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Prominent Immunotherapy Researcher Sees Success Beyond the Challenges

Activating the immune system for therapeutic benefit in cancer patients has long been a goal in the scientific community. After decades of disappointment, this intriguing approach has come to the forefront of cancer research, showing promising results in several malignancies. To keep abreast of...

prostate cancer

Low-Risk Prostate Cancer and Principles of Active Surveillance

For specific diseases, many physicians tend to recommend interventions and therapies with which they are most comfortable and familiar. It is not surprising that urologists and radiation oncologists did so in the study reported by Hoffman and colleagues in JAMA Internal Medicine and reviewed in...

prostate cancer

Active Surveillance in Low-Risk Prostate Cancer: When Will We Pay It More Than Just Lip Service?

Active surveillance is well established as an appropriate management option for men with low-risk prostate cancer and particularly for those over 65 years of age. Its legitimacy is now enshrined within National Comprehensive Cancer Network guidelines, in the American Society for Radiation Oncology...

prostate cancer

Minority of Older Patients With Low-Risk Prostate Cancer Managed by Observation, Rates Vary Widely Among Urologists and Radiation Oncologists

Most older men with low-risk prostate cancer receive upfront treatment, despite the absence of a clear survival benefit and potential for morbidity. In a retrospective cohort study reported in JAMA Internal Medicine, Karen E. Hoffman, MD, MHSc, MPH, of The University of Texas MD Anderson Cancer...

breast cancer

Circulating Tumor Cells in Metastatic Breast Cancer: Are We Afraid of the Truth?

All truths are easy to understand once they are discovered; the point is to discover them.” —Galileo Galilei   There are several “truths” in breast oncology that have been discovered over the years, become widely understood, and changed the way we practice. Prospective randomized studies have...

breast cancer

Early Change in Chemotherapy Based on Elevated Circulating Tumor Cells Does Not Improve Outcome in Metastatic Breast Cancer

Elevated circulating tumor cells are associated with poor prognosis in metastatic breast cancer. In a phase III trial (Southwest Oncology Group [SWOG] S0500) reported in Journal of Clinical Oncology, Jeffrey B. Smerage, MD, PhD, Clinical Associate Professor in Medical Oncology at the University of...

lung cancer

FDA Approval of Ceritinib for the Treatment of ALK-Positive Non–Small Cell Lung Cancer

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, FDA oncologists Sean Khozin, MD, MPH, and Dikran Kazandjian, MD, discuss anaplastic lymphoma kinase (ALK)-positive non–small cell...

issues in oncology

Our First Charge: Fostering the Next Generation of Oncologists and Cancer Researchers

Gary H. Lyman, MD, MPH, FASCO, is Co-Director of the Hutchinson Institute for Cancer Outcomes Research, a Full Member of the Divisions of Public Health Sciences and Clinical Research at the Fred Hutchinson Cancer Research Center, and Professor of Medicine, Public Health, and Pharmacy at the...

breast cancer

Patience Remains a Virtue: The Ongoing Quest to Optimize Adjuvant Endocrine Therapy in Breast Cancer

The most recent ASCO Clinical Practice Guideline update—summarized in this issue of The ASCO Post—represents the latest chapter in the ongoing evolution of adjuvant endocrine therapy for hormone-sensitive breast cancer.1 Rather than including a comprehensive review of the 2010 guidelines, this...

pancreatic cancer

Study Finds New Genetic Risk Markers in Pancreatic Cancer

A large DNA analysis of people with and without pancreatic cancer has identified several new genetic markers that signal increased risk of developing the disease, report scientists from ­Dana-Farber Cancer Institute and other institutions worldwide. The markers are variations in the inherited DNA...

prostate cancer

College of American Pathologists Publishes Recommendations for Prostate Cancer Active Surveillance

Recommendations from the United States Preventive Services Task Force and randomized trials have drawn attention to overtreatment of localized, low-risk prostate cancer. PSA screening and changing consensus on PSA testing practices are among the many factors that contribute to the overdiagnosis and ...

prostate cancer

Enzalutamide and the Landscape of Castration-Resistant Prostate Cancer: Integrating New Indications With Existing Agents

The androgen receptor axis is a validated target for the treatment of castration-resistant prostate cancer. Several perturbations in this pathway are postulated to lead to androgen-independent growth, including androgen receptor mutation and amplification as well as the autocrine production of...

prostate cancer

PREVAIL Trial: Enzalutamide Before Chemotherapy Prolongs Survival in Metastatic Prostate Cancer

The androgen-receptor inhibitor enzalutamide (Xtandi) has been shown to prolong survival in men with metastatic castration-resistant prostate cancer with progressive disease after chemotherapy. In the phase III PREVAIL trial reported in The New England Journal of Medicine, Tomasz M. Beer, MD, of...

gastroesophageal cancer

EGFR as a Therapeutic Target for Gastroesophageal Cancer—or Is It Really?

The epidermal growth factor receptor (EGFR) gene is often amplified and its protein overexpressed in upper gastrointestinal cancers—and overexpression has prognostic value. With the advent of monoclonal antibodies and tyrosine kinase inhibitors against EGFR, we have witnessed a rash of randomized...

head and neck cancer
global cancer care

90 Countries Participate in the 5th World Congress of the International Federation of Head and Neck Oncologic Societies in New York

A spectacular parade of nations from 90 countries led by the Emerald Society Pipes and Drums from the New York City Police Department opened the 5th World Congress of the International Federation of Head and Neck Oncologic Societies (IFHNOS) on July 27 in New York City. The 4-day event was held in...

breast cancer

Tackling the Heterogeneity of Triple-Negative Breast Cancer

Triple-negative breast cancer is now recognized as a very complex subtype for which one treatment will not be applicable to all, according to Mohammad Jahanzeb, MD, Professor of Clinical Medicine at the University of Miami and Director of the UM Sylvester Deerfield Campus, who gave an update on...

lung cancer

Mixed Results for Targeting MET in Non–Small Cell Lung Cancer

Two different abstracts explored the potential for MET as a therapeutic target in patients with metastatic non–small cell lung cancer (NSCLC), with different results. A phase III study found that onartuzumab, an antibody that targets the MET receptor, combined with erlotinib (Tarceva) was not as...

health-care policy

Does the United States Have the Best Health-Care System in the World?

Many concerns were raised and dire speculations predicted during the further implementation of the Affordable Care Act this year. So far, the trickling news is good: An estimated total of 20 million people gained coverage under the new law as of May 1,1 about 6 million enrolled in the law’s...

leukemia
lymphoma

Recent FDA Drug Approvals Foster Growing Treatment Armamentarium for Chronic Lymphocytic Leukemia and Rare B-Cell Lymphomas

Recent approvals announced by the U.S. Food and Drug Administration (FDA) have led to increased treatment options for managing several difficult-to-treat hematologic B-cell cancers. The newly approved drugs and/or their indications include the oral PI3K delta inhibitor idelalisib (Zydelig) for the...

Pioneer in Fight Against Tobacco, Emanuel Farber, MD, PhD, Dies at 85

On December 11, 1969, a soft-spoken pathologist wearing outsized spectacles answered a long and complex series of questions by the legal team representing Liggett & Myers Tobacco Company, the maker of Chesterfield cigarettes. The tobacco lawyers contended that one Leslie Thayer—a lifelong...

Jesse L. Steinfeld, MD, and The War on Cancer

In “Stories on the History of Cancer,” available on ASCO’s Cancer.Progress.Net, past ASCO presidents and other oncology luminaries discuss the founding of ASCO, the early days of cancer treatment, and the notable changes that have occurred since then—both in the care of people with cancer and in...

Jesse L. Steinfeld, MD, Past Surgeon General, ASCO President, Dies at 87

The 1964 Surgeon General’s Report on Smoking and Health started a culture change in the way Americans viewed tobacco and their health, and has saved countless million of lives. But the 1964 Report remained scientifically ambiguous on certain vital issues, such as the effect smoking had on the...

lymphoma

First Prospective Study of Rare Lymphoma Shows Promising but Inconclusive Results With DA-EPOCH-R

Presenting “the first prospective study” of mediastinal gray zone lymphoma, researchers from the National Cancer Institute reported that DA-EPOCH-R (infusional dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine, prednisone, and rituximab (Rituxan) and filgrastim (Neupogen)...

skin cancer

Simple Bedside Assessment of Pain and Itch Is Valuable Tool for the Evaluation of Suspicious Skin Lesions

A prospective, clinicopathologic study involving 268 patients with biopsy-proven basal cell carcinoma, squamous cell carcinoma, malignant melanoma, or melanoma in situ “revealed that pain is associated with histologic features that involve deeper dermal processes in [squamous cell carcinoma]...

lung cancer

NIH Announces Launch of Precision Medicine Trials in Early-Stage Lung Cancer

The National Institutes of Health (NIH) recently announced the launch of the Adjuvant Lung Cancer Enrichment Marker Identification and Sequencing Trials, or ALCHEMIST. The purpose of the trial, which has three components, is to identify patients with early-stage lung cancer whose tumors harbor...

breast cancer

Postmenopausal Breast Cancer Risk Decreases Rapidly After Starting Regular Physical Activity

Postmenopausal women who in the past 4 years had undertaken regular physical activity equivalent to at least 4 hours of walking per week had a lower risk for invasive breast cancer compared with women who exercised less during those 4 years, according to data published recently in Cancer...

breast cancer

Survival Benefit of Contralateral Prophylactic Mastectomy Less Than 1% at 20 Years, but Numbers of Procedures Have Increased

For women with stage I and II breast cancer without BRCA mutations, the absolute 20-year survival benefit from contralateral prophylactic mastectomy was less than 1%, regardless of age, estrogen receptor status, and cancer stage, according to a decision analysis study using a Markov model to...

gynecologic cancers
global cancer care

Gynecologic Cancer Care: Collaboration With Resource-Challenged Ethiopia

Over the past 40 years, largely because of universal Pap screening, cervical cancer deaths have been drastically reduced in the United States and other wealthy industrialized countries. However, cervical cancer is still a leading cause of cancer death among women in resource-challenged areas of the ...

How Pharmaceutical Companies Are Partnering With Patient Advocates to Ensure Access to Oncology Care

Thomas P. Sellers, MPA, has been a tireless advocate for patients’ rights for more than 20 years. A 15-year prostate cancer survivor and only child, Mr. Sellers said it was his mother’s death from lung cancer when she was 51, followed by the death of his father from glioblastoma multiforme that led ...

A New Book Explores an Old Subject: Aging

Title: Lighter as We Go: Virtues, Character Strengths, and AgingAuthors: Mindy Greenstein, PhD, and Jimmie Holland, MDPublisher: Oxford University Press Publication date: September 2014Price: $27.95; Hardcover, 320 pages   Death is the universal experience shared by Earth’s 7 billion or so...

issues in oncology

Identifying Impending Death Helps Patients and Caregivers

Significant weight loss, cachexia, and being bedbound signal that a cancer patient is dying. However, identifying the specific signs that give physicians the ability to predict death is not well described in the literature. To better understand why predicting death is an important part of the care...

ASTRO Awards $35,500 in Individual Grants to 43 Researchers

The American Society for Radiation Oncology (ASTRO) has selected 43 recipients to receive a total of $35,500 for the 2014 Annual Meeting Abstract Awards. The awardees will be recognized at ASTRO’s 56th Annual Meeting. ASTRO’s 56th Annual Meeting, takes place San Francisco’s Moscone Center,...

leukemia

Program Offers Unique Intervention for Acute Promyelocytic Leukemia

If Anand P. Jillella, MD, has his way, no future patient with acute promyelocytic leukemia (APL) will experience a delay in treatment or lack for an expert consult—and few, if any, will die of this condition. Mortality from APL is much higher than most oncologists think, especially during the first ...

lung cancer

Failure of IGF-1R Inhibitor Figitumumab in Advanced Nonadenocarcinoma Non–Small Cell Lung Cancer

The vast majority of non–small cell lung cancer (NSCLC) patients present with advanced disease, and many will develop metastases after primary curative therapy. Until recently, despite its low efficacy, chemotherapy remained the only treatment modality in metastatic NSCLC. Within the past decade,...

lung cancer

Phase III Trial of Figitumumab Plus Chemotherapy in Advanced NSCLC Stopped Early for Futility and Increased Harm

In the first phase III trial assessing the combination of an insulin-like growth factor 1 receptor (IGF-1R) inhibitor with chemotherapy as first-line treatment for advanced nonadenocarcinoma non–small cell lung cancer (NSCLC), the addition of the fully human immunoglobulin G2 monoclonal antibody...

#WeConquerCancer: Creative Fundraisers From Committed Conquerors

Conquer Cancer Foundation donors are a consistently creative bunch when it comes to encouraging others to help conquer cancer: Tyler invited his friends and family to a charity spin class; elementary school students in Malibu, California, sold bracelets in honor of their principal; Steve competed...

Expert Point of View: Wyndham H. Wilson, MD, PhD

Since the presentation on mediastinal lymphoma at the Pan Pacific Lymphoma Conference, Wyndham H. Wilson, MD, PhD, Chief of the Hematological Malignancies Therapeutics Section, Metabolism Branch, Cancer Research Center, of the National Cancer Institute in Bethesda, Maryland, offered The ASCO Post...

leukemia

Protocol Modifications Decrease Toxicity, Increase Event-Free Survival in Children With Down Syndrome Treated for ALL

Protocol modifications to address increased risk of toxicity and excess early mortality among children with Down syndrome being treated for B-cell acute lymphoblastic leukemia (ALL) proved safe for patients with Down syndrome, and these patients had event-free survival similar to those without Down ...

leukemia

Emerging Approaches in Acute Myeloid Leukemia

With the emergence of molecular diagnostics and new therapeutics, the treatment of acute myeloid leukemia (AML) is entering a new era. Hugo F. Fernandez, MD, Associate Chief of Blood and Marrow Transplantation at Moffitt Cancer Center in Tampa, Florida, spoke with The ASCO Post about how he...

issues in oncology

Quest for Targeted Therapeutic ‘Cocktails’ Hits Roadblocks

The use of cutting-edge technology and bioinformatics to inform clinical decision-making in oncology is still a ways off, according to Mark Pegram, MD, the Susy Yuan-Huey Hung Professor of Oncology and Director of the Stanford Breast Oncology Program, Stanford University, Palo Alto, California. At...

multiple myeloma

Treating Multiple Myeloma in 2014

The field of multiple myeloma is rapidly changing, and the shifts that are occurring impact the management of these patients, from initial diagnosis through multiple relapses. At the 9th Annual New Orleans Summer Cancer Meeting, Sergio A. Giralt, MD, Chief of the Adult Bone Marrow Transplant...

gynecologic cancers

September Is Ovarian Cancer Awareness Month

In recognition of September as Ovarian Cancer Awareness month, David A. Fishman, MD, Director of the Mount Sinai Ovarian Cancer Risk Assessment Program and Professor and Fellowship Director in the Division of Gynecologic Oncology, Department of Obstetrics, Gynecology and Reproductive Medicine at...

lymphoma

Study Estimates Risk of Premature Menopause After Treatment for Hodgkin Lymphoma

Previous research has suggested that women with Hodgkin lymphoma who receive certain types of chemotherapy or radiotherapy are at increased risk of future infertility, but there was insufficient information to provide patients with detailed advice. In a study published in the Journal of the...

lymphoma

Jury Still Out on Interim PET for Response-Adapted Therapy in Hodgkin Lymphoma

Interim positron-emission tomography (PET) scans provide good prognostic information in patients with Hodgkin lymphoma, but more research is needed to determine whether patients benefit when the findings are used to alter treatment, according to Oliver Press, MD, PhD, Professor at the University of ...

lymphoma

International Group Updates Recommendations on Managing Lymphoma

An international multidisciplinary group of experts has updated their recommendations for staging and treatment response assessment in patients with Hodgkin and non-Hodgkin lymphomas. Bruce D. Cheson, MD, Professor of Medicine, Deputy Chief of Hematology-Oncology, and Head of Hematology at the...

Expert Point of View: Richard L. Schilsky, MD

Information on the drivers of cancer care is important in helping to deliver higher-quality and potentially less costly cancer treatments, noted Richard L. Schilsky, MD, ASCO’s Chief Medical Officer, in a commentary accompanying the study by ­Dotan et al.1 Moreover, practice change can be a complex ...

issues in oncology

Oncology Practice: What Are the Factors Driving Change?

Clinical practice changes in response to new medical evidence, but not always immediately or all at once. So what else determines whether and how quickly practice changes in response to evidence, for instance, that a widely used drug is effective only in patients with a certain biomarker? In a new...

lung cancer

Stereotactic Body Radiation Therapy an Effective Option for Early-Stage Lung Cancer Patients

Stereotactic body radiation therapy (SBRT) is safe and effective in early-stage non–small cell lung cancer (NSCLC), as it confers local control in 90% or more patients with T1 disease, according to Roy Decker, MD, PhD, Associate Professor in the Department of Therapeutic Radiology at Yale Cancer...

John H. Saiki, MD, SWOG Investigator, Dies at 77

John “Jack” Harris Saiki, MD, Professor Emeritus at the University of New Mexico Department of Medicine, Hematology/Oncology Division, lived the history of modern day oncology with a career spanning 44 years. In the early days of his career, with the support of a grant from the federally funded New ...

lymphoma

Para-Aortic Lymph Node Radiation Raises Risk of Developing Diabetes Mellitus in Hodgkin Lymphoma Survivors

Radiation to the para-aortic lymph nodes, “leading to radiation exposure of the pancreas, is associated with a dose-dependent increased risk” of developing diabetes mellitus among long-term survivors of Hodgkin lymphoma (HL), according to a study by Frederika A. van Nimwegen, MSc, of the...

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