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Showing 7401 - 7450Managing High-Risk Patients With Febrile Neutropenia
Febrile neutropenia is of particular concern in high-risk patients who have undergone stem cell transplant, according to William J. Hogan, MB, BCh, Assistant Professor of Medicine at the Mayo Clinic in Rochester, Minnesota. Dr. Hogan delivered an update on febrile neutropenia management in this...
Mantle Cell Lymphoma: Is Transplantation Still Necessary?
Autologous stem cell transplantation has played a critical role in the treatment of mantle cell lymphoma, but in the age of novel treatments, is it always warranted? Two experts in the field explored the question at the 2015 Debates and Didactics in Hematology and Oncology Conference sponsored by...
Our Children’s Future Is Our Responsibility
Cancer prevention is a child-care issue. With many of cancer’s instigators planting their seeds during childhood, we—as a profession and as a nation—must seize this important window of opportunity to protect the health and well-being of future generations. Current estimates suggest that up to...
Diagnosis of Additional Small Cancers Suggests Screening Mammography Leads to Overdiagnosis
A study of screening mammography across U.S. counties found that “the clearest result of mammography screening is the diagnosis of additional small cancers” but without a “concomitant decline in the detection of larger cancers, which might explain the absence of any significant difference in the...
Extraordinary Medical Advances and the Conundrum They Pose
BOOKMARK Title: Ordinary Medicine: Extraordinary Treatments, Longer Lives, and Where to Draw the LineAuthor: Sharon R. KaufmanPublisher: Duke University PressPublication date: May 29, 2015Price: $26.95 paperback, 336 pages Medicine has changed radically over the past 15 years. Who doesn’t welcome...
Expect Questions About Treatment for Ductal Carcinoma in Situ
The recent study findings that women diagnosed with ductal carcinoma in situ had a low breast cancer–specific mortality and that preventing ipsilateral recurrences did not prevent breast cancer mortality1 might lead some women diagnosed with ductal carcinoma in situ to question the need for...
Varied Reactions to Study Finding That Preventing Ipsilateral Recurrence Did Not Prevent Death From Breast Cancer
Women diagnosed with ductal carcinoma in situ have a low risk of dying of breast cancer, according to an observational study looking at data from 108,196 women diagnosed with ductal carcinoma in situ between 1988 and 2011.1 The breast cancer–specific mortality rate for these women was 1.1% at 10...
Pembrolizumab Increases Progression-Free Survival in Ipilimumab-Refractory Advanced Melanoma
In a randomized phase II trial (KEYNOTE-002) reported in The Lancet Oncology, Antoni Ribas, MD, of UCLA Jonsson Comprehensive Cancer Center, Los Angeles, and colleagues found that treatment with the anti–PD-1 (programmed cell death protein 1) antibody pembrolizumab (Keytruda) prolonged...
Focus on Geriatric Oncology: ASCO Prepares for an Aging Nation
The United States—and much of the world—is experiencing unprecedented demographic shifts in the population of older people, defined as people age 65 and over. In 2012, the population of older people in the United States reached a never-before seen height of 43.1 million, a number that will more...
Increased Risk of Death From Breast Cancer for Women With Ductal Carcinoma in Situ vs General Population
In a study reported in JAMA Oncology, Steven A. Narod, MD, FRCPC, of Women’s College Research Institute, Women’s College Hospital, and the University of Toronto, and colleagues found that the risk of breast cancer mortality was elevated in patients with ductal carcinoma in situ compared with the...
Older Patients With Cancer: A Growing Population in Need of Evidence-Based Care
The 2013 Institute of Medicine (IOM) report Delivering High Quality Cancer Care: Charting a New Course for a System in Crisis1 identified the dearth of evidence on older adults as a major quality-of-care issue. The U.S. population is aging at a rapid rate, and cancer is a disease that primarily...
ASCO Statement: Improving the Evidence Base for Treating Older Adults With Cancer
Older persons are the fastest-growing segment of the U.S. population and account for the majority of cancer diagnoses and deaths and the majority of cancer survivors. However, since this population is underrepresented in clinical trials, the evidence base for treating older patients is poor. As...
Docetaxel Chemohormonal Therapy in Metastatic Hormone-Sensitive Prostate Cancer
Sweeney et al reported on the results of a seminal phase III trial (E3805) of chemohormonal therapy vs androgen-deprivation therapy in metastatic hormone-sensitive prostate cancer in a recent issue of The New England Journal of Medicine,1 and the study is summarized in this issue of The ASCO Post....
Adding Docetaxel to Androgen-Deprivation Therapy Prolongs Overall Survival in Metastatic Prostate Cancer
In a phase III trial (E3805) reported in The New England Journal of Medicine, Christopher J. Sweeney, MBBS, of Dana-Farber Cancer Institute, Boston, and colleagues found that chemohormonal therapy with docetaxel plus androgen-deprivation therapy produced a significant 13.6-month increase in median...
Male Breast Cancer: An Understudied Disease and Clinical Challenge
Male breast cancer is an uncommon disease, although the incidence has increased over the past couple of decades. As with many other “orphan” diseases, male breast cancer is understudied, especially in randomized controlled trials. Although it shares similarities with female breast cancer, some...
Adjuvant Treatment of Early-Stage Breast Cancer: Meta-analyses Provide More Clarity
The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) continues its practice of being a lighthouse, shedding its beacon of light on the vast ocean of breast cancer research through the publication of two large, individual patient level–data meta-analyses on the management of women with...
EBCTCG Meta-analyses Show Improved Outcomes With Aromatase Inhibitors vs Tamoxifen and a Potential Benefit of Adjuvant Bisphosphonates Limited to Postmenopausal Women
The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) patient-level meta-analyses, concurrently reported in The Lancet, sought to clarify the effects of adjuvant aromatase inhibitor vs tamoxifen treatment and adjuvant bisphosphonate treatment in early breast cancer.1,2 The endocrine...
Bridging the Gap Between Pediatric and Adult Oncology Care
According to the National Cancer Institute (NCI), about 70,000 adolescents and young adults—defined by the NCI as those in the 15- to 39-year-old range—are diagnosed with cancer each year in the United States, about six times the number of cases diagnosed in children aged 0 to 14.1 And, although...
Better Definitions and Biomarkers Needed to Reduce Cancer Overdiagnosis
At the third annual Preventing Overdiagnosis Conference, speakers described the prevalence and consequences of overdiagnosis in several medical specialties, including cancer. The Conference, which had the theme “Winding Back the Harms of Too Much Medicine,” was co-sponsored by the National Cancer...
Patient and Survivor Care Studies Yield Useful Results to Improve Quality of Life
Recent studies have yielded useful results that clinicians can put into practice, some right now, to help improve the quality of life for patients with cancer. Concerns addressed included cachexia, pain, “chemobrain,” and fertility preservation. At the Best of ASCO®/Chicago meeting, Arif Kamal,...
Nivolumab in Lung Cancer Supported by Updated Trial Data
For the treatment of advanced squamous non–small cell lung cancer (NSCLC), the programmed cell death protein 1 (PD-1) antibody nivolumab (Opdivo) continues to show results in key trials that now report 18-month data. The updates were reported at the 16th World Conference on Lung Cancer in Denver,...
Lung Cancer Rates Doubling Among Nonsmokers
Lung cancer is becoming an equal-opportunity malignancy—with rates rising among never-smokers, especially females, according to studies presented at the 16th World Conference on Lung Cancer in Denver. British investigators reported that in one large tertiary medical center, the proportion of...
Noted Integrative Oncology Specialist Mitchell L. Gaynor, MD, Dies at 59
Integrative oncology had a long road to acceptance by the mainstream medical community; the field is now widely accepted for its healthful benefits, especially in assuaging the more troublesome side effects of cancer treatments. Many well-known oncologists have adapted integrative oncology into...
Patients Whose Treatment Included Bevacizumab Were More Likely to Experience Toxicity but Less Likely to Be Hospitalized
A study among patients with advanced non–small cell lung cancer (NSCLC) treated with carboplatin-paclitaxel or carboplatin-paclitaxel-bevacizumab (Avastin) found that those receiving the triplet were more likely to experience a toxicity event but less likely to be hospitalized within 180 days after ...
Expect Questions From Patients About Daily Aspirin to Prevent Colorectal Cancer
Updating previous recommendations, the U.S. Preventive Services Task Force now recommends low-dose aspirin for the primary prevention of colorectal cancer among most adults age 50 to 59. This a draft recommendation, but it has generated major media coverage noting that this is the first time the...
Important Caveats to Consider Concerning Low-Dose Daily Aspirin for the Primary Prevention of Colorectal Cancer
The use of low-dose aspirin by most adults aged 50 to 59 for the primary prevention of colorectal cancer is now included in the U.S. Preventive Services Task Force (USPSTF) updated draft recommendation statement, “Aspirin to Prevent Cardiovascular Disease and Cancer.”1 The release of the statement...
A Snapshot of Early Immunotherapy
Over the past several years, immunotherapy has had a renaissance of sorts, emerging as one of the most active areas in cancer research. For instance, we have seen the therapeutic promise of disrupting the programmed cell death protein 1 (PD-1) and its ligand (PD-L1) immune checkpoints in cancer,...
Pain, Still Undertreated and Misunderstood
Bookmark Title: A Nation in Pain: Healing Our Biggest Health ProblemAuthor: Judy ForemanPublisher: Oxford University PressPublication date: May 1, 2015Price: $19.95, paperback; 464 pages The subject of pain has been written about extensively, from the intriguing sociopolitical history of opium to...
Trifluridine/Tipiracil in Previously Treated Metastatic Colorectal 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 September 22, 2015, trifluridine/tipiracil (Lonsurf) was...
Addition of Bevacizumab to Standard Chemotherapy Improves Overall Survival Only in High-Risk Ovarian Cancer
Final overall survival results of the phase III ICON7 trial reported in The Lancet Oncology by Amit M. Oza, MD, and colleagues indicate no significant improvement with the addition of bevacizumab (Avastin) to standard chemotherapy in women with newly diagnosed ovarian cancer.1 However, an overall...
Addition of Necitumumab to First-Line Gemcitabine/Cisplatin Improves Overall Survival in Stage IV Squamous NSCLC
In the phase III SQUIRE trial reported in The Lancet Oncology, Nick Thatcher, PhD, FRCP, of The Christie Hospital NHS Trust, Manchester, UK, and colleagues found that the addition of the second-generation epidermal growth factor receptor (EGFR) antibody necitumumab to first-line...
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...
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...
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,...
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...
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,...
Smoking Cessation Reduces Mortality in Lung Cancer Screening Population
Data from an analysis of lung cancer screening programs in Italy add further evidence that smoking cessation reduces mortality. Heavy smokers screened by low-dose computed tomography (CT) who stopped smoking before or during the screening period had a three- to fivefold reduction in mortality...
MRI Improves Breast Cancer Detection in Women at Average Risk
Magnetic resonance imaging (MRI) screening of women at average risk for breast cancer achieved a mean additional cancer yield of 15.8 cases per 1,000 women, greatly surpassing yields for supplemental digital breast tomosynthesis (1.25 per 1,000) or supplemental ultrasound (4.1 per 1,000). The...
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...
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...
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...
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 ...
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...
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...
Tamoxifen Use and Access to Fertility-Preservation Options Among Premenopausal Women With Breast Cancer
A multivariable analysis of clinical factors associated with tamoxifen use among premenopausal women with hormone receptor–positive breast cancer showed that fertility preservation was a significant factor and “the only predictor of both noninitiation and early cessation” of tamoxifen. “Among...
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...
A Cancer Diagnosis Can Lead to Significant Loss of Working Hours, Income
A new analysis indicates that when American adults are diagnosed with cancer, they experience significant decreases in the probability of working, in the number of hours they work, and correspondingly, in their incomes. Such negative impacts of a cancer diagnosis are particularly pronounced among...
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...
Questions: Primary Diffuse Large B-Cell Lymphoma of the Central Nervous System
The ASCO Post is pleased to present Hematology Expert Review, an occasional feature that includes a case report detailing a particular hematologic condition followed by questions. Answers to each question appear here with expert commentary. In the October 25 issue of The ASCO Post, part 1 of a...
