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Showing 6601 - 6650Access to and Appropriate Use of Oncology Drugs Called Into Question by ASCO Studies
Studies presented at this year’s ASCO Annual Meeting suggest that despite the wealth of amazing oncolytics on the market, drug shortages persist, drug substitutions are common, off-label use of drugs occurs frequently, and patients find their costs burdensome. Drug Shortage Persists The shortage of ...
Low Risk of Transformation to Melanoma for Biopsy-Diagnosed Mildly or Moderately Dysplastic Nevi
The risk of transformation to melanoma appears very low for biopsy-diagnosed mildly or moderately dysplastic nevi, and routine surgical excision of nevi with a positive biopsy margin may not be indicated. Patients with biopsy-diagnosed moderately-to-severely and severely atypical nevi, however,...
FDA on CLL Drug Approval and Expanded Access
The ASCO Post article, “Ibrutinib CLL Trial: Where is the Equipoise?” published in May 2013, inaccurately conveyed that the Food and Drug Administration (FDA) requires an improvement in overall survival for chronic lymphocytic leukemia (CLL) drug approval and opposes allowing crossover in the...
Pharmacyclics' Reply
We acknowledge the letters submitted to The ASCO Post from a patient advocate and a chronic lymphocytic leukemia (CLL) patient enrolled on the RESONATE study (PCYC-1112-CA). At Pharmacyclics, we are committed to adhering to high scientific and ethical standards as we strive to develop novel...
Clinical Trials, Crossover, and Clinical Equipoise: An Advocate's Perspective
In a previous issue of The ASCO Post, Dr. Susan O’Brien wrote, “It is my understanding that the FDA strongly opposed allowing crossover [in the RESONATE trial]. I presume that is because the FDA also wants to see if there is a survival advantage.”1 The lack of crossover seems a valid concern to me...
Clinical Trials, Crossover, and Clinical Equipoise: A Patient's Perspective
I am writing with regard to two articles on the ethical imperative of clinical equipoise written by Susan O’Brien, MD, and Stephen J. Schuster, MD, and published recently in The ASCO Post.1,2 I was a victim of Pharmacyclics’ policies during one of their randomized ibrutinib trials (PCI-32765)...
SIDEBAR: Expect Questions From Your Patients
Physicians and patients should engage in open discussion” about the complex issues of cancer screening, overdiagnosis, and overtreatment, according to a report from the chairs of a National Cancer Institute working group tasked with developing a strategy to improve the current approach to cancer...
Tackling Overdiagnosis and Overtreatment, by Words and by Deeds
The complexity of the pathologic condition called cancer,” according to a Viewpoint article in the Journal of the American Medical Association,1 “complicates the goal of early diagnosis.” Failure to recognize that cancers are heterogeneous, and that not all progress to metastases and death, can...
Prominent Surgeon and Teacher LaSalle D. Leffall, Jr, MD, Promotes Hard Work and Education to Overcome Boundaries
Reminiscing about his 65 years in medicine, LaSalle Doheny Leffall, Jr, MD, FACS, cites three events in his early childhood that would ultimately lead him to his position today as the Charles R. Drew Professor of Surgery at Howard University College of Medicine in Washington, DC. First, he was...
The Oncologist as Author: On Guiding Patients Through Cancer
When Tumor Is the Rumor and Cancer Is the Answer is the guidebook to cancer that Kevin P. Ryan, MD, FACP, COL, USAF (ret) wished his patients had during his 30 years of practicing oncology. The book, recently published by AuthorHouse, is an authoritative, inspiring, and even philosophical guide for ...
Communicating the Promise Science Offers to Society
ASCO President Clifford Hudis, MD, FACP, will be serving during a particularly notable year: 2014, the Society’s 50th anniversary. This occasion brings with it much to reflect on, from the advances in the field of oncology to the growth of ASCO’s influence, but Dr. Hudis takes a moment to simply...
ASCO Congratulates QOPI-Certified Practices
QCP™: Recognizing Excellence The QOPI® Certification Program (QCP™) recognizes medical oncology and hematology/oncology practices that are committed to delivering the highest quality of cancer care. QCP evaluates an individual practice’s performance in areas that affect patient care and safety. The ...
Postresection Adenovirus-Mediated Gene Therapy Improves Time to Death/Reintervention but Not Survival in Adult Glioblastoma
In an open-label phase III trial (ASPECT) reported in Lancet Oncology, Manfred Westphal, MD, of University Hospital Eppendorf in Hamburg, and colleagues assessed the effects of locally applied adenovirus-mediated gene therapy with sitimagene ceradenovec followed by IV ganciclovir after surgical...
The BEATRICE Study: Where Does Targeting Breast Cancer Vasculature Stand in 2013?
Antiangiogenic strategies using the anti–vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (Avastin) gained traction in breast cancer with the publication of the Eastern Cooperative Oncology Group (ECOG) 2100 trial in 2007. That study demonstrated a progression-free survival ...
No Invasive Disease–Free Survival Benefit for Bevacizumab Added to Adjuvant Chemotherapy in Triple-Negative Breast Cancer
In a study (BEATRICE trial) reported in Lancet Oncology, David Cameron, MD, Professor of Oncology and Director of Cancer Services, NHS Lothian at the University of Edinburgh, and colleagues evaluated the strategy of adding the antiangiogenic agent bevacizumab (Avastin) to adjuvant chemotherapy in...
Timely Findings From the Ovarian Tumor Tissue Analysis Consortium
In the Ovarian Tumor Tissue Analysis Consortium Study recently published by Sieh et al,1 tissue microarrays from 2,933 cases of epithelial ovarian carcinoma demonstrated that progesterone receptor (PR) expression and estrogen receptor (ER) expression were associated with significantly improved...
Pretreatment Lymph Node Dissection May Improve Survival in Advanced Cervical Cancer, But for Too Few?
Women with cervical cancer metastasized to para-aortic lymph nodes have historically had a poor prognosis, with 3-year overall survival rates of 25% to 40%.1-3 This has been attributed to the presence of occult systemic disease at the time of presentation and a high rate of distant recurrences...
Undertreatment of Cancer Pain Remains a Persistent Problem in Oncology
Data indicate that for more than 2 decades, cancer pain has been undertreated in the United States. The paradox of this stubborn clinical problem is that oncology has the ability to manage the great majority of cancer pain. To clarify this issue, The ASCO Post recently spoke with nationally...
Prescribing of Off-Label Chemotherapy Is Common, and Most Off-Label Drug Use Meets NCCN Compendium Criteria
Off-label prescribing of drugs remains common in oncology, but about two-thirds of off-label prescribing is consistent with the National Comprehensive Care Network (NCCN) compendium, according to a study1 reviewed at the Best of ASCO® ’13 meeting in Chicago by Monika K. Krzyzanowska, MD, MPH,...
Paging Dr. Google: Practicing Oncology in the Era of Social Media and Telemedicine
Over the past few decades, economic and political factors have reshaped oncology, especially in the community setting. To defray risk, we’ve seen a trend toward oncology practices partnering with hospitals or aggregating into larger networks. Moreover, the Internet and the advent of telemedicine...
Jane Weeks, MD, MSc, National Leader in Outcomes Research, Dies at 61
On September 10, Jane Carrie Weeks, MD, MSc, a prominent researcher at Dana-Farber Cancer Center, died of cancer in her Boston home. She was 61. At the time of her death, Dr. Weeks was Professor of Medicine at Harvard Medical School, Professor of Health Policy and Management at the Harvard School...
Sunscreen Use Infrequently Discussed With Patients
Although the incidence of skin cancer in increasing, “the rate at which physicians are mentioning sunscreen at patient visits is quite low, even for patients with a history of skin cancer,” according to an analysis of data from more than 18.30 billion patient visits. “Sun-protection counseling...
Pomalidomide In Patients With Disease Progression Who Are Refractory to Bortezomib and Lenalidomide
The second-generation immunomodulatory drug pomalidomide (Pomalyst) “has shown impressive results in patients with multiple myeloma who are refractory to lenalidomide [Revlimid] and bortezomib [Velcade],” according to a review of clinical data leading to the drug’s approval by the FDA. In February, ...
Smoking App for Teens
E-cigarettes are one of the many issues addressed in the Tobacco-Free Teens app developed at MD Anderson Cancer Center in Houston. “What we are trying to say to teens is that you might as well avoid trying any of the cigarettes, or small cigars, or nicotine delivery devices, such as e-cigarettes,”...
What You Need to Know About E-Cigarettes
“I’ve seen a lot of puzzled people,” Alexander V. Prokhorov, MD, PhD, said, referring to people who see others using electronic or e-cigarettes. That puzzlement can go beyond wondering why people are smoking in public places and whether they are breaking the law, or just being annoying, to...
Donatori di Musica Initiative Creates a Unique Environment for Oncology Patients
“Surely again, to heal men’s wounds by music’s spell.” —Euripides, Medea (480-406 BC) Commonly defined as organized sound, music has a unique power to stir human emotions, moods, and impressions. The salutary effect of music on the sick has been reported since antiquity. Aristotle and Plato wrote...
Herb-Drug Interactions in Oncology
Guest Editor Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering...
Advances in Medical Oncology Over the Next Decade
The next 10 years are expected to usher in unprecedented advances in oncology, including molecularly driven diagnostic and therapeutic developments, whole genome sequencing that results in true precision-based medicine, survivorship care plans that address long-term quality of life concerns, and...
Cancer Does Not Discriminate
Looking back, my son Max’s fall as he was running after another little boy while playing baseball was such a blessing. Although he landed on his right arm, the fall didn’t seem severe enough to cause him to cry out in such excruciating pain. But after several hours of icing the bruise failed to...
ASTRO Offers Five Recommendations as Part of Choosing Wisely Campaign
The American Society for Radiation Oncology (ASTRO) released its list of five radiation oncology-specific treatments that are commonly ordered but may not always be appropriate as part of the national Choosing Wisely® campaign, an initiative of the American Board of Internal Medicine Foundation....
Radium-223 and Beyond in Metastatic Castration-Resistant Prostate Cancer
Metastasis to bone is the hallmark of prostate cancer and a major source of disease-related morbidity and mortality. In addition to prostate cancer cells, other major players in the vicious interactive cycle of prostate cancer bone metastasis are osteoblasts, osteoclasts, and mineralized bone...
ALSYMPCA Trial: Updated Analysis of Survival With Radium-223 Treatment in Metastatic Prostate Cancer
In a trial (ALSYMPCA trial) reported in The New England Journal of Medicine, Chris Parker, MD, from Royal Marsden Hospital in Surrey, UK, and colleagues compared the alpha emitter radium-223 dichloride (Xofigo) with best standard of care in men with castration-resistant prostate cancer and bone...
Progression-Free Survival With Pazopanib Not Inferior to Sunitinib Benefit in Metastatic Renal Cell Carcinoma
Pazopanib (Votrient) and sunitinib (Sutent) have been shown to provide progression-free survival benefit compared with placebo or interferon in phase III trials in metastatic renal cell carcinoma. In a noninferiority trial reported in The New England Journal of Medicine by Robert J. Motzer, MD, of...
Comparative Effectiveness Research: Its Time Has Arrived
Reigning in the nation’s runaway medical costs was an underlying theme of President Obama’s health-care reform platform. Citing projects like The Dartmouth Atlas of Health Care, which documented large gaps in the quality, costs, and outcomes of health services around the country, the...
Germline Mutations and Breast Cancer Prognosis: Does the Cause Matter?
Since the discovery of BRCA1 and BRCA2, investigators have sought to determine whether the presence of a germline mutation independently influences the outcome of a breast cancer diagnosed in a woman with an inherited mutation. The question is highly relevant to an unaffected woman with a mutation, ...
New President and CEO of Fox Chase Cancer Center Reflects on Challenges and Opportunities Ahead
On October 8, 1904, a group of Philadelphia physicians and businessmen who were concerned about the escalating incidence of cancer in the city signed a charter that established the American Oncologic Hospital, one of the nation’s first hospitals solely devoted to cancer care. Seven decades later—2...
More Active Physician Intervention Needed to Keep Patients From Smoking
More active support and interventions by physicians are required to get patients who still smoke to stop, according to two articles published online by the Journal of Oncology Practice (JOP),1,2 and to prevent school-aged children and adolescents from starting to use tobacco, according to a U.S....
ASCO Releases Statement on the Impact of the Government Shutdown on Cancer Care
All nonessential government services were suspended at midnight on October 1, 2013, after Congress failed to reach a budget compromise to keep the government funded before the start of the new fiscal year beginning on October 1, 2013. ASCO issued a statement in response to the government shutdown...
Study Shows Increased Risk of Mental Disorders in Childhood Cancer Survivors and Potential Increased Risk in Young Siblings
Survivors of childhood cancer are at risk for long-term adverse physical and mental effects, but little is known about the effects of illness in siblings of these patients. In a study reported in The Lancet Oncology, Lasse Wegener Lund, MD, of the Danish Cancer Society Research Centre and...
Challenging and Changing the Standard of Care for Cervical and Ovarian Cancers
“It was a very exciting session this year, particularly for cervical cancers,” said Paul Haluska MD, PhD, of the Mayo Clinic, Rochester, Minnesota, in speaking of the 2013 ASCO Annual Meeting’s gynecologic oncology session and the abstracts highlighted recently at Best of ASCO in Chicago. In one...
Radiation Therapy Is Safe in the Management of Ductal Carcinoma In Situ: No Increase in Risk of Cardiovascular Disease
Radiation therapy as part of the management of ductal carcinoma in situ (DCIS) did not increase the risk of cardiovascular disease 10 years after treatment, according to a large retrospective study presented at a press conference held just prior to the 2013 Breast Cancer Symposium.1 Longer...
Expert Point of View on ductal carcinoma in situ
In an e-mail interview, E. Shelley Hwang, MD, an expert who has coauthored several papers on ductal carcinoma in situ (DCIS), weighed in on the two abstracts about management of DCIS featured in this issue of The ASCO Post—one presented by Melissa L. Pilewskie, MD (perioperative MRI in DCIS, page...
Trying to Improve Value in Cancer Care: An Experiment
One of the more significant problems in modern oncology practice is to provide increased value at a time when costs are spiraling upward, and new parameters of “success” are being introduced into the equation—most visibly, inside the Beltway in Washington, DC. Thus, oncologists will need to address ...
Contemporary Studies Dispute Findings of Radiation-Induced Cardiotoxicity
At the 2013 Breast Cancer Symposium, studies suggested that with current radiotherapy techniques the mean radiation doses to the heart are much lower—and thus radiotherapy is presumably much safer—than findings suggested by an article published in The New England Journal of Medicine last spring.1...
Better Risk Communication Strategies Needed to Ensure Decision to Have Contralateral Prophylactic Mastectomy Is Evidence-Based
Overestimating the risk that cancer in one breast will affect the other breast may cause many young women with breast cancer to choose contralateral prophylactic mastectomy even though most know it does not clearly improve survival. In a survey of 123 women who were diagnosed with cancer in one...
Claudia I. Henschke, PhD, MD, Took a Circuitous Route to Her Groundbreaking Work in Lung Cancer Screening
“Once you have tasted flight, you will forever walk the earth with your eyes turned skyward, for there you have been, and there you will always long to return.” —Leonardo da Vinci Lung cancer CT screening may have had no greater advocate than Claudia I. Henschke, PhD, MD. In the face of...
Low-Dose CT Screening Identifies More Early Lung Cancer but Has Lower Positive Predictive Value vs Radiography
Results of the two rounds of annual incidence screening with low-dose computed tomography (CT) vs radiography in the National Lung Screening Trial (NLST) were recently reported by Denise R. Aberle, MD, Professor of Radiology and Bioengineering at the University of California at Los Angeles and...
Nab-Paclitaxel in Metastatic Pancreas 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 September 6, paclitaxel protein-bound particles...
Having Breast Cancer Has Actually Been a Positive Experience
I know it sounds strange, but being diagnosed with cancer was one of the best things to have happened to me. I don’t mean to diminish the traumatic experience of hearing the words, “You have breast cancer.” That was over 11 years ago, and I’m still reeling from the diagnosis and its aftereffects....
Modifiable Risk Factors Potentiate Therapy-Associated Risk for Major Cardiac Events in Adult Survivors of Childhood Cancer
In a study reported in the Journal of Clinical Oncology, Gregory T. Armstrong, MD, of St. Jude Children’s Research Hospital in Memphis, and colleagues assessed the frequency of major cardiac events and cardiovascular risk factors among adult survivors of childhood cancer and their siblings.1 They...
