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health-care policy
legislation

President Obama Signs High-mortality Cancer Bill into Law

Just hours before the end of the 112th Congress, constitutional deadline for approval of a bill passed by that Congress, President Barack Obama signed into law the first legislation requiring comprehensive plans of research action for high-mortality cancers, with lung and pancreatic cancers given...

issues in oncology

Teens and Young Adults with Cancer Want a Voice in End-of-life Care

A top the list of concerns of adolescents and young adults with a life-threatening cancer are these two considerations: being able to choose the kind of medical treatment they want (or do not want) and expressing their wishes to family and friends about how they want to be remembered, according to...

prostate cancer

Online Prostate Cancer Information Is Written at Reading Levels above Many Americans’ Literacy Skills

Although 61% of Americans are going online to access health information,1 many of them may not understand what they find there, including information about prostate cancer treatment options. According to a new study published in The Journal of Urology,2 as many as 90 million Americans have literacy ...

issues in oncology

Community Research Forum Addresses Conundrums Common to Community Practices that Conduct Research 

It is every research site’s biggest concern. The National Cancer Institute (NCI), the FDA, or drug company sponsors could arrive at any time to comb through a site’s documents related to a specific trial. It’s called an audit, and it’s common. And yet, not all sites that conduct research have...

prostate cancer

Elekta Receives FDA 510(k) Clearance for Clarity 4D Monitoring

Elekta has received 510(k) clearance from the FDA for its Clarity 4D Monitoring software, enabling U.S. medical centers to implement a new way of reducing the uncertainty caused by prostate motion during radiation treatment. Physicians will be able to monitor the motion of the prostate and...

cns cancers

Management of Brain Metastases

Pearls in Neuro-oncology is guest edited by Tracy Batchelor, MD, Director, Division of Neuro-Oncology, Massachusetts General Hospital Cancer Center, and Professor of Neurology, Harvard Medical School, Boston. The series is intended to provide the practicing oncologist with guidance in managing...

issues in oncology

Developing Cancer Care Pathways for the New Environment

As community practices and the insurance industry seek cost-effective ways to adapt to the Patient Protection and Affordable Care Act, the evolving concept of cancer care pathways is emerging as a strategy that may help control oncology costs and add value to care. At ASCO’s recent Quality Care...

issues in oncology

ASCO’s Approach to Health Information Technology and the Rapid-learning System

The slow, but inevitable evolution of electronic oncology health-care systems has already, at least conceptually, moved to the next generation of machines that not only store and process data, but also have the ability to provide real-time clinical decision support. At ASCO’s first Quality Care...

issues in oncology

Measuring and Improving Quality in Oncology Practices

The seed for ASCO’s Quality Oncology Practice Initiative (QOPI®) was planted a decade ago by Joseph Simone, MD, when he contemplated the feasibility of studying a volunteer group of oncologists to measure the quality of care they provide and share those results with their colleagues. Dr. Simone’s...

breast cancer

Radiation Therapy for Patients with Invasive Breast Cancer: 3 Weeks Proves as Effective as 5 Weeks

Ten-year follow-up of the two-part UK Standardisation of Breast Radiotherapy Trials (START) supported the 5-year findings, demonstrating that a 3-week course of adjuvant radiation therapy is equivalent to a 5-week course of radiation for women with invasive breast cancer. The update was presented...

issues in oncology

National Comprehensive Cancer Network Appoints New CEO

The National Comprehensive Cancer Network (NCCN) recently appointed nationally regarded breast cancer expert Robert W. Carlson, MD, as its new CEO. Previously, Dr. Carlson was Professor of Medicine in the Division of Oncology and Medical Informatics, Stanford University Medical Center; he first...

hematologic malignancies
leukemia

Pivotal Trial Shows Robust Activity of Ponatinib in Some Heavily Pretreated Leukemias

The pivotal phase II Ponatinib Ph+ ALL and CML Evaluation (PACE trial) found that 1 year of treatment with the novel investigational drug ponatinib achieved robust activity in heavily pretreated patients with chronic myeloid leukemia (CML) and Philadelphia chromosome–positive acute lymphoblastic...

breast cancer

'Practice-changing' ATLAS Study Supports 10 vs 5 Years of Tamoxifen Therapy in Women with Breast Cancer

"Practice-changing" is the term several physicians and researchers used when asked by the media to describe the results of a study showing that extending tamoxifen therapy from 5 to 10 years for women with estrogen receptor (ER)-positive breast cancer further reduced recurrence and mortality....

issues in oncology

Helping Patients Prepare for Cancer Treatment Decisions

Under the stress of a cancer diagnosis and overwhelmed with the influx of information, patients often report that they feel unprepared to engage fully in the discussion with their health-care provider around a critical treatment decision. Consequently, the Cancer Support Community—an international...

SIDEBAR: REPORT ADVERSE EVENTS

Health-care professionals should report all serious adverse events suspected to be associated with the use of any medicine or device to FDA’s MedWatch Reporting System by completing a form online at http://www.fda.gov/medwatch/report.htm, by faxing (1-800-FDA-0178), by mailing the postage-paid...

thyroid cancer

Cabozantinib in Metastatic Medullary Thyroid Cancer 

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.  Indication On November 29, 2012, cabozantinib (Cometriq) was...

The Conquer Cancer Foundation Announces Its Sustaining Donor Program

You can help the Conquer Cancer Foundation fulfill its mission of creating a world free from the fear of cancer when you make a monthly gift today. When you become a sustaining donor to the Foundation, your monthly gift will provide a reliable stream of support that is so vital to ensuring that the ...

Coalition of Cancer Cooperative Groups Celebrates 10 Years of Clinical Trial Participation Awards

For any community practice, participation in a clinical trial can be a time-consuming, intense commitment. But this commitment is integral to the advancement of new methods and therapies, which is why the Coalition of Cancer Cooperative Groups has exactly one mission: increasing clinical trial...

breast cancer

Primary Endpoint Not Met for Eribulin vs Capecitabine in Breast Cancer 

While a global phase III trial failed to meet its primary endpoint in showing an overall or progression-free survival benefit for eribulin (Halavan) in metastatic breast cancer, a trend toward greater efficacy than capecitabine (Xeloda) was observed, researchers reported at the 2012 San Antonio...

leukemia

Inotuzumab Moves Forward in Relapsed/Refractory ALL 

Single-agent inotuzumab ozogamicin achieved an encouraging overall response rate of 57% in the treatment of relapsed/refractory acute lymphoblastic leukemia (ALL) in a phase II trial reported at the 54th Annual Meeting of the American Society of Hematology (ASH). Response was independent of monthly ...

cost of care

Cost of Cancer Drugs: What Price for What Benefit?

In 2011, national health-care spending in the United States was about $2.7 trillion, larger than the entire French national budget.1 U.S. national health-care spending is about 17% of the national gross domestic product. Total Medicare expenditures in 2011 were $549 million.2 In the debate about...

issues in oncology

Patient Expectations of Benefit in Early-phase Trials: Ethics Issues in Informed Consent 

It has been found that many patients in early-phase oncology trials believe their chance of benefit to be much higher than estimates derived from historical data.1-3 In a recently reported study in Journal of Clinical Oncology, Kevin P. Weinfurt, PhD, of Duke Clinical Research Institute, and...

cns cancers

Surgery of Primary Tumor Site Has No Impact on Local Control and Outcome in Patients ≥ 18 Months with Stage IV Disease 

“In intensively treated patients with stage IV neuroblastoma age 18 months or older at diagnosis, surgery of the primary tumor site has no impact on local control rate and outcome,” according to findings from the German prospective clinical trial NB97. “The results of the study,” the researchers...

colorectal cancer

Even at NCCN Institutions, a 'Sizable Minority' of Patients with Rectal Cancer Are Not Treated per NCCN Guidelines 

Even at the eight cancer centers participating in the National Comprehensive Cancer Network (NCCN) Colorectal Cancer Outcomes project, a “sizable minority” of patients with stage II/III rectal cancer treated with curative intent neoadjuvant chemoradiotherapy did not complete postoperative...

SIDEBAR: Expect Questions from Patients with Diabetes and Cancer

Patients with diabetes and cancer need to know that some chemotherapy drugs and adjuvant agents may require modifications in how they manage their diabetes. For example, patients who are receiving steroids might have to further restrict their diet to keep blood sugar levels under control. “You...

issues in oncology

Keeping Diabetes under Control Is Critical to Good Outcomes for Patients Who Also Have 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. Cancer and diabetes can be comorbid...

David A. Karnofsky's Early Contributions to Cancer Research Helped Establish Oncology as a Medical Discipline 

For nearly 30 years, from the time he was a young resident at the Collis P. Huntington Memorial Hospital for Cancer Research of Harvard University, until his death from lung cancer on August 31, 1969, David A. Karnofsky, MD, dedicated himself to the pursuit of scientific excellence and the...

breast cancer

Subcutaneous Trastuzumab a Potential Alternative to Intravenous Administration in Breast Cancer 

Subcutaneous administration of trastuzumab might offer improvements in patient convenience and resource use compared with conventional intravenous administration (Herceptin). A new subcutaneous trastuzumab formulation containing a fixed dose of 600 mg and recombinant human hyaluronidase PH-20...

breast cancer

Treatment of HER2-positive Disease in 2013 

From the initial discovery of the HER2 family of receptors in the mid-1980s to the present, a “wealth of riches” has been uncovered in terms of agents that can target pathways relevant to this aggressive breast cancer type, notes Hope S. Rugo, MD, Director of Breast Oncology and Clinical Trials...

cost of care
health-care policy

The Doctor Who Championed Patient Navigation in Harlem 

After completing his residency at Memorial Sloan-Kettering Cancer Center, Harold P. Freeman, MD, arrived at Harlem Hospital Center in 1967, where the overwhelming majority of his patients presented with late-stage disease. That early experience with underserved patients would shape his career as...

Young Investigator Award's Humble Beginnings Mark the Start of Something Big

Judith Kaur, MD, was presented with the very first Young Investigator Award (YIA) at the 1984 ASCO Annual Meeting in Toronto in what she felt was a “very prestigious event”—having breakfast with the ASCO president. The purpose of the new YIA program was to provide grant funding to help a young...

breast cancer

Research Roundup from San Antonio: New Data on Triple-negative, HER2-positive, Local, and Advanced Breast Cancer 

The 2012 San Antonio Breast Cancer Symposium featured more than 2,500 abstracts and lectures, including timely research in the field and discussions for scientists and clinicians alike. In addition to nearly two dozen in-depth reports from the meeting, The ASCO Post brings readers the following...

prostate cancer

Abiraterone in Patients with Metastatic Castration-resistant Prostate Cancer and No Prior Chemotherapy

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. Indication On December 10, 2012, abiraterone acetate (Zytiga)...

breast cancer

Novel Oral Agent plus Letrozole Improves Progression-free Survival in ER-positive Advanced Breast Cancer 

The combination of letrozole plus a novel oral inhibitor of cyclin-dependent kinase 4/6 called PD 0332991 achieved an unprecedented improvement in progression-free survival among women with advanced estrogen receptor–positive/HER2-negative breast cancer. Median progression-free survival was 26.1...

breast cancer
leukemia

Chemotherapy for Breast Cancer Carries a Small, but Concerning, Risk for Leukemia 

The risk for developing a secondary malignancy after chemotherapy for breast cancer is very small, but it is statistically significantly higher than for the general population, a review of the National Comprehensive Cancer Network (NCCN) database revealed in a study presented at the 2012 San...

lung cancer

Selumetinib/Docetaxel Shows Promising Activity in Previously Treated KRAS-mutant Non-Small Cell Lung Cancer

Currently, there are no approved therapies for KRAS-mutant non–small cell lung cancer (NSCLC), and few clinical trials have been performed specifically in this setting. In a recent article in Lancet Oncology, Pasi A. Jänne, MD, PhD, Scientific Director, Belfer Institute for Applied Cancer Science,...

issues in oncology
cost of care

Integration across the Spectrum: Community Perspective on the Medical Oncology Home Model 

The term “patient-centered cancer care” has become ingrained in today’s health-care vernacular. However, no matter what modifications occur in clinical oncology practice, the terms value and cost-effectiveness are now a solid part of the equation. At ASCO’s Quality Care Symposium, Linda D....

leukemia
lymphoma
multiple myeloma

More Brief Reports from ASH, Including New Data in Leukemia, Lymphoma, and Myelodysplastic Syndrome

At the 54th Annual Meeting of the American Society of Hematology (ASH), held in Atlanta, nearly 5,000 abstracts were presented in oral sessions and posters. As part of our ongoing comprehensive coverage from the meeting, here are several more studies of note. New Targets in Acute Myeloid Leukemia...

Make a Lasting Difference: Choose the Giving Option that Works for You

If you are like the many supporters of the Conquer Cancer Foundation, you may have reached a point where you would welcome the opportunity to influence not only the future ownership of your possessions, but the meaning that others assign to your life. One way to accomplish this is by considering...

breast cancer

Dose-dense Chemotherapy in Breast Cancer: Epirubicin-based Regimens Studied in German and UK Trials

In the treatment of early breast cancer, dose-dense regimens (given every 2 weeks) have proven superior to conventionally dosed chemotherapy (given every 3 weeks), but data on long-term survival are lacking. Two studies presented at the San Antonio Breast Cancer Symposium evaluated the benefit of...

cns cancers

The Challenges and Rewards of Neuro-oncology 

Despite the extremely difficult clinical challenges posed by brain tumors, mortality rates in this disease have decreased somewhat over the past several decades due, in part, to advances in surgical techniques and therapies. The ASCO Post recently discussed contemporary issues in neuro-oncology...

issues in oncology

On Radiation and Cancer Risk

We owe our life to radiation. The universe was created in a thermonuclear explosion, and continued existence of life on Earth depends on plants using chlorophyll to capture light energy emitted by the sun (and exploding supernovas) and converting it into chemical energy, with the subsequent...

issues in oncology

Large Epidemiologic Studies Re-examine Hazards of Smoking

“Smokers lose at least one decade of life expectancy, as compared with those who have never smoked,” and the increased risk of death from cigarettes smoking “are now nearly identical for men and women,” according to two separate studies published online by TheNew England Journal of Medicine. One...

head and neck cancer
lung cancer
issues in oncology

Patients with Cancer Need to Know That It Is Never Too Late to Quit Smoking 

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. Patients with head and neck or lung...

integrative oncology

Fitness: Can Exercise Lengthen Survival in Patients with Cancer? 

Regular physical activity has long been associated with decreased risk of disease, including many types of cancer. Such benefits may translate into increased life expectancy of up to 4.5 years, with even the lowest levels of activity providing some survival advantage.1 Most strikingly, however,...

breast cancer

My Life Will Never Be Normal 

After being diagnosed with stage II invasive ductal carcinoma in my right breast in 2004, I did an Internet search to learn more about my treatment options so I could be prepared when I met with my oncologist to discuss my treatment plan. I was especially interested in therapies that would be...

Expert Point of View: Nancy L. Keating, MD, MPH

By Nancy L. Keating, MD, MPH In this large study examining care for patients with a variety of tumor types in the Veterans Health Administration (VA), we found no clear association of tumor boards with better quality of care or outcomes. It is unclear if our findings can be generalized outside of...

issues in oncology
health-care policy

Focus on the Medical Oncology Association of Southern California 

For more than 2 decades, the guiding principle of the Medical Oncology Association of Southern California (MOASC) has been to ensure the continuation of the private practice of medical oncology and to provide the highest quality care to cancer patients. Founded in 1990, MOASC is the largest...

gynecologic cancers

Analysis Shows No 10-year Survival Advantage in Patients with Ovarian Cancer and BRCA1 or BRCA2 Mutations 

Several studies have suggested that short-term overall survival for women with ovarian cancer and BRCA1 or BRCA2 mutations is better than that in patients without such mutations. Indeed, a recent report by Kelly L. Bolton, PhD, and colleagues indicated that 5-year overall survival was 36% for...

issues in oncology

Enhanced Electronic Module Aims to Prevent Errors in Oral Chemotherapy Prescribing

An oral chemotherapy prescription-writing module grafted to a shared electronic medical record is part of a series of quality improvement efforts undertaken at Dana-Farber Cancer Institute in Boston to prevent errors in prescribing oral chemotherapy agents. While oncologists have readily accepted...

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