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health-care policy
issues in oncology

Evolving Tools for Clinical Decision-Making

Value in cancer care—and how to define it—is a hot topic. There is general agreement that it is some measure of benefit vs cost, but “should the focus be on providing value to patients at a population level or at an individual level?” asked Alan Balch, PhD, CEO of the Patient Advocate Foundation,...

Expert Point of View: Elizabeth Plimack, MD

The Egyptian study presented by Brian Baumann, MD, of the University of Pennsylvania, Philadelphia, was a “valiant effort” to determine whether sequential adjuvant chemotherapy added to adjuvant radiation would improve disease-free survival, said formal discussant of this trial Elizabeth Plimack,...

prostate cancer

Active Holistic Surveillance May Prevent Unnecessary Biopsies in Low- and Low/Intermediate-Risk Prostate Cancer

The use of prostate-specific antigen (PSA) screening has led to a dramatic rise in the number of men diagnosed with low-grade prostate cancer. Active surveillance is recommended to manage patients with favorable-risk, low-grade prostate cancer, with the goal of avoiding overtreatment of these...

head and neck cancer

2016 Head and Neck Cancer Symposium: Uninsured and Medicaid Patients More Likely to Present With Advanced Tumors, Experience Cancer-Specific Mortality

Compared to patients with non-Medicaid insurance, uninsured patients and patients with Medicaid are more likely to present with advanced stages of head and neck cancer and have higher overall and cancer-specific mortality rates, according to research presented by Churilla et al at the 2016...

head and neck cancer
cost of care

2016 Head and Neck Cancer Symposium: Cost-Coping Strategies and Perceived Social Isolation in Locally Advanced Head and Neck Cancer

The majority of patients with locally advanced head and neck cancers rely on cost-coping strategies that alter their lifestyle in order to manage the financial burden of their care, according to research presented by Kung et al at the 2016 Multidisciplinary Head and Neck Cancer Symposium (Abstract...

Expert Point of View: Claus Rödel, MD

Claus Rödel, MD, Director and Chair of the Department of Radiotherapy and Oncology, University of Frankfurt, Germany, and invited discussant of the study, pointed out that these investigators found “the opposite” of what most previous studies have shown: Others have found an increased risk for...

solid tumors
issues in oncology

Serum Tumor Marker Testing Overused, Especially for Solid Tumors

A retrospective review to evaluate the frequency of serum tumor marker testing “found a high rate of serum tumor marker testing overuse and extreme overuse in patients with advanced solid tumors,” Melissa K. Accordino, MD, of Columbia University College of Physicians and Surgeons, New...

colorectal cancer

Shorter Radiation Course May Benefit Patients With Locally Advanced Rectal Cancer

As neoadjuvant treatment for locally advanced rectal cancer, a shorter course of radiation therapy followed by chemotherapy may be as good as, or better than, standard chemoradiotherapy, according to a study from the Polish Colorectal Study Group presented at the 2016 Gastrointestinal Cancers...

pancreatic cancer

Optimizing Outcomes in Pancreatic Cancer

Evidence has long supported a volume-outcome relationship for surgical resection of pancreatic cancer, yet surgery alone is not enough to prolong survival in patients with localized disease. James L. Abbruzzese, MD, of Duke University and Duke Cancer Institute, Durham, North Carolina, discussed his ...

cost of care

Cost in the Context of Value for Cancer Medicines

Bringing new cancer therapies through the discovery and development process entails considerable risk and many years of study. It also requires substantial investment and incentives from the public and private sectors to fuel future investment and discovery. A system that rewards advances in cancer ...

survivorship

Surveillance for Recurrence and Second Cancers: Guidelines and Caveats

Striking the right balance between under- and oversurveillance of cancer survivors is challenging, and oncology providers are best served by knowing and following guidelines—though they can change often. Cancer recurrence and second cancers are two of the major threats to the health of cancer...

hematologic malignancies

Antithymocyte Globulin Reduces Need for Immunosuppressants After Hematopoietic Cell Transplantation From Unrelated Donors

In a phase III trial reported in The Lancet Oncology, Walker et al found that treatment with antithymocyte globulin reduced the need for immunosuppressive therapy in patients with hematologic malignancies receiving hematopoietic cell transplantation from unrelated donors. Study Details In this...

leukemia
issues in oncology

Inherited Genetic Variations That Lead to Severe Drug Toxicity in Pediatric Leukemia Discovered

An international research team has determined how inherited gene variations lead to severe drug toxicity that may threaten chances for a cure in children with leukemia. St. Jude Children’s Research Hospital scientists led the study, results of which set the stage to expand the use of a...

colorectal cancer
issues in oncology
issues in oncology

Updated Guidelines Recommend That Patients With Colorectal Cancer Undergo Colonoscopy After Cancer Resection

According to new recommendations from the U.S. Multi-Society Task Force on Colorectal Cancer published by Kahi et al in Gastroenterology, postoperative colonoscopy is associated with improved overall survival for colorectal cancer patients. Therefore, it is critically important that colorectal...

breast cancer
pancreatic cancer

Study Finds Mechanism by Which Obesity Promotes Pancreatic and Breast Cancers

Massachusetts General Hospital (MGH) investigators may have uncovered a novel mechanism behind the ability of obesity to promote cancer progression. In their report published by Incio et al in Clinical Cancer Research, the research team describes finding an association between obesity and an...

sarcoma

Eribulin Improves Overall Survival vs Dacarbazine in Advanced Liposarcoma or Leiomyosarcoma

In a phase III trial reported in The Lancet, Schöffski et al found that eribulin improved overall survival vs dacarbazine in patients with advanced or metastatic soft-tissue sarcoma who had received at least two prior systemic treatments for advanced disease. Outcome in the subgroup with...

prostate cancer

Study Finds Enzalutamide Increases Progression-Free Survival vs Bicalutamide in Metastatic Prostate Cancer

Use of the androgen receptor–inhibitor enzalutamide (Xtandi) more than doubled progression-free survival vs the nonsteroidal antiandrogen bicalutamide in patients with metastatic prostate cancer progressing on androgen-deprivation therapy, according to the randomized phase II TERRAIN trial...

pancreatic cancer
issues in oncology

Preclinical Device Hits Pancreatic Tumors With Drug Cocktail, Sparing the Body

A highly lethal cancer sometimes requires large doses of highly toxic drugs. However, a blitzkrieg approach can be unfeasible for some patients due to severe side effects. Now a team of researchers at the University of North Carolina at Chapel Hill has found that an implantable device can deliver a ...

leukemia
lymphoma
survivorship

Reduction in Late Mortality in Childhood Cancer Survivors in the Childhood Cancer Survivor Study Cohort

In a study reported in The New England Journal of Medicine, Armstrong et al found that late mortality decreased over time among 5-year survivors of childhood cancer in the Childhood Cancer Survivor Study cohort. The reduction is consistent with efforts during recent decades to modify treatment with ...

issues in oncology
head and neck cancer

Possible Marker for Recurring HPV-Linked Oropharyngeal Cancers

A retrospective analysis of human papillomavirus (HPV) antibodies in patients treated for oropharyngeal cancers linked to HPV infection suggests at least one of the antibodies could be useful in identifying those at risk for a recurrence of the cancer, said scientists at The Johns Hopkins...

issues in oncology

ASCO Issues Policy Statement Calling for Improvements to Clinical Pathway Programs in Oncology

ASCO released a new policy statement with recommendations to ensure that clinical pathways in oncology promote—not hinder—the care of patients with cancer. Published by Zon et al in the Journal of Oncology Practice,1 the statement asserted that the way in which these treatment management tools in...

lung cancer

Alectinib in ALK-Positive Metastatic NSCLC After Crizotinib

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 11, 2015, alectinib (Alecensa) was granted...

head and neck cancer

No Benefit of Adding Adjuvant and Maintenance Lapatinib to Chemoradiation in High-Risk Patients With Resected Squamous Cell Carcinoma of the Head and Neck

In a phase III trial reported in the Journal of Clinical Oncology, Harrington et al found that the addition of concurrent adjuvant lapatinib (Tykerb) to chemoradiation therapy and the use of maintenance lapatinib did not improve disease-free or overall survival in high-risk patients with resected...

Immunotherapy Expert Crystal Mackall, MD, Joins Stanford Medicine Faculty

Cancer immunotherapy expert Crystal Mackall, MD, joined the Stanford University School of Medicine faculty on January 1 as Professor of Pediatrics and Medicine, as well as Associate Director of the Stanford Cancer Institute and Co-Medical Director of the Stanford Laboratory for Cell and Gene...

myelodysplastic syndromes

Selected Abstracts From 2015 ASH Annual Meeting: Part 2

Here are several more abstracts selected from the proceedings of the 2015 American Society of Hematology (ASH) Annual Meeting and Exposition, highlighting therapeutics in acute leukemias and myelodysplastic syndromes. For five other top abstracts on therapies for acute leukemias and myelodysplastic ...

skin cancer

Expanded Approval of Pembrolizumab in 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 18, 2015, approval of the programmed cell death...

A Famous French Oncologist’s Gastronomic Advice for Reducing Cancer Risk

BookmarkTitle: The Anti-cancer Diet: Reduce Cancer Risk Through the Foods You EatAuthors:  David Khayat, MDPublisher: W.W. Norton & CompanyPublication date: April 2015Price: $26.95; hardcover, 288 pages   In 2002, David Khayat, MD, was in Turkey on holiday with friends when he received a call...

Fear’s Many Deleterious Consequences

Bookmark Title: The Fear Cure: Cultivating Courage as Medicine for the Body, Mind, and Soul Author: Lissa Rankin, MD Publisher: Hay House, Inc Publication date: February 23, 2015 Price: $25.99; hardcover, 336 pages   Fear is a healthy survival mechanism, a fight-or-flight response designed to put...

A Pioneering Oncologist’s Roadmap Forward

Bookmark Title: The Death of Cancer: After Fifty Years on the Front Lines of Medicine, a Pioneering Oncologist Reveals Why the War on Cancer Is Winnable—and How We Can Get There Authors: Vincent T. DeVita, Jr, MD, and Elizabeth DeVita-Raeburn Publisher: Farrar, Straus and Giroux Publication date:...

breast cancer

Looking at the Real-World Effects of Genetic Testing

According to the most recent estimates, 55% to 65% of women who inherit the BRCA1 mutation and about 45% of women who inherit the BRCA2 mutation will develop breast cancer by the time they are 70 years old. There is also a substantial increase in the probability of developing ovarian cancers in...

Defibrotide Under Review for Transplant-Related Complication

A potentially fatal complication of hematopoietic stem cell transplantation may be reversed with the use of a novel drug currently under priority review at the U.S. Food and Drug Administration (FDA). Hepatic veno-occlusive disease/sinusoidal obstruction syndrome is usually a serious complication...

symptom management

How Cancer and Its Treatments Affect Cognitive Function

Although chemotherapy is often cited as the main culprit for diminishing cognitive function in patients with cancer, ushering the term “chemobrain” into the vernacular, research by Tim A. Ahles, PhD, and his colleagues is showing that multiple factors may contribute to the condition.1 Using breast...

colorectal cancer

Transcription Factor CDX2 May Be Prognostic Biomarker in Stage II and III Colon Cancer

In a study reported in The New England Journal of Medicine, Dalerba et al found that absence of the transcription factor CDX2, although prognostic for poor outcome in stage II and III colon cancer vs cancers with CDX2 expression, identified a subgroup of high-risk patients who appeared to benefit...

leukemia
issues in oncology

New Assay Detects Persistent Disease in Leukemia Patients Thought to Be in Remission

The outcomes of chronic myeloid leukemia (CML) have dramatically improved as the result of tyrosine kinase inhibitor treatment. Use of a tyrosine kinase inhibitor regimen can lower the blood CML biomarker to levels imperceptible by current detection methods. For patients in “molecular...

leukemia

Bone Loss Associated With Leukemia Therapy Occurs Sooner Than Previously Thought

Investigators at Children’s Hospital Los Angeles (CHLA) have found that significant bone loss occurs during the first month of chemotherapy for acute lymphoblastic leukemia (ALL), which is far earlier than previously assumed. Results of the study were published by Orgel et al in the...

issues in oncology

World Cancer Day 2016: We Can. I Can.

Cancer will kill more than 8 million people worldwide this year, which is equivalent to the entire population of New York. Half of these will be people of working age (30–69 years old). It has been estimated that the cost implications on world economies caused by cancer and the other...

breast cancer

For Postmenopausal Women With Ductal Carcinoma in Situ: NSABP B-35 and IBIS-II DCIS Trials Offer a Choice of Endocrine Therapy

The past year has produced an embarrassment of riches regarding the value of aromatase inhibitors for women with ductal carcinoma in situ of the breast. The long-awaited NSABP B-35 study matured and was reported by Margolese and colleagues at the 2015 ASCO Annual Meeting this past summer, followed...

ASCO Names Advance of the Year, Highlights Major Top Research Trends

Research is the bedrock of progress against cancer, and discoveries in cancer biology are moving from bench to bedside faster than ever. No recent advance has been more transformative than the rise of immunotherapy, particularly over the past year, making this treatment strategy ASCO’s Advance of...

breast cancer

Tamoxifen or Anastrozole for Ductal Carcinoma in Situ?

Ductal carcinoma in situ is a relatively benign form of breast cancer (stage 0), yet up to 10% of women with ductal carcinoma in situ will have a recurrence within 10 years. At present, there is no way to identify which women will recur, so standard treatment is lumpectomy plus radiation therapy....

breast cancer

Synthetic 2D Mammography May Hold Advantages Over 2D/3D Mammography

In screening for breast cancer, results from a study in the United Kingdom suggest that the use of “synthetic” two-dimensional (2D) mammography, rather than 2D/three-dimensional (3D) combinations, could save radiologists’ time and patients’ exposure to radiation as well as result in many fewer...

breast cancer

Selected Abstracts From 2015 San Antonio Breast Cancer Symposium

The 2015 San Antonio Breast Cancer Symposium (SABCS), hosted by the American Association for Cancer Research, the Cancer Therapy & Research Center at The University of Texas Health Sciences Center at San Antonio, and Baylor College of Medicine, was held in December 2015. As has been true for...

Expert Point of View: Thierry Facon, MD

Several experts commented that an all-oral regimen would bring convenience to the treatment of myeloma. Thierry Facon, MD, of Lille University Hospital in France, told The ASCO Post that although ixazomib (Ninlaro) may not be more active than other proteasome inhibitors, “It definitely has...

multiple myeloma

Studies Confirm and Extend the Benefits of Ixazomib in Multiple Myeloma

Patients with multiple myeloma now have access to an all-oral regimen, with the recent approval of the oral proteasome inhibitor ixazomib (Ninlaro) in previously treated patients. New pairings for the drug in relapsed/refractory and newly diagnosed patients are being studied, with investigators...

Expert Point of View: Sumanta K. Pal, MD

Commenting on both the CheckMate 025 and METEOR studies, Sumanta K. Pal, MD, Co-Director of the Kidney Cancer Program at City of Hope Comprehensive Cancer Center, Duarte, California, said, “Cabozantinib (Cometriq) will probably be approved for advanced renal cell carcinoma. There is debate about...

Expert Point of View: Christian K. ­Kollmannsberger, MD

Commenting on both of these studies, Christian K. ­Kollmannsberger, MD, of the British Columbia Cancer Center, Vancouver, Canada, said: “These studies suggest a more personalized approach to testicular cancer. Clearly, we need to do better than traditional risk factors used to guide therapy for...

issues in oncology

Cancer Registries and the Evolving Role of Big Data in Cancer Care

In 1956, the American College of Surgeons encouraged the development of hospital-based registries, but for the most part, these efforts were clumsy, inaccessible card files of data. Today, advanced microcomputer technology has increased the ability to not only collect and cull cancer data but also...

prostate cancer

Study Finds Association Between Androgen-Deprivation Therapy in Prostate Cancer and Risk of Alzheimer’s Disease

In a retrospective analysis reported in the Journal of Clinical Oncology, Nead et al found that use of androgen-deprivation therapy in the treatment of prostate cancer was associated with an increased risk of subsequent Alzheimer’s disease. Study Details In the study, a text-processing...

lymphoma

Higher Mortality Risk in Poor or Minority Adolescents and Young Adults vs White Patients With Hodgkin Lymphoma

Despite improvements in survival for adolescents and young adults diagnosed with Hodgkin lymphoma, the gains have not been shared uniformly across this patient population. A large population-based study by Keegan et al investigating the impact of race/ethnicity, socioeconomic status, influence of...

breast cancer
issues in oncology

Higher Dietary Fiber Intake in Adolescence and Young Adulthood May Reduce Breast Cancer Risk

Women who eat more high-fiber foods during adolescence and young adulthood—especially fruits and vegetables—may have significantly lower breast cancer risk than those who eat less dietary fiber when young, according to a new large-scale study led by researchers at Harvard T.H. Chan...

UK Study Finds No Association Between Self-Reported Unhappiness and Mortality Risk

As reported in The Lancet by Liu et al, a study in UK women that attempted to adjust for the effect of health and lifestyle factors found that self-reported unhappiness was not associated with an increased risk of mortality from cancer or other conditions. Study Details The study involved data...

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