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Showing 3951 - 4000Are Clinical Pathways Inevitable in Oncology’s Future?
Our health-care system is undergoing a gradual but inevitable sea change, shifting from traditional fee-for-service to fee-for-value. A session at this year’s Association of Community Cancer Centers meeting in Washington, DC, shed light on how this trend will reshape incentives and the clinical...
Expert Point of View: Exemestane Prevents Invasive and Preinvasive Breast Cancers in MAP.3 Trial
According to Andrea De Censi, MD, of the E.O. Ospedali Galliera in Genoa, Italy, the invited discussant of the paper presented by Paul Goss, MD, PhD, at the 2011 ASCO Annual Meeting, “MAP.3 provides a paradigm shift for breast cancer prevention. Avoiding breast cancer with manageable toxicity is...
Evaluating Risk for Suicide in People Diagnosed or Living with Cancer
The challenges of life-threatening physical illness can sometimes lead to suicide. In fact, given the critical stressors that a person with cancer faces, we might expect suicide to be a more common reaction. Patients with cancer are at increased risk of completed suicide, though the prevalence of...
New Safety Information Reported for 5-alpha Reductase Inhibitors
The FDA announced that the Warnings and Precautions section of the labels for the 5-alpha reductase inhibitor class of drugs has been revised to include new safety information about the increased risk of being diagnosed with high-grade prostate cancer. This risk appears to be low, but health-care...
Sorafenib Acceptable in Child-Pugh B Patients with Hepatocellular Carcinoma
Patients with hepatocellular carcinoma and moderate liver dysfunction can derive benefit from, and be treated safely with, sorafenib (Nexavar), according to the second interim analysis of the GIDEON trial, presented at the 2011 ASCO Annual Meeting by Jorge A. Marrero, MD, of the University of...
Second Primary Malignancies Explored in Multiple Myeloma
Three randomized controlled trials presented at the 2010 Annual Meeting of the American Society of Hematology (ASH) suggested that treating multiple myeloma with lenalidomide (Revlimid) increased the risk of second primary malignancies; of particular concern is transformation to acute myeloid...
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....
Updated Drug Label Approved for Pioglitazone after Safety Review
The FDA recently approved updated drug labels for pioglitazone (Actos) and other pioglitazone-containing medicines (in combination with metformin, Actoplus Met and Actoplus Met XR; and with glimepiride, Duetact) to include safety information that the use of pioglitazone for more than 1 year may be...
At 5 Years, Brachytherapy Shows Quality-of-life Advantages over Radical Prostatectomy for Favorable-risk Prostate Cancer
Five years after treatment for favorable-risk prostate cancer, men who either chose or were randomly assigned to receive brachytherapy reported quality-of-life advantages in urinary and sexual domains and in patient satisfaction compared to men who received radical prostatectomy, according to a...
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...
UN Summit to Focus on Noncommunicable Diseases This Month
For the second time since its inception 65 years ago, the United Nations General Assembly is holding a “High-level Meeting” that will focus on health. During the September 19–20 meeting, world leaders will shine a spotlight on the devastation that noncommunicable diseases are causing and have...
Screening for Ovarian Cancer Does Not Reduce Mortality and Leads to Unnecessary Tests for False-Positives
Formal discussant of this trial, Usha Menon, MD, Professor of Gynecological Oncology at the Institute for Women’s Health, University College, London, raised several important issues about the design of the PLCO trial particularly related to the dilution of the screening effect due to prolonged...
Screening for Ovarian Cancer Does Not Reduce Mortality and Leads to Unnecessary Tests for False-Positives
Using a CA-125 blood test combined with transvaginal ultrasound for early detection of ovarian cancer failed to reduce the risk of mortality associated with the disease and led to a large number of false-positive tests with unnecessary related biopsies and other follow-up procedures in the large,...
Adjuvant Immunotherapy Provides No Clinical Benefit in Patients with High‑risk Renal Cell Carcinoma
For renal cell carcinoma patients at high risk of relapse following nephrectomy, adjuvant therapy with the combination of interleukin-2 (Proleukin), interferon alfa, and fluorouracil (5-FU) provides no survival benefit over observation alone, according to a phase III trial conducted by the European ...
Fixing the Drug Shortage: It’s About Time
I have spent the past 30 years trying to improve the results of treatment for advanced cancer. I had the privilege of working with Sir Michael Peckham when the late Professor Tim McElwain and he were evolving variants of the PVB (cisplatin, vinblastine, bleomycin) and PEB (cisplatin, etoposide,...
Increased Use of Hospital Services Boosts Oncology Spending
For our ongoing series on the rising costs of cancer care, The ASCO Post spoke with Lee N. Newcomer, MD, Senior Vice President of Oncology for UnitedHealthcare. Dr. Newcomer is responsible for improving cost-effective cancer care at the nation’s largest health insurer. He shed light on areas of...
Treating Cancer in Japan: A Conversation with Kensei Tobinai, MD
In this installment of Oncology Worldwide, internationally regarded lymphoma expert and cancer survivor, Kensei Tobinai, MD, Chief, National Cancer Center Hospital, Tokyo, sheds light on the Japanese oncology experience. Medical Education What was the medical school experience in Japan like? When...
Integrative Oncology Modalities Supported by Varying Levels of Evidence, but More Research Needed Overall
Over the past couple of decades, unregulated nonstandard oncology approaches have gained growing popularity among cancer patients. The relatively new field of integrative oncology was established to promote a more holistic and multidisciplinary approach to cancer care and to encourage scientific...
Developing Targeted-agent Combinations: Business and Regulatory Issues, and Legal Obstacles
The Institute of Medicine’s National Cancer Policy Forum recently convened a public workshop, “Facilitating Collaborations to Develop Combination Investigational Cancer Therapies,” to address the promises and challenges involved in the development of combination oncologic drug therapies. In the...
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...
‘Hot Chemotherapy’ Generates Heated Debate about Its Use with Cytoreductive Surgery to Manage Peritoneal Metastases
"Hot chemotherapy” has become the common term for hyperthermic intraperitoneal chemotherapy (HIPEC), which together with cytoreductive surgery is being used by some surgeons to treat patients with carcinomatosis from colorectal cancer. While HIPEC is not considered the most important component of...
SIDEBAR: Letter to President Obama
Excerpt from a letter signed by ASCO and other leading cancer organizations to President Barack Obama (July 13, 2011) urging him to resist proposed cuts to Medicare reimbursement for oncology drugs: “Due to financial and administrative burdens that currently exist, community oncology practices...
Yoga, Geriatric Assessment, and Nausea/Vomiting Addressed in Session on Supportive Care and Survivorship Issues
Marie E. Wood, MD, of the Familial Cancer Program at the University of Vermont, Burlington, addressed clinically relevant issues in supportive care and survivorship at the Best of ASCO® Annual Meeting ‘11 in Miami. Delayed Nausea and Vomiting Two studies addressed the problem of...
ASCO Study Shows Integrating Nonphysician Providers into Oncology Practices Is a Win for Patients and Providers
Is the expanded use of nonphysician providers (NPPs) a viable way to help ease the challenges oncology practices could feel if the number of oncologists entering the field does not keep pace with potential growth in the demand for their services? The ASCO Workforce Advisory Group thought the...
SIDEBAR: The March of Progress in Lung Cancer Treatment
Before the discovery of predictive molecular tests (eg, EGFR mutation and ALK rearrangement), each chemotherapy drug for stage IV non–small cell lung cancer had about the same chance of success. Progress was made as more drugs were discovered. Patients lived longer with second- and third-line...
New ASCO Focused Update Recommendation on Maintenance Treatment of Stage IV Non–Small Cell Lung Cancer
A focused update to the 2009 ASCO Clinical Practice Guideline Update on Chemotherapy for Stage IV Non-Small-Cell Lung Cancer reflects new evidence on maintenance therapy in patients with response or stable disease after four cycles of first-line cytotoxic chemotherapy.1 The 2009 update...
Novel Approaches and Agents Making Headway against Sarcoma
Novel approaches and agents reported at the ASCO 2011 Annual Meeting are improving outcomes in sarcoma, a heterogeneous disease with historically poor outcomes, according to William D. Tap, MD, Section Chief of Sarcoma Oncology at Memorial Sloan-Kettering Cancer Center in New York. Dr. Tap...
SIDEBAR: Searching for More Efficacious, Less Toxic Adjuvant Chemotherapy for NSCLC
Accumulating data are helping to better define the risk-benefit profile of various adjuvant chemotherapy regimens for non–small cell lung cancer (NSCLC) and the impact of adding biologic agents to the mix, according to H. Jack West, MD, of the Swedish Cancer Institute in Seattle. In the randomized ...
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...
AACR Issues Landmark Report on Cancer Progress
At a recent press conference in Washington, DC, the American Association for Cancer Research (AACR) assembled luminaries from the cancer research and care communities to discuss the salient points of the association’s newly released progress report on the current and future state of cancer research ...
Geriatric Oncology, a Much Needed Discipline for Future Cancer Care
The U.S. health-care system, with its rapidly aging population, faces a multitude of difficult clinical and financial challenges in caring for its burgeoning population of older patients with cancer. Moreover, age-related social and medical issues among older patients need to be addressed by a...
Expert Point of View: Chemotherapy Generally Safe in Pregnancy
Chemotherapy delivered in the first trimester is associated with a 10% to 30% risk of abortion and 10% to 25% risk of malformations. Therefore, it should be postponed until the second or third trimester, when most regimens appear to be safe, according to Nicholas Pavlidis, MD, of the University of...
Sunitinib and Everolimus: New Indications in Pancreatic Neuroendocrine Tumors
With In the Clinic, The ASCO Post 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. Sunitinib Indication—The oral kinase inhibitor...
Novel HDAC Inhibitor May Restore Estrogen Sensitivity in Breast Cancer
The addition of the investigational histone deacetylase (HDAC) inhibitor entinostat significantly delayed breast cancer progression and showed a trend for a survival benefit in the phase II ENCORE 301 study. The study was conducted in women with advanced estrogen receptor–positive breast cancer...
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...
SIDEBAR: Key Dates in the Medicare Physician Reimbursement Saga
October 21, 2009: SB 1776 (“the Doc Fix”) is introduced in the Senate [but fails to pass] November 19, 2009: House of Representatives passes HR 3961 (the Medicare Physician Payment Reform Act) [but Senate fails to pass] December 19, 2009: Congress passes Department of Defense appropriations bill...
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 ...
Significantly Longer Survival with Axitinib Compared to Sorafenib in Patients with Renal Cell Carcinoma
A phase III study comparing the vascular endothelial growth factor receptor (VEGFR) inhibitors axitinib and sorafenib (Nexavar) as second-line therapy in patients with metastatic renal cell carcinoma found that axitinib produced significantly longer progression-free survival. Published in The...
The Art and Grace of Just Letting Go
Like a breeze rippling across a lake, the end of your career is approaching and you cannot escape its path. You can see it coming, and before you know it the inexorable movement will rush past you. You have two choices: Build a sail so that you can capture the energy and move with it, or remain...
SIDEBAR: Patient Advocates Form Huge Presence at EMCC 2011
Patient advocate and two-time breast cancer survivor Kathi Apostolidis from Greece spoke at a session on patients’ and physicians’ use of social media. “Social media is not a fad. It has real value,” she said. She uses social media to connect with oncologists and policymakers across the globe, and...
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...
ASCO Issues Blueprint for Transforming Cancer Research in the ‘Molecular Era’
On November 3, ASCO issued a new report that lays out ASCO’s vision for transforming clinical and translational research to deliver more effective and personalized cancer therapies faster. The report, Accelerating Progress Against Cancer: ASCO’s Blueprint for Transforming Clinical and Translational ...
Gathering Data Point to Potential Advantages of Vismodegib in Basal Cell Carcinoma and Other Advanced Cancers
Vismodegib is a small-molecule, orally active hedgehog pathway inhibitor that has shown considerable promise in treating basal cell carcinoma and is currently being evaluated alone and in combination in early-phase trials in medulloblastoma and a long list of other cancers.1 Owing to its...
Benefit of Panitumumab Seen Primarily in Patients with Recurrent or Metastatic Head and Neck Cancer and HPV-negative Tumors
The addition of panitumumab (Vectibix) to chemotherapy improved overall and progression-free survival in patients with recurrent or metastatic squamous cell carcinoma of the head and neck, but its benefit was limited to patients whose tumors were negative for the human papillomavirus (HPV).1 The...
Important Briefs from the 2011 European Multidisciplinary Cancer Congress
Nearly 16,000 people from 16 countries attended this year’s European Multidisciplinary Cancer Congress, held recently in Stockholm. The ASCO Post has featured several key reports from the meeting and will offer further coverage in upcoming issues. Additional noteworthy studies presented at the...
New Drug Approved to Treat Acute Lymphoblastic Leukemia
The FDA has approved asparaginase Erwinia chrysanthemi (Erwinaze) to treat patients with acute lymphoblastic leukemia who have developed hypersensitivity to Escherichia coli–derived asparaginase (Elspar) and pegaspargase (Oncaspar). Acute lymphoblastic leukemia is the most commonly diagnosed...
2011 in Review: Oncology Drugs/Indications Newly Approved by FDA
At press time, the FDA had granted approval for the following new agents and indications for cancer treatment in 2011. Asparaginase Erwinia chrysanthemi (Erwinaze) as a component of a multiagent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia in patients who have...
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...
Breast Cancer Experts Voice Opinion and Express ‘Disappointment’ over FDA Decision
Gabriel N. Hortobagyi, MD, Chair of Medical Breast Oncology at The University of Texas MD Anderson Cancer Center, Houston, said he was “disappointed but not surprised” at the FDA decision to withdraw the bevacizumab (Avastin) indication in breast cancer. “Once the FDA put this in the hands of ODAC, ...
Humor Is Helping Me Survive Cancer
Despite a strong family history of colon cancer—all five of my mother’s siblings had colon cancer, and my mother died of the disease 10 years ago—when some flecks of blood started showing up on my toilet tissue in early 2005, I figured it was from hemorrhoids. At 38, I was a marathon runner and in...
