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breast cancer
issues in oncology

Closing the Racial Survival Disparity Gap in Breast Cancer: Models for Change From Chicago, New York, and Beyond

It has long been said that white women of European ancestry are more likely to be diagnosed with breast cancer, but African American women are more likely to die of it. This statement has introduced multiple articles on the topic of the racial survival disparity in breast cancer, including our own...

issues in oncology

Filial Gaze at Our Noble Profession

As we stood outside patient X’s room going over the vitals, from a distance, I saw the father of the patient by the side of her bed. I saw him standing there and looking down at his child conveying what I guess were words of reassurance and reinforcing the pillars of strength needed for her...

Expect Questions About Prostate Cancer Screening and Active Surveillance

A study finding that the incidence of prostate cancer has declined in recent years may at first seem like good news to physicians and patients, but, as widely reported by the media, the decline is not seen as an indication that prostate cancer has become less prevalent, but that screening for it...

Closure

The following essay by ­Kenneth R. Adler, MD, FACP, 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....

issues in oncology

Beautiful Imperfections

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,...

palliative care

Perceptions of End-of-Life Care Differ Sharply Between African Americans and White Americans

Studies demonstrate that patients with advanced cancer who are not actively engaged in planning their end-of-life care often receive overly aggressive, physically taxing, costly and unnecessary treatment toward life’s end. Recent findings indicate that African Americans appear to be more apt to...

The Lawless and Uncertain World of Medicine

Bookmark Title: The Laws of Medicine: Field Notes From an Uncertain Science Author: Siddhartha Mukherjee Publisher: TED Books/Simon & Schuster Publication date: October 13, 2015 Price: $16.99; hardcover, 96 pages The Emperor of All Maladies, written by the Indian-born American oncologist...

issues in oncology

How to Help Mentees Succeed

Although formal mentoring programs in medical education were not launched in the United States until the late 1990s,1 today they are regarded as playing an essential role in the career development of medical trainees and have been associated with improvements in research, teaching, and patient...

hematologic malignancies
leukemia
issues in oncology

Acute Myeloid Leukemia in the Elderly: Trial Data Stir Hope for the Transplant Option

Older patients with acute myeloid leukemia (AML) have high relapse rates after induction chemotherapy, low survival rates, and fewer treatment options compared with younger patients. One of the options for both younger and older patients is hematopoietic cell transplantation, but relatively few...

lung cancer

ASCO Endorsement of ACCP Guideline on Treating SCLC: Moving Forward to Better Outcomes in Oncology

In the current climate of rising health-care costs, particularly in the field of oncology, clinical guidelines provide a crucial tool to guide practitioners in evidence-based care and to improve the quality and consistency of care.1 The ASCO review and endorsement of the American College of Chest...

breast cancer

Ductal Carcinoma in Situ and Relevant Endpoints for Omission of Standard Treatments: Are We There Yet?

The optimal management strategy for ductal carcinoma in situ has become increasingly controversial with respect to potential overdiagnosis and overtreatment. Much of the controversy for ductal carcinoma in situ stems from its exceptional breast cancer–specific survival, which approaches close to...

Journal of Oncology Practice Expands Research Coverage and Debuts a New Look

Launched by ASCO in 2005 to provide oncologists with original research on the delivery of high-quality cancer care, the Journal of Oncology Practice (JOP) enters its 11th year with a new look and feel. Beginning in January 2016, JOP will be copublished by ASCO and Harborside Press, the publisher of ...

health-care policy
issues in oncology

Clinical Trial System Badly in Need of Overhaul, Say Panelists at Friends-Brookings Conference

Cancer clinical trials in three distinct phases, as they have been conducted for decades, are probably no longer the best way to bring a drug or biologic agent to market. This was the consensus of three panels at the 8th Annual Conference on Clinical Cancer Research convened by Friends of Cancer...

breast cancer
survivorship

Breast Cancer Survivors May Expect More Extensive or Frequent Follow-up Testing Than Recommended

Patients who have been treated for breast cancer may overestimate the value of follow-up testing and may expect—or even ask for—more testing than recommended, Harold J. ­Burstein, MD, PhD, of the Dana-Farber Cancer Institute and Harvard Medical School, Boston, told participants at the Lynn Sage...

palliative care

ASCO and AAHPM Define Primary Palliative Care in Oncology

A new guidance statement from ASCO and the American Academy of Hospice and Palliative Medicine (AAHPM) could potentially lead to more standardized primary palliative care delivery across oncology settings, according to Kathleen E. Bickel, MD, MPhil, who presented the study findings at the 2015...

leukemia

Pediatric Regimen Achieves Higher-Than-Expected Survival in Young Adults With Acute Lymphoblastic Leukemia

Adolescents and younger adults with acute lymphoblastic leukemia (ALL) had superior outcomes on a “pediatric” regimen compared with adult treatment protocols. A multicenter phase II study included patients aged 18–50, extending the upper limit of “younger,” since most other trials of this approach...

breast cancer
issues in oncology

Travel Distance Is Still a Barrier to Breast Reconstruction After Mastectomy

Long travel distances continue to be a significant obstacle to breast reconstruction after mastectomy for breast cancer, according to a study published by Abornoz et al in Plastic and Reconstructive Surgery. “While greater patient awareness and insurance coverage have contributed to greater...

solid tumors

Mental Health Status Prior to Radical Cystectomy Can Indicate Risk of Complications

A patient's mental health prior to surgery can influence postoperative outcomes. Removal of the bladder, or radical cystectomy, is an effective treatment for locally advanced bladder cancer, but complications occur in as many as 66% of patients. In a study published by Sharma et al in The Journal...

multiple myeloma

ASH 2015: Multiple Myeloma Patient Study Shows Promise for Natural Killer Cells

A first-in-human phase I study of multiple myeloma patients combined expanded cord blood-derived natural killer cells with transplantation of a patient’s own stem cells and high-dose chemotherapy, with little or none of the side effects seen with current treatments. Results from the clinical...

hematologic malignancies
leukemia
lymphoma
lymphoma

ASH 2015: High Response Rates, Long-Term Remissions in Relapsed/Refractory Pediatric ALL, Lymphomas After CTL019 Immunotherapy

Ninety-three percent of pediatric patients (55 of 59) with relapsed/refractory acute lymphoblastic leukemia (ALL) went into remission after receiving an investigational therapy made from their own immune cells, with continuous remissions of over 1 year in 18 patients and over 2 years in nine...

multiple myeloma

ASH 2015: First-in-Human Trial Using Engineered Cells to Target Multiple Myeloma Shows Early Promise

A study (Abstract LBA1) to be reported by Abbas Ali et al at the 57th American Society of Hematology (ASH) Annual Meeting demonstrated promising early outcomes of a first-in-human trial using a patient’s own genetically modified immune cells to eradicate multiple myeloma. The study...

hematologic malignancies
issues in oncology

ASH 2015: American Society of Hematology Releases Compilation of Top Choosing Wisely Recommendations Relevant to Hematology

The American Society of Hematology (ASH) has released a list of five hematology-related tests and procedures to question based on recommendations from other medical societies taking part in the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely® campaign. This list...

Chitosane-Based Injectable Biogel Delivers Anticancer Agents Directly Into Tumors in Laboratory Setting

A new, injectable “biogel” is effective in delivering anticancer agents directly into cancerous tumors and killing them, according to a study published by Monette et al in Biomaterials. The technology was developed by researchers at the University of Montreal Hospital Research Centre...

breast cancer
issues in oncology

Some Rare HER2 Mutations May Not Be Capable of Causing Breast Cancer Growth

Results of a new laboratory study by Johns Hopkins Kimmel Cancer Center researchers suggest that some rare “missense” mutations in the HER2 gene are apparently not—on their own—capable of causing breast cancer growth or spread. In a related finding, the research team said...

breast cancer
issues in oncology

Exercise Could Provide a Margin of Safety for Women Who Want to Delay Preventive Mastectomy

Regular physical activity could play a role in helping women at high-risk of breast cancer delay the need for drastic preventive measures such as prophylactic mastectomy, according to new research led by the Perelman School of Medicine at the University of Pennsylvania. Results of the WISER Sister...

prostate cancer
issues in oncology
issues in oncology

ASTRO 2015: Genomic Classifier Appears to Predict Metastasis in Patients With Prostate Cancer Following Prostatectomy

For men with prostate cancer who have had a prostatectomy and salvage radiation therapy, analyzing their tumor genome provides clues as to whether their cancer will metastasize, thereby enabling clinicians to better personalize treatment options, according to research presented by Den et al...

supportive care
palliative care

Palliative Care 2015: Study Finds the Answer to One Question Can Help Identify Patients Nearing the End of Life

Determining the answer to a simple question, “Would you be surprised if this patient died within the next year?” can be an important tool to help predict which patients with cancer may be in their final year of life, according to the findings from a study by Vick et al. The tool, known...

prostate cancer
issues in oncology

Postprostatectomy Radiation Therapy Yields Low Toxicity and Favorable Patient-Reported Quality of Life

A prospective study of guideline-based, postoperative, image-guided intensity-modulated radiation therapy in patients with prostate cancer found low toxicity profiles and favorable patient-reported quality of life following treatment, with researchers concluding that toxicity and health-related...

cns cancers
solid tumors

ECC 2015: Advanced Gastrointestinal Neuroendocrine Tumors and Results From the NETTER-1 Trial

Results from a multicenter randomized international trial of an innovative treatment show a marked improvement in the length of time patients with midgut neuroendocrine tumors experience progression-free survival, researchers reported at the 2015 European Cancer Congressin Vienna, Austria, on...

survivorship

Tailored Education Improves Awareness of Risk for Therapy-Related Complications Among Childhood Cancer Survivors

In a study reported in the Journal of Clinical Oncology, Landier et al found that education tailored to personal risk for therapy-related complications improved risk awareness in survivors of childhood cancer. The level of awareness appeared to reach a maximum after several educational sessions....

leukemia

Long-Term Remissions Reported in CLL Personalized Cell Therapy Trial

In the first trial of the University of Pennsylvania's personalized cellular therapy for chronic lymphocytic leukemia (CLL), 8 of 14 patients responded to the therapy, with some complete remissions continuing past 4.5 years. These results, published by Porter et al in Science Translational...

issues in oncology

Study Validates Method for Patient Reporting of Cancer Drug–Related Adverse Events

In cancer clinical trials, doctors typically report side effects that patients experience—not patients themselves. Previous research has shown that doctors underreport these symptoms. Ethan Basch, MD, MSc, Director of the UNC Lineberger Cancer Outcomes Research Program and Associate...

breast cancer
issues in oncology

Hypofractionation of Breast Radiotherapy Associated With Reduced Acute Toxicity

In an analysis reported in JAMA Oncology, Jagsi et al found that hypofractionation of whole-breast radiotherapy was associated with reduced acute toxicity compared with conventional fractionation. Study Details The study involved data on physician-assessed toxic effects and patient-reported...

breast cancer
issues in oncology

Successful Preservation of Fertility After Aromatase Inhibitor Treatment and Ovarian Stimulation in Women With Breast Cancer

In a study reported in the Journal of Clinical Oncology, Oktay et al found that fertility could be preserved in women with breast cancer via embryo freezing after concurrent aromatase inhibitor treatment and ovarian stimulation. In the study, 131 women with stage ≤ III breast cancer underwent...

palliative care
cns cancers
issues in oncology
issues in oncology

ASCO 2015: Gene Therapy Paired With Traditional Surgical Resection Benefits Patients With Glioblastoma

Houston Methodist Neurological Institute neurosurgeon David Baskin, MD, presented preliminary data from a phase II clinical trial that suggests gene therapy  (AdV-Tk therapy), which uses a mediated herpes simplex virus, combined with a traditional treatment—surgical resection—could ...

gynecologic cancers
gynecologic cancers

ASCO 2015: IMGN853 Demonstrates Single-Agent Activity for Patients With Platinum-Resistant Ovarian Cancer

In a phase I trial, the investigational agent mirvetuximab soravtansine (IMGN853) was found to be active in patients with platinum-resistant ovarian cancer. ImmunoGen, Inc, announced the first clinical findings of this folate-receptor alpha (FRα)-targeting antibody-drug conjugate at the...

breast cancer

ASCO 2015: Anastrozole Offers Higher Breast Cancer–Free Interval Rates Than Tamoxifen Following Lumpectomy and Radiation for DCIS

A phase III trial comparing 5 years of tamoxifen vs 5 years of the aromatase inhibitor anastrozole for postmenopausal women treated for ductal carcinoma in situ (DCIS) found 10-year breast cancer–free interval rates were higher in the anastrozole group than in the tamoxifen group (93.5% vs...

breast cancer
issues in oncology
issues in oncology
issues in oncology
issues in oncology

One-Third of Breast Cancer Patients Concerned About Genetic Risk

A new study from the University of Michigan Comprehensive Cancer Center found that many women diagnosed with breast cancer are concerned about the genetic risk of developing other cancers themselves, or of a loved one developing cancer. These findings were published by Jagsi et al in the Journal of ...

issues in oncology
survivorship
issues in oncology

Cancer Patients Lack Knowledge but Desire More Information on Radiation-Based Medical Imaging Tests

A substantial gap exists between patient expectations and current practices for providing information about medical imaging tests that use radiation, according to a new study published by Thornton et al in the journal Radiology. Researchers said the findings highlight a need for better...

supportive care
issues in oncology

No Differences in Patient-Reported Outcomes or Resource Use With Early vs Delayed Initiation of Palliative Care Intervention

In the ENABLE III study reported in the Journal of Clinical Oncology, Bakitas et al found that early vs delayed initiation of a palliative care intervention did not result in improved patient-reported outcomes or resource use. Early initiation was associated with better 1-year survival. Study...

leukemia
issues in oncology

Chromosomal Rearrangement May Be the Key to Progress Against Aggressive Infant Leukemia

The St. Jude Children's Research Hospital–Washington University Pediatric Cancer Genome Project reports that a highly aggressive form of leukemia in infants has surprisingly few mutations beyond the chromosomal rearrangement that affects the MLL gene. The findings, reported by Andersson et al ...

kidney cancer
issues in oncology

Study Finds Lycopene May Be Associated With Lower Risk for Kidney Cancer in Postmenopausal Women

A higher intake by postmenopausal women of lycopene, an antioxidant found in foods like tomatoes, watermelon, and papaya, may lower the risk of renal cell carcinoma, a type of kidney cancer. A study describing these findings was published by Ho et al in Cancer. In 2014, 63,920 estimated new cases...

cns cancers

Preclinical Study Shows Promise for the Development of Personalized Cellular Therapy for Brain Cancer

Immune cells engineered to seek out and attack a type of deadly brain cancer were found to be safe and effective at controlling tumor growth in mice that were treated with these modified cells, according a team from the Perelman School of Medicine at the University of Pennsylvania and the Novartis...

prostate cancer

Sipuleucel-T Demonstrates Sustained Immune Response 2 Years After Treatment in Biochemically Recurrent Prostate Cancer

Preliminary results from the phase II STAND trial have demonstrated a robust immune response with sipuleucel-T (Provenge) that continues 2 years after completing treatment in men with biochemically recurrent prostate cancer. The findings, along with data from an ongoing phase IV registry related to ...

colorectal cancer

New Approach to Colorectal Surgical Care Results in Shorter Recovery Times, Lower Costs

A new, multidisciplinary approach to managing patients undergoing a colorectal operation results in shorter hospital stays, fewer complications, and lower medical costs, according a study published by Thiele et al in the Journal of the American College of Surgeons. Currently, patients undergoing...

issues in oncology

Study Finds Whole-Genome Sequencing Is Successful in Identifying Patients’ Risk for Inherited Cancers

After performing whole-genome sequencing on patients found to have BRCA1or BRCA2 mutations as well as on those that were not carriers of either mutation, researchers found cancer risk–related potentially pathogenic variants in those without BRCA mutations. While the results highlight the ...

bladder cancer

Laparoscopic Surgery for Bladder Cancer Leads to Good Long-Term Cancer Control

Long-term survival rates following laparoscopic surgery for bladder cancer are comparable to those of open surgery, according to a study published in BJU International. The findings, which come from the largest study to date with long-term follow-up after this type of minimally invasive surgery,...

breast cancer

SABCS 2014: Oncotype DX DCIS Score Reliably Predicts Breast Cancer Recurrence in Patients With DCIS

Ductal carcinoma in situ (DCIS), which accounts for 30% of all newly diagnosed breast cancer, is actually a precancerous lesion. A proportion of patients will have progression to invasive breast cancer, but up until recently, it has not been possible to identify which patients require further...

leukemia

ASH 2014: CD19-Directed CAR T-Cell Therapy Yields High Rate of Durable Remissions in Pediatric Acute Lymphoblastic Leukemia

As more experience is gained with the use of genetically engineered chimeric antigen receptor (CAR) T cells in pediatric patients with relapsed/refractory acute lymphoblastic leukemia (ALL), the data continue to be highly encouraging. To date, 36 of 39 pediatric ALL patients (92%) treated with...

breast cancer

Language and Communication Cognitive Complaints Worsen After Initiation of Endocrine Therapy in Early-Stage Breast Cancer

Data suggest that cancer treatment puts patients at risk of cognitive impairment and that many patients exhibit impairment prior to treatment. In an observational cohort study reported in the Journal of Clinical Oncology, Ganz et al found that language and communication cognitive complaints were...

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