MD, one of the founders of modern pediatric radiation oncology, presciently called for...
Reduction in Late Mortality in Childhood Cancer Survivors
In a study reported in The New England Journal of Medicine, Gregory T. Armstrong, MD, MSCE, of St. Jude Children’s Research Hospital, Memphis, and colleagues found that late mortality has decreased over time among 5-year survivors of childhood cancer in the Childhood Cancer Survivor Study cohort.1...
FDA Approves Crizotinib for ROS1-Positive Metastatic Non–Small Cell Lung Cancer
The U.S. Food and Drug Administration has approved the tyrosine kinase inhibitor crizotinib (Xalkori) for the treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors are ROS1-positive. Crizotinib was first approved in 2011 for the treatment of patients whose tumors are ...
Anticoagulation in Patients With Cancer: Understanding the Complexities of Prophylaxis and Management
Venous thromboembolic events are more prevalent in patients with cancer than in persons without it. Cancer is associated with a high rate of venous thromboembolism recurrence, bleeding, requirement for long-term anticoagulation, and reduced quality of life. Moreover, thrombosis is the second most...
Chronic Lymphocytic Leukemia: The Golden Drug Only for Golden Agers?
As reviewed in this issue of The ASCO Post, Burger and colleagues recently reported findings of the RESONATE-2 trial of ibrutinib (Imbruvica) vs chlorambucil (Leukeran) as initial therapy for elderly patients with chronic lymphocytic leukemia (CLL).1 The study met its primary endpoint of...
First-Line Ibrutinib Improves Progression-Free and Overall Survival vs Chlorambucil in Older Patients With Chronic Lymphocytic Leukemia
As reported in The New England Journal of Medicine and at the 2015 American Society of Hematology Annual Meeting, Jan A. Burger, MD, PhD, and colleagues found that first-line treatment with the oral Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) improved progression-free and overall...
Selected Abstracts From 2015 ASH Annual Meeting: Part 3
Here are several more abstracts selected from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, focusing on the topic of anticoagulation and the cancer patient. For other selected abstracts from this conference, see the December 25, 2015, and the...
Role of Ado-Trastuzumab Emtansine in Metastatic Breast Cancer Solidified
Ado-trastuzumab emtansine (formerly T-DM1; Kadcyla) improved overall survival compared with treatment of physician’s choice of therapy for patients with pretreated HER2-positive metastatic breast cancer, according to the phase III TH3RESA trial.1 Patients enrolled in the trial had previously been...
Survivorship Care in Manitoba: Transition Appointments and Follow-up Care Plans
Working with specialized oncology teams, a provincial agency in Manitoba, Canada, has developed standardized care plans and guidelines for cancer survivors that are implemented in a transition appointment.1 This appointment, which follows the end of active treatment, marks the transfer of medical...
Study Finds No Progression-Free Survival Benefit for Weekly Dose-Dense vs Every-3-Week Paclitaxel Plus Carboplatin in Ovarian Cancer
Weekly dose-dense paclitaxel did not provide a progression-free survival benefit over every-3-week paclitaxel in combination with carboplatin and with or without elective bevacizumab (Avastin) in patients with previously untreated ovarian cancer, according to the results of the phase III GOG-0262...
Mistletoe
The use of dietary supplements by patients with cancer has increased significantly over the past 20 years 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...
Nivolumab Plus Ipilimumab in Unresectable or Metastatic Melanoma Regardless of BRAF Mutation Status
On January 23, 2016, the indication for nivolumab (Opdivo) plus ipilimumab (Yervoy) in unresectable or metastatic melanoma was expanded through accelerated approval to include patients regardless of BRAF V600 mutation status.1 The combination was previously approved for treatment of patients with...
Management of Advanced Lung Cancer in the Elderly: A Reason to Rejoice or a Cause for Concern?
There is ample evidence to suggest that older adults with a good performance status (0 or 1) with advanced non–small cell lung cancer (NSCLC) should be treated with combination chemotherapy akin to younger patients.1,2 However, older adults comprise a heterogeneous group that has been...
New Technology to Characterize Circulating Tumor Cells Suggests Better Treatment Decision-Making in Prostate Cancer
An early study showed that an experimental blood test (ie, “liquid biopsy”) that characterizes the phenotype and genomic characteristics of circulating tumor cells appears to have utility in personalizing treatment decisions for individual men with advanced prostate cancer.1 The assay—developed and ...
Clinic-Based Weight-Loss Intervention Successful in Cancer Survivors
A randomized clinical trial examining the effect of a 15-week healthy living program on weight loss in cancer survivors showed a 5.3% decrease in baseline body weight in those participating in the program.1 “Cancer survivors randomized to a 15-week clinic-based weight-loss intervention lost an...
Bridging the Medical Gap in Long-Term Cancer Survivorship Care
Although more people than ever before are surviving cancer—there are currently 14.5 million cancer survivors, and that number is expected to climb to 19 million by 20241—they often experience long-lasting physical, emotional, and financial concerns related to the disease. To address the unmet...
Surveillance for Recurrence and Second Cancers: Guidelines and Caveats
Striking the right balance between under- and oversurveillance of cancer survivors is challenging, and oncology providers are best served by knowing and following guidelines—though they can change often. Cancer recurrence and second cancers are two of the major threats to the health of cancer...
Fecal Immunochemical Test Sensitive and Effective for Annual Colorectal Cancer Screening
Annual screening with the fecal immunochemical test is highly sensitive for detecting colorectal cancer and “is feasible and effective for population-level colorectal cancer screening,” according to a large-scale retrospective cohort study assessing the fecal immunochemical...
Dutch Study Shows Increased Risk of Second Cancer for Survivors of Hodgkin Lymphoma During Long-Term Follow-up
In a Dutch study reported in The New England Journal of Medicine, Schaapveld et al found that survivors of Hodgkin lymphoma treated between 1965 and 2000 were at a 4.6-fold greater risk of second cancer vs the general population during long-term follow-up. There was no significant difference in the ...
Reduction in Late Mortality in Childhood Cancer Survivors in the Childhood Cancer Survivor Study Cohort
In a study reported in The New England Journal of Medicine, Armstrong et al found that late mortality decreased over time among 5-year survivors of childhood cancer in the Childhood Cancer Survivor Study cohort. The reduction is consistent with efforts during recent decades to modify treatment with ...
Expanded Approval of Pembrolizumab in Unresectable or Metastatic Melanoma
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 December 18, 2015, approval of the programmed cell death...
Transcription Factor CDX2 May Be Prognostic Biomarker in Stage II and III Colon Cancer
In a study reported in The New England Journal of Medicine, Dalerba et al found that absence of the transcription factor CDX2, although prognostic for poor outcome in stage II and III colon cancer vs cancers with CDX2 expression, identified a subgroup of high-risk patients who appeared to benefit...
Dr. Abraham’s Top-10 Picks for the Most Clinically Relevant Breast Cancer Studies of 2015
Sparano JA, Gray RJ, Makower DF, et al: Prospective validation of a 21-gene expression assay in breast cancer. N Engl J Med 373:2005-2014, 2015. Chagpar AB, Killelea BK, Tsangaris TN, et al: A randomized, controlled trial of cavity shave margins in breast cancer. N Engl J Med 373:503-510, 2015....
Selected Abstracts From 2015 San Antonio Breast Cancer Symposium
The 2015 San Antonio Breast Cancer Symposium (SABCS), hosted by the American Association for Cancer Research, the Cancer Therapy & Research Center at The University of Texas Health Sciences Center at San Antonio, and Baylor College of Medicine, was held in December 2015. As has been true for...
Pembrolizumab Label Updated With New Clinical Trial Information
Late in 2015, the U. S. Food and Drug Administration (FDA) expanded the label for pembrolizumab (Keytruda), a humanized antibody, to include the initial treatment of patients with unresectable or metastatic melanoma. Previously, pembrolizumab had received accelerated approval in patients with...
Pieces of Grief
The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...
Acupuncture for Cancer Symptom Clusters
Acupuncture has been practiced for thousands of years in Eastern Asian cultures as a component of traditional Chinese medicine.1 In the United States, acupuncture became known to the public as a complementary and alternative medicine technique in the 1970s, but it took many years before it was...
Winning the Battle at the Front Lines: Lenalidomide Plus Rituximab— A Promising Initial Treatment for Mantle Cell Lymphoma
Mantle cell lymphoma is a pernicious, incurable disease. Front-line therapies for this disease are not currently standardized; however, novel therapies for relapsed or refractory mantle cell lymphoma can ideally be translated into beneficial treatments for newly diagnosed patients, as clearly...
Lenalidomide Plus Rituximab Highly Active in Initial Treatment of Mantle Cell Lymphoma
In a phase II trial reported in The New England Journal of Medicine by Jia Ruan, MD, PhD, and colleagues, first-line treatment with the immunomodulatory agent lenalidomide (Revlimid) and the anti-CD20 antibody rituximab (Rituxan) followed by maintenance lenalidomide and rituximab produced a high...
How Effective Communication Can Improve Patient Care—and Reduce Physician Burnout
Surveys conducted between 1950 and 1970 show that most physicians considered it inhumane to give patients with a poor cancer prognosis the bad news.1,2 Since then, it has been well established that open communication between physician and patient is an essential part of effective cancer care and...
The Evolving Treatment Landscape of ALK-Positive NSCLC
Since the initial discovery of ALK rearrangement in non–small cell lung cancer (NSCLC) in 2007,1 small molecule tyrosine kinase inhibitors of ALK have transformed the course of disease for those patients with ALK-rearranged (ie, ALK-positive) NSCLC. Crizotinib (Xalkori), a multitargeted tyrosine...
Homologous Recombination Deficiency Score Correlated With Response to Platinum in Breast Cancer
The homologous recombination deficiency (HRD) score may be a predictive biomarker of response to neoadjuvant platinum-based therapy in patients with triple-negative breast cancer, according to studies presented at the 2015 San Antonio Breast Cancer Symposium. “We found, in our adjusted analysis,...
Study Finds Colorectal Cancer More Likely to Affect Minorities at Younger Age
Researchers at the University of Missouri School of Medicine reported that minority and ethnic groups are being diagnosed with colorectal cancer at younger ages and more advanced stages than non-Hispanic whites. The study was recently published in Cancer Medicine.1 “While we know the risk of...
Elotuzumab in Previously Treated Multiple Myeloma
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 30, 2015, elotuzumab (Empliciti) was approved for...
Plasma-Based Test Identifies Impactful Mutations in BOLERO-2 Population
A plasma-based cell-free DNA test identified mutations in the estrogen receptor 1 gene (ESR1) in 30% of patients from the BOLERO-2 trial of everolimus (Afinitor) plus exemestane, and these mutations were correlated with survival. The results, which support the use of plasma as a source of...
The 340B Drug Pricing Program: Background, Concerns, and Solutions
The 340B Drug Pricing Program was created by Congress through the Veterans Health Care Act of 1992 to allow some health-care entities—including safety-net providers with large shares of uninsured and low-income patients and other “covered entities”—to obtain drugs at discounted prices.1,2 Congress...
Study Finds Fecal Immunochemical Test Effective for Annual Colon Cancer Screening
Although the fecal immunochemical test is a common method for colorectal cancer screening, its acceptability and performance over several rounds of annual testing are largely unknown. Now, a large retrospective cohort study by Jensen et al assessing the fecal immunochemical...
American College of Physicians Issues Advice for Evaluating Hematuria as a Marker of Urinary Tract Cancer
Although little controversy exists regarding the indication for urologic evaluation for patients with gross hematuria, the evaluation of patients with the much more common finding of microscopic hematuria is complicated by a lack of clarity regarding indications for clinical referral, according to...
Hormone Replacement and Ovarian Cancer: Competing Risks in Decisions about Bilateral Salpingo-oophorectomy
Recently reported findings that bilateral salpingo-oophorectomy and hysterectomy decreased the risk of ovarian cancer compared to ovarian conservation and hysterectomy, without increasing cardiovascular, fracture, and other cancer risks, should “challenge” current thinking about bilateral...
Death Rates Significantly Reduced for Men Having Radical Prostatectomy vs Watchful Waiting
Estimated 15-year results from the Scandinavian Prostate Cancer Group Study (SPCG-4) show that men diagnosed with early prostate cancer and randomly assigned to radical prostatectomy continued to have significantly reduced rates of death from prostate cancer, death from any cause, and risk of...
Understanding Crizotinib, 1 Year after High-profile Presentation
The findings from a phase I study of crizotinib in non–small cell lung cancer (NSCLC) were presented in a Plenary Session at the 2010 ASCO Annual Meeting—an unusual event, since such early-phase data are not generally the topic of plenary sessions. The study showed that a majority of mostly...
Iniparib Fails to Improve Outcomes in Triple-negative Breast Cancer
As reported in the March 15 issue of The ASCO Post, a phase III trial of the novel agent iniparib failed to demonstrate a significant improvement in survival for women with metastatic triple-negative breast cancer. The “top-line” results were communicated in the spring via press releases from...
Novel Agents Improve Survival in Patients with Metastatic Melanoma
Novel treatments for metastatic melanoma dominated the buzz at the 2011 ASCO Annual Meeting and across the major news outlets, with reports that two agents with entirely different mechanisms of action could extend survival. The studies’ inclusion in the ASCO Plenary Session attested to the...
Conflicts of Interest in Health-care Reform?
Last year’s health-care reform legislation, the Patient Protection and Affordable Care Act, was designed to incrementally roll out major new bureaucratic entities, oversight, and mandates for the practice of medicine between its enactment and 2013, after the next presidential election. A new...
Exemestane Prevents Invasive and Preinvasive Breast Cancers in MAP.3 Trial
The aromatase inhibitor exemestane, taken for 5 years, significantly reduced invasive and preinvasive breast cancers in postmenopausal women at increased risk for the disease, in the large Canadian NCIC CTG MAP.3 randomized trial. Results of the trial were presented at the recent ASCO Annual...
Conventional Induction Chemotherapy Beneficial in Only a Subset of Older Adults with AML
Over the past several decades, progress in the treatment of acute myeloid leukemia (AML) in the older population (generally considered to be older than 60 years) has been limited (Fig. 1). In particular, the outcome of patients over age 70 has been poor, with few long-term survivors. Although AML...
