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Ambitious Call to Arms Seeks a Shift in Priorities to Eradicate Cancer

It has been more than 4 decades since our nation loaded its medical cannons and declared war on cancer, self-assured that money and American scientific resolve would lead to victory. But cancer has proved to be a humbling enemy. The war is now fought in targeted skirmishes; the weaponry is a...

issues in oncology
cost of care
health-care policy

The Ethics of Rationing Cancer Care

Should cost be a consideration when deciding on treatment for patients with cancer, and if so, what kind of ethical dilemma does that pose for oncologists? With U.S. spending on oncology drugs expected to climb more than 20% annually over the next decade—reaching $173 billion by 2020, according to...

health-care policy

How Sequestration May Affect Cancer Research

Senator Sherrod Brown (D-Ohio) began his political career in 1974 as a state representative in Ohio. He served as Ohio’s Secretary of State between 1983 and 1991, went on to serve in the U.S. Congress from 1993 to 2006, and was elected to the Senate in 2006. A supporter of biomedical and cancer...

Gene-expression Profiles of Triple-negative Breast Cancers Differ between African American and Native African Women

Triple-negative breast cancers in African-American women and native African women have differing gene-expression profiles that may have implications for treatment, according to the first study to directly compare tumor gene expression between these populations. Results were reported at the Fifth...

Screening for Ovarian Cancer: A Gynecologic Oncologist’s Perspective

The recent U.S. Preventive Services Task Force (USPSTF) Reaffirmation Recommendation Statement concluded that in the population of asymptomatic women without known genetic mutations that increase risk for ovarian cancer, clinicians should not screen for ovarian cancer using transvaginal ultrasound...

leukemia

Chlorambucil, but Not Fludarabine, Confers Significant Benefit in Older Patients with CLL

Among patients aged 70 years and older with chronic lymphocytic leukemia (CLL), “front-line therapy with fludarabine does not improve outcomes” compared to chlorambucil (Leukeran), according to an analysis of patients enrolled in successive front-line Cancer and Leukemia Group B (CALGB) studies...

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

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...

issues in oncology

Are We Winning the War on Cancer?

On December 23, 1971, President Richard Nixon signed the U.S. National Cancer Act. This date is widely considered to mark the beginning of the so-called “War on Cancer,” although that phrase was introduced only later on. Over recent decades, journalists have from time to time questioned whether we...

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...

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...

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...

kidney cancer

PET/CT With 124I-Girentuximab Can Identify Clear Cell Renal Cell Carcinoma While Minimizing Invasive Diagnostic Risks 

Positron-emission tomography/computed tomography (PET/CT) with iodine-124 (124I) –girentuximab “can accurately and noninvasively identify” clear cell renal cell carcinoma, according to a phase III multicenter study reported in the Journal of Clinical Oncology. In addition, “PET/CT with...

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...

solid tumors
pancreatic cancer

Finding New Strategies to More Effectively Treat Pancreatic Cancer

While some progress has been made in understanding the molecular pathogenesis, genetic risk factors, and genomics of pancreatic adenocarcinoma, the disease remains one of the most challenging malignancies. According to Surveillance, Epidemiology, and End Results (SEER) figures, 44,000 people were...

health-care policy
legislation

Focus on the Louisiana Oncology Society 

Founded on September 1, 1992, by John M. Rainey, MD, the Louisiana Oncology Society has had numerous legislative successes (see sidebar) since that time, including leading the effort to support Louisiana’s Oral Chemotherapy Parity Law, which was passed in 2012 and is now in effect throughout the...

colorectal cancer

CT Colonography Reconsidered

The parallel SIGGAR trials recently published in Lancet add to the growing body of literature regarding the utility of computed tomographic (CT) colonography in the detection of colorectal polyps and cancers. These papers reinforce the results seen in other large multicenter trials1-3 and echo the...

NCCN Adds Two New Member Institutions

The National Comprehensive Cancer Network (NCCN) recently announced the addition of two new NCCN Member Institutions: UC San Diego Moores Cancer Center in La Jolla, California, and the University of Colorado Cancer Center in Aurora, Colorado. “We are extremely pleased that UC San Diego Moores...

prostate cancer

SIDEBAR: Two Caveats on the PCOS Follow-up 

Dr. Resnick and colleagues are to be congratulated for following men on the PCOS study out to 15 years. The main result—“At 15 years, no significant relative differences in disease-specific functional outcomes were observed among men undergoing prostatectomy or radiotherapy”—should be interpreted...

survivorship

Sexual Health after Cancer: Communicating with Your Patients 

Studies show virtually all cancer survivors will experience some form of sexual dysfunction following a cancer diagnosis and treatment. Yet few cancer survivors seek help for physical problems they may be experiencing, such as vaginal dryness, dyspareunia, chemically induced menopause, reduced...

hematologic malignancies
leukemia

A Promising New Agent's Road to Approval in CLL Raises Questions, Stirs Controversy 

Early trial results in single-agent therapy with the oral Bruton’s tyrosine kinase (BTK) inhibitor ibrutinib have produced excellent responses in patients with chronic lymphocytic leukemia (CLL). Moreover, ibrutinib is extremely well tolerated, allowing patients to remain on trial and receive the...

solid tumors
colorectal cancer

More Recreational Physical Activity Associated with Reduced All-cause Mortality in Patients with Colorectal Cancer 

In a study recently reported in Journal of Clinical Oncology, Peter T. Campbell, PhD, and colleagues from the Epidemiology Research Program of the American Cancer Society, Atlanta, found that more recreational physical activity before and after a diagnosis of colorectal cancer was associated with...

skin cancer

Sentinel Node Biopsy in Melanoma: Essential or Optional? 

Is sentinel node biopsy in melanoma an essential component of care? Despite a large multinational trial and recently published or updated guidelines, the question is still a thorny one according to experts who debated the issue at the recent meeting of the Society of Surgical Oncology in...

pancreatic cancer

The Intriguing Potential of S-1 in Pancreatic Cancer 

The results of the GEST study by Ueno and colleagues add to the intriguing potential role of the oral fluoropyrimidine S-1 in the treatment of pancreas adenocarcinoma. S-1 is a three-component drug consisting of tegafur (a prodrug of fluorouracil), gimeracil (5-chloro-2,4 dihydropyridine, or CDHP,...

gynecologic cancers

Lynch Syndrome: A Multitude of Predispositions 

The current uncertainty regarding the relative frequencies of cancers of various anatomic sites in Lynch syndrome poses a difficulty in commenting on the syndrome’s overall cancer spectrum. It is even more vexing to address the order in which these cancers are prone to occur. What we do know is...

hematologic malignancies
leukemia

Preliminary Progress with Genetically Engineered T Cells in Treating Childhood ALL 

Two small phase I studies at separate centers demonstrated encouraging results in the treatment of children with acute lymphoblastic leukemia (ALL) using reinfused autologous genetically engineered T cells. Results of both studies were presented at the Annual Meeting of the American Association for ...

issues in oncology

Women in Oncology: Trending in the Right Direction 

According to ASCO President ­Sandra M. Swain, MD, FACP, an important part of her Presidential theme, “Building Bridges to Conquer Cancer,” is finding creative ways to ensure that we have enough oncologists to care for our burgeoning cancer patient population. Adding more women to the oncology...

A New Center for Lymphoid Malignancies Aims to Provide Precision Patient Care  

In January, New York-Presbyterian Hospital/Columbia University Medical Center opened the Center for Lymphoid Malignancies, a 3,700 square foot outpatient clinic, in the heart of Midtown Manhattan. The Center is solely focused on the treatment of all forms of Hodgkin and non-Hodgkin lymphoma,...

Focus on the Georgia Society of Clinical Oncology 

With a roster of over 600 members that includes community and institutional oncologists, administrators, registered nurses, and patient navigators, the Georgia Society of Clinical Oncology (GASCO) is one of ASCO’s largest State Affiliates. Founded in 1986, the Atlanta-based Society is active in...

issues in oncology

Financial Revamping of Medical Education 

The American medical education system was in a state of crisis in 1910 when Abraham Flexner published his treatise, Report on Medical Education in the United States and Canada (Carnegie Foundation Bulletin Number Four).1 A century later, we face another crisis in medical education—not in terms of...

breast cancer

Cognitive Complaints after Breast Cancer Treatment and Neuropsychological Testing

About one in five patients who had completed primary breast cancer treatments but had not started endocrine therapy “had elevated memory and/or executive function complaints that were statistically significantly associated with domain-specific” neuropsychological test performances and depressive...

lymphoma

Déjà Vu Redux: Lessons from the SWOG-8516 Study in Aggressive Lymphomas

Joseph M. Connors, MD, authored a commentary in the June 25 issue of The ASCO Post inspired by a recent New England Journal of Medicine publication on dose-adjusted EPOCH-R chemotherapy (etoposide, prednisone, vincristine, cyclophosphamide, doxorubicin, and rituximab) for primary mediastinal B-cell ...

prostate cancer

Seeking Clarity on the PSA Story

My feature interview in the August 15, 2012, issue of The ASCO Post, entitled “Rethinking the Role of PSA Screening in Public Health”1 drew swift reaction from well-known figures in the prostate cancer field. The subsequent Letters to the Editor, three in all, constituted a two-pronged attack. They ...

supportive care

FDA Issues Warning on Rare but Serious Skin Reactions with Acetaminophen

The FDA recently issued a warning that acetaminophen has been associated with a risk of rare but serious skin reactions.  These skin reactions, known as Stevens-Johnson Syndrome, toxic epidermal necrolysis, and acute generalized exanthematous pustulosis, can be fatal.  Serious Adverse Reactions FDA ...

survivorship

Living and Working with Cancer 

The most recent figures from the National Cancer Institute put the number of cancer survivors in the United States at nearly 14 million—by 2022, that number is expected to top 18 million. And for the vast majority of those survivors—more than 80%—returning to work after treatment is a top priority...

breast cancer
colorectal cancer
lymphoma

ASCO Studies Support Limited Use of 'Routine' Imaging 

The overuse of imaging in oncology workup and surveillance is a timely concern, as health-care dollars shrink and the risk for second malignancies becomes clearer. At this year’s ASCO Annual Meeting, several studies showed that although many routine imaging studies may be unnecessary, physicians...

lymphoma

PET/CT Superior to Bone Marrow Biopsy for Diagnosis, Prognosis in Lymphoma 

A more precise method for determining bone marrow involvement in patients with diffuse large B-cell lymphoma has been identified by researchers in a study published recently in The Journal of Nuclear Medicine.1 Imaging with 18F–fluorodeoxyglucose positron-emission tomography/computed tomography...

issues in oncology

Molecular Tests and Precision Medicine: Not So Fast Now!

The era of the application of genomic, proteomic, and a host of other “omic” analyses to guide decision-making in the therapeutic selection of drugs and biologics is now a key part of cancer care. Medical practice is working to keep up with the scientific advances, evaluate them, and add a variety...

cost of care

Oncologists Speak Out Against the High Cost of Cancer Drugs 

That the United States spends twice as much on health care than other industrialized countries—about $2.8 trillion in 2012—without reaping appreciably better outcomes1 is not news. The topic has been dissected on the front pages of leading newspapers for years and was the subject of the entire...

lung cancer

Non–Small Cell Lung Cancer Maintenance Therapy: None, Single Agent, Multiple Agents? 

Barlesi et al have reported results of a randomized trial comparing bevacizumab (Avastin) vs pemetrexed (Alimta)/bevacizumab as maintenance therapy in patients with stage IV nonsquamous cell non–small cell lung cancer (NSCLC). It is important to consider their observations in relation to data from...

lung cancer

Paul A. Bunn, Jr, MD, Offers Insights About a Hopeful Era in Lung Cancer Treatment 

The treatment of non–small cell lung cancer (NSCLC) is rapidly evolving as molecular targets are being refined and targeted drugs are designed to combat acquired resistance. In his State of the Art Lecture at the 14th International Lung Cancer Congress, Dr. Bunn, Professor of Medicine and the James ...

skin cancer

What Is the Optimal Treatment of Advanced Melanoma?  

With exciting targeted and immunotherapeutic agents now part of the arsenal for metastatic melanoma, which drug should move to the head of the line? Mario Sznol, MD, Professor of Medicine at Yale University School of Medicine, New Haven, Connecticut, has been involved in key clinical trials of the...

breast cancer

Alcohol Consumption Between Menarche and Pregnancy and Breast Cancer Risk: Factors in Risk Accumulation   

In a study recently published in the Journal of the National Cancer Institute and summarized in this issue of The ASCO Post, we found a relationship between alcohol intake between menarche and first pregnancy and risk for breast cancer. Placing this study in context can help us interpret the data...

breast cancer

What Is on the Horizon in the Management of Breast Cancer? 

In Keynote Lectures during the 2013 ASCO Breast Cancer Symposium, experts George Sledge, MD, and Monica Morrow, MD, offered their opinions and outlook on how the medical and surgical management of breast cancer may continue to evolve over the next 5 to 10 years.1 Dr. Sledge is Chief of Oncology at...

ASCO Reconfirms Commitment to Choosing Wisely® Campaign 

In collaboration with the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely® campaign, ASCO recently released a second “Top Five” opportunities list of common practices or procedures in oncology whose clinical value is not supported by available evidence and if eliminated, can ...

breast cancer

Nodal Status and Tumor Size Predicted Late Recurrences of ER-Positive Breast Cancer in Postmenopausal Women 

Only nodal status and tumor size provided statistically significant prognostic information for predicting recurrences 5 to 10 years after diagnosis for postmenopausal women with early estrogen receptor–positive breast cancer enrolled in the monotherapy arms of the ATAC (Arimidex, Tamoxifen, Alone...

A New Gift to Add to Your List—One to Conquer Cancer

Conquering cancer requires the commitment, talent, and resources of all members of our community. It requires the innovation of researchers and the insight of clinicians, the courage of our worldwide community of patients and survivors, and it requires the generosity of everyone who believes in a...

pancreatic cancer

Long-Term CONKO-001 Results: Adjuvant Therapy Improves Survival 

From 12% to 15% of the approximately 45,000 patients diagnosed with pancreas adenocarcinoma undergo a potentially curative resection each year in North America, translating into roughly 5,000 to 7,000 patients who are candidates for adjuvant therapy. About 80% of these patients will relapse and...

lymphoma

Brentuximab Vedotin Improves Response Rates to ABVD in Hodgkin Lymphoma

For the front-line treatment of advanced Hodgkin lymphoma, ABVD is a standard treatment, but not all patients have good outcomes with this regimen. The addition of brentuximab vedotin (Adcetris), or its substitution for bleomycin, produces high complete response rates but with a moderate increase...

health-care policy
cost of care

Innovative Payment Models Needed to Sustain Quality Cancer Care  

Nationally regarded health-care expert Lee N. Newcomer, MD, MHA, began his presentation at this year’s ASCO Quality Care Symposium with a rhetorical question. “Why are we talking about money when we’re gathered in San Diego for 2 days to discuss some wonderful ways to impact the quality of cancer...

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