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issues in oncology
solid tumors
hematologic malignancies

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 ...

Expert Point of View: Researchers Find Remarkable Heterogeneity in Sarcomas

Historically, studying sarcoma has been problematic for several reasons. Sarcomas represent only about 1% of all adult cancers, and there are many subtypes, so getting a group of patients with one type of sarcoma together for a clinical trial in a single institution can be challenging. In the past, ...

issues in oncology

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...

issues in oncology

Need for Data Capture Crucial, Now and After ‘Meaningful Use’

It’s never enough. Whether it is the Centers for Medicare & Medicaid Services (CMS), other payers, pharmaceutical manufacturers, or specialty companies, one can never provide enough data. When will it all end? The problem, or the opportunity for many, is that it won’t end. The need for discrete ...

issues in oncology

Oncologists Need Hands-on Approach in Developing Next Generation of EHRs

The electronic health record system offered by vendors is more like a filing cabinet, not the sophisticated, interactive database needed by busy oncologists, according to Kevin S. Hughes, MD, FACS, Co-Director, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, who...

issues in oncology

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 ...

Medical Students Can Now Be ASCO Members, Thanks to an Intern Who Pressed

ASCO has just added a membership category for medical students, spurred on by—you guessed it—a medical student. Daniel G. Stover, MD, knew he wanted to go into oncology from very early on. But when he contacted ASCO to join as an intern, having just graduated from Vanderbilt School of Medicine, he...

global cancer care

Lessons from a Northern Neighbor: A Conversation with Joseph M. Connors, MD

Policy analysts searching for a better understanding of health-care models often compare the cancer delivery systems of Canada and the United States. The ASCO Post recently spoke with Joseph M. Connors, MD, Clinical Professor and Director of the BC Cancer Agency’s Centre for Lymphoid Cancer,...

prostate cancer

Prostate Cancer Screening Reconsidered

Prostate cancer is the most prevalent nonskin cancer in men. An estimated 16% of men are diagnosed with prostate cancer, yet only 3% of men die from it.1 Unlike other cancers, prostate cancer is associated with a prolonged lead-time, meaning it can take anywhere from 5 to 12 years to become...

issues in oncology
health-care policy

A Conversation with Ezekiel J. Emanuel, MD, PhD

Last September, Ezekiel J. Emanuel, MD, PhD, a leading scholar in bioethics and health-care policy, was named the Diane v.S. Levy and Robert M. Levy University Professor and Vice Provost for Global Initiatives at the University of Pennsylvania in Philadelphia. His appointment will be shared between ...

breast cancer
issues in oncology

FDA Announces Bevacizumab Decision: Agency Will Revoke Breast Cancer Indication

On November 18, FDA Commissioner Margaret A. Hamburg, MD, said she is revoking the agency’s approval of the breast cancer indication for bevacizumab (Avastin) after concluding that the drug has not been shown to be safe and effective for that use. Bevacizumab will remain on the market as an...

colorectal cancer

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...

SIDEBAR: Expect Questions from Your Patients

“The message” of a meta-analysis of 17 randomized trials of breast-conserving surgery with or without radiation, “should be that the benefits of radiation are not temporary, that it provides an increased chance of cure,” Thomas A. Buchholz, MD, told The ASCO Post. The meta-analysis was conducted by ...

breast cancer

Benefits of Radiation after Breast-conserving Surgery Cut Risk of Recurrence in Half

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. “After breast-conserving surgery,...

issues in oncology

MD Anderson Cancer Center’s New President Has a Bold Vision

On September 1, 2011, Ronald A. DePinho, MD, became only the fourth President in the 70-year history of The University of Texas MD Anderson Cancer Center in Houston. Dr. DePinho spent the previous 14 years as head of Dana-Farber’s Belfer Institute for Applied Cancer Science. In a recent interview...

issues in oncology

The Newly Diagnosed Patient with Cancer and Access to Care

A study presented at the 2011 ASCO Annual Meeting raised concerns that newly diagnosed cancer patients are having trouble seeing an oncologist. Interviews with several cancer centers and community practices, however, suggest that the process runs smoothly, for the most part. Majority of Patients...

SIDEBAR: About the Nachman Award

Plans call for the first James B. Nachman ASCO Junior Faculty Award in Pediatric Oncology to be awarded at the 2012 ASCO Annual Meeting. The award will be given each year to a junior faculty member who submits the highest-scoring abstract in pediatric oncology for the ASCO Annual Meeting, as...

ASCO President Michael P. Link, MD, Joins Colleagues in Honoring a Friend and Touching the Future through Philanthropy

As an active member of ASCO, and as a leader of the Society in recent years, ASCO President Michael P. Link, MD, has a long history of giving to the Society-affiliated Conquer Cancer Foundation. “Our family has always felt that it’s a good thing to support,” he said. “The Foundation supports...

Weekly Online Polls Help Define Key Concerns of ASCO Members

ASCO members now have the opportunity to help the Society gather information and opinions about important cancer policy issues. ASCO in Action, ASCO’s revamped policy news website (http://ascoaction.asco.org), features weekly polls designed to gauge the views of ASCO members on a variety of topics ...

breast cancer

CLEOPATRA Trial Finds Dual HER2 Blockade Improves Progression-free Survival in Advanced Breast Cancer

Women with HER2-positive advanced breast cancer are much less likely to have disease progression or die when two agents are used instead of one to target the HER2 signaling pathway, investigators for the international phase III CLEOPATRA trial found. The 808 women studied were randomly assigned to...

integrative oncology

Integrative Oncology: Essential to Cancer Care

During the 1960s and 1970s, the concept of an expanded approach to oncologic treatment encompassing “body, mind, and spirit” grew in patient popularity and morphed into two basic categories: “alternative” and “complementary” therapies. Together, these later became known by the acronym CAM, for...

hematologic malignancies

Ruxolitinib for Myelofibrosis Therapy: A Good Start but a Long Road Ahead

Following a priority review process for orphan diseases, ruxolitinb (Jakafi) recently became the first drug to receive FDA approval for the treatment of intermediate- and high-risk myelofibrosis. Discovery in 2004 of the JAK2V617F mutation in a significant proportion of patients with...

breast cancer

BOLERO-2: Everolimus Thwarts Resistance to Hormonal Therapy in Advanced Breast Cancer

Adding an inhibitor of the mammalian target of rapamycin (mTOR) to hormonal therapy for advanced breast cancer effectively circumvents resistance, suggest updated results of the randomized BOLERO-2 trial. With a median follow-up of 12.5 months, the likelihood of disease progression or death among...

cns cancers

Don’t Take Away Our Hope

After experiencing the loss of my wife Dina’s first pregnancy during her second trimester, we naturally worried that something would go wrong when she became pregnant again. But when our son Will was delivered at full term, we thought we could finally relax. Born at a whopping 10 lb, Will seemed...

cns cancers

Everolimus for Tumors Associated with Carcinoid Syndrome

The combination of everolimus (Afinitor) plus octreotide (Sandostatin) long-acting repeatable (LAR) formulation improved progression-free survival by 23% over placebo plus octreotide LAR in a randomized phase III study of patients with advanced neuroendocrine tumors associated with carcinoid...

SIDEBAR: Expect Questions from Your Patients

The current lack of awareness about the high risk of venous thromboembolism (VTE) among people being treated for cancer as outpatients means “there’s a great role for provider education,” Alok Khorana, MD, told The ASCO Post. Here are Dr. Khorana’s answers to some likely questions from patients....

supportive care

Outpatients Need to Be Aware of High Risk of Developing Venous Thromboembolism

Most patients who develop venous thromboembolisms (VTE) while being treated for cancer, do so as outpatients, according to results of a retrospective, observational study comparing the incidence of VTE among inpatients and outpatients with cancer. Yet many outpatients do not even realize that they...

lung cancer

Studies Reveal that Hormonal Factors Influence Lung Cancer Risk in Women

In an effort to understand lung cancer risk factors and develop prevention strategies for the disease, Christina S. Baik, MD, MPH, thoracic oncologist and staff scientist at the Seattle Cancer Care Alliance and Fred Hutchinson Cancer Research Center, has examined epidemiologic trends in lung...

issues in oncology

Shortening the Learning Curve of the U.S. Health-care System

If we are able to harness the full potential of digital technologies, computerized registries, databases, and the Web, could we solve many of the current woes of our sluggish and costly health-care system? Yes, according to Lynn Etheredge, a consultant with the Rapid Learning Project at the George...

lymphoma
geriatric oncology

Expert Point of View: Therapy for Hodgkin Lymphoma in the Elderly Remains Undefined

Elderly Hodgkin lymphoma, typically defined as affecting individuals ≥ 60 years of age, remains a disease for which no standard treatment recommendation exists. This population is underrepresented in clinical studies, and survival rates in older patients with Hodgkin lymphoma are significantly and ...

breast cancer

Changes in Receptor Status during Breast Cancer Progression Warrant Rebiopsies at Relapse and Metastasis

Oncologists should be aware that common clinical tumor markers (denoting hormonal and HER2 status) change as breast cancer progresses, because these changes can affect treatment selection. Estrogen receptor (ER), progesterone receptor (PR), and HER2 receptor status was changed from the time of the...

Renewing Our Commitment to Conquering Cancer

Congress passed a resolution in December recognizing the 40th anniversary of the National Cancer Act of 1971 and the more than 12 million cancer survivors who are alive as a result of the nation’s commitment to cancer research and advances in cancer prevention, detection, diagnosis, and treatment....

integrative oncology

NIH Director Calls for Rigorous Evaluation of Integrative Medicine to Provide Evidence of Efficacy

“Many new frontiers exist in integrative medicine,” NIH Director Francis Collins, MD, PhD, stated in his keynote address at the Eighth International Conference of the Society for Integrative Oncology (SIO) in Cleveland. “The evidence is overwhelming that these approaches are being used by many...

integrative oncology

‘New Science, New Solutions’ Explored at Society for Integrative Oncology Conference

“Innovating Integrative Oncology: New Science, New Solutions” was the title of the Society for Integrative Oncology (SIO) Eighth International Conference. Topics ranged from molecular biology to mitigation of treatment toxicity to mind-body medicine. A total of 505 people attended the conference,...

breast cancer
symptom management

Estrogen for Vulvovaginal Atrophy in Breast Cancer: Debate Continues

Vulvovaginal atrophy is a concern for the majority of patients with breast cancer, not only because of its physical and psychosexual consequences, but because the optimal treatment—estrogen replacement—is controversial. Patients and physicians alike remain concerned that external estradiol may...

prostate cancer

NIH Panel Endorses Active Surveillance in Low-risk Prostate Cancer

Active surveillance of localized prostate cancer is a viable management option that should be offered to low-risk patients in place of immediate treatment, said a panel of experts convened by the National Institutes of Health. A fairly new concept, active surveillance takes a more proactive...

breast cancer

Bevacizumab Breast Cancer Indication Rescinded: What Are the Downstream Implications?

Leading up to FDA’s resolution to revoke the breast cancer indication for bevacizumab (Avastin), the debate over the drug’s clinical value was imbued with contentious ideologic overtones, which culminated in a 2-day public hearing that exposed deep divisions not only in the scientific community,...

supportive care

Depression Is Dangerous among Patients with Cancer, but Talking and Pharmacologic Treatments Can Be Effective

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. “Depression is a very dangerous...

issues in oncology

Oncologists Examine Promise vs Reality of Personalized Medicine

Personalized medicine: It’s a phrase that reverberates across all cancer meetings. “Matching the right drug to the right patient” will be accomplished, in the not too distant future, through genomic sequencing of the tumor and targeted, less toxic therapy. This much has been established—or has it?...

issues in oncology

CancerConnect Offers Online Alternative Networking for Patients

Social networking sites like Facebook and Twitter are rapidly growing, giving patients with cancer a place to connect with others. But an alternative networking website claims to be a more comprehensive, responsible, “commercial-free” alternative. Over 10,000 patients with cancer have registered at ...

hepatobiliary cancer

Laparoscopic Liver Resections Can Be Safe and Oncologically Efficient

Laparoscopic resection of primary and metastatic liver cancers can be safe and oncologically efficient and reduce postoperative length of stay, a single-center study from the United Kingdom found.1 The investigators cautioned, however, that “adequate patient selection and extensive experience in...

breast cancer

Ablation of Small Primary Breast Tumors: The Next Step in Local Therapy?

Local treatment of breast cancer is trending toward less invasive procedures that achieve comparable outcomes to standard interventions. What will the next step along this continuum be? According to Michael S. Sabel, MD, a surgical oncologist at the University of Michigan Comprehensive Cancer...

breast cancer

AVEREL Trial Shows Benefit of Bevacizumab in HER2-positive Locally Recurrent or Metastatic Breast Cancer

In findings likely to intensify the debate about the role of bevacizumab (Avastin) in advanced breast cancer, the AVEREL trial concludes that adding this antiangiogenic antibody to standard therapy prolongs progression-free survival by about 3 months in women with HER2-positive locally recurrent...

issues in oncology
health-care policy

Drug Shortages Hit Oncology Hard: Experts Weigh in on Challenges and Solutions

Periodic drug shortages are an unavoidable reality in our complicated pharmaceutical supply chain; however, over the past several years, drug shortages have expanded to crisis levels, putting vulnerable patients at risk. In 2010, there were 178 drug shortages reported to the FDA, 132 of which were...

lymphoma

Expert Point of View: Maintenance Rituximab vs Retreatment Rituximab in Patients with Low–Tumor-Burden Follicular Lymphoma

The findings of RESORT1 have tremendous implications, both clinically and economically, commented Andrew D. Zelenetz, MD, Chief of the Lymphoma Service at Memorial Sloan-Kettering Cancer Center, New York, in an interview. “The maintenance arm received rituximab [Rituxan] every 3 months...

lymphoma

Maintenance Rituximab vs Retreatment Rituximab in Patients with Low–Tumor-Burden Follicular Lymphoma

For patients with low–tumor-burden follicular lymphoma treated upfront with rituximab (Rituxan), retreating upon disease progression was as effective as extended dosing, or maintenance therapy, in a randomized phase III study that compared the approaches.1 Given the excellent outcomes, lack of a...

multiple myeloma

Expert Point of View: Monoclonal Antibody Promising in Multiple Myeloma

With a wealth of new agents of various classes in the pipeline, “myeloma is going to become a chronic illness, with sustained complete responses achieved in a significant fraction of patients,” according to Kenneth C. Anderson, MD, of Dana-Farber Cancer Institute and Harvard Medical School, ...

leukemia

BELA Trial Reborn: Bosutinib Produces Improved Results in Chronic Myeloid Leukemia

The initial reports of the BELA trial (Bosutinib Efficacy and safety in chronic myeloid LeukemiA), presented at ASH 2010, were deflating. At 12-month follow-up, bosutinib failed to meet BELA’s primary endpoint. Things have since turned around, however, and results from the 24-month analysis...

breast cancer

Expert Point of View: Everolimus plus Exemestane Significantly Prolongs Remission in BOLERO-2

Signaling of mammalian target of rapamycin (mTOR) is required for estrogen-induced breast tumor cell proliferation, and hyperactivation of the mTOR pathway is observed in endocrine-resistant breast cancer cells. Clinically, this makes for a rational one-two punch in endocrine-resistant breast...

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