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Showing 2101 - 2150New Molecular Testing Guideline for Selection of Lung Cancer Patients for EGFR and ALK Tyrosine Kinase Inhibitor Treatment
A new guideline for molecular testing to select lung cancer patients for treatment with epidermal growth factor receptor (EGFR) and anaplastic lymphoma kinase (ALK) tyrosine kinase inhibitors has been jointly developed by the College of American Pathologists, International Association for the Study ...
How Is Sequestration Affecting Health Care?
The Budget Control Act of 2011, which calls for $1.2 trillion in federal funding cuts in national defense and nondefense programs, went into effect on March 1. The across-the-board cuts affect 21 agencies and programs directly involved in the health-care sector, including: Centers for Disease...
Profound and Rapid Molecular Remission with CD19-targeted T Cells in Relapsed B-cell ALL
As was recently reported in Science Translational Medicine, Renier J. Brentjens, MD, and colleagues at Memorial Sloan-Kettering Cancer Center, New York, found that profound molecular remission was rapidly induced in patients with relapsed B-cell acute lymphoblastic leukemia (ALL) using autologous T ...
Expect Questions from Your Patients
Patients reading or hearing about the updated draft recommendation statement from the U.S. Preventive Services Task Force (USPSTF) on the use of medications to reduce risk for primary breast cancer1 may ask if and how it applies to them. To help answer those questions, the information presented...
Women at Increased Risk for Breast Cancer Should Be Offered Medications to Reduce Risk, Draft Recommendations Advise
Clinicians should engage in shared decision-making with women who are at increased risk of breast cancer about using medications, such as tamoxifen and raloxifene (Evista), to reduce risk, and should offer prescriptions to women considered at low risk for adverse effects from these medications,...
Making Prevention and Early Detection of Cancer a Priority
Conquering cancer has been the goal of Bert Vogelstein, MD, since he was a teenager in Baltimore. For more than 3 decades, Dr. Vogelstein, Co-Director of the Ludwig Center for Cancer Genetics and Therapeutics and Investigator of the Howard Hughes Medical Institute at Johns Hopkins Medical...
Ginger
The use of dietary supplements by cancer patients has risen 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 the...
Low-dose CT Detects Twice as Many Early-stage Lung Cancers as Chest X-ray, According to Additional NLST Results
Results of the first of three planned annual screening examinations from the National Lung Screening Trial (NLST) were recently published and physicians may now have more information to share with their patients about the benefits and risks of low-dose computed tomography lung cancer screening.1...
Death with Dignity Program at Seattle Cancer Care Alliance
After passage of the Washington Death with Dignity Act in November 2008, the Seattle Cancer Care Alliance—the site of outpatient care for patients with cancer from Fred Hutchinson–University of Washington Cancer Consortium—developed a Death with Dignity program. The program is adapted from existing ...
SIDEBAR: Physician-assisted Suicide
Readers’ comments extracted from www.nejm.org To force people to live simply because we possess the technology to do so does not speak to either the ethics or the morality of such a decision. Suffering has existential dimensions. Symptoms can be treated with greatest chance. My grandfather...
One Cancer Center's Approach to Death with Dignity
In November 2008, the Washington State legislature passed the Washington Death with Dignity Act allowing patients with a terminal diagnosis and less than 6 months to live to request and self-administer lethal medication. After considerable internal debate, our cancer center elected to develop a...
Caring for the Whole Patient Both during Active Treatment and at End of Life
Despite studies showing that a majority of patients prefer to die at home rather than in an institutional setting,1 in many parts of the country, over 30% die in nursing homes and over 50% die in hospitals, according to Ira Byock, MD, Director of Palliative Medicine, Dartmouth-Hitchcock Medical...
The Road to ASCO Presidency, Paved by Education and Persistence
ASCO President Clifford A. Hudis, MD, grew up in northeast Philadelphia in the 1960s, a robust period in U.S. history dominated by American industry and ingenuity. His early memories are of a hard-working blue-collar neighborhood of identical row and semidetached twin houses and of a time of...
Trametinib in Unresectable or Metastatic Melanoma with BRAF V600E or BRAF V600K Mutation
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 29, 2013, trametinib (Mekinist) was approved by...
Vitamin D and Cancer: A Uniform Dose Is Unlikely to Fit All Patients
Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center...
Identification of Oncogenic Mutations in Chronic Neutrophilic Leukemia and Atypical Chronic Myeloid Leukemia
Among the hematologic cancers for which molecular causes remain unclear are chronic neutrophilic leukemia and atypical (BCR-ABL1–negative) chronic myeloid leukemia. Both disorders currently are diagnosed on the basis of neoplastic expansion of granulocytic cells and exclusion of genetic factors...
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...
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...
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...
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...
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...
'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 ...
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...
Expert Point of View: Marc Lippman, MD and C. Kent Osborne, MD
An editorial by Marc Lippman, MD, Leonard M. Miller School of Medicine, University of Miami, and C. Kent Osborne, MD, Breast Center, Baylor College of Medicine, Houston,1 accompanied the study by Dawson and colleagues. These authors commented that the study’s key findings—that variation in the...
Measurement of Circulating Tumor DNA Shows Promise in Monitoring Metastatic Breast Cancer
Management of metastatic breast cancer requires monitoring of tumor burden to assess response to treatment, and there is a need for biomarkers that can measure tumor burden with high sensitivity and specificity. Assays measuring serum cancer antigen (CA) 15-3 and circulating tumor cells have been...
Molecular Landscaping of Acute Myeloid Leukemia: Are We Relearning the Past or Informing the Future?
Acute myeloid leukemia (AML) is a clinically and molecularly heterogeneous disease.1 This concept has been supported by more than 4 decades of studies showing distinct outcomes of subsets of patients that differ in age, disease type (primary vs secondary vs therapy-related), and cytogenetic and...
Genomic and Epigenomic Characterization of Acute Myeloid Leukemia
In a study by the Cancer Genome Atlas Research Network reported in The New England Journal of Medicine, genomes of 200 adult cases of de novo acute myeloid leukemia (AML) were analyzed by whole-genome sequencing (n = 50) or whole-exome sequencing (n = 150) to identify mutations and relationships...
Venous Thromboembolism in Patients with Cancer: Real-world Challenges for the Practicing Oncologist
The close association between cancer and thrombosis has been recognized now for more than 150 years.1 Not only is it now known that patients with cancer are at substantially increased risk of developing venous thromboembolism, even prior to the diagnosis of cancer, but the association between...
Management of Anaplastic Oligodendroglial Tumors
Pearls in Neuro-oncology is guest edited by Tracy Batchelor, MD, Director, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, and Professor of Neurology, Harvard Medical School, Boston. The series is intended to provide the practicing oncologist with guidance in managing...
Just Say 'Know'
In 1989, Denardo and associates reported the results of intensive care unit (ICU) therapy in a series of patients who developed acute respiratory failure and required mechanical ventilation after bone marrow transplantation. Of those on mechanical ventilatory support longer than 4 days, not one...
Shorter Duration of Hormone Therapy Feasible in Localized High-risk Prostate Cancer
Men with localized high-risk prostate cancer treated with adjuvant radiotherapy had similar overall and disease-free survival when treated with 18 months of androgen deprivation therapy vs 36 months of androgen deprivation therapy, the current standard of care in this setting. These results were...
Expert Point of View: Hedy Lee Kindler, MD
Hedy Lee Kindler, MD, Associate Professor of Medicine at the University of Chicago, the invited discussant of three of these presentations, emphasized the persistent lethality of advanced pancreatic cancer. She predicted that within this decade, pancreatic cancer will become the second leading...
Déjà Vu Redux: Lessons from the SWOG-8516 Study in Aggressive Lymphomas
Joseph M. Connors, MD, authored a commentary in the June 25 issue of The ASCO Post inspired by a recent New England Journal of Medicine publication on dose-adjusted EPOCH-R chemotherapy (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) for primary mediastinal B-cell ...
Seeking Clarity on the PSA Story
My feature interview in the August 15, 2012, issue of The ASCO Post, entitled “Rethinking the Role of PSA Screening in Public Health”1 drew swift reaction from well-known figures in the prostate cancer field. The subsequent Letters to the Editor, three in all, constituted a two-pronged attack. They ...
ATRA and Arsenic Trioxide May Be Even Better Than ATRA and Chemotherapy in Treating Low-to-Intermediate Risk Acute Promyelocytic Leukemia
All-trans retinoic acid (ATRA) plus arsenic trioxide bested the already high remission rates achieved by ATRA with chemotherapy, the standard of care for acute promyelocytic leukemia, in a phase III multicenter trial among patients with low-to-intermediate risk acute promyelocytic leukemia....
Anti-PD-1 Antibody Lambrolizumab Produces Durable Responses with Low Toxicity in Patients with Advanced Melanoma
Lambrolizumab produced a high rate of sustained tumor regression when tested among 135 patients with advanced melanoma in a multi-institutional, international, phase I expansion study reported in The New England Journal of Medicine. At a median follow-up of 11 months, responses were durable in the...
Living and Working with Cancer
The most recent figures from the National Cancer Institute put the number of cancer survivors in the United States at nearly 14 million—by 2022, that number is expected to top 18 million. And for the vast majority of those survivors—more than 80%—returning to work after treatment is a top priority...
The Sunshine Act Calls for Greater Transparency in Industry-Doctor Relationships
Signed into law on March 23, 2010, the Patient Protection and Affordable Care Act represents the most significant overhaul of the U.S. health-care system since the passage of Medicare and Medicaid in 1965. Because of the law’s sheer scope, parts of it still remain obfuscated by its 2,400 or so...
Oncofetal Protein SALL4 Is a Marker of Aggressive Hepatocellular Carcinoma and a Potential Therapeutic Target
Hepatocellular carcinomas with characteristics of embryonic stem cell and progenitor cell gene expression are associated with particularly poor prognosis. SALL4 is an oncofetal protein that is expressed in the human fetal liver and normally silenced in the adult liver, but re-expressed in a...
Evolving Issues in Low-dose CT Lung Cancer Screening
Over a decade has passed since the start of the National Lung Cancer Screening Trial and more than 2 years since the first report indicating that this randomized study had demonstrated a significant reduction in lung cancer mortality with low-dose computed tomography (CT) screening.1 That favorable ...
Low-dose CT Screening for Lung Cancer: Details of First Round of Screening in National Lung Screening Trial
The National Lung Screening Trial found that 3 years of annual screening with low-dose helical computed tomography (CT) reduced lung cancer mortality compared with chest radiography in older persons who were heavy smokers.1 The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial also...
Crizotinib Improves Progression-free Survival vs Pemetrexed or Docetaxel in Advanced ALK-positive NSCLC
In a phase III trial reported by Alice T. Shaw, MD, PhD, a thoracic oncologist at Massachusetts General Hospital, Boston, and colleagues in The New England Journal of Medicine, crizotinib (Xalkori) improved progression-free survival compared with standard chemotherapy in previously treated patients ...
PET/CT Superior to Bone Marrow Biopsy for Diagnosis, Prognosis in Lymphoma
A more precise method for determining bone marrow involvement in patients with diffuse large B-cell lymphoma has been identified by researchers in a study published recently in The Journal of Nuclear Medicine.1 Imaging with 18F–fluorodeoxyglucose positron-emission tomography/computed tomography...
Ibrutinib Produces High Response Rate in Patients with Refractory Mantle Cell Lymphoma
Ibrutinib is a first-in-class oral covalent inhibitor of Bruton’s tyrosine kinase, a mediator of the B cell-receptor signaling pathway implicated in the pathogenesis of B-cell cancers. As reported in The New England Journal of Medicine, Michael L. Wang, MD, of The University of Texas MD Anderson...
High Rate of Durable Remissions with Ibrutinib in Patients with Relapsed Chronic Lymphocytic Leukemia
Durable remissions are uncommon with current treatments for relapsed chronic lymphocytic leukemia (CLL). Bruton’s tyrosine kinase is an essential component of B cell–receptor signaling that mediates interactions with the tumor microenvironment and promotes survival and proliferation of CLL cells....
Acquired Resistance to Crizotinib from ROS1 G2032R Mutation
The ALK inhibitor crizotinib (Xalkori) has also shown activity in lung cancers with ROS1 translocations. As recently reported by Mark M. Awad, MD, PhD, of Massachusetts General Hospital, Boston, and colleagues in The New England Journal of Medicine, a mutation conferring resistance to crizotinib...
Ginseng
Guest Editor Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering...
Ginseng in the Spotlight
I read the study by Barton and colleagues in Journal of the National Cancer Institute with great interest. Ginseng seems potentially to be one treatment for cancer-related fatigue, a poorly understood but debilitating symptom that patients experience during and after treatment.1 I am impressed that ...
Molecular Profiling Improves Classification of Nodal Peripheral T-Cell Lymphomas
One of the primary obstacles we face in caring for patients with peripheral T-cell lymphomas is a too often inadequate response to chemotherapy with low rates of progression-free and overall survival.1 And while more intensive treatment programs and the availability of novel agents give a greater...
Olaparib Shows Robust Progression-Free Survival Benefit in Patients With BRCA Mutations
Maintenance therapy with olaparib extended progression-free survival and the time to disease progression after a second subsequent therapy in patients with platinum-sensitive relapsed serous ovarian cancer and a BRCA mutation, according to an updated analysis of Study 19 presented at the 2013 ASCO...
