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issues in oncology

Hookah Tobacco Smoking Among Students

Educational campaigns meant to dissuade college students from initiating hookah tobacco smoking may be more successful if they combat positive perceptions of hookah use as attractive and romantic, rather than focusing solely on the harmful components of hookah tobacco smoke, a new University of...

supportive care

Helping Young Adults Cope With Cancer

For young adults diagnosed with cancer, coping with the aftermath of the disease can be especially daunting. Although all cancer survivors share some common concerns and distress, for young adults grappling with body image, sexuality, peer pressure, dating, marriage, family planning, education, and ...

breast cancer

Should Breast Cancer Patients With One to Three Positive Nodes Routinely Receive Postmastectomy Radiation?

The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) continues to provide valuable clinically relevant and practice-influencing information garnered from individual patient-level data from numerous randomized trials in breast cancer. The large numbers of patients and long-term follow-up...

breast cancer

Postmastectomy Radiotherapy Reduces Breast Cancer Recurrence and Mortality in Women With One to Three Positive Nodes

Meta-analyses have shown that postmastectomy radiotherapy reduces risks of recurrence and breast cancer mortality in the population of all women with node-positive disease, but outcomes in those with only one to three positive nodes have not been specifically examined. As reported by Paul McGale,...

breast cancer

ASCO Guideline Update Extends Sentinel Node Biopsy Indications in Breast Cancer

The American Society of Clinical Oncology (ASCO) published its first guideline for sentinel lymph node biopsy in 2005.1 Since that time, many new randomized and cohort studies have been published investigating the indications and outcomes of the procedure. The updated 2014 guideline, recently...

breast cancer

ASCO Clinical Practice Guideline Update: Sentinel Lymph Node Biopsy for Patients With Early-Stage Breast Cancer

ASCO recently convened an update committee of experts in medical oncology, pathology, radiation oncology, surgical oncology, guideline implementation, and advocacy to develop evidence-based recommendations that update the ASCO 2005 clinical practice guideline on use of sentinel node biopsy in...

health-care policy

Unprecedented Release of Medicare Data Raises Concerns About Lack of Context: Statements From COA and ASTRO

In April, as part of the Obama administration’s work to make the U.S. health-care system more transparent, affordable, and accountable, the Centers for Medicare & Medicaid Services (CMS) released a vast amount of privacy-protected data on services and procedures provided to Medicare...

health-care policy

Patients Benefit From Faster FDA Drug Approval Process

In an increasing spirit of cooperation, U.S. Food and Drug Administration (FDA) and several pharmaceutical companies are bringing to fruition the newest in a series of ways to expedite drug development and review. Breakthrough therapy is the designation instituted in 2012 by the FDA Safety and...

leukemia

Looking Ahead in Treating Chronic Lymphocytic Leukemia

It’s the dawn of a new era in the treatment of chronic lymphocytic leukemia (CLL), largely due to the development of agents targeting the BCR signaling pathway, according to John C. Byrd, MD, of The Ohio State University Comprehensive Cancer Center, Columbus. At the 19th Annual Conference of the...

issues in oncology
supportive care

NCCN Roundtable: When a Parent Has Cancer

Attendees at this year’s annual conference of the National Comprehensive Cancer Network (NCCN) not only got up to date on the Guidelines but left with a better understanding of how children deal with a parent’s cancer, and how oncology providers can best help. Panelists for the NCCN roundtable...

survivorship
supportive care
bladder cancer

NCCN Scientific Posters Include New Findings in Bladder Cancer, Survivorship Care, and Antiemetic Therapy

The 19th Annual Conference of the National Comprehensive Cancer Network (NCCN), recently held in Hollywood, Florida, featured a number of scientific posters by member organizations and meeting sponsors. The ASCO Post captured some of the most interesting findings for our readers, including these...

survivorship

Study Calls for Revisiting Guidelines for Screening Childhood Cancer Survivors at Risk of Congestive Heart Failure

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 suggests that less frequent screening than currently recommended may yield similar clinical benefit. The...

colorectal cancer

Surveillance After Colon Cancer Surgery: Too Much of a Good Thing?

Finding salvageable colon cancer recurrence is akin to finding a needle in a haystack, rendering routine patient surveillance of little value. But finding that needle offers an opportunity for treating recurrent disease early, which makes surveillance worthwhile. These were the opposing views...

skin cancer

Phase III Study of Talimogene Laherparepvec in Patients With Metastatic Melanoma: Overall Survival Analysis Reported

Amgen recently announced top-line results from the primary overall survival analysis of a phase III trial in melanoma, which evaluated the efficacy and safety of talimogene laherparepvec (also known as T-VEC) for the treatment of unresected stage IIIB, IIIC, or IV melanoma compared to treatment...

health-care policy
geriatric oncology

AACR Calls on Congress to Support Cancer Research Funding to Meet the Challenges of Our Aging Population

Great progress is being made in the battle against cancer, but a renewed commitment of federal support for medical research is needed to speed its eradication, according to leaders of the American Association for Cancer Research (AACR), commenting in connection with a recent Senate hearing on “The...

cns cancers

Glioblastoma: Can We Make This Intractable Disease Tractable?

In the clinical array of brain tumors, glioblastoma is the most difficult to treat, and despite decades of research and the advent of new therapies, patients with glioblastoma continue to have a very poor prognosis. Leading brain tumor experts at the recent 25th Annual Cancer Progress Conference in ...

leukemia

Mercaptopurine Oral Suspension for Acute Lymphoblastic Leukemia

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 April 28, 2014, an oral suspension of mercaptopurine (Purixan) ...

issues in oncology

IASLC Issues Statement on E-Cigarettes

There are currently no evidence-based guidelines to support the recommendation of e-cigarettes as a cessation tool to help patients stop smoking. In a recent article in the Journal of Thoracic Oncology,1 members of the International Association for the Study of Lung Cancer (IASLC) Tobacco Control...

breast cancer

Axillary Radiotherapy Associated With Fewer Side Effects Than Lymph Node Dissection in AMAROS Analysis

Radiation therapy is associated with significantly fewer postoperative complications than axillary lymph node dissection, according to a detailed analysis of morbidity from the AMAROS (After Mapping of the Axilla: Radiotherapy or Surgery?) trial presented at a press briefing prior to the American...

breast cancer

Cryoablation of Breast Tumors Shows Promise in Patients With Early-Stage Disease

Cryoablation of breast tumors, which destroys lesions by exposing them to extremely low temperatures, shows promise as an alternative to surgery in carefully selected women with early-stage disease, according to a study presented at the American Society of Breast Surgeons Annual Meeting in Las...

Expert Point of View: Clifford A. Hudis, MD, FACP

“To our surprise, obesity had a negative prognostic effect on premenopausal patients with breast cancer but not on those who were postmenopausal. We need to consider these findings in the context of results from other data sources that suggest that obesity remains a negative prognostic feature in...

Guides for Oncology Providers and Patients Now Available

As the prevalence of obesity increases in the U.S. population and potentially complicates all aspects of cancer treatment and survival, many cancer care providers struggle with addressing the topics of weight loss and weight management with their patients. Obesity and Cancer: A Guide for Oncology...

breast cancer

Obesity Increases Breast Cancer Mortality in Premenopausal Women With Estrogen Receptor–Positive Disease

According to results of a large study of women with early breast cancer, the presence of obesity increased the risk of breast cancer–related mortality by 34% in premenopausal women with estrogen receptor–positive breast cancer. Obesity had little effect on breast cancer–related mortality in...

Expert Point of View: Peter P. Yu, MD

Discussing the study on immediate vs deferred androgen deprivation therapy in the setting of prostate cancer with prostate-specific antigen (PSA)-only relapse, ASCO President Peter P. Yu, MD, noted that more than 60,000 men each year will face the dilemma of when to start androgen deprivation...

prostate cancer

Delaying Androgen Deprivation Therapy May Not Compromise Survival in Men With Prostate Cancer and PSA-Only Relapse

In men with prostate cancer and a prostate-specific antigen (PSA)-only recurrence after curative surgery or radiation, delaying androgen deprivation therapy for at least 2 years or until clinical progression (ie, new symptoms, metastasis by imaging techniques or short PSA doubling time) did not...

Expert Point of View: Peter P. Yu, MD

Commenting on the study by Jänne et al, ASCO President Peter P. Yu, MD, said that the issue of drug resistance is important to understand for all cancers, but it is difficult to overcome resistance. “This clinical trial has important implications not only for NSCLC patients but for all patients...

lung cancer

Phase I Study of Novel Third-Generation EGFR Inhibitor Holds Promise Against Resistance Mutation in Patients With Non–Small Cell Lung Cancer

Preliminary evidence suggests that AZD9291, a novel mutant-selective epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor, may become a treatment option for patients with advanced, EGFR-mutant, non–small cell lung cancer (NSCLC) that has progressed on standard EGFR inhibitors....

Expert Point of View: George W. Sledge, Jr, MD

In his commentary on the ALTTO results, George W. Sledge, Jr, MD, Professor of Medicine and Director of the Division of Oncology at Stanford University, reminded attendees that the announcement of the first results for adjuvant trastuzumab, which occurred at the 2005 ASCO Annual Meeting, was “a...

breast cancer

ALTTO Trial Finds Dual Anti-HER2 Therapy No Better Than Trastuzumab Alone

The highly anticipated results from the phase III ALTTO trial show no additional benefit for adding lapatinib (Tykerb) to trastuzumab (Herceptin) in the adjuvant treatment of HER2-positive breast cancer.1 The results were presented at the 2014 ASCO Annual Meeting’s Plenary Session by Martine J....

SIDEBAR: MEDCAC Roster

Rita Redberg, MD, MS, Chair Professor of Medicine UCSF School of Medicine Division of Cardiology University of California, San Francisco, Medical Center Art Sedrakyan, MD, PhD, Vice ChairAssociate Professor and DirectorPatient Centered Comparative Outcomes Research ProgramWeill Cornell Medical...

SIDEBAR: How the MEDCAC Panelists Voted

Grading their responses on a 5-point scale, where 5 represented the highest level of confidence, Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) members were asked the following questions: How confident are you that there is adequate evidence to determine if the benefits ...

lung cancer
issues in oncology

Medicare Advisory Panel Cast Doubts on Lung Cancer Screening, Leaving Advocates Dismayed but Undaunted

On April 30, 2014, the Centers for Medicare & Medicaid Services (CMS) convened the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) to assess the value of low-dose computed tomography (CT) lung cancer screening in the Medicare population. After a decades-long battle,...

issues in oncology

'Small Practices Like Mine'

Recently, I participated in ASCO’s Congressional news briefing in Washington, DC, following the release of its report, The State of Cancer Care in America: 2014. During my presentation I talked about the workforce shortage of approximately 1,500 medical oncologists that is predicted by 2025. A...

Expert Point of View: Michael J. Morris, MD

Formal discussant of the E3805 study, Michael J. Morris, MD, Associate Member at Memorial Sloan Kettering Cancer Center in New York, said that these results confirm the role of upfront chemotherapy along with androgen-deprivation therapy in men with newly diagnosed metastatic hormone-sensitive...

prostate cancer

‘Unprecedented’ Survival Benefit in Prostate Cancer With Addition of Docetaxel to Hormone Therapy

Adding docetaxel to standard androgen ablation therapy (ie, testosterone suppression) extended survival by more than 1 year in men with newly diagnosed metastatic hormone-sensitive prostate cancer in the phase III E3805 trial, funded by the National Institutes of Health. As reported at the ASCO...

Sharing 50 Years of Christmas: A Quality Metric?

A very pleasant 68-year-old woman was referred to my clinic with biopsy-proven liver metastasis from primary colon cancer. She was initially diagnosed with colon cancer, which was resected, and she then received chemotherapy. A suspicious liver lesion was biopsied in the adjuvant setting, which...

Leading Cancer Researcher and Public Health-Care Expert, Eddie Reed, MD, Dies

In a 2010 interview, Eddie Reed, MD, a pioneer in the molecular pharmacology of DNA-damaging anticancer agents and the clinical development of paclitaxel for ovarian cancer, was asked what lay ahead. Before answering, Dr. Reed first acknowledged the esteemed mentors who gave him their most precious ...

breast cancer

Long-Term Follow-up Confirms Low Incidence of Cardiac Events Associated With Trastuzumab

At a median follow-up of 8 years, patients receiving trastuzumab (Herceptin) sequentially after chemotherapy and radiotherapy in the Herceptin Adjuvant (HERA) trial had a low incidence of cardiac events and these were reversible in the vast majority of patients. This long-term assessment confirms...

colorectal cancer
geriatric oncology

Colorectal Cancer Screening Recommended Past Age 75 for Previously Unscreened Patients

Colorectal cancer screening is cost-effective and “should be considered well beyond age 75 years” for individuals not previously screened, according to a computer simulation study published in the Annals of Internal Medicine. The researchers noted that while the U.S. Preventive Services Task Force...

Focus on the Washington State Medical Oncology Society

The Washington State Medical Oncology Society (WSMOS) was formed in 1993 in response to the health-care reform legislation then being proposed by President Bill Clinton. “The law never passed, but it spurred the development of our Society, so some good came out of the law’s defeat,” said Vicky E....

Expect Questions From Patients

With the extensive media coverage of a study indicating that injections with the luteinizing hormone–releasing hormone (LHRH) agonist goserelin (Zoladex) may offer a new option for preserving fertility among women treated for breast cancer, physicians can expect questions from interested patients....

breast cancer

New Option for Preserving Fertility in Women Being Treated With Chemotherapy for Early-Stage Breast Cancer

One of the most reported studies emanating from the 2014 ASCO Annual Meeting involves the use of the luteinizing hormone–releasing hormone (LHRH) agonist goserelin (Zoladex) to reduce the risk of ovarian failure among women being treated with chemotherapy for early-stage breast cancer, and to...

2014 Oncology Meetings

JUNE MASCC/ISOO International Symposium on Supportive Care in CancerJune 26-28 • Miami, Florida For more information: www.mascc.org/symposium European Conference of Oncology Pharmacy 2June 26-28 • Krakow, Poland For more information: http://ecop2014.wordpress.com 6th International Workshop on...

issues in oncology

Genomic Confidence and Competence

As reported in the Journal of Clinical Oncology and reviewed in this issue of The ASCO Post, Stacy W. Gray, MD, AM, a medical oncologist at Dana-Farber Cancer Institute, Boston, and colleagues presented one of the first studies evaluating how academic oncologists perceive the incorporation of a...

issues in oncology

Physician Attitudes About Multiplex Tumor Genomic Testing: Variation in Projected Use and Confidence

It is a widely expressed belief that predictive multiplex somatic genomic testing represents the ability to transform cancer care by identifying targetable alterations in multiple cancer genes. Do oncologists share this belief? How do they intend to use such tests in practice? In a study reported...

cost of care
health-care policy

Cancer Care Under the Affordable Care Act

The problematic rollout of the Affordable Care Act’s website, HealthCare.gov, made good political theater, but while much of the heated discussion centered on the plan’s need to enroll “young invincibles,” America’s cancer care system and the older patients it serves were also affected by parts of...

pain management

Federal Pain Research Database Launched

The Interagency Pain Research Portfolio (IPRP), a database that provides information about pain research and training activities supported by the federal government, has been launched by six federal agencies. “This database will provide the public and the research community with an important tool...

David Craig, PharmD, Named to FDA Advisory Committee

Moffitt Cancer Center recently announced that Clinical Pharmacist David Craig, PharmD, has been appointed to the U.S. Food and Drug Administration’s Anesthetic and Analgesic Drug Products Advisory Committee. Dr. Craig specializes in pain medicine and palliative care. The Anesthetic and Analgesic...

Marie-Josée and Henry R. Kravis Foundation Provides $100 Million Gift to Support Precision Oncology Work at Memorial Sloan Kettering Cancer Center

Memorial Sloan Kettering Cancer Center has launched an initiative to improve cancer care and research through genomic analysis. The new program will reshape clinical trials and speed the translation of novel molecular discoveries into routine clinical practice. The Marie-Josée and Henry R. Kravis...

Maurie Markman, MD, Named President of Medicine & Science Unit, Cancer Treatment Centers of America

Cancer Treatment Centers of America (CTCA) recently announced the appointment of Maurie Markman, MD, as President of the company’s Medicine & Science unit. He will be responsible for advancing the organization’s overall commitment to clinical excellence, innovation, safety, and patient...

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