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issues in oncology

Measles Presents Greater Risks in Children Being Treated for Cancer

Measles outbreaks in the United States during 2014 and early 2015 have yielded an unprecedented number of cases nationwide, raising concerns about the threat measles poses to cancer patients (especially children) who may be at risk for severe complications and even death due to measles infection....

breast cancer

Palbociclib as Initial Endocrine-Based Therapy in Postmenopausal Women With Metastatic Breast Cancer

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.   On February 3, 2015, palbociclib (Ibrance) was granted...

hematologic malignancies

The Current State of Hematologic Malignancies

Due in part to the refinement of bone marrow transplantation and its many innovations, some leukemias that once were death sentences now have cure rates of up to 90%. As research in transplantation and other promising areas accelerates, we are on the verge of breaking new clinical boundaries in...

head and neck cancer

Treating Head and Neck Cancer in 2015

Each year in the United States, about 55,000 people will be diagnosed with head and neck cancer, and of them, about 12,000 will die of the disease. Although advances have been made in the treatment of head and neck cancer, this disease remains persistently problematic, due, in part, to the complex...

lymphoma

PD-1 Blockade With Nivolumab Produces High Response Rate in Relapsed/Refractory Hodgkin Lymphoma

Anti–PD-1 antibodies have been shown to be effective in solid tumors. There is evidence that the malignant Reed-Sternberg cells in Hodgkin lymphomas use the programmed cell death protein 1 (PD-1) pathway to evade immune detection, with alterations in chromosome 9p24.1 increasing levels of the PD-1...

breast cancer

Combination Treatment Every 2 Weeks May Benefit Some Women With High-Risk Early-Stage Breast Cancer

In a phase III trial (SWOG S0221) reported in the Journal of Clinical Oncology, George T. Budd, MD, of Taussig Cancer Center, Cleveland Clinic, and colleagues found no difference in disease-free survival among four different combinations of continuous or every-other-week...

palliative care

Highlights From the 2014 Palliative Care in Oncology Symposium

The inaugural 2014 Palliative Care in Oncology Symposium was held October 24 to 25 in Boston. Over 200 abstracts were presented, covering topics such as the integration of palliative care into treatment and the financial hardships facing people living with cancer. The following abstracts were among ...

hematologic malignancies

Clonal Hematopoiesis With Somatic Mutations Increases Risk of Hematologic Cancer, Mortality, and Cardiovascular Disease

In two studies recently reported in The New England Journal of Medicine,1,2 whole-exome sequencing of DNA from peripheral blood cells of individuals unselected for hematologic phenotype showed that clonal hematopoiesis with somatic mutations is increasingly common with increasing age and is...

lymphoma

HIV-Related Lymphoma Can Be Safely Treated With Transplant

Human immunodeficiency virus (HIV)-positive patients with relapsed/refractory lymphoma can safely undergo autologous hematopoietic cell transplantation, according to results of a phase II multicenter trial presented at the 56th American Society of Hematology (ASH) Annual Meeting and Exposition in...

breast cancer

PI3K Inhibition in Hormone Receptor–Positive Breast Cancer ‘Not Ready for Prime Time’

Interest is high in studying the PI3K pathway in hormone receptor–positive breast cancer, but it is not clear which of the PI3K inhibitors under development—if any—will be a “home run.” The phase II FERGI study, reported at the 2014 San Antonio Breast Cancer Symposium, failed to meet its primary...

prostate cancer

Active Surveillance in Intermediate-Risk Prostate Cancer Called Into Question

A study presented at the 2015 Genitourinary Cancers Symposium calls into question the use of active surveillance in patients with intermediate-risk prostate cancer. Patients with intermediate-risk prostate cancer managed with active surveillance had almost a four times higher risk of prostate...

pain management

Key Evidence Gaps and Research Priorities Should Be Addressed So Physicians Can Identify Patients Most Likely to Benefit From Opioids

Key evidence gaps and research priorities must be addressed “so that physicians can recognize patients for whom opioids are most appropriate and use optimal regimens for these patients,” according to the National Institutes of Health (NIH) Pathways to Prevention Workshop final report on the role of ...

multiple myeloma

Five Questions Can Guide the Treatment of Relapsed Myeloma

Joseph Mikhael, MD, MEd, myeloma expert at the Mayo Clinic in Arizona, Scottsdale, and Associate Dean of the Mayo School of Graduate Medical Education, considers five questions when selecting treatment for patients with multiple myeloma who relapse. “With prolonged survival, which approaches 10...

multiple myeloma

Panobinostat in Combination With Bortezomib‑Dexamethasone in Previously Treated Multiple Myeloma

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.   On February 23, 2015, panobinostat (Farydak) was granted...

issues in oncology

Development and Approval of Biosimilar 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, Leah Christl, PhD, and Albert Deisseroth, MD, PhD, answer questions about biosimilar products. Dr. Christl is the Associate Director...

breast cancer

Increasing the Use of Hypofractionated Radiation in Early-Stage Breast Cancer: The Way Forward

Bekelman and colleagues are to be congratulated on the publication of an important paper—reviewed in this issue of The ASCO Post—alerting us all to the underutilization of hypofractionated whole-breast irradiation in the treatment of early-stage breast cancer.1 As background, recent randomized...

colorectal cancer

Don’t Disregard Questions About Possible Symptoms of Colorectal Cancer Just Because the Patient Is ‘Too Young’

While colorectal cancer predominantly occurs in people over 50 years old, rates are increasing among younger patients. It is important for physicians not to ignore symptoms in patients who are young, “simply because they are young,” Jason A. Zell, DO, MPH, told The ASCO Post. Dr. Zell is the...

issues in oncology
lung cancer

The Ongoing Struggle Against Tobacco: Past Accomplishments, Future Steps

In 1913, 10 doctors and 5 laypersons in New York founded the American Cancer Society (ACS). At that time, a cancer diagnosis was almost always fatal and was rarely discussed in public. The Society’s original charter was to raise awareness about cancer, and although that mission has remained firm,...

multiple myeloma

Increased Progression-Free Survival With Addition of Carfilzomib to Lenalidomide/Dexamethasone in Relapsed Multiple Myeloma

In a planned interim analysis of the phase III ASPIRE trial reported in The New England Journal of Medicine, A. Keith Stewart, MB, ChB, of the Mayo Clinic, Scottsdale, Arizona, and colleagues found that the addition of the proteasome inhibitor carfilzomib (Kyprolis) to lenalidomide...

gastrointestinal cancer

The Emerging Role of Radiation Therapy in Gastrointestinal Cancers

The use of radiation therapy in the treatment of gastrointestinal cancer has evolved over the past several decades, in a gradual, stepwise fashion. Since most gastrointestinal cancers are diagnosed at a locally advanced stage, coupled with the inherent sensitivity of most parts of the...

bladder cancer

Adjuvant Chemotherapy and Overall Survival in Muscle-Invasive Bladder Cancer: Still Climbing the Mountain

Muscle-invasive bladder cancer can be a lethal disease despite curative intent local therapy, with 5-year survival that can be as low as 30% based on the extent of T status and/or lymph node involvement. The use of neoadjuvant chemotherapy with MVAC (methotrexate, vinblastine, doxorubicin, and...

bladder cancer

No Overall Survival Difference for Immediate vs Deferred Chemotherapy After Radical Cystectomy in Muscle-Invasive Bladder Cancer

In the European Organisation for Research and Treatment of Cancer (EORTC) 30994 trial, a phase III intergroup study reported in The Lancet Oncology,1 Cora N. Sternberg, MD, FACP, Chief of Medical Oncology at San Camillo and Forlanini Hospitals, Rome, and colleagues found no overall survival...

cns cancers

Dinutuximab in Pediatric High-Risk Neuroblastoma

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.   On March 10, 2015, the chimeric monoclonal antibody dinutuximab...

Expert Point of View: Eric J. Small, MD

Eric J. Small, MD, of the University of California at San Francisco, discussed what he thought went wrong for cabozantinib (Cometriq) in the ­COMET-1 trial, yet another example of a phase III trial that failed to deliver on the promise of phase II results. “Although this was a negative study,...

prostate cancer

Cabozantinib Fails to Improve Survival in Metastatic Castration-Resistant Prostate Cancer

Final results of the phase III, randomized double-blind, controlled COMET-1 trial were disappointing. Although the oral tyrosine kinase inhibitor cabozantinib (Cometriq) improved several secondary endpoints compared with prednisone, including bone scan response and progression-free survival, the...

breast cancer

Understanding the Role of Immune Function in the Treatment of HER2-Positive Breast Cancer

The addition of trastuzumab (Herceptin) to adjuvant chemotherapy undoubtedly transformed HER2-positive breast cancer from one of the most deadly subtypes to a highly treatable disease. Randomized phase III trials established adjuvant trastuzumab as standard of care in HER2-positive breast...

kidney cancer

No Survival Benefit From Adjuvant Sorafenib or Sunitinib in Kidney Cancer

Adjuvant therapy with sorafenib (Nexavar) or sunitinib (Sutent) failed to make any inroads in improving disease-free survival in patients with locally advanced kidney cancer in the randomized, placebo-controlled, multicenter, phase III Adjuvant Sorafenib and Sunitinib for Unfavorable Renal...

lymphoma

Risk Assessment for Hodgkin Lymphoma Evolving and Promises Greater Precision and Specific Clinical Relevance

“Risk assessment in Hodgkin lymphoma is continuously evolving and promises even greater precision and specific clinical relevance in the future,” Joseph M. Connors, MD, stated in Blood. Dr. Connors is Clinical Professor, British Columbia Cancer Agency Centre for Lymphoid Cancer and the University...

issues in oncology

Staff Support Sessions in an Oncology Setting

Work-related issues such as coping skills, stress management, burnout, and compassion fatigue are among the challenges faced by clinical and other staff in cancer treatment centers. Given the emotional consequences of professional caregiving, staff support group meetings are valuable resources for...

Owen N. Witte, MD, Recognized With AACR G.H.A. Clowes Memorial Award

The American Association for Cancer Research (AACR) honored Owen N. Witte, MD, Founding Director of the Eli & Edythe Broad Center of Regenerative Medicine & Stem Cell Research, and Distinguished Professor of Microbiology, Immunology, and Molecular Genetics at the University of California,...

colorectal cancer

Aspirin as Adjuvant Therapy for Colon Cancer: Is the Time Right?

Aspirin has long proved to be a multipotent drug, with efficacy as a pain reliever, anti-inflammatory agent, antiplatelet agent, and cardioprotective agent. In the cancer world, a large literature has accumulated demonstrating its ability to prevent various epithelial malignancies, most notably...

colorectal cancer

Overweight Girls Face Increased Risk of Colorectal Cancer Later in Life

Girls who are overweight as young children and teens may face increased risk for colorectal cancer decades later, regardless of what they weigh as adults, suggests a new study published by Xuehong Zhang, MD, ScD, Instructor at Harvard Medical School, and colleagues in Cancer Epidemiology,...

breast cancer

Should We Be Worried If Patients Tolerate Endocrine Therapy Well?

When meeting with patients to discuss adjuvant endocrine therapy for breast cancer, the question often arises, “How will I know that the treatment is working?” While the efficacy of these treatments has been demonstrated for the majority of patients in multiple large randomized clinical trials,...

breast cancer

Analysis Shows No Link Between Aromatase Inhibitor–Related Musculoskeletal/Vasomotor Symptoms and Relapse-Free Survival

Retrospective analyses of the ATAC, TEAM, and BIG 1-98 adjuvant endocrine therapy trials in breast cancer have suggested that treatment-emergent endocrine symptoms may be associated with superior survival outcomes. In a study reported in the Journal of Clinical Oncology, Vered Stearns, MD,...

breast cancer
issues in oncology

PRIME II and the Omission of Radiation Therapy in Low-Risk, Elderly Patients Undergoing Breast Conservation: The Time Has Come

Despite the high prevalence of breast cancer worldwide, it is important to recognize that > 40% of all cases occur in women aged 65 years or older in both the United States and the United Kingdom.1,2 Breast cancers in older patients are more often associated with indolent features and with...

multiple myeloma
geriatric oncology

‘Frailty Profile’ Predicts Survival and Toxicities in Elderly Patients With Multiple Myeloma

A frailty score predicts mortality and the risk of toxicity in elderly patients with multiple myeloma and can be used to determine more suitable therapies for these patients, the International Myeloma Working Group reported in Blood. “Chronologic age, performance status, and physician’s clinical...

gynecologic cancers
issues in oncology

Bombarded With Changes in Health Care and Beyond, Gynecologic Oncologists Prepare for the Challenges Ahead

Physicians are being “bombarded” with changes in health care and beyond, Richard R. Barakat, MD, FACS, noted in his Presidential Address at the Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer. These changes are being precipitated by steeply rising health-care costs amid...

issues in oncology
breast cancer

Informing Decision-Making About Mammography Screening

Overdiagnosis associated with breast cancer screening has been the subject of much attention in recent years. The notion that cancer screening—largely believed to be beneficial—could actually be harmful is simultaneously fascinating and difficult to believe. With the publication of multiple studies ...

lymphoma

Brentuximab Vedotin After Autologous Stem Cell Transplantation in High-Risk Hodgkin Lymphoma: Implications of the AETHERA Trial

Hodgkin lymphoma is generally thought to be a malignancy with a favorable prognosis. Overall, approximately 80% of patients will have durable, long-term remissions with initial chemotherapy. Some patients, however, demonstrate evidence of disease progression, and these patients usually receive...

lymphoma

Improved Progression-Free Survival With Brentuximab Vedotin After Transplantation in Hodgkin Lymphoma Patients

In the phase III AETHERA trial reported in The Lancet, Craig H. Moskowitz, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that brentuximab vedotin (Adcetris) consolidation therapy after autologous stem cell transplantation prolonged progression-free survival by 18 months vs...

skin cancer

Combination Immunotherapy Better Than Monotherapy in Advanced Melanoma

As clinical research struggles to keep up with the pace of new immunotherapies, one of the burning questions is how best to combine the new drugs. A new study found that the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) is superior to ipilimumab alone as front-line therapy for untreated ...

cost of care
health-care policy

Creating a Collective Path Forward to Optimize Value in Cancer Care

The Centers for Medicare and Medicaid Services projects that U.S. health-care spending will reach $4.3 trillion and account for 19.3% of the nation’s gross domestic product by 2019.1 Although cancer care represents a small fraction of overall health-care costs, the cost of cancer care is rapidly...

Profile: Julie M. Vose, MD, MBA, FASCO, Making a Difference in Both Clinical Medicine and Research

At this year’s ASCO Annual Meeting, Julie M. Vose, MD, MBA, FASCO, will begin her term as the Society’s 51st President. It is fitting that the meeting will be held in Chicago, the city where the first seven visionaries met over lunch in 1964 to formulate a medical organization centered on cancer...

issues in oncology

Just Engaging in ‘Some’ Leisure Time Physical Activity Reduces Overall and Cancer-Specific Mortality

There’s good news for those who recognize the benefits of exercise but feel they have neither the time nor energy for frequent workouts: A recent study reported in JAMA Internal Medicine1 has found that just performing “some” leisure time physical activity, even below the recommended minimum level, ...

Article on Rare Cancer Generates Enthusiastic Response

The article “Shining a Spotlight on Epithelioid Hemangioendothelioma,” written by Jane Gutkovich and published in the April 10, 2015, issue of The ASCO Post, generated an enthusiastic response from the patient and advocate community of individuals with this rare cancer. Here, we are pleased to...

breast cancer

CLEOPATRA Overall Survival Analysis: Significant Benefit for Pertuzumab Plus Trastuzumab/Docetaxel in HER2-Positive Metastatic Breast Cancer

As reported in The New England Journal of Medicine by Sandra M. Swain, MD, of Washington Cancer Institute, MedStar Washington Hospital Center, and colleagues, the final prespecified overall survival analysis in the phase III CLEOPATRA study showed a significant 15.7-month increase in median overall ...

Learning to Communicate Science More Effectively

Alan Alda’s passion and appreciation for science extend nearly as far back to his early life as his love of acting. The son of actor Robert Alda, Mr. Alda began his acting career at the age of 16. Although he has appeared in such widely acclaimed films as The Seduction of Joe Tynan, Crimes and...

skin cancer

Anti–PD-1 Antibody Pembrolizumab Improves Progression-Free and Overall Survival vs Ipilimumab in Advanced Melanoma

In the phase III KEYNOTE-006 trial reported in The New England Journal of Medicine,1 Caroline Robert, MD, PhD, Head of the Dermatology Unit at the Institut Gustave Roussy, Paris, and colleagues found that the anti–programmed cell death protein 1 (PD-1) antibody pembrolizumab (Keytruda) increased...

issues in oncology
geriatric oncology

Guidelines for the Treatment of Older Cancer Patients: Task Forces of the International Society of Geriatric Oncology

Geriatrics for the Oncologist is guest edited by Stuart Lichtman, MD, FACP, FASCO, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Visit SIOG.org for more on geriatric oncology. The Task Forces of the International Society of Geriatric Oncology (SIOG) are ...

thyroid cancer

Welcome to Multikinase Inhibitors in Radioiodine-Refractory Thyroid Cancer

In the past 2 decades, the incidence of thyroid cancer has risen steeply, with rates now growing by 5.5% annually.1 In 2014, 62,980 new cases of thyroid cancer were diagnosed in the United States. The good news is that, overall, the prognosis of thyroid cancer remains excellent; 97.8% of patients...

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