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issues in oncology

Institute Initiatives Help Oncologists Integrate Evidence-based Guidelines in Practice

Building on ASCO’s longstanding commitment to drive quality, value, and accountability in cancer care, the Institute for Quality’s initiatives provide oncologists with resources to ensure that every patient receives the highest level of cancer care. Established in 2011, the Institute for Quality...

supportive care

Venous Thromboembolism in Patients with Cancer: Real-world Challenges for the Practicing Oncologist 

The close association between cancer and thrombosis has been recognized now for more than 150 years.1 Not only is it now known that patients with cancer are at substantially increased risk of developing venous thromboembolism, even prior to the diagnosis of cancer, but the association between...

colorectal cancer

Best First-line Treatment for Advanced Colorectal Cancer Remains Unclear 

In patients with advanced colorectal cancer, it remains unclear which biologic agent added to standard chemotherapy is best, even after a head-to-head comparison of two commonly used agents. In the phase III FIRE-3 trial, conducted by the German AIO CRC Study Group, the addition of cetuximab...

colorectal cancer

Looking for Drivers in the Rearview Mirror 

The latest clinical trial looking at combining vascular endothelial growth factor (VEGF) and epidermal growth factor receptor (EGFR) inhibition in metastatic colorectal cancer adds little to our overall understanding of the mechanisms for optimizing selection of patients to receive such therapies....

colorectal cancer

Addition of Brivanib to Cetuximab in Chemotherapy-refractory Metastatic Wild-type KRAS Colorectal Cancer: Key Results 

The addition of a combination of epidermal growth factor receptor (EGFR) and vascular endothelial growth factor (VEGF) inhibitors to chemotherapy has not improved outcome in first-line treatment of advanced colorectal cancer. However, in early-phase evaluation, the addition of the investigational...

breast cancer
skin cancer
multiple myeloma
supportive care
gastroesophageal cancer

New Research Presented in Breast, Gastric, Esophageal Cancers, Melanoma, and Multiple Myeloma, plus Supportive Care 

Attendees at the ASCO Annual Meeting are faced with a major challenge of trying to attend as many important sessions as they can over a 4-day period. Our challenge is to feature the major news in The ASCO Post. In addition to our regular comprehensive coverage of key presentations, the following...

SIDEBAR: Societies Call for Protection of Patient Access to Clinical Trials

American Academy of NeurologyAmerican Association for Cancer ResearchAmerican Cancer Society Cancer Action NetworkAmerican Childhood Cancer FoundationAmerican Diabetes AssociationAmerican Epilepsy SocietyAmerican Heart Association/American Stroke AssociationAmerican Lung AssociationAmerican Society ...

issues in oncology

ASCO Targets Health Disparities, Need for Research in Achieving Health Equity

The American Society of Clinical Oncology (ASCO), the Association of Black Cardiologists (ABC), and the Heart Failure Society of America (HSFA) recently held a Capitol Hill Briefing to draw attention to health disparities among minority and underserved patients and opportunities to achieve health...

issues in oncology

Genomic Heterogeneity Can Lead to the Selection of 'Incorrect' Targeted Inhibitors 

Genomic heterogeneity within tumors and among lesions varies widely, and “discordance among lesions could lead to the selection of the ‘incorrect’ targeted inhibitor,” according to David B. Solit, MD, of Memorial Sloan-Kettering Cancer Center, who spoke at the ASCO/American Association for Cancer...

issues in oncology

Adolescents, Young Adults with Cancer Often Challenged By Unmet Needs Following Treatment 

About 70,000 adolescents and young adults (AYAs) between the ages of 15 and 39 are diagnosed with cancer each year, and in the past 30 years, there has been little or no improvement in survival in this population. In addition to the disease itself, they face many other challenges: reentry into...

colorectal cancer

Link between Red Meat Consumption and Mortality Clarified in Patients with Nonmetastatic Colorectal Cancer  

Evidence shows that diets high in red and processed meat are associated with an increased risk of colorectal cancer. In a study reported in the Journal of Clinical Oncology, Marjorie L. McCullough, ScD, Strategic Director of Nutritional Epidemiology, and colleagues from the Epidemiology Research...

Michael J. Stamos, MD, Elected ASCRS President, Terry C. Hicks, MD, Chosen President-Elect

Michael J. Stamos, MD, Orange, California, was elected President of the American Society of Colon and Rectal Surgeons (ASCRS) at the Society’s Annual Meeting in Phoenix, succeeding Alan G. Thorson, MD, Omaha. Dr. Stamos is the John E. Connolly Professor and Chair of the Department of Surgery at the ...

issues in oncology

Whole-exome Sequencing of NCI-60 Cell Line Panel Provides Genomic Resource for Cancer Biology and Pharmacology 

The NCI-60 cell lines, which represent cancers of the lung, colon, brain, ovary, breast, prostate, and kidney, as well as leukemia and melanoma, are the most frequently studied human tumor cell lines in cancer research and have generated the most extensive cancer pharmacology database worldwide. As ...

colorectal cancer

New Campaign Addresses Rise in Young-onset Colon Cancer

The Colon Cancer Alliance has partnered with Bowel Cancer UK and the Colon Cancer Prevention Project to launch the international Never Too Young awareness campaign, addressing the rise in young-onset (younger than 50 years) colon cancer diagnoses and mortality rates. This global collaboration comes ...

breast cancer
colorectal cancer
lymphoma

ASCO Studies Support Limited Use of 'Routine' Imaging 

The overuse of imaging in oncology workup and surveillance is a timely concern, as health-care dollars shrink and the risk for second malignancies becomes clearer. At this year’s ASCO Annual Meeting, several studies showed that although many routine imaging studies may be unnecessary, physicians...

lung cancer

Low-dose CT Screening for Lung Cancer: Details of First Round of Screening in National Lung Screening Trial 

The National Lung Screening Trial found that 3 years of annual screening with low-dose helical computed tomography (CT) reduced lung cancer mortality compared with chest radiography in older persons who were heavy smokers.1 The Prostate, Lung, Colorectal, and Ovarian Cancer Screening Trial also...

cost of care

Oncologists Speak Out Against the High Cost of Cancer Drugs 

That the United States spends twice as much on health care than other industrialized countries—about $2.8 trillion in 2012—without reaping appreciably better outcomes1 is not news. The topic has been dissected on the front pages of leading newspapers for years and was the subject of the entire...

Expert Point of View: Tim Maughan, MD

Maintenance treatment with capecitabine plus bevacizumab can be considered in clinical practice, according to Tim Maughan, MD, Professor of Clinical Oncology at Oxford University in the United Kingdom, who discussed CAIRO3 at the session. He said that approximately 60% of patients with metastatic...

colorectal cancer

Maintenance Treatment Delays Progression in Metastatic Colorectal Cancer 

For patients with unresectable metastatic colorectal cancer, maintenance treatment with capecitabine (Xeloda) and bevacizumab (Avastin) significantly delayed disease progression and improved overall survival in the phase III CAIRO3 study by the Dutch Colorectal Cancer Group. Miriam Koopman, MD,...

integrative oncology

Ginseng 

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...

skin cancer

Enhanced Treatment, Surveillance Needed for Patients With BRAF-Mutant Melanoma to Prevent Secondary Cancers

Researchers at Moffitt Cancer Center suggest secondary cancers seen in melanoma patients who are being treated for a BRAF gene mutation may require new strategies, such as enhanced surveillance and combining BRAF inhibitor therapy with other inhibitors, especially as they become more widely used....

lung cancer

Will Funding for Lung Cancer Ever Improve?

Lung cancer is the most common cause of cancer-related death in the world. In the United States alone, an estimated 228,190 new cases of lung cancer and 159,480 deaths from lung cancer will occur in 2013. These are alarming statistics when compared to the next four common causes of cancer-related...

issues in oncology

Access to and Appropriate Use of Oncology Drugs Called Into Question by ASCO Studies 

Studies presented at this year’s ASCO Annual Meeting suggest that despite the wealth of amazing oncolytics on the market, drug shortages persist, drug substitutions are common, off-label use of drugs occurs frequently, and patients find their costs burdensome. Drug Shortage Persists The shortage of ...

issues in oncology

Tackling Overdiagnosis and Overtreatment, by Words and by Deeds  

The complexity of the pathologic condition called cancer,” according to a Viewpoint article in the Journal of the American Medical Association,1 “complicates the goal of early diagnosis.” Failure to recognize that cancers are heterogeneous, and that not all progress to metastases and death, can...

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...

solid tumors

Felice Schnoll-Sussman, MD, Named Director of Jay Monahan Center for Gastrointestinal Health at NewYork-Presbyterian/Weill Cornell 

NewYork-Presbyterian/Weill Cornell Medical Center has appointed Felice Schnoll-Sussman, MD, Director of its Jay Monahan Center for Gastrointestinal Health. Dr. Schnoll-Sussman, has served as the Center’s Director of Research since 2007 and Acting Director since 2012. As Director, Dr....

breast cancer

Alcohol Consumption Between Menarche and Pregnancy and Breast Cancer Risk: Factors in Risk Accumulation   

In a study recently published in the Journal of the National Cancer Institute and summarized in this issue of The ASCO Post, we found a relationship between alcohol intake between menarche and first pregnancy and risk for breast cancer. Placing this study in context can help us interpret the data...

colorectal cancer

Important Findings in Metastatic Colorectal Cancer Studies Address Treatment, Management Options

At the Best of ASCO Meeting in Los Angeles, Tony Reid, MD, PhD, Director of the Early Phase Clinical Research Program and Professor of Hematology/Oncology at the University of California, San Diego, reviewed important findings in metastatic colorectal cancer presented at the 2013 ASCO Annual...

breast cancer
colorectal cancer

FDA Approves First Generic Capecitabine to Treat Colorectal and Breast Cancers

The U.S. Food and Drug Administration (FDA) has approved the first generic version of capecitabine (Xeloda), an oral chemotherapy agent used in the treatment of metastatic colorectal cancer and breast cancers. Teva Pharmaceuticals USA has gained FDA approval to market generic capecitabine in 150...

palliative care

Inequality in Delivery of Palliative Radiotherapy Among Black Patients With Cancer and Elderly With Comorbidities  

An analysis of data from more than 51,000 patients with stage IV cancer shows “significant inequality” in the delivery of palliative radiotherapy among the elderly, patients with comorbidity, and black patients with prostate and colorectal cancer, reported James D. Murphy, MD, MS, and colleagues...

SIDEBAR: 2013 New Drug/Indication Approvals* 

1. September 30, 2013: Pertuzumab (Perjeta) Accelerated approval in combination with trastuzumab and docetaxel for the neoadjuvant treatment of HER2-positive, locally advanced, inflammatory, or early-stage breast cancer.  2. September 6, 2013: Paclitaxel protein-bound particles (albumin-bound)...

ASCO President-Elect Candidate Lynn M. Schuchter, MD, FASCO

Cost of Care and Federal Funding How can ASCO address the high cost of cancer care and diminishing federal resources for basic and translational research? In answer to the first part of this question, the rising cost of cancer care has certainly become a focus of national conversation given the...

colorectal cancer

The AVEX Trial

As reported in The Lancet Oncology by Cunningham and colleagues and reviewed in this issue of The ASCO Post, the AVEX trial was an open-label randomized phase III trial limited to patients over the age of 70 years with previously untreated, unresectable metastatic colorectal cancer who were not...

colorectal cancer

Bevacizumab/Capecitabine Improves Progression-Free Survival in Older Patients With Treatment-Naive Metastatic Colorectal Cancer 

Elderly patients are often underrepresented in clinical trials of metastatic colorectal cancer. In the phase III AVEX trial reported in The Lancet ­Oncology,1 David Cunningham, MD, of Royal Marsden Hospital in London and colleagues assessed the addition of bevacizumab (Avastin) to capecitabine in...

colorectal cancer

Panitumumab vs Cetuximab in Chemorefractory Colorectal Cancer: Survival Benefits Comparable  

For the treatment of wild-type KRAS metastatic colorectal cancer in previously treated patients, a head-to-head comparison of the two antibodies—cetuximab (Erbitux) and panitumumab (Vectibix)—that target the epidermal growth factor receptor (EGFR) concluded that they convey similar overall survival ...

Expert Point of View: Alberto Sobrero, MD

Alberto Sobrero, MD, who discussed the VICTOR trial at the European Cancer Congress, said that at this point, adjuvant trials may be unethical, if the findings of multiple observational studies are to be trusted. Apparently, Dr. Sobrero is a believer: He introduced his remarks at the ECC session by ...

colorectal cancer

Aspirin Protects Against Colorectal Cancer Recurrence in PIK3CA-Mutant Tumors 

At the 2013 European Cancer Congress, two investigative teams attempted to explain how aspirin may protect against colorectal cancer recurrences, with one study showing PIK3CA mutations associated with protection from aspirin, but not a COX-2 inhibitor, and the other study implicating HLA class I...

survivorship
supportive care

'Clear and Consistent Protective Effect of Marriage' Found in Patients With 10 Most Clinically Significant Cancers  

A clear and consistent protective effect of marriage among patients harboring one of the 10 most clinically significant malignancies affecting Americans” was found in a study analyzing Surveillance, Epidemiology, and End Results (SEE) data for 734,889 patients diagnosed with lung, colorectal,...

integrative oncology

Omega-3

Common Name: Polyunsaturated fatty acids (PUFAs) Brand Names:  Omegaven, Max-EPA 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...

New Recommendations on HER2 Testing and Colorectal Cancer Follow-up Care

The latest additions to Cancer.Net’s patient-friendly versions of ASCO’s Clinical Practice Guidelines include guidance on HER2 testing, as well as an endorsement of colorectal cancer follow-up care recommendations from Cancer Care Ontario. ASCO Care and Treatment Recommendations (formerly called...

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...

colorectal cancer

Long-Term Colorectal Cancer Incidence and Mortality After Lower Endoscopy

Colonoscopy and sigmoidoscopy have been shown to provide protection against colorectal cancer, but the magnitude and duration of protection, particularly against proximal colon cancer, remain undefined. A study of long-term colorectal cancer incidence and mortality after lower endoscopy reported in ...

colorectal cancer

In Mismatch Repair–Deficient Colon Cancer, Side Matters

In general, we have come to think of mismatch repair–deficient colon cancer as having a more favorable prognosis, being less likely to metastasize to regional nodes or distant sites, and being resistant to fluoropyrimidines. Much of our data, however, come from trials combining stage II and III...

colorectal cancer

Impact of Deficient DNA Mismatch Repair on Disease-Free Survival in Stage III Colon Cancer 

In an analysis reported in the Journal of Clinical Oncology, Frank A. Sinicrope, MD, of the Mayo Clinic and North Central Cancer Treatment Group (NCCTG), and colleagues investigated the association of deficient DNA mismatch repair with prognosis in patients with stage III colon cancer treated with...

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...

colorectal cancer

One in Three American Adults Do Not Comply With Screening Guidelines for Colorectal Cancer 

The percentage of American adults aged 50 to 75 who are up-to-date with recommended screening for colorectal cancer “increased from 54% in 2002 to 65% in 2010, primarily driven by increased use of colonoscopy,” according to data from the 2012 Behavioral Risk Factor Surveillance System survey....

breast cancer

With Genetic Discoveries, Breast Cancer Complexity Grows

Oncologists are getting a handle on BRCA1/2 in breast cancer, becoming more adept at treating and counseling patients with these mutations. But the BRCA mutation is only one example of a host of genetic variations that can increase breast cancer risk, according to James M. Ford, MD, Associate...

palliative care
cost of care

Two Studies Highlight Communication Challenges Facing Medical Oncology

In one study presented at ASCO’s second annual Quality Care Symposium in San Diego, patients receiving chemotherapy with palliative care intent were at high risk of side-effect–related hospitalization, which defeats the clinical purpose and adds preventable costs to health care.1 “There is an...

colorectal cancer

Cetuximab Confers Survival Benefit in All-RAS Wild-Type Colorectal Tumors

The FIRE-3 study compared the two epidermal growth factor receptor (EGFR) antibodies, on top of chemotherapy, in the first-line treatment of metastatic colorectal cancer. A preplanned analysis of KRAS wild-type patients without RAS mutations, ie, “all-RAS wild-type,” showed overall survival to be...

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