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issues in oncology

NCCN Working Group on Value Tools Presents Preliminary Findings and Recommendations

Over the past several years, the introduction of decision-making tools for patients from major cancer organizations, including ASCO and the National Comprehensive Cancer Network® (NCCN®), has been news, applauded as a step toward more patient-centered care and featured at many meetings. Next steps, ...

breast cancer
symptom management

Randomized Trial Demonstrates Benefit of Scalp-Cooling in Prevention of Chemotherapy-Induced Hair Loss

A scalp-cooling device was found safe and effective in preventing chemotherapy-induced hair loss in women undergoing adjuvant treatment for breast cancer in an interim analysis of the first prospective, randomized trial of a modern scalp-cooling system. The study was presented at the 2016 San...

What Have We Got to Lose?

Tuesday morning was the regular time for the departmental meeting—an opportunity to discuss cases, troubleshoot, debrief, and expedite the necessary allied health referrals. As usual, patient cases were being discussed in alphabetical order of the attending oncologist. We were already three...

integrative oncology

Vitamin D and Cancer: A Uniform Dose Is Unlikely to Fit All Patients

Technically, vitamin D is a secosteroid hormone, not a vitamin. Increasing evidence indicates that vitamin D exerts effects beyond calcium homeostasis. Importantly, for example, higher serum vitamin D levels are associated with better cancer outcomes, including survival.1-3 The protective effects...

issues in oncology

Predicting Outcomes in Older Patients With Cancer

In the French ELCAPA14 study reported in the Journal of Clinical Oncology, Ferrat et al found that four frailty classifications performed well in predicting outcomes in a cohort of patients aged ≥ 70 years with various cancers. Study Details The study involved 763 in- or outpatients with...

breast cancer

Selected Abstracts From the 2016 San Antonio Breast Cancer Symposium

Each year, The ASCO Post asks Jame Abraham, MD, Director of the Breast Oncology Program at Taussig Cancer Institute and Co-Director of the Cleveland Clinic Comprehensive Breast Cancer Program, to give his picks for the most important research presented at the San Antonio Breast Cancer Symposium....

breast cancer

Expert Point of View: Howard A. “Skip” Burris, MD

Howard A. “Skip” Burris, MD, President of Clinical Operations and Chief Medical Officer at Sarah Cannon Research Institute, Nashville, commented on the poster presentation for The ASCO Post. He said the results “fit the whole paradigm” that is desired for triple-negative breast cancer, which is to ...

leukemia

Expert Point of View: Richard Furman, MD

“These results are interesting, important, and relevant for maintenance post chemotherapy, but if we are not using chemotherapy, they may not be relevant,” said Richard Furman, MD, of Weill Cornell Medical College, New York Presbyterian Hospital, New York. He said that newer drugs such as...

leukemia

Lenalidomide Maintenance Extends Progression-Free Survival in CLL

Lenalidomide (Revlimid), a cornerstone of therapy for multiple myeloma in the modern era, is making headway as maintenance therapy in chronic lymphocytic leukemia (CLL). Separate phase III studies presented at the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition showed...

leukemia

Treating the Whole Person

Twenty-five years ago, I was a physically fit woman of 45 in training to run a marathon, which had been a lifelong goal. I was feeling fine and had no hint of the illness that would nearly take my life and has forever changed it. While ramping up to go the 26.2-mile distance, I decided to have a...

multiple myeloma

Expert Point of View: Sergio A. Giralt, MD

Sergio A. Giralt, MD, Chief of the Adult Bone Marrow Transplant Service at Memorial Sloan Kettering Cancer Center, New York, and the Melvin Berlin Family Chair in Multiple Myeloma, commented on the findings of the StaMINA trial for The ASCO Post. He said the results of the largest randomized U.S....

leukemia

Achieving Complete Response Is Key to Improving Survival in Older Patients With AML

The importance of achieving complete response after intensive therapy in older adults with acute myeloid leukemia (AML) was confirmed in a follow-up analysis of the E2906 North American Intergroup trial.1 Patients in complete response had superior survival in this landmark analysis. This finding...

Overcoming the Physical, Emotional, and Financial Effects of Cancer

Although my diagnosis of stage IIIB melanoma 5 years ago came as a shock, in hindsight, it shouldn’t have been so surprising. I had noticed a small freckle-like lesion on my upper left thigh that had become itchy and occasionally bled, but it didn’t fit the ABCDE (Asymmetry, Border irregularity,...

Profound Answers to Simple Questions

A few years ago, I had the good fortune to join a research team that intended to create a device to help dying children express their wants and needs despite communication challenges. The brain tumor team at SickKids [also known as The Hospital for Sick Children] had cared for several children...

breast cancer

Treatment of Early HER2-Positive Breast Cancer: One Size Does Not Fit All

Despite the routine use of HER2 blockade in early HER2-positive breast cancer, clinicians can always benefit from a refresher on key treatment considerations. Clinical pearls and controversial issues were the topic of a presentation at the 14th Annual School of Breast Oncology at Emory University, ...

solid tumors

Mutanome-Directed Immunotherapy: Finding the Best Treatment Match

Oncologists may be accustomed to looking for commonalities in patients, but highly personalized therapies are now being developed based on mutational analysis of tumors. According to data presented at the Cedars-Sinai annual symposium on New Therapeutics in Oncology: The Road to Personalized...

multiple myeloma

ASH 2016: Additions to Standard Multiple Myeloma Therapy Do Not Appear to Yield Additional Benefit

Trial results presented by Stadtmauer during the 58th American Society of Hematology (ASH) Annual Meeting & Exposition in San Diego (Abstract LBA-1) suggest two therapies that are often added to standard therapy in patients with multiple myeloma do not improve rates of progression-free survival ...

leukemia

ASH 2016: Interim Analysis Shows Adding Lenalidomide Maintenance Therapy to Chemoimmunotherapy Prolongs Progression-Free Survival in High-Risk CLL

The combined use of genetic markers and minimal residual disease assessment (MRD) has made it easier to identify chronic lymphocytic leukemia (CLL) patients likely to have a poor outcome after receiving frontline chemoimmunotherapy. Interim results from the phase III German CLL M1 study presented...

hematologic malignancies

Optimizing Allogeneic Stem Cell Transplantation in Myelofibrosis

Allogeneic hematopoietic stem cell transplantation is the only potentially curative treatment for myelofibrosis. The ASCO Post asked an expert in this field, Ayalew Tefferi, MD, how and when he uses stem cell transplant in myelofibrosis, which is a topic he outlined in greater detail in the...

health-care policy

How ASCO Is Preparing Members for MACRA

On October 14, 2016, the Centers for Medicare & Medicaid Services (CMS) announced its final policy on what physicians need to do to begin implementing the Quality Payment Program outlined in the Medicare Access and CHIP Reauthorization Act of 2015 ­(MACRA). The Quality Payment Program is a...

palliative care

Quality Improvement Project Results in Timelier Hospice Referrals

A quality improvement project conducted within the OhioHealth system showed that oncologists can change their behavior and refer patients earlier to hospice care. After a relatively minor intervention, 18 medical oncologists in private practice doubled the mean length of stay in hospice care for...

New Member Categories Provide Specialized Support to Cancer Care Team Members

As part of ASCO’s ongoing effort to fully support all members of the cancer care team, it recently created three new member categories: Advanced Practice Providers, Practice Administrators, and Patient Advocates (see sidebar). Originally part of the Affiliated Health Professionals member category, ...

pancreatic cancer

Precision Promise Clinical Trial Focuses on Precision Medicine, Collaboration, and Data-Sharing in Pancreatic Cancer

The Pancreatic Cancer Action Network recently announced Precision Promise, the first large-scale precision medicine trial designed to transform outcomes for patients with pancreatic cancer. The organization also announced the 12 initial Precision Promise Clinical Trial Consortium sites selected to...

gynecologic cancers

SGO and ASCO Clinical Practice Guideline on Neoadjuvant Chemotherapy for Newly Diagnosed Advanced Ovarian Cancer

As reported by Alexi A. Wright, MD, MPH, of Dana-Farber Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO and the Society of Gynecologic Oncology (SGO) have released a clinical practice guideline on neoadjuvant therapy for patients with newly diagnosed stage IIIC or IV...

Salk Institute’s Clodagh O’Shea, PhD, Named Howard Hughes Medical Institute Faculty Scholar

Clodagh O’Shea, PhD, Associate Professor in the Salk Institute’s Molecular and Cell Biology Laboratory, is among the first recipients of a grant from the Faculty Scholars Program, a new partnership of Howard Hughes Medical Institute (HHMI), the Bill and Melinda Gates Foundation, and the Simons...

hematologic malignancies
leukemia
lymphoma
multiple myeloma

Roundup of Selected Abstracts in Multiple Myeloma, Acute and Chronic Leukemia, and Advanced Lymphoma

In June 2016, the European Hematology Association Congress convened in Copenhagen, Denmark. The educational and scientific program highlighted state-of-the-art clinical practice and the latest findings in hematology research. The ASCO Post brings its readers brief summaries of some of the important ...

hematologic malignancies

Autologous Stem Cell Transplant May Age Immune Cells as Much as 30 Years

University of North Carolina (UNC) Lineberger Comprehensive Cancer Center researchers, by tracking p16INK4a, a molecular marker that has been shown to increase in white blood cells as people age, have uncovered clues suggesting that stem cell transplant is linked to a marked increase in the...

gynecologic cancers

ASCO and SGO Release Clinical Practice Guideline on Neoadjuvant Therapy for Newly Diagnosed Advanced Ovarian Cancer

As reported by Alexi A. Wright, MD, MPH, of Dana-Farber Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO and the Society of Gynecologic Oncology (SGO) have released a clinical practice guideline on neoadjuvant therapy for patients with newly diagnosed stage IIIC or IV...

supportive care
symptom management

Scalp Cooling for Chemotherapy-Induced Alopecia Becoming Mainstream

Hair loss can be a devastating side effect of chemotherapy, but the recent U.S. Food and Drug Administration (FDA) approval of the DigniCap Cooling System and the growing acceptance of scalp-cooling methods in the United States may improve the quality of life for many patients receiving...

leukemia

New Upfront Treatment Algorithm Emerges for Chronic Lymphocytic Leukemia

According to Susan M. O’Brien, MD, an expert in the treatment of chronic lymphocytic leukemia (CLL), novel agents and new data on patient subsets have led to a new upfront treatment algorithm for this malignancy. Speaking at the 2016 Pan Pacific Lymphoma Conference in Koloa, Hawaii, Dr. O’Brien...

gynecologic cancers

ASCO and SGO Issue New Guideline on Ovarian Cancer Treatment

ASCO and the Society of Gynecologic Oncology (SGO) today issued a joint clinical practice guideline on ovarian cancer treatment. The guideline provides evidence-based recommendations on whether to use neoadjuvant chemotherapy or surgery as the initial treatment for women with stage IIIC and IV...

colorectal cancer

Multiple Means to Realize the Benefits of Colorectal Cancer Screening

In an updated recommendation statement, the U.S. Preventive Services Task Force (USPSTF) continues to strongly recommend screening for colorectal cancer for asymptomatic adults aged 50 through 75; but rather than emphasize specific screening strategies, it notes there are multiple screening...

cost of care

ASCO Plenary Studies: Assessing the ‘Value’ of New Treatments

At the 2016 ASCO Annual Meeting, studies presented at the Plenary Session gave attendees new treatment strategies to employ back home. But in the emerging push to contain the cost of new cancer treatments, do the four interventions fit within the new “value framework” for oncology? Deborah Schrag, ...

lung cancer

Lung Cancer Screening: Beneficial for Certain Populations but Not Without Controversy

The National Cancer Policy Forum of the National Academies of Sciences took up the issue of lung cancer screening at its mid-June workshop. Greta Massetti, PhD, Associate Director for Science, Division of Cancer Prevention and Control, Centers for Disease Control and Prevention (CDC), and chair of ...

colorectal cancer
issues in oncology

What’s Driving the Rising Rates of Colorectal Cancer in Young Adults?

The study statistics are alarming—and perplexing. According to an analysis of data from the Surveillance, Epidemiology, and End Results (SEER) colorectal cancer registry, colon cancer incidence among young adults aged 20 to 34 is expected to increase 90% by 2030, and the incidence of rectosigmoid...

geriatric oncology
supportive care
leukemia

Assessment of Fitness, Function, and Quality of Life Essential in Treatment of Older Patients With CLL

Significant progress has been made in the past 2 decades in the care of patients with chronic lymphocytic leukemia (CLL). Recently, the therapeutic armamentarium has expanded for such patients with the introduction of new targeted agents. CLL is predominantly a disease of the elderly, with a...

gastrointestinal cancer
pancreatic cancer
colorectal cancer

Treatment Update in Gastric, Pancreatic, and Colorectal Cancers

Although new gastrointestinal cancers are on the rise, advancements in their treatment, as well as the upcoming results of perioperative trials, could prove to be “clinical practice game-changers,” declared Thomas J. George, Jr, MD, FACP, at the 2016 Community Oncology Conference in Orlando,...

colorectal cancer

USPSTF Issues New Recommendations for Colorectal Cancer Screening

As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF) has issued new recommendations for colorectal cancer screening. In brief, the USPSTF recommends colorectal cancer screening starting at age 50 years and continuing until age 75 years (grade A recommendation = “The USPSTF...

cost of care
issues in oncology

ASCO Releases the Updated Version of Its Value Framework

Last June, ASCO published its initial concept for a value framework in the Journal of Clinical Oncology (JCO).1 The framework, developed by ­ASCO’s Value in Cancer Care Task Force, is designed to provide a standardized approach to assist physicians and patients in assessing the “value” of a new...

An Unusual Memoir of Cancer

“A book about the future must be written in advance. Later I won’t have the energy. So I will do it now.” So begins The Iceberg, a memoir set in Britain of a woman, Marion Coutts, whose husband was diagnosed with a brain tumor, which eventually killed him. Unfortunately, cancer memoirs flood the...

prostate cancer

Increased Survival and Toxicity With Docetaxel, No Benefit of Zoledronic Acid, When Added to First-Line Hormone Therapy in Prostate Cancer

As reported in The Lancet by Nicholas D. James, BSc, MBBS, PhD, of the University of Warwick, and colleagues, survival results of the STAMPEDE trial, which used a multiarm, multistage seamless phase II/III design, provide little evidence of benefit of zoledronic acid and showed increased survival ...

Expert Point of View: Stuart A. Grossman, MD, and Deborah Schrag, MD

Formal discussant of this trial Stuart A. Grossman, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, commented that the trial did not include a best standard-of-care arm. The pivotal trial defined optimal radiotherapy as 60 Gy over 6 weeks, but this...

leukemia

First-Line Fludarabine, Cyclophosphamide, and Rituximab vs Bendamustine/Rituximab in Advanced CLL

In a European phase III noninferiority trial reported in The Lancet Oncology, Eichhorst et al found that progression-free survival was better with standard first-line fludarabine/cyclophosphamide/rituximab vs bendamustine/rituximab in fit patients with advanced chronic lymphocytic leukemia (CLL)...

International Authority on Radiation Effects, Robert Peter Gale, MD, PhD, Has Pushed Scientific Boundaries in Search of Answers

It is widely reported that the first use of sargramostim (Leukine) in humans (granulocyte macrophage colony-stimulating factor; GM-CSF) was to treat victims of the Goiânia, Brazil, radiation accident in 1987. However, recently declassified documents show that sargramostim was first used a year...

With an Illustrious Career in Breast Oncology, Daniel F. Hayes, MD, FASCO, Follows in the Footsteps of Giants as ASCO President-Elect

ASCO President-Elect Daniel F. Hayes, MD, FASCO, was born in Shelbyville, Indiana, a small city in the center of the state. “My dream was to become a high school basketball and track and field coach; my older brother wanted to be a doctor, and his ambitions also began in first grade,” revealed Dr....

supportive care
geriatric oncology

The Role of Occupational and Physical Therapy in Geriatric Oncology

With individuals aged 65 and older accounting for more than 50% of the U.S. population diagnosed with cancer,1 the demand for occupational and physical therapists to treat this population will increase in the years to come. Thus, it is essential for primary care providers to know that the...

bladder cancer

ASCO Endorses European Association of Urology Guideline on Muscle-Invasive and Metastatic Bladder Cancers

As reported in the Journal of Clinical Oncology by Matthew I. Milowsky, MD, of the University of North Carolina Lineberger Comprehensive Cancer Center, and colleagues,1 ASCO has endorsed the European Association of Urology clinical practice guideline on muscle-invasive and metastatic bladder...

breast cancer

ExteNET Trial of Neratinib: One Size Does Not Fit All in HER2-Positive Breast Cancer

Neratinib is an oral anti-HER2 tyrosine kinase inhibitor that has shown promising activity in the treatment of HER2-positive metastatic breast cancer.1 It differs from monoclonal antibodies such as trastuzumab (Herceptin) because, as a small molecule, neratinib blocks the ATP binding site on the...

multiple myeloma

Upfront Transplant Remains Standard of Care in Multiple Myeloma

Upfront autologous stem cell transplant remains the standard of care in patients with newly diagnosed multiple myeloma, even in the era of novel agents, according to a phase III study of the European Myeloma Network.1 “Our findings show that autologous stem cell transplant should remain the...

issues in oncology

Breakthrough Therapy Efforts Result in Unprecedented Success

Friends of Cancer Research (Friends) and the U.S. Food and Drug Administration (FDA) have been working together for many years on an idea known as breakthrough therapy, and it has produced results beyond anyone’s hopes. Said Ellen Sigal, PhD, Friends Chair and Founder, “When we were first talking...

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