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issues in oncology

Is Proton-Beam Therapy Facing a Difficult Future?

Health-care experts are questioning whether proton-beam therapy is on the verge of an economic bubble—ie, a rapid surge in growth for the industry beyond its intrinsic value, inevitably leading to a drastic drop in earnings for proton centers when the “bubble bursts.” A proton-beam facility can...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia: Answers From Hematology Expert Review Questions

Question 1: What is the best first step in management of this patient? Correct Answer: C. Start plasma exchange. Expert Perspective Although distinguishing among thrombotic thrombocytopenic purpura, typical hemolytic uremic syndrome, and atypical hemolytic uremic syndrome (see Table 1 in the...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia: Questions

Hematology Expert Review is an occasional feature that includes a case report followed by questions, answers, and expert commentary. In the July 25 issue of The ASCO Post, part 1 of a case report was published and focused on diagnosis (see summary below). Here, in part 2, the management of this...

breast cancer

The Conundrum of Estrogen-Receptor Signaling in HER2-Positive Breast Cancer

BOLERO-1—reviewed in this issue of The ASCO Post—is the next installment in a series of randomized trials evaluating the addition of everolimus (Afinitor) to standard therapy in metastatic breast cancer.1 The initial evaluation of everolimus in the HER2-positive metastatic setting looked extremely...

multiple myeloma

Carfilzomib in Combination With Lenalidomide and Dexamethasone in Relapsed Multiple Myeloma

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.   On July 24, 2015, carfilzomib (Kyprolis) was approved for use in...

issues in oncology

Cancer Diagnosis Among Patients With Diabetes Reduced Adherence to Evidence-Based Medications

“A cancer diagnosis among patients with diabetes reduced adherence with evidence-based medications, particularly if patients’ life expectancy was short,” according to a study among Medicare beneficiaries reported in the Journal of Oncology Practice. “These findings emphasize the vulnerability of...

hepatobiliary cancer

More Than One-Third of Those Diagnosed With Hepatocellular Carcinoma as Outpatients Have Diagnostic Delays of 3 or More Months

Nearly 20% of patients with hepatocellular carcinoma “wait more than 3 months from presentation to diagnosis, which can contribute to interval tumor growth,” Nishant Patel, MD, and colleagues concluded in the Journal of the National Comprehensive Cancer Network. They based their conclusions on a...

ASCO and UICC Collaborate to Extend Reach of the Journal of Global Oncology

ASCO and the Union for International Cancer Control (UICC) announced their partnership to expand the reach of the Journal of Global Oncology (JGO), a new open-access journal that will focus on cancer care, research, and care delivery issues unique to countries and settings with limited health-care...

integrative oncology

Coriolus versicolor

The use of dietary supplements by patients with cancer has increased significantly over the past 20 years 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 ...

breast cancer

I’m Living a Full and Happy Life With Stage IV Breast Cancer

After coping with breast cancer for more than a decade, it is difficult for me to put into words exactly how grateful I am to all the doctors, nurses, and researchers whose efforts have kept me alive for all these years. And not just alive, but thriving. A routine mammogram had discovered two...

issues in oncology

Access to Cancer Medicines Not Uniform Across Europe

Access to cancer medicines—including some old standbys—is inconsistent across Europe, depriving many patients of treatments that are the standard of care elsewhere,1 according to Alexandru E. Eniu, MD, PhD, Chair of the European Society for Medical Oncology (ESMO) Emerging Countries Committee and...

solid tumors

State-of-the-Art Management of Germ Cell Tumors Produces High Cure Rates

Pasquale W. Benedetto, MD, the Leonard M. Miller Professor of Medicine at the University of Miami/Sylvester Comprehensive Cancer Center, recently spoke at the 2015 New Orleans Summer Cancer Meeting about his approach to diagnosing and treating germ cell tumors in men.1 The ASCO Post was there to...

issues in oncology

Emerging Technology Will Help Tackle Tumor Complexity

Emerging laboratory technology will be “moving the bar forward” in terms of molecular markers, genomics, and gene-expression profiling, with the potential for huge payoffs to oncologists and patients, according to Mark Pegram, MD, the Susy Yuan-Huey Hung Professor of Medicine at Stanford School of...

issues in oncology

New Techniques in Oncologic Surgery and Radiology: Some Worth the Expense, Some Not So Much

In recent years, patients with cancer have had the benefit of much high technology: proton-beam radiotherapy, intensity-modulated radiation therapy, various minimally invasive surgery techniques, and robots in the operating room. They all receive hype in the professional and public press, and...

Three New Officers Elected to ASTRO’s Board of Directors

The American Society for Radiation Oncology (ASTRO) has elected three new officers to the Board of Directors and three members to serve on the Nominating Committee. Terms for all positions begin on October 20, 2015 at ASTRO’s 57th Annual Meeting. The new officers to the Board of Directors are:...

breast cancer

Role of Surgery and Adjuvant Radiotherapy in the Treatment of Breast Cancer Explored

Two separate retrospective studies have further refined our understanding of the respective contributions of surgery and radiotherapy in the treatment of breast cancer. However, these studies are not definitive, and “gold standard” trials are needed to arrive at definitive recommendations. Both...

colorectal cancer

Secondary Prevention in Metastatic Colorectal Cancer: Benefits of Vitamin D and Aspirin Explored

Two low-cost, low-tech options may lead to a survival benefit in metastatic colorectal cancer, according to separate retrospective studies selected for the Best of ASCO® 2015. The first study suggested that vitamin D supplementation is worthy of investigation in this regard,1 and the second study...

lymphoma

Indolent Lymphoma: A More Complex Malignancy Than Once Thought

With a growing number of options for follicular lymphoma, clinicians may wonder whether there is one best regimen. James O. Armitage, MD, FACP, FRCP, Professor of Medicine at the University of Nebraska, Omaha—and Editor-in-Chief of The ASCO Post—tackled this question and offered recommendations at...

Charting a New Course: From Clinical Investigator to University President

What first intrigued Fadlo R. Khuri, MD, FACP, about the prospect of becoming the 16th President of the American University of Beirut (AUB) in Lebanon was the chance to give back to an institution and a country that had given him so much. Born in Boston, Massachusetts, in 1963, Dr. Khuri was raised ...

issues in oncology

Our Patients Are the True Heroes of Cancer Research

A few weeks ago, I read an op-ed1 in The New York Times written by Stan Collender, a patient with Merkel cell carcinoma, a rare and aggressive type of skin cancer. In his article, he described his participation in a clinical trial for a new drug he is hoping will stem progression of his cancer and...

multiple myeloma

Elotuzumab Ushers in a New Era in Myeloma Therapy

The long wait for monoclonal antibodies for the treatment of multiple myeloma is over. In the landmark ELOQUENT-2 study, reviewed in this issue of The ASCO Post, Lonial and colleagues convincingly demonstrate the effectiveness of elotuzumab, a monoclonal antibody directed against SLAMF7, in the...

leukemia

Azacitidine Increased Median Overall Survival Among Patients Aged 65 and Older With > 30% Blasts

A multicenter, randomized, open-label, phase III trial among the difficult-to-treat population of patients aged aged 65 and older with acute myeloid leukemia (AML) with > 30% bone marrow blasts “showed that azacitidine was associated with a clinically meaningful improvement” in median overall...

issues in oncology

ASCO Policy Statement Update: Genetic and Genomic Testing for Cancer Susceptibility

As reported in the Journal of Clinical Oncology by Mark E. Robson, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, ASCO has issued a policy statement update on genetic and genomic testing for cancer susceptibility.1 The statement, commissioned by ASCO’s Cancer Prevention and Ethics...

An Unvarnished, Behind-the-Scenes Look at the Hospital Nurse

BOOKMARK Title: The Nurses: A Year of Secrets, Drama, and Miracles With the Heroes of the HospitalAuthor: Alexandra RobbinsPublisher: Workman Publishing CompanyPublication date: April 14, 20155Price: $17.53; hardcover, 368 pages Florence Nightingale, the most famous and influential figure in...

integrative oncology

Why It Is Important to Have a Physiatrist on a Cancer Care Team

Physical medicine and rehabilitation in oncology care explores the benefits of cancer rehabilitation in oncology clinical practice to screen survivors for physical and cognitive impairments along the care continuum to minimize survivors’ disability and maximize their quality of life. According to a ...

prostate cancer

Statin Use at Start of Androgen-Deprivation Therapy Increases Time to Progression During Treatment of Prostate Cancer

Statin use has been associated with improved outcomes in prostate cancer. In a study reported in JAMA Oncology, Lauren C. Harshman, MD, of Dana-Farber Cancer Institute, Boston, and colleagues found that statin use at the time of the initiation of androgen-deprivation therapy was associated with...

Conquer Cancer Foundation Donor Spotlight: Fibrolamellar Cancer Foundation

When Tucker Davis was diagnosed with fibrolamellar hepatocellular carcinoma (FL-HCC) in 2008, there was very little information about this very rare cancer and, as Tucker would soon discover, even fewer treatment options available. An annoying cough and sharp pain radiating down his back leg...

palliative care

One Doctor’s Road to Palliative Care Services in the Inner City

St. Barnabas Hospital is located in the heart of Bronx, New York, and as such, it has a culturally diverse, largely poor, patient population. The backbone of successful palliative care services is the doctor-patient communication bonding process. However, many of the patients with late-stage cancer ...

lung cancer

Bevacizumab Plus Standard Chemotherapy Improves Survival in Mesothelioma

The standard of care for malignant pleural mesothelioma may be poised for change, judging by results from a study by the French Cooperative Thoracic Intergroup. The addition of bevacizumab (Avastin) in the first-line setting to the current standard of care, pemetrexed (Alimta)/cisplatin, improved...

symptom management

Managing High-Risk Patients With Febrile Neutropenia

Febrile neutropenia is of particular concern in high-risk patients who have undergone stem cell transplant, according to William J. Hogan, MB, BCh, Assistant Professor of Medicine at the Mayo Clinic in Rochester, Minnesota. Dr. Hogan delivered an update on febrile neutropenia management in this...

head and neck cancer

HPV-Positive Head and Neck Cancer: When Can Chemotherapy Be Omitted?

Are there patients with locally advanced squamous cell carcinoma of the head and neck associated with human papillomavirus (HPV) for whom chemotherapy can be omitted? Experts debated this question at the 2015 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia,...

lymphoma

Mantle Cell Lymphoma: Is Transplantation Still Necessary?

Autologous stem cell transplantation has played a critical role in the treatment of mantle cell lymphoma, but in the age of novel treatments, is it always warranted? Two experts in the field explored the question at the 2015 Debates and Didactics in Hematology and Oncology Conference sponsored by...

lymphoma

Double-Hit Lymphoma: Many Treatment Strategies, No Standard of Care

"Double-hit lymphoma” represents a challenging malignancy without a standard-of-care treatment, although outcomes for some patients are better than was once believed, according to Jonathon B. ­Cohen, MD, Assistant Professor of Hematology and Medical Oncology at Emory University, Atlanta. Dr. Cohen...

cost of care

Making Their Voices Heard: 118 Oncologists Speak Out About Stemming the High Cost of Cancer Drugs

In a bold move to shed light on the ramifications of the ever-increasing cost of cancer drugs for patients with cancer and for the health-care system, 118 prominent oncologists came together to write a commentary in Mayo Clinic Proceedings detailing their concerns.1 To learn more about these...

issues in oncology

Our Children’s Future Is Our Responsibility

Cancer prevention is a child-care issue. With many of cancer’s instigators planting their seeds during childhood, we—as a profession and as a nation—must seize this important window of opportunity to protect the health and well-being of future generations. Current estimates suggest that up to...

issues in oncology
global cancer care

Over Three-Quarters of People With Cancer Worldwide Have No Access to Safe Surgery

Over 80% of the 15 million people diagnosed with cancer worldwide in 2015 will need surgery, but less than one-quarter of them will have access to proper, safe, affordable surgical care when they need it, according to a major new Commission examining the state of global cancer surgery. The...

prostate cancer

Decreased Mortality in Men With Unfavorable-Risk Prostate Cancer and Moderate or Severe Comorbidities Treated With Radiotherapy Alone

Men with unfavorable-risk prostate cancer and moderate or severe comorbidities had significantly decreased overall and cardiac mortality when treated with radiotherapy alone vs radiotherapy and androgen-deprivation therapy, according to a study described in a research letter in The Journal of the...

Expect Questions About Treatment for Ductal Carcinoma in Situ

The recent study findings that women diagnosed with ductal carcinoma in situ had a low breast cancer–specific mortality and that preventing ipsilateral recurrences did not prevent breast cancer mortality1 might lead some women diagnosed with ductal carcinoma in situ to question the need for...

breast cancer

Varied Reactions to Study Finding That Preventing Ipsilateral Recurrence Did Not Prevent Death From Breast Cancer

Women diagnosed with ductal carcinoma in situ have a low risk of dying of breast cancer, according to an observational study looking at data from 108,196 women diagnosed with ductal carcinoma in situ between 1988 and 2011.1 The breast cancer–specific mortality rate for these women was 1.1% at 10...

ASCO, ACS, ASTRO Study Finds Increased Travel Distance Affects Whether Patients Receive Adjuvant Chemotherapy

A new study conducted by ASCO in collaboration with the American Cancer Society (ACS) and the American Society for Radiation Oncology (ASTRO) and published in the Journal of Clinical Oncology1 found that patients who have to travel farther to appointments are less likely to receive adjuvant...

breast cancer

Increased Risk of Death From Breast Cancer for Women With Ductal Carcinoma in Situ vs General Population

In a study reported in JAMA Oncology, Steven A. Narod, MD, FRCPC, of Women’s College Research Institute, Women’s College Hospital, and the University of Toronto, and colleagues found that the risk of breast cancer mortality was elevated in patients with ductal carcinoma in situ compared with the...

prostate cancer

Docetaxel Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer

Sweeney et al reported on the results of a seminal phase III trial (E3805) of chemohormonal therapy vs androgen-deprivation therapy in metastatic hormone-sensitive prostate cancer in a recent issue of The New England Journal of Medicine,1 and the study is summarized in this issue of The ASCO Post....

prostate cancer

Adding Docetaxel to Androgen-Deprivation Therapy Prolongs Overall Survival in Metastatic Prostate Cancer

In a phase III trial (E3805) reported in The New England Journal of Medicine, Christopher J. Sweeney, MBBS, of Dana-Farber Cancer Institute, Boston, and colleagues found that chemohormonal therapy with docetaxel plus androgen-deprivation therapy produced a significant 13.6-month increase in median...

lung cancer

Nivolumab in Lung Cancer Supported by Updated Trial Data

For the treatment of advanced squamous non–small cell lung cancer (NSCLC), the programmed cell death protein 1 (PD-1) antibody nivolumab (Opdivo) continues to show results in key trials that now report 18-month data. The updates were reported at the 16th World Conference on Lung Cancer in Denver,...

breast cancer

Ductal Carcinoma in Situ: Where We Have Been and Where We Can Be

Ductal carcinoma in situ has been a recent topic of debate in the news because of a recent article by Narod et al1 and an accompanying editorial2 about the study in JAMA Oncology. This study, summarized in this issue of The ASCO Post, chronicled the long-term outcomes for women diagnosed with...

issues in oncology

NCCN Turns 20: Value-Based Care Has Arrived

Twenty years ago, the National Comprehensive Cancer Network (NCCN) began as a cooperative effort of 12 prestigious cancer centers, working to define and promote national guidelines for the care of patients with cancer. A major goal was to encourage uniformity in the management of malignant...

What Do You Say When She Is No Longer Living With Cancer?

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,...

Expect Questions From Patients About Daily Aspirin to Prevent Colorectal Cancer

Updating previous recommendations, the U.S. Preventive Services Task Force now recommends low-dose aspirin for the primary prevention of colorectal cancer among most adults age 50 to 59. This a draft recommendation, but it has generated major media coverage noting that this is the first time the...

colorectal cancer
issues in oncology

Important Caveats to Consider Concerning Low-Dose Daily Aspirin for the Primary Prevention of Colorectal Cancer

The use of low-dose aspirin by most adults aged 50 to 59 for the primary prevention of colorectal cancer is now included in the U.S. Preventive Services Task Force (USPSTF) updated draft recommendation statement, “Aspirin to Prevent Cardiovascular Disease and Cancer.”1 The release of the statement...

hematologic malignancies

Early Research of David G. Nathan, MD, Ushered in the Field of Pediatric Hematology

When David G. Nathan, MD, was admitted to Harvard University in 1947, he had every intention of becoming an English professor. It was only his lack of writing talent that dissuaded him from a life in the classroom and propelled him into a medical career that has spanned more than 5 decades and has...

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