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cost of care
health-care policy

Increased Use of Hospital Services Boosts Oncology Spending

For our ongoing series on the rising costs of cancer care, The ASCO Post spoke with Lee N. Newcomer, MD, Senior Vice President of Oncology for UnitedHealthcare. Dr. Newcomer is responsible for improving cost-effective cancer care at the nation’s largest health insurer. He shed light on areas of...

lung cancer

World Conference on Lung Cancer: Personalized Approaches to Treatment

The 14th World Conference on Lung Cancer hosted more than 7,000 attendees in Amsterdam recently, with the theme “Better Care through Personalized Medical Approaches.” The following are brief summaries of key data presented at the conference, with perspective provided by Roy S. Herbst, MD, PhD, of...

prostate cancer

Androgen Deprivation plus Radiotherapy Increases Survival in Men with Localized Prostate Cancer

Adding short-term androgen-deprivation therapy to radiotherapy “conferred a modest but significant increase in the 10-year rate of overall survival, from 57% to 62%,” in men with localized prostate cancer enrolled in Radiation Therapy Oncology Group (RTOG) trial 94-08. “This increase was...

thyroid cancer

Wide Variation in Use of Radioactive Iodine for Thyroid Cancer

The proportion of patients with well-differentiated thyroid cancer who received radioactive iodine following total thyroidectomy increased significantly since 1990, and there is wide variation in the use of adjuvant radioactive iodine, according to a study in the Journal of the American Medical...

breast cancer

Many Women Treated for High-risk Breast Cancer Do Not Receive Recommended Postmastectomy Radiation Therapy

Despite major studies showing that postmastectomy radiation therapy improves survival for women with high-risk breast cancer and evidence-based guidelines supporting the use of postmastectomy radiotherapy, 45% of these patients do not receive such treatment, according to an analysis of data from...

supportive care

Lifestyle Changes Can Benefit Patients with Cancer

Oncologists may successfully manage their patients with cancer by following treatment guidelines, but they come up short when it comes to prescribing simple measures to enhance their patients’ health, according to Ann Partridge, MD, MPH, of Dana-Farber Cancer Institute, Boston, who spoke on the...

leukemia

FDA Clears Genetic FISH Panel for Leukemia Patient Prognosis

Abbott announced it has received 510k clearance from the FDA for a new in vitro diagnostic test to aid in determining the prognosis of patients with chronic lymphocytic leukemia (CLL). Abbott’s Vysis CLL FISH Probe Kit is the first FDA-cleared CLL test to aid in prognosis. The test detects genetic...

ASCO’s Immediate Past President Helps Build Future of Cancer Research and Care by Supporting Conquer Cancer Foundation

George W. Sledge, Jr, MD, has been treating patients with breast cancer, and pursuing research in the field, for more than 30 years—the last few electrified by a rapid proliferation of knowledge. “We have so much to offer our patients today,” says Dr. Sledge, who serves as Ballve-Lantero Professor...

issues in oncology
health-care policy

Developing Targeted-agent Combinations: Business and Regulatory Issues, and Legal Obstacles

The Institute of Medicine’s National Cancer Policy Forum recently convened a public workshop, “Facilitating Collaborations to Develop Combination Investigational Cancer Therapies,” to address the promises and challenges involved in the development of combination oncologic drug therapies. In the...

health-care policy

A Conversation with Monica Morrow, MD, FACS

Over the past 15 years, practice guidelines have become an accepted tool to help physicians optimize patient care by offering informed assessment of the benefits and potential harms associated with various care options. However, a plethora of new guidelines have entered the market, many of which...

skin cancer

Using the New Melanoma Drugs in the Clinic

With two effective new treatments for advanced melanoma, the question has become how to best use them and how to manage their toxicities.  Vemurafenib (Zelboraf) and ipilimumab (Yervoy)1 have different pharmacokinetics, which lend themselves to different patient types. Omid Hamid, MD, of The...

issues in oncology

We Can Conduct Clinical Trials of Protons

A great deal has been written about proton therapy, with a good deal of heat and only a modest amount of light. I would like to comment on an aspect of the proton vs photon controversy that I believe has not been adequately addressed: Should we run clinical trials that would allow us to prove that...

cost of care
palliative care
health-care policy

Palliative Care, Quality of Life, and Cost

More than half of our nation’s patients with cancer are Medicare beneficiaries, making the entitlement program ground zero in the heated debate on health-care spending. Total Medicare expenditures attributable to beneficiaries in their last year of life runs upward of 30%; this statistic serves as...

lymphoma

FDA Approves Brentuximab Vedotin in Two Lymphoma Indications

The antibody-drug conjugate brentuximab vedotin (Adcetris) was granted accelerated approval on August 19 for the treatment of relapsed or refractory Hodgkin lymphoma and systemic anaplastic large cell lymphoma. Brentuximab vedotin is the first new drug to be approved in Hodgkin lymphoma in more...

colorectal cancer

Hepatic Resection Remains Preferred Strategy for Colorectal Liver Metastases

Hepatic resection was shown to be superior to radiofrequency ablation (RFA) for the treatment of colorectal liver metastases, according to a model used to stimulate a randomized controlled trial. Researchers from the Hepatobiliary and Pancreatic Surgery Program at the Providence Portland Medical...

gynecologic cancers
geriatric oncology

Elderly Patients with Ovarian Cancer Least Likely to Receive Chemotherapy

An analysis of data for 4,617 women aged 65 years or older diagnosed with epithelial ovarian cancer found that those in the oldest age group, 80 and up, were least likely to receive any chemotherapy. While 53% of patients 80 and older received no chemotherapy, the rate was less than half (22%) for...

colorectal cancer

‘Hot Chemotherapy’ Generates Heated Debate about Its Use with Cytoreductive Surgery to Manage Peritoneal Metastases

"Hot chemotherapy” has become the common term for hyperthermic intraperitoneal chemotherapy (HIPEC), which together with cytoreductive surgery is being used by some surgeons to treat patients with carcinomatosis from colorectal cancer. While HIPEC is not considered the most important component of...

health-care policy

Oncology Community Faces Complex Challenges in Evolving Policy Arena

As the political environment heats up in advance of the upcoming presidential campaign season, many issues crucial to the oncology community are being placed on the political chopping block as policymakers seek ways to reduce the mounting debt and soaring health-care spending. To help clarify some...

survivorship
supportive care
geriatric oncology

Yoga, Geriatric Assessment, and Nausea/Vomiting Addressed in Session on Supportive Care and Survivorship Issues

Marie E. Wood, MD, of the Familial Cancer Program at the University of Vermont, Burlington, addressed clinically relevant issues in supportive care and survivorship at the Best of ASCO® Annual Meeting ‘11 in Miami. Delayed Nausea and Vomiting Two studies addressed the problem of...

SIDEBAR: Novel Agents Are Still Needed to Address Cytopenias in Myelofibrosis

Despite improving splenomegaly and symptoms in patients with myelofibrosis, ruxolitinib has not been helpful for managing cytopenias in this population, according to Wendy Stock, MD, of the University of Chicago. “Additional trials are underway with novel [JAK] inhibitors, with some hints about...

leukemia

Improvements Highlighted in Treatment of Leukemias and Preleukemias

Certain preleukemic conditions and leukemia in high-risk patients have remained challenging to treat despite advances in hematology, according to Wendy Stock, MD, of the University of Chicago. But studies reported at the Best of ASCO® Annual Meeting ‘11 in Seattle show progress even in these ...

skin cancer

Novel Drugs Ipilimumab and Vemurafenib for Advanced Melanoma

In this introductory installment of In the Clinic, The ASCO Post provides an overview of two new melanoma agents recently approved by FDA, with discussion on pivotal data leading to approval, dosage and administration, and managing drug-related toxicities. Watch for more on clinical use of novel...

ASCO Study Shows Integrating Nonphysician Providers into Oncology Practices Is a Win for Patients and Providers

Is the expanded use of nonphysician providers (NPPs) a viable way to help ease the challenges oncology practices could feel if the number of oncologists entering the field does not keep pace with potential growth in the demand for their services? The ASCO Workforce Advisory Group thought the...

prostate cancer

Short-term Androgen Deprivation plus Radiotherapy Improves Outcomes in Intermediate-risk Prostate Cancer

The addition of short-term androgen-deprivation therapy to external-beam radiation therapy improved overall and disease-specific survival in men with nonbulky localized prostate cancer and prostate-specific antigen (PSA) levels up to 20 ng/mL, as reported recently in The New England Journal of...

gynecologic cancers

New Biomarker Test Cleared to Evaluate Ovarian Cancer Likelihood

Fujirebio Diagnostics announced that it has received 510(k) clearance from the FDA to market the company’s HE4 Test in an algorithm called ROMA to aid in assessing whether a premenopausal or postmenopausal woman who presents with an ovarian adnexal mass is at high or low likelihood of finding...

health-care policy

Can Bayesian Design Streamline Our Sluggish Clinical Trial System?

The randomized controlled clinical trial has long been the gold standard for new cancer drugs to demonstrate worthiness of FDA approval; however, many experts contend that that our method of bringing drugs to the market is plagued by undue costs, long delays, and overregulation. According to Donald ...

Expert Point of View: International Prostate Cancer Studies Report Inroads in Managing Bone Metastases

"Radium-223 chloride is an effective, well tolerated, and convenient treatment, and it has a survival benefit. These favorable characteristics may well promote its use in clinical practice,” said formal discussant of this abstract, Wim J.G. Oyen, MD, Radboud University Nijmegen Medical Center,...

health-care policy

Health-care Policy: A Three-act Play

The health of Americans, the economy, the debt crisis, and the action or inaction in Washington are all seriously interrelated. Decades ago, the bank robber Willie Sutton was asked why he robs banks. His famous answer, “Because that’s where the money is,” succinctly describes the approach that...

Expert Point of View: Studies Validate Safety of Breast-conserving Surgery in Young Patients with Breast Cancer

Rakesh Patel, MD, Medical Director of the Targeted Radiation Institute at Western Radiation Oncology, Pleasanton, California, was the invited discussant of the second study. He noted that in spite of well documented equivalent survival rates between the surgical approaches, mastectomy rates are...

SIDEBAR: Expert Q and A

D. Neil Hayes, MD, MPH, of the University of North Carolina, Chapel Hill, discusses the role of HPV status in head and neck cancer. Are you convinced human papillomavirus (HPV) positivity is associated with better prognosis? Dr. D. Neil Hayes: The HPV story influences almost everything we do in...

head and neck cancer

New Therapies and Prognostic Techniques Highlighted in Head and Neck Cancer

D. Neil Hayes, MD, MPH, of the University of North Carolina at Chapel Hill, described efforts to position the epidermal growth factor receptor (EGFR) inhibitor cetuximab (Erbitux) in head and neck cancer treatment. Surprisingly negative results came from the phase III Radiation Therapy Oncology...

SIDEBAR: Questions and Answers about Adjuvant Imatinib in GIST

"As clinicians, we really need to ask who should receive adjuvant [imatinib], and we have several ways to risk-stratify patients, including tumor characteristics (size, location, mitotic index), mutational analyses, and a recently published nomogram for patient-specific survival,” said William D....

sarcoma

Novel Approaches and Agents Making Headway against Sarcoma

Novel approaches and agents reported at the ASCO 2011 Annual Meeting are improving outcomes in sarcoma, a heterogeneous disease with historically poor outcomes, according to William D. Tap, MD, Section Chief of Sarcoma Oncology at Memorial Sloan-Kettering Cancer Center in New York. Dr. Tap...

SIDEBAR: Can Society Afford Bevacizumab in Ovarian Cancer?

For bevacizumab (Avastin), as for all targeted agents, there is a critical need to identify likely responders as well as patients at risk for serious toxicities, agreed Daniela Matei, MD, of the Indiana University Melvin and Bren Simon Cancer Center, and session moderator Daniel F. Hayes, MD, of...

gynecologic cancers

Screening for Ovarian Cancer May Do More Harm Than Good, but New Therapies for the Disease Are Improving Outcomes

At the Best of ASCO Miami meeting, Daniela Matei, MD, Indiana University Melvin and Bren Simon Cancer Center, Indianapolis, described how new approaches are significantly prolonging remission in ovarian cancer. Ovarian Screening Provides No Benefit The Prostate, Lung, Colorectal, and Ovarian (PLCO) ...

kidney cancer
prostate cancer

Novel Management Strategies Assessed in Renal Cell and Prostate Cancers

At the Best of ASCO Miami meeting, William Oh, MD, of the Tisch Cancer Institute, Mount Sinai School of Medicine, New York, described new trends and remaining questions in the management of renal cell and prostate cancers. Axitinib vs Sorafenib in Second-line RCC Axitinib, a potent and selective...

SIDEBAR: A Cautious Approach to Maintenance Therapy

Hematologists should weigh the risks and benefits carefully when considering lenalidomide (Revlimid) or other maintenance therapy for their patients with myeloma, according to William I. Bensinger, MD, of the Fred Hutchinson Cancer Research Center, Seattle. Lenalidomide is associated with...

multiple myeloma

Multiple Myeloma Research Spotlights Treatment Concerns and Advances

Myeloma data reported at this year’s ASCO meeting raise concern about the safety of a mainstay class of drugs in this disease, while also hinting at good efficacy of some novel drugs and approaches, according to William I. Bensinger, MD, of the Fred Hutchinson Cancer Research Center, Seattle....

lymphoma

Similar Outcomes Confirmed in Variety of Lymphoma Treatment Comparisons

Three abstracts reported at the Best of ASCO® meeting in Seattle provide guidance to hematologists when it comes to long-standing gray areas in lymphoma management, according to Oliver Press, MD, PhD, of the Fred Hutchinson Cancer Research Center and the University of Washington, Seattle....

SIDEBAR: Risk-based Approach Needed for Stage II Colorectal Cancer

Management of stage II colorectal cancer remains a considerable gray area where an individualized risk-based approach and more molecular research are needed, according to Axel Grothey, MD, of the Mayo Clinic in Rochester, Minnesota. “Stage II is a little bit more complicated than stage III,” he...

SIDEBAR: Is G13D KRAS Mutational Status Ready for Prime Time?

Individual oncologists will have to decide for themselves whether the results from the pooled analysis of cetuximab trials regarding G13D KRAS mutational status are ready for clinical application, according to Axel Grothey, MD, of the Mayo Clinic in Rochester, Minnesota. “We still need...

SIDEBAR: Stay Tuned for More Information on Neuropathy-related Genes

According to Daniel F. Hayes, MD, of the University of Michigan, Ann Arbor, who moderated the Best of ASCO® Miami conference, taxane-induced neuropathy is a more complicated story than the study by Schneider and colleagues may suggest. “There are now three observations regarding inherited germline ...

breast cancer

Other Breast Cancer Studies of Note

At this year’s Best of ASCO® Miami meeting, Harold Burstein, MD, PhD, discussed several studies he found interesting and relevant to clinical practice. Genomic Assays One study examined two genomic assays for ER-positive breast cancer, Oncotype DX and PAM50, and found considerable overlap among the ...

SIDEBAR: Studies Sparked Questions to Breast Cancer Specialists

Based on the MAP.3 findings, should we be using exemestane to prevent breast cancer in high-risk patients? Dr. Harold Burstein: The risk of developing breast cancer was 2.5% in the placebo arm, vs 1% to 1.5% risk with exemestane. Also, the cancers that were avoided were probably ones with good...

breast cancer

Breast Cancer Studies Explore Wide Variety of Prevention and Treatment Strategies, Offering New Insights

At the Best of ASCO® meeting in Miami, Harold Burstein, MD, PhD, Dana-Farber Cancer Institute, Boston, and Carey K. Anders, MD, University of North Carolina at Chapel Hill, presented high-impact breast cancer abstracts that will enable clinicians to optimize their use of radiotherapy and biologics. ...

lung cancer

Incremental Advances Demonstrated in Management of Locoregional Lung Cancer

Data presented at the ASCO Annual Meeting this year on the management of locoregional lung cancer present a mixed picture, with some advances and some disappointments, according to H. Jack West, MD, of the Swedish Cancer Institute in Seattle, who reviewed studies in this area at the Best of ASCO...

SIDEBAR: Molecular Heterogeneity Complicates Management of Resistance

The molecular heterogeneity of lung cancers will make it a challenge to manage resistance in this era of targeted therapy, according to D. Ross Camidge, MD, PhD, of the University of Colorado, Denver. A case in point: the anaplastic lymphoma kinase (ALK) story. Recently updated data for crizotinib ...

lung cancer

Research Increasingly Points to the Role of Molecular Diversity in Metastatic Lung Cancer

Molecular diversity—its existence, extent, and implications for therapy—was a central theme of key metastatic lung cancer studies presented at this year’s ASCO meeting, according to D. Ross Camidge, MD, PhD, of the University of Colorado, Denver, who addressed major findings in advanced lung cancer ...

SIDEBAR: American Association for Cancer Research on Tobacco Use

Roy S. Herbst, MD, Professor of Medicine and Chief of Medical Oncology, Yale Comprehensive Cancer Center, serves as the Chairperson of the AACR Task Force on Tobacco and Cancer. At the 4th Annual Conference on the Science of Cancer Health Disparities, he said that the evidence against tobacco use...

global cancer care
health-care policy

Tobacco Remains the Dominant Global Risk Factor Underlying Cancer

Despite clear evidence that tobacco causes at least 18 types of cancer, as well as many other diseases, many people all over the world smoke or chew tobacco, or are exposed to secondhand smoke. Although smoking among Americans has declined slowly but steadily over the past 40 years, it remains the...

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