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Showing 4901 - 4950Racial/Ethnic Differences in Diagnosis of Breast Cancer at Stage I and Subsequent Survival Reflect Biologic Differences
In a study reported in JAMA, Javaid Iqbal, MD, of Women’s College Research Institute, Toronto, and colleagues found racial/ethnic differences in the likelihood of breast cancer diagnosis at stage I and subsequent survival in U.S. breast cancer patients.1 These differences seemed largely to reflect...
Optimizing Treatment for Small, Lymph Node–Negative, HER2-Overexpressing Breast Cancers
Large, randomized phase III clinical trials showed that the addition of HER2-targeted therapy to chemotherapy for patients with early-stage, HER2-overexpressing breast cancers substantially decreased the risk of recurrence and improved survival. The chemotherapy given in these trials varied, but it ...
High Invasive Disease-Free Survival With Adjuvant Paclitaxel and Trastuzumab in Small, Node‑Negative, HER2-Positive Breast Cancers
In a phase II study reported in The New England Journal of Medicine, Sara M. Tolaney, MD, MPH, of Dana-Farber Cancer Institute, and colleagues found that adjuvant paclitaxel and trastuzumab (Herceptin) was associated with high invasive disease-free survival in women with small, node-negative,...
ASCO and NCI Calling on Clinicians and Researchers for Best Oncology Clinical Care Practice Models
ASCO and the National Cancer Institute (NCI) have launched a project to apply team-based oncology clinical care delivery and are calling for writing teams to submit the best clinical oncology patient-centered practices. The two organizations will work with interested authors to create writing teams ...
Addition of Lenalidomide to Docetaxel-Prednisone Worsens Survival in Chemotherapy-Naive Metastatic Castration-Resistant Prostate Cancer
In the phase III MAINSAIL trial reported in The Lancet Oncology, Daniel P. Petrylak, MD, of Yale Cancer Center, New Haven, Connecticut, and colleagues found that the addition of lenalidomide (Revlimid) to docetaxel-prednisone in chemotherapy-naive men with metastatic castration-resistant prostate...
HPV-Related Anal Cancer on the Rise
More than 7,200 cases of anal cancer were diagnosed in 2014—approximately 2,600 in men and 4,600 in women—representing an increase of more than 4,000 from 8 years ago. In more than 90% of patients, infection with the human papillomavirus (HPV) is the cause, tagging anal cancer as a largely...
Managing Breast Cancer in 2015
Since 1990, we have seen an approximate 35% reduction in breast cancer mortality among women in the United States. Three protagonists can share this clinical success story: prevention, early detection, and better therapies. To shed light on the current state of breast cancer research and therapy,...
Many Miles to Go: Targeted Treatment Based on Whole-Genome Sequencing
The ability to do genomic analysis of patients’ tumors holds great promise for revolutionizing cancer treatment, and genomics has already made some great strides. However, the Individualized Molecular Pancreatic Cancer Therapy (IMPaCT) trial is a cautionary tale about the hurdles involved in...
Andrew C. von Eschenbach, MD, Went From the Front Lines of Cancer Care to a Bird’s-Eye View of the Changing Oncology Landscape
At the end of the day, I’m still a kid from South Philly,” Andrew C. von Eschenbach, MD, former Director of the National Cancer Institute (NCI) and Commissioner of the U.S. Food and Drug Administration (FDA), told The ASCO Post. Dr. von Eschenbach is the product of a closely knit yet culturally...
Global Leader in Drug Development John L. Marshall, MD, Calls for a Smarter War on Cancer
John L. Marshall, MD, a global leader in the research and treatment of gastrointestinal cancers, grew up in Lexington, Kentucky, in a family that put high value on education. As a young boy, science was already on his mind; he enjoyed the explorative nature that chemistry and biology offered....
Lymphoma Expert and Industry Leader Sandra J. Horning, MD, Pushes the Frontiers of Drug Development and Oncology Research
Due to childhood health issues, Sandra J. Horning, MD, formed an opinion about doctors at a young age: They were good people who helped other people. By her early teens, Dr. Horning began to ponder a career in medicine, which offered the possibility of blending her love of science with a career...
Incidence of Fractures Is ‘Compellingly Higher’ After Hematopoietic Stem Cell Transplantation
The incidence of fractures is “compellingly higher” after receiving hematopoietic stem cell transplantation, according to a retrospective study of patients receiving transplants for treatment of multiple myeloma, other hematologic malignancies, and some solid tumors (mostly breast and ovarian) as...
Another Angiogenesis Inhibitor Shows Benefit in Metastatic Colorectal Cancer, but Where Do We Go Next?
The phase III RAISE trial—reported by Tabernero and colleagues in The Lancet Oncology1 and reviewed in this issue of The ASCO Post—demonstrated that ramucirumab (Cyramza), a fully human IgG1 monoclonal antibody to the vascular endothelial growth factor receptor 2 (VEGFR2) extracellular domain, in...
Fulfilling NCI’s Commitment to Supporting the Best Science
On April 1, 2015, Douglas R. Lowy, MD, became Acting Director of the National Cancer Institute (NCI), succeeding Harold Varmus, MD, who left NCI to join the faculty of Weill Cornell Medical College in New York. (See “The Next Step in a Storied Career,” in the May 25, 2015 issue of The ASCO Post.)...
The Promise of Immune Checkpoint Inhibition: Changing the Therapeutic Landscape for Melanoma and Other Malignancies
The past 3 years have witnessed transformative changes in the way that solid tumors and hematologic malignancies are approached, in almost every instance now including consideration of some form of immunomodulation in the first- or later-line therapeutic setting. The greatest success has occurred...
Outcomes of the CUSTOM ‘Basket’ Trial of Molecular Profiling and Targeted Therapy in Advanced Thoracic Malignancies
In the phase II CUSTOM trial reported in the Journal of Clinical Oncology, Ariel Lopez-Chavez, MD, Anish Thomas, MD, and colleagues performed molecular profiling of tumors in patients with advanced non–small cell lung cancer (NSCLC), small cell lung cancer (SCLC), or thymic malignancies and...
What Is the Future of Intraperitoneal Treatment in Advanced Ovarian Cancer?
An analysis of Gynecologic Oncology Group (GOG) studies recently reported in the Journal of Clinical Oncology by Tewari and colleagues and reviewed in this issue of The ASCO Post showed a survival benefit of intraperitoneal chemotherapy vs intravenous chemotherapy over long-term follow-up in women...
New Studies Call for Smarter Approach to Prostate Cancer Screening
Prostate cancer is one of the most common cancers in American men, yet controversy over the utilization and frequency of prostate-specific antigen (PSA) screening methods remains, due to the overdiagnosis and overtreatment of men with low-grade, less-aggressive forms of the disease. At the 110th...
Nipple-Sparing Mastectomy Shown to Be Oncologically Safe
Mastectomies that preserve the nipple and an envelope of breast skin are as safe as more radical operations for qualifying early-stage breast cancer patients, according to a meta-analysis and systematic literature review presented at the American Society of Breast Surgeons 16th Annual Meeting.1...
Intensified Therapy Improves Survival in Wilms Tumor Patients With Rare Genetic Abnormality
Data from two phase III studies led by the Children’s Oncology Group show that augmenting or intensifying therapy for children with high-risk Wilms tumor improved relapse-free survival. These children are deemed to be at high risk due to a specific chromosomal abnormality that confers worse...
Deciphering the Genetic Variability of Cancer to Advance Precision Oncology Care
In 2014, Memorial Sloan Kettering Cancer Center (MSKCC) in New York opened the Marie-Josée and Henry R. Kravis Center for Molecular Oncology with the sole purpose of expediting the translation of novel molecular discoveries into clinical innovations to turn the goal of precision oncology care into...
Expert Point of View: Ian Tannock, MD, PhD, DSc
Formal discussant of this trial Ian Tannock, MD, PhD, DSc, of Princess Margaret Cancer Centre and University of Toronto, Canada, took issue with the design of RTOG 0521. He questioned the use of one-sided P values instead of conventional two-sided P values, noting that overall survival would have...
Adjuvant Chemotherapy Proves Effective in Localized, High-Risk Prostate Cancer
For the first time, a large randomized trial has suggested that overall survival is improved by the addition of adjuvant chemotherapy to androgen suppression and radiotherapy in men with localized, high-risk, hormone-sensitive prostate cancer. Docetaxel has been used to treat metastatic...
Two Factors Predict for Recurrent Venous Thromboembolism in Patients With Cancer
Patients with cancer who develop venous thromboembolism are at high risk of such obstructive disease recurring despite adequate anticoagulation. A prespecified analysis of the CATCH trial identified two major predictors of recurrence: venous compression by the tumor and a diagnosis of hepatobiliary ...
ASCO Releases Details of Its Conceptual Framework for Assessing Value in Cancer Care
Defining and ensuring the delivery of high-value oncology care has been one of ASCO’s major goals for more than a decade. In 2007, ASCO formed the Task Force on the Cost of Cancer Care, now called the Value in Cancer Care Task Force, to identify the drivers of the increasing costs of oncology care...
Date of Last Chemotherapy Is Not a Proxy for Deciding When to Stop Treating Metastatic NSCLC
“Patients, their families, and oncologists recognize the administration of chemotherapy near death as aggressive and poor-quality care,” William F. Pirl, MD, MPH, and colleagues from Massachusetts General Hospital, Boston, wrote in the Journal of Oncology Practice. “However, rates have been slowly...
Translating Study Recommendations Into Medicare Coverage
Lung cancer doggedly remains the leading cause of cancer-related death in the United States. This grim mortality figure is due, in part, to a lack of early detection methods; more than half of all lung cancers have metastasized at the time of diagnosis. For decades, lung cancer advocates lobbied...
PD-1 Inhibitor Pembrolizumab Active in Advanced NSCLC: Outcomes Better With Higher PD-L1 Expression
In the phase I KEYNOTE-001 trial reported in The New England Journal of Medicine,1 Edward B. Garon, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues found that the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda)...
Assessing and Improving Imaging Interpretation in Breast Cancer Screening
The quality of mammography images has markedly improved over the past few decades. However, the quality of the interpretation of mammograms remains variable. That said, more than 38 million mammograms are performed annually in the United States. So said Diana Buist, PhD, Senior Scientific...
Poliovirus for Glioblastoma Grabs National Attention
Researchers at The Preston Robert Tisch Brain Tumor Center at Duke University are being barraged by patients wishing to enroll in their clinical trial of an engineered poliovirus for recurrent glioblastoma. This comes as a result of a CBS 60 Minutes interview with lead researcher Matthias...
Pacritinib for Myelofibrosis: Effective in Patients With Thrombocytopenia
An emerging JAK inhibitor, pacritinib, appears not only effective in a broad population of patients with myelofibrosis but also among a subset with very low platelet counts, investigators from the global phase III PERSIST-1 trial reported at the 2015 ASCO Annual Meeting.1 “There is a huge unmet...
Anastrozole and Tamoxifen: Both Options for Ductal Carcinoma in Situ
Anastrozole was found to be at least as safe and effective as tamoxifen in preventing breast cancer recurrence in women with ductal carcinoma in situ, in the large NSABP B-35/SWOG-35 study.1 Among all women in the trial, however, the 10-year breast cancer–free interval rates were higher in women...
Survivors of Childhood Cancer Living Longer, Largely Due to Treatment Improvements
Survivors of childhood cancers can expect longer lives than their peers of 30 years ago. Improvements in the care of children with cancer have reduced the long-term mortality rate, according to an analysis of 34,000 participants in the Childhood Cancer Survivor Study.1 Cumulative all-cause late...
Durable Responses at 3-Year Follow-up for CLL Patients Receiving Single-Agent Ibrutinib
At a median follow-up of 3 years, ibrutinib (Imbruvica) demonstrated continued activity with durable responses that improved in quality with extended treatment of patients with chronic lymphocytic leukemia (CLL). In addition, grade 3 toxicity and adverse events leading to treatment discontinuation...
FDA’s Pregnancy Category Labeling
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 supervisory toxicologist Todd Palmby, PhD, and pharmacologist Eias Zahalka, PhD, MBA, discuss the approach taken in the Office of ...
Microangiopathic Hemolytic Anemia and Thrombocytopenia
Question 1: In this case, what is the most appropriate next best test? Correct Answer: B. Peripheral blood smear examination. Expert Perspective In the appropriate clinical setting, information obtained from a carefully examined peripheral blood smear film is indispensable. The peripheral blood...
Carfilzomib/Dexamethasone Doubles Progression-Free Survival vs Bortezomib/Dexamethasone in Patients With Relapsed Multiple Myeloma
In the first head-to-head study comparing two proteasome inhibitors in relapsed multiple myeloma, carfilzomib (Kyprolis)/dexamethasone provided a doubling in progression-free survival, compared with bortezomib (Velcade)/dexamethasone.1 Results of the phase III ENDEAVOR trial of the two regimens in...
CancerCare Announces National Study: Patient Access and Engagement Report
CancerCare, a national nonprofit organization that provides free psychosocial support, education, and financial assistance to anyone affected by cancer, has announced the launch of a bold, new research initiative. Through surveys among a nationally representative sample of thousands of people with...
Translational Research: Dogs and Humans Nearly Interchangeable in the Laboratory
“Between animal and human medicine there is no dividing line—nor should there be. The object is different but the experience obtained constitutes the basis of all medicine.” — Rudolf Virchow (1821–1902) Everyone has seen photographs of people who look like their dogs: the young woman with long...
ODAC Discussion ‘Constructive’ About Necitumumab for Squamous NSCLC
The U.S. Food and Drug Administration’s (FDA) Oncologic Drugs Advisory Committee (ODAC) favored the approval of necitumumab in combination with gemcitabine and cisplatin for use in first-line treatment of patients with locally advanced or metastatic squamous non–small cell lung cancer (NSCLC). In...
Is Proton-Beam Therapy Facing a Difficult Future?
Health-care experts are questioning whether proton-beam therapy is on the verge of an economic bubble—ie, a rapid surge in growth for the industry beyond its intrinsic value, inevitably leading to a drastic drop in earnings for proton centers when the “bubble bursts.” A proton-beam facility can...
Value: What Do We Mean, Who Should Decide?
Oscar Wilde famously defined a cynic as “a man who knows the price of everything and the value of nothing.” I do not think that oncologists need to be as cynical as this, but it was very appropriate that a major theme of this year’s ASCO Annual Meeting was the concept of “value.” It is clear that...
Microangiopathic Hemolytic Anemia and Thrombocytopenia: Answers From Hematology Expert Review Questions
Question 1: What is the best first step in management of this patient? Correct Answer: C. Start plasma exchange. Expert Perspective Although distinguishing among thrombotic thrombocytopenic purpura, typical hemolytic uremic syndrome, and atypical hemolytic uremic syndrome (see Table 1 in the...
Strengthening the Doctor-Patient Relationship: An Interview With Lidia Schapira, MD, FASCO
Earlier this summer, Lidia Schapira, MD, FASCO, a medical oncologist at Massachusetts General Hospital Cancer Center and Associate Professor of Medicine at Harvard Medical School, was named Editor-in-Chief of Cancer.Net, ASCO’s patient information website. Prior to taking on this role, Dr....
Conquer Cancer Foundation Donor Spotlight: Ludwig Cancer Research
Among the Conquer Cancer Foundation’s newest supporters, Ludwig Cancer Research is an international community of distinguished scientists dedicated to preventing and controlling cancer. Its emphasis on collaboration and long-term support has fostered its role as a leader in immunotherapy and other...
Sonidegib in Basal Cell Carcinoma
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 July 24, 2015, sonidegib (Odomzo) was approved for treatment...
Geriatric Oncology: A Geriatrician’s Perspective
“The management of older individuals, including older cancer patients, involves a wisdom developed over a lifetime, thanks to time-consuming listening and painstaking collection and interpretation of clinical details.” —Lodovico Balducci, MD It is not simple to be a geriatrician in a world of...
Adding Everolimus to First-Line Trastuzumab/Paclitaxel Does Not Increase Progression-Free Survival in HER2-Positive Metastatic Breast Cancer
In the phase III BOLERO-1 trial, reported in The Lancet Oncology, Sara A. Hurvitz, MD, of the University of California, Los Angeles, and colleagues found that the addition of the mTOR inhibitor everolimus (Afinitor) to trastuzumab (Herceptin)/paclitaxel did not significantly increase...
Carfilzomib in Combination With Lenalidomide and Dexamethasone in Relapsed 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 July 24, 2015, carfilzomib (Kyprolis) was approved for use in...
Regorafenib Improves Overall Survival in Asian Patients With Previously Treated Metastatic Colorectal Cancer
In a phase III trial (CONCUR) reported in The Lancet Oncology, Jin Li, MD, and colleagues found that the multikinase inhibitor regorafenib (Stivarga) improved overall survival vs placebo in Asian patients with previously treated metastatic colorectal cancer.1 Regorafenib is approved in the United...
