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issues in oncology

A Cancer Care Model for Rural Areas

Rural cancer patients have long had to adjust to difficult geographic and financial barriers to access high-quality cancer care. These problems are exacerbated by today’s fiscal challenges, which have disrupted many of the small community practices that once served rural communities. In 2006, the...

‘Modern’ Surgical Scene, Circa 1945

A Century of Progress The text and photographs on this page are excerpted from a four-volume series of books titled Oncology Tumors & Treatment: A Photographic History, by Stanley B. Burns, MD, FACS. The photos below are from the volume titled “The Anesthesia Era: 1916–1945.” To view...

pain management

The Need for a Multidisciplinary Approach to Combating Cancer-Related Pain

The statistics are staggering. Despite the development of novel analgesics and the increasing awareness of the importance of adequately controlling pain from cancer or its treatment, up to 50% of patients undergoing treatment and between 70% and 90% of patients with advanced disease experience some ...

skin cancer

Anti–PD-1 Superior to Chemotherapy in the KEYNOTE-002 Trial

Immunotherapy, once considered a niche treatment for a few specific cancers, has rapidly emerged as an additional pillar of cancer therapeutics. With the proliferation of promising results, clinical trials, and new drug approvals, one cannot help but be amazed that only 3 years have elapsed since...

cost of care
health-care policy

ASCO Asks CMS to Revisit Its Payment Policy to Support Optimal Cancer Care

ASCO has called on the Centers for Medicare & Medicaid Services (CMS) to reconsider revisions to payment policies that could be administratively burdensome to oncology practices and result in reimbursement that inadequately supports optimal cancer patient care. In a comment letter to CMS on...

Journal of Oncology Practice to Expand in 2016: New Section Dedicated to Practical, Authoritative Clinical Reviews

In early 2016, readers of Journal of Oncology Practice (JOP) will be greeted with an expanded journal, featuring a new section of succinct, focused, practical clinical reviews authored by expert opinion leaders in oncology. These reviews are designed to provide busy, full-time clinicians with...

issues in oncology

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...

issues in oncology

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...

prostate cancer

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....

breast cancer

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...

breast cancer

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...

issues in oncology

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...

Expert Point of View: Solange Peters, MD, PhD

Solange Peters, MD, PhD, of the Lausanne University Hospital, Switzerland, put these updates in context of what is known about programmed cell death protein 1 (PD-1) antibodies in non–small cell lung cancer (NSCLC), concluding that nivolumab (Opdivo) is “one of the best options” for...

Expert Point of View: Martin Reck, MD, PhD

Martin Reck, MD, PhD, of the Department of Thoracic Oncology at the Lung Clinic Grosshansdorf in Germany, discussed the studies. In pretreated patients, he said, “We have seen confirmed efficacy” [for AZD9291] and “impressive activity.” In the first-line setting, its efficacy is still being...

lung cancer

AZD9291 Updates Encouraging for Treatment-Resistant NSCLC

At the 16th World Conference on Lung Cancer, several studies showed consistent activity with the investigational third-generation inhibitor AZD9291 in patients with advanced non–small cell lung cancer (NSCLC) that is resistant to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors....

issues in oncology

NCCN Turns 20: Value-Based Care Has Arrived

Twenty years ago, the National Comprehensive Cancer Network (NCCN) began as a cooperative effort of 12 prestigious cancer centers, working to define and promote national guidelines for the care of patients with cancer. A major goal was to encourage uniformity in the management of malignant...

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...

breast cancer

Mayo Clinic Receives Federal Grant to Fund Clinical Test of Triple-Negative Breast Cancer Vaccine

Researchers on Mayo Clinic’s Florida campus have been awarded a $13.3 million, 5-year federal grant to test a vaccine designed to prevent the recurrence of triple-negative breast cancer. This Breakthrough Award from the U.S. Department of Defense’s Breast Cancer Research Program will fund a...

UC Davis Granted $15.5 Million to Build World’s First Total-Body PET Scanner

A University of California, Davis research team has been awarded $15.5 million to build the world’s first total-body positron emission tomography (PET) scanner, which could fundamentally change the way cancers are tracked and treated. The Transformative Research Award, part of the National...

colorectal cancer
issues in oncology

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...

American Cancer Society Awards 2015 Medals of Honor

The American Cancer Society has bestowed its highest honor on four individuals and one foundation during the Society’s 2015 Medal of Honor ceremony and celebration dinner in Washington, DC. The Medal of Honor is awarded to those who have made the most valuable contributions and impact in the fight...

solid tumors

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,...

lymphoma

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

Question 1: What is the most likely diagnosis for this patient? Correct Answer: B. Primary central nervous system lymphoma. Expert Perspective In an immunocompetent host, the differential diagnosis of isolated or multiple brain lesion(s) includes autoimmune etiologies such as neurosarcoidosis,...

Confessions of a Neurosurgeon

BookmarkTitle: Do No Harm: Stories of Life, Death, and Brain SurgeryAuthor:  Henry Marsh, CBE, FRCSPublisher: Thomas Dunne BooksPublication date: May 26, 2015Price: $25.99, hardcover; 288 pages “I often have to cut into the brain and it is something I hate doing. With a pair of diathermy forceps I ...

A Neurologist’s Life: Oliver Sacks, MD

BookmarkTitle: On the Move: A LifeAuthor: Oliver Sacks, MDPublisher: Alfred A. KnopfPublication date: April 28, 2015Price: $27.95, hardcover; 416 pages Our ability to detect cancer has grown markedly over the past several decades, with the advent of more sensitive screening methods, new...

pain management

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...

Glimpses of the Human Condition Through Lively, Medically Themed Short Stories

BookmarkTitle: A View From the Inside: A Collection of Medically Oriented Short StoriesAuthor: Augustine L. Perrotta, DOPublisher: Keith Publications, LLCPublication date: March 31, 2015Price: $14.95, paperback; 246 pages The field of medicine, ripe with dramatic tension, offers an endless array...

colorectal cancer

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...

Michael Reney, MBA, Named CFO at Dana-Farber Cancer Institute

Dana-Farber Cancer Institute has named Michael Reney, MBA, its Chief Financial Officer (CFO), where he will be responsible for all financial operations, including accounts payable, financial planning and reporting, payroll, capital asset management, tax, and general and patient accounting....

lung cancer

Anti-EGFR Therapy in Squamous Cell Lung Carcinoma: Swimming With or Against the Tide?

Lung cancer is the most common, lethal, and costly cancer worldwide, accounting for at least 1.8 million new cases per year (12.9% of the total).1 Over the past decade, there has been a major shift in the treatment of non–small cell lung cancer (NSCLC), especially in adenocarcinoma, accompanied by...

cns cancers

FDA Approves Expanded Indication for Medical Device to Treat Newly Diagnosed Glioblastoma Multiforme

The U.S. Food and Drug Administration (FDA) has approved an expanded indication for the Optune tumor-treating fields device to treat patients with newly diagnosed glioblastoma multiforme. It is given along with the chemotherapy drug temozolomide following standard treatments that include surgery,...

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...

lung cancer

FDA Approves Use of Nivolumab in Metastatic Nonsquamous Lung Cancer

The U.S. Food and Drug Administration (FDA) has approved nivolumab (Opdivo) to treat patients with metastatic nonsquamous non–small cell lung cancer (NSCLC) whose disease progressed during or after platinum-based chemotherapy. Nivolumab is a monoclonal antibody that that blocks the PD-1/PD-L1...

Three Young Investigators Named Winners of 2015 Paul Marks Prize for Cancer Research

Memorial Sloan Kettering Cancer Center (MSKCC) has named three investigators as recipients of this year’s Paul Marks Prize for Cancer Research. The award recognizes promising investigators aged 45 or younger for their efforts in advancing cancer research. The winners are Bradley E. ­Bernstein, MD,...

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...

colorectal cancer

Many Patients Do Not Accurately Recall Important Colonoscopy Details as Time Lapses

As time lapses, many patients who have undergone a colonoscopy become less and less likely to recall when and where they last had the procedure performed, who the doctor was who performed it, whether polyps were found, and, if so, the number and size of those polyps, according to new study results...

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...

Community Research Forum Holds 2015 Annual Meeting, Explores Developments and Strategies in Conducting Clinical Research

ASCO’s Community Research Forum (CRF) held its 2015 Annual Meeting September 20–21 at ASCO Headquarters in Alexandria, Virginia. Over 75 physician investigators, program directors, and research staff attended the meeting, representing a wide range of community-based practices and research sites...

Journal of Clinical Oncology’s Fall Special Series, Journal of Global Oncology’s Inaugural Issue

This fall, the Journal of Clinical Oncology (JCO) presented two special series: “Pediatric Cancer—Progress Through Collaboration” and “Head and Neck Cancer: Recent Advances, Changing Epidemiology, and Future Directions.” The Pediatric Special Series highlighted collaborative efforts that have...

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,...

breast cancer

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...

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...

Expert Point of View: Enrique Grande, MD

Enrique Grande, MD, Head of the Endocrine and Genitourinary Tumors Section of the Medical Oncology Service at Ramon y Cajal University Hospital, Madrid, discussed the NETTER-1 and RADIANT-4 studies at the Presidential Session of the 2015 European Cancer Congress. “There is now a stronger rationale...

kidney cancer

Phase III METEOR Trial Finds Cabozantinib Improves Progression-Free Survival vs Everolimus in Advanced Renal Cell Carcinoma

Cabozantinib (Cometriq) nearly doubled progression-free survival compared with standard everolimus (Afinitor) therapy in patients with advanced renal cell carcinoma, according to the phase III METEOR trial.1 Additionally, a preplanned interim analysis found an encouraging trend toward overall...

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. ...

Expert Point of View: Cora N. Sternberg, MD, FACP

Cora N. Sternberg, MD, FACP, Chief of Medical Oncology at San Camillo Forlanini Hospital in Rome, Italy, formally discussed CheckMate 025 at the Presidential Session of the 2015 European Cancer Congress as well as findings from the METEOR trial of cabozantinib (Cometriq) in metastatic renal cell...

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...

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