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breast cancer

Noteworthy Abstracts From the Breast Cancer Symposium Include Studies of Novel Therapies and of the Impact of Disease Subtypes on Outcomes

More than 150 oral and poster presentations were featured at the 2014 Breast Cancer Symposium, held September 4–6 in San Francisco. The multidisciplinary meeting is sponsored by ASCO, the American Society of Breast Disease, American Society of Breast Surgeons, American Society for Radiation...

cost of care

Financial Toxicity Potentially Harmful Treatment‑Related Effect

It turns out that in addition to treatment-related toxicity, cancer patients commonly experience “financial toxicity,” a phrase that is increasingly coming into parlance in the cancer community. Patients should be assessed for financial toxicity as early as possible following diagnosis so that they ...

cost of care

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 ...

issues in oncology

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...

gynecologic cancers

Scientists Develop New Approach to Treating HPV-Related Cervical Cancer

Cidofovir, an antiviral drug that is well established as a treatment for infection of the retina in people with AIDS, has been shown to be effective in combination with chemoradiation in a phase I study of women with human papillomavirus (HPV)-related cervical cancer. The study results were...

colorectal cancer

NORCCAP Trial Shows Reduced Colorectal Cancer Incidence and Mortality With Flexible Sigmoidoscopy Screening at 11 Years

The Norwegian Colorectal Cancer Prevention (NORCCAP) trial comparing colorectal cancer screening with flexible sigmoidoscopy vs no screening showed no reduction in colorectal cancer incidence or mortality after 7 years of follow-up. As reported by Øyvind Holme, MD, of Sorlandet Hospital...

global cancer care

The Harvard Global Equity Initiative: From Research to Policy

The Harvard Global Equity Initiative is a research program at Harvard University that is dedicated to promoting equitable global development, with a strong emphasis on health-care issues. This initiative brings together scholars, policymakers, advocates, and practitioners from around the world to...

leukemia
issues in oncology

Childhood Obesity and Leukemia: Is It Time to Intervene?

"Obesity is associated with cancer mortality,” said Steven D. Mittelman, MD, PhD, at the recent American Association for Cancer Research (AACR) International Conference on Frontiers in Cancer Prevention Research.1 Dr. Mittelman presented a wealth of data to explain the link between obesity and...

colorectal cancer
lung cancer

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...

breast cancer
cost of care

Medicare Part D Low-Income Subsidy Program Improves Adherence to Hormone Therapy After Breast Cancer Surgery

Findings from a study of more than 23,000 women suggest that the Medicare Part D Extra Help program, which provides low-income subsidies for medications, improves adherence to hormone therapy after breast cancer surgery in all racial/ethnic groups and reduces racial/ethnic disparities. The study,...

gynecologic cancers

FDA Approves Bevacizumab Plus Chemotherapy for Platinum-Resistant, Recurrent Ovarian Cancer

The U.S. Food and Drug Administration (FDA) approved bevacizumab (Avastin) in combination with paclitaxel, pegylated liposomal doxorubicin, or topotecan for the treatment of patients with platinum-resistant, recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer. The approval is ...

symptom management

Benefits of Exercise for Relieving Fatigue in Cancer Survivors

Fatigue is such a common—and ongoing—problem among cancer survivors, last spring, ASCO published a clinical practice guideline1 to address screening, assessment, and treatment approaches for the management of fatigue after patients have completed treatment. Among the strategies included in the...

skin cancer

Hedgehog Inhibitors Can Be Life-Altering in Patients With Advanced Basal Cell Carcinoma

What advanced basal cell carcinomas lack in frequency, they make up for in morbidity, and for these challenging patients, the hedgehog inhibitors have changed lives, according to experts at the 3rd Annual World Cutaneous Malignancies Congress, held recently in San Francisco. “The majority of basal...

breast cancer

3D Mammography Improves Cancer Detection in Dense Breasts

A study presented at the annual meeting of the Radiological Society of North America (RSNA 2014) has found that digital breast tomosynthesis, also known as three-dimensional (3D) mammography, has the potential to significantly increase the cancer detection rate in mammography screening of women...

lung cancer

Revisiting Successes in Advanced NSCLC to Test Value in Earlier-Stage Disease

Some pretty good evidence suggests that chemotherapy that works in advanced disease probably works even better in early-stage disease,” said Fadlo R. Khuri, MD, Chair, Department of Hematology and Medical Oncology at Winship Cancer Institute in Atlanta, in summarizing results from ­trials of...

lung cancer

Lung Cancer Expert Offers Recommendations for Treating Toxicities Associated With Targeted Therapies

Clearly life as a thoracic oncologist has changed. Our paradigm for giving one-size-fits-all chemotherapy seems a bit dated, as we now are learning that there are multiple targets that we can treat effectively with the right drugs,” Jyoti D. Patel, MD, Associate Professor of Medicine at...

gynecologic cancers

Gardasil 9 Adds Protection Against Cancer Caused by Additional Human Papillomavirus Types

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 December 10, 2014, Gardasil 9 (human papillomavirus 9-valent...

multiple myeloma

Cleveland Clinic Piloting ‘Adaptive Therapy’ Approach in Multiple Myeloma

For newly diagnosed multiple myeloma patients, Cleveland Clinic specialists believe two drugs may suffice for most patients, bucking the trend toward using triplets for all patients and reserving them for patients with insufficient response to two. They described a pilot study of their “carepath”...

prostate cancer

Physical Activity Improves Survival for Men With Localized Prostate Cancer

Among a large group of men with localized prostate cancer, those who engaged in higher levels of physical activity had lower rates of overall mortality and lower rates of prostate cancer-specific mortality, according to a study published in Cancer Epidemiology, Biomarkers & Prevention.1 “Our...

head and neck cancer
lung cancer

Coupling Head and Neck Cancer Screening and Lung Cancer Scans Could Improve Early Detection, Survival

Adding head and neck cancer screenings to recommended lung cancer screenings would likely improve early detection and survival, according to a multidisciplinary team led by scientists affiliated with the University of Pittsburgh Cancer Institute (UPCI), a partner with the University of Pittsburgh...

breast cancer

Ultrasonography Detects Mammographically Occult Invasive Cancers

Mammograms often miss occult breast cancers concealed in dense breasts. Women with dense breasts represent about 40% to 50% of women who undergo mammography screening. In some states and centers in the United States, women with dense breasts are routinely offered ultrasonography following a...

issues in oncology

More Than 1.5 Million Cancer Deaths Averted During 2 Decades of Dropping Mortality

The American Cancer Society’s annual cancer statistics report found that a 22% drop in cancer mortality over 2 ­decades led to the avoidance of more than 1.5 million cancer deaths that would have occurred if peak rates had persisted. And while cancer death rates have declined in every state, the...

breast cancer

Contralateral Prophylactic Mastectomy: Know the Data When Discussing the Option With Patients

Oncologists need a better understanding of why women choose contralateral prophylactic mastectomies without indication, and they need data to counter their patients’ misperceptions about this treatment choice. “Many women who choose [contralateral prophylactic mastectomy] are not at increased risk...

issues in oncology

What Is a Physician? Call a Spade a Spade

Anyone who has awoken from a decades-long amnestic spell can be forgiven for thinking that physicians cannot do anything right nowadays. Compared with decades ago, when physicians did mostly right, we now seem to be nowhere close to correctness. Nearly every malady that befalls the health-care...

gastroesophageal cancer

High Genetic Propensity to Obesity Raises Risk of Esophageal Adenocarcinoma

“People with a high genetic propensity to obesity have higher risks of esophageal metaplasia and neoplasia than people with a low genetic propensity,” according to analyses of data from the Barrett’s and Esophageal Adenocarcinoma Genetic Susceptibility Study. “These analyses provide the strongest...

bladder cancer

Molecular Classification Predicts Postcystectomy Recurrence in High-Risk Bladder Cancer

Radical cystectomy is the standard therapeutic option for patients with muscle-invasive bladder cancer. However, 5-year overall survival for high-risk patients with pT3, pT4, pN-negative, and pN-positive M0 bladder cancer after radical cystectomy is only about 50% and ranges from 32% in patients...

breast cancer

News Roundup From the 2014 San Antonio Breast Cancer Symposium

Highlighted here are summaries of four abstracts presented at the 2014 San Antonio Breast Cancer Symposium: They focus on the EPO-ANE-3010 clinical trial of epoetin alfa (Epogen, Procrit) in anemic patients with metastatic breast cancer, a New York Cancer Consortium trial of fulvestrant (Faslodex)...

pancreatic cancer

Modified Nab-Paclitaxel/Gemcitabine in Pancreatic Cancer: Efficacious, Less Toxic, Less Costly

A less intensive regimen of nab-paclitaxel (Abraxane) plus gemcitabine appears to be as efficacious as the standard regimen in first-line treatment for metastatic pancreatic cancer, but less toxic and far less expensive, according to a study that earned a Merit Award at the 2015 Gastrointestinal...

Expect Questions About Atypical Hyperplasia as an Important Risk Factor for Breast Cancer

A special report in The New England Journal of Medicine concluded that atypical hyperplasia of the breast “confers an absolute risk of later breast cancer of 30% at 25 years of follow-up.1” This is higher than previously recognized, and the report’s authors urged “more intensive screening and...

breast cancer

Atypical Hyperplasia as a Predictor of Future Breast Cancer: Focus on Chemoprevention and Screening

Atypical hyperplasia of the breast has “special importance as a predictor of future breast cancer,” according to a special report in The New England Journal of Medicine.1 That special importance is based on the high incidence of atypical hyperplasia—found in around 10% of the 1 million breast...

lung cancer
issues in oncology
health-care policy

At Long Last: CMS Will Cover Lung Cancer Screening

Few issues in health-care debates are more contentious and polarizing than population screening for the early detection of cancer. After a decades-long battle, lung cancer screening advocates have just received what they have long sought: The Centers for Medicare & Medicaid Services (CMS) has...

issues in oncology

Pharmacokinetics and Exposure Response in Drug Development

INSIDE THE BLACK BOX is an occasional column offering insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, former clinical pharmacology team leader Julie Bullock, PharmD, and current team leader Nitin Mehrotra, PhD, discuss how...

lung cancer

CMS Issues Final Decision to Cover Lung CT Screening

Earlier this month the Centers for Medicare & Medicaid Services (CMS) issued a final national coverage determination that provides for Medicare coverage of screening for lung cancer with low-dose computed tomography (LDCT). Effective immediately, Medicare will now cover lung cancer screening...

lymphoma

Tailoring Therapy for Diffuse Large B-Cell Lymphoma by Interim PET May Be Problematic

In a study that reflected clinical practice, treatment of diffuse large B-cell lymphoma based on the results of interim positron-emission tomography (PET) was feasible; however, switching PET-positive patients to an alternative treatment still resulted in inferior treatment outcomes, and the...

pancreatic cancer

Pancreatic Cancer: Latest Drug Development Hits and Misses

Targeting one of the deadliest cancers and seeking to fill an unmet need, drug development in pancreatic cancer is an area of high interest. This was certainly the case at the 2015 Gastrointestinal Cancers Symposium, where results were impressive for some novel agents but disappointing for several...

survivorship
gynecologic cancers

Cancer Was My Wake-Up Call to a Healthier Life

I come from strong physical stock and inherited a sort of “tough it out mentality” when it comes to coping with the usual aches and pains that creep up as you age. So by the time I realized that my legs had become so swollen and my breathing so labored it was difficult for me to walk, I could...

palliative care

Improving the Quality of Palliative Care in Oncology

Two years ago, ASCO collaborated with the American Academy of Hospice and Palliative Medicine to develop the Virtual Learning Collaborative, a virtual quality improvement program intended to address the complex care needs of patients with advanced cancer and the care quality for all patients with...

breast cancer

Combination Treatment Every 2 Weeks May Benefit Some Women With High-Risk Early-Stage Breast Cancer

In a phase III trial (SWOG S0221) reported in the Journal of Clinical Oncology, George T. Budd, MD, of Taussig Cancer Center, Cleveland Clinic, and colleagues found no difference in disease-free survival among four different combinations of continuous or every-other-week...

hematologic malignancies

Clonal Hematopoiesis With Somatic Mutations Increases Risk of Hematologic Cancer, Mortality, and Cardiovascular Disease

In two studies recently reported in The New England Journal of Medicine,1,2 whole-exome sequencing of DNA from peripheral blood cells of individuals unselected for hematologic phenotype showed that clonal hematopoiesis with somatic mutations is increasingly common with increasing age and is...

thyroid cancer

Lenvatinib in Advanced Radioiodine-Refractory Differentiated Thyroid 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 February 13, 2015, lenvatinib (Lenvima) was approved for the...

hepatobiliary cancer

Targeting Biliary Tract Cancers Through Genomic Profiling

Biliary tract cancers are challenging, but a large genomic profiling study has identified potentially clinically relevant genomic alterations in up to two-thirds of patients.1 “The diverse landscape of clinically relevant genomic alterations in biliary tract cancers can serve as targets for...

colorectal cancer
pancreatic cancer
gastrointestinal cancer

New Data Reported in Colorectal, Gastric, and Pancreatic Cancers

The 2015 Gastrointestinal Cancers Symposium, held January 15–17 in San Francisco, attracted almost 4,000 attendees, who heard or viewed data from nearly 800 scientific abstracts and lectures. Here are our summaries of some of the many important developments from the meeting. Bevacizumab Plus...

global cancer care

Addressing the Global Cancer Burden

Since 1990, the annual global death toll from cancer has risen about 40%, and that number is projected to increase from the current level of approximately 8 million cancer deaths per year to more than 13 million by 2030. The poorer, resource-challenged regions of the world will suffer a...

prostate cancer

Selenium Supplements After Diagnosis of Nonmetastatic Prostate Cancer May Raise Prostate Cancer Mortality Risk

“Selenium supplementation of 140 or more μg/d after diagnosis of nonmetastatic prostate cancer may increase risk of prostate cancer mortality,” according to a prospective study following 4,459 men initially diagnosed with nonmetastatic prostate cancer in the Health Professionals Follow-up Study...

multiple myeloma

Panobinostat in Combination With Bortezomib‑Dexamethasone in Previously Treated Multiple Myeloma

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 February 23, 2015, panobinostat (Farydak) was granted...

issues in oncology
health-care policy

Ongoing Controversies in Allocating Our Health‑Care Resources

Disparities of care that result in poorer outcomes among certain populations have long been an issue addressed by the cancer community and its major organizations such as ASCO. While ethnicity and race play key roles in this ongoing debate over equitable allocation of our precious health-care...

breast cancer

Hypofractionated Whole-Breast Irradiation After Breast-Conserving Surgery Used in Up to One-Third of Eligible Patients

In a study reported in JAMA, Justin E. Bekelman, MD, of the University of Pennsylvania Perelman School of Medicine, and colleagues found that approximately two-thirds of patients with early-stage breast cancer for whom hypofractionated whole-breast irradiation (for 3–5 weeks) was endorsed received...

Expert Point of View: Andrew Loblaw, MD

Commenting on this study, formal discussant D. Andrew Loblaw, MD, a radiation oncologist at the Odette Cancer Centre, Sunnybrook Health Sciences Centre, Toronto, Canada, said: “The trial showed that after a median follow-up of 7.0 years, there were no differences in overall survival between the two ...

issues in oncology
health-care policy

Health-Care Fraud and Abuse: Implications for Oncology

Health-care fraud is a long-standing problem in the United States, accounting for $75 billion in government expenses per year,1 while total spending on government health-care programs is over $1 trillion. Two decades ago, the Department of Justice increased its efforts to combat health-care fraud....

breast cancer

Are Physicians Choosing Wisely When Imaging for Distant Metastases in Early-Stage Breast Cancer?

Patients with early-stage breast cancer still undergo imaging for distant metastases despite evidence-based local, national, and international guidelines—and a recommendation from ASCO—to avoid such imaging, according to a retrospective review of staging imaging for distant metastases in patients...

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