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issues in oncology
health-care policy

The Surgeon General’s Report on Tobacco Turns 50: Much Success, Much Work Ahead

On January 11, 2014, the nation commemorated the 50th anniversary of a document that transformed our public health landscape and has saved millions of lives: Smoking and Health: Report of the Advisory Committee to the Surgeon General of the Public Health Service. This groundbreaking report, which...

Expert Point of View: Rebecca Miksad, MD, MPH

Rebecca Miksad, MD, MPH, Assistant Professor of Medicine at Harvard Medical School and Attending Physician, Gastrointestinal Medical Oncology, Beth Israel Deaconess Medical Center, Boston, discussed the findings at the symposium and the potential for immunotherapy in pancreatic cancer....

pain management

Short-Term Follow-Up Reveals Suboptimal Pain Relief and Marked Pain Worsening in Ambulatory Patients With Cancer

In an analysis reported in the Journal of Clinical Oncology, Fengmin Zhao, MS, PhD, Dana-Farber Cancer Institute, Boston, and colleagues assessed factors associated with pain severity changes in ambulatory patients with invasive solid tumors (breast, prostate, colon/rectum, or lung) in the Eastern...

breast cancer

The Canadian National Breast Screening Trial Had So Many Flaws That Its Results Should Not Be Used to Guide Screening Recommendations

If a randomized, controlled trial of therapy for breast cancer was submitted for publication in which 1. The drug being tested was old and ineffective, and 2. prior to randomization, the women underwent a clinical breast examination and the study coordinators knew who had the largest cancers, and...

breast cancer

No Mortality Benefit of Breast Cancer Mammography Screening in 25-Year Follow-up of Canadian National Breast Screening Study

As reported in BMJ by Anthony B. Miller, MD, Professor Emeritus at the Dalla Lana School of Public Health, University of Toronto, and colleagues, the 25-year follow-up of the Canadian National Breast Screening Study has shown no mortality benefit of annual mammography screening for breast cancer...

Cancer Progress in Jeopardy: Stories From the Front Lines

ASCO is exploring what is happening on the front lines in the laboratory and the clinic due to the shrinking federal funding for cancer research and clinical trials with a series of stories about oncologists. The series is posted on ASCO.org (www.asco.org/nihfunding). In the first article, Robert...

issues in oncology

ASCO Supports Reinforcing FDA Capacity to Monitor Nation’s Drug Supply

“The GAO report identifies production lapses due to quality problems and constrained manufacturing capacity as being the central causes of the widespread incidence and persistence of drug shortages.   “The report also emphasizes that the FDA has made significant progress in preventing shortages by ...

issues in oncology

U.S. Government Accountability Office Issues Report on Drug Shortages

The U.S. Government Accountability Office (GAO) recently issued a report evaluating drug shortages and the associated public health threats, including prolonged duration of a disease, permanent injury, and death.1 This report follows a recommendation by GAO in 2011 that the U.S. Food and Drug...

colorectal cancer

Irinotecan Drug-Eluting Beads Improve Outcomes in Colorectal Cancer Patients With Liver Metastases

Irinotecan drug-eluting beads (DEBIRI) given simultaneously with FOLFOX (leucovorin, fluorouracil, oxaliplatin) and bevacizumab (Avastin) in patients with unresectable colorectal liver metastasis improved response rates, increased resectability, and prolonged hepatic progression–free survival in a...

prostate cancer

PREVAIL Trial Shows Enzalutamide to Be a Promising Option for Metastatic Castration-Resistant Prostate Cancer

Encouraging results of the large phase III PREVAIL trial represent another positive milestone for men with metastatic castration-resistant prostate cancer. Enzalutamide (Xtandi) improved overall survival by 29% and reduced the risk of radiographic progression of disease by 81% in men who had not...

thyroid cancer

‘Epidemic of Diagnosis’ of Thyroid Cancer Is Most Acute for Women

The epidemiology of the increased incidence of thyroid cancer, which has nearly tripled since 1975, “suggests that it is not an epidemic of disease but rather an epidemic of diagnosis,” Louise Davies, MD, MS, and H. Gilbert Welch, MD, MPH, concluded after analyzing trends in patients diagnosed with ...

colorectal cancer
issues in oncology

National Colorectal Cancer Awareness Month

March is Colorectal Cancer Awareness Month, and the U.S. Department of Health and Human Services is committed to boosting public awareness about the importance of screening and treatment for colorectal cancer. Colorectal cancer poses the greatest risk to adults over age 50, and the U.S. Preventive...

integrative oncology

The Ketogenic Diet in Cancer Control

Ketogenic (or very-low-carbohydrate) diets have been employed since the 1920s as nonpharmacologic therapies for epilepsy and, in some instances, have obviated the need for medication for that disease. Since the 1960s, the ketogenic diet has become better known as a means of managing obesity. This...

issues in oncology

Telephone Education and Counseling Effective in Programs Targeting Familial/Genetic Cancer Risk Screening

Two studies recently reported in the Journal of Clinical Oncology indicate that telephone-based education or counseling initiatives can be successful in educating individuals at familial or genetic risk of cancer and in inducing these at-risk individuals to undergo recommended screening. In the...

solid tumors
issues in oncology

How Decoding the Genomes of Exceptional Responders Is Leading to More Effective Treatment for All Patients With Cancer

In 2012, David B. Solit, MD, Geoffrey Beene Chair and Director of the Center for Molecular Oncology at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, and his colleagues published the results of a phase II study1 of 45 patients with advanced bladder cancer. The purpose of the clinical...

breast cancer
health-care policy

Affordable Care Act to Cover Chemoprevention for Women at High Risk for Breast Cancer

On January 9, 2014, Kathleen Sebelius, Secretary of the Department of Health and Human Services, announced that under the Patient Protection and Affordable Care Act, women at increased risk of breast cancer will be entitled to preventive medications without incurring out-of-pocket costs (with the...

leukemia

Ibrutinib for Previously Treated Chronic Lymphocytic Leukemia

On February 12, 2014, ibrutinib (Imbruvica) was granted accelerated approval for the treatment of patients with chronic lymphocytic leukemia (CLL) who have received at least one prior therapy.1,2 Ibrutinib previously received accelerated approval for the treatment of patients with mantle cell...

breast cancer

Impact of Delayed Initiation of Adjuvant Chemotherapy for Breast Cancer Varies by Tumor Subtype

The optimal time interval between surgery and initiation of adjuvant chemotherapy for early-stage breast cancer is not well established. Although most physicians aim to initiate adjuvant chemotherapy within a few weeks of surgery, clinical factors may cause delay. The influence of delay on relapse...

prostate cancer
skin cancer

History of Prostate Cancer Increases Risk of Melanoma in White Men

History of severe acne, which is a surrogate for high androgen activity, has been associated with increased risk of prostate cancer, and recent data suggest that severe teenage acne is a risk factor for melanoma. Such findings suggest a role of androgens in etiology for both prostate cancer and...

leukemia

Gemtuzumab Ozogamicin Reduces Relapse, Improves Event-Free Survival in Pediatric AML

The monoclonal antibody gemtuzumab ozogamicin (Mylotarg) improved event-free survival and reduced the risk of relapse in children with acute myeloid leukemia (AML) in a study from the Children’s Oncology Group, presented at the 55th American Society of Hematology (ASH) Annual Meeting and Exposition ...

lymphoma

Idelalisib Achieves High Response Rates in ‘Double-Refractory’ Indolent NHL

In patients with indolent B-cell non-Hodgkin lymphoma (NHL) refractory to both rituximab (Rituxan) and an alkylating agent, monotherapy with the selective oral PI3K-delta inhibitor idelalisib produced a high response rate, with responses persisting for 1 year in the average patient, according to...

lymphoma

Promising Results Demonstrated for Brentuximab Vedotin in Cutaneous T-Cell Lymphoma

Phase II results suggest that brentuximab vedotin (Adcetris) has encouraging activity in CD30-positive cutaneous T-cell lymphomas and lymphoproliferative disorders, including mycosis fungoides, the most common type of cutaneous T-cell lymphoma. High levels of responses were achieved in a 48-patient ...

leukemia

Novel Therapies May Help Wipe Out Residual Acute Lymphoblastic Leukemia

Minimal residual disease after induction and consolidation for the treatment of acute leukemia might be eradicated by novel therapies, thus obviating the need for stem cell transplantation. That is the prediction of Matthew J. Wieduwilt, MD, PhD, Assistant Clinical Professor of Medicine at the...

colorectal cancer

Outcomes in Metastatic Colorectal Cancer: Studies Examine Relative Merits, Cost-Effectiveness

Targeted biologic agents have improved long-term outcomes in metastatic colorectal cancer, but debate continues as to their relative efficacy and proper sequencing. At the 2014 Gastrointestinal Cancers Symposium, a number of studies attempted to answer these questions by interrogating the clinical...

prostate cancer

State-of-the-Art Update on Prostate Cancer

The 2014 Genitourinary Cancers Symposium, held in San Francisco from January 29 to February 1, brought together more than 3,100 participants from around the world involved in the care of patients with genitourinary malignancies. The abstract presentations and plenary discussions offered the latest...

leukemia

Long-Term Benefit With Dasatinib After Imatinib Failure in Chronic-Phase Chronic Myeloid Leukemia

Patients with chronic myeloid leukemia (CML) in the chronic phase who are resistant or intolerant to imatinib (Gleevec) can experience long-term benefit with dasatinib (Sprycel), according to long-term results of a randomized phase III study. The CA180-034 study also found that early molecular and...

integrative oncology

Reishi Mushroom

Scientific name: Ganoderma lucidum Common names: Ling zhi, lin zi, mushroom of immortality Overview A fungus, reishi mushroom is an important component of the traditional medical systems of China, Japan, Korea, and other Asian countries. It is used to increase energy, stimulate the immune system,...

multiple myeloma

Lenalidomide Acts in Myeloma by Degrading Lymphoid Transcription Factors IKZF1 and IKZF3

The mechanism of action of lenalidomide (Revlimid) in multiple myeloma and other B-cell neoplasms remains largely uncharacterized. In a study reported in Science, Krönke and colleagues identified one of the effects of lenalidomide in this setting. Use of quantitative proteomics showed that...

supportive care

Two Behavioral Interventions Help Cancer Patients Struggling With Sleep Issues, Penn Medicine Study Finds

Patients with cancer who are struggling with sleep troubles, due in part to pain or side effects of treatment, can count on two behavioral interventions for relief—cognitive behavioral therapy for insomnia and mindfulness-based stress reduction—Penn Medicine researchers reported in a recent study...

health-care policy

ASCO Calls for Clear Guidance on Tobacco Cessation Benefits in the Affordable Care Act

ASCO has signed a joint letter to U.S. Department of Health and Human Services Secretary Kathleen Sebelius asking for clear and comprehensive guidance on the tobacco cessation benefit in the Affordable Care Act regulations. In the letter, the organizations applaud the Department of Health and Human ...

Recent Study Finds Tripling in Thyroid Cancer

According to a recent report by Davies and Welch,1 the incidence of thyroid cancer in the United States has nearly tripled since 1975, from 4.9 to 14.3 per 100,000 persons, with most of the increase due to papillary thyroid cancer, which has increased from 3.4 to 12.5 per 100,000 persons. The...

thyroid cancer

Thyroid Cancer On the Rise: Is It Clinically Meaningful?

According to data from the Surveillance, Epidemiology, and End Results (SEER) program, rates for new cases of thyroid cancer in the United States have been rising on average 6.4% each year over the past 10 years, and death rates have been rising on average 0.9% each year over the same period. The...

prostate cancer

Long-Term Complications of Prostate Cancer Treatment May Have Been Underappreciated

The recent study by Nam et al in The Lancet Oncology—reviewed in this issue of The ASCO Post—provides a fresh perspective on complications other than incontinence or erectile dysfunction that commonly arise after primary treatment of localized prostate cancer.1 The authors conducted a...

prostate cancer

Prostatectomy vs Radiotherapy: A Study for Cautious Interpretation

Men with newly diagnosed localized prostate cancer face a decision between prostatectomy and radiotherapy, treatments deemed similarly effective but with well-established trade-offs in terms of treatment-related morbidity. Numerous clinical trials and other prospective studies, from both academic...

colorectal cancer

Will Colorectal Cancer Surveillance Change Based on the Results of the FACS Trial?

Colorectal cancer is a common malignancy that will impact 1.4 million individuals globally each year.1 Approximately 70% to 75% of patients will present with locally advanced disease. For patients with stage III colon cancer, adjuvant chemotherapy is commonly offered, whereas chemotherapy for those ...

colorectal cancer

FACS Trial: Intensive Follow-up Increases Surgical Treatment of Recurrence With Curative Intent in Colorectal Cancer

In the FACS trial, reported in JAMA, John N. Primrose, MD, FRCS, of University of Southampton, England, and colleagues compared outcomes with intensive follow-up with carcinoembryonic antigen (CEA) measurement, computed tomography (CT), both, or minimum follow-up after curative surgery for primary...

breast cancer

The Canadian National Breast Screening Trial Had So Many Flaws That Its Results Should Not Be Used to Guide Screening Recommendations

If a randomized, controlled trial of therapy for breast cancer was submitted for publication in which 1. The drug being tested was old and ineffective, and 2. prior to randomization, the women underwent a clinical breast examination and the study coordinators knew who had the largest cancers, and...

breast cancer

No Mortality Benefit of Mammography Screening in 25-Year Follow-up of Canadian National Breast Screening Study

As reported in BMJ by Anthony B. Miller, MD, Professor Emeritus at the Dalla Lana School of Public Health, University of Toronto, and colleagues, the 25-year follow-up of the Canadian National Breast Screening Study has shown no mortality benefit of annual mammography screening for breast cancer...

kidney cancer

A Conversation With Arie Belldegrun, MD, FACS, and Allan Pantuck, MD, MS, FACS

Cancer Immunotherapy What is the role of immunotherapy in the treatment of metastatic renal cell carcinoma? The harnessing of the immune system as an effective treatment for cancer was recently selected by the journal Science as the top scientific Breakthrough of the Year for 2013.1 With this...

health-care policy

The Outlook on Cancer Research in This Era of Leaner Federal Funding

In the March 1, 2014, issue of The ASCO Post we talked with Francis S. Collins, MD, PhD, Director of the National Institutes of Health (NIH), about the future of biomedical research at the NIH during this time of constrained federal funding. We continue that conversation here with our interview of...

breast cancer

SSO-ASTRO Margin Guideline: Why Now and What Does It Mean?

Although breast-conserving therapy has been a standard practice for more than 20 years, controversy still exists over what constitutes the appropriate margin of normal breast tissue around a tumor that minimizes local recurrence while maintaining a good cosmetic outcome. Surveys of surgeons1 and...

lymphoma

Brentuximab Vedotin Shows Antitumor Activity in Patients With Relapsed Peripheral T-Cell Lymphoma

In a phase II study, the 34 evaluable patients with peripheral T-cell lymphomas who received brentuximab vedotin (Adcetris) had an overall response rate of 41%, including an overall response rate of 54% among the 13 patients with angioimmunoblastic T-cell lymphoma. The median progression-free...

Expert Point of View: Joyce F. Liu, MD, MPH, of Dana-Farber Cancer Institute, and Stephen A. Cannistra, MD

In an editorial accompanying publication of the AURELIA study results, Joyce F. Liu, MD, MPH, of Dana-Farber Cancer Institute, and Stephen A. Cannistra, MD, of Beth Israel Deaconess Medical Center, Boston, considered the implications of the benefits observed in the trial and limitations in...

gynecologic cancers

AURELIA Trial: Adding Bevacizumab to Chemotherapy Improves Outcomes in Platinum-Resistant Recurrent Ovarian Cancer

Single-agent chemotherapy is standard in platinum-resistant ovarian cancer. In the open-label phase III AURELIA trial reported in the Journal of Clinical Oncology, Eric Pujade-Lauraine, MD, PhD, of Université Paris Descartes, and colleagues found that the addition of bevacizumab (Avastin) to...

gynecologic cancers

Preliminary Study Suggests Veliparib May Be Effective in Resistant, BRCA-Mutated Ovarian Cancers

Veliparib, an oral poly(ADP-ribose) polymerase (PARP) inhibitor, appears to be of value in treating women with BRCA-mutated gynecologic cancers that are resistant to other therapies. These preliminary findings of a phase II study support the concept that BRCA-associated ovarian cancers are...

gynecologic cancers

Bariatric Surgery Reduces Risk of Uterine Cancer in Obese Women

Bariatric surgery for weight loss appears to protect obese women from developing uterine cancer, according to a large retrospective study presented at the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer, held March 22–25 in Tampa, Florida. The study found that obese women who ...

Expert Point of View: William Cliby, MD

When asked to comment on the study presented by Lin et al at the Annual Meeting on Women’s Cancer, William Cliby, MD, Chair, Division of Surgery, The Mayo Clinic, Rochester, Minnesota, said, “This study is important because of its size and the utilization of the National Cancer Data Base—the...

multiple myeloma

Promising Compounds in Development for Multiple Myeloma

The term “novel agents” has been used for the past decade to describe proteasome inhibitors and immunomodulatory drugs that are now conventionally used for multiple myeloma. However, even newer agents in development will be considered truly novel when they hit the market, as they represent new...

sarcoma

Surgery Plus Radiation Offers Mixed Results in Soft-Tissue Sarcoma

Adjuvant radiation following surgery for soft-tissue sarcomas of the extremities did not lead to a survival benefit and seemed to be associated with some degree of long-term limb complications, according to a presentation at the 2014 Society of Surgical Oncology (SSO) Cancer Symposium in Phoenix.1...

breast cancer

LY2835219 Shows Strong Single-Agent Activity in Preliminary Study in Metastatic Breast Cancer

Inhibitors of cyclin-dependent kinase (CDK) 4/6 are getting attention as a novel approach for the treatment of breast cancer. At the 2014 American Association for Cancer Research (AACR) Annual Meeting, two presentations focused on these new agents. One was a phase II study of Pfizer’s compound...

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