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skin cancer

Novel Drugs Ipilimumab and Vemurafenib for Advanced Melanoma

In this introductory installment of In the Clinic, The ASCO Post provides an overview of two new melanoma agents recently approved by FDA, with discussion on pivotal data leading to approval, dosage and administration, and managing drug-related toxicities. Watch for more on clinical use of novel...

JCO Implements Rapid Review Program

In an effort to support the practice-changing or time-dependent results of select articles submitted to the Journal of Clinical Oncology, the publication has introduced a new Rapid Review program. This fast-paced track gives authors an opportunity to have their important findings accelerated...

ASCO Study Shows Integrating Nonphysician Providers into Oncology Practices Is a Win for Patients and Providers

Is the expanded use of nonphysician providers (NPPs) a viable way to help ease the challenges oncology practices could feel if the number of oncologists entering the field does not keep pace with potential growth in the demand for their services? The ASCO Workforce Advisory Group thought the...

lung cancer

New ASCO Focused Update Recommendation on Maintenance Treatment of Stage IV Non–Small Cell Lung Cancer

A focused update to the 2009 ASCO Clinical Practice Guideline Update on Chemotherapy for Stage IV Non-Small-Cell Lung Cancer reflects new evidence on maintenance therapy in patients with response or stable disease after four cycles of first-line cytotoxic chemotherapy.1 The 2009 update...

health-care policy

Can Bayesian Design Streamline Our Sluggish Clinical Trial System?

The randomized controlled clinical trial has long been the gold standard for new cancer drugs to demonstrate worthiness of FDA approval; however, many experts contend that that our method of bringing drugs to the market is plagued by undue costs, long delays, and overregulation. According to Donald ...

Expert Point of View: International Prostate Cancer Studies Report Inroads in Managing Bone Metastases

"Radium-223 chloride is an effective, well tolerated, and convenient treatment, and it has a survival benefit. These favorable characteristics may well promote its use in clinical practice,” said formal discussant of this abstract, Wim J.G. Oyen, MD, Radboud University Nijmegen Medical Center,...

skin cancer

Adjuvant Treatment Still Standard in Melanoma, but New Drugs Prolong Life in Metastatic Setting

At the Best of ASCO® Miami meeting, Omid Hamid, MD, The Angeles Clinic and Research Institute (www.theangelesclinic.org), Los Angeles, California, reviewed abstracts that received a great deal of attention at this year’s Annual Meeting—the new treatments for metastatic melanoma. He also described...

multiple myeloma

Multiple Myeloma Research Spotlights Treatment Concerns and Advances

Myeloma data reported at this year’s ASCO meeting raise concern about the safety of a mainstay class of drugs in this disease, while also hinting at good efficacy of some novel drugs and approaches, according to William I. Bensinger, MD, of the Fred Hutchinson Cancer Research Center, Seattle....

gastrointestinal cancer

Practice-changing Evidence in Treatment of Noncolorectal GI Cancers

Studies presented at the ASCO Annual Meeting in the field of noncolorectal gastrointestinal cancer both reaffirmed certain standards of care and introduced some practice-changing data, according to A. Craig Lockhart, MD, of Washington University in St. Louis. Perioperative Therapy for Gastric...

colorectal cancer

Standards of Care Confirmed in Latest Group of Colorectal Cancer Trials

Colorectal cancer studies reported at this year’s ASCO meeting offered little in the way of practice-changing information, according to Axel Grothey, MD, of the Mayo Clinic in Rochester, Minnesota. But they did confirm existing standards of care, he noted at the Best of ASCO® meeting in Seattle....

SIDEBAR: Stay Tuned for More Information on Neuropathy-related Genes

According to Daniel F. Hayes, MD, of the University of Michigan, Ann Arbor, who moderated the Best of ASCO® Miami conference, taxane-induced neuropathy is a more complicated story than the study by Schneider and colleagues may suggest. “There are now three observations regarding inherited germline ...

SIDEBAR: Studies Sparked Questions to Breast Cancer Specialists

Based on the MAP.3 findings, should we be using exemestane to prevent breast cancer in high-risk patients? Dr. Harold Burstein: The risk of developing breast cancer was 2.5% in the placebo arm, vs 1% to 1.5% risk with exemestane. Also, the cancers that were avoided were probably ones with good...

SIDEBAR: Searching for More Efficacious, Less Toxic Adjuvant Chemotherapy for NSCLC

Accumulating data are helping to better define the risk-benefit profile of various adjuvant chemotherapy regimens for non–small cell lung cancer (NSCLC) and the impact of adding biologic agents to the mix, according to H. Jack West, MD, of the Swedish Cancer Institute in Seattle. In the randomized ...

lung cancer

Incremental Advances Demonstrated in Management of Locoregional Lung Cancer

Data presented at the ASCO Annual Meeting this year on the management of locoregional lung cancer present a mixed picture, with some advances and some disappointments, according to H. Jack West, MD, of the Swedish Cancer Institute in Seattle, who reviewed studies in this area at the Best of ASCO...

colorectal cancer

Fear of the Unknown: Cancer Treatment Can Be Scarier than the Disease Itself

Two years ago, I was feeling fine except for a nagging problem with severe constipation. I believed this was caused by some loperamide I had taken to quell the episodes of diarrhea I experienced following dinner at a local barbecue restaurant. When the symptoms persisted for a couple of months, I...

breast cancer

Important Briefs from the 2011 Breast Cancer Symposium

The 2011 Breast Cancer Symposium was recently held in San Francisco, bringing together a multidisciplinary group of specialists and sponsored by ASCO, the American Society for Radiation Oncology, the Society of Surgical Oncology, the American Society of Breast Disease, the American Society of...

colorectal cancer

Panitumumab Is Not Beneficial in KRAS Mutations: No Exceptions

The need to restrict treatment with panitumumab (Vectibix) to metastatic colorectal cancer patients with wild-type (normal) KRAS tumors was upheld in a study presented at the 2011 European Multidisciplinary Cancer Congress (EMCC). The investigation found a consistent lack of benefit for the drug...

cost of care

New Technologies Are Driving Up Costs: Are They Worth the Price?

Expensive new cancer therapies and technologies are alluring for both physicians and their patients. Prostate cancer, because of the sheer volume of cases and the variability of treatment options, serves as a dynamic disease model in the ongoing debate over how to curb spending and maintain...

issues in oncology
cost of care

A Conversation with Richard J. Gilbertson, MD, PhD

St. Jude Children’s Research Hospital, Memphis, the country’s first and only NCI-designated Comprehensive Cancer Center devoted solely to children, recently appointed internationally regarded pediatric brain tumor researcher, Richard J. Gilbertson, MD, PhD, as its new Cancer Center Director. In a...

issues in oncology

Do We Need the USPSTF?

Like most of the folks reading this commentary, I’m a taxpayer. Although I sometimes become impatient with the strategic games on Capitol Hill, I basically appreciate that government helps many things to work, and some of them even work well. However, there are aspects of government function that...

breast cancer

Everolimus Overcomes Resistance to Hormonal Therapy in Advanced Breast Cancer

Adding everolimus (Afinitor) to exemestane in postmenopausal women with advanced breast cancer resistant to aromatase inhibitors significantly improved outcomes, according to the phase III BOLERO-2 trial reported at the 2011 European Multidisciplinary Cancer Congress, held September 23–27 in...

breast cancer

FDA Commissioner Announces Decision on Bevacizumab

On November 18, FDA Commissioner Margaret A. Hamburg, MD, said she is revoking the agency’s approval of the breast cancer indication for bevacizumab (Avastin) after concluding that the drug has not been shown to be safe and effective for that use. Bevacizumab will still remain on the market as an...

breast cancer

Challenging Perceptions about Treatment Options for Younger Women with Early-stage Breast Cancer

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. “There is a perception out there...

breast cancer

Researchers Explore Reasons for Higher Risk of Triple-negative Breast Cancer in Underserved African-American Women

Triple-negative breast cancer, one of the most aggressive forms of the disease, has a bad reputation, and among socioeconomically disadvantaged black women, that reputation is especially well deserved. In fact, according to Lisa A. Newman, MD, Director of the Breast Care Center, University of...

gynecologic cancers

Fighting to Get Back Control

I’ve had raging hormones since I was 18, when I was diagnosed with a benign pituitary adenoma. The tumor caused unpredictable menstrual cycles that remained constant throughout my life, even after it had been successfully treated. So 2 years ago, when I turned 40 and started having sudden bouts of...

palliative care

A Conversation with Judith Redwing Keyssar, RN

The number of patients seeking hospice and palliative care has grown significantly since 1974, when the NCI funded the first hospice facility in Branford, Connecticut. Nevertheless, according to the National Center for Health Statistics, 85% of Americans still die in hospitals or nursing homes....

geriatric oncology

Geriatric Oncology, a Much Needed Discipline for Future Cancer Care

The U.S. health-care system, with its rapidly aging population, faces a multitude of difficult clinical and financial challenges in caring for its burgeoning population of older patients with cancer. Moreover, age-related social and medical issues among older patients need to be addressed by a...

issues in oncology

Chemotherapy Generally Safe in Pregnancy

The diagnosis of cancer in a pregnant woman causes concerns for both the mother and her unborn child. But studies suggest that most chemotherapy regimens can be delivered with reasonable safety after the first trimester. Cancer is diagnosed in about 1 per 1,000 to 2,000 pregnancies, mostly breast...

issues in oncology

Biosimilars in Cancer Treatment: What Should the Oncology Community Expect?

Alternative versions of biologic agents, ie, “biosimilars,” will presumably be getting the green light by the FDA, giving oncologists more choices for treatments that come at lower costs to patients and society. The FDA plans to issue its guidance on biosimilars by the end of this year, paving the...

breast cancer

Tamoxifen vs Surgery Study Shows Older Patients with Breast Cancer Can Achieve a ‘Personal Cure’

A truly final review—when all the patients in the trial have died and the cause of death is known for each—of a randomized trial comparing tamoxifen to surgery in patients over the age of 70 with operable breast cancer found no differences in the survival rates or deaths attributable to breast...

gastroesophageal cancer

Preoperative Chemoradiotherapy May Extend Survival for Patients with Esophagogastric Junction Adenocarcinoma

Several American and European clinical trials have yielded mixed results on the survival advantage of preoperative chemoradiotherapy for patients with locally advanced esophagogastric junction adenonocarcinoma. However, a distinguished panel at the 2011 ASTRO Annual Meeting did agree that surgery...

issues in oncology

Chemotherapy Drug Shortages: A Preventable Human Disaster

The issue of chemotherapy drug shortages continues with no end in sight. Many heartfelt human interest stories have been told on television, in newspapers, and even to Congress, but the bottom line is that little, if any, action has been taken. Uniquely American Problem News of the generic...

issues in oncology

Important Lessons for Oncology from the Front Lines of the AIDS Pandemic

On June 5, 1981, the CDC issued a warning about a rare type of pneumonia discovered among a small group of young gay men in Los Angeles, later determined to be AIDS-related, ushering in the HIV/AIDS epidemic. Early on, AIDS-related malignancies brought the oncology community into this formidable...

symptom management

Neural Stem Cell Transplantation May Improve Cognitive Function in Brain Cancer

The potentially devastating long-term consequences on cognitive function in patients with brain cancer following cranial irradiation led Charles L. Limoli, PhD, Professor of Radiation Oncology, University of California, Irvine, to study neural stem cell transplantation and how the procedure may...

SIDEBAR: Key Dates in the Medicare Physician Reimbursement Saga

October 21, 2009: SB 1776 (“the Doc Fix”) is introduced in the Senate [but fails to pass] November 19, 2009: House of Representatives passes HR 3961 (the Medicare Physician Payment Reform Act) [but Senate fails to pass] December 19, 2009: Congress passes Department of Defense appropriations bill...

health-care policy

Medicare Reimbursement to Physicians: Déjà Vu All Over Again

In February 2011, The ASCO Post published an opinion piece (“Congress and the ‘Doctor Fix’: Looking Back, Looking Ahead”) about the ping-pong of legislative continuing resolutions to avert a 21.3% cut in physician reimbursement. These continuing resolutions were necessary because the Affordable...

issues in oncology
solid tumors
hematologic malignancies

Solid Organ Transplant Recipients Have Increased Risk for Broad Range of Malignancies

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. The Transplant Cancer Match Study, a ...

issues in oncology

Oncologists Need Hands-on Approach in Developing Next Generation of EHRs

The electronic health record system offered by vendors is more like a filing cabinet, not the sophisticated, interactive database needed by busy oncologists, according to Kevin S. Hughes, MD, FACS, Co-Director, Avon Comprehensive Breast Evaluation Center, Massachusetts General Hospital, who...

breast cancer

Male Breast Cancer Differs from Breast Cancer in Women, but Little Data Informs Treatment

Although a rare occurrence, men do get breast cancer, and when they do, it has a distinct biology from that of female breast cancer. About 90% of cases most closely resemble postmenopausal female invasive ductal carcinoma, and 10% are ductal carcinoma in situ (DCIS), which accounts for 25% of...

solid tumors

510(k) Clearance Granted for OncoTrac

Translational Sciences Corporation announced that it has received FDA 510(k) clearance for commercialization of its OncoTrac medical imaging software. OncoTrac is designed for efficient quantitative assessment of treatment response of metastatic tumors including those of the breast, lung,...

ASCO Issues Blueprint for Transforming Cancer Research in the ‘Molecular Era’

On November 3, ASCO issued a new report that lays out ASCO’s vision for transforming clinical and translational research to deliver more effective and personalized cancer therapies faster. The report, Accelerating Progress Against Cancer: ASCO’s Blueprint for Transforming Clinical and Translational ...

global cancer care

Lessons from a Northern Neighbor: A Conversation with Joseph M. Connors, MD

Policy analysts searching for a better understanding of health-care models often compare the cancer delivery systems of Canada and the United States. The ASCO Post recently spoke with Joseph M. Connors, MD, Clinical Professor and Director of the BC Cancer Agency’s Centre for Lymphoid Cancer,...

head and neck cancer

Benefit of Panitumumab Seen Primarily in Patients with Recurrent or Metastatic Head and Neck Cancer and HPV-negative Tumors

The addition of panitumumab (Vectibix) to chemotherapy improved overall and progression-free survival in patients with recurrent or metastatic squamous cell carcinoma of the head and neck, but its benefit was limited to patients whose tumors were negative for the human papillomavirus (HPV).1 The...

prostate cancer

Prostate Cancer Screening Reconsidered

Prostate cancer is the most prevalent nonskin cancer in men. An estimated 16% of men are diagnosed with prostate cancer, yet only 3% of men die from it.1 Unlike other cancers, prostate cancer is associated with a prolonged lead-time, meaning it can take anywhere from 5 to 12 years to become...

issues in oncology
health-care policy

A Conversation with Ezekiel J. Emanuel, MD, PhD

Last September, Ezekiel J. Emanuel, MD, PhD, a leading scholar in bioethics and health-care policy, was named the Diane v.S. Levy and Robert M. Levy University Professor and Vice Provost for Global Initiatives at the University of Pennsylvania in Philadelphia. His appointment will be shared between ...

breast cancer
issues in oncology

Breast Cancer Experts Voice Opinion and Express ‘Disappointment’ over FDA Decision

Gabriel N. Hortobagyi, MD, Chair of Medical Breast Oncology at The University of Texas MD Anderson Cancer Center, Houston, said he was “disappointed but not surprised” at the FDA decision to withdraw the bevacizumab (Avastin) indication in breast cancer. “Once the FDA put this in the hands of ODAC, ...

colorectal cancer

Humor Is Helping Me Survive Cancer

Despite a strong family history of colon cancer—all five of my mother’s siblings had colon cancer, and my mother died of the disease 10 years ago—when some flecks of blood started showing up on my toilet tissue in early 2005, I figured it was from hemorrhoids. At 38, I was a marathon runner and in...

breast cancer

Benefits of Radiation after Breast-conserving Surgery Cut Risk of Recurrence in Half

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. “After breast-conserving surgery,...

head and neck cancer

New Indication for Cetuximab in Squamous Cell Carcinoma of the Head and Neck

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Cetuximab (Erbitux) was recently approved by the FDA for use in...

breast cancer

CLEOPATRA Trial Finds Dual HER2 Blockade Improves Progression-free Survival in Advanced Breast Cancer

Women with HER2-positive advanced breast cancer are much less likely to have disease progression or die when two agents are used instead of one to target the HER2 signaling pathway, investigators for the international phase III CLEOPATRA trial found. The 808 women studied were randomly assigned to...

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