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gynecologic cancers

Bevacizumab in Ovarian Cancer: Results of ICON7

Based on preclinical (in vitro and in vivo) data, there is a strong biologic rationale for the addition of an antiangiogenic drug strategy in the treatment of epithelial ovarian cancer.1 Single-agent trials have confirmed both the biologic and clinical activity of bevacizumab (Avastin) in the...

lung cancer

Pembrolizumab in Previously Treated PD-L1–Positive Metastatic NSCLC

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 October 2, 2015, the U.S. Food and Drug Administration granted...

skin cancer

Nivolumab in Combination With Ipilimumab in BRAF V600 Wild-Type 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 September 30, 2015, the U.S. Food and Drug Administration...

issues in oncology

Maternal Cancer During Pregnancy Does Not Appear to Affect Cognitive or General Development in Early Childhood

In a study reported in The New England Journal of Medicine, Frederic Amant, MD, PhD, of University Hospitals Leuven, Belgium, and colleagues in the International Network on Cancer, Infertility, and Pregnancy found that cancer diagnosed during pregnancy did not appear to affect cognitive, cardiac,...

kidney cancer

Nivolumab and Cabozantinib Improve Outcomes vs Everolimus in Previously Treated Advanced Renal Cell Carcinoma

The CheckMate 025 trial, reported in The New England Journal of Medicine by Robert J. Motzer, MD, and colleagues, showed that treatment with the programmed cell death protein (PD-1) checkpoint inhibitor nivolumab (Opdivo) increased overall survival vs the mTOR inhibitor everolimus (Afinitor) in...

breast cancer

Endocrine Therapy Alone Linked to Low Risk of Breast Cancer Recurrence in Women With a Low-Risk Score on 21-Gene Assay

A prospective validation study of a 21-gene expression assay showed that treatment with endocrine therapy alone in women with hormone receptor–positive, HER2-negative breast cancer who had a low recurrence risk score resulted in low risk of recurrence. All patients included in the study were...

health-care policy

Inconsistent Federal Regulations Undercut U.S. Research Productivity, National Academies’ Report Finds

Ask any U.S. academic investigator whether research is hindered by duplicative or confusing federal regulations, and the answer is usually a resounding “Yes.” Now comes a report written by representatives of research administrators, former federal government officials, and principal...

Alternative Therapies: Knowledge Is Power, but Consider the Source

The use of dietary supplements and other complementary and “alternative” therapies by patients with cancer has increased significantly over the past 20 years despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about complementary therapies can be...

palliative care

Important Research in the Palliative Care of Patients With Cancer

The emphasis at this year’s Palliative Care in Oncology Symposium, held earlier this month in Boston, was on patient-centered care throughout the cancer continuum. The meeting attracted more than 650 attendees and included six general sessions featuring best practices in communication,...

Expert Point of View: William J. Gradishar, MD

Discussant William J. Gradishar, MD, the Betsy Bramsen Professor of Breast Oncology at the Robert H. Lurie Comprehensive Cancer Center of Northwestern University in Chicago, endorsed Dr. Shafaee’s conclusions, while highlighting caution in interpreting the results. “At first blush, it certainly is...

breast cancer

Aromatase Inhibitors May Decrease Risk of Contralateral Breast Cancer in BRCA Mutation–Positive Patients

Given that BRCA1 and BRCA2 mutation carriers have an estimated 40% to 85% lifetime risk of breast cancer and an increased risk of developing contralateral breast cancer, risk reduction in this population remains essential. According to a study presented at the 2015 Breast Cancer Symposium, use of...

breast cancer

TAILORx: Chemotherapy Not Necessary for Women With a Low Recurrence Score

The long-awaited first results are in from the TAILORx study, showing that patients with early breast cancer considered at low risk for recurrence can forgo chemotherapy and be treated with endocrine therapy alone.1 “Women with axillary node-negative, estrogen receptor–positive, HER2-negative...

Expert Point of View: Michael F. Greene, MD, and Dan L. Longo, MD

In an accompanying editorial in The New England Journal of Medicine, Michael F. Greene, MD, Chief of Obstetrics at Massachusetts General Hospital, and Dan L. Longo, MD, Professor of Medicine at Harvard Medical School and Dana-Farber Cancer Institute, mentioned the low odds for both oncologists and...

issues in oncology

Chemotherapy/Radiotherapy Safe in Second and Third Trimesters of Pregnancy

Children with in utero exposure to chemotherapy and/or radiation therapy during maternal treatment for cancer had no impairment in cognition, cardiac function, and general early childhood development, according to a study reported at the European Cancer Congress in Vienna, Austria, and published...

Expert Point of View: Luis Paz-Ares, MD

This is the first time we have seen data from the BIRCH trial in these three different cohorts using biomarker expression on tumor cells and immune cells,” said formal discussant Luis Paz-Ares, MD, Professor Medicine at the Hospital Universitario 12 de Octubre, Madrid, Spain. “BIRCH confirms the...

lung cancer

Atezolizumab Makes Inroads in Non–Small Cell Lung Cancer

The anti–PD-L1 (programmed cell death-ligand 1) antibody atezolizumab (formerly known as MPDL3280A) achieved encouraging outcomes in patients with non–small lung cancer (NSCLC) in two different trials: POPLAR1 and BIRCH.2 PD-L1 has emerged as a predictive biomarker for atezolizumab response in both ...

breast cancer
issues in oncology

Ovarian Suppression During Chemotherapy Preserves Fertility in Young Women With Breast Cancer

Several studies have addressed the risks and benefits of ovarian suppression during chemotherapy for breast cancer in women of childbearing age. A new meta-analysis of randomized trials found that it prevented premature ovarian failure and was associated with a higher number of pregnancies post...

cost of care

Discussing Financial Toxicity With Patients Who Have Cancer

Patient: “Doc, how much are these drugs going to cost me?” Physician: “They are expensive, and you can see our financial counselor to help you understand the costs.”   Cancer care is not a black-and-white endeavor, and costs are considered a distasteful subject to be passed over in tactful silence. ...

kidney cancer

Nivolumab Produces Survival Benefit in Advanced Renal Cell Carcinoma

Patients with advanced renal cell carcinoma treated with nivolumab (Opdivo) were 27% less likely to die than those receiving everolimus (Afinitor), in a planned interim analysis of the open-label phase III CheckMate 025 trial.1 These positive results prompted an early termination of the study by...

solid tumors

Multiple Copies of TP53 Tumor-Suppressor Gene Potentially Related to Lower-Than-Expected Cancer Rate in Elephants

A lower-than-expected rate of cancer among elephants could be potentially related to multiple copies of TP53, “a crucial tumor suppressor gene mutated in the majority of human cancers,” according to a study published online by The Journal of the American Medical Association. “Compared with human...

gynecologic cancers

ASCO-Endorsed ASTRO Guidelines: Searching for Consensus on Radiotherapy for Endometrial Cancer

Endometrial cancer is the most common gynecologic cancer, but there has been little consensus about the appropriate indications for adjuvant therapy. One reason for the lack of consensus is the absence of randomized studies in endometrial cancer that report an overall survival benefit. This may be...

gynecologic cancers

ASCO Endorses ASTRO Guideline on Postoperative Radiation Therapy for Endometrial Cancer

As reported in the Journal of Clinical Oncology by Larissa A. Meyer, MD, MPH, and colleagues, ASCO has endorsed the recently published American Society for Radiation Oncology (ASTRO) guideline on postoperative radiation therapy for endometrial cancer.1 The ASCO clinical practice guideline...

breast cancer
leukemia

Shadowed by Cancer

Although genetic testing has not turned up any inherited mutations that might explain the number of cancers that have plagued my immediate family, over the past 15 years, I have lost my father, aunt, and sister to the disease. In 2001, my husband, Wayne, died of acute promyelocytic leukemia, and...

Equanimity

The following essay by S. Vincent Rajkumar, 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. It was...

lymphoma

Answers: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System

Question 1: What is next best step in the management of this patient? Correct Answer: C. Ophthalmoscopy/slit lamp examination. Expert Perspective Ophthalmic involvement should be sought by noninvasive procedures such as slit lamp examination and ophthalmoscopy and abnormal findings must be...

A Pandemic’s Story of Tragedy and Success

Bookmark Title: AIDS Between Science and Politics Author:  Peter Piot Publisher: Columbia University Press Publication date: May 2015 Price: $29.95; hardcover, 216 pages AIDS is a global phenomenon that recognizes neither national boundaries nor social strata. The AIDS pandemic was one of the...

lung cancer

Nivolumab in Metastatic NSCLC After Platinum Therapy

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 October 9, 2015, the anti–programmed cell death protein 1...

ASCO Calls for Comprehensive Payment Reform to Address Issue of Site Neutrality

ASCO recently called for comprehensive physician payment reform to support the full scope of services required by patients with cancer, rather than jeopardizing patient outcomes by reducing the available resources in a particular cancer care setting in an effort to achieve “site neutrality” in...

lung cancer

Clinical Trials Actively Recruiting Patients With Lung Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for patients with lung cancer. The trials are investigating DNA, RNA, and protein changes contributing to carcinogenesis; new prevention strategies; combination therapies; radiation,...

geriatric oncology

Geriatric Oncology in Europe: A Commitment to Improving Cancer Care for Older Patients

In Europe, the field of geriatric oncology has a long history of development, and its organization and implementation continue to improve every day. This would not have happened without the strong commitment of national authorities to health policies, a critical success factor. Four Missions In...

breast cancer

Improved Overall Survival With Neoadjuvant Plus Adjuvant Bevacizumab in Early HER2-Negative Breast Cancer

The phase III National Surgical Adjuvant Breast and Bowel Project (NSABP) B-40 (NRG Oncology) trial showed that the addition of bevacizumab (Avastin) to docetaxel + anthracycline-based neoadjuvant chemotherapy improved pathologic complete response rate, the primary endpoint, in patients with early...

palliative care

End-of-Life Clinical Decisions Still Need Conversations About Improving Care

In 2014, the Institute of Medicine report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life called for more conversations about improving care for those who are dying. Improving the care of the imminently dying is an important issue in the oncology...

Expert Point of View: Fabrice André, MD, PhD, and Peter Naredi, MD, PhD

In discussing the findings of this study on genetic sequencing of breast cancer tissue, Fabrice André, MD, PhD, of the Gustave Roussy Institute, in Villejuif, France, questioned whether all the genes that were found to be enriched in the relapsed samples were driving the relapse and whether any...

solid tumors
bladder cancer
skin cancer

PD-1/PD-L1 Inhibitors Show Promise in Additional Tumor Types

While inhibitors of programmed cell death protein 1 (PD-1) or its ligand (PD-L1) are becoming established in melanoma, non–small cell lung cancer, and renal cell carcinoma, their efficacy is also being evaluated in numerous other tumor types, with promising results, according to studies presented...

Expert Point of View: Ronald de Wit, MD, PhD

Ronald de Wit, MD, PhD, of Erasmus Medical Center, Rotterdam, Netherlands, called the use of docetaxel in addition to androgen-deprivation therapy “the latest paradigm shift” in the treatment of prostate cancer. The data showing a 10% absolute improvement in survival in the metastatic setting “are...

prostate cancer

Meta-analysis Evaluates Benefit of Docetaxel and Bisphosphonates in Hormone-Sensitive Prostate Cancer

The results of a meta-analysis conducted in the United Kingdom may guide clinicians in the use of docetaxel and bisphosphonates in patients with hormone-sensitive prostate cancer.1 Claire L. Vale, PhD, Senior Research Scientist at the Medical Research Council Clinical Trials Unit at University...

issues in oncology

Is Health Care in the United States a Basic Human Right or an Entitlement?

Mercy Killers is a one-man show that details the consequences of a medical health-care catastrophe (breast cancer) in a family.1 This disturbing fictional account is actually a daily event in cancer centers: losing insurance for technicalities, losing a home because of an inability to pay the...

lung cancer

Intensity-Modulated Radiotherapy Gains Ground for Treatment of Stage III Non–Small Cell Lung Cancer

Intensity-modulated radiation therapy appears to be preferable to three-dimensional (3D) conformal radiation therapy as part of treatment for patients with locally advanced (stage III) non–small cell lung cancer (NSCLC). Compared with 3D conformal radiotherapy, intensity-modulated radiotherapy...

pancreatic cancer

Irinotecan Liposome Injection Plus Fluorouracil/Leucovorin to Treat Patients With Metastatic Pancreatic 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 October 22, 2015, irinotecan liposome injection (Onivyde)...

Expect Questions About Updated Breast Cancer Screening Guidelines

As Chair of the American Cancer Society (ACS) panel that issued an updated guideline for breast cancer screening, Kevin C. Oeffinger, MD, has answered questions and offered perspective on the updated guideline and its development for The New York Times, USA Today, and other major media outlets. As...

breast cancer
issues in oncology

Updated ACS Breast Cancer Screening Guideline Recognizes Greater Role for Individual’s Values and Preferences

The reactions to the updated breast cancer screening guideline from the American Cancer Society (ACS) have been many, varied, and not consistently favorable but not surprising to Kevin C. Oeffinger, MD, who chaired the ACS panel that issued the guideline. Breast cancer screening “is an area that...

Cancer Cured My Life

The following essay by Richard M. Levine, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which is coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and the bigcasino.org. I’m a...

solid tumors

Engaging Clinicians in the Collection of Cancer Registry Data to Improve Clinical Research

In June, the Commission on Cancer of the American College of Surgeons published a revision of its Facility Oncology Registry Data Standards (FORDS) manual, which contains all the data items, codes, and rules to abstract data into cancer registries at the more than 1,500 Commission on...

issues in oncology

ASCO Launches TAPUR to Assess the Off-Label Use of Targeted Therapies for Patients With Advanced Cancers

Two years ago, Richard L. ­Schilsky, MD, FACP, FASCO, Chief Medical Officer of ASCO, proposed a unique clinical trial concept during an educational session on the challenges of delivering precision medicine services in a community setting at ASCO’s Annual Meeting. The idea was to design a clinical...

sarcoma

Trabectedin in Unresectable or Metastatic Liposarcoma or Leiomyosarcoma

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 October 23, 2015, trabectedin (Yondelis) was approved for the...

head and neck cancer

The Role of Botulinum Toxin in Head and Neck Cancer

Head and neck cancer and its treatment can result in a variety of neuromuscular and musculoskeletal pain and functional sequelae. Commonly seen conditions in patients with the disease include neck pain and spasm, hemifacial spasm, trismus, dysphonia, dysarthria, neuropathic pain, and salivary...

lung cancer

Checkmate 057: Nivolumab Improves Survival vs Docetaxel  in Advanced Nonsquamous Non–Small Cell Lung Cancer

In the phase III CheckMate 057 trial, reported in The New England Journal of Medicine by Hossein Borghaei, DO, of Fox Chase Cancer Center, and colleagues, the programmed cell death protein 1 (PD-1) inhibitor nivolumab (Opdivo) improved overall survival vs docetaxel in patients with advanced...

A Shrink Tells the Inside Story of Psychiatry

Bookmark Title: Shrinks: The Untold Story of PsychiatryAuthor:   Jeffrey A. Lieberman, MD, with Ogi OgasPublisher: Little, Brown and CompanyPublication date: March 10, 2015Price: $28.00, hardcover; 352 pages Jeffrey A. Lieberman, MD, is the Lawrence C. Kolb Professor and Chairman of Psychiatry at...

breast cancer
issues in oncology

Getting the Content and the Message Right in Breast Cancer Screening Guidelines

According to recent national headlines, the American Cancer Society (ACS) now recommends that women at average risk of breast cancer should “screen later and less often.”1 While the new ACS recommendations (summarized in this issue of The ASCO Post) might initially be taken as casting doubt on the...

breast cancer
issues in oncology

ACS Guideline Update on Breast Cancer Screening for Women at Average Risk

As reported in JAMA by Kevin C. Oeffinger, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues, the American Cancer Society (ACS) has issued an update to its 2003 guideline on breast cancer screening for women at average risk of breast cancer.1 Robert A. Smith, PhD, of the...

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