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issues in oncology

Interruption of Radiation Therapy Due to Noncompliance Risks Cancer Recurrence

Cancer patients who miss two or more radiation therapy sessions (except for planned treatment breaks) have a worse outcome than fully compliant patients, investigators at Montefiore Einstein Center for Cancer Care (MECCC) and Albert Einstein College of Medicine's Albert Einstein Cancer Center have...

prostate cancer

Study Finds Enzalutamide Increases Progression-Free Survival vs Bicalutamide in Metastatic Prostate Cancer

Use of the androgen receptor–inhibitor enzalutamide (Xtandi) more than doubled progression-free survival vs the nonsteroidal antiandrogen bicalutamide in patients with metastatic prostate cancer progressing on androgen-deprivation therapy, according to the randomized phase II TERRAIN trial...

breast cancer
survivorship

ACS/ASCO Breast Cancer Survivorship Care Guideline

The American Cancer Society (ACS) and ASCO have issued a Breast Cancer Survivorship Care guideline, published jointly in the Journal of Clinical Oncology and CA: A Cancer Journal for Clinicians. The guideline recommendations were formulated by a multidisciplinary expert work group and are based on...

leukemia
lymphoma
survivorship

Reduction in Late Mortality in Childhood Cancer Survivors in the Childhood Cancer Survivor Study Cohort

In a study reported in The New England Journal of Medicine, Armstrong et al found that late mortality decreased over time among 5-year survivors of childhood cancer in the Childhood Cancer Survivor Study cohort. The reduction is consistent with efforts during recent decades to modify treatment with ...

lung cancer

Alectinib in ALK-Positive Metastatic NSCLC After Crizotinib

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 December 11, 2015, alectinib (Alecensa) was granted...

head and neck cancer

No Benefit of Adding Adjuvant and Maintenance Lapatinib to Chemoradiation in High-Risk Patients With Resected Squamous Cell Carcinoma of the Head and Neck

In a phase III trial reported in the Journal of Clinical Oncology, Harrington et al found that the addition of concurrent adjuvant lapatinib (Tykerb) to chemoradiation therapy and the use of maintenance lapatinib did not improve disease-free or overall survival in high-risk patients with resected...

Richard ‘Buz’ Cooper, MD, Noted Health Policy Expert, Dies at 79

Addressing disparities of cancer care that result in poorer outcomes among certain populations remains a persistent challenge in the oncology community and in the health-care system at large. It is, to a large degree, a medical story of haves and have-nots. Richard “Buz” Cooper, MD, a preeminent...

skin cancer

Increased Incidence of in Situ and Invasive Melanoma in Denmark

In a study reported in JAMA Dermatology,1 Neel Maria Helvind, MD, of the University Hospital Rigshospitalet, Copenhagen, Denmark, and colleagues analyzed the increases in melanoma incidence seen in Denmark between 1985 and 2012. Over that time, the incidence of malignant melanoma doubled to rates...

issues in oncology

World Cancer Day 2016: We Can. I Can.

Cancer will kill more than 8 million people worldwide this year, which is equivalent to the entire population of New York. Half of these will be people of working age (30–69 years old). It has been estimated that the cost implications on world economies caused by cancer and the other...

breast cancer

Synthetic 2D Mammography May Hold Advantages Over 2D/3D Mammography

In screening for breast cancer, results from a study in the United Kingdom suggest that the use of “synthetic” two-dimensional (2D) mammography, rather than 2D/three-dimensional (3D) combinations, could save radiologists’ time and patients’ exposure to radiation as well as result in many fewer...

health-care policy

Many Americans Favor a Tax Increase to Support the 'Moonshot' Cancer Initiative

Vice President Joe Biden's “moonshot” initiative to defeat cancer earned support for a tax increase to fund cancer research among half of respondents (50%) in a new national public opinion survey commissioned by Research!America. Thirty-eight percent disagree and an additional 12% are...

health-care policy

ASCO Praises President’s Sharp Focus on Cancer

ASCO applauds President Obama for his bold vision to launch a national effort on cancer, which he described during his State of the Union address on January 12, 2016. We also join him in recognizing Vice President Biden’s leadership in calling for a “moonshot” that will reduce the cancer-related...

Evolution

Ten years ago, ASCO created the Journal of Oncology Practice to address a gap in the literature; there were no peer-reviewed journals dedicated to the practical issues of delivering quality oncology care. The original research and editorials published in JOP focus on care delivery topics such as...

gynecologic cancers
issues in oncology

Could a Screening Test That Would Reduce Deaths From Ovarian Cancer Be on the Way?

"A solid triple but not a home run” is how Karen H. Lu, MD, characterized a study in The Lancet reporting a reduction in deaths from ovarian cancer with the use of multimodal ovarian cancer screening.1 Dr. Lu’s remark was one of several, mostly but not universally, favorable and optimistic comments ...

supportive care

Uridine Triacetate Granules for Fluorouracil or Capecitabine Overdose or Early Severe Toxicity

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 December 11, 2015, uridine triacetate (Vistogard) was approved...

breast cancer

Role of Carboplatin in Triple-Negative Breast Cancer Still Unclear

Studies presented at the 2015 San Antonio Breast Cancer Symposium built upon an increasing body of data in support of the neoadjuvant use of carboplatin in patients with triple-negative breast cancer. Overall, however, the studies fell short of establishing carboplatin’s role in this malignancy and ...

leukemia

Self-Reports Overestimate Mercaptopurine Intake in Childhood Acute Lymphoblastic Leukemia

Mercaptopurine is critical for maintaining remission in childhood acute lymphoblastic leukemia (ALL). However, a study has shown that overreporting of intake is common, and self-reports of intake are not as reliable as electronic reporting.1 About 86% of parents and children overreported the number ...

lung cancer

Bevacizumab Plus Chemotherapy Fails to Prolong Survival in Early-Stage Lung Cancer

Overall survival in patients with surgically resected early-stage non–small cell lung cancer (NSCLC) did not improve with the addition of bevacizumab (Avastin) to chemotherapy, according to the findings of a study researchers have called a “top abstract” from the 16th World Conference on Lung...

breast cancer
issues in oncology

UK Study Suggests Association Between Screen-Detected Ductal Carcinoma in Situ and Reduced Invasive Interval Breast Cancers

In a UK retrospective population-based study reported in The Lancet Oncology, Duffy et al found a significant inverse association between the detection of ductal carcinoma in situ in breast cancer screening and the incidence of invasive interval cancers diagnosed within 3 years after screening....

solid tumors
issues in oncology

American College of Physicians Issues Advice for Evaluating Hematuria as a Marker of Urinary Tract Cancer

Although little controversy exists regarding the indication for urologic evaluation for patients with gross hematuria, the evaluation of patients with the much more common finding of microscopic hematuria is complicated by a lack of clarity regarding indications for clinical referral, according to...

issues in oncology

Quality Improvement Projects Aim at Reducing Prescribing Errors for Chemotherapy

Two quality improvement projects described by Bryant-Bova in the Journal of Oncology Practiceresulted in reduced errors in prescribing intravenous and oral chemotherapy. A project at The University of Texas Medical Branch at Galveston outpatient infusion centers first identified 15 different types ...

breast cancer
issues in oncology

Higher Risk of Radiation-Induced Breast Cancer Found in Women Screened More Frequently and in Women With Larger Breasts

Radiation-induced breast cancer risk from digital mammography is low for the majority of women, but the risk is higher in women with large breasts, who received 2.3 times more radiation and required more views per examination to image as much of the breast as possible compared to those with small...

lung cancer

Statistically Significant Decline in Lung Cancer Incidence and Death Rates among Women

More than a decade after lung cancer incidence and death rates began to decline in men, a statistically significant decrease in the rates are occurring among women. The Annual Report to the Nation on the Status of Cancer, 1975 to 2007, is the first to document these decreases, the report’s authors...

issues in oncology

2011 ASCO Annual Meeting: Genes May Predict Taxane-related Peripheral Neuropathy

The first identification of potential genetic biomarkers for taxane-induced peripheral neuropathy was reported at the 2011 ASCO Annual Meeting by researchers from Indiana University in Indianapolis.1 The presence of two single nucleotide polymorphisms (SNPs), or common genetic variations, residing...

gynecologic cancers

2011 ASCO Annual Meeting: 3-Year Screening Interval Safe for Women with HPV-negative and Normal Pap Tests, Data Show

A large, “real-world” study has validated current recommendations from the American Congress of Obstetricians and Gynecologists (ACOG), American Cancer Society (ACS), and American Society for Colposcopy and Cervical Pathology (ASCCP) endorsing a 3-year cervical cancer screening interval for women...

lymphoma

Important Briefs: Lymphoma Research on Improved Chemotherapy, Biomarker Associations, and Stem Cell Transplant Approaches

The 11th International Conference on Malignant Lymphoma was held June 15–18 in Lugano, Switzerland. More than 3,000 hematologists, clinical oncologists, pathologists, and researchers attended the meeting, which was first convened in 1981. Topics of discussion included lymphoma staging in the new...

colorectal cancer

Smoking and Lack of Exercise Increase Risk of Some Cancers, but Moderate Alcohol Consumption Reduces Colon Cancer Risk

A substudy of the large prospective National Surgical Adjuvant Breast and Bowel Project (NSABP) Breast Cancer Prevention Trial revealed both expected and surprising findings related to the association between lifestyle factors (cigarette smoking, alcohol, and exercise) and cancer risk. As might be...

issues in oncology

A Conversation with David Henry, MD

Given the intricate nature of oncology workflow, terminology, cancer staging, and the high risk associated with chemotherapy administration, an oncology electronic medical record (EMR) system needs to be much more than a storehouse of patient information. According to David Henry, MD, Clinical...

prostate cancer

Cabozantinib Shows Encouraging Activity in Metastatic Castrate‑resistant Prostate Cancer

Cabozantinib, a dual inhibitor of MET kinase and the vascular endothelial growth factor (VEGF) receptor, exhibits high, early single-agent activity in men with metastatic castrate-resistant prostate cancer, according to Maha Hussain, MD, FACP, who presented these findings at the 2011 ASCO Annual...

health-care policy

Conflicts of Interest in Health-care Reform?

Last year’s health-care reform legislation, the Patient Protection and Affordable Care Act, was designed to incrementally roll out major new bureaucratic entities, oversight, and mandates for the practice of medicine between its enactment and 2013, after the next presidential election. A new...

ASCO’s Oncology Slide Library Functions as a Share‑and‑Exchange Forum

ASCO’s Oncology Slide Library—which allows ASCO meeting attendees to upload and share their ASCO meeting presentation slides with slide-library subscribers—may only be a year old, but participation is already very high. This year’s Annual Meeting in June marked the first time ASCO gave each speaker ...

prostate cancer

Intermittent or Continuous Androgen Suppression Produces Comparable Survival after Radical Therapy in Prostate Cancer

Men with prostate cancer who receive intermittent courses of androgen-suppressing therapy can live as long as those who are treated with continuous therapy, according to results of a recently concluded study. Until now, standard treatment has consisted of continuous therapy, but this is expected to ...

Expert Point of View: Bevacizumab Makes Inroads against Ovarian Cancer

Formal discussant, Anil Sood, MD, The University of Texas MD Anderson Cancer Center, Houston, said that both studies presented important information, but several issues should be considered, including the best combination with bevacizumab, whether the benefits accrue from bevacizumab alone or...

cost of care
health-care policy

Rising Costs of Cancer Care: It's More Than Drugs

All parties—the government, payers, and consumers—agree that, left unchecked, rising health-care costs will eventually hamstring vital portions of our delivery system. For example, Medicare, which covers more than 50% of the nation’s patients with cancer, is marching headlong toward insolvency....

head and neck cancer

Circulating Tumor Cell Assay Shows Potential for Predicting Prognosis in Head and Neck Carcinoma

According to the NCI, an estimated 49,260 new cases of oral cavity, pharyngeal, and laryngeal cancers occurred in the United States in 2010, and approximately 11,480 deaths were attributed to these cases. It is estimated that 95% or more of these cases are squamous cell carcinomas. Currently, the...

lung cancer

World Conference on Lung Cancer: Personalized Approaches to Treatment

The 14th World Conference on Lung Cancer hosted more than 7,000 attendees in Amsterdam recently, with the theme “Better Care through Personalized Medical Approaches.” The following are brief summaries of key data presented at the conference, with perspective provided by Roy S. Herbst, MD, PhD, of...

supportive care

Lifestyle Changes Can Benefit Patients with Cancer

Oncologists may successfully manage their patients with cancer by following treatment guidelines, but they come up short when it comes to prescribing simple measures to enhance their patients’ health, according to Ann Partridge, MD, MPH, of Dana-Farber Cancer Institute, Boston, who spoke on the...

issues in oncology
health-care policy

Oncology Drug Shortage: An Unintended Consequence of the Medicare Modernization Act and Free-market Forces?

Oncology has a drug shortage problem, and the FDA says that it is getting worse. Drug shortages are not a new phenomenon, but over the past few years we have seen a rapidly growing number of shortfalls that are limiting providers’ ability to care for their patients. In 2004, the FDA reported 58...

breast cancer

LETTER TO THE EDITOR: Treating Cancer or Fear?

I read the article by Deb Stewart, “Acting on Fear” (The ASCO Post, August 15, 2011, page 1) with interest, disappointment, and empathy. “Acting on fear” in cancer treatment generally, and particularly in breast cancer, is not uncommon. Hence, I was most interested in the article’s major thrust, as ...

skin cancer

Novel Drugs Ipilimumab and Vemurafenib for Advanced Melanoma

In this introductory installment of In the Clinic, The ASCO Post provides an overview of two new melanoma agents recently approved by FDA, with discussion on pivotal data leading to approval, dosage and administration, and managing drug-related toxicities. Watch for more on clinical use of novel...

breast cancer

Expert Point of View: No Value for Axillary Dissection in Patients with Breast Cancer and Occult Nodal Metastases

Two breast cancer studies presented at the 2011 Breast Cancer Symposium—NSABP B‑32 and ACOSOG Z11—suggest that aggressive approaches to surgically remove occult metastases are not necessary. Armando E. Giuliano, MD, of Cedars-Sinai Medical Center, Los Angeles, and principal investigator of ACOSOG...

breast cancer

No Value for Axillary Dissection in Patients with Breast Cancer and Occult Nodal Metastases

In a subanalysis of the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-32 study, nearly 16% of clinically node-negative patients were found to have occult metastases upon more detailed assessment of the sentinel lymph nodes. While a slight difference in outcomes was found among this...

skin cancer

Adjuvant Treatment Still Standard in Melanoma, but New Drugs Prolong Life in Metastatic Setting

At the Best of ASCO® Miami meeting, Omid Hamid, MD, The Angeles Clinic and Research Institute (www.theangelesclinic.org), Los Angeles, California, reviewed abstracts that received a great deal of attention at this year’s Annual Meeting—the new treatments for metastatic melanoma. He also described...

kidney cancer
prostate cancer

Novel Management Strategies Assessed in Renal Cell and Prostate Cancers

At the Best of ASCO Miami meeting, William Oh, MD, of the Tisch Cancer Institute, Mount Sinai School of Medicine, New York, described new trends and remaining questions in the management of renal cell and prostate cancers. Axitinib vs Sorafenib in Second-line RCC Axitinib, a potent and selective...

SIDEBAR: A Cautious Approach to Maintenance Therapy

Hematologists should weigh the risks and benefits carefully when considering lenalidomide (Revlimid) or other maintenance therapy for their patients with myeloma, according to William I. Bensinger, MD, of the Fred Hutchinson Cancer Research Center, Seattle. Lenalidomide is associated with...

breast cancer

Breast Cancer Studies Explore Wide Variety of Prevention and Treatment Strategies, Offering New Insights

At the Best of ASCO® meeting in Miami, Harold Burstein, MD, PhD, Dana-Farber Cancer Institute, Boston, and Carey K. Anders, MD, University of North Carolina at Chapel Hill, presented high-impact breast cancer abstracts that will enable clinicians to optimize their use of radiotherapy and biologics. ...

lung cancer

Incremental Advances Demonstrated in Management of Locoregional Lung Cancer

Data presented at the ASCO Annual Meeting this year on the management of locoregional lung cancer present a mixed picture, with some advances and some disappointments, according to H. Jack West, MD, of the Swedish Cancer Institute in Seattle, who reviewed studies in this area at the Best of ASCO...

breast cancer

Important Briefs from the 2011 Breast Cancer Symposium

The 2011 Breast Cancer Symposium was recently held in San Francisco, bringing together a multidisciplinary group of specialists and sponsored by ASCO, the American Society for Radiation Oncology, the Society of Surgical Oncology, the American Society of Breast Disease, the American Society of...

integrative oncology

Integrative Medicine Offers Added Value for Patients with Cancer

Addressing a patient’s physical, emotional, and spiritual needs during the cancer journey, integrative medicine combines such time-honored therapies as nutrition, exercise, and meditation alongside allopathic approaches to cancer care, with the ultimate goal of improving survival rates and reducing ...

lung cancer

Crizotinib: New Drug for ALK-positive Advanced Non–Small Cell Lung Cancer

Indication Crizotinib (Xalkori) is an oral inhibitor of receptor tyrosine kinases including anaplastic lymphoma kinase (ALK), hepatocyte growth factor receptor (HGFR, c-Met), and recepteur d’origine nantais (RON). In August 2011, the FDA granted the drug accelerated approval for the treatment of...

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