INSIDE THE BLACK BOX is an occasional column offering insight into the FDA and its policies and procedures. This installment addresses a changing paradigm in the treatment of lung cancer, exemplified by concurrent approval of a companion diagnostic with each of several new targeted agents or new...
We have an aging population, which is a good thing since people are living longer. [But] cancer is a disease that tends to occur most frequently in older people, so the combination of those two events will lead to many more older people with cancer, a larger cancer population in general, and a...
One of the key questions in geriatric oncology is: How can we use all of the work geriatricians have done over the years in general geriatrics and apply that to the field of oncology? One-quarter to one-third of us are going to develop cancer throughout our lifetime, and half of the time it is...
As the American Society of Clinical Oncology celebrates its 50th anniversary, ASCO’s Chief Executive Officer Allen S. Lichter, MD, FASCO, recently talked with The ASCO Post about the Society’s past, present, and future. Important Milestone What are your thoughts about ASCO’s origins and its 50th...
People with weakened immune systems due to diseases like cancer are at increased risk of severe complications from the flu virus and should get flu shots annually. The Centers for Disease Control and Prevention (CDC) strongly encourages this practice, and most oncologists would recommend that for...
Widespread influenza activity continues to be reported by the Centers for Disease Control and Prevention (CDC), with a recent increase in flu-related hospitalizations.1,2 Patients with cancer are at increased risk from flu complications and should receive the flu shot, but not the flu nasal spray...
“Tomorrow is the most important thing in life. Comes into us at midnight very clean. It’s perfect when it arrives and it puts itself in our hands. It hopes we’ve learned something from yesterday.” —John Wayne Donald L. Morton, MD, transformed the management of melanoma and breast cancer by...
Fourteen years ago, when I was just 29, I was feeling weak and fatigued and had severe pain in my abdomen. I’d had these symptoms for about a year, but none of the several doctors I saw or any of the tests they performed could find the source of my problems. I even had one nurse practitioner tell...
With the advent of Breakthrough Therapy designation, there are now four FDA programs to expedite the development of promising new agents: Fast Track, Breakthrough Therapy, Priority Review, and Accelerated Approval (Table 1). These programs complement one another and serve a common goal: to speed...
It has been a little over a decade since the Institute of Medicine landmark report Unequal Treatment: Confronting Racial and Ethnic Disparities in Health Care found overwhelming evidence of racial disparities in the U.S. health-care system. Since then, ASCO has been dedicated to minimizing these...
PI3K-mediated activation of downstream effectors allows tumors to escape from negative growth control, and this action may be checked with PI3K inhibitors. At the 2013 American Society of Hematology (ASH) Annual Meeting, researchers reported results in patients with relapsed or refractory lymphoma...
Neal J. Meropol, MD, Chief of Hematology and Oncology at University Hospitals Seidman Cancer Center and Case Western Reserve University, discussed the CAIRO3 results at the Gastrointestinal Cancers Symposium. He said there are three main lessons from CAIRO3: (1) It is feasible yet challenging to...
Last September, Jamie H. Von Roenn, MD, left her position as Professor of Medicine at the Northwestern University Feinberg School of Medicine in Chicago to join ASCO as its Senior Director of Education, Science and Professional Development. In her new position, Dr. Von Roenn will provide strategic...
As a medical oncologist and palliative care physician, I’ve had the privilege of caring for cancer patients and delivering primary palliative care and symptom control, as well as the chance to care for patients especially referred for complex pain and symptom problems (in secondary and even...
Jeffrey Miller, MD, Professor of Medicine at the University of Minnesota and Deputy Director of the Masonic Cancer Clinic in Minneapolis, commented on the haploidentical hematopoietic stem cell transplantation studies presented at the American Society of Hematology meeting for The ASCO Post “The...
Michael A. Thompson, MD, PhD, a Medical Oncologist for Aurora Cancer Care and the Medical Director of Early Cancer Research at Aurora Health Care in Wisconsin, has become something of an expert on the Conquer Cancer Foundation. It began in 2006, when he received a Conquer Cancer Foundation of ASCO...
An innovative approach to streamlining the testing of novel agents in breast cancer has yielded some of its first results, which were reported at the 2013 San Antonio Breast Cancer Symposium.1 Adaptive Trial Design The veliparib/carboplatin plus standard neoadjuvant therapy regimen is currently...
The explosion of new therapies for metastatic renal cell carcinoma is a welcome advance, but studies have not yet defined optimal sequencing of the newer therapies. According to the phase III SWITCH trial, it matters little whether therapy for metastatic renal cell carcinoma begins with sorafenib...
In January, Congress approved a $1 trillion appropriations bill for the rest of fiscal year 2014. While the new bill includes $29.9 billion for the National Institutes of Health (NIH)—$1 billion above FY2013 levels after sequestration—including $4.9 billion for the National Cancer Institute (NCI),...
Encouraging results of the large phase III PREVAIL trial represent another positive milestone for men with metastatic castration-resistant prostate cancer. Enzalutamide (Xtandi) improved overall survival by 29% and reduced the risk of radiographic progression of disease by 81% in men who had not...
The state of Virginia encompasses a vast area of 40,000 square miles and is divided into five regions: the Atlantic Coastal Plain, the Piedmont, the Blue Ridge, the Appalachian Ridge and Valley Region, and the Appalachian Plateau. The diverse geography of the state creates unique challenges for...
In 2012, David B. Solit, MD, Geoffrey Beene Chair and Director of the Center for Molecular Oncology at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, and his colleagues published the results of a phase II study1 of 45 patients with advanced bladder cancer. The purpose of the clinical...
Medicare patients make up 61% of new cancer cases in the United States, and as the population ages, that proportion is expected to rise to 70% by 2030. Over the past decade, the oncology community has been financially challenged by alterations in the Medicare payment system. To address the changes...
Encourage your patients to use social media to stay-up-to-date with the new resources available on Cancer.Net. It is easier than ever for patients to get the latest cancer information on their computer or mobile device by subscribing to the Cancer.Net Blog at www.cancer.net/blog, or on...
In 1999, Kornelia Polyak, MD, PhD, of the Dana-Farber Cancer Institute, received a Career Development Award from the Conquer Cancer Foundation for her project, “Isolation of Tumor Suppressor Genes Inactivated in DCIS of the Breast.” “The Career Development Award got me started,” she said. “When...
The professional paths of advanced practitioners (APs) in oncology are as varied as the locations in which they work. The first annual JADPRO Live 2014 educational symposium was held in St. Petersburg, Florida, and hosted by JADPRO, the Journal of the Advanced Practitioner in Oncology. A...
Phase II results suggest that brentuximab vedotin (Adcetris) has encouraging activity in CD30-positive cutaneous T-cell lymphomas and lymphoproliferative disorders, including mycosis fungoides, the most common type of cutaneous T-cell lymphoma. High levels of responses were achieved in a 48-patient ...
There may be an immunogenic phenotype in breast cancer that could benefit from immune modulation as part of treatment, according to results from studies that correlated high levels of tumor-infiltrating lymphocytes with both pathologic complete responses and long-term outcomes. Studies presented at ...
Early last year, just as I returned to my residency in neurologic surgery at Stanford University after completing 2 years of my postdoctoral fellowship in a laboratory developing optogenetic techniques, I started losing weight—dropping from 180 lb to 160 lb in just 6 months—and I was having fairly...
Oncology is a demanding field that requires special qualities to care for very sick patients, many of whom will die prematurely of their disease. Research indicates that years of facing life-and-death decisions in the clinic can be associated with oncology burnout syndrome, which effects physician...
Extended follow-up in the Scandinavian Prostate Cancer Group Study Number 4 (SPCG4), reported recently in The New England Journal of Medicine,1 found that men with early-stage prostate cancer, particularly those under 65 years old, who were treated with radical prostatectomy had increased survival...
When I was diagnosed with multiple myeloma in 2008, at just 47, I was lucky. I was asymptomatic, my cancer was detected through a routine blood test, and I had the smoldering type, so I didn’t need immediate treatment. Plus, I knew that recent advances in more effective therapies were making it...
In 2011, the Multiple Myeloma Research Foundation (MMRF) announced the launch of CoMMpass (Relating Clinical Outcomes in Multiple Myeloma to Personal Assessment of Genetic Profile), a clinical study at the heart of its Personalized Medicine Initiative. CoMMpass will follow 1,000 newly diagnosed...
Although cancer survival rates among pediatric and older adult patients continue to rise, survival rates for adolescents and young adults (AYAs), defined by the National Cancer Institute as those between the ages of 15 and 39, have remained stagnant for decades. In breast cancer especially, AYAs...
Margaret Foti, PhD, MD (hc), CEO of the American Association for Cancer Research (AACR), welcomed about 150 congressional staffers to a March briefing in Washington, DC, with a plea for increased federal funding. “Extraordinary progress is being made in cancer research today, as evidenced by the...
Learning about the particulars of each cancer patient’s pain and treating each case uniquely is the key to keeping pain manageable. That is the goal of the Duffey Pain and Palliative Care Program at The Sidney Kimmel Comprehensive Cancer Center in Baltimore. The team consists of physicians, nurse...
Preclinical models have suggested that cancer stem cells play a role in tumor recurrence and metastasis following adjuvant therapy, and Max S. Wicha, MD, and his research team are deciphering the mechanisms by which this might happen. A true understanding of cancer stem cells will have important...
"Double-hit” lymphomas remain challenging tumors, and the best means of treatment remains somewhat elusive, according to studies presented at the 2013 American Society of Hematology (ASH) Annual Meeting in New Orleans, and experts who commented on these findings. “We still don’t have a standard of...
For much of her career in oncology, Teresa A. Gilewski, MD, has sought to bridge the science of medicine with the humanistic aspect of care. She has created the Art of Medicine lecture series at Memorial Sloan Kettering Cancer Center in New York, where she is a medical oncologist on the Breast...
In February, the American Psychosocial Oncology Society (APOS) held its 11th Annual Conference in Tampa, Florida, and it marked a number of firsts. With over 500 registrants and more than 300 abstracts presented over the 3-day program, this was the largest APOS event to date. The theme of this...
Throughout the year, we are celebrating not only ASCO’s 50th anniversary, but also the tremendous progress achieved against cancer in the last 50 years. Thanks to the dedication and contributions of patients and researchers, and our nation’s long-standing commitment to funding clinical research,...
The term “novel agents” has been used for the past decade to describe proteasome inhibitors and immunomodulatory drugs that are now conventionally used for multiple myeloma. However, even newer agents in development will be considered truly novel when they hit the market, as they represent new...
The panel presented two case studies—one on high-dose methotrexate toxicity and one on 5-FU toxicity—as a platform for discussion of considerations, challenges, and interconnected roles of oncologists, nurse practitioners, physician assistants, and clinical pharmacists in safely managing patients...
The challenge of deciding when to administer uridine triacetate was explored by the panel. Dr. Schwartzberg: I assume uridine triacetate would work more effectively if given very early; otherwise we would see the same kind of downstream toxicity we see with methotrexate. Dr. Campen: Exactly, but...
Q. What is uridine triacetate? A. It is an investigational, orally active prodrug of uridine currently under development as an antidote to overexposure of fluorouracil (5-FU). Although not yet approved by the U.S. Food and Drug Administration, it has been shown to be effective in treating patients...
Indications and Dosing of Methotrexate and 5-FU Dr. Campen: The interesting thing about methotrexate is that it has been used for such a long time. You would think there would be a specific dose that would be considered “high dose,” but high dose is actually quite variable. [Dosage] depends on the...
In an op-ed article in The New York Times (February 27, 2014) about the challenges of designing training courses to help physicians communicate more effectively with patients about important topics such as end-of-life care, Timothy D. Gilligan, MD, and Mikkael A. Sekeres, MD, of the Cleveland...
Although most patients want to know about the potential outcome of their disease and whether treatment is likely to have a significant impact on it, the information needs of patients and how best to fulfill those needs are very variable, Walter F. Baile, MD, told The ASCO Post. Dr. Baile is...
When the prognosis is poor, breaking the bad news badly can exacerbate the distress experienced by cancer patients and their families. A lack of sensitivity to patient and family emotions and not being attuned to how individual patients would prefer to be informed about their prognoses can result...
I’ve been health conscious all my life. I have never smoked, I eat a healthy diet, and I have maintained a near-daily exercise routine since I was 20. I’m also steadfast about keeping yearly medical checkups and screenings. So when I felt a sharp, lightning-bolt of pain that went from the top of my ...