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prostate cancer

Intermittent or Continuous Androgen Suppression Produces Comparable Survival after Radical Therapy in Prostate Cancer

Men with prostate cancer who receive intermittent courses of androgen-suppressing therapy can live as long as those who are treated with continuous therapy, according to results of a recently concluded study. Until now, standard treatment has consisted of continuous therapy, but this is expected to ...

Expert Point of View: Bevacizumab Makes Inroads against Ovarian Cancer

Formal discussant, Anil Sood, MD, The University of Texas MD Anderson Cancer Center, Houston, said that both studies presented important information, but several issues should be considered, including the best combination with bevacizumab, whether the benefits accrue from bevacizumab alone or...

gynecologic cancers

Bevacizumab Makes Inroads against Ovarian Cancer

Bevacizumab (Avastin) administered with chemotherapy and continued after chemotherapy improves outcomes in ovarian cancer, according to two multicenter, randomized, double-blind phase III investigations presented at the 2011 ASCO Annual Meeting. The first study, ICON7, incorporated bevacizumab as...

Expert Point of View: Second Primary Malignancies Explored in Multiple Myeloma

Formal discussant Ola Landgren, MD, PhD, Chief of the Multiple Myeloma Section at NCI, had some additional comments about the 2011 ASCO presentations on second primary malignancies in lenalidomide-treated patients.1 He said that the reporting of second primaries has several limitations that...

multiple myeloma

Second Primary Malignancies Explored in Multiple Myeloma

Three randomized controlled trials presented at the 2010 Annual Meeting of the American Society of Hematology (ASH) suggested that treating multiple myeloma with lenalidomide (Revlimid) increased the risk of second primary malignancies; of particular concern is transformation to acute myeloid...

Expert Point of View: Patients with Early Breast Cancer Benefit from Regional Nodal Irradiation

Thomas Buchholz, MD, of the University of Texas MD Anderson Cancer Center, Houston, commented that the “well conducted and analyzed” MA.20 study addressed a “simple clinically relevant question,” and the findings “add to the conclusive evidence that radiation eradication of local-regional...

breast cancer

Patients with Early Breast Cancer Benefit from Regional Nodal Irradiation

Findings from a Canadian study presented at the 2011 ASCO Annual Meeting may expand the pool of patients with lymph node–positive breast cancer offered extended-field irradiation.1 “Results from MA.20 suggest that all women with node-positive disease following breast-conserving surgery be offered...

cost of care
health-care policy

Rising Costs of Cancer Care: It's More Than Drugs

All parties—the government, payers, and consumers—agree that, left unchecked, rising health-care costs will eventually hamstring vital portions of our delivery system. For example, Medicare, which covers more than 50% of the nation’s patients with cancer, is marching headlong toward insolvency....

breast cancer

Acting on Fear

When I was first diagnosed with breast cancer in 1979 there was no global movement to raise awareness of the disease, there were no pink ribbon pins to show support, and there was no Internet with which to search for information. My doctor gave me the news on a Friday night, and the following...

SIDEBAR: American Lung Association Reflects on the National Lung Screening Trial

The American Lung Association is optimistic about the promising results of NCI’s National Lung Screening Trial, which indicate low-dose CT scans can have significant impact on lung cancer mortality. This study is the first comprehensive clinical trial to find that screening high-risk individuals...

lung cancer

A Clinician Weighs In on the National Lung Screening Trial

The results of the National Lung Screening Trial (NLST) will have important implications for practicing oncologists if low-dose helical CT screening is used routinely in the clinic. First, we will begin to find many more small tumors than we do now. This will pose new sets of questions for...

lung cancer

A Landmark Lung Screening Trial: What Does It Mean for Clinicians and Their Patients?

The NCI-funded National Lung Screening Trial (NLST), published recently in The New England Journal of Medicine,1 was heralded as a landmark study in lung cancer detection. This study is the first comprehensive clinical trial to find that screening high-risk individuals with low-dose CT reduces lung ...

colorectal cancer

Surgical Site Infections after Colectomy More Likely in Obese Patients

Obese patients appear to have a significantly increased risk of developing a surgical site infection after segmental or total colectomy for colon cancer, diverticulitis, or inflammatory bowel disease, and the presence of infection increases the cost associated with the procedure, according to a...

bladder cancer

Neoadjuvant Chemotherapy with CMV Improves Outcome for Invasive Bladder Cancer

Long-term results from a phase III trial show that neoadjuvant chemotherapy with CMV (cisplatin, methotrexate, and vinblastine) improves the outcome for patients with muscle-invasive urothelial cancer of the bladder treated by cystectomy and/or radiotherapy. “Three cycles of CMV before cystectomy...

prostate cancer

Androgen Deprivation Therapy plus Radiotherapy Increases Survival in Men with Localized Prostate Cancer

The addition of short-term androgen deprivation therapy to radiotherapy for men with stage T1b, T1c, T2a, or T2b prostate adenocarcinoma and a prostate-specific antigen (PSA) level of 20 ng/mL or less “conferred a modest but significant increase in the 10-year rate of overall survival, from 57 to...

lung cancer

Identifying Genetic Factors That Predict Response to Chemotherapy in NSCLC

A genetic variation in the chemokine-like receptor 1 (CMKLR1) gene was statistically significantly associated with poor overall survival in patients with non–small cell lung cancer (NSCLC) who were treated with platinum-based chemotherapy with or without radiation. The variation was identified by a ...

SIDEBAR: NY State Law Mandates Discussion on End-of-life Care

Earlier this year, the New York State legislature passed a law requiring physicians and nurse practitioners to talk to patients with an expected survival of less than 6 months about their options, including hospice care and aggressive vs palliative treatment, although patients can refuse to discuss ...

issues in oncology

‘Unrealistic Optimism’ Poses Ethical Challenges, May Affect Informed Consent Process

Does a patient’s optimistic expectation of reaping a health benefit from participating in phase I and phase II oncology studies, even when he understands that these early trials are not designed to provide direct therapeutic benefit, compromise the informed consent process? And, does that...

bladder cancer

Updated Drug Label Approved for Pioglitazone after Safety Review

The FDA recently approved updated drug labels for pioglitazone (Actos) and other pioglitazone-containing medicines (in combination with metformin, Actoplus Met and Actoplus Met XR; and with glimepiride, Duetact) to include safety information that the use of pioglitazone for more than 1 year may be...

SIDEBAR: Age at Diagnosis and Importance of Long-term Considerations

"Patients are willing to accept self-limited acute adverse effects associated with recovery” after brachytherapy and radical prostatectomy, according to the study authors. These effects “have been well documented for both modalities and are quite different. Late effects have been less well...

SIDEBAR: The Anonymity Advantage

This study has the advantage of not only being patient-reported but also of patient anonymity; the questionnaires were not administered or discussed with the patients by any of the treating physicians,” the study authors reported. “I know that patients often want to please their doctor. They don’t ...

prostate cancer

At 5 Years, Brachytherapy Shows Quality-of-life Advantages over Radical Prostatectomy for Favorable-risk Prostate Cancer

Five years after treatment for favorable-risk prostate cancer, men who either chose or were randomly assigned to receive brachytherapy reported quality-of-life advantages in urinary and sexual domains and in patient satisfaction compared to men who received radical prostatectomy, according to a...

supportive care
symptom management

Experts Address Cancer-related Distress—the ‘Sixth Vital Sign’

More research is needed to investigate the effects of screening and treatment for distress in cancer care, according to a recent issue of the international journal Psycho‑Oncology. This special edition of the journal includes a review of screening for distress and depression over 40 years in cancer ...

global cancer care
health-care policy

Cancer Care in the UK: A Conversation with Chris Parker, MD

In the contentious debate over rising health-care spending, the cancer care policies of the British National Health Service (NHS) are often cited by U.S. policymakers as an example of how health-care rationing denies patients life-prolonging treatments based on costs. The ASCO Post recently spoke...

issues in oncology

Research in Combining Targeted Agents Faces Numerous Challenges

If the clinical trials endeavor in oncology is falling short of its goals and if targeted agents have not kept their promise, can a new approach to drug development provide a solution? Very possibly, said John Hohneker, MD, Chair of the Workshop Planning Committee for the conference, “Facilitating...

head and neck cancer

Circulating Tumor Cell Assay Shows Potential for Predicting Prognosis in Head and Neck Carcinoma

According to the NCI, an estimated 49,260 new cases of oral cavity, pharyngeal, and laryngeal cancers occurred in the United States in 2010, and approximately 11,480 deaths were attributed to these cases. It is estimated that 95% or more of these cases are squamous cell carcinomas. Currently, the...

ASCO Examines Impact of Health-care Reform on Cancer Care Disparities

In a new policy statement, ASCO outlines specific provisions of the 2010 Patient Protection and Affordable Care Act that have the potential to reduce cancer care disparities. ASCO’s statement makes recommendations to ensure that such provisions are carried out effectively, and urges additional...

UN Summit to Focus on Noncommunicable Diseases This Month

For the second time since its inception 65 years ago, the United Nations General Assembly is holding a “High-level Meeting” that will focus on health. During the September 19–20 meeting, world leaders will shine a spotlight on the devastation that noncommunicable diseases are causing and have...

Measures of Success for Cooperative Group Reorganization

ASCO continues to work with the NCI and others to transform the Cooperative Group Program through implementation of recommendations of the 2010 Institute of Medicine (IOM) report, “A National Cancer Clinical Trials System for the 21st Century: Reinvigorating the Cooperative Group Program.” Five...

ASCO Connection Adds New Columnists, Launches Group Creation Option

ASCO’s professional networking site, ASCOconnection.org, continues to build depth in areas of interest to the oncology community, adding as its newest commentator ASCO President Michael P. Link, MD, the Lydia J. Lee Professor in Pediatric Oncology at Stanford University School of Medicine, as well...

breast cancer
symptom management

A Conversation with Constance M. Chen, MD, MPH

Although incidence data vary widely, breast cancer–related lymphedema may affect as many  as 54% of the 2.3 million survivors of breast cancer in the United States. The condition is often disabling and can result in both long-term devastating physical consequences for survivors, including the loss...

issues in oncology
health-care policy

Congressional Hearing Highlights Oncology Drug Shortages

Some oncology drugs are in such short supply that the situation is now critical, with almost 200 drugs affected—triple that of 2003. This was the background described by speakers at a July 2011 congressional briefing sponsored by the Association of Community Cancer Centers (ACCC), ASCO, and other...

Screening for Ovarian Cancer Does Not Reduce Mortality and Leads to Unnecessary Tests for False-Positives

Formal discussant of this trial, Usha Menon, MD, Professor of Gynecological Oncology at the Institute for Women’s Health, University College, London, raised several important issues about the design of the PLCO trial particularly related to the dilution of the screening effect due to prolonged...

gynecologic cancers

Screening for Ovarian Cancer Does Not Reduce Mortality and Leads to Unnecessary Tests for False-Positives

Using a CA-125 blood test combined with transvaginal ultrasound for early detection of ovarian cancer failed to reduce the risk of mortality associated with the disease and led to a large number of false-positive tests with unnecessary related biopsies and other follow-up procedures in the large,...

Expert Point of View: Adjuvant Immunotherapy Provides No Clinical Benefit in Patients with High‑risk Renal Cell Carcinoma

Commenting on the renal cell carcinoma study presented in abstract 4505 at the 2011 ASCO Annual Meeting, Walter M. Stadler, MD, of The University of Chicago, said, “The EORTC and investigators should be congratulated for conducting and completing this extremely difficult trial.” Unfortunately, he...

kidney cancer

Adjuvant Immunotherapy Provides No Clinical Benefit in Patients with High‑risk Renal Cell Carcinoma

For renal cell carcinoma patients at high risk of relapse following nephrectomy, adjuvant therapy with the combination of interleukin-2 (Proleukin), interferon alfa, and fluorouracil (5-FU) provides no survival benefit over observation alone, according to a phase III trial conducted by the European ...

breast cancer

Genomic Researchers Identify Weak Points in Breast Cancer Cells

A large-scale project in genetic profiling has identified weak points in breast tumor cells that not only represent potentially new “druggable” targets but could lead to an entirely new classification of all cancers. The findings were recently reported in Cancer Discovery, a journal of the American ...

issues in oncology

A Conversation with Samuel Silver, MD, PhD

Over the past 2 decades, significant therapeutic advances have led to greater survival rates and quality of life for patients with cancer. During the same period there has been a transformation in the way oncology services are both perceived and delivered. In a recent conversation with The ASCO...

issues in oncology
health-care policy

Fixing the Drug Shortage: It’s About Time

I have spent the past 30 years trying to improve the results of treatment for advanced cancer. I had the privilege of working with Sir Michael Peckham when the late Professor Tim McElwain and he were evolving variants of the PVB (cisplatin, vinblastine, bleomycin) and PEB (cisplatin, etoposide,...

cost of care
health-care policy

Increased Use of Hospital Services Boosts Oncology Spending

For our ongoing series on the rising costs of cancer care, The ASCO Post spoke with Lee N. Newcomer, MD, Senior Vice President of Oncology for UnitedHealthcare. Dr. Newcomer is responsible for improving cost-effective cancer care at the nation’s largest health insurer. He shed light on areas of...

Expert Point of View: World Conference on Lung Cancer

The EURTAC study provides additional evidence of the efficacy of the oral EGFR inhibitors in the first-line treatment of patients with mutated EGFR—and, importantly, in Western patients, rather than Asians, for whom data are more abundant. “The findings speak to the fact that all patients with...

lung cancer

World Conference on Lung Cancer: Personalized Approaches to Treatment

The 14th World Conference on Lung Cancer hosted more than 7,000 attendees in Amsterdam recently, with the theme “Better Care through Personalized Medical Approaches.” The following are brief summaries of key data presented at the conference, with perspective provided by Roy S. Herbst, MD, PhD, of...

prostate cancer

Keeping a Positive Attitude

I’ve been in alcohol and drug recovery for 20 years, and my wife of nearly 50 years, Arlene, and I have been through a lot together during that time. So 2 years ago, when my doctor told us that I had stage III prostate cancer and a Gleason score of 8, we both looked at him and asked if we could...

issues in oncology

Pathways Reconsidered: Let’s Not Stop ‘Thinking Outside the Box’

I read “Are Clinical Pathways Inevitable in Oncology’s Future?” (The ASCO Post, July 15, 2011) including Lesli Lord’s interview with great interest and agree with most everything said in the article. However, I do want to make one comment: There is no specialty for which the 80/20 rule applies more ...

breast cancer

Unexpected Results May Push Breast Cancer Research toward More Productive Approaches

Two recent articles on breast cancer prognostic factors in the Journal of Clinical Oncology “do not jibe with accepted—and profoundly influential—notions of malignant progression,” according to an editorial accompanying the articles in the Journal of Clinical Oncology. One of the articles found...

breast cancer

Patients with HER2-positive Breast Cancer Benefit from Trastuzumab plus Chemotherapy

Adding trastuzumab (Herceptin) to standard anthracycline/taxane–based chemotherapy continued to produce disease-free and overall survival benefits in patients with HER2-positive breast cancer enrolled in the North Central Cancer Treatment Group (NCCTG) N9831 and the National Surgical Adjuvant...

breast cancer

Comorbidities Can Be as Important as Stage in Predicting Breast Cancer Survival in Older Patients

Comorbidities can be as important as stage in predicting survival among older women with breast cancer, according to a study in the Journal of the National Cancer Institute. While previous studies have combined comorbidities into a summary measure or comorbidity index, the current study assessed...

prostate cancer

Androgen Deprivation plus Radiotherapy Increases Survival in Men with Localized Prostate Cancer

Adding short-term androgen-deprivation therapy to radiotherapy “conferred a modest but significant increase in the 10-year rate of overall survival, from 57% to 62%,” in men with localized prostate cancer enrolled in Radiation Therapy Oncology Group (RTOG) trial 94-08. “This increase was...

thyroid cancer

Wide Variation in Use of Radioactive Iodine for Thyroid Cancer

The proportion of patients with well-differentiated thyroid cancer who received radioactive iodine following total thyroidectomy increased significantly since 1990, and there is wide variation in the use of adjuvant radioactive iodine, according to a study in the Journal of the American Medical...

prostate cancer

Long-term Data Show Benefit of Degarelix Beyond 3 Years in Advanced Hormone-dependent Prostate Cancer

Degarelix (Firmagon) is effective and well tolerated beyond 3 years in patients with advanced prostate cancer, according to a recent study published in The Journal of Urology.1 The new study (CS21A) extends the conclusions of the pivotal phase III study (CS21) in which the risk of prostate-specific ...

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