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issues in oncology

NIH Commits $24 Million Annually for Big Data Centers of Excellence

The National Institutes of Health will fund up to $24 million per year for 4 years to establish six to eight investigator-initiated Big Data to Knowledge Centers of Excellence. The centers will improve the ability of the research community to use increasingly large and complex datasets through the...

survivorship

Living and Working with Cancer 

The most recent figures from the National Cancer Institute put the number of cancer survivors in the United States at nearly 14 million—by 2022, that number is expected to top 18 million. And for the vast majority of those survivors—more than 80%—returning to work after treatment is a top priority...

integrative oncology

Western Science Catching Up with Traditional Chinese Medicine 

Since the National Institutes of Health Consensus Statement in 1997 concluded that the evidence to date suggests acupuncture is effective in the treatment of chemotherapy-induced nausea and vomiting,1 numerous additional indications for its use in relieving symptoms related to cancer or its...

integrative oncology

Acupuncture May Reduce Arm Lymphedema in Patients with Breast Cancer 

Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering Cancer Center...

prostate cancer

David Penson, MD, MPH, Receives $2 Million Research Award to Study Prostate Cancer  

David Penson, MD, MPH, Professor of Urologic Surgery, Vanderbilt University Medical Center, Nashville, has received a $2 million research award from the Patient-Centered Outcomes Research Institute to study localized prostate cancer. Dr. Penson is also Director of the Vanderbilt Center for Surgical ...

SIDEBAR: Key Issues in Joint Commission Statement by American Psychosocial Oncology Society,  Association of Oncology Social Work, and Oncology Nursing Society 

It is imperative that [Commission on Cancer]-accredited programs adopt a universal definition of distress. We concur with the National Comprehensive Cancer Network definition of distress as an “unpleasant emotional experience of a psychological (cognitive, behavioral, emotional), social, and/or...

supportive care

Professional Societies Endorse 2015 Standard for Cancer Center Accreditation by Commission on Cancer 

In 2015, the American College of Surgeons (ACoS) Commission on Cancer (CoC) will require cancer centers to implement screening programs for psychosocial distress as a new criterion for accreditation. The American Psychosocial Oncology Society (APOS) recently announced recommendations to support a...

issues in oncology

Adolescents, Young Adults with Cancer Often Challenged By Unmet Needs Following Treatment 

About 70,000 adolescents and young adults (AYAs) between the ages of 15 and 39 are diagnosed with cancer each year, and in the past 30 years, there has been little or no improvement in survival in this population. In addition to the disease itself, they face many other challenges: reentry into...

lung cancer

Significant Improvement in Overall Survival Seen with Pemetrexed Maintenance after Pemetrexed/Cisplatin Induction in Patients with Advanced NSCLC 

In the phase III PARAMOUNT trial, pemetrexed (Alimta) continuation maintenance therapy significantly reduced the risk of disease progression by 38% compared with placebo after pemetrexed/cisplatin induction in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Final overall...

lung cancer

Intercalated Chemotherapy/Erlotinib Improves Progression-free Survival in Advanced NSCLC  

EGFR mutation status may not be known at the time treatment is started in patients with advanced non–small cell lung cancer (NSCLC). Further, some data suggest that the efficacy of concurrent treatment with an EGFR tyrosine kinase inhibitor and chemotherapy is reduced because the G1 cell-cycle...

issues in oncology

Policy Update Aims to Advance Tobacco Cessation and Control Worldwide

In response to scientific advances and the evolving regulatory and policy environment, ASCO recently released an update to its 2003 policy statement on tobacco cessation and control. The statement reviews advancements that have been made since 2003 and outlines a refined set of recommendations...

issues in oncology

A Look Ahead: The Next Decade in Pediatric Oncology 

The past 10 years have seen dramatic advances in cancer care, especially in better screening methods and earlier detection, genomic sequencing, and more effective therapies, which have led to increased survival rates in both childhood and adult cancers. According to the National Cancer Institute...

global cancer care

Program Aims to Overcome Barriers to Early Cancer Care in Colombia 

According to a report from the International Agency for Research on Cancer’s  GLOBOCAN project, one woman dies every minute from breast cancer and one woman dies every 2 minutes from cervical cancer.1 The majority of these deaths occur in developing countries, where access to health care is limited ...

issues in oncology

Whole-exome Sequencing of NCI-60 Cell Line Panel Provides Genomic Resource for Cancer Biology and Pharmacology 

The NCI-60 cell lines, which represent cancers of the lung, colon, brain, ovary, breast, prostate, and kidney, as well as leukemia and melanoma, are the most frequently studied human tumor cell lines in cancer research and have generated the most extensive cancer pharmacology database worldwide. As ...

lung cancer

Further Support for Front-line Targeted EGFR Therapy 

LUX-Lung 3 is the sixth, and largest, prospective, randomized trial to evaluate targeted EGFR inhibition vs front-line platinum doublet chemotherapy for patients with EGFR mutations. LUX-Lung 3 distinguishes itself from the previous trials (see Table 1) by using afatinib (Gilotrif), a...

lung cancer

Afatinib as First-line Treatment for Metastatic NSCLC with EGFR Exon 19 Deletions or Exon 21 (L858R) Substitution Mutations 

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 July 12, 2013, afatinib (Gilotrif) was approved for...

breast cancer
colorectal cancer
lymphoma

ASCO Studies Support Limited Use of 'Routine' Imaging 

The overuse of imaging in oncology workup and surveillance is a timely concern, as health-care dollars shrink and the risk for second malignancies becomes clearer. At this year’s ASCO Annual Meeting, several studies showed that although many routine imaging studies may be unnecessary, physicians...

hepatobiliary cancer

Targeted Suppression of a Reactivated Developmental Pathway in Hepatocellular Cancer 

This issue of The ASCO Post summarizes the results of an important study recently published in The New England Journal of Medicine by Yong and colleagues. As outlined, investigators from the National University of Singapore Yong Loo Lin School of Medicine have identified re-expression of SALL4 as a ...

lung cancer

Where Are We With ALK Inhibition in Lung Cancer? 

The prospective phase III PROFILE 1007 study compared the ALK inhibitor crizotinib (Xalkori) to chemotherapy in patients with advanced non–small cell lung cancer (NSCLC) with ALK gene–rearranged tumors refractory to previous chemotherapy. The study showed a clear superiority for crizotinib in terms ...

multiple myeloma

New Guidelines Issued in the Treatment of Multiple Myeloma-Related Bone Disease 

The International Myeloma Working Group (IMWG) has developed clinical practice recommendations for the management of multiple myeloma-related bone disease based on published study data through August 2012. Consensus of the interdisciplinary panel of clinical experts on the plasma cell cancer was...

leukemia

High Rate of Durable Remissions with Ibrutinib in Patients with Relapsed Chronic Lymphocytic Leukemia 

Durable remissions are uncommon with current treatments for relapsed chronic lymphocytic leukemia (CLL). Bruton’s tyrosine kinase is an essential component of B cell–receptor signaling that mediates interactions with the tumor microenvironment and promotes survival and proliferation of CLL cells....

issues in oncology

FDA Invites Public Input on Menthol in Cigarettes

The U.S. Food and Drug Administration (FDA) has issued an Advance Notice of Proposed Rulemaking (ANPRM) seeking additional information to help the agency make informed decisions about menthol in cigarettes. Despite decades of work to reduce tobacco use in the United States, it continues to be the...

Expert Point of View: Ranjana Advani, MD

At the 2013 ASCO Annual Meeting, Ranjana Advani, MD, the Saul A. Rosenberg, MD, Professor of Lymphoma at Stanford University Medical Center, Palo Alto, California, discussed the promise of the B-cell signaling inhibitors idelalisib and ibrutinib in lymphoma. Biggest Question Given the...

lung cancer

SIDEBAR: ‘Major Milestone in War on Cancer’ 

The recommendation by the U.S. Preventative Services Task Force (USPSTF) for the use of low-dose, computed tomography (CT) to detect early lung cancer in high-risk individuals is a major milestone in the war on cancer. Lung cancer is the leading cause of cancer death across the world. Despite...

issues in oncology

Molecular Tests and Precision Medicine: Not So Fast Now!

The era of the application of genomic, proteomic, and a host of other “omic” analyses to guide decision-making in the therapeutic selection of drugs and biologics is now a key part of cancer care. Medical practice is working to keep up with the scientific advances, evaluate them, and add a variety...

cost of care

Oncologists Speak Out Against the High Cost of Cancer Drugs 

That the United States spends twice as much on health care than other industrialized countries—about $2.8 trillion in 2012—without reaping appreciably better outcomes1 is not news. The topic has been dissected on the front pages of leading newspapers for years and was the subject of the entire...

Expert Point of View: Tim Maughan, MD

Maintenance treatment with capecitabine plus bevacizumab can be considered in clinical practice, according to Tim Maughan, MD, Professor of Clinical Oncology at Oxford University in the United Kingdom, who discussed CAIRO3 at the session. He said that approximately 60% of patients with metastatic...

colorectal cancer

Maintenance Treatment Delays Progression in Metastatic Colorectal Cancer 

For patients with unresectable metastatic colorectal cancer, maintenance treatment with capecitabine (Xeloda) and bevacizumab (Avastin) significantly delayed disease progression and improved overall survival in the phase III CAIRO3 study by the Dutch Colorectal Cancer Group. Miriam Koopman, MD,...

gynecologic cancers

'Best-Ever' Published Prognostic Factor for Early-Stage Type 1 Endometrial Cancer 

Immunohistochemical demonstration of the L1 cell adhesion molecule (L1CAM; CD171) “has been shown to be the best-ever published prognostic factor” in Federation Internationale de Gynecologie et d’Obstetrique (FIGO) stage I, type I endometrial cancers “and shows clear superiority over the standardly ...

breast cancer

Long-Term Current Use of Calcium Channel Blockers Is Associated With Higher Risk of Breast Cancer  

Long-term use of a calcium channel blocker to treat hypertension is associated with higher breast cancer risk, according to a report published online by JAMA Internal Medicine. Researchers evaluated associations between various classes of hypertensives, the most commonly prescribed class of...

lung cancer

Role of Erlotinib in EGFR Wild-Type Lung Cancer 

I welcomed Matthew Stenger’s Journal Spotlight on the TAILOR trial in the August 15 issue of The ASCO Post (“Docetaxel Superior to Erlotinib in Second-Line Treatment of Advanced Non–Small Cell Lung Cancer With Wild-Type EGFR”). The trial was recently published online in Lancet Oncology,1 and...

Expect Questions From Patients About Active Surveillance 

While National Comprehensive Cancer Network (NCCN) practice guidelines for prostate cancer advise that active surveillance is usually appropriate for men with very low-risk prostate cancer and a life expectancy ≤ 20 years, a Johns Hopkins study suggests that outcomes for African American men...

integrative oncology

Ginseng 

Guest Editor Integrative Oncology is guest edited by Barrie R. Cassileth, MS, PhD, Chief of the Integrative Medicine Service and Laurance S. Rockefeller Chair in Integrative Medicine at Memorial Sloan-Kettering Cancer Center, New York. The Integrative Medicine Service at Memorial Sloan-Kettering...

issues in oncology
health-care policy

Combining Community Practice and Health Policy Advocacy 

Barbara L. McAneny, MD, is a board-certified medical oncologist/hematologist with a robust community practice in Albuquerque, New Mexico. Dr. McAneny, who has held many leadership roles in oncology associations, became a delegate to the American Medical Association (AMA) from ASCO in 2002, was...

issues in oncology
legislation

Legislative Endorsement Update From ASCO 

ASCO recently announced its endorsement of the Tobacco Tax Equity Act of 2014 (S. 194), which would close tax loopholes that allow tobacco companies to avoid the federal cigarette tax by making taxes on pipe tobacco equivalent to cigarette tobacco. “Raising tobacco taxes is one of the most...

integrative oncology

Ginseng in the Spotlight 

I read the study by Barton and colleagues in Journal of the National Cancer Institute with great interest. Ginseng seems potentially to be one treatment for cancer-related fatigue, a poorly understood but debilitating symptom that patients experience during and after treatment.1 I am impressed that ...

integrative oncology

American Ginseng Improves Cancer-Related Fatigue 

In a collaborative phase III trial of the North Central Cancer Treatment Group and Mayo Clinic (N07C2) reported in Journal of the National Cancer Institute by Debra L. Barton, RN, PhD, AOCN, FAAN, of the Mayo Clinic and colleagues, patients with cancer-related fatigue were treated with Wisconsin...

issues in oncology

ASCO Examines the Future of Cancer Care Over the Next 2 Decades 

While the many scientific advances over the past 50 years have led to improved outcomes for millions of patients with cancer—increasing the number of survivors from just 3 million in the 1970s to nearly 14 million today—the next 20 years promise to bring even greater opportunities to improve the...

skin cancer

Enhanced Treatment, Surveillance Needed for Patients With BRAF-Mutant Melanoma to Prevent Secondary Cancers

Researchers at Moffitt Cancer Center suggest secondary cancers seen in melanoma patients who are being treated for a BRAF gene mutation may require new strategies, such as enhanced surveillance and combining BRAF inhibitor therapy with other inhibitors, especially as they become more widely used....

issues in oncology

Integrating Genomic Sequencing Into Clinical Care  

Although the price of next-generation genomic sequencing is coming way down, making it available to more people interested in determining their risk for disease, figuring out how to interpret the results and applying that information in the routine medical care of individual patients remains a...

survivorship

Fertility Rates in Childhood Cancer Survivors Suggest Strategies for Follow-up Care 

Childhood cancer survivors with clinical infertility have a good chance of achieving pregnancy, according to new findings from the Childhood Cancer Survivor Study (CCSS). Study Background As a group, women who survive childhood cancer are known to have lower fertility rates. This study, however,...

FDA Approves First Rapid Diagnostic Test to Detect Both HIV-1 Antigen and HIV-1/2 Antibodies

The U.S. Food and Drug Administration (FDA) approved the first rapid human immunodeficiency virus (HIV) test for the simultaneous detection of HIV-1 p24 antigen as well as antibodies to both HIV-1 and HIV-2 in human serum, plasma, and venous or fingerstick whole blood specimens. Approved for use as ...

lung cancer

Significant Improvement in Overall Survival Seen With Pemetrexed Maintenance After Pemetrexed/Cisplatin Induction in Patients With Advanced Nonsquamous NSCLC 

In the phase III PARAMOUNT trial, pemetrexed (Alimta) continuation maintenance therapy significantly reduced the risk of disease progression by 38% compared with placebo after pemetrexed/cisplatin induction in patients with advanced nonsquamous non–small cell lung cancer (NSCLC). Final overall...

lymphoma

Molecular Profiling Improves Classification of Nodal Peripheral T-Cell Lymphomas 

One of the primary obstacles we face in caring for patients with peripheral T-cell lymphomas is a too often inadequate response to chemotherapy with low rates of progression-free and overall survival.1 And while more intensive treatment programs and the availability of novel agents give a greater...

skin cancer

Merkel Cell Carcinoma: Hints of Immune Mediation May Enhance Treatment Options 

Merkel cell carcinoma is a rare but aggressive skin cancer with poor outcomes and suboptimal therapeutic options. With a 46% mortality rate, it is three times more lethal than melanoma, and its reported incidence is rising. “Merkel cell carcinoma is a nasty cancer and we have zero FDA-approved...

issues in oncology

Access to and Appropriate Use of Oncology Drugs Called Into Question by ASCO Studies 

Studies presented at this year’s ASCO Annual Meeting suggest that despite the wealth of amazing oncolytics on the market, drug shortages persist, drug substitutions are common, off-label use of drugs occurs frequently, and patients find their costs burdensome. Drug Shortage Persists The shortage of ...

skin cancer

Addressing the Key Clinical Questions in Advanced Melanoma 

At the 3rd Annual World Cutaneous Malignancies Congress, in La Jolla, California, Steven J. O’Day, MD, Director of Clinical Research at the Beverly Hills Cancer Center and Adjunct Member of the John Wayne Cancer Institute, Los Angeles, addressed what he labeled the “key clinical questions” about...

head and neck cancer

Many Patients With Head and Neck Cancer Report Being Depressed, but Few Use Mental Health Services  

Despite a relatively high rate of depression among patients with head and neck cancer following radiation therapy, mental health services were severely underutilized in this group, concluded researchers who analyzed questionnaire results from 211 patients. The patients had been previously treated...

skin cancer

Indoor Tanning Common Among Young White Females Despite Skin Cancer Risk 

Indoor tanning, defined as using a tanning booth, sun bed, or sunlamp, is common among non-Hispanic white female high school students and young adults, despite risks of melanoma and nonmelanoma skin cancer, according to a study published online by JAMA Internal Medicine.  Using data from the 2011...

leukemia

FDA on CLL Drug Approval and Expanded Access

The ASCO Post article, “Ibrutinib CLL Trial: Where is the Equipoise?” published in May 2013, inaccurately conveyed that the Food and Drug Administration (FDA) requires an improvement in overall survival for chronic lymphocytic leukemia (CLL) drug approval and opposes allowing crossover in the...

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