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Showing 7101 - 7150Striving for Quality, Not Quantity, of Life
Advances in science and medicine have led to humans living longer than at any other time in history. According to a new report1 on mortality from the Centers for Disease Control and Prevention’s National Center for Health Statistics, life expectancy in the United States is at an all-time high of...
The Next-to-Last Frontier in Managing Acute Promyelocytic Leukemia
The treatment of acute promyelocytic leukemia (APL) represents one of the major triumphs in the field of hematologic malignancies. With either the vitamin A derivative all-trans retinoic acid (ATRA) combined with anthracycline-based chemotherapy or ATRA plus arsenic trioxide (Trisenox),...
IMPRESS Trial: Lung Cancer Progression on First-Line Tyrosine Kinase Inhibitor Indicates the Drug Should Be Stopped
The IMPRESS trial found no benefit for continuing treatment with the epidermal growth factor receptor (EFGR) tyrosine kinase inhibitor gefitinib (Iressa, discontinued in the United States) plus chemotherapy vs chemotherapy alone in patients with EGFR-mutated non–small cell lung cancer (NSCLC) who...
Risk of Premature Menopause Raised by Some but Not All Hodgkin Lymphoma Therapies
An analysis of nonsurgical menopause risk among 2,127 women treated for Hodgkin lymphoma found that “risk of premature menopause increased more than 20-fold” after ovarian radiotherapy, alkylating chemotherapy other than dacarbazine, or BEAM (carmustine [BiCNU], etoposide, cytarabine, melphalan)...
Customizing Surveillance Strategy in Patients With Esophageal Adenocarcinoma
A surveillance strategy for patients with esophageal adenocarcinoma treated with chemoradiation and surgery (trimodality therapy) can potentially be customized based on surgical pathology stage, according to an analysis of 518 patients with esophageal adenocarcinoma who underwent trimodality...
South Korean Study Sparks Warnings About the Hazards of Overscreening
An “epidemic of diagnosis” of thyroid cancer is occurring in South Korea and “absolutely could happen here,” according to H. Gilbert Welch, MD, MPH, Professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire. Dr. Welch is coauthor of an article...
Chevalier Jackson, MD, Performing Bronchoscopy, Philadelphia, Circa 1920
The bronchoscope was first used for extracting foreign bodies and the evaluation of infectious processes, especially abscesses. By the end of the twentieth century, the bronchoscope had been determined the single most useful tool for accurate diagnosis of lung cancer. It allowed for the collection...
Bevacizumab Plus Chemotherapy in Platinum-Resistant Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal 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 November 14, 2014, bevacizumab (Avastin) in combination with...
A Good Life, All the Way to the Very End
BOOKMARKTitle: Being MortalAuthor: Atul Gawande, MDPublisher: Metropolitan BooksPublication date: October 7, 2014Price: $26.00; hardcover, 304 pages Mortality is the invisible observer in the oncology exam room. When people hear the three words, “You have cancer,” they see their world as they...
Discussing Cessation of Medications Near the End of Life
Discussions with patients and families about stopping non–cancer-related medications near the end of life are thorny but necessary, according to Arif H. Kamal, MD, of Duke Cancer Institute, at the Best of ASCO meeting in Seattle. “What’s happening now is that a lot of hospices are having a...
How the Earlier Introduction of Palliative Care Improves Quality of Life for Patients With Advanced Cancer
A 4-year study1 involving 461 patients with advanced stages of lung, gastrointestinal, genitourinary, breast, and gynecologic cancers has found that providing early outpatient palliative care vs standard oncology care alone improved quality of life and patient satisfaction. The study participants...
Helping Adolescents and Young Adults Cope With Cancer
Each year, about 70,000 adolescents and young adults (AYAs) are diagnosed with cancer in the United States, almost six times the number of cases diagnosed in children up to 14 years of age. While overall cancer survival rates continue to rise—according to the American Cancer Society, there are...
Study Finds Wide Variation in Quality, Content of Clinical Cancer Guidelines
What’s the best way to treat rectal cancer? Consult any of five top clinical guidelines for rectal cancer and you will get a different answer, according to a new study by researchers at the University of Michigan Comprehensive Cancer Center. Their findings were published online in the journal...
Adding Pan-Deacetylase Inhibitor Panobinostat to Bortezomib and Dexamethasone Improves Progression-Free Survival in Relapsed Myeloma
In the phase III PANORAMA 1 trial reported in The Lancet Oncology, Jesus F. San-Miguel, MD, of Clinica Universidad de Navarra-CIMA, Pamplona, Spain, and colleagues found that adding the pan-deacetylase inhibitor panobinostat to bortezomib (Velcade) and dexamethasone improved progression-free...
Sigmoidoscopy or Colonoscopy for Colorectal Cancer Screening: Is It Still the Question?
Mortality from colorectal cancer remains a public-health concern, being the second leading cause of cancer-related death for men and women combined. The major preventive measure for colorectal cancer is to screen for and remove adenomatous polyps. Average-risk individuals (ie, those who do not have ...
NORCCAP Trial Shows Reduced Colorectal Cancer Incidence and Mortality With Flexible Sigmoidoscopy Screening at 11 Years
The Norwegian Colorectal Cancer Prevention (NORCCAP) trial comparing colorectal cancer screening with flexible sigmoidoscopy vs no screening showed no reduction in colorectal cancer incidence or mortality after 7 years of follow-up. As reported by Øyvind Holme, MD, of Sorlandet Hospital...
The Harvard Global Equity Initiative: From Research to Policy
The Harvard Global Equity Initiative is a research program at Harvard University that is dedicated to promoting equitable global development, with a strong emphasis on health-care issues. This initiative brings together scholars, policymakers, advocates, and practitioners from around the world to...
Tumor Board Participation Associated With Improved Survival in Stage IV Lung and Colorectal Cancers
A large, population-based, observational study suggests that participation in weekly tumor boards can improve outcomes in oncologic care. Specifically, oncologist participation in weekly tumor board meetings was associated with improved survival in patients with stage IV small cell lung cancer and...
Having Dependent Children Motivates Parents With Advanced Cancer to Pursue More Aggressive, Life-Extending Treatments
Findings from a pilot study of 42 parents with advanced cancer indicate that parental status is an important factor in treatment decision-making. When asked how having children influences their treatment decisions, the majority of parents (64%) responded that being a parent motivates them to pursue ...
A National Cancer Database and Cancer Care Quality Improvement
At this year’s Quality Care Symposium, Lawrence N. Shulman, MD, Chief of Staff and Director of the Center for Global Cancer Medicine at Dana-Farber Cancer Institute, Boston, looked at the issue of quality infrastructure development through the prism of several tools developed by the American...
Hormonal Therapy for Early Breast Cancer: Do We Learn From Past Mistakes?
Guidelines can be incorrect if they are not based on incontrovertible evidence. Such was the case with the National Cancer Institute (NCI) 1995 guidelines recommending 5 years of tamoxifen adjuvant therapy for stage I to III hormone receptor–positive breast cancer. With more definitive evidence,...
When Should We Stop Prescribing?
This year’s European Society for Medical Oncology (ESMO) meeting held in Madrid was attended by 19,000 delegates, and it was encouraging to see among that number so many young oncologists being given time off for education and discussion. There has never before been a time when so much new...
Small Risk-Adjusted Variation in Hospital Readmissions Following Colorectal Cancer Surgery
“Little risk-adjusted variation exists in hospital readmission rates after colorectal surgery,” according to an analysis of data from 44,822 patients who underwent colorectal resection for cancer at 1,401 U.S. hospitals between 1997 and 2002. “The use of readmission rates as a high-stakes quality...
Patients With Metastatic Colorectal Cancer Have Improved Outcome With FOLFOXIRI and Bevacizumab
Patients with untreated metastatic colorectal cancer who received FOLFOXIRI (folinic acid, fluorouracil, oxaliplatin, irintotecan) plus bevacizumab (Avastin) had improved survival compared with patients who received FOLFIRI (folinic acid, fluorouracil, irintotecan) plus bevacizumab in a phase III...
Debate Over Legalizing Physician-Assisted Death for the Terminally Ill
On November 1, 2014, 29-year-old Brittany Maynard ended her life through physician-assisted death, reigniting the controversy surrounding Death With Dignity laws, which allow physicians to prescribe life-ending drugs to terminally ill patients. Diagnosed with glioblastoma multiforme in January, Ms. ...
Conquer Cancer Foundation and Michael’s Mission Work Together to Conquer Colorectal Cancer
"Nobody tells a 28 year old to get a colonoscopy.” It’s the sad but true reality that many young adults may be at risk for colorectal cancer. Unfortunately, many people, young adults in particular, are not aware of the risk factors and do not get screened early enough to catch the disease when it...
Phase II Study Shows Improved Survival With Addition of Sargramostim to Ipilimumab in Metastatic Melanoma
Use of the granulocyte-macrophage colony-stimulating factor (GM-CSF) sargramostim (Leukine) together with the cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4) inhibitor ipilimumab (Yervoy) prolonged overall survival but not progression-free survival in patients with metastatic melanoma,...
Crizotinib Is Highly Active in ROS1-Rearranged NSCLC
Crizotinib (Xalkori) produced a high response rate and durable responses in patients with ROS1-rearranged non–small cell lung cancer (NSCLC), according to a study reported in The New England Journal of Medicine.1 Lead authors Alice T. Shaw, MD, PhD, of Massachusetts General Hospital Cancer Center,...
Private Payer and Academic Center Data Capture Inappropriate Use of End-of-Life Care
Data sharing between a comprehensive cancer center and a private insurer appears to be a novel way to capture practice patterns that can point to potential quality improvements. A study that combined data from Dana-Farber Cancer Institute and Blue Cross Blue Shield of Massachusetts showed that some ...
CMS Issues Preliminary Decision to Cover Annual Lung Cancer Screening
In a long-awaited decision, the Centers for Medicare & Medicaid Services (CMS) has issued a preliminary proposal to cover annual lung cancer screening with low-dose computed tomography for appropriate beneficiaries following counseling and a shared–decision-making visit with a qualified...
Mammographic Density Is Highly Heritable, Possibly Explaining the Familial Aggregation of Breast Cancer
Using a fully automated method to ascertain volumetric mammographic density, a study conducted by the Karolinska Mammography (KARMA) project for risk prediction of breast cancer in Sweden confirmed the high heritability of mammographic density, although estimates were weaker for absolute than for...
About 25% of Patients Who Undergo Breast-Conservation Surgery for Stage 0 to II Carcinoma Have Subsequent Surgery
“Approximately one-fourth of all patients who undergo initial breast-conservation surgery for breast cancer will have a subsequent operative intervention,” concluded a study published online by JAMA Surgery. “The rate of repeat surgeries varies by patient, tumor, and facility factors,” reported Lee ...
Clinical Trials Actively Recruiting Children and Young Adults With Cancer
The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies of children and young adult cancer survivors. The studies include phase I, I/II, III, observational, and interventional trials investigating genomic profiling to personalize treatment;...
Life Is Like Riding a Bicycle
The following essay by Bruce D. Cheson, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. The ride...
CDC Awards Grant to Program for Young Women With Breast Cancer at Dana-Farber Cancer Institute
The Centers for Disease Control and Prevention’s (CDC’s) Division of Cancer Prevention and Control has awarded a $1.75 million, 5-year grant to the Program for Young Women with Breast Cancer at Dana-Farber Cancer Institute to increase the awareness of breast cancer among women and enhance the...
Olaparib for BRCA-Mutated Previously Treated Advanced Ovarian 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 December 19, 2014, olaparib (Lynparza) was granted accelerated...
Incorporating Physical Medicine and Rehabilitation Into Palliative Care
Although cancer rehabilitation has been a part of oncology clinical practice for several decades, it has largely gone unrecognized as an integral part of palliative medicine and survivorship care. Now, the role of physical medicine and rehabilitation in oncology care may increase as patients with...
‘Mother of Bone Marrow Transplantation’ Dorothy ‘Dottie’ Thomas Dies at 92
Dorothy “Dottie” Thomas, wife and research partner to 1990 Nobel laureate E. Donnall Thomas, MD, died Friday, January 9, at her home near Seattle. She was 92. Dr. Donnall Thomas, Pioneer of the Bone Marrow Transplant and former Director of the Clinical Research Division at Fred Hutchinson Cancer...
Victory for Pediatric Regimens in Adolescents and Young Adults With ALL
Long in the works, early results of the U.S. Intergroup C10403 trial clearly showed that treating acute lymphoblastic leukemia (ALL) in adolescents and young adults using a pediatric-inspired regimen improves event-free survival and overall survival and should be the backbone for future studies in...
Blinatumomab Achieves Complete Molecular Responses in Majority of B-Cell Leukemia Patients
Results from the international phase II BLAST study show that one cycle of blinatumomab (Blincyto) immunotherapy achieved complete minimal residual disease response in 78% of patients with acute lymphoblastic leukemia.1 Complete minimal residual disease response was achieved in 80% of patients...
No Benefit of Adding Lapatinib to Fulvestrant in Hormone Receptor–Positive Advanced Breast Cancer
In a phase III trial (Cancer and Leukemia Group B [CALGB] 40302/Alliance) reported in the Journal of Clinical Oncology, Harold J. Burstein, MD, PhD, of Dana-Farber Cancer Institute, Boston, and colleagues found that the addition of the dual EGFR-HER2 inhibitor lapatinib (Tykerb) to endocrine...
Lanreotide in Gastroenteropancreatic Neuroendocrine Tumors
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 December 16, 2014, lanreotide (Somatuline depot injection) was ...
Nivolumab Improves Outcomes vs Dacarbazine in Previously Untreated Advanced Melanoma Without a BRAF Mutation
In a phase III trial reported in The New England Journal of Medicine, Robert and colleagues found that the programmed cell death protein-1 (PD-1) immune-checkpoint–inhibitor antibody nivolumab (Opdivo) significantly increased overall survival, progression-free survival, and objective response rate...
Ultrasonography Detects Mammographically Occult Invasive Cancers
Mammograms often miss occult breast cancers concealed in dense breasts. Women with dense breasts represent about 40% to 50% of women who undergo mammography screening. In some states and centers in the United States, women with dense breasts are routinely offered ultrasonography following a...
Nab-Paclitaxel Boosts Pathologic Complete Response in High-Risk Breast Cancer
Nab-paclitaxel (Abraxane) achieved superior results compared with conventional solvent-based paclitaxel in patients with early-stage high-risk breast cancer in the large phase III GeparSepto trial from the German Breast Group (GBG).1 The study, presented at the 2014 San Antonio Breast Cancer...
Expert Point of View: Benjamin O. Anderson, MD
Commenting on this study, Benjamin O. Anderson, MD, Director of the Breast Health Clinic, Seattle Cancer Care Alliance, Washington, said: “This new analysis of the Oncotype DX DCIS assay strengthens the findings of earlier studies performed in more limited subgroups, validating that the assay...
No Benefit for Adjuvant Capecitabine Monotherapy in Elderly Patients With Early-Stage Breast Cancer
Adjuvant therapy with capecitabine plus ibandronate failed to improve outcomes vs ibandronate alone in elderly patients with moderate-to-high-risk early-stage breast cancer in the ICE study—the largest study to date conducted in elderly women with breast cancer.1 “Capecitabine is frequently used in ...
Top 10 Myths About FDA’s Office of Hematology and Oncology Products
INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, FDA oncologists Gideon Blumenthal, MD, and Tatiana Prowell, MD, discuss 10 common myths about FDA’s Office of Hematology and Oncology ...
Anti–PD-1 Antibody Nivolumab in Previously Treated Unresectable or Metastatic 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. On December 22, 2014, the anti–PD-1 (programmed cell death...
ASCO and AACR Call for Regulation of E-Cigarettes and Other Electronic Nicotine Delivery Systems
The American Association for Cancer Research (AACR) and ASCO have outlined steps in a joint statement to guide policymakers as they work to minimize the potential negative consequences of electronic cigarettes (e-cigarettes) and other electronic nicotine delivery systems without undermining their...
