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Reflections from the Old World

A few years ago, I was a key witness for a patent dispute at a trial in Delaware. Acting for the complainant, I was briefed that the opening gambit of the opposition lawyer would be to discredit my CV and, therefore, the value of my testimony. “So you are a full Professor at the University of...

health-care policy

The Affordable Care Act Stands: Now What?

On March 23, 2010, President Obama signed the Patient Protection and Affordable Care Act into law—a hotly contested bill that enacted sweeping changes to the U.S. health-care system. The debate over the Affordable Care Act continued all the way to the Supreme Court, spearheaded by the case Florida...

Genomics vs Site of Cancer Origin as Basis for Treatment of Cancer Is ‘False Dichotomy’

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. Despite recent news reports...

issues in oncology

Symposium Focuses on Policy Issues in Personalized Cancer Care

“What is the biggest barrier to progress in personalized medicine?” asked moderator Anna Barker, PhD, leading a panel discussion at a recent meeting convened by the Washington-based advocacy group, the Personalized Medicine Coalition, with the American Association for Cancer Research and Feinstein...

lung cancer

Study Reports ‘Strong and Consistent Relation’ between Exposure to Diesel Exhaust and Risk of Dying of Lung Cancer

A nested case-control study of 198 lung cancer deaths among a cohort of 12,315 mine workers “showed a strong and consistent relation between quantitative exposure to diesel exhaust and increased risk of dying of lung cancer,” researchers reported in the Journal of the National Cancer Institute.1...

issues in oncology

Information Service Provides Innovative Resource for Patients and Providers

Jennifer Levin Carter, MD, MPH is Founder and President of N-of-One. A board-certified internist and entrepreneur, she has more than 20 years of experience evaluating existing and emerging markets, new medical technologies, and early-stage companies in the health-care field. Formerly, Dr. Carter...

issues in oncology

Taking Family History and Referral to Genetic Counseling Could Be Improved, Survey Finds

Obtaining a thorough family history of cancer should be a key component in evaluating patients and deciding whether to refer those at increased risk of either primary or second cancers for genetic counseling and testing. Many community oncology practices comply with this practice, but there is room ...

supportive care

Antidepressant Drug Has ‘Clinically Meaningful’ Effect on Chemotherapy-induced Painful Neuropathy

The oral antidepressant duloxetine (Cymbalta) at 60 mg/d improved chemotherapy-induced painful neuropathy in a randomized, double-blind, placebo-controlled, phase III trial.1 Overall, 59% of patients treated with duloxetine experienced some pain relief, 33% reported at least a 30% decrease in pain, ...

solid tumors
kidney cancer

Patient Preference Studied in Treatment Selection for Renal Cell Carcinoma

More attention is being paid to the importance of patient preference as a factor in treatment selection. An innovative randomized, double-blind study in patients with metastatic kidney cancer demonstrates that quality of life and side effects drive patient preference.1 Results also suggest that...

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 ...

Trailblazer in Argentinean Oncology Remains Optimistic about War on Cancer

Eduardo Cazap, MD, PhD, is founder and first President of the Latin American and Caribbean Society of Medical Oncology (SLACOM). In 2008, he was elected to a 2-year term as President of the International Union against Cancer (UICC). The ASCO Post recently spoke with Dr. Cazap about his roots in...

Clinicians to Benefit from New JCO Initiatives

Journal of Clinical Oncology (JCO) has recently launched several new features for readers under the direction of Stephen A. Cannistra, MD, who began his tenure as Editor-in-Chief in June 2011. These initiatives include the creation of two new article types: Rapid Communications (RC) and...

issues in oncology
health-care policy

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...

thyroid cancer

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...

breast cancer

‘Young and Strong’ Program Addresses Multiple Needs of Women in 40s and Younger Diagnosed with Breast Cancer

“Young and Strong” is an exportable model of a program developed at Dana-Farber Cancer Institute and Brigham and Women’s Hospital in Boston to address the significant challenges facing young women with breast cancer. The new model has been designed to “serve young women with breast cancer who are...

supportive care
palliative care

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...

Expert Point of View: Bruno C. Medeiros, MD

Bruno C. Medeiros, MD, of Stanford University School of Medicine, Palo Alto, commented, “It’s clear to say that new treatment strategies are needed for adults with [acute lymphocytic leukemia (ALL)] to improve outcomes of relapsed disease and to prevent relapses to begin with.” He noted that while ...

Expert Point of View: Constantine S. Tam, MBBS, MD

The findings in chronic lymphocytic leukemia (CLL) were discussed by Constantine S. Tam, MBBS, MD, of St. Vincent’s Hospital in Melbourne, Australia, who observed, “There is a long list of novel agents in CLL. I think some of the most promising are those targeting the B-cell receptor pathway. This...

prostate cancer
issues in oncology

Rethinking the Role of PSA Screening in Public Health

Population screening to identify preclinical disease is considered a central factor in the decades-long decrease in mortality seen in certain cancers. However, hope in the face of deadly disease can sometimes blind us to the scientific evidence. According to the recent U.S. Preventive Services Task ...

Expert Point of View: James O. Armitage, MD

In an accompanying editorial entitled “Who Benefits From Surveillance Imaging?” James O. Armitage, MD, University of Nebraska Medical Center, Omaha, noted that data on surveillance imaging (CT or PET/CT) indicate a general absence of survival benefit in adults with lymphomas, while pointing out...

Conquer Cancer Foundation $10K Challenge: Multiply Your Donation’s Impact in September

The Foundation proudly announces its first-ever Conquer Cancer Foundation $10K Challenge. In September, a portion of online gifts to the Conquer Cancer Foundation of the American Society of Clinical Oncology will be matched by the generous support of Ariad Pharmaceuticals®. The Conquer Cancer...

The 2013 Gastrointestinal Cancers Symposium Will Observe the Meeting’s 10-Year Anniversary

A decade after its start in 2003 with a few hundred attendees, the Gastrointestinal Cancers Symposium now boasts more than 3,000 participants from all over the world. The next implementation marks the meeting’s 10th anniversary. The 3-day meeting—to be held January 24–26 in San Francisco—is...

global cancer care

Despite Challenges, Initiatives Bring Gradual Improvements to Cancer Care in Lebanon

Nagi S. El Saghir, MD, FACP, Professor of Clinical Medicine and Hematology-Oncology at the American University of Beirut, is the founding President of the Lebanese Society of Medical Oncology (LSMO). Dr. El Saghir has focused much of his research on the early detection, prevention, and treatment of ...

The Science of Resilience: Exploring the Process of Grieving from a New Perspective

How human beings cope with bereavement, loss, extreme adversity, and life-threatening illness has dominated the research interests of George A. Bonanno, PhD, Professor of Clinical Psychology, Teachers College at Columbia University, New York, for more than 20 years. In his book, The Other Side of...

prostate cancer

Letter to the Editor: Dr. Ablin’s Reply

Given my explanation and widely publicized opinion on the improper use of the prostate-specific antigen (PSA) test for screening asymptomatic men for prostate cancer—most recently expressed in a feature article in The ASCO Post (August 15, 2012)—I was pleased to read that Drs. James Mohler and...

High-cost Imaging Used Frequently in Elderly with Stage IV Cancer

Patients with stage IV breast, colorectal, lung, and prostate cancers undergo frequent high-cost imaging procedures throughout the continuum of their care, and rates of imaging have steadily increased, according to an analysis of claims from the Surveillance, Epidemiology, and End Results...

prostate cancer

FDA Grants Priority Review to Supplemental New Drug Application for Abiraterone Acetate in Metastatic Castration-resistant Prostate Cancer

Janssen Research & Development, LLC, announced that the FDA has granted Priority Review to the supplemental New Drug Application (sNDA) for abiraterone acetate (Zytiga) administered in combination with prednisone for the treatment of patients with metastatic castration-resistant prostate cancer ...

Inaugural Quality Care Symposium Will Detail How to Pioneer Successful Quality Initiatives in Your Practice

Over the past 10 years, Wilshire Oncology Medical Group of La Verne, California, has reengineered itself so that all processes—from front-desk operations at all eight locations to the 10 oncologists’ interactions with patients and payers—capture quality data that can be used for robust benchmarking ...

A Great IDEA: Supporting the Next Generation of Oncology Leaders in Low- and Middle-income Countries

Leadership has been cited as a critical success factor in improving access to cancer care in low- and middle-income countries.1 Effective clinical leaders in these countries can be transformative by supporting the development of cancer treatments to meet the needs of their patients, by advocating...

Genitourinary Cancers Symposium Still Intimate Despite Record Growth

Despite its exponential growth since launching in 2007—from 1,450 attendees then to a record 2,530 last year—the Genitourinary (GU) Cancers Symposium remains an inviting meeting that feels small, accessible, and comfortable. And that’s the perfect blend for networking, said Jeff Michalski, MD,...

breast cancer
supportive care

Sexual Dysfunction in Female Cancer Survivors Is Prevalent

Although medical experts put the proportion of female survivors facing some form of sexual dysfunction following a cancer diagnosis and treatment at nearly 100%, very few women raise sexual health concerns with their oncologist. In a study of 261 patients with gynecologic or breast cancer published ...

Anticancer Effect of Diabetes Drug Metformin

Retrospective analyses have indicated that the antidiabetic agent metformin may be associated with a quite substantial reduction in risk of cancers. There is evidence that the anticancer effects of metformin are related to inhibition of the growth of certain cancers via activation of AMP kinase...

Faculty Q&A Discussion: Anaplastic Large-cell Lymphoma

 Dr. Armitage: For ALK-negative anaplastic large cell lymphoma, brentuximab vedotin is the best thing we have to deal with patients with recurrent disease, and who knows where it will end up in primary therapy. But if the patient is ALK-positive, there is a potential for crizotinib (Xalkori) to...

Faculty Q&A Discussion: Brentuximab Vedotin

 Dr. Armitage: It is no surprise that brentuximab vedotin is really an exciting agent, and it gives us a new opportunity in treating classical Hodgkin lymphoma. What if this person Dr. Engert just presented was at the same point with nodular lymphocyte-predominant lymphoma and no CD30 positivity....

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...

lymphoma

Which Rituximab-based Regimen Works Best in Non-Hodgkin Lymphoma?

The treatment of non-Hodgkin lymphoma (NHL) patients has been recently informed by several important studies, which were discussed at the Best of ASCO Boston meeting by Michael E. Williams, MD, of the University of Virginia Cancer Center in Charlottesville. Bendamustine Outperforms R-CHOP in NHL...

SIDEBAR: A Tough Call: The T1a HER2-positive Tumor

The optimal adjuvant management of T1a HER2-positive breast cancers is uncertain and requires an individualized approach, according to Hope S. Rugo, MD, Professor of Medicine and Director, Breast Oncology and Clinical Trials Education at the UCSF Helen Diller Family Comprehensive Cancer Center....

SIDEBAR: Browsing the Anti-HER2 Options

“Where do current findings leave us in terms of anti-HER2 therapy options?” asked Harold J. Burstein, MD, PhD, of Dana-Farber Cancer Center, Boston, who moderated the Best of ASCO Boston meeting. New drugs are joining trastuzumab (Herceptin) and lapatinib (Tykerb), and there will be some juggling...

SIDEBAR: Molecular Testing Requires Planning at Time of Biopsy

The molecular analysis of lung cancer patients is becoming more and more complex,” and clinicians therefore need to consider any additional tissue requirements upfront, Dr. Horn commented. At Vanderbilt University, testing for EGFR, KRAS, and eight other mutations is done using the Lung SnaPshot...

New Therapies Capitalize on Lung Cancer’s Molecular Vulnerabilities

Research reported at this year’s ASCO Annual Meeting attests to the tremendous molecular diversity of non–small cell lung cancer (NSCLC) and the power of appropriately selected treatment, according to Leora Horn, MD, of Vanderbilt University Medical Center, who presented data on molecular findings...

issues in oncology

LETTER TO THE EDITOR: Individualism in Clinical Decision-making

I found a statement by Dr. Peter Bach in the August 15, 2012, issue of The ASCO Post (in the article, “As Conflicting Guidelines Evolve, Experts Continue to Debate the Merits of Cancer Screening”) very troubling. To wit: There’s a cognitive dissonance between the practice of evidence-based medicine ...

Einstein-Montefiore Scientists Awarded NCI Grants to Study ‘Provocative Questions’ in Cancer Research

Two research teams at Albert Einstein College of Medicine of Yeshiva University and Montefiore Medical Center, the University Hospital for Einstein, have each been awarded grants from the National Cancer Institute (NCI) as part of their “Provocative Questions” program. The innovative effort is...

issues in oncology

Cancer Memoir Provides Inspiration for Those with Terminal Illness and Their Caregivers

“It almost always begins in darkness, my memory’s trip back to China where Terrence and I meet.” So begins Amanda Bennett’s moving new memoir, The Cost of Hope, the story of an intensely devoted marriage, cruelly shortened by the cancer that killed her husband. The word “darkness” in Ms. Bennett’s...

American Psychosocial Oncology Society Provides Helpline for Counseling Services

The American Psychosocial Oncology Society (APOS) offers a toll-free national Helpline as a resource to help people with cancer and their caregivers find counseling services in their own communities. Patients with cancer, caregivers, and advocacy organizations may obtain referrals for local...

issues in oncology

The Language of Cancer

For more than a year, Don S. Dizon, MD, FACP, has been blogging at ASCO Connection (connection.asco.org) about such diverse topics as cancer survivorship, the redesign of clinical studies based on patients’ molecular characteristics, and the power of laughter. Last May, Dr. Dizon tackled the impact ...

FDA Approves New Treatment for Severe Neutropenia

The FDA recently approved Sicor Biotech’s tbo-filgrastim (Neutroval) to reduce the time certain patients receiving chemotherapy experience severe neutropenia. The new drug is a short-acting recombinant granulocyte colony-stimulating factor (G-CSF) agent. It is marketed as Tevagrastim in Europe,...

Conquer Cancer Foundation Honors Oncology Professionals for High-quality Research in Breast Cancer

More than 15 leading young oncology professionals were honored this year by the Conquer Cancer Foundation of the American Society of Clinical Oncology (ASCO) with 2012 Breast Cancer Symposium Merit Awards for their work in breast cancer research. These trainees submitted high-quality abstracts...

Pediatric Pathologist Sidney Farber, MD: The ‘Father of Modern Chemotherapy’ and Cofounder of the Jimmy Fund

In June 3, 1948, The New England Journal of Medicine published a study by Sidney Farber, MD, showing that a synthetic compound, 4-aminopteroylglutamic acid (aminopterin), could induce remissions in seriously ill children with acute leukemia.1 Although the study was small—just 16 children—10 showed...

cns cancers

Cognitive Impairment in Patients with Cancer

Cancer therapy, including radiation and chemotherapy, can be harmful to multiple organ systems. The central nervous system (CNS) has generally been considered less vulnerable to the toxic effects of cancer therapy. However, the use of more aggressive treatment modalities combined with prolonged...

SIDEBAR: From Small Centers to Academic Centers

The use of cytoreduction plus hyperthermic intraperitoneal chemotherapy (HIPEC) to treat carcinomatosis “came from the smaller centers,” noted Nita Ahuja, MD, Director of the Peritoneal Surface Malignancies Program at Johns Hopkins Medicine. “A lot of things in medicine come from academia and move...

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