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leukemia

Point of View: Should Patients Over 70 Receive Aggressive Therapy for Acute Myeloid Leukemia?

Despite Advances, Little Overall Improvement Seen in Treatment of Older Adults with AMLBy Charles A. Schiffer, MD The outcome of treatment of older adults with acute myeloid leukemia (AML) remains unsatisfactory, although certainly not a totally futile exercise. Patients satisfying the entry...

SIDEBAR: First International Conference on Integrative Care

Last March, nearly 250 oncology professionals and representatives of patient organizations, insurance companies, and government agencies from 12 countries attended the First International Conference on Integrative Care for the Future held in Amsterdam. Barrie R. Cassileth, PhD, chaired the event....

SIDEBAR: Making Evidence-based Integrative Medicine Part of Mainstream Cancer Care

During the 1960s and 1970s, the concept of a holistic approach to treating disease that took into account the body, mind, and spirit grew in patient popularity and morphed into two basic categories: alternative and complementary, which later became known by its acronym CAM (complementary and...

integrative oncology

A Conversation with Barrie R. Cassileth, PhD

Barrie R. Cassileth, PhD, Chief, Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center (MSKCC) in New York, recently spoke with The ASCO Post about her quest to stamp out the illegitimate use of alternative medicine in cancer care and the results from her latest research. A...

SIDEBAR: Timing of Prostate Cancer Drugs: Earlier But Not Too Early?

While sipuleucel-T, abiraterone, and cabazitaxel have been approved for patients with advanced disease, they might also be used in patients with earlier-stage disease, according to Christopher J. Logothetis, MD, of MD Anderson Cancer Center. “I think it is fair to say that they will be used better...

SIDEBAR: Expect Questions from Your Patients

Drugs for the treatment of prostate cancer have been in the news because of recent approvals by the FDA, the costs connected with their use, and associated improvements in survival.1 More recently reported was the decision to allow Medicare coverage of sipuleucel-T treatment for men who met the FDA ...

prostate cancer

Optimizing Treatment for Advanced Prostate Cancer Requires Shifting Focus from Individual Drugs to Integrated Therapies

Newer drugs, including sipuleucel-T (Provenge), cabazitaxel (Jevtana), and abiraterone (Zytiga), can extend survival modestly and ease symptoms for men with advanced prostate cancer. Maximizing the benefit to patients will require shifting the focus from developing individual drugs to developing...

lymphoma

Combined Therapy Produces Good Outcomes in Primary Testicular Diffuse Large B-cell Lymphoma

Final results of an international phase II trial of first-line treatment for primary testicular diffuse large B-cell lymphoma show that using a combined treatment strategy including chemotherapy and central nervous system and testicular prophlaxis “was associated with a good outcome.” The results...

supportive care

Evaluating Risk for Suicide in People Diagnosed or Living with Cancer

The challenges of life-threatening physical illness can sometimes lead to suicide. In fact, given the critical stressors that a person with cancer faces, we might expect suicide to be a more common reaction. Patients with cancer are at increased risk of completed suicide, though the prevalence of...

issues in oncology

FDA Outlines Oversight of Mobile Medical Applications

The FDA is seeking input on its proposed oversight approach for mobile medical applications (“apps”) designed for use on smartphones and other mobile computing devices. This approach encourages the development of new apps, focuses only on a select group of applications, and will not regulate the...

prostate cancer

New Safety Information Reported for 5-alpha Reductase Inhibitors

The FDA announced that the Warnings and Precautions section of the labels for the 5-alpha reductase inhibitor class of drugs has been revised to include new safety information about the increased risk of being diagnosed with high-grade prostate cancer. This risk appears to be low, but health-care...

Help Your Patients Manage the Cost of Cancer Care

Because the cost of cancer care can be high, it is important for your patients to understand what to expect before starting treatment so that they can manage the financial effect of cancer in the most effective way possible. To that end, Cancer.Net, ASCO’s patient information website, offers a...

ASCO’s Oncology Slide Library Functions as a Share‑and‑Exchange Forum

ASCO’s Oncology Slide Library—which allows ASCO meeting attendees to upload and share their ASCO meeting presentation slides with slide-library subscribers—may only be a year old, but participation is already very high. This year’s Annual Meeting in June marked the first time ASCO gave each speaker ...

Oncology Community Briefs Members of Congress and Calls for Action

ASCO and seven other oncology organizations held a Capitol Hill briefing in July and explained to nearly 200 members of Congress and their staffs how widespread cancer drug shortages are creating “a crisis in care.” According to the University of Utah Drug Information Service, the number of drug...

ASCO’s International Cancer Corps Launches Initiatives in Ethiopia and Vietnam

Imagine just four oncologists attempting to provide care for a population of 82 million people living in a country covering twice the territory of Texas. That’s the state of cancer care in Ethiopia. And imagine a country of more than 90 million people—more than twice the population of...

lymphoma

ODAC Recommends Accelerated Approval for Brentuximab

Seattle Genetics, Inc, announced that the FDA’s Oncologic Drugs Advisory Committee (ODAC) voted 10-0 to recommend that the agency grant accelerated approval of brentuximab vedotin (ADCETRIS) for the treatment of patients with Hodgkin lymphoma who relapse after autologous stem cell transplant...

issues in oncology

FDA Issues Guidance for Diagnostic Tests Used with Targeted Therapies

The FDA issued a new draft guidance to facilitate the development and review of “companion diagnostics”—tests used to help health-care professionals determine whether a patient with a particular disease or condition should receive a particular drug therapy or how much of the drug to give. The draft ...

Expert Point of View: Sorafenib Acceptable in Child-Pugh B Patients with Hepatocellular Carcinoma

The GIDEON trial “can provide us with important information on safety and single-arm efficacy in the Child-Pugh B population,” said Bert H. O’Neil, MD, of the University of North Carolina Lineberger Comprehensive Cancer Center in Chapel Hill. “The results suggest that safety is similar between...

hepatobiliary cancer

Sorafenib Acceptable in Child-Pugh B Patients with Hepatocellular Carcinoma

Patients with hepatocellular carcinoma and moderate liver dysfunction can derive benefit from, and be treated safely with, sorafenib (Nexavar), according to the second interim analysis of the GIDEON trial, presented at the 2011 ASCO Annual Meeting by Jorge A. Marrero, MD, of the University of...

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 ...

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...

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 ...

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...

Pick up Cancer.Net Materials for Your Patients at the Breast Cancer Symposium

Stop by the ASCO booth in the Exhibit Hall at the Breast Cancer Symposium, September 8–10 in San Francisco, to pick up samples of some of the materials Cancer.Net has available for your patients. At the booth, you can learn about the Cancer.Net Guide to Breast Cancer and pick up fact sheets about...

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...

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