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Showing 2301 - 2350Prostatectomy vs Radiotherapy: A Study for Cautious Interpretation
Men with newly diagnosed localized prostate cancer face a decision between prostatectomy and radiotherapy, treatments deemed similarly effective but with well-established trade-offs in terms of treatment-related morbidity. Numerous clinical trials and other prospective studies, from both academic...
Overdiagnosis of Breast Cancer: New Research Directions
Currently, one of the most challenging problems in oncology is to accurately predict whether neoplastic lesions detected by screening tests will progress. The focus on developing ever-more sensitive cancer screening tests has produced the clinical dilemma of overdiagnosis. Overdiagnosis occurs when ...
The Canadian National Breast Screening Trial Had So Many Flaws That Its Results Should Not Be Used to Guide Screening Recommendations
If a randomized, controlled trial of therapy for breast cancer was submitted for publication in which 1. The drug being tested was old and ineffective, and 2. prior to randomization, the women underwent a clinical breast examination and the study coordinators knew who had the largest cancers, and...
Flaws in CNBSS Are Vast, Impact on Screening Recommendations Is Nil
The recent report from the Canadian National Breast Screening Study (CNBSS)—published in BMJ and reviewed in this issue of The ASCO Post—concluded that annual mammography in women aged 40 to 59 does not result in a reduction in mortality from breast cancer beyond that of physical examination alone...
A Conversation With Arie Belldegrun, MD, FACS, and Allan Pantuck, MD, MS, FACS
Cancer Immunotherapy What is the role of immunotherapy in the treatment of metastatic renal cell carcinoma? The harnessing of the immune system as an effective treatment for cancer was recently selected by the journal Science as the top scientific Breakthrough of the Year for 2013.1 With this...
A Conversation With David I. Quinn, MBBS, PhD, FRACP
First-Line Therapy Please describe current medical oncology approaches to first-line therapy for metastatic renal cell carcinoma. The current first-line therapy for most patients with good- to intermediate-risk metastatic renal cell carcinoma is a vascular endothelial growth factor (VEGF) receptor...
SSO-ASTRO Margin Guideline: Why Now and What Does It Mean?
Although breast-conserving therapy has been a standard practice for more than 20 years, controversy still exists over what constitutes the appropriate margin of normal breast tissue around a tumor that minimizes local recurrence while maintaining a good cosmetic outcome. Surveys of surgeons1 and...
SIDEBAR: Should You Treat Smoldering Multiple Myeloma?
A recent article in The New England Journal of Medicine has provoked conversation about the management of smoldering multiple myeloma.1 At the recent National Comprehensive Cancer Network (NCCN) Annual Conference, Kenneth C. Anderson, MD, of Dana-Farber Cancer Institute, Boston, shared his thoughts ...
Maintenance Therapy in Multiple Myeloma
In 2012, three randomized placebo-controlled trials reported a significant prolongation of progression-free survival with lenalidomide (Revlimid) as maintenance therapy for multiple myeloma.1-3 Two of these trials tested lenalidomide maintenance after stem cell transplantation, and one investigated ...
DNA Repair Pathway Recombination Proficiency Score Correlates With Tumor Sensitivity to Chemotherapy
As reported in Science Translational Medicine, Pitroda and colleagues developed a recombination proficiency score that measures the efficiency of DNA repair pathways in the context of cancer therapy aimed at generating DNA damage. The score is based on expression levels of four genes involved in...
Epigenetic Reprogramming of HOXC10 Results in Endocrine Resistance in Breast Cancer
Resistance to aromatase inhibitors is a major problem in treatment of estrogen receptor (ER)-positive breast cancer. In a study reported in Science Translational Medicine, Pathiraja and colleagues found pervasive DNA hyper- and hypomethylation and enrichment for promoter hypermethylation of...
IL-15 Deletion Linked to Reduced Local Proliferation of B and T Cells and Poorer Outcome in Colorectal Cancer
The tumor microenvironment contains a complex network of cytokines that contribute to the nature of intratumoral immune reactions. In a study reported in Science Translational Medicine, Mlecnik and colleagues assessed chromosomal gains and losses and expression of 59 cytokines and receptors and...
ASCO Cofounder Jane Cooke Wright, MD, Defied Racial/Gender Barriers and Helped Usher in the Modern Age of Chemotherapy
When Jane Cooke Wright, MD, met with six other oncologists at the Edgewater Beach Hotel in Chicago on April 9, 1964, to discuss the creation of American Society of Clinical Oncology, the first medical society dedicated to bringing patient-oriented issues to clinical oncology, the Civil Rights Act...
Schwartz Center Rounds® Programs Foster Clinical Teamwork and Enhance Patient Care
In the fall of 1994, 40-year-old Kenneth B. Schwartz, a health-care lawyer, was diagnosed with lung cancer. Radiation and chemotherapy failed to stop progression of the disease, and 10 months later he died. During his treatment, Mr. Schwartz wrote about the ordeal of coming to grips with the...
Improving Quality of Life in Cancer Survivors
The number of cancer survivors has been steadily increasing in recent years. According to the Ministry of Health National Cancer Registry, in 2010 there were 254,000 cancer survivors in Israel (3.3% of the population) compared with 15,700 (0.4% of the population, P < .005) in 1975.1 Forty years...
Surgical Resection of Newly Diagnosed Glioblastoma: What Is the Standard of Care?
The neurosurgeon is often the gateway provider when patients present with what on magnetic resonance imaging (MRI) appears to be a new glioblastoma. Because histology-based diagnosis is a prerequisite for initiating standard therapy with radiation and chemotherapy, the first question that the...
Maximizing the Benefits of Exercise in Patients With Cancer
Many nonpharmacologic therapies increase both physical and emotional strength during cancer treatment as well as throughout survivorship. These therapies include the mind-body practices of meditation, self-hypnosis, guided imagery, and breath awareness, touch therapies including massage and...
Getting It Right in the End: Individualization of Care for Patients With Rectal Cancer
Data from trials conducted mostly in the 1970s and 1980s established the paradigm that optimal treatment of rectal cancer requires a combination of radiation therapy, chemotherapy, and surgery.1 Virtually all of these trials, however, demonstrated that radiotherapy added only to the local control...
Beyond the Cystoscope: Thinkers and Technicians
I have spent my career working with urologists. Over a long period of time, I have concluded that they are fine and interesting people who work hard, live well, support interesting hobbies, generally take good care of their families, and are very enjoyable company at parties. The recent discussion...
Continued Survival Benefits Seen With Radical Prostatectomy vs Watchful Waiting in Long-Term Follow-up of the SPCG-4 Trial
The long-term benefits of radical prostatectomy vs watchful waiting in men with localized prostate cancer has remained a debated issue. As reported in The New England Journal of Medicine by Anna Bill-Axelson, MD, of Uppsala University Hospital, and colleagues, additional long-term follow-up in the...
Ceritinib Highly Active in Patients With ALK-Rearranged Advanced NSCLC
Non-small cell lung cancer (NSCLC) harboring ALK rearrangement is sensitive to the ALK inhibitor crizotinib (Xalkori), but resistance ultimately occurs. In a phase I study reported in The New England Journal of Medicine, Alice T. Shaw, MD, PhD, of Dana-Farber/Harvard Cancer Center, Boston, and...
A Coast-to-Coast Road to an Illustrious Career in Radiation Oncology
Nationally regarded radiation oncologist and lymphoma expert Richard Hoppe, MD, was reared in Seaford, a small town hugging the South Shore of Long Island, New York. “I grew up in the early part of Long Island’s suburban sprawl, and my childhood was a fairly typical experience for that time,”...
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...
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...
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...
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...
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...
Study Calls for Revisiting Guidelines for Screening Childhood Cancer Survivors at Risk of Congestive Heart Failure
One of the first studies to analyze the effectiveness of screening survivors of childhood cancer for early signs of impending congestive heart failure found improved health outcomes but suggests that less frequent screening than currently recommended may yield similar clinical benefit. The...
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...
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 ...
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...
Cancer Care Under the Affordable Care Act
The problematic rollout of the Affordable Care Act’s website, HealthCare.gov, made good political theater, but while much of the heated discussion centered on the plan’s need to enroll “young invincibles,” America’s cancer care system and the older patients it serves were also affected by parts of...
Colon Cancer Prevention: It’s All About Mindset and Minute Details
I would like to congratulate Corley and his colleagues for their seminal work on the association between adenoma detection rate and risk of colorectal cancer, advanced colorectal cancer, and colorectal cancer mortality. The impact of their findings—reported in The New England Journal of Medicine1...
Colonoscopy Adenoma Detection Rate Inversely Proportional to Risk of Interval Colorectal Cancer and Colorectal Cancer Mortality
In a study of health-care organization data reported in The New England Journal of Medicine, Douglas A. Corley, MD, PhD, of Kaiser Permanente, and colleagues assessed the relationship between proportion of colonoscopies performed by a gastroenterologist that detect an adenoma and risk of subsequent ...
Issues in the Management of the Axilla in Patients With Breast Cancer
For the past 40 years the story of breast cancer surgery in general, and for the past 20 years the management of the axilla in particular, has been one of increasing conservatism. To give our readers insight into the current and future direction of axillary management, The ASCO Post spoke with...
A New Era in the Management of Advanced HER2-Positive Breast Cancer
Approximately 20% of all breast cancers are human epidermal growth factor receptor 2 (HER2)-positive. Prior to the era of HER2-targeted therapy, HER2-positive breast cancer was characterized by a poor prognosis.1,2 The development of the first HER2-targeted therapy, trastuzumab (Herceptin), led to...
Colorectal Cancer Screening Poised for Change
New screening modalities and the customization of the screening population could soon change the way that screening for colorectal cancer is done. At Digestive Disease Week 2014, the largest gathering of gastrointestinal disease specialists in the world, researchers presented data suggesting that...
Updated Information on Prostate Cancer Drugs: Enzalutamide, Orteronel, and Cixutumumab
Three separate studies of treatments for prostate cancer reported at the 2014 ASCO Annual Meeting in Chicago showed excellent, intermediate, and disappointing results. An update of the previously reported PREVAIL trial (see March 1 issue of The ASCO Post, page 1) was overwhelmingly positive for the ...
Exemestane/Ovarian Suppression Reduces Recurrence vs Tamoxifen/Ovarian Suppression in Premenopausal Breast Cancer
A joint analysis of two important phase III clinical trials—TEXT (Tamoxifen and Exemestane Trial) and SOFT (Suppression of Ovarian Function Trial)—showed that exemestane plus ovarian function suppression was superior to tamoxifen plus ovarian suppression in preventing recurrence in premenopausal...
'Physician Education Is Key' to Continued Advances in Geriatric Oncology
Several times during his lecture at the 2014 ASCO Annual Meeting, Stuart M. Lichtman, MD, FACP, FASCO, the recipient of the B.J. Kennedy Award for Scientific Excellence in Geriatric Oncology, emphasized, “Physician education is the key” to continued advances in geriatric oncology. He specified that ...
Ado-Trastuzumab Emtansine as a Late Treatment for HER2-Positive Metastatic Breast Cancer—Better and Less Toxic Than Physician’s Choice
TH3RESA is a randomized phase III open-label study, reported in The Lancet Oncology and summarized in this issue of The ASCO Post, which examined the activity of ado-trastuzumab emtansine (Kadcyla) in heavily pretreated HER2-positive metastatic breast cancer.1 Formerly known as T-DM1,...
Ado-Trastuzumab Emtansine Improves Progression-Free Survival vs Physician’s Choice in Advanced HER2-Positive Breast Cancer
There are few treatment options for breast cancer patients with progressive disease after two or more HER2-directed regimens for recurrent or metastatic disease. In the open-label phase III TH3RESA trial reported in The Lancet Oncology by Ian E. Krop, MD, PhD, of the Dana-Farber Cancer Institute,...
Concurrent Immunotherapy Pays Off in Advanced Melanoma
In advanced melanoma, two immune checkpoint inhibitors may be better than one, according to the promising outcomes of a study reported at the 2014 ASCO Annual Meeting. Concurrent treatment with the anti–CTLA-4 antibody ipilimumab (Yervoy) and nivolumab, an antibody targeting the programmed death...
Vaccine Targeting Tumor Antigen to Dendritic Cell Receptors Induces Antigen-Specific Immunity
Anticancer immunity may be enhanced by harnessing the ability of dendritic cells to initiate T-cell immunity through efficient uptake and presentation of endocytosed material. In preclinical models, delivery of tumor-associated antigens to dendritic cells using receptor-specific monoclonal...
EGFR Activation Increases Cancer Cell ‘Visibility’ for Cytotoxic T Lymphocytes
The antitumor activities of cytolytic T lymphocytes and natural killer cells are being increasingly investigated and exploited in cancer immunotherapy. One mechanism by which these cells recognize tumor cells is by engagement of NKG2D, an activating receptor on cytolytic T lymphocytes and natural...
Avoiding Antioxidant-Drug Interactions During Cancer Treatment
Many potential drug-nutrient interactions can affect cancer treatment. It is important to consider these interactions given the significant use of supplements and other self-treatment options during cancer care. Antioxidants account for a large portion of the $32 billion in supplement industry...
Ongoing Clinical Trials Actively Recruiting Children With Cancer
The information in this Clinical Trials Resource Guide includes actively recruiting clinical studies of children with cancer. The studies include pilot and phase I and II studies evaluating new therapies, functional imaging tests, tests to measure the neuropsychological and behavioral function in...
Swiss Medical Board Recommendation to End Mammography Screening: A Disturbing Proposal
Despite evidence from a number of prospective, randomized controlled trials showing that screening mammography reduces breast cancer mortality, screening mammography has been the subject of continual debate, controversy, and conflicting guidelines. Recently, the Swiss Medical Board, tasked with...
Swiss Medical Board Members Discuss Recommendation to Phase Out Mammography Screening
In a New England Journal of Medicine “Perspective” article, Nikola Biller-Andorno, MD, PhD, of the University of Zurich and Harvard Medical School, and Peter Jüni, MD, of the University of Bern, provide the rationale for a recent report by the Swiss Medical Board advocating the phasing out of...
Expert Point of View: Philip McCarthy, MD
Melphalan, prednisone, and thalidomide (Thalomid), or MPT, was a widely accepted regimen in newly diagnosed multiple myeloma when the E1A06 trial was launched, noted Philip McCarthy, MD, Director of the Blood and Marrow Transplant Program at the Roswell Park Cancer Institute, Buffalo, New York....
