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NCCN Clinical Practice Guidelines in Oncology: 2013 Updates 

At the 18th Annual Conference of the National Comprehensive Cancer Network (NCCN), representatives of NCCN Guidelines panels presented two new sets of guidelines along with updates for several tumor types, summarized in this issue of The ASCO Post. New NCCN Guidelines for Survivorship “The...

On the Potential for Conflicts of Interest

In a recent issue of The ASCO Post, I counted 14 expert commentaries where the authority who wrote or was interviewed for the piece reported “no potential conflicts of interest.” I wondered how likely that was. We need to be clearer on the meaning of potential conflicts of interest. How often have...

How Is Sequestration Affecting Health Care? 

The Budget Control Act of 2011, which calls for $1.2 trillion in federal funding cuts in national defense and nondefense programs, went into effect on March 1. The across-the-board cuts affect 21 agencies and programs directly involved in the health-care sector, including: Centers for Disease...

health-care policy
legislation

Sequestration's Impact on Cancer Care  

On March 1, the deficit-budget mechanism known as sequestration took effect, triggering $85 billion in across-the-board cuts to most federal agencies over the remaining 7 months in fiscal year 2013. The total federal deficit reduction budget under the Budget Control Act of 2011 calls for $1.2...

Proof of Principle for Adoptive T-cell Therapy in Cancer 

In a recently published study, Memorial Sloan-Kettering Cancer Center investigators demonstrated the considerable antitumor efficacy of 19-28z chimeric antigen receptor (CAR)-modified T cells in patients with relapsed/refractory B-cell acute lymphoblastic leukemia (ALL). The ASCO Post asked lead...

solid tumors
leukemia

Profound and Rapid Molecular Remission with CD19-targeted T Cells in Relapsed B-cell ALL 

As was recently reported in Science Translational Medicine, Renier J. Brentjens, MD, and colleagues at Memorial Sloan-Kettering Cancer Center, New York, found that profound molecular remission was rapidly induced in patients with relapsed B-cell acute lymphoblastic leukemia (ALL) using autologous T ...

More Recollections on Emil 'Tom' Frei III, MD

I have read with interest the recent tributes to Emil “Tom” Frei III, MD, who passed away in April. I was backstage at the ASCO Annual Meeting in 1981, when Dr. Frei was giving his Karnofsky acceptance address. I had a slide presentation at the combined ASCO/American Association for Cancer Research ...

supportive care

Patients with Cancer Can Have Cachexia-related Poor Prognostic Factors Regardless of Overall Weight 

“Patients with cancer who are cachexic by the conventional criterion (involuntary weight loss) and by two additional criteria (muscle depletion and low muscle attenuation) share a poor prognosis, regardless of overall body weight,” concluded a study in the Journal of Clinical Oncology. Researchers...

supportive care
palliative care

Older Patients and Those with Comorbidities Are Less Likely to Receive Palliative Radiotherapy 

Older patients and those with comorbid conditions are less likely to receive palliative radiotherapy, according to an analysis of data from 51,610 patients with stage IV breast, prostate, lung, or colorectal cancer. The study also found that black patients with prostate cancer were 20% less likely...

breast cancer
issues in oncology

Smoking Early in Life Is More Strongly Associated with Increased Risk of Breast Cancer 

Analyses of data from 73,388 women in the American Cancer Society’s Cancer Prevention Study II (CPS-II) Nutrition Cohort and from a meta-analysis including 14 other studies “support the hypothesis that active smoking increases the risk of breast cancer, especially when smoking begins at an early...

breast cancer

Black, Asian, and Younger Women at Increased Risk of PTSD after Diagnosis of Localized Breast Cancer 

Nearly one-quarter of women in a large prospective study of racially diverse patients with stage I to III breast cancer reported symptoms consistent with posttraumatic stress disorder (PTSD), with increased risk of PTSD among black, Asian, and younger women. “These potential risk factors can be...

breast cancer

Surgery Delays Longer Than 6 Weeks in Young Women with Breast Cancer Decrease Survival 

Delays of more than 6 weeks from time of diagnosis until surgical treatment of breast cancer among young women significantly decreases survival times compared to those with a shorter treatment delay time, according to a study in JAMA Surgery. “This adverse impact on survival was more pronounced in...

breast cancer
issues in oncology

Some Stage II/III HER2-positive Tumors May Be Treated with Targeted Therapy without Chemotherapy 

Results from a multicenter phase II study of patients with locally advanced HER2-positive breast cancer who receive targeted therapy with trastuzumab (Herceptin) and lapatinib (Tykerb) “support the hypothesis that selected patients with HER2-positive tumors may not need chemotherapy,” investigators ...

SIDEBAR: BI-RADS: Breast Imaging-Reporting and Data Systema 

0: Incomplete 1: Negative 2: Benign finding(s) 3: Probably benign 4: Suspicious abnormality 5: Highly suggestive of ­malignancy 6: Known biopsy-proven ­malignancy aPublished and trademarked by the American College of Radiology.  

breast cancer

Study Clarifies Appropriate Timing of Follow-up Imaging after Benign Breast Biopsies 

Follow-up imaging for patients with benign breast biopsies can be safely done at 12 months rather than 6 months, when radiologic and pathologic findings are concordant, according to a study reported at the American Society of Breast Surgeons Annual Meeting in Chicago.1 Current guidelines from the...

Expect Questions from Your Patients 

Patients reading or hearing about the updated draft recommendation statement from the U.S. Preventive Services Task Force (USPSTF) on the use of medications to reduce risk for primary breast cancer1 may ask if and how it applies to them. To help answer those questions, the information presented...

breast cancer

Women at Increased Risk for Breast Cancer Should Be Offered Medications to Reduce Risk, Draft Recommendations Advise 

Clinicians should engage in shared decision-making with women who are at increased risk of breast cancer about using medications, such as tamoxifen and raloxifene (Evista), to reduce risk, and should offer prescriptions to women considered at low risk for adverse effects from these medications,...

SIDEBAR: IBD and Melanoma 

Inflammatory bowel disease (including Crohn’s disease and ulcerative colitis) is associated with a 37% greater risk for melanoma. Given the new data, physicians should appropriately counsel patients with inflammatory bowel disease about the risk of melanoma.

skin cancer

Inflammatory Bowel Disease Raises Risk of Melanoma

Patients with inflammatory bowel disease are at higher risk of melanoma, reported researchers at Mayo Clinic. Researchers found that inflammatory bowel disease is associated with a 37% greater risk for the disease. The findings were presented at the Digestive Disease Week 2013 conference in...

Innovator Award Won by Kenneth Tsai, MD, PhD, for Plan to Map Molecular Path to Skin Cancer

A proposal to examine the cellular journey from normal skin to precancerous lesion to skin cancer earned Kenneth Tsai, MD, PhD, the Sixth Annual Landon Foundation–AACR Innovator Award for Cancer Prevention Research at the American Association for Cancer Research (AACR) Annual Meeting, held recently ...

issues in oncology

Francis Crick's Discovery of the Structure of DNA Transformed 20th Century Biologic Sciences 

“My Dear Michael, Jim Watson and I have probably made a most important discovery. We have built a model for the structure of des-oxy-ribose-nucleic-acid, called DNA for short.… In other words we think we have found the basic copying mechanism by which life comes from life,” wrote Francis Crick,...

Oncology Meetings

June Molecular and Translational Oncology WorkshopJune 14-18 • Fort Myers, FloridaFor more information: www.cancereducationconsortium.org/programs_mtow.html 12th International Conference on Malignant LymphomaJune 19-22 • Lugano, SwitzerlandFor more information: www.lymphcon.ch British...

head and neck cancer

Coping with Tongue Cancer: A Lonely Journey 

Thirteen years ago, at just 34 years old, I never expected that my life could be interrupted by cancer. A nonsmoker and nondrinker, I had always practiced a healthy lifestyle and wasn’t concerned initially when what looked like a cold sore popped up on the left side of my tongue. But as several...

issues in oncology
legislation

Innovative State Program Reduces Colorectal Cancer Disparities, Mortality Rates Among African American Patients

A study analyzing the impact of the Delaware Cancer Consortium, the state’s cancer control program, reports a 41% reduction in colorectal mortality rates for African Americans.1 The recently published study provided analysis on a novel design and approach used to eliminate colorectal cancer...

Focus on the Delaware Society for Clinical Oncology 

Although the state of Delaware comprises just 2,489 square miles, giving it an area ranking of 49 out of 50 states, its small size gives its population of nearly 1 million an advantage many larger states do not have: ready access to local politicians to address complex issues such as improving...

University of New Mexico Health Sciences and Cancer Centers Recruit Four Cancer Experts to Top Positions

The University of New Mexico Health Sciences Center and the University of New Mexico Cancer Center, Albuquerque, recently announced the recruitment of four cancer physicians and scientists. The UNM Cancer Center is the Official Cancer Center of the State of New Mexico and one of the nation’s 60...

gynecologic cancers

Gold Nanoparticles Can Help Fight Ovarian Cancer

Positively charged gold nanoparticles are usually toxic to cells, but cancer cells somehow manage to avoid nanoparticle toxicity. Mayo Clinic researchers found out why and determined how to make the nanoparticles effective against ovarian cancer cells. The discovery is detailed in the current...

SIDEBAR: How to Help

The American Cancer Society encourages all to assist in efforts to fight cancer by: Donating at cancer.org/fight Participating in a local Relay For Life or Making Strides Against Breast Cancer walk in their community Enrolling in its Cancer Prevention Study-3 to find better ways to prevent...

American Cancer Society Marks 100th Year Anniversary 

The American Cancer Society announced the Society’s 100th birthday on May 22, 2013. Founded 100 years ago by 15 prominent physicians and business leaders in New York, the American Cancer Society, first known as the American Society for the Control of Cancer, launched the fight against a disease...

issues in oncology

Making Prevention and Early Detection of Cancer a Priority 

Conquering cancer has been the goal of Bert Vogelstein, MD, since he was a teenager in Baltimore. For more than 3 decades, Dr. Vogelstein, Co-Director of the Ludwig Center for Cancer Genetics and Therapeutics and Investigator of the Howard Hughes Medical Institute at Johns Hopkins Medical...

integrative oncology

Ginger

The use of dietary supplements by cancer patients has risen significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the...

American Association for Cancer Research CEO Recognized with Prestigious Award from Fox Chase Cancer Center

Margaret Foti, PhD, MD (hc), Chief Executive Officer of the American Association for Cancer Research (AACR), was honored with the 2013 Stanley P. Reimann Honor Award for her deep and far-reaching contributions to cancer science and medicine at a celebration hosted by Fox Chase Cancer Center, held...

prostate cancer
issues in oncology

Mayo Clinic Genomic Analysis Lends Insight to Prostate Cancer

Mayo Clinic researchers have used next-generation genomic analysis to determine that some of the more aggressive prostate cancer tumors have similar genetic origins, which may help in predicting cancer progression. The findings appeared online recently in the journal Cancer Research.1 Gleason...

Tailored Intervention Protocol for Oral Chemotherapy Adherence Studied 

In a study testing the effectiveness of three strategies to improve oral chemotherapy adherence, tailored coaching was beneficial for some patients, reducing barriers to adherence, reported Susan M. Schneider, PhD, RN, AOCN, ACNS-BC, FAAN, Associate Professor and Director of Oncology Nursing...

SIDEBAR

As of the ONS Annual Congress, three patients at Memorial Sloan-Kettering Cancer Center had been successfully treated in the outpatient setting with genetically modified T cell therapy, without major events or readmissions to the hospital, reported study author Cheryl Caravano, RN. Ms. Caravano...

hematologic malignancies
leukemia
issues in oncology

Genetically Modified T-cell Therapy for Patients with CLL: The Role of the Oncology Nurse 

Quality nursing and ongoing education are critical for success in using gene-modified T-cell therapy for patients with chronic lymphocytic leukemia (CLL), said Cheryl Caravano, RN, at the recent Annual Congress of the Oncology Nursing Society.  Ms. Caravano is a clinical nurse IV at Memorial...

SIDEBAR: Mara Mogensen Flagherty Lecture  

The annual memorial lecture is named for a remarkable patient with cancer who was the “model of survivorship,” sharing her story and helping others cope with the disease. The talk always focuses on a psychosocial aspect of cancer. Since its inception, over 125,000 nurses have attended Mara Mogensen ...

issues in oncology

Attention to Patient Concerns Leads to Customized Treatment and Improved Care, Explains Oncology Nurse Researcher 

The Mara Mogensen Flagherty Lecture at this year’s 38th Annual Congress of the Oncology Nursing Society in Washington, DC, focused on the importance of listening to and acknowledging the individual stories of patients with cancer and survivors. Once they are adept at listening, clinicians need to...

solid tumors
prostate cancer

Phase II Trial Targeting Genetic Anomaly in Castration-resistant Metastatic Prostate Cancer Underway

A new clinical trial is testing whether targeting treatments to a genetic anomaly can lead to better treatments for castration-resistant metastatic prostate cancer. The trial, led by investigators at the University of Michigan Comprehensive Cancer Center, is being conducted at 11 sites throughout...

solid tumors
colorectal cancer

Smoking Linked to Shorter Disease-free Survival in Stage III Colon Cancer 

According to an analysis reported by Amanda Phipps, PhD, MPH, Assistant Professor of Epidemiology at the University of Washington and Assistant Member at Fred Hutchinson Cancer Research Center, Seattle, and colleagues in the Journal of Clinical Oncology, patients with stage III colon cancer who...

solid tumors
breast cancer

EGFR Prevents Maturation of microRNAs under Hypoxic Conditions

The epidermal growth factor receptor (EGFR) sends signals that thwart the development of tumor-suppressing microRNAs under conditions of hypoxia, an international team led by scientists at The University of Texas MD Anderson Cancer Center discovered. The results were reported in an early online...

Utilizing the Power of Rapid Learning Health-care Systems to Improve Patient Care 

Lynn Etheredge’s career in shaping national health-care and social policy spans more than 4 decades and four Presidential administrations. He was the lead analyst in the development of health insurance proposals for Medicare and Medicaid while working in the White House Office of Management and...

solid tumors
head and neck cancer

Genetic Diversity May Predict Outcomes in Head and Neck Cancer

A new measure of cell heterogeneity within a tumor may predict treatment outcomes of patients with squamous cell carcinoma of the head and neck.  In a recent report,1 investigators at Massachusetts General Hospital and Massachusetts Eye and Ear Infirmary reported how the mutant allele tumor...

hematologic malignancies
lymphoma

Breaking News on Lymphoma and Myeloma to Be Reported at European Hematology Congress in Stockholm

In order to support high-quality science, the European Hematology Association collaborates with 16 Scientific Working Groups (SWGs) and concentrates on fostering activities directed towards basic and translational research. In simultaneous sessions on Thursday, June 13, during the European...

solid tumors

HIV Infection Does Not Adversely Affect Outcomes of Liver Transplantation for Hepatocellular Carcinoma

Liver transplantation for hepatocellular carcinoma is feasible for HIV-infected patients, with no differences in post-transplant survival or hepatocellular carcinoma recurrence rates compared with liver transplantation for hepatocellular carcinoma in HIV-uninfected patients. The study, published in ...

SIDEBAR: Low-dose CT Screening 

The first-screening results strongly suggest that the 20% reduction in lung cancer mortality with low-dose CT vs x-ray reported in the original NLST paper is achievable at experienced screening centers.

lung cancer
issues in oncology

Low-dose CT Detects Twice as Many Early-stage Lung Cancers as Chest X-ray, According to Additional NLST Results

Results of the first of three planned annual screening examinations from the National Lung Screening Trial (NLST) were recently published and physicians may now have more information to share with their patients about the benefits and risks of low-dose computed tomography lung cancer screening.1...

solid tumors
kidney cancer

No Difference in Overall Survival with Axitinib or Sorafenib in Second-line Treatment for Advanced Renal Cell Carcinoma 

The phase III open-label AXIS trial comparing axitinib (Inlyta) vs sorafenib (Nexavar) as second-line treatment for metastatic renal cell carcinoma showed significantly prolonged independent radiology committee–assessed progression-free survival with axitinib treatment (hazard ratio [HR] = 0.665, P ...

lung cancer

Peregrine Pharmaceuticals Reaches Agreement with FDA on Phase III Trial Design for Bavituximab in NSCLC

Peregrine Pharmaceuticals recently announced that it has reached agreement with the U.S. Food and Drug Administration (FDA) on a phase III registration trial design of the company’s lead clinical immunotherapeutic candidate bavituximab in second-line non–small cell lung cancer (NSCLC). The trial...

Expert Point of View: Giulia Veronesi, MD

The study discussant, Giulia Veronesi, MD, of the Division of Thoracic Surgery, European Institute of Oncology, Milan, Italy, said that diagnostic algorithms aim to strike a balance between a too-invasive workup that exposes screened persons to useless invasive procedures and overtreatment, and...

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