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Expert Point of View: Howard A. Fine, MD and Martin J. van den Bent, MD

Session moderator Howard A. Fine, MD, the Anne Murnick Cogan and David H. Cogan Professor of Oncology and Director of the Brain Tumor Center at New York University Cancer Institute, shared his enthusiasm over the findings of the RTOG 9802 study. “I don’t know of any other tumor type where the...

hepatobiliary cancer

Everolimus Did Not Improve Survival in Hepatocellular Cancer After Progression on Sorafenib

“Despite the strong scientific rationale and preclinical data, everolimus [Afinitor] plus best supportive care failed to improve survival over placebo plus best supportive care” among patients with advanced hepatocellular cancer that progressed during or after receiving sorafenib (Nexavar), or who...

colorectal cancer

High False-Positive Rate of Elevated CEA Seen in Patients With Resected Colorectal Cancer

A retrospective study finding a 49% false-positive of carcinoembryonic antigen (CEA) testing among patients with a history of resected colorectal cancer, “suggests that confirmation of an ongoing increase in CEA level should be universal practice before an extensive workup is initiated,” Anya...

lung cancer

New Clinical Study Aims to Investigate the Genomics of Young Lung Cancer

The Addario Lung Cancer Medical Institute (ALCMI) recently launched a new study, the Genomics of Young Lung Cancer, to understand why lung cancer occurs in young adults, who quite often are athletic, never smokers and do not exhibit any of the known lung cancer genetic mutations. ALCMI, a...

prostate cancer

‘Reasonable’ to Advise Men Who Have Had Vasectomies That They Have a Small Increased Risk for Lethal Prostate Cancers

Long-term results from the Health Professionals Follow-up Health Study have shown a 20% increased risk of advanced prostate cancer and a 19% increased risk of lethal prostate cancer among men who had vasectomies.1 According to the study’s lead author, Mohummad Minhaj Siddiqui, MD, it is...

multiple myeloma
issues in oncology
survivorship

Cancer Survivor and Patient Advocate Michael S. Katz, MBA,  Has Helped Alter the Standard of Care for Myeloma Survivors

Michael S. Katz, MBA, has lived longer than any of his doctors thought he would. A two-time cancer survivor, Mr. Katz was diagnosed, first with multiple myeloma in 1990 and then with colorectal cancer in 2008, and has spent the past 2 decades tirelessly advocating for patients with cancer. The...

survivorship

Taking Charge of Your Care

The first sign I had that something might be wrong was an uncontrollable itch all over my body. Although I had never had anything like that before, the problem was easy to initially dismiss. I’m a respiratory therapist and visit patients in their homes daily, so I chalked up the itchiness to an...

issues in oncology

How Technology Is Helping Bring Health Care to Patients

The term “telemedicine,” which is sometimes used interchangeably with “telehealth” and “m-health” (for mobile health) and is now collectively called “connected health,” involves the use of information and communications technology to connect patients with their providers through a variety of...

head and neck cancer

Michael Douglas Shares His Experience With Stage IV Oropharyngeal Cancer

Academy Award winning actor and producer Michael Douglas was the guest of honor at the opening day of the International Federation of Head and Neck Oncologic Societies (IFHNOS) 5th World Congress on July 27 in New York (see page 22 for more on the World Congress). He came not to plug the release of ...

Book Excerpt: Family

I've witnessed incredible courage and zest for life among so many patients from so many walks of life—individuals committed to helping others in spite of their own adversity. Forty years ago, when survival for patients with multiple myeloma was a matter of months, I knew that every person I sat...

palliative care

Using Patient-Reported Outcome Measures in Palliative Care Clinical Practice

Incorporating patient-reported outcomes into the palliative care clinical setting can improve patients’ symptom management, quality of life, and overall communication with their oncologists, according to Ethan Basch, MD. Dr. Basch is Director of the Cancer Outcomes Research Program and Associate...

Facing Cancer Together

David sits at his desk, tapping angrily. He’s tired of his abusive, ignorant boss, the VP for regional sales. The man’s sales targets are absurdly high, he’s impossible to reach on the phone, his “motivational” speeches evoke the stress of Glengarry Glen Ross, and even his fake all-light-brown hair ...

Pioneering Medical Oncologist Remembers a Time Before the Subspecialty Was Created

While the first written record of cancer dates back to ancient Egypt, the history of modern oncology is fairly short, dating back only slightly more than half a century. Clinical trials in the early days of the National Cancer Institute (NCI) and the emerging cooperative groups were led by a...

leukemia

Ibrutinib in Previously Treated CLL and CLL With 17p Deletion

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 28, 2014, the approved use of ibrutinib (Imbruvica) in...

leukemia
lymphoma

Idelalisib for Relapsed CLL in Combination With Rituximab and for Relapsed Follicular Lymphoma or Small Lymphocytic Lymphoma

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 23, 2014, idelalisib (Zydelig) was approved for  use in...

Prominent Immunotherapy Researcher Sees Success Beyond the Challenges

Activating the immune system for therapeutic benefit in cancer patients has long been a goal in the scientific community. After decades of disappointment, this intriguing approach has come to the forefront of cancer research, showing promising results in several malignancies. To keep abreast of...

integrative oncology

Getting Results: How Oncologists and Pathologists Can Work Together to Facilitate Molecular Testing

Advances in molecular testing mean that highly specific information can be detailed about the molecular characteristics of a patient’s tumor, as well as indications of potential responsiveness to targeted therapy. But getting those detailed results from the pathologists can be a challenge to many...

prostate cancer

Active Surveillance in Low-Risk Prostate Cancer: When Will We Pay It More Than Just Lip Service?

Active surveillance is well established as an appropriate management option for men with low-risk prostate cancer and particularly for those over 65 years of age. Its legitimacy is now enshrined within National Comprehensive Cancer Network guidelines, in the American Society for Radiation Oncology...

breast cancer

Circulating Tumor Cells in Metastatic Breast Cancer: Are We Afraid of the Truth?

All truths are easy to understand once they are discovered; the point is to discover them.” —Galileo Galilei   There are several “truths” in breast oncology that have been discovered over the years, become widely understood, and changed the way we practice. Prospective randomized studies have...

breast cancer

Early Change in Chemotherapy Based on Elevated Circulating Tumor Cells Does Not Improve Outcome in Metastatic Breast Cancer

Elevated circulating tumor cells are associated with poor prognosis in metastatic breast cancer. In a phase III trial (Southwest Oncology Group [SWOG] S0500) reported in Journal of Clinical Oncology, Jeffrey B. Smerage, MD, PhD, Clinical Associate Professor in Medical Oncology at the University of...

breast cancer

Patience Remains a Virtue: The Ongoing Quest to Optimize Adjuvant Endocrine Therapy in Breast Cancer

The most recent ASCO Clinical Practice Guideline update—summarized in this issue of The ASCO Post—represents the latest chapter in the ongoing evolution of adjuvant endocrine therapy for hormone-sensitive breast cancer.1 Rather than including a comprehensive review of the 2010 guidelines, this...

solid tumors

The Evolving Role of Surgery in Germ Cell Tumors

Over the past several decades, the role of postchemotherapy surgery for advanced testicular cancer has evolved with regard to patient selection, surgical planning, lymph node dissection, and surgical technique. To add clarity to this complex clinical setting, The ASCO Post recently spoke with...

prostate cancer

PREVAIL Trial: Enzalutamide Before Chemotherapy Prolongs Survival in Metastatic Prostate Cancer

The androgen-receptor inhibitor enzalutamide (Xtandi) has been shown to prolong survival in men with metastatic castration-resistant prostate cancer with progressive disease after chemotherapy. In the phase III PREVAIL trial reported in The New England Journal of Medicine, Tomasz M. Beer, MD, of...

gastroesophageal cancer

EGFR as a Therapeutic Target for Gastroesophageal Cancer—or Is It Really?

The epidermal growth factor receptor (EGFR) gene is often amplified and its protein overexpressed in upper gastrointestinal cancers—and overexpression has prognostic value. With the advent of monoclonal antibodies and tyrosine kinase inhibitors against EGFR, we have witnessed a rash of randomized...

gastroesophageal cancer
palliative care

No Overall Survival Improvement but Some Palliative Benefit With Gefitinib in Esophageal Cancer Progressing Postchemotherapy

In what may be the first randomized trial of systemic therapy in this setting, Susan J. Dutton, MSc, of University of Oxford, United Kingdom, and colleagues evaluated the epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor gefitinib vs placebo in patients with esophageal cancer...

lymphoma

Rational Strategies Are Advancing Combination Lymphoma Therapies

Rational strategies informed by knowledge of a drug’s molecular mechanisms are helping to bring new combinations of lymphoma therapies to the clinic, according to Anas Younes, MD, Chief of the Lymphoma Service at Memorial Sloan Kettering Cancer Center in New York. The Challenge of Too Many Drugs...

issues in oncology

Precision Medicine: Precisely Where Are We Really?

Having attended ASCO Annual Meetings for almost 40 years, I believe that this year’s 50th anniversary celebration was one of the best ever. In many of the presentations and discussions, I experienced a sense of reality about the true state of cancer management that in previous years has sometimes...

lung cancer

Mixed Results for Targeting MET in Non–Small Cell Lung Cancer

Two different abstracts explored the potential for MET as a therapeutic target in patients with metastatic non–small cell lung cancer (NSCLC), with different results. A phase III study found that onartuzumab, an antibody that targets the MET receptor, combined with erlotinib (Tarceva) was not as...

issues in oncology

Who Will Care for Patients With Cancer?

The workforce numbers show a disturbing trend. According to a recent study by ASCO, by 2025, overall demand for oncology services is projected to grow by 40%, but physician supply is predicted to increase by only 25%, generating a shortage of 2,258 oncologists providing full-time equivalent...

health-care policy

Does the United States Have the Best Health-Care System in the World?

Many concerns were raised and dire speculations predicted during the further implementation of the Affordable Care Act this year. So far, the trickling news is good: An estimated total of 20 million people gained coverage under the new law as of May 1,1 about 6 million enrolled in the law’s...

leukemia
lymphoma

Recent FDA Drug Approvals Foster Growing Treatment Armamentarium for Chronic Lymphocytic Leukemia and Rare B-Cell Lymphomas

Recent approvals announced by the U.S. Food and Drug Administration (FDA) have led to increased treatment options for managing several difficult-to-treat hematologic B-cell cancers. The newly approved drugs and/or their indications include the oral PI3K delta inhibitor idelalisib (Zydelig) for the...

Pioneer in Fight Against Tobacco, Emanuel Farber, MD, PhD, Dies at 85

On December 11, 1969, a soft-spoken pathologist wearing outsized spectacles answered a long and complex series of questions by the legal team representing Liggett & Myers Tobacco Company, the maker of Chesterfield cigarettes. The tobacco lawyers contended that one Leslie Thayer—a lifelong...

survivorship

Cancer Has Given Me Courage

In 1986, I was pregnant with my third child and excited to be interviewing for a job on the assembly line at a General Motors plant near my home in Brodhead, Wisconsin. Hiring requirements included a physical examination and a chest x-ray, which was done by my obstetrician to avoid any radiation...

gynecologic cancers
global cancer care

Gynecologic Cancer Care: Collaboration With Resource-Challenged Ethiopia

Over the past 40 years, largely because of universal Pap screening, cervical cancer deaths have been drastically reduced in the United States and other wealthy industrialized countries. However, cervical cancer is still a leading cause of cancer death among women in resource-challenged areas of the ...

leukemia

Program Offers Unique Intervention for Acute Promyelocytic Leukemia

If Anand P. Jillella, MD, has his way, no future patient with acute promyelocytic leukemia (APL) will experience a delay in treatment or lack for an expert consult—and few, if any, will die of this condition. Mortality from APL is much higher than most oncologists think, especially during the first ...

lung cancer

Phase III Trial of Figitumumab Plus Chemotherapy in Advanced NSCLC Stopped Early for Futility and Increased Harm

In the first phase III trial assessing the combination of an insulin-like growth factor 1 receptor (IGF-1R) inhibitor with chemotherapy as first-line treatment for advanced nonadenocarcinoma non–small cell lung cancer (NSCLC), the addition of the fully human immunoglobulin G2 monoclonal antibody...

gynecologic cancers

Bevacizumab in Persistent, Recurrent, or Metastatic Cervical 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.   On August 14, 2014, bevacizumab (Avastin) was approved for the...

A Conversation With Lidia Schapira, MD, the New JCO Art of Oncology Editor

The popular Art of Oncology (AOO) section of the Journal of Clinical Oncology (JCO) brings a human perspective to the art and science of practicing oncology. Lidia Schapira, MD, FASCO, Assistant Professor at Harvard Medical School and Massachusetts General Hospital, became the Art of Oncology...

leukemia

Protocol Modifications Decrease Toxicity, Increase Event-Free Survival in Children With Down Syndrome Treated for ALL

Protocol modifications to address increased risk of toxicity and excess early mortality among children with Down syndrome being treated for B-cell acute lymphoblastic leukemia (ALL) proved safe for patients with Down syndrome, and these patients had event-free survival similar to those without Down ...

multiple myeloma

Bortezomib Retreatment in 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 August 8, 2014, the approved use of bortezomib (Velcade) in...

multiple myeloma

Treating Multiple Myeloma in 2014

The field of multiple myeloma is rapidly changing, and the shifts that are occurring impact the management of these patients, from initial diagnosis through multiple relapses. At the 9th Annual New Orleans Summer Cancer Meeting, Sergio A. Giralt, MD, Chief of the Adult Bone Marrow Transplant...

lung cancer

Stereotactic Body Radiation Therapy an Effective Option for Early-Stage Lung Cancer Patients

Stereotactic body radiation therapy (SBRT) is safe and effective in early-stage non–small cell lung cancer (NSCLC), as it confers local control in 90% or more patients with T1 disease, according to Roy Decker, MD, PhD, Associate Professor in the Department of Therapeutic Radiology at Yale Cancer...

solid tumors

How Evolutionary Game Theory Is Offering Clues to Disrupt Cancer Cell Metabolism

Kenneth J. Pienta, MD, and his colleagues at Johns Hopkins Medicine in Baltimore are using the principles of evolutionary game theory to learn how cancer cells cooperate within a tumor to gather energy and metastasize. Game theory, the mathematic study of strategic decision-making that is commonly...

lymphoma

Pro-oxidant Molecule Imexon Shows Clinical Activity in Relapsed/Refractory B-Cell NHL

The pro-oxidant molecule imexon (Amplimexon/NSC-714597) produced an overall response rate of 30% in patients with relapsed/refractory B-cell non-Hodgkin lymphoma (NHL) participating in a phase II study. Noting that “lymphoma cells are subject to higher levels of oxidative stress than their normal...

breast cancer

News of Mutations in PALB2 Gene Raising Risk of Breast Cancer Offers Opportunity to Explain Limits of Genetic Testing

The response among patients to news reports about mutations in a gene known as PALB2 raising the risk of breast cancer “has been predictable,” Theodora Ross, MD, PhD, wrote in The New York Times.1 As an example, Dr. Ross, Director of the Cancer Genetics Program at The University of Texas...

issues in oncology

Potential of Liquid Biopsies in Detecting Cancer and Establishing Prognosis

Tests in development to detect circulating tumor cells that escape from solid tumors and travel through the blood, spreading cancer to new sites, may serve as an alternative to conventional tissue biopsy for early cancer diagnosis and gene-expression analysis over the next decade. According to...

issues in oncology
global cancer care
health-care policy

Delivering Cancer Care in Low-Income Countries

In eealthy industrialized nations like the United States, escalating costs of cancer care have put the term “cost-effective care” on the forefront of health-care policy discussions. However, the cost issues we wrestle with in our $3 trillion health-care system are vague abstractions for much of the ...

issues in oncology

Using Electronic Health Records to Improve Communication With Patients

Clinicians may argue that electronic health records (EHRs) interfere with the patient-physician relationship, and patients may complain about “distracted doctors,” too busy with computer screens to make eye contact, but according to Thomas W. LeBlanc, MD, MA, of Duke University School of Medicine...

cns cancers

Gene Therapy Betters Chemotherapy Tolerance, Effectiveness in Small Glioblastoma Study

Using gene therapy and a combination of chemotherapy drugs, researchers at Fred Hutchinson Cancer Research Center have been able to enhance the tolerance and effectiveness of medications used in treating glioblastoma while also protecting healthy cells from their toxic effects. The report,...

Expert Point of View: Karla Kerlikowske, MD

In an accompanying editorial,1 Karla Kerlikowske, MD, of the University of California, San Francisco, and colleagues point out that while the finding of Killelea et al that digital mammography screening was not associated with downstaging of disease may not be surprising, given the similar accuracy ...

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