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Expert Point of View: Daniel J. Canter, MD

“We have a lot of options for first-line therapy [in renal cell carcinoma] these days. The question is, what do we do with first-line failures?” said Daniel J. Canter, MD, formal discussant of the SWITCH trial at the Genitourinary Cancers Symposium. Dr. Canter is Vice Chairman of the Urologic...

issues in oncology

The Future of Biomedical Research

In January, Congress approved a $1 trillion appropriations bill for the rest of fiscal year 2014. While the new bill includes $29.9 billion for the National Institutes of Health (NIH)—$1 billion above FY2013 levels after sequestration—including $4.9 billion for the National Cancer Institute (NCI),...

issues in oncology

Focus on the Virginia Association of Hematologists and Oncologists

The state of Virginia encompasses a vast area of 40,000 square miles and is divided into five regions: the Atlantic Coastal Plain, the Piedmont, the Blue Ridge, the Appalachian Ridge and Valley Region, and the Appalachian Plateau. The diverse geography of the state creates unique challenges for...

gynecologic cancers

Cancer Has Allowed Me to Put My Goals First

Despite my family history of cancer—my father had colorectal cancer, his father had gallbladder cancer, and my father’s mother died of what was believed to be uterine cancer—when I complained to my gynecologist about postmenopausal bleeding in the spring of 2011, I was told not to worry about it....

supportive care

Music Therapy Yields Positive Effects on Coping Skills, Social Integration, and Family Environment for Young Patients With Cancer

A collaborative multisite study has found that teens and young adults undergoing stem cell transplantation as part of cancer treatment gain coping skills and resilience-related outcomes when participating with a board-certified music therapist in a therapeutic music protocol that includes writing...

breast cancer
cns cancers

How to Approach the Problem of CNS Metastasis in HER2-Positive Patients

Central nervous system (CNS) metastasis is a pervasive problem in the setting of HER2-positive breast cancer. While some patients can be managed easily, others are challenging, said Eric P. Winer, MD, Chief of the Division of Women’s Cancers and the Thompson Senior Investigator for Breast Cancer...

solid tumors
issues in oncology

How Decoding the Genomes of Exceptional Responders Is Leading to More Effective Treatment for All Patients With Cancer

In 2012, David B. Solit, MD, Geoffrey Beene Chair and Director of the Center for Molecular Oncology at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, and his colleagues published the results of a phase II study1 of 45 patients with advanced bladder cancer. The purpose of the clinical...

palliative care

St. Jude Children’s Research Hospital Committee Identifies Eight Palliative Care Priorities in Pediatric Oncology

About 2½ years ago, St. Jude Children’s Research Hospital in Memphis conducted a series of focus groups to better understand the palliative care priorities of bereaved parents. Their findings were never intended to be generalized, but rather to be used to formulate a strategic plan for an...

cns cancers

Neuro-Oncology Community Convenes in Workshop to Advance Imaging-Related Endpoints in Clinical Trials

Leaders from key cross-sections of the neuro-oncology community came together at a recent Brain Tumor Clinical Trial Endpoints Workshop to confront a critical challenge in developing and testing treatments for glioblastoma multiforme. Participants were able to adjourn the workshop with the...

breast cancer

Support from 1999 Career Development Award Launched Dr. Kornelia Polyak’s Quest to Advance Understanding of DCIS of the Breast

In 1999, Kornelia Polyak, MD, PhD, of the Dana-Farber Cancer Institute, received a Career Development Award from the Conquer Cancer Foundation for her project, “Isolation of Tumor Suppressor Genes Inactivated in DCIS of the Breast.” “The Career Development Award got me started,” she said. “When...

issues in oncology

Charting the Successes: CancerProgress.Net Chronicles More Than 50 Years of ASCO and Progress Against Cancer

On this historic year, as ASCO proudly commemorates its 50th anniversary and decades of evolutionary change and growth, it also celebrates the significant progress that has been made against cancer throughout history. ASCO’s anniversary website, CancerProgress.Net, chronicles these achievements and ...

skin cancer

Staging of Cutaneous Squamous Cell Carcinoma

Neoplasms originating from skin keratinocytes are increasing in frequency in the United States and include a spectrum of diseases culminating in the development of invasive cutaneous squamous cell carcinoma. Although most cases of cutaneous squamous cell carcinoma can be treated conservatively with ...

cost of care

Who Pays for Noncompliance? The Hidden Costs of Our Current System

The development of novel targeted therapies that capitalize on our growing understanding of the molecular underpinnings and vulnerabilities of specific malignancies has to rank among the most important advances we have seen in the 50 years since the American Society of Clinical Oncology was...

prostate cancer
skin cancer

Melanoma and Prostate Cancer: Two Sides of One Coin?

In a recent study, reviewed in this issue of The ASCO Post, Li et al present data from two long- term prospective studies—the Physicians Health Study (PHS, from 1982 to 1998), and the Health Professionals’ Follow-up Study (HPFS, from 1986 to 2010)—both of which suggest a strong association between...

lymphoma

Idelalisib Achieves High Response Rates in ‘Double-Refractory’ Indolent NHL

In patients with indolent B-cell non-Hodgkin lymphoma (NHL) refractory to both rituximab (Rituxan) and an alkylating agent, monotherapy with the selective oral PI3K-delta inhibitor idelalisib produced a high response rate, with responses persisting for 1 year in the average patient, according to...

breast cancer

Zoledronic Acid Fails to Benefit Women With Chemoresistant Breast Cancer

Zoledronic acid does not improve outcomes in patients with early breast cancer who do not have a full response to neoadjuvant anthracycline/taxane–based chemotherapy, according to results of the Neo-Adjuvant Trial Add-On (NATAN) study presented at the 2013 San Antonio Breast Cancer Symposium.1 A...

breast cancer

Immune Modulation May Aid Some Breast Cancer Subtypes

There may be an immunogenic phenotype in breast cancer that could benefit from immune modulation as part of treatment, according to results from studies that correlated high levels of tumor-infiltrating lymphocytes with both pathologic complete responses and long-term outcomes. Studies presented at ...

leukemia

Minimal Residual Disease Before and After Transplant: What Does It Mean?

In patients with acute leukemia, outcomes after hematopoietic stem cell transplantation are negatively impacted by the presence of minimal residual disease. However, transplant can prolong survival in patients with minimal residual disease after consolidation, according to two studies presented at...

SIDEBAR: Colorectal Cancer Survivors’ Comments on Strategies to Regulate Bowel Function

Avoiding Foods I don’t eat beans, I don’t eat onions. I’m kind of careful on greens because they just don’t digest well. I don’t eat as many salads. I couldn’t because they went right through. Behavioral Adjustments You learn, over the years, what you can and can’t do. And you can’t overeat....

health-care policy

The Evolution of U.S. Cooperative Group Trials: Publicly Funded Cancer Research at a Crossroads

Over the past 5 decades, National Cancer Institute (NCI) Clinical Trials Cooperative Groups have played an enormous role in the fight against cancer, tackling a broad social agenda, including cancer prevention, quality-of-life issues for patients with cancer, and comparison of benefits among...

lung cancer

I Refuse to Capitulate to Cancer

Early last year, just as I returned to my residency in neurologic surgery at Stanford University after completing 2 years of my postdoctoral fellowship in a laboratory developing optogenetic techniques, I started losing weight—dropping from 180 lb to 160 lb in just 6 months—and I was having fairly...

prostate cancer

State-of-the-Art Update on Prostate Cancer

The 2014 Genitourinary Cancers Symposium, held in San Francisco from January 29 to February 1, brought together more than 3,100 participants from around the world involved in the care of patients with genitourinary malignancies. The abstract presentations and plenary discussions offered the latest...

breast cancer

Breast Reconstruction Has Increased Over Time but Varies Widely by Region

Analysis of data from 20,560 women undergoing mastectomy for breast cancer found that breast reconstruction use “increased from 46% in 1998 to 63% in 2007 (P< .001), with increased use of implants and decreased use of autologous techniques over time (P < .001),” according to a report...

Expect Questions From Patients

Results from the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4), showing that men with early-stage prostate cancer, particularly men under 65 years old, treated with radical prostatectomy had increased survival compared to those assigned to watchful waiting, has raised concerns among...

prostate cancer

Prostate Cancer Study Showing Increased Survival for Younger Men Undergoing Prostatectomy Not Expected to Increase Surgeries

Extended follow-up in the Scandinavian Prostate Cancer Group Study Number 4 (SPCG4), reported recently in The New England Journal of Medicine,1 found that men with early-stage prostate cancer, particularly those under 65 years old, who were treated with radical prostatectomy had increased survival...

integrative oncology

Reishi Mushroom

Scientific name: Ganoderma lucidum Common names: Ling zhi, lin zi, mushroom of immortality Overview A fungus, reishi mushroom is an important component of the traditional medical systems of China, Japan, Korea, and other Asian countries. It is used to increase energy, stimulate the immune system,...

MD Anderson Honors Two Champions for Women in Medicine and Research

Two champions of gender equality in medicine and research were recently honored by The University of Texas MD Anderson Cancer Center. Laurie Glimcher, MD, the Stephen and Suzanne Weiss Dean of Weill Cornell Medical College and Provost for Medical Affairs of Cornell University since 2012, received...

health-care policy

The FDA’s Bad Ad Program

INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this installment, Robert Dean, MBA, Director, and Michael Sauers, Deputy Director, of Division II in the FDA’s Office of Prescription Drug Promotion discuss the FDA’s Bad Ad program. The...

multiple myeloma

Unraveling the Molecular Complexity of Multiple Myeloma

In 2011, the Multiple Myeloma Research Foundation (MMRF) announced the launch of CoMMpass (Relating Clinical Outcomes in Multiple Myeloma to Personal Assessment of Genetic Profile), a clinical study at the heart of its Personalized Medicine Initiative. CoMMpass will follow 1,000 newly diagnosed...

lung cancer

Decision Time for Lung Cancer Screening in High‑Risk Populations

For decades, dedicated members of the oncology community have fought to increase the nation’s focus on lung cancer prevention and treatment. Although smoking cessation initiatives have reduced cigarette consumption, lung cancer 5-year survival has remained stagnant at 15%, lagging far below most...

issues in oncology

‘How Am I Doing, Doc?’

The goal of effective adjuvant therapy is to increase overall survival. It has been suggested cynically that all we need to accomplish, actually, is to delay recurrence until after the time the patients die from another cause. However, patients want to hear from us that “it’s never coming back,”...

issues in oncology

Utah Center for Genetic Discovery to Integrate Genome Data Into Patient Care

The USTAR Center for Genetic Discovery is partnering with California-based Omicia, Inc, to make analyzing a patient’s genome as routine as performing a blood test. The center, codirected by Mark Yandell, PhD, and Gabor Marth, DSc, was launched this month with $6 million from the University of Utah...

breast cancer

Determining Why Younger Women With Breast Cancer Are Less Likely to Survive Than Their Older Counterparts

Although cancer survival rates among pediatric and older adult patients continue to rise, survival rates for adolescents and young adults (AYAs), defined by the National Cancer Institute as those between the ages of 15 and 39, have remained stagnant for decades. In breast cancer especially, AYAs...

issues in oncology

Informed Consent: Not Just About Blood Tests and Procedures Anymore

On February 24, the Institute of Medicine National Cancer Policy Forum convened a workshop, “Contemporary Issues in Human Subjects Protection in Cancer Research,” in Washington, DC. In his introduction to the workshop, Steven Piantadosi, MD, PhD, Director, Samuel Oschin Cancer Institute,...

issues in oncology

Amended 2013 Conflicts of Interest Policy Expands Requirements for Financial Disclosures

The Society’s 2013 Policy for Relationships with Companies is scheduled to go into effect on April 22, with one large change to its original requirements. The policy will still require the full disclosure of all financial relationships by all authors; however, since announcing the new policy in...

Raj Mantena, RPh, Makes $1 Million Donation to Conquer Cancer Foundation to Help Build the Future of Cancer Care

It is a challenge faced time and time again by oncologists: how to achieve the best possible outcomes for patients while simultaneously controlling costs, providing care that is both high quality and high value. Raj Mantena, RPh, the first individual to donate $1 million dollars to the Conquer...

issues in oncology

Cancer Research Funding Still Tight—and Getting Tighter

Margaret Foti, PhD, MD (hc), CEO of the American Association for Cancer Research (AACR), welcomed about 150 congressional staffers to a March briefing in Washington, DC, with a plea for increased federal funding. “Extraordinary progress is being made in cancer research today, as evidenced by the...

pain management

Individualized Care Key to Cancer Pain Management at Sidney Kimmel Comprehensive Cancer Center

Learning about the particulars of each cancer patient’s pain and treating each case uniquely is the key to keeping pain manageable. That is the goal of the Duffey Pain and Palliative Care Program at The Sidney Kimmel Comprehensive Cancer Center in Baltimore. The team consists of physicians, nurse...

thyroid cancer

Thyroid Cancer On the Rise: Is It Clinically Meaningful?

According to data from the Surveillance, Epidemiology, and End Results (SEER) program, rates for new cases of thyroid cancer in the United States have been rising on average 6.4% each year over the past 10 years, and death rates have been rising on average 0.9% each year over the same period. The...

palliative care

Overcoming Physician Bias in Recommending Palliative Care

In 2010, Jennifer S. Temel, MD, published her landmark study in The New England Journal of Medicine showing that the introduction of palliative care early after a diagnosis of metastatic non–small cell lung cancer, along with cancer therapy, not only provided patients with a better quality of life...

survivorship

Detecting Accelerated Aging in Adult Survivors of Childhood Cancer

Last fall, Kirsten K. Ness, PhD, published her study1 on the prevalence of frailty as a sign of accelerated aging in adult survivors of childhood cancer, and the results are startling. Among the 1,922 participants in the study, the prevalence of prefrailty was 31.5% among women and 12.9% among men; ...

prostate cancer

Long-Term Complications of Prostate Cancer Treatment May Have Been Underappreciated

The recent study by Nam et al in The Lancet Oncology—reviewed in this issue of The ASCO Post—provides a fresh perspective on complications other than incontinence or erectile dysfunction that commonly arise after primary treatment of localized prostate cancer.1 The authors conducted a...

breast cancer

Overdiagnosis of Breast Cancer: New Research Directions

Currently, one of the most challenging problems in oncology is to accurately predict whether neoplastic lesions detected by screening tests will progress. The focus on developing ever-more sensitive cancer screening tests has produced the clinical dilemma of overdiagnosis. Overdiagnosis occurs when ...

lymphoma

Better Options Emerging for Salvage Therapy in Hodgkin Lymphoma

Emerging effective treatment options for salvage therapy in Hodgkin lymphoma were described by Anas Younes, MD, Chief of the Lymphoma Service at Memorial Sloan Kettering Cancer Center, New York, at the 2014 Highlights of ASH in North America meeting in Miami. “This is an exciting time in Hodgkin...

kidney cancer

A Conversation With Arie Belldegrun, MD, FACS, and Allan Pantuck, MD, MS, FACS

Cancer Immunotherapy What is the role of immunotherapy in the treatment of metastatic renal cell carcinoma? The harnessing of the immune system as an effective treatment for cancer was recently selected by the journal Science as the top scientific Breakthrough of the Year for 2013.1 With this...

kidney cancer

A Conversation With David I. Quinn, MBBS, PhD, FRACP

First-Line Therapy Please describe current medical oncology approaches to first-line therapy for metastatic renal cell carcinoma. The current first-line therapy for most patients with good- to intermediate-risk metastatic renal cell carcinoma is a vascular endothelial growth factor (VEGF) receptor...

health-care policy

The Outlook on Cancer Research in This Era of Leaner Federal Funding

In the March 1, 2014, issue of The ASCO Post we talked with Francis S. Collins, MD, PhD, Director of the National Institutes of Health (NIH), about the future of biomedical research at the NIH during this time of constrained federal funding. We continue that conversation here with our interview of...

breast cancer

SSO-ASTRO Margin Guideline: Why Now and What Does It Mean?

Although breast-conserving therapy has been a standard practice for more than 20 years, controversy still exists over what constitutes the appropriate margin of normal breast tissue around a tumor that minimizes local recurrence while maintaining a good cosmetic outcome. Surveys of surgeons1 and...

breast cancer

SSO-ASTRO Consensus Guideline on Margins for Breast-Conserving Surgery in Stage I/II Invasive Breast Cancer

The Society of Surgical Oncology (SSO) and American Society for Radiation Oncology (ASTRO) formed a multidisciplinary expert panel in 2013 to examine the relationship between surgical margin width and ipsilateral breast tumor recurrence and develop guidelines on margins for breast-conserving...

Bringing the Humanistic Approach to Palliative Care: From Diagnosis and Throughout Disease Course

For much of her career in oncology, Teresa A. Gilewski, MD, has sought to bridge the science of medicine with the humanistic aspect of care. She has created the Art of Medicine lecture series at Memorial Sloan Kettering Cancer Center in New York, where she is a medical oncologist on the Breast...

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