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issues in oncology

Pharmacokinetics and Exposure Response in Drug Development

INSIDE THE BLACK BOX is an occasional column offering insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, former clinical pharmacology team leader Julie Bullock, PharmD, and current team leader Nitin Mehrotra, PhD, discuss how...

Conquer Cancer Foundation Researchers Lead Six Key Studies Featured in Clinical Cancer Advances 2015

Six of the studies featured in the recently released Clinical Cancer Advances 2015: ASCO’s Annual Report on Progress Against Cancer were led by researchers that whom Conquer Cancer Foundation (CCF) funded early in their careers through its signature Young Investigator Award (YIA) and Career...

colorectal cancer

ASCO Endorsement of ESMO Guidelines on Hereditary Colorectal Cancer Syndromes

In a recent issue of the Journal of Clinical Oncology,1 and as reviewed in this issue of The ASCO Post, an ASCO expert endorsement panel reviewed and endorsed, with minor qualifications, the European Society for Medical Oncology (ESMO) clinical practice guidelines for management of familial/genetic ...

lymphoma

Tailoring Therapy for Diffuse Large B-Cell Lymphoma by Interim PET May Be Problematic

In a study that reflected clinical practice, treatment of diffuse large B-cell lymphoma based on the results of interim positron-emission tomography (PET) was feasible; however, switching PET-positive patients to an alternative treatment still resulted in inferior treatment outcomes, and the...

multiple myeloma

Oral Proteasome Inhibitors Advancing in Multiple Myeloma Trials

Two orally administered proteasome inhibitors—oprozomib and ixazomib—looked encouraging in multiple myeloma studies presented at the 2014 ASH Annual Meeting and Exposition. Study Details for Oprozomib Oprozomib, given as a single agent in a dose-escalation study of heavily pretreated patients,...

Expert Point of View: David Ilson, MD

David Ilson, MD, of Memorial Sloan Kettering Cancer Center in New York, criticized the trial presented by Dr. Penniment at the 2015 Gastrointestinal Cancers Symposium for lacking a chemotherapy-alone arm. “Chemotherapy alone, in phase III trials, has achieved dysphagia relief in 70% of patients,”...

issues in oncology

ABIM President Richard J. Baron, MD, Announces Immediate Changes to Maintenance of Certification Program

The American Board of Internal Medicine (ABIM) announced substantial changes to its Maintenance of Certification (MOC) program and indicated a desire to work more closely with the internal medicine community. ABIM President and CEO Richard J. Baron, MD, MACP, reached out to diplomates via e-mail to ...

supportive care

Cutaneous Adverse Effects Associated With Tyrosine Kinase Inhibitors May Impact Quality of Life and Adherence to Treatment

Tyrosine kinase inhibitors “are associated with numerous adverse effects, many of which are cutaneous and can affect patients’ quality of life and impede their adherence to long-term treatment,” National Cancer Institute (NCI) investigators concluded after studying the adverse effects of the...

issues in oncology

Measles Presents Greater Risks in Children Being Treated for Cancer

Measles outbreaks in the United States during 2014 and early 2015 have yielded an unprecedented number of cases nationwide, raising concerns about the threat measles poses to cancer patients (especially children) who may be at risk for severe complications and even death due to measles infection....

Bringing the History of Cancer to Film

Ken Burns Presents Cancer: The Emperor of All Maladies, A Film by Barak Goodman will be broadcast on PBS on March 30, March 31, and April 1. Check local listings for broadcast times.   Like the book it’s based on, the television documentary Ken Burns Presents Cancer: The Emperor of All Maladies, A...

hematologic malignancies

The Current State of Hematologic Malignancies

Due in part to the refinement of bone marrow transplantation and its many innovations, some leukemias that once were death sentences now have cure rates of up to 90%. As research in transplantation and other promising areas accelerates, we are on the verge of breaking new clinical boundaries in...

issues in oncology

Clinically Inappropriate Patient Demands of Oncologists Happen More Infrequently Than Expected

A new study1 conducted at outpatient oncology centers found that only 1% of 5,050 patient-clinician encounters resulted in a clinically inappropriate request, of which very few were complied with by physicians. Ezekiel J. Emanuel, MD, PhD, of the University of Pennsylvania, and colleagues analyzed...

lymphoma

For Hodgkin Lymphoma Patients, It Ain’t Over

With less than 10,000 patients diagnosed with Hodgkin lymphoma each year and a cure rate of approximately 75% to 80%, drug development for this disease was never a priority for pharmaceutical companies. So when the antibody-drug conjugate brentuximab vedotin (Adcetris) was approved by the U.S. Food ...

hepatobiliary cancer

Targeting Biliary Tract Cancers Through Genomic Profiling

Biliary tract cancers are challenging, but a large genomic profiling study has identified potentially clinically relevant genomic alterations in up to two-thirds of patients.1 “The diverse landscape of clinically relevant genomic alterations in biliary tract cancers can serve as targets for...

issues in oncology

Big Data and the Promise of Precision Medicine in Cancer

Precision medicine—and its promise to revolutionize how we understand disease and care for our patients—is a concept that oncology has understood and embraced for well over a decade. But millions of Americans recently heard about the concept for the first time when President Obama announced a...

breast cancer

Nearly Half of Women Taking Tamoxifen for Primary Prevention Discontinue Its Use Before 5 Years

After 4.5 years of taking tamoxifen for primary prevention of breast cancer, 46% of women discontinued its use, according to research conducted within the Sister Study, a prospective cohort of women who had a sister diagnosed with breast cancer but did not have breast cancer themselves. Eligible...

palliative care

Caregivers May Want to Know About a Patient’s Impending Death but May Be Afraid to Ask

The likelihood of impending death of patients with advanced cancer “is one of those questions that many people want to know about, but they are too afraid to ask,” David Hui, MD, MSc, said in an interview with The ASCO Post. Dr. Hui is lead author of a study, published in Cancer, on clinical signs...

issues in oncology
health-care policy

Ongoing Controversies in Allocating Our Health‑Care Resources

Disparities of care that result in poorer outcomes among certain populations have long been an issue addressed by the cancer community and its major organizations such as ASCO. While ethnicity and race play key roles in this ongoing debate over equitable allocation of our precious health-care...

bladder cancer

Antiangiogenesis Plus Chemotherapy Pursued in Advanced Bladder Cancer

Two separate phase II studies lend support to the concept of antiangiogenesis in advanced bladder cancer. The combination of an antiangiogenic agent and chemotherapy may fulfill an unmet need in this disease, the studies suggest. Both studies were presented at the 2015 Genitourinary Cancers...

triple-negative

Our Aging Population: Challenges in Caring for Older Patients With Cancer

Managing older-aged cancer patients represents one of the major challenges to our health-care system. Caring for older cancer patients, with their frequent multiple morbidities and a variable health status, requires special integration of an oncologic and geriatric approach. Moreover, our aging...

sarcoma

Shining a Spotlight on Epithelioid Hemangioendothelioma

In the winter of 2013, my son, Dmitriy, now 26, had a cough that wouldn’t go away. After several rounds of antibiotics failed to halt the persistent problem, a pulmonologist we consulted ordered a chest x-ray, which showed a large tumor lodged between Dmitriy’s lungs. Although the doctor said the...

A Surgeon Cuts to the Chase

BookmarkTitle: The Cost of Cutting: A Surgeon Reveals the Truth Behind a Multibillion-Dollar IndustryAuthor: Paul A. Ruggieri, MDPublisher: Berkley BooksPublication date: September 2014Price: $16.00; paperback, 320 pages The woman seated on the exam table was lean and fit and seemed perfectly at...

issues in oncology
lung cancer

The Ongoing Struggle Against Tobacco: Past Accomplishments, Future Steps

In 1913, 10 doctors and 5 laypersons in New York founded the American Cancer Society (ACS). At that time, a cancer diagnosis was almost always fatal and was rarely discussed in public. The Society’s original charter was to raise awareness about cancer, and although that mission has remained firm,...

issues in oncology
palliative care

Why Just Having ‘Good’ Communication Skills Is Not Enough for Talking With Seriously Ill Patients

In the Institute of Medicine’s 2014 report Dying in America,1 the report’s authors found that while frequent clinician-patient conversations about end-of-life care, goals, and preferences are necessary to avoid unwanted treatment, most patients do not have those conversations with their physicians. ...

solid tumors

Current Progress Against Cancer and What Lies Ahead in the Next Decade

In January, ASCO released its report, Clinical Cancer Advances 2015: An Annual Report on Progress Against Cancer,1 which details research advances over the past decade that have led to longer survival and better quality of life for the more than half-a-million people diagnosed with cancer each...

breast cancer
issues in oncology

Too Early to Use Genome Sequencing for Breast Cancers in the Clinic

The role of next-generation sequencing (high-throughput technologies that allow DNA and RNA to be analyzed more quickly and inexpensively than earlier techniques) in breast cancer remains unclear and at present is primarily a research tool. Therefore, clinicians should be cautious in using genetic...

issues in oncology

Clinical Trial Participation: ‘Is It All Worth It?’

Clinical trials have become increasingly complex over the past several years, and unfortunately, this has resulted in the typical scenario described below. We are fortunate that there are so many promising agents available for patients, and we want to encourage their participation in clinical...

symptom management

Scalp Cooling Caps Offer Option to Prevent Hair Loss During Chemotherapy

Hair loss remains one of the most dreaded side effects of chemotherapy, particularly for women. Scalp cooling caps worn by patients during chemotherapy infusion and for brief periods of time before and after offer these patients an option to preserve 50% or more of the hair on their heads. Although ...

gastroesophageal cancer

Too Young to Have Cancer

The first inkling I had that something could be seriously wrong occurred just over a year ago, when I was suddenly inflicted with such severe heartburn it kept me awake at night. Prescriptions from my doctor for ranitidine (Zantac) and meloxicam (Mobic) not only failed to tamp down the fiery pain,...

issues in oncology

20 Years of NCCN: The Best Is Yet to Come

As the National Comprehensive Cancer Network (NCCN) celebrates its 20th year, The ASCO Post asked its Chief Executive Officer, Robert W. Carlson, MD, to reflect on the organization’s accomplishments, mission, and future and on the role he may have played in its success.  The Early Years You became...

global cancer care

How the International Innovation Grant Is Improving Cancer Care for Women in Myanmar

In 2014, the Conquer Cancer Foundation awarded four inaugural International Innovation Grants to aid novel research projects in Colombia, Myanmar, Nigeria, and Tanzania. The program, which supports a 1-year research grant of up to $20,000 to a nonprofit organization or governmental agency in a low- ...

pancreatic cancer

Heal Thy Patient … Reflections on the Human Side of Medicine

The first time I met Mrs. X and her husband was to discuss the surgical treatment options for pancreatic cancer. She had just been diagnosed with pancreatic cancer at her local hospital and was being referred to a tertiary care center for operative management. Mrs. X and her husband were no...

breast cancer

Cancer Has Left an Indelible Mark on Me

Even though today I’m cancer-free, the experience of getting a cancer diagnosis and going through treatment leaves an indelible mark on your psyche—as well as your body—that time doesn’t erase. Once you have cancer, you become a cancer survivor, and that status doesn’t change. I’ve known many...

supportive care

Researchers Discuss Pilot Study on Hallucinogenic Therapies for Cancer Anxiety

Although varying levels of existential distress are near-ubiquitous among patients with cancer, evidence-based interventions in this clinical area remain somewhat elusive. Seeking to explore novel approaches in the palliative care environment, New York University (NYU) School of Medicine principal...

supportive care

Childhood Cancers: Significant Medical Success but Many Psychosocial Needs Still Unmet

Treatment of childhood cancer is remarkably successful, but still, 2,000 children die of it each year, and for some forms of the disease, no progress has been made at all, said Otis Brawley, MD, Chief Medical Officer, American Cancer Society (ACS). “At least half of all pediatric cancer survivors...

issues in oncology
breast cancer

Informing Decision-Making About Mammography Screening

Overdiagnosis associated with breast cancer screening has been the subject of much attention in recent years. The notion that cancer screening—largely believed to be beneficial—could actually be harmful is simultaneously fascinating and difficult to believe. With the publication of multiple studies ...

breast cancer
gynecologic cancers
kidney cancer
skin cancer
cost of care

NCCN Posters of Interest Included Studies in Kidney, Breast, and Endometrial Cancers, Melanoma, and Cost Issues

The quality and quantity of original research presented at the National Comprehensive Cancer Network (NCCN) Annual Conference continue to grow since poster sessions debuted a few years ago. The ASCO Post offers summaries for just a few that caught our eye, out of more than 65 presented this year....

health-care policy

After Decades of Uncertainty, the Sustainable Growth Rate Formula Is Repealed by Congress

The U.S. Congress recently did something remarkable: both parties reached across the aisle and overwhelmingly passed H.R. 2, a bill that will permanently repeal the sustainable growth rate (SGR), the problematic formula for Medicare reimbursement. It just needed the President’s signature, which it...

p53 Takes Center Stage

BOOKMARKTitle: p53: The Gene That Cracked the Cancer CodeAuthor: Sue ArmstrongPublisher: Bloomsbury PublishingPublication date: November 20, 2014Price: $19.98; hardcover, 288 pages   Completed in April 2003, the Human Genome Project was one of the greatest feats of scientific exploration, an inward ...

lung cancer

Prior Cancer Does Not Affect Outcomes Among Patients With Advanced Lung Cancer, Suggesting They Be Included in Clinical Trials

Analysis of data from 102,929 patients with stage IV lung cancer found that “prior cancer does not convey an adverse effect on clinical outcomes, regardless of prior cancer stage, type, or timing.” Based on these findings, investigators from the Harold C. Simmons Cancer Center, University of Texas...

Remembering Mark R. Green, MD, a Leader in Lung Cancer Research and Treatment

Few people have impacted cancer clinical research in the past quarter century as much as Mark Green. His expertise in lung cancer and clinical trial design led to the successful completion of seminal studies combining radiation and chemotherapy that forever changed the management of patients with...

Remembering Multiple Myeloma Patient Advocate Michael S. Katz, MBA

I first met Michael Katz, MBA, in 2004, 3 years after my brother, Dom, was diagnosed with multiple myeloma, and we were at a crossroads in his care and needed advice. Although an experimental regimen of thalidomide (Thalomid) and dexamethasone had successfully put Dom in remission for a year (the...

issues in oncology

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,...

solid tumors

Living With a Rare Cancer—My Dr. Seuss World

No one ever expects to hear the words “you have cancer,” but over the course of the day, over 5,000 people in the United States are given that news.1 I first heard those words in the summer of 2007 and have been living with cancer ever since. At the time of my diagnosis, I knew this would forever...

Sarcoma of the Arm, Circa 1874

The text and photographs on this page are excerpted from a four-volume series of books titled Oncology Tumors & Treatment: A Photographic History, by Stanley B. Burns, MD, FACS. The photos below are from the volume titled “The Anesthesia Era: 1845–1875.” To view additional photos from this...

breast cancer

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 ...

breast cancer

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...

ASCO’s Train the Trainer Program Extends the Reach of Multidisciplinary Cancer Management Education

Multidisciplinary Cancer Management Courses (MCMCs) offered by ASCO International, in collaboration with other organizations, seek to improve cancer care globally through the promotion of interdisciplinary cancer management. Attendees of select MCMCs have the option to attend a 1- to 2-day training ...

Exploring the History and Psychology of Pain: Beyond the Clinical Setting

BOOKMARKTitle: The Story of Pain: From Prayer to PainkillersAuthor: Joanna BourkePublisher: Oxford University PressPublication date: 2014Price: $34.95: hardcover, 416 page   “Pain may even kill. It may overwhelm the nervous system by its mere magnitude & duration.” —Peter Mere Latham, 1871...

cns cancers

Will the PVS-RIPO Poliovirus Be a Game Changer in the Treatment of Recurrent Glioblastoma?

Although the idea of using viruses to target cancer cells dates back more than 100 years, technologic advances in the genetic engineering of viruses are now making it possible to safely test oncolytic virotherapy as a valid strategy against cancer cells. One type of genetically engineered virus...

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