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Showing 2401 - 2450Expert Point of View: Bevacizumab Progression-free Survival Benefit Upheld in AVEREL Trial
Modest benefit reported from AVEREL1 triggered comments among trialists about the future of bevacizumab (Avastin) in breast cancer. “Although there’s controversy about the recent revoking of FDA approval of bevacizumab for metastatic breast cancer, I think there is a consensus in our disappointment ...
Bevacizumab Progression-free Survival Benefit Upheld in AVEREL Trial
Bevacizumamb (Avastin) added to trastuzumab (Herceptin) and docetaxel as first-line therapy for HER2-positive advanced breast cancer moderately improved progression-free survival in the phase III AVEREL trial, presented at the 2011 San Antonio Breast Cancer Symposium by Luca Gianni, MD, of the San ...
Carfilzomib May Offer Advantages in Patients with Relapsed/Refractory Multiple Myeloma
Carfilzomib is an oral second-generation proteasome inhibitor with a mechanism of action that may increase efficacy and reduce adverse effects currently associated with proteasome inhibitor therapy. It is being investigated for use in multiple myeloma and select solid tumors, and the FDA has...
What You Should Know about Peginterferon Alfa-2b for Adjuvant Treatment of Melanoma
In the Clinic 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. Indication Peginterferon alfa-2b (PegIntron, Sylatron) was recently ...
Lung Cancer Alliance Announces National Framework for Lung Cancer Screening Excellence
The Lung Cancer Alliance (LCA) moved lung cancer screening to a national platform by announcing a Framework for Lung Cancer Screening Excellence, which includes a bill of rights for the at-risk public and guiding principles for lung cancer screening sites. “The science is indisputable: Screening...
How I Work up the Patient with Thrombocytosis
Thrombocytosis is defined as a platelet count greater than 400 × 109/L. In routine clinical practice, thrombocytosis is much more likely to be reactive (> 80% of cases) than primary. Reactive thrombocytosis is usually associated with infections, inflammation, trauma, hemolysis, metastatic...
FDA Drug Approvals, January–March 2012
Imatinib mesylate tablets (Gleevec) approved for the adjuvant treatment of adult patients following complete gross resection of Kit (CD117) positive gastrointestinal stromal tumors (GIST). Accelerated approval for this indication was granted in December 2008. Vismodegib (Erivedge) capsules...
Rising Costs in Radiation Oncology Linked to Medicare Coverage
In the ongoing debate over how to control rising cancer care costs, it is vital to identify usage patterns of expensive new technologies. A recent study examined the relationship between Medicare reimbursement and the increasing use of intensity-modulated radiation therapy (IMRT).1 The ASCO Post...
Autologous Transplant vs Consolidation Chemotherapy in Acute Myeloid Leukemia: A Recent European Trial
Investigators in the Dutch-Belgian Hemato-Oncology Cooperative Group and the Swiss Group for Clinical Cancer Research Collaborative Group recently reported in the journal Blood that autologous peripheral blood stem cell transplantation significantly reduced relapse rate compared with intensive...
Autologous Hematopoietic Cell Transplantation for Adult Acute Myeloid Leukemia: A Question That Doesn’t Go Away
More than 3 decades ago, the first trials of autologous hematopoietic cell transplantation as consolidation therapy for acute myeloid leukemia (AML) in first remission were conducted. The initial results were inconclusive; most patients survived the procedure, but post-transplant relapse was common ...
Immune Changes Reported with Early Use of Sipuleucel-T in Neoadjuvant Setting for Prostate Cancer
Sipuleucel-T (Provenge) can generate a circulating immune response to treat men with metastatic castrate-resistant prostate cancer, as per its FDA-approved indication.1 A neoadjuvant trial was performed to investigate whether earlier use of sipuleucel-T can generate an immune response in the...
Moving the Field of Geriatric Oncology Forward
With the aging of the population, virtually all of the subspecialties of oncology will soon be concerned primarily with the care of older patients. While there is not one precise definition of the age of “geriatric” patients, it is clear that the aging of our society has necessitated a focus on the ...
FDA Drug Approvals, January–April 2012
Imatinib mesylate tablets (Gleevec) approved for the adjuvant treatment of adult patients following complete gross resection of Kit (CD117) positive gastrointestinal stromal tumors (GIST). Vismodegib capsules (Erivedge) approved for the treatment of metastatic basal cell carcinoma or locally...
New Data Guide Treatment for Rare Form of Hodgkin Lymphoma
Nodular lymphocyte predominant Hodgkin lymphoma (NLPHL) accounts for approximately 5% of Hodgkin lymphoma cases. It is distinguished from classic Hodgkin lymphoma by a variety of clinical and pathologic features, including expression of B-cell associated antigens such as CD20. Given that the...
Update on Novel Anticoagulants: Dabigatran Etexilate
Efficacy and safety of traditional anticoagulants (eg, vitamin K antagonists) are well recognized, given their long-standing use in clinical practice. However, the novel anticoagulants have several potential advantages over the vitamin K antagonists. Even so, in light of their recent introduction...
Advances in Axillary Surgery for Patients with Breast Cancer
Results from the American College of Surgeons Oncology Group (ACOSOG) Z0011 trial, which found no benefit for completion axillary nodal dissection in patients with breast cancer involving one to two positive sentinel nodes,1 have led to changes in breast cancer management, though points of...
AACR Inducts Frank McCormick, PhD, FRS, DSc (hon) as President; Elects Charles L. Sawyers, MD, as President-elect, 2012-2013
Leadership of the American Association for Cancer Research (AACR) inducted Frank McCormick, PhD, FRS, DSc (hon), as President of the society during the AACR Annual Meeting held earlier this month Dr. McCormick is the Director of the University of California, San Francisco (UCSF) Helen Diller Family ...
ACCC Releases Survey on ‘Oncology Medical Home’
The Association of Community Cancer Centers (ACCC) released findings from a survey that explores how community-based cancer care programs view the concept of the “oncology medical home”—a patient-centered model for coordinated care, whereby payers would reimburse physicians for services that keep...
George Kovach, MD, Named as President of the Association of Community Cancer Centers
George Kovach, MD, became President of the Association of Community Cancer Centers (ACCC) at its 38th Annual National Meeting in March 2012. Dr. Kovach is the medical director of the Genesis Cancer Center, Davenport, Iowa, and one of the founding members of the Iowa Oncology Society (IOS). “I am...
ACCC Meeting Focuses on Affordable Care Act: Its Future, and What It Might Accomplish
The Association of Community Cancer Centers (ACCC) mid-March Annual Meeting devoted several sessions to the Patient Protection and Affordable Care Act: Will it still be here after the Supreme Court decides its fate? If so, how much of it will survive, and how will it affect oncology practice? In...
SIDEBAR: Expect Questions from Your Patients: Cervical Cancer Screening Guidelines
Changes in the cervical cancer screening guidelines, as recommended by the U.S. Preventive Services Task Force (USPSTF), mainly concern longer intervals between screening tests and recommended ages when women should start and stop being screened. USPSTF Co-Vice Chair Michael L. LeFevre, MD, MSPH,...
SIDEBAR: Women Who Received HPV Vaccine Still Need Cervical Cancer Screening
The updated cervical cancer screening guidelines from the the U.S. Preventive Services Task Force (USPSTF) note that women who receive the HPV vaccine still need to be screened for cervical cancer because the vaccine does not protect against all strains of HPV that can cause cervical cancer. “The...
SIDEBAR: Could HPV Testing Be Used Alone?
“In the United States, there are no recommendations currently for HPV screening alone as a primary screening test for cervical cancer,” Michael L. LeFevre, MD, MSPH, Co-Vice Chair of the U.S. Preventive Services Task Force (USPSTF) told The ASCO Post. “Cytology picks up very few cases of...
New Guidelines Recommend Less Frequent Screening for Cervical Cancer, but That Doesn’t Mean Screening Is Less Important
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. In March 2012, the U.S. Preventive...
Constructing a Top Five List in Oncology
The American Society of Clinical Oncology has joined the American Board of Internal Medicine (ABIM) Foundation and eight other medical specialty societies to take a collective stand in improving patient care and addressing rising health-care costs. As part of the ABIM Foundation’s Choosing Wisely®...
Clinical Findings and Consequences of Distributing Counterfeit Drugs for Hematology and Oncology
As introduced in our report on page 1 of this issue, counterfeit pharmaceuticals are an increasingly important safety concern, and three of the most prominent drug-counterfeiting episodes in recent years have involved hematology/oncology products. Counterfeit Erythropoietin Helen B., a 61-year-old...
Caveat Oncologist: Counterfeit Pharmaceuticals
In 2002, Tim F., a 17-year-old liver transplant patient, received 40,000 units of erythropoietin weekly, beginning immediately after his transplantation procedure.1 His family had purchased the product from the local CVS Pharmacy, upon his discharge from a Manhattan hospital. After each injection,...
Women Treated with Breast-conserving Surgery More Likely to Have Diagnostic and Invasive Procedures over Time
Women with ductal carcinoma in situ (DCIS) treated with breast-conserving surgery “continue to have diagnostic and invasive breast procedures in the conserved breast over an extended period,” according to a study reported in the Journal of the National Cancer Institute. “The estimated 10-year...
Concepts about Effects of Menopausal Hormone Therapy on Breast Cancer Continue to Change
In 2002, it was thought that menopausal hormone therapy using estrogen alone increases breast cancer risk, although not as quickly as combined estrogen plus progestin. Current thinking about estrogen alone is that it reduces breast cancer risk. This is just one example of changing concepts about...
Fellows of the American Society of Clinical Oncology: 2012 Recipients Will be Honored at ASCO Annual Meeting
Formerly called the ASCO Statesman Award, which launched in 2007, the new distinction of Fellow of the American Society of Clinical Oncology (FASCO) is designed to honor ASCO’s most active volunteer members. “The FASCO status represents recognition for the most dedicated volunteer members inside...
Brachytherapy Associated with Increased Complications Compared to Whole-breast Irradiation following Lumpectomy for Breast Cancer
Among older women with invasive breast cancer and treated with lumpectomy, brachytherapy compared with whole-breast irradiation was associated with a decreased likelihood of long-term breast preservation and an increased likelihood of complications, but no difference in overall survival, according...
Oncology Practices Recognized for Important Work in Clinical Trials
The Conquer Cancer Foundation of ASCO is recognizing six oncology practices from around the country for their work in improving access to clinical trials for patients in their communities. In addition, three ASCO State Affiliate societies are being honored for new projects that enhance cancer care...
Before Accepting a ‘Friend’ Request on Social Media, Carefully Consider the Potential Pitfalls and Perils
To friend or not to friend? That is the question many social networkers ponder daily. Oncologists and other health professionals considering “friend” requests from patients would be wise to first consider the potential pitfalls and perils of accepting such requests, according to an article written...
New Research Shows Promise in Cachexia, a Persistent Clinical Challenge
In the late 1980s, researchers led by Alfred L. Goldberg, PhD, first isolated the large protein complexes now called 26S proteasomes, which are the sites where most cellular proteins are degraded back to amino acids. Protein degradation by the proteasome pathway is critical in regulating many...
Maintenance of Certification in Medical Oncology
It is said that time is perhaps the most treasured asset we have. If you are a practicing oncologist, everyone wants more and more of your time, and I’m not referring to patients. Rather, there is an increasing proliferation of folks who want to make sure we’re doing a good job, and they are...
The Semantics of Palliative Care
The interview with Thomas J. Smith, MD (The ASCO Post, April 15, 2012), the lead author of the ASCO Palliative Care Provisional Clinical Opinion, was timely. However, it left many clinical terms and issues unclear. A significant percentage of modern medicine, including cancer care, is palliative....
Acai Berry
The use of dietary supplements by patients with cancer has risen 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 the...
What You Need to Know About Glucarpidase Injection for Toxic Methotrexate Levels in Renal Impairment
In the Clinic 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. Indication In January 2012, glucarpidase injection (Voraxaze) was...
Denosumab Delays Time to First Bone Metastasis in Men with Castration-resistant Prostate Cancer
Denosumab (Xgeva) significantly delayed time to first bone metastases among men with nonmetastatic castration-resistant prostate cancer enrolled in a phase III randomized, placebo-controlled trial. The time to first bone metastasis was 33.2 months among the 716 patients randomly assigned to receive ...
Markers in Cancer 2012, to be Held October 11–13, Will Seek to Move the Field of Biomarkers to the Next Phase
There are hundreds and hundreds of papers published on biomarkers in cancer each year, but very few make it over the hurdles necessary to be used in actual patient care, said James L. Abbruzzese, MD, Chair of the Department of Gastrointestinal Medical Oncology at the University of Texas MD Anderson ...
Study Validates Prognostic Role of Tumor Lymphocytic Infiltration in Resectable Non–Small Cell Lung Cancer
The benefit from platinum-based adjuvant chemotherapy in non–small cell lung cancer (NSCLC) was demonstrated in four randomized trials (International Adjuvant Lung Cancer Trial [IALT], Canadian JBR.10 trial, Cancer and Leukemia Group B [CALGB] 9633 trial, and Adjuvant Navelbine International...
Cancer Survivors Stand Up, Give Thanks, and Give Back
“I have me back,” is how breast cancer survivor Jeanette Daniel of Memphis described her life after being treated on a clinical trial at Vanderbilt-Ingram Cancer Center in Nashville. Being conducted by the Stand Up To Cancer P13K Dream Team, whose leader discovered the PI3K pathway, the trial...
Maintenance Lenalidomide Improves Progression-free Survival and Time to Progression in Patients with Multiple Myeloma
Three phase III, double-blind, multicenter, randomized studies showed that lenalidomide (Revlimid) maintenance therapy for patients with multiple myeloma significantly improved progression-free survival or time to progression, the primary endpoints of the studies published in The New England...
Better Information Needed for Primary Care Providers Who Treat Cancer Survivors
Many primary care providers are unaware of the late effects of chemotherapy, according to survey results presented at the ASCO Annual Meeting.1 For three out of four commonly used chemotherapy agents, medical oncologists performed well on the survey, but 29% to 38% of medical oncologists were...
Radiotherapy in Early-stage Hodgkin Lymphoma
The treatment of patients with Hodgkin lymphoma is one of the major success stories in medical oncology. Depending on clinical stage, clinical risk factors, and the treatment given, 60% to 90% of all patients can be cured of their malignancy long-term. Hodgkin lymphoma survivors represent one of...
Decoding the Genetic Blueprint of Cancer Cells: Findings in Multiple Myeloma and Breast Cancer
Advances in next-generation DNA sequencing technologies are allowing scientists to decipher the whole genome or whole exome (ie, the coding region of the genome) of cancer specimens more quickly and inexpensively than ever before. And the results are revealing genes that had not previously been...
T-DM1 Proves More Effective, Less Toxic Than Standard Treatment for Metastatic Breast Cancer
Positive results continue to be reported for trastuzumab emtansine (T‑DM1), the antibody-drug conjugate linking trastuzumab (Herceptin) to a cytotoxic agent. Early results of the international phase III EMILIA study, presented at the 2012 ASCO Annual Meeting, showed a 35% reduction in risk of...
New PSA Recommendations: The Debate over Prostate Cancer Screening Continues
The U.S. Preventive Services Task Force (USPSTF) recently issued a recommendation statement advising against the use of prostate-specific antigen (PSA)-based testing for prostate cancer,1 leaving many in the oncology community concerned that decades of clinical progress will be stalled, and setting ...
Soy Phytoestrogens and Breast Cancer: An Enduring Dilemma
The impact of soy consumption on breast cancer diagnosis and outcome has remained of concern to clinicians and researchers for the past 20 years. Although studied extensively in epidemiologic studies as well as lab and animal research, no medical consensus on soy’s effects has emerged. Many studies ...
New Study on Communicating Bad News, from the Patient’s Perspective
There is limited evidence in the literature about how oncologists should discuss bad or serious news with their patients. A recent study sought to understand what patients with cancer value when their doctors communicate news of recurrence.1 The ASCO Post spoke with the study’s lead author, Anthony ...
