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Showing 4701 - 4750SIDEBAR: Progression-free Survival Curve for Regorafenib Hints at Subgroup Effect
In all likelihood, only a subset of patients given regorafenib derive benefit, as suggested by the progression-free survival curve seen in the CORRECT trial, according to Dr. Overman. “This is a very interesting curve. The medians don’t really capture the difference.… If you look more at the area...
Evidence Is Changing Colorectal Cancer Treatment Landscape
Key colorectal cancer studies presented at this year’s ASCO Annual Meeting are changing the treatment landscape in this disease, according to Michael Overman, MD, of The University of Texas MD Anderson Cancer Center, who reviewed the data at the Best of ASCO San Diego meeting. The mix included...
SIDEBAR: Should EGFR Tyrosine Kinase Inhibitors Be Continued Beyond Progression?
It is not yet clear if it is beneficial to continue first-line EGFR tyrosine kinase inhibitors in patients with EGFR-mutated lung cancer who experience progression and are started on chemotherapy, according to Dr. Horn. Two trials, one in Asia (looking at gefitinib [Iressa]) and one in North...
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...
On Mentoring: Looking Back with Gratitude and Paying It Forward
Upon graduation from medical school, doctors are given a gift that lasts a lifetime—the gift of respect. That respect needs to be re-earned every day, but it is accompanied by other rewards that come with caring for people: the ability to gain another’s trust, to reverse illness that alters the...
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 ...
2012 Is ‘Banner Year’ for Research on Symptom Management
The year 2012 was “a banner year for symptom management,” according to Debra L. Barton, RN, PhD, of the Mayo Clinic, Rochester, Minnesota, who presented data on patient and survivor care at the Best of ASCO San Diego meeting. “I have been doing symptom management for about 20 years, and it seems...
Link Found between Aspirin and Reduced Risk of Death Due to Prostate Cancer
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. Over the past few weeks, Stanley L....
Starting Over after Cancer Treatment
When bloody discharge started oozing from the nipple on my left breast, I knew instinctively that it was serious. Although I was just 43, having lost two aunts to breast cancer, I knew my family history increased my risk for developing the disease. So when I saw my gynecologist for an exam, I was...
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...
Tweeting at ASCO Annual Meetings Can Enhance the Experience
Tweeting at concerts or plays may earn you scornful looks or even stern warnings from ushers, but tweeting at the ASCO Annual Meeting may enhance the meeting experience for you and others. In a study comparing trends in Twitter use by physicians during the 2010 and 2011 ASCO Annual Meetings, some...
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 ...
For Advanced Sarcomas, New Agents Prolong Remission but Not Survival
“We are beginning to understand the molecular biology underlying a portion of the 80 or so subtypes of sarcomas, and we hope this will lead to subtype-specific treatments,” said William D. Tap, MD, of Memorial Sloan-Kettering Cancer Center, New York, at the Best of ASCO Boston meeting. “And in...
SIDEBAR: Trials’ Shortcomings Leave Role of Induction Chemotherapy Unclear
Given certain shortcomings of the DeCIDE and PARADIGM trials, the true role of induction chemotherapy in head and neck cancer is still not clear, said George R. Blumenschein, Jr, MD, Associate Professor at The Unviersity of Texas MD Anderson Cancer Center, Houston, at the Best of ASCO San Diego...
Pivotal Trials in Head and Neck Cancers Yield Mixed Results
The latest research in head and neck cancer reported at this year’s ASCO Annual Meeting presents a mixed picture, according to George R. Blumenschein, Jr, MD, Associate Professor at The Unviersity of Texas MD Anderson Cancer Center, Houston, who presented the data at the Best of ASCO San Diego...
SIDEBAR: Trials Establish New Standard of Care for Anaplastic Oligodendroglioma
Long-term results of two cooperative group phase III trials have determined radiation therapy and chemotherapy is the new standard of care for newly diagnosed anaplastic oligodendroglioma with 1p19q loss,” commented Eric L. Chang, MD, of the USC Norris Cancer Hospital and Keck School of Medicine,...
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...
Successful Use of Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy May Hinge on Prior Experience
A review of 60 consecutive patients with peritoneal carcinomatosis who underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC)—sometimes called “hot chemotherapy”—found 0% mortality and 33% morbidity, with “a significant reduction of grade III/IV morbidity,...
Expert Point of View: Clifford A. Hudis, MD
Clifford A. Hudis, MD, of Memorial Sloan-Kettering Cancer Center, New York, said that the findings of the US Oncology study should be “very reassuring” to physicians and patients. “Several recent publications and SEER (Surveillance, Epidemiology, and End Results) database analyses have reported...
Adjuvant Chemotherapy for Breast Cancer Not Linked to Acute Myeloid Leukemia and Myelodysplastic Syndromes
Contradicting what some previous investigations have found, a study from The US Oncology Network found that adjuvant chemotherapy for breast cancer does not increase the risk of acute myeloid leukemia and myelodysplastic syndromes (AML/MDS), at least within the first 3 years of treatment.1 The...
Novel Device May Eliminate Need for Re-excision after Lumpectomy
A novel device employed during breast surgery reduces the need for re-excision due to positive margins. This lessens patient anxiety, lowers treatment costs, and helps preserve the cosmetic appearance of the breast, according to a large prospective study reported at the 2012 Breast Cancer...
Noncolorectal GI Cancer Evidence Incorporated into Guidelines
The noncolorectal gastrointestinal cancer studies selected for this year’s Best of ASCO meetings include some whose results are being folded into practice guidelines or are good candidates for incorporation, according to Alexandria T. Phan, MD, Associate Professor at The University of Texas MD...
Developments in Hematologic Cancers Include New Considerations in Treating Challenging Leukemias and Multiple Myelomas
Speakers at the National Comprehensive Cancer Network (NCCN) 7th Annual Congress on Hematologic Malignancies reviewed the current standard of care for various hematologic cancers and explored new concepts in treatment. Below are highlights from presentations on chronic myelogenous leukemia (CML),...
On Mentoring: Looking Back with Gratitude and Paying It Forward
Upon graduation from medical school, doctors are given a gift that lasts a lifetime—the gift of respect. That respect needs to be re-earned every day, but it is accompanied by other rewards that come with caring for people: the ability to gain another’s trust, to reverse illness that alters the...
Despite Progress, Chemotherapy Drug Shortages Still Vex the Oncology Community
During the first week of November 2011, President Obama signed an Executive Order directing the FDA to take steps to help resolve the drug shortages that were affecting patient care across the country. The oncology community was hit especially hard; many of the drug shortfalls were generic...
Feminist Author Babette Rosmond Helped Propel the Adoption of Patients’ Rights to Choose Their Cancer Treatment
Then writer and editor Babette Rosmond was diagnosed with breast cancer in 1971, the second wave of the Women’s Liberation Movement that began in the mid-1960s was in its infancy. Still, when told by her doctor that she would need a radical mastectomy—a procedure developed by William Stewart...
SIDEBAR: Don’t Expect Direct Questions from Patients about Pain
Just asking patients “Is there something else you want to address in the visit,” rather than “Is there anything else you want to address in the visit today,” dramatically reduced patients’ unmet concerns during a primary care visit, according to a 2007 study.1 That learning can be applied to...
Pain Remains Prevalent among Oncology Outpatients, with Odds of Undertreatment Twice as High among Minority Patients
In 1994, a landmark study of pain among oncology outpatients prompted a host of pain management initiatives.1 More than 18 years later, a recent study among more than 2,000 cancer outpatients has found that “one-third of the patients who had pain or used analgesics received inadequate treatment for ...
SIDEBAR: All Eyes on Trials of IV vs IP Chemotherapy for Ovarian Cancer
The positive findings from the NOVEL trial add to the debate about how intravenous (IV) chemotherapy stacks up against intraperitoneal (IP) chemotherapy when treating ovarian cancer and the role of dose-dense approaches in general, according to Jonathan S. Berek, MD, of the Stanford Women’s Cancer...
Major Strides Seen in Treatment of Gynecologic Cancers
Research reported at this year’s ASCO Annual Meeting shows major strides in treating ovarian and cervical cancers, suggesting the potential of new agents and adding evidence in areas where optimal management is unclear, according to Jonathan S. Berek, MD, of the Stanford Women’s Cancer Center,...
Novel Drug Combinations Present New Hope for Effective Treatments in Multiple Myeloma
Developing early-phase clinical trials that incorporate combinations of novel agents targeting different pathways in the hematologic cancer multiple myeloma is a leading focus of the work of Sagar Lonial, MD, Professor of Hematology and Vice Chair of Clinical Affairs in the Department of Hematology ...
Karnofsky Award Winner Honors Mentors through Gift to Conquer Cancer Foundation
Kanti R. Rai, MD, and his wife Susan have been loyal donors to the Conquer Cancer Foundation for the past 9 years, but in 2012, a momentous occasion in his career inspired Dr. Rai to make a unique gift. A Moment of Reflection In the spring of 2012, Dr. Rai, an internationally recognized expert on ...
Role of Crizotinib in Previously Treated ALK-positive Advanced NSCLC
In yet another success story for personalized medicine, a targeted therapy extended survival in patients whose cancers expressed the target. Crizotinib (Xalkori), the first-in-class ALK inhibitor, extended progression-free survival and improved response rates compared with single-agent chemotherapy ...
SIDEBAR: Dacomitinib: Better in Whom? Better in What?
Drug development is a highly competitive business. A new drug must be proven to be better than the standard one before it can be registered for public use. Starting with preclinical data, there should be evidence of lower 50% inhibitory concentrations in selective cell lines or a broader spectrum...
Challenging Times: A Day in the Life of a Community Oncologist
Community oncologists man the front line of cancer care, treating upward of 85% of our nation’s patients. Over the past 2 decades, regulatory and economic changes have left many practices in a state of flux and uncertainty, some struggling to keep their doors open. To shed light on the community...
Ignoring Level 1 Evidence in Invasive Bladder Cancer: Is Ignorance Bliss?
I’ve been part of the uro-oncology community for more than 30 years and have been proud to be involved in a good number of well-powered, enthusiastically subscribed randomized clinical trials. These have dated back to a time before randomization was necessarily the fashion. I have had the pleasure...
Expert Point of View: Reinhard Dummer, MD
Although the effects of BRAF inhibition were initially unprecedented in patients with BRAF-mutated metastatic melanoma, “the problem is that the effect is not durable,” said formal discussant of this trial, Reinhard Dummer, MD, University Hospital of Zurich, Switzerland. The development of...
Media Campaign with Real Smokers a Success
Real smokers sharing in graphic terms what it is like to live with disfiguring or disabling tobacco-related diseases were the featured spokespersons for the Centers for Disease Control and Prevention (CDC) national media campaign to encourage smokers to quit. Based on short-term response, the CDC...
Surrounded by Breast Cancer
Nine women on my mother’s side of the family have been diagnosed with breast cancer, and nearly half have died from their disease, including my mother. With odds like these, I was determined to do what I could to stay ahead of this dreaded monster I thought was surely coming for me. First Tests...
Explaining Research to Patients
Everyone understands the need for medical research, especially regarding cancer. However, only a minority of the public understand what is actually involved in taking part in a clinical trial. As professionals, we are responsible for designing relevant studies, for their conduct and analysis, and...
Delivering Affordable Cancer Care: Is It Possible and What Will It Entail?
Many experts agree that at 18% of gross domestic product, health care (to paraphrase Shakespeare) is eating the country out of house and home. “The average cost of treating the most common cancers has increased, and as more expensive targeted therapies and other new technologies become the...
Options Shifting for First-line Treatment of Renal Cell Carcinoma
Trials with pazopanib (Votrient) have “provided significant efficacy, toxicity, and tolerability data for pazopanib to be established as a first-line standard of care” for renal cell carcinoma,” Tim Eisen, PhD, of the University of Cambridge, United Kingdom, stated at the 11th International Kidney...
Novel Agents for Breast Cancer and Prostate Cancer Impressive in Early Trials
Several sessions at the 2012 European Society for Medical Oncology (ESMO) Congress in Vienna focused on novel targeted therapies in various stages of development. Summarized here are data on two promising drugs for breast cancer and two for prostate cancer. E-3810 in Breast Cancer Two experimental...
Integrative Medicine Showing Benefits in Cancer Management
Donald I. Abrams, MD, Chief of Hematology-Oncology at San Francisco General Hospital and Integrative Oncologist at the University of California, San Francisco, Osher Center for Integrative Medicine, has been investigating and incorporating integrative medicine approaches in his clinical treatment...
SIDEBAR: Mammography Study Stokes Overdiagnosis Debate
Overdiagnosis and the harms associated with unnecessary procedures is becoming a vibrant subject in today’s health-care dialogue, with serious implications for providers and patients alike. A new study from the Norwegian Screening Program concluded that 15% to 25% of breast cancers identified on...
Seeking Solutions to the Dilemmas of Overdiagnosis and Overtreatment
Widespread use of screening technologies has markedly increased early detection rates of cancer, saving countless lives. However, while screening technologies have remarkable sensitivity, their inability to identify which tumors will progress and which will not has created the phenomenon of...
Defining a Cure for Chronic Myeloid Leukemia and Strategies to Achieve this Goal
In chronic myeloid leukemia (CML), continued long-term therapy that prevents both progression to accelerated-phase disease and the emergence of resistance may be thought of as an “operational” or “functional” cure. However, long-term disease control without the requirement for continuous treatment...
Managing Treatment Failure in Chronic Myeloid Leukemia
As John Goldman, DM, FRCP, FRCPath, FMedSci, discussed earlier, a substantial minority of patients with chronic myeloid leukemia (CML) experience treatment failure. Jorge Cortes, MD, of The University of Texas MD Anderson Cancer Center, introduced this session with two patient cases to illustrate...
Defining and Recognizing the Causes of Imatinib Resistance and the Importance of Adherence
Imatinib (Gleevec) is a highly effective therapy for the majority of patients with chronic myeloid leukemia (CML). In the IRIS study, only 30% of patients could be considered to have failed imatinib treatment after 6 years.1 However, these 30% of patients are a substantial minority. John Goldman,...
Beyond Molecular Monitoring: Cytogenetic Testing and Mutational Analysis in Chronic Myeloid Leukemia
Cytogenetic analysis remains an important component of patient monitoring until a complete cytogenetic response is achieved. In addition, the ability of conventional cytogenetics to identify additional chromosomal abnormalities not detected by fluorescence in situ hybridization is noteworthy. Jorge ...
