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Showing 20151 - 20200Cancer Care Through Nonpharmacologic Symptom Management
Nonpharmacologic approaches to managing pain have a fairly robust base of science and research supporting their use but are not as widely accepted and understood as drug therapy in the realm of cancer care. In a breakout session at the 2015 Palliative Care in Oncology Symposium in Boston, experts...
Expert Point of View: Charles Loprinzi, MD
Charles Loprinzi, MD, Regis Professor of Breast Cancer Research, Mayo Clinic, Rochester, Minnesota, commented on these study findings to The ASCO Post: “This is a clinical application of the ghrelin agonist story that’s been brewing for maybe a decade. Is it better than megestrol acetate, the drug...
Olanzapine Significantly Reduces Chemotherapy-Induced Nausea and Vomiting
The addition of olanzapine to standard antiemetics significantly reduced chemotherapy-induced nausea and vomiting in patients receiving highly emetogenic chemotherapy, according to Rudolph M. Navari, MD, PhD, and colleagues. “As far as I know, this is the first trial that looked at no nausea as the ...
Combining Molecular-Driven Approach and Immunotherapy to Improve Treatment for Patients With Inflammatory Breast Cancer
We have a responsibility to develop better treatment for inflammatory breast cancer,” Massimo Cristofanilli, MD, FACP, told participants at the 17th Annual Lynn Sage Breast Cancer Symposium in Chicago. As recently appointed Associate Director of Translational Research and Precision Medicine at the ...
ASCO Guideline on the Use of Biomarkers in Treatment Decisions in Metastatic Breast Cancer: Shedding Light on an Often Mysterious Art
As summarized in this issue of The ASCO Post (see "ASCO Clinical Practice Guideline: Use of Biomarkers to Guide Systemic Therapy for Women With Metastatic Breast Cancer"), Van Poznak and colleagues recently presented an ASCO clinical practice guideline on the use of biomarkers for decisions...
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...
November Yields Record Number of FDA Approvals for New Oncology Drugs and Drug Indications
In 2014, the U.S. Food and Drug Administration (FDA) approved 9 new drugs and biologics in the treatment of cancer and added 10 notable new indications or formulations to existing drug labels, marking a year of significant progress in improving the quality of cancer care in the United States. So...
FDA Oncology New Drug/New Indication Approvals for 2015
The following new hematology/oncology agents and expanded indications were approved by the U.S. Food and Drug Administration (FDA) Center for Drug Evaluation and Research in 2015: Alectinib (Alecensa), an ALK inhibitor, for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive...
Mixing Metaphors to Change the Language of Cancer
BookmarkTitle: Malignant Metaphor: Confronting Cancer MythsAuthor: Alanna MitchellPublisher: ECW PressPublication date: September 15, 2015Price: $24.95; hardcover, 184 pages Illness is the night-side of life, a more onerous citizenship. Everyone who is born holds dual citizenship, in the kingdom...
‘Substantial Number’ of Patients Requiring Palliative Radiotherapy for Stage IV NSCLC Are Overtreated
An analysis of data from 46,803 patients with stage IV non–small cell lung cancer (NSCLC) who received palliative chest radiation therapy found that 49% received radiotherapy for longer than 15 fractions, and 28% received more than 25 fractions. This treatment pattern “is inconsistent with the...
Women Coinfected With Human Papillomavirus Had Reduced Risk for Invasive Cervical Cancer
Women co-infected with low-risk and high-risk human papillomavirus (HPV) had a reduced risk for invasive squamous cervical carcinoma and a longer time to progression than did women infected with high-risk human papillomavirus alone, according to a Swedish study published in the Journal of the...
Better Quality of Life With Melphalan and Prednisone Used With Lenalidomide Than With Thalidomide
A phase III Eastern Cooperative Oncology Group (ECOG) trial (E1A060) comparing melphalan, prednisone, and thalidomide (Thalomid) with melphalan, prednisone, and lenalidomide (Revlimid) in elderly patients with untreated multiple myeloma found that at the end of the induction period, patients...
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...
Decline in PSA Testing and Incidence of Early Prostate Cancer Coincide With 2012 Recommendation Against PSA Screening
Two recent studies1,2 found that the rates of prostate-specific antigen (PSA) screening have declined since the U.S. Preventive Services Task Force (USPSTF) recommended against PSA screening in 2012. One of those studies additionally found that the incidence of early-stage prostate cancer also...
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....
Hoping for a Cure
Unless you have a type of cancer that can be surgically removed or blasted into oblivion with chemotherapy or radiation therapy rendering a cure, having a chronic cancer like multiple myeloma robs you of a normal life. Learning to accept that fact is an adjustment. I was diagnosed with multiple...
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,...
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...
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...
SIOG Annual Conference Explores Global Perspectives on Geriatric Oncology and Supportive Care
The 15th Annual Conference of the International Society of Geriatric Oncology (SIOG) took place in Prague, Czech Republic, over 3 days (November 12–14, 2015). At the heart of the meeting were presentations on supportive care, comprehensive geriatric assessment and treatment—so that we fully...
Clinical Trials Actively Recruiting Patients With Pancreatic Cancer
The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with pancreatic cancer. The trials are investigating preoperative rehabilitation; chimeric antigen receptors; T-cell transplants; combination chemotherapy; chemoradiotherapy; ...
Are Academic Cancer Centers a National Treasure?
The Association of American Cancer Institutes (AACI) is developing a marketing campaign to highlight the value of academic cancer centers to their communities and the nation. Called “The Academic Difference,” the 2-year campaign is the initiative of AACI President George J. Weiner, MD, Director of...
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...
A Primary Care Doctor’s Tough-Love Medicare Fix
Bookmark Title: Curing Medicare: One Doctor’s View of How Our Health Care System Is Failing the Elderly and How to Fix It Author: Andy Lazris, MD Publisher: CreateSpace Publication date: September 13, 2014 Price: $13.75; paperback, 290 pages Several years ago I decided to write a book about...
Opening Doors: ASCO Aims to Increase Workforce Diversity Through Physician Mentoring Program
Olumide Gbolahan, MD, faced a familiar dilemma among aspiring oncologists. Dr. Gbolahan, an internal medicine resident of the Morehouse School of Medicine, wanted extra time and experience in an oncologic elective summer rotation to ease his transition from internal medicine to oncology. Unsure of...
The Promise of Immune Checkpoint Blockade in Cancer Therapy
The concept of using activation of the innate immune system and an inflammatory response against a bacterial component to instigate an antitumor response was studied in the 1960s, which led to the development of intravesical bacillus Calmette-Guérin, now used in the treatment of superficial bladder ...
A: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System
Question 1: Based on the rationale for the current “standard of care” for primary diffuse large B-cell lymphoma of the CNS, what is the optimal induction therapy? Correct Answer: C. A high-dose methotrexate–based regimen. Expert Perspective Untreated primary diffuse large B-cell lymphoma of the CNS ...
Selected Abstracts From 2015 ASH Annual Meeting
Here are several abstracts selected from the proceedings of this year’s American Society of Hematology (ASH) Annual Meeting and Exposition, highlighting therapeutics in acute leukemias and myelodysplastic syndromes. For full details of these study abstracts, visit...
Necitumumab in Metastatic Squamous Non–Small Cell Lung Cancer
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 24, 2015, necitumumab (Portrazza) was approved for use ...
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...
ASCO Endorses ACCP Guideline on Treatment of Small Cell Lung Cancer
As reported in the Journal of Clinical Oncology,1 ASCO has endorsed the current American College of Chest Physicians (ACCP) guideline on treatment of small cell lung cancer (SCLC), released in 2013.2 After review of evidence from an updated literature search covering 2011 to March 2015, an ASCO...
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...
Surgical Excision Without Radiation Therapy in Women With Low-Risk Ductal Carcinoma in Situ
Lawrence J. Solin, MD, of Albert Einstein Healthcare Network, Philadelphia, and colleagues reported the 12-year results from the ECOG-ACRIN E5194 trial in the Journal of Clinical Oncology. Among women with ductal carcinoma in situ with low-risk clinical and pathologic characteristics, they found...
Minimally Invasive Surgery for Rectal Cancer: An Evolving Issue
Over 10 years ago, we welcomed a new approach to cancer surgery when the 2004 COST trial demonstrated the benefits of laparoscopic compared with open surgery for colon cancer. This randomized trial of 872 patients showed improved perioperative recovery with laparoscopic colectomy without...
Phase III Trials Fail to Show Noninferiority of Surgical Outcome for Laparoscopic vs Open Resection in Rectal Cancer
Two phase III trials, reported in JAMA by James Fleshman, MD, of Baylor University Medical Center, Dallas, and colleagues1 and Andrew R. Stevenson, MBBS, FRACS, of the University of Queensland, Brisbane, Australia, and colleagues,2 failed to show noninferiority of surgical outcome for laparoscopic...
Expert Point of View: Vincent Grégoire, MD, PhD
After presentation of the study by Cheng and colleagues at the 2015 European Cancer Congress, formal discussant Vincent Grégoire, MD, PhD, Department of Radiation Oncology, UCL St-Luc University Hospital, Brussels, Belgium, was cautious in endorsing a surgical approach for stage III and IV...
Surgery for Head and Neck Cancer Improves Survival—in Taiwan
A large study presented at the 2015 European Cancer Congress in Vienna found that patients with advanced oropharyngeal or hypopharyngeal cancer had improved survival if their primary treatment included surgery.1 The caveat is that these patients were treated in Taiwan, and the results may not be...
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 ...
Friends of Cancer Research Releases White Paper on Patient-Reported Outcomes
On November 17, Friends of Cancer Research (FOCR) released a white paper report, Enhancing Use of Patient-Centered Data in Regulatory Decision Making.1 The contents of that paper are summarized below. Improving Patient Input Many stakeholders agree that to ensure truly transformational therapies,...
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 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...
Partnering Therapies for Estrogen Receptor–Positive Breast Cancer Requires Close Monitoring and Patient Communication
Partnering endocrine therapy with new targeted agents for women with estrogen receptor–positive breast cancer “changes the nature of endocrine therapy from something easily tolerated, with not a lot that you have to do as physicians to monitor it,” William J. Gradishar, MD, of the Robert H. Lurie...
Optimizing the Treatment of HIV-Associated Lymphoma
Non-Hodgkin lymphoma (NHL) associated with human immunodeficiency virus (HIV) infection generally can be treated the same as lymphoma in non–HIV-infected patients, with a few caveats, according to Lawrence D. Kaplan, MD, of the Helen Diller Family Comprehensive Cancer Center of the University of...
Nivolumab as Single-Agent Treatment for BRAF V600 Wild-Type 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 November 24, 2015, nivolumab (Opdivo) was approved for use as...
More, Earlier, and Better Goals-of-Care Conversations at the End of Life Are Feasible
An intervention called the Serious Illness Care Program helps clinicians to conduct more, earlier, and better conversations about goals of care with their seriously ill patients, according to Rachelle E. Bernacki, MD, MS, who presented the preliminary results of a study using this approach at the...
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...
Expert Point of View: Karen Ballen, MD
This is a group of patients who have not done very well over the years. The cure rate for children with acute lymphoblastic leukemia (ALL) is over 90%, whereas this group of patients (ie, aged 18–50) typically has a 5-year survival of 40% to 50%. Use of pediatric regimens has boosted that survival, ...
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...
Promising Upfront Combination in Older Patients With Acute Lymphoblastic Leukemia
Frontline treatment with the antibody-drug conjugate inotuzumab ozogamicin plus deintensified chemotherapy is a promising option for older patients with Philadelphia chromosome–negative acute lymphoblastic leukemia (ALL). Phase II results suggest that this combination has the ability to improve...
