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breast cancer

Flaws in CNBSS Are Vast, Impact on Screening Recommendations Is Nil

The recent report from the Canadian National Breast Screening Study (CNBSS)—published in BMJ and reviewed in The ASCO Post, early release online—concluded that annual mammography in women aged 40 to 59 does not result in a reduction in mortality from breast cancer beyond that of physical...

leukemia

First-Line Obinutuzumab/Chlorambucil Improves Outcomes Over Rituximab/Chlorambucil in Older CLL Patients With Comorbidities

Obinutuzumab (Gazyva) plus chloramubucil outperformed rituximab (Rituxan) plus chlorambucil (Leukeran) as first-line therapy in older patients with chronic lymphocytic leukemia (CLL) and comorbidities in the large CLL 11 trial. Final results showed that obinutuzumab/chloramubucil improved overall...

hematologic malignancies

Haploidentical Stem Cell Transplantation Producing Good Outcomes, Expanding Transplant Pool

HLA-haploidentical hematopoietic stem cell transplantation can be performed safely, yield good outcomes, and greatly expand the number of patients with hematologic malignancies who can be treated with stem cell transplant, studies presented at the 2013 American Society of Hematology (ASH) Annual...

Amplifying the Signal: Foundation Donor Takes His Advocacy Into the Twittersphere

Michael A. Thompson, MD, PhD, a Medical Oncologist for Aurora Cancer Care and the Medical Director of Early Cancer Research at Aurora Health Care in Wisconsin, has become something of an expert on the Conquer Cancer Foundation. It began in 2006, when he received a Conquer Cancer Foundation of ASCO...

breast cancer
pain management

Exercise Program Reduces Aromatase Inhibitor–Associated Joint Pain

Amid studies of novel targeted therapies, genetic analyses of tumors, and new ways to approach the treatment of breast cancer, a low-tech study presented at the 2013 San Antonio Breast Cancer Symposium found that a yearlong exercise program reduced joint pain associated with aromatase inhibitors in ...

Expert Point of View: Debu Tripathy, MD

Debu Tripathy, MD, Professor of Medicine, Co-Leader of the Women’s Cancer Program, and the Priscilla and Art Ulene Chair in Women’s Cancer at the University of Southern California Norris Cancer Center, Los Angeles, commented on the APT study for The ASCO Post. “In treating early-stage HER2-positive ...

Expert Point of View: Daniel J. Canter, MD

“We have a lot of options for first-line therapy [in renal cell carcinoma] these days. The question is, what do we do with first-line failures?” said Daniel J. Canter, MD, formal discussant of the SWITCH trial at the Genitourinary Cancers Symposium. Dr. Canter is Vice Chairman of the Urologic...

kidney cancer

Sequencing Sorafenib and Sunitinib in Either Order Does Not Affect Survival in Metastatic Renal Cell Carcinoma

The explosion of new therapies for metastatic renal cell carcinoma is a welcome advance, but studies have not yet defined optimal sequencing of the newer therapies. According to the phase III SWITCH trial, it matters little whether therapy for metastatic renal cell carcinoma begins with sorafenib...

legislation

Congress Agrees on Repeal of Sustainable Growth Rate

The U.S. Congress recently did something rarely seen on Capitol Hill: Leaders from both sides of the aisle agreed on a piece of legislation. On February 6, 2014, the House Energy and Commerce and Ways and Means Committees and the Senate Finance Committee announced its agreement on a bill—the SGR...

issues in oncology

The Future of Biomedical Research

In January, Congress approved a $1 trillion appropriations bill for the rest of fiscal year 2014. While the new bill includes $29.9 billion for the National Institutes of Health (NIH)—$1 billion above FY2013 levels after sequestration—including $4.9 billion for the National Cancer Institute (NCI),...

issues in oncology

The Author Replies

I read with interest the note from Jeff Boyd, PhD, Senior Vice-President for Molecular Medicine at Fox Chase Cancer Center, calling into question my recent commentary about the high costs of partly validated testing in the domain of molecular medicine. One of the oldest tricks in the book is to...

skin cancer
cost of care

Dermatologists Defend Mohs Surgery as Effective and Cost-Efficient With Low Rate of Recurrence

The headline, “Patients’ Costs Skyrocket, Specialists’ Incomes Soar,” aptly encapsulates the theme of a recent article in The New York Times,1 part of a series entitled, “Paying Till It Hurts.” “Oncologists benefit from the ability to mark up (and profit from) each dose of chemotherapy they...

gynecologic cancers

Cancer Has Allowed Me to Put My Goals First

Despite my family history of cancer—my father had colorectal cancer, his father had gallbladder cancer, and my father’s mother died of what was believed to be uterine cancer—when I complained to my gynecologist about postmenopausal bleeding in the spring of 2011, I was told not to worry about it....

supportive care

Music Therapy Yields Positive Effects on Coping Skills, Social Integration, and Family Environment for Young Patients With Cancer

A collaborative multisite study has found that teens and young adults undergoing stem cell transplantation as part of cancer treatment gain coping skills and resilience-related outcomes when participating with a board-certified music therapist in a therapeutic music protocol that includes writing...

breast cancer
cns cancers

How to Approach the Problem of CNS Metastasis in HER2-Positive Patients

Central nervous system (CNS) metastasis is a pervasive problem in the setting of HER2-positive breast cancer. While some patients can be managed easily, others are challenging, said Eric P. Winer, MD, Chief of the Division of Women’s Cancers and the Thompson Senior Investigator for Breast Cancer...

issues in oncology

Telemedicine: Efficiency in Cancer Screening and Outreach

As defined by the U.S. Health Resources and Services Administration teleheath is “the use of electronic information and telecommunications technologies to support long-distance clinical health care, patient and professional health-related education, public health, and health administration.” It has ...

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...

health-care policy

President Obama’s FY 2015 Budget Proposal

[On March 4, 2014], President Obama released his proposed budget for fiscal year 2015. Among several cost-cutting measures designed to preserve Medicare solvency is a proposal to reduce reimbursement for life-sustaining cancer drugs. Currently, reimbursement to physicians for “Part B” drugs is...

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...

health-care policy

ASCO Addresses Changes in Medicare for 2014

Medicare patients make up 61% of new cancer cases in the United States, and as the population ages, that proportion is expected to rise to 70% by 2030. Over the past decade, the oncology community has been financially challenged by alterations in the Medicare payment system. To address the changes...

breast cancer

National Program to Screen Ashkenazi Women in Israel for BRCA Mutations Is Being Explored

Citing a World Health Organization report that lists Israel as having one of the highest rates of breast cancer in the world, The New York Times reported on a proposed screening program to identify women with BRCA1 and BRCA2 mutations.1 “A number of influential geneticists and cancer doctors from...

breast cancer

Support from 1999 Career Development Award Launched Dr. Kornelia Polyak’s Quest to Advance Understanding of DCIS of the Breast

In 1999, Kornelia Polyak, MD, PhD, of the Dana-Farber Cancer Institute, received a Career Development Award from the Conquer Cancer Foundation for her project, “Isolation of Tumor Suppressor Genes Inactivated in DCIS of the Breast.” “The Career Development Award got me started,” she said. “When...

cost of care

Who Pays for Noncompliance? The Hidden Costs of Our Current System

The development of novel targeted therapies that capitalize on our growing understanding of the molecular underpinnings and vulnerabilities of specific malignancies has to rank among the most important advances we have seen in the 50 years since the American Society of Clinical Oncology was...

leukemia
cost of care

Higher Copayment Associated With Greater Discontinuation of and Nonadherence to Tyrosine Kinase Inhibitor Treatment in CML

The availability of the tyrosine kinase inhibitor imatinib (Gleevec) has dramatically increased survival in chronic myeloid leukemia (CML). Nonadherence to therapy with imatinib and other tyrosine kinase inhibitors is associated with disease progression and treatment resistance. In a study reported ...

prostate cancer
skin cancer

Melanoma and Prostate Cancer: Two Sides of One Coin?

In a recent study, reviewed in this issue of The ASCO Post, Li et al present data from two long- term prospective studies—the Physicians Health Study (PHS, from 1982 to 1998), and the Health Professionals’ Follow-up Study (HPFS, from 1986 to 2010)—both of which suggest a strong association between...

leukemia

FDA Grants Orphan Drug Status to Pracinostat for the Treatment of Acute Myeloid Leukemia

The U.S. Food and Drug Administration (FDA) has granted orphan drug designation to the investigational drug pracinostat for the treatment of acute myeloid leukemia (AML). The FDA’s Orphan Drug Designation program provides orphan status to drugs defined as those intended for the safe and effective...

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...

Expert Point of View: Jennifer R. Brown, MD, PhD

Idelalisib is being studied in three ongoing registration trials. [Study 116] was stopped early after idelalisib/rituximab demonstrated high efficacy in relapsed chronic lymphocytic leukemia [CLL],” said Jennifer R. Brown, MD, PhD, Director of the CLL Center at Dana-Farber Cancer Institute, Boston. ...

breast cancer

Adding Bevacizumab to Adjuvant Chemotherapy/Trastuzumab Fails to Improve Survival in HER2-Positive Breast Cancer

The addition of bevacizumab (Avastin) to adjuvant chemotherapy did not improve invasive disease-free survival or overall survival in patients with high-risk HER2-positive breast cancer in the large randomized phase III BETH trial. Although not specifically designed to answer this question, BETH...

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...

leukemia

Minimal Residual Disease Before and After Transplant: What Does It Mean?

In patients with acute leukemia, outcomes after hematopoietic stem cell transplantation are negatively impacted by the presence of minimal residual disease. However, transplant can prolong survival in patients with minimal residual disease after consolidation, according to two studies presented at...

SIDEBAR: Colorectal Cancer Survivors’ Comments on Strategies to Regulate Bowel Function

Avoiding Foods I don’t eat beans, I don’t eat onions. I’m kind of careful on greens because they just don’t digest well. I don’t eat as many salads. I couldn’t because they went right through. Behavioral Adjustments You learn, over the years, what you can and can’t do. And you can’t overeat....

Expert Point of View: Neal J. Meropol, MD

Neal J. Meropol, MD, Chief of Hematology and Oncology at University Hospitals ­Seidman Cancer Center and Case Western Reserve University, Cleveland, discussed the study by Kothari et al presented at the Gastrointestinal Cancers Symposium. He noted that complex interactions exist between PIK3CA and...

kidney cancer
prostate cancer

Five Key Studies in Prostate Cancer and Renal Cell Carcinoma

The 10th Genitourinary Cancers Symposium, sponsored by ASCO, the American Society for Radiation Oncology, and the Society of Urologic Oncology, was held January 29–February 1, 2014, in San Francisco. The more than 630 abstracts presented addressed essential research in genitourinary malignancies,...

health-care policy

The Evolution of U.S. Cooperative Group Trials: Publicly Funded Cancer Research at a Crossroads

Over the past 5 decades, National Cancer Institute (NCI) Clinical Trials Cooperative Groups have played an enormous role in the fight against cancer, tackling a broad social agenda, including cancer prevention, quality-of-life issues for patients with cancer, and comparison of benefits among...

lung cancer

I Refuse to Capitulate to Cancer

Early last year, just as I returned to my residency in neurologic surgery at Stanford University after completing 2 years of my postdoctoral fellowship in a laboratory developing optogenetic techniques, I started losing weight—dropping from 180 lb to 160 lb in just 6 months—and I was having fairly...

breast cancer

Breast Reconstruction Has Increased Over Time but Varies Widely by Region

Analysis of data from 20,560 women undergoing mastectomy for breast cancer found that breast reconstruction use “increased from 46% in 1998 to 63% in 2007 (P< .001), with increased use of implants and decreased use of autologous techniques over time (P < .001),” according to a report...

prostate cancer

Prostate Cancer Study Showing Increased Survival for Younger Men Undergoing Prostatectomy Not Expected to Increase Surgeries

Extended follow-up in the Scandinavian Prostate Cancer Group Study Number 4 (SPCG4), reported recently in The New England Journal of Medicine,1 found that men with early-stage prostate cancer, particularly those under 65 years old, who were treated with radical prostatectomy had increased survival...

multiple myeloma

The CoMMpass Trial in Multiple Myeloma

When I was diagnosed with multiple myeloma in 2008, at just 47, I was lucky. I was asymptomatic, my cancer was detected through a routine blood test, and I had the smoldering type, so I didn’t need immediate treatment. Plus, I knew that recent advances in more effective therapies were making it...

multiple myeloma

Unraveling the Molecular Complexity of Multiple Myeloma

In 2011, the Multiple Myeloma Research Foundation (MMRF) announced the launch of CoMMpass (Relating Clinical Outcomes in Multiple Myeloma to Personal Assessment of Genetic Profile), a clinical study at the heart of its Personalized Medicine Initiative. CoMMpass will follow 1,000 newly diagnosed...

prostate cancer

Does ‘Specialist Bias’ Contribute to Overtreatment of Prostate Cancer?

Specialist bias, in which specialists recommend the therapy that they are capable of delivering, is thought to influence the treatment of patients with localized prostate cancer and to contribute to overtreatment of men with limited life expectancy,” Ayal A. Aizer, MD, MPH, and colleagues, from the ...

lung cancer

Decision Time for Lung Cancer Screening in High‑Risk Populations

For decades, dedicated members of the oncology community have fought to increase the nation’s focus on lung cancer prevention and treatment. Although smoking cessation initiatives have reduced cigarette consumption, lung cancer 5-year survival has remained stagnant at 15%, lagging far below most...

issues in oncology

Informed Consent: Not Just About Blood Tests and Procedures Anymore

On February 24, the Institute of Medicine National Cancer Policy Forum convened a workshop, “Contemporary Issues in Human Subjects Protection in Cancer Research,” in Washington, DC. In his introduction to the workshop, Steven Piantadosi, MD, PhD, Director, Samuel Oschin Cancer Institute,...

issues in oncology

Amended 2013 Conflicts of Interest Policy Expands Requirements for Financial Disclosures

The Society’s 2013 Policy for Relationships with Companies is scheduled to go into effect on April 22, with one large change to its original requirements. The policy will still require the full disclosure of all financial relationships by all authors; however, since announcing the new policy in...

issues in oncology

Cancer Research Funding Still Tight—and Getting Tighter

Margaret Foti, PhD, MD (hc), CEO of the American Association for Cancer Research (AACR), welcomed about 150 congressional staffers to a March briefing in Washington, DC, with a plea for increased federal funding. “Extraordinary progress is being made in cancer research today, as evidenced by the...

pain management

Individualized Care Key to Cancer Pain Management at Sidney Kimmel Comprehensive Cancer Center

Learning about the particulars of each cancer patient’s pain and treating each case uniquely is the key to keeping pain manageable. That is the goal of the Duffey Pain and Palliative Care Program at The Sidney Kimmel Comprehensive Cancer Center in Baltimore. The team consists of physicians, nurse...

cost of care
health-care policy

American College of Radiology Issues Statement on Budgetary Efforts to Curtail Imaging and Radiation Oncology Self-Referral

The American College of Radiology (ACR) recently issued a statement applauding steps to reign in medical imaging and radiation oncology self-referral included in the President’s fiscal year 2015 budget. However, prior authorization for imaging services, also included in the FY2015 budget, is...

issues in oncology

Electronic Cigarette Use and Smoking Among Adolescents

Use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among U.S. adolescents.” This was the conclusion of a cross-sectional analysis of survey data from a representative sample of middle and high school students who completed the National Youth Tobacco Survey (NYTS) ...

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...

breast cancer

Targeting Cancer Stem Cells in Breast Cancer: A Potential Clinical Strategy

Preclinical models have suggested that cancer stem cells play a role in tumor recurrence and metastasis following adjuvant therapy, and Max S. Wicha, MD, and his research team are deciphering the mechanisms by which this might happen. A true understanding of cancer stem cells will have important...

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