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Showing 2601 - 2650Discussing Financial Toxicity With Patients Who Have Cancer
Patient: “Doc, how much are these drugs going to cost me?” Physician: “They are expensive, and you can see our financial counselor to help you understand the costs.” Cancer care is not a black-and-white endeavor, and costs are considered a distasteful subject to be passed over in tactful silence. ...
Nivolumab Produces Survival Benefit in Advanced Renal Cell Carcinoma
Patients with advanced renal cell carcinoma treated with nivolumab (Opdivo) were 27% less likely to die than those receiving everolimus (Afinitor), in a planned interim analysis of the open-label phase III CheckMate 025 trial.1 These positive results prompted an early termination of the study by...
Answers: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System
Question 1: What is next best step in the management of this patient? Correct Answer: C. Ophthalmoscopy/slit lamp examination. Expert Perspective Ophthalmic involvement should be sought by noninvasive procedures such as slit lamp examination and ophthalmoscopy and abnormal findings must be...
Nivolumab in Metastatic NSCLC After Platinum Therapy
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 October 9, 2015, the anti–programmed cell death protein 1...
Survival and Bevacizumab in Early Breast Cancer: Time to Reconsider?
In metastatic HER2-negative breast cancer, several trials have shown that the addition of the anti–vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (Avastin) to different chemotherapy regimens significantly improved response rates and progression-free survival by various...
Improved Overall Survival With Neoadjuvant Plus Adjuvant Bevacizumab in Early HER2-Negative Breast Cancer
The phase III National Surgical Adjuvant Breast and Bowel Project (NSABP) B-40 (NRG Oncology) trial showed that the addition of bevacizumab (Avastin) to docetaxel + anthracycline-based neoadjuvant chemotherapy improved pathologic complete response rate, the primary endpoint, in patients with early...
ASCO Recommendations for Use of White Blood Cell Growth Factors: What Remains the Same and What Has Been Modified
Neutropenic complications remain the main dose-limiting toxicity of cancer chemotherapy treatment and are associated with considerable morbidity, mortality, and costs.1 Although patients who have experienced a prior neutropenic event are at increased risk of subsequent events, several studies have...
Ovarian Cancer Trialists Forming Work Group to Standardize Definition of Pathologic Complete Response
Ovarian cancer clinical trialists are forming a working group to develop a standard definition of pathologic complete response in ovarian cancer treated with neoadjuvant chemotherapy. Such agreement within the field potentially would enable the U.S. Food and Drug Administration (FDA) to consider...
Antibody-Drug Conjugate Makes Strong Showing in Small Cell Lung Cancer
The antibody-drug conjugate rovalpituzumab tesirine has shown strong clinical activity as second- and third-line treatment for small cell lung cancer in a phase I/Ib multicenter study,1 especially in the subset with high expression of the delta-like protein 3 (DLL3), which the drug targets. This...
Debate Over Physician-Assisted Suicide Continues, State by State
In 1997, after surviving a storm of high-court legal challenges, Oregon’s Death With Dignity Act went into effect, making Oregon the first American state to legalize physician-assisted suicide. The Supreme Court ruled that there was no right to assisted suicide in the Constitution but implied that...
Is Health Care in the United States a Basic Human Right or an Entitlement?
Mercy Killers is a one-man show that details the consequences of a medical health-care catastrophe (breast cancer) in a family.1 This disturbing fictional account is actually a daily event in cancer centers: losing insurance for technicalities, losing a home because of an inability to pay the...
William Dameshek, MD, Helped Take Hematology From a Minor Medical Discipline to a Major Scientific Field
Although William Dameshek, MD, is renowned for his work in hematology, especially in advancing the understanding of myeloproliferative disorders and their interrelatedness, his early interest in medicine was instead focused on such diverse diseases as hyperthyroidism and typhus fever. Born on May...
Increased Lifetime Risk of Developing Cancer in Patients With HIV
The effectiveness of antiretroviral therapy has enabled patients with HIV to live long enough to have high lifetime risks for several types of cancer. The finding has important clinical implications for cancer screening, as well as primary prevention, according to the results of a study funded by...
A Selfless Act
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,...
Pilot Study: Research Team Used Focused Ultrasound to Open Blood-Brain Barrier in Patient With Malignant Brain Tumor
A team at Sunnybrook Health Sciences Centre in Toronto has used focused ultrasound to enable temporary and targeted opening of the blood-brain barrier, allowing the more effective delivery of chemotherapy into a patient’s malignant brain tumor. This is the first known report of the noninvasive...
The Role of Botulinum Toxin in Head and Neck Cancer
Head and neck cancer and its treatment can result in a variety of neuromuscular and musculoskeletal pain and functional sequelae. Commonly seen conditions in patients with the disease include neck pain and spasm, hemifacial spasm, trismus, dysphonia, dysarthria, neuropathic pain, and salivary...
Diet and Cancer: How Will We Make Progress?
Not only is breast cancer among the most common cancers in women, but it is also one of the most common causes of premature death. Rates of death from the disease vary widely around the world, reflecting variations in risk, screening, and access to highest quality treatment. Although female gender...
Mediterranean Diet Supplemented With Extra-Virgin Olive Oil Reduces Risk for Invasive Breast Cancer
As reported in JAMA Internal Medicine by Estefania Toledo, MD, MPH, PhD, and colleagues, a large Spanish primary prevention nutrition intervention trial in patients at high cardiovascular risk (PREDIMED) showed a large reduction in the risk for invasive breast cancer among women 60 to 80 years of...
Checkmate 057: Nivolumab Improves Survival vs Docetaxel in Advanced Nonsquamous Non–Small Cell Lung Cancer
In the phase III CheckMate 057 trial, reported in The New England Journal of Medicine by Hossein Borghaei, DO, of Fox Chase Cancer Center, and colleagues, the programmed cell death protein 1 (PD-1) inhibitor nivolumab (Opdivo) improved overall survival vs docetaxel in patients with advanced...
Graviola
The use of dietary supplements by patients with cancer has increased significantly over the past 25 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 ...
Changing Landscape in the Treatment of Metastatic Renal Cell Carcinoma: Findings With Nivolumab and Cabozantinib
In the October 25 issue of The ASCO Post, we presented two important studies in previously treated advanced renal cell carcinoma, including the paper by Motzer et al “Nivolumab versus everolimus in advanced renal-cell carcinoma” (CheckMate 025), published in The New England Journal of Medicine,...
Updated Guidelines for Treating Stage IV NSCLC: Trying to Keep Up
In late August 2015, Gregory A. Masters, MD, and colleagues published an update to the ASCO guidelines for systemic therapy for stage IV non–small cell lung cancer (NSCLC), summarized in this issue of The ASCO Post.1 This builds on the full guidelines published in 20092 and the additional switch...
ACS Breast Cancer Screening Guidelines: Balancing the Benefits and Harms of Mammography
For the past 30 years, mammography screening has been one of the most contentious issues in medicine. Controversy has generally centered on the age at which to begin mammography screening (40 vs 50 years) and also, to a lesser extent, on the age at which it should stop. The recent American Cancer...
Getting the Content and the Message Right in Breast Cancer Screening Guidelines
According to recent national headlines, the American Cancer Society (ACS) now recommends that women at average risk of breast cancer should “screen later and less often.”1 While the new ACS recommendations (summarized in this issue of The ASCO Post) might initially be taken as casting doubt on the...
Oncologists Encouraged to Learn More About Lesser-Known Heritable Gastrointestinal Cancers
The genetic basis for inherited colorectal cancer is proving to be a much bigger and more complicated “pie” than was appreciated just a few years ago, according to Michael Hall, MD, Director of Gastrointestinal Risk Assessment at Fox Chase Cancer Center, Philadelphia. “With next-generation...
Genomics Now Driving Treatment of Waldenström’s Macroglobulinemia
The treatment of Waldenström’s macroglobulinemia has been greatly impacted by an understanding of its genomics, according to Steven P. Treon, MD, PhD, of Dana-Farber/Brigham and Women’s Cancer Center and Massachusetts General Hospital Cancer Center, Boston. Dr. Treon brought listeners up to date on ...
Integrating Spirituality Into Palliative Care Services
Over the past couple of decades, the oncology community has made great strides in mediating the psychosocial needs of our patients. However, a patient’s spirituality is a subjective and uncomfortable issue for many oncologists, which leaves a gap in the continuum of care. To reach a better...
The Complex Interactions of Treatment Costs, Clinical Outcomes, and Patient Expectations
A clinical dilemma that is receiving a great deal of attention in the oncology community is the undue financial burden some patients face during their treatment and into survivorship. While much emphasis is put on methods to reduce and help patients navigate the complex payment system, little is...
Nodal Irradiation in Node-Positive Breast Cancer: It Is Not Time to Change Practice
Management of the regional nodes in breast cancer has evolved from the era of the extended radical mastectomy to exclusion of axillary dissection in appropriately selected patients. Throughout this evolution, studies of nodal irradiation have been shown to improve locoregional control, usually...
Regional Nodal Irradiation in Early Breast Cancer Yields Significant Disease-Free Survival Benefit in Two Trials
Two phase III trials recently reported in The New England Journal of Medicine indicated that the addition of regional nodal irradiation was associated with no or marginal overall survival benefit but significantly improved disease-free survival in patients with early-stage breast cancer.1,2 NCIC...
Nivolumab Improves Overall Survival vs Docetaxel in Advanced Previously Treated Squamous Cell NSCLC
In a phase III trial reported in The New England Journal of Medicine, Julie Brahmer, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, and colleagues found that treatment with the programmed cell death protein 1 (PD-1) immune checkpoint inhibitor antibody nivolumab...
Closing the Racial Survival Disparity Gap in Breast Cancer: Models for Change From Chicago, New York, and Beyond
It has long been said that white women of European ancestry are more likely to be diagnosed with breast cancer, but African American women are more likely to die of it. This statement has introduced multiple articles on the topic of the racial survival disparity in breast cancer, including our own...
Reducing Racial Disparities in Breast Cancer Incidence and Mortality Trends to Improve Outcomes
A recent report by DeSantis and colleagues from the American Cancer Society, summarized in this issue of The ASCO Post, presented breast cancer incidence and mortality data from an extensive analysis of the U.S. system of state-based tumor registries.1 The data showed that the incidence of breast...
Cobimetinib in BRAF-Mutant Unresectable or Metastatic Melanoma in Combination With Vemurafenib
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 November 10, 2015, the U.S. Food and Drug Administration...
Molecularly Targeted Therapy Brings New Hope to Patients With Relapsed/Refractory Hairy Cell Leukemia
The treatment of hairy cell leukemia is one of the great success stories in hematologic malignancies, with patients now having a survival that is only slightly inferior to an age-matched normal population. Purine analogs, such as cladribine, are the mainstay of first-line therapy, with...
BRAF Inhibition Successful in Relapsed/Refractory Hairy Cell Leukemia
In two phase II studies reported in The New England Journal of Medicine, Enrico Tiacci, MD, of the University of Perugia, Italy, and colleagues found that the BRAF inhibitor vemurafenib (Zelboraf) produced responses in nearly all patients with BRAF V600E–positive hairy cell leukemia that relapsed...
2015 Review of Newly Approved Oncologic Therapies
Over the past year or so, a host of new agents were approved for the treatment of patients with various types of cancer (see related article on page 1). Patrick Medina, PharmD, of the University of Oklahoma College of Pharmacy, Oklahoma City, and Monique Giordana, PharmD, BCOP, of Regions...
Ovarian Cancer: Current Treatment and Patient Management
Tough initial treatment decisions have “long-lasting ramifications and affect the entire treatment paradigm” for women with ovarian cancer, according to Bradley J. Monk, MD, FACS, FACOG, of the University of Arizona Cancer Center, Phoenix. In a true collaborative presentation at the Annual JADPRO...
How to Help Mentees Succeed
Although formal mentoring programs in medical education were not launched in the United States until the late 1990s,1 today they are regarded as playing an essential role in the career development of medical trainees and have been associated with improvements in research, teaching, and patient...
SIOG Annual Conference Explores Global Perspectives on Geriatric Oncology and Supportive Care
The 15th Annual Conference of the International Society of Geriatric Oncology (SIOG) took place in Prague, Czech Republic, over 3 days (November 12–14, 2015). At the heart of the meeting were presentations on supportive care, comprehensive geriatric assessment and treatment—so that we fully...
ASCO Endorsement of ACCP Guideline on Treating SCLC: Moving Forward to Better Outcomes in Oncology
In the current climate of rising health-care costs, particularly in the field of oncology, clinical guidelines provide a crucial tool to guide practitioners in evidence-based care and to improve the quality and consistency of care.1 The ASCO review and endorsement of the American College of Chest...
Minimally Invasive Surgery for Rectal Cancer: An Evolving Issue
Over 10 years ago, we welcomed a new approach to cancer surgery when the 2004 COST trial demonstrated the benefits of laparoscopic compared with open surgery for colon cancer. This randomized trial of 872 patients showed improved perioperative recovery with laparoscopic colectomy without...
Partnering Therapies for Estrogen Receptor–Positive Breast Cancer Requires Close Monitoring and Patient Communication
Partnering endocrine therapy with new targeted agents for women with estrogen receptor–positive breast cancer “changes the nature of endocrine therapy from something easily tolerated, with not a lot that you have to do as physicians to monitor it,” William J. Gradishar, MD, of the Robert H. Lurie...
Nivolumab as Single-Agent Treatment for BRAF V600 Wild-Type Unresectable or Metastatic Melanoma
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 November 24, 2015, nivolumab (Opdivo) was approved for use as...
Nivolumab in Advanced Renal Cell Carcinoma After Antiangiogenic Therapy
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 November 23, 2015, nivolumab (Opdivo) was approved for use in...
Ibrutinib Bests Standard of Care for Elderly Patients With CLL
First-line treatment with the Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) significantly reduced the risk of dying or disease progression compared with chlorambucil (Leukeran) in older treatment-naive patients with chronic lymphocytic leukemia (CLL) in the RESONATE-2 trial. At the time...
A Shot to End Cancer: HPV Vaccination
As health-care providers, we have an obligation and a responsibility not only to care for our patients, but also to educate them—and the general public—about their cancer risk and ways to reduce or prevent it. We are living in the golden era of cancer prevention and treatment, made possible by...
Study Finds Cardiovascular Disease Is Prevalent and Often Asymptomatic in Childhood Cancer Survivors
Although historically the leading cause of death among survivors of childhood cancer has been cancer recurrence, adverse late effects of cancer therapy have become the leading cause of death 30 years after diagnosis, and those deaths are frequently attributed to premature cardiovascular disease,...
Study Finds No Improvement in Diagnostic Accuracy of Digital Screening Mammography With Computer-Aided Detection
In a study reported in JAMA Internal Medicine, Lehman et al found no difference in the diagnostic accuracy of digital screening mammography with vs without computer-aided detection. Study Details The study assessed the accuracy of digital screening mammography interpreted with (n = 495,818) vs...
Researchers Call for Hospitals to Establish Bereavement Programs for Families of Deceased Patients
Backed by a growing body of research, investigators at Dana-Farber Cancer Institute are calling for all hospitals to establish bereavement programs for families of deceased patients. In a report published by Morris and Block in the Journal of Palliative Medicine, researchers say such...
