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health-care policy

Patients Benefit From Faster FDA Drug Approval Process

In an increasing spirit of cooperation, U.S. Food and Drug Administration (FDA) and several pharmaceutical companies are bringing to fruition the newest in a series of ways to expedite drug development and review. Breakthrough therapy is the designation instituted in 2012 by the FDA Safety and...

leukemia

Looking Ahead in Treating Chronic Lymphocytic Leukemia

It’s the dawn of a new era in the treatment of chronic lymphocytic leukemia (CLL), largely due to the development of agents targeting the BCR signaling pathway, according to John C. Byrd, MD, of The Ohio State University Comprehensive Cancer Center, Columbus. At the 19th Annual Conference of the...

issues in oncology
supportive care

NCCN Roundtable: When a Parent Has Cancer

Attendees at this year’s annual conference of the National Comprehensive Cancer Network (NCCN) not only got up to date on the Guidelines but left with a better understanding of how children deal with a parent’s cancer, and how oncology providers can best help. Panelists for the NCCN roundtable...

survivorship

Study Calls for Revisiting Guidelines for Screening Childhood Cancer Survivors at Risk of Congestive Heart Failure

One of the first studies to analyze the effectiveness of screening survivors of childhood cancer for early signs of impending congestive heart failure found improved health outcomes but suggests that less frequent screening than currently recommended may yield similar clinical benefit. The...

colorectal cancer

Surveillance After Colon Cancer Surgery: Too Much of a Good Thing?

Finding salvageable colon cancer recurrence is akin to finding a needle in a haystack, rendering routine patient surveillance of little value. But finding that needle offers an opportunity for treating recurrent disease early, which makes surveillance worthwhile. These were the opposing views...

cns cancers

Glioblastoma: Can We Make This Intractable Disease Tractable?

In the clinical array of brain tumors, glioblastoma is the most difficult to treat, and despite decades of research and the advent of new therapies, patients with glioblastoma continue to have a very poor prognosis. Leading brain tumor experts at the recent 25th Annual Cancer Progress Conference in ...

breast cancer

Axillary Radiotherapy Associated With Fewer Side Effects Than Lymph Node Dissection in AMAROS Analysis

Radiation therapy is associated with significantly fewer postoperative complications than axillary lymph node dissection, according to a detailed analysis of morbidity from the AMAROS (After Mapping of the Axilla: Radiotherapy or Surgery?) trial presented at a press briefing prior to the American...

breast cancer

Cryoablation of Breast Tumors Shows Promise in Patients With Early-Stage Disease

Cryoablation of breast tumors, which destroys lesions by exposing them to extremely low temperatures, shows promise as an alternative to surgery in carefully selected women with early-stage disease, according to a study presented at the American Society of Breast Surgeons Annual Meeting in Las...

breast cancer

Obesity Increases Breast Cancer Mortality in Premenopausal Women With Estrogen Receptor–Positive Disease

According to results of a large study of women with early breast cancer, the presence of obesity increased the risk of breast cancer–related mortality by 34% in premenopausal women with estrogen receptor–positive breast cancer. Obesity had little effect on breast cancer–related mortality in...

Expert Point of View: George W. Sledge, Jr, MD

In his commentary on the ALTTO results, George W. Sledge, Jr, MD, Professor of Medicine and Director of the Division of Oncology at Stanford University, reminded attendees that the announcement of the first results for adjuvant trastuzumab, which occurred at the 2005 ASCO Annual Meeting, was “a...

breast cancer

ALTTO Trial Finds Dual Anti-HER2 Therapy No Better Than Trastuzumab Alone

The highly anticipated results from the phase III ALTTO trial show no additional benefit for adding lapatinib (Tykerb) to trastuzumab (Herceptin) in the adjuvant treatment of HER2-positive breast cancer.1 The results were presented at the 2014 ASCO Annual Meeting’s Plenary Session by Martine J....

lung cancer
issues in oncology

Medicare Advisory Panel Cast Doubts on Lung Cancer Screening, Leaving Advocates Dismayed but Undaunted

On April 30, 2014, the Centers for Medicare & Medicaid Services (CMS) convened the Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) to assess the value of low-dose computed tomography (CT) lung cancer screening in the Medicare population. After a decades-long battle,...

issues in oncology

'Small Practices Like Mine'

Recently, I participated in ASCO’s Congressional news briefing in Washington, DC, following the release of its report, The State of Cancer Care in America: 2014. During my presentation I talked about the workforce shortage of approximately 1,500 medical oncologists that is predicted by 2025. A...

Expert Point of View: Michael J. Morris, MD

Formal discussant of the E3805 study, Michael J. Morris, MD, Associate Member at Memorial Sloan Kettering Cancer Center in New York, said that these results confirm the role of upfront chemotherapy along with androgen-deprivation therapy in men with newly diagnosed metastatic hormone-sensitive...

prostate cancer

‘Unprecedented’ Survival Benefit in Prostate Cancer With Addition of Docetaxel to Hormone Therapy

Adding docetaxel to standard androgen ablation therapy (ie, testosterone suppression) extended survival by more than 1 year in men with newly diagnosed metastatic hormone-sensitive prostate cancer in the phase III E3805 trial, funded by the National Institutes of Health. As reported at the ASCO...

Leading Cancer Researcher and Public Health-Care Expert, Eddie Reed, MD, Dies

In a 2010 interview, Eddie Reed, MD, a pioneer in the molecular pharmacology of DNA-damaging anticancer agents and the clinical development of paclitaxel for ovarian cancer, was asked what lay ahead. Before answering, Dr. Reed first acknowledged the esteemed mentors who gave him their most precious ...

colorectal cancer

Aflibercept More Active Than Bevacizumab in Patient-Derived Colorectal Cancer Xenografts

Some evidence suggests that dual targeting of vascular endothelial growth factor (VEGF) and placental growth factor (which binds to VEGFR-1) might provide more effective antiangiogenic therapy. In a study reported in Molecular Cancer Therapeutics, Chiron and colleagues compared the antitumor...

breast cancer

Long-Term Follow-up Confirms Low Incidence of Cardiac Events Associated With Trastuzumab

At a median follow-up of 8 years, patients receiving trastuzumab (Herceptin) sequentially after chemotherapy and radiotherapy in the Herceptin Adjuvant (HERA) trial had a low incidence of cardiac events and these were reversible in the vast majority of patients. This long-term assessment confirms...

colorectal cancer
geriatric oncology

Colorectal Cancer Screening Recommended Past Age 75 for Previously Unscreened Patients

Colorectal cancer screening is cost-effective and “should be considered well beyond age 75 years” for individuals not previously screened, according to a computer simulation study published in the Annals of Internal Medicine. The researchers noted that while the U.S. Preventive Services Task Force...

Expect Questions From Patients

With the extensive media coverage of a study indicating that injections with the luteinizing hormone–releasing hormone (LHRH) agonist goserelin (Zoladex) may offer a new option for preserving fertility among women treated for breast cancer, physicians can expect questions from interested patients....

breast cancer

New Option for Preserving Fertility in Women Being Treated With Chemotherapy for Early-Stage Breast Cancer

One of the most reported studies emanating from the 2014 ASCO Annual Meeting involves the use of the luteinizing hormone–releasing hormone (LHRH) agonist goserelin (Zoladex) to reduce the risk of ovarian failure among women being treated with chemotherapy for early-stage breast cancer, and to...

cost of care
health-care policy

Cancer Care Under the Affordable Care Act

The problematic rollout of the Affordable Care Act’s website, HealthCare.gov, made good political theater, but while much of the heated discussion centered on the plan’s need to enroll “young invincibles,” America’s cancer care system and the older patients it serves were also affected by parts of...

colorectal cancer

Colonoscopy Adenoma Detection Rate Inversely Proportional to Risk of Interval Colorectal Cancer and Colorectal Cancer Mortality

In a study of health-care organization data reported in The New England Journal of Medicine, Douglas A. Corley, MD, PhD, of Kaiser Permanente, and colleagues assessed the relationship between proportion of colonoscopies performed by a gastroenterologist that detect an adenoma and risk of subsequent ...

Paying It Forward: Breakthrough Prize Winners and Institutions Commit $3 Million in Support of Next Generation of Scientists

Following last year’s announcement of the first-ever Breakthrough Prizes, established by a group of Silicon Valley entrepreneurs to celebrate scientists and encourage careers in the field, the winners were frequently asked what they would do with their newfound prize money of $3 million each. Three ...

breast cancer

Issues in the Management of the Axilla in Patients With Breast Cancer

For the past 40 years the story of breast cancer surgery in general, and for the past 20 years the management of the axilla in particular, has been one of increasing conservatism. To give our readers insight into the current and future direction of axillary management, The ASCO Post spoke with...

breast cancer

A New Era in the Management of Advanced HER2-Positive Breast Cancer

Approximately 20% of all breast cancers are human epidermal growth factor receptor 2 (HER2)-positive. Prior to the era of HER2-targeted therapy, HER2-positive breast cancer was characterized by a poor prognosis.1,2 The development of the first HER2-targeted therapy, trastuzumab (Herceptin), led to...

breast cancer

ASCO Clinical Practice Guideline: Systemic Therapy for Patients With Advanced HER2-Positive Breast Cancer

Approximately 15% of patients with breast cancer have tumors that overexpress the HER2 protein and these patients can benefit from HER2-targeted therapies. The American Society of Clinical Oncology recently released a clinical practice guideline on systemic therapy for patients with advanced...

Videos Tell Stories of 50 Years of Progress Against Cancer

Nearly 3 years ago, ASCO launched CancerProgress.Net to mark the 40th anniversary of the signing of the U.S. National Cancer Act, which led to major new investments in cancer research and significant increases in cancer survival. The site provides a dynamic and interactive history of progress...

The 2014 Conquer Cancer Foundation Grants and Awards

The Conquer Cancer Foundation of ASCO presented more than $5 million in grants and awards to more than 250 promising oncology researchers at the 2014 ASCO Annual Meeting, held May 30 to June 3 in Chicago, Illinois. The Conquer Cancer Foundation and ASCO congratulate the 2014 grant and award...

colorectal cancer

Colorectal Cancer Screening Poised for Change

New screening modalities and the customization of the screening population could soon change the way that screening for colorectal cancer is done. At Digestive Disease Week 2014, the largest gathering of gastrointestinal disease specialists in the world, researchers presented data suggesting that...

breast cancer

Preoperative Breast MRI: Does Higher Sensitivity Equal Better Outcomes?

Breast magnetic resonance imaging (MRI) is superior to more commonly used imaging modalities in preoperative breast cancer staging and should be a key element in routine workup. But despite its high sensitivity for catching cancers, breast MRI still does not deliver maximum value for the patient....

pancreatic cancer

Research Insights From the AACR Special Conference on Pancreatic Cancer

Pancreatic cancer still kills 40,000 Americans a year out of approximately 44,000 diagnosed. While advances in diagnosis and treatment are extending the lives of patients with other cancers, pancreatic ductal adenocarcinoma remains the second most lethal tumor (behind lung cancer). While a magic...

Expert Point of View: Sherene Loi, MD PhD

Sherene Loi, MD PhD, Head of the Translational Breast Cancer Genomics Lab at the Peter McCallum Cancer Centre, Victoria, Australia, commented on the N9831 study presentation and referred to her group’s own work on tumor-infiltrating lymphocytes. These investigators have shown a positive association ...

breast cancer

Immune-Related Genes Predictive of Trastuzumab Benefit

Improved relapse-free survival following treatment with adjuvant trastuzumab (Herceptin) appears to be associated with a heightened state of immunologic function, according to genomic analysis that resulted in a 14-gene profile predictive of outcomes in the landmark NCCTG (Alliance) N9831 trial.1...

Expert Point of View: Sharon H. Giordano, MD, MPH

Formal discussant Sharon H. Giordano, MD, MPH, Professor of Medicine and Chair of Health Services Research at The University of Texas MD Anderson Cancer Center, Houston, emphasized how important it is to preserve fertility in these younger patients with breast cancer. “The main downside is an...

breast cancer

Goserelin With Chemotherapy Prevents Early Menopause, Helps Preserve Fertility in Younger Women With Hormone Receptor–Negative Breast Cancer

The good news for younger women with hormone receptor–negative early breast cancer is that adding goserelin (Zoladex), a luteinizing hormone–releasing hormone (LHRH) agonist, to chemotherapy can prevent sudden menopause, better preserve ovarian function and fertility, and lead to successful...

lung cancer

Pieces of the Puzzle in Treating Early Non–Small Cell Lung Cancer

Separate studies in early-stage non–small cell lung cancer (NSCLC) found that the addition of consolidation chemotherapy to concurrent chemoradiotherapy did not improve survival and that adjuvant erlotinib (Tarceva) did not improve survival. There was a suggestion of benefit for adjuvant erlotinib...

leukemia

Ibrutinib Surpasses Ofatumumab as Second-Line Treatment of Chronic Lymphocytic Leukemia

Ibrutinib (Imbruvica) significantly improved progression-free survival, overall survival, and response when compared with ofatumumab (Arzerra) as second-line treatment of chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL) in the phase III RESONATE study. The study results were...

gynecologic cancers

Early Study Explores New Approach to Treating Advanced Cervical Cancer

A small, federally funded study of nine patients treated with human papillomavirus (HPV)-targeted adoptive T-cell therapy gives reason to hope that this type of therapy may be a new effective approach for patients with metastatic cervical cancer and possibly other solid tumors.1 In the study, two...

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

Despite the availability of hormonal therapy for the treatment of metastatic prostate cancer and the high response rates for these agents, most patients eventually experience progression to castration-resistant disease. “Multidisciplinary team approaches have contributed to the enormous progress...

prostate cancer

Updated Information on Prostate Cancer Drugs: Enzalutamide, Orteronel, and Cixutumumab

Three separate studies of treatments for prostate cancer reported at the 2014 ASCO Annual Meeting in Chicago showed excellent, intermediate, and disappointing results. An update of the previously reported PREVAIL trial (see March 1 issue of The ASCO Post, page 1) was overwhelmingly positive for the ...

Advancing Immune Checkpoint Targeting in Cancer Treatment

James P. Allison, PhD, Professor and Chair of the Department of Immunology, Executive Director of the Moon Shots Immunotherapy Platform, and Deputy Directory of the David H. Koch Center for Applied Research of Genitourinary Cancers at The University of Texas MD Anderson Cancer Center, Houston, is...

lung cancer
issues in oncology

Time to Move Forward With Lung Screening

Start with the most lethal cancer globally—lung cancer—for which standard approaches result in a modest 5-year survival. Then consider the results from the National Lung Screening Trial (NLST), suggesting in a well done randomized study that significant mortality reduction does occur with low-dose...

Expert Point of View: Nancy E. Davidson, MD, and Claudine Isaacs, MD

This study provides key insights into the longstanding and vexing debate about optimal systemic therapy for these young women. We wonder about the role of tamoxifen, aromatase inhibitors, chemotherapy, and ancillary therapies like bisphosphonates,” said Nancy E. Davidson, MD, Director of the...

breast cancer

Exemestane/Ovarian Suppression Reduces Recurrence vs Tamoxifen/Ovarian Suppression in Premenopausal Breast Cancer

A joint analysis of two important phase III clinical trials—TEXT (Tamoxifen and Exemestane Trial) and SOFT (Suppression of Ovarian Function Trial)—showed that exemestane plus ovarian function suppression was superior to tamoxifen plus ovarian suppression in preventing recurrence in premenopausal...

head and neck cancer
issues in oncology

Limited Public Awareness of Head and Neck Cancers Raises Concerns About Prevention and Detection

Public awareness of head and neck cancer is limited, with the lack of awareness including the term head and neck cancer and common symptoms and risk factors, such as tobacco use and human papillomavirus (HPV), according to results of a cross-sectional online survey reported in JAMA...

breast cancer

Underuse of Trimodality Treatment for Patients With Inflammatory Breast Cancer Negatively Impacts Survival

Analysis of data for 10,197 women treated for nonmetastatic inflammatory breast cancer treated over a 12-year-period found that the use of trimodality treatment (chemotherapy, surgery, and radiation therapy) fluctuated annually between 58.4% and 73%. “Underutilization of trimodality therapy...

palliative care

Discontinuing Statins Near the End of Life Is Safe, Can Reduce Symptom Burden, and Is Generally Acceptable to Patients

Discontinuing statins for patients near the end of life is safe, saves money, spares patients from swallowing yet another pill and from the symptoms associated with statins, and is generally welcomed by patients. That last bit might come as a surprise to some physicians who worry that discontinuing ...

ASTRO Names Three Radiation Oncologists as Recipients of Society’s 2014 Gold Medal

The American Society for Radiation Oncology (ASTRO) has announced the names of three recipients of the Society’s highest honor, the ASTRO Gold Medal. Mary K. Gospodarowicz, MD, FASTRO, Leonard L. ­Gunderson, MD, MS, FASTRO, and Nancy J. ­Tarbell, MD, FASTRO, will receive the ­ASTRO Gold Medal...

issues in oncology

UC Davis Comprehensive Cancer Center Tailors Pilot Program to Help Patients Adhere to Oral Chemotherapy

A University of California, Davis, Comprehensive Cancer Center program designed to better manage cancer patients taking oral chemotherapy drugs has demonstrated that one-on-one counseling, education, and monitoring can improve adherence to therapy. Issues in Adherence The rise in oral chemotherapy...

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