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ASCO President’s Personal Philanthropy Honors Founder Jane C. Wright, MD

During her term as ASCO President, Sandra M. Swain, MD, FACP, of the Washington Cancer Institute has kept a solid focus on her presidential and 2013 ASCO Annual Meeting theme of “Building Bridges to Conquer Cancer.” These bridges take many forms, spanning challenges to be overcome in oncology...

issues in oncology
health-care policy

Disparities in Cancer Care: How A Deep South Community Overcame Them 

Racial inequities were a daily observation for Edward E. Partridge, MD, growing up in Alabama during the civil rights era. When he became a physician, he saw that these disparities extended into his own field, gynecologic oncology. He decided to do something about it. Dr. Partridge recently...

hematologic malignancies

Majority of Children Readmitted to Hospital Following Stem Cell Transplant

Nearly two-thirds of children receiving stem cell transplants returned to the hospital within 6 months for treatment of unexplained fevers, infections, or other problems, according to a study performed at Dana-Farber/Children’s Hospital Cancer Center in Boston. Children who received donor cells...

hematologic malignancies
leukemia

Preliminary Progress with Genetically Engineered T Cells in Treating Childhood ALL 

Two small phase I studies at separate centers demonstrated encouraging results in the treatment of children with acute lymphoblastic leukemia (ALL) using reinfused autologous genetically engineered T cells. Results of both studies were presented at the Annual Meeting of the American Association for ...

lymphoma

Role of Stem Cell Transplantation in Follicular Lymphoma 

The place of either autologous or allogeneic hematopoietic stem cell transplantation in the care of patients with follicular lymphoma has been a point of controversy. However, for patients in whom an effective chemotherapy or chemoimmunotherapy regimen for low-grade follicular lymphoma fails, I...

issues in oncology

Women in Oncology: Trending in the Right Direction 

According to ASCO President ­Sandra M. Swain, MD, FACP, an important part of her Presidential theme, “Building Bridges to Conquer Cancer,” is finding creative ways to ensure that we have enough oncologists to care for our burgeoning cancer patient population. Adding more women to the oncology...

breast cancer

Reducing Incidental Cardiac Irradiation during Breast Radiotherapy  

In the treatment of breast cancer, a wealth of data from prospective clinical trials and meta-analyses has documented the benefits of radiation to prevent local-regional recurrence and improve survival. Accordingly, important quality indicators in breast cancer care include: (1) receipt of...

SIDEBAR: Left-sided Adjuvant Breast Radiotherapy: A Change of Heart? 

Darby and colleagues are to be congratulated for an ambitious population-based case-control study that demonstrates the impact of postoperative adjuvant ionizing radiation for early-stage breast cancer on ischemic heart disease.1 The study examined roughly 1,000 cases and 1,000 controls in Sweden...

SIDEBAR: Critical Information on Radiation's Heart Effects  

The paper by Darby et al provides extremely important information on quantitative estimates of the effect of radiotherapy on coronary events in women with breast cancer.1 The authors have determined a direct relationship between radiation dose and effects on the heart and provide strong evidence...

lung cancer

Greater Prediagnosis Soy Food Consumption Associated with Improved Survival in Women with Lung Cancer 

As recently reported by Gong Yang, MD, MPH, Research Associate Professor at Vanderbilt University School of Medicine, Nashville, and colleagues in the Journal of Clinical Oncology,1 higher prediagnosis consumption of soy food was associated with improved overall survival in Chinese women with lung...

NCCN Clinical Practice Guidelines in Oncology: 2013 Updates 

At the 18th Annual Conference of the National Comprehensive Cancer Network (NCCN), representatives of NCCN Guidelines panels presented two new sets of guidelines along with updates for several tumor types, summarized in this issue of The ASCO Post. New NCCN Guidelines for Survivorship “The...

On the Potential for Conflicts of Interest

In a recent issue of The ASCO Post, I counted 14 expert commentaries where the authority who wrote or was interviewed for the piece reported “no potential conflicts of interest.” I wondered how likely that was. We need to be clearer on the meaning of potential conflicts of interest. How often have...

solid tumors
leukemia

Profound and Rapid Molecular Remission with CD19-targeted T Cells in Relapsed B-cell ALL 

As was recently reported in Science Translational Medicine, Renier J. Brentjens, MD, and colleagues at Memorial Sloan-Kettering Cancer Center, New York, found that profound molecular remission was rapidly induced in patients with relapsed B-cell acute lymphoblastic leukemia (ALL) using autologous T ...

supportive care

Patients with Cancer Can Have Cachexia-related Poor Prognostic Factors Regardless of Overall Weight 

“Patients with cancer who are cachexic by the conventional criterion (involuntary weight loss) and by two additional criteria (muscle depletion and low muscle attenuation) share a poor prognosis, regardless of overall body weight,” concluded a study in the Journal of Clinical Oncology. Researchers...

breast cancer

Surgery Delays Longer Than 6 Weeks in Young Women with Breast Cancer Decrease Survival 

Delays of more than 6 weeks from time of diagnosis until surgical treatment of breast cancer among young women significantly decreases survival times compared to those with a shorter treatment delay time, according to a study in JAMA Surgery. “This adverse impact on survival was more pronounced in...

breast cancer
issues in oncology

Some Stage II/III HER2-positive Tumors May Be Treated with Targeted Therapy without Chemotherapy 

Results from a multicenter phase II study of patients with locally advanced HER2-positive breast cancer who receive targeted therapy with trastuzumab (Herceptin) and lapatinib (Tykerb) “support the hypothesis that selected patients with HER2-positive tumors may not need chemotherapy,” investigators ...

Expect Questions from Your Patients 

Patients reading or hearing about the updated draft recommendation statement from the U.S. Preventive Services Task Force (USPSTF) on the use of medications to reduce risk for primary breast cancer1 may ask if and how it applies to them. To help answer those questions, the information presented...

breast cancer

Women at Increased Risk for Breast Cancer Should Be Offered Medications to Reduce Risk, Draft Recommendations Advise 

Clinicians should engage in shared decision-making with women who are at increased risk of breast cancer about using medications, such as tamoxifen and raloxifene (Evista), to reduce risk, and should offer prescriptions to women considered at low risk for adverse effects from these medications,...

integrative oncology

Ginger

The use of dietary supplements by cancer patients has risen significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the...

solid tumors
breast cancer

EGFR Prevents Maturation of microRNAs under Hypoxic Conditions

The epidermal growth factor receptor (EGFR) sends signals that thwart the development of tumor-suppressing microRNAs under conditions of hypoxia, an international team led by scientists at The University of Texas MD Anderson Cancer Center discovered. The results were reported in an early online...

Utilizing the Power of Rapid Learning Health-care Systems to Improve Patient Care 

Lynn Etheredge’s career in shaping national health-care and social policy spans more than 4 decades and four Presidential administrations. He was the lead analyst in the development of health insurance proposals for Medicare and Medicaid while working in the White House Office of Management and...

SIDEBAR: Low-dose CT Screening 

The first-screening results strongly suggest that the 20% reduction in lung cancer mortality with low-dose CT vs x-ray reported in the original NLST paper is achievable at experienced screening centers.

lung cancer
issues in oncology

Low-dose CT Detects Twice as Many Early-stage Lung Cancers as Chest X-ray, According to Additional NLST Results

Results of the first of three planned annual screening examinations from the National Lung Screening Trial (NLST) were recently published and physicians may now have more information to share with their patients about the benefits and risks of low-dose computed tomography lung cancer screening.1...

Expert Point of View: Giulia Veronesi, MD

The study discussant, Giulia Veronesi, MD, of the Division of Thoracic Surgery, European Institute of Oncology, Milan, Italy, said that diagnostic algorithms aim to strike a balance between a too-invasive workup that exposes screened persons to useless invasive procedures and overtreatment, and...

lung cancer
issues in oncology

Evaluation of Lung Cancer Screening Strategy in the First Three Rounds of the NELSON Trial

The Dutch-Belgian Randomized Lung Cancer Screening Trial (Dutch acronym: NELSON study) was designed to investigate whether screening for lung cancer by low-dose multidetector computed tomography (CT) in high-risk subjects would lead to a decrease in 10-year lung cancer mortality of at least 25%...

issues in oncology

Determining the Best Diet for Patients with Cancer  

How much does diet and body weight influence the effectiveness of cancer treatment and reduce the risk of cancer recurrence? What is the optimal diet for patients with cancer and survivors to follow? There are currently no hard and fast rules, but some dietary clues are starting to emerge. Search...

hematologic malignancies
leukemia

Intensified Liposomal Daunorubicin May Offer High Survival Rates without Added Cardiotoxicity for Children with Leukemia

Treating pediatric leukemia patients with a liposomal formulation of anthracycline-based chemotherapy at an intensified dose during initial treatment may result in high survival rates without causing any added heart toxicity, according to the results of a study published online in Blood.1 Acute...

hematologic malignancies
leukemia

Postinduction Dexamethasone and Individualized Dosing of Asparaginase Improve Outcome in Pediatric ALL 

Findings from the Dana-Farber Cancer Institute ALL Consortium Protocol 00-01, recently reported by Lynda M. Vrooman, MD, Dana-Farber Cancer Institute, and colleagues in Journal of Clinical Oncology, indicate that postinduction dexamethasone and individualized dosing of Escherichia coli–derived...

breast cancer

Double the Mastectomy, Double the Complications 

A retrospective analysis of a large surgical database has documented that bilateral mastectomy is associated with a doubling in complication rates, compared with unilateral mastectomy. Researchers reported the findings at the 14th Annual Meeting of the American Society of Breast Surgeons in...

colorectal cancer
lung cancer

Pulmonary Metastasectomy in Patients with Colorectal Cancer 

The largest-to-date and only prospective Spanish series of 549 patients who underwent surgical resection of lung metastases from colorectal carcinoma demonstrated a good postoperative recovery from the procedure. A further analysis on morbidity, the correlation between imaging studies and...

Expert Point of View: Alison Freifeld, MD

The EORTC Infectious Diseases Group Trial XV “is a long-awaited study because it finally is an investigation of outpatient management of low-risk fever and neutropenia in a large number of patients,” Alison Freifeld, MD, of the University of Nebraska Medical Center in Omaha, commented in an...

supportive care

Once-daily Moxifloxacin for Low-risk Patients with Febrile Neutropenia 

Once-daily oral moxifloxacin works at least as well as twice-daily oral ciprofloxacin plus amoxicillin–clavulanic acid when it comes to treating febrile neutropenia in patients who are at low risk for complications, according to a randomized, double-blind trial reported in the Journal of Clinical...

palliative care

Death with Dignity Program at Seattle Cancer Care Alliance 

After passage of the Washington Death with Dignity Act in November 2008, the Seattle Cancer Care Alliance—the site of outpatient care for patients with cancer from Fred Hutchinson–University of Washington Cancer Consortium—developed a Death with Dignity program. The program is adapted from existing ...

Expert Point of View: Andrew D. Zelenetz, MD, PhD

In a separate interview, Andrew D. Zelenetz, MD, PhD, Chief of the Lymphoma Service at Memorial Sloan-Kettering Cancer Center in New York, said that he found the relapse rate of 20% observed in this study to be quite low, and he wanted to know the characteristics of the 537 patients included in the ...

Expert Point of View: Roy S. Herbst, MD, PhD

This study should be placed in the context of treating to cure, said Roy S. Herbst, MD, PhD, Ensign Professor of Medicine and Chief of Medical Oncology at Yale University School of Medicine, New Haven, Connecticut. “If we can further increase the cure rate in stage III non–small cell lung cancer...

solid tumors

Impressive Results Shown for Immune Checkpoint Inhibitors: Anti-PD1 and Anti-PD-L1 Antibodies 

Antibody-mediated blockade of the programmed death 1 protein (PD-1) and its ligand (PD-L1) resulted in potent and durable tumor regression and prolonged stabilization of disease in patients with advanced solid tumors, according to early data on these drugs presented at the 2013 ASCO Annual Meeting. ...

palliative care

Caring for the Whole Patient Both during Active Treatment and at End of Life

Despite studies showing that a majority of patients prefer to die at home rather than in an institutional setting,1 in many parts of the country, over 30% die in nursing homes and over 50% die in hospitals, according to Ira Byock, MD, Director of Palliative Medicine, Dartmouth-Hitchcock Medical...

UICC President Balances Innovation and Pragmatism to Reduce the Global Burden of Cancer 

Mary K. Gospodarowicz, MD, FRCPC, is determined to help reduce the worldwide burden of cancer, a problem of epic proportions. Her approach is simple: adopt what works and reject what doesn’t. Much progress in the fight against cancer can be made without waiting for the next paradigm-changing...

After a Distinguished Career, Trailblazing Swiss Oncologist Remains Devoted to Addressing the Global Cancer Challenge 

Switzerland, a landlocked country with a population about that of New York City, has four geographic regions, each with its own official language. Internationally regarded lymphoma and breast cancer expert, Franco Cavalli, MD, FRCP, was born and raised in Locarno, a town in the Italian region of...

issues in oncology
supportive care

FDA Clears Multicenter Trial of Treatment for Hair Loss Related to Chemotherapy

The FDA has approved initiation of a multicenter trial of the DigniCap System, a scalp-cooling device for chemotherapy-related hair loss. The trial is the second and final phase of study for the DigniCap System. A pilot study previously conducted by researchers at the University of California San...

breast cancer

DCIS Score Quantifies Risk of Recurrence after Excision

The ductal carcinoma in situ (DCIS) Score, a multigene expression assay, quantifies the risk of local recurrence and invasive local recurrence for women with DCIS treated with surgical excision, researchers reported in the Journal of the National Cancer Institute. “The DCIS Score can aid clinical...

pancreatic cancer

Elevated Serum miR-1290 May Distinguish Early Pancreatic Cancer  

In studies to identify circulating microRNA levels that could distinguish low-stage pancreatic cancer from healthy and disease controls, Li and colleagues, measured 735 microRNAs in pancreatic cancer case and control sera and selected 18 microRNA candidates for validation in an independent set of...

integrative oncology

Vitamin D and Cancer: A Uniform Dose Is Unlikely to Fit All Patients 

Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center...

cns cancers

Improving Treatment and Care for Patients with Primary Brain Cancers 

Despite advances in neuroimaging, the development of focused radiation therapy, and more effective chemotherapy, life expectancy for patients with primary malignant tumors of the brain and spinal cord remains stubbornly low at between 15 and 18 months. However, there are significant advances on the ...

lung cancer

No Survival Benefit of ERCC1 and RRM1 Expression-based Chemotherapy in Patients with Advanced NSCLC 

A trial reported by Gerold Bepler, MD, PhD, of Karmanos Cancer Institute, Detroit, and colleagues in Journal of Clinical Oncology assessed whether chemotherapy selected on the basis of in situ ERCC1 and RRM1 protein levels could improve outcomes in patients with advanced non–small cell lung cancer...

issues in oncology

Reducing Unnecessary and High-dose Pediatric CT Scans Could Cut Future Cancers by More than Half

A study examining trends in x-ray computed tomography (CT) use in children in the United States has found that reducing unnecessary scans and lowering the doses for the highest-dose scans could lower the overall lifetime risk of future imaging-related cancers by 62%. The research was published...

breast cancer

Axillary Radiotherapy: New Standard of Care in Node-positive Breast Cancer? 

Radiotherapy to the axilla may replace axillary lymph node dissection for local tumor control in selected patients with sentinel node–positive breast cancer, sparing many patients lymphedema, according to the final results of the European Organisation for Research and Treatment of Cancer (EORTC)...

Expert Point of View: Electra D. Paskett, PhD

Formal discussant Electra D. Paskett, PhD, Professor of Medicine at The Ohio State University, was enthusiastic about these trial results and the potential of visual inspection with acetic acid screening, as well as low-cost human papillomavirus (HPV) screening to save lives in the developing...

gynecologic cancers
global cancer care

Simple Rapid Vinegar Test Cuts Cervical Cancer Death Rates by One-third in Rural India 

In the era of personalized medicine for cancer care, it was both surprising and encouraging to hear about a simple low-tech intervention delivered by women in the community that cut the rate of death from cervical cancer in India by about one-third. The intervention, a simple visual inspection...

gynecologic cancers

Practice-changing Study Shows Survival Benefit for Antiangiogenesis in Advanced Cervical Cancer 

The addition of bevacizumab (Avastin) to chemotherapy prolongs overall survival in women with metastatic cervical cancer compared with chemotherapy alone, according to the results of a randomized phase III study presented at the Plenary Session of the ASCO Annual Meeting.1 Women on the...

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