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Showing 2651 - 2700Genomics 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...
Experimental Drug Shown to Prevent Neuroblastoma in Preclinical Study
Australian scientists have identified a critical molecular “feedback loop” that helps initiate and drive neuroblastoma, a cancer of the nervous system in children that is triggered in embryonal nerve cells. This feedback loop massively accelerates cancer development. The research team...
ASTRO 2015: A Shorter Radiation Therapy Schedule Can Be as Effective as a Conventional Schedule for Men With Low-Risk Prostate Cancer
Hypofractionated radiation therapy results in similar rates of cure and side effects compared to a longer treatment schedule for some men with low-risk prostate cancer, according to research (Abstract LBA6) presented by Lee et al October 19, 2015, at the American Society for Radiation Oncology...
Diagnosis of Additional Small Breast Cancers Suggests Screening Mammography May Lead to Overdiagnosis
A study of screening mammography across U.S. counties found that “the clearest result of mammography screening is the diagnosis of additional small cancers” but without a “concomitant decline in the detection of larger cancers, which might explain the absence of any significant...
Study Shows Nearly 15 Million Women Live Prohibitively Far From Access to Gynecologic Cancer Care
More than one-third of counties in the United States are located more than 50 miles from the nearest gynecologic oncologist, making access to specialty care for ovarian and other gynecologic cancers difficult for nearly 15 million women. Although most of these “low-access” counties are...
Increased Lifetime Risk of Cardiovascular Disease for Patients Treated for Hodgkin Lymphoma as Adolescents or Adults
Survivors of Hodgkin lymphoma treated as adolescents or adults are at increased risk of cardiovascular disease throughout their lives, according to results of a retrospective cohort study of 2,524 Dutch patients followed for a median of 20 years. “Treating physicians and patients should be...
Neoadjuvant Chemotherapy for Breast Cancer Increases Chances of Lumpectomy, Decreases Chances of Mastectomy
Patients with larger malignant tumors of the breast who undergo chemotherapy before a breast cancer operation are more likely to undergo a lumpectomy than a mastectomy, according to a study published by Killelea et al in the Journal of the American College of Surgeons. Study investigators from...
Preclinical Study Shows Promise for the Development of Personalized Cellular Therapy for Brain Cancer
Immune cells engineered to seek out and attack a type of deadly brain cancer were found to be safe and effective at controlling tumor growth in mice that were treated with these modified cells, according a team from the Perelman School of Medicine at the University of Pennsylvania and the Novartis...
FOLFOXIRI/Bevacizumab Bests FOLFIRI/Bevacizumab in Metastatic Colorectal Cancer
Patients with untreated metastatic colorectal cancer who received FOLFOXIRI (fluorouracil [5-FU], leucovorin, oxaliplatin, irinotecan) plus bevacizumab (Avastin) had improved survival compared to patients who received FOLFIRI (5-FU, leucovorin, irinotecan) plus bevacizumab in a phase III...
Study Finds Increase in Colonoscopy Rates Has Lead to Overuse
A retrospective study led by researchers at Brigham and Women's Hospital has found an overuse of colonoscopies for colorectal cancer screening and surveillance. The study demonstrated that endoscopists commonly recommended shorter follow-up intervals than established guidelines support, and these...
Swedish Study Indicates No Increased Risk of Breast Cancer With 5 Years of Continuous Exposure to Calcium Channel Blockers
A recently reported U.S. population-based case-control study in women aged 55 to 74 years indicated that current use of calcium channel blockers for ≥ 10 years was associated with increased risk of ductal breast cancer (odds ratio [OR] = 2.4) and lobular breast cancer. In a Swedish case-control...
Modeling Study Critical of Intensive Colonoscopy Screening in Medicare Population
A modeling study reported in JAMA Internal Medicine by van Hees and colleagues showed that colonoscopy screening at intervals shorter than 10 years or continuing past 75 years of age in the Medicare population is associated with a reduced net health benefit from a societal perspective. Study ...
Low Incidence of Colorectal Cancer, Elevated Rate of Postprocedure Hospitalization in Elderly Patients Undergoing Surveillance Colonoscopy
In a retrospective cohort study reported in JAMA Internal Medicine, Tran et al found a low rate of colorectal cancer and a relatively high rate of postprocedure hospitalization in elderly patients undergoing surveillance colonoscopy. Study Details The study involved patients aged ≥ 50 years...
More Than 50% of Older, Sick Adults Receive Cancer Screenings Unlikely to Provide Benefit
Despite updates on cancer screening guidelines from several medical societies—including ASCO, the American Cancer Society, the American Urological Association, the American College of Physicians, as well as the U.S. Preventive Services Task Force—which use life expectancy and/or age as...
American College of Physicians Issues Guideline Recommending Against Routine Pelvic Exams for Asymptomatic Women
A new evidence-based clinical practice guideline from the American College of Physicians (ACP) is recommending that physicians should not offer routine pelvic examinations to asymptomatic, average-risk, nonpregnant women. The recommendation stems from a review of 52 published articles from 1946...
Study Suggests Less Frequent Cardiac Screening May Be Preferable for Survivors of Childhood Cancer
One of the first studies to analyze the effectiveness of screening survivors of childhood cancer for early signs of impending congestive heart failure found improved health outcomes but suggested that less frequent screening than currently recommended may yield similar clinical benefit. Researchers ...
Low Use of Chemotherapy in Last 14 Days of Life at MD Anderson Cancer Canter
A proposed metric of quality of cancer care is whether chemotherapy is administered in the last 14 days of life. In a retrospective study of patients at The University of Texas MD Anderson Cancer Center reported in JAMA Internal Medicine, Rodriguez et al found an overall rate of chemotherapy use in ...
False-Positive Screening Mammograms Associated With Short-Term Anxiety but No Reduced Intention to Undergo Subsequent Mammography
The effect of false-positive mammograms on women undergoing screening is being investigated by the U.S. Preventive Services Task Force. In a study reported in JAMA Internal Medicine, Tosteson et al assessed responses to false-positive screening mammograms. According to the authors, their findings...
Sildenafil Use May Be Associated With Increased Risk of Melanoma
In a prospective cohort study reported in JAMA Internal Medicine, Li et al found that recent and ever use of sildenafil for erectile dysfunction was associated with increased risk of subsequent melanoma, but not squamous cell or basal cell carcinoma. The RAS/RAF/MAPK and ERK kinase/ERK cascade is...
HLA Class I Antigen Expression Predicts Overall Survival Benefit With Aspirin Use in Colon Cancer
In a cohort study reported in JAMA Internal Medicine, Reimers et al found that aspirin use was associated with a significant 47% reduction in mortality risk after diagnosis of colon cancer expressing HLA class I antigen. There was no difference in aspirin benefit according to strong or weak...
Women Are Infrequently First or Corresponding Authors in Collaborative Group Publications in Oncology
As reported in a research letter in JAMA Internal Medicine, Sun et al studied the frequency with which women lead clinical trial publications from organized collaborative groups in oncology. They found that women are very infrequently lead or corresponding authors, with the percentages not changing ...
Pilot Study Shows Decision Aid Helps in Decision-Making Regarding Mammography Screening in Women Aged ≥ 75 Years
Although it is recommended that women aged ≥ 75 years be informed of the benefits and risks of mammography before being screened, it appears that this is not common practice. As reported in JAMA Internal Medicine by Schonberg et al, a decision aid developed by the investigators helped improved...
CAR T-Cell Therapy Yields Promising Complete Response Rates in Patients With Relapsed/Refractory B-Cell ALL
In a recent study published in Science Translational Medicine, Davila et al found that 88% of patients with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL) who were treated with genetically modified versions of their own immune cells achieved overall complete response. Most...
Promising Effects of High-Dose Parenteral Ascorbate in Ovarian Cancer
Oral ascorbate, or vitamin C, has been shown to be ineffective in cancer clinical trials. However, recent studies have indicated that millimolar concentrations of ascorbate achieved in blood and tissue with intravenous dosing is associated with cancer cell killing without harm to normal tissue. In...
Most Physicians Would Enroll in Hospice If They Were Terminally Ill With Cancer, Study Finds
In a research letter published in JAMA Internal Medicine, Chinn et al surveyed physicians’ attitudes towards hospice treatment if they were terminally ill with cancer and assessed how physician preferences might affect timing of hospice discussions with their terminally ill patients. They...
Low-Dose CT Screening May Result in Overdiagnosis of Lung Cancer
In a study reported in JAMA Internal Medicine, Patz et al of the NLST Overdiagnosis Manuscript Writing Team estimated the magnitude of overdiagnosis using low-dose computed tomography (CT) screening for lung cancer in the National Lung Screening Trial (NLST). They estimated that more than 18% of...
