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Showing 8501 - 8550Better Risk Communication Strategies Needed to Ensure Decision to Have Contralateral Prophylactic Mastectomy Is Evidence-Based
Overestimating the risk that cancer in one breast will affect the other breast may cause many young women with breast cancer to choose contralateral prophylactic mastectomy even though most know it does not clearly improve survival. In a survey of 123 women who were diagnosed with cancer in one...
Claudia I. Henschke, PhD, MD, Took a Circuitous Route to Her Groundbreaking Work in Lung Cancer Screening
“Once you have tasted flight, you will forever walk the earth with your eyes turned skyward, for there you have been, and there you will always long to return.” —Leonardo da Vinci Lung cancer CT screening may have had no greater advocate than Claudia I. Henschke, PhD, MD. In the face of...
Lung Cancer Screening: Actionable Evidence
This recent paper in The New England Journal of Medicine outlines the details of the clinical outcomes with two incidence screens that were conducted as part of the National Lung Screening Trial (NLST).1 In the wake of the positive review of the U.S. Preventive Services Task Force (USPSTF) draft...
Low-Dose CT Screening Identifies More Early Lung Cancer but Has Lower Positive Predictive Value vs Radiography
Results of the two rounds of annual incidence screening with low-dose computed tomography (CT) vs radiography in the National Lung Screening Trial (NLST) were recently reported by Denise R. Aberle, MD, Professor of Radiology and Bioengineering at the University of California at Los Angeles and...
Having Breast Cancer Has Actually Been a Positive Experience
I know it sounds strange, but being diagnosed with cancer was one of the best things to have happened to me. I don’t mean to diminish the traumatic experience of hearing the words, “You have breast cancer.” That was over 11 years ago, and I’m still reeling from the diagnosis and its aftereffects....
Cabozantinib in Medullary Thyroid Cancer: A Landscape-Shaping New Treatment
Medullary thyroid cancer is derived from parafollicular C cells in the thyroid gland. The disease is sporadic in about 75% of cases and hereditary in the remaining 25%.1 Oncogenic mutations in the gene for tyrosine kinase receptor rearranged during transfection (RET) are driver genetic alterations...
Cabozantinib Improves Disease-Free Survival in Progressive Medullary Thyroid Cancer
Cabozantinib (Cometriq) is an inhibitor of hepatocyte growth factor receptor (MET), vascular endothelial growth factor receptor 2 (VEGFR2), and rearranged during transfection (RET) tyrosine kinases. In a phase III trial reported in Journal of Clinical Oncology, Rossella Elisei, MD, of University of ...
Cardiovascular Risk Factors in Cancer Survivors
Armstrong et al evaluated the prevalence of self-reported hypertension, diabetes mellitus, dyslipidemia, and obesity and the incidence of self-reported major cardiac events such as coronary artery disease, heart failure, valvular disease, and arrhythmias in adult survivors of childhood cancer in...
Modifiable Risk Factors Potentiate Therapy-Associated Risk for Major Cardiac Events in Adult Survivors of Childhood Cancer
In a study reported in the Journal of Clinical Oncology, Gregory T. Armstrong, MD, of St. Jude Children’s Research Hospital in Memphis, and colleagues assessed the frequency of major cardiac events and cardiovascular risk factors among adult survivors of childhood cancer and their siblings.1 They...
'Master Protocol' Could Revolutionalize Trials in Lung Cancer, and Eventually Other Cancers
Cancer advocates and clinical trialists, for some time, have been proposing a radical change to the laborious drug development process—that industry, academia, funding sources, and other stakeholders actually pool their brain power and financial means and work together, not separately, to develop...
SIDEBAR: 2013 New Drug/Indication Approvals*
1. September 30, 2013: Pertuzumab (Perjeta) Accelerated approval in combination with trastuzumab and docetaxel for the neoadjuvant treatment of HER2-positive, locally advanced, inflammatory, or early-stage breast cancer. 2. September 6, 2013: Paclitaxel protein-bound particles (albumin-bound)...
A Look Ahead: How the FDA Is Adapting in the Era of Precision Medicine
Dubbed “Cancer Czar” by the media, Richard Pazdur, MD, Director of the U.S. Food and Drug Administration (FDA) Office of Hematology and Oncology Products, said he has the “best job in oncology, with a unique vantage point in cancer drug development.” An oncologist for more than 30 years—including...
ASCO President-Elect Candidate Julie M. Vose, MD, MBA, FASCO
Cost of Care and Federal Funding How can ASCO address the high cost of cancer care and diminishing federal resources for basic and translational research? We need to work with the Centers for Medicare & Medicaid Services, private insurers, and health-care systems to encourage evidence-based...
Zhe-Bin Liu, MD, PhD, of China Receives 2013 Long-Term International Fellowship in Breast Cancer
Zhe-Bin Liu, MD, PhD, of Shanghai Cancer Center, Fudan University, China, is the recipient of the 2013 Conquer Cancer Foundation of ASCO Long-Term International Fellowship (LIFe) in Breast Cancer, generously supported by The Breast Cancer Research Foundation. The LIFe provides early-career...
Take-Home Messages From the NCCN Hematologic Malignancies Conference
As the National Comprehensive Cancer Network (NCCN) 8th Annual Congress: Hematologic Malignancies was drawing to a close, The ASCO Post spoke with Andrew D. Zelenetz, MD, PhD, about the themes of the meeting and the take-home messages for attendees and for our readers. Dr. Zelenetz is Vice Chair...
New Strategies for Relapsed/Refractory Multiple Myeloma Explored
Although upfront therapy can achieve remission in multiple myeloma, most patients will ultimately relapse. Newer targeted therapies and genomic analysis are moving the management of relapsed/refractory multiple myeloma forward, according to Kenneth C. Anderson, MD, Director, Jerome Lipper Multiple...
The AVEX Trial
As reported in The Lancet Oncology by Cunningham and colleagues and reviewed in this issue of The ASCO Post, the AVEX trial was an open-label randomized phase III trial limited to patients over the age of 70 years with previously untreated, unresectable metastatic colorectal cancer who were not...
Aspirin Protects Against Colorectal Cancer Recurrence in PIK3CA-Mutant Tumors
At the 2013 European Cancer Congress, two investigative teams attempted to explain how aspirin may protect against colorectal cancer recurrences, with one study showing PIK3CA mutations associated with protection from aspirin, but not a COX-2 inhibitor, and the other study implicating HLA class I...
SIDEBAR: Highlighted Abstracts to Watch in San Antonio
S1-01. Piccart-Gebhart M, Holmes AP, de Azambuja E, et al: The association between event-free survival and pathological complete response to neoadjuvant lapatinib, trastuzumab or their combination in HER2-positive breast cancer. Survival follow-up analysis of the NeoALTTO study (BIG 1-06) S1-02....
Women Undergoing Mammography Fail to Understand Breast Cancer Risk
More than 90% of women undergoing mammography screening could not give an accurate estimate of their personal risk of developing breast cancer, according to results of a large survey reported at the 2013 ASCO Breast Cancer Symposium and featured in a premeeting presscast. The survey showed that a...
The Devastating Impact of Sequestration on Medical Research
The primacy of science and the overwhelming belief in medical research by the American people has sustained the research community and improved quality of life roughly since the turn of the 20th century. Almost without exception, the American people have voted for politicians who promise improved...
ASCO's 2013 Top Five List in Oncology for Choosing Wisely Campaign
ASCO recognizes the importance of evidence-based cancer care and making wise choices in the diagnosis and management of patients with cancer. After careful consideration by experienced oncologists, ASCO annually highlights five categories of tests, procedures and/or treatments annually whose common ...
Patient Assistance Programs Provide Psychosocial but Not Practical Help
“Patients with breast cancer who connect to relevant patient assistance programs receive useful informational and psychosocial but not practical help,” concluded Nina A. Bickell, MD, MPH, of Mount Sinai School of Medicine in New York, and colleagues who conducted a randomized trial among 374 women...
'Clear and Consistent Protective Effect of Marriage' Found in Patients With 10 Most Clinically Significant Cancers
A clear and consistent protective effect of marriage among patients harboring one of the 10 most clinically significant malignancies affecting Americans” was found in a study analyzing Surveillance, Epidemiology, and End Results (SEE) data for 734,889 patients diagnosed with lung, colorectal,...
Decoding Annie Parker: Hunting the Breast Cancer Gene
Based on true events, Decoding Annie Parker follows the parallel stories of two women obsessed with finding a genetic link to breast cancer. And from the film’s opening frame until the closing credits roll, the absorbing tale never allows your mind to wander. Attempting to Elude Fate One woman is...
Having Bladder Cancer Has Taught Me Important Life Lessons
I think one of the most frightening—and embarrassing—things that can happen to an adult is losing control of your bladder and wetting the bed. When that happened to me in the spring of 2012 while I was on a camping trip with my wife Kimberly and our two teenage daughters, I knew something was very...
FDA Hears Proposals on Codevelopment of Companion Diagnostics for Breakthrough Therapies
A companion diagnostic developed for use with a drug that has received Breakthrough Therapy designation from the U.S. Food and Drug Administration (FDA) should automatically be eligible for priority review, according to an expert panel that presented this proposal and four others to the FDA in...
Yoga Improves Sleep Quality in Patients With Cancer Suffering From Sleep Disruption
It is estimated that 30% to 90% of patients with cancer experience impairment of sleep quality post-treatment, and such impairment can be severe enough to increase morbidity and mortality. Preliminary evidence indicates that yoga may improve sleep in cancer patients. In a study reported in the...
In International Study, Patients Prefer Subcutaneous Over Intravenous Trastuzumab for Breast Cancer
Subcutaneous trastuzumab (not available in the United States) has been shown to have noninferior efficacy and similar pharmacokinetic and safety profiles compared with intravenous trastuzumab (Herceptin) in patients with early-stage HER2-positive breast cancer. In the PrefHer trial reported in...
Two Patients in One, Mom and Baby: Managing Coincident Pregnancy and Lymphoma
The news that she is both pregnant and has been found to have a potentially lethal malignancy is one of the most emotionally wrenching events any young woman ever faces. Understandably, the patient, her partner, their families, and even their caregivers find this experience fraught with anxiety and ...
Multicenter Analysis of Outcomes of Lymphoma in Pregnancy
Lymphoma is the fourth most frequent cancer to occur in pregnant women. In a multicenter retrospective analysis reported in Journal of Clinical Oncology, Andrew M. Evens, DO, MSc, Chief of Hematology/Oncology at Tufts University Medical Center, Boston, and colleagues examined treatment,...
New Report Examines Trends in End-of-Life Care
Although fewer Medicare patients with cancer died in the hospital in 2010 than in the years 2003–2007, aggressive treatment continues at the end of life, according to a new report from the Dartmouth Atlas Project.1 The findings also show that a significant number of patients were likely to receive...
Illness Is Personal!
For clinicians and health service researchers striving to improve care for people living with life-threatening conditions, September was a sobering month. The Dartmouth Atlas group released a brief report on Trends in Cancer Care Near the End of Life1 showing that while the proportion of patients...
Breast Cancer Index Assay Prognostic for Distant Recurrence in Estrogen Receptor–Positive, Node-Negative Breast Cancer
In a study reported in The Lancet Oncology, Dennis C. Sgroi, MD, of Massachusetts General Hospital, and colleagues compared the ability of the breast-cancer index (BCI) assay, 21-gene recurrence score (Oncotype DX), and an immunohistochemical prognostic model (IHC4) to predict early and late...
ASCO Reconfirms Commitment to Choosing Wisely® Campaign
In collaboration with the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely® campaign, ASCO recently released a second “Top Five” opportunities list of common practices or procedures in oncology whose clinical value is not supported by available evidence and if eliminated, can ...
Pertuzumab in Neoadjuvant Treatment of HER2-Positive Early 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 On September 30, 2013, pertuzumab injection (Perjeta)...
FDA Announces Strategic Plan to Prevent Drug Shortages
The U.S. Food and Drug Administration (FDA) is taking two actions to further enhance the agency’s ongoing efforts to prevent and resolve drug shortages. The FDA has released a strategic plan called for in the Food and Drug Administration Safety and Innovation Act (FDASIA) of 2012 to improve the...
Neoadjuvant Treatment of Early Breast Cancer
INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this first installment, FDA Clinical Reviewers Laleh Amiri-Kordestani, MD, and Suparna Wedam, MD, discuss FDA’s recent approval of pertuzumab (Perjeta) for the neoadjuvant treatment of...
Brivanib Fails to Live Up to the Promise of Early Studies
Hepatocellular carcinoma is a devastating disease worldwide. Although advances in liver transplantation, surgery, and locoregional therapies have made tumor control or even cure possible for a minority of patients, the majority of patients diagnosed with hepatocellular carcinoma will develop...
Investigational ALK Inhibitor Shows Promise in Patients With Crizotinib-Refractory, ALK-Positive NSCLC
Patients with non–small cell lung cancer (NSCLC) whose tumors have the ALK gene rearrangement usually respond to the drug crizotinib (Xalkori), with a median duration of response of approximately 10 months. In a study reported by Shirish Gadgeel, MD, of Karmanos Cancer Institute in Detroit, and...
Oncogene Addiction and the Rationale for Molecular Targeted Therapy in Lung Cancer
Over the past decade, Fadlo R. Khuri, MD, Professor and Roberto C. Goizueta Distinguished Chair of Hematology and Medical Oncology, and Deputy Director of the Winship Cancer Institute of Emory University, Atlanta, has focused his research and clinical career on investigating novel approaches in the ...
Sale of Ponatinib Suspended Due to Risk of Life-Threatening Blood Clots
The U.S. Food and Drug Administration (FDA) has asked the manufacturer of the tyrosine kinase inhibitor ponatinib (Iclusig) to suspend marketing and sales of the drug because of the risk of life-threatening blood clots and severe narrowing of blood vessels. Ariad Pharmaceuticals has agreed to...
Important News Briefs: New Data Reported in Breast, Renal Cell, Head and Neck, and Lung Cancer
The 2013 European Cancer Congress (ECC), held September 27 to October 1 in Amsterdam, was jointly sponsored by the European Society of Medical Oncology, the European Cancer Organization, and the European Society of Radiation Oncology. With the Congress theme being “Reinforcing Multidisciplinarity,” ...
Standardizing the Interpretation of PET Scans: An INR Equivalent
Since its introduction, the positron-emission tomography (PET) scan has shown great potential to improve our ability to care for patients with lymphoma. By demonstrating which masses seen on a computed tomography (CT) scan represent viable tumor, and by identifying viable tumor in places that were...
Nodal Status and Tumor Size Predicted Late Recurrences of ER-Positive Breast Cancer in Postmenopausal Women
Only nodal status and tumor size provided statistically significant prognostic information for predicting recurrences 5 to 10 years after diagnosis for postmenopausal women with early estrogen receptor–positive breast cancer enrolled in the monotherapy arms of the ATAC (Arimidex, Tamoxifen, Alone...
SIDEBAR: Expect Questions From Your Patients
Risk-reducing salpingo-oophorectomy “is an important strategy for reducing both breast and gynecologic cancer risk for women with BRCA1 or BRCA2 mutations and is proven to improve life expectancy,” Noah D. Kauff, MD, told The ASCO Post. Questions persist, however, about whether women undergoing...
Cost-Effectiveness of MRI Screening for Women With Familial Risk of Breast Cancer in the Netherlands
Annual screening for breast cancer with magnetic resonance imaging (MRI) has been found to be cost-effective in women aged 30 to 60 years who are BRCA1 or BRCA2 carriers or who have a 50% chance of being a carrier, and such screening is recommended in these women by many authorities. It is unclear...
Spanning a Spectrum of Issues Related to Head and Neck Cancers
Five recent articles in JAMA Otolaryngology–Head & Neck Surgery1-5 span a spectrum of issues related to head and neck cancers. These include risk factors, concentration of care to teaching hospitals, avoiding venous thromboembolism, and encouraging patients to eat and do swallowing exercises to ...
Improving Quality Measurement in Cancer Care: Policy Recommendations
Quality measurement—how we assess cost and effectiveness of cancer care—cannot be separated from policy decisions that have a profound influence on the overall health-care system. At the recent ASCO Quality Care Symposium, Jennifer L. Malin, MD, PhD, Medical Director for Oncology at WellPoint, Inc, ...
Living With Cancer: The Role of Palliative Care in Long-Term Survivorship Care
According to data from the Surveillance, Epidemiology, and End Results Program (SEER) and the U.S. Census Bureau registries,1 there are currently about 13.7 million cancer survivors in the United States, and that number is projected to grow to 18 million by 2022. In addition, 64% of this population ...
