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Showing 3051 - 3100Cooperative Group Study Finds Radiation May Benefit Patients With Atypical Meningiomas
Management of the vast majority of meningiomas is straightforward, but treatment of atypical meningiomas has been controversial. Should radiation be part of therapy or not has been the question. The first analysis of Radiation Therapy Oncology Group (RTOG) 0539 suggested that patients will have...
Debate Over Physician-Assisted Suicide Continues, State by State
In 1997, after surviving a storm of high-court legal challenges, Oregon’s Death With Dignity Act went into effect, making Oregon the first American state to legalize physician-assisted suicide. The Supreme Court ruled that there was no right to assisted suicide in the Constitution but implied that...
Is Health Care in the United States a Basic Human Right or an Entitlement?
Mercy Killers is a one-man show that details the consequences of a medical health-care catastrophe (breast cancer) in a family.1 This disturbing fictional account is actually a daily event in cancer centers: losing insurance for technicalities, losing a home because of an inability to pay the...
William Dameshek, MD, Helped Take Hematology From a Minor Medical Discipline to a Major Scientific Field
Although William Dameshek, MD, is renowned for his work in hematology, especially in advancing the understanding of myeloproliferative disorders and their interrelatedness, his early interest in medicine was instead focused on such diverse diseases as hyperthyroidism and typhus fever. Born on May...
A Selfless Act
The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...
Engaging Clinicians in the Collection of Cancer Registry Data to Improve Clinical Research
In June, the Commission on Cancer of the American College of Surgeons published a revision of its Facility Oncology Registry Data Standards (FORDS) manual, which contains all the data items, codes, and rules to abstract data into cancer registries at the more than 1,500 Commission on...
ASCO Launches TAPUR to Assess the Off-Label Use of Targeted Therapies for Patients With Advanced Cancers
Two years ago, Richard L. Schilsky, MD, FACP, FASCO, Chief Medical Officer of ASCO, proposed a unique clinical trial concept during an educational session on the challenges of delivering precision medicine services in a community setting at ASCO’s Annual Meeting. The idea was to design a clinical...
The Role of Botulinum Toxin in Head and Neck Cancer
Head and neck cancer and its treatment can result in a variety of neuromuscular and musculoskeletal pain and functional sequelae. Commonly seen conditions in patients with the disease include neck pain and spasm, hemifacial spasm, trismus, dysphonia, dysarthria, neuropathic pain, and salivary...
Mediterranean Diet Supplemented With Extra-Virgin Olive Oil Reduces Risk for Invasive Breast Cancer
As reported in JAMA Internal Medicine by Estefania Toledo, MD, MPH, PhD, and colleagues, a large Spanish primary prevention nutrition intervention trial in patients at high cardiovascular risk (PREDIMED) showed a large reduction in the risk for invasive breast cancer among women 60 to 80 years of...
Checkmate 057: Nivolumab Improves Survival vs Docetaxel in Advanced Nonsquamous Non–Small Cell Lung Cancer
In the phase III CheckMate 057 trial, reported in The New England Journal of Medicine by Hossein Borghaei, DO, of Fox Chase Cancer Center, and colleagues, the programmed cell death protein 1 (PD-1) inhibitor nivolumab (Opdivo) improved overall survival vs docetaxel in patients with advanced...
Graviola
The use of dietary supplements by patients with cancer has increased significantly over the past 25 years 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 ...
ACS Breast Cancer Screening Guidelines: Balancing the Benefits and Harms of Mammography
For the past 30 years, mammography screening has been one of the most contentious issues in medicine. Controversy has generally centered on the age at which to begin mammography screening (40 vs 50 years) and also, to a lesser extent, on the age at which it should stop. The recent American Cancer...
Applications Open for ASCO’s New Policy Fellowship Program
On October 15, ASCO launched a new fellowship program aimed at providing physicians with the necessary skills to shape cancer policy. ASCO is actively recruiting oncologists in the early phase of their careers that have leadership, civic, policy, or advocacy experience, and a keen interest in...
TAPUR: ASCO’s First Clinical Trial Addresses Critical Gaps in Understanding of and Access to Targeted Therapies
ASCO is preparing to expand the boundaries of precision medicine with the launch of its first clinical trial. At a press briefing during the 2015 ASCO Annual Meeting, the Society formally announced its plans for the Targeted Agent and Profiling Utilization Registry (TAPUR) study. At a time when...
Lenvatinib in Refractory Thyroid Cancer: Survival Benefit or Not?
In the original phase III SELECT trial, no overall survival benefit was observed for lenvatinib (Lenvima) vs placebo in progressive radioactive iodine–refractory differentiated thyroid cancer. Overall survival was a secondary endpoint in that trial. However, in an updated analysis of SELECT, which...
Hypofractionated Radiotherapy Makes Inroads as Primary Treatment of Prostate Cancer
Several studies presented at the 2015 ASTRO Annual Meeting explored the use of hypofractionation (delivering higher doses of radiation in fewer fractions) in the treatment of patients with prostate cancer. These studies found comparable outcomes in terms of efficacy and adverse events. Although...
Genomic Test Identifies Patients With Prostate Cancer in Need of Intensified Salvage Therapy
Prostate cancer has been slow to catch up with breast cancer in terms of using biomarkers, but a new study represents progress in this regard. A genomic classifier called Decipher® provides important information that can be used to make treatment decisions for men with prostate cancer and a rising...
Genomics Now Driving Treatment of Waldenström’s Macroglobulinemia
The treatment of Waldenström’s macroglobulinemia has been greatly impacted by an understanding of its genomics, according to Steven P. Treon, MD, PhD, of Dana-Farber/Brigham and Women’s Cancer Center and Massachusetts General Hospital Cancer Center, Boston. Dr. Treon brought listeners up to date on ...
5-Year Results of GEC-ESTRO Trial of Accelerated Partial-Breast Irradiation vs Whole-Breast Irradiation: Is There Any Impact?
There is a strong rationale for the use of accelerated partial-breast irradiation: The large majority of in-breast recurrences are at or near the primary site, limiting the radiation dose to the primary site has the potential to decrease side effects, and treatment can be delivered over a shorter...
Starting Over
My diagnosis of pleural mesothelioma early in 2015 couldn’t have been more surprising. In one day, I went from being a healthy, vibrant woman with a busy career and the excitement of launching a promising new business venture to a woman facing the greatest challenge of her life. The fact that my...
Foot Care in Oncology: The Cancer Patient From Ankle to Toe
There is as yet no clinical or research focus on foot complications that result from cancer therapies. Foot conditions, however, are common and have a considerable negative impact on patients’ ambulation, quality of life, and consistent dosing of antineoplastic agents.1-4 There are currently no...
Cancer on the Global Stage: Incidence and Cancer-Related Mortality in Argentina
The ASCO Post is pleased to continue this special feature on the worldwide cancer burden. In this issue, we feature a close look at the cancer incidence and mortality rates in Argentina. The aim of this special feature is to highlight the global cancer burden for various countries of the world. For ...
Gut Bacteria May Facilitate Efficacy of Anti–PD-L1 Agents
Could the manipulation of bacteria in the gut pack the same punch in melanoma as antibodies targeting the programmed cell death protein and its ligand (PD-1/PD-L1)? It’s possible, at least in mice, according to research from the University of Chicago, recently published in Science.1 The researchers ...
Cancer Researchers and Clinicians Elected as 2015 AAAS Fellows
The American Association for the Advancement of Science (AAAS) Council elected 347 fellows for 2015, in recognition of their contributions to innovation, education, and scientific leadership. The tradition of electing AAAS fellows began in 1874 to recognize members for their scientifically or...
Reducing Racial Disparities in Breast Cancer Incidence and Mortality Trends to Improve Outcomes
A recent report by DeSantis and colleagues from the American Cancer Society, summarized in this issue of The ASCO Post, presented breast cancer incidence and mortality data from an extensive analysis of the U.S. system of state-based tumor registries.1 The data showed that the incidence of breast...
Trabectedin in Liposarcoma/Leiomyosarcoma: The Drug Is Approved, Now the Real Drug Development Begins!
Led by George Demetri, MD, of Dana-Farber Cancer Institute, Boston, expert medical oncology investigators from leading academic sarcoma centers and Janssen Pharmaceuticals employees performed a phase III trial in order to provide evidence for the U.S. Food and Drug Administration (FDA) approval of...
Molecularly Targeted Therapy Brings New Hope to Patients With Relapsed/Refractory Hairy Cell Leukemia
The treatment of hairy cell leukemia is one of the great success stories in hematologic malignancies, with patients now having a survival that is only slightly inferior to an age-matched normal population. Purine analogs, such as cladribine, are the mainstay of first-line therapy, with...
BRAF Inhibition Successful in Relapsed/Refractory Hairy Cell Leukemia
In two phase II studies reported in The New England Journal of Medicine, Enrico Tiacci, MD, of the University of Perugia, Italy, and colleagues found that the BRAF inhibitor vemurafenib (Zelboraf) produced responses in nearly all patients with BRAF V600E–positive hairy cell leukemia that relapsed...
2015 Review of Newly Approved Oncologic Therapies
Over the past year or so, a host of new agents were approved for the treatment of patients with various types of cancer (see related article on page 1). Patrick Medina, PharmD, of the University of Oklahoma College of Pharmacy, Oklahoma City, and Monique Giordana, PharmD, BCOP, of Regions...
Cancer Care Through Nonpharmacologic Symptom Management
Nonpharmacologic approaches to managing pain have a fairly robust base of science and research supporting their use but are not as widely accepted and understood as drug therapy in the realm of cancer care. In a breakout session at the 2015 Palliative Care in Oncology Symposium in Boston, experts...
ASCO Guideline on the Use of Biomarkers in Treatment Decisions in Metastatic Breast Cancer: Shedding Light on an Often Mysterious Art
As summarized in this issue of The ASCO Post (see "ASCO Clinical Practice Guideline: Use of Biomarkers to Guide Systemic Therapy for Women With Metastatic Breast Cancer"), Van Poznak and colleagues recently presented an ASCO clinical practice guideline on the use of biomarkers for decisions...
Filial Gaze at Our Noble Profession
As we stood outside patient X’s room going over the vitals, from a distance, I saw the father of the patient by the side of her bed. I saw him standing there and looking down at his child conveying what I guess were words of reassurance and reinforcing the pillars of strength needed for her...
NIH Awards City of Hope $4.8 Million to Study Environment and Breast Cancer
The National Institutes of Health has awarded City of Hope a 5-year, $4.8 million grant to study the possible role of chemicals in the environment in the development of breast cancer during the menopausal transition in women. The coprincipal investigators on the study are two City of Hope...
How to Help Mentees Succeed
Although formal mentoring programs in medical education were not launched in the United States until the late 1990s,1 today they are regarded as playing an essential role in the career development of medical trainees and have been associated with improvements in research, teaching, and patient...
SIOG Annual Conference Explores Global Perspectives on Geriatric Oncology and Supportive Care
The 15th Annual Conference of the International Society of Geriatric Oncology (SIOG) took place in Prague, Czech Republic, over 3 days (November 12–14, 2015). At the heart of the meeting were presentations on supportive care, comprehensive geriatric assessment and treatment—so that we fully...
Joseph Smith, Jr, MD, Awarded Huggins Medal
The Society of Urologic Oncology (SUO) recognized Joseph Smith, Jr, MD, William L. Bray Professor of Urologic Surgery at Vanderbilt University School of Medicine, with the Huggins Medal, its highest honor. Dr. Smith was chosen for his lifetime contributions to the progress in treatment for patients ...
2015 NCI Outstanding Investigator Award Recipients
The first class of National Cancer Institute (NCI) Outstanding Investigator Award recipients showcases the cutting edge of oncologic research and the 43 investigators behind it. NCI’s Outstanding Investigator Award supports accomplished leaders in cancer research, who are providing significant...
A: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System
Question 1: Based on the rationale for the current “standard of care” for primary diffuse large B-cell lymphoma of the CNS, what is the optimal induction therapy? Correct Answer: C. A high-dose methotrexate–based regimen. Expert Perspective Untreated primary diffuse large B-cell lymphoma of the CNS ...
Q: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System
The ASCO Post is pleased to present Hematology Expert Review, an occasional feature that includes a case report detailing a particular hematologic condition followed by questions. Answers to each question appear on page 84 with expert commentary. In the November 10 issue of The ASCO Post, part 2 of ...
Selected Abstracts From 2015 ASH Annual Meeting
Here are several abstracts selected from the proceedings of this year’s American Society of Hematology (ASH) Annual Meeting and Exposition, highlighting therapeutics in acute leukemias and myelodysplastic syndromes. For full details of these study abstracts, visit...
Necitumumab in Metastatic Squamous Non–Small Cell Lung 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. On November 24, 2015, necitumumab (Portrazza) was approved for use ...
Ductal Carcinoma in Situ and Relevant Endpoints for Omission of Standard Treatments: Are We There Yet?
The optimal management strategy for ductal carcinoma in situ has become increasingly controversial with respect to potential overdiagnosis and overtreatment. Much of the controversy for ductal carcinoma in situ stems from its exceptional breast cancer–specific survival, which approaches close to...
More, Earlier, and Better Goals-of-Care Conversations at the End of Life Are Feasible
An intervention called the Serious Illness Care Program helps clinicians to conduct more, earlier, and better conversations about goals of care with their seriously ill patients, according to Rachelle E. Bernacki, MD, MS, who presented the preliminary results of a study using this approach at the...
Andrew Seidman, MD, and Erica Mayer, MD, MPH, on Results of the PALLAS Clinical Trial
Andrew Seidman, MD, of Memorial Sloan Kettering Cancer Center, and Erica L. Mayer, MD, MPH, of the Dana-Farber Cancer Institute, discuss this phase 3 trial of palbociclib with adjuvant endocrine therapy vs endocrine therapy alone for HR-positive/HER2-negative early breast cancer. (Abstract...
Clifford Hudis, MD, and Carlos Arteaga, MD, on Metabolic Syndrome and Obesity in Breast Cancer
Clifford A. Hudis, MD, of Memorial Sloan Kettering Cancer Center, and Carlos L. Arteaga, MD, of Vanderbilt University, discuss the roles of IGF/insulin signaling, adipokines and inflammation, and metformin and lifestyle change in breast cancer and risk for the disease.
Periodontal Disease Linked to Increased Risk of Breast Cancer in Postmenopausal Women, Especially Smokers
A large prospective study of postmenopausal women investigating an association between periodontal disease and breast cancer risk has found that among all women in the study, the risk of breast cancer was 14% higher in women who had periodontal disease. Among women who had quit smoking within the...
Higher BMI Associated With Increased Risk of Breast Cancer–Related Lymphedema
Each year, about 1.38 million women worldwide are diagnosed with breast cancer. Advances in treatment have facilitated a 90% 5-year survival rate among those treated. Given the increased rate and length of survival following breast cancer, more and more survivors are facing a lifetime risk of...
SABCS 2015: ESR1 Gene Mutations Are Associated With Worse Overall Survival in Metastatic ER-Positive Breast Cancer
A study by Chandarlapaty et al investigating whether mutations in the estrogen receptor are common in patients with advanced breast cancer and how they affect patient outcomes has found that the D538G and Y537S mutations in the estrogen receptor 1 (ESR1) gene are prevalent in patients with advanced ...
Prognostic Factors in Men With Brain Metastases From Germ Cell Tumors
As reported in the Journal of Clinical Oncology, Feldman et al, of the Global Germ Cell Cancer Group, identified prognostic factors in men with brain metastases from germ cell cancer at initial diagnosis or relapse. Overall survival was better in patients with metastases at diagnosis, a greater...
Women’s Health Initiative Clinical Trial Suggests Endogenous Estrogens May Protect Against Colorectal Tumorigenesis in Postmenopausal Women
In a nested case-control study in the Women’s Health Initiative Clinical Trial, reported in Journal of the National Cancer Institute by Murphy et al, endogenous estrogen levels were inversely associated with and sex hormone–binding globulin (SHBG) levels were positively associated with...
