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JOP Content Now Available Online before Print

Journal of Oncology Practice (JOP) recently began publishing the majority of its articles online ahead of print. This exciting initiative benefits both JOP’s authors and readers by making practice-changing content readily available online in a timely manner. With the launch of the...

integrative oncology

NIH Director Calls for Rigorous Evaluation of Integrative Medicine to Provide Evidence of Efficacy

“Many new frontiers exist in integrative medicine,” NIH Director Francis Collins, MD, PhD, stated in his keynote address at the Eighth International Conference of the Society for Integrative Oncology (SIO) in Cleveland. “The evidence is overwhelming that these approaches are being used by many...

breast cancer
symptom management

Estrogen for Vulvovaginal Atrophy in Breast Cancer: Debate Continues

Vulvovaginal atrophy is a concern for the majority of patients with breast cancer, not only because of its physical and psychosexual consequences, but because the optimal treatment—estrogen replacement—is controversial. Patients and physicians alike remain concerned that external estradiol may...

prostate cancer

Data on Watchful Waiting for Low-risk Prostate Cancer May Swing Focus to Higher-risk Tumors and Quality of Life

Surgery did not increase survival rates compared to watchful waiting in men with clinically localized prostate cancer. Results were particularly strong for men with prostate-specific antigen (PSA) levels of 10 ng/dL and under, and those who have low-risk disease, according to data from the Prostate ...

prostate cancer

NIH Panel Endorses Active Surveillance in Low-risk Prostate Cancer

Active surveillance of localized prostate cancer is a viable management option that should be offered to low-risk patients in place of immediate treatment, said a panel of experts convened by the National Institutes of Health. A fairly new concept, active surveillance takes a more proactive...

Package Inserts Revised for IV Methotrexate Products

The FDA has approved changes to the package inserts for methotrexate products for intravenous administration. Additional information regarding concomitant proton pump inhibitor (PPI) therapy has been added to the Warning section of the label. Specifically, the new text includes the following...

gynecologic cancers

New System for Cervical Cancer Screening Approved

Hologic announced that the FDA has approved its Cervista HTA (high throughput automation) system for use with its previously approved Cervista human papillomavirus (HPV) HR test. The Company’s Cervista HTA system automates the DNA extraction and detection steps of the Hologic Cervista HPV HR test,...

SIDEBAR: Bevacizumab in Breast Cancer: Additional Perspective

A recent poll by MDoutlook1 concluded that payer coverage would have a significant role in bevacizumab’s use in metastatic breast cancer. Usage of the drug could be cut by two-thirds in the United States and by one-third outside the United States. The NCCN has kept its recommendation of bevacizumab ...

breast cancer

Bevacizumab Breast Cancer Indication Rescinded: What Are the Downstream Implications?

Leading up to FDA’s resolution to revoke the breast cancer indication for bevacizumab (Avastin), the debate over the drug’s clinical value was imbued with contentious ideologic overtones, which culminated in a 2-day public hearing that exposed deep divisions not only in the scientific community,...

lymphoma

Favorable Early-stage Hodgkin Lymphoma and HD.6: The Take-Home and Don’t–Take-Home Messages

The Canadian HD.6 randomized study in patients with nonbulky early-stage Hodgkin lymphoma is mostly of historic interest.1,2 It has little relevance to current treatment standards or questions, and the risk for its inappropriate interpretation is of great concern. Radical Radiation Approach Long...

thyroid cancer

Vandetanib Demonstrates Therapeutic Efficacy in Patients with Advanced Medullary Thyroid Cancer

A phase III trial among patients with locally advanced or metastatic medullary thyroid cancer met its primary objective of progression-free survival prolongation among patients receiving vandetanib compared to placebo. The secondary efficacy endpoints of objective response rate, disease control...

issues in oncology

CancerConnect Offers Online Alternative Networking for Patients

Social networking sites like Facebook and Twitter are rapidly growing, giving patients with cancer a place to connect with others. But an alternative networking website claims to be a more comprehensive, responsible, “commercial-free” alternative. Over 10,000 patients with cancer have registered at ...

hematologic malignancies

JAK2 and MPL Mutation Screening: What Are the Indications and How to Interpret the Results

The World Health Organization system organizes myeloid malignancies into five major categories, which are subsequently further subclassified using a combination of bone marrow morphology and cytogenetic/molecular information (Table 1).1 JAK2 and MPL mutations are not disease-specific and occur...

ASCO Membership Categories Offer a Place for Everyone

If your work touches those who have cancer, you have a place within ASCO. That’s the message that the organization, during its 48 years, has gotten across in many ways, not the least of which is its membership categories, which have expanded right along with the field of cancer care. “ASCO is...

Integration of QOPI® Helps Michigan Insurer Earn ‘Best of Blue’ Award

By working to improve oncology care in practices in Michigan through integration of ASCO’s Quality Oncology Practice Initiative (QOPI) into its Physician Group Incentive Program, Blue Cross Blue Shield of Michigan (BCBSM) has been selected as a 2011 “Best of Blue Clinical Distinction Award” winner...

issues in oncology

QOPI® Certifies 100th Practice for Delivering High-quality Cancer Care

Less than 2 years since launching the first national program to help oncology practices deliver the highest quality of cancer care, ASCO and its affiliate, the Quality Oncology Practice Initiative (QOPI®) Certification Program, announced that more than 100 practices have achieved QOPI...

breast cancer

Ablation of Small Primary Breast Tumors: The Next Step in Local Therapy?

Local treatment of breast cancer is trending toward less invasive procedures that achieve comparable outcomes to standard interventions. What will the next step along this continuum be? According to Michael S. Sabel, MD, a surgical oncologist at the University of Michigan Comprehensive Cancer...

breast cancer

Study Questions Use of Partial Breast Brachytherapy in Older Women

Partial breast brachytherapy is less effective and more toxic than whole-breast irradiation when used after lumpectomy, suggests an analysis of Medicare claims data. In the 2000–2007 study of more than 130,000 older women with breast cancer—the largest of its kind to date—the rate of mastectomy in...

breast cancer

AVEREL Trial Shows Benefit of Bevacizumab in HER2-positive Locally Recurrent or Metastatic Breast Cancer

In findings likely to intensify the debate about the role of bevacizumab (Avastin) in advanced breast cancer, the AVEREL trial concludes that adding this antiangiogenic antibody to standard therapy prolongs progression-free survival by about 3 months in women with HER2-positive locally recurrent...

health-care policy

FDA Completes Work on Three Drug User Fee Programs

The FDA recently completed its recommendations for three user fee programs that will help speed safe and effective drugs and lower-cost generic drug and biosimilar biologic products to patients, according to FDA Commissioner Margaret A. Hamburg, MD. The programs include the fifth authorization of...

multiple myeloma

Expert Point of View: Next-generation Proteasome Inhibitors Will Improve Outcomes in Bortezomib-refractory Myeloma Patients

Myeloma experts agree that the new proteosome inhibitors are particularly welcome because they are at least as effective as bortezomib (Velcade) but produce much less neuropathy. Dramatic Results “The activity of MLN 9708 is very encouraging,” said Paul G. Richardson, MD, of Dana-Farber Cancer...

breast cancer

Dual HER2 Blockade Substantially Delays Disease Progression

There is an emerging theme in HER2-positive breast cancer: The greater the pathway inhibition, the better the outcome. The latest evidence comes from the phase III Clinical Evaluation of Pertuzumab and Trastuzumab (CLEOPATRA) trial of 808 patients with previously untreated metastatic disease. The...

gynecologic cancers

Nearly Identical Survival for Laparoscopy vs Laparatomy in Patients with Stage I/IIA Disease

Building on previously reported results that laparoscopic surgical management of uterine cancer is superior for short-term safety and length-of-stay endpoints, the Gynecologic Oncology Group reported small and lower than anticipated potential for increase risk of cancer recurrence with laparoscopy...

multiple myeloma

Carfilzomib May Offer Advantages in Patients with Relapsed/Refractory Multiple Myeloma

Carfilzomib is an oral second-generation proteasome inhibitor with a mechanism of action that may increase efficacy and reduce adverse effects currently associated with proteasome inhibitor therapy. It is being investigated for use in multiple myeloma and select solid tumors, and the FDA has...

skin cancer

What You Should Know about Peginterferon Alfa-2b for Adjuvant Treatment of Melanoma

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 Peginterferon alfa-2b (PegIntron, Sylatron) was recently ...

head and neck cancer

Challenges, Progress, and Future Directions in Head and Neck Cancer

Although head and neck cancer remains a major therapeutic challenge, significant advances have been made over the past few decades. The ASCO Post recently spoke with Marshall R. Posner, MD, Medical Director of the Head and Neck Oncology Program, Mount Sinai Medical Center, New York, about the...

issues in oncology

Starting Down the Path toward Electronic QOPI®: ASCO and US Oncology Collaborate in Quality Measurement

The Quality Oncology Practice Initiative (QOPI®), ASCO’s quality measurement program, is entering its 6th successful year and continuing to grow, both in number of participants and in quality measures evaluated. In the truest spirit of quality improvement, ASCO’s oncologist leaders have determined...

SIDEBAR: Leadership to Legacy

Through the Conquer Cancer Foundation Leadership to Legacy campaign, ASCO members and other field leaders have the opportunity to personally invest in the future of oncology by supporting the work of its most talented young researchers. Contributions to the Leadership to Legacy campaign not only...

Important News Briefs: New Data Reported in Gastric, Colorectal, and Hepatocellular Cancers

Findings presented at the 2012 Gastrointestinal Cancers Symposium will impact the future care of patients with these malignancies. The ASCO Post has summarized some of the most newsworthy data in the following briefs. In the phase III GRANITE-1 trial (n = 656), single-agent treatment with...

lung cancer

Lung Cancer Alliance Announces National Framework for Lung Cancer Screening Excellence

The Lung Cancer Alliance (LCA) moved lung cancer screening to a national platform by announcing a Framework for Lung Cancer Screening Excellence, which includes a bill of rights for the at-risk public and guiding principles for lung cancer screening sites. “The science is indisputable: Screening...

global cancer care
pain management

Inefficient Markets Impede Cancer Pain Relief

The potent analgesic property of morphine was first isolated in 1804, and after more than 2 centuries morphine is still the gold standard for moderate to severe pain. It is relatively easy to produce, and compared to most pharmaceuticals, morphine is dirt-cheap. Therein lies the cruel conundrum:...

colorectal cancer

Survival Advantage of Oxaliplatin Extends to Diverse Group of Patients

The survival advantage conferred by adding oxaliplatin to adjuvant chemotherapy with fluorouracil (5-FU), as previously shown in randomized controlled trials, extends to patients in the general population, including older and minority group patients and those with higher comorbidity. These results, ...

breast cancer

Surviving Cancer Means Making Many Difficult Decisions

The best advice I received after getting a diagnosis of stage I invasive lobular carcinoma in my left breast was from my radiologist, who told me, “Remember, be your own best advocate.” Those words have stayed with me through my 6-year struggle with breast cancer and its aftermath. Extraordinary...

SIDEBAR: Expect and Ask Questions about Sex and Fertility Preservation

What most concerns the adolescent and young adult population? “If they are worried about anything, it is sex and having families,” according to Archie Bleyer, MD. Years ago, he said, “oncologists were so worried about just getting them in remission, treating their cancers, and getting them to...

issues in oncology

Adolescents and Young Adults with Cancer: A Distinct Population of Patients Who Need to Be Treated Differently

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 among adolescents and young...

hematologic malignancies
leukemia
lymphoma

ASH 2011 Presentations Include Novel Agents and New Strategies in Leukemia, Lymphoma, and Myeloma

Attendees at the 53rd Annual Meeting of the American Society of Hematology (ASH), held recently in in San Diego, were able to choose from a wide range of interesting and important sessions exploring hematologic malignancies. In addition to The ASCO Post’s regular news coverage from the meeting,...

health-care policy

AACR Urges Congress to Maintain, Preferably Increase, Cancer Research Funding

December 23, 2011, marked the 40th anniversary of the National Cancer Act. To mark that occasion, on February 2, the American Association for Cancer Research (AACR) held a Congressional briefing, attended by about 100 legislative aides, to remind Congress that the war on cancer is far from over....

health-care policy

Research Funding Key to Continued Progress in Cancer Care

American Association for Cancer Research (AACR) President and ASCO member Judy Garber, MD, MPH, recently spoke with The ASCO Post about the findings of AACR’s landmark Cancer Progress Report,1 In addition, she offered her perspective on the current and future state of cancer research. Project...

breast cancer

Context May Affect Benefit of Adjuvant Clodronate in Breast Cancer

A benefit of the oral bisphosphonate clodronate when used as adjuvant therapy for early breast cancer may depend on factors such as the endpoint assessed and patient age, suggests the randomized B-34 trial conducted by the National Surgical Adjuvant Breast and Bowel Project (NSABP). The trial,...

hematologic malignancies

How I Work up the Patient with Thrombocytosis

Thrombocytosis is defined as a platelet count greater than 400 × 109/L. In routine clinical practice, thrombocytosis is much more likely to be reactive (> 80% of cases) than primary. Reactive thrombocytosis is usually associated with infections, inflammation, trauma, hemolysis, metastatic...

prostate cancer

First Urine-based Molecular Test to Gauge Need for Repeat Prostate Biopsies

Gen-Probe announced the FDA has approved its PROGENSA PCA3 (prostate cancer gene 3) assay, the first molecular test to help determine the need for repeat prostate biopsies in men who have had a previous negative biopsy. “Overexpression of the PCA3 gene is highly specific to cancerous prostate...

ASCO Launches Community Research Forum to Tackle Top Research Conundrums

Just how many research-focused staff members is it optimal to have when conducting clinical trials in a community-practice setting? To properly gauge that, should the practice look closely at how many studies it’s working on? The complexity of those studies? The number of patients enrolled? Some...

health-care policy

Rising Costs in Radiation Oncology Linked to Medicare Coverage

In the ongoing debate over how to control rising cancer care costs, it is vital to identify usage patterns of expensive new technologies. A recent study examined the relationship between Medicare reimbursement and the increasing use of intensity-modulated radiation therapy (IMRT).1 The ASCO Post...

colorectal cancer

Adjuvant Therapy for Stage III Colon Cancer: Survival Advantage of Oxaliplatin Reported in Clinical Trials Extends to Diverse Group of Patients

The survival advantage conferred by adding oxaliplatin to adjuvant chemotherapy with fluorouracil (5-FU) in stage III colon cancer, as previously shown in patients in randomized controlled trials, extends to patients in the general population, including older and minority group patients and those...

prostate cancer

Immune Changes Reported with Early Use of Sipuleucel-T in Neoadjuvant Setting for Prostate Cancer

Sipuleucel-T (Provenge) can generate a circulating immune response to treat men with metastatic castrate-resistant prostate cancer, as per its FDA-approved indication.1 A neoadjuvant trial was performed to investigate whether earlier use of sipuleucel-T can generate an immune response in the...

gastrointestinal cancer

New Assays, Surveillance Techniques Reported for GI Malignancies

Two studies highlighted in press conferences and one presented during an invited lecture at the 2012 Gastrointestinal Cancers Symposium, held recently in San Francisco, suggest that early detection of pancreatic, esophageal, and colorectal cancers could soon improve. Enzyme Immunoassay Spots...

prostate cancer

Expert Point of View: Prostate Cancer Studies Compare Outcomes, Toxicities, and Costs

Nicholas B. Vogelzang, MD, moderator of the press briefing where these findings were presented, agreed that the first study supports intensity-modulated radiotherapy (IMRT) as the current standard of care. With costs of health care increasing exponentially, it is important to establish the...

geriatric oncology

Moving the Field of Geriatric Oncology Forward

With the aging of the population, virtually all of the subspecialties of oncology will soon be concerned primarily with the care of older patients. While there is not one precise definition of the age of “geriatric” patients, it is clear that the aging of our society has necessitated a focus on the ...

issues in oncology
health-care policy

Searching for Quality in an Increasingly Complex Health-care Environment

With the Presidential election just around the corner, the health-care debate will undoubtedly heat up. The ASCO Post spoke with Sean R. Tunis, MD, MSc, Founder and Director, Center for Medical Technology Policy, and former Chief Medical Officer for the Centers for Medicare & Medicaid Services, ...

cns cancers

Re-analysis of RADIANT-2 Finds Benefit for Everolimus in Patients with Carcinoid Tumors

A re-analysis of the RADIANT-2 trial, which evaluated everolimus (Afinitor) in patients with advanced nonpancreatic neuroendocrine tumors, has yielded prognostic factors that identify a group of patients who are not only at high risk for recurrence but who may derive benefit from treatment with...

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