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Showing 4101 - 4150SIDEBAR: Private/Public Health-care Divide Creates Disparity in Cancer Pain Treatment in South Africa
Approximately 15% of South Africa’s people have private health-care insurance and use private hospitals and clinics; another 10% also use private care paid out of pocket. However, the remaining 75% of South Africans use public health care, which is spread out over rural and urban areas. Although...
Cancer Care in India: Complex Challenges in a Populous Nation
With 1.22 billion people, India is the second most populous country in the world. Experts project that cancer incidence in India will increase by more than two-thirds over the next 20 years, to approximately 1.7 million new cases per year. Due to a range of economic and social issues, most of...
Immunotherapy Clinical Trials Show Benefits for Patients with Advanced Cancers
Immunotherapeutic approaches, including vaccines, a monoclonal antibody, and a combination of low-dose interleukin (IL)-2 (Proleukin) and retinoic acid, are showing some success in clinical trials investigating the prevention of breast cancer recurrence in women at high risk, the treatment of...
Managing Febrile Neutropenia: What Are the Best Antibiotic Regimens?
Management of patients with cancer who have fever and a low neutrophil count is one of the most common scenarios oncologists face today. “Physicians have to be keenly aware of the infection risks, diagnostic methods, and microbial therapies required for managing febrile neutropenic patients because ...
ASCO Issues New Guideline on Chemotherapy Dosing for Obese Patients
In April, ASCO released a new clinical practice guideline on the appropriate dosing of chemotherapy drugs given to obese adult patients with cancer. The result of an analysis by a panel of experts assembled by ASCO, the guideline calls for the use of a patient's actual body weight when calculating...
What You Need to Know About Glucarpidase Injection for Toxic Methotrexate Levels in Renal Impairment
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. Indication In January 2012, glucarpidase injection (Voraxaze) was...
ASCO Reexamines the Oncology Workforce Shortage
A study commissioned by ASCO in 2006 predicted a significant shortage of medical and gynecologic oncologists in the United States by 2020. As a result, the organization created the Workforce Implementation Group to develop recommendations to stem the projected workforce shortfall and ensure ongoing ...
New Drug Application Submitted for Regorafenib for the Treatment of Metastatic Colorectal Cancer
Bayer HealthCare announced that it has submitted a New Drug Application (NDA) to the FDA seeking approval for the oral multikinase inhibitor regorafenib for the treatment of patients with metastatic colorectal cancer. The submission is based on the results of the pivotal, global phase III CORRECT...
Maintenance Lenalidomide Improves Progression-free Survival and Time to Progression in Patients with Multiple Myeloma
Three phase III, double-blind, multicenter, randomized studies showed that lenalidomide (Revlimid) maintenance therapy for patients with multiple myeloma significantly improved progression-free survival or time to progression, the primary endpoints of the studies published in The New England...
Can Whole-genome Sequencing Predict Cancer Risk and Improve Public Health?
If, as expected, the cost of whole-genome sequencing continues to drop, perhaps down to the $1,000 vicinity, it may become an alluring option for consumers who want to know about their risks for cancer and other diseases. But can genome sequencing really provide practical information about...
Radiotherapy in Early-stage Hodgkin Lymphoma
The treatment of patients with Hodgkin lymphoma is one of the major success stories in medical oncology. Depending on clinical stage, clinical risk factors, and the treatment given, 60% to 90% of all patients can be cured of their malignancy long-term. Hodgkin lymphoma survivors represent one of...
Trailblazing Oncologist Had Instrumental Role in France’s War on Cancer
David Khayat, MD, PhD, Chair of the Department of Medical Oncology at the Pitié-Salpêtrière Hospital in Paris, was inspired to become an oncologist by an episode that could have been ripped from the pages of one of his best-selling novels. At the age of 18, Dr. Khayat was the witness at his best...
To Scan or Not to Scan for Colon Cancer Recurrence?
Over the past 2 decades, we have seen a substantial increase in the 5-year survival of patients with stage II and III colon cancer, marking an evolving oncologic success story. However, in the postoperative setting, the value of regular CT screening to monitor for recurrence has been greeted with...
Everolimus: New Indication in Renal Angiomyolipoma Associated with Tuberous Sclerosis Complex
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. Indication In April 2012, the kinase inhibitor everolimus...
Multicenter Phase II Trial Supporting Approval of Brentuximab Vedotin in Anaplastic Large-cell Lymphoma
Systemic anaplastic large-cell lymphoma (ALCL) is an aggressive T-cell lymphoma subtype characterized by uniform expression of CD30. Apart from low- to intermediate-risk patients with ALK-positive disease, patients with ALCL have a poor prognosis when treated with conventional, anthracycline-based...
Expert Point of View: Kathy Miller, MD
“Our old friends are sometimes worth keeping, and that is certainly true for weekly paclitaxel,” said the invited discussant of CALGB 40502, Kathy Miller, MD, of Indiana University School of Medicine, Indianapolis, at the ASCO Annual Meeting. She noted that Dr. Rugo must “remain strict to the...
Bevacizumab and Olaparib Boost Progression-free Survival in Ovarian Cancer
A trio of randomized, controlled trials of different molecularly targeted therapies showed variable results in ovarian cancer, as reported at the 2012 ASCO Annual Meeting in Chicago. The phase III AURELIA trial demonstrated that the addition of the vascular endothelial growth factor (VEGF)...
Breast Cancer and Noncommunicable Diseases: Where in the World Do We Start?
As the world’s most common cancer among women, and the most likely reason around the globe that a woman will die of cancer, breast cancer affects countries at all economic levels. Despite the common misconception that breast cancer is primarily a problem of high-income countries, the majority of...
New PSA Recommendations: The Debate over Prostate Cancer Screening Continues
The U.S. Preventive Services Task Force (USPSTF) recently issued a recommendation statement advising against the use of prostate-specific antigen (PSA)-based testing for prostate cancer,1 leaving many in the oncology community concerned that decades of clinical progress will be stalled, and setting ...
Expert Point of View: PD-1 Immune Checkpoint Inhibitors Look Promising in Multiple Solid Tumors
Oncologists can expect to hear more about immune checkpoint blockade, according to two discussants of these abstracts. In fact, five PD-1 immune checkpoint compounds are already in the pipeline (Table 1), according to Giuseppe Giaccone, MD, PhD, of the National Cancer Institute, Bethesda, Maryland. ...
Cabozantinib Prolongs Progression-free Survival in Advanced Medullary Thyroid Cancer
Cabozantinib prolonged progression-free survival in patients with unresectable, locally advanced, or metastatic medullary thyroid cancer with documented disease progression in the phase III EXAM trial. Based on these results, Exelixis submitted a New Drug Application to the FDA in May 2012. The...
New Study Examines Racial Disparities in Breast Cancer Mortality
According to the first national study looking at racial disparity in breast cancer mortality rates at the city level in the United States, societal factors—especially poverty and residential segregation—are resulting in the unnecessary deaths of five black women every day—more than 1,700 deaths a...
Blood Test to Improve Prostate Cancer Detection
Beckman Coulter, Inc, recently announced Premarket Approval from the FDA for the Prostate Health Index, a simple, noninvasive blood test that is 2.5 times more specific in detecting prostate cancer than prostate-specific antigen (PSA) in patients with PSA values in the 4 to 10 ng/mL range and has...
After a Decade of Decline in Smoking Rates, Progress Has Stalled
Approximately 20% of all Americans smoke, and 443,000 of them will die each year as a result. Tobacco use is the leading cause of preventable death in the United States and the greatest behavioral determinant of morbidity and mortality (6%–10% of U.S. health-care costs). Nearly 30% of all cancer...
Updated Findings Further Define Role of Tyrosine Kinase Inhibitors in CML
With three available tyrosine kinase inhibitors for the treatment of chronic myeloid leukemia (CML), attention has turned from the ability to achieve a sustained response to the possibility of “curing” patients. Updates of pivotal trials presented at ASCO may help define the role of the tyrosine...
Richard Goldberg, MD, Gives First Moertel Lecture
Richard Goldberg, MD, Physician-in-Chief of The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute, presented the first Charles G. Moertel Lecture of the Alliance for Clinical Trials in Oncology during the plenary session of the group’s recent...
Increased Adjuvant Therapy Use and Improved Survival in Dutch Elderly Patients with Stage III Colon Cancer: A Direct Correlation?
A survival benefit of adjuvant chemotherapy has been reported for select elderly patients with stage III colon cancer, but many elderly patients are not candidates for or are not given adjuvant therapy due to comorbidities and fear of toxicity. In a recent Annals of Oncology article, van...
ASCO Studies Point to Risks Associated with Treating Childhood Cancers
Risks associated with being a young cancer survivor were emphasized by two studies highlighted in press briefings at the 2012 ASCO Annual Meeting. Investigators from the Children’s Oncology Group (COG) reported that adolescents and young adults treated for high-risk B-precursor acute lymphoblastic ...
First-line Afatinib Superior to Standard Chemotherapy in Advanced EGFR-mutated Non–Small Cell Lung Cancer
First-line therapy with the investigational oral agent afatinib improved progression-free survival compared with standard chemotherapy (pemetrexed (Alimta)/cisplatin) in patients with advanced non–small cell lung cancer (NSCLC) harboring an EGFR mutation. Afatinib improved progression-free survival ...
Children with Favorable-risk Disease and Complete Response to Chemotherapy Have High Survival Rates without Radiotherapy
Among children with favorable-risk Hodgkin lymphoma, those who achieved a complete response after two cycles of chemotherapy and received no radiotherapy had high rates of survival similar to those who had a less complete response to chemotherapy and received radiotherapy, according to a study in...
Expert Point of View: Eun-Sil Shelley Hwang, MD, MPH
Eun-Sil Shelley Hwang, MD, MPH, of Duke University Medical Center, Durham, North Carolina, who discussed both papers on ductal carcinoma in situ at the ASCO Annual Meeting, noted that better risk stratification and treatments are substantially changing the outlook for DCIS. “We are getting close to ...
No Improvement in Overall Survival, Worse Toxicity with Motesanib Added to Chemotherapy in Non–Small Cell Lung Cancer
Two trials (E4599 and AVAiL) have suggested a benefit to adding the anti–vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (Avastin) to chemotherapy in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Bevacizumab acts by binding directly to circulating...
Everolimus Approved for Advanced Breast Cancer
The FDA has approved everolimus tablets (Afinitor) for use in combination with exemestane to treat postmenopausal women with advanced hormone receptor–positive, HER2-negative breast cancer after failure of treatment with letrozole or anastrozole. The approval was based on a randomized,...
As Conflicting Guidelines Evolve, Experts Continue to Debate the Merits of Cancer Screening
In the 1930s and 1940s, when the American Cancer Society [ACS] first brought forth the message that early cancer detection saves lives, it was a broad brushstroke and an appropriate message. The problem now is that new technology enables us to find [tumors that would never progress to invasive...
Differentiated Thyroid Cancer: Who, When, and How to Treat?
Differentiated thyroid cancer—papillary, follicular, and Hürthle cell carcinomas—has historically been managed by endocrinologists, surgeons, and radiation oncologists, but recent progress in the field has led to greater involvement by medical oncologists, especially in the care of patients with...
Supportive Care Research Runs the Gamut from Genetic Markers of Treatment Side Effects to Neuropathic Pain Therapies
Attendees from around the world gathered for the Multinational Association for Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) International Symposium on Supportive Care in Cancer, held June 28–30 in New York. Below are highlights from the meeting, representing...
Study Shows Routine CT Surveillance Overused in Pediatric Hodgkin Lymphoma
The value of routine CT surveillance monitoring of pediatric patients for recurrence of Hodgkin lymphoma has been unclear. A study of CT surveillance recently reported by Stephan D. Voss, MD, PhD, and colleagues from the Children’s Oncology Group (COG) in the Journal of Clinical Oncology showed...
It’s Time to Get Ready for New Medicare Reporting Requirements
As if you didn’t already have enough to worry about, now add this: If your practice doesn’t meet the requirements of the Physicians Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive, you don’t just miss out on the bonuses the programs offered as incentive in recent years....
No Advantage to Longer Adjuvant Chemotherapy in Women with Early Breast Cancer: CALGB 40101 Trial
The ideal duration of adjuvant therapy for women with lower-risk primary breast cancer remains unknown. The National Surgical Adjuvant Breast and Bowel Project (NSABP) B-15 trial, reported more than 20 years ago, found no difference in outcomes between six cycles of cyclophosphamide, methotrexate,...
CT Scans in Childhood Can Triple Risk of Leukemia and Brain Cancer Later in Life, Study Finds
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. Computed tomography scans with...
Kidney Cancer Association Works with Conquer Cancer Foundation to Stimulate Breakthrough Research
For any nonprofit cancer organization, a key challenge is how to balance the enormous task of supporting cancer patients with the latest information about current treatments while helping to advance the search for new breakthroughs in therapeutic options. For the past 6 years, the Kidney Cancer...
Is There a Role for Metronomic Chemotherapy in Patients with Highly Refractory Multiple Myeloma?
Metronomic chemotherapy using a multidrug regimen appears beneficial and fairly well tolerated in patients with multiple myeloma that is highly refractory to previous treatments, investigators from the Myeloma Institute for Research and Therapy in Little Rock, Arkansas, reported.1 Their results...
Biomedical Research Faces Imminent $2.4 Billion Budget Cut Unless Congress Acts
The National Institutes of Health (NIH) faces a significant budget reduction in January 2013 due to automatic across-the-board cuts, known as sequestration, required under the federal Budget Control Act of 2011. The estimated $2.4 billion NIH cut could result in 700 to 2,300 fewer research grants...
Expert Point of View: Fritz H. Schröder, MD
I am happy to accept the invitation by The ASCO Post to comment on the recent, long-awaited publication of the PIVOT study (Wilt et al: N Engl J Med 367:203-213, 2012) and the accompanying editorial by Thompson and Tangen (N Engl J Med 367:270-271, 2012). The editorial both points out weaknesses of ...
Expert Point of View: Timothy Wilt, MD, MPH
PIVOT is the largest and longest randomized trial conducted in men with early-stage prostate cancer detected during the era of widespread PSA testing. The trial enrolled 731 men and followed them for up to 15 years after randomization. PIVOT results demonstrate that compared to observation, radical ...
No Survival Benefit of Radical Prostatectomy vs Observation for Localized Prostate Cancer Detected by PSA Testing
The relative benefits of surgery or observation in men with prostate cancer detected by prostate-specific antigen (PSA) testing have not been defined. Randomized trials comparing radical prostatectomy with observation were conducted before widespread use of PSA testing and an observational study...
Importance of Dermatologic Care for Patients with Cancer
I first became interested in treating skin issues associated with cancer about 10 years ago, during my dermatology residency training at the University of Chicago. Many of the agents under clinical development at the time, such as cetuximab (Erbitux) or sorafenib (Nexavar), were causing...
Contagious Cancer and an Unexplained Phenomenon Might Inspire Future Therapies
A deadly contagious cancer known as devil facial tumor disease is pushing the world’s largest carnivorous marsupial, the Tasmanian devil (Sarcophilius harrisii), to the brink of extinction. The loss of an interesting creature aside, the plight of the Tasmanian devil raises provocative questions...
Management of a Patient with Systemic Anaplastic Large Cell Lymphoma following Failure of One or More Combination Regimens
Case Summary presented by Steven M. Horwitz, MD, Assistant Attending, Lymphoma Service, Memorial Sloan-Kettering Cancer Center, New York. This is a case of a 49-year-old woman who developed an enlarged right axillary lymph node. The woman had noticed some discomfort under her right arm, which she...
SIDEBAR: Melanoma Treatment Options Exploding, but Old Standbys Should Remain
New drugs are rapidly changing the treatment paradigm for stage IV melanoma, but there is still validity to some of the old standbys, according to Michael Sabel, MD, of the University of Michigan, Ann Arbor, who described the shifting landscape of melanoma treatment at the Best of ASCO Boston...
