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colorectal cancer

Conquer Cancer Foundation and Michael’s Mission Work Together to Conquer Colorectal Cancer

"Nobody tells a 28 year old to get a colonoscopy.” It’s the sad but true reality that many young adults may be at risk for colorectal cancer. Unfortunately, many people, young adults in particular, are not aware of the risk factors and do not get screened early enough to catch the disease when it...

health-care policy

Policy Issues in Molecularly Targeted Therapy: The Science, the Money, the Applications

In the past decade, much new knowledge about the molecular underpinnings of cancer has accumulated, and the array of molecular aberrations in each individual tumor can be assessed through genomic sequencing and other tests. The rationale for and feasibility of developing molecularly targeted...

solid tumors

Immune-Suppressing Protein in Noncancerous Cells of Cancer Patients Offers Clue to Drug Response

A multicenter phase I study using an investigational immune therapy drug has found that the presence of the immune-suppressing protein PD-L1 in noncancerous immune cells can predict how patients with different types of advanced cancer will respond to treatment.  The study, led by a Yale Cancer...

symptom management

Benefits of Exercise for Relieving Fatigue in Cancer Survivors

Fatigue is such a common—and ongoing—problem among cancer survivors, last spring, ASCO published a clinical practice guideline1 to address screening, assessment, and treatment approaches for the management of fatigue after patients have completed treatment. Among the strategies included in the...

leukemia

Racing Against Acute Lymphoblastic Leukemia: CTL019 Is a Fast CAR With Sustained Endurance

The long-term outcome for patients with relapsed or refractory acute lymphoblastic leukemia (ALL) is poor, with 5-year overall survival from first relapse being only approximately 10%.1,2 Patients with disease relapse following allogeneic transplant have the worse prognosis and are typically...

skin cancer

Getting the Most Out of Ipilimumab in Melanoma

Ipilimumab (Yervoy) was first approved by the U.S. Food and Drug Administration (FDA) in 2011 on the basis of an improvement in overall survival compared with gp100 vaccine in patients with advanced melanoma.1 Response rates with ipilimumab have been modest at best—10% to 15% using 3 mg/kg and 15%...

skin cancer

Phase II Study Shows Improved Survival With Addition of Sargramostim to Ipilimumab in Metastatic Melanoma

Use of the granulocyte-macrophage colony-stimulating factor (GM-CSF) sargramostim (Leukine) together with the cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) inhibitor ipilimumab (Yervoy) prolonged overall survival but not progression-free survival in patients with metastatic melanoma,...

lung cancer

Moving a Mountain: Crizotinib in ROS1-Rearranged NSCLC

It was thousands of years ago in China. An elderly man was unhappy with the mountain that embraced his seaside village. He would need to walk for hours before he could reach the nearest town. So, as the old fable goes, he set his mind to move the mountain. Every day, he dug up basketfuls of rocks...

lung cancer

Crizotinib Is Highly Active in ROS1-Rearranged NSCLC

Crizotinib (Xalkori) produced a high response rate and durable responses in patients with ROS1-rearranged non–small cell lung cancer (NSCLC), according to a study reported in The New England Journal of Medicine.1 Lead authors Alice T. Shaw, MD, PhD, of Massachusetts General Hospital Cancer Center,...

survivorship

ASCO Expert Statement on Cancer Survivorship Care Planning: Timing Is Everything

As the saying goes, “Timing is everything.” And so it is with the recently released ASCO Clinical Expert Statement on survivorship care planning.1 Although there has been extensive discussion and debate about the use of survivorship care plans since the publication of the 2005 Institute of Medicine ...

survivorship

ASCO Clinical Expert Statement on Cancer Survivorship Care Planning

Efforts at implementing survivorship care plans have met with limited success in oncology practice, in part due to the time required to complete them, the lack of role clarity, and the lack of reimbursement for time to complete the documents. In response, ASCO convened a Survivorship Care Planning...

Expert Point of View: Justin Gainor, MD

This is a very exciting time in lung cancer. Immunotherapy is extremely promising,” stated Justin Gainor, MD, a thoracic oncologist at Massachusetts General Hospital in Boston. The promise of immunotherapy extends to a broad patient population. Targeted treatments have transformed the lives of...

lung cancer

Lung Cancer: Next Frontier for Immunotherapy

Immune checkpoint inhibitors, particularly PD-1 (programmed cell death-1) and PD-L1 (programmed death-ligand 1) inhibitors, are being studied extensively in lung cancer. These agents, alone and in combination, appear to have the potential to change the management of non–small cell lung cancer...

Expert Point of View: Alan Venook, MD

During the discussion, Alan Venook, MD, of Helen Diller Comprehensive Cancer Center, University of California, San Francisco, raised the concern that nab-paclitaxel appears to be the platform of choice for clinical trials going forward. “I’m not sure if this is based on market or merit,” he...

pancreatic cancer

Choice for Metastatic Pancreatic Cancer: FOLFIRINOX or Gemcitabine/Nab-Paclitaxel?

The choice between FOLFIRINOX (fluorouracil [5-FU], leucovorin, irinotecan, oxaliplatin) vs the combination of gemcitabine and nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) for first-line treatment of metastatic pancreatic cancer is not much of a contest, judging by a discussion of...

skin cancer

New Serologic Assay May Help Predict Recurrences in Merkel Cell Carcinoma

A new and inexpensive serologic assay may help to predict recurrences of Merkel cell carcinoma, according to Paul Nghiem, MD, PhD, the Michael Piepkorn Endowed Chair in Dermatology Research at the University of Washington, Seattle, who helped develop the test.1 Dr. Nghiem and other experts in...

skin cancer

Hedgehog Inhibitors Can Be Life-Altering in Patients With Advanced Basal Cell Carcinoma

What advanced basal cell carcinomas lack in frequency, they make up for in morbidity, and for these challenging patients, the hedgehog inhibitors have changed lives, according to experts at the 3rd Annual World Cutaneous Malignancies Congress, held recently in San Francisco. “The majority of basal...

breast cancer

3D Mammography Improves Cancer Detection in Dense Breasts

A study presented at the annual meeting of the Radiological Society of North America (RSNA 2014) has found that digital breast tomosynthesis, also known as three-dimensional (3D) mammography, has the potential to significantly increase the cancer detection rate in mammography screening of women...

breast cancer

Breast Cancer Research Foundation Commits Record $58.6 Million in Research Grants

The Breast Cancer Research Foundation (BCRF) announced its dedication of $58.6 million to breast cancer research at its annual Symposium & Awards Luncheon. Totaling $47 million, the 2014–2015 annual grants, awarded to more than 220 physicians and scientists on six continents, continue to fuel...

Expert Point of View: Ethan Basch, MD

Formal discussant of the patient-reported outcomes study by Smith et al presented at the Quality Care Symposium in Boston, Ethan Basch, MD, Director of the Cancer Outcomes Research Program at the University of North Carolina School of Medicine in Chapel Hill, praised the research for its important...

symptom management

Study Reveals Gaps in Symptom Management

The Patient-Reported Outcomes Symptoms and Side-Effects Study demonstrated that many cancer patients treated in community cancer centers are not discussing their common symptoms like pain, fatigue, and emotional distress with their oncologists/health-care team or receiving advice about how to...

Expert Point of View: Deborah Schrag, MD, MPH

Formal discussant of this abstract, Deborah Schrag, MD, MPH, Dana-Farber Cancer Institute, praised this effort. “Dr. Stuver’s abstract provides ample evidence of overuse of intensive care at the end of life. Patients and their families do not want to be in the hospital or emergency department at...

palliative care

Private Payer and Academic Center Data Capture Inappropriate Use of End-of-Life Care

Data sharing between a comprehensive cancer center and a private insurer appears to be a novel way to capture practice patterns that can point to potential quality improvements. A study that combined data from Dana-Farber Cancer Institute and Blue Cross Blue Shield of Massachusetts showed that some ...

lung cancer

Revisiting Successes in Advanced NSCLC to Test Value in Earlier-Stage Disease

Some pretty good evidence suggests that chemotherapy that works in advanced disease probably works even better in early-stage disease,” said Fadlo R. Khuri, MD, Chair, Department of Hematology and Medical Oncology at Winship Cancer Institute in Atlanta, in summarizing results from ­trials of...

lung cancer

Lung Cancer Expert Offers Recommendations for Treating Toxicities Associated With Targeted Therapies

Clearly life as a thoracic oncologist has changed. Our paradigm for giving one-size-fits-all chemotherapy seems a bit dated, as we now are learning that there are multiple targets that we can treat effectively with the right drugs,” Jyoti D. Patel, MD, Associate Professor of Medicine at...

lung cancer
health-care policy

CMS Issues Preliminary Decision to Cover Annual Lung Cancer Screening

In a long-awaited decision, the Centers for Medicare & Medicaid Services (CMS) has issued a preliminary proposal to cover annual lung cancer screening with low-dose computed tomography for appropriate beneficiaries following counseling and a shared–decision-making visit with a qualified...

leukemia

Transplants for AML in First Remission: A Great Leap Forward, Sideways, or Backward?

“All great truths begin as blasphemies.” —George Bernard Shaw (Annajanksa, 1918)   Until about 15 years ago, persons with acute myelogenous leukemia (AML) were considered candidates to receive a blood cell or bone marrow allotransplant in first remission only if they had had an HLA-identical...

lymphoma

PD-1 Blockade Moves Into Hematology

The promise of the programmed death receptor-1 (PD-1) inhibitors seen in solid tumors, especially melanoma, may hold true for at least one hematologic malignancy, according to studies presented at the 56th American Society of Hematology (ASH) Annual Meeting and Exposition. At a press briefing, data ...

palliative care

Better Studies Needed to Dispel Confusion Over When to Refer a Patient to Hospice

I read the article on “Private Payer and Academic Center Data Capture Inappropriate Use of End-of Life Care” (The ASCO Post, December 15, 2014, page 11). The data highlight Dr. Deborah Schrag’s notion that there is “ample evidence of overuse of intensive care at the end of life.” However, there is...

breast cancer

Mammographic Density Is Highly Heritable, Possibly Explaining the Familial Aggregation of Breast Cancer

Using a fully automated method to ascertain volumetric mammographic density, a study conducted by the Karolinska Mammography (KARMA) project for risk prediction of breast cancer in Sweden confirmed the high heritability of mammographic density, although estimates were weaker for absolute than for...

breast cancer

About 25% of Patients Who Undergo Breast-Conservation Surgery for Stage 0 to II Carcinoma Have Subsequent Surgery

“Approximately one-fourth of all patients who undergo initial breast-conservation surgery for breast cancer will have a subsequent operative intervention,” concluded a study published online by JAMA Surgery. “The rate of repeat surgeries varies by patient, tumor, and facility factors,” reported Lee ...

leukemia

Patients With Chronic Lymphocytic Leukemia Who Progress After Front-line Treatment May Be Candidates for Novel Noncytotoxic Therapies

Although patients who relapse within 3 years of front-line fludarabine, cyclophosphamide, and rituximab (Rituxan; FCR) therapy have poor survival when treated with conventional salvage regimens, these patients may be candidates for novel noncytotoxic therapies, according to an analysis of extended...

colorectal cancer

AJCC Cancer Staging System Is Most Accurate Measuring Response to Chemoradiation in Locally Advanced Rectal Cancer

When classifying response to chemoradiation among patients with locally advanced rectal cancer, the American Joint Committee on Cancer (AJCC) Cancer Staging Manual (7th edition) system “is most accurate and should be adopted as the standard,” Attaphorn Trakarnsanga, MD, and colleagues at Memorial...

Citing Guidelines May Reassure Patients

Whether deviations from treatment guidelines are warranted to provide optimal personalized care, or should be financially penalized for straying from evidence-based care, has raised questions among insurers and physicians and caused a stir in the press. In general, however, patients with cancer are ...

issues in oncology

Physicians Need to Maintain Flexibility to Deviate From Treatment Guidelines Without Financial Penalties

With the provocative headline, “How Medical Care Is Being Corrupted,” an op-ed piece in The New York Times argued that “financial forces largely hidden from the public are beginning to corrupt care and undermine the bond of trust between doctors and patients.”1 The article warned that insurers,...

gynecologic cancers

Electro-Gynecology, Philadelphia, 1883

Through the Lens of Oncology History A Century of Progress The text and photographs on these pages represent the establishment of oncology as a viable medical specialty during the mid-1800s. The images and captions are excerpted from a four-volume series of books titled Oncology Tumors &...

breast cancer

Man With Tumor of the Breast, Albumen Print, Paris, 1873

Through the Lens of Oncology History A Century of Progress The text and photographs on these pages represent the establishment of oncology as a viable medical specialty during the mid-1800s. The images and captions are excerpted from a four-volume series of books titled Oncology Tumors &...

gynecologic cancers

Ovarian Cancer Has Taught Me to Be Fearless

In 2013, I was at the top of my professional game. I was a lead performer in the hit Broadway show Motown: The Musical, playing singing legend Diana Ross, which earned me a Tony Award nomination. Performing eight shows a week is exhausting, but I had no problem meeting the physical demands of the...

hematologic malignancies
solid tumors

Clinical Trials Actively Recruiting Children and Young Adults With Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies of children and young adult cancer survivors. The studies include phase I, I/II, III, observational, and interventional trials investigating genomic profiling to personalize treatment;...

lymphoma

Life Is Like Riding a Bicycle

The following essay by Bruce D. Cheson, MD, 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.   The ride...

integrative oncology

The Long and Winding Road to Modern Integrative Oncology

It has been a long road from the blind acceptance of unproven “alternative” remedies for the treatment of cancer to the development of rigorous guidelines for integrative care, which address symptom control. The recently released Society for Integrative Oncology (SIO) guidelines applicable to...

breast cancer
supportive care
integrative oncology

SIO Clinical Practice Guidelines on the Use of Integrative Therapies as Supportive Care in Patients Treated for Breast Cancer

The Society for Integrative Oncology (SIO) Guidelines Working Group has recently released clinical practice guidelines on the use of integrative therapies as supportive care in patients receiving treatment for breast cancer. The guidelines, reported by Heather Greenlee, ND, PhD, MPH, of Mailman...

issues in oncology
cost of care

MD Anderson, UnitedHealthcare Launch New Cancer Care Payment Model

The University of Texas MD Anderson Cancer Center and UnitedHealthcare have launched a pilot to explore a new cancer care payment model for head and neck cancers that focuses on quality patient care and outcomes. The collaboration is among the first using bundled payments in a large, comprehensive...

palliative care

Incorporating Physical Medicine and Rehabilitation Into Palliative Care

Although cancer rehabilitation has been a part of oncology clinical practice for several decades, it has largely gone unrecognized as an integral part of palliative medicine and survivorship care. Now, the role of physical medicine and rehabilitation in oncology care may increase as patients with...

‘Mother of Bone Marrow Transplantation’ Dorothy ‘Dottie’ Thomas Dies at 92

Dorothy “Dottie” Thomas, wife and research partner to 1990 Nobel laureate E. Donnall Thomas, MD, died Friday, January 9, at her home near Seattle. She was 92. Dr. Donnall Thomas, Pioneer of the Bone Marrow Transplant and former Director of the Clinical Research Division at Fred Hutchinson Cancer...

issues in oncology
palliative care

What It Means to Be Mortal

“I learned a lot of things in medical school, but mortality wasn’t one of them,” writes Atul Gawande, MD, MPH, in his new book on the medicalization of aging and dying, Being Mortal: Medicine and What Matters in the End (Metropolitan Books, 2014). In the book, Dr. Gawande critiques the American...

issues in oncology

Smarter Trial Design Saves Money and Produces Better Drugs

The process of identifying a promising molecule and moving it from the laboratory through the highly complex series of clinical trials necessary to garner U.S. Food and Drug Administration (FDA) approval is a costly scientific gauntlet during which many new agents fail. New trial design,...

gynecologic cancers

Gardasil 9 Adds Protection Against Cancer Caused by Additional Human Papillomavirus Types

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 10, 2014, Gardasil 9 (human papillomavirus 9-valent...

issues in oncology
cost of care

Panelists Lambast, Explore the High Cost of Cancer Drugs

At the 2014 American Society of Hematology Annual Meeting, a symposium on the high cost of cancer drugs proved provocative and a bit testy as panelists presented their various points of view. ‘Medical Darwinian System’ Already known for his outspoken views on the topic is Hagop M. Kantarjian, MD,...

breast cancer
gynecologic cancers

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

A study by researchers at The University of Texas Southwestern Medical Center in Dallas and The Ohio State University in Columbus of whole-genome sequencing on patients found to have BRCA1 or BRCA2 mutations as well as on those who were not carriers of a BRCA1/2 mutation has found cancer risk of...

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