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breast cancer

Anthracycline Use Steadily Declining in Early Breast Cancer Population

Anthracycline use in early-stage breast cancer has been steadily declining, especially for patients with stage I/II or HER2-positive disease, according to an analysis of patients treated at the University of California, San Francisco (UCSF) School of Medicine.1 Treatment Alternatives Lead author...

solid tumors

Noncolorectal GI Cancer Evidence Incorporated into Guidelines

The noncolorectal gastrointestinal cancer studies selected for this year’s Best of ASCO meetings include some whose results are being folded into practice guidelines or are good candidates for incorporation, according to Alexandria T. Phan, MD, Associate Professor at The University of Texas MD...

global cancer care

Viral Infection and Liver Cancer: A Global Health Crisis

It is estimated that at least 15% of all cancers worldwide can be attributed to infectious etiologies, mostly viral infections. At this year’s ASCO Annual Meeting, an intriguing session on virally induced cancers provided critical clues that could be of real practical value in advancing our battle...

NCCN Appoints Dr. Robert Carlson as Chief Executive Officer

The National Comprehensive Cancer Network (NCCN) has appointed Robert W. Carlson, MD, a leading expert in the field of breast medical oncology, as Chief Executive Officer. “Dr. Carlson is highly regarded in the oncology community, and NCCN is extremely pleased to appoint him as CEO. Over the last...

leukemia
lymphoma

Developments in Hematologic Cancers Include New Considerations in Treating Challenging Leukemias and Multiple Myelomas

Speakers at the National Comprehensive Cancer Network (NCCN) 7th Annual Congress on Hematologic Malignancies reviewed the current standard of care for various hematologic cancers and explored new concepts in treatment. Below are highlights from presentations on chronic myelogenous leukemia (CML),...

colorectal cancer

Regorafenib Approved for Advanced Colorectal Cancer

The FDA recently approved regorafenib (Stivarga) to treat patients with metastatic colorectal cancer that has progressed after treatment. Regorafenib is a multikinase inhibitor that blocks several enzymes that promote cancer growth. The drug was reviewed under the FDA’s priority review program that ...

On Mentoring: Looking Back with Gratitude and Paying It Forward

Upon graduation from medical school, doctors are given a gift that lasts a lifetime—the gift of respect. That respect needs to be re-earned every day, but it is accompanied by other rewards that come with caring for people: the ability to gain another’s trust, to reverse illness that alters the...

issues in oncology

Despite Progress, Chemotherapy Drug Shortages Still Vex the Oncology Community

During the first week of November 2011, President Obama signed an Executive Order directing the FDA to take steps to help resolve the drug shortages that were affecting patient care across the country. The oncology community was hit especially hard; many of the drug shortfalls were generic...

Breast Cancer Symposium Features Surgical Data, Updated Results from BOLERO-2, and Other Important News

The annual Breast Cancer Symposium, held September 13 to 15 in San Francisco, is jointly sponsored by ASCO, the American Society for Radiation Oncology, the American Society of Breast Disease, the American Society of Breast Surgeons, the National Consortium of Breast Cancers, and the Society of...

colorectal cancer

Patients with Lynch Syndrome Who Have Had Colorectal Cancer Are at Increased Risk of Other Cancers

Patients who have had colorectal cancer and who are carriers of the DNA mismatch repair gene mutations that cause Lynch syndrome “have an increased risk of a greater range of cancers than the recognized spectrum of Lynch syndrome cancers, including breast and prostate cancers,” according to a study ...

breast cancer

Short Interval between Initial and Contralateral Breast Cancer Increases Risk of Dying

Breast cancer survivors who develop contralateral breast cancer have an increased risk of dying from breast cancer throughout a follow-up period of 10 or more years, according to a study of a cohort of 42,670 women diagnosed with breast cancer in Sweden. “The added risk is considerable if the...

breast cancer

Pathologic Nodal Status and Tumor Response Can Predict Risk of Locoregional Recurrence

Pathologic nodal status/breast tumor response following neoadjuvant chemotherapy can be used to predict locoregional recurrence in women with operable, palpable breast cancer (T1-3, N0-1, M0) previously treated with mastectomy or lumpectomy plus radiotherapy. These results from the combined...

breast cancer

Feminist Author Babette Rosmond Helped Propel the Adoption of Patients’ Rights to Choose Their Cancer Treatment

Then writer and editor Babette Rosmond was diagnosed with breast cancer in 1971, the second wave of the Women’s Liberation Movement that began in the mid-1960s was in its infancy. Still, when told by her doctor that she would need a radical mastectomy—a procedure developed by William Stewart...

supportive care
pain management

SIDEBAR: Don’t Expect Direct Questions from Patients about Pain

Just asking patients “Is there something else you want to address in the visit,” rather than “Is there anything else you want to address in the visit today,” dramatically reduced patients’ unmet concerns during a primary care visit, according to a 2007 study.1 That learning can be applied to...

supportive care
pain management

Pain Remains Prevalent among Oncology Outpatients, with Odds of Undertreatment Twice as High among Minority Patients

In 1994, a landmark study of pain among oncology outpatients prompted a host of pain management initiatives.1 More than 18 years later, a recent study among more than 2,000 cancer outpatients has found that “one-third of the patients who had pain or used analgesics received inadequate treatment for ...

Cancer Genome Atlas Network Reports Comprehensive Molecular Portraits of Breast Tumors

The Cancer Genome Atlas Network recently reported findings of analyses of primary breast cancers in a total of 825 patients using genomic DNA copy number arrays, DNA methylation, exome sequencing, mRNA arrays, microRNA sequencing, and reverse-phase protein arrays.1 Integration of information across ...

pancreatic cancer

A Series of Medical Missteps

Since the beginning of my symptoms—occasional pain on the upper left side of my abdomen, accompanied at times by nausea—which started nearly 20 years ago, my condition, pancreatic neuroendocrine tumor, either remained undetected or was completely misdiagnosed until just recently. A series of...

Despite the Rhetoric, Cancer Care Costs Keep Skyrocketing: Is There a Solution?

Although health-care experts routinely agree that the rising costs of oncology services are untenable, there is disagreement about how to reduce expenditures without harming access and quality of care. At this year’s ASCO Annual Meeting, Thomas J. Smith, MD, FACP, offered some interesting ideas...

solid tumors

Socioeconomic Disparity in Colorectal Cancer Rates Attributed to Obesity and Behavioral Risks

More than one-third of the excess risk of invasive adenocarcinoma of the colon and rectum resulting from low socioeconomic status “could be explained by differences in exposure to behavioral risk factors, particularly a healthy diet,” researchers recently reported in the Journal of the National...

gynecologic cancers

Major Strides Seen in Treatment of Gynecologic Cancers

Research reported at this year’s ASCO Annual Meeting shows major strides in treating ovarian and cervical cancers, suggesting the potential of new agents and adding evidence in areas where optimal management is unclear, according to Jonathan S. Berek, MD, of the Stanford Women’s Cancer Center,...

multiple myeloma

Novel Drug Combinations Present New Hope for Effective Treatments in Multiple Myeloma

Developing early-phase clinical trials that incorporate combinations of novel agents targeting different pathways in the hematologic cancer multiple myeloma is a leading focus of the work of Sagar Lonial, MD, Professor of Hematology and Vice Chair of Clinical Affairs in the Department of Hematology ...

Karnofsky Award Winner Honors Mentors through Gift to Conquer Cancer Foundation

Kanti R. Rai, MD, and his wife Susan have been loyal donors to the Conquer Cancer Foundation for the past 9 years, but in 2012, a momentous occasion in his career inspired Dr. Rai to make a unique gift. A Moment of Reflection In the spring of 2012, Dr. Rai, an internationally recognized expert on ...

health-care policy

American Association for Cancer Research Mourns the Loss of Senator Arlen Specter

The American Association for Cancer Research (AACR) mourns the loss of Arlen Specter, who represented Pennsylvania in the U.S. Senate from 1981 to 2011. With his passing, the cancer research and biomedical science community lost one of its greatest supporters and promoters. During his five terms...

skin cancer

Vismodegib: Novel Agent for Treating Advanced Basal Cell Carcinoma

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 In January 2012, vismodegib (Erivedge) was approved...

kidney cancer

Expert Point of View: Tim Eisen, MD, and Robert Figlin, MD

Over the past few years, we have gone from famine to feast.… We now have sorafenib [Nexavar] and sunitinib [Sutent], temsirolimus [Torisel], and everolimus [Afinitor], and interferon plus bevacizumab [Avastin] for treatment of metastatic renal cell carcinoma. If these drugs [in COMPARZ] are...

kidney cancer

Pazopanib Noninferior to Sunitinib as Front-line Therapy for Metastatic Renal Cell Carcinoma

Pazopanib (Votrient) is poised to become another option for first-line therapy of metastatic renal cell carcinoma based on results of the phase III COMPARZ trial reported at the 2012 ESMO Congress in Vienna.1 The study met its primary endpoint by demonstrating that pazopanib was noninferior to...

lung cancer

SIDEBAR: European Database

In a separate presentation at the 2012 ESMO Congress, Fiona Blackhall, MD, Manchester University and Christie Hospital NHS Foundation Trust, Manchester, UK, reported findings from the European Thoracic Oncology Platform (ETOP) Lungscape Project.1 This is the first large European dataset to evaluate ...

Role of Crizotinib in Previously Treated ALK-positive Advanced NSCLC

In yet another success story for personalized medicine, a targeted therapy extended survival in patients whose cancers expressed the target. Crizotinib (Xalkori), the first-in-class ALK inhibitor, extended progression-free survival and improved response rates compared with single-agent chemotherapy ...

issues in oncology

Genome-wide Analysis Reveals Molecular Pathway Aberrations in Uterine Serous Cancer

The molecular pathogenesis of uterine serous carcinoma, the most aggressive form of uterine cancer, remains largely undefined. Kuhn and colleagues from Johns Hopkins Medical Institutions recently identified prominent genetic alterations in uterine serous carcinoma using whole-exome sequencing....

issues in oncology

Whole-blood RNA Expression Profiles as Prognostic Models for Castration-resistant Prostate Cancer

Survival among patients with castration-resistant prostate cancer is highly variable, and there is a scarcity of prognostic markers that could be used to stratify patients in clinical trials, improve treatment, and accelerate drug development. Two recent studies reported in Lancet Oncology have...

issues in oncology

Noninvasive Measurement of Interstitial Fluid Pressure as Marker of Tumor Aggressiveness

Increased interstitial fluid pressure in tumors can cause metastatic dissemination and treatment resistance. Study of interstitial fluid pressure has been challenging due to a lack of noninvasive imaging strategies. In a recent study, Hompland and colleagues from the Institute of Cancer Research at ...

breast cancer

SIDEBAR: Dealing with the Toxicity of Everolimus/Exemestane

While packing a punch in terms of clinical benefit, everolimus plus exemestane can also be a tough pill to swallow for many patients. The management of the potential toxicities associated with this new regimen was addressed at the 2012 Breast Cancer Symposium by Matthew J. Ellis, MB, PhD, of...

breast cancer

Will mTOR Inhibitors Change the Treatment of Endocrine-sensitive HER2-negative Breast Cancer?

For the treatment of endocrine-sensitive metastatic breast cancer, the combination of an mTOR inhibitor and an endocrine agent represents a promising new option. At the 2012 Breast Cancer Symposium, the 18-month update of BOLERO-2, which tested therapy with everolimus (Afinitor) plus exemestane,...

lung cancer
issues in oncology

SIDEBAR: Dacomitinib: Better in Whom? Better in What?

Drug development is a highly competitive business. A new drug must be proven to be better than the standard one before it can be registered for public use. Starting with preclinical data, there should be evidence of lower 50% inhibitory concentrations in selective cell lines or a broader spectrum...

lung cancer
issues in oncology

Phase II Study Suggests Advantage of Irreversible Pan-HER Inhibition in Advanced NSCLC

Dacomitinib is a new tyrosine kinase inhibitor that forms irreversible covalent bonds with the ATP domain of each of the three kinase-active members of the HER family—EGFR/HER1, HER2, and HER4. Agents such as erlotinib (Tarceva) and gefitinib (Iressa), which are of proven benefit in advanced...

leukemia

Challenges Persist in Treatment of Elderly Patients with CLL, but Novel Agents Hold Promise for Future Strategies

Chronic lymphocytic leukemia (CLL) is mainly a disease of the elderly, and the lack of a standard regimen for elderly patients has been a major challenge. The myelosuppressive regimens used to treat younger patients are not well tolerated by the elderly. However, some newer approaches currently...

pain management

Study Reveals Global Picture of Obstacles to Pain Control in Patients with Cancer

Hundreds of millions of patients with cancer around the world are suffering from unrelieved cancer pain, despite the availability of morphine and other drugs that could alleviate that suffering. The major barriers are twofold: governments failing to ensure an adequate supply of morphine and other...

SIDEBAR: Cardiac Events Evaluated in Trastuzumab Studies

The effect of duration on cardiac events was a key question for the PHARE and HERA trials to answer. In general, longer duration of treatment was associated with more cardiac events, especially declines in left-ventricular function, but overall the risks were low. Cardiac Endpoints In the PHARE...

breast cancer

Expert Point of View: Sandra M. Swain, MD

Commenting on the PHARE trial and HERA update presented at ESMO, ASCO President Sandra M. Swain, MD, of Washington Hospital Center’s Washington Cancer Institute, said “Today we have seen that 12 months of trastuzumab is better than 6 months, and 12 months is the same as 2 years of treatment, so...

breast cancer

One Year of Trastuzumab Remains the Standard of Care in HER2-positive Breast Cancer

For HER2-positive early breast cancer, 1 year of treatment with trastuzumab (Herceptin)—rather than 6 months or 2 years—remains the standard of care, based on two pivotal studies presented at the 2012 European Society for Medical Oncology (ESMO) Congress. The optimal duration of anti-HER2 adjuvant ...

issues in oncology

Nab-paclitaxel Approved in First-line Metastatic NSCLC

The FDA has approved paclitaxel protein-bound particles for injectable suspension, albumin-bound (nab-paclitaxel, Abraxane) for use in combination with carboplatin for the initial treatment of patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) who are not candidates for ...

issues in oncology

Challenging Times: A Day in the Life of a Community Oncologist

Community oncologists man the front line of cancer care, treating upward of 85% of our nation’s patients. Over the past 2 decades, regulatory and economic changes have left many practices in a state of flux and uncertainty, some struggling to keep their doors open. To shed light on the community...

Ignoring Level 1 Evidence in Invasive Bladder Cancer: Is Ignorance Bliss?

I’ve been part of the uro-oncology community for more than 30 years and have been proud to be involved in a good number of well-powered, enthusiastically subscribed randomized clinical trials. These have dated back to a time before randomization was necessarily the fashion. I have had the pleasure...

Expert Point of View: Reinhard Dummer, MD

Although the effects of BRAF inhibition were initially unprecedented in patients with BRAF-mutated metastatic melanoma, “the problem is that the effect is not durable,” said formal discussant of this trial, Reinhard Dummer, MD, University Hospital of Zurich, Switzerland. The development of...

skin cancer

Combination of BRAF and MEK Inhibitors Paves Way for Phase III Studies in BRAF-mutated Metastatic Melanoma

Two late-breaking studies presented at the 2012 European Society for Medical Oncology (ESMO) Congress highlight the promising potential of combining dual BRAF and MEK inhibitors for the treatment of BRAF-mutated metastatic melanoma. A phase II study showed that combining full doses of the BRAF...

Nobel Laureate E. Donnall Thomas, MD, Dies at 92

In his 1990 Nobel Prize Lecture, Eduard Donnall Thomas, MD, with characteristic humility, acknowledged that the success he celebrated “was made possible by the work of many others in this and related fields.” Dr. Thomas, whose groundbreaking work in bone marrow transplantation marked a new era in...

kidney cancer

Pulmonary Radiotherapy Can Usually Be Omitted for Nephroblastoma and Pulmonary Metastases

For the majority of patients with nephroblastoma and pulmonary metastases, pulmonary radiotherapy can be omitted and the patients will still have a relatively good outcome, according to a study published in the Journal of Clinical Oncology. “The rationale of omitting pulmonary [radiotherapy] for...

issues in oncology

Media Campaign with Real Smokers a Success

Real smokers sharing in graphic terms what it is like to live with disfiguring or disabling tobacco-related diseases were the featured spokespersons for the Centers for Disease Control and Prevention (CDC) national media campaign to encourage smokers to quit. Based on short-term response, the CDC...

lymphoma

Novel Mechlorethamine Gel Considered Safe and Effective for Treatment of Mycosis Fungoides

A novel mechlorethamine, 0.02%, gel produced comparable or higher response rates (depending on the measurement used) than did mechlorethamine, 0.02%, compounded ointment, in a randomized controlled, multicenter study among 260 patients with stage IA to IIA mycosis fungoides, the most common form of ...

breast cancer

Surrounded by Breast Cancer

Nine women on my mother’s side of the family have been diagnosed with breast cancer, and nearly half have died from their disease, including my mother. With odds like these, I was determined to do what I could to stay ahead of this dreaded monster I thought was surely coming for me. First Tests...

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