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breast cancer
symptom management

Estrogen for Vulvovaginal Atrophy in Breast Cancer: Debate Continues

Vulvovaginal atrophy is a concern for the majority of patients with breast cancer, not only because of its physical and psychosexual consequences, but because the optimal treatment—estrogen replacement—is controversial. Patients and physicians alike remain concerned that external estradiol may...

prostate cancer

NIH Panel Endorses Active Surveillance in Low-risk Prostate Cancer

Active surveillance of localized prostate cancer is a viable management option that should be offered to low-risk patients in place of immediate treatment, said a panel of experts convened by the National Institutes of Health. A fairly new concept, active surveillance takes a more proactive...

breast cancer

Gene Classifier Spots Different Recurrence Patterns in Patients with ER-positive Breast Cancer

A new gene classifier differentiates between women with estrogen receptor (ER)-positive breast cancer who go on to develop metastases early vs late, possibly paving the way for tailored adjuvant therapy. Using pretreatment tumor biopsies, a team led by Minetta C. Liu, MD, of the Georgetown...

breast cancer

Bevacizumab Breast Cancer Indication Rescinded: What Are the Downstream Implications?

Leading up to FDA’s resolution to revoke the breast cancer indication for bevacizumab (Avastin), the debate over the drug’s clinical value was imbued with contentious ideologic overtones, which culminated in a 2-day public hearing that exposed deep divisions not only in the scientific community,...

lymphoma

Favorable Early-stage Hodgkin Lymphoma and HD.6: The Take-Home and Don’t–Take-Home Messages

The Canadian HD.6 randomized study in patients with nonbulky early-stage Hodgkin lymphoma is mostly of historic interest.1,2 It has little relevance to current treatment standards or questions, and the risk for its inappropriate interpretation is of great concern. Radical Radiation Approach Long...

supportive care

Depression Is Dangerous among Patients with Cancer, but Talking and Pharmacologic Treatments Can Be Effective

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. “Depression is a very dangerous...

issues in oncology

Oncologists Examine Promise vs Reality of Personalized Medicine

Personalized medicine: It’s a phrase that reverberates across all cancer meetings. “Matching the right drug to the right patient” will be accomplished, in the not too distant future, through genomic sequencing of the tumor and targeted, less toxic therapy. This much has been established—or has it?...

lung cancer

Lung Cancer Advocates Seek to Raise Awareness (and Research Funding)

Although lung cancer is the leading cause of cancer death in the United States for both men and women—nearly 157,000 deaths from lung cancer occurred in 2011, according to the American Cancer Society—survey results from the Lung Cancer Research Foundation (LCRF) show that 60% of Americans are...

breast cancer

Ablation of Small Primary Breast Tumors: The Next Step in Local Therapy?

Local treatment of breast cancer is trending toward less invasive procedures that achieve comparable outcomes to standard interventions. What will the next step along this continuum be? According to Michael S. Sabel, MD, a surgical oncologist at the University of Michigan Comprehensive Cancer...

breast cancer

Study Questions Use of Partial Breast Brachytherapy in Older Women

Partial breast brachytherapy is less effective and more toxic than whole-breast irradiation when used after lumpectomy, suggests an analysis of Medicare claims data. In the 2000–2007 study of more than 130,000 older women with breast cancer—the largest of its kind to date—the rate of mastectomy in...

issues in oncology
health-care policy

Drug Shortages Hit Oncology Hard: Experts Weigh in on Challenges and Solutions

Periodic drug shortages are an unavoidable reality in our complicated pharmaceutical supply chain; however, over the past several years, drug shortages have expanded to crisis levels, putting vulnerable patients at risk. In 2010, there were 178 drug shortages reported to the FDA, 132 of which were...

lymphoma

Expert Point of View: Maintenance Rituximab vs Retreatment Rituximab in Patients with Low–Tumor-Burden Follicular Lymphoma

The findings of RESORT1 have tremendous implications, both clinically and economically, commented Andrew D. Zelenetz, MD, Chief of the Lymphoma Service at Memorial Sloan-Kettering Cancer Center, New York, in an interview. “The maintenance arm received rituximab [Rituxan] every 3 months...

multiple myeloma

Expert Point of View: Monoclonal Antibody Promising in Multiple Myeloma

With a wealth of new agents of various classes in the pipeline, “myeloma is going to become a chronic illness, with sustained complete responses achieved in a significant fraction of patients,” according to Kenneth C. Anderson, MD, of Dana-Farber Cancer Institute and Harvard Medical School, ...

leukemia

A Second Chance for Gemtuzumab in Acute Myeloid Leukemia

Gemtuzumab ozogamicin (Mylotarg) may have a second chance for regulatory acceptance, as studies presented at ASH 2011 demonstrated that gemtuzumab can be safely and effectively given by adjusting the dosing and treatment schedule. Gemtuzumab ozogamicin was approved for the treatment of acute...

breast cancer

Expert Point of View: Can Molecular Profiling Identify ER-positive Patients Destined for Relapse?

Eastern Cooperative Oncology Group (ECOG) trials have demonstrated that recurrence patterns are different for estrogen receptor (ER)-positive vs ER-negative breast cancer. While ER-negative disease carries a high risk for early recurrence—peaking around year 1.5 from diagnosis—risk steadily...

issues in oncology

A Patient with Cancer Saw a Need and Left a Living Legacy

It is well documented that the rigors of delivering cancer care can unintentionally supersede valuable doctor-patient communication. Before he died in 1995, Kenneth B. Schwartz, a patient with cancer at Massachusetts General Hospital, recognized this phenomenon and founded the Kenneth B. Schwartz...

head and neck cancer

Challenges, Progress, and Future Directions in Head and Neck Cancer

Although head and neck cancer remains a major therapeutic challenge, significant advances have been made over the past few decades. The ASCO Post recently spoke with Marshall R. Posner, MD, Medical Director of the Head and Neck Oncology Program, Mount Sinai Medical Center, New York, about the...

health-care policy

A Dose of Destruction and Tough Love for Health Care

Title: The Creative Destruction of Medicine: How the Digital Revolution Will Create Better Health Care
 Author: Eric Topol, MD Publisher: Basic Books Publication date: February 1, 2012 Price: $27.99 / $31.00 (CAN), Hardcover, 320 pages More information: http://creativedestructionofmedicine.com/...

issues in oncology

Starting Down the Path toward Electronic QOPI®: ASCO and US Oncology Collaborate in Quality Measurement

The Quality Oncology Practice Initiative (QOPI®), ASCO’s quality measurement program, is entering its 6th successful year and continuing to grow, both in number of participants and in quality measures evaluated. In the truest spirit of quality improvement, ASCO’s oncologist leaders have determined...

global cancer care
pain management

Inefficient Markets Impede Cancer Pain Relief

The potent analgesic property of morphine was first isolated in 1804, and after more than 2 centuries morphine is still the gold standard for moderate to severe pain. It is relatively easy to produce, and compared to most pharmaceuticals, morphine is dirt-cheap. Therein lies the cruel conundrum:...

health-care policy

A Visionary Call for the ‘Creative Destruction’ of Medicine

According to nationally regarded cardiologist and geneticist Eric Topol, MD, Chief Academic Officer of Scripps Health, the next frontier of the digital revolution can create exponentially better health care. Dr. Topol, who is also Director of the Scripps Translational Science Institute and...

Expert Point of View: Two Novel Agents Prolong Survival in Advanced Prostate Cancer

“My comment on the AFFIRM trial is ‘wow, very impressive.’ The median survival and the declines in PSA levels are impressive, and this is going to change the way we care for patients in our practices,” said Nicholas Vogelzang, MD, medical oncologist with Comprehensive Cancer Centers of Nevada and...

issues in oncology

Adolescents and Young Adults with Cancer: A Distinct Population of Patients Who Need to Be Treated Differently

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Cancer among adolescents and young...

health-care policy

Research Funding Key to Continued Progress in Cancer Care

American Association for Cancer Research (AACR) President and ASCO member Judy Garber, MD, MPH, recently spoke with The ASCO Post about the findings of AACR’s landmark Cancer Progress Report,1 In addition, she offered her perspective on the current and future state of cancer research. Project...

breast cancer

Context May Affect Benefit of Adjuvant Clodronate in Breast Cancer

A benefit of the oral bisphosphonate clodronate when used as adjuvant therapy for early breast cancer may depend on factors such as the endpoint assessed and patient age, suggests the randomized B-34 trial conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP). The trial,...

Expert Point of View: Maintenance with Lenalidomide or Bortezomib Prolongs Remission in Elderly Patients with Multiple Myeloma

David S. Siegel, MD, PhD, of the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey, commented to The ASCO Post that essentially all patients with multiple myeloma could be candidates for maintenance therapy. “But I don’t know that we have established that maintenance...

lung cancer

Researchers Map Potential Genetic Origins, Pathways of Lung Cancer in Never-smokers

Findings from a small study on potential gene mutations and pathway alterations that could lead to lung cancer in never-smokers were presented in a poster at the American Association for Cancer Research–International Association for the Study of Lung Cancer Joint Conference on Molecular Origins of...

health-care policy

Rising Costs in Radiation Oncology Linked to Medicare Coverage

In the ongoing debate over how to control rising cancer care costs, it is vital to identify usage patterns of expensive new technologies. A recent study examined the relationship between Medicare reimbursement and the increasing use of intensity-modulated radiation therapy (IMRT).1 The ASCO Post...

prostate cancer

Expert Point of View: Prostate Cancer Studies Compare Outcomes, Toxicities, and Costs

Nicholas B. Vogelzang, MD, moderator of the press briefing where these findings were presented, agreed that the first study supports intensity-modulated radiotherapy (IMRT) as the current standard of care. With costs of health care increasing exponentially, it is important to establish the...

geriatric oncology

Moving the Field of Geriatric Oncology Forward

With the aging of the population, virtually all of the subspecialties of oncology will soon be concerned primarily with the care of older patients. While there is not one precise definition of the age of “geriatric” patients, it is clear that the aging of our society has necessitated a focus on the ...

issues in oncology
health-care policy

Searching for Quality in an Increasingly Complex Health-care Environment

With the Presidential election just around the corner, the health-care debate will undoubtedly heat up. The ASCO Post spoke with Sean R. Tunis, MD, MSc, Founder and Director, Center for Medical Technology Policy, and former Chief Medical Officer for the Centers for Medicare & Medicaid Services, ...

issues in oncology

Options for Preserving Fertility Should Be Considered Early to Maximize the Likelihood of Success

Most cancer survivors prefer to have biologic offspring despite concerns about the possible effects of cancer treatment on the child, the child’s lifetime cancer risk, or their own longevity, according to an ASCO panel that developed guidelines on fertility preservation in patients with cancer.1...

issues in oncology

ASCO’s Blueprint Sets Goals for Accelerating Cancer Progress

ASCO recently issued a report, Accelerating Progress Against Cancer: ASCO’s Blueprint for Transforming Clinical and Translational Cancer Research, which outlines the Society’s 10-year plan for improving cancer outcomes. Central to achieving that goal are three steps, including (1) therapy...

Expert Point of View: New Biomarker Predicts Survival in Advanced Prostate Cancer

“The Bone Scan Index (BSI) is a very important new quantitative imaging biomarker to help us better assess patients with metastatic prostate cancer in a robust and reproducible way, particularly those with bone-dominant disease,” said Lawrence Schwartz, MD, Chair of the Department of Radiology at...

prostate cancer

New Biomarker Predicts Survival in Advanced Prostate Cancer

Researchers at Memorial Sloan-Kettering Cancer Center have developed the Bone Scan Index (BSI), which is the first quantitative imaging response biomarker that can assess response to treatment and prognosticates for survival in men with metastatic castration-resistant prostate cancer. Based on Bone ...

issues in oncology

Cancer Informatics: A Future Necessity, but Challenges Abound

The National Cancer Policy Forum of the Institute of Medicine (IOM) recently convened a workshop on cancer informatics to examine and discuss needs and challenges facing biomedical researchers, which will in turn affect the way oncology is practiced in the future. “This is a time of huge scientific ...

lung cancer

Not All KRAS Mutations Are Alike in Non–Small Cell Lung Cancer

Mutations in the KRAS oncogene play a critical role in cancer cell growth and resistance to treatment. In colorectal cancer, the presence of any mutant amino acid substitution in the K-Ras protein predicts a poorer response to targeted therapy. In non–small cell lung cancer (NSCLC), however, there...

palliative care

ASCO Releases Palliative Care Provisional Clinical Opinion

ASCO has released a provisional clinical opinion (PCO) addressing the integration of palliative care services into standard oncology care.1 The ASCO Post recently spoke with one of the PCO’s lead authors, Thomas J. Smith, MD, Director of Palliative Care for Johns Hopkins Medicine and the Johns...

health-care policy

ACCC Meeting Focuses on Affordable Care Act: Its Future, and What It Might Accomplish

The Association of Community Cancer Centers (ACCC) mid-March Annual Meeting devoted several sessions to the Patient Protection and Affordable Care Act: Will it still be here after the Supreme Court decides its fate? If so, how much of it will survive, and how will it affect oncology practice? In...

colorectal cancer

Adding Cetuximab to Adjuvant Therapy with Modified FOLFOX6 Does Not Improve Survival

Adding cetuximab (Erbitux) to adjuvant treatment with mFOLFOX6, the modified sixth version of FOLFOX (leucovorin, fluorouracil, oxaliplatin) did not improve disease-free survival among patients with resected stage III colon cancer, even those with wild-type KRAS, according to a phase III study in...

colorectal cancer

Quality of Life Is What’s Most Important to Me

For me, getting a cancer diagnosis has been more annoying than frightening. Mainly, I’m annoyed at myself for not taking care of an anal skin tag sooner. (I’d had it since birth.) The growth hadn’t been a problem until I got pregnant with my first child and it became temporarily engorged with...

SIDEBAR: Could HPV Testing Be Used Alone?

“In the United States, there are no recommendations currently for HPV screening alone as a primary screening test for cervical cancer,” Michael L. LeFevre, MD, MSPH, Co-Vice Chair of the U.S. Preventive Services Task Force (USPSTF) told The ASCO Post. “Cytology picks up very few cases of...

colorectal cancer

Expert Point of View: ColoPrint Gene Assay Can Guide Treatment Decisions in Stage II Colon Cancer

Axel Grothey, MD, of the Mayo Clinic, Rochester, Minnesota, told The ASCO Post that he finds the data “intriguing” and that the study exemplifies the value of developing molecular signatures for use in colon cancer. “It identifies patients with an excellent prognosis, who perhaps should not be...

colorectal cancer

Novel Multikinase Inhibitor Improves Survival in Metastatic Colorectal Cancer

The novel tyrosine kinase inhibitor regorafenib, given as a single agent to patients with treatment-refractory metastatic colorectal cancer, significantly improved overall survival and delayed disease progression in an international phase III trial presented at the 2012 Gastrointestinal Cancers...

issues in oncology

ASCO Continues to Support Oncologists in Electronic Health Records Adoption at 2012 Annual Meeting

As part of its ongoing effort to support oncology practices in adopting Electronic Health Records (EHR) to improve their quality of care, ASCO is holding its sixth annual EHR Vendor Lab, from June 2-4 at the 2012 ASCO Annual Meeting in Chicago. This resource gives attendees the opportunity to test...

leukemia

Integrated Genetic Profiling Can Identify Predictors of Outcome and Improve Risk Stratification in AML Patients

A mutational analysis of 18 genes in 398 patients with acute myeloid leukemia (AML) found at least one somatic alteration in 97.3% of the patients and identified genetic predictors of outcome that improved risk stratification among patients with AML, independent of age, white-cell count, induction...

issues in oncology
health-care policy

Update on Oncology Drug Shortage: Better for Now, But Permanent Solutions Must Address Underlying Issues

Over the past few years, drug shortages in the United States have been on the rise, involving hundreds of agents, many of which are lifesaving medications for patients with cancer. In recent months, the FDA has taken steps to alleviate some of the most critical oncology drug shortages. “We should...

issues in oncology

Novel Initiative to Address Oncology Drug Crisis

Much has been written about the oncology drug shortage crisis in the United States. In the spirit of being part of the solution to that problem, a group of oncologists has formed the Citizen’s Oncology Foundation (COF). The goal of the start-up not-for-profit association is two-pronged: to find...

geriatric oncology

Geriatric Oncologists: A Small but Passionate Group

Although age is the major risk factor for developing cancer, geriatric oncology is still a relatively new discipline within the oncology community. To gain insight into this evolving component of cancer care, The ASCO Post recently spoke with a leader in the field, Stuart M. Lichtman, MD, FACP,...

SIDEBAR: Social Media: A Generational Thing?

Overheard Monday morning conversations about concerns expressed by patients and family members over the weekend triggered the idea for the article about the challenges of using social media to communicate with patients in the oncology setting, according to the article’s lead author, Lori Wiener,...

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