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issues in oncology

Striving for Quality, Not Quantity, of Life

Advances in science and medicine have led to humans living longer than at any other time in history. According to a new report1 on mortality from the Centers for Disease Control and Prevention’s National Center for Health Statistics, life expectancy in the United States is at an all-time high of...

Expert Point of View: Solange Peters, MD, PhD

The IMPRESS trial asks a simple question: Should you continue an [epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor] while you switch to chemotherapy,” said Solange Peters, MD, PhD, Head of the Thoracic Malignancies Program at the University of Lausanne, Switzerland, at the European ...

lung cancer

IMPRESS Trial: Lung Cancer Progression on First-Line Tyrosine Kinase Inhibitor Indicates the Drug Should Be Stopped

The IMPRESS trial found no benefit for continuing treatment with the epidermal growth factor receptor (EFGR) tyrosine kinase inhibitor gefitinib (Iressa, discontinued in the United States) plus chemotherapy vs chemotherapy alone in patients with EGFR-mutated non–small cell lung cancer (NSCLC) who...

Oncology on Canvas Art Competition Winning Artwork

The 10th anniversary of the Lilly Oncology On Canvas Art Competition was celebrated with the presentation of awards and display of winning entries in New York’s Grand Central Terminal on October 23, 2014. First-, second-, and third-place winners were published in the November 15 issue of The ASCO...

pain management

Unique Barriers to Pain Control

I read with great interest your interview with Virginia LeBaron, PhD, APRN, about barriers to adequate pain control (“Despite Growing Awareness, the Global Crisis of Untreated Cancer Pain Persists,” The ASCO Post, October 15, 2014). Having served as the medical director of a hospice, I am...

lymphoma

Risk of Premature Menopause Raised by Some but Not All Hodgkin Lymphoma Therapies

An analysis of nonsurgical menopause risk among 2,127 women treated for Hodgkin lymphoma found that “risk of premature menopause increased more than 20-fold” after ovarian radiotherapy, alkylating chemotherapy other than dacarbazine, or BEAM (carmustine [BiCNU], etoposide, cytarabine, melphalan)...

lymphoma

Second-Line Gemcitabine the Preferred Option for Relapsed or Refractory Lymphoma

For patients with relapsed or refractory aggressive lymphoma in a National Cancer Institute of Canada clinical trial, second-line treatment with GDP (gemcitabine, dexamethasone, and cisplatin) was as effective as DHAP (dexamethasone, cytarabine, and cisplatin). Treatment with GDP “can be considered ...

gastroesophageal cancer

Customizing Surveillance Strategy in Patients With Esophageal Adenocarcinoma

A surveillance strategy for patients with esophageal adenocarcinoma treated with chemoradiation and surgery (trimodality therapy) can potentially be customized based on surgical pathology stage, according to an analysis of 518 patients with esophageal adenocarcinoma who underwent trimodality...

issues in oncology

Over 14 Million Major Medical Conditions in U.S. Adults Linked to Cigarette Smoking

At least 14 million major medical conditions among U.S. adults aged 35 years and older were attributed to cigarette smoking by a study estimating the disease burden of cigarette smoking, which, according to the study’s authors, “remains immense.” Among current and former smokers, prevalence ratios...

head and neck cancer
issues in oncology

mTOR Cotargeting Active in Cetuximab-Resistant Head/Neck Cancers With PIK3CA and RAS Mutations

In a study reported in Journal of the National Cancer Institute, Wang and colleagues found that adding an mTOR inhibitor to cetuximab (Erbitux) resulted in marked improvement in antitumor activity in squamous cell carcinomas of the head and neck expressing PIK3CA and RAS oncogenes. Cetuximab...

breast cancer
issues in oncology

Single-Nucleus Genome Sequencing Shows Early Aneuploid Rearrangement and Gradual Clonal Evolution in Breast Cancer

In a study reported in Nature, Wang and colleagues developed a whole-genome and exome single-cell sequencing approach (nuc-seq) using G2/M nuclei and used the method to sequence single normal and tumor nuclei from an estrogen receptor–positive breast cancer and a triple-negative ductal carcinoma....

Hyperthermia Reduces Gemcitabine Resistance

Removal of incorporated gemcitabine by DNA repair mechanisms may contribute to resistance to the agent in solid tumors. In a study reported in Journal of the National Cancer Institute, Raoof and colleagues found that radiofrequency-induced hyperthermia blocked repair of gemcitabine-stalled...

issues in oncology

PRC2 Loss Amplifies RAS-Driven Transcription and Results in Sensitivity to Bromodomain Inhibition

PRC2 (polycomb repressive complex 2) has been shown to promote oncogenesis in many tumor types; however, loss of function mutations in PRC2 components has also been shown to occur in some hematopoietic malignancies, raising questions about the precise role of the complex in cancer. In a study...

solid tumors

Selective Generation of Reactive Oxygen Species in Tumor Cells

In a study reported in Clinical Cancer Research, Shin and colleagues synthesized a novel polyphenol conjugate (DPP-23) that exerted antitumor effects by targeting the unfolded protein response in the endoplasmic reticulum via production of reactive oxygen species in cancer cells but not in normal...

Antitumor Effect of Intratumoral Injection of Clostridium Spores

Species of Clostridium bacteria have been shown to kill tumor cells growing under hypoxic conditions. In a study reported in Science Translational Medicine, Roberts and colleagues showed that intratumoral injection of an attenuated strain of Clostridium novyi (C novyi-NT) produced a microscopically ...

Expect Questions From Patients

Screening for thyroid cancer should be discouraged to prevent an “epidemic of diagnosis”—like the one occurring in South Korea—from happening in the United States and other countries, according to the authors of an analysis of the South Korean screening program. That study was published in The New...

issues in oncology
thyroid cancer

South Korean Study Sparks Warnings About the Hazards of Overscreening

An “epidemic of diagnosis” of thyroid cancer is occurring in South Korea and “absolutely could happen here,” according to H. Gilbert Welch, MD, MPH, Professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire. Dr. Welch is coauthor of an article...

Fred Hutchinson Cancer Research Center Recruits D. Gary Gilliland, MD, PhD as New President and Director

Fred Hutchinson Cancer Research Center announced that it has named D. Gary Gilliland, MD, PhD, an expert in cancer genetics and precision medicine as its new President and Director. He will take the helm as the Center’s new leader on January 2. Dr. Gilliland comes to Fred Hutchinson from the...

ACCC Honors Nicholas J. Petrelli, MD, With 2014 Clinical Research Award

Nicholas J. Petrelli, MD, FACS, the Bank of America endowed Medical Director of Christiana Care’s Helen F. Graham Cancer Center & Research Institute, Newark, Delaware, received the 2014 Clinical Research Award from the Association of Community Cancer Centers (ACCC) in recognition of his...

lung cancer

Beating the Odds

I know it sounds odd, but the past 10 years spent living with non–small cell lung cancer (NSCLC) have been very productive, wonderful years. It is not the life I had before my diagnosis, but it is the life I remember most clearly, and knowing how deadly this cancer is, I’m grateful for every day of ...

Chevalier Jackson, MD, Performing Bronchoscopy, Philadelphia, Circa 1920

The bronchoscope was first used for extracting foreign bodies and the evaluation of infectious processes, especially abscesses. By the end of the twentieth century, the bronchoscope had been determined the single most useful tool for accurate diagnosis of lung cancer. It allowed for the collection...

Fluoroscopy for Lung Disease, Boston, 1903

When Thomas Alva Edison, the Wizard of Menlo Park, heard of Roentgen’s discovery of the x-ray, he directed his research staff to create x-ray tubes and better screens on which to view the images. Edison owned America’s first industrial research laboratory and could easily supply the know-how,...

Preoperative Rodent Cancer: Patient of Charles Moore, MD, Albumen Print, London, 1864

A disease more repulsive and distressing can hardly be conceived than a Rodent Cancer of the face. Commencing in some trifling manner in the skin, and then sometimes producing so little irritation as scarcely to attract notice, it spreads abroad in all directions with a slow but unswerving advance. ...

Bevacizumab Plus Chemotherapy in Platinum-Resistant Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal 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. On November 14, 2014, bevacizumab (Avastin) in combination with...

A Good Life, All the Way to the Very End

BOOKMARKTitle: Being MortalAuthor: Atul Gawande, MDPublisher: Metropolitan BooksPublication date: October 7, 2014Price: $26.00; hardcover, 304 pages   Mortality is the invisible observer in the oncology exam room. When people hear the three words, “You have cancer,” they see their world as they...

When Life Couldn’t Be Better

The following essay by Carolyn D. Runowicz, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. Just...

skin cancer

Memorial Sloan Kettering Team Discovery Advances Understanding of Immunotherapy’s Successes—and Its Failures

A collaborative team of leaders in the field of cancer immunology from Memorial Sloan Kettering Cancer Center has made a key discovery that advances the understanding of why some patients respond to the CTLA-4 blocking antibody ipilimumab ­(Yervoy), an immunotherapy drug, while others do not. A...

survivorship

Major Strides Seen This Year in Survivorship Care

"This year was actually a boon for the patient and survivor care section,” Arif H. Kamal, MD, said at the Best of ASCO meeting in Seattle, where he reviewed the leading abstracts and gave some of his own perspective. “What you see is a lot of the limitations of research in the palliative care and...

supportive care
palliative care

Experts Stress the Need for Integrating Palliative Care Into Standard Oncology Care

The overriding consensus from the 2014 Palliative Care in Oncology Symposium: Patient-Centered Care Across the Cancer Continuum held in Boston was that achieving optimal high-quality cancer care requires both state-of-the-art cancer therapy and the integration of palliative care principles...

palliative care

Use of Hospice Care by Medicare Patients Associated With Lower Rate of Hospitalization, ICU Admission, Invasive Procedures, and Costs

Medicare patients with poor­prognosis cancers who received hospice care had significantly lower rates of hospitalization, intensive care unit (ICU) admissions and invasive procedures at the end of life, along with significantly lower health care expenditures during the last year of life, according...

palliative care

How the Earlier Introduction of Palliative Care Improves Quality of Life for Patients With Advanced Cancer

A 4-year study1 involving 461 patients with advanced stages of lung, gastrointestinal, genitourinary, breast, and gynecologic cancers has found that providing early outpatient palliative care vs standard oncology care alone improved quality of life and patient satisfaction. The study participants...

solid tumors
issues in oncology

Proteome-Scale Map of the Human Interactome Network Created

Researchers have produced a new largest-scale map of human protein interactions that will better enable scientists to trace how genetic changes lead to diseases ranging from cancer to Huntington’s disease. The expanded map, published in the journal Cell,1 is about 30% larger than the combination of ...

Helping Adolescents and Young Adults Cope With Cancer

Each year, about 70,000 adolescents and young adults (AYAs) are diagnosed with cancer in the United States, almost six times the number of cases diagnosed in children up to 14 years of age. While overall cancer survival rates continue to rise—according to the American Cancer Society, there are...

gynecologic cancers

Scientists Develop New Approach to Treating HPV-Related Cervical Cancer

Cidofovir, an antiviral drug that is well established as a treatment for infection of the retina in people with AIDS, has been shown to be effective in combination with chemoradiation in a phase I study of women with human papillomavirus (HPV)-related cervical cancer. The study results were...

cns cancers

Treating Brain Cancer in 2014

While primary malignant brain tumors account for only 2% of all adult cancers, these deadly neoplasms cause severe cancer-related disability; the 5-year survival rates for brain tumors rank third lowest among all cancers, with those for pancreas and lung cancers being first and second lowest,...

Study Finds Wide Variation in Quality, Content of Clinical Cancer Guidelines

What’s the best way to treat rectal cancer? Consult any of five top clinical guidelines for rectal cancer and you will get a different answer, according to a new study by researchers at the University of Michigan Comprehensive Cancer Center. Their findings were published online in the journal...

multiple myeloma

HDAC Inhibitors and Triple Therapy in Relapsed Myeloma

The use of histone deacetylase (HDAC) inhibitors as human cancer therapy has focused on the impact of these agents on epigenetic regulation and gene transcription. However, the use of HDAC inhibitors in myeloma may be working through a different mechanism. Specifically, HDAC6 is known to regulate...

multiple myeloma

Adding Pan-Deacetylase Inhibitor Panobinostat to Bortezomib and Dexamethasone Improves Progression-Free Survival in Relapsed Myeloma

In the phase III PANORAMA 1 trial reported in The Lancet Oncology, Jesus F. San-Miguel, MD, of Clinica Universidad de Navarra-CIMA, Pamplona, Spain, and colleagues found that adding the pan-deacetylase inhibitor panobinostat to bortezomib (Velcade) and dexamethasone improved progression-free...

gynecologic cancers

Cancer-Killing Virus Plus Chemotherapy Studied in Recurrent Ovarian Cancer

In 6 out of 10 cases, ovarian cancer is diagnosed when the disease is advanced and 5-year survival is only 27%. A new study suggests that a cancer-killing virus combined with a chemotherapy drug might safely and effectively treat advanced or recurrent forms of the disease. Researchers at The Ohio...

issues in oncology

Advancing ASCO’s Commitment to Quality to Ensure That Every Patient Receives the Highest Level of Cancer Care

On December 3, 2014, Robert S. Miller, MD, FACP, FASCO, will start his new position as Medical Director of ASCO’s Institute for Quality (iQ). Established in 2012 to oversee the development of clinical practice guidelines, the Quality Oncology Practice Initiative (QOPI), the QOPI Certification...

issues in oncology

Charting the Successes: CancerProgress.Net Chronicles More Than 50 Years of ASCO and Progress Against Cancer

On this historic year, as ASCO proudly commemorates its 50th anniversary and decades of evolutionary change and growth, it also celebrates the significant progress that has been made against cancer throughout history. ASCO’s anniversary website, CancerProgress.Net, chronicles these achievements and ...

survivorship
supportive care

New ASCO Survivorship Care Plan Template Is Simpler, Faster for Health-Care Providers

ASCO has issued a new template for health-care professionals to use when providing a survivorship care plan to patients who have completed curative cancer therapy. The survivorship care plan contains important information about treatment the patient received, the patient’s need for future checkups...

issues in oncology

Top 5 Features of ASCO’s Newly Redesigned Patient Education Website Highlighted

ASCO recently launched a new and redesigned version of Cancer.Net, its patient-facing website that includes timely, comprehensive, and oncologist-approved information. With support from the Conquer Cancer Foundation, Cancer.Net is able to bring the expertise and resources of ASCO to your patients...

Why They Voted: Comments From the Oncology Community

1965: MOPP chemotherapy cures Hodgkin lymphoma “This was the clearest proof of concept that cancer was/is curable. It gave great impulse to therapeutic research that ultimately improved outcomes in breast, colon, kidney cancer, the leukemias, and most childhood malignancies.” 2006: HPV vaccine...

issues in oncology

ASCO Announces Top 5 Advances in Modern Oncology

To mark ASCO’s 50th anniversary, the Society called on the oncology community to select the five most pivotal advances in cancer research and patient care over the past 50 years. Now, with more than 2,000 votes cast, ASCO has announced the results on CancerProgress.Net, its interactive website on...

issues in oncology

Focused Ultrasound, a Young Technology, Begins to Grow

In the United States, it’s been a good 2 years for focused ultrasound. The technology, which uses multiple, intersecting ultrasound beams to treat cancer and other diseases, completed its first successful U.S. phase III oncology trial—to alleviate the pain of bone metastases—and received approval...

prostate cancer

Systemic Therapy in Men With Metastatic Castration-Resistant Prostate Cancer: ASCO/CCO Clinical Practice Guideline

The ASCO Clinical Practice Guidelines Committee and the Cancer Care Ontario (CCO) program in evidence-based care have released a clinical practice guideline on systemic therapy in men with metastatic castration-resistant prostate cancer. The guideline was published in the Journal of Clinical...

colorectal cancer

Sigmoidoscopy or Colonoscopy for Colorectal Cancer Screening: Is It Still the Question?

Mortality from colorectal cancer remains a public-health concern, being the second leading cause of cancer-related death for men and women combined. The major preventive measure for colorectal cancer is to screen for and remove adenomatous polyps. Average-risk individuals (ie, those who do not have ...

colorectal cancer

NORCCAP Trial Shows Reduced Colorectal Cancer Incidence and Mortality With Flexible Sigmoidoscopy Screening at 11 Years

The Norwegian Colorectal Cancer Prevention (NORCCAP) trial comparing colorectal cancer screening with flexible sigmoidoscopy vs no screening showed no reduction in colorectal cancer incidence or mortality after 7 years of follow-up. As reported by Øyvind Holme, MD, of Sorlandet Hospital...

issues in oncology

New Imaging Technique Identifies Receptors for Targeted Cancer Therapy

Dartmouth researchers have developed a fluorescence imaging technique that can more accurately identify receptors for targeted cancer therapies without a tissue biopsy. They report on their findings in a recently published article in Cancer Research.1 “Protein overexpression is a hallmark of...

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