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integrative oncology

Highlights From the 10th International Conference of the Society for Integrative Oncology 

The 10th International Conference of the Society for Integrative Oncology (SIO) was held recently in Vancouver, British Columbia, Canada, and attracted over 300 oncologists and internal medicine physicians, researchers, nurses, integrative medicine practitioners, cancer survivors, and patient...

Assessment Tools to Measure Impact of Dermatologic and Mucosal Adverse Eventsa

aEditor’s Note: References to these tools are provided for educational purposes only. Terms of use for these tools may vary and some may be subject to copyright restrictions. Patient-Reported Outcomes version of the CTCAE (PRO-CTCAE) Patient Completed mcAEs Specific Symptom Experience...

symptom management

How to Measure the Impact of Dermatologic and Mucosal Adverse Events on Symptom Burden and Quality of Life

Targeted anticancer therapies like epidermal growth factor receptor (EGFR) inhibitors, multitargeted tyrosine kinase inhibitors (mTKIs), and mammalian target of rapamycin (mTOR) inhibitors frequently result in dermatologic adverse events and mucosal adverse events, or, taken together, mucocutaneous ...

health-care policy

National Cancer Policy Summit: Setting Priorities for the Next 3 Years

Welcome to the meeting we hold every 3 years to choose our next projects,” said John Mendelsohn, MD, Chair of the National Cancer Policy Forum and Director of the Khalifa Institute for Personalized Cancer Therapy at The University of Texas M.D. Anderson Cancer Center, Houston. “We have here a...

issues in oncology

Patient-Reported Outcomes, a Central Component to Value and Rapid-Learning Systems

With the passage of the Patient Protection and Affordable Care Act in 2010, value became the operative word in assessing the success of health care, from outcomes to cost. To drive more value, the Affordable Care Act seeks to implement initiatives such as comparative effectiveness research that...

issues in oncology

Oncology Drug Dosing: Can an Optimal Dose Be Fine-Tuned for Each Patient?

ASCO Chief Medical Officer Richard L. Schilsky, MD, and other oncology drug experts presented a panel on drug dosing at a recent meeting, cosponsored by the Friends of Cancer Research and the Brookings Institution, in Washington, DC.1 The presentations made it clear that issues surrounding drug...

Expert Point of View: Daniel F. Hayes, MD, FASCO

Daniel F. Hayes, MD, FASCO, the Stuart B. Padnos Professor of Breast Cancer Research at the University of Michigan, Ann Arbor, wrote an accompanying editorial on the value of these newly developed omics-related criteria.1 Dr. Hayes pointed out that since the cloning of the human genome, there has...

issues in oncology

NCI-Led Scientists Develop Criteria for 'Omics' Tests Used in Clinical Investigations

High-throughput “omics” technologies that generate molecular profiles on tumor specimens are increasingly being incorporated into clinical trials, but some of these assays have not been well validated, leading many in the research community to question their fitness for use in patient-care...

cns cancers

Valganciclovir in Glioblastoma, Selection Bias, and Flawed Conclusions

As reviewed in this issue of The ASCO Post, Söderberg-Nauclér et al from the Karolinska Institute have written a provocative letter to The New England Journal of Medicine suggesting that long-term administration of valganciclovir (Valcyte), a drug that targets cytomegalovirus (CMV), improves...

cns cancers

Investigators Report Valganciclovir May Increase Survival in Glioblastoma

In a letter to The New England Journal of Medicine, Cecilia Söderberg-­Nauclér, MD, PhD, and colleagues from the Karolinska Institutet, Stockholm, described experience with the anti-cytomegalovirus (CMV) agent valganciclovir (Valcyte) in the treatment of glioblastoma, citing dramatically improved...

prostate cancer

Correctly Assessing Pain Progression and Quality-of-Life Deterioration in Metastatic Castration-Resistant Prostate Cancer

The therapeutic landscape for the treatment of castration-resistant prostate cancer has changed dramatically in the past 4 years, as five new agents affecting different aspects of the malignant process were proven to prolong life. The results are a great benefit to patients, but at the same time...

prostate cancer

Adding Abiraterone to Prednisone Significantly Prolongs Time to Pain Progression in Chemotherapy-Naive Men With Metastatic Castration-Resistant Prostate Cancer

An interim analysis of the COU-AA-302 phase III trial in asymptomatic or mildly symptomatic chemotherapy-naive men with metastatic castration-resistant prostate cancer showed that the addition of abiraterone (Zytiga) to prednisone significantly delayed radiographic progression and improved overall...

breast cancer

Breast Cancer Vaccines for Primary Prevention Move Toward Clinical Use

The first candidate vaccine to prevent recurrence of breast cancer entered clinical trials about 8 years ago, and since then, the idea of a vaccine for secondary prevention has gained traction; more such vaccines are now in development. But this fall, it was vaccines for primary prevention that had ...

issues in oncology

Centers in Massachusetts Collaborate in Joint Center for Cancer Precision Medicine 

The Joint Center for Cancer Precision Medicine, a collaborative initiative among Dana-Farber Cancer Institute, Brigham and Women’s Hospital, Boston Children’s Hospital, and the Broad Institute of MIT and Harvard, has been established to create “precision medicine treatment pathways” for patients...

gynecologic cancers

Continuous, Combined Hormone Replacement Therapy Protects Against Endometrial Cancer

According to an analysis of the Women’s Health Initiative, continuous combined use of estrogen plus progestin reduces the risk of endometrial cancer among postmenopausal women. The study was reported at the 2013 European Cancer Congress by Rowan T. Chlebowski, MD, PhD, Professor and Chief of...

Expert Point of View: Kjell Oberg, MD, PhD

Kjell Oberg, MD, PhD, Professor in the Department of Medical Sciences at the University Hospital in Uppsala, Sweden, discussed the CLARINET paper at the Presidential Session during the European Cancer Congress in Amsterdam. Dr. Oberg noted the curious observation that median progression-free...

neuroendocrine tumors

Extended-Release Lanreotide Significantly Delays Disease Progression in Patients With Neuroendocrine Tumors in Large Phase III CLARINET Trial

A strong antiproliferative response was shown for the somatostatin analog lanreotide (subcutaneous, extended-release formulation, Somatuline Autogel [Somatuline Depot in the United States]) in patients with gastroenteropancreatic neuroendocrine tumors, in the large multinational prospective phase...

lymphoma

Transplant Now or Later for High-Risk Aggressive Non-Hodgkin Lymphoma?

The use of high-dose chemotherapy and autologous hematopoietic blood or marrow transplantation for high-risk aggressive non-Hodgkin lymphoma has been extensively evaluated over the past few decades. This treatment was originally used only for patients with relapsed aggressive lymphoma. However, as...

lymphoma

S9704 Trial: Autologous Transplantation as Consolidation in Aggressive Lymphoma

Autologous bone marrow or stem cell transplantation has had an important role in the treatment of aggressive lymphoma for several decades. The important results of the PARMA study1 demonstrated that patients in first relapse who remained chemosensitive had improved progression-free and overall...

SIDEBAR: Shared Decisions: What Should We Expect?

There is growing interest by patients, policymakers, and clinicians in shared decision-making as a means to include patients in health decisions and translate patient evidence into clinical practice. Conceptually, sharing of information seems like a natural interplay between doctors and their...

issues in oncology

Sharing Treatment Decision-Making With Patients: Where’s the Evidence of Value?

Though certainly not new to oncologists, “shared decision-making” between doctors and patients is receiving increased attention in the medical community today. While it’s an idea with merit, Steven J. Katz, MD, MPH, a specialist in quality care issues, maintains that expectations about the...

colorectal cancer

Call for Expanded Genetic Profiling in Colorectal Cancer

Testing for codons 12 and 13 on the KRAS gene and BRAF testing can predict whether patients with colorectal cancer will respond to anti–epidermal growth factor receptor (EGFR) therapies. However, genetic alterations not captured by testing for KRAS codon 12 and 13 mutations may play an important...

issues in oncology

African Americans Report Receiving Few Positive Recommendations by Physicians About Joining Clinical Trial 

A study among African American patients with cancer who had declined to participate in a therapeutic clinical trial found that few patients reported receiving a positive recommendation from their physician to participate in the trial. “Patients gave multiple refusal reasons,” researchers led by...

lymphoma

Increased Ultraviolet Radiation Exposure May Protect Against HL, Particularly in Those With EBV-Positive Disease

Increased exposure to ultraviolet radiation may offer protection against Hodgkin lymphoma (HL), particularly against Epstein-Barr virus (EBV)-positive HL, according to a pooled analysis of studies involving 1,320 HL patients and 6.381 controls.  “Our pooled analysis of 7,701 participants from 4...

breast cancer
gynecologic cancers

Effects of Oral Contraceptives on Breast/Ovarian Cancer Risks Are Similar Regardless of BRCA Mutation Status

The effects of oral contraceptives on breast and ovarian risks are similar for women with BRCA1 or BRCA2 mutations and for women in the general population, according to analyses of observational studies. Oral contraceptive use “is inversely associated with ovarian cancer risk, whereas a modest but...

breast cancer
supportive care

No Significant Improvement With Decongestive Therapy vs More Conservative Approach to Treating Arm Lymphedema 

Daily manual lymphatic drainage and bandaging followed by compression garments did not result in significant improvement in lymphedema compared to a more conservative approach with compression garments only, according to a study evaluating 95 women previously treated for breast cancer with...

SIDEBAR: Expect Questions From Your Patients About Hyperthermia

Most but not all cancer treatment with hyperthermia is still being done in clinical trials. The exception is using hyperthermia for superficial cancers, most commonly chest wall recurrences in the breast. Using hyperthermia for superficial cancer “is approved and reimbursable by Medicare,” Mark W....

gynecologic cancers

Using Hyperthermia for Cancer Treatment: Proofs, Promises, and Uncertainties

With the headline, “Rare Cancer Treatments, Cleared by F.D.A. but Not Subject to Scrutiny,” a recent article in The New York Times reported that several medical centers were treating patients with cancer using a hyperthermia system that had received a Humanitarian Use Device approval from the U.S....

With the Goal of Curing Cancer, Ezra M. Greenspan, MD, Helped Usher in the Modern Era of Chemotherapy

Two events in Ezra M. Greenspan’s early adult life convinced him to pursue a career in medicine: the death of a college friend from pneumonia when the two were students at Cornell University College of Arts and Sciences and his own bout with the disease soon after. Saved by a local physician who...

survivorship

Making Progress in Survivorship Care Planning

The recommendation that a survivorship care plan be provided to patients and their primary care providers was first presented in the 2006 Institute of Medicine (IOM) report, From Cancer Patient to Cancer Survivor: Lost in Transition. The IOM committee proposed that this document include two parts—a ...

survivorship

Improvements Needed in Use of Survivorship Care Plans 

Survivorship care plans, consisting of treatment summaries and follow-up plans, are intended to promote coordination of post-treatment cancer care, but little is known about how survivorship care plans are being used in routine oncology practice. In a study reported in the Journal of the National...

palliative care

Assessing Patients for Palliative Care

In 2012, ASCO issued a provisional clinical opinion addressing the integration of palliative care services into standard oncology practice at the time a patient is diagnosed with metastatic or advanced cancer and for patients with uncontrolled symptoms.1 However, despite ASCO’s provisional clinical ...

issues in oncology

Developing Intermediate Endpoints in Immunotherapy

“The immune system holds tremendous potential for long-term sustained antitumor activity,” said James P. Allison, PhD, Immunology Chair, The University of Texas MD Anderson Cancer Center, Houston, as he opened a panel discussion at a meeting cosponsored by the Friends of Cancer Research and the...

lung cancer

Activation of Innovative Lung Cancer Master Protocol Officially Announced, Enrollment to Begin in March

At a recent meeting in Washington, DC, Friends of Cancer Research and the Engelberg Center for Health Care Reform at the Brookings Institution officially announced activation of the Lung Cancer Master Protocol, a new research strategy that has the potential to hurdle or bypass known clinical trial...

supportive care

Diagnosing and Treating Chronic Mucocutaneous Graft-vs-Host Disease

Chronic graft-vs-host disease is a major cause of late, nonrelapse death following allogeneic hematopoietic stem cell transplantation. In addition, chronic graft-vs-host disease results in significant functional impairment and decreased quality of life for long-term survivors of stem cell...

lung cancer

Adjuvant Gefitinib in Patients With NSCLC: Bad Idea or Wrong Patient Selection?

Despite optimal surgical resection and adjuvant chemotherapy with cisplatin-based doublets, the 5-year overall survival for patients with early-stage non–small cell lung cancer (NSCLC) remains suboptimal. In the International Association for the Study of Lung Cancer (IASLC) staging project, the...

health-care policy

IOM Makes Clinical Data Available for Research

In 1979, Congress mandated that an epidemiologic study be launched to evaluate the frequency and type of adverse health conditions experienced by military personal as a result of their exposure to Agent Orange and other herbicides used during the Vietnam War. Called the Air Force Health Study...

issues in oncology

Overcoming Drug Development Challenges in the New Era of Cancer Care

While the last 15 years have brought unprecedented advances in oncology drug development, the next 10 years promise to usher in even greater opportunities to realize the goal of precision medicine in the treatment of cancer, providing patients with more effective care and better outcomes. Reaching...

thyroid cancer

Sorafenib in Differentiated Thyroid Carcinoma

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. New Indication On November 22, 2013, sorafenib (Nexavar) was...

prostate cancer

L-Type Amino Acid Transporters (LAT) Inhibition May Be a New Therapeutic Option for Metastatic Castration-Resistant Prostate Cancer

L-type amino acid transporters (LATs) uptake neutral amino acids including L-leucine into cells, stimulating mTOR complex 1 (mTORC1) signaling and protein synthesis. LAT1 and LAT3 are overexpressed at different stages of prostate cancer and are involved in increasing nutrients and stimulating cell...

Cancer.Net Launches New Brand of Printed Materials With Four Guides to Cancer

During the second half of 2013, four new guides to cancer, known collectively as the ASCO Answers Guides to Cancer, were released on Cancer.Net, ASCO’s patient information website. The guides to breast, prostate, lung, and colorectal cancer were completely redesigned and reimagined to help newly...

ASCO Celebrates 50 Years of Advancing Progress Against Cancer

Fifty years ago, cancer was viewed as a monolithic and largely untreatable disease, with only a handful of hard-to-tolerate and mostly ineffective therapies available. Stigma and silence left many patients with cancer with little support or information. Determined to change this, a group of seven...

breast cancer
colorectal cancer
lung cancer
prostate cancer

Ongoing NCI-Funded Clinical Trials Actively Recruiting Patients With Advanced Cancer

This issue of The ASCO Post launches a Clinical Trials Resource Guide to increase awareness of NCI-funded phase I, II, and III clinical studies for your patients with advanced cancer. All of the studies are listed on the National Institutes of Health website at ClinicalTrials.gov. The clinical...

breast cancer

Cautious Comments on the TARGIT-A Trial

Numerous randomized trials have demonstrated that whole-breast irradiation plays an important role after breast-conserving surgery for invasive breast cancer. A recent meta-analysis of these trials indicated that whole-breast irradiation decreased the risk of total breast cancer relapse events and...

lung cancer

Molecularly Targeted Therapy for Lung Cancer

INSIDE THE BLACK BOX is an occasional column offering insight into the FDA and its policies and procedures. This installment addresses a changing paradigm in the treatment of lung cancer, exemplified by concurrent approval of a companion diagnostic with each of several new targeted agents or new...

multiple myeloma

IFM 2005-02 Update Differs From CALGB 100104: Why? 

The updated analysis of the Intergroupe Francophone du Myelome (IFM) 2005-02 trial in newly diagnosed multiple myeloma patients showed that lenalidomide (Revlimid) maintenance prolongs progression-free survival after stem cell transplantation, but does not improve overall survival, according to...

colorectal cancer

Study Explores Protective Effect of Aspirin Against Colorectal Cancer

It has been posited that aspirin treatment may reduce risk for colorectal cancer through inhibition of WNT/cadherin-associated protein β1 (CTNNB1, or β-catenin) signaling. In a study reported recently in the Journal of the National Cancer Institute, Nan et al investigated the potential role of the...

breast cancer

Younger Women With Younger Children Less Likely to Receive Radiation Therapy After Breast-Conserving Surgery for Breast Cancer

In a study reported in the Journal of the National Cancer Institute, Pan et al assessed factors associated with noncompliance with recommended radiation therapy following breast-conserving surgery for breast cancer.1 A primary factor in underuse of radiation therapy was younger patients having...

breast cancer

Seven Studies at SABCS Make Dr. Jame Abraham's List of 'Practice-Changing' Talks

From December 10 to 14, the American Association for Cancer Research, the Cancer Therapy & Research Center at The University of Texas Health Sciences Center at San Antonio, and Baylor College of Medicine once again hosted the San Antonio Breast Cancer Symposium (SABCS), presenting...

geriatric oncology

Evaluating and Screening Geriatric Patients for Treatment

One of the key questions in geriatric oncology is: How can we use all of the work geriatricians have done over the years in general geriatrics and apply that to the field of oncology? One-quarter to one-third of us are going to develop cancer throughout our lifetime, and half of the time it is...

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