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Kevin C. Oeffinger, MD, on Controversies in Breast Cancer Screening Strategies
Kevin C. Oeffinger, MD, of Memorial Sloan Kettering Cancer Center, discusses American Cancer Society recommendations, including the advice that women with an average risk of breast cancer should undergo regular screening mammography starting at age 45, and that women 55 and older should have...
Effects of Chemotherapy on Pregnancy for Survivors of Childhood Cancer Treated Between 1970 and 1999
In an analysis in the Childhood Cancer Survivor Study cohort reported in The Lancet Oncology, Chow et al found that increasing doses of several alkylating agents reduced the likelihood of fathering a pregnancy among male survivors of childhood cancer, with fewer drug associations with pregnancy...
ASCO Endorses Cancer Care Ontario Recommendations on Decision-Making in Adjuvant Systemic Therapy for Early-Stage, Operable Breast Cancer
As reported in the Journal of Clinical Oncology by N. Lynn Henry, MD, PhD, of the University of Michigan Comprehensive Cancer Center, and colleagues, ASCO has endorsed Cancer Care Ontario (CCO) guideline recommendations on the role of patient and disease factors in decisions on adjuvant systemic...
Lower Vitamin D Levels Associated With Adverse Pathology at Prostatectomy in Men With Localized Prostate Cancer
In a study reported in the Journal of Clinical Oncology, Nyame et al found that lower serum 25-hydroxyvitamin D (25-OH D) levels were associated with an increased likelihood of adverse pathology at radical prostatectomy in men with localized prostate cancer. Study Details The cross-sectional...
Increased Frequency of BRCA Mutation Testing in Young Women With Breast Cancer
Rosenberg et al found that the proportion of women diagnosed with breast cancer at age ≤ 40 years who have undergone BRCA1 and BRCA2 testing has increased during recent years. These findings, which were reported in JAMA Oncology, were part of the ongoing prospective Helping Ourselves, Helping...
Danish Study Shows Increased Risk for Cancers in Addition to Breast Cancer in CHEK2 Mutation Heterozygotes
In a study reported in the Journal of Clinical Oncology, Näslund-Koch et al found an increased risk for cancers in addition to breast cancer in individuals heterozygous for the CHEK2*1100delC germline mutation associated with an increased breast cancer risk. CHEK2 is a cell-cycle checkpoint...
Epoetin Alfa vs Best Standard of Care in Treatment of Anemia in Patients With Metastatic Breast Cancer Receiving Chemotherapy
Use of epoetin alfa (Epogen, Procrit) vs best standard of care to treat anemia did not achieve noninferiority for investigator-assessed progression-free survival in patients receiving chemotherapy for metastatic breast cancer, reported Leyland-Jones et al in the Journal of Clinical Oncology....
No Treatment Failure or Survival Benefit but Less Toxicity With Comprehensive Geriatric Assessment in Elderly Patients With Advanced NSCLC
Use of comprehensive geriatric assessment to guide therapy in elderly patients with stage IV non–small cell lung cancer (NSCLC) did not improve treatment failure–free or overall survival but was associated with slightly reduced toxicity, based on the results of the phase III...
Survivors of Adolescent and Young Adult Cancer May Be at Increased Risk of Cardiovascular Disease
Survivors of adolescent and young adult cancer were at a greater than twofold increased risk for cardiovascular disease than their counterparts without cancer, according to a study reported in the Journal of Clinical Oncology by Chao et al. Study Details The study involved data from a...
Japanese Trial Shows Reduced Risk of Subsequent Colorectal Adenomas and Polyps With Low-Dose Metformin
Treatment with low-dose metformin reduced the risk of metachronous colorectal adenomas and polyps over 12 months in nondiabetic patients who had undergone endoscopic polypectomy, according to a report by Higurashi et al in The Lancet Oncology. Study Details In the double-blind phase III trial,...
Low-Magnitude, High-Frequency Mechanical Stimulation May Improve Bone Mineral Density in Young Childhood Cancer Survivors
In a small trial reported in JAMA Oncology, Mogil et al found that low-magnitude, high-frequency mechanical stimulation improved the whole-body bone mineral density score in childhood cancer survivors with low bone mineral density. Study Details In the double-blind trial, 65 survivors of...
Patients Diagnosed With Stage I to III Rectal Cancer at Younger Age Have Increased Risk for Positive Lymph Nodes
Patients diagnosed with stage I to III rectal cancer at a younger age are at increased risk of having positive lymph nodes, according to an analysis of data published in the Journal of the National Cancer Institute. “This finding merits further investigation and may ultimately impact treatment...
Increased Risk of Cardiovascular Disease Among Survivors of Some Adult-Onset Cancers
In a study using managed-care organization data reported in the Journal of Clinical Oncology, Armenian et al found that survivors of adult-onset multiple myeloma, non-Hodgkin lymphoma, lung/bronchus cancer, and breast cancer had an increased risk for subsequent cardiovascular disease. Study...
Enzalutamide Improves Progression-Free Survival vs Bicalutamide in Nonmetastatic and Metastatic Castration-Resistant Prostate Cancer
Treatment with enzalutamide (Xtandi) tripled median progression-free survival vs bicalutamide in patients with nonmetastatic or metastatic castration-resistant prostate cancer, according to the phase II STRIVE trial reported in the Journal of Clinical Oncology by Penson et al. Study Details In...
ASCO Issues Report on State of Cancer Care in America: 2016
The State of Cancer Care in America: 2016, published online in the Journal of Oncology Practice1 and presented earlier this month at a Congressional briefing in Washington, DC, is ASCO’s third annual assessment of national trends in cancer care delivery. The report highlights many promising cancer...
Fecal Immunochemical Test Highly Sensitive and Effective When Used for Colorectal Cancer Annual Screening Programs
Annual screening with the fecal immunochemical test is highly sensitive for detecting colorectal cancer and “is feasible and effective for population-level colorectal cancer screening,” according to a large-scale retrospective cohort study assessing this test over four rounds of annual screening....
A Drop of Blood
I was a third-year internal medicine resident, rotating through the oncology service, when I was asked to perform my first circumcision. My team was rounding on Tom, a 52-year-old gentleman currently receiving third-line treatment for metastatic esophageal cancer; we were discussing at length his...
Benefiting From Mind-Body Therapy
My diagnosis of early-stage breast cancer at age 35 was a shock, also because I come from a family with no history of cancer. In disbelief, I was literally speechless—I lost my voice completely for several days. I grew up in the former Soviet Union and then in the newly independent Kyrgyzstan. My...
Study Shows Breast-Conserving Therapy Beats Mastectomy, but Questions Remain
Breast-conserving therapy (lumpectomy plus radiation therapy) appears to improve 10-year overall survival for women with early breast cancer compared with mastectomy, according to a very large population-based study from the Netherlands.1 However, the study raises more questions than it answers,...
The Time Is Now for the Worldwide Cancer Community to Be Proactive
The ASCO Post recently spoke with nationally recognized surgical oncologist Chandrakanth Are, MBBS, MBA, FRCS, FACS, Jerald L & Carolynn J. Varner Professor of Surgical Oncology & Global Health; Vice Chair of Education; and Program Director, General Surgery Residency, University of Nebraska ...
PARP Inhibitor Olaparib Produces High Response Rate in Metastatic Prostate Cancer With DNA-Repair Defects
In the TOPARP-A phase II trial reported in The New England Journal of Medicine, Joaquin Mateo, MD, of the Institute of Cancer Research and The Royal Marsden in London, and colleagues, found that the PARP inhibitor olaparib (Lynparza) produced a high response rate in patients with previously treated ...
Introduction of New Diagnostic Devices in Oncology: New Is Not Necessarily Better
“New!” “Improved!” “Throw out that old [fill in the blank] and go buy a new [fill in the blank]!” Sound familiar? The key to marketing is to convince customers that they need a product without which they had previously been quite happy. All too often, this strategy is accompanied by a caveat emptor ...
Potential Overdiagnosis of Contralateral Breast Cancer With Preoperative Breast MRI in Older Women With Breast Cancer
In an analysis of the Surveillance, Epidemiology, and End Results (SEER)-Medicare database reported in the Journal of Clinical Oncology, Shi-Yi Wang, MD, PhD, of Yale School of Public Health, and colleagues found that the use of preoperative magnetic resonance imaging (MRI) was associated with...
How Rehabilitation Services Provide Benefit for Patients With Spinal Metastases
The benefits of rehabilitation in traumatic spinal injuries are well established. Recently, studies have shown similarly positive results in cancer-related spinal injuries, indicating that rehabilitation can play a complementary role in the care management of this patient population....
Increased Travel Burden Decreases Likelihood of Receiving Radiation Therapy for Rectal Cancer Treatment
Increased travel distance to a cancer treatment facility negatively impacts the likelihood that patients with stage II/III rectal cancer will receive radiation therapy to treat their disease, according to a study analyzing 26,845 patient records from the National Cancer Data Base (NCDB) published...
Neratinib Improves Invasive Disease–Free Survival After Trastuzumab-Based Therapy in HER2-Positive Breast Cancer
Chan et al found that 1 year of treatment with the HER1, 2, and 4 tyrosine kinase inhibitor neratinib improved invasive disease–free survival vs placebo after trastuzumab (Herceptin)-based adjuvant therapy in patients with early-stage HER2-positive breast cancer, in the phase III ExteNET...
Closing the Clinical Trial Gap for Adolescents and Young Adults With Cancer
Although overall survival rates for patients with cancer continue to soar—with 14.5 million cancer survivors today1—most of that gain is among pediatric and older adult patients. For adolescents and young adults with cancer—defined by the National Cancer Institute (NCI) as those in the 15- to...
Geriatric Assessment of Transplant-Ineligible Older Adults With Multiple Myeloma: A Novel Approach in the Era of Novel Agents
Myeloma is a disease of aging, with a median age at diagnosis in the United States of 69 years.1 As the population ages, forecasts estimate that, within 20 years, 3 of every 4 people diagnosed with multiple myeloma in the United States will be between the ages of 64 and 84 years.2 In anticipation...
Obinutuzumab in Relapsed or Refractory Follicular Lymphoma
On February 26, 2016, obinutuzumab (Gazyva) was approved for use in combination with bendamustine (Bendeka, Treanda) followed by obinutuzumab monotherapy for treatment of patients with follicular lymphoma who have relapsed after or are refractory to a rituximab (Rituxan)-containing regimen.1,2...
Study Finds Correlation Between Number of Drug Suppliers and Drug Shortages
Astudy published in the Journal of Oncology Practice1 found that individual drugs with fewer suppliers were associated with an increased likelihood of shortages compared to drugs with a large number of suppliers. The article titled, “Association between the Number of Suppliers for Critical...
Palbociclib Combined With Fulvestrant in Advanced Breast Cancer Progressing After Endocrine Therapy
On February 19, 2016, palbociclib (Ibrance) was approved for use in combination with fulvestrant (Faslodex) for treatment of hormone receptor–positive, HER2-negative advanced or metastatic breast cancer with disease progression following endocrine therapy.1,2 In February 2015, palbociclib in...
Cancer Survivorship Research: Learning From the Past to Improve Future Outcomes
Soon after effective therapies for some childhood malignancies were first identified, early leaders in our field had concerns about what would happen to surviving patients as they aged. In 1975, Giulio D’Angio, MD, one of the founders of modern pediatric radiation oncology, presciently called for...
Reduction in Late Mortality in Childhood Cancer Survivors
In a study reported in The New England Journal of Medicine, Gregory T. Armstrong, MD, MSCE, of St. Jude Children’s Research Hospital, Memphis, and colleagues found that late mortality has decreased over time among 5-year survivors of childhood cancer in the Childhood Cancer Survivor Study cohort.1...
Everolimus in Advanced Neuroendocrine Tumors
On February 26, 2016, everolimus (Afinitor) was approved for treatment of adult patients with progressive, well-differentiated, nonfunctional neuroendocrine tumors of gastrointestinal or lung origin that are unresectable, locally advanced, or metastatic.1,2 The drug was previously approved for...
Markedly Improved Toxicity Rates With Proton-Beam Reirradiation for Recurrent Head and Neck Cancer
Proton-beam radiation therapy may be an attractive option for reirradiation of recurrent head and neck cancer, with encouraging disease control and survival rates and improved toxicity rates compared to photon reirradiation, according to John Han-Chih Chang, MD. Most head and neck cancers present...
Late Toxicity Improved With Response-Adapted Volume De-escalation in Locally Advanced Head and Neck Cancer
Efforts to reduce the late toxicity associated with chemoradiotherapy for locally advanced head and neck squamous cell cancer have focused on radiation therapy dose de-escalation in select populations, according to James Melotek, MD, a radiation oncologist at the University of Chicago. “Patients...
Study Supports an Immune Effect of Chemoradiation in Head and Neck Cancer
Definitive radiation, with or without chemotherapy, induces a combination of immune-stimulating and inhibitory effects in patients with squamous cell carcinoma of the head and neck, according to research presented by Jonathan Schoenfeld, MD, MPhil, MPH, at the 2016 Multidisciplinary Head and Neck...
FDA Approves Crizotinib for ROS1-Positive Metastatic Non–Small Cell Lung Cancer
The U.S. Food and Drug Administration has approved the tyrosine kinase inhibitor crizotinib (Xalkori) for the treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors are ROS1-positive. Crizotinib was first approved in 2011 for the treatment of patients whose tumors are ...
First-Line Ibrutinib Improves Progression-Free and Overall Survival vs Chlorambucil in Older Patients With Chronic Lymphocytic Leukemia
As reported in The New England Journal of Medicine and at the 2015 American Society of Hematology Annual Meeting, Jan A. Burger, MD, PhD, and colleagues found that first-line treatment with the oral Bruton’s tyrosine kinase inhibitor ibrutinib (Imbruvica) improved progression-free and overall...
Families of Cancer Decedents See Early Hospice, ICU Avoidance, and Death Outside the Hospital as Better End-of-Life Care
Families of patients dying with lung or colorectal cancer judged end-of-life care as better when it was less aggressive, involved earlier hospice, avoided intensive care unit (ICU) admission, and included death outside of the hospital, according to a study reported by Wright et al in JAMA. Study...
Atezolizumab Improves Survival vs Docetaxel in Advanced NSCLC in Relation to Increased PD-L1 Expression
In the phase II POPLAR trial reported in The Lancet, Fehrenbacher et al found that the anti–PD-L1 (programmed cell death ligand 1) antibody atezolizumab improved overall survival vs docetaxel in patients with non–small cell lung cancer (NSCLC) who had progressed on prior platinum-based...
ASCO Report Finds U.S. Cancer Care System Ill-Equipped to Deliver New Advances to Patients
As the nation embarks on an ambitious “moonshot” to accelerate progress against cancer, our system for delivering today's cancer treatments must be better prepared to bring advances to all patients, warns a new report from ASCO. The State of Cancer Care in America: 2016, published...
Early MRI Screening Reduces Risk of Breast Cancer Death for Survivors of Childhood Hodgkin Lymphoma
Researchers at Princess Margaret Cancer Centre have confirmed in a screening effectiveness study that early screening with magnetic resonance imaging (MRI) can reduce breast cancer mortality for female survivors of childhood Hodgkin lymphoma who received chest radiation. The findings published by...
Atezolizumab Active in Previously Treated Locally Advanced or Metastatic Urothelial Carcinoma
The anti–PD-L1 (programmed cell death ligand 1) antibody atezolizumab produced durable responses in a marked proportion of patients with previously treated locally advanced or metastatic urothelial carcinoma, according to a phase II trial reported in The Lancet by Rosenberg et al. The...
Severe Adverse Event Clusters Identified Using NCI Common Terminology Criteria in Advanced Prostate Cancer
Using the National Cancer Institute’s Common Terminology Criteria for Adverse Events (CTCAE), researchers from Columbia University, New York, and Fred Hutchinson Cancer Research Center, Seattle, identified six severe adverse events clusters in patients with advanced prostate cancer. The...
FDA Approves Crizotinib for ROS1-Positive Metastatic NSCLC
The U.S. Food and Drug Administration today approved the tyrosine kinase inhibitor crizotinib (Xalkori) for the treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors are ROS1-positive. Crizotinib was first approved in 2011 for the treatment of patients...
Family Perspectives Support Advance Care Planning With Patient Preferences in End-of-Life Care
Three measures of aggressive end-of-life care “were associated with relatively large differences in family member–reported quality ratings for end-of-life care and a lower likelihood that patients with advanced-stage cancer received care congruent with their preferences,”...
Cultural Awareness and Sensitivity Among Surgeons Do Not Always Result in Culturally Competent Care
A survey of oncology surgeons from six hospitals in Washington State found that the surgeons in the sample “displayed and valued cultural awareness and sensitivity” but that “cultural awareness and sensitivity did not necessarily result in culturally competent behavior.” These findings highlight...
Increasing the Dose of Obinutuzumab Monotherapy Raised the Response Rate
A randomized phase II study in symptomatic, untreated patients with chronic lymphocytic leukemia (CLL) found an increased overall response rate with obinutuzumab (Gazyva) at a 2,000 mg vs 1,000 dose. In addition, the “data demonstrate that obinutuzumab produces a higher response rate in...
Questions From Younger Patients About Colorectal Cancer Should Be Addressed Promptly
A study in Cancer1 finding an increasing rate of colorectal cancer among patients under the age of 50 should serve to raise awareness about the need for testing among those with “red-flag” symptoms and earlier screening for those at high risk, the study’s corresponding author, Samantha Hendren, MD, ...
