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issues in oncology

Significant Reduction in Cancer Risk Seen with Daily Multivitamin Use in Middle-aged and Older Men

Large-scale trials over the past several years have shown a general lack of effect of single vitamins or small numbers of vitamins given at high doses in preventing cancer. However, as recently reported in JAMA by Gaziano and colleagues, the Physicians’ Health Study II has found a modest but...

cns cancers

Revised Everolimus Dosing and New Safety/Efficacy Data for Approval in Subependymal Giant Cell Astrocytoma

On August 29, 2012, everolimus in a tablet for oral suspension form (Afinitor Disperz) was given accelerated approval for the treatment of pediatric and adult patients with tuberous sclerosis complex who have subependymal giant cell astrocytoma (SEGA) that requires therapeutic intervention but...

issues in oncology
symptom management

Statin Use Associated with Reduced Cancer-related Mortality in Danish Study

Cancer-related mortality among patients in the Danish population receiving a diagnosis of cancer at age ≥ 40 years between 1995 and 2007 was significantly reduced in those who were receiving statin therapy at the time of diagnosis, according to an analysis reported by Nielsen and colleagues in The...

Screening for Ovarian Cancer: A Gynecologic Oncologist’s Perspective

The recent U.S. Preventive Services Task Force (USPSTF) Reaffirmation Recommendation Statement concluded that in the population of asymptomatic women without known genetic mutations that increase risk for ovarian cancer, clinicians should not screen for ovarian cancer using transvaginal ultrasound...

head and neck cancer

Four-plus Cups of Coffee Daily Linked to Lower Risk of Death from Oral/Pharyngeal Cancer 

Consuming four or more cups per day of caffeinated coffee could almost halve the risk of dying from oral/pharyngeal cancer compared to drinking no coffee or drinking it only occasionally, researchers reported in the American Journal of Epidemiology. “A dose-related decline in relative risk was...

breast cancer

Analysis Suggests Screening Mammography Results in Substantial Overdiagnosis with Small Effect on Mortality

An analysis of Surveillance, Epidemiology, and End Results (SEER) data from 1976 through 2008 “suggests that whatever the mortality benefit, breast-cancer screening involved a substantial harm of excess detection of additional early-stage cancers that was not matched by a reduction in late-stage...

colorectal cancer

Patients Treated for Colon Cancer Can Reduce Risk of Recurrence with Balanced Diet and Lower Carbohydrate Intake 

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. Patients who have received standard...

issues in oncology

NCI Director Assesses Barriers to Faster Progress in Cancer Research

At a National Press Club media event in Washington, DC, on September 25, 2012, National Cancer Institute (NCI) Director Harold E. Varmus, MD, addressed a group of 75 reporters and officials. His discussion focused on impediments—biologic, economic, institutional, and cultural—to faster cancer...

cns cancers

Management of Brain Metastases

Pearls in Neuro-oncology is guest edited by Tracy Batchelor, MD, Director, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, and Professor of Neurology, Harvard Medical School, Boston. The series is intended to provide the practicing oncologist with guidance in managing...

health-care policy

Does Health-care Quality Translate to Value?

On March 23rd, 2010, President Obama signed into law the Patient Protection and Affordable Care Act, enacting sweeping change in our health-care system. An underlying theme of the legislation is the realignment of our payment system so that it places value over volume of services. At ASCO’s first...

issues in oncology

Are We Winning the War on Cancer?

On December 23, 1971, President Richard Nixon signed the U.S. National Cancer Act. This date is widely considered to mark the beginning of the so-called “War on Cancer,” although that phrase was introduced only later on. Over recent decades, journalists have from time to time questioned whether we...

breast cancer

'Practice-changing' ATLAS Study Supports 10 vs 5 Years of Tamoxifen Therapy in Women with Breast Cancer

"Practice-changing" is the term several physicians and researchers used when asked by the media to describe the results of a study showing that extending tamoxifen therapy from 5 to 10 years for women with estrogen receptor (ER)-positive breast cancer further reduced recurrence and mortality....

lymphoma

PET-negative Scan after Short-course Chemotherapy Identifies Early Hodgkin Lymphoma Patients Who Can Forgo Radiation

Positron-emission tomography (PET)-directed therapy is promising for early-stage Hodgkin lymphoma, according to results of the UK NCRI RAPID trial presented at the 54th Annual Meeting of the American Society of Hematology (ASH).1 The use of PET scan enabled the identification of a population of...

breast cancer

Primary Endpoint Not Met for Eribulin vs Capecitabine in Breast Cancer 

While a global phase III trial failed to meet its primary endpoint in showing an overall or progression-free survival benefit for eribulin (Halavan) in metastatic breast cancer, a trend toward greater efficacy than capecitabine (Xeloda) was observed, researchers reported at the 2012 San Antonio...

lymphoma

Ibrutinib in Mantle Cell Lymphoma Yields 'Unprecedented' Response Rates 

The investigational agent ibrutinib demonstrated “unprecedented” single-agent activity in relapsed or refractory mantle cell lymphoma, according to the lead author of an international phase II study reported at the Annual Meeting of the American Society of Hematology (ASH).1 Durable Responses “The...

cost of care

Cost of Cancer Drugs: What Price for What Benefit?

In 2011, national health-care spending in the United States was about $2.7 trillion, larger than the entire French national budget.1 U.S. national health-care spending is about 17% of the national gross domestic product. Total Medicare expenditures in 2011 were $549 million.2 In the debate about...

multiple myeloma

Survival Benefit Achieved with Four Drugs plus Maintenance in Myeloma

An overall survival benefit in newly diagnosed multiple myeloma was attained with a four-drug induction regimen followed by a duet for maintenance in a study from the Italian GIMEMA network. Antonio Palumbo, MD, Chief of the Myeloma Unit at the University of Torino in Italy, reported the findings...

colorectal cancer

Even at NCCN Institutions, a 'Sizable Minority' of Patients with Rectal Cancer Are Not Treated per NCCN Guidelines 

Even at the eight cancer centers participating in the National Comprehensive Cancer Network (NCCN) Colorectal Cancer Outcomes project, a “sizable minority” of patients with stage II/III rectal cancer treated with curative intent neoadjuvant chemoradiotherapy did not complete postoperative...

leukemia

Ponatinib in Chronic Myeloid Leukemia and Philadelphia Chromosome–positive Acute Lymphoblastic Leukemia 

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. Indication On December 14, 2012, ponatinib (Iclusig) was granted...

breast cancer

Subcutaneous Trastuzumab a Potential Alternative to Intravenous Administration in Breast Cancer 

Subcutaneous administration of trastuzumab might offer improvements in patient convenience and resource use compared with conventional intravenous administration (Herceptin). A new subcutaneous trastuzumab formulation containing a fixed dose of 600 mg and recombinant human hyaluronidase PH-20...

global cancer care

International Members Cite Networking, Enhanced Patient Care Among Benefits of ASCO Membership 

Thanks to the membership category ASCO designed for physicians in developing countries, Brazilian oncologist Milena Mak, MD, can greatly enhance the care she delivers in the very busy 580-bed Instituto do Cancer do Estado de Sao Paulo. And radiation oncologist Pooja Nandwani Patel, MD, can use the...

breast cancer
leukemia

Chemotherapy for Breast Cancer Carries a Small, but Concerning, Risk for Leukemia 

The risk for developing a secondary malignancy after chemotherapy for breast cancer is very small, but it is statistically significantly higher than for the general population, a review of the National Comprehensive Cancer Network (NCCN) database revealed in a study presented at the 2012 San...

leukemia

Chemotherapy-free Regimen Successful in Acute Promyelocytic Leukemia 

For the first time, a chemotherapy-free regimen was superior to conventional cytotoxic chemotherapy for the treatment of acute promyelocytic leukemia (APL). The combination of all-trans retinoic acid (ATRA) plus arsenic trioxide (Trisenox) achieved significantly superior overall survival compared...

colorectal cancer

Bevacizumab plus Chemotherapy after Progression of Metastatic Colorectal Cancer on First-line Therapy Including Bevacizumab 

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. Indication On January 23, 2013, bevacizumab (Avastin) was approved...

hematologic malignancies

No Rationale for Eliminating Prophylactic Platelet Transfusions in Patients with Hematologic Malignancies 

Prophylactic platelet transfusions should remain the standard of care for many patients with hematologic malignancies who are thrombocytopenic during intensive treatment or stem cell transplant, investigators of the TOPPS trial (noninferiority Trial Of Prophylactic Platelet transfusionS)...

issues in oncology

On Radiation and Cancer Risk

We owe our life to radiation. The universe was created in a thermonuclear explosion, and continued existence of life on Earth depends on plants using chlorophyll to capture light energy emitted by the sun (and exploding supernovas) and converting it into chemical energy, with the subsequent...

head and neck cancer
lung cancer
issues in oncology

Patients with Cancer Need to Know That It Is Never Too Late to Quit Smoking 

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. Patients with head and neck or lung...

integrative oncology

Fitness: Can Exercise Lengthen Survival in Patients with Cancer? 

Regular physical activity has long been associated with decreased risk of disease, including many types of cancer. Such benefits may translate into increased life expectancy of up to 4.5 years, with even the lowest levels of activity providing some survival advantage.1 Most strikingly, however,...

issues in oncology

Preparing for the Next Superstorm: Protecting Patients during Natural Disasters 

When Hurricane Sandy slammed into the East Coast last October, the magnitude of devastation it left in its wake exceeded even the most dire predictions. Eighty mile per hour winds and record storm surges destroyed antiquated electrical grids and flooded subway stations, leaving much of New York...

solid tumors
colorectal cancer

Colorectal Cancer: A Decade of Progress 

The 2013 Gastrointestinal Cancers Symposium marked the 10th anniversary of the meeting. Richard M. Goldberg, MD, the Klotz Family Chair in Cancer Research, Professor of Medicine, and James Cancer Hospital Physician-in-Chief at The Ohio State University, looked back over the decade to highlight the...

head and neck cancer

Two Studies Focus on Treatment Strategies for Preserving the Larynx While Increasing Survival

Two recent studies in the Journal of Clinical Oncology focused on treatment strategies to preserve the larynx while increasing survival of patients with cancer of larynx. RTOG 91-11 Ten-year results from the Radiation Therapy Oncology Group (RTOG) 91-11 trial found that both chemotherapy regimens...

SIDEBAR: The ‘About Herbs’ Website 

The “About Herbs” site (http://www.mskcc.org/cancer-care/integrative-medicine/about-herbs-botanicals-other-products) provides objective information for oncologists and health-care professionals, including a clinical summary for each agent and details about constituents, adverse effects,...

integrative oncology

Barrie R. Cassileth, MS, PhD, Champion of Integrative Oncology, Continues to Nurture Growth of the Field 

Over the past decade, integrative oncology has gained wide acceptance as an evidenced-based way to improve the lives of patients with cancer throughout the continuum of their care. The ASCO Post recently spoke with Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance ...

Alex's Lemonade Stand Foundation Introduces Centers of Excellence Program to Further Childhood Cancer Research

Alex’s Lemonade Stand Foundation (ALSF), a registered 501(c)(3) charity, is furthering its commitment to finding cures for all children with cancer by introducing the ALSF Centers of Excellence program. The Centers of Excellence program aims to fund the research of leading childhood cancer...

gynecologic cancers

Majority of Ovarian Cancer Patients Do Not Receive Recommended Treatment, Study Shows 

Women are 30% less likely to die of ovarian cancer if they have guideline-recommended treatment, yet nearly two-thirds of those with the disease do not receive it, often because they are cared for at hospitals that treat a small number of ovarian cancer patients. These are the findings of a study...

breast cancer

CDC Reports Racial Disparity in Breast Cancer Mortality  

Breast cancer deaths have declined over the past 2 decades, with approximately half of the decrease estimated to be due to advances in early detection and treatment. However, not all racial groups have benefited equally from these advances. A recent report from the Centers for Disease Control and...

breast cancer

Effects of Menarche and Menopause on Breast Cancer Risk: Meta-analysis Findings 

Menarche and menopause mark the onset and offset of ovarian and endocrine activity associated with reproduction, and early menarche and late menopause are known to increase risk of breast cancer. In a recent Lancet Oncology article, the Collaborative Group on Hormonal Factors in Breast Cancer...

breast cancer
integrative oncology

Qigong Practice Associated with Quality-of-life Benefits in Women Undergoing Radiation Therapy for Breast Cancer 

Qigong (“qi” or “chi” = energy flow, “gong” = skill or achievement) is an integrated mind-body exercise and meditative practice that involves rhythmic breathing coordinated with repetition of fluid movements and calm focus on the body. A study reported in Cancer by Zhen Chen, MD, and colleagues...

skin cancer

New Data Reported on Melanoma, Cutaneous T-cell Lymphoma, Basal Cell Carcinoma, and Cancer Treatment Side Effects 

At the recent American Academy of Dermatology 71st Annual Meeting in Miami Beach, researchers presented interesting findings regarding melanoma and other skin cancers. The ASCO Post brings you the following news briefs on these topics. Melanoma Incidence Decreases among Adolescents and Children An...

breast cancer

Ado-Trastuzumab Emtansine in Metastatic Breast Cancer 

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.  Indication On February 22, 2013, ado-trastuzumab emtansine...

colorectal cancer

Is Aspirin Protective against Colorectal Cancer? 

A growing body of evidence provides biologic and clinical evidence that nonsteroidal anti-inflammatory agents are protective against colorectal cancer. “It is fascinating for me as a medical oncologist and epidemiologist to see how the worlds of colorectal cancer treatment and epidemiology are...

breast cancer

Progression-free Survival in HER2-positive Metastatic Breast Cancer Improved with T-DM1 

First-line treatment with ado-trastuzumab emtansine (T-DM1) “provided a significant improvement” in progression-free survival when compared to trastuzumab (Herceptin) plus docetaxel in a randomized phase II study among patients with HER2-positive metastatic or recurrent locally advanced breast...

breast cancer

Increase in Advanced Breast Cancer among Younger Women Is Small but Significant, and Trend Is Likely to Continue 

The incidence of advanced breast cancer among women aged 25 to 39 years increased by an average of 2.07% per year from 1976 to 2009 and the trend seems likely to continue, according to an analysis of data for 936,497 women diagnosed with malignant breast cancer. The small but statistically...

health-care policy

Rally for Medical Research Draws Thousands in Person and on Social Media 

In estimated 10,000 demonstrators filled the streets in front of Washington, DC’s historic Carnegie Library on April 8 to protest budget cuts at the National Institutes of Health. The Rally for Medical Research was held to “emphasize to our policymakers that medical research must become a national...

SIDEBAR: Take-home Message

Perhaps the most important take-home point of our study is that physicians should consider counseling colorectal cancer survivors to adopt a more physically active lifestyle that is consistent with a patient’s abilities and overall medical condition. Physicians should be reminded that most patients ...

solid tumors
colorectal cancer

More Recreational Physical Activity Associated with Reduced All-cause Mortality in Patients with Colorectal Cancer 

In a study recently reported in Journal of Clinical Oncology, Peter T. Campbell, PhD, and colleagues from the Epidemiology Research Program of the American Cancer Society, Atlanta, found that more recreational physical activity before and after a diagnosis of colorectal cancer was associated with...

solid tumors
colorectal cancer

Benefit of Continued Antiangiogenic Treatment with Bevacizumab after Progression in Metastatic Colorectal Cancer 

As reported recently in Lancet Oncology by Jaafar Bennouna, MD, of Institut de Cancérologie de l’Ouest, Nantes, France, and colleagues, the phase III ML18147 trial showed a survival benefit with continued bevacizumab (Avastin) treatment after first progression in metastatic colorectal cancer.1 The...

solid tumors
hepatobiliary cancer

Medical Oncologists Underestimate Resectability of Liver Metastases 

Medical oncologists are apt to underestimate the resectability of liver metastases in patients with colorectal cancer and therefore often fail to refer potential surgical candidates for surgical consultation, according to a study presented at the 18th Annual Conference of the National Comprehensive ...

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...

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...

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