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SIDEBAR: The Ethical Imperative of Clinical Equipoise 

In her editorial about the RESONATE trial (page 1), Dr. O’Brien raises the issue of equipoise in this phase III clinical trial that compares the efficacy of ibrutinib and ofatumumab (Arzerra) in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) who are not appropriate...

leukemia

Ibrutinib CLL Trial: Where Is the Equipoise?

The RESONATE trial is randomly assigning patients with refractory or relapsed CLL to either ofatumumab (Arzerra) or the investigational oral agent ibrutinib. Ofatumumab is an anti-CD20 monoclonal antibody like rituximab (Rituxan), but is more potent as a single agent. It was approved for refractory ...

skin cancer

Does Every Melanoma Patient with a Positive Sentinel Node Need More Lymph Nodes Removed? 

When sentinel node biopsy was shown to predict whether early melanoma had spread to regional lymph nodes, it revolutionized care. Before that, dissection of all regional lymph nodes was the norm for most patients. After that, the standard of care became a sentinel node biopsy and then—only if the...

Expert Point of View: Louis M. Weiner, MD

Commenting on both Dr. Baselga’s study in breast cancer and Dr. Liu’s study in ovarian cancer at the AACR press conference, Louis M. Weiner, MD, Director of the Georgetown University Lombardi Comprehensive Cancer Center, Washington, DC, said that antibody-drug conjugates “represent the fulfillment...

SIDEBAR: First Report of Antibody-Drug Conjugate in Advanced Ovarian Cancer

In a related presentation at the AACR Annual Meeting,1 the antibody-drug conjugate DMUC5754A showed encouraging activity in women with ovarian cancer, particularly those with platinum-resistant disease, which currently lacks effective treatment options. The first-in-human phase I study included 44...

breast cancer

Higher HER2 Expression Linked to Best Results with T-DM1 in Patients with HER2-positive Metastatic Breast Cancer

A biomarker analysis of the pivotal EMILIA trial suggests that women with metastatic HER2-positive breast cancer with tumors that have high expression of HER2 derive the most robust benefit from treatment with the antibody-drug conjugate T-DM1 (also now known as ado-trastuzumab emtansine...

Emil 'Tom' Frei III, MD, Trailblazer in the Development of Combination Chemotherapy, Dies at 89 

The pages of medical history are dog-eared with breakthroughs that have transformed medicine and saved lives. One of those dog-eared pages belongs to Emil Frei III, MD, known to his colleagues and friends as Tom. In the dawn of oncology, Dr. Frei, along with his associate, Emil Freireich, MD, did...

Saul N. Weingart, MD, PhD, Named New Chief Medical Officer of Tufts Medical Center

Tufts Medical Center has appointed Saul N. Weingart, MD, PhD, of Newton, Massachusetts as its next Chief Medical Officer.  Dr. Weingart is currently serving as Vice President for Quality Improvement and Patient Safety at Dana-Farber Cancer Institute in Boston. He is a nationally renowned leader in...

High Levels of Psychological Distress Are Common among Parents of Children with Advanced Cancer 

High to severe levels of psychological distress are common among parents of children with advanced cancer, according to a study conducted at three children’s hospitals—Boston Children’s Hospital, Children’s Hospital of Philadelphia, and Seattle Children’s Hospital. The cohort study was embedded in...

issues in oncology

Ruxolitinib Results in Clinically Meaningful Symptom Improvement 

Patients with myelofibrosis who received ruxolitinib (Jakafi) therapy experienced “meaningful reductions in symptom burden” and improvements in quality of life in a double-blind, placebo-controlled phase III trial published in the Journal of Clinical Oncology. The COMFORT-I (Controlled...

kidney cancer

Cisplatin and Radiotherapy Linked to Increased Renal Cancer Risk in Childhood Cancer Survivors

Survivors of childhood cancer have an increased risk of subsequent renal cancers compared to the general population, researchers reported in the Journal of the National Cancer Institute. The risk is particularly high among survivors of neuroblastoma and those who have had irradiation involving the...

leukemia

High-dose Liposomal Vincristine Produces Durable Responses in Advanced ALL

High-dose monotherapy with vincristine sulfate liposome injection (Marqibo) resulted in meaningful clinical outcomes, including durable responses and bridging to hematopoietic cell transplantation, in adult patients with advanced, relapsed, and refractory Philadelphia chromosome (Ph)-negative acute ...

gynecologic cancers

Higher Prediagnosis Body Mass Index Raises Mortality Risk in Endometrial Cancer

Higher prediagnosis body mass index (BMI) increases risk of overall and disease-specific mortality among women diagnosed with endometrial cancer, suggested a study published in the Journal of the National Cancer Institute. Physical activity was associated with reduced risk of all-cause, but not...

breast cancer

Exemestane an Adjuvant Option for Postmenopausal Hormone Receptor–positive Breast Cancer

A phase III open-label trial of exemestane vs anastrozole in postmenopausal women with hormone-dependent early breast cancer found that both agents produced similar median rates of event-free survival—91% for exemestane and 91.2% for anastrozole—as well as similar distant disease-free and...

SIDEBAR: Going Public with Ovarian Cancer Outcomes  

Commenting on the study finding that most women with ovarian cancer are not being treated with the recommended standard of care, a New York Times editorial noted, “One of the surest ways to improve performance would be to analyze and make public how well individual doctors and hospitals do in...

Expect Questions about Experience and Outcomes  

“Patients are becoming more sophisticated in their ability and willingness to interrogate the health-care system about their care,” according to Robert E. Bristow, MD, MBA, lead author of the study finding that many women with ovarian cancer are not receiving care consistent with National...

gynecologic cancers

Most Women with Ovarian Cancer Do Not Get Guideline-specified Treatment Linked to Survival Benefits 

Most women with ovarian cancer are not receiving adequate treatment, as specified in National Comprehensive Cancer Network (NCCN) Guidelines,1 and as a result are being deprived of the survival benefits correlated with guideline-recommended treatment, according to a study presented at the Society...

solid tumors
prostate cancer

Obese Men with Benign Biopsy at High Risk for Prostate Cancer

Obese men were more likely to have precancerous lesions detected in their benign prostate biopsies compared with nonobese men and were at a greater risk for subsequently developing prostate cancer, according to data published recently in Cancer Epidemiology, Biomarkers & Prevention.1 “Our study ...

integrative oncology

Symptom Management with Complementary Therapies for Patients Receiving Radiation Therapy

The supportive care of patients with cancer receiving radiotherapy is an important responsibility for the radiation oncologist, and complementary therapies are an integral component of many patients’ treatment strategy.A recent prospective study suggests that 54% of patients with breast cancer...

Society of Interventional Radiology 2013–2014 Officers and Executive Council Members Assume New Roles

Scott C. Goodwin, MD, FSIR, an interventional radiologist and Hasso Brothers Professor and Chair of the Department of Radiological Sciences at the University of California, Irvine, assumed office as the 2013–2014 President of the Society of Interventional Radiology (SIR) during the Society’s 38th...

breast cancer

Common Deletion in APOBEC3 Genes Associated with Increased Risk of Breast Cancer 

Genome-wide association studies have identified numerous genetic susceptibility loci for breast cancer, although these loci explain only a small proportion of heritability. Relatively few studies have assessed associations of breast cancer risk with copy number variation, another important source...

lung cancer

HDAC Inhibition Circumvents EGFR Tyrosine Kinase Inhibitor Resistance Due to BIM Polymorphism 

Upregulation of BIM (BCL2L11), a proapoptotic member of the BCL2 protein family, is required for induction of apoptosis by EGFR tyrosine kinase inhibitors in EGFR-mutant forms of non–small cell lung cancer (NSCLC). A BIM deletion polymorphism occurs naturally in approximately 13% of East Asian...

breast cancer

Epithelial-to-mesenchymal Transition and Autophagy Induction in Breast Carcinoma Promote Escape from T-cell–mediated Lysis

Epithelial-to-mesenchymal transition is known to mediate cancer cell invasion, metastasis, and drug resistance, but its impact on cancer immune surveillance is less well defined. In a study reported in Cancer Research, Akalay and colleagues found that epithelial-to-mesenchymal transition and...

C-Reactive Protein Downregulates TRAIL, a Cytokine with Key Role in Cancer Immune Surveillance 

C-reactive protein is a biomarker of acute and chronic inflammation that is frequently elevated in patients with cancer. In a study reported in Clinical Cancer Research, Secchiero and colleagues found that increased levels of C-reactive protein were associated with downregulation of TRAIL, a...

multiple myeloma

Control of Autophagic Cell Death by Caspase-10 in Multiple Myeloma

Multiple myeloma subtypes are driven by a variety of genetic abnormalities. Given the genetic diversity of the disease, identification of oncogenic mechanisms common to all subtypes is highly desirable. In a study reported in Cancer Cell, Lamy and colleagues found that that all multiple myeloma...

breast cancer
issues in oncology

Mammography Screening and DCIS

I would like to suggest that ASCO take a proactive approach to the treatment of ductal carcinoma in situ (DCIS) and the problem it presents to the oncology community. There has been and continues to be heated debate around the value of mammography screening because of “overdiagnosis,” which in my...

issues in oncology

FDA Warns about Potential Medication Errors 

The FDA recently alerted health-care professionals that the use of the incorrect nonproprietary name for the breast cancer drug Kadcyla (ado-trastuzumab emtansine, also known as T-DM1 during preapproval clinical trials) in some medication-related electronic systems poses a risk of mix-up with...

Seasons: A Series of Haiku 

sunrise the winter tree not so bare   I forget to take my pain medication … first robin   long summer hikes my vitamin D level  still low   ignoring my no another leaf falls …   About the Author Jyothirmai Gubili is an editor with the Integrative Medicine Service at Memorial Sloan-Kettering Cancer...

The ASCO Post Up Close: Our Reporters and Contributors

About the Writers Charlotte Bath has been writing about cancer and related fields of medicine since serving as Public Information Director of the American Cancer Society, Long Island Division, from 1975 to 1979. She subsequently worked as a writer for Memorial Sloan-Kettering Cancer Center and...

George Salti, MD, Appointed as Co–Medical Director of Edward Cancer Center, Naperville, Illinois

George Salti, MD, FACS, Surgical Oncologist and Associate Professor of Surgery at the University of Illinois at Chicago, has joined the Edward Cancer Center in Naperville, Illinois.  Dr. Salti will serve as the Co-Medical Director of the Edward Cancer Center and Medical Director of the Edward...

breast cancer

Living with the Fear of Cancer 

After a friend was diagnosed with breast cancer, I became so worried it would happen to me, I decided to perform regular breast self-exams so I could familiarize myself with the normal feel of my breasts, and quickly spot any changes. My friend’s diagnosis scared me, and that fear probably saved my ...

solid tumors
breast cancer
survivorship

Dr. Bernard Fisher's Breast Cancer Research Left a Lasting Legacy of Improved Therapeutic Efficacy and Survival 

Bernard Fisher, MD, is recognized today for his groundbreaking research in breast cancer, which ultimately ended the standard practice of performing the Halsted radical mastectomy, a treatment that had been in place for more than 75 years. His laboratory and clinical investigations led to more...

Robert S. Miller, MD, FACP, Appointed Editor-in-Chief of ASCO's Patient Information Website, Cancer.Net

Robert S. Miller, MD, FACP, has been appointed Editor-in-Chief of ASCO’s patient information website, Cancer.Net. Dr. Miller will assume this role at the 2013 ASCO Annual Meeting in Chicago on June 1, and succeeds Diane Blum, MSW, Chief Executive Officer for the Lymphoma Research Foundation, who...

leukemia

Drug Approvals in Acute Myeloid Leukemia: Can We Do Better? 

Forty years ago, President Richard Nixon announced a “war on cancer.” Some of that war’s first battles were won in the field of acute myeloid leukemia (AML) with two agents, cytarabine and daunorubicin, receiving U.S. Food and Drug Administration (FDA) approval based on their ability to produce...

Focus on Alaska's Denali Oncology Group

Located in Anchorage, Alaska, the Denali Oncology Group faces the dual challenge of serving a diverse and large population of more than 731,000 spread across a vast state of 586,000 square miles, with just 20 medical oncologists and 5 radiation oncologists located mainly in Alaska’s two biggest...

Memorial Sloan-Kettering Cancer Center Announces New Appointments

Memorial Sloan-Kettering Cancer Center in New York recently announced the following appointments: Chief of Lymphoma Anas Younes, MD, has been named Chief of the Lymphoma Service in the Division of Hematologic Oncology, Department of Medicine. An internationally recognized medical oncologist with...

Oncology Meetings

May Northern New England Clinical Oncology Society Spring MeetingMay 17 • Manchester, New HampshireFor more information: www.nnecos.org Iowa Oncology Society Spring Membership ConferenceMay 17-18 • West Des Moines, IowaFor more information: www.ios-iowa.com California Breast Cancer Research...

pancreatic cancer

The Intriguing Potential of S-1 in Pancreatic Cancer 

The results of the GEST study by Ueno and colleagues add to the intriguing potential role of the oral fluoropyrimidine S-1 in the treatment of pancreas adenocarcinoma. S-1 is a three-component drug consisting of tegafur (a prodrug of fluorouracil), gimeracil (5-chloro-2,4 dihydropyridine, or CDHP,...

solid tumors
pancreatic cancer
global cancer care

Oral S-1 Noninferior to Gemcitabine in Advanced Pancreatic Cancer in Japan and Taiwan 

As reported by Hideki Ueno, MD, PhD, of National Cancer Center Hospital, Tokyo, and colleagues in Journal of Clinical Oncology, treatment with the oral fluoropyrimidine derivative S-1 was associated with noninferior overall survival and reduced hematologic toxicity compared with gemcitabine...

gynecologic cancers

Lynch Syndrome: A Multitude of Predispositions 

The current uncertainty regarding the relative frequencies of cancers of various anatomic sites in Lynch syndrome poses a difficulty in commenting on the syndrome’s overall cancer spectrum. It is even more vexing to address the order in which these cancers are prone to occur. What we do know is...

gynecologic cancers

Women with Lynch Syndrome and Endometrial Cancer Are at Increased Risk of Other Cancers 

Lynch syndrome is an autosomal dominantly inherited disorder due to germline mutations in DNA mismatch repair genes. Mismatch repair mutation carriers are at increased risk of several cancers, with endometrial cancer being one of the most commonly diagnosed cancers in women with Lynch syndrome. In...

Expert Point of View: Louis M. Weiner, MD

Commenting on this study, Louis M. Weiner, MD, Director of the Georgetown University Lombardi Comprehensive Cancer Center in Washington, DC, commended this study of a combinatorial immunologic approach. “Immunology matters when it comes to cancer research. Drugs designed to harness the power of the ...

gynecologic cancers

Combinatorial Immunologic Approach Yields Benefit in Preliminary Study of Recurrent Ovarian Cancer

A two-step immunologic approach that includes a personalized dendritic cell vaccine for each patient followed by adoptive T-cell therapy holds promise for the treatment of recurrent ovarian cancer, according to results of two consecutive phase I studies presented at the American Association for...

SIDEBAR: Mismatch Repair Genes 

Mismatch repair genes are involved in numerous cellular functions, including the recognition and correction of errors in DNA replication. Germline mutations of mismatch repair genes have been shown to be involved in various types of cancer. ■

colorectal cancer

Emerging Prognostic Markers in Colon Cancer 

Patients with stage II colon cancer generally have a favorable prognosis, with about 80% of patients surviving 5 years after surgery and the majority of these long-term survivors presumed to be cured. Clearly though, some patients are destined to recur after surgery, and there is an urgent need to...

solid tumors
colorectal cancer

12-Gene Recurrence Score Predicts Recurrence in Stage II Colon Cancer in CALGB 9851 Population 

As reported by Alan P. Venook, MD, Professor of Medicine (Hematology/Oncology) at the University of California, San Francisco, and colleagues in Journal of Clinical Oncology, a 12-gene recurrence score (Oncotype DX Colon Cancer Assay) was shown to predict recurrence in stage II colon cancer in a...

solid tumors
prostate cancer
issues in oncology

AUA Releases New Clinical Guideline on Prostate Cancer Screening

Men ages 55 to 69 who are considering prostate cancer screening should talk with their doctors about the benefits and harms of testing and proceed based on their personal values and preferences, according to a new clinical practice guideline released by the American Urological Association (AUA)....

gynecologic cancers
lymphoma
issues in oncology

Guideline Adherence and Geriatric Assessment Studies among NCCN Scientific Posters of Interest 

For the first time at the National Comprehensive Cancer Network (NCCN) Annual Conference, scientific posters were included as part of the program. The ASCO Post captured some of the most interesting findings for our readers, including the following news briefs. The findings of these studies support ...

University of Denver and Exempla Healthcare Study Finds Patient Distress Screenings Practical, Helpful 

Researchers at the University of Denver and Exempla Healthcare found that multiple distress screenings per patient over the course of cancer treatment informs health-care providers about emotional distress patterns and supportive needs over time. The information gathered allows providers to improve ...

SIDEBAR: NCCN Patient Guidelines for Adolescents and Young Adults 

NCCN Patient Guidelines for Adolescents and Young Adults with Cancer are now available. Visit www.nccn.com to view these and other NCCN guidelines for patients. Patient versions of the NCCN Guidelines are available in the following categories: Adolescents and young adults Breast cancer Chronic...

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