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leukemia

Clinical Trials, Crossover, and Clinical Equipoise: A Patient's Perspective

I am writing with regard to two articles on the ethical imperative of clinical equipoise written by Susan O’Brien, MD, and Stephen J. Schuster, MD, and published recently in The ASCO Post.1,2 I was a victim of Pharmacyclics’ policies during one of their randomized ibrutinib trials (PCI-32765)...

issues in oncology

Preventing Tobacco Use in Children

The U.S. Preventive Services Task Force recently released its final recommendation statement on primary care interventions to prevent tobacco use in children and adolescents.1 The Task Force recommends that primary care clinicians provide interventions, including education or brief counseling, to...

issues in oncology

Tackling Overdiagnosis and Overtreatment, by Words and by Deeds  

The complexity of the pathologic condition called cancer,” according to a Viewpoint article in the Journal of the American Medical Association,1 “complicates the goal of early diagnosis.” Failure to recognize that cancers are heterogeneous, and that not all progress to metastases and death, can...

Genitourinary Cancer Expert Walter M. Stadler, MD, Named Section Chief of Hematology/Oncology at the University of Chicago Medicine

Walter M. Stadler, MD, an authority on prostate, kidney, bladder, and testicular cancers, has been named Chief of the Section of Hematology/Oncology at the University of Chicago Medicine. This position became effective August 15, 2013. Dr. Stadler, the Fred C. Buffet Professor of Medicine and...

issues in oncology

ASCO Launches New Site to Seek Feedback from Cancer Community on Clinical Practice Guidelines

ASCO has launched a new wiki site to engage the cancer community in its clinical practice guideline development process. The new site will provide oncologists, practitioners and patients with an opportunity to provide feedback or submit evidence on individual published guidelines and can be...

issues in oncology

The Direction of Immunotherapy Over the Next Decade 

The use of immunotherapy to target malignant cells in a variety of cancers—especially the PD-1 inhibitors lambrolizumab and nivolumab in the treatment of metastatic melanoma and the anti–PD-L1 agent MPDL3280A in the treatment of melanoma and lung, kidney, colorectal, and gastric cancers—made...

Final Publication of IOM Report on Learning Health Systems Available 

The Institute of Medicine (IOM) has issued the final publication of its report, Best Care at Lower Cost: The Path to Continuously Learning Health Care in America. ASCO continues to support the IOM report’s core recommendations for establishing a “learning health system” in the United States and...

Communicating the Promise Science Offers to Society 

ASCO President Clifford Hudis, MD, FACP, will be serving during a particularly notable year: 2014, the Society’s 50th anniversary. This occasion brings with it much to reflect on, from the advances in the field of oncology to the growth of ASCO’s influence, but Dr. Hudis takes a moment to simply...

cns cancers

Sitimagene Ceradenovec/IV Ganciclovir in Glioblastoma: Legitimizing the Gene Therapy Approach for Brain Tumors 

The ASPECT study,1 a randomized, open-label, phase III trial examining adenovirus-mediated gene therapy with sitimagene ceradenovec followed by IV ganciclovir for patients with operable high-grade glioma, is an important achievement for both neuro-oncology and gene therapy. As vector engineering...

cns cancers

Postresection Adenovirus-Mediated Gene Therapy Improves Time to Death/Reintervention but Not Survival in Adult Glioblastoma 

In an open-label phase III trial (ASPECT) reported in Lancet Oncology, Manfred Westphal, MD, of University Hospital Eppendorf in Hamburg, and colleagues assessed the effects of locally applied adenovirus-mediated gene therapy with sitimagene ceradenovec followed by IV ganciclovir after surgical...

breast cancer

Tamoxifen in Women With BRCA1 and BRCA2 Mutations: Another Option? 

In analyses of pooled information from cohorts of women with BRCA1 and BRCA2 mutations who have had a prior breast cancer diagnosis, Phillips and colleagues examined the association between tamoxifen use compared to nonuse on contralateral breast cancer risk.1 Tamoxifen use was associated with...

breast cancer

Cohort Analysis: Adjuvant Tamoxifen Reduces Risk of Contralateral Breast Cancer in BRCA1/2 Mutation Carriers 

In a study reported in the Journal of Clinical Oncology, Kelly-Anne Phillips, MBBS, MD, of the University of Melbourne, and colleagues analyzed the association of adjuvant tamoxifen use and risk of contralateral breast cancer among women carrying BRCA1 and BRCA2 mutations in the International BRCA1 ...

lymphoma

FDA Approves Mechlorethamine Gel for Cutaneous T-Cell Lymphoma

Ceptaris Therapeutics, Inc, recently announced that the U.S. Food and Drug Administration (FDA) has granted marketing approval for the orphan drug mechlorethamine gel (Valchlor) for the topical treatment of stage IA and IB mycosis fungoides-type cutaneous T-cell lymphoma (CTCL) in patients who have ...

leukemia

Treatment of Relapse of Acute Leukemia Post-Transplant: Still Hope for Patients With Chemosensitive Disease 

Disease recurrence is a devastating event after allogeneic hematopoietic stem cell transplantation as treatment for acute myeloid leukemia (AML). Median time to relapse is approximately 4 months and the majority of relapses occur within 2 years after transplant. The prognosis is usually poor....

pain management

Undertreatment of Cancer Pain Remains a Persistent Problem in Oncology 

Data indicate that for more than 2 decades, cancer pain has been undertreated in the United States. The paradox of this stubborn clinical problem is that oncology has the ability to manage the great majority of cancer pain. To clarify this issue, The ASCO Post recently spoke with nationally...

skin cancer

What Is the Optimal Treatment of Advanced Melanoma?  

With exciting targeted and immunotherapeutic agents now part of the arsenal for metastatic melanoma, which drug should move to the head of the line? Mario Sznol, MD, Professor of Medicine at Yale University School of Medicine, New Haven, Connecticut, has been involved in key clinical trials of the...

skin cancer

Three 'Game-Changers' in the Treatment of Melanoma 

There have been three “game-changers” in the treatment of melanoma, Mark R. Albertini, MD, Associate Professor of Medicine at the University of Wisconsin in Madison, contended at the Best of ASCO Chicago meeting. The first, he explained, was the recognition of different genetic driver...

SIDEBAR: The Good, the Bad, and the Ugly 

Reviewing a study on off-label use of chemotherapy, Monika K. Krzyzanowska, MD, MPH, of Princess Margaret Cancer Centre University of Toronto, reflected on what she called the good, the bad, and the ugly of off-label drug use. “Certainly there are some good aspects about off-label therapy,” she...

issues in oncology

Prescribing of Off-Label Chemotherapy Is Common, and Most Off-Label Drug Use Meets NCCN Compendium Criteria  

Off-label prescribing of drugs remains common in oncology, but about two-thirds of off-label prescribing is consistent with the National Comprehensive Care Network (NCCN) compendium, according to a study1 reviewed at the Best of ASCO® ’13 meeting in Chicago by Monika K. Krzyzanowska, MD, MPH,...

issues in oncology

Paging Dr. Google: Practicing Oncology in the Era of Social Media and Telemedicine  

Over the past few decades, economic and political factors have reshaped oncology, especially in the community setting. To defray risk, we’ve seen a trend toward oncology practices partnering with hospitals or aggregating into larger networks. Moreover, the Internet and the advent of telemedicine...

breast cancer

Platinum Agents in Triple-Negative Breast Cancer: Encouraging New Data 

For the treatment of triple-negative breast cancer, there is renewed interest in investigating the role of platinum chemotherapy, according to Melinda L. Telli, MD, Assistant Professor of Medicine at Stanford University, Palo Alto. At the Best of ASCO meeting in Los Angeles, Dr. Telli reviewed the...

'Doing Nothing' Is Not an Option

I applaud The ASCO Post for continuing to raise awareness about futile medical care at the close of life with the recent publication of a commentary by Dr. Chandrakanth Are (“A Great Privilege to Die Beneath an Open Sky,” The ASCO Post, September 15, 2013, page 1). I would suggest, however, that we ...

skin cancer

Sunscreen Use Infrequently Discussed With Patients  

Although the incidence of skin cancer in increasing, “the rate at which physicians are mentioning sunscreen at patient visits is quite low, even for patients with a history of skin cancer,” according to an analysis of data from more than 18.30 billion patient visits. “Sun-protection counseling...

multiple myeloma

Pomalidomide In Patients With Disease Progression Who Are Refractory to Bortezomib and Lenalidomide  

The second-generation immunomodulatory drug pomalidomide (Pomalyst) “has shown impressive results in patients with multiple myeloma who are refractory to lenalidomide [Revlimid] and bortezomib [Velcade],” according to a review of clinical data leading to the drug’s approval by the FDA. In February, ...

SIDEBAR: Expect Questions About E-Cigarettes 

E-cigarettes are in the news, in advertising, and in stores, and because their public use is still largely unregulated, they may be in your face. Being prepared to answer questions about their use may help patients make wise decisions. What are e-cigarettes? Electronic cigarettes or e-cigarettes, ...

issues in oncology

What You Need to Know About E-Cigarettes 

“I’ve seen a lot of puzzled people,” Alexander V. Prokhorov, MD, PhD, said, referring to people who see others using electronic or e-cigarettes. That puzzlement can go beyond wondering why people are smoking in public places and whether they are breaking the law, or just being annoying, to...

skin cancer

How to Recognize and Manage Ipilimumab-Induced Dermatologic Adverse Events 

Ipilimumab (Yervoy) is a fully humanized immunoglobulin (Ig)G1 monoclonal antibody that binds to and inhibits cytotoxic T-lymphocyte–associated antigen 4 (CTLA-4). It acts as a T-cell potentiator, leading to increases in T-cell activation and interleukin-2 secretion. Ipilimumab is U.S. Food and...

health-care policy

Straight Talk: The Future of Medical and Health Research 

Nearly 200 scientists and stakeholders in the research community attended Research!America’s National Health Research Forum on September 12, at the Newseum’s Knight Conference Center in Washington, DC. Research!America’s President and CEO, Mary Woolley, opened the program. “The theme for this...

hematologic malignancies

Focus on the Wisconsin Association of Hematology & Oncology 

The Wisconsin Association of Hematology & Oncology (WAHO) is among the youngest of ASCO’s State Affiliates. Formerly known as the Wisconsin Association of Medical Oncologists, WAHO was officially formed just 2 years ago and is already having an impact on oncologists and patients with cancer...

American/International Psychosocial Oncology Societies Host Event to Support Science and Practice of Psychosocial Care for Patients With Cancer 

Recently the American Psychosocial Oncology Society (APOS) and the International Psycho-Oncology Society (IPOS) held a fundraising event, Cruise for a Cause: Improving Psychosocial and Supportive Cancer Care, to raise money to advance the science and practice of psychosocial care for patients with...

integrative oncology

Herb-Drug Interactions in Oncology  

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...

ASTRO Offers Five Recommendations as Part of Choosing Wisely Campaign

The American Society for Radiation Oncology (ASTRO) released its list of five radiation oncology-specific treatments that are commonly ordered but may not always be appropriate as part of the national Choosing Wisely® campaign, an initiative of the American Board of Internal Medicine Foundation....

prostate cancer

Radium-223 and Beyond in Metastatic Castration-Resistant Prostate Cancer 

Metastasis to bone is the hallmark of prostate cancer and a major source of disease-related morbidity and mortality. In addition to prostate cancer cells, other major players in the vicious interactive cycle of prostate cancer bone metastasis are osteoblasts, osteoclasts, and mineralized bone...

prostate cancer

ALSYMPCA Trial: Updated Analysis of Survival With Radium-223 Treatment in Metastatic Prostate Cancer 

In a trial (ALSYMPCA trial) reported in The New England Journal of Medicine, Chris Parker, MD, from Royal Marsden Hospital in Surrey, UK, and colleagues compared the alpha emitter radium-223 dichloride (Xofigo) with best standard of care in men with castration-resistant prostate cancer and bone...

breast cancer

Alcohol Consumption Between Menarche and Pregnancy and Breast Cancer Risk: Factors in Risk Accumulation   

In a study recently published in the Journal of the National Cancer Institute and summarized in this issue of The ASCO Post, we found a relationship between alcohol intake between menarche and first pregnancy and risk for breast cancer. Placing this study in context can help us interpret the data...

breast cancer

Increased Alcohol Consumption Between Menarche and Pregnancy Increases Breast Cancer Risk  

Adult alcohol consumption during the previous year is related to breast cancer risk, and breast tissue is particularly susceptible to carcinogens between menarche and first full-term pregnancy. In a study reported in Journal of the National Cancer Institute, Ying Liu, MD, PhD, of Washington...

breast cancer

Accelerated Partial-Breast Irradiation Using 3D Conformal Radiation Therapy Causes More Adverse Events Compared With Whole-Breast Irradiation 

The RAPID trial compared accelerated partial-breast irradiation using three-dimensional (3D) conformal external-beam radiation therapy vs whole-breast irradiation in women with invasive or in situ breast cancer ≤ 3 cm. As reported by Ivo A. ­Olivotto, MD, FRCPC, of the British Columbia Cancer...

kidney cancer

Progression-Free Survival With Pazopanib Not Inferior to Sunitinib Benefit in Metastatic Renal Cell Carcinoma  

Pazopanib (Votrient) and sunitinib (Sutent) have been shown to provide progression-free survival benefit compared with placebo or interferon in phase III trials in metastatic renal cell carcinoma. In a noninferiority trial reported in The New England Journal of Medicine by Robert J. Motzer, MD, of...

issues in oncology

ASCO Survey: Drug Shortages Still a Problem Despite Slight Improvement

As part of its continued effort to monitor and assess the impact of oncology drug shortages, ASCO will be conducting the third round of its biannual survey of members. The results of the first two surveys indicated that serious problems persist in the accessibility of life-extending oncology drugs, ...

issues in oncology

Comparative Effectiveness Research: Its Time Has Arrived 

Reigning in the nation’s runaway medical costs was an underlying theme of President Obama’s health-care reform platform. Citing projects like The Dartmouth Atlas of Health Care, which documented large gaps in the quality, costs, and outcomes of health services around the country, the...

breast cancer

Germline Mutations and Breast Cancer Prognosis: Does the Cause Matter? 

Since the discovery of BRCA1 and BRCA2, investigators have sought to determine whether the presence of a germline mutation independently influences the outcome of a breast cancer diagnosed in a woman with an inherited mutation. The question is highly relevant to an unaffected woman with a mutation, ...

breast cancer

10-Year Breast Cancer Survival Similar Regardless of BRCA1 Mutation Status  

In a study reported in Journal of Clinical Oncology, Tomasz Huzarski, MD, PhD, of Pomeranian Medical University, Szczecin, Poland, and colleagues from the Polish Hereditary Breast Cancer Consortium assessed survival among women with early-onset breast cancer with and without BRCA1 mutation and...

SIDEBAR: Highlights From Fox Chase Cancer Center 

1945: Hugh J. Creech, PhD, begins his 31-year career at the Institute. Dr. Creech would become widely recognized for pioneering work in developing chemotherapy agents. 1959: Peter C. Nowell, MD, University of Pennsylvania School of Medicine, and his research fellow David A. Hungerford, Fox Chase...

issues in oncology

More Active Physician Intervention Needed to Keep Patients From Smoking  

More active support and interventions by physicians are required to get patients who still smoke to stop, according to two articles published online by the Journal of Oncology Practice (JOP),1,2 and to prevent school-aged children and adolescents from starting to use tobacco, according to a U.S....

lung cancer

Stereotactic Body Radiation Therapy Offers Near-Complete Tumor Control for Medically Inoperable Early-Stage NSCLC 

Patients with stage I non–small cell lung cancer (NSCLC) who are medically inoperable have an excellent chance at full local tumor control and long-term survival with stereotactic body radiation therapy. Hak Choy, MD, Professor and Chairman of the Department of Radiation Oncology at The University...

lung cancer

Ancient Chinese Military Tactics Might Help Win the War on Lung Cancer  

At the 14th International Lung Cancer Congress, held recently in Huntington Beach, California, Tony S.K. Mok, MD, Professor of Clinical Oncology at the Chinese University of Hong Kong, was the honored recipient of the Bonnie J. Addario Lung Cancer Foundation Award. The award was presented by Ms....

gynecologic cancers

Challenging and Changing the Standard of Care for Cervical and Ovarian Cancers 

“It was a very exciting session this year, particularly for cervical cancers,” said Paul Haluska MD, PhD, of the Mayo Clinic, Rochester, Minnesota, in speaking of the 2013 ASCO Annual Meeting’s gynecologic oncology session and the abstracts highlighted recently at Best of ASCO in Chicago. In one...

colorectal cancer

Important Findings in Metastatic Colorectal Cancer Studies Address Treatment, Management Options

At the Best of ASCO Meeting in Los Angeles, Tony Reid, MD, PhD, Director of the Early Phase Clinical Research Program and Professor of Hematology/Oncology at the University of California, San Diego, reviewed important findings in metastatic colorectal cancer presented at the 2013 ASCO Annual...

prostate cancer

Telomere Length May Be a Prognostic Marker for Prostate Cancer

Cancer cells are known to have short telomeres, but just how short they are from cancer cell to cancer cell may be a determining factor in a prostate cancer patient’s prognosis, according to a study1 led by scientists at Johns Hopkins. “Doctors are looking for new ways to accurately predict...

issues in oncology

Applying Molecular Profiling to Clinical Practice: Promises and Challenges 

A “new kind of pathology,” with anatomy and histology being supplemented by molecular etiology, has been emerging over the past decade and promises better response rates among patients with cancer, as genomic alterations continue to be identified and treated with targeted therapies. “The list of...

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