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Showing 2101 - 2150Bevacizumab plus Capecitabine Has Robust Effect in Elderly Patients with Colorectal Cancer
In elderly patients with treatment-naive metastatic colorectal cancer, a trend toward a survival benefit was observed for bevacizumab (Avastin) plus capecitabine (Xeloda) in the international phase III AVEX trial, which was presented at the 2013 Gastrointestinal Cancers Symposium by David...
Modified and Updated Risk-prediction Model Is More Efficient in Identifying Persons for Lung Cancer Screening
An updated and modified lung-cancer risk-prediction model developed from the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial “was more sensitive” for lung cancer detection than criteria from the National Lung Cancer Screening Trial (NLST), according to a study in TheNew...
Recently Reported Long-term Outcomes Could Motivate More Men with Prostate Cancer to Consider Active Surveillance
Fifteen years after being treated with radical prostatectomy or external-beam radiation for localized prostate cancer, “the prevalence of erectile dysfunction was nearly universal,” among men enrolled in a long-term functional outcomes analysis of the Prostate Cancer Outcomes Study (PCOS). There...
Qigong Practice Associated with Quality-of-life Benefits in Women Undergoing Radiation Therapy for Breast Cancer
Qigong (“qi” or “chi” = energy flow, “gong” = skill or achievement) is an integrated mind-body exercise and meditative practice that involves rhythmic breathing coordinated with repetition of fluid movements and calm focus on the body. A study reported in Cancer by Zhen Chen, MD, and colleagues...
New Partnership Will Harness Technology to Foster Improved Palliative Care in Oncology
ASCO and the American Academy of Hospice and Palliative Care Medicine (AAHPM) have announced a joint initiative to support delivery of high-quality palliative care in medical oncology. The initiative, funded by the Agency for Health Care Research & Quality, aims to address the complex care...
Gene Transfer Therapy Is Producing Prolonged Remissions in Patients with Advanced Leukemia
In August 2011, researchers from the University of Pennsylvania published their breakthrough findings of a pilot study showing sustained remissions of up to 1 year in a small number of patients with advanced chronic lymphocytic leukemia (CLL) who had been treated with genetically engineered...
Similar Outcomes for 18 vs 36 Months of Androgen Blockade in High-risk Prostate Cancer Treated with Radiation
Eighteen months of hormone therapy appears to be as safe and effective as 36 months when combined with radiation for patients with high-risk prostate cancer.1 Patients who received the shorter course of hormone therapy plus radiation had survival rates similar to those who received 36 months of...
CT Colonography Reconsidered
The parallel SIGGAR trials recently published in Lancet add to the growing body of literature regarding the utility of computed tomographic (CT) colonography in the detection of colorectal polyps and cancers. These papers reinforce the results seen in other large multicenter trials1-3 and echo the...
The Risk of Death From Smoking Now Nearly Identical for Men and Women
Researchers from multiple organizations, including the American Cancer Society (ACS), studied the smoking trends among men and women over the last 50 years and found that women’s smoking habits in that time have significantly increased their risk of dying from lung cancer and chronic obstructive...
Study Shows Lung Cancer CT Screening Could Save 12,000 Lives Annually
Screening all current and former heavy smokers could prevent over 12,000 lung cancer deaths a year, according to a new study published in Cancer.1 The study, funded by the American Cancer Society, arrived at that number based on data from the National Lung Screening Trial (NLST),2 which found that...
Ado-Trastuzumab Emtansine in Metastatic Breast 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. Indication On February 22, 2013, ado-trastuzumab emtansine...
Similar 15-year Functional Outcomes after Prostatectomy or Radiotherapy for Localized Prostate Cancer
Comparative longer-term functional outcomes of radical prostatectomy and external-beam radiation therapy for localized prostate cancer remain undefined. In a study recently reported in The New England Journal of Medicine,1 Matthew J. Resnick, MD, and colleagues at Vanderbilt University, Nashville,...
Is Aspirin Protective against Colorectal Cancer?
A growing body of evidence provides biologic and clinical evidence that nonsteroidal anti-inflammatory agents are protective against colorectal cancer. “It is fascinating for me as a medical oncologist and epidemiologist to see how the worlds of colorectal cancer treatment and epidemiology are...
Sentinel Node Biopsy in Melanoma: Essential or Optional?
Is sentinel node biopsy in melanoma an essential component of care? Despite a large multinational trial and recently published or updated guidelines, the question is still a thorny one according to experts who debated the issue at the recent meeting of the Society of Surgical Oncology in...
Symptom Management with Complementary Therapies for Patients Receiving Radiation Therapy
The supportive care of patients with cancer receiving radiotherapy is an important responsibility for the radiation oncologist, and complementary therapies are an integral component of many patients’ treatment strategy.A recent prospective study suggests that 54% of patients with breast cancer...
Drug Approvals in Acute Myeloid Leukemia: Can We Do Better?
Forty years ago, President Richard Nixon announced a “war on cancer.” Some of that war’s first battles were won in the field of acute myeloid leukemia (AML) with two agents, cytarabine and daunorubicin, receiving U.S. Food and Drug Administration (FDA) approval based on their ability to produce...
Lynch Syndrome: A Multitude of Predispositions
The current uncertainty regarding the relative frequencies of cancers of various anatomic sites in Lynch syndrome poses a difficulty in commenting on the syndrome’s overall cancer spectrum. It is even more vexing to address the order in which these cancers are prone to occur. What we do know is...
Novel Regimen Produces High Pathologic Complete Response Rates in Triple-negative Breast Cancer
Interim results from a small neoadjuvant study of patients with triple-negative breast cancer has found high rates of pathologic complete response with the combination of nab-paclitaxel (Abraxane), carboplatin, and bevacizumab (Avastin).1 The study was presented at the 18th Annual Conference of the ...
Lessons of 2 Decades' Experience with CHESS
Our work on an Internet-based intervention for lung cancer confirmed what many other studies have shown about technologic interventions for health-care consumers—that such interventions can improve quality of life for caregivers and patients.1 We expected this result in part because of the...
Breakthroughs in Targeted Therapies for Breast Cancer Are Improving Patient Survival Rates
For more than 20 years, José Baselga, MD, PhD, has devoted his medical and scientific career to caring for breast cancer patients and the development of novel molecular targeted agents to treat the disease. From 1996 to 2010, he was Head of the Oncology Department of Vall d’Hebron University...
Reducing Incidental Cardiac Irradiation during Breast Radiotherapy
In the treatment of breast cancer, a wealth of data from prospective clinical trials and meta-analyses has documented the benefits of radiation to prevent local-regional recurrence and improve survival. Accordingly, important quality indicators in breast cancer care include: (1) receipt of...
SIDEBAR: Left-sided Adjuvant Breast Radiotherapy: A Change of Heart?
Darby and colleagues are to be congratulated for an ambitious population-based case-control study that demonstrates the impact of postoperative adjuvant ionizing radiation for early-stage breast cancer on ischemic heart disease.1 The study examined roughly 1,000 cases and 1,000 controls in Sweden...
SIDEBAR: Critical Information on Radiation's Heart Effects
The paper by Darby et al provides extremely important information on quantitative estimates of the effect of radiotherapy on coronary events in women with breast cancer.1 The authors have determined a direct relationship between radiation dose and effects on the heart and provide strong evidence...
Risk for Ischemic Heart Disease after Radiotherapy for Breast Cancer
A population-based case-control study reported by Sarah C. Darby, PhD, Professor of Medical Statistics in the Clinical Trial Service Unit and Epidemiologic Studies Unit at the University of Oxford, and colleagues in The New England Journal of Medicine indicates that incidental exposure of the heart ...
New 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...
