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colorectal cancer

Maintenance Treatment Delays Progression in Metastatic Colorectal Cancer 

For patients with unresectable metastatic colorectal cancer, maintenance treatment with capecitabine (Xeloda) and bevacizumab (Avastin) significantly delayed disease progression and improved overall survival in the phase III CAIRO3 study by the Dutch Colorectal Cancer Group. Miriam Koopman, MD,...

issues in oncology
health-care policy

Combining Community Practice and Health Policy Advocacy 

Barbara L. McAneny, MD, is a board-certified medical oncologist/hematologist with a robust community practice in Albuquerque, New Mexico. Dr. McAneny, who has held many leadership roles in oncology associations, became a delegate to the American Medical Association (AMA) from ASCO in 2002, was...

integrative oncology

Ginseng in the Spotlight 

I read the study by Barton and colleagues in Journal of the National Cancer Institute with great interest. Ginseng seems potentially to be one treatment for cancer-related fatigue, a poorly understood but debilitating symptom that patients experience during and after treatment.1 I am impressed that ...

lymphoma
multiple myeloma

Dr. Julie Vose Finds the Best of Both Worlds—Patient Care and Cutting-Edge Research—in Academic Medicine 

Julie M. Vose, MD, MBA, is the Neumann M. and Mildred E. Harris Professor and Chief of the Division of Hematology/Oncology at the University of Nebraska Medical Center. She grew up in Mitchell, South Dakota, a small town nestled on the banks of the James River. Mitchell is home to the Corn Palace,...

lung cancer

Will Funding for Lung Cancer Ever Improve?

Lung cancer is the most common cause of cancer-related death in the world. In the United States alone, an estimated 228,190 new cases of lung cancer and 159,480 deaths from lung cancer will occur in 2013. These are alarming statistics when compared to the next four common causes of cancer-related...

issues in oncology

Access to and Appropriate Use of Oncology Drugs Called Into Question by ASCO Studies 

Studies presented at this year’s ASCO Annual Meeting suggest that despite the wealth of amazing oncolytics on the market, drug shortages persist, drug substitutions are common, off-label use of drugs occurs frequently, and patients find their costs burdensome. Drug Shortage Persists The shortage of ...

multiple myeloma

Panobinostat Combined With Bortezomib and Dexamethasone Can Recapture Responses in Heavily Pretreated Patients 

The combination of the investigational histone deacetylase inhibitor panobinostat (Faridak) with bortezomib (Velcade) and dexamethasone was able to recapture responses in 34.5% of heavily pretreated, bortezomib-refractory patients with multiple myeloma in the phase II PANORAMA 2 trial. The 55...

thyroid cancer

More Prudent Interpretation of Thyroid Ultrasound Could Reduce Unnecessary Biopsies 

Thyroid ultrasound imaging could be used to identify patients who have a low risk of thyroid cancer for whom biopsy could be deferred, according to a retrospective case-control study reported in JAMA Internal Medicine. Reviewing 11,618 thyroid ultrasound imaging examinations from 8,806 patients...

skin cancer

Indoor Tanning Common Among Young White Females Despite Skin Cancer Risk 

Indoor tanning, defined as using a tanning booth, sun bed, or sunlamp, is common among non-Hispanic white female high school students and young adults, despite risks of melanoma and nonmelanoma skin cancer, according to a study published online by JAMA Internal Medicine.  Using data from the 2011...

thyroid cancer

High-Tech Imaging Contributes to Overdiagnosis, Overtreatment of Low-Risk Thyroid Cancers  

A study from the Mayo Clinic Center for the Science of Health Care Delivery finds that advances in imaging technologies, including ultrasound, computed tomography, and magnetic resonance imaging, are fueling an epidemic in the diagnosis and treatment of thyroid cancers that are unlikely to ever...

lung cancer

VeriStrat Assay Helps Select NSCLC Patients for Second-Line Therapy 

VeriStrat, a serum-based protein assay, can help select which patients with non–small cell lung cancer (NSCLC) not known to have epidermal growth factor receptor (EGFR) mutations might benefit from an ­EGFR-targeted agent, according to a study presented at the ASCO Annual Meeting by Vanesa Gregorc, ...

prostate cancer

Shiftworkers Likely to Have Increased Risk  

A strong positive association with shiftwork and elevated prostate-specific antigen (PSA) level was found in an analysis of three National Health and Nutrition Examination Survey (NHANES) studies. “Our data support the notion that sleep or circadian disruption is associated with elevated PSA,...

breast cancer

Mindfulness-Based Stress Reduction Therapy for Patients With Distress 

Mindfulness-based cancer recovery was shown to be superior to supportive-expressive group therapy “for decreasing symptoms of stress and also for improving overall quality of life and social support” among women who had stage I to III breast cancer and were assessed as experiencing distress,...

integrative oncology

Herb-Drug Interactions in Oncology  

Guest Editor Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering...

global cancer care

Aftermath of the AIDS Pandemic: Cancer Care in Botswana  

The Republic of Botswana is slightly smaller than the state of Texas and with a population of just over 2 million people it is one of the world’s most sparsely populated countries. Botswana was among Africa’s poorest countries at the time it gained independence from the United Kingdom in 1966....

breast cancer

Increased Alcohol Consumption Between Menarche and Pregnancy Increases Breast Cancer Risk  

Adult alcohol consumption during the previous year is related to breast cancer risk, and breast tissue is particularly susceptible to carcinogens between menarche and first full-term pregnancy. In a study reported in Journal of the National Cancer Institute, Ying Liu, MD, PhD, of Washington...

kidney cancer

Progression-Free Survival With Pazopanib Not Inferior to Sunitinib Benefit in Metastatic Renal Cell Carcinoma  

Pazopanib (Votrient) and sunitinib (Sutent) have been shown to provide progression-free survival benefit compared with placebo or interferon in phase III trials in metastatic renal cell carcinoma. In a noninferiority trial reported in The New England Journal of Medicine by Robert J. Motzer, MD, of...

lung cancer

Ancient Chinese Military Tactics Might Help Win the War on Lung Cancer  

At the 14th International Lung Cancer Congress, held recently in Huntington Beach, California, Tony S.K. Mok, MD, Professor of Clinical Oncology at the Chinese University of Hong Kong, was the honored recipient of the Bonnie J. Addario Lung Cancer Foundation Award. The award was presented by Ms....

gynecologic cancers

Challenging and Changing the Standard of Care for Cervical and Ovarian Cancers 

“It was a very exciting session this year, particularly for cervical cancers,” said Paul Haluska MD, PhD, of the Mayo Clinic, Rochester, Minnesota, in speaking of the 2013 ASCO Annual Meeting’s gynecologic oncology session and the abstracts highlighted recently at Best of ASCO in Chicago. In one...

breast cancer

Could MRI Be a Better Breast Cancer Screening Tool Than Mammography? 

German investigators reported at the 2013 Breast Cancer Symposium in San Francisco that an abridged magnetic resonance imaging (MRI) protocol can accurately detect cancers among women whose mammographic screenings were negative.1 MRI, therefore, may reveal the type of tumor that mammography...

health-care policy

Trying to Improve Value in Cancer Care: An Experiment

One of the more significant problems in modern oncology practice is to provide increased value at a time when costs are spiraling upward, and new parameters of “success” are being introduced into the equation—most visibly, inside the Beltway in Washington, DC. Thus, oncologists will need to address ...

breast cancer

Breast Cancer Radiotherapy and Cardiotoxicity: What Is the True Risk?  

Evidence has long been accumulating that radiotherapy involving the heart can result in premature ischemic heart disease, but interest peaked last spring when a case control study published in The New England Journal of Medicine1 found an increased risk for cardiac-related deaths in breast cancer...

lung cancer

Low-Dose CT Screening Identifies More Early Lung Cancer but Has Lower Positive Predictive Value vs Radiography  

Results of the two rounds of annual incidence screening with low-dose computed tomography (CT) vs radiography in the National Lung Screening Trial (NLST) were recently reported by Denise R. Aberle, MD, Professor of Radiology and Bioengineering at the University of California at Los Angeles and...

thyroid cancer

Cabozantinib Improves Disease-Free Survival in Progressive Medullary Thyroid Cancer 

Cabozantinib (Cometriq) is an inhibitor of hepatocyte growth factor receptor (MET), vascular endothelial growth factor receptor 2 (VEGFR2), and rearranged during transfection (RET) tyrosine kinases. In a phase III trial reported in Journal of Clinical Oncology, Rossella Elisei, MD, of University of ...

lung cancer

'Master Protocol' Could Revolutionalize Trials in  Lung Cancer, and Eventually Other Cancers 

Cancer advocates and clinical trialists, for some time, have been proposing a radical change to the laborious drug development process—that industry, academia, funding sources, and other stakeholders actually pool their brain power and financial means and work together, not separately, to develop...

supportive care

Yoga to Manage Sleep Disruption in Cancer Survivors: A Low-Risk Intervention With High Potential for Benefit

Impaired sleep quality is a concerning problem for many patients with cancer, and pharmacologic treatments come with many negative effects. Several small studies indicate that yoga improves persistent fatigue, sleep disturbance, anxiety, and quality of life, in addition to reducing the need for...

supportive care

Yoga Improves Sleep Quality in Patients With Cancer Suffering From Sleep Disruption

It is estimated that 30% to 90% of patients with cancer experience impairment of sleep quality post-treatment, and such impairment can be severe enough to increase morbidity and mortality. Preliminary evidence indicates that yoga may improve sleep in cancer patients. In a study reported in the...

Expert Point of View: Edith A. Perez, MD

The PrefHer trial provides notable data showing that > 90% of patients favored the quicker subcutaneous administration of trastuzumab (Herceptin) compared to the standard intravenous infusion. The primary reasons for this preference, as per patients in the trial, included that it was timesaving...

breast cancer

Circulating Estrogens and Androgens Associated With Breast Cancer Risk in Premenopausal Women

In a study reported in The Lancet Oncology, Timothy Key, DPhil, of Oxford University, and colleagues in the Endogenous Hormones and Breast Cancer Collaborative Group analyzed data from seven prospective studies to determine associations between sex hormones and risk of breast cancer in...

lung cancer

Interim Data Reported From Phase IB Study of Investigational Anti-PD-1 Immunotherapy for NSCLC 

Interim data from a Phase IB trial evaluating the investigational anti-PD-1 immunotherapy, MK-3475, in patients with previously treated non-small cell lung cancer (NSCLC) were presented recently at the 15th World Conference on Lung Cancer in Sydney, Australia. Edward Garon, MD, Director of Thoracic ...

prostate cancer

Finasteride for Prostate Cancer Prevention: Long-Term Results Disappointing but Reassuring

All medical care should seek to achieve one or more of three goals: to relieve suffering, to prevent future suffering, or to prolong life. Care for cancer is no exception, and minimizing suffering from cancer and prolonging life has primarily resulted from advances in treatment. Although there are...

hepatobiliary cancer

Brivanib Studied in First- and Second-Line Therapy for Advanced Hepatocellular Carcinoma 

The investigational drug brivanib is a dual inhibitor of vascular endothelial growth factor and fibroblast growth factor signaling, both implicated in hepatocellular carcinoma. The agent was recently evaluated in two phase III trials, one comparing first-line brivanib with sorafenib (Nexavar) in...

breast cancer
head and neck cancer
kidney cancer
lung cancer

Important News Briefs: New Data Reported in Breast, Renal Cell, Head and Neck, and Lung Cancer

The 2013 European Cancer Congress (ECC), held September 27 to October 1 in Amsterdam, was jointly sponsored by the European Society of Medical Oncology, the European Cancer Organization, and the European Society of Radiation Oncology. With the Congress theme being “Reinforcing Multidisciplinarity,” ...

gynecologic cancers

Impact of Pelvic Radiotherapy and Lymphadenectomy on Endometrial Cancer Mortality 

Analysis of data from 58,172 patients identified from Surveillance, Epidemiology, and End Results (SEER) registries as having stage I or II endometrial adenocarcinoma found that pelvic radiotherapy and lymphadenectomy were associated with statistically significantly reduced noncancer mortality,...

breast cancer
cost of care

Evaluation of Breast Cancer MRI Screening Strategies

Recent years have witnessed much heated debate about the benefits of breast cancer screening and optimal screening strategies. Unlike with mammography, no randomized data are available to determine whether screening with magnetic resonance imaging (MRI) reduces mortality from breast cancer....

breast cancer
cost of care

Cost-Effectiveness of MRI Screening for Women With Familial Risk of Breast Cancer in the Netherlands 

Annual screening for breast cancer with magnetic resonance imaging (MRI) has been found to be cost-effective in women aged 30 to 60 years who are BRCA1 or BRCA2 carriers or who have a 50% chance of being a carrier, and such screening is recommended in these women by many authorities. It is unclear...

palliative care
cost of care

Two Studies Highlight Communication Challenges Facing Medical Oncology

In one study presented at ASCO’s second annual Quality Care Symposium in San Diego, patients receiving chemotherapy with palliative care intent were at high risk of side-effect–related hospitalization, which defeats the clinical purpose and adds preventable costs to health care.1 “There is an...

skin cancer

Metastatic Melanoma: Encouraging Data Keep Coming 

Excitement continues to build in the metastatic melanoma arena, as novel agents keep upping the ante for efficacy. The following news from the 2013 European Cancer Congress has added to the buzz. New MEK Inhibitor In the phase IB BRIM7 study, cobimetinib, a novel MEK inhibitor, when combined with...

health-care policy
cost of care

Innovative Payment Models Needed to Sustain Quality Cancer Care  

Nationally regarded health-care expert Lee N. Newcomer, MD, MHA, began his presentation at this year’s ASCO Quality Care Symposium with a rhetorical question. “Why are we talking about money when we’re gathered in San Diego for 2 days to discuss some wonderful ways to impact the quality of cancer...

lymphoma

Ibrutinib in Previously Treated Mantle Cell Lymphoma

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 November 13, 2013, ibrutinib (Imbruvica) was granted...

health-care policy

National Cancer Policy Summit: Setting Priorities for the Next 3 Years

Welcome to the meeting we hold every 3 years to choose our next projects,” said John Mendelsohn, MD, Chair of the National Cancer Policy Forum and Director of the Khalifa Institute for Personalized Cancer Therapy at The University of Texas M.D. Anderson Cancer Center, Houston. “We have here a...

issues in oncology

Clinical Cancer Advances 2013: ASCO's Annual Report on Progress Against Cancer

The Society has recently published Clinical Cancer Advances 2013: ASCO’s Annual Report on Progress Against Cancer, a comprehensive review of progress in clinical cancer research that has come to fruition in 2013. The report highlights advances across the entire continuum of cancer care, from...

breast cancer

Similar High Complete Response Rate With Neoadjuvant Trastuzumab, Lapatinib, and Combined Therapy in HER2-Positive Breast Cancer

In a phase III trial (NSABP B-41) performed to assess the potential benefit of neoadjuvant dual HER2 blockade in HER2-positive breast cancer, André Robidoux, MD, of Centre Hospitalier de l’Université de Montréal, and colleagues in the National Surgical Adjuvant Breast and Bowel Project (NSABP)...

breast cancer

Adjuvant Trastuzumab Duration: When Is Enough, Enough?

The duration of adjuvant systemic chemotherapy for breast cancer has been a subject of investigation, scrutiny, and meta-analysis.1,2 With the appreciation that prolonged regimens of cytotoxic chemotherapy of, for example, 1 to 2 years in duration were not superior in reducing breast cancer...

breast cancer

PIK3CA-Mutant Tumors Not Likely to Respond to Neoadjuvant HER2 Blockade

In early breast cancer patients receiving anti-HER2 therapy in the NeoALTTO trial, mutations in PIK3CA were associated with lower rates of pathologic complete response, according to a study reported at the 2013 European Cancer Congress by José Baselga, MD, Physician-in-Chief at Memorial...

issues in oncology

Sharing Treatment Decision-Making With Patients: Where’s the Evidence of Value?

Though certainly not new to oncologists, “shared decision-making” between doctors and patients is receiving increased attention in the medical community today. While it’s an idea with merit, Steven J. Katz, MD, MPH, a specialist in quality care issues, maintains that expectations about the...

breast cancer
supportive care

No Significant Improvement With Decongestive Therapy vs More Conservative Approach to Treating Arm Lymphedema 

Daily manual lymphatic drainage and bandaging followed by compression garments did not result in significant improvement in lymphedema compared to a more conservative approach with compression garments only, according to a study evaluating 95 women previously treated for breast cancer with...

survivorship

Improvements Needed in Use of Survivorship Care Plans 

Survivorship care plans, consisting of treatment summaries and follow-up plans, are intended to promote coordination of post-treatment cancer care, but little is known about how survivorship care plans are being used in routine oncology practice. In a study reported in the Journal of the National...

breast cancer

Targeted Intraoperative Radiotherapy Plus Lumpectomy Noninferior to External-Beam Radiotherapy in Preventing Breast Cancer Recurrence

In the randomized noninferiority TARGIT-A trial reported in The Lancet, Jayant S. Vaidya, PhD, FRCS, and Michael Baum, MD, FRCS, of University College London, and colleagues compared risk-adapted radiotherapy using single-dose targeted intraoperative radiotherapy vs fractionated external-beam...

multiple myeloma

Surprising Findings for Lenalidomide Maintenance in Updated IFM 2005-02 Analysis 

A new analysis of the multiple myeloma Intergroupe Francophone du Myelome (IFM) 2005-02 trial showed that lenalidomide (Revlimid) maintenance prolongs progression-free survival after stem cell transplantation, but does not improve overall survival.1 This is possibly attributed to the shorter...

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