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health-care policy

ASCO Supports the United Nations Political Declaration on Noncommunicable Diseases

In September, government leaders from around the world as well as representatives from civil society, the private sector and academia gathered at the United Nations in New York for the first-ever summit on the growing economic and human crisis posed by noncommunicable diseases (NCDs), especially in ...

gynecologic cancers

Alternative Treatment for Advanced Ovarian Cancer Reduces Neurotoxicity and Alopecia

A randomized phase III clinical trial found that carboplatin/pegylated liposomal doxorubicin (Doxil) was not superior in prolonging progression compared to the standard carboplatin/paclitaxel as first-line therapy of patients with advanced ovarian cancer. The carboplatin/liposomal doxorubicin...

issues in oncology

Chemotherapy Generally Safe in Pregnancy

The diagnosis of cancer in a pregnant woman causes concerns for both the mother and her unborn child. But studies suggest that most chemotherapy regimens can be delivered with reasonable safety after the first trimester. Cancer is diagnosed in about 1 per 1,000 to 2,000 pregnancies, mostly breast...

issues in oncology

Biosimilars in Cancer Treatment: What Should the Oncology Community Expect?

Alternative versions of biologic agents, ie, “biosimilars,” will presumably be getting the green light by the FDA, giving oncologists more choices for treatments that come at lower costs to patients and society. The FDA plans to issue its guidance on biosimilars by the end of this year, paving the...

breast cancer

Tamoxifen vs Surgery Study Shows Older Patients with Breast Cancer Can Achieve a ‘Personal Cure’

A truly final review—when all the patients in the trial have died and the cause of death is known for each—of a randomized trial comparing tamoxifen to surgery in patients over the age of 70 with operable breast cancer found no differences in the survival rates or deaths attributable to breast...

Expert Point of View: Hypofractionated Radiotherapy Effectively Controls High-risk Prostate Cancer

The take-home message of the study findings from the Fox Chase trial reported at the 53rd ASTRO Annual Meeting plenary session supports the use of hypofractionated intensity-modulated radiotherapy as a more convenient and cost-effective alternative than conventional IMRT, according to formal...

ASCO in Action Online: Your Source for Policy News and Information

The recently enhanced ASCO in Action site ascoaction.asco.org is a one-stop source for the latest policy news related to quality cancer care and research. Whether it is information about legislation that affects cancer patients or oncology practices, easy links to ASCO’s recent policy positions,...

Global Trials: Do Benefits Outweigh Pitfalls?

Global clinical trials have many advantages and are essential in many disease settings, but there are also challenges that confront global industry-sponsored research, said Sandra Horning, MD, Senior Vice President and Global Head of Clinical Development in Hematology/Oncology for Genentech (Table...

solid tumors

Sunitinib and Everolimus: New Indications in Pancreatic Neuroendocrine Tumors

With In the Clinic, The ASCO Post 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. Sunitinib Indication—The oral kinase inhibitor...

issues in oncology

Predictive Biomarker for Bevacizumab: Are We Getting Closer?

The need to identify a biomarker to guide treatment with bevacizumab (Avastin) is abundantly clear, and studies presented at the 2011 European Multidisciplinary Cancer Congress suggest this goal may be in sight. “Finding predictive biomarkers is a challenge, but there are candidates,” said Eric Van ...

kidney cancer

Significantly Longer Survival with Axitinib Compared to Sorafenib in Patients with Renal Cell Carcinoma

A phase III study comparing the vascular endothelial growth factor receptor (VEGFR) inhibitors axitinib and sorafenib (Nexavar) as second-line therapy in patients with metastatic renal cell carcinoma found that axitinib produced significantly longer progression-free survival. Published in The...

Reflections from The ASCO Post

The editors gratefully acknowledge all contributors to The ASCO Post and thank the columnists who contributed to Volume 2, January–December 2011: Al B. Benson III, MD, FACP Richard Boxer, MD, FACS Carlton G. Brown, RN, PhD, AOCN Barrie R. Cassileth, PhD E. David Crawford, MD Emil J. Freireich, MD, ...

issues in oncology

Oncologists Need Hands-on Approach in Developing Next Generation of EHRs

The electronic health record system offered by vendors is more like a filing cabinet, not the sophisticated, interactive database needed by busy oncologists, according to Kevin S. Hughes, MD, FACS, Co-Director, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, who...

2012 GU Cancers Symposium to Reflect the Field’s Focus on Personalized Cancer Care

The 2012 Genitourinary Cancers Symposium, to be held in San Francisco February 2–4, will feature some exciting advancements in the field that center on personalized cancer care. “The major cancer discussed at the meeting tends to be prostate cancer, and there hasn’t yet been a lot of specific...

skin cancer

Gathering Data Point to Potential Advantages of Vismodegib in Basal Cell Carcinoma and Other Advanced Cancers

Vismodegib is a small-molecule, orally active hedgehog pathway inhibitor that has shown considerable promise in treating basal cell carcinoma and is currently being evaluated alone and in combination in early-phase trials in medulloblastoma and a long list of other cancers.1 Owing to its...

lung cancer
gynecologic cancers
colorectal cancer
hepatobiliary cancer

Important Briefs from the 2011 European Multidisciplinary Cancer Congress

Nearly 16,000 people from 16 countries attended this year’s European Multidisciplinary Cancer Congress, held recently in Stockholm. The ASCO Post has featured several key reports from the meeting and will offer further coverage in upcoming issues. Additional noteworthy studies presented at the...

breast cancer

Optimizing HER2-directed Therapy in the Clinic

Seminal research in the treatment of HER2-positive breast cancer has been led by Edith A. Perez, MD, the Serene M. and Frances C. Durling Professor of Medicine at the Mayo Clinic, Jacksonville, Florida. The ASCO Post asked Dr. Perez to share her approach to HER2-directed therapy. Testing...

gastrointestinal cancer

Adjuvant Chemotherapy with S-1 Improves Survival in Stage II/III Gastric Cancer

Postoperative adjuvant therapy with the oral fluoropyrimidine derivative S-1 improved overall survival and relapse-free survival in patients with stage II or III gastric cancer who had D2 gastrectomy. Five-year survival rates in the phase III study were 71.7% for patients in the S-1 group vs 61.1%...

breast cancer

CLEOPATRA Trial Finds Dual HER2 Blockade Improves Progression-free Survival in Advanced Breast Cancer

Women with HER2-positive advanced breast cancer are much less likely to have disease progression or die when two agents are used instead of one to target the HER2 signaling pathway, investigators for the international phase III CLEOPATRA trial found. The 808 women studied were randomly assigned to...

integrative oncology

Integrative Oncology: Essential to Cancer Care

During the 1960s and 1970s, the concept of an expanded approach to oncologic treatment encompassing “body, mind, and spirit” grew in patient popularity and morphed into two basic categories: “alternative” and “complementary” therapies. Together, these later became known by the acronym CAM, for...

hematologic malignancies

Ruxolitinib for Myelofibrosis Therapy: A Good Start but a Long Road Ahead

Following a priority review process for orphan diseases, ruxolitinb (Jakafi) recently became the first drug to receive FDA approval for the treatment of intermediate- and high-risk myelofibrosis. Discovery in 2004 of the JAK2V617F mutation in a significant proportion of patients with...

breast cancer

BOLERO-2: Everolimus Thwarts Resistance to Hormonal Therapy in Advanced Breast Cancer

Adding an inhibitor of the mammalian target of rapamycin (mTOR) to hormonal therapy for advanced breast cancer effectively circumvents resistance, suggest updated results of the randomized BOLERO-2 trial. With a median follow-up of 12.5 months, the likelihood of disease progression or death among...

lung cancer

Studies Reveal that Hormonal Factors Influence Lung Cancer Risk in Women

In an effort to understand lung cancer risk factors and develop prevention strategies for the disease, Christina S. Baik, MD, MPH, thoracic oncologist and staff scientist at the Seattle Cancer Care Alliance and Fred Hutchinson Cancer Research Center, has examined epidemiologic trends in lung...

lymphoma
geriatric oncology

Expert Point of View: Therapy for Hodgkin Lymphoma in the Elderly Remains Undefined

Elderly Hodgkin lymphoma, typically defined as affecting individuals ≥ 60 years of age, remains a disease for which no standard treatment recommendation exists. This population is underrepresented in clinical studies, and survival rates in older patients with Hodgkin lymphoma are significantly and ...

Renewing Our Commitment to Conquering Cancer

Congress passed a resolution in December recognizing the 40th anniversary of the National Cancer Act of 1971 and the more than 12 million cancer survivors who are alive as a result of the nation’s commitment to cancer research and advances in cancer prevention, detection, diagnosis, and treatment....

ASCO Launches FASCO Designation

ASCO has announced the designation of Fellow of the American Society of Clinical Oncology, otherwise known as FASCO. Formerly called the ASCO Statesman Award and launched in 2007, the distinction is designed to honor ASCO’s most active volunteer members. “The FASCO status represents recognition for ...

breast cancer
symptom management

Estrogen 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...

thyroid cancer
pancreatic cancer
colorectal cancer
breast cancer

Oncology Research a Strong Presence at the American College of Surgeons Meeting: New Data in Pancreatic, Rectal, Thyroid, and Breast Cancers

Research in cancer staging, surgical procedures, outcomes, and medical treatment was included among the 2,000 abstracts presented at the 97th Annual American College of Surgeons Clinical Congress in San Francisco. The ASCO Post was there to capture the latest findings. Neoadjuvant Chemotherapy in...

skin cancer

Sentinel Lymph Node Biopsy for Thin Melanomas?

When sentinel lymph node biopsy for the regional staging of melanoma was first introduced, it was recommended for any patient with a melanoma 1.0 mm in Breslow thickness or greater. Patients with thin melanomas were not thought to have a sufficiently high risk to warrant the additional cost and...

lymphoma

Improved Survival with Chemotherapy Alone in Limited-stage Hodgkin Lymphoma

An important study suggests that radiotherapy may not be a necessary addition to chemotherapy in previously untreated patients with limited-stage Hodgkin lymphoma, sparing patients the risks of late radiation-induced cardiac effects and second cancers. These data were based on 12 years of follow-up ...

breast cancer

Partial Breast Irradiation with Brachytherapy in Early Breast Cancer: Retrospective Analysis Looks at Trends and Guidelines

Accelerated partial breast irradiation using brachytherapy (APBIb) as an alternative to whole-breast irradiation (WBI) after breast-conserving surgery has been rapidly adopted in the United States, but the majority of patients receiving APBIb may not be considered suitable for it. A retrospective...

hepatobiliary cancer

Laparoscopic Liver Resections Can Be Safe and Oncologically Efficient

Laparoscopic resection of primary and metastatic liver cancers can be safe and oncologically efficient and reduce postoperative length of stay, a single-center study from the United Kingdom found.1 The investigators cautioned, however, that “adequate patient selection and extensive experience in...

kidney cancer

Tyrosine Kinase Inhibitor Therapy Yields Complete Remission in Patients with Metastatic Renal Cell Carcinoma

Targeted therapies have markedly improved outcomes in patients with advanced renal cell carcinoma, with median overall survival of greater than 2 years having been observed with sunitinib (Sutent) treatment. Objective responses, consisting mostly of partial responses, are observed in approximately...

ASCO Membership Categories Offer a Place for Everyone

If your work touches those who have cancer, you have a place within ASCO. That’s the message that the organization, during its 48 years, has gotten across in many ways, not the least of which is its membership categories, which have expanded right along with the field of cancer care. “ASCO is...

Integration of QOPI® Helps Michigan Insurer Earn ‘Best of Blue’ Award

By working to improve oncology care in practices in Michigan through integration of ASCO’s Quality Oncology Practice Initiative (QOPI) into its Physician Group Incentive Program, Blue Cross Blue Shield of Michigan (BCBSM) has been selected as a 2011 “Best of Blue Clinical Distinction Award” winner...

issues in oncology

QOPI® Certifies 100th Practice for Delivering High-quality Cancer Care

Less than 2 years since launching the first national program to help oncology practices deliver the highest quality of cancer care, ASCO and its affiliate, the Quality Oncology Practice Initiative (QOPI®) Certification Program, announced that more than 100 practices have achieved QOPI...

breast cancer

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...

leukemia

Is Gemtuzumab a Therapeutic Option in Older Patients with Acute Myeloid Leukemia?

Previous studies of gemtuzumab ozogamicin (Mylotarg) had variable results in acute myeloid leukemia (AML). Before trials reported at the 2011 ASH Annual Meeting, two major studies had compared chemotherapy with or without gemtuzumab in patients with AML, said Martin Tallman, MD, Chief of the...

leukemia

Is Gemtuzumab a Therapeutic Option in Older Patients with Acute Myeloid Leukemia?

A study presented at the Plenary Session of the 53rd Annual Meeting of the American Society of Hematology (ASH) breathes new life into an older drug for acute myeloid leukemia (AML) that is no longer available in the United States.1 Gemtuzumab ozogamicin (Mylotarg) appears to be a promising...

kidney cancer

Axitinib Receives FDA Approval in Advanced Renal Cell Carcinoma

The FDA has approved the kinase inhibitor axitinib (Inlyta) for the treatment of advanced renal cell carcinoma after failure of one prior systemic therapy. The approval is based on an international, randomized, open-label trial that enrolled 723 patients: 361 were assigned to receive axitinib at 5 ...

issues in oncology
health-care policy

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...

multiple myeloma

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...

multiple myeloma

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, ...

multiple myeloma

Monoclonal Antibody Promising in Multiple Myeloma

Elotuzumab, a humanized IgG1 monoclonal antibody targeting human CS1, a cell-surface glycoprotein expressed on 95% of myeloma cells, elicited responses in 82% of relapsed/refractory myeloma patients in a phase II study reported at the ASH Annual Meeting.1 Objective response rates exceeded 90% in...

leukemia

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...

leukemia

Novel Agent Efficacious in Chronic Lymphocytic Leukemia

A novel inhibitor of B-cell receptor signaling produced high rates of remission and was well tolerated in patients with chronic lymphocytic leukemia (CLL) who were refractory to at least two previous treatments, reported Susan O’Brien, MD, of The University of Texas MD Anderson Cancer Center,...

leukemia

Three Novel Agents Show Promise in Acute Lymphoblastic Leukemia

Susan O’Brien, MD, Professor in the Department of Leukemia at The University of Texas MD Anderson Cancer Center, Houston, has a special interest in novel developments in the treatment of acute lymphoblastic leukemia (ALL). At the 2011 ASH Annual Meeting, she discussed her picks of top newsmakers in ...

lymphoma

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...

breast cancer

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 ...

breast cancer

Dual HER2 Blockade Substantially Delays Disease Progression

There is an emerging theme in HER2-positive breast cancer: The greater the pathway inhibition, the better the outcome. The latest evidence comes from the phase III Clinical Evaluation of Pertuzumab and Trastuzumab (CLEOPATRA) trial of 808 patients with previously untreated metastatic disease. The...

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