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ASCO Receives Additional Funding for Virtual Learning Collaborative From California HealthCare Foundation

ASCO is pleased to announce grant funding from the California HealthCare Foundation to support the Virtual Learning Collaborative (VLC). This pilot project will use the VLC to improve the quality of palliative care in routine medical oncology practice. ASCO is also collaborating with the American...

ASCO Reconfirms Commitment to Choosing Wisely® Campaign 

In collaboration with the American Board of Internal Medicine (ABIM) Foundation’s Choosing Wisely® campaign, ASCO recently released a second “Top Five” opportunities list of common practices or procedures in oncology whose clinical value is not supported by available evidence and if eliminated, can ...

breast cancer

Pertuzumab in Neoadjuvant Treatment of HER2-Positive Early Breast Cancer

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 September 30, 2013, pertuzumab injection (Perjeta)...

issues in oncology

FDA Announces Strategic Plan to Prevent Drug Shortages

The U.S. Food and Drug Administration (FDA) is taking two actions to further enhance the agency’s ongoing efforts to prevent and resolve drug shortages. The FDA has released a strategic plan called for in the Food and Drug Administration Safety and Innovation Act (FDASIA) of 2012 to improve the...

prostate cancer

Finasteride for Prostate Cancer Prevention: Long-Term Results Disappointing but Reassuring

All medical care should seek to achieve one or more of three goals: to relieve suffering, to prevent future suffering, or to prolong life. Care for cancer is no exception, and minimizing suffering from cancer and prolonging life has primarily resulted from advances in treatment. Although there are...

prostate cancer

No Difference in Long-Term Survival With Finasteride or Placebo in the Prostate Cancer Prevention Trial 

In the Prostate Cancer Prevention Trial (PCPT), initially reported in 2003, finasteride significantly reduced the risk of prostate cancer by 24.8% but was associated with a relative 26.9% increase in risk of high-grade disease compared with placebo. In a study reported in The New England Journal of ...

issues in oncology

Technologic Innovations Are Likely to Transform Oncology Care

Oncology and medicine as a whole are likely to benefit from a variety of technologic innovations recently showcased at the third annual The Atlantic Meets the Pacific symposium, according to Peter P. Yu, MD, President-Elect of the American Society of Clinical Oncology, and medical oncologist and...

breast cancer

Neoadjuvant Treatment of Early Breast Cancer

INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this first installment, FDA Clinical Reviewers Laleh Amiri-Kordestani, MD, and Suparna Wedam, MD, discuss FDA’s recent approval of pertuzumab (Perjeta) for the neoadjuvant treatment of...

hepatobiliary cancer

Brivanib Fails to Live Up to the Promise of Early Studies

Hepatocellular carcinoma is a devastating disease worldwide. Although advances in liver transplantation, surgery, and locoregional therapies have made tumor control or even cure possible for a minority of patients, the majority of patients diagnosed with hepatocellular carcinoma will develop...

lung cancer

Oncogene Addiction and the Rationale for Molecular Targeted Therapy in Lung Cancer

Over the past decade, Fadlo R. Khuri, MD, Professor and Roberto C. Goizueta Distinguished Chair of Hematology and Medical Oncology, and Deputy Director of the Winship Cancer Institute of Emory University, Atlanta, has focused his research and clinical career on investigating novel approaches in the ...

leukemia

Sale of Ponatinib Suspended Due to Risk of Life-Threatening Blood Clots

The U.S. Food and Drug Administration (FDA) has asked the manufacturer of the tyrosine kinase inhibitor ponatinib (Iclusig) to suspend marketing and sales of the drug because of the risk of life-threatening blood clots and severe narrowing of blood vessels. Ariad Pharmaceuticals has agreed to...

pain management

FDA Approves First Extended-Release, Single-Entity Hydrocodone Product

The U.S. Food and Drug Administration (FDA) today approved hydrocodone bitartrate extended-release capsules (Zohydro ER) for the management of pain severe enough to require daily, around-the-clock, long-term treatment and for which alternative treatment options are inadequate. The drug, a Schedule...

colorectal cancer

Long-Term Colorectal Cancer Incidence and Mortality After Lower Endoscopy

Colonoscopy and sigmoidoscopy have been shown to provide protection against colorectal cancer, but the magnitude and duration of protection, particularly against proximal colon cancer, remain undefined. A study of long-term colorectal cancer incidence and mortality after lower endoscopy reported in ...

breast cancer
head and neck cancer
kidney cancer
lung cancer

Important News Briefs: New Data Reported in Breast, Renal Cell, Head and Neck, and Lung Cancer

The 2013 European Cancer Congress (ECC), held September 27 to October 1 in Amsterdam, was jointly sponsored by the European Society of Medical Oncology, the European Cancer Organization, and the European Society of Radiation Oncology. With the Congress theme being “Reinforcing Multidisciplinarity,” ...

gynecologic cancers

Two Trials Explore the Evolving Role of Bevacizumab in Ovarian Cancer

The optimal use of bevacizumab (Avastin) in ovarian cancer appears to be in high-risk subgroups and in patients with platinum-resistant ovarian cancer, according to results of two phase III trials presented at the 2013 European Cancer Congress (ECC) in Amsterdam. AURELIA investigated the safety and ...

breast cancer

Strong Showing for Ado-Trastuzumab Emtansine in Advanced HER2-Positive Heavily Pretreated Breast Cancer

Results of the phase III TH3RESA trial show that the antibody-conjugate ado-trastuzumab emtansine (Kadcyla), formerly known as T-DM1, extends progression-free survival in women with advanced HER2-positive breast cancer that progressed on two or more previous HER2-directed therapies including...

lymphoma

Standardizing the Interpretation of PET Scans: An INR Equivalent

Since its introduction, the positron-emission tomography (PET) scan has shown great potential to improve our ability to care for patients with lymphoma. By demonstrating which masses seen on a computed tomography (CT) scan represent viable tumor, and by identifying viable tumor in places that were...

health-care policy

IOM Report Illuminates U.S. Cancer Care Crisis and Offers Framework for Change

In September, the Institute of Medicine (IOM) of the National Academies issued its report, Delivering High-Quality Cancer Care: Charting a New Course for a System in Crisis,1 published more than a decade after its first study on the quality of cancer care in the United States. The authors of the...

skin cancer

Ipilimumab Conveys Long-Term Survival Benefit in Pooled Analysis of Metastatic Melanoma Patients

In the treatment of metastatic or locally advanced unresectable melanoma, the anti–CTLA-4 monoclonal antibody ipilimumab (Yervoy) conveys long-term survival benefits, with some patients alive out to 10 years, according to the largest survival analysis of the immunomodulating agent, presented at the ...

colorectal cancer

One in Three American Adults Do Not Comply With Screening Guidelines for Colorectal Cancer 

The percentage of American adults aged 50 to 75 who are up-to-date with recommended screening for colorectal cancer “increased from 54% in 2002 to 65% in 2010, primarily driven by increased use of colonoscopy,” according to data from the 2012 Behavioral Risk Factor Surveillance System survey....

breast cancer
cost of care

Evaluation of Breast Cancer MRI Screening Strategies

Recent years have witnessed much heated debate about the benefits of breast cancer screening and optimal screening strategies. Unlike with mammography, no randomized data are available to determine whether screening with magnetic resonance imaging (MRI) reduces mortality from breast cancer....

head and neck cancer

Spanning a Spectrum of Issues Related to Head and Neck Cancers

Five recent articles in JAMA Otolaryngology–Head & Neck Surgery1-5 span a spectrum of issues related to head and neck cancers. These include risk factors, concentration of care to teaching hospitals, avoiding venous thromboembolism, and encouraging patients to eat and do swallowing exercises to ...

cost of care
health-care policy

Improving Quality Measurement in Cancer Care: Policy Recommendations

Quality measurement—how we assess cost and effectiveness of cancer care—cannot be separated from policy decisions that have a profound influence on the overall health-care system. At the recent ASCO Quality Care Symposium, Jennifer L. Malin, MD, PhD, Medical Director for Oncology at WellPoint, Inc, ...

breast cancer

Alliance Trial Evaluates Sentinel Node Surgery After Neoadjuvant Chemotherapy for Node-Positive cN1 Breast Cancer

Sentinel lymph node surgery provides reliable nodal staging information and is associated with less morbidity than axillary lymph node dissection in patients with clinically node-negative (cN0) breast cancer. The American College of Surgeons Oncology Group (ACOSOG) Z1071 (Alliance) trial examined...

survivorship
palliative care

Living With Cancer: The Role of Palliative Care in Long-Term Survivorship Care

According to data from the Surveillance, Epidemiology, and End Results Program (SEER) and the U.S. Census Bureau registries,1 there are currently about 13.7 million cancer survivors in the United States, and that number is projected to grow to 18 million by 2022. In addition, 64% of this population ...

breast cancer

Where Is Adjuvant Bisphosphonate Therapy Now? 

The adjuvant use of bisphosphonates in breast cancer continues to yield seemingly contradictory data despite a sound biologic basis and smaller pilot studies suggesting that dampening bone turnover with bisphosphonates can lessen the bone reservoir of micrometastases.1,2 Early adjuvant trials with...

University of Chicago Names Ernst Lengyel, MD, PhD, Chair of Obstetrics and Gynecology

Ernst Lengyel, MD, PhD, was recently named Chair of the Department of Obstetrics and Gynecology at the University of Chicago. He succeeds Arthur Haney, MD, who served as Chair of the Department of Obstetrics and Gynecology since April 2003. Under the leadership of Dr. Haney, the Department...

leukemia

Obinutuzumab in Previously Untreated Chronic Lymphocytic Leukemia

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 November 1, 2013, obinutuzumab (Gazyva) was approved...

leukemia

FDA Grants Ofatumumab Breakthrough Therapy Designation for Previously Untreated CLL

The U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation for ofatumumab (Arzerra) in combination with chlorambucil (Leukeran) for the treatment of patients with chronic lymphocytic leukemia (CLL) who have not received prior treatment and are inappropriate for...

gastrointestinal cancer

Gastric Cancer: Time to Revisit Angiogenesis

Progress in the treatment of gastric cancer has lagged behind advances in other solid tumor malignancies. A modest but clear survival benefit with the use of adjuvant therapy combined with surgery has been achieved, including the use of postoperative adjuvant chemotherapy as shown in large-scale...

pancreatic cancer

Has a New Standard of Care for Metastatic Pancreatic Cancer Been Established?

For a number of years following the approval of gemcitabine for advanced pancreatic cancer, one phase III clinical trial after the next failed to demonstrate a survival benefit of combination chemotherapy compared to gemcitabine alone. Even the one positive study from the mid-2000s—the PA.3 trial...

pancreatic cancer

Long-Term CONKO-001 Results: Adjuvant Therapy Improves Survival 

From 12% to 15% of the approximately 45,000 patients diagnosed with pancreas adenocarcinoma undergo a potentially curative resection each year in North America, translating into roughly 5,000 to 7,000 patients who are candidates for adjuvant therapy. About 80% of these patients will relapse and...

pancreatic cancer

Adjuvant Gemcitabine Improves Long-Term Survival in Patients With Resected Pancreatic Cancer

An initial report from the phase III Charité Onkologie (CONKO) 001 trial of adjuvant gemcitabine vs observation in patients with completely resected pancreas cancer showed that gemcitabine treatment was associated with a significant prolongation of disease-free survival.1 As reported in JAMA by...

palliative care

Standardized Approach Improves Palliative Care Services and Outcomes 

Standardized criteria for initiating palliative care consultations can substantially improve the care of patients with advanced solid tumors, according to research from Mount Sinai School of Medicine, New York, led by Kerin Adelson, MD, Coordinator for Ambulatory Oncology Quality for the Tisch...

palliative care
cost of care

Two Studies Highlight Communication Challenges Facing Medical Oncology

In one study presented at ASCO’s second annual Quality Care Symposium in San Diego, patients receiving chemotherapy with palliative care intent were at high risk of side-effect–related hospitalization, which defeats the clinical purpose and adds preventable costs to health care.1 “There is an...

Expert Point of View: Eric Van Cutsem, MD, PhD

Eric Van Cutsem, MD, PhD, Professor of Internal Medicine at the University of Leuven in Belgium, the formal discussant of the late-breaking abstract, noted there is strong rationale for studying TP53 status in relation to rectal cancer outcomes, but he felt the findings of EXPERT-C could not yet be ...

Expert Point of View: Frances A. Shepherd, MD, FRCPC

Formal discussant of the AP26113 trial at the European Cancer Congress, Frances A. Shepherd, MD, FRCPC, Professor at the University of Toronto Faculty of Medicine and Scott Taylor Chair in Lung Cancer Research at the Princess Margaret Cancer Centre, Toronto, Canada, explained that ALK...

SIDEBAR: Addition of Novel Agents May Improve Outcomes With ABVD

In North America, the standard front-line treatment for advanced Hodgkin lymphoma is ABVD (doxorubicin, bleomycin, vinblastine, dacarbazine), but this regimen is not effective in all patient subsets. To improve upon the regimen’s efficacy, researchers are evaluating new combinations, said Stephen...

lymphoma

Brentuximab Vedotin Improves Response Rates to ABVD in Hodgkin Lymphoma

For the front-line treatment of advanced Hodgkin lymphoma, ABVD is a standard treatment, but not all patients have good outcomes with this regimen. The addition of brentuximab vedotin (Adcetris), or its substitution for bleomycin, produces high complete response rates but with a moderate increase...

multiple myeloma

What Does ‘Myeloma’ Mean?

Over the centuries it has become clear that, as physicians, what we say and how we say it can have a major impact on those who seek our help. Our pronouncement that a patient is in remission or harbors a serious illness carries with it a large number of spoken and unspoken implications. So when we...

health-care policy
cost of care

Innovative Payment Models Needed to Sustain Quality Cancer Care  

Nationally regarded health-care expert Lee N. Newcomer, MD, MHA, began his presentation at this year’s ASCO Quality Care Symposium with a rhetorical question. “Why are we talking about money when we’re gathered in San Diego for 2 days to discuss some wonderful ways to impact the quality of cancer...

breast cancer

Response-Guided Neoadjuvant Therapy for Breast Cancer: A Promising Model Warranting Additional Investigation 

GeparTrio was an innovative phase III trial conducted by the German Breast Group, enrolling over 2,000 women with early breast cancer who were candidates for neoadjuvant chemotherapy. Patients with evidence of early response, defined as reduction in clinical tumor size by 50% or more, following two ...

issues in oncology

Young Tobacco Consumers Frequently Use Products Other Than Cigarettes

“A substantial proportion of youth tobacco use occurs with products other than cigarettes, so monitoring and prevention of youth tobacco use needs to incorporate other products, including new and emerging products,” according to the Morbidity and Mortality Weekly Report, published by the Centers...

cost of care

Disclosing Medical Costs Can Help Avoid 'Financial Toxicity'

High costs of cancer treatments can be an “undisclosed toxicity” that can harm a patient’s overall health and well-being, according to an article in The New England Journal of Medicine.1 High medical bills can not only cause stress and anxiety but may also compel patients to cut back on spending...

issues in oncology

Focus on the Massachusetts Society of Clinical Oncologists

The Massachusetts Society of Clinical Oncologists (MSCO) is among the oldest and largest of ASCO’s State Affiliates. Based in the same building as the Massachusetts Medical Society in Waltham, MSCO was founded in 1985 and has a growing membership of 160 members, including medical, surgical, and...

Dr. Weisenthal Replies

Dr. Mason states that I implied that Dr. Telli supports the routine application of chemosensitivity assays. I have no knowledge regarding Dr. Telli’s views on this subject, nor did I in any way attempt to represent her views, much less imply that she was supportive of anything relating to...

lymphoma

Ibrutinib in Previously Treated Mantle Cell Lymphoma

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 November 13, 2013, ibrutinib (Imbruvica) was granted...

issues in oncology

The Quest to Optimize Personalized Therapies for Cancer

In the late 1980s, Brian J. Druker, MD, was investigating the BCR-ABL tyrosine kinase as a target for therapeutic intervention for chronic myeloid leukemia (CML) in a laboratory at Dana-Farber Cancer Institute in Boston. By 1993, Dr. Druker had moved to Oregon Health & Science University in...

integrative oncology

Ginkgo biloba

The use of dietary supplements by patients with cancer has increased significantly over the past 2 decades despite insufficient evidence of safety and effectiveness. Finding reliable sources of information about dietary supplements can be daunting. Patients typically rely on family, friends, and...

integrative oncology

Society for Integrative Oncology Is Helping to Advance Evidence-Based, Comprehensive Integrative Health Care

Heather Greenlee, ND, PhD, was named President of the Society for Integrative Oncology (SIO) at the organization’s 10th International Conference in October. Dr. Greenlee is Assistant Professor in the Department of Epidemiology at the Mailman School of Public Health at Columbia University in New...

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