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'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...

pancreatic cancer

FDA Approves Nab-Paclitaxel for Late-Stage Pancreatic Cancer

The U.S. Food and Drug Administration (FDA) has expanded the approved uses of paclitaxel protein-bound particles for injectable suspension, albumin-bound (nab-paclitaxel, Abraxane) to treat patients with late-stage pancreatic cancer. “Patients with pancreatic cancer are often diagnosed after the...

breast cancer

Pathologic Complete Response as a Test Bed for Novel Therapies: Proceed—With Caution! 

Pathologic complete response as assessed surgically after neoadjuvant treatment is being touted by some researchers as a stand-alone endpoint justifying early drug approval for breast cancer. They argue that it provides a more efficient means of testing the value of agents that might be useful in...

Expert Point of View on ductal carcinoma in situ

In an e-mail interview, E. Shelley Hwang, MD, an expert who has coauthored several papers on ductal carcinoma in situ (DCIS), weighed in on the two abstracts about management of DCIS featured in this issue of The ASCO Post—one presented by Melissa L. Pilewskie, MD (perioperative MRI in DCIS, page...

Expert Point of View: Steven J. O’Day, MD

This is an important large retrospective single-institution study …[conducted in the context of a] tremendous increase in use of MRI for invasive and noninvasive breast cancer,” said Steven J. O’Day, MD, who moderated a presscast held just prior to the 2013 Breast Cancer Symposium. “The study...

breast cancer

Single-Institution Study Evaluates Routine Use of Perioperative MRI in Patients With Ductal Carcinoma In Situ 

Perioperative MRI for patients with ductal carcinoma in situ (DCIS) was not associated with a reduction in locoregional recurrence or contralateral breast cancer development in a large single-center study reported at the 2013 ASCO Breast Cancer Symposium. The study also was presented at a...

breast cancer

What Is on the Horizon in the Management of Breast Cancer? 

In Keynote Lectures during the 2013 ASCO Breast Cancer Symposium, experts George Sledge, MD, and Monica Morrow, MD, offered their opinions and outlook on how the medical and surgical management of breast cancer may continue to evolve over the next 5 to 10 years.1 Dr. Sledge is Chief of Oncology at...

health-care policy

Trying to Improve Value in Cancer Care: An Experiment

One of the more significant problems in modern oncology practice is to provide increased value at a time when costs are spiraling upward, and new parameters of “success” are being introduced into the equation—most visibly, inside the Beltway in Washington, DC. Thus, oncologists will need to address ...

breast cancer
issues in oncology

Breast Cancer Care in the Era of Accountable Care Organizations

Prepare for big changes ahead, Lawrence N. Shulman, MD, Senior Vice President for Medical Affairs at the Dana-Farber Cancer Institute, Brigham and Women’s Hospital, and Harvard Medical School in Boston, told oncologists at the 2013 Breast Cancer Symposium.1 One change is the emergence of...

palliative care

Inequality in Delivery of Palliative Radiotherapy Among Black Patients With Cancer and Elderly With Comorbidities  

An analysis of data from more than 51,000 patients with stage IV cancer shows “significant inequality” in the delivery of palliative radiotherapy among the elderly, patients with comorbidity, and black patients with prostate and colorectal cancer, reported James D. Murphy, MD, MS, and colleagues...

leukemia

Front-Line Treatment Strategies to Achieve Long-Term Control of CLL Combined With Optimal Quality of Life 

“The management of chronic lymphocytic leukemia (CLL) is undergoing profound changes. Several new drugs have been approved for CLL treatment (fludarabine, bendamustine [Treanda], and the monoclonal antibodies alemtuzumab [Campath], rituximab [Rituxan], and ofatumumab [Arzerra]), and many more drugs ...

breast cancer

Calcium Channel Blockers Linked to Increased Risk of Lobular/Ductal Breast Cancer  

Women who are currently using calcium channel blockers and have been doing so for 10 or more years are at increased risk of the two most common histologic types of breast cancer, invasive ductal carcinoma and invasive lobular carcinoma, according to a population-based case control study. “While...

skin cancer

Intralesional Cytokine Therapy in Cutaneous Melanoma: A Call for Clinical Trials

Cutaneous melanomas are mostly an immunogenic group of tumors, but they are also heterogeneous. Therefore, therapeutic specificity and autogenetic approaches are essential to secure beneficial results. The objective of sentinel lymph node biopsy, at the time of diagnosis, is to identify patients...

breast cancer

Better Risk Communication Strategies Needed to Ensure Decision to Have Contralateral Prophylactic Mastectomy Is Evidence-Based 

Overestimating the risk that cancer in one breast will affect the other breast may cause many young women with breast cancer to choose contralateral prophylactic mastectomy even though most know it does not clearly improve survival. In a survey of 123 women who were diagnosed with cancer in one...

cost of care

CancerCare Launches New Edition of Financial Resource Guide for People With Cancer 

CancerCare recently announced the launch of a new edition of A Helping Hand: The Resource Guide for People With Cancer, Financial Edition, a reference guide to assist patients with cancer and their families in navigating the financial resources available to them. A Helping Hand is a comprehensive...

pancreatic cancer

Nab-Paclitaxel in Metastatic Pancreas 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 6, paclitaxel protein-bound particles...

thyroid cancer

Cabozantinib in Medullary Thyroid Cancer: A Landscape-Shaping New Treatment 

Medullary thyroid cancer is derived from parafollicular C cells in the thyroid gland. The disease is sporadic in about 75% of cases and hereditary in the remaining 25%.1 Oncogenic mutations in the gene for tyrosine kinase receptor rearranged during transfection (RET) are driver genetic alterations...

health-care policy

AACR Cancer Progress Report 2013 Highlights Critical Importance of Biomedical Research 

On September 17, the American Association for Cancer Research (AACR) presented highlights of its 2013 Cancer Progress Report1 at the National Press Club in Washington, DC. AACR Chief Executive Officer Margaret Foti, PhD, MD (hc), opened the program with a double-edged message, first citing the...

SIDEBAR: 2013 New Drug/Indication Approvals* 

1. September 30, 2013: Pertuzumab (Perjeta) Accelerated approval in combination with trastuzumab and docetaxel for the neoadjuvant treatment of HER2-positive, locally advanced, inflammatory, or early-stage breast cancer.  2. September 6, 2013: Paclitaxel protein-bound particles (albumin-bound)...

issues in oncology
legislation

A Look Ahead: How the FDA Is Adapting in the Era of Precision Medicine  

Dubbed “Cancer Czar” by the media, Richard Pazdur, MD, Director of the U.S. Food and Drug Administration (FDA) Office of Hematology and Oncology Products, said he has the “best job in oncology, with a unique vantage point in cancer drug development.” An oncologist for more than 30 years—including...

ASCO President-Elect Candidate Julie M. Vose, MD, MBA, FASCO

Cost of Care and Federal Funding How can ASCO address the high cost of cancer care and diminishing federal resources for basic and translational research? We need to work with the Centers for Medicare & Medicaid Services, private insurers, and health-care systems to encourage evidence-based...

pain management

FDA Announces Class-Wide Safety Labeling Changes for Long-Acting Opioid Analgesics to Combat Abuse

The U.S. Food and Drug Administration (FDA) announced class-wide safety labeling changes and new postmarketing study requirements for all extended-release and long-acting opioid analgesics intended to treat pain. “The FDA is invoking its authority to require safety labeling changes and postmarket...

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