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issues in oncology

A Proposal for Patient-Selected Controlled Trials: Good Science and Good Medicine

The Clinical Trials and Translational Research Advisory Committee (CTAC) of the National Cancer Institute (NCI) met for the 22nd time on March 12, 2014, in their ongoing effort to improve efficiency and effectiveness of cancer clinical trials. A significant portion of the meeting addressed lagging...

colorectal cancer

FDA Approves Panitumumab Plus FOLFOX for  Wild-Type KRAS Metastatic Colorectal Cancer

The U.S. Food and Drug Administration (FDA) has approved panitumumab (Vectibix) for use in combination with FOLFOX (fluorouracil, leucovorin, oxaliplatin) as first-line treatment in patients with wild-type KRAS (exon 2) metastatic colorectal cancer. This approval converts the accelerated...

supportive care

FDA Approves Palonosetron Hydrochloride for Prevention of Chemotherapy-Induced Nausea and Vomiting in Pediatric Patients

The U.S. Food and Drug Administration (FDA) has approved palonosetron hydrochloride (Aloxi) injection for the prevention of acute nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including highly emetogenic cancer chemotherapy, in children aged 1...

palliative care

Bringing Palliative Care Services to Local Community Clinical Practices and Health Facilities Throughout the World

In 2007, the Billings Clinic Cancer Center in Billings, Montana, became one of 15 community-based oncology centers nationwide to receive funding from the National Cancer Institute (NCI) to expand programs for clinical trials, health-care disparities outreach, survivorship and palliative care,...

integrative oncology

St. John's Wort

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...

issues in oncology

Randomized Trials vs Meta-analyses: Which Is the Better Bet?

Two surgical oncology experts who squared off in a “Great Debate” at the 2014 Society of Surgical Oncology (SSO) Annual Cancer Symposium in Phoenix. Heidi Nelson, MD, Professor of Surgery at the Mayo Clinic in Rochester, Minnesota, argued for the superiority of randomized controlled trials in...

Arizona Oncology Announces Retirement of Kenneth Luk, MD

Brian Schade, Executive Director of Arizona Oncology, recently announced the retirement of Kenneth Luk, MD, a well-respected radiation oncologist in Phoenix for over 20 years. Dr. Luk is a Fellow of the American College of Radiology and Clinical Professor at the Midwestern University School of...

prostate cancer

17-Gene Assay Is a Significant Predictor of Prostate Cancer Aggressiveness

Results from three studies published recently in European Urology indicate that the 17-gene Oncotype DX Genomic Prostate Score is a significant predictor of disease aggressiveness at the time of diagnosis before intervention with radiation or surgery.1 The test provides precise and individualized...

breast cancer

Margin Reassessment in Breast-Conservation Therapy

Significant progress has been made in local-regional and systemic treatments of breast cancer. Most patients currently diagnosed with breast cancer in the United States are diagnosed with early-stage disease and achieve excellent outcomes with breast-conservation therapy. Indeed, outcomes have...

breast cancer

ASCO Endorses SSO/ASTRO Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stage I/II Breast Cancer

As reported in the Journal of Clinical Oncology,1 ASCO has endorsed the recently published Society of Surgical Oncology (SSO) and American Society for Radiation Oncology (ASTRO) consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stage I and II invasive...

NIH Addiction Science Award

Lily Wei Lee, a high school senior at Stuyvesant High School in New York City, was named the recipient of the top Addiction Science Award at the 2014 Intel International Science and Engineering Fair (ISEF) for her project, “Assessment of Third-Hand Exposure to Nicotine from Electronic Cigarettes.”...

lung cancer

Experts Share Keys to a Successful Lung Screening Program

There are currently 172 computed tomography (CT)-based lung screening centers up and running in the United States, according to the Lung Cancer Alliance.1 In a presentation at the American Roentgen Ray Society (ARRS) 2014 Annual Meeting in San Diego, Reginald Munden, MD, DMD, MBA, and Ralph...

lung cancer

Ceritinib in ALK-Positive Metastatic NSCLC Patients With Progression on or Intolerance to Crizotinib

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 April 29, 2014, ceritinib (Zykadia) was granted accelerated...

ASCO Takes Aim at the Link Between Obesity and Cancer

ASCO is stepping up its efforts to address the link between obesity and cancer—both as a leading cause of cancer and as a complicating factor for treatment. In recent years, research has demonstrated that a growing number of cancers are linked to obesity, and public health researchers predict that...

Cancer Center at Johns Hopkins Set to Expand With $65 Million Gift

The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins has announced it will use a $65 million gift toward the construction of a new patient care building that will be named for the late Albert P. “Skip” ­Viragh, Jr. Mr. Viragh, a Maryland mutual fund investment leader and philanthropist,...

issues in oncology

A Way Forward in Genomic Medicine

Over the past several decades, the convergence of scientific discovery, technology, and therapeutic developments has created an unparalleled opportunity to integrate our growing knowledge of genomics into the clinical practice of oncology. To shed light on the current state and future of...

Demetrius H. Bagley, MD, Honored With AUA Lifetime Achievement Award

The American Urological Association (AUA) has presented ­Demetrius H. Bagley, MD, with its 2014 Lifetime Achievement Award for visionary leadership and education in ureteroscopy and minimally invasive surgical techniques for the upper urinary tract. Dr. Bagley is The Nathan Lewis Hatfield Professor ...

issues in oncology

Hookah Tobacco Smoking Among Students

Educational campaigns meant to dissuade college students from initiating hookah tobacco smoking may be more successful if they combat positive perceptions of hookah use as attractive and romantic, rather than focusing solely on the harmful components of hookah tobacco smoke, a new University of...

supportive care

Helping Young Adults Cope With Cancer

For young adults diagnosed with cancer, coping with the aftermath of the disease can be especially daunting. Although all cancer survivors share some common concerns and distress, for young adults grappling with body image, sexuality, peer pressure, dating, marriage, family planning, education, and ...

breast cancer

Should Breast Cancer Patients With One to Three Positive Nodes Routinely Receive Postmastectomy Radiation?

The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) continues to provide valuable clinically relevant and practice-influencing information garnered from individual patient-level data from numerous randomized trials in breast cancer. The large numbers of patients and long-term follow-up...

breast cancer

Postmastectomy Radiotherapy Reduces Breast Cancer Recurrence and Mortality in Women With One to Three Positive Nodes

Meta-analyses have shown that postmastectomy radiotherapy reduces risks of recurrence and breast cancer mortality in the population of all women with node-positive disease, but outcomes in those with only one to three positive nodes have not been specifically examined. As reported by Paul McGale,...

breast cancer

ASCO Guideline Update Extends Sentinel Node Biopsy Indications in Breast Cancer

The American Society of Clinical Oncology (ASCO) published its first guideline for sentinel lymph node biopsy in 2005.1 Since that time, many new randomized and cohort studies have been published investigating the indications and outcomes of the procedure. The updated 2014 guideline, recently...

breast cancer

ASCO Clinical Practice Guideline Update: Sentinel Lymph Node Biopsy for Patients With Early-Stage Breast Cancer

ASCO recently convened an update committee of experts in medical oncology, pathology, radiation oncology, surgical oncology, guideline implementation, and advocacy to develop evidence-based recommendations that update the ASCO 2005 clinical practice guideline on use of sentinel node biopsy in...

health-care policy

Patients Benefit From Faster FDA Drug Approval Process

In an increasing spirit of cooperation, U.S. Food and Drug Administration (FDA) and several pharmaceutical companies are bringing to fruition the newest in a series of ways to expedite drug development and review. Breakthrough therapy is the designation instituted in 2012 by the FDA Safety and...

leukemia

Looking Ahead in Treating Chronic Lymphocytic Leukemia

It’s the dawn of a new era in the treatment of chronic lymphocytic leukemia (CLL), largely due to the development of agents targeting the BCR signaling pathway, according to John C. Byrd, MD, of The Ohio State University Comprehensive Cancer Center, Columbus. At the 19th Annual Conference of the...

issues in oncology
supportive care

NCCN Roundtable: When a Parent Has Cancer

Attendees at this year’s annual conference of the National Comprehensive Cancer Network (NCCN) not only got up to date on the Guidelines but left with a better understanding of how children deal with a parent’s cancer, and how oncology providers can best help. Panelists for the NCCN roundtable...

survivorship
supportive care
bladder cancer

NCCN Scientific Posters Include New Findings in Bladder Cancer, Survivorship Care, and Antiemetic Therapy

The 19th Annual Conference of the National Comprehensive Cancer Network (NCCN), recently held in Hollywood, Florida, featured a number of scientific posters by member organizations and meeting sponsors. The ASCO Post captured some of the most interesting findings for our readers, including these...

colorectal cancer

Surveillance After Colon Cancer Surgery: Too Much of a Good Thing?

Finding salvageable colon cancer recurrence is akin to finding a needle in a haystack, rendering routine patient surveillance of little value. But finding that needle offers an opportunity for treating recurrent disease early, which makes surveillance worthwhile. These were the opposing views...

skin cancer

Phase III Study of Talimogene Laherparepvec in Patients With Metastatic Melanoma: Overall Survival Analysis Reported

Amgen recently announced top-line results from the primary overall survival analysis of a phase III trial in melanoma, which evaluated the efficacy and safety of talimogene laherparepvec (also known as T-VEC) for the treatment of unresected stage IIIB, IIIC, or IV melanoma compared to treatment...

cns cancers

Glioblastoma: Can We Make This Intractable Disease Tractable?

In the clinical array of brain tumors, glioblastoma is the most difficult to treat, and despite decades of research and the advent of new therapies, patients with glioblastoma continue to have a very poor prognosis. Leading brain tumor experts at the recent 25th Annual Cancer Progress Conference in ...

leukemia

Mercaptopurine Oral Suspension for Acute Lymphoblastic Leukemia

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 April 28, 2014, an oral suspension of mercaptopurine (Purixan) ...

breast cancer

Axillary Radiotherapy Associated With Fewer Side Effects Than Lymph Node Dissection in AMAROS Analysis

Radiation therapy is associated with significantly fewer postoperative complications than axillary lymph node dissection, according to a detailed analysis of morbidity from the AMAROS (After Mapping of the Axilla: Radiotherapy or Surgery?) trial presented at a press briefing prior to the American...

breast cancer

Cryoablation of Breast Tumors Shows Promise in Patients With Early-Stage Disease

Cryoablation of breast tumors, which destroys lesions by exposing them to extremely low temperatures, shows promise as an alternative to surgery in carefully selected women with early-stage disease, according to a study presented at the American Society of Breast Surgeons Annual Meeting in Las...

breast cancer

Obesity Increases Breast Cancer Mortality in Premenopausal Women With Estrogen Receptor–Positive Disease

According to results of a large study of women with early breast cancer, the presence of obesity increased the risk of breast cancer–related mortality by 34% in premenopausal women with estrogen receptor–positive breast cancer. Obesity had little effect on breast cancer–related mortality in...

prostate cancer

Delaying Androgen Deprivation Therapy May Not Compromise Survival in Men With Prostate Cancer and PSA-Only Relapse

In men with prostate cancer and a prostate-specific antigen (PSA)-only recurrence after curative surgery or radiation, delaying androgen deprivation therapy for at least 2 years or until clinical progression (ie, new symptoms, metastasis by imaging techniques or short PSA doubling time) did not...

lung cancer

Phase I Study of Novel Third-Generation EGFR Inhibitor Holds Promise Against Resistance Mutation in Patients With Non–Small Cell Lung Cancer

Preliminary evidence suggests that AZD9291, a novel mutant-selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, may become a treatment option for patients with advanced, EGFR-mutant, non–small cell lung cancer (NSCLC) that has progressed on standard EGFR inhibitors....

Expert Point of View: George W. Sledge, Jr, MD

In his commentary on the ALTTO results, George W. Sledge, Jr, MD, Professor of Medicine and Director of the Division of Oncology at Stanford University, reminded attendees that the announcement of the first results for adjuvant trastuzumab, which occurred at the 2005 ASCO Annual Meeting, was “a...

breast cancer

ALTTO Trial Finds Dual Anti-HER2 Therapy No Better Than Trastuzumab Alone

The highly anticipated results from the phase III ALTTO trial show no additional benefit for adding lapatinib (Tykerb) to trastuzumab (Herceptin) in the adjuvant treatment of HER2-positive breast cancer.1 The results were presented at the 2014 ASCO Annual Meeting’s Plenary Session by Martine J....

lung cancer
issues in oncology

Medicare Advisory Panel Cast Doubts on Lung Cancer Screening, Leaving Advocates Dismayed but Undaunted

On April 30, 2014, the Centers for Medicare & Medicaid Services (CMS) convened the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) to assess the value of low-dose computed tomography (CT) lung cancer screening in the Medicare population. After a decades-long battle,...

issues in oncology

'Small Practices Like Mine'

Recently, I participated in ASCO’s Congressional news briefing in Washington, DC, following the release of its report, The State of Cancer Care in America: 2014. During my presentation I talked about the workforce shortage of approximately 1,500 medical oncologists that is predicted by 2025. A...

Expert Point of View: Michael J. Morris, MD

Formal discussant of the E3805 study, Michael J. Morris, MD, Associate Member at Memorial Sloan Kettering Cancer Center in New York, said that these results confirm the role of upfront chemotherapy along with androgen-deprivation therapy in men with newly diagnosed metastatic hormone-sensitive...

prostate cancer

‘Unprecedented’ Survival Benefit in Prostate Cancer With Addition of Docetaxel to Hormone Therapy

Adding docetaxel to standard androgen ablation therapy (ie, testosterone suppression) extended survival by more than 1 year in men with newly diagnosed metastatic hormone-sensitive prostate cancer in the phase III E3805 trial, funded by the National Institutes of Health. As reported at the ASCO...

Sharing 50 Years of Christmas: A Quality Metric?

A very pleasant 68-year-old woman was referred to my clinic with biopsy-proven liver metastasis from primary colon cancer. She was initially diagnosed with colon cancer, which was resected, and she then received chemotherapy. A suspicious liver lesion was biopsied in the adjuvant setting, which...

Leading Cancer Researcher and Public Health-Care Expert, Eddie Reed, MD, Dies

In a 2010 interview, Eddie Reed, MD, a pioneer in the molecular pharmacology of DNA-damaging anticancer agents and the clinical development of paclitaxel for ovarian cancer, was asked what lay ahead. Before answering, Dr. Reed first acknowledged the esteemed mentors who gave him their most precious ...

colorectal cancer

Aflibercept More Active Than Bevacizumab in Patient-Derived Colorectal Cancer Xenografts

Some evidence suggests that dual targeting of vascular endothelial growth factor (VEGF) and placental growth factor (which binds to VEGFR-1) might provide more effective antiangiogenic therapy. In a study reported in Molecular Cancer Therapeutics, Chiron and colleagues compared the antitumor...

breast cancer

Long-Term Follow-up Confirms Low Incidence of Cardiac Events Associated With Trastuzumab

At a median follow-up of 8 years, patients receiving trastuzumab (Herceptin) sequentially after chemotherapy and radiotherapy in the Herceptin Adjuvant (HERA) trial had a low incidence of cardiac events and these were reversible in the vast majority of patients. This long-term assessment confirms...

colorectal cancer
geriatric oncology

Colorectal Cancer Screening Recommended Past Age 75 for Previously Unscreened Patients

Colorectal cancer screening is cost-effective and “should be considered well beyond age 75 years” for individuals not previously screened, according to a computer simulation study published in the Annals of Internal Medicine. The researchers noted that while the U.S. Preventive Services Task Force...

Focus on the Washington State Medical Oncology Society

The Washington State Medical Oncology Society (WSMOS) was formed in 1993 in response to the health-care reform legislation then being proposed by President Bill Clinton. “The law never passed, but it spurred the development of our Society, so some good came out of the law’s defeat,” said Vicky E....

breast cancer

New Option for Preserving Fertility in Women Being Treated With Chemotherapy for Early-Stage Breast Cancer

One of the most reported studies emanating from the 2014 ASCO Annual Meeting involves the use of the luteinizing hormone–releasing hormone (LHRH) agonist goserelin (Zoladex) to reduce the risk of ovarian failure among women being treated with chemotherapy for early-stage breast cancer, and to...

issues in oncology

Genomic Confidence and Competence

As reported in the Journal of Clinical Oncology and reviewed in this issue of The ASCO Post, Stacy W. Gray, MD, AM, a medical oncologist at Dana-Farber Cancer Institute, Boston, and colleagues presented one of the first studies evaluating how academic oncologists perceive the incorporation of a...

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