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palliative care
skin cancer
issues in oncology

Blood Test That Monitors ctDNA Better Than the Standard in Tracking Metastatic Melanoma

Physicians treating patients with metastatic melanoma may soon have a superior tool in their efforts to closely track the disease. A new study shows that a blood test that monitors blood levels of DNA fragments from dead cancer cells does a better job than the current standard test at tracking the...

gynecologic cancers
gynecologic cancers
issues in oncology

Study Shows ACA Coverage Expansion Resulted in Increased Cervical Cancer Diagnosis at Early Stage in Young Women

In a study reported in a research letter in JAMA, Robbins et al found evidence that the Affordable Care Act Dependent Coverage Expansion (ACA-DCE) has resulted in increased diagnosis of cervical cancer at an early stage and increased use of fertility-sparing treatments in women aged 21 to 25 years. ...

skin cancer

LETTER TO THE EDITOR: Adjuvant Therapy in Cutaneous Melanoma: The Need for a New Approach

Melanoma of the skin remains a fatal disease, and its incidence continues to rise, mostly in young adults during their prime. Surgery remains the most effective therapeutic modality, but patients’ survival depends on the stage of the disease at the time of diagnosis. Various therapeutic agents have ...

prostate cancer

Death Rates Significantly Reduced for Men Having Radical Prostatectomy vs Watchful Waiting

Estimated 15-year results from the Scandinavian Prostate Cancer Group Study (SPCG-4) show that men diagnosed with early prostate cancer and randomly assigned to radical prostatectomy continued to have significantly reduced rates of death from prostate cancer, death from any cause, and risk of...

Breast Cancer Symposium to Offer Uniquely Interdisciplinary Approach for Attendees

Many breast cancer–focused meetings and conferences are held each year, but the Breast Cancer Symposium, which takes place this year in San Francisco, September 8–11, is one of the few that takes an interdisciplinary approach to delivering practical, how-to clinical information for attendees from...

ASCO Launches Initiative to Showcase Progress Against Cancer

To demonstrate the value of the U.S. clinical cancer research system and the urgent need to strengthen and support clinical trials, a new ASCO website highlights the great progress made in clinical cancer research since the signing of the National Cancer Act in 1971. Over the past 40 years, major...

SIDEBAR: Nonrandomized Analysis Viewed with Skepticism

The findings from Grumley et al contradict the results from randomized trials of lumpectomy vs lumpectomy and radiotherapy for ductal carcinoma in situ (DCIS) and highlight the potential pitfalls of retrospective analyses. The meta-analysis of the DCIS trials revealed a significant 54% reduction in ...

breast cancer

‘Paradoxical’ Result Tying Estrogen to Reduced Risk of Breast Cancer Is Consistent with Laboratory Data

Results from the Women’s Health Initiative1 showing a decreased incidence of breast cancer among postmenopausal hysterectomized women who took estrogen replacement therapy (ERT) may seem paradoxical, but “comply exactly” with laboratory research, according to V. Craig Jordan, OBE, PhD, DSc,...

Expert Point of View: Cabozantinib Broadly Active in Multiple Tumor Types

Mark G. Kris, MD, Chair of the ASCO Cancer Communications Committee, commented at the press briefing that the study represents “an example of the evolution of targeted cancer therapies in that we are seeing early signs of benefit by going after multiple targets in the cancer cell. We saw important...

health-care policy

Opinion: The FDA–Pharmaceutical Industry Complex

On January 17, 1961, President Dwight D. Eisenhower, in his farewell address to the nation, coined the term “the military-industrial complex.” His purpose was to warn of the inefficiencies that could result from such a relationship, which would imperil the strength of our military and the safety of ...

gynecologic cancers

Cancer Diagnosis Can Spark Worry over Numerous Health Concerns

The early discovery of my endometrial cancer is a prime example of the health rewards you can reap if you are lucky enough to have good medical care and a dogged physician. Long past menopause, I wasn’t experiencing any of the typical warning signs of the disease—vaginal bleeding or pelvic...

skin cancer

Changes Introduced to Better Inform Consumers about Sunscreen

The FDA announced that sunscreen products meeting modern standards for effectiveness may be labeled with new information to help consumers find products that, when used with other sun protection measures, reduce the risk of skin cancer and early skin aging, as well as help prevent sunburn. The...

lung cancer

Understanding Crizotinib, 1 Year after High-profile Presentation

The findings from a phase I study of crizotinib in non–small cell lung cancer (NSCLC) were presented in a Plenary Session at the 2010 ASCO Annual Meeting—an unusual event, since such early-phase data are not generally the topic of plenary sessions. The study showed that a majority of mostly...

symptom management

Vanderbilt Oncologists Partner with Cardiologists to Research Chemotherapy-related Cardiac Toxicity

Cardiac toxicity related to chemotherapy is not a new topic but it is an increasingly important one, as concerns are no longer limited to the anthracyclines. Targeted agents unfortunately “target” the cardiovascular system as well, especially bevacizumab (Avastin), trastuzumab (Herceptin) when...

leukemia

Plenary Report: High-dose Methotrexate Improves Outcome for High-risk Acute Lymphoblastic Leukemia in Younger Patients

High-dose methotrexate achieved superior event-free survival rates compared with standard Capizzi (escalating) methotrexate treatment in children and young adults with high-risk acute lymphoblastic leukemia (ALL), according to a practice-changing study reported during the Plenary Session of the...

Bequest from Dr. Nora Janjan and Jack Calvin Supports Conquer Cancer Foundation’s Work in Palliative Care

For Nora Janjan, MD, MPSA, MBA, the practice of oncology is rooted in purpose, empathy, and trust. “You walk into the hospital and you know exactly why you’re there,” she says. “You are there to help patients and their loved ones through probably the most difficult experience that they will ever...

lymphoma

Important Briefs: Lymphoma Research on Improved Chemotherapy, Biomarker Associations, and Stem Cell Transplant Approaches

The 11th International Conference on Malignant Lymphoma was held June 15–18 in Lugano, Switzerland. More than 3,000 hematologists, clinical oncologists, pathologists, and researchers attended the meeting, which was first convened in 1981. Topics of discussion included lymphoma staging in the new...

colorectal cancer

Smoking and Lack of Exercise Increase Risk of Some Cancers, but Moderate Alcohol Consumption Reduces Colon Cancer Risk

A substudy of the large prospective National Surgical Adjuvant Breast and Bowel Project (NSABP) Breast Cancer Prevention Trial revealed both expected and surprising findings related to the association between lifestyle factors (cigarette smoking, alcohol, and exercise) and cancer risk. As might be...

hematologic malignancies

On William Osler: The Old Art and the New Science

William Osler (1849–1919) is one of the most revered physicians in the history of medicine. He was an outstanding clinician who emphasized bedside teaching, hard work, medical history, and lifelong learning.1 As Professor of Medicine at four institutions in three countries, he exerted a profound...

Expert Point of View: Longer Imatinib Treatment Is Better in High-risk GIST

Charles D. Blanke, MD, Chief of Medical Oncology at the University of British Columbia in Vancouver, critiqued the SSGXVIII study, noting its “goals were reasonable and the methodologies for primary and secondary objectives were sound. The conclusion regarding recurrence-free survival is valid, as...

Expert Point of View: Novel Agents Improve Survival in Patients with Metastatic Melanoma

Discussing the melanoma studies at the Plenary Session, Kim Margolin, MD, of the University of Washington Fred Hutchinson Cancer Research Center in Seattle, noted that while the new therapies are welcomed, they are not without their challenges. “Ipilimumab now shows a survival benefit in...

skin cancer

Novel Agents Improve Survival in Patients with Metastatic Melanoma

Novel treatments for metastatic melanoma dominated the buzz at the 2011 ASCO Annual Meeting and across the major news outlets, with reports that two agents with entirely different mechanisms of action could extend survival. The studies’ inclusion in the ASCO Plenary Session attested to the...

breast cancer

Stalked by Cancer: One Woman’s Story

Cancer has been stalking me all my life. My mother’s mother had died of breast cancer at a relatively young age. My mother was diagnosed with breast cancer in the early 1960s, when she was 35 and I was just 5 years old. Although she was told that she probably wouldn’t live more than 2 years, she...

issues in oncology

A Conversation with David Henry, MD

Given the intricate nature of oncology workflow, terminology, cancer staging, and the high risk associated with chemotherapy administration, an oncology electronic medical record (EMR) system needs to be much more than a storehouse of patient information. According to David Henry, MD, Clinical...

prostate cancer

Cabozantinib Shows Encouraging Activity in Metastatic Castrate‑resistant Prostate Cancer

Cabozantinib, a dual inhibitor of MET kinase and the vascular endothelial growth factor (VEGF) receptor, exhibits high, early single-agent activity in men with metastatic castrate-resistant prostate cancer, according to Maha Hussain, MD, FACP, who presented these findings at the 2011 ASCO Annual...

issues in oncology

Is Subspecialization an Option or a Necessity in Community Practices?

Should oncologists in community practices subspecialize? What would that mean for them and for their patients? These are some of the issues tackled in a Journal of Oncology Practice (JOP) Strategies for Career Success article entitled “Subspecialization in Community Oncology: Option or Necessity?”...

global cancer care

A Prominent Oncologist Retraces Her Steps from Baghdad

Maha Hussain, MD, FACP, Professor of Medicine and Urology, is the Associate Director for Clinical Research at the University of Michigan Comprehensive Cancer Center (UMCCC) and Co-leader of its Prostate Cancer/GU Oncology program. Dr. Hussain recently spoke with The ASCO Post about becoming a...

Stephen Cannistra, MD, Takes Over as Editor-in-Chief of Journal of Clinical Oncology

Since 1989, Stephen Cannistra, MD, has been working to make the Journal of Clinical Oncology (JCO) the most credible, authoritative resource for disseminating significant clinical oncology research while acting as a reviewer, Consultant Editor, Associate Editor, Editorial Board Member, and as of...

SIDEBAR: Early Clinical Findings with JAK2 Inhibition

Two small preliminary studies of JAK2 inhibitors CYT387 and SB1518 had encouraging results in patients with myelofibrosis, and these studies were reported in poster presentations at the Annual Meeting.1,2 Both drugs reduced splenomegaly and achieved improvement in constitutional symptoms. SB1518...

hematologic malignancies

Novel JAK Inhibitor May Be an Option for Patients with Myelofibrosis

A new approach to treating myelofibrosis appears to be paying off, according to several studies presented at the 2011 ASCO Annual Meeting. Treatment with a novel JAK inhibitor called ruxolitinib demonstrated significant and sustained improvement in splenomegaly and overall quality of life,...

Expert Point of View: Maintenance Therapy Prolongs Progression-free Survival in Advanced NSCLC but Produces No Overall Survival Benefit

Maintenance therapy in NSCLC is an ever-contentious issue,” stated formal discussant of these trials, Martin Edelman, MD, University of Maryland Greenebaum Cancer Center, Baltimore, at the ASCO Annual Meeting. “The maintenance approach is based on two observations: limited benefit from more than...

lung cancer

Emerging Targeted Therapies Offer Glimmer of Hope for NSCLC but Biomarkers for Response Needed

Among the newer approaches to treatment of non–small cell lung cancer (NSCLC) are heat-shock protein 90 (Hsp90) inhibitors, toll-like receptor 2 (TLR2) agonists, and vascular-disrupting agents. So far, none appears to be a “home run,” but Hsp90 inhibition may be the most promising of the three...

health-care policy

Conflicts of Interest in Health-care Reform?

Last year’s health-care reform legislation, the Patient Protection and Affordable Care Act, was designed to incrementally roll out major new bureaucratic entities, oversight, and mandates for the practice of medicine between its enactment and 2013, after the next presidential election. A new...

breast cancer

Exemestane Prevents Invasive and Preinvasive Breast Cancers in MAP.3 Trial

The aromatase inhibitor exemestane, taken for 5 years, significantly reduced invasive and preinvasive breast cancers in postmenopausal women at increased risk for the disease, in the large Canadian NCIC CTG MAP.3 randomized trial. Results of the trial were presented at the recent ASCO Annual...

breast cancer

Higher Risk of Recurrence for Triple-negative Breast Cancer after Modified Radical Mastectomy without Radiation

“The paucity of therapeutic options” for women with triple-negative breast cancer “emphasizes the urgent need to optimize the current locoregional management of patients with [triple-negative breast cancer] and reduce their risk of locoregional recurrence,” noted the authors of a Canadian study...

integrative oncology

A Conversation with Barrie R. Cassileth, PhD

Barrie R. Cassileth, PhD, Chief, Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center (MSKCC) in New York, recently spoke with The ASCO Post about her quest to stamp out the illegitimate use of alternative medicine in cancer care and the results from her latest research. A...

SIDEBAR: Timing of Prostate Cancer Drugs: Earlier But Not Too Early?

While sipuleucel-T, abiraterone, and cabazitaxel have been approved for patients with advanced disease, they might also be used in patients with earlier-stage disease, according to Christopher J. Logothetis, MD, of MD Anderson Cancer Center. “I think it is fair to say that they will be used better...

prostate cancer

Optimizing Treatment for Advanced Prostate Cancer Requires Shifting Focus from Individual Drugs to Integrated Therapies

Newer drugs, including sipuleucel-T (Provenge), cabazitaxel (Jevtana), and abiraterone (Zytiga), can extend survival modestly and ease symptoms for men with advanced prostate cancer. Maximizing the benefit to patients will require shifting the focus from developing individual drugs to developing...

supportive care

Evaluating Risk for Suicide in People Diagnosed or Living with Cancer

The challenges of life-threatening physical illness can sometimes lead to suicide. In fact, given the critical stressors that a person with cancer faces, we might expect suicide to be a more common reaction. Patients with cancer are at increased risk of completed suicide, though the prevalence of...

issues in oncology

FDA Issues Guidance for Diagnostic Tests Used with Targeted Therapies

The FDA issued a new draft guidance to facilitate the development and review of “companion diagnostics”—tests used to help health-care professionals determine whether a patient with a particular disease or condition should receive a particular drug therapy or how much of the drug to give. The draft ...

prostate cancer

Intermittent or Continuous Androgen Suppression Produces Comparable Survival after Radical Therapy in Prostate Cancer

Men with prostate cancer who receive intermittent courses of androgen-suppressing therapy can live as long as those who are treated with continuous therapy, according to results of a recently concluded study. Until now, standard treatment has consisted of continuous therapy, but this is expected to ...

gynecologic cancers

Bevacizumab Makes Inroads against Ovarian Cancer

Bevacizumab (Avastin) administered with chemotherapy and continued after chemotherapy improves outcomes in ovarian cancer, according to two multicenter, randomized, double-blind phase III investigations presented at the 2011 ASCO Annual Meeting. The first study, ICON7, incorporated bevacizumab as...

Expert Point of View: Patients with Early Breast Cancer Benefit from Regional Nodal Irradiation

Thomas Buchholz, MD, of the University of Texas MD Anderson Cancer Center, Houston, commented that the “well conducted and analyzed” MA.20 study addressed a “simple clinically relevant question,” and the findings “add to the conclusive evidence that radiation eradication of local-regional...

breast cancer

Patients with Early Breast Cancer Benefit from Regional Nodal Irradiation

Findings from a Canadian study presented at the 2011 ASCO Annual Meeting may expand the pool of patients with lymph node–positive breast cancer offered extended-field irradiation.1 “Results from MA.20 suggest that all women with node-positive disease following breast-conserving surgery be offered...

cost of care
health-care policy

Rising Costs of Cancer Care: It's More Than Drugs

All parties—the government, payers, and consumers—agree that, left unchecked, rising health-care costs will eventually hamstring vital portions of our delivery system. For example, Medicare, which covers more than 50% of the nation’s patients with cancer, is marching headlong toward insolvency....

lung cancer

A Landmark Lung Screening Trial: What Does It Mean for Clinicians and Their Patients?

The NCI-funded National Lung Screening Trial (NLST), published recently in The New England Journal of Medicine,1 was heralded as a landmark study in lung cancer detection. This study is the first comprehensive clinical trial to find that screening high-risk individuals with low-dose CT reduces lung ...

colorectal cancer

Surgical Site Infections after Colectomy More Likely in Obese Patients

Obese patients appear to have a significantly increased risk of developing a surgical site infection after segmental or total colectomy for colon cancer, diverticulitis, or inflammatory bowel disease, and the presence of infection increases the cost associated with the procedure, according to a...

issues in oncology

‘Unrealistic Optimism’ Poses Ethical Challenges, May Affect Informed Consent Process

Does a patient’s optimistic expectation of reaping a health benefit from participating in phase I and phase II oncology studies, even when he understands that these early trials are not designed to provide direct therapeutic benefit, compromise the informed consent process? And, does that...

issues in oncology

Research in Combining Targeted Agents Faces Numerous Challenges

If the clinical trials endeavor in oncology is falling short of its goals and if targeted agents have not kept their promise, can a new approach to drug development provide a solution? Very possibly, said John Hohneker, MD, Chair of the Workshop Planning Committee for the conference, “Facilitating...

ASCO Examines Impact of Health-care Reform on Cancer Care Disparities

In a new policy statement, ASCO outlines specific provisions of the 2010 Patient Protection and Affordable Care Act that have the potential to reduce cancer care disparities. ASCO’s statement makes recommendations to ensure that such provisions are carried out effectively, and urges additional...

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