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Expert Point of View: Carlos L. Arteaga, MD

Commenting on the results of the HOPE Study presented at the 2013 San Antonio Breast Cancer Symposium, Carlos L. Arteaga, MD, said, “We all know that this is the right thing to do. This important study provides us with new guidelines and a structure so that patients find it easier to follow the...

breast cancer
pain management

Exercise Program Reduces Aromatase Inhibitor–Associated Joint Pain

Amid studies of novel targeted therapies, genetic analyses of tumors, and new ways to approach the treatment of breast cancer, a low-tech study presented at the 2013 San Antonio Breast Cancer Symposium found that a yearlong exercise program reduced joint pain associated with aromatase inhibitors in ...

colorectal cancer
pancreatic cancer

GI Symposium Presentations Include Important Updates in Treatment and Prognosis of Pancreatic and Colorectal Cancers

More than 650 studies were presented at the 2014 Gastrointestinal Cancers Symposium, which attracted a multidisciplinary group of more than 3,500 medical, surgical, and radiation oncologists and gastroenterologists. The following briefs highlight a handful of noteworthy studies from the meeting....

issues in oncology

ASCO Supports Reinforcing FDA Capacity to Monitor Nation’s Drug Supply

“The GAO report identifies production lapses due to quality problems and constrained manufacturing capacity as being the central causes of the widespread incidence and persistence of drug shortages.   “The report also emphasizes that the FDA has made significant progress in preventing shortages by ...

thyroid cancer

‘Epidemic of Diagnosis’ of Thyroid Cancer Is Most Acute for Women

The epidemiology of the increased incidence of thyroid cancer, which has nearly tripled since 1975, “suggests that it is not an epidemic of disease but rather an epidemic of diagnosis,” Louise Davies, MD, MS, and H. Gilbert Welch, MD, MPH, concluded after analyzing trends in patients diagnosed with ...

skin cancer
cost of care

Dermatologists Defend Mohs Surgery as Effective and Cost-Efficient With Low Rate of Recurrence

The headline, “Patients’ Costs Skyrocket, Specialists’ Incomes Soar,” aptly encapsulates the theme of a recent article in The New York Times,1 part of a series entitled, “Paying Till It Hurts.” “Oncologists benefit from the ability to mark up (and profit from) each dose of chemotherapy they...

supportive care

Music Therapy Yields Positive Effects on Coping Skills, Social Integration, and Family Environment for Young Patients With Cancer

A collaborative multisite study has found that teens and young adults undergoing stem cell transplantation as part of cancer treatment gain coping skills and resilience-related outcomes when participating with a board-certified music therapist in a therapeutic music protocol that includes writing...

health-care policy

ASCO Addresses Changes in Medicare for 2014

Medicare patients make up 61% of new cancer cases in the United States, and as the population ages, that proportion is expected to rise to 70% by 2030. Over the past decade, the oncology community has been financially challenged by alterations in the Medicare payment system. To address the changes...

breast cancer

Impact of Delayed Initiation of Adjuvant Chemotherapy for Breast Cancer Varies by Tumor Subtype

The optimal time interval between surgery and initiation of adjuvant chemotherapy for early-stage breast cancer is not well established. Although most physicians aim to initiate adjuvant chemotherapy within a few weeks of surgery, clinical factors may cause delay. The influence of delay on relapse...

breast cancer

Support from 1999 Career Development Award Launched Dr. Kornelia Polyak’s Quest to Advance Understanding of DCIS of the Breast

In 1999, Kornelia Polyak, MD, PhD, of the Dana-Farber Cancer Institute, received a Career Development Award from the Conquer Cancer Foundation for her project, “Isolation of Tumor Suppressor Genes Inactivated in DCIS of the Breast.” “The Career Development Award got me started,” she said. “When...

breast cancer

Adding Bevacizumab to Adjuvant Chemotherapy/Trastuzumab Fails to Improve Survival in HER2-Positive Breast Cancer

The addition of bevacizumab (Avastin) to adjuvant chemotherapy did not improve invasive disease-free survival or overall survival in patients with high-risk HER2-positive breast cancer in the large randomized phase III BETH trial. Although not specifically designed to answer this question, BETH...

neuroendocrine tumors

For Progressive Neuroendocrine Tumors, Clinical Benefit Is High With Capecitabine Plus Temozolomide

In an interim analysis of a phase II trial, 97% of patients with progressive metastatic neuroendocrine tumors achieved clinical benefit with the combination of capecitabine and temozolomide (CAPTEM). The results were reported at the 2014 Gastrointestinal Cancers Symposium by Robert L. Fine, MD,...

health-care policy

The Evolution of U.S. Cooperative Group Trials: Publicly Funded Cancer Research at a Crossroads

Over the past 5 decades, National Cancer Institute (NCI) Clinical Trials Cooperative Groups have played an enormous role in the fight against cancer, tackling a broad social agenda, including cancer prevention, quality-of-life issues for patients with cancer, and comparison of benefits among...

USPSTF Appoints New Chair and Co-Vice Chair

The U.S. Preventive Services Task Force recently announced the appointments of Michael L. LeFevre, MD, MSPH, as Chair of the Task Force and Kirsten Bibbins-Domingo, PhD, MD, as Co-Vice Chair. Albert L. Siu, MD, MSPH, current Co-Vice Chair, will remain in his position. Dr. LeFevre and Dr....

American Association for Cancer Research Welcomes New Board of Directors, Nominating Committee Members

The members of the American Association for Cancer Research (AACR) have elected five members to serve on the AACR Board of Directors for the 2014–2017 term and four members to serve on the Nominating Committee for the 2014–2016 term. They assumed their roles at the AACR Annual Meeting 2014, held in ...

prostate cancer

Prostate Cancer Study Showing Increased Survival for Younger Men Undergoing Prostatectomy Not Expected to Increase Surgeries

Extended follow-up in the Scandinavian Prostate Cancer Group Study Number 4 (SPCG4), reported recently in The New England Journal of Medicine,1 found that men with early-stage prostate cancer, particularly those under 65 years old, who were treated with radical prostatectomy had increased survival...

MD Anderson Honors Two Champions for Women in Medicine and Research

Two champions of gender equality in medicine and research were recently honored by The University of Texas MD Anderson Cancer Center. Laurie Glimcher, MD, the Stephen and Suzanne Weiss Dean of Weill Cornell Medical College and Provost for Medical Affairs of Cornell University since 2012, received...

survivorship

Ongoing Clinical Trials Actively Recruiting Adolescent and Young Adult Survivors of Childhood Cancer

ADOLESCENT AND YOUNG ADULT CHILDHOOD CANCER SURVIVORS Study Type: Randomized/interventional Study Title: A Randomized Web-Based Physical Activity Intervention in Adolescent Survivors of Childhood Cancer Study Sponsor and Collaborators: St. Jude Children’s Research Hospital Purpose: Five-year...

issues in oncology

‘How Am I Doing, Doc?’

The goal of effective adjuvant therapy is to increase overall survival. It has been suggested cynically that all we need to accomplish, actually, is to delay recurrence until after the time the patients die from another cause. However, patients want to hear from us that “it’s never coming back,”...

breast cancer

Study Shows Pathologic Complete Response to Neoadjuvant Therapy for Breast Cancer of Prognostic Value but Not for Use as Surrogate for Survival

Pathologic complete response to neoadjuvant therapy has been proposed as a surrogate endpoint for long-term clinical benefit in breast cancer. The U.S. Food and Drug Administration (FDA) established the international Collaborative Trials in Neoadjuvant Breast Cancer (CTNeoBC) working group to...

breast cancer

Determining Why Younger Women With Breast Cancer Are Less Likely to Survive Than Their Older Counterparts

Although cancer survival rates among pediatric and older adult patients continue to rise, survival rates for adolescents and young adults (AYAs), defined by the National Cancer Institute as those between the ages of 15 and 39, have remained stagnant for decades. In breast cancer especially, AYAs...

issues in oncology

Amended 2013 Conflicts of Interest Policy Expands Requirements for Financial Disclosures

The Society’s 2013 Policy for Relationships with Companies is scheduled to go into effect on April 22, with one large change to its original requirements. The policy will still require the full disclosure of all financial relationships by all authors; however, since announcing the new policy in...

issues in oncology

Cancer Research Funding Still Tight—and Getting Tighter

Margaret Foti, PhD, MD (hc), CEO of the American Association for Cancer Research (AACR), welcomed about 150 congressional staffers to a March briefing in Washington, DC, with a plea for increased federal funding. “Extraordinary progress is being made in cancer research today, as evidenced by the...

Recent Study Finds Tripling in Thyroid Cancer

According to a recent report by Davies and Welch,1 the incidence of thyroid cancer in the United States has nearly tripled since 1975, from 4.9 to 14.3 per 100,000 persons, with most of the increase due to papillary thyroid cancer, which has increased from 3.4 to 12.5 per 100,000 persons. The...

thyroid cancer

Thyroid Cancer On the Rise: Is It Clinically Meaningful?

According to data from the Surveillance, Epidemiology, and End Results (SEER) program, rates for new cases of thyroid cancer in the United States have been rising on average 6.4% each year over the past 10 years, and death rates have been rising on average 0.9% each year over the same period. The...

prostate cancer

Prostatectomy vs Radiotherapy: A Study for Cautious Interpretation

Men with newly diagnosed localized prostate cancer face a decision between prostatectomy and radiotherapy, treatments deemed similarly effective but with well-established trade-offs in terms of treatment-related morbidity. Numerous clinical trials and other prospective studies, from both academic...

colorectal cancer

FACS Trial: Intensive Follow-up Increases Surgical Treatment of Recurrence With Curative Intent in Colorectal Cancer

In the FACS trial, reported in JAMA, John N. Primrose, MD, FRCS, of University of Southampton, England, and colleagues compared outcomes with intensive follow-up with carcinoembryonic antigen (CEA) measurement, computed tomography (CT), both, or minimum follow-up after curative surgery for primary...

breast cancer

The Canadian National Breast Screening Trial Had So Many Flaws That Its Results Should Not Be Used to Guide Screening Recommendations

If a randomized, controlled trial of therapy for breast cancer was submitted for publication in which 1. The drug being tested was old and ineffective, and 2. prior to randomization, the women underwent a clinical breast examination and the study coordinators knew who had the largest cancers, and...

breast cancer

Flaws in CNBSS Are Vast, Impact on Screening Recommendations Is Nil

The recent report from the Canadian National Breast Screening Study (CNBSS)—published in BMJ and reviewed in this issue of The ASCO Post—concluded that annual mammography in women aged 40 to 59 does not result in a reduction in mortality from breast cancer beyond that of physical examination alone...

kidney cancer

A Conversation With Arie Belldegrun, MD, FACS, and Allan Pantuck, MD, MS, FACS

Cancer Immunotherapy What is the role of immunotherapy in the treatment of metastatic renal cell carcinoma? The harnessing of the immune system as an effective treatment for cancer was recently selected by the journal Science as the top scientific Breakthrough of the Year for 2013.1 With this...

breast cancer

SSO-ASTRO Margin Guideline: Why Now and What Does It Mean?

Although breast-conserving therapy has been a standard practice for more than 20 years, controversy still exists over what constitutes the appropriate margin of normal breast tissue around a tumor that minimizes local recurrence while maintaining a good cosmetic outcome. Surveys of surgeons1 and...

American Association for Cancer Research Inaugurates 2014 Class of Fellows

The American Association for Cancer Research (AACR) inducted the 2014 class of elected Fellows of the AACR Academy at the Association’s Annual Meeting, held recently in San Diego. The AACR Academy is an entity within the AACR that recognizes those individuals who have made exceptional contributions ...

gynecologic cancers

Preliminary Study Suggests Veliparib May Be Effective in Resistant, BRCA-Mutated Ovarian Cancers

Veliparib, an oral poly(ADP-ribose) polymerase (PARP) inhibitor, appears to be of value in treating women with BRCA-mutated gynecologic cancers that are resistant to other therapies. These preliminary findings of a phase II study support the concept that BRCA-associated ovarian cancers are...

skin cancer

PD-L1 Studied as Biomarker for Anti–PD-1 Immunotherapy

The anti–PD-1 inhibitor MK-3475 (formerly lambrolizumab) is in late-stage trials for advanced melanoma and is also being studied in other malignancies, including non–small cell lung cancer (NSCLC). An important aspect of Merck’s development program for MK-3475, as well as for other anti–PD-1 agents ...

Case Studies: Collaborative Practice in Action

The panel presented two case studies—one on high-dose methotrexate toxicity and one on 5-FU toxicity—as a platform for discussion of considerations, challenges, and interconnected roles of oncologists, nurse practitioners, physician assistants, and clinical pharmacists in safely managing patients...

Collaborative Exchange: Timing of Uridine Triacetate

The challenge of deciding when to administer uridine triacetate was explored by the panel. Dr. Schwartzberg: I assume uridine triacetate would work more effectively if given very early; otherwise we would see the same kind of downstream toxicity we see with methotrexate. Dr. Campen: Exactly, but...

leukemia

Ofatumumab Plus Chlorambucil for Previously Untreated CLL in Patients Not Treatable With Fludarabine-Based Regimens

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 17, 2014, ofatumumab (Arzerra) received regular approval...

Becky L. DeKay, MBA, Becomes President of ACCC

Becky L. DeKay, MBA, became President of the Association of Community Cancer Centers (ACCC) at its 40th Annual National Meeting in April. She is Director of Oncology Services at the Feist-Weiller Cancer Center at Louisiana State University (LSU) Health Shreveport, in ­Louisiana.  “I am honored to...

survivorship
global cancer care

Improving Quality of Life in Cancer Survivors

The number of cancer survivors has been steadily increasing in recent years. According to the Ministry of Health National Cancer Registry, in 2010 there were 254,000 cancer survivors in Israel (3.3% of the population) compared with 15,700 (0.4% of the population, P < .005) in 1975.1 Forty years...

American Association for Cancer Research Inaugurates New Leadership at 2014 Annual Meeting

The American Association for Cancer Research welcomed Carlos L. Arteaga, MD, as President of the Organization for 2014–2015. Dr. Arteaga was inaugurated during the AACR’s Annual Meeting. Dr. Arteaga is Professor of Medicine and Cancer Biology at Vanderbilt University School of Medicine, where he...

thyroid cancer

Increased Incidence of Thyroid Cancer: An Epidemic of Diagnosis?

In a study reported in JAMA Otolaryngology Head & Neck Surgery,1 Davies and Welch found that the incidence of thyroid cancer has nearly tripled since 1975. However, the increase appears to represent an “epidemic of diagnosis” and to almost exclusively represent increased diagnosis of papillary...

supportive care
survivorship

Maximizing the Benefits of Exercise in Patients With Cancer

Many nonpharmacologic therapies increase both physical and emotional strength during cancer treatment as well as throughout survivorship. These therapies include the mind-body practices of meditation, self-hypnosis, guided imagery, and breath awareness, touch therapies including massage and...

palliative care

The Role of Psychosocial Supportive Services in Palliative Care

More than 2 decades ago, Deane L. Wolcott, MD, helped develop comprehensive patient-centered psycho-oncology care in cancer centers across the country. Today, many aspects of that patient-centered care, including psychiatric, dietary, pain management, cancer rehabilitation medicine, survivorship,...

myelodysplastic syndromes

Forward Progress in Myelodysplastic Syndromes Is Largely in Genetics

Most recent advances in the management of myelodysplastic syndrome (MDS) are in the area of genetics, according to Steven Gore, MD, of Yale University School of Medicine, New Haven. “New genomics research is leading to a better understanding of MDS heterogeneity and disease biology, and may...

global cancer care

American Society of Clinical Oncology Honors Researchers, Patient Advocates, and Leaders of the Global Oncology Community

Leaders in cancer care will be recognized as part of the American Society of Clinical Oncology Special Awards Program at the 2014 ASCO Annual Meeting. The Special Awards recognize the dedication and significant contributions of researchers, patient advocates, and leaders of the global oncology...

Centers for Disease Control and Prevention Awards Grants of More Than $1.25 Million to College of American Pathologists

The College of American Pathologists (CAP) has been awarded two grants from the Centers for Disease Control and Prevention (CDC). The funding, totaling more than $1.25 million, will be used to improve the adoption of evidence-based laboratory testing guidelines and to standardize reporting of...

issues in oncology

Project Data Sphere: Megadata in the Cloud Could Speed Clinical Trials Here on Earth

Project Data Sphere, which launched on April 8, is a “giant digital laboratory, an enormous library containing data about tens of thousands of patients and hundreds of clinical trials, all of which will be in the public domain,” said Martin J. Murphy, Jr, DMedSc, PhD, FASCO, Chief Executive Officer ...

prostate cancer

Beyond the Cystoscope: Thinkers and Technicians

I have spent my career working with urologists. Over a long period of time, I have concluded that they are fine and interesting people who work hard, live well, support interesting hobbies, generally take good care of their families, and are very enjoyable company at parties. The recent discussion...

prostate cancer

Continued Survival Benefits Seen With Radical Prostatectomy vs Watchful Waiting in Long-Term Follow-up of the SPCG-4 Trial

The long-term benefits of radical prostatectomy vs watchful waiting in men with localized prostate cancer has remained a debated issue. As reported in The New England Journal of Medicine by Anna Bill-Axelson, MD, of Uppsala University Hospital, and colleagues, additional long-term follow-up in the...

issues in oncology

Cancer Chemotherapy Use During Pregnancy

INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this installment, National Toxicology Program scientists Kembra L. Howdeshell, PhD, and Michael D. Shelby, PhD, discuss a recently completed monograph that reviews the published data on...

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