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Showing 8101 - 8150After a Decade of Decline in Smoking Rates, Progress Has Stalled
Approximately 20% of all Americans smoke, and 443,000 of them will die each year as a result. Tobacco use is the leading cause of preventable death in the United States and the greatest behavioral determinant of morbidity and mortality (6%–10% of U.S. health-care costs). Nearly 30% of all cancer...
Prognostic Value of Integrated Cytogenetic and Mutational Risk Classification in Acute Myeloid Leukemia
Jay P. Patel, BS, and colleagues from Memorial Sloan-Kettering Cancer Center in New York recently performed mutational analysis of 18 genes in a subgroup of newly diagnosed acute myeloid leukemia (AML) patients who had been randomized to receive cytarabine plus high-dose or standard-dose...
PACE Trial Update: Ponatinib Produces High Response Rates in CML
The third-generation tyrosine kinase inhibitor ponatinib showed robust efficacy in the 10-month follow-up of the phase II PACE trial (Ponatinib Ph+ALL and CML Evaluation), which is evaluating ponatinib in treatment-refractory chronic myeloid leukemia (CML)1 At the 2012 ASCO Annual Meeting, Jorge E. ...
New Study on Communicating Bad News, from the Patient’s Perspective
There is limited evidence in the literature about how oncologists should discuss bad or serious news with their patients. A recent study sought to understand what patients with cancer value when their doctors communicate news of recurrence.1 The ASCO Post spoke with the study’s lead author, Anthony ...
Increased Adjuvant Therapy Use and Improved Survival in Dutch Elderly Patients with Stage III Colon Cancer: A Direct Correlation?
A survival benefit of adjuvant chemotherapy has been reported for select elderly patients with stage III colon cancer, but many elderly patients are not candidates for or are not given adjuvant therapy due to comorbidities and fear of toxicity. In a recent Annals of Oncology article, van...
Expert Point of View: Alan Venook, MD
Invited discussant Alan Venook, MD, of the University of California, San Francisco, pointed out that the hazard ratio of 0.81 and the 1.4-month improvement in overall survival in the TML trial did not reach the target hazard ratio of 0.77 in the statistical design of the study. However, “it is...
Expert Point of View: Benjamin J. Solomon, MBBS, PhD
“The LUX-Lung 3 study has been much awaited. It is the first study to use cisplatin/pemetrexed [Alimta], which we now recognize as the best comparator arm. The study was positive for afatinib. While the use of maintenance pemetrexed may have dented the hazard ratio, I doubt this would have impacted ...
First-line Afatinib Superior to Standard Chemotherapy in Advanced EGFR-mutated Non–Small Cell Lung Cancer
First-line therapy with the investigational oral agent afatinib improved progression-free survival compared with standard chemotherapy (pemetrexed (Alimta)/cisplatin) in patients with advanced non–small cell lung cancer (NSCLC) harboring an EGFR mutation. Afatinib improved progression-free survival ...
Landscape for Treatment of Metastatic Melanoma Is Expanding
Metastatic melanoma was long considered untreatable and incurable. The FDA approval of ipilimumab (Yervoy) and vemurafenib (Zelboraf) ushered in a new era for this disease, and now additional treatment options are in late stages of clinical development. Dabrafenib, a novel oral BRAF inhibitor, and...
Reflections from the Old World
A few years ago, I was a key witness for a patent dispute at a trial in Delaware. Acting for the complainant, I was briefed that the opening gambit of the opposition lawyer would be to discredit my CV and, therefore, the value of my testimony. “So you are a full Professor at the University of...
Expert Point of View: TAILOR
Formal discussant of the TAILOR trial, Benjamin J. Solomon, MBBS, PhD, of the Peter MacCallum Cancer Centre, East Melbourne, Australia, noted that the study asks an important question about the benefit of an EGFR inhibitor in patients with wild-type EGFR. The progression-free survival reported in...
Expert Point of View: PARAMOUNT
Formal discussant Gregory Peter Kalemkerian, MD, of the University of Michigan Comprehensive Cancer Center, Ann Arbor, questioned whether all patients need maintenance therapy, since some patients on placebo lived as long as those on pemetrexed maintenance, and quality of life, as reported...
Second-line Treatments Tested in Patients with Non-Small Cell Lung Cancer
Results of two late-breaking phase III trials presented at 2012 ASCO Annual Meeting add to the evolving understanding of how best to treat non–small cell lung cancer (NSCLC). The TAILOR trial suggested the benefit of chemotherapy over EGFR-targeted therapy as second-line treatment of patients with...
Adjuvant Chemotherapy May Improve Survival for Patients with Periampullary Disease
The European Study Group for Pancreatic Cancer (ESPAC)-3 periampullary cancer trial found that adjuvant chemotherapy following surgical resection of periampullary adenocarcinoma “was not associated with a significant survival benefit in the primary analysis; however, multivariate analysis adjusting ...
Genomics vs Site of Cancer Origin as Basis for Treatment of Cancer Is ‘False Dichotomy’
In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Despite recent news reports...
Astragalus
The use of dietary supplements by cancer patients has risen significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and the...
Pertuzumab: New Drug for HER2-positive Metastatic Breast 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. Indication In June 2012, pertuzumab (Perjeta) was approved for use...
Symposium Focuses on Policy Issues in Personalized Cancer Care
“What is the biggest barrier to progress in personalized medicine?” asked moderator Anna Barker, PhD, leading a panel discussion at a recent meeting convened by the Washington-based advocacy group, the Personalized Medicine Coalition, with the American Association for Cancer Research and Feinstein...
Information Service Provides Innovative Resource for Patients and Providers
Jennifer Levin Carter, MD, MPH is Founder and President of N-of-One. A board-certified internist and entrepreneur, she has more than 20 years of experience evaluating existing and emerging markets, new medical technologies, and early-stage companies in the health-care field. Formerly, Dr. Carter...
New Assessment Tools in Development to Guide Care for Older Patients
More than 1,400 people from 62 countries attended the 2012 Multinational Association of Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) International Symposium on Supportive Care in Cancer, held in New York last June. One of the featured sessions, which was jointly...
A Physician, Who Is Also a Cancer Patient, Talks about Medical Errors
In a whispered but resolute voice, Itzhak Brook, MD, MSc, led off his presentation at the 2012 ASCO Annual Meeting1 by telling the audience his voice is weak because he doesn’t have vocal cords. He spoke with the aid of a tracheoesophageal voice prosthesis. “I have practiced medicine for more than ...
Supportive Care Experts Explore 30 Years of Progress in the Field
Thirty years ago, when the first supportive care meeting as a forerunner of the Multinational Association of Supportive Care in Cancer (MASCC) Symposium was held in New York, supportive care was largely ignored, with little discussion at major cancer meetings, which focused primarily on...
Rush’s New Hospital Building Listed as One of the Most Innovative Infrastructure Projects in the World
The new hospital at Rush University Medical Center, Chicago, has been listed in KPMG’s recent second edition of Infrastructure 100: World Cities Edition, a report showcasing 100 of the most innovative and inspiring urban infrastructure projects from around the world. Rush is one of only 10...
No Improvement in Overall Survival, Worse Toxicity with Motesanib Added to Chemotherapy in Non–Small Cell Lung Cancer
Two trials (E4599 and AVAiL) have suggested a benefit to adding the anti–vascular endothelial growth factor (VEGF) monoclonal antibody bevacizumab (Avastin) to chemotherapy in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Bevacizumab acts by binding directly to circulating...
Everolimus Approved for Advanced Breast Cancer
The FDA has approved everolimus tablets (Afinitor) for use in combination with exemestane to treat postmenopausal women with advanced hormone receptor–positive, HER2-negative breast cancer after failure of treatment with letrozole or anastrozole. The approval was based on a randomized,...
FDA Grants Accelerated Approval to Carfilzomib for Multiple Myeloma
Onyx Pharmaceuticals announced that the FDA has granted accelerated approval to carfilzomib (Kyprolis) for the treatment of patients with multiple myeloma who have received at least two prior therapies, including treatment with bortezomib (Velcade) and an immunomodulatory therapy, and have...
As Conflicting Guidelines Evolve, Experts Continue to Debate the Merits of Cancer Screening
In the 1930s and 1940s, when the American Cancer Society [ACS] first brought forth the message that early cancer detection saves lives, it was a broad brushstroke and an appropriate message. The problem now is that new technology enables us to find [tumors that would never progress to invasive...
Differentiated Thyroid Cancer: Who, When, and How to Treat?
Differentiated thyroid cancer—papillary, follicular, and Hürthle cell carcinomas—has historically been managed by endocrinologists, surgeons, and radiation oncologists, but recent progress in the field has led to greater involvement by medical oncologists, especially in the care of patients with...
Supportive Care Research Runs the Gamut from Genetic Markers of Treatment Side Effects to Neuropathic Pain Therapies
Attendees from around the world gathered for the Multinational Association for Supportive Care in Cancer/International Society of Oral Oncology (MASCC/ISOO) International Symposium on Supportive Care in Cancer, held June 28–30 in New York. Below are highlights from the meeting, representing...
FDA Approves Ziv-aflibercept for Metastatic Colorectal Cancer
The FDA has approved ziv-aflibercept (Zaltrap) for use in combination with a FOLFIRI (leucovorin, fluorouracil, irinotecan) chemotherapy regimen to treat adults with colorectal cancer. Ziv-aflibercept is an angiogenesis inhibitor that inhibits the blood supply to tumors. It is intended for patients ...
Rethinking the Role of PSA Screening in Public Health
Population screening to identify preclinical disease is considered a central factor in the decades-long decrease in mortality seen in certain cancers. However, hope in the face of deadly disease can sometimes blind us to the scientific evidence. According to the recent U.S. Preventive Services Task ...
Expert Point of View: James O. Armitage, MD
In an accompanying editorial entitled “Who Benefits From Surveillance Imaging?” James O. Armitage, MD, University of Nebraska Medical Center, Omaha, noted that data on surveillance imaging (CT or PET/CT) indicate a general absence of survival benefit in adults with lymphomas, while pointing out...
Study Shows Routine CT Surveillance Overused in Pediatric Hodgkin Lymphoma
The value of routine CT surveillance monitoring of pediatric patients for recurrence of Hodgkin lymphoma has been unclear. A study of CT surveillance recently reported by Stephan D. Voss, MD, PhD, and colleagues from the Children’s Oncology Group (COG) in the Journal of Clinical Oncology showed...
Adolescent and Young Adult Patients Report Unmet Needs for Cancer Information and Psychosocial Support Services
In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Psychosocial care needs are not...
New Agents That Improve Efficacy Can Also Increase Morbidity and Treatment-related Mortality
Newly approved anticancer drugs that lead to improvements in efficacy can also lead to increased morbidity and treatment-related mortality, according to a study in the Journal of Clinical Oncology. The investigators conducted a meta-analysis of 38 randomized controlled trials evaluating agents...
It’s Time to Get Ready for New Medicare Reporting Requirements
As if you didn’t already have enough to worry about, now add this: If your practice doesn’t meet the requirements of the Physicians Quality Reporting System (PQRS) and Electronic Prescribing (eRx) Incentive, you don’t just miss out on the bonuses the programs offered as incentive in recent years....
ASCO Expert Panel Concludes Evidence Supports Physician Discussion of PSA Testing for Men with Longer Life Expectancies
ASCO has issued a new evidence-based provisional clinical opinion (PCO) on the use of prostate-specific antigen (PSA) testing for prostate cancer screening. To facilitate informed decisions, ASCO also released a new, detailed decision aid to help men and their physicians understand the risks and...
Carfilzomib: New Drug with Accelerated Approval for Multiple Myeloma
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. Indication In July 2012, carfilzomib (Kyprolis) was granted...
Ongoing and Future Directions in Pancreatic Cancer Research
Margaret A. Tempero, MD, is a pioneer in pancreatic cancer treatment and research. She has long been a leader in the research and development of therapeutics for pancreatic ductal adenocarcinoma, particularly in studying investigational antibody-based therapies, developing the fixed-dose-rate...
Liposomal Vincristine Approved in Acute Lymphoblastic Leukemia
The FDA has approved vincristine sulfate liposome injection (Marqibo) to treat adults with Philadelphia chromosome–negative acute lymphoblastic leukemia (ALL). Administered once a week, liposomal vincristine is approved for patients whose leukemia has relapsed two or more times, or whose leukemia...
Letter to the Editor: Dr. Ablin’s Reply
Given my explanation and widely publicized opinion on the improper use of the prostate-specific antigen (PSA) test for screening asymptomatic men for prostate cancer—most recently expressed in a feature article in The ASCO Post (August 15, 2012)—I was pleased to read that Drs. James Mohler and...
Letter to the Editor: More Thoughts on PSA
An article that appeared in the August 15 issue of The ASCO Post (“Rethinking the Role of PSA Screening in Public Health”) contains false statements about the discovery of prostate-specific antigen (PSA) and its effectiveness as a test for early detection of prostate cancer. Contrary to what’s...
High-cost Imaging Used Frequently in Elderly with Stage IV Cancer
Patients with stage IV breast, colorectal, lung, and prostate cancers undergo frequent high-cost imaging procedures throughout the continuum of their care, and rates of imaging have steadily increased, according to an analysis of claims from the Surveillance, Epidemiology, and End Results...
Patients with Unresectable Metastases Can Be Spared Noncurative Resection of Intact Primary Tumor
Patients with surgically unresectable metastatic colon cancer and an asymptomatic intact primary tumor can be spared initial noncurative resection of their intact primary tumor, National Surgical Adjuvant Breast and Bowel Project (NSABP) C-10 trial investigators reported in the Journal of Clinical...
CT Scans in Childhood Can Triple Risk of Leukemia and Brain Cancer Later in Life, Study Finds
In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Computed tomography scans with...
Ziv-aflibercept with FOLFIRI in Metastatic Colorectal Cancer
In August 2012, the antiangiogenic agent ziv-aflibercept (Zaltrap) was approved for use in combination with FOLFIRI (fluorouracil, leucovorin, irinotecan) for the treatment of metastatic colorectal cancer resistant to or progressing after an oxaliplatin-containing regimen.1,2 Approval was based on...
New Indication for Cetuximab plus FOLFIRI to Treat EGFR-positive, Wild-type KRAS 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. Indication In July 2012, cetuximab (Erbitux) was approved for use...
A Great IDEA: Supporting the Next Generation of Oncology Leaders in Low- and Middle-income Countries
Leadership has been cited as a critical success factor in improving access to cancer care in low- and middle-income countries.1 Effective clinical leaders in these countries can be transformative by supporting the development of cancer treatments to meet the needs of their patients, by advocating...
All Oncology Care Practices Urged to ‘Be Counted’ in Groundbreaking Census
The National Oncology Census, sponsored by the American Society of Clinical Oncology (ASCO), represents the first-ever attempt to capture comprehensive, real-time data on the state of oncology practice in the United States. ASCO is urging all U.S. oncology practices—representing oncologists in...
Is There a Role for Metronomic Chemotherapy in Patients with Highly Refractory Multiple Myeloma?
Metronomic chemotherapy using a multidrug regimen appears beneficial and fairly well tolerated in patients with multiple myeloma that is highly refractory to previous treatments, investigators from the Myeloma Institute for Research and Therapy in Little Rock, Arkansas, reported.1 Their results...
