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issues in oncology

The Future of Biomedical Research

In January, Congress approved a $1 trillion appropriations bill for the rest of fiscal year 2014. While the new bill includes $29.9 billion for the National Institutes of Health (NIH)—$1 billion above FY2013 levels after sequestration—including $4.9 billion for the National Cancer Institute (NCI),...

Expert Point of View: Charles Ryan, MD

Charles Ryan, MD, moderator of the press conference at the Genitourinary Cancers Symposium where the PREVAIL trial data were discussed, emphasized that this study breaks new ground for enzalutamide (Xtandi) in chemotherapy-naive patients with metastatic castration-resistant prostate cancer. “The...

prostate cancer

PREVAIL Trial Shows Enzalutamide to Be a Promising Option for Metastatic Castration-Resistant Prostate Cancer

Encouraging results of the large phase III PREVAIL trial represent another positive milestone for men with metastatic castration-resistant prostate cancer. Enzalutamide (Xtandi) improved overall survival by 29% and reduced the risk of radiographic progression of disease by 81% in men who had not...

issues in oncology

The Author Replies

I read with interest the note from Jeff Boyd, PhD, Senior Vice-President for Molecular Medicine at Fox Chase Cancer Center, calling into question my recent commentary about the high costs of partly validated testing in the domain of molecular medicine. One of the oldest tricks in the book is to...

issues in oncology

Cancer Genes and Molecular Medicine: More Education Needed

I read with interest and concern the Perspective piece, “Cancer Genes, Promiscuity, and the National Debt,” which appeared on page 1 of the February 1st issue of The ASCO Post. The underlying premise of this wide-ranging and provocative article would appear to be that in a rush to implement...

thyroid cancer

‘Epidemic of Diagnosis’ of Thyroid Cancer Is Most Acute for Women

The epidemiology of the increased incidence of thyroid cancer, which has nearly tripled since 1975, “suggests that it is not an epidemic of disease but rather an epidemic of diagnosis,” Louise Davies, MD, MS, and H. Gilbert Welch, MD, MPH, concluded after analyzing trends in patients diagnosed with ...

colorectal cancer
issues in oncology

National Colorectal Cancer Awareness Month

March is Colorectal Cancer Awareness Month, and the U.S. Department of Health and Human Services is committed to boosting public awareness about the importance of screening and treatment for colorectal cancer. Colorectal cancer poses the greatest risk to adults over age 50, and the U.S. Preventive...

issues in oncology

Focus on the Virginia Association of Hematologists and Oncologists

The state of Virginia encompasses a vast area of 40,000 square miles and is divided into five regions: the Atlantic Coastal Plain, the Piedmont, the Blue Ridge, the Appalachian Ridge and Valley Region, and the Appalachian Plateau. The diverse geography of the state creates unique challenges for...

supportive care

Music Therapy Yields Positive Effects on Coping Skills, Social Integration, and Family Environment for Young Patients With Cancer

A collaborative multisite study has found that teens and young adults undergoing stem cell transplantation as part of cancer treatment gain coping skills and resilience-related outcomes when participating with a board-certified music therapist in a therapeutic music protocol that includes writing...

breast cancer
cns cancers

How to Approach the Problem of CNS Metastasis in HER2-Positive Patients

Central nervous system (CNS) metastasis is a pervasive problem in the setting of HER2-positive breast cancer. While some patients can be managed easily, others are challenging, said Eric P. Winer, MD, Chief of the Division of Women’s Cancers and the Thompson Senior Investigator for Breast Cancer...

breast cancer

SSO/ASTRO Release Consensus Guideline on Breast Cancer Treatment

The Society of Surgical Oncology (SSO) has announced the availability of a comprehensive consensus guideline for physicians treating breast cancer developed to help reduce health-care costs and improve the course of treatment. Developed in conjunction with the American Society of Radiation Oncology ...

solid tumors
issues in oncology

How Decoding the Genomes of Exceptional Responders Is Leading to More Effective Treatment for All Patients With Cancer

In 2012, David B. Solit, MD, Geoffrey Beene Chair and Director of the Center for Molecular Oncology at Memorial Sloan Kettering Cancer Center (MSKCC) in New York, and his colleagues published the results of a phase II study1 of 45 patients with advanced bladder cancer. The purpose of the clinical...

health-care policy

President Obama’s FY 2015 Budget Proposal

[On March 4, 2014], President Obama released his proposed budget for fiscal year 2015. Among several cost-cutting measures designed to preserve Medicare solvency is a proposal to reduce reimbursement for life-sustaining cancer drugs. Currently, reimbursement to physicians for “Part B” drugs is...

palliative care

St. Jude Children’s Research Hospital Committee Identifies Eight Palliative Care Priorities in Pediatric Oncology

About 2½ years ago, St. Jude Children’s Research Hospital in Memphis conducted a series of focus groups to better understand the palliative care priorities of bereaved parents. Their findings were never intended to be generalized, but rather to be used to formulate a strategic plan for an...

breast cancer

Impact of Delayed Initiation of Adjuvant Chemotherapy for Breast Cancer Varies by Tumor Subtype

The optimal time interval between surgery and initiation of adjuvant chemotherapy for early-stage breast cancer is not well established. Although most physicians aim to initiate adjuvant chemotherapy within a few weeks of surgery, clinical factors may cause delay. The influence of delay on relapse...

CD137 Identifies and Enriches for Tumor-Reactive T Cells

In a study reported in Clinical Cancer Research, Ye and colleagues showed that CD137 can be used to identify tumor-reactive T cells and to enrich for tumor-infiltrating lymphocytes and tumor-associated lymphocytes for use in adoptive immunotherapy. In the study, tumor-infiltrating lymphocytes from...

lung cancer

Protein Expression–Based Risk Model for Recurrence in Resected NSCLC

In a study reported in Clinical Cancer Research, Gold and colleagues developed a risk model for recurrence of resected non–small cell lung cancer (NSCLC) based on protein expression and clinical variables. The study involved analysis of samples from 370 patients with NSCLC resected between 2002 and ...

colorectal cancer

Decreased Diversity of Gut Bacteria Associated With  Risk of Colorectal Cancer

In a study reported in the Journal of the National Cancer Institute, Ahn and colleagues found that decreased diversity of gut bacteria and differences in levels of specific bacteria were associated with significantly increased risk of colorectal cancer. The study involved measurement of 16S...

solid tumors

Antitumor Immunity Affected by Standard Lab Mouse Housing Temperature

In a study reported in Proceedings of the National Academy of Sciences USA, Kokolusa and colleagues showed that fundamental aspects of antitumor immunity are significantly affected by ambient housing temperature for lab mice. Standard ambient temperature in research facility lab mice housing is...

breast cancer

Support from 1999 Career Development Award Launched Dr. Kornelia Polyak’s Quest to Advance Understanding of DCIS of the Breast

In 1999, Kornelia Polyak, MD, PhD, of the Dana-Farber Cancer Institute, received a Career Development Award from the Conquer Cancer Foundation for her project, “Isolation of Tumor Suppressor Genes Inactivated in DCIS of the Breast.” “The Career Development Award got me started,” she said. “When...

ASCO Holds Leadership Summit to Address Value in Cancer Care, Cost of Cancer Drugs and Technologies

ASCO convened a leadership summit in late January with pharmaceutical representatives, insurance payers, patient advocates, and physicians to initiate a dialogue on the challenge of defining value in cancer care. This meeting was held amid growing concerns about the sustainability of continued...

cost of care

Who Pays for Noncompliance? The Hidden Costs of Our Current System

The development of novel targeted therapies that capitalize on our growing understanding of the molecular underpinnings and vulnerabilities of specific malignancies has to rank among the most important advances we have seen in the 50 years since the American Society of Clinical Oncology was...

leukemia
cost of care

Higher Copayment Associated With Greater Discontinuation of and Nonadherence to Tyrosine Kinase Inhibitor Treatment in CML

The availability of the tyrosine kinase inhibitor imatinib (Gleevec) has dramatically increased survival in chronic myeloid leukemia (CML). Nonadherence to therapy with imatinib and other tyrosine kinase inhibitors is associated with disease progression and treatment resistance. In a study reported ...

prostate cancer
skin cancer

History of Prostate Cancer Increases Risk of Melanoma in White Men

History of severe acne, which is a surrogate for high androgen activity, has been associated with increased risk of prostate cancer, and recent data suggest that severe teenage acne is a risk factor for melanoma. Such findings suggest a role of androgens in etiology for both prostate cancer and...

issues in oncology

Advanced Practitioners in Oncology: Diverse Experiences, Shared Challenges

The professional paths of advanced practitioners (APs) in oncology are as varied as the locations in which they work. The first annual JADPRO Live 2014 educational symposium was held in St. Petersburg, Florida, and hosted by JADPRO, the Journal of the Advanced Practitioner in Oncology. A...

lymphoma

Crizotinib Proves Effective in ALK-Positive Lymphoma

Crizotinib (Xalkori) produced promising results in patients with ALK-positive lymphoma in two small studies presented at the 2013 American Society of Hematology (ASH) Annual Meeting. Crizotinib exerted potent antitumor activity in advanced ALK-positive lymphoma and achieved durable responses in...

leukemia

Gemtuzumab Ozogamicin Reduces Relapse, Improves Event-Free Survival in Pediatric AML

The monoclonal antibody gemtuzumab ozogamicin (Mylotarg) improved event-free survival and reduced the risk of relapse in children with acute myeloid leukemia (AML) in a study from the Children’s Oncology Group, presented at the 55th American Society of Hematology (ASH) Annual Meeting and Exposition ...

breast cancer

Adding Bevacizumab to Adjuvant Chemotherapy/Trastuzumab Fails to Improve Survival in HER2-Positive Breast Cancer

The addition of bevacizumab (Avastin) to adjuvant chemotherapy did not improve invasive disease-free survival or overall survival in patients with high-risk HER2-positive breast cancer in the large randomized phase III BETH trial. Although not specifically designed to answer this question, BETH...

leukemia

Minimal Residual Disease Before and After Transplant: What Does It Mean?

In patients with acute leukemia, outcomes after hematopoietic stem cell transplantation are negatively impacted by the presence of minimal residual disease. However, transplant can prolong survival in patients with minimal residual disease after consolidation, according to two studies presented at...

neuroendocrine tumors

For Progressive Neuroendocrine Tumors, Clinical Benefit Is High With Capecitabine Plus Temozolomide

In an interim analysis of a phase II trial, 97% of patients with progressive metastatic neuroendocrine tumors achieved clinical benefit with the combination of capecitabine and temozolomide (CAPTEM). The results were reported at the 2014 Gastrointestinal Cancers Symposium by Robert L. Fine, MD,...

colorectal cancer

Outcomes in Metastatic Colorectal Cancer: Studies Examine Relative Merits, Cost-Effectiveness

Targeted biologic agents have improved long-term outcomes in metastatic colorectal cancer, but debate continues as to their relative efficacy and proper sequencing. At the 2014 Gastrointestinal Cancers Symposium, a number of studies attempted to answer these questions by interrogating the clinical...

Expert Point of View: Neal J. Meropol, MD

Neal J. Meropol, MD, Chief of Hematology and Oncology at University Hospitals Case Medical Center at Case Western Reserve University, Cleveland, discussed the various findings in RAS mutations at the Gastrointestinal Cancers Symposium. “RAS mutations beyond exon 2 are common, occurring in about 15% ...

colorectal cancer

Aspirin Use Not Associated With Survival in PIK3CA-Mutant Colorectal Cancer

Contrary to emerging data from other studies, the regular use of aspirin was not associated with improved survival in patients with PIK3CA-mutant metastatic colorectal cancer in a study reported at the 2014 Gastrointestinal Cancers Symposium in San Francisco.1 Large Dataset “We did not validate...

health-care policy

The Evolution of U.S. Cooperative Group Trials: Publicly Funded Cancer Research at a Crossroads

Over the past 5 decades, National Cancer Institute (NCI) Clinical Trials Cooperative Groups have played an enormous role in the fight against cancer, tackling a broad social agenda, including cancer prevention, quality-of-life issues for patients with cancer, and comparison of benefits among...

lung cancer

I Refuse to Capitulate to Cancer

Early last year, just as I returned to my residency in neurologic surgery at Stanford University after completing 2 years of my postdoctoral fellowship in a laboratory developing optogenetic techniques, I started losing weight—dropping from 180 lb to 160 lb in just 6 months—and I was having fairly...

prostate cancer

State-of-the-Art Update on Prostate Cancer

The 2014 Genitourinary Cancers Symposium, held in San Francisco from January 29 to February 1, brought together more than 3,100 participants from around the world involved in the care of patients with genitourinary malignancies. The abstract presentations and plenary discussions offered the latest...

issues in oncology

Transition From Busy Oncologist to Retiree: Challenges and Opportunities

Oncology is a demanding field that requires special qualities to care for very sick patients, many of whom will die prematurely of their disease. Research indicates that years of facing life-and-death decisions in the clinic can be associated with oncology burnout syndrome, which effects physician...

breast cancer

Breast Reconstruction Has Increased Over Time but Varies Widely by Region

Analysis of data from 20,560 women undergoing mastectomy for breast cancer found that breast reconstruction use “increased from 46% in 1998 to 63% in 2007 (P< .001), with increased use of implants and decreased use of autologous techniques over time (P < .001),” according to a report...

American Association for Cancer Research Elects José Baselga, MD, PhD, as President-Elect 2014–2015

The members of the American Association for Cancer Research (AACR) have elected José Baselga, MD, PhD, Physician-in-Chief at Memorial Sloan Kettering Cancer Center in New York, as their President-Elect for 2014–2015. Dr. Baselga is an internationally recognized physician-scientist whose research...

prostate cancer

Does ‘Specialist Bias’ Contribute to Overtreatment of Prostate Cancer?

Specialist bias, in which specialists recommend the therapy that they are capable of delivering, is thought to influence the treatment of patients with localized prostate cancer and to contribute to overtreatment of men with limited life expectancy,” Ayal A. Aizer, MD, MPH, and colleagues, from the ...

William Pao, MD, PhD, Joins Roche to Lead Oncology Research

Roche recently announced that William Pao, MD, PhD, Professor of Medicine and Head of the Hematology-Oncology Division at Vanderbilt University Medical Center, Nashville, will join Roche Pharma Research and Early Development (pRED) as Global Head of the Oncology Disease and Translational Area...

lung cancer

Decision Time for Lung Cancer Screening in High‑Risk Populations

For decades, dedicated members of the oncology community have fought to increase the nation’s focus on lung cancer prevention and treatment. Although smoking cessation initiatives have reduced cigarette consumption, lung cancer 5-year survival has remained stagnant at 15%, lagging far below most...

issues in oncology

‘How Am I Doing, Doc?’

The goal of effective adjuvant therapy is to increase overall survival. It has been suggested cynically that all we need to accomplish, actually, is to delay recurrence until after the time the patients die from another cause. However, patients want to hear from us that “it’s never coming back,”...

breast cancer

Study Shows Pathologic Complete Response to Neoadjuvant Therapy for Breast Cancer of Prognostic Value but Not for Use as Surrogate for Survival

Pathologic complete response to neoadjuvant therapy has been proposed as a surrogate endpoint for long-term clinical benefit in breast cancer. The U.S. Food and Drug Administration (FDA) established the international Collaborative Trials in Neoadjuvant Breast Cancer (CTNeoBC) working group to...

Association of Community Cancer Centers Honors Researcher and Community Oncologist With National Award

In recognition of his dedication to cancer research and education, and for promoting the goals of cancer prevention, early detection, and quality cancer treatment, John Powderly II, MD, Certified Physician Investigator, President and Founder of Carolina BioOncology Institute, Huntersville, North...

issues in oncology

Utah Center for Genetic Discovery to Integrate Genome Data Into Patient Care

The USTAR Center for Genetic Discovery is partnering with California-based Omicia, Inc, to make analyzing a patient’s genome as routine as performing a blood test. The center, codirected by Mark Yandell, PhD, and Gabor Marth, DSc, was launched this month with $6 million from the University of Utah...

breast cancer

Determining Why Younger Women With Breast Cancer Are Less Likely to Survive Than Their Older Counterparts

Although cancer survival rates among pediatric and older adult patients continue to rise, survival rates for adolescents and young adults (AYAs), defined by the National Cancer Institute as those between the ages of 15 and 39, have remained stagnant for decades. In breast cancer especially, AYAs...

issues in oncology

Informed Consent: Not Just About Blood Tests and Procedures Anymore

On February 24, the Institute of Medicine National Cancer Policy Forum convened a workshop, “Contemporary Issues in Human Subjects Protection in Cancer Research,” in Washington, DC. In his introduction to the workshop, Steven Piantadosi, MD, PhD, Director, Samuel Oschin Cancer Institute,...

NIH Opens Its Doors to Research for Extramural/Intramural Collaboration

Ten projects that will enable nongovernment researchers to conduct clinical research at the National Institutes of Health (NIH) Clinical Center in Bethesda, Maryland, were announced recently. Through these 3-year, renewable awards of up to $500,000 per year, scientists from institutions across the...

Become a Cornerstone of the Conquer Cancer Foundation

Have you given any thought to the legacy you would like to leave? For many of you, your professional legacy will include the patients you have cared for, the research you have conducted, the students you have mentored, and the lives you have touched in the world of cancer care. You also have your...

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