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Showing 8201 - 8250Cognitive Impairment in Patients with Cancer
Cancer therapy, including radiation and chemotherapy, can be harmful to multiple organ systems. The central nervous system (CNS) has generally been considered less vulnerable to the toxic effects of cancer therapy. However, the use of more aggressive treatment modalities combined with prolonged...
Neuropathy Not Predictive of Outcomes with Adjuvant Taxane Therapy in Breast Cancer
Neuropathy is a common and potentially disabling adverse effect of taxane therapy, particularly weekly paclitaxel. A number of recent studies have identified single nucleotide polymorphisms that appear to increase risk of grade 2 to 4 neuropathy in patients with breast cancer who receive taxanes....
Progress, Slow but Sure, Seen for Current Lung Cancer Therapies
This year, we have some abstracts that help move things forward in lung cancer, maybe at a little bit slower pace than in previous years. But there are important points that we can learn from some of these abstracts,” commented Karen L. Reckamp, MD, of the City of Hope, who presented findings on...
SIDEBAR: From Small Centers to Academic Centers
The use of cytoreduction plus hyperthermic intraperitoneal chemotherapy (HIPEC) to treat carcinomatosis “came from the smaller centers,” noted Nita Ahuja, MD, Director of the Peritoneal Surface Malignancies Program at Johns Hopkins Medicine. “A lot of things in medicine come from academia and move...
Successful Use of Cytoreduction and Hyperthermic Intraperitoneal Chemotherapy May Hinge on Prior Experience
A review of 60 consecutive patients with peritoneal carcinomatosis who underwent cytoreductive surgery plus hyperthermic intraperitoneal chemotherapy (HIPEC)—sometimes called “hot chemotherapy”—found 0% mortality and 33% morbidity, with “a significant reduction of grade III/IV morbidity,...
21-gene Recurrence Score Predicts Outcomes of Node-positive, ER-positive Patients after Adjuvant Chemoendocrine Therapy
The 21-gene recurrence score (obtained with Oncotype DX) can help identify patients with estrogen receptor (ER)-positive, node-positive breast cancer who do not respond well to adjuvant chemoendocrine therapy, according to a retrospective analysis of the National Surgical Adjuvant Breast and Bowel...
Expert Point of View: Stephen E. Jones, MD
In a debate about the benefit of anthracycline therapy at the Symposium, Stephen E. Jones, MD, of US Oncology Research, The Woodlands, Texas, advocated for greater use of non–anthracycline-containing regimens. Dr. Jones was the principal investigator of US Oncology Research Trial 9735,1 which found ...
Anthracycline Use Steadily Declining in Early Breast Cancer Population
Anthracycline use in early-stage breast cancer has been steadily declining, especially for patients with stage I/II or HER2-positive disease, according to an analysis of patients treated at the University of California, San Francisco (UCSF) School of Medicine.1 Treatment Alternatives Lead author...
Despite Progress, Chemotherapy Drug Shortages Still Vex the Oncology Community
During the first week of November 2011, President Obama signed an Executive Order directing the FDA to take steps to help resolve the drug shortages that were affecting patient care across the country. The oncology community was hit especially hard; many of the drug shortfalls were generic...
Breast Cancer Symposium Features Surgical Data, Updated Results from BOLERO-2, and Other Important News
The annual Breast Cancer Symposium, held September 13 to 15 in San Francisco, is jointly sponsored by ASCO, the American Society for Radiation Oncology, the American Society of Breast Disease, the American Society of Breast Surgeons, the National Consortium of Breast Cancers, and the Society of...
Pathologic Nodal Status and Tumor Response Can Predict Risk of Locoregional Recurrence
Pathologic nodal status/breast tumor response following neoadjuvant chemotherapy can be used to predict locoregional recurrence in women with operable, palpable breast cancer (T1-3, N0-1, M0) previously treated with mastectomy or lumpectomy plus radiotherapy. These results from the combined...
SIDEBAR: Don’t Expect Direct Questions from Patients about Pain
Just asking patients “Is there something else you want to address in the visit,” rather than “Is there anything else you want to address in the visit today,” dramatically reduced patients’ unmet concerns during a primary care visit, according to a 2007 study.1 That learning can be applied to...
Cancer Genome Atlas Network Reports Comprehensive Molecular Portraits of Breast Tumors
The Cancer Genome Atlas Network recently reported findings of analyses of primary breast cancers in a total of 825 patients using genomic DNA copy number arrays, DNA methylation, exome sequencing, mRNA arrays, microRNA sequencing, and reverse-phase protein arrays.1 Integration of information across ...
Despite the Rhetoric, Cancer Care Costs Keep Skyrocketing: Is There a Solution?
Although health-care experts routinely agree that the rising costs of oncology services are untenable, there is disagreement about how to reduce expenditures without harming access and quality of care. At this year’s ASCO Annual Meeting, Thomas J. Smith, MD, FACP, offered some interesting ideas...
SIDEBAR: Future of PARP Inhibitors in Ovarian Cancer Hangs in Balance
"It’s become clear that the PARP inhibitors in general … are active in this disease, and we are just trying to find out the level of activity and … get to the point hopefully where at least one of these agents will be approved for use” in ovarian and related cancers, commented Jonathan S. Berek,...
Major Strides Seen in Treatment of Gynecologic Cancers
Research reported at this year’s ASCO Annual Meeting shows major strides in treating ovarian and cervical cancers, suggesting the potential of new agents and adding evidence in areas where optimal management is unclear, according to Jonathan S. Berek, MD, of the Stanford Women’s Cancer Center,...
Novel Drug Combinations Present New Hope for Effective Treatments in Multiple Myeloma
Developing early-phase clinical trials that incorporate combinations of novel agents targeting different pathways in the hematologic cancer multiple myeloma is a leading focus of the work of Sagar Lonial, MD, Professor of Hematology and Vice Chair of Clinical Affairs in the Department of Hematology ...
Fellowship Breathes ‘LIFe’ into the Careers of Young Oncologists in Developing Countries
The Conquer Cancer Foundation of the American Society of Clinical Oncology supports one-on-one training and research grants for the brightest minds in cancer care around the world through the Long-term International Fellowship (LIFe) and other programs. Through this 1-year fellowship, early-career...
Vismodegib: Novel Agent for Treating Advanced Basal Cell Carcinoma
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 January 2012, vismodegib (Erivedge) was approved...
SIDEBAR: Dealing with the Toxicity of Everolimus/Exemestane
While packing a punch in terms of clinical benefit, everolimus plus exemestane can also be a tough pill to swallow for many patients. The management of the potential toxicities associated with this new regimen was addressed at the 2012 Breast Cancer Symposium by Matthew J. Ellis, MB, PhD, of...
Will mTOR Inhibitors Change the Treatment of Endocrine-sensitive HER2-negative Breast Cancer?
For the treatment of endocrine-sensitive metastatic breast cancer, the combination of an mTOR inhibitor and an endocrine agent represents a promising new option. At the 2012 Breast Cancer Symposium, the 18-month update of BOLERO-2, which tested therapy with everolimus (Afinitor) plus exemestane,...
SIDEBAR: Dacomitinib: Better in Whom? Better in What?
Drug development is a highly competitive business. A new drug must be proven to be better than the standard one before it can be registered for public use. Starting with preclinical data, there should be evidence of lower 50% inhibitory concentrations in selective cell lines or a broader spectrum...
Challenges Persist in Treatment of Elderly Patients with CLL, but Novel Agents Hold Promise for Future Strategies
Chronic lymphocytic leukemia (CLL) is mainly a disease of the elderly, and the lack of a standard regimen for elderly patients has been a major challenge. The myelosuppressive regimens used to treat younger patients are not well tolerated by the elderly. However, some newer approaches currently...
Nab-paclitaxel Approved in First-line Metastatic NSCLC
The FDA has approved paclitaxel protein-bound particles for injectable suspension, albumin-bound (nab-paclitaxel, Abraxane) for use in combination with carboplatin for the initial treatment of patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) who are not candidates for ...
Challenging Times: A Day in the Life of a Community Oncologist
Community oncologists man the front line of cancer care, treating upward of 85% of our nation’s patients. Over the past 2 decades, regulatory and economic changes have left many practices in a state of flux and uncertainty, some struggling to keep their doors open. To shed light on the community...
Ignoring Level 1 Evidence in Invasive Bladder Cancer: Is Ignorance Bliss?
I’ve been part of the uro-oncology community for more than 30 years and have been proud to be involved in a good number of well-powered, enthusiastically subscribed randomized clinical trials. These have dated back to a time before randomization was necessarily the fashion. I have had the pleasure...
Expert Point of View: Reinhard Dummer, MD
Although the effects of BRAF inhibition were initially unprecedented in patients with BRAF-mutated metastatic melanoma, “the problem is that the effect is not durable,” said formal discussant of this trial, Reinhard Dummer, MD, University Hospital of Zurich, Switzerland. The development of...
Pulmonary Radiotherapy Can Usually Be Omitted for Nephroblastoma and Pulmonary Metastases
For the majority of patients with nephroblastoma and pulmonary metastases, pulmonary radiotherapy can be omitted and the patients will still have a relatively good outcome, according to a study published in the Journal of Clinical Oncology. “The rationale of omitting pulmonary [radiotherapy] for...
Media Campaign with Real Smokers a Success
Real smokers sharing in graphic terms what it is like to live with disfiguring or disabling tobacco-related diseases were the featured spokespersons for the Centers for Disease Control and Prevention (CDC) national media campaign to encourage smokers to quit. Based on short-term response, the CDC...
Novel Mechlorethamine Gel Considered Safe and Effective for Treatment of Mycosis Fungoides
A novel mechlorethamine, 0.02%, gel produced comparable or higher response rates (depending on the measurement used) than did mechlorethamine, 0.02%, compounded ointment, in a randomized controlled, multicenter study among 260 patients with stage IA to IIA mycosis fungoides, the most common form of ...
Strong Association Increasingly Recognized Between Obesity and Cancer Incidence/Poor Prognosis
The rise in obesity in the United States coincides with greater recognition of the role of obesity in cancer and other diseases.1 While decades of research have indicated a strong association between obesity and cancer, “several forces have made that association increasingly recognized,” according...
Conquer Cancer Foundation of ASCO Honors Researchers for Work in Measuring and Improving Quality of Cancer Care
The Conquer Cancer Foundation of the American Society of Clinical Oncology (ASCO) recently announced the first-ever recipients of its Quality Care Symposium Merit Awards. This year’s recipients will be recognized at ASCO’s inaugural Quality Care Symposium, taking place November 30 and December 1 in ...
Dong Quai
Scientific Name: Angelica sinensis Common Names: Chinese angelica, dang gui, tang kuei, tan kue Overview Dong quai is a perennial herb indigenous to China, Japan, and Korea. Its root has been used for centuries as a spice, tonic, and medicine. Dong quai is mentioned in Shen Nong Ben Cao Jing, the...
PD-1 Blockade Increases Transferred T-cell Migration to Tumors
One reason that adoptive cell transfer has met with limited clinical success is that approaches based on this strategy have not fully taken into account the role of the tumor microenvironment as a limiting factor in immunotherapy. Recently reported studies by Peng and colleagues1 from The...
Sorafenib Fails to Improve Survival as Third- or Fourth-line Treatment of Advanced Non–Small Cell Lung Cancer
Third- or fourth-line therapy with sorafenib (Nexavar) failed to extend overall survival in patients with advanced non–small cell lung cancer (NSCLC), according to the main results of the phase III MISSION trial. However, a post hoc biomarker analysis of MISSION suggested that patients with...
Ruxolitinib: Novel Drug for Myelofibrosis
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 November 2011, ruxolitinib (Jakafi) was approved for...
Risk Reduction for Patients with Multiple Primary Cancers
The number of patients with multiple primary cancers is increasing so that second malignant neoplasms now represent approximately 16%, or 1 in 6 cancers reported to the Surveillance, Epidemiology, and End Results (SEER) Program. While some second malignant neoplasms are treatment-related, others...
Delivering Affordable Cancer Care: Is It Possible and What Will It Entail?
Many experts agree that at 18% of gross domestic product, health care (to paraphrase Shakespeare) is eating the country out of house and home. “The average cost of treating the most common cancers has increased, and as more expensive targeted therapies and other new technologies become the...
FDA Approves New Use of Pemetrexed in the Maintenance Setting for NSCLC
The FDA has expanded labeling to include the results of an additional trial evaluating the safety and efficacy of pemetrexed (Alimta) for the initial treatment of patients with locally advanced or metastatic, nonsquamous, non–small cell lung cancer (NSCLC) followed by pemetrexed maintenance in...
Options Shifting for First-line Treatment of Renal Cell Carcinoma
Trials with pazopanib (Votrient) have “provided significant efficacy, toxicity, and tolerability data for pazopanib to be established as a first-line standard of care” for renal cell carcinoma,” Tim Eisen, PhD, of the University of Cambridge, United Kingdom, stated at the 11th International Kidney...
Albumin-bound Paclitaxel in First-line Treatment of Advanced 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. Indication On October 11, 2012, paclitaxel protein-bound particles...
Adjuvant Chemotherapy for Breast Cancer Predicted by Disease, Age, and Insurance Type, but Not by Race
Breast cancer mortality has been found to be higher among black and Hispanic women than among white women, with the differences in outcome being attributed in part to more advanced disease stage and greater frequency of unfavorable tumor biology among black and Hispanic women. Studies to date have...
Highlights From the Ninth International Conference of the Society for Integrative Oncology
The theme of this year’s International Conference of the Society for Integrative Oncology (SIO) was “Honoring Diversity in Cancer Prevention and Control.” The conference was held October 8–10, 2012, in Albuquerque, New Mexico, and examined such varied topics as health-care disparities, novel...
Integrative Medicine Showing Benefits in Cancer Management
Donald I. Abrams, MD, Chief of Hematology-Oncology at San Francisco General Hospital and Integrative Oncologist at the University of California, San Francisco, Osher Center for Integrative Medicine, has been investigating and incorporating integrative medicine approaches in his clinical treatment...
Regorafenib, Multikinase Inhibitor, for 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. Indication On September 27, 2012, regorafenib (Stivarga) was...
FDA Approves Noninvasive Radiation Therapy to Treat Pain from Bone Metastases
InSightec Ltd announced that the FDA has approved ExAblate MRI-guided focused ultrasound as a therapy to treat pain from bone metastases in patients who do not respond or cannot undergo radiation treatment for their pain. This is the second FDA approval for ExAblate since it was approved in 2004 as ...
SIDEBAR: Mammography Study Stokes Overdiagnosis Debate
Overdiagnosis and the harms associated with unnecessary procedures is becoming a vibrant subject in today’s health-care dialogue, with serious implications for providers and patients alike. A new study from the Norwegian Screening Program concluded that 15% to 25% of breast cancers identified on...
Who Should Receive First-line BEACOPP Therapy for Hodgkin Lymphoma?
At the Pan Pacific Lymphoma Conference, held this year in Maui, Hawaii, Andreas Engert, MD, Chairman of the German Hodgkin Study Group, University Hospital of Cologne, Germany, led off the Hodgkin lymphoma section of the conference with a presentation on optimizing the use of BEACOPP (bleomycin,...
Seeking Solutions to the Dilemmas of Overdiagnosis and Overtreatment
Widespread use of screening technologies has markedly increased early detection rates of cancer, saving countless lives. However, while screening technologies have remarkable sensitivity, their inability to identify which tumors will progress and which will not has created the phenomenon of...
Defining a Cure for Chronic Myeloid Leukemia and Strategies to Achieve this Goal
In chronic myeloid leukemia (CML), continued long-term therapy that prevents both progression to accelerated-phase disease and the emergence of resistance may be thought of as an “operational” or “functional” cure. However, long-term disease control without the requirement for continuous treatment...
