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Nuns Work Where None Work

It was December 9, 1975—a cold morning in the tribal village in Mahuadanr in Bihar, India. The valley was filled with an eerie mist coming down from the hills surrounding the village. Champa, a 5-year-old malnourished girl with sunken eyes, an emaciated face, and a huge ascites, was carried by her...

lung cancer
global cancer care

Study Finds 36% Increase in Number of Male Smokers in India Over 17 Years

The number of men smoking tobacco in India rose by more than one third to 108 million between 1998 and 2015, according to a new study published in the journal BMJ Global Health. The study also found that cigarettes were replacing the traditional bidi, a small, inexpensive Indian cigarette,...

issues in oncology

Cancer Statistics for African Americans, 2016

A new report outlines substantial progress in reducing the mortality gap between blacks and whites for some cancers, while the gap has widened or remained level for two leading cancers: breast cancer in women and colorectal cancer in men. The findings are included in Cancer Statistics for African...

skin cancer

Improved Melanoma-Specific Survival Reported With Wider Excision Margin in High-Risk Primary Melanoma

Wider excision margins in high-risk primary cutaneous melanoma were associated with improved melanoma-specific survival, according to long-term follow-up in a UK-led trial reported by Hayes et al in The Lancet Oncology. No significant improvement in overall survival was observed. The initial report ...

solid tumors

Increased Cancer Mortality Among Recipients of Solid-Organ Transplants

Solid-organ transplant recipients have a higher rate of cancer mortality than that expected in the general population, according to a Canadian study published in JAMA Oncology. Cancer mortality among transplant recipients “was significantly elevated compared with the Ontario population,” with a...

hematologic malignancies

First-in-Class Drug ONC201 Shows Potential for Some Blood Cancers

ONC201, an investigational anticancer drug that triggers cell death in various tumor types, may have clinical potential for some blood cancers including mantle cell lymphoma and acute myeloid leukemia (AML), according to a recent clinical study. A research team led by Michael Andreeff, MD, PhD,...

lung cancer

UK Trial Shows No Survival Benefit of Low–Molecular-Weight Heparin in Patients With Lung Cancer

In the UK phase III FRAGMATIC trial reported in the Journal of Clinical Oncology, Macbeth et al found no survival benefit of adding low–molecular-weight heparin to standard treatment in patients with lung cancer. Previous evidence suggested that low–molecular-weight heparin might...

integrative oncology

Mistletoe

The use of dietary supplements by patients with cancer has increased significantly over the past 20 years despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and...

breast cancer

FDA Approves Palbociclib in Combination With Fulvestrant in Hormone Receptor–Positive, HER2-Negative Advanced or Metastatic Breast Cancer

On February 19, 2016, the U.S. Food and Drug Administration approved palbociclib (Ibrance) in combination with fulvestrant for the treatment of women with hormone receptor–positive, human epidermal growth factor receptor 2 (HER2)–negative advanced or metastatic breast cancer with...

lung cancer

No Survival Benefit of Pemetrexed/Cisplatin Chemoradiation vs Standard Treatment in Nonresectable Stage III NSCLC

As reported by Senan et al in the Journal of Clinical Oncology, the phase III PROCLAIM trial showed no significant improvement in overall survival for chemoradiation with pemetrexed (Alimta)/cisplatin vs etoposide/cisplatin followed by consolidation pemetrexed vs a platinum-based doublet in...

head and neck cancer

2016 Head and Neck Cancer Symposium: Most Recurrences of HPV-Positive Oropharyngeal Cancer Can Be Found Within 6 Months

For patients treated with definitive radiation therapy for oropharyngeal cancer caused by human papillomavirus (HPV), the majority of recurrences can be detected by post-treatment imaging at 3 months and physical exams during the 6 months following treatment, according to research presented by...

Expect Questions About Updated Dietary Guidelines

The 2015–2020 Dietary Guidelines for Americans1 have generated comments and controversy, with some organizations expressing concern that the guidelines did not recommend limiting the consumption of red and processed meat. These organizations include the American Institute for Cancer Research...

leukemia

Ofatumumab for Extended Treatment of Patients With Recurrent or Progressive Chronic Lymphocytic Leukemia

On January 19, 2016, ofatumumab (Arzerra) was approved for extended treatment of patients in complete or partial response after at least two lines of therapy for recurrent or progressive chronic lymphocytic leukemia (CLL).1,2 Ofatumumab was previously approved for treatment of untreated patients...

health-care policy
issues in oncology

Evolving Tools for Clinical Decision-Making

Value in cancer care—and how to define it—is a hot topic. There is general agreement that it is some measure of benefit vs cost, but “should the focus be on providing value to patients at a population level or at an individual level?” asked Alan Balch, PhD, CEO of the Patient Advocate Foundation,...

issues in oncology

Cultural Awareness and Sensitivity Among Oncology Surgeons Do Not Necessarily Result in Culturally Competent Care

A survey of oncology surgeons from six hospitals in Washington State found that the surgeons in the sample “displayed and valued cultural awareness and sensitivity” but that “cultural awareness and sensitivity did not necessarily result in culturally competent behavior.”...

Expert Point of View: Bertram Wiedenmann, MD, PhD and Markus Moehler, MD, PhD

Commenting on the programmed cell death protein 1 (PD-1)/PD-1 ligand (PD-L1) antibodies in tumors with mismatch repair deficiency, Bertram Wiedenmann, MD, PhD, Professor of Internal Medicine and Gastroenterology, Universitätsmedizin Berlin, Germany, suggested, “The efficacy of pembrolizumab...

survivorship

Norwegian Male Cancer Survivors Less Likely to Reproduce

A study of all Norwegian men born between 1965 and 1985 showed that male cancer survivors are less likely to have children than those without a cancer diagnosis. “These findings are important for male cancer survivors, seeing as we can identify groups at risk of having reproduction...

sarcoma

Eribulin Improves Overall Survival vs Dacarbazine in Advanced Liposarcoma or Leiomyosarcoma

In a phase III trial reported in The Lancet, Schöffski et al found that eribulin improved overall survival vs dacarbazine in patients with advanced or metastatic soft-tissue sarcoma who had received at least two prior systemic treatments for advanced disease. Outcome in the subgroup with...

issues in oncology

Interruption of Radiation Therapy Due to Noncompliance Risks Cancer Recurrence

Cancer patients who miss two or more radiation therapy sessions (except for planned treatment breaks) have a worse outcome than fully compliant patients, investigators at Montefiore Einstein Center for Cancer Care (MECCC) and Albert Einstein College of Medicine's Albert Einstein Cancer Center have...

prostate cancer

Study Finds Enzalutamide Increases Progression-Free Survival vs Bicalutamide in Metastatic Prostate Cancer

Use of the androgen receptor–inhibitor enzalutamide (Xtandi) more than doubled progression-free survival vs the nonsteroidal antiandrogen bicalutamide in patients with metastatic prostate cancer progressing on androgen-deprivation therapy, according to the randomized phase II TERRAIN trial...

pancreatic cancer
issues in oncology

Preclinical Device Hits Pancreatic Tumors With Drug Cocktail, Sparing the Body

A highly lethal cancer sometimes requires large doses of highly toxic drugs. However, a blitzkrieg approach can be unfeasible for some patients due to severe side effects. Now a team of researchers at the University of North Carolina at Chapel Hill has found that an implantable device can deliver a ...

head and neck cancer

No Benefit of Adding Adjuvant and Maintenance Lapatinib to Chemoradiation in High-Risk Patients With Resected Squamous Cell Carcinoma of the Head and Neck

In a phase III trial reported in the Journal of Clinical Oncology, Harrington et al found that the addition of concurrent adjuvant lapatinib (Tykerb) to chemoradiation therapy and the use of maintenance lapatinib did not improve disease-free or overall survival in high-risk patients with resected...

The Sohn Conference Foundation Unveils The Sohn Precision Medicine Program at Columbia University Medical Center

The Sohn Conference Foundation unveiled The Sohn Precision Medicine Program at Columbia University Medical Center (CUMC) on January 14, 2016. Funded by a $1.5 million grant provided by The Sohn Conference Foundation over approximately a 3-year period, the Program will provide high-risk pediatric...

symptom management

How Cancer and Its Treatments Affect Cognitive Function

Although chemotherapy is often cited as the main culprit for diminishing cognitive function in patients with cancer, ushering the term “chemobrain” into the vernacular, research by Tim A. Ahles, PhD, and his colleagues is showing that multiple factors may contribute to the condition.1 Using breast...

solid tumors
prostate cancer

Increased Survival and Toxicity With Docetaxel, No Apparent Benefit of Zoledronic Acid in Prostate Cancer

As reported in The Lancet by James et al, results of the STAMPEDE trial, which used a multiarm, multistage seamless phase II/III design, showed increased survival and toxicity with docetaxel and little benefit of zoledronic acid when added to first-line long-term hormone therapy in patients with...

breast cancer

Comparing Recurrence Risk With Anastrozole vs Tamoxifen in Postmenopausal Women With Ductal Carcinoma in Situ

Two recently reported phase III trials compared adjuvant anastrozole vs tamoxifen in postmenopausal women with hormone receptor–positive ductal carcinoma in situ. As reported in The Lancet by Margolese et al,1 the National Surgical Adjuvant Breast and Bowel Project (NSABP) B-35 trial, performed in...

breast cancer

Selected Abstracts From 2015 San Antonio Breast Cancer Symposium

The 2015 San Antonio Breast Cancer Symposium (SABCS), hosted by the American Association for Cancer Research, the Cancer Therapy & Research Center at The University of Texas Health Sciences Center at San Antonio, and Baylor College of Medicine, was held in December 2015. As has been true for...

solid tumors

Improved Outcomes in Patients With Germ Cell Testicular Tumors in the Modern Era

Although patients with poor-risk metastatic testicular germ cell tumors continue to have less favorable outcomes, the bar has been raised by contemporary treatment. There is still room for improvement in managing metastatic testicular germ cell tumors, especially in poor-risk patients, but if...

issues in oncology

Cancer Registries and the Evolving Role of Big Data in Cancer Care

In 1956, the American College of Surgeons encouraged the development of hospital-based registries, but for the most part, these efforts were clumsy, inaccessible card files of data. Today, advanced microcomputer technology has increased the ability to not only collect and cull cancer data but also...

issues in oncology

'Doctor, We Prayed for You'

A 70-year-old female patient underwent a cardiac procedure to repair her mitral valve, and at the same time, she also underwent a coronary artery bypass grafting. She had an uneventful course for the first four postoperative days. On the sixth postoperative day, she started complaining of abdominal ...

prostate cancer

Study Finds Association Between Androgen-Deprivation Therapy in Prostate Cancer and Risk of Alzheimer’s Disease

In a retrospective analysis reported in the Journal of Clinical Oncology, Nead et al found that use of androgen-deprivation therapy in the treatment of prostate cancer was associated with an increased risk of subsequent Alzheimer’s disease. Study Details In the study, a text-processing...

survivorship
issues in oncology

Material and Psychological Financial Hardship for U.S. Cancer Patients

In a population-based study reported in the Journal of Clinical Oncology, Yabroff et al found that cancer and its treatment were associated with material financial hardship for 29% and psychological financial hardship for 32% of patients aged 18 to 64 years in the United States. Financial hardship...

gynecologic cancers
issues in oncology

Could a Screening Test That Would Reduce Deaths From Ovarian Cancer Be on the Way?

"A solid triple but not a home run” is how Karen H. Lu, MD, characterized a study in The Lancet reporting a reduction in deaths from ovarian cancer with the use of multimodal ovarian cancer screening.1 Dr. Lu’s remark was one of several, mostly but not universally, favorable and optimistic comments ...

lung cancer

Stage Increase in Lung Cancer More Frequent After Open vs Closed Thoracic Surgery

An increase in the stage of non–small cell lung cancer (NSCLC) due to cancer-positive lymph node discovery was more common following open chest surgery for lung lobe removal of early-stage lung cancer compared to the closed-chest procedure known as video-assisted thoracic surgery (VATS). The...

lymphoma

Ibrutinib in Relapsed Mantle Cell Lymphoma

Treatment of mantle cell lymphoma continues to evolve, both in the front-line and relapsed settings. Key advances include better use of established agents, such as the incorporation of high-dose cytarabine into initial induction regimens and application of rituximab (Rituxan)...

lymphoma

Winning the Battle at the Front Lines: Lenalidomide Plus Rituximab— A Promising Initial Treatment for Mantle Cell Lymphoma

Mantle cell lymphoma is a pernicious, incurable disease. Front-line therapies for this disease are not currently standardized; however, novel therapies for relapsed or refractory mantle cell lymphoma can ideally be translated into beneficial treatments for newly diagnosed patients, as clearly...

hematologic malignancies
lymphoma

Lenalidomide Plus Rituximab Highly Active in  Initial Treatment of Mantle Cell Lymphoma

In a phase II trial reported in The New England Journal of Medicine by Jia Ruan, MD, PhD, and colleagues, first-line treatment with the immunomodulatory agent lenalidomide (Revlimid) and the anti-CD20 antibody rituximab (Rituxan) followed by maintenance lenalidomide and rituximab produced a high...

lung cancer

The Evolving Treatment Landscape of ALK-Positive NSCLC

Since the initial discovery of ALK rearrangement in non–small cell lung cancer (NSCLC) in 2007,1 small molecule tyrosine kinase inhibitors of ALK have transformed the course of disease for those patients with ALK-rearranged (ie, ALK-positive) NSCLC. Crizotinib (Xalkori), a multitargeted tyrosine...

breast cancer

International Innovation Grant Supports Novel Breast Cancer Health Education Program in Mexico

The International Innovation Grant, funded by the Conquer Cancer Foundation (CCF) of ASCO, provides research funding in support of novel and innovative projects that can have a significant impact on cancer control in low- and middle-income countries. The grant is intended to support research that...

lung cancer

Global and North American Phase II Studies Show Alectinib Is Highly Active in Crizotinib-Resistant/Refractory ALK-Rearranged NSCLC

In two phase II trials, reported in the Journal of Clinical Oncology and The Lancet Oncology, the ALK inhibitor alectinib (Alecensa), which is active against acquired crizotinib resistance mutations and exhibits high central nervous system (CNS) penetration, was associated with considerable...

breast cancer

Exploratory Analysis of ExteNET Trial Shows Consistency of Benefit With Neratinib

An exploratory analysis of the ­ExteNET study of neratinib in early HER2-positive breast cancer after treatment with trastuzumab (Herceptin) upheld the findings previously reported for the 2-year analysis, according to the study’s principal investigator Arlene Chan, MD, of the Breast Cancer...

supportive care

Uridine Triacetate Granules for Fluorouracil or Capecitabine Overdose or Early Severe Toxicity

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 11, 2015, uridine triacetate (Vistogard) was approved...

Expert Point of View: Angela DeMichele, MD, and Melinda L. Telli, MD

The formal discussant for the CALGB 40603 and GeparSixto studies at the San Antonio Breast Cancer Symposium was Angela DeMichele, MD, Professor of Medicine and Miller Chair in Breast Cancer Excellence at the Perelman School of Medicine, University of Pennyslvania. “The key questions raised by these ...

breast cancer

Prophylactic Beta-Blocker Preserves Left-Ventricular Function in Patients Receiving Trastuzumab

The beta-blocker bisoprolol was able to prevent trastuzumab (Herceptin)-associated declines in left-ventricular ejection fraction, whereas the effect of the angiotensin-converting–enzyme (ACE) inhibitor perindopril was less robust. Use of bisoprolol reduced dose interruptions for trastuzumab due to ...

breast cancer
issues in oncology

PI3K Inhibitor Buparlisib Extends Progression-Free Survival  in Advanced Breast Cancer

Addition of the oral investigational pan-PI3K inhibitor buparlisib to the endocrine agent fulvestrant (Faslodex) improved progression-free survival among postmenopausal women with advanced hormone receptor–positive/HER2-negative advanced breast cancer. “We are happy to announce that the phase III...

leukemia

Venetoclax May Prove to Be Strong Weapon Against Poor-Prognosis Chronic Lymphocytic Leukemia

Venetoclax, the latest entry into the field of treatment of chronic lymphocytic leukemia (CLL), is a powerful investigational therapy that promises to fill an important niche: treatment of high-risk relapsed/refractory patients with deletions of 17p. Nearly 80% of patients with relapsed/refractory...

lung cancer

Bevacizumab Plus Chemotherapy Fails to Prolong Survival in Early-Stage Lung Cancer

Overall survival in patients with surgically resected early-stage non–small cell lung cancer (NSCLC) did not improve with the addition of bevacizumab (Avastin) to chemotherapy, according to the findings of a study researchers have called a “top abstract” from the 16th World Conference on Lung...

cost of care

The 340B Drug Pricing Program: Background, Concerns, and Solutions

The 340B Drug Pricing Program was created by Congress through the Veterans Health Care Act of 1992 to allow some health-care entities—including safety-net providers with large shares of uninsured and low-income patients and other “covered entities”—to obtain drugs at discounted prices.1,2 Congress...

lung cancer

Study Finds Alectinib Highly Active in ALK-Positive, Crizotinib-Resistant NSCLC

In a North American phase II trial reported in The Lancet Oncology, Shaw et al found that alectinib (Alecensa), which is active against acquired crizotinib (Xalkori) resistance mutations and exhibits high central nervous system (CNS) penetration, was associated with considerable activity in...

palliative care
colorectal cancer

One in Seven Colorectal Cancer Patients Diagnosed Before Recommended Screening Age

Nearly 15% of patients diagnosed with colorectal cancer were younger than 50, the age at which screening recommendations begin. The study by researchers at the University of Michigan Comprehensive Cancer Center also found that younger patients were more likely to have advanced disease. The authors ...

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