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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...

survivorship

Ongoing Clinical Trials Actively Recruiting Adolescent and Young Adult Survivors of Childhood Cancer

ADOLESCENT AND YOUNG ADULT CHILDHOOD CANCER SURVIVORS Study Type: Randomized/interventional Study Title: A Randomized Web-Based Physical Activity Intervention in Adolescent Survivors of Childhood Cancer Study Sponsor and Collaborators: St. Jude Children’s Research Hospital Purpose: Five-year...

multiple myeloma

The CoMMpass Trial in Multiple Myeloma

When I was diagnosed with multiple myeloma in 2008, at just 47, I was lucky. I was asymptomatic, my cancer was detected through a routine blood test, and I had the smoldering type, so I didn’t need immediate treatment. Plus, I knew that recent advances in more effective therapies were making it...

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...

prostate cancer

Does ‘Specialist Bias’ Contribute to Overtreatment of Prostate Cancer?

Specialist bias, in which specialists recommend the therapy that they are capable of delivering, is thought to influence the treatment of patients with localized prostate cancer and to contribute to overtreatment of men with limited life expectancy,” Ayal A. Aizer, MD, MPH, and colleagues, from the ...

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...

breast cancer

Study Shows Pathologic Complete Response to Neoadjuvant Therapy for Breast Cancer of Prognostic Value but Not for Use as Surrogate for Survival

Pathologic complete response to neoadjuvant therapy has been proposed as a surrogate endpoint for long-term clinical benefit in breast cancer. The U.S. Food and Drug Administration (FDA) established the international Collaborative Trials in Neoadjuvant Breast Cancer (CTNeoBC) working group to...

breast cancer

Targeting Cancer Stem Cells in Breast Cancer: A Potential Clinical Strategy

Preclinical models have suggested that cancer stem cells play a role in tumor recurrence and metastasis following adjuvant therapy, and Max S. Wicha, MD, and his research team are deciphering the mechanisms by which this might happen. A true understanding of cancer stem cells will have important...

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...

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...

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...

gynecologic cancers

High-Risk Uterine Cancers Found in BRCA1 Mutation Carriers Who Had Preventive Oophorectomy but Not Hysterectomy

Prophylactic surgery to remove the ovaries and fallopian tubes is advised for women who carry BRCA mutations to reduce the risk of breast and ovarian cancer. This procedure, referred to as risk-reducing salpingo-oophorectomy, typically does not require a hysterectomy. However, a new study presented ...

Expert Point of View: William Cliby, MD

When asked to comment on the study presented by Lin et al at the Annual Meeting on Women’s Cancer, William Cliby, MD, Chair, Division of Surgery, The Mayo Clinic, Rochester, Minnesota, said, “This study is important because of its size and the utilization of the National Cancer Data Base—the...

gynecologic cancers

Gynecologic Cancer Treatment at High-Volume Centers May Be Lifesaving

Women with gynecologic cancers who are treated at hospitals that frequently manage these conditions appear to live significantly longer than those who receive their care at lower-volume centers, according to a large study presented at the Society of Gynecologic Oncology (SGO) Annual Meeting on...

multiple myeloma

Promising Compounds in Development for Multiple Myeloma

The term “novel agents” has been used for the past decade to describe proteasome inhibitors and immunomodulatory drugs that are now conventionally used for multiple myeloma. However, even newer agents in development will be considered truly novel when they hit the market, as they represent new...

sarcoma

Surgery Plus Radiation Offers Mixed Results in Soft-Tissue Sarcoma

Adjuvant radiation following surgery for soft-tissue sarcomas of the extremities did not lead to a survival benefit and seemed to be associated with some degree of long-term limb complications, according to a presentation at the 2014 Society of Surgical Oncology (SSO) Cancer Symposium in Phoenix.1...

Expert Point of View: Mario Sznol, MD

Mario Sznol, MD, of Yale Cancer Center, New Haven, Connecticut, was formal discussant of the MK-3475 presentations at the American Association for Cancer Research (AACR) Annual Meeting. He alluded to all the factors that complicate assays of PD-L1: the disparate nature of the assays themselves, the ...

Collaborative Exchange: Indications and Dosing

Indications and Dosing of Methotrexate and 5-FU Dr. Campen: The interesting thing about methotrexate is that it has been used for such a long time. You would think there would be a specific dose that would be considered “high dose,” but high dose is actually quite variable. [Dosage] depends on the...

issues in oncology

Breaking Bad News Badly Can Add to Upset

When the prognosis is poor, breaking the bad news badly can exacerbate the distress experienced by cancer patients and their families. A lack of sensitivity to patient and family emotions and not being attuned to how individual patients would prefer to be informed about their prognoses can result...

solid tumors

DNA Repair Pathway Recombination Proficiency Score Correlates With Tumor Sensitivity to Chemotherapy

As reported in Science Translational Medicine, Pitroda and colleagues developed a recombination proficiency score that measures the efficiency of DNA repair pathways in the context of cancer therapy aimed at generating DNA damage. The score is based on expression levels of four genes involved in...

ASCO’s Visionary Founders

On April 9, 1964, seven physicians—Jane Cooke Wright, MD, FASCO; Arnoldus Goudsmit, MD, PhD; Fred J. Ansfield, MD, FASCO; Harry F. Bisel, MD, FASCO; Herman H. Freckman, MD, FASCO; Robert W. Talley, MD, FASCO; and William Wilson, MD, FASCO—met for lunch at the Edgewater Beach Hotel in Chicago. They...

One Community

My Presidential theme was One Community. I think that theme continues to express much of our goal in oncology, which is to make sure that all members of the cancer care team work together—oncologists, nurses, scientists, nutritionists, psychologists, social workers, administrators, and others. I...

cns cancers

Surgical Resection of Newly Diagnosed Glioblastoma: What Is the Standard of Care?

The neurosurgeon is often the gateway provider when patients present with what on magnetic resonance imaging (MRI) appears to be a new glioblastoma. Because histology-based diagnosis is a prerequisite for initiating standard therapy with radiation and chemotherapy, the first question that the...

myelodysplastic syndromes

Forward Progress in Myelodysplastic Syndromes Is Largely in Genetics

Most recent advances in the management of myelodysplastic syndrome (MDS) are in the area of genetics, according to Steven Gore, MD, of Yale University School of Medicine, New Haven. “New genomics research is leading to a better understanding of MDS heterogeneity and disease biology, and may...

ASCO Launches New Resources for Providers and Patients to Address Link Between Obesity and Cancer

As the obesity epidemic takes its toll on the nation’s health, ASCO is making strides to address this growing concern as it relates to cancer. ASCO has developed a suite of educational resources designed to help oncology providers educate their patients about the negative effects of obesity on...

colorectal cancer

Neoadjuvant Chemotherapy Without Routine Radiotherapy Shows Promise in Patients With Locally Advanced Rectal Cancer

In a pilot study reported in the Journal of Clinical Oncology, Deborah Schrag, MD, MPH, and colleagues from Memorial Sloan Kettering Cancer Center, New York, assessed outcomes with neoadjuvant FOLFOX (fluorouracil, leucovorin, oxaliplatin)/bevacizumab (Avastin) with selective use of...

prostate cancer

Continued Survival Benefits Seen With Radical Prostatectomy vs Watchful Waiting in Long-Term Follow-up of the SPCG-4 Trial

The long-term benefits of radical prostatectomy vs watchful waiting in men with localized prostate cancer has remained a debated issue. As reported in The New England Journal of Medicine by Anna Bill-Axelson, MD, of Uppsala University Hospital, and colleagues, additional long-term follow-up in the...

issues in oncology

Cancer Chemotherapy Use During Pregnancy

INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this installment, National Toxicology Program scientists Kembra L. Howdeshell, PhD, and Michael D. Shelby, PhD, discuss a recently completed monograph that reviews the published data on...

supportive care

ASCO Releases Adapted Guideline on Screening, Assessment, and Care of Anxiety and Depressive Symptoms in Adults With Cancer

Detection of depression is suboptimal, and its severity is underestimated in the general population, but it is known psychiatric disorders are more common in patients with cancer than in those with any other chronic illness. Although studies in cancer patients have yielded varying figures, it is...

lymphoma
geriatric oncology

Andrew D. Zelenetz, MD, PhD, on Treating the Elderly Lymphoma Patient With Elevated Bilirubin

At the 19th Annual Conference of the National Comprehensive Cancer Network (NCCN), lymphoma expert and NCCN Panel Chair on Lymphoma, Andrew D. Zelenetz, MD, PhD, fielded questions from oncologists. The ASCO Post was there to capture his recommendations for a common clinical scenario—treating the...

lung cancer
lymphoma

Belinostat Moves Forward in Trials for Two Aggressive Cancers

In February, the U.S. Food and Drug Administration (FDA) granted belinostat (Beleodaq), a targeted histone deacetylase (HDAC) inhibitor, priority review status based on a pivotal phase II trial in peripheral T-cell lymphoma. Just 1 month later, researchers at the National Cancer Institute (NCI) in...

breast cancer

Survival Analysis of Contralateral Prophylactic Mastectomy Sparks Discussion

Contralateral prophylactic mastectomy improved breast cancer patients’ odds of overall survival by 23% compared with single mastectomy alone, according to a retrospective analysis of nearly 170,000 patients in a U.S. database, but surgical breast cancer specialists warned that the data needed to be ...

breast cancer
colorectal cancer
lung cancer
prostate cancer
skin cancer
leukemia
lymphoma
multiple myeloma
survivorship

NCCN Clinical Practice Guidelines in Oncology: 2014 Updates

At the 19th Annual Conference of the National Comprehensive Cancer Network (NCCN), held recently in Hollywood, Florida, NCCN Panel members presented updates for several tumor types, briefly summarized here. For a more complete description of all updates, visit www.nccn.org. Breast Cancer Guidelines ...

survivorship
symptom management

ASCO Releases Guideline on Prevention and Management of Chemotherapy-Induced Peripheral Neuropathy in Survivors of Adult Cancers

ASCO has released a clinical practice guideline on prevention and treatment of chemotherapy-induced peripheral neuropathy in adult cancer patients, published in the Journal of Clinical Oncology.1 The guidelines resulted from the efforts of an expert panel, with representation from the fields of...

ASCO’s Visionary Founders

On April 9, 1964, seven physicians—Jane Cooke Wright, MD, FASCO; Arnoldus Goudsmit, MD, PhD; Fred J. Ansfield, MD, FASCO; Harry F. Bisel, MD, FASCO; Herman H. Freckman, MD, FASCO; Robert W. Talley, MD, FASCO; and William Wilson, MD, FASCO—met for lunch at the Edgewater Beach Hotel in Chicago. They...

Remembering Selma Ruth Schimmel

My last conversation with Selma Schimmel was 2 months ago. She had been uncharacteristically out of touch for a few weeks, and I had a nagging feeling the severe pain in her psoas muscle caused by advancing ovarian cancer—which had plagued her for months and she described as in a “league of its...

supportive care

Cancer Patients at High Recurrence Risk for Venous Thromboembolism Should Be Considered for Secondary Prophylaxis

The risk of recurrence of venous thromboembolism in cancer patients can be stratified. “In particular, patients with brain, lung, stage IV pancreatic or ovarian cancer, myeloproliferative or myelodysplastic disorders, [other] stage IV cancer, cancer stage progression or leg paresis have the highest ...

breast cancer

Cancer Has Robbed Me of My Physical Beauty but Not My Inner Strength

I’ve been plagued with various ailments all my life. Physically and emotionally abused by my stepfather as a child, over the years I’ve developed severe psychological issues including depression and anxiety disorder. I am also in constant physical pain from cervical degenerative disc disease,...

issues in oncology

A Proposal for Patient-Selected Controlled Trials: Good Science and Good Medicine

The Clinical Trials and Translational Research Advisory Committee (CTAC) of the National Cancer Institute (NCI) met for the 22nd time on March 12, 2014, in their ongoing effort to improve efficiency and effectiveness of cancer clinical trials. A significant portion of the meeting addressed lagging...

issues in oncology

Randomized Trials vs Meta-analyses: Which Is the Better Bet?

Two surgical oncology experts who squared off in a “Great Debate” at the 2014 Society of Surgical Oncology (SSO) Annual Cancer Symposium in Phoenix. Heidi Nelson, MD, Professor of Surgery at the Mayo Clinic in Rochester, Minnesota, argued for the superiority of randomized controlled trials in...

University of Louisville Receives $5.5 Million Grant From Helmsley Charitable Trust to Support Innovative Cancer Research

Noting the significant progress in drug and vaccine development over the past 3 years, the Leona M. and Harry B. Helmsley Charitable Trust, has provided a 3-year, $5.5 million grant to the James Graham Brown Cancer Center at the University of Louisville, Kentucky, to develop new treatments and...

breast cancer

ASCO Endorses SSO/ASTRO Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stage I/II Breast Cancer

As reported in the Journal of Clinical Oncology,1 ASCO has endorsed the recently published Society of Surgical Oncology (SSO) and American Society for Radiation Oncology (ASTRO) consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stage I and II invasive...

lung cancer

Experts Share Keys to a Successful Lung Screening Program

There are currently 172 computed tomography (CT)-based lung screening centers up and running in the United States, according to the Lung Cancer Alliance.1 In a presentation at the American Roentgen Ray Society (ARRS) 2014 Annual Meeting in San Diego, Reginald Munden, MD, DMD, MBA, and Ralph...

ASCO Takes Aim at the Link Between Obesity and Cancer

ASCO is stepping up its efforts to address the link between obesity and cancer—both as a leading cause of cancer and as a complicating factor for treatment. In recent years, research has demonstrated that a growing number of cancers are linked to obesity, and public health researchers predict that...

breast cancer

Should Breast Cancer Patients With One to Three Positive Nodes Routinely Receive Postmastectomy Radiation?

The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) continues to provide valuable clinically relevant and practice-influencing information garnered from individual patient-level data from numerous randomized trials in breast cancer. The large numbers of patients and long-term follow-up...

breast cancer

ASCO Guideline Update Extends Sentinel Node Biopsy Indications in Breast Cancer

The American Society of Clinical Oncology (ASCO) published its first guideline for sentinel lymph node biopsy in 2005.1 Since that time, many new randomized and cohort studies have been published investigating the indications and outcomes of the procedure. The updated 2014 guideline, recently...

breast cancer

ASCO Clinical Practice Guideline Update: Sentinel Lymph Node Biopsy for Patients With Early-Stage Breast Cancer

ASCO recently convened an update committee of experts in medical oncology, pathology, radiation oncology, surgical oncology, guideline implementation, and advocacy to develop evidence-based recommendations that update the ASCO 2005 clinical practice guideline on use of sentinel node biopsy in...

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