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Expert Point of View: Panitumumab Is Not Beneficial in KRAS Mutations: No Exceptions

Axel Grothey, MD, of the Mayo Clinic, Rochester, Minnesota, found the findings presented by Marc Peeters, MD, PhD,1 at the 2011 European Multidisciplinary Cancer Congress to be of great interest, from both clinical and research perspectives. “We have two discrepant analyses now for G13D. When we...

colorectal cancer

Panitumumab Is Not Beneficial in KRAS Mutations: No Exceptions

The need to restrict treatment with panitumumab (Vectibix) to metastatic colorectal cancer patients with wild-type (normal) KRAS tumors was upheld in a study presented at the 2011 European Multidisciplinary Cancer Congress (EMCC). The investigation found a consistent lack of benefit for the drug...

lung cancer

Time to Reconsider Treatment Paradigm for Elderly Patients with Advanced Non–Small Cell Lung Cancer?

Significantly longer median overall survival among elderly patients with advanced non–small cell lung cancer (NSCLC) receiving doublet chemotherapy rather than monotherapy yielded a 36% reduction in mortality risk in a phase III randomized trial. “We saw a survival benefit with doublet chemotherapy ...

lung cancer

Crizotinib: New Drug for ALK-positive Advanced Non–Small Cell Lung Cancer

Indication Crizotinib (Xalkori) is an oral inhibitor of receptor tyrosine kinases including anaplastic lymphoma kinase (ALK), hepatocyte growth factor receptor (HGFR, c-Met), and recepteur d’origine nantais (RON). In August 2011, the FDA granted the drug accelerated approval for the treatment of...

cost of care

New Technologies Are Driving Up Costs: Are They Worth the Price?

Expensive new cancer therapies and technologies are alluring for both physicians and their patients. Prostate cancer, because of the sheer volume of cases and the variability of treatment options, serves as a dynamic disease model in the ongoing debate over how to curb spending and maintain...

Coming Soon—Survivorship Booklet for Patients and Their Families

A new booklet from Cancer.Net explains survivorship and gives an overview of the challenges faced by cancer survivors. It provides the next steps cancer survivors can take after treatment, including the importance of follow-up care, rehabilitation, managing long-term side effects, and maintaining...

ASCO Symposium Helps Practices Leverage Health IT, Understand EHR Policy Changes

To help community oncology practices and large institutions navigate recent health-care policy changes and leverage health information technology (HIT) to improve the quality of care, ASCO will hold the 2011 HIT/EHR Symposium at the Westin Peachtree Plaza in Atlanta on November 4–5. “This symposium ...

GI Symposium Helps Oncologists Stay Abreast of Fast-moving Research

Gastrointestinal cancers are a key therapeutic area in research, and science is moving forward in that arena at a fast clip. But how are those who focus on gastrointestinal malignancies in the clinic supposed to stay on top of it all? One great way is to attend the annual Gastrointestinal Cancers...

Susan Halabi, PhD, Is Helping to Fund Future of Cancer Research

Susan Halabi, PhD, thinks in terms of probabilities. Based at Duke University School of Medicine, where she is an Associate Professor of Biostatistics and Bioinformatics, Dr. Halabi specializes in the design and analysis of clinical trials, statistical analysis of biomarker and microarray data, and ...

issues in oncology
cost of care

A Conversation with Richard J. Gilbertson, MD, PhD

St. Jude Children’s Research Hospital, Memphis, the country’s first and only NCI-designated Comprehensive Cancer Center devoted solely to children, recently appointed internationally regarded pediatric brain tumor researcher, Richard J. Gilbertson, MD, PhD, as its new Cancer Center Director. In a...

SIDEBAR: The HCP Manual: A Legal Resource Guide for Oncology Health Care Professionals (2nd Edition - 2011)

This manual is a resource for health-care professionals (eg, doctors, nurses, social workers, psychosocial care providers, patient navigators, and advocates) on the various questions and issues often faced by patients coping with cancer, and provides valuable information about cancer-related legal...

issues in oncology

National Organization Offers Guidance on Employment and Financial Issues for Patients with Cancer and Survivors

The Cancer Legal Resource Center (CLRC) is a joint program of the Disability Rights Legal Center and Loyola Law School Los Angeles. This national organization provides free and confidential information on cancer-related financial and legal issues to cancer survivors, families, employers,...

health-care policy

AACR Issues Landmark Report on Cancer Progress

At a recent press conference in Washington, DC, the American Association for Cancer Research (AACR) assembled luminaries from the cancer research and care communities to discuss the salient points of the association’s newly released progress report on the current and future state of cancer research ...

Expert Point of View: U.S. Perspective

“This is an exciting drug,” said Hope Rugo, MD, Professor of Medicine at University of California, San Francisco. “It is highly effective and extremely well tolerated, with no hair loss, which is very important to patients. It also enables using a lower dose of trastuzumab.” Dr. Rugo cited these...

Expert Point of View: European Perspective

Martine Piccart, MD, of the Institut Jules Bordet, Brussels, Belgium, and President-Elect of the European Society for Medical Oncology, was highly enthusiastic about the findings of the phase II T-DM1 study, but said, “We have to remember this is an open-label trial, and in a study like this,...

breast cancer

T-DM1: Antibody Drug Conjugate Outperforms Standard Anti‑HER2 Therapy in Metastatic HER2-positive Breast Cancer

The investigational antibody-drug conjugate T-DM1 improved progression-free survival over standard chemotherapy with docetaxel plus trastuzumab (Herceptin) when given as first-line treatment of HER2-positive metastatic breast cancer, according to an open-label phase II study reported at the 2011...

lung cancer

No Improvement in Survival with High-dose over Standard-dose Radiation for Stage III Non–Small Cell Lung Cancer

Surprisingly, less may be more when it comes to radiation therapy with concurrent chemotherapy for patients with stage III non–small cell lung cancer (NSCLC), according to an interim analysis of the randomized phase III Radiation Therapy Oncology Group (RTOG) 0617 trial presented at the 53rd Annual ...

survivorship

Helping Cancer Survivors Return to Work

For many of the 12 million cancer survivors throughout the United States, remaining in the workforce is an important expectation that requires the support and attention of the oncology community. And while continuing employment can be critically important for economic reasons (especially in the...

issues in oncology

Do We Need the USPSTF?

Like most of the folks reading this commentary, I’m a taxpayer. Although I sometimes become impatient with the strategic games on Capitol Hill, I basically appreciate that government helps many things to work, and some of them even work well. However, there are aspects of government function that...

lung cancer

NSCLC Studies: Bevacizumab/Pemetrexed Maintenance Improves Survival, KRAS Status Has No Impact on Outcomes with Sorafenib

Maintenance therapy with bevacizumab (Avastin) plus pemetrexed (Alimta) showed a modest improvement in progression-free survival vs bevacizumab alone in patients with advanced non–small cell lung cancer (NSCLC), according to the final analysis of the AVAPERL study. In a separate study, selecting...

Expert Point of View: Everolimus Overcomes Resistance to Hormonal Therapy in Advanced Breast Cancer

The goal of this study was to reverse the resistance to endocrine therapy and delay time to chemotherapy, explained Fabrice Andre, MD, Institut Gustave Roissy, Villejuif, France. “The control group is appropriate because we have no better endocrine therapy than exemestane. Progression-free survival ...

breast cancer

Everolimus Overcomes Resistance to Hormonal Therapy in Advanced Breast Cancer

Adding everolimus (Afinitor) to exemestane in postmenopausal women with advanced breast cancer resistant to aromatase inhibitors significantly improved outcomes, according to the phase III BOLERO-2 trial reported at the 2011 European Multidisciplinary Cancer Congress, held September 23–27 in...

breast cancer

FDA Commissioner Announces Decision on Bevacizumab

On November 18, FDA Commissioner Margaret A. Hamburg, MD, said she is revoking the agency’s approval of the breast cancer indication for bevacizumab (Avastin) after concluding that the drug has not been shown to be safe and effective for that use. Bevacizumab will still remain on the market as an...

health-care policy

ASCO Supports the United Nations Political Declaration on Noncommunicable Diseases

In September, government leaders from around the world as well as representatives from civil society, the private sector and academia gathered at the United Nations in New York for the first-ever summit on the growing economic and human crisis posed by noncommunicable diseases (NCDs), especially in ...

head and neck cancer

Rates of Surgery and Survival Increasing for Early-stage Cancers

Surgery is increasingly being used to treat patients with early-stage laryngeal cancer in the United States, and chemotherapy in combination with radiation therapy is being used increasingly to treat patients in an advanced stage of the disease, according to a report in the October issue of...

gynecologic cancers

Alternative Treatment for Advanced Ovarian Cancer Reduces Neurotoxicity and Alopecia

A randomized phase III clinical trial found that carboplatin/pegylated liposomal doxorubicin (Doxil) was not superior in prolonging progression compared to the standard carboplatin/paclitaxel as first-line therapy of patients with advanced ovarian cancer. The carboplatin/liposomal doxorubicin...

breast cancer

Fewer False-positives, Small Increased Risk of Late Diagnosis with Biennial Mammography

Screening mammography every other year reduced false-positive recalls by about one-third compared to annual screening, but was associated with a small increase in the probability of late-stage cancer diagnosis, according to a study funded by the NCI and published in Annals of Internal Medicine. To...

breast cancer

Low-level Expression of ESR1 Tied to Tamoxifen Resistance

Data from a retrospective analysis of two pivotal breast cancer studies suggest that the low-level expression of the estrogen receptor (ER) gene ESR1 “is a determinant of tamoxifen resistance in ER-positive breast cancer,” reported researchers in the Journal of Clinical Oncology. “We performed...

colorectal cancer

Oxaliplatin Improved Overall Survival in Patients under 70

The addition of oxaliplatin to fluorouracil (5-FU) plus leucovorin improved overall survival in patients younger than 70 years old participating in the National Surgical Adjuvant Breast and Bowel Project (NSABP) C-07 trial. Patients eligible for the trial had either stage II or III colon cancer and ...

colorectal cancer

Should Age at Initial Screening Colonoscopy Be Younger for Men?

A study to investigate the most appropriate age for initial screening colonoscopy to improve detection of adenomas, advanced adenomas, and colorectal cancer, and lower colorectal cancer mortality found that the most appropriate age might be different for men and women. “In our study, analysis of...

colorectal cancer

MRI Helps Predict Survival Outcomes in Patients with Rectal Cancer

Magnetic resonance imaging (MRI) can be used after neoadjuvant therapy for rectal cancer to predict survival outcomes for good and poor responders and offer patients additional treatment options before definitive surgery, according to a study conducted at 11 specialist colorectal cancer units in...

breast cancer

Adjuvant Trastuzumab in Nonanthracycline Regimen Studied

One of four large, randomized trials to evaluate adjuvant trastuzumab (Herceptin) in early-stage HER2-positive breast cancer—and the only study to include a nonanthracycline chemotherapy regimen—found that regimen had similar efficacy to anthracycline-containing regimens, but with lower rates of...

SIDEBAR: Expect Questions from Your Patients

Young women with early-stage breast cancer “should be counseled appropriately regarding their treatment options, and should not choose a mastectomy based on the assumption of improved survival,” maintained investigators presenting a retrospective study at the 2011 Breast Cancer Symposium. Their...

breast cancer

Challenging Perceptions about Treatment Options for Younger Women with Early-stage Breast Cancer

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. “There is a perception out there...

cost of care
issues in oncology

A Conversation with Craig B. Thompson, MD

In November 2010, Craig B. Thompson, MD, was named President and CEO of Memorial Sloan-Kettering Cancer Center (MSK) in New York, succeeding Harold Varmus, MD, who is now Director of the NCI. A cancer clinician and researcher, before coming to Memorial Sloan-Kettering Dr. Thompson was Director of...

breast cancer

Researchers Explore Reasons for Higher Risk of Triple-negative Breast Cancer in Underserved African-American Women

Triple-negative breast cancer, one of the most aggressive forms of the disease, has a bad reputation, and among socioeconomically disadvantaged black women, that reputation is especially well deserved. In fact, according to Lisa A. Newman, MD, Director of the Breast Care Center, University of...

gynecologic cancers

Fighting to Get Back Control

I’ve had raging hormones since I was 18, when I was diagnosed with a benign pituitary adenoma. The tumor caused unpredictable menstrual cycles that remained constant throughout my life, even after it had been successfully treated. So 2 years ago, when I turned 40 and started having sudden bouts of...

Expert Point of View: ‘Breakthrough’ Approach to Advanced Basal Cell Carcinoma via Inhibition of Hedgehog Pathway

“Vismodegib is a breakthrough for advanced basal cell carcinoma. These responses were convincing and spectacular, with a clinical benefit in more than 80% of patients and progression-free survival of 10 months,” said Caroline Robert, MD, Institut Gustav Roussy, Villejuif Paris-Sud, France, who was...

skin cancer

‘Breakthrough’ Approach to Advanced Basal Cell Carcinoma via Inhibition of Hedgehog Pathway

The first-in-class Hedgehog pathway inhibitor vismodegib appears to be a successful treatment for advanced basal cell carcinoma, a disfiguring and debilitating disease, according to a pivotal multicenter nonrandomized trial presented as a Best Abstract at a Presidential Session during the recent...

Expert Point of View: Lessening Patients’ Suffering at the End of Life

In her interview with The ASCO Post, Judith Redwing Keyssar, RN, sheds light on easing the suffering of patients facing the end of life. Although what she says is appropriate for patients who are clearly dying, I would emphasize that palliative care is also pertinent to patients who are not...

palliative care

A Conversation with Judith Redwing Keyssar, RN

The number of patients seeking hospice and palliative care has grown significantly since 1974, when the NCI funded the first hospice facility in Branford, Connecticut. Nevertheless, according to the National Center for Health Statistics, 85% of Americans still die in hospitals or nursing homes....

head and neck cancer

FDA Approves Cetuximab to Treat Metastatic Head and Neck Cancer

On November 7, the FDA approved cetuximab (Erbitux) in combination with platinum-based therapy plus fluorouracil (5-FU) for the first-line treatment of patients with recurrent locoregional disease and/or metastatic squamous cell carcinoma of the head and neck. The approval was based primarily on...

geriatric oncology

Geriatric Oncology, a Much Needed Discipline for Future Cancer Care

The U.S. health-care system, with its rapidly aging population, faces a multitude of difficult clinical and financial challenges in caring for its burgeoning population of older patients with cancer. Moreover, age-related social and medical issues among older patients need to be addressed by a...

Expert Point of View: Chemotherapy Generally Safe in Pregnancy

Chemotherapy delivered in the first trimester is associated with a 10% to 30% risk of abortion and 10% to 25% risk of malformations. Therefore, it should be postponed until the second or third trimester, when most regimens appear to be safe, according to Nicholas Pavlidis, MD, of the University of...

issues in oncology

Chemotherapy Generally Safe in Pregnancy

The diagnosis of cancer in a pregnant woman causes concerns for both the mother and her unborn child. But studies suggest that most chemotherapy regimens can be delivered with reasonable safety after the first trimester. Cancer is diagnosed in about 1 per 1,000 to 2,000 pregnancies, mostly breast...

issues in oncology

Impact of Basic Science Advances on Cancer Management Highlighted at AACR Conference

New research in basic science labs coupled with advanced information technology is leading to a more sophisticated understanding of the causes of cancer, how it progresses, and potential methods of treatment, said Elizabeth H. Blackburn, PhD, Nobel Laureate and Chairperson of the Second Annual...

skin cancer

Investigators Unlocking the Mysteries of Merkel Cell Carcinoma

Researchers at the University of Pittsburgh Cancer Institute have documented the molecular activity through which the Merkel cell polyomavirus contributes to 80% of cases of Merkel cell carcinoma—a finding that holds promise for future therapies. The researchers are now working on testing more than ...

American Society of Hematology Recognizes Christoph Klein, MD, PhD, with William Dameshek Prize

The American Society of Hematology (ASH) will honor ­Christoph Klein, MD, PhD, of Children’s Hospital, Ludwig-Maximilians University in Munich, Germany, with the 2011 William Dameshek Prize, at the upcoming Annual Meeting in San Diego. Dr. Klein is being recognized by ASH for his many...

issues in oncology

Biosimilars in Cancer Treatment: What Should the Oncology Community Expect?

Alternative versions of biologic agents, ie, “biosimilars,” will presumably be getting the green light by the FDA, giving oncologists more choices for treatments that come at lower costs to patients and society. The FDA plans to issue its guidance on biosimilars by the end of this year, paving the...

leukemia

Test for AML Prognosis Cleared by FDA

Abbott announced today it has received 510(k) clearance from the FDA for a new in vitro diagnostic test to aid in determining the prognosis of patients with acute myeloid leukemia (AML) Abbott’s Vysis EGR1 FISH Probe Kit, the third Abbott fluorescence in situ hybridization (FISH) assay approved or...

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