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issues in oncology

Reducing Unnecessary and High-dose Pediatric CT Scans Could Cut Future Cancers by More than Half

A study examining trends in x-ray computed tomography (CT) use in children in the United States has found that reducing unnecessary scans and lowering the doses for the highest-dose scans could lower the overall lifetime risk of future imaging-related cancers by 62%. The research was published...

legislation
issues in oncology

National Institutes of Health Issues Projected Impact of Sequestration on Programs 

Earlier this month, the National Institutes of Health (NIH) released its updated projections of reductions in programs due to the deficit-budget mechanism known as sequestration, which took effect on March 1, 2013. The sequestration law requires NIH to cut 5%, or $1.55 billion, of its fiscal year...

lung cancer

Mitigating the Anxiety over Tumor Heterogeneity 

This collaborative study with Foundation Medicine (Cambridge, Massachusetts), using very sensitive deep sequencing, partially mitigates some of the anxiety generated by the identification of tumor heterogeneity. While our data in lung cancer confirm that such heterogeneity exists, they also...

lung cancer

KRAS Status Not Associated with Survival in Pooled Adjuvant Therapy Trials in Early-stage Lung Cancer 

KRAS mutations have been reported in approximately 30% of lung adenocarcinomas. They occur most frequently in codons 12 and 13 in non–small cell lung cancer (NSCLC), and are most common in cancer in smokers and in nonsquamous NSCLC. Some data suggest that KRAS mutation is associated with poorer...

skin cancer

FDA Approves Two Drugs, Companion Diagnostic Test for Advanced Skin Cancer

The U.S. Food and Drug Administration (FDA) recently approved two new drugs, dabrafenib (Tafinlar) and trametinib (Mekinist), for patients with advanced or unresectable melanoma. Dabrafenib, a BRAF inhibitor, is approved to treat patients with melanoma whose tumors express the BRAF V600E gene...

ASTRO to Award Society's Highest Honor to Three Physicians and Researchers

The American Society for Radiation Oncology (ASTRO) will award Amato J. Giaccia, PhD, Radhe Mohan, PhD, FASTRO, and Prabhakar Tripuraneni, MD, FASTRO, with the Society’s highest honor—the ASTRO Gold Medal. The 2013 awardees will receive the ASTRO Gold Medal during the society’s 55th Annual Meeting...

lymphoma

Radiation-sparing Dose-adjusted EPOCH-Rituximab for Primary Mediastinal B-cell Lymphoma 

Tumor control is frequently not achieved with standard immunochemotherapy in patients with primary mediastinal B-cell lymphoma, requiring consolidation with mediastinal radiotherapy. However, radiotherapy is associated with serious late adverse effects and is still associated with disease...

gynecologic cancers

Pazopanib Maintenance Therapy Extends Progression‑free Survival in Patients with Ovarian Cancer 

Maintenance therapy with the targeted therapy pazopanib (Votrient) extended progression-free survival in women with ovarian cancer who were disease-free following initial treatment with surgery and chemotherapy, according to results of a phase III trial presented at the 49th Annual Meeting of...

issues in oncology
global cancer care

ASCO Joins a Global Alliance to Enable Responsible Sharing of Genomic and Clinical Data

ASCO has joined more than 70 leading health care, research, and disease advocacy organizations from around the world in taking the first steps to form an international alliance dedicated to enabling secure sharing of genomic and clinical data. The cost of genome sequencing has fallen one-million...

Brian Druker, MD, and Charles Sawyers, MD, Receive 2013 Taubman Prize for Excellence in Translational Medical Science

Brian Druker, MD, of Oregon Health & Science University in Portland, and Charles Sawyers, MD, of Memorial Sloan-Kettering Cancer Center in New York, will share the 2013 Taubman Prize for Excellence in Translational Medical Science.  The $100,000 prize is given by the A. Alfred Taubman Medical...

Expert Point of View: Andrew Seidman, MD

This study shows us that less can be more in the sentinel lymph node era. We can avoid complete axillary resection. As a medical oncologist, I have learned that less can be more in many settings. As a result of this study, I will be able to reassure my patients that radiation therapy to the axilla...

breast cancer

Axillary Radiotherapy: New Standard of Care in Node-positive Breast Cancer? 

Radiotherapy to the axilla may replace axillary lymph node dissection for local tumor control in selected patients with sentinel node–positive breast cancer, sparing many patients lymphedema, according to the final results of the European Organisation for Research and Treatment of Cancer (EORTC)...

breast cancer

FDA Approves New Silicone Gel-filled Breast Implant

The FDA recently approved the MemoryShape Breast Implant for breast augmentation in women at least 22 years old and for breast reconstruction in women of any age. The MemoryShape Breast Implants are manufactured by Mentor Worldwide LLC. The FDA’s approval is based on 6 years of data from 955 women...

Expert Point of View: Ann Partridge, MD

This study showed that 10 years of adjuvant tamoxifen reduced the risk of late recurrence in hormone receptor-positive breast cancer, which is a major problem. The study also showed that ‘patience is a virtue’,” stated formal discussant Ann Partridge, MD, Director of the Adult Survivorship Program...

breast cancer

Study Confirms 10 Years of Adjuvant Tamoxifen Is Superior to 5 Years 

The landmark aTTom study showed that 10 years of adjuvant tamoxifen is superior to 5 years of tamoxifen in reducing the risk of breast cancer recurrence or death but that the full survival benefits of extended treatment do not emerge until after the 10 years of treatment. These findings, which were ...

Expert Point of View: Lynn Mara Schuchter, MD and Michael A. Davies, MD, PhD

Lynn Mara Schuchter, MD, the C. Willard Robinson Professor of Hematology-Oncology and Program Leader of the Melanoma Program at Abramson Cancer Center of the University of Pennsylvania, Philadelphia, commented at a press briefing that the study “will ultimately be practice-changing.” She noted,...

skin cancer

MEK Inhibitor Improves Outcomes in Metastatic Uveal Melanoma 

For the first time, a drug has proven effective in the treatment of uveal (ocular) melanoma that has metastasized, according to a randomized multicenter phase II study presented at the 2013 ASCO Annual Meeting.1 “This study is the first to demonstrate an improved clinical outcome with any systemic...

ASCO President Clifford Hudis, MD, on the 2013 ASCO Annual Meeting

This year’s ASCO Annual Meeting was really exciting in two specific ways. First, we saw the development of high-tech novel therapies and combinations that effectively manipulate the immune system and extend survival in historically difficult-to-treat diseases, like metastatic melanoma (eg,...

Expert Point of View: Ezra Cohen, MD

“These patients finally have options,” commented the DECISION trial’s discussant at the ASCO Plenary Session, Ezra Cohen, MD, Associate Professor of Medicine and Associate Director for Education at the University of Chicago Comprehensive Cancer Center. He further noted that differentiated thyroid...

thyroid cancer

Sorafenib Halts Disease Progression in Metastatic Differentiated Thyroid Cancer  

For the first time in decades, a drug has halted disease progression in treatment-resistant differentiated thyroid cancer, according to the results of a phase III study presented at the 2013 ASCO Annual Meeting.1 No new drugs have been approved for differentiated thyroid cancer in 40 years, but...

Expert Point of View: Electra D. Paskett, PhD

Formal discussant Electra D. Paskett, PhD, Professor of Medicine at The Ohio State University, was enthusiastic about these trial results and the potential of visual inspection with acetic acid screening, as well as low-cost human papillomavirus (HPV) screening to save lives in the developing...

gynecologic cancers
global cancer care

Simple Rapid Vinegar Test Cuts Cervical Cancer Death Rates by One-third in Rural India 

In the era of personalized medicine for cancer care, it was both surprising and encouraging to hear about a simple low-tech intervention delivered by women in the community that cut the rate of death from cervical cancer in India by about one-third. The intervention, a simple visual inspection...

Expert Point of View: Gottfried Konecny, MD

Formal discussant Gottfried Konecny, MD, Associate Professor of Medicine, David Geffen School of Medicine at UCLA, also viewed the study as a game changer. He cited the strengths of the study, including its design, randomization with stratification, P values adjusted for multiple testing, and the...

gynecologic cancers

Practice-changing Study Shows Survival Benefit for Antiangiogenesis in Advanced Cervical Cancer 

The addition of bevacizumab (Avastin) to chemotherapy prolongs overall survival in women with metastatic cervical cancer compared with chemotherapy alone, according to the results of a randomized phase III study presented at the Plenary Session of the ASCO Annual Meeting.1 Women on the...

lymphoma

It’s Déjà Vu All Over Again

Yogi Berra offered the comment “It’s déjà vu all over again” when he witnessed Mickey Mantle and Roger Maris repeatedly hitting back-to-back home runs in the early 1960s. His pithy remark neatly summarizes my reaction when I read the article, “Dose-Adjusted EPOCH-Rituximab Therapy in Primary...

SIDEBAR: GM-CSF plus Ipilimumab: Ready to Use in the Clinic?

Lynn Mara Schuchter, MD, the C. Willard Robinson Professor of Hematology-Oncology and Program Leader of the Melanoma Program at Abramson Cancer Center of the University of Pennsylvania, Philadelphia, commented on the wealth of promising agents now dotting the formerly barren landscape for...

skin cancer

GM-CSF Boosts Survival Benefit of Ipilimumab in Metastatic Melanoma 

For metastatic melanoma, the activity of ipilimumab can be boosted by the addition of granulocyte-macrophage colony-stimulating factor (GM-CSF, Leukine), according to a phase II study that found the combination improved overall survival, vs ipilimumab alone. The results were presented at the 2013...

lymphoma

Plasma Epstein-Barr Virus DNA a Potential Marker for Treatment Response in Advanced Hodgkin Lymphoma 

Plasma Epstein-Barr Virus (EBV) DNA has prognostic significance in Hodgkin lymphoma, both prior to therapy and at 6 months of follow-up, according to results of a study published in Blood. “Plasma EBV-DNA positivity at month 6 is associated with particularly poor outcomes and may serve as an...

prostate cancer

Replacing Animal Fat with Vegetable Fat May Reduce Mortality Risk in Men with Nonmetastatic Disease

“Among men with nonmetastatic prostate cancer, replacing carbohydrates and animal fat with vegetable fat may reduce the risk of all-cause mortality,” according to a prospective study of 4,577 men with nonmetastatic prostate cancer in the Health Professionals Follow-up Study. Vegetable fat intake...

kidney cancer

Using Quality Indicators Can Improve Outcomes among Patients with Renal Cell Carcinoma

An expert panel of 13 urologic and medical oncologists worked together to identify 23 quality indicators for renal cell carcinoma, as described in an article in the Journal of Oncology Practice. “These 23 [quality indicators] will provide a means of evaluating the quality of [renal cell carcinoma]...

breast cancer

Survival Benefits of DCIS Management Strategies Compared 

Overall survival benefits of six management strategies for ductal carcinoma in situ (DCIS) are within 1 year of each other, according to a disease simulation model integrating empirical data from published literature and quantifying the tradeoffs among the different management strategies with...

integrative oncology

Shiitake Mushroom 

The use of dietary supplements by patients with cancer has increased significantly over the past 2 decades 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...

gynecologic cancers

Driven by the Past 

When I was 9 years old, a bout of nausea, vomiting, and abdominal pain sent me to the emergency room. The physicians diagnosed appendicitis and rushed me to the operating room. But what the surgeon found instead was a 10-cm-wide, grade 2, immature teratoma. In 1968, treatment for malignant ovarian...

SIDEBAR: Expect Questions about Programmed Death Receptors 

In today’s high-tech, sci-fi–loving culture, “programmed death receptor” seems like a term apt to stir up public interest, particularly when those receptors are being “targeted” by “agents.” In this case, however, the agents are antibodies that target programmed death 1 (PD-1) receptor and disable...

skin cancer

'Spectacular' Results with Immunotherapies in Melanoma Galvanize the Oncology Community 

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Much of the news about immunotherapy ...

issues in oncology

Focus on the Society of Rhode Island Clinical Oncologists 

Founded in 1994, just 1 year after ASCO launched the State/Regional Affiliate Program, the Society of Rhode Island Clinical Oncologists is one of ASCO’s oldest state affiliates. Like many other ASCO affiliates, the Providence-based group is facing a myriad of challenges, including ensuring...

issues in oncology

Big Ten Universities Join Together in Cancer Research Consortium

Leaders from cancer centers affiliated with the “Big Ten” universities joined together in launching the Big Ten Cancer Research Consortium on June 1 in Chicago. The group is uniting to transform cancer research through collaborative oncology trials that leverage the scientific and clinical...

issues in oncology

Newly Approved Drugs and Indications

FDA has approved the following new drugs and/or indications in 2013: Denosumab (Xgeva subcutaneous injection) for giant cell tumor of bone. Lenalidomide (Revlimid capsules) for relapsed/refractory mantle cell lymphoma FDA approved. Trametinib (Mekinist tablets) for unresectable or metastatic...

Gary L. Dillehay, MD, Is New President, Society of Nuclear Medicine and Molecular Imaging

The Society of Nuclear Medicine and Molecular Imaging (SNMMI) recently announced the appointment of Gary L. Dillehay, MD, FACNM, FACR, to 2013-2014 President, SNMMI, during the Society’s Annual Meeting in Vancouver. Dr. Dillehay is Professor of Radiology at Northwestern Memorial Hospital in...

cns cancers

Molecular Imaging Improves Care in Pediatric Glioma

The amino acid imaging agent, O-(2-[18F]-fluoroethyl)-L-tyrosine (F-18 FET), may improve upon standard magnetic resonance imaging (MRI) and its diagnostic benefit for imaging pediatric gliomas when conventional MRI is not sufficient, said researchers at the Society of Nuclear Medicine and Molecular ...

kidney cancer

Results of AXIS Trial Indicate a Significant Improvement over Historical Survival Data in Renal Cell Carcinoma 

The phase III open-label AXIS trial comparing axitinib (Inlyta) vs sorafenib (Nexavar) as second-line treatment for metastatic renal cell carcinoma has shown a significant difference in median progression-free survival (8.3 months in the axitinib group vs 5.7 months in the sorafenib group; hazard...

kidney cancer

Progression of Renal Cell Carcinoma Linked to Shifts in Tumor Metabolism

Investigators in The Cancer Genome Atlas (TCGA) Research Network have uncovered a connection between how tumor cells use energy from metabolic processes and the aggressiveness of the most common form of kidney cancer, clear cell renal cell carcinoma. Their findings demonstrate that normal...

gastrointestinal cancer

SEER Analysis Shows Increased Survival with Surgery and Radiation Therapy in Metastatic Gastric Cancer 

A Surveillance, Epidemiology, and End Results (SEER) database analysis reported by Ravi Shridhar, MD, PhD, and colleagues in Cancer indicates that patients receiving surgery and radiation therapy for metastatic gastric cancer have prolonged survival compared with those receiving either alone or...

gynecologic cancers

Learning to Negotiate the Genomic Complexities of Cancer

The Cancer Genome Atlas (TCGA) Research Network recently reported the results of an integrated analysis of the genomic features of 373 endometrial carcinomas.1 This report joins previously published results of similar analyses in ovarian, breast, and colorectal cancers, squamous cell carcinoma of...

gynecologic cancers

Integrated Genomic Characterization of Endometrial Carcinomas Suggests New Classification Scheme 

As recently reported in Nature, investigators in The Cancer Genome Atlas Research Network performed an integrated genomic, transcriptomic, and proteomic characterization of 373 endometrial carcinomas, including 307 endometrioid and 66 serous or mixed histology cases, using array- and...

issues in oncology

Study Shows HPV Vaccine Reduced Rate of Infection in Teenage Girls by 56% 

A new government study investigating the prevalence of human papillomavirus (HPV) infections in females aged 14 to 59 before and after the introduction in 2006 of the HPV vaccine found that the rate of the HPV infection dropped by 56%, decreasing from 11.5% in 2006 to 5.1% in 2010 among female...

lung cancer

Erlotinib in First-line Treatment of Metastatic NSCLC with EGFR Exon 19 Deletion or Exon 21 (L858R) Substitution 

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 May 14, 2013, erlotinib (Tarceva) was approved for...

SIDEBAR: Notes from the Lead Investigator 

We conducted this study to clarify a hypothesis that had been generated from preclinical work and small clinical datasets. One additional background point that should be made is that although not all previously reported small datasets had demonstrated a relationship between PTEN expression and...

breast cancer

Outcomes with Adjuvant Trastuzumab in HER2-positive Breast Cancer Not Affected by PTEN Status 

PTEN is a negative regulator of PI3K/AKT signaling. PI3K/AKT signaling can be activated by HER2, and it has been hypothesized that alteration in this pathway may affect sensitivity to trastuzumab (Herceptin). Preclinical data and some of the limited available clinical data suggest that loss or...

lung cancer

Immunohistochemistry Effectively Detects ALK Rearrangement in Non-small Cell Lung Cancer Study

ALK rearrangement has been demonstrated to be a potent oncogenic driver and a promising therapeutic target in non-small cell lung cancer. It defines a distinct molecular subset of NSCLC, in particular adenocarcinoma that can benefit by the treatment of ALK-inhibitors. Development of robust and...

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