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health-care policy
cost of care

Tough Questions About Health-Care Reform Put Economist in Hot Seat

Although diverse stakeholders agree that health reform is needed, there is little consensus on the specifics of that reform. Best of ASCO Seattle attendees put a number of pointed questions to health economist Rena Conti, PhD, of the University of Chicago, asking about thorny issues such as cost...

issues in oncology

Relevance of the Hippocratic Oath in the 21st Century

On the face of it, the idea that a code of professional conduct dating to the ancient Iron Age could possibly retain any relevance in the current era of “Big Data,” religious and cultural pluralism, trillion-dollar government budgets, and nanotechnology seems preposterous. Yet the well-publicized...

Expert Point of View: Benjamin Movsas, MD

Benjamin Movsas, MD, Chair of Radiation Oncology at Henry Ford Hospital in Detroit, served as moderator at a press conference where the two SBRT studies by Timmerman et al and Ashworth et al were reported.1,2 Dr. Movsas said that SBRT is a promising approach, noting that the therapy facilitates...

A History of Medical Oncology

BOOKMARK Title: Therapeutic Revolution: The History of Medical Oncology From Early Days to the Creation of the SubspecialtyAuthor: Pierre R. BandPublisher: Bentham SciencePublication date: 2014Price: $39.00 (eBook); $78.00 (print on demand); 213 pagesAvailable at: eurekaselect.com   According to...

lung cancer

Clinical Trials Actively Recruiting Patients With Lung Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies of people with lung neoplasms, including stage I and II small cell and non–small cell lung cancers. The studies include phase Ib, II, III, observational, and interventional trials...

head and neck cancer

Adding Cetuximab to Chemoradiation Did Not Benefit Patients With Advanced Head and Neck Cancer: What Were the Reasons?

Two landmark randomized studies demonstrated improved survival of patients with head and neck cancer receiving the epidermal growth factor receptor (EGFR) antibody cetuximab (Erbitux) concurrent with radiotherapy compared with radiotherapy alone,1 and similar improvement in patients with...

Expert Point of View: Andrew D. Zelenetz, MD, PhD

I am a believer in intriguing preliminary data that suggests we can modify the poor outcome associated with non–[germinal center B-cell] lymphoma—for example, using R2-CHOP (lenalidomide [Revlimid] and rituximab [Rituxan] plus cyclophosphamide, doxorubicin, vincristine, and prednisone), ibrutinib...

lymphoma

Beyond R-CHOP for Lymphoma

The R-CHOP regimen (rituximab [Rituxan] plus cyclophosphamide, doxorubicin, vincristine, and prednisone) was a major advance in treating diffuse large B-cell lymphoma, but experts are seeking to up the ante and identify ways to continue to improve outcomes beyond that achieved with R-CHOP. “We are...

thyroid cancer

Lenvatinib Receives Priority Review Designation for Advanced Thyroid Cancer

The U.S. Food and Drug Administration (FDA) has given Priority Review designation to the New Drug Application for lenvatinib mesylate as a treatment for progressive radioactive iodine–refractory differentiated thyroid cancer. Lenvatinib is an oral multiple receptor tyrosine kinase inhibitor with a...

issues in oncology

E-Cigarettes Unhelpful in Smoking Cessation Among Patients With Cancer

In a new study of patients with cancer who smoke, those using e-cigarettes in addition to traditional cigarettes were more nicotine-dependent and equally or less likely to have quit smoking traditional cigarettes than nonusers.1 The rising use of e-cigarettes has raised many questions among...

prostate cancer

Radiotherapy Should Be Added to Hormone Therapy in Node-Positive Prostate Cancer

Node-positive prostate cancer has typically been excluded from clinical trials, leaving oncologists with little evidence to guide management for this group of patients. A study presented at the European Society for Medical Oncology (ESMO) 2014 Congress sheds light on this issue, providing the...

lung cancer
palliative care

Novel Oral Agent Treats Cachexia in Patients With Non–Small Cell Lung Cancer

For the first time, studies show that a drug is effective in treating several domains of cancer-related cachexia. Oral anamorelin increased lean body mass, achieved weight gain, and improved quality of life in patients with cancer-related cachexia in two pivotal phase III studies presented together ...

More on Chemotherapy Costs

I took exception to a number of the comments made by Rena Conti, PhD, in The ASCO Post (“Health-Care Reform Is Changing the Oncology Landscape,” October 15, 2014, page 1). I realize that The ASCO Post is not a peer-reviewed and indexed publication, but as an ASCO member, I also recognize that the...

breast cancer

RNA-Binding Protein Destabilizes Transcripts of Novel Metastasis Suppressor Genes in Breast Cancer

In a study reported in Nature, Goodarzi and colleagues attempted to identify post-transcriptional modulators of mRNA stability in breast cancer via whole-genome transcript stability measurements in poorly and highly metastatic isogenic human breast cancers. They identified a family of structural...

Printed NCCN Guidelines for Patients Now Available Through Amazon.com

The National Comprehensive Cancer Network (NCCN), with the support of the NCCN Foundation, recently announced the availability of printed versions of the NCCN Guidelines for Patients for order on Amazon.com for the following cancer types: Breast (Stages 0–IV), Colon, and Pancreatic Cancers;...

issues in oncology
lymphoma

The Power of Laughter

The following essay by Julie Vose, MD, MBA, FASCO, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories (May 2014), coedited by Stan Winokur, MD, and Vincent Coppola. The book is available on Amazon.com and thebigcasino.org.   When I met Cindy, she was...

colorectal cancer

Clinical Trials Actively Recruiting Patients With Colon or Rectal Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies of people with colon or rectal cancer in the newly diagnosed and metastatic settings. The studies include phase I, Ib, II, observational, and interventional trials investigating new drug...

lung cancer

ASCO Endorses CAP/IASLC/AMP Guidelines for Molecular Testing of Patients With Non–Small Cell Lung Cancer

Personalized medicine is an established treatment concept for patients with advanced non–small cell lung cancer (NSCLC), and molecular characterization of tumors is crucial for choice of (first-line) therapy. As of right now, we have U.S. Food and Drug Administration (FDA)-approved drugs for two...

leukemia

Kinase-Activating Alterations Identified in Most Cases of  Philadelphia Chromosome–Like Acute Lymphoblastic Leukemia May Be Targetable With Available Tyrosine Kinase Inhibitors

In a study reported in The New England Journal of Medicine, Kathryn G. Roberts, PhD, of St. Jude Children’s Research Hospital, and colleagues performed detailed genomic analysis of patients with Philadelphia chromosome–like acute lymphoblastic leukemia (ALL) and identified kinase-activating...

issues in oncology
colorectal cancer

Half of Premature Colorectal Cancer Deaths Due to Socioeconomic Inequality

Half of all premature deaths from colorectal cancer (described as deaths in people ages 25 to 64) in the United States are linked to ethnic, socioeconomic, and geographic inequalities, and therefore could be prevented according to a new study by American Cancer Society researchers. The report,...

gastrointestinal cancer

Adding VEGFR2 Inhibitor Ramucirumab to Paclitaxel Increases Overall Survival as Second-Line Treatment for Advanced Gastric Cancer

In the phase III RAINBOW trial reported in The Lancet Oncology, Hansjochen Wilke, MD, Director of Medical Oncology/Hematology at Kliniken Essen-Mitte, Essen, Germany, and colleagues found that adding the vascular endothelial growth factor receptor 2 (VEGFR2) inhibitor ramucirumab (Cyramza) to...

multiple myeloma

High-Dose Melphalan, Early Stem Cell Transplant, and Lenalidomide Maintenance in Myeloma: One Size Still Does Not Fit All

In an important recent study by Dr. Antonio Palumbo and colleagues,1 reviewed in this issue of The ASCO Post (page 128), 273 patients aged ≤ 65 years were randomly assigned to early transplant or consolidation therapy using MPR (melphalan, prednisone, and lenalidomide [Revlimid]) after successful...

hematologic malignancies
solid tumors
issues in oncology

Top 10 Myths About FDA’s Office of Hematology and Oncology Products

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, FDA oncologists Gideon Blumenthal, MD, and Tatiana Prowell, MD, discuss 10 common myths about FDA’s Office of Hematology and Oncology ...

gynecologic cancers

Maintenance Therapy in Ovarian Cancer: What’s at Stake?

Maintenance therapy in ovarian cancer refers to a cohort of women achieving response to initial adjuvant chemotherapy who then go on to additional therapy in the hopes of extending time to recurrence or inducing a lasting remission. The concept is not new and retains its scientific and clinical...

gynecologic cancers

Pazopanib Maintenance Improves Progression-Free Survival in Ovarian Cancer

In a phase III trial reported in the Journal of Clinical Oncology, ­Andreas du Bois, MD, PhD, Professor of Gynecologic Oncology at Kliniken Essen-Mitte in Essen, Germany, and colleagues found that maintenance therapy with the vascular endothelial growth factor receptor (VEGFR) and platelet-derived...

breast cancer

Study Finds Significant Increase in Bilateral Mastectomy for Unilateral Breast Cancer Despite Lack of Survival Benefit

In an observational cohort study reported in JAMA, Allison W. Kurian, MD, MSc, Assistant Professor of Medicine and of Health Research and Policy at Stanford University School of Medicine, and colleagues assessed use of and mortality after bilateral mastectomy, breast-conserving surgery plus...

ASTRO Initiatives Aimed at Practice Improvement

At the opening press conference of the 56th Annual Meeting of the American Society for Radiation Oncology (ASTRO), 2014 President Bruce G. Haffty, MD, FASTRO, Professor and Chairman of the Department of Radiation Oncology at Rutgers–Robert Wood Johnson Medical School and Associate Director at the...

Expert Point of View: Giorgio V. Scagliotti, MD, PhD

Formal discussant Giorgio V. Scagliotti, MD, PhD, Professor and Chair of Medical Oncology at the University of Turin and San Luigi Hospital, Orbassano, Italy, tackled each of the studies presented at the European Society for Medical Oncology (ESMO) session on metastatic non–small cell lung cancer...

lung cancer

Moving Forward With Biomarkers in Non–Small Cell Lung Cancer

The effort to identify new biomarkers for response and outcomes in lung cancer is advancing, according to studies presented at the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid. Immunohistochemical expression of folate receptor for vintafolide and thymidylate synthase for...

lung cancer

Postoperative Radiation Therapy Improves Overall Survival for Patients With Resected Pathologic N2 Non–Small Cell Lung Cancer

Patients who received postoperative radiation therapy lived an average of 4 months longer when compared to the patients who had the same disease site, tumor histology, and treatment criteria and who did not receive postoperative radiotherapy, according to research presented at the 2014 Chicago...

lung cancer

Emerging Drugs Effectively Tackle Non–Small Cell Lung Cancer Mutations

For advanced nonsquamous non–small cell lung cancer (NSCLC), targeting of the epidermal growth factor receptor (EGFR) mutation and the ALK abnormality has become an established strategy. Later-generation drugs in these categories are now showing efficacy in trials, including for the treatment of...

prostate cancer

Genomic Score Predicts Aggressiveness of Prostate Cancer in Biopsy Specimens

A prospectively designed study establishes the17-gene Oncotype DX prostate cancer test as a robust and independent predictor of the aggressiveness of prostate cancer based on a patient’s diagnostic specimen. Tumor aggressiveness, as measured by the test’s Genomic Prostate Score, was similar in...

Expert Point of View: Axel Grothey, MD

Putting the maintenance trials into context was Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, who commented, “These studies inform our clinical practice and have a meaningful impact on how we treat our patients.” DREAM Trial In the DREAM Trial, Dr. Grothey...

colorectal cancer

European Studies Explore Maintenance Strategies for Metastatic Colorectal Cancer

Studies presented at the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid added insight regarding maintenance therapy in metastatic colorectal cancer, an area lacking a clear recommended strategy following first-line regimens. Two phase III trials found benefit for bevacizumab...

lung cancer

FDA Grants Breakthrough Therapy Designation Pembrolizumab in Advanced Non–Small Cell Lung Cancer

Pembrolizumab is a humanized monoclonal antibody that blocks the interaction between PD-1 and its ligands, PD-L1 and PD-L2. By binding to the PD-1 receptor and blocking the interaction with the receptor ligands, pembrolizumab releases the PD-1 pathway–mediated inhibition of the immune response,...

issues in oncology
cost of care

Tackling the Complexity of Cancer: Finding Common Ground on Value and Progress

To kick off the second national Turning the Tide Against Cancer conference, sponsored by the American Association for Cancer Research, Personalized Medicine Coalition (PMC), and Feinstein Kean Healthcare, Edward Abrahams, PhD, President of PMC, noted that U.S. health-care costs are unsustainable...

breast cancer

Noteworthy Abstracts From the Breast Cancer Symposium Include Studies of Novel Therapies and of the Impact of Disease Subtypes on Outcomes

More than 150 oral and poster presentations were featured at the 2014 Breast Cancer Symposium, held September 4–6 in San Francisco. The multidisciplinary meeting is sponsored by ASCO, the American Society of Breast Disease, American Society of Breast Surgeons, American Society for Radiation...

lymphoma

Targeted Therapies in Indolent Lymphoma: Challenging the Current Paradigm

The use of targeted therapies in indolent non-Hodgkin lymphoma (NHL) is a burgeoning area. New targeted therapies directed at the cell surface, intracellular pathways, and the microenvironment are being studied for relapsed indolent NHL. These treatments, if validated in large randomized trials,...

colorectal cancer

For Selected Patients With Metastatic Colorectal Cancer, Taking a Break From Combination Chemotherapy Might Be Appropriate and Appreciated

Two phase III studies presented at the Best of ASCO meeting in Chicago shed more light on the role of maintenance therapy in patients with metastatic colorectal cancer undergoing first-line treatment with oxaliplatin-based chemotherapy. The two studies compared maintenance therapy with bevacizumab...

issues in oncology

Studies Address Impact of Social Factors on Cancer Treatment Disparities

New studies reported at ASCO’s 2014 Quality Care Symposium provided insight on the role social factors play in cancer treatment disparities, as well as effective approaches to improving the quality of care.   “The research presented [here] highlights how the conditions facing people living with...

Expert Point of View: Solange Peters, MD, PhD

The IMPRESS trial asks a simple question: Should you continue an [epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor] while you switch to chemotherapy,” said Solange Peters, MD, PhD, Head of the Thoracic Malignancies Program at the University of Lausanne, Switzerland, at the European ...

lung cancer

IMPRESS Trial: Lung Cancer Progression on First-Line Tyrosine Kinase Inhibitor Indicates the Drug Should Be Stopped

The IMPRESS trial found no benefit for continuing treatment with the epidermal growth factor receptor (EFGR) tyrosine kinase inhibitor gefitinib (Iressa, discontinued in the United States) plus chemotherapy vs chemotherapy alone in patients with EGFR-mutated non–small cell lung cancer (NSCLC) who...

issues in oncology

NCCN Publishes 20th Annual Guidelines in NSCLC, Reflecting Advances in Screening, Diagnosis, Radiology, and Systemic Therapies

The National Comprehensive Cancer Network (NCCN) has published the 20th annual edition of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Non-Small Cell Lung Cancer (NSCLC), one of the eight original NCCN Guidelines published in November 1996. “Since the first NCCN...

lymphoma

Clinical Trials Actively Recruiting Patients With Hodgkin Lymphoma and Non-Hodgkin Lymphoma

The information contained in this Clinical Trials Resource Guide includes clinical studies actively recruiting people with Hodgkin lymphoma, non-Hodgkin lymphoma (NHL), including AIDS-related NHL, as well as studies that are also recruiting patients with multiple myeloma and mantle cell lymphoma....

lung cancer

Beating the Odds

I know it sounds odd, but the past 10 years spent living with non–small cell lung cancer (NSCLC) have been very productive, wonderful years. It is not the life I had before my diagnosis, but it is the life I remember most clearly, and knowing how deadly this cancer is, I’m grateful for every day of ...

Tapping Palliative Care’s Survival Benefit

A trial reported in 2010 found that adding palliative care to standard care at the time of lung cancer diagnosis prolonged overall survival by an average of about 2.6 months,1 Arif H. Kamal, MD, told attendees at the Best of ASCO meeting in Seattle. Dr. Kamal is Director of Quality and Outcomes at...

Discussing Cessation of Medications Near the End of Life

Discussions with patients and families about stopping non–cancer-related medications near the end of life are thorny but necessary, according to Arif H. Kamal, MD, of Duke Cancer Institute, at the Best of ASCO meeting in Seattle. “What’s happening now is that a lot of hospices are having a...

cns cancers

Treating Brain Cancer in 2014

While primary malignant brain tumors account for only 2% of all adult cancers, these deadly neoplasms cause severe cancer-related disability; the 5-year survival rates for brain tumors rank third lowest among all cancers, with those for pancreas and lung cancers being first and second lowest,...

multiple myeloma

HDAC Inhibitors and Triple Therapy in Relapsed Myeloma

The use of histone deacetylase (HDAC) inhibitors as human cancer therapy has focused on the impact of these agents on epigenetic regulation and gene transcription. However, the use of HDAC inhibitors in myeloma may be working through a different mechanism. Specifically, HDAC6 is known to regulate...

issues in oncology

Assessing the Nature of Unplanned Emergency Cancer Care Situations

Unplanned cancer care—emergency department presentations and other unanticipated events—can result in poor outcomes that are potentially preventable. Suzanne Tamang, PhD, Stanford University, Stanford, California, addressed this important issue in her presentation at this year’s Quality Care...

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