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Showing 4451 - 4500Estrogen 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...
Data on Watchful Waiting for Low-risk Prostate Cancer May Swing Focus to Higher-risk Tumors and Quality of Life
Surgery did not increase survival rates compared to watchful waiting in men with clinically localized prostate cancer. Results were particularly strong for men with prostate-specific antigen (PSA) levels of 10 ng/dL and under, and those who have low-risk disease, according to data from the Prostate ...
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...
Bevacizumab Breast Cancer Indication Rescinded: What Are the Downstream Implications?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,...
Favorable Early-stage Hodgkin Lymphoma and HD.6: The Take-Home and Don’t–Take-Home Messages
The Canadian HD.6 randomized study in patients with nonbulky early-stage Hodgkin lymphoma is mostly of historic interest.1,2 It has little relevance to current treatment standards or questions, and the risk for its inappropriate interpretation is of great concern. Radical Radiation Approach Long...
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...
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?...
JAK2 and MPL Mutation Screening: What Are the Indications and How to Interpret the Results
The World Health Organization system organizes myeloid malignancies into five major categories, which are subsequently further subclassified using a combination of bone marrow morphology and cytogenetic/molecular information (Table 1).1 JAK2 and MPL mutations are not disease-specific and occur...
Surgical Oncology: Advances and Challenges in Breast Cancer Surgery
Mortality rates for breast cancer have declined steadily in the United States since 1990, resulting in an improvement in survival. Multiple factors have contributed to this positive trend, one of which is the combination of earlier detection and more sophisticated surgical techniques. The ASCO Post ...
Epigenetic Therapy Shows Positive Results in Late-stage Lung Cancer
A small phase I/II clinical study from Johns Hopkins University in Baltimore found that epigenetic therapy with a combination of azacitidine (Vidaza) and entinostat (an investigational agent) produced responses in some patients with refractory advanced non–small cell lung cancer. The study results, ...
I Never Expected to Get Lung Cancer
When intermittent chest pains sent me to the emergency room nearly a decade ago, I worried that I was having some kind of cardiac event. The ER doctor wanted to make sure that I didn’t have a pulmonary embolism, so in addition to ordering a complete cardiac workup, she also ordered a chest x-ray to ...
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...
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...
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...
Expert Point of View: Next-generation Proteasome Inhibitors Will Improve Outcomes in Bortezomib-refractory Myeloma Patients
Myeloma experts agree that the new proteosome inhibitors are particularly welcome because they are at least as effective as bortezomib (Velcade) but produce much less neuropathy. Dramatic Results “The activity of MLN 9708 is very encouraging,” said Paul G. Richardson, MD, of Dana-Farber Cancer...
Next-generation Proteasome Inhibitors Will Improve Outcomes in Bortezomib-refractory Myeloma Patients
The next-generation proteasome inhibitor carfilzomib is expected to gain FDA approval in the near future, offering a treatment option that may be as effective as and less neurotoxic than bortezomib (Velcade). Studies presented at the ASH Annual Meeting upheld benefits of the drug observed in...
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, ...
A Second Chance for Gemtuzumab in Acute Myeloid Leukemia
Gemtuzumab ozogamicin (Mylotarg) may have a second chance for regulatory acceptance, as studies presented at ASH 2011 demonstrated that gemtuzumab can be safely and effectively given by adjusting the dosing and treatment schedule. Gemtuzumab ozogamicin was approved for the treatment of acute...
Expert Point of View: BELA Trial Reborn: Bosutinib Produces Improved Results in Chronic Myeloid Leukemia
Given the results of the BELA trial, with the problems of treatment side-effect management realized and seemingly resolved, Elias Jabbour, MD, Assistant Professor of Medicine at The University of Texas MD Anderson Cancer Center, Houston, assumes bosutinib will be approved in chronic myeloid...
Expert Point of View: Post-CHOP Radioimmunotherapy Comparable to Rituximab Given along with CHOP in Previously Untreated Follicular Lymphoma
SWOG S0016, which compared treatment with CHOP-R (cyclophosphamide, doxorubicin, vincristine, prednisone, plus rituximab [Rituxan]) and CHOP-RIT (CHOP plus tositumomab/iodine-131 tositumomab [Bexxar]) in patients with follicular lymphoma, was one of the most important studies at the 2011 ASH...
Can Molecular Profiling Identify ER-positive Patients Destined for Relapse?
Estrogen receptor (ER)-positive breast cancer often recurs years after the initial diagnosis, and understanding the patterns of timing regarding relapse could identify patients needing more aggressive treatment. At the 2011 San Antonio Breast Cancer Symposium, several investigative teams reported...
Expert Point of View: Bevacizumab Progression-free Survival Benefit Upheld in AVEREL Trial
Modest benefit reported from AVEREL1 triggered comments among trialists about the future of bevacizumab (Avastin) in breast cancer. “Although there’s controversy about the recent revoking of FDA approval of bevacizumab for metastatic breast cancer, I think there is a consensus in our disappointment ...
Expert Point of View: Dual HER2 Blockade Substantially Delays Disease Progression
The availability of effective therapies for HER2-positive tumors has made breast cancer a better managed disease, but outcomes could be further enhanced through the targeting of other players in this pathway, emerging data suggest. C. Kent Osborne, MD, of Baylor College of Medicine, Houston,...
Facing the Future without Fear of Breast Cancer Recurrence
A year ago, I was living my dream. Married to a wonderful man, Danny, and with two young children to raise, Karl, 7, and Marcus, 4, I had given up a career in accounting to be a stay-at-home mom. At age 34, I was enjoying life, helping my children with their homework and going to their soccer and...
A Patient with Cancer Saw a Need and Left a Living Legacy
It is well documented that the rigors of delivering cancer care can unintentionally supersede valuable doctor-patient communication. Before he died in 1995, Kenneth B. Schwartz, a patient with cancer at Massachusetts General Hospital, recognized this phenomenon and founded the Kenneth B. Schwartz...
SIDEBAR: Expect Questions from Your Patients
The possibility of reexcision after breast-conservation surgery should be discussed with patients before the initial surgery, advised Laurence E. McCahill, MD, lead investigator of the JAMA study on reexcision following breast-conservation surgery, which showed wide variability in reexcision...
Reexcision Rates Following Breast-conservation Surgery Vary Widely
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. Reexcision rates for women with...
Expert Point of View: Peripheral Blood or Bone Marrow as Unrelated Donor Stem Cell Source
This large randomized, controlled trial took a lot of time and extensive resources, and yet survival was the same between the two types of unrelated donor transplant sources, noted Stephanie J. Lee, MD, Professor of Medicine at Washington University and the Fred Hutchinson Cancer Center in Seattle. ...
What You Should Know about Peginterferon Alfa-2b for Adjuvant Treatment of Melanoma
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 Peginterferon alfa-2b (PegIntron, Sylatron) was recently ...
Challenges, Progress, and Future Directions in Head and Neck Cancer
Although head and neck cancer remains a major therapeutic challenge, significant advances have been made over the past few decades. The ASCO Post recently spoke with Marshall R. Posner, MD, Medical Director of the Head and Neck Oncology Program, Mount Sinai Medical Center, New York, about the...
Career Development Award Recipient Susan K. Parsons, MD, Supports Next Generation of Researchers
Like all pediatric oncologists, Susan K. Parsons, MD, MRP, knows that when a child is diagnosed with cancer, it happens to the whole family. Siblings must cope with everything from disruption of routine to reduced parental attention, to the often-new possibility of mortality. Parents must navigate...
Expert Point of View: Genomics Projects Plumb Breast Cancer’s Inner Workings
Charles M. Perou, PhD, the May Goldman Shaw Distinguished Professor of Molecular Oncology at the University of North Carolina, Chapel Hill, commented on the research being conducted by The Cancer Genome Atlas (TCGA) and the International Cancer Genome Consortium (ICGC). “The TCGA and ICGC efforts...
Genomics Projects Plumb Breast Cancer’s Inner Workings
Two large collaborative genomics projects are producing new and sometimes surprising findings about what makes breast cancers tick—information that may ultimately be applied to improve clinical outcomes. In a special session titled “Genome Data for the Masses: Presentation of TCGA and ICGC Breast...
Atypical Breast Lesions: How High Is the Cancer Risk?
Women with atypical breast lesions have approximately a 5% to 11% risk of developing breast cancer within 5 years, depending on histology, and this risk can be reduced with chemoprevention, according to a presentation at the 2011 San Antonio Breast Cancer Symposium.1 Investigators tracked the...
What Were the Take-home Messages from the 2012 Gastrointestinal Cancers Symposium?
Richard M. Goldberg, MD, of The Ohio State University Medical Center, chaired the steering committee of the 2012 Gastrointestinal Cancers Symposium in San Francisco, which attracted approximately 4,000 registrants who viewed data from some 700 scientific abstracts. The ASCO Post asked Dr. Goldberg...
Inefficient Markets Impede Cancer Pain Relief
The potent analgesic property of morphine was first isolated in 1804, and after more than 2 centuries morphine is still the gold standard for moderate to severe pain. It is relatively easy to produce, and compared to most pharmaceuticals, morphine is dirt-cheap. Therein lies the cruel conundrum:...
A Visionary Call for the ‘Creative Destruction’ of Medicine
According to nationally regarded cardiologist and geneticist Eric Topol, MD, Chief Academic Officer of Scripps Health, the next frontier of the digital revolution can create exponentially better health care. Dr. Topol, who is also Director of the Scripps Translational Science Institute and...
Surviving Cancer Means Making Many Difficult Decisions
The best advice I received after getting a diagnosis of stage I invasive lobular carcinoma in my left breast was from my radiologist, who told me, “Remember, be your own best advocate.” Those words have stayed with me through my 6-year struggle with breast cancer and its aftermath. Extraordinary...
SIDEBAR: Expect and Ask Questions about Sex and Fertility Preservation
What most concerns the adolescent and young adult population? “If they are worried about anything, it is sex and having families,” according to Archie Bleyer, MD. Years ago, he said, “oncologists were so worried about just getting them in remission, treating their cancers, and getting them to...
Adolescents and Young Adults with Cancer: A Distinct Population of Patients Who Need to Be Treated Differently
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. Cancer among adolescents and young...
Some Patients Using Complementary and Alternative Therapies May Be Receiving ‘Parallel’ Rather Than Integrative Care
Most patients with cancer receiving complementary and alternative medicine do so not as part of integrative care, but rather as “parallel care,” according to Lynda Balneaves, RN, PhD, Associate Professor, University of British Columbia, School of Nursing in Vancouver. Dr. Balneaves is lead...
Research Funding Key to Continued Progress in Cancer Care
American Association for Cancer Research (AACR) President and ASCO member Judy Garber, MD, MPH, recently spoke with The ASCO Post about the findings of AACR’s landmark Cancer Progress Report,1 In addition, she offered her perspective on the current and future state of cancer research. Project...
Context May Affect Benefit of Adjuvant Clodronate in Breast Cancer
A benefit of the oral bisphosphonate clodronate when used as adjuvant therapy for early breast cancer may depend on factors such as the endpoint assessed and patient age, suggests the randomized B-34 trial conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP). The trial,...
Expert Point of View: Maintenance with Lenalidomide or Bortezomib Prolongs Remission in Elderly Patients with Multiple Myeloma
David S. Siegel, MD, PhD, of the John Theurer Cancer Center at Hackensack University Medical Center in New Jersey, commented to The ASCO Post that essentially all patients with multiple myeloma could be candidates for maintenance therapy. “But I don’t know that we have established that maintenance...
Maintenance with Lenalidomide or Bortezomib Prolongs Remission in Elderly Patients with Multiple Myeloma
The benefit of maintenance therapy in newly diagnosed multiple myeloma patients ineligible for stem cell transplant, such as the elderly, is still debated, though value appears to be emerging, according to studies presented at the 2011 American Society of Hematology (ASH) Annual Meeting....
Researchers Map Potential Genetic Origins, Pathways of Lung Cancer in Never-smokers
Findings from a small study on potential gene mutations and pathway alterations that could lead to lung cancer in never-smokers were presented in a poster at the American Association for Cancer Research–International Association for the Study of Lung Cancer Joint Conference on Molecular Origins of...
ASCO Submits Testimony for Congressional Hearing Examining Quality Programs that Reward High-quality Care
The House Ways and Means Health Subcommittee recently held a hearing on programs and initiatives that reward physicians who deliver high-quality, efficient care. ASCO submitted written testimony from CEO Allen S. Lichter, MD, on many aspects of quality care, including how the Quality Oncology...
Research of Former Foundation Grantee James Yao Highlighted at the GI Cancers Symposium
A study led by James C. Yao, MD, Assistant Professor and Deputy Chair of Gastrointestinal Oncology at The University of Texas MD Anderson Cancer Center, Houston, was presented at the 2012 Gastrointestinal (GI) Cancers Symposium in San Francisco and highlighted in the meeting’s press program. In the ...
What You Need to Know About Axitinib, New Agent for Treating Advanced Renal Cell Carcinoma
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, the second-generation vascular...
Rising Costs in Radiation Oncology Linked to Medicare Coverage
In the ongoing debate over how to control rising cancer care costs, it is vital to identify usage patterns of expensive new technologies. A recent study examined the relationship between Medicare reimbursement and the increasing use of intensity-modulated radiation therapy (IMRT).1 The ASCO Post...
