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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...

cost of care

New Technologies Are Driving Up Costs: Are They Worth the Price?

Expensive new cancer therapies and technologies are alluring for both physicians and their patients. Prostate cancer, because of the sheer volume of cases and the variability of treatment options, serves as a dynamic disease model in the ongoing debate over how to curb spending and maintain...

issues in oncology

Do We Need the USPSTF?

Like most of the folks reading this commentary, I’m a taxpayer. Although I sometimes become impatient with the strategic games on Capitol Hill, I basically appreciate that government helps many things to work, and some of them even work well. However, there are aspects of government function that...

lung cancer

Improved Survival with Concurrent Chemotherapy plus Radiotherapy for Patients with Stage III Non–Small Cell Lung Cancer

Five-year survival was statistically significantly higher for patients with stage III non–small cell lung cancer (NSCLC) who received concurrent rather than sequential cisplatin-based chemotherapy combined with thoracic radiotherapy, according to the phase III Radiation Therapy Oncology Group...

issues in oncology

Chemotherapy Generally Safe in Pregnancy

The diagnosis of cancer in a pregnant woman causes concerns for both the mother and her unborn child. But studies suggest that most chemotherapy regimens can be delivered with reasonable safety after the first trimester. Cancer is diagnosed in about 1 per 1,000 to 2,000 pregnancies, mostly breast...

Expert Point of View: Hypofractionated Radiotherapy Effectively Controls High-risk Prostate Cancer

The take-home message of the study findings from the Fox Chase trial reported at the 53rd ASTRO Annual Meeting plenary session supports the use of hypofractionated intensity-modulated radiotherapy as a more convenient and cost-effective alternative than conventional IMRT, according to formal...

symptom management

Neural Stem Cell Transplantation May Improve Cognitive Function in Brain Cancer

The potentially devastating long-term consequences on cognitive function in patients with brain cancer following cranial irradiation led Charles L. Limoli, PhD, Professor of Radiation Oncology, University of California, Irvine, to study neural stem cell transplantation and how the procedure may...

issues in oncology
solid tumors
hematologic malignancies

Solid Organ Transplant Recipients Have Increased Risk for Broad Range of Malignancies

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. The Transplant Cancer Match Study, a ...

lung cancer

Evidence of Improved Survival for Lobectomy vs Limited Resection in Early-stage Lung Cancer

“Evidence is statistically inconclusive but suggestive that lobectomy, compared with limited resection, is associated with increased long-term survival for early-stage lung cancer,” according to a study reported in the Journal of the National Cancer Institute. The study analyzed data from 679...

issues in oncology

Improving Quality and Safety with Health Information Technology

A well-documented flaw in paper-based health care is the propensity for medical errors. According to Blackford Middleton, MD, MPH, MSc, implementing clinical decision support software can decrease medical error, improve outcomes, and lower the costs of care. Presenting a session titled “Improving...

breast cancer

Male Breast Cancer Differs from Breast Cancer in Women, but Little Data Informs Treatment

Although a rare occurrence, men do get breast cancer, and when they do, it has a distinct biology from that of female breast cancer. About 90% of cases most closely resemble postmenopausal female invasive ductal carcinoma, and 10% are ductal carcinoma in situ (DCIS), which accounts for 25% of...

breast cancer

Optimizing HER2-directed Therapy in the Clinic

Seminal research in the treatment of HER2-positive breast cancer has been led by Edith A. Perez, MD, the Serene M. and Frances C. Durling Professor of Medicine at the Mayo Clinic, Jacksonville, Florida. The ASCO Post asked Dr. Perez to share her approach to HER2-directed therapy. Testing...

prostate cancer

Prostate Cancer Screening Reconsidered

Prostate cancer is the most prevalent nonskin cancer in men. An estimated 16% of men are diagnosed with prostate cancer, yet only 3% of men die from it.1 Unlike other cancers, prostate cancer is associated with a prolonged lead-time, meaning it can take anywhere from 5 to 12 years to become...

breast cancer

Benefits of Radiation after Breast-conserving Surgery Cut Risk of Recurrence in Half

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. “After breast-conserving surgery,...

issues in oncology

MD Anderson Cancer Center’s New President Has a Bold Vision

On September 1, 2011, Ronald A. DePinho, MD, became only the fourth President in the 70-year history of The University of Texas MD Anderson Cancer Center in Houston. Dr. DePinho spent the previous 14 years as head of Dana-Farber’s Belfer Institute for Applied Cancer Science. In a recent interview...

issues in oncology

The Newly Diagnosed Patient with Cancer and Access to Care

A study presented at the 2011 ASCO Annual Meeting raised concerns that newly diagnosed cancer patients are having trouble seeing an oncologist. Interviews with several cancer centers and community practices, however, suggest that the process runs smoothly, for the most part. Majority of Patients...

gastrointestinal cancer

Gastric Cancer Is on the Rise: Screening and Education Are Vital

Gastric cancer is diagnosed in nearly 1 million people globally each year and is responsible for 740,000 deaths, making it the second leading cause of cancer death in the world. According to the American Cancer Society, more than 21,000 people in the United States were diagnosed with gastric...

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