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Showing 2551 - 2600Expect Questions About Physical Activity and Reduced Mortality Risks
A study finding that just doing some leisure time physical activity reduces overall and cancer-specific mortality by 20% and that more activity can provide even greater survival benefits concludes that health-care professionals should encourage inactive patients to perform more leisure time...
Just Engaging in ‘Some’ Leisure Time Physical Activity Reduces Overall and Cancer-Specific Mortality
There’s good news for those who recognize the benefits of exercise but feel they have neither the time nor energy for frequent workouts: A recent study reported in JAMA Internal Medicine1 has found that just performing “some” leisure time physical activity, even below the recommended minimum level, ...
IGF2 May Be Target in Colorectal Cancer With Stable Disease As Response to Anti-EGFR Therapy
In a study exploring the mechanisms of stabilized disease vs tumor regression with targeted anti–epidermal growth factor receptor (EGFR) therapy in colorectal cancer reported in Science Translational Medicine, Zanella and colleagues found that stable disease as response was characterized by...
The Paradox of Positive Thinking
The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...
Unexpectedly Huge Survival Benefit With Pertuzumab and Trastuzumab in HER2-Positive Metastatic Breast Cancer
In my opinion, the combination of pertuzumab (Perjeta) and trastuzumab (Herceptin) is one of the most important advances in the field of metastatic breast cancer in the past 10 years. As recently reported by Swain, my other colleagues, and me and reviewed in this issue of The ASCO Post, the...
CLEOPATRA Overall Survival Analysis: Significant Benefit for Pertuzumab Plus Trastuzumab/Docetaxel in HER2-Positive Metastatic Breast Cancer
As reported in The New England Journal of Medicine by Sandra M. Swain, MD, of Washington Cancer Institute, MedStar Washington Hospital Center, and colleagues, the final prespecified overall survival analysis in the phase III CLEOPATRA study showed a significant 15.7-month increase in median overall ...
Pembrolizumab vs Ipilimumab: Good vs Better
The treatment landscape for metastatic melanoma has recently undergone a remarkable transformation. Prior to 2011, clinicians and patients were presented with difficult decisions between therapies without proven survival benefit. Now, similarly difficult but much more hopeful choices are posed...
Anti–PD-1 Antibody Pembrolizumab Improves Progression-Free and Overall Survival vs Ipilimumab in Advanced Melanoma
In the phase III KEYNOTE-006 trial reported in The New England Journal of Medicine,1 Caroline Robert, MD, PhD, Head of the Dermatology Unit at the Institut Gustave Roussy, Paris, and colleagues found that the anti–programmed cell death protein 1 (PD-1) antibody pembrolizumab (Keytruda) increased...
Welcome to Multikinase Inhibitors in Radioiodine-Refractory Thyroid Cancer
In the past 2 decades, the incidence of thyroid cancer has risen steeply, with rates now growing by 5.5% annually.1 In 2014, 62,980 new cases of thyroid cancer were diagnosed in the United States. The good news is that, overall, the prognosis of thyroid cancer remains excellent; 97.8% of patients...
Large Improvement in Progression-Free Survival With Lenvatinib in Radioiodine-Refractory Thyroid Cancer
In a phase III trial reported in The New England Journal of Medicine, Martin Schlumberger, MD, of Institut Gustave Roussy, and colleagues found that the multikinase inhibitor lenvatinib (Lenvima) produced a large improvement in progression-free survival vs placebo in patients with advanced...
Optimizing Treatment for Small, Lymph Node–Negative, HER2-Overexpressing Breast Cancers
Large, randomized phase III clinical trials showed that the addition of HER2-targeted therapy to chemotherapy for patients with early-stage, HER2-overexpressing breast cancers substantially decreased the risk of recurrence and improved survival. The chemotherapy given in these trials varied, but it ...
High Invasive Disease-Free Survival With Adjuvant Paclitaxel and Trastuzumab in Small, Node‑Negative, HER2-Positive Breast Cancers
In a phase II study reported in The New England Journal of Medicine, Sara M. Tolaney, MD, MPH, of Dana-Farber Cancer Institute, and colleagues found that adjuvant paclitaxel and trastuzumab (Herceptin) was associated with high invasive disease-free survival in women with small, node-negative,...
Increased Risk of Secondary Bone Marrow Neoplasia After Adjuvant Breast Cancer Treatment: Risk/Benefit Analysis and Biologic Insights
Ever since the early application of adjuvant chemotherapy for breast cancer decades ago, it has been recognized that there is always a price to pay for its success in reducing breast cancer mortality. Most of that “cost” is commonly considered in terms of the potential morbid short- and long-term...
Maitake
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...
MAINSAIL Trial: Worse Outcomes With Addition of Lenalidomide to Docetaxel-Prednisone in Prostate Cancer
The combination of docetaxel plus prednisone has been a standard therapy in advanced prostate cancer since 2004.1 Since then, there have been multiple randomized phase III trials comparing this standard of care with additional drug therapy. None has demonstrated improvement in outcome. Lenalidomide ...
Answers: Case Report on Chronic Myelogenous Leukemia
Question 1: In the current era of tyrosine kinase inhibitor therapy, which prognostic model is best to assess the prognosis of a person with a new diagnosis of CML? Correct Answer: D. All of the above Expert Perspective Despite not being perfect, all of these scores are reasonably effective at...
PARP Inhibitors: The First Potential Treatment of Hereditary Ovarian Cancers
Poly(ADP-ribose) polymerase (PARP) inhibitors are one of the most exciting new classes of agents in development for the treatment of ovarian cancer. Olaparib (Lynparza), the lead oral PARP inhibitor, received accelerated approval by the U.S. Food and Drug Administration (FDA) for the treatment of...
American College of Physicians Releases Best Practice Advice for Cervical Cancer Screening in Average-Risk Women
In April 2015, the American College of Physicians (ACP) released its clinical advice guideline, Cervical Cancer Screening in Average-Risk Women: Best Practice Advice From the Clinical Guidelines Committee of the American College of Physicians.1 The guideline aims to reduce the overuse of cervical...
Pembrolizumab Safe and Effective in Patients With NSCLC, Especially in Those With Tumors Showing High Levels of PD-L1 Expression
Add lung cancer to the growing list of cancers that may derive benefit from immunotherapy. The KEYNOTE-001 trial found that pembrolizumab (Keytruda) achieved durable responses in a proportion of patients with non–small cell lung cancer (NSCLC) and high levels of expression of the protein PD-L1...
Expert Point of View: Philip L. McCarthy, MD
Another exciting multiple myeloma treatment will be presented at the 2015 ASCO Annual Meeting,” Philip L. McCarthy, MD, Professor of Oncology and Director of the Blood and Marrow Transplant Center at Roswell Park Cancer Institute, Buffalo, New York, commented in an interview with The ASCO Post....
After a Long and Distinguished Career, Robert C. Young, MD, Shows No Sign of Slowing Down
Robert C. Young, MD, ASCO Past President, longtime leader of Fox Chase Cancer Center, and an internationally recognized expert in lymphoma and ovarian cancer, is a forward-looking doctor who is confident about something not in his future: retirement. “I’ll never quit working; I’m just not wired...
Andrew C. von Eschenbach, MD, Went From the Front Lines of Cancer Care to a Bird’s-Eye View of the Changing Oncology Landscape
At the end of the day, I’m still a kid from South Philly,” Andrew C. von Eschenbach, MD, former Director of the National Cancer Institute (NCI) and Commissioner of the U.S. Food and Drug Administration (FDA), told The ASCO Post. Dr. von Eschenbach is the product of a closely knit yet culturally...
Giving Effective Feedback
Charlene M. Dewey, MD, MEd, FACP, Assistant Dean of Educator Development; Associate Professor of Medical Education and Administration; and Associate Professor of Medicine at Vanderbilt University School of Medicine in Nashville, offers these suggestions for effectively communicating feedback to...
How and When to Give Professional Feedback
Providing students and residents with feedback on their medical performance is a key element in their learning and development and ensures that high standards are met, according to Charlene M. Dewey, MD, MEd, FACP, Assistant Dean of Educator Development; Associate Professor of Medical Education and ...
The Promise of Immune Checkpoint Inhibition: Changing the Therapeutic Landscape for Melanoma and Other Malignancies
The past 3 years have witnessed transformative changes in the way that solid tumors and hematologic malignancies are approached, in almost every instance now including consideration of some form of immunomodulation in the first- or later-line therapeutic setting. The greatest success has occurred...
The Basket Trial: An Evolving Clinical Trial Design
The recently published results of the CUSTOM (Molecular Profiling and Targeted Therapies in Advanced Thoracic Malignancies) trial, reviewed in this issue of The ASCO Post, describe a basket trial focused on identifying molecular biomarkers in advanced non–small cell lung cancer (NSCLC), small...
What Is the Future of Intraperitoneal Treatment in Advanced Ovarian Cancer?
An analysis of Gynecologic Oncology Group (GOG) studies recently reported in the Journal of Clinical Oncology by Tewari and colleagues and reviewed in this issue of The ASCO Post showed a survival benefit of intraperitoneal chemotherapy vs intravenous chemotherapy over long-term follow-up in women...
Routine Resection of Cavity Shave Margins Halved Reexcision Rates in Breast Cancer
Taking additional tissue circumferentially around the cavity left by partial mastectomy (“cavity shave margins”) cut the rate of positive margins by nearly 50% and the rate of reexcision for margin clearance by more than 50% compared with standard partial mastectomy with or without the surgeon...
Elective Neck Dissection Beats Watch and Wait Approach in Early Oral Cancer
Elective neck dissection of node-negative early-stage oral cancer at the time of primary surgery improves overall survival and disease-free survival compared with therapeutic neck dissection (ie, therapeutic neck dissection at the time of nodal relapse, or “watch and wait” approach), according to a ...
Agreement on High-Value Screening for Five Common Cancers
Finding agreement on high-value cancer screening among organizations publishing screening guidelines, the American College of Physicians (ACP) issued advice listing the least-intensive screening strategies that all the organizations recommend—as well as strategies not recommended—for five common...
The Pediatric Fitness Program: A Mind-Body Approach
The fundamental challenge in treating children with cancer centers on how to help relieve their suffering while they undergo difficult care. Typically, they do not yet have adult coping skills, and even if they had some ability to cope, many of the issues they face during treatment are...
Pembrolizumab in Advanced NSCLC: The Promise of Immune Checkpoint Inhibitors
Drugs targeting the immune-checkpoint pathways have shown promising activity in non–small cell lung cancer (NSCLC). In a recent article in The New England Journal of Medicine, Garon and colleagues reported the results of the KEYNOTE-001 clinical trial evaluating single-agent pembrolizumab...
PD-1 Inhibitor Pembrolizumab Active in Advanced NSCLC: Outcomes Better With Higher PD-L1 Expression
In the phase I KEYNOTE-001 trial reported in The New England Journal of Medicine,1 Edward B. Garon, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues found that the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda)...
Adjuvant Ipilimumab in High-Risk Stage III Melanoma: Encouraging Study Results Yet Questions Remain
Ipilimumab (Yervoy) is a fully human monoclonal antibody that blocks the negative T-cell regulator cytotoxic T-lymphocyte antigen 4 (CTLA-4) and has improved overall survival for patients with unresectable or metastatic melanoma in two phase III studies.1,2 Based upon these results, ipilimumab was...
American Ginseng
The use of dietary supplements by patients with cancer has increased significantly over the past 20 years 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 ...
Microangiopathic Hemolytic Anemia and Thrombocytopenia
Question 1: In this case, what is the most appropriate next best test? Correct Answer: B. Peripheral blood smear examination. Expert Perspective In the appropriate clinical setting, information obtained from a carefully examined peripheral blood smear film is indispensable. The peripheral blood...
Progress in the Treatment of Patients With EGFR-Mutated NSCLC
Approximately 10% to 15% of patients with advanced non–small cell lung (NSCLC) cancer have mutations in the epidermal growth factor receptor (EGFR) in tumor cells. Specific therapies to inhibit the activity of EGFR-mutated NSCLC have now been clearly shown to improve response rate and...
Early-Phase Studies Show Activity of Novel EGFR Inhibitors Rociletinib and AZD9291 in T790M-Positive NSCLC
Two early-phase studies have shown that the novel epidermal growth factor receptor (EGFR) inhibitors rociletinib and AZD9291 exhibit high activity in non–small cell lung cancer (NSCLC) patients with the EGFR T790M mutation who had progressed on prior EGFR inhibitor therapy.1,2 The T790M mutation...
Cost vs Our Values in Cancer Care
An 80-year-old patient with metastatic prostate cancer asked me to discontinue his treatments, which were costing him more than $1,000 every 3 months. Although he had Medicare, he did not have secondary insurance. I told him that I would seek compassionate-care payment from the pharmaceutical...
A Lasting Legacy
When Emil J Freireich, MD, retires from the University of Texas MD Anderson Cancer Center on September 1, he will have spent 50 years at the institution and a total of 60 years in the pursuit of curing childhood leukemia as well as other cancers and in the educational development of young...
American College of Physicians Releases High Value Care Screening Advice for Five Common Cancers
In a paper published in Annals of Internal Medicine1, the American College of Physicians (ACP) issued advice for screening average risk adults without symptoms for five common cancers: breast, colorectal, ovarian, prostate, and cervical. In a companion piece also published in Annals2, ACP outlined...
Magnetic Resonance Imaging/Ultrasound Fusion: A Promising Technology for Image-Guided Prostate Biopsy
An elegant study by Siddiqui et al1—reviewed in this issue of The ASCO Post—offers compelling evidence for the diagnostic utility of “targeted” prostate biopsy using multiparametric magnetic resonance imaging (MRI) data fused with ultrasound images. The technique involves first performing a...
Microangiopathic Hemolytic Anemia and Thrombocytopenia: Answers From Hematology Expert Review Questions
Question 1: What is the best first step in management of this patient? Correct Answer: C. Start plasma exchange. Expert Perspective Although distinguishing among thrombotic thrombocytopenic purpura, typical hemolytic uremic syndrome, and atypical hemolytic uremic syndrome (see Table 1 in the...
Conquer Cancer Foundation Donor Spotlight: Ludwig Cancer Research
Among the Conquer Cancer Foundation’s newest supporters, Ludwig Cancer Research is an international community of distinguished scientists dedicated to preventing and controlling cancer. Its emphasis on collaboration and long-term support has fostered its role as a leader in immunotherapy and other...
Improved Understanding of Glioma Tumor Biology
The management of patients with lower-grade gliomas is evolving. As evidenced by two recent publications in The New England Journal of Medicine,1,2 reviewed in this issue of The ASCO Post, there has been a substantial increase in our knowledge of the molecular characteristics of these neoplasms....
New Molecular Classifications of Gliomas Established
Two studies reported in The New England Journal of Medicine identified new molecular classifications of glioma that capture biologic and prognostic differences. The Cancer Genome Atlas Research Network identified three prognostically significant subtypes of lower-grade glioma that were identified...
The Conundrum of Estrogen-Receptor Signaling in HER2-Positive Breast Cancer
BOLERO-1—reviewed in this issue of The ASCO Post—is the next installment in a series of randomized trials evaluating the addition of everolimus (Afinitor) to standard therapy in metastatic breast cancer.1 The initial evaluation of everolimus in the HER2-positive metastatic setting looked extremely...
Carfilzomib in Combination With Lenalidomide and Dexamethasone in Relapsed Multiple Myeloma
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. On July 24, 2015, carfilzomib (Kyprolis) was approved for use in...
Moving Forward in Non–Small Cell Lung Cancer: Targeted Combinations and Immunotherapy
The newer targeted therapies and immunotherapies have proven to be a boon to the treatment of lung and other cancers, but how best to deploy those therapies remains a burning question. Another important focus of current research is the identification and validation of biomarkers for these...
‘Right to Try’ Laws: Helpful or Harmful?
Since 2014, “Right to Try” legislation has been sweeping the nation. Created to enable terminally ill patients to gain access to experimental drugs, biologics, and devices by sidestepping the approval process of the U.S. Food and Drug Administration (FDA), at press time, 22 states have enacted...
