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breast cancer

Improved Overall Survival With Neoadjuvant Plus Adjuvant Bevacizumab in Early HER2-Negative Breast Cancer

The phase III National Surgical Adjuvant Breast and Bowel Project (NSABP) B-40 (NRG Oncology) trial showed that the addition of bevacizumab (Avastin) to docetaxel + anthracycline-based neoadjuvant chemotherapy improved pathologic complete response rate, the primary endpoint, in patients with early...

issues in oncology

Study Finds Quality of Physician Recommendation to Parents Key to Encourage/Discourage HPV Vaccination of Adolescents

A nationwide online survey of 776 pediatricians and family physicians assessing the quality of their human papillomavirus (HPV) vaccine recommendations to parents has found that approximately 27% of respondents said they do not strongly endorse HPV vaccination; further, 26% and 39% of respondents...

gynecologic cancers

Ovarian Cancer Trialists Forming Work Group to Standardize Definition of Pathologic Complete Response

Ovarian cancer clinical trialists are forming a working group to develop a standard definition of pathologic complete response in ovarian cancer treated with neoadjuvant chemotherapy. Such agreement within the field potentially would enable the U.S. Food and Drug Administration (FDA) to consider...

lung cancer

Combined EGFR and VEGF Inhibition Ameliorates the Impact of  the EGFR T790M Mutation in NSCLC

Treatment with erlotinib and bevacizumab (Avastin) may help overcome the poor prognosis associated with T790M mutations present at diagnosis in advanced non–small cell lung cancer (NSCLC), according to the results of the phase II BELIEF trial.1 At the 2015 European Cancer Congress, Rolf A. Stahel,...

prostate cancer

Update on Clinical Trials in Metastatic Prostate Cancer

Despite the proliferation of new drugs to treat prostate cancer, further progress is proving somewhat elusive, according to three trials presented at the 2015 European Cancer Congress. One study had positive results with orteronel maintenance therapy in patients with metastatic castration-resistant ...

pancreatic cancer

FDA Approves Liposomal Irinotecan for Advanced Pancreatic Cancer

The U.S. Food and Drug Administration has approved irinotecan liposome injection (Onivyde), in combination with fluorouracil (5-FU) and leucovorin, to treat patients with metastatic pancreatic cancer who have been previously treated with gemcitabine-based chemotherapy. The effectiveness of...

pain management

Dexamethasone to Preempt Radiation-Induced Pain

Bone is a common site of metastasis for prostate, breast, and lung cancers, and palliative radiotherapy is often used to treat these metastases. Although it is an effective therapy, severe pain flare following radiation occurs in about one-third of patients. It usually resolves within 10 days, but...

issues in oncology
legislation

Debate Over Physician-Assisted Suicide Continues, State by State

In 1997, after surviving a storm of high-court legal challenges, Oregon’s Death With Dignity Act went into effect, making Oregon the first American state to legalize physician-assisted suicide. The Supreme Court ruled that there was no right to assisted suicide in the Constitution but implied that...

issues in oncology

Increased Lifetime Risk of Developing Cancer in Patients With HIV

The effectiveness of antiretroviral therapy has enabled patients with HIV to live long enough to have high lifetime risks for several types of cancer. The finding has important clinical implications for cancer screening, as well as primary prevention, according to the results of a study funded by...

pancreatic cancer

Irinotecan Liposome Injection Plus Fluorouracil/Leucovorin to Treat Patients With Metastatic Pancreatic 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 October 22, 2015, irinotecan liposome injection (Onivyde)...

issues in oncology

ASCO Launches TAPUR to Assess the Off-Label Use of Targeted Therapies for Patients With Advanced Cancers

Two years ago, Richard L. ­Schilsky, MD, FACP, FASCO, Chief Medical Officer of ASCO, proposed a unique clinical trial concept during an educational session on the challenges of delivering precision medicine services in a community setting at ASCO’s Annual Meeting. The idea was to design a clinical...

sarcoma

Trabectedin in Unresectable or Metastatic Liposarcoma or Leiomyosarcoma

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 October 23, 2015, trabectedin (Yondelis) was approved for the...

head and neck cancer

The Role of Botulinum Toxin in Head and Neck Cancer

Head and neck cancer and its treatment can result in a variety of neuromuscular and musculoskeletal pain and functional sequelae. Commonly seen conditions in patients with the disease include neck pain and spasm, hemifacial spasm, trismus, dysphonia, dysarthria, neuropathic pain, and salivary...

lung cancer

Checkmate 057: Nivolumab Improves Survival vs Docetaxel  in Advanced Nonsquamous Non–Small Cell Lung Cancer

In the phase III CheckMate 057 trial, reported in The New England Journal of Medicine by Hossein Borghaei, DO, of Fox Chase Cancer Center, and colleagues, the programmed cell death protein 1 (PD-1) inhibitor nivolumab (Opdivo) improved overall survival vs docetaxel in patients with advanced...

issues in oncology

ACS Breast Cancer Screening Guidelines: Balancing the Benefits and Harms of Mammography

For the past 30 years, mammography screening has been one of the most contentious issues in medicine. Controversy has generally centered on the age at which to begin mammography screening (40 vs 50 years) and also, to a lesser extent, on the age at which it should stop. The recent American Cancer...

breast cancer
issues in oncology

Getting the Content and the Message Right in Breast Cancer Screening Guidelines

According to recent national headlines, the American Cancer Society (ACS) now recommends that women at average risk of breast cancer should “screen later and less often.”1 While the new ACS recommendations (summarized in this issue of The ASCO Post) might initially be taken as casting doubt on the...

breast cancer
issues in oncology

ACS Guideline Update on Breast Cancer Screening for Women at Average Risk

As reported in JAMA by Kevin C. Oeffinger, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues, the American Cancer Society (ACS) has issued an update to its 2003 guideline on breast cancer screening for women at average risk of breast cancer.1 Robert A. Smith, PhD, of the...

breast cancer

Accelerated Partial-Breast vs Whole-Breast Irradiation After Surgery for Early Breast Cancer

As reported in The Lancet by Vratislav Strnad, MD, of University Hospital Erlangen, Germany, and colleagues, 5-year results of a phase III noninferiority trial showed no difference in local relapse, disease-free survival, or overall survival with adjuvant accelerated partial breast irradiation...

skin cancer

Ipilimumab in Adjuvant Treatment of Cutaneous Melanoma With Nodal Involvement

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 October 28, 2015, ipilimumab (Yervoy) was approved for adjuvant ...

Expert Point of View: Peter Naredi, MD, and Michael Brada, MD

Peter Naredi, MD, European CanCer Organization (ECCO) Scientific Co-Chair of the Congress, stated in a press release: “In my view, Dr. Brastianos and colleagues very elegantly show what we mean with precision medicine, how genetic profiling can support our understanding of the metastatic process,...

breast cancer
kidney cancer
prostate cancer
skin cancer

Quick Takes From ECC 2015 Include New Data in Melanoma, Prostate and Breast Cancers, and Renal Cell Carcinoma

The 2015 European Cancer Congress (ECC), held recently in Vienna, represented the combined efforts of the European Cancer Organisation (ECCO), the European Society for Medical Oncology (ESMO), and other partner organisations, constituting the largest European platform for oncology education. At...

leukemia

Changing the Outlook for Chronic Lymphocytic Leukemia

Small-molecule inhibitors, especially ibrutinib (Imbruvica) and idelalisib (Zydelig), have greatly changed the outlook for patients with chronic lymphocytic leukemia. William G. Wierda, MD, PhD, Professor and Center Medical Director in the Department of Leukemia at The University of Texas MD...

hematologic malignancies

Genomics Now Driving Treatment of Waldenström’s Macroglobulinemia

The treatment of Waldenström’s macroglobulinemia has been greatly impacted by an understanding of its genomics, according to Steven P. Treon, MD, PhD, of Dana-Farber/Brigham and Women’s Cancer Center and Massachusetts General Hospital Cancer Center, Boston. Dr. Treon brought listeners up to date on ...

breast cancer
supportive care

APF530 Superior to Ondansetron in Preventing Chemotherapy-Induced Nausea or Vomiting

As part of a three-drug regimen, APF530 (extended-release formulation of granisetron) has become the first 5-HT3 (5-hydroxytryptamine) receptor antagonist to demonstrate superiority over the standard of care for delayed nausea and vomiting after highly emetogenic chemotherapy. According to the...

Expert Point of View: Clifford Hudis, MD, Shanu Modi, MD, and Richard Gelber, PhD

Discussant Clifford Hudis, MD, Chief of Breast Medicine Service at Memorial Sloan Kettering Cancer Center, New York, highlighted neratinib’s benefits while also advocating caution in interpreting the results due to incomplete data, the serious side effect of diarrhea, and the potentially...

multiple myeloma

Daratumumab 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 November 16, 2015, daratumumab injection (Darzalex) was...

Lung Cancer: Hope From Science

The following essay by Paul A. Bunn, Jr, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. I grew up...

Dario Marchetti, PhD, Named Director of the Center for Biomarkers

Dario Marchetti, PhD, recently joined Houston Methodist Hospital as the new Director of the Center for Biomarkers. Over the past 7 years, Dr. Marchetti’s laboratory at Baylor College of Medicine has made key discoveries in the biology and clinical use of circulating tumor cells. Dr. Marchetti’s...

issues in oncology
health-care policy

Cancer Care in Low-Resource Areas: Some Improvements Over the Years, but Serious Problems Remain

Low- and middle-income countries bear a larger share of the global cancer burden than does the developed world,” said Greta ­Massetti, PhD, Associate Director for Science, Centers for Disease Control and Prevention (CDC) Division of Cancer Prevention and Control and Co-Chair of the National Cancer...

lung cancer

Nivolumab Improves Overall Survival vs Docetaxel in Advanced Previously Treated Squamous Cell NSCLC

In a phase III trial reported in The New England Journal of Medicine, ­Julie Brahmer, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, and colleagues found that treatment with the programmed cell death protein 1 (PD-1) immune checkpoint inhibitor antibody nivolumab...

issues in oncology

Understanding Health-Care Disparities Among Lesbian, Gay, Bisexual, and Transgender Patients to Ensure More Effective Cancer Care

A new study examining the health-care needs of lesbian, gay, bisexual, and transgender/transsexual patients has found myriad disparities in access to cancer care.1 The researchers reviewed nearly 170 papers published over the past 15 years on the health-care needs among this population. Although...

breast cancer
issues in oncology

Closing the Racial Survival Disparity Gap in Breast Cancer: Models for Change From Chicago, New York, and Beyond

It has long been said that white women of European ancestry are more likely to be diagnosed with breast cancer, but African American women are more likely to die of it. This statement has introduced multiple articles on the topic of the racial survival disparity in breast cancer, including our own...

sarcoma

Improved Progression-Free Survival With Trabectedin vs Dacarbazine After Chemotherapy Failure in Liposarcoma or Leiomyosarcoma

In a phase III trial reported in the Journal of Clinical Oncology, George D. Demetri, MD, of Harvard Medical School and Dana-Farber Cancer Institute, Boston, and colleagues found that treatment with trabectedin (Yondelis) significantly improved progression-free survival vs dacarbazine in patients...

hematologic malignancies

Molecularly Targeted Therapy Brings New Hope to Patients With Relapsed/Refractory Hairy Cell Leukemia

The treatment of hairy cell leukemia is one of the great success stories in hematologic malignancies, with patients now having a survival that is only slightly inferior to an age-matched normal population. Purine analogs, such as cladribine, are the mainstay of first-line therapy, with...

hematologic malignancies
leukemia

BRAF Inhibition Successful in Relapsed/Refractory Hairy Cell Leukemia

In two phase II studies reported in The New England Journal of Medicine, ­Enrico Tiacci, MD, of the University of Perugia, Italy, and colleagues found that the BRAF inhibitor vemurafenib (Zelboraf) produced responses in nearly all patients with BRAF V600E–positive hairy cell leukemia that relapsed...

Mind-Body Therapies Were the Focus at the 12th International Conference of the Society for Integrative Oncology

Among the highlights at the 12th International Conference of the Society for Integrative Oncology (SIO) was a 1-day joint meeting on acupuncture, oncology, and fascia cosponsored by SIO, the Society for Acupuncture Research, the Fascia Research Society, and the Osher Center for Integrative...

breast cancer

Combining Molecular-Driven Approach and Immunotherapy to Improve Treatment for Patients With Inflammatory Breast Cancer

We have a responsibility to develop better treatment for inflammatory breast cancer,” Massimo Cristofanilli, MD, FACP, told participants at the 17th Annual Lynn Sage Breast Cancer Symposium in Chicago. As recently appointed Associate Director of Translational Research and Precision Medicine at the ...

issues in oncology

Filial Gaze at Our Noble Profession

As we stood outside patient X’s room going over the vitals, from a distance, I saw the father of the patient by the side of her bed. I saw him standing there and looking down at his child conveying what I guess were words of reassurance and reinforcing the pillars of strength needed for her...

breast cancer

Breast Care Services at Henry Ford Health System Gains New Director, Three New Surgeons

Internationally renowned breast cancer surgeon Lisa A. Newman, MD, MPH, has joined Henry Ford Health System to lead its metro Detroit breast cancer program and new international breast cancer research center. She begins work in December as the Director of the Breast Cancer Program at Henry Ford....

palliative care

Perceptions of End-of-Life Care Differ Sharply Between African Americans and White Americans

Studies demonstrate that patients with advanced cancer who are not actively engaged in planning their end-of-life care often receive overly aggressive, physically taxing, costly and unnecessary treatment toward life’s end. Recent findings indicate that African Americans appear to be more apt to...

supportive care

SIOG Annual Conference Explores Global Perspectives on Geriatric Oncology and Supportive Care

The 15th Annual Conference of the International Society of Geriatric Oncology (SIOG) took place in Prague, Czech Republic, over 3 days (November 12–14, 2015). At the heart of the meeting were presentations on supportive care, comprehensive geriatric assessment and treatment—so that we fully...

hematologic malignancies
leukemia
issues in oncology

Acute Myeloid Leukemia in the Elderly: Trial Data Stir Hope for the Transplant Option

Older patients with acute myeloid leukemia (AML) have high relapse rates after induction chemotherapy, low survival rates, and fewer treatment options compared with younger patients. One of the options for both younger and older patients is hematopoietic cell transplantation, but relatively few...

2015–2016 Leadership Development Program Participants Examine Genomics, Data Collection, Team-Based Cancer Care, and Meeting Experience

ASCO’s Leadership Development Program (LDP) offers mid-career oncologists the opportunity to learn valuable leadership skills from ASCO’s exceptional leaders and participate in networking and mentoring opportunities. Participants work on strategy development, interpersonal effectiveness and...

sarcoma

Researcher Spotlight: Conquering Cancer With Dr. Heske

Sometimes, cancer treatments that initially appear promising begin to lose their effectiveness. This is due to the ability diseases like cancer have to develop resistance to treatments over time and, essentially, outsmart them. But what if there were ways to ensure this didn’t happen? What if...

lymphoma

A: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

Question 1: Based on the rationale for the current “standard of care” for primary diffuse large B-cell lymphoma of the CNS, what is the optimal induction therapy? Correct Answer: C. A high-dose methotrexate–based regimen. Expert Perspective Untreated primary diffuse large B-cell lymphoma of the CNS ...

lung cancer

Necitumumab in Metastatic Squamous Non–Small Cell Lung 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 November 24, 2015, necitumumab (Portrazza) was approved for use ...

lung cancer

ASCO Endorsement of ACCP Guideline on Treating SCLC: Moving Forward to Better Outcomes in Oncology

In the current climate of rising health-care costs, particularly in the field of oncology, clinical guidelines provide a crucial tool to guide practitioners in evidence-based care and to improve the quality and consistency of care.1 The ASCO review and endorsement of the American College of Chest...

lung cancer

ASCO Endorses ACCP Guideline on Treatment of Small Cell Lung Cancer

As reported in the Journal of Clinical Oncology,1 ASCO has endorsed the current American College of Chest Physicians (ACCP) guideline on treatment of small cell lung cancer (SCLC), released in 2013.2 After review of evidence from an updated literature search covering 2011 to March 2015, an ASCO...

head and neck cancer

Surgery for Head and Neck Cancer Improves Survival—in Taiwan

A large study presented at the 2015 European Cancer Congress in Vienna found that patients with advanced oropharyngeal or hypopharyngeal cancer had improved survival if their primary treatment included surgery.1 The caveat is that these patients were treated in Taiwan, and the results may not be...

hematologic malignancies

Optimizing the Treatment of HIV-Associated Lymphoma

Non-Hodgkin lymphoma (NHL) associated with human immunodeficiency virus (HIV) infection generally can be treated the same as lymphoma in non–HIV-infected patients, with a few caveats, according to Lawrence D. Kaplan, MD, of the Helen Diller Family Comprehensive Cancer Center of the University of...

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