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Showing 2851 - 2900Complexity of the Contralateral Prophylactic Mastectomy Decision
The powerful and important study by Kurian et al,1 reviewed in this issue of The ASCO Post, adds vital information to the discussion regarding use of contralateral prophylactic mastectomy among patients with unilateral breast cancer in the United States.2,3 Based upon data from the California...
Study Finds Significant Increase in Bilateral Mastectomy for Unilateral Breast Cancer Despite Lack of Survival Benefit
In an observational cohort study reported in JAMA, Allison W. Kurian, MD, MSc, Assistant Professor of Medicine and of Health Research and Policy at Stanford University School of Medicine, and colleagues assessed use of and mortality after bilateral mastectomy, breast-conserving surgery plus...
Treatment of Newly Diagnosed Multiple Myeloma With Lenalidomide Plus Low-Dose Dexamethasone
The FIRST trial—reported by Benboubker and colleagues in The New England Journal of Medicine and summarized in this issue of The ASCO Post (page 93)—is a landmark study.1 It is one of the largest randomized trials in multiple myeloma ever conducted. More importantly, it is a well-designed trial...
Continuous Lenalidomide/Dexamethasone Improves Progression-Free Survival in Transplant-Ineligible Patients With Myeloma
In the phase III FIRST trial reported in The New England Journal of Medicine, Lotfi Benboubker, MD, Service d’Hématologie et Thérapie Cellulaire, Hôpital Bretonneau, Centre Hospitalier Régional Universitaire (CHRU), Tours, France, and colleagues found that continuous lenalidomide (Revlimid) plus...
David G. Nathan, MD, Wins Lifetime Impact Award at Boston Children’s Hospital Innovation Summit
David G. Nathan, MD, President Emeritus of Dana-Farber Cancer Institute and Physician-in-Chief Emeritus of Boston Children’s Hospital, was recently honored as the inaugural recipient of the Boston Children’s Hospital Lifetime Impact Award at the Hospital’s second Annual Global Pediatric Innovation...
Postoperative Radiation Therapy Improves Overall Survival for Patients With Resected Pathologic N2 Non–Small Cell Lung Cancer
Patients who received postoperative radiation therapy lived an average of 4 months longer when compared to the patients who had the same disease site, tumor histology, and treatment criteria and who did not receive postoperative radiotherapy, according to research presented at the 2014 Chicago...
All-RAS Testing in Metastatic Colorectal Cancer: Just the First Step
Now that clinicians know to “think beyond KRAS” in metastatic colorectal cancer—and test for all RAS mutations, not just those in exon 2—it seems this is still not sufficient for selecting the best drugs. At the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid, a proffered paper ...
For Selected Patients With Metastatic Colorectal Cancer, Taking a Break From Combination Chemotherapy Might Be Appropriate and Appreciated
Two phase III studies presented at the Best of ASCO meeting in Chicago shed more light on the role of maintenance therapy in patients with metastatic colorectal cancer undergoing first-line treatment with oxaliplatin-based chemotherapy. The two studies compared maintenance therapy with bevacizumab...
Choosing Wildly: A Patient’s Perspective on Overtreatment and Quality Care
Over the past decade, there has been growing concern in the oncology community about overdiagnosis and overtreatment of cancers that prove to be indolent and nonlethal, resulting in unnecessary and sometimes harmful procedures. At this year’s ASCO Quality Care Symposium in Boston, this important...
Overutilization a Key Target in Efforts to Control Health-Care Costs
Overutilization of health-care interventions has become a prime target of efforts to rein in health-care costs. Overtreatment of cancer patients is associated with a number of common harms to the patient—not just financial harm to the health-care system. At the recent ASCO Quality Care Symposium in ...
Striving for Quality, Not Quantity, of Life
Advances in science and medicine have led to humans living longer than at any other time in history. According to a new report1 on mortality from the Centers for Disease Control and Prevention’s National Center for Health Statistics, life expectancy in the United States is at an all-time high of...
The Next-to-Last Frontier in Managing Acute Promyelocytic Leukemia
The treatment of acute promyelocytic leukemia (APL) represents one of the major triumphs in the field of hematologic malignancies. With either the vitamin A derivative all-trans retinoic acid (ATRA) combined with anthracycline-based chemotherapy or ATRA plus arsenic trioxide (Trisenox),...
Unique Barriers to Pain Control
I read with great interest your interview with Virginia LeBaron, PhD, APRN, about barriers to adequate pain control (“Despite Growing Awareness, the Global Crisis of Untreated Cancer Pain Persists,” The ASCO Post, October 15, 2014). Having served as the medical director of a hospice, I am...
Over 14 Million Major Medical Conditions in U.S. Adults Linked to Cigarette Smoking
At least 14 million major medical conditions among U.S. adults aged 35 years and older were attributed to cigarette smoking by a study estimating the disease burden of cigarette smoking, which, according to the study’s authors, “remains immense.” Among current and former smokers, prevalence ratios...
Clinical Trials Actively Recruiting Patients With Hodgkin Lymphoma and Non-Hodgkin Lymphoma
The information contained in this Clinical Trials Resource Guide includes clinical studies actively recruiting people with Hodgkin lymphoma, non-Hodgkin lymphoma (NHL), including AIDS-related NHL, as well as studies that are also recruiting patients with multiple myeloma and mantle cell lymphoma....
Expert Point of View: Joan M. Teno, MD, MS, and Pedro L. Gozalo, PhD
Joan M. Teno, MD, MS, and Pedro L. Gozalo, PhD, of the Brown University School of Public Health, Providence, Rhode Island, commented on end-of-life care in an editorial accompanying the JAMA study by Obermeyer et al. “As financial incentives change in the U.S. health-care system, valid measures of ...
Study Finds Wide Variation in Quality, Content of Clinical Cancer Guidelines
What’s the best way to treat rectal cancer? Consult any of five top clinical guidelines for rectal cancer and you will get a different answer, according to a new study by researchers at the University of Michigan Comprehensive Cancer Center. Their findings were published online in the journal...
HDAC Inhibitors and Triple Therapy in Relapsed Myeloma
The use of histone deacetylase (HDAC) inhibitors as human cancer therapy has focused on the impact of these agents on epigenetic regulation and gene transcription. However, the use of HDAC inhibitors in myeloma may be working through a different mechanism. Specifically, HDAC6 is known to regulate...
CD19-Directed CAR T Cells Produce Sustained Remission in Relapsed/Refractory Acute Lymphoblastic Leukemia
In a study reported in The New England Journal of Medicine, Shannon L. Maude, MD, PhD, of Children’s Hospital of Philadelphia, and Noelle Frey, MD, of the Perelman School of Medicine, University of Pennsylvania, and colleagues reported achieving sustained remissions in children and adults with...
Tumor Board Participation Associated With Improved Survival in Stage IV Lung and Colorectal Cancers
A large, population-based, observational study suggests that participation in weekly tumor boards can improve outcomes in oncologic care. Specifically, oncologist participation in weekly tumor board meetings was associated with improved survival in patients with stage IV small cell lung cancer and...
Optimizing HER2 Therapy in Early and Advanced Breast Cancers
Trastuzumab (Herceptin) has been the cornerstone of therapy for HER2-positive tumors, which comprise about 20% of all breast tumors. Additional therapies targeted to other HER2 pathways or other targets to be used in combination with trastuzumab are being explored in both the adjuvant and...
2014 Featured Columnists
The ASCO Post wishes to acknowledge and thank all contributors to the publication during 2014. Here we recognize those who shared their personal thoughts in our Op-Ed department. If you are interested in contributing to The ASCO Post in 2015, write to editor@ASCOPost.com. Robert Peter Gale, MD,...
Personalized Genetic and Environmental Risk Assessment Does Not Increase Use of Colorectal Cancer Screening
Individualized genetic and environmental risk assessment of susceptibility to colorectal cancer does not influence adherence to screening in average-risk persons, according to results from a two-group, randomized, controlled trial. Among patients who received genetic and environmental risk...
Small Risk-Adjusted Variation in Hospital Readmissions Following Colorectal Cancer Surgery
“Little risk-adjusted variation exists in hospital readmission rates after colorectal surgery,” according to an analysis of data from 44,822 patients who underwent colorectal resection for cancer at 1,401 U.S. hospitals between 1997 and 2002. “The use of readmission rates as a high-stakes quality...
Clinical Trials Actively Recruiting Patients With Soft-Tissue Sarcomas
The information contained in this Clinical Trials Resource Guide includes details of actively recruiting clinical studies of children and adults with various types of soft-tissue sarcoma, including non-rhabdomyosarcoma, Ewing sarcoma, gastrointestinal stromal tumor, and Kaposi sarcoma. The studies...
Aloe Vera
The use of dietary supplements by patients with cancer has increased 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...
Second Annual JADPRO Live Conference Attracts 400 Advanced Practitioners in Oncology From Across the Nation
The second annual JADPRO Live: Transforming Oncology Practice was held October 30 to November 2 in Orlando, Florida. The conference drew nearly 400 nurse practitioners, physician assistants, clinical nurse specialists, advanced-degree nurses, hematology/oncology nurses, pharmacists, and...
Dr. Matthew J. Ellis Named Director of Lester and Sue Smith Breast Center
Matthew J. Ellis, MD, PhD, a renowned clinician scientist in the area of genomics and molecular profiling of breast cancer, was named the new Director of the Lester and Sue Smith Breast Center at Baylor College of Medicine. Dr. Ellis assumed his new role in September 2014, succeeding C. Kent...
Racing Against Acute Lymphoblastic Leukemia: CTL019 Is a Fast CAR With Sustained Endurance
The long-term outcome for patients with relapsed or refractory acute lymphoblastic leukemia (ALL) is poor, with 5-year overall survival from first relapse being only approximately 10%.1,2 Patients with disease relapse following allogeneic transplant have the worse prognosis and are typically...
Getting the Most Out of Ipilimumab in Melanoma
Ipilimumab (Yervoy) was first approved by the U.S. Food and Drug Administration (FDA) in 2011 on the basis of an improvement in overall survival compared with gp100 vaccine in patients with advanced melanoma.1 Response rates with ipilimumab have been modest at best—10% to 15% using 3 mg/kg and 15%...
Moving a Mountain: Crizotinib in ROS1-Rearranged NSCLC
It was thousands of years ago in China. An elderly man was unhappy with the mountain that embraced his seaside village. He would need to walk for hours before he could reach the nearest town. So, as the old fable goes, he set his mind to move the mountain. Every day, he dug up basketfuls of rocks...
ASCO Expert Statement on Cancer Survivorship Care Planning: Timing Is Everything
As the saying goes, “Timing is everything.” And so it is with the recently released ASCO Clinical Expert Statement on survivorship care planning.1 Although there has been extensive discussion and debate about the use of survivorship care plans since the publication of the 2005 Institute of Medicine ...
Lung Cancer: Next Frontier for Immunotherapy
Immune checkpoint inhibitors, particularly PD-1 (programmed cell death-1) and PD-L1 (programmed death-ligand 1) inhibitors, are being studied extensively in lung cancer. These agents, alone and in combination, appear to have the potential to change the management of non–small cell lung cancer...
Transplants for AML in First Remission: A Great Leap Forward, Sideways, or Backward?
“All great truths begin as blasphemies.” —George Bernard Shaw (Annajanksa, 1918) Until about 15 years ago, persons with acute myelogenous leukemia (AML) were considered candidates to receive a blood cell or bone marrow allotransplant in first remission only if they had had an HLA-identical...
Clinical Trials Actively Recruiting Children and Young Adults With Cancer
The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies of children and young adult cancer survivors. The studies include phase I, I/II, III, observational, and interventional trials investigating genomic profiling to personalize treatment;...
SIO Clinical Practice Guidelines on the Use of Integrative Therapies as Supportive Care in Patients Treated for Breast Cancer
The Society for Integrative Oncology (SIO) Guidelines Working Group has recently released clinical practice guidelines on the use of integrative therapies as supportive care in patients receiving treatment for breast cancer. The guidelines, reported by Heather Greenlee, ND, PhD, MPH, of Mailman...
MD Anderson, UnitedHealthcare Launch New Cancer Care Payment Model
The University of Texas MD Anderson Cancer Center and UnitedHealthcare have launched a pilot to explore a new cancer care payment model for head and neck cancers that focuses on quality patient care and outcomes. The collaboration is among the first using bundled payments in a large, comprehensive...
Victory for Pediatric Regimens in Adolescents and Young Adults With ALL
Long in the works, early results of the U.S. Intergroup C10403 trial clearly showed that treating acute lymphoblastic leukemia (ALL) in adolescents and young adults using a pediatric-inspired regimen improves event-free survival and overall survival and should be the backbone for future studies in...
Crizotinib in ROS1-Positive NSCLC: A Next Step Forward
Advances in the molecular characterization of non–small cell lung cancer (NSCLC) have led to the identification of molecularly defined distinct subsets of patients who derive benefit from targeted therapies. Currently, two such groups of agents have moved widely into clinical practice: epidermal...
Expert Point of View: Benjamin O. Anderson, MD
Commenting on this study, Benjamin O. Anderson, MD, Director of the Breast Health Clinic, Seattle Cancer Care Alliance, Washington, said: “This new analysis of the Oncotype DX DCIS assay strengthens the findings of earlier studies performed in more limited subgroups, validating that the assay...
Low-Fat Diet Reduces Mortality in Breast Cancer Subset
The final survival analysis of the landmark Women’s Intervention Nutrition Study (WINS) confirmed that a low-fat diet can reduce the risk of dying for a subset of breast cancer patients.1 At the San Antonio Breast Cancer Symposium, Rowan T. Chlebowski, MD, PhD, of the Los Angeles Biomedical...
New ASCO Study Aims to Learn From Patient Access to Targeted Cancer Drugs Used Off-Label
ASCO plans to launch a first-ever study that will offer cancer patients access to molecularly targeted cancer drugs and collect “real-world” data on clinical outcomes to help oncologists learn the best uses of these drugs outside of approved indications. “One of the major challenges to implementing ...
ASCO and AACR Call for Regulation of E-Cigarettes and Other Electronic Nicotine Delivery Systems
The American Association for Cancer Research (AACR) and ASCO have outlined steps in a joint statement to guide policymakers as they work to minimize the potential negative consequences of electronic cigarettes (e-cigarettes) and other electronic nicotine delivery systems without undermining their...
Colorectal Cancer 2015
Despite advances in detection and treatment, colorectal cancer remains the third deadliest cancer among men and women in the United States. To get a better understanding of the current state of this disease and what lies ahead, The ASCO Post recently spoke with colorectal cancer expert John L....
Fulvestrant Surpasses Anastrozole in First-Line Treatment of Metastatic Breast Cancer
Fulvestrant (Faslodex) at a 500-mg dose was superior to anastrozole as first-line therapy for advanced hormone receptor–positive breast cancer in the phase II FIRST study.1 Overall survival and time to disease progression were significantly better with fulvestrant than with the current standard of...
BOLERO-1: Everolimus Plus Trastuzumab/Paclitaxel Misses the Mark in First‑Line HER2-Positive Advanced Breast Cancer
The addition of everolimus (Afinitor) to weekly trastuzumab (Herceptin) plus paclitaxel in the first-line metastatic breast cancer setting did not improve outcomes in the phase III BOLERO-1/TRIO-019 but did provide a “signal” in the hormone receptor–negative subset. The study was reported at the...
Expert Point of View: Mary L. Disis, MD
Study discussant Mary L. Disis, MD, Professor of Medicine and Associate Dean of Translational Science at the University of Washington, Seattle, commented that the response rate, approaching 20%, is “in the ballpark” of those observed in melanoma, lung cancer, and renal cancer. She pointed out that...
Ovarian Suppression Plus Hormonal Therapy May Be Practice-Changing in Premenopausal Hormone Receptor–Positive Early-Stage Breast Cancer
Results of the large International Breast Cancer Study Group (IBCSG)-coordinated SOFT trial present a convincing argument for the addition of ovarian function suppression to adjuvant hormonal therapy to reduce the risk of tumor recurrence in younger women with hormone receptor–positive early-stage...
Mammographically Dense Breasts Highly Prevalent Among American Women
A study on the prevalence of mammographically dense breasts in the United States “estimated that approximately 43% of women aged 40 to 74 years have heterogeneously or extremely dense breasts, corresponding to approximately 27.6 million U.S. women,” researchers reported in the Journal of the...
Loretta Doan, PhD, Named Vice President of Policy and Global Affairs at AACC
The American Association of Clinical Chemistry (AACC) has announced that Loretta L. Doan, PhD, has assumed the position of Vice President of Policy and Global Affairs. Prior to joining AACC, Dr. Doan served as Director of Science Policy at the Endocrine Society, an organization representing more...
