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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...

lung cancer

Improved Survival with Concurrent Chemotherapy plus Radiotherapy for Patients with Stage III Non–Small Cell Lung Cancer

Five-year survival was statistically significantly higher for patients with stage III non–small cell lung cancer (NSCLC) who received concurrent rather than sequential cisplatin-based chemotherapy combined with thoracic radiotherapy, according to the phase III Radiation Therapy Oncology Group...

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...

solid tumors

VGX-100 Investigational New Drug Application Approved

The Australian biotechnology company Circadian Technologies announced that its subsidiary, Vegenics Pty Ltd, has received approval for its investigational new drug (IND) application from the FDA to initiate clinical trials of VGX-100. The first phase I trial will study VGX-100 in patients with a...

gynecologic cancers

FDA Approves Molecular Test to Detect HPV

Gen-Probe recently announced that the FDA has approved its APTIMA HPV assay, an amplified nucleic acid test that detects high-risk strains of human papillomavirus (HPV) that are associated with cervical cancer and precancerous lesions. The test has been approved to run on Gen-Probe’s fully...

breast cancer

Tamoxifen vs Surgery Study Shows Older Patients with Breast Cancer Can Achieve a ‘Personal Cure’

A truly final review—when all the patients in the trial have died and the cause of death is known for each—of a randomized trial comparing tamoxifen to surgery in patients over the age of 70 with operable breast cancer found no differences in the survival rates or deaths attributable to breast...

Expert Point of View: Hypofractionated Radiotherapy Effectively Controls High-risk Prostate Cancer

The take-home message of the study findings from the Fox Chase trial reported at the 53rd ASTRO Annual Meeting plenary session supports the use of hypofractionated intensity-modulated radiotherapy as a more convenient and cost-effective alternative than conventional IMRT, according to formal...

prostate cancer

Hypofractionated Radiotherapy Effectively Controls High-risk Prostate Cancer

The use of hypofractionated intensity-modulated radiotherapy (IMRT) appears to be a reasonable option for men with intermediate- to high-risk prostate cancer,1 reported Alan Pollack, MD, Chairman of Radiation Oncology at the University of Miami Miller School of Medicine in Miami and lead...

Help Your Patients Understand Lung Cancer

Did you know that November is Lung Cancer Awareness Month? For an introduction to lung cancer, direct your patients to the fact sheet ASCO Answers: Lung Cancer at www.cancer.net/factsheets. For more detailed information, your patients can read the Cancer.Net Guide to Lung Cancer at...

ASCO in Action Online: Your Source for Policy News and Information

The recently enhanced ASCO in Action site ascoaction.asco.org is a one-stop source for the latest policy news related to quality cancer care and research. Whether it is information about legislation that affects cancer patients or oncology practices, easy links to ASCO’s recent policy positions,...

ASCO Journal Apps Now Available for iPad and iPhone

Users of the market-leading mobile devices have been able to access optimized versions of the Journal of Clinical Oncology (JCO) and Journal of Oncology Practice (JOP) websites since the spring of 2011. Now, iPad and iPhone users can download free JCO and JOP apps from the iTunes store. Smooth and...

Oncology’s Only Benchmark Report, National Practice Benchmark, Is Now a Yearly JOP Supplement

Would it surprise you to learn that 40% of your peers in oncology who responded to a survey last year have a certified electronic medical record system in place? Or that 86% of them are in physician-owned practices? Or that the average number of full-time equivalent hematology/oncology physicians...

Global Trials: Do Benefits Outweigh Pitfalls?

Global clinical trials have many advantages and are essential in many disease settings, but there are also challenges that confront global industry-sponsored research, said Sandra Horning, MD, Senior Vice President and Global Head of Clinical Development in Hematology/Oncology for Genentech (Table...

solid tumors

Sunitinib and Everolimus: New Indications in Pancreatic Neuroendocrine Tumors

With In the Clinic, The ASCO Post 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. Sunitinib Indication—The oral kinase inhibitor...

lung cancer

NCCN Guidelines® for Lung Cancer Screening Now Available

The new NCCN Guidelines for Lung Cancer Screening primarily refer to non–small cell lung cancer, the most common type of lung cancer, and recommend helical low-dose computed tomography (LDCT) screening for select patients at high risk for the disease. In addition to outlining the appropriate use of ...

issues in oncology

Predictive Biomarker for Bevacizumab: Are We Getting Closer?

The need to identify a biomarker to guide treatment with bevacizumab (Avastin) is abundantly clear, and studies presented at the 2011 European Multidisciplinary Cancer Congress suggest this goal may be in sight. “Finding predictive biomarkers is a challenge, but there are candidates,” said Eric Van ...

colorectal cancer

Despite Challenges, Combined-modality Therapy Warranted for Locally Recurrent Colorectal Cancer

Encouraging outcomes have been achieved with a combined-modality treatment approach for patients with locally recurrent colorectal cancer in both curative and palliative settings, although room for improvement remains. During a session presented at the American Society for Radiation Oncology...

gastroesophageal cancer

Preoperative Chemoradiotherapy May Extend Survival for Patients with Esophagogastric Junction Adenocarcinoma

Several American and European clinical trials have yielded mixed results on the survival advantage of preoperative chemoradiotherapy for patients with locally advanced esophagogastric junction adenonocarcinoma. However, a distinguished panel at the 2011 ASTRO Annual Meeting did agree that surgery...

Expert Point of View: Fewer Rectal Side Effects with IMRT than with 3D-CRT for Prostate Cancer

Although the early toxicity findings of RTOG 0126 seem to favor IMRT over 3D-CRT, formal discussant of this trial, Juanita Crook, MD, FRCPC, of the British Columbia Cancer Agency, Kelowna, British Columbia, Canada, put the study’s findings in perspective. “Whether or not this is a significant...

prostate cancer

Fewer Rectal Side Effects with IMRT than with 3D-CRT for Prostate Cancer

The use of intensity-modulated radiation therapy (IMRT) is associated with fewer acute and late toxic effects than is three-dimensional conformal radiation therapy (3D-CRT) in men with localized prostate cancer, according to preliminary analysis of the Radiation Therapy Oncology Group (RTOG) 0126...

hematologic malignancies
leukemia
lymphoma
multiple myeloma

NCCN Meeting Addresses Issues in Hematologic Malignancies

The National Comprehensive Cancer Network (NCCN) 6th Annual Congress on Hematologic Malignancies, held recently in New York, included reviews of the management of hematologic diseases as well as discussions of outstanding issues in the field. The following is a synopsis of some of the important...

Expert Point of View: Novel HDAC Inhibitor May Restore Estrogen Sensitivity in Breast Cancer

Joyce O’Shaughnessy, MD, of Baylor Sammons Cancer Center in Dallas, who moderated the symposium where the results were presented, called the use of entinostat in advanced estrogen receptor–positive breast cancer “very, very promising.” She added, “I agree that it’s time for a phase III trial of...

breast cancer

Novel HDAC Inhibitor May Restore Estrogen Sensitivity in Breast Cancer

The addition of the investigational histone deacetylase (HDAC) inhibitor entinostat significantly delayed breast cancer progression and showed a trend for a survival benefit in the phase II ENCORE 301 study. The study was conducted in women with advanced estrogen receptor–positive breast cancer...

SIDEBAR: White House Issues Executive Order on Drug Shortage

On October 31, President Barack Obama issued an executive order instructing the FDA to broaden reporting of potential drug shortages, expedite reviews of applications to begin or modify production of these drugs, and provide more information to the Justice Department about possible cases of...

issues in oncology

Chemotherapy Drug Shortages: A Preventable Human Disaster

The issue of chemotherapy drug shortages continues with no end in sight. Many heartfelt human interest stories have been told on television, in newspapers, and even to Congress, but the bottom line is that little, if any, action has been taken. Uniquely American Problem News of the generic...

issues in oncology

Important Lessons for Oncology from the Front Lines of the AIDS Pandemic

On June 5, 1981, the CDC issued a warning about a rare type of pneumonia discovered among a small group of young gay men in Los Angeles, later determined to be AIDS-related, ushering in the HIV/AIDS epidemic. Early on, AIDS-related malignancies brought the oncology community into this formidable...

Expert Point of View: Aflibercept Improves Overall Survival in Patients with Metastatic Colorectal Cancer

David Kerr, MD, of the University of Oxford, United Kingdom, who is also President of the European Society of Medical Oncology, formally discussed the study, which he called “well designed and well conducted.” He applauded the investigators for performing a preplanned subgroup analysis with a...

colorectal cancer

Aflibercept Improves Overall Survival in Patients with Metastatic Colorectal Cancer

The novel fusion protein aflibercept added to standard chemotherapy led to an overall survival benefit in a global phase III trial of second-line metastatic colorectal cancer, reported at the 2011 European Multidisciplinary Cancer Congress in Stockholm.1 “Adding aflibercept to FOLFIRI [leucovorin,...

symptom management

Neural Stem Cell Transplantation May Improve Cognitive Function in Brain Cancer

The potentially devastating long-term consequences on cognitive function in patients with brain cancer following cranial irradiation led Charles L. Limoli, PhD, Professor of Radiation Oncology, University of California, Irvine, to study neural stem cell transplantation and how the procedure may...

SIDEBAR: Key Dates in the Medicare Physician Reimbursement Saga

October 21, 2009: SB 1776 (“the Doc Fix”) is introduced in the Senate [but fails to pass] November 19, 2009: House of Representatives passes HR 3961 (the Medicare Physician Payment Reform Act) [but Senate fails to pass] December 19, 2009: Congress passes Department of Defense appropriations bill...

health-care policy

Medicare Reimbursement to Physicians: Déjà Vu All Over Again

In February 2011, The ASCO Post published an opinion piece (“Congress and the ‘Doctor Fix’: Looking Back, Looking Ahead”) about the ping-pong of legislative continuing resolutions to avert a 21.3% cut in physician reimbursement. These continuing resolutions were necessary because the Affordable...

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