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lung cancer

Bevacizumab/Pemetrexed Maintenance Increases Progression-Free Survival vs Bevacizumab Alone in Advanced Nonsquamous NSCLC 

Maintenance therapy is associated with improved survival in non–small cell lung cancer (NSCLC), but few studies have compared active agents in this setting. In a phase III trial (AVAPERL trial) reported in the Journal of Clinical Oncology by Fabrice Barlesi, MD, PhD, of Aix Marseille...

lung cancer

Significant Improvement in Overall Survival Seen With Pemetrexed Maintenance After Pemetrexed/Cisplatin Induction in Patients With Advanced Nonsquamous NSCLC 

In the phase III PARAMOUNT trial, pemetrexed (Alimta) continuation maintenance therapy significantly reduced the risk of disease progression by 38% compared with placebo after pemetrexed/cisplatin induction in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Final overall...

lymphoma

Can Obinutuzumab Benefit Patients With Rituximab-Refractory Non-Hodgkin Lymphoma? 

Obinutuzumab is a glycoengineered type II antibody that differs from type I anti-CD20 antibodies by being associated with actin reorganization and adhesion followed by direct cell death.1 Obinutuzumab has been glycoengineered by reduction in fucose content of the Fc region, which increases its...

skin cancer

Merkel Cell Carcinoma: Hints of Immune Mediation May Enhance Treatment Options 

Merkel cell carcinoma is a rare but aggressive skin cancer with poor outcomes and suboptimal therapeutic options. With a 46% mortality rate, it is three times more lethal than melanoma, and its reported incidence is rising. “Merkel cell carcinoma is a nasty cancer and we have zero FDA-approved...

lung cancer

Researchers Identify Gene Variations in Lung Cancer Patients That May Help Predict an Individual's Treatment Response

Researchers at the Moffitt Cancer Center have identified four inherited genetic variants in patients with non–small cell lung cancer that can help predict survival and treatment response. Their findings, published in Carcinogenesis,1 could help lead to more personalized treatment options and...

head and neck cancer

Many Patients With Head and Neck Cancer Report Being Depressed, but Few Use Mental Health Services  

Despite a relatively high rate of depression among patients with head and neck cancer following radiation therapy, mental health services were severely underutilized in this group, concluded researchers who analyzed questionnaire results from 211 patients. The patients had been previously treated...

Prominent Surgeon and Teacher LaSalle D. Leffall, Jr, MD, Promotes Hard Work and Education to Overcome Boundaries 

Reminiscing about his 65 years in medicine, LaSalle Doheny Leffall, Jr, MD, FACS, cites three events in his early childhood that would ultimately lead him to his position today as the Charles R. Drew Professor of Surgery at Howard University College of Medicine in Washington, DC. First, he was...

issues in oncology

The Direction of Immunotherapy Over the Next Decade 

The use of immunotherapy to target malignant cells in a variety of cancers—especially the PD-1 inhibitors lambrolizumab and nivolumab in the treatment of metastatic melanoma and the anti–PD-L1 agent MPDL3280A in the treatment of melanoma and lung, kidney, colorectal, and gastric cancers—made...

Communicating the Promise Science Offers to Society 

ASCO President Clifford Hudis, MD, FACP, will be serving during a particularly notable year: 2014, the Society’s 50th anniversary. This occasion brings with it much to reflect on, from the advances in the field of oncology to the growth of ASCO’s influence, but Dr. Hudis takes a moment to simply...

gynecologic cancers

Progesterone and Estrogen Receptor Expression Are Prognostic Markers for Endometrioid and High-Grade Serous Ovarian Cancer 

Few markers of ovarian cancer prognosis have been established, perhaps because potential subtype associations are missed in studies including patients with all histopathologic subtypes. In a study reported in The Lancet Oncology, Weiva Sieh, MD, PhD, Assistant Professor of Health Research and...

gynecologic cancers

Pretreatment Lymph Node Dissection May Improve Survival in Advanced Cervical Cancer, But for Too Few? 

Women with cervical cancer metastasized to para-aortic lymph nodes have historically had a poor prognosis, with 3-year overall survival rates of 25% to 40%.1-3 This has been attributed to the presence of occult systemic disease at the time of presentation and a high rate of distant recurrences...

skin cancer

Three 'Game-Changers' in the Treatment of Melanoma 

There have been three “game-changers” in the treatment of melanoma, Mark R. Albertini, MD, Associate Professor of Medicine at the University of Wisconsin in Madison, contended at the Best of ASCO Chicago meeting. The first, he explained, was the recognition of different genetic driver...

issues in oncology

A Great Privilege to Die Beneath an Open Sky 

It was 1:00 AM, and my beeping pager awakened me. When you’re a surgical oncologist, you know that a page from your chief resident at this hour of the morning usually means someone may need to go to the operating room. And, yes, it was the chief resident about a patient in crisis. Except in this...

issues in oncology

Paging Dr. Google: Practicing Oncology in the Era of Social Media and Telemedicine  

Over the past few decades, economic and political factors have reshaped oncology, especially in the community setting. To defray risk, we’ve seen a trend toward oncology practices partnering with hospitals or aggregating into larger networks. Moreover, the Internet and the advent of telemedicine...

issues in oncology

What You Need to Know About E-Cigarettes 

“I’ve seen a lot of puzzled people,” Alexander V. Prokhorov, MD, PhD, said, referring to people who see others using electronic or e-cigarettes. That puzzlement can go beyond wondering why people are smoking in public places and whether they are breaking the law, or just being annoying, to...

PCORI Board Approves $114 Million for Patient-Centered Outcomes Research

The Patient-Centered Outcomes Research Institute (PCORI) Board of Governors recently approved 71 awards, totaling more than $114 million over 3 years, to fund comparative clinical effectiveness research designed to answer questions most important to patients and those who care for them. The awards...

Donatori di Musica Initiative Creates a Unique Environment for Oncology Patients 

“Surely again, to heal men’s wounds by music’s spell.” —Euripides, Medea (480-406 BC) Commonly defined as organized sound, music has a unique power to stir human emotions, moods, and impressions. The salutary effect of music on the sick has been reported since antiquity. Aristotle and Plato wrote...

integrative oncology

Herb-Drug Interactions in Oncology  

Guest Editor Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering...

palliative care

Advances in Medical Oncology Over the Next Decade 

The next 10 years are expected to usher in unprecedented advances in oncology, including molecularly driven diagnostic and therapeutic developments, whole genome sequencing that results in true precision-based medicine, survivorship care plans that address long-term quality of life concerns, and...

lymphoma

Cancer Does Not Discriminate 

Looking back, my son Max’s fall as he was running after another little boy while playing baseball was such a blessing. Although he landed on his right arm, the fall didn’t seem severe enough to cause him to cry out in such excruciating pain. But after several hours of icing the bruise failed to...

breast cancer

Accelerated Partial-Breast Irradiation Using 3D Conformal Radiation Therapy Causes More Adverse Events Compared With Whole-Breast Irradiation 

The RAPID trial compared accelerated partial-breast irradiation using three-dimensional (3D) conformal external-beam radiation therapy vs whole-breast irradiation in women with invasive or in situ breast cancer ≤ 3 cm. As reported by Ivo A. ­Olivotto, MD, FRCPC, of the British Columbia Cancer...

survivorship

Study Shows Increased Risk of Mental Disorders in Childhood Cancer Survivors and Potential Increased Risk in Young Siblings  

Survivors of childhood cancer are at risk for long-term adverse physical and mental effects, but little is known about the effects of illness in siblings of these patients. In a study reported in The Lancet Oncology, Lasse Wegener Lund, MD, of the Danish Cancer Society Research Centre and...

issues in oncology

Applying Molecular Profiling to Clinical Practice: Promises and Challenges 

A “new kind of pathology,” with anatomy and histology being supplemented by molecular etiology, has been emerging over the past decade and promises better response rates among patients with cancer, as genomic alterations continue to be identified and treated with targeted therapies. “The list of...

leukemia

Front-Line Treatment Strategies to Achieve Long-Term Control of CLL Combined With Optimal Quality of Life 

“The management of chronic lymphocytic leukemia (CLL) is undergoing profound changes. Several new drugs have been approved for CLL treatment (fludarabine, bendamustine [Treanda], and the monoclonal antibodies alemtuzumab [Campath], rituximab [Rituxan], and ofatumumab [Arzerra]), and many more drugs ...

skin cancer

Intralesional Cytokine Therapy in Cutaneous Melanoma: A Call for Clinical Trials

Cutaneous melanomas are mostly an immunogenic group of tumors, but they are also heterogeneous. Therefore, therapeutic specificity and autogenetic approaches are essential to secure beneficial results. The objective of sentinel lymph node biopsy, at the time of diagnosis, is to identify patients...

SIDEBAR: Expect Questions About Contralateral Prophylactic Mastectomy: Carefully Review Risks and Alternatives

Physicians were considered the most important source of information about contralateral prophylactic mastectomy in a survey of 123 women who were diagnosed with cancer in one breast and chose to have the contralateral procedure. While 80% of the women reported that they spoke with their physicians...

lung cancer

Low-Dose CT Screening Identifies More Early Lung Cancer but Has Lower Positive Predictive Value vs Radiography  

Results of the two rounds of annual incidence screening with low-dose computed tomography (CT) vs radiography in the National Lung Screening Trial (NLST) were recently reported by Denise R. Aberle, MD, Professor of Radiology and Bioengineering at the University of California at Los Angeles and...

thyroid cancer

Cabozantinib in Medullary Thyroid Cancer: A Landscape-Shaping New Treatment 

Medullary thyroid cancer is derived from parafollicular C cells in the thyroid gland. The disease is sporadic in about 75% of cases and hereditary in the remaining 25%.1 Oncogenic mutations in the gene for tyrosine kinase receptor rearranged during transfection (RET) are driver genetic alterations...

health-care policy

AACR Cancer Progress Report 2013 Highlights Critical Importance of Biomedical Research 

On September 17, the American Association for Cancer Research (AACR) presented highlights of its 2013 Cancer Progress Report1 at the National Press Club in Washington, DC. AACR Chief Executive Officer Margaret Foti, PhD, MD (hc), opened the program with a double-edged message, first citing the...

lung cancer

'Master Protocol' Could Revolutionalize Trials in  Lung Cancer, and Eventually Other Cancers 

Cancer advocates and clinical trialists, for some time, have been proposing a radical change to the laborious drug development process—that industry, academia, funding sources, and other stakeholders actually pool their brain power and financial means and work together, not separately, to develop...

issues in oncology
legislation

A Look Ahead: How the FDA Is Adapting in the Era of Precision Medicine  

Dubbed “Cancer Czar” by the media, Richard Pazdur, MD, Director of the U.S. Food and Drug Administration (FDA) Office of Hematology and Oncology Products, said he has the “best job in oncology, with a unique vantage point in cancer drug development.” An oncologist for more than 30 years—including...

legislation

The Devastating Impact of Sequestration on Medical Research

The primacy of science and the overwhelming belief in medical research by the American people has sustained the research community and improved quality of life roughly since the turn of the 20th century. Almost without exception, the American people have voted for politicians who promise improved...

Expert Point of View: Paul Baas, MD, PhD

“It is very good to have a drug for patients who are smokers and former smokers. The antibody works in both adenocarcinoma and squamous cell carcinoma, and is already very active in phase I with very few side effects. This is such impressive data that [perhaps] we could leap directly to a phase III ...

issues in oncology

FDA Hears Proposals on Codevelopment of Companion Diagnostics for Breakthrough Therapies

A companion diagnostic developed for use with a drug that has received Breakthrough Therapy designation from the U.S. Food and Drug Administration (FDA) should automatically be eligible for priority review, according to an expert panel that presented this proposal and four others to the FDA in...

lymphoma

Two Patients in One, Mom and Baby: Managing Coincident Pregnancy and Lymphoma

The news that she is both pregnant and has been found to have a potentially lethal malignancy is one of the most emotionally wrenching events any young woman ever faces. Understandably, the patient, her partner, their families, and even their caregivers find this experience fraught with anxiety and ...

lymphoma

Multicenter Analysis of Outcomes of Lymphoma in Pregnancy

Lymphoma is the fourth most frequent cancer to occur in pregnant women. In a multicenter retrospective analysis reported in Journal of Clinical Oncology, Andrew M. Evens, DO, MSc, Chief of Hematology/Oncology at Tufts University Medical Center, Boston, and colleagues examined treatment,...

palliative care

New Report Examines Trends in End-of-Life Care

Although fewer Medicare patients with cancer died in the hospital in 2010 than in the years 2003–2007, aggressive treatment continues at the end of life, according to a new report from the Dartmouth Atlas Project.1 The findings also show that a significant number of patients were likely to receive...

prostate cancer

Finasteride for Prostate Cancer Prevention: Long-Term Results Disappointing but Reassuring

All medical care should seek to achieve one or more of three goals: to relieve suffering, to prevent future suffering, or to prolong life. Care for cancer is no exception, and minimizing suffering from cancer and prolonging life has primarily resulted from advances in treatment. Although there are...

gynecologic cancers

Trebananib Improves Progression-Free Survival in Recurrent Ovarian Cancer

Trebananib, an investigational antiangiogenesis inhibitor with a different mechanism of action than bevacizumab (Avastin), significantly improved progression-free survival in recurrent platinum-resistant and partially platinum-sensitive ovarian cancer in the phase III TRINOVA-1 trial. The addition...

gynecologic cancers

Cediranib Achieves 'Groundbreaking' Results in Relapsed Ovarian Cancer

The investigational oral vascular endothelial growth factor (VEGF) inhibitor cediranib extended progression-free survival when given with platinum-based chemotherapy and improved overall survival when given as maintenance therapy in patients with recurrent ovarian cancer. Experts are hopeful that...

breast cancer

Strong Showing for Ado-Trastuzumab Emtansine in Advanced HER2-Positive Heavily Pretreated Breast Cancer

Results of the phase III TH3RESA trial show that the antibody-conjugate ado-trastuzumab emtansine (Kadcyla), formerly known as T-DM1, extends progression-free survival in women with advanced HER2-positive breast cancer that progressed on two or more previous HER2-directed therapies including...

health-care policy

IOM Report Illuminates U.S. Cancer Care Crisis and Offers Framework for Change

In September, the Institute of Medicine (IOM) of the National Academies issued its report, Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis,1 published more than a decade after its first study on the quality of cancer care in the United States. The authors of the...

skin cancer

Ipilimumab Conveys Long-Term Survival Benefit in Pooled Analysis of Metastatic Melanoma Patients

In the treatment of metastatic or locally advanced unresectable melanoma, the anti–CTLA-4 monoclonal antibody ipilimumab (Yervoy) conveys long-term survival benefits, with some patients alive out to 10 years, according to the largest survival analysis of the immunomodulating agent, presented at the ...

gastrointestinal cancer

Gastric Cancer: Time to Revisit Angiogenesis

Progress in the treatment of gastric cancer has lagged behind advances in other solid tumor malignancies. A modest but clear survival benefit with the use of adjuvant therapy combined with surgery has been achieved, including the use of postoperative adjuvant chemotherapy as shown in large-scale...

survivorship

Benefits and Controversies in Survivorship Care Plans

Since the Institute of Medicine’s (IOM’s) 2005 report, From Cancer Patient to Cancer Survivor: Lost in Translation,1 survivorship plans have received growing attention. In short, a survivorship care plan is the record of a patient’s cancer history and recommendations for follow-up care. At ASCO’s...

Expert Point of View: Eric Van Cutsem, MD, PhD

Eric Van Cutsem, MD, PhD, Professor of Internal Medicine at the University of Leuven in Belgium, the formal discussant of the late-breaking abstract, noted there is strong rationale for studying TP53 status in relation to rectal cancer outcomes, but he felt the findings of EXPERT-C could not yet be ...

health-care policy
cost of care

Innovative Payment Models Needed to Sustain Quality Cancer Care  

Nationally regarded health-care expert Lee N. Newcomer, MD, MHA, began his presentation at this year’s ASCO Quality Care Symposium with a rhetorical question. “Why are we talking about money when we’re gathered in San Diego for 2 days to discuss some wonderful ways to impact the quality of cancer...

kidney cancer

Cancer Has Given Me a Greater Appreciation for Life

I’ve been blessed with good health for most of my life, and I was careful to keep it that way. I don’t smoke, I eat a healthy diet, and I maintain a healthy weight. I also was fortunate to be born with pretty good genes and have no family history of cancer. In fact, except for an occasional...

integrative oncology

Ginkgo biloba

The use of dietary supplements by patients with cancer has increased significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and...

health-care policy

National Cancer Policy Summit: Setting Priorities for the Next 3 Years

Welcome to the meeting we hold every 3 years to choose our next projects,” said John Mendelsohn, MD, Chair of the National Cancer Policy Forum and Director of the Khalifa Institute for Personalized Cancer Therapy at The University of Texas M.D. Anderson Cancer Center, Houston. “We have here a...

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