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Expert Point of View: Richard Little, MD

The National Cancer Institute (NCI) sees a real need for additional study of treatment options for human immunodeficiency virus (HIV)-infected patients with malignancies. The results of this trial make us confident that exclusion from autologous transplant studies on the basis of HIV serostatus is...

multiple myeloma

From ASH 2014: What’s New in the Myeloma Treatment Arsenal?

At the 56th American Society of Hematology (ASH) Annual Meeting and Exposition, attendance at many multiple myeloma sessions outnumbered the room size, as data from studies of novel agents, such as the monoclonal antibodies, and from key trials, such as ASPIRE, drew crowds. The ASCO Post covered...

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...

hepatobiliary cancer

Targeting Biliary Tract Cancers Through Genomic Profiling

Biliary tract cancers are challenging, but a large genomic profiling study has identified potentially clinically relevant genomic alterations in up to two-thirds of patients.1 “The diverse landscape of clinically relevant genomic alterations in biliary tract cancers can serve as targets for...

Harold Varmus, MD, Steps Down as NCI Director, Douglas Lowy, MD, Named Acting Director

Harold Varmus, MD, who has led the National Cancer Institute (NCI) at the National Institutes of Health (NIH) for nearly 5 years, has announced that he will step down from his post, effective March 31, 2015. “It has been our great fortune to have Dr. Varmus at the helm of the NCI,” said NIH...

integrative oncology

Herbal Supplements: Increasing Problems

In Don Quixote, the 1605 Spanish literary masterpiece by Miguel Cervantes, “Balsam of Fierabras” is mentioned often as a therapeutic panacea. It calls for mixing rosemary, wine, oil, and salt. As the story goes, the knight relied heavily on this herbal preparation to relieve him of pain from the...

gastroesophageal cancer

Clinical Trials Actively Recruiting Patients With Esophageal Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting observational, interventional, phase I, phase II, and phase III clinical studies for patients with newly diagnosed or recurrent esophageal cancer. All of the studies are listed on the National Institutes...

health-care policy
cost of care

Medicine Turned Upside Down

BookmarkTitle: The Patient Will See You Now: The Future of Medicine Is in Your HandsAuthor: Eric Topol, MDPublisher: Basic BooksPublication date: January 2015Price: $28.99; hardcover, 384 pagesMost books about health care center on fixing broken parts of the massive $3 trillion system, as seen with ...

issues in oncology

Avoiding Burnout and Maintaining Well-Being While Caring for Seriously Ill Patients

A variety of studies, including one published this past year in the Journal of Clinical Oncology,1 have showed that clinicians who care for seriously ill patients are at high risk for diminished personal well-being, including high rates of burnout; moral distress, defined as the inability to act in ...

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...

issues in oncology
health-care policy

Ongoing Controversies in Allocating Our Health‑Care Resources

Disparities of care that result in poorer outcomes among certain populations have long been an issue addressed by the cancer community and its major organizations such as ASCO. While ethnicity and race play key roles in this ongoing debate over equitable allocation of our precious health-care...

breast cancer
gastrointestinal cancer

Gastric, Breast Cancer Risk in Carriers of CDH1 Gene Mutations

In a new study,1 more precise estimates of age-associated risks of gastric and breast cancer were derived for carriers of the CDH1 gene mutation, a cancer-predisposing gene that is abnormal in families meeting criteria for clinically defined hereditary diffuse gastric cancer (HDGC). David G....

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...

supportive care

Many Cancer Patients at Risk for Hepatitis B Virus Reactivation

In 2015, no cancer patients should be cured of their malignancy only to die of reactivation of hepatitis B virus (HBV),” according to Anna S. Lok, MD, the Alice Lohrman Andrews Research Professor in Hepatology and Director of Clinical Hepatology at the University of Michigan, Ann Arbor. “I...

bladder cancer

Antiangiogenesis Plus Chemotherapy Pursued in Advanced Bladder Cancer

Two separate phase II studies lend support to the concept of antiangiogenesis in advanced bladder cancer. The combination of an antiangiogenic agent and chemotherapy may fulfill an unmet need in this disease, the studies suggest. Both studies were presented at the 2015 Genitourinary Cancers...

issues in oncology
health-care policy

Health-Care Fraud and Abuse: Implications for Oncology

Health-care fraud is a long-standing problem in the United States, accounting for $75 billion in government expenses per year,1 while total spending on government health-care programs is over $1 trillion. Two decades ago, the Department of Justice increased its efforts to combat health-care fraud....

lymphoma

Radiotherapy in Good-Prognosis DLBCL

I was disturbed by the article on “Radiotherapy in Good-Prognosis ­DLBCL” published recently in The ASCO Post.1 As a practicing radiation oncologist for 30 years, I have seen the evolution of radiation techniques (and philosophy) for non-Hodgkin lymphoma progress from regional—or even...

A Surgeon Cuts to the Chase

BookmarkTitle: The Cost of Cutting: A Surgeon Reveals the Truth Behind a Multibillion-Dollar IndustryAuthor: Paul A. Ruggieri, MDPublisher: Berkley BooksPublication date: September 2014Price: $16.00; paperback, 320 pages The woman seated on the exam table was lean and fit and seemed perfectly at...

colorectal cancer

Refining the ‘Right Patient, Right Drug’ Pairing in Cancer Care: RAS Profiling in Metastatic Colorectal Cancer

In an important post hoc analysis (reviewed in this issue of The ASCO Post), Van Cutsem and colleagues have further refined our knowledge of who are the “right” patients with metastatic colorectal cancer to receive treatment with cetuximab (Erbitux).1 This refinement was accomplished through the...

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...

Researchers and Scientists Honored for Improving Cancer Prevention, Treatment, and Patient Care

The ASCO Special Awards recognize the dedication and significant contributions of researchers, patient advocates, and leaders of the global oncology community to enhancing cancer prevention, treatment, and patient care. Among this year’s awardees are an international leader in geriatric oncology...

global cancer care

Global Oncology Launches Global Cancer Project Map With NCI

Nonprofit Global Oncology, Inc (GO) announced the launch of the Global Cancer Project Map, a novel online resource and virtual information exchange connecting the global cancer community. Developed by Global Oncology in collaboration with the National Cancer Institute (NCI) Center for Global...

NCCN Honors Joseph V. Simone, MD,  FASCO, and John A. Gentile, Jr, at Group’s 20th Annual Conference

At the National Comprehensive Cancer Network (NCCN) 20th Annual Conference held last month in Hollywood, Florida, NCCN honored Joseph V. Simone, MD, FASCO, and John (Jack) A. Gentile, Jr, with the NCCN Board of Producers Award. Dr. Simone is President of Simone Consulting Company, which advises...

breast cancer

Breast Cancer Management in Review

Anyone who has attended the major oncology meetings knows that research from clinical trials in breast cancer often dominates the stage, with countless abstracts featuring new and updated results. To help the readers of The ASCO Post stay up to date with the latest discoveries and findings...

issues in oncology
supportive care

FDA Approves First Biosimilar Product Filgrastim-Sndz

The U.S. Food and Drug Administration (FDA) has approved filgrastim-sndz (Zarxio), the first biosimilar product approved in the United States. A biosimilar product is a biologic product that is approved based on a showing that it is highly similar to an already-approved biologic. The biosimilar...

Calculating H-Score

Immunohistochemistry results can be further evaluated by a semiquantitative approach used to assign an H-score (or “histo” score) to tumor samples.1,2 First, membrane staining intensity (0, 1+, 2+, or 3+) is determined for each cell in a fixed field. The H-score may simply be based on a predominant ...

health-care policy
legislation

State Oncology Societies Join ASCO’s Call on Congress to Replace SGR Formula

In a show of solidarity, state oncology societies from across the United States joined ASCO in its call on Congress to repeal Medicare’s Sustainable Growth Rate (SGR) formula before the current payment patch expires. In a letter to U.S. House and Senate leadership, 48 signatories, representing tens ...

health-care policy

ASCO Commends U.S. House of Representatives for Voting to Repeal the SGR, Urges Senate to Pass Legislation

We applaud the House of Representatives for passing legislation that eliminates the Sustainable Growth Rate [SGR] formula and takes a giant leap toward meaningful and urgently needed Medicare physician payment reform. Cancer incidence among Medicare beneficiaries is expected to increase by 67% by...

breast cancer
issues in oncology

Too Early to Use Genome Sequencing for Breast Cancers in the Clinic

The role of next-generation sequencing (high-throughput technologies that allow DNA and RNA to be analyzed more quickly and inexpensively than earlier techniques) in breast cancer remains unclear and at present is primarily a research tool. Therefore, clinicians should be cautious in using genetic...

breast cancer
issues in oncology

Should Oncologists Be Ordering Breast Cancer Gene Panels?

Two oncologic surgeons squared off at the 32nd Miami Breast Cancer Conference to debate whether breast cancer genetic susceptibility panel testing is ready for routine use in the clinic. J. Michael Dixon, MD, Professor of Surgery and Consultant Surgeon at the Edinburgh Breast Unit in the United...

AACR Honors Cancer Pioneers at the 2015 Annual Meeting

The American Association for Cancer Research (AACR) recognized six oncologists making valuable contributions to their fields with awards at the Association’s Annual Meeting 2015, held in Philadelphia from April 18–22. William C. Hahn, MD, PhD, was awarded with the 39th Annual AACR–Richard and Hinda ...

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...

geriatric oncology

Preparing for the ‘Silver Tsunami’ and the Impact of an Aging Population on Cancer Care

“Older adults constitute the only increasing natural resource in the entire world.” —Linda Fried, PhD, Columbia School of Public Health The good and bad news about our changing demographic world is that the population of older adults is increasing in the United States and worldwide. While it is...

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...

breast cancer
survivorship

Breast Cancer Management in Review

With the field of breast oncology as complex as ever, a brief update of the latest findings impacting breast cancer treatment seems timely. To that end, I have assembled highlights from a collection of newsworthy studies featured over the past year and into early 2015. Part 1 of this review, which...

Richard Pazdur, MD, and Anthony S. Fauci, MD, Included in Fortune’s List of the World’s 50 Greatest Leaders

Richard Pazdur, MD, Director of the Office of Oncology and Hematology Products at the U.S. Food and Drug Administration (FDA) was named one of the world’s 50 greatest leaders by Fortune Magazine. The list also included names such as Pope Francis, Apple CEO Tim Cook, Chief Justice of the United...

gynecologic cancers

Complete Regression of Metastatic Cervical Cancer Is Observed After Treatment With HPV-Targeted Tumor-Infiltrating T Cells

As reported in the Journal of Clinical Oncology,1 researchers at the National Cancer Institute observed complete regression of metastatic cervical tumors in two patients following a single infusion of human papillomavirus (HPV)-targeted tumor-infiltrating T cells. In the protocol, nine patients...

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...

breast cancer
issues in oncology

Radiotherapy or Not in Older Women Receiving Breast-Conserving Surgery and Endocrine Treatment?

In the phase III PRIME II trial, designed to assess whether whole-breast irradiation could be omitted in women aged ≥ 65 years with early-stage breast cancer undergoing breast-conserving surgery and receiving adjuvant endocrine treatment, Ian H. Kunkler, MB BChir, FRCR, of Western General Hospital, ...

supportive care

A Cautionary Note on Psilocybin Therapy

The controversial nature of [psilocybin] is garnering attention before [the NYU investigators’] work has been peer-reviewed, which is concerning. Could psilocybin therapy be a helpful anxiolytic in any patient? Yes, I suppose, but I’d like to see the data. Is psilocybin an anxiolytic in cancer...

supportive care

Researchers Discuss Pilot Study on Hallucinogenic Therapies for Cancer Anxiety

Although varying levels of existential distress are near-ubiquitous among patients with cancer, evidence-based interventions in this clinical area remain somewhat elusive. Seeking to explore novel approaches in the palliative care environment, New York University (NYU) School of Medicine principal...

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 ...

lung cancer

Crizotinib Receives Breakthrough Therapy Designation for ROS1-Positive NSCLC

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to crizotinib (Xalkori) for the potential treatment of patients with ROS1-positive non–small cell lung cancer (NSCLC). Crizotinib currently is FDA-approved for the treatment of patients with metastatic NSCLC...

breast cancer

Experts Debate: Can We Cure Metastatic Breast Cancer?

Can metastatic breast cancer ever be cured? This issue was debated at the 32nd Annual Miami Breast Cancer Conference by two experts in the field: George W. Sledge, Jr, MD, Professor of Medicine at Stanford University Medical Center, Palo Alto, California, and Clifford A. Hudis, MD, Chief of the...

HOPA Announces New President and 2015 Membership Award Winners

The Hematology/Oncology Pharmacy Association (HOPA) has elected Scott Soefje, PharmD, MBA, BCOP, FCCP, to serve as President for the 2015–2016 term. His term began at the 11th HOPA Annual Conference, held March 25–28. Dr. Soefje has served as President-Elect since March 2014. Dr. Soefje is a...

lung cancer

EGFR L858R Mutation in Blood Sample May Serve as Surrogate for Biopsy in Determining EGFR-Mutation Status

Using a novel polymerase chain reaction assay “to efficiently assess” epidermal growth factor receptor (EGFR) mutations in circulating free DNA (cfDNA) from blood samples of patients with advanced non–small cell lung cancer (NSCLC), the Spanish Lung Cancer Group has “shown that the EGFR L858R...

Remembering Multiple Myeloma Patient Advocate Michael S. Katz, MBA

I first met Michael Katz, MBA, in 2004, 3 years after my brother, Dom, was diagnosed with multiple myeloma, and we were at a crossroads in his care and needed advice. Although an experimental regimen of thalidomide (Thalomid) and dexamethasone had successfully put Dom in remission for a year (the...

issues in oncology

Bispecific Antibody Recruitment to Increase Antitumor Activity of Adoptive T-Cell Transfer

In a study reported in the Journal of the National Cancer Institute, Kobold and colleagues assessed whether combining tumor-specific T cells modified with a marker antigen and a bispecific antibody that selectively recognizes transduced T cells and tumor cells could improve T-cell recruitment to...

issues in oncology

The Paradox of Positive Thinking

The ASCO Post is pleased to reproduce installments of the “Art of Oncology” as published previously in the Journal of Clinical Oncology (JCO). These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

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 ...

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