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issues in oncology

Patient-Reported Outcomes in Hematology and Oncology Product Development

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, Virginia Kwitkowski, MS, RN, ACNP-BC, and Elektra Papadopoulos, MD, MPH, discuss FDA’s current approach to the review of study...

lung cancer

Optimal Chemoradiotherapy Dosing and Recurrence After Stereotactic Body Radiotherapy Explored in Lung Cancer Webinar

Cetuximab (Erbitux) added no survival benefit to chemoradiation in stage III non–small cell lung cancer (NSCLC), according to results reported in a Plenary Session of the 2013 World Conference on Lung Cancer in Sydney, Australia.1 It was the second surprise result from the Radiation Therapy...

2014 Lasker Award

The Albert and Mary Lasker Foundation has announced Mary-Claire King, PhD, of the University of Washington, Seattle, will receive the 2014 Lasker~Koshland Special Achievement Award for her contributions to medical science and human rights.  Dr. King’s demonstration of the existence of familial...

gynecologic cancers

Angiogenesis in Ovarian Cancer: Are We Missing the Clinical Target?

Production of vascular endothelial growth factor (VEGF) is increased during normal ovulation, and can account for much of the reversible toxicity associated with ovarian hyperstimulation.1,2 We also have compelling data from multiple clinical trials to validate the importance of tumor-associated...

prostate cancer

PSA—It Just Keeps Getting Better, So Why Should It Stand Alone?

The updated results of the European Randomised Study of Screening for Prostate Cancer (ERSPC)—reported in The Lancet by Fritz H. Schröder, MD, of Erasmus University Medical Center, and colleagues1 and reviewed in this issue of The ASCO Post—show a continued decline, as predicted,2 in the number...

hematologic malignancies

‘Paradigm-Shifting’ Results in Treatment of Hematologic Disorders

The three leukemia/lymphoma studies selected from the many 2014 ASCO Annual Meeting abstracts for presentation at the recent Best of ASCO meeting in Chicago “are really paradigm-shifting,” noted Lucy A. Godley, MD, PhD, of the University of Chicago. These studies, she said, “give great promise for...

issues in oncology

Will Oncologists Be the First to Cure Heart Disease?

Oncologists love jargon—a language peculiar to a particular trade, profession, or group that facilitates communication among members. Our day-to-day communications, medical notes, and journal reports are filled with this type of jargon. Other definitions of jargon are less flattering, including...

lung cancer

Can Metastatic Lung Cancer Be Cured?

Don’t expect metastatic lung cancer to be cured any time soon, says Paul A. Bunn, Jr, MD, Professor and James Dudley Chair in Cancer Research at the University of Colorado School of Medicine, Denver. “You have to be disease-free for some length of time in order to be cured, which is our goal,” he...

sarcoma

Social Media Is Helping Me Cope With Cancer

Despite a diagnosis in August 2013 of stage III high-grade spindle cell sarcoma and subsequent disease recurrence, I’m mindful of how fortunate I am that my cancer was found before widespread metastases could take hold, making treatment futile. It was just happenstance, 2 months before, on a long...

issues in oncology

On Being A Mentee and the Value of the Conquer Cancer Foundation’s Career Development Award

At the ASCO Annual Meeting in June, the Conquer Cancer Foundation presented the 2014 recipients of prestigious grants and awards, including the Young Investigator Award, Career Development Award, and the Advanced Clinical Research Award in Breast Cancer. In announcing the awards, Charles W. Penley, ...

global cancer care
gastrointestinal cancer

IARC Calls on Countries With High Stomach Cancer Burden to Act to Prevent the Disease

A new report from the International Agency for Research on Cancer (IARC), an agency of the World Health Organization, urges health authorities of countries with high stomach cancer burden to include stomach cancer in their national cancer control programs and allocate more resources to control the...

sarcoma

Treating Sarcomas in 2014

In 2014, about 15,000 people in the United States will be diagnosed with some form of sarcoma, and of those, approximately 5,000 adults and children are expected to die of the disease. Sarcomas are a heterogeneous group of mesenchymal malignancies that have historically been difficult to diagnose...

lymphoma

Time to Treatment Failure Similar With Rituximab Retreatment vs Maintenance in Low–Tumor Burden Follicular Lymphoma

Maintenance rituximab (Rituxan) has been shown to improve progression-free survival vs observation in low–tumor burden follicular lymphoma. In the Eastern Cooperative Oncology Group (ECOG) E4402 Trial ­(RESORT), reported in the Journal of Clinical Oncology, Brad S. Kahl, MD, of the University of...

colorectal cancer

Lower- vs Higher-Than-Expected Long-Term Colorectal Cancer Mortality After Removal of Lower- vs Higher-Risk Adenomas

Few data are available on long-term risk of colorectal cancer mortality after adenoma removal. In a Norwegian study reported in The New England Journal of Medicine, Magnus Løberg, MD, of the Department of Health Management and Health Economics, University of Oslo, and colleagues found that patients ...

supportive care

Life-Threatening Dermatologic Toxicity

A variety of life-threatening dermatologic adverse events may occur in association with cancer drug therapies. Here, we discuss the recognition and management of three types of such toxicities: type I hypersensitivity/anaphylaxis, Stevens-Johnson syndrome/toxic epidermal necrolysis, and drug rash...

lung cancer

REVEL: Winning a Questionable Race

The investigators and sponsors of the phase III REVEL trial should be congratulated and probably commiserated. In this large study, reported by Garon and colleagues in The Lancet and reviewed in this issue of The ASCO Post, 1,253 patients with advanced non–small cell lung cancer (NSCLC) were...

breast cancer

How Accurate Is the Pathologic Assessment of the Partial Mastectomy Specimen?

The pathologic evaluation of lumpectomy margins is “fraught with problems and pitfalls,” said Stuart J. Schnitt, MD, Director of Anatomic Pathology at Beth Israel Deaconess Medical Center and Professor of Pathology at Harvard Medical School, Boston, who was part of a multidisciplinary discussion of ...

issues in oncology

Best of ASCO Seattle Proves Engaging, Provocative

This year’s Best of ASCO meeting held in Seattle featured topics that both riveted attendees and pushed their buttons, according to program chair Alan P. Venook, MD, of the University of California, San Francisco. “I am extremely pleased with the quality of the presentations from the faculty, but...

lung cancer

Stereotactic Body Radiation Therapy Benefits Patients With Early-Stage Inoperable or Advanced Oligometastatic Lung Cancer

The door is open for expanded use of stereotactic body radiation therapy (SBRT) in patients with inoperable early-stage lung cancer and for patients with oligometastatic stage IV non-small cell lung cancer (NSCLC), according to results of two studies presented at the 56th Annual Meeting of the...

health-care policy

Health-Care Reform Is Changing the Oncology Landscape

Value-based health-care reform is happening. We have to get on board,” Rena Conti, PhD, a health economist at the University of Chicago, advised attendees of the Best of ASCO Seattle meeting. She discussed highlights from Annual Meeting sessions that addressed the impact of the Affordable Care Act...

issues in oncology

Relevance of the Hippocratic Oath in the 21st Century

On the face of it, the idea that a code of professional conduct dating to the ancient Iron Age could possibly retain any relevance in the current era of “Big Data,” religious and cultural pluralism, trillion-dollar government budgets, and nanotechnology seems preposterous. Yet the well-publicized...

leukemia

Obinutuzumab Could Have Synergistic Action With New Tyrosine Kinase Inhibitors

Final results from the phase I/II GAUGUIN study showed that obinutuzumab (Gazyva) monotherapy was active in patients with heavily pretreated relapsed or refractory chronic lymphocytic leukemia, European researchers reported in Blood. In phase II, median progression-free survival was 10.7 months and ...

leukemia

Lessons From Cancer

For a year before I was diagnosed with acute myeloid leukemia (AML) in December 2011, I had what I thought were the lingering remnants of a bad case of bronchitis. My breathing was labored, I had a chronic cough, and occasionally my voice would give out. Every time I saw my pulmonologist, I would...

A History of Medical Oncology

BOOKMARK Title: Therapeutic Revolution: The History of Medical Oncology From Early Days to the Creation of the SubspecialtyAuthor: Pierre R. BandPublisher: Bentham SciencePublication date: 2014Price: $39.00 (eBook); $78.00 (print on demand); 213 pagesAvailable at: eurekaselect.com   According to...

solid tumors

Treating Testicular Cancer in 2014

Testicular cancer is one of oncology’s true success stories. It is a highly treatable disease, usually curable, that most often develops in young and middle-aged men. Despite the success in testicular cancer, there are still clinical challenges ranging from staging to optimum therapeutic...

multiple myeloma

Experts Debate the Need for Upfront vs Late Stem Cell Transplant in Multiple Myeloma

With powerful new drugs capable of achieving sustained and deep remissions in multiple myeloma, the role of upfront stem cell transplantation is being questioned by experts, who debated the pros and cons at the National Comprehensive Cancer Network (NCCN) 9th Annual Congress on Hematologic...

breast cancer

Variety of Adjuvant Strategies Explored in HER2‑Positive and Other Breast Cancer Types

Adjuvant trastuzumab (Herceptin) was shown to be effective in patients with breast cancers ≤ 2 cm, regardless of estrogen receptor status, in a meta-analysis1 of five chemotherapy trials, but a “pressing question” remaining is whether T1a/b, N0 tumors warrant the use of adjuvant trastuzumab, Andrew ...

Despite Potential to Overwhelm, Surveys Still Essential Research Tool

The age of the Internet and worldwide connectivity has made it easier than ever to send out surveys to a wide audience quickly and easily. This ease of access can make surveys an affordable and readily available research tool for independent investigators, but it can also make surveys an...

lung cancer
palliative care

Novel Oral Agent Treats Cachexia in Patients With Non–Small Cell Lung Cancer

For the first time, studies show that a drug is effective in treating several domains of cancer-related cachexia. Oral anamorelin increased lean body mass, achieved weight gain, and improved quality of life in patients with cancer-related cachexia in two pivotal phase III studies presented together ...

issues in oncology

Partnering With Community Centers to Advance Oncology Care

Last fall, Richard R. Barakat, MD, FACS, the Ronald O. Perelman Chair in Gynecologic Surgery at Memorial Sloan Kettering Cancer Center, was named to the new position of Deputy Physician-in-Chief for the Memorial Sloan Kettering Regional Care Network and Cancer Alliance, a new initiative meant to...

leukemia

Linking Biology and Therapy in Chronic Lymphocytic Leukemia

Recent discoveries in biology, therapy, and (most importantly) the interplay between these two have led to groundbreaking advances in chronic lymphocytic leukemia (CLL). These advances underline the impact of the “translational” approach to cancer management in general. Standard of Care...

breast cancer

Neoadjuvant Chemotherapy Plus Two Anti-HER2 Agents Optimal for HER2-Positive Breast Cancer

For women with human epidermal growth factor receptor 2 (HER2)-positive breast cancer, combining two anti-HER2 agents with chemotherapy is the most effective treatment modality in the neoadjuvant setting, according to a meta-analysis published in the Journal of the National Cancer Institute. The...

cns cancers

A Candidly Humorous Approach to the Cancer Journey

BOOKMARK Title: Shrinkage: Manhood, Marriage, and the Tumor That Tried to Kill MeAuthor: Bryan BishopPublisher: Thomas Dunne BooksPublication date: April 29, 2014Price: $25.99; hardcover, 336 pages   At 30 years old, Bryan Bishop was having the time of his life. Known to millions of radio fans as...

issues in oncology

A Father and Son’s Journey Through Medicine

BOOKMARK Title: The Good Doctor: A Father, a Son, and the Evolution of Medical EthicsAuthor: Barron H. Lerner, MDPublisher: Beacon PressPublication date: May 13, 2014Price: $25.95; hardcover, 240 pages   One morning in 1996, an infectious disease specialist was making rounds when he and his team...

lung cancer

ASCO Endorses CAP/IASLC/AMP Guidelines for Molecular Testing of Patients With Non–Small Cell Lung Cancer

Personalized medicine is an established treatment concept for patients with advanced non–small cell lung cancer (NSCLC), and molecular characterization of tumors is crucial for choice of (first-line) therapy. As of right now, we have U.S. Food and Drug Administration (FDA)-approved drugs for two...

lung cancer

ASCO Endorses Guideline for Molecular Testing for Selecting Lung Cancer Patients for EGFR and ALK Inhibitor Treatment

ASCO has endorsed the recently developed joint College of American Pathologists (CAP), International Association for the Study of Lung Cancer (IASLC), and Association for Molecular Pathology (AMP) guideline on molecular testing for selection of patients with lung cancer for EGFR and ALK inhibitor...

issues in oncology
colorectal cancer

Half of Premature Colorectal Cancer Deaths Due to Socioeconomic Inequality

Half of all premature deaths from colorectal cancer (described as deaths in people ages 25 to 64) in the United States are linked to ethnic, socioeconomic, and geographic inequalities, and therefore could be prevented according to a new study by American Cancer Society researchers. The report,...

skin cancer

BRAF/MEK Inhibition in BRAF-Mutant Advanced Melanoma

Preliminary evidence of efficacy for BRAF inhibitors as monotherapy in advanced melanoma first emerged in 2009.1 Phase II and III trials rapidly ensued for vemurafenib (Zelboraf) and dabrafenib (Tafinlar), leading to U.S. Food and Drug Administration (FDA) approval in 2011. As a result of melanoma...

lung cancer

X-Ray of Metastatic Carcinoma of the Lungs, Washington, DC, 1924

One hundred years ago, primary lung cancer was considered a rarity, with only a few hundred cases acknowledged in the world literature. Until the middle of the 1920s, medical textbooks by noted authors continued to label the disease “rare,” although metastatic lung disease was recognized and...

head and neck cancer

Radiation Treatment for Facial Cancer, Boston, 1903

Diseases and cancers of the face were so visible and disfiguring that they were usually brought to the attention of a physician in their early stages. The effect and success produced by Finsen’s light therapy on lupus, eczema, psoriasis, other skin diseases and even infections, such as...

lung cancer

Emerging Drugs Effectively Tackle Non–Small Cell Lung Cancer Mutations

For advanced nonsquamous non–small cell lung cancer (NSCLC), targeting of the epidermal growth factor receptor (EGFR) mutation and the ALK abnormality has become an established strategy. Later-generation drugs in these categories are now showing efficacy in trials, including for the treatment of...

Expert Point of View: Axel Grothey, MD

Putting the maintenance trials into context was Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, who commented, “These studies inform our clinical practice and have a meaningful impact on how we treat our patients.” DREAM Trial In the DREAM Trial, Dr. Grothey...

issues in oncology

Young Adults With Cancer: Unique Issues Highlight Importance of Patient-Centered Care

Suleika Jaouad, a journalist, was 22 and had just gotten her first chance to cover a major news story—the revolution underway in Tunisia—when she was diagnosed with myelodysplastic syndrome that had evolved into acute myeloid leukemia (AML). Months into her treatment, she began to write again, but...

lymphoma

Targeted Therapies in Indolent Lymphoma: Challenging the Current Paradigm

The use of targeted therapies in indolent non-Hodgkin lymphoma (NHL) is a burgeoning area. New targeted therapies directed at the cell surface, intracellular pathways, and the microenvironment are being studied for relapsed indolent NHL. These treatments, if validated in large randomized trials,...

sarcoma

Advances in Sarcoma Owe Much to Children’s Oncology Group

Improvements over the past 3 decades in 5-year survival rates for patients with osteosarcoma and Ewing’s sarcoma owe a lot to chemotherapy clinical trials conducted by the Children’s Oncology Group (COG), Mark Agulnik, MD, acknowledged at the Best of ASCO meeting in Chicago. Dr. Agulnik is...

issues in oncology

Striving for Quality, Not Quantity, of Life

Advances in science and medicine have led to humans living longer than at any other time in history. According to a new report1 on mortality from the Centers for Disease Control and Prevention’s National Center for Health Statistics, life expectancy in the United States is at an all-time high of...

leukemia

The Next-to-Last Frontier in Managing Acute Promyelocytic Leukemia

The treatment of acute promyelocytic leukemia (APL) represents one of the major triumphs in the field of hematologic malignancies. With either the vitamin A derivative all-trans retinoic acid (ATRA) combined with anthracycline-based chemotherapy or ATRA plus arsenic trioxide (Trisenox),...

pain management

Unique Barriers to Pain Control

I read with great interest your interview with Virginia LeBaron, PhD, APRN, about barriers to adequate pain control (“Despite Growing Awareness, the Global Crisis of Untreated Cancer Pain Persists,” The ASCO Post, October 15, 2014). Having served as the medical director of a hospice, I am...

gastroesophageal cancer

Customizing Surveillance Strategy in Patients With Esophageal Adenocarcinoma

A surveillance strategy for patients with esophageal adenocarcinoma treated with chemoradiation and surgery (trimodality therapy) can potentially be customized based on surgical pathology stage, according to an analysis of 518 patients with esophageal adenocarcinoma who underwent trimodality...

head and neck cancer
issues in oncology

mTOR Cotargeting Active in Cetuximab-Resistant Head/Neck Cancers With PIK3CA and RAS Mutations

In a study reported in Journal of the National Cancer Institute, Wang and colleagues found that adding an mTOR inhibitor to cetuximab (Erbitux) resulted in marked improvement in antitumor activity in squamous cell carcinomas of the head and neck expressing PIK3CA and RAS oncogenes. Cetuximab...

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