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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...

hepatobiliary cancer

Targeted Suppression of a Reactivated Developmental Pathway in Hepatocellular Cancer 

This issue of The ASCO Post summarizes the results of an important study recently published in The New England Journal of Medicine by Yong and colleagues. As outlined, investigators from the National University of Singapore Yong Loo Lin School of Medicine have identified re-expression of SALL4 as a ...

hepatobiliary cancer

Oncofetal Protein SALL4 Is a Marker of Aggressive Hepatocellular Carcinoma and a Potential Therapeutic Target  

Hepatocellular carcinomas with characteristics of embryonic stem cell and progenitor cell gene expression are associated with particularly poor prognosis. SALL4 is an oncofetal protein that is expressed in the human fetal liver and normally silenced in the adult liver, but re-expressed in a...

palliative care

Diane E. Meier, MD: From Early Lessons in Critical Thinking to 'Palliative Care Everywhere' 

Although the world is full of suffering, it is full also of the overcoming of it.  —Helen Keller, Optimism, 1903 Shortly past 8:00 AM on July 1977, Diane E. Meier, MD, FACP, began the first day of her medical internship. Within minutes she would experience another first: the death of a patient...

lung cancer

Evolving Issues in Low-dose CT Lung Cancer Screening 

Over a decade has passed since the start of the National Lung Cancer Screening Trial and more than 2 years since the first report indicating that this randomized study had demonstrated a significant reduction in lung cancer mortality with low-dose computed tomography (CT) screening.1 That favorable ...

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...

lung cancer

Where Are We With ALK Inhibition in Lung Cancer? 

The prospective phase III PROFILE 1007 study compared the ALK inhibitor crizotinib (Xalkori) to chemotherapy in patients with advanced non–small cell lung cancer (NSCLC) with ALK gene–rearranged tumors refractory to previous chemotherapy. The study showed a clear superiority for crizotinib in terms ...

lung cancer

Crizotinib Improves Progression-free Survival vs Pemetrexed or Docetaxel in Advanced ALK-positive NSCLC  

In a phase III trial reported by Alice T. Shaw, MD, PhD, a thoracic oncologist at Massachusetts General Hospital, Boston, and colleagues in The New England Journal of Medicine, crizotinib (Xalkori) improved progression-free survival compared with standard chemotherapy in previously treated patients ...

lymphoma

PET/CT Superior to Bone Marrow Biopsy for Diagnosis, Prognosis in Lymphoma 

A more precise method for determining bone marrow involvement in patients with diffuse large B-cell lymphoma has been identified by researchers in a study published recently in The Journal of Nuclear Medicine.1 Imaging with 18F–fluorodeoxyglucose positron-emission tomography/computed tomography...

lymphoma

Ibrutinib Produces High Response Rate in Patients with Refractory Mantle Cell Lymphoma

Ibrutinib is a first-in-class oral covalent inhibitor of Bruton’s tyrosine kinase, a mediator of the B cell-receptor signaling pathway implicated in the pathogenesis of B-cell cancers. As reported in The New England Journal of Medicine, Michael L. Wang, MD, of The University of Texas MD Anderson...

leukemia

High Rate of Durable Remissions with Ibrutinib in Patients with Relapsed Chronic Lymphocytic Leukemia 

Durable remissions are uncommon with current treatments for relapsed chronic lymphocytic leukemia (CLL). Bruton’s tyrosine kinase is an essential component of B cell–receptor signaling that mediates interactions with the tumor microenvironment and promotes survival and proliferation of CLL cells....

gynecologic cancers

CDC Report Shows Stagnated HPV Vaccination Rate for Girls 

For the first time since the human papillomavirus (HPV) vaccine became available for adolescent girls in 2006, the vaccination rate for teenagers has stalled, according to data published in the Centers for Disease Control and Prevention’s (CDC’s) Morbidity and Mortality Weekly Report. The data...

issues in oncology

FDA Invites Public Input on Menthol in Cigarettes

The U.S. Food and Drug Administration (FDA) has issued an Advance Notice of Proposed Rulemaking (ANPRM) seeking additional information to help the agency make informed decisions about menthol in cigarettes. Despite decades of work to reduce tobacco use in the United States, it continues to be the...

Expert Point of View: Ranjana Advani, MD

At the 2013 ASCO Annual Meeting, Ranjana Advani, MD, the Saul A. Rosenberg, MD, Professor of Lymphoma at Stanford University Medical Center, Palo Alto, California, discussed the promise of the B-cell signaling inhibitors idelalisib and ibrutinib in lymphoma. Biggest Question Given the...

lymphoma

B-cell Receptor Signaling Inhibitors Moving Forward in Lymphoma 

Though still in early-phase studies, novel B-cell receptor signaling inhibitors look very promising for the treatment of lymphoma, according to reports from the 2013 ASCO Annual Meeting. Idelalisib in Non-Hodgkin Lymphoma In non-Hodgkin lymphoma (NHL), idelalisib looked impressive as both a single...

Expert Point of View: ­Johan F. Vansteenkiste, MD, PhD

Formal discussant Johan F. Vansteenkiste, MD, PhD, Professor of Internal Medicine at University Hospital KU, Leuven, Belgium, was also enthusiastic about the findings in the concurrent chemoradiotherapy arm, and believes that a confirmatory trial should be done. “Does the promise of immunotherapy...

lung cancer

Tecemotide Vaccine Warrants Further Study in Unresectable Stage III Non–Small Cell Lung Cancer 

Results of the START trial suggest that maintenance therapy with the investigational immunotherapy tecemotide (formerly known as L-BLP25) may have a role in the treatment of patients with unresectable stage III non–small cell lung cancer (NSCLC). Although there was no significant overall survival...

lung cancer

Acquired Resistance to Crizotinib from ROS1 G2032R Mutation  

The ALK inhibitor crizotinib (Xalkori) has also shown activity in lung cancers with ROS1 translocations. As recently reported by Mark M. Awad, MD, PhD, of Massachusetts General Hospital, Boston, and colleagues in The New England Journal of Medicine, a mutation conferring resistance to crizotinib...

lung cancer

SIDEBAR: ‘Major Milestone in War on Cancer’ 

The recommendation by the U.S. Preventative Services Task Force (USPSTF) for the use of low-dose, computed tomography (CT) to detect early lung cancer in high-risk individuals is a major milestone in the war on cancer. Lung cancer is the leading cause of cancer death across the world. Despite...

lung cancer

U.S. Preventive Services Task Force Recommends CT Screening for Lung Cancer in High-risk Individuals

The U.S. Preventive Services Task Force recently posted its final evidence report and draft recommendation statement on screening for lung cancer. The Task Force is providing an opportunity for public comment on this draft recommendation statement until August 26. All public comments will be...

Expert Point of View: ­Jonathan S. Berek, MD 

The CHORUS trial had similar results to the previous European Organisation for Research and Treatment of Cancer (EORTC) 55971 study, showing noninferiority for primary debulking surgery followed by chemotherapy vs neoadjuvant chemotherapy followed by surgery and additional chemotherapy, said formal ...

Expert Point of View: ­Jonathan S. Berek, MD

Weekly vs every-3-week therapy is a somewhat controversial area in ovarian cancer, said formal discussant of the MITO-7 trial, ­Jonathan S. Berek, MD, Director of the Stanford Women’s Cancer Center, Palo Alto, California. “[Japan Clinical Oncology Group (JCOG)]-16 showed a survival advantage for...

gynecologic cancers

Weekly Carboplatin/Paclitaxel Improves Quality of Life, Toxicity vs Every-3-week Regimen in Advanced Ovarian Cancer 

Patients with advanced ovarian cancer have similar survival outcomes thus far with a weekly regimen of carboplatin/paclitaxel vs the standard every-3-week regimen, but the weekly regimen is much better tolerated with improved quality of life, according to final results of the Multicenter Italian...

Expert Point of View: Judy Garber, MD, MPH

Judy Garber, MD, MPH, Professor of Medicine at Harvard Medical School and Director of the Cancer Risk and Prevention Center at Dana-Farber Cancer Institute, Boston, was the formal discussant of the GeparSixto paper. The rationale for studying platinum in triple-negative breast cancer is clear: The...

breast cancer

GeparSixto Study Finds Benefit for Neoadjuvant Carboplatin in Triple-negative Breast Cancer 

In patients with triple-negative breast cancer, the addition of carboplatin significantly improved the rate of pathologic complete response after neoadjuvant chemotherapy in a study by the German Breast Group (GBG)/Gynecologic Oncology Working Group–Breast (AGO-B) reported at the 2013 ASCO Annual...

issues in oncology

Molecular Tests and Precision Medicine: Not So Fast Now!

The era of the application of genomic, proteomic, and a host of other “omic” analyses to guide decision-making in the therapeutic selection of drugs and biologics is now a key part of cancer care. Medical practice is working to keep up with the scientific advances, evaluate them, and add a variety...

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,...

prostate cancer

Printed and Web-Based Decision Aids Improved Informed Decision-Making but Didn’t Alter Screening 

Amid conflicting recommendations for prostate cancer screening and mixed messages communicated to the public about screening effectiveness, decision aids can assist men in making informed choices. A comparison of two different types of decision aids, one print-based and one Web-based, found that...

gynecologic cancers

'Best-Ever' Published Prognostic Factor for Early-Stage Type 1 Endometrial Cancer 

Immunohistochemical demonstration of the L1 cell adhesion molecule (L1CAM; CD171) “has been shown to be the best-ever published prognostic factor” in Federation Internationale de Gynecologie et d’Obstetrique (FIGO) stage I, type I endometrial cancers “and shows clear superiority over the standardly ...

breast cancer

Long-Term Current Use of Calcium Channel Blockers Is Associated With Higher Risk of Breast Cancer  

Long-term use of a calcium channel blocker to treat hypertension is associated with higher breast cancer risk, according to a report published online by JAMA Internal Medicine. Researchers evaluated associations between various classes of hypertensives, the most commonly prescribed class of...

breast cancer

Nodal Metastases More Likely if Tumors Have Breast Cancer Stem and Progenitor Cells With PI3K/Akt Signaling Defects 

Patients with breast tumors in which breast cancer stem and progenitor cells have a genetic abnormality of the PI3K/Akt signaling pathway are more likely to have lymph node metastases, according to a study in JAMA Surgery. “These oncogenic defects may be missed by gross molecular testing of the...

lung cancer

Role of Erlotinib in EGFR Wild-Type Lung Cancer 

I welcomed Matthew Stenger’s Journal Spotlight on the TAILOR trial in the August 15 issue of The ASCO Post (“Docetaxel Superior to Erlotinib in Second-Line Treatment of Advanced Non–Small Cell Lung Cancer With Wild-Type EGFR”). The trial was recently published online in Lancet Oncology,1 and...

Expect Questions From Patients About Active Surveillance 

While National Comprehensive Cancer Network (NCCN) practice guidelines for prostate cancer advise that active surveillance is usually appropriate for men with very low-risk prostate cancer and a life expectancy ≤ 20 years, a Johns Hopkins study suggests that outcomes for African American men...

prostate cancer

Active Surveillance of Very Low-Risk Prostate Cancer Might Not Be Suitable Option for African American Men 

African American men with prostate cancer that meets current criteria for very low-risk disease might actually be harboring larger and more aggressive tumors that make active surveillance a less viable option, according to the results of a study published online in the Journal of Clinical Oncology1 ...

lymphoma
survivorship

I'm Not the Person I Was Before Cancer 

I’ve been the caretaker for my husband Will since he suffered three strokes in March 2011, followed by a diagnosis of leukemia a few months later. Now, our roles have reversed, and Will is taking care of me as I go through treatment for stage III follicular non-Hodgkin lymphoma (NHL). It’s been a...

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...

gynecologic cancers

Role of Epithelial-to-Mesenchymal Transition in Ovarian Cancer 

In a study of ovarian cancer cells taken from patients, scientists from Georgia Institute of Technology have confirmed that metastasizing cancer cells have a different molecular structure from primary tumor cells and display genetic signatures consistent with epithelial-to-mesenchymal transition....

issues in oncology

Family Members of Children With Cancer Are Also at Risk for the Disease 

Parents and siblings of children with cancer have between a two- and four-times increased risk of developing cancer than first-degree relatives with no childhood cancer patients, according to a study published in the International Journal of Cancer.1 The study, led by Joshua Schiffman, MD, Medical...

Oncology Meetings

September Georgia Society of Clinical Oncology 2013 GASCO Annual MeetingSeptember 6 • Atlanta, GeorgiaFor more information: www.gasco.us SGI Summit Turkey 2013: Innovations in Obstetrics and GynecologySeptember 6-8 • Istanbul, TurkeyFor more information: www.sgiturkey2013.org/ Breast Cancer...

issues in oncology
health-care policy

Combining Community Practice and Health Policy Advocacy 

Barbara L. McAneny, MD, is a board-certified medical oncologist/hematologist with a robust community practice in Albuquerque, New Mexico. Dr. McAneny, who has held many leadership roles in oncology associations, became a delegate to the American Medical Association (AMA) from ASCO in 2002, was...

hematologic malignancies

ASH Announces 2013 Honorific Award Recipients

The American Society of Hematology (ASH) announced the seven scientists who have received 2013 Honorific Awards for their significant contributions to the understanding and treatment of hematologic diseases. The Honorific Awards are the Society’s most prestigious awards. This year’s awards will be...

ASCO University® Appoints First Editor-in-Chief

ASCO has appointed Daniel G. Haller, MD, as the first Editor-in-Chief of ASCO University®, an eLearning center designed to serve as the educational home for physicians, nurses, advanced practice providers, and patient educators at every stage of their careers. As head of the editorial board, Dr....

breast cancer

What the Latest Breast Cancer News Means for Patients

Direct your patients to www.cancer.net/breastsymposium to read patient-friendly summaries that explain the research highlighted at the 2013 Breast Cancer Symposium and provide a list of questions to ask their doctors and additional resources to learn more. Also, your patients can listen to a...

ASCO Challenges Its Members to Double Their Impact During the Month of September 

For the entire month of September, donors to the Conquer Cancer Foundation of the American Society of Clinical Oncology have the opportunity to double their impact through a matching gift from an anonymous individual donor. From September 1 to 30, 2013, all donations—whether made online, through...

issues in oncology
legislation

Legislative Endorsement Update From ASCO 

ASCO recently announced its endorsement of the Tobacco Tax Equity Act of 2014 (S. 194), which would close tax loopholes that allow tobacco companies to avoid the federal cigarette tax by making taxes on pipe tobacco equivalent to cigarette tobacco. “Raising tobacco taxes is one of the most...

Conquer Cancer Foundation Donor and ASCO Member Denis Hammond, MD: Spreading the Word to Help Conquer Cancer

Oncology care professionals answer hundreds of questions from patients and their families every day. Over the course of months and years doctors and nurses address everything from medical questions about drug regimens and side effects, to personal questions about how cancer may affect work or...

integrative oncology

Ginseng in the Spotlight 

I read the study by Barton and colleagues in Journal of the National Cancer Institute with great interest. Ginseng seems potentially to be one treatment for cancer-related fatigue, a poorly understood but debilitating symptom that patients experience during and after treatment.1 I am impressed that ...

integrative oncology

American Ginseng Improves Cancer-Related Fatigue 

In a collaborative phase III trial of the North Central Cancer Treatment Group and Mayo Clinic (N07C2) reported in Journal of the National Cancer Institute by Debra L. Barton, RN, PhD, AOCN, FAAN, of the Mayo Clinic and colleagues, patients with cancer-related fatigue were treated with Wisconsin...

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