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multiple myeloma

Treatment of Newly Diagnosed Multiple Myeloma With Lenalidomide Plus Low-Dose Dexamethasone

The FIRST trial—reported by Benboubker and colleagues in The New England Journal of Medicine and summarized in this issue of The ASCO Post (page 93)—is a landmark study.1 It is one of the largest randomized trials in multiple myeloma ever conducted. More importantly, it is a well-designed trial...

Commentary: Screening Young Adults for Nonhereditary Colorectal Cancer

In a related commentary, ­Kiran K. Turaga, MD, MPH, of the Medical College of Wisconsin, Milwaukee, writes: “In the setting of these congratulatory reports of a successful public health screening program, this report from Bailey et al is rather unsettling.” “Nevertheless, assuming that this...

colorectal cancer

Incidence of Colorectal Cancer in Young Adults Expected to Rise

While the incidence of colorectal cancer in people 50 years or older has declined, the incidence among people 20 to 49 years has increased, according to a report published online recently by JAMA Surgery.1 From 1998 through 2006, the incidence of colorectal cancer declined 3% per year in men and...

breast cancer

Studies Evaluate Maintenance Bevacizumab in Metastatic Breast Cancer

Although bevacizumab (Avastin) may no longer be an active player in metastatic breast cancer, phase III studies presented at this year’s European Society for Medical Oncology (ESMO) Congress reignited interest in the drug as part of maintenance therapy. The TANIA trial met its primary endpoint,...

lung cancer

Moving Forward With Biomarkers in Non–Small Cell Lung Cancer

The effort to identify new biomarkers for response and outcomes in lung cancer is advancing, according to studies presented at the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid. Immunohistochemical expression of folate receptor for vintafolide and thymidylate synthase for...

multiple myeloma

Single-Agent Carfilzomib, Compared to Corticosteroids Plus Cyclophosphamide, Fails to Improve Survival in Myeloma

Carfilzomib (Kyprolis), as a single agent, failed to improve survival in relapsed and refractory myeloma patients, as compared with a corticosteroid and optional cyclophosphamide, in the phase III FOCUS trial, presented at the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid.1...

Expert Point of View: Andrés Cervantes, MD, PhD

During a special session at the European Society for Medical Oncology (ESMO) 2014 Congress, additional analyses from the FIRE-3 and Cancer and Leukemia Group B ­(CALGB)/SWOG 80405 trial were presented, and an expert panel was charged with putting the findings into context. Role of Subsequent...

colorectal cancer

All-RAS Testing in Metastatic Colorectal Cancer: Just the First Step

Now that clinicians know to “think beyond KRAS” in metastatic colorectal cancer—and test for all RAS mutations, not just those in exon 2—it seems this is still not sufficient for selecting the best drugs. At the European Society for Medical Oncology (ESMO) 2014 Congress in Madrid, a proffered paper ...

issues in oncology

Young Adults With Cancer: Unique Issues Highlight Importance of Patient-Centered Care

Suleika Jaouad, a journalist, was 22 and had just gotten her first chance to cover a major news story—the revolution underway in Tunisia—when she was diagnosed with myelodysplastic syndrome that had evolved into acute myeloid leukemia (AML). Months into her treatment, she began to write again, but...

breast cancer

Noteworthy Abstracts From the Breast Cancer Symposium Include Studies of Novel Therapies and of the Impact of Disease Subtypes on Outcomes

More than 150 oral and poster presentations were featured at the 2014 Breast Cancer Symposium, held September 4–6 in San Francisco. The multidisciplinary meeting is sponsored by ASCO, the American Society of Breast Disease, American Society of Breast Surgeons, American Society for Radiation...

lymphoma

Targeted Therapies in Indolent Lymphoma: Challenging the Current Paradigm

The use of targeted therapies in indolent non-Hodgkin lymphoma (NHL) is a burgeoning area. New targeted therapies directed at the cell surface, intracellular pathways, and the microenvironment are being studied for relapsed indolent NHL. These treatments, if validated in large randomized trials,...

prostate cancer

ASCO Endorses AUA/ASTRO Guideline on Adjuvant and Salvage Radiotherapy After Prostatectomy

ASCO has issued an endorsement of the American Urological Association (AUA)/American Society for Radiation Oncology (ASTRO) guideline on the use of adjuvant and salvage radiotherapy after prostatectomy, which was based on a systematic review of medical literature. The ASCO endorsement was published ...

colorectal cancer

‘Incredible Changes’ in the Field of Colorectal Cancer

Over the past 50 years, there have been incredible changes in the field of colorectal cancer,” Emily K. Bergsland, MD, noted in opening the colorectal cancer session at the Best of ASCO meeting in Chicago. Dr. Bergsland is a gastrointestinal oncologist at the Helen Diller Family Comprehensive...

sarcoma

Targeted Agents Making Inroads Against Sarcoma

Targeted agents have started to make inroads in sarcoma therapies, and gastrointestinal stromal tumor (GIST) is the poster child for this success,” Mark Agulnik, MD, stated in summarizing progress in GIST and other sarcomas at the Best of ASCO meeting in Chicago. Dr. Agulnik is Associate Professor, ...

cost of care

Financial Toxicity Potentially Harmful Treatment‑Related Effect

It turns out that in addition to treatment-related toxicity, cancer patients commonly experience “financial toxicity,” a phrase that is increasingly coming into parlance in the cancer community. Patients should be assessed for financial toxicity as early as possible following diagnosis so that they ...

geriatric oncology

The ‘Silver Oncologic Tsunami’: Rise in Elderly Cancer Patients Brings New Challenges to Oncology Workforce

The “graying of America” poses increasing challenges for the cancer community in terms of rising numbers of cases of cancer and costs associated with geriatric care. The scope of this problem and potential solutions were explored by Andrew E. Chapman, DO, FACP, at the ASCO Quality Care Symposium in ...

issues in oncology

Why I Think Dr. Ezekiel Emanuel Is Wrong About Aging

The image of aging that Ezekiel Emanuel, MD, PhD, expresses in his essay, “Why I Hope to Die at 75,” in the October issue of The Atlantic,1 is bleak indeed and one that has contributed mightily to the negative views of aging imbedded in our society. But I refute his description of growing older as...

leukemia

The Next-to-Last Frontier in Managing Acute Promyelocytic Leukemia

The treatment of acute promyelocytic leukemia (APL) represents one of the major triumphs in the field of hematologic malignancies. With either the vitamin A derivative all-trans retinoic acid (ATRA) combined with anthracycline-based chemotherapy or ATRA plus arsenic trioxide (Trisenox),...

lymphoma

Second-Line Gemcitabine the Preferred Option for Relapsed or Refractory Lymphoma

For patients with relapsed or refractory aggressive lymphoma in a National Cancer Institute of Canada clinical trial, second-line treatment with GDP (gemcitabine, dexamethasone, and cisplatin) was as effective as DHAP (dexamethasone, cytarabine, and cisplatin). Treatment with GDP “can be considered ...

issues in oncology

Over 14 Million Major Medical Conditions in U.S. Adults Linked to Cigarette Smoking

At least 14 million major medical conditions among U.S. adults aged 35 years and older were attributed to cigarette smoking by a study estimating the disease burden of cigarette smoking, which, according to the study’s authors, “remains immense.” Among current and former smokers, prevalence ratios...

breast cancer
issues in oncology

Single-Nucleus Genome Sequencing Shows Early Aneuploid Rearrangement and Gradual Clonal Evolution in Breast Cancer

In a study reported in Nature, Wang and colleagues developed a whole-genome and exome single-cell sequencing approach (nuc-seq) using G2/M nuclei and used the method to sequence single normal and tumor nuclei from an estrogen receptor–positive breast cancer and a triple-negative ductal carcinoma....

Huntsman Cancer Institute Investigator Receives Leadership Award from the National Cancer Institute

Neeraj Agarwal, MD, a Huntsman Cancer Institute investigator and Associate Professor of Medicine at the University of Utah, has received the 2014 Cancer Clinical Investigator Team Leadership Award from the National Cancer Institute (NCI). This highly competitive award recognizes exceptional cancer...

Expect Questions From Patients

Screening for thyroid cancer should be discouraged to prevent an “epidemic of diagnosis”—like the one occurring in South Korea—from happening in the United States and other countries, according to the authors of an analysis of the South Korean screening program. That study was published in The New...

issues in oncology
thyroid cancer

South Korean Study Sparks Warnings About the Hazards of Overscreening

An “epidemic of diagnosis” of thyroid cancer is occurring in South Korea and “absolutely could happen here,” according to H. Gilbert Welch, MD, MPH, Professor of Medicine at the Dartmouth Institute for Health Policy and Clinical Practice, Hanover, New Hampshire. Dr. Welch is coauthor of an article...

Chevalier Jackson, MD, Performing Bronchoscopy, Philadelphia, Circa 1920

The bronchoscope was first used for extracting foreign bodies and the evaluation of infectious processes, especially abscesses. By the end of the twentieth century, the bronchoscope had been determined the single most useful tool for accurate diagnosis of lung cancer. It allowed for the collection...

A Good Life, All the Way to the Very End

BOOKMARKTitle: Being MortalAuthor: Atul Gawande, MDPublisher: Metropolitan BooksPublication date: October 7, 2014Price: $26.00; hardcover, 304 pages   Mortality is the invisible observer in the oncology exam room. When people hear the three words, “You have cancer,” they see their world as they...

When Life Couldn’t Be Better

The following essay by Carolyn D. Runowicz, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. Just...

skin cancer

Memorial Sloan Kettering Team Discovery Advances Understanding of Immunotherapy’s Successes—and Its Failures

A collaborative team of leaders in the field of cancer immunology from Memorial Sloan Kettering Cancer Center has made a key discovery that advances the understanding of why some patients respond to the CTLA-4 blocking antibody ipilimumab ­(Yervoy), an immunotherapy drug, while others do not. A...

Tapping Palliative Care’s Survival Benefit

A trial reported in 2010 found that adding palliative care to standard care at the time of lung cancer diagnosis prolonged overall survival by an average of about 2.6 months,1 Arif H. Kamal, MD, told attendees at the Best of ASCO meeting in Seattle. Dr. Kamal is Director of Quality and Outcomes at...

survivorship

Major Strides Seen This Year in Survivorship Care

"This year was actually a boon for the patient and survivor care section,” Arif H. Kamal, MD, said at the Best of ASCO meeting in Seattle, where he reviewed the leading abstracts and gave some of his own perspective. “What you see is a lot of the limitations of research in the palliative care and...

supportive care
palliative care

Experts Stress the Need for Integrating Palliative Care Into Standard Oncology Care

The overriding consensus from the 2014 Palliative Care in Oncology Symposium: Patient-Centered Care Across the Cancer Continuum held in Boston was that achieving optimal high-quality cancer care requires both state-of-the-art cancer therapy and the integration of palliative care principles...

palliative care

How the Earlier Introduction of Palliative Care Improves Quality of Life for Patients With Advanced Cancer

A 4-year study1 involving 461 patients with advanced stages of lung, gastrointestinal, genitourinary, breast, and gynecologic cancers has found that providing early outpatient palliative care vs standard oncology care alone improved quality of life and patient satisfaction. The study participants...

solid tumors
issues in oncology

Proteome-Scale Map of the Human Interactome Network Created

Researchers have produced a new largest-scale map of human protein interactions that will better enable scientists to trace how genetic changes lead to diseases ranging from cancer to Huntington’s disease. The expanded map, published in the journal Cell,1 is about 30% larger than the combination of ...

Helping Adolescents and Young Adults Cope With Cancer

Each year, about 70,000 adolescents and young adults (AYAs) are diagnosed with cancer in the United States, almost six times the number of cases diagnosed in children up to 14 years of age. While overall cancer survival rates continue to rise—according to the American Cancer Society, there are...

cns cancers

Treating Brain Cancer in 2014

While primary malignant brain tumors account for only 2% of all adult cancers, these deadly neoplasms cause severe cancer-related disability; the 5-year survival rates for brain tumors rank third lowest among all cancers, with those for pancreas and lung cancers being first and second lowest,...

Study Finds Wide Variation in Quality, Content of Clinical Cancer Guidelines

What’s the best way to treat rectal cancer? Consult any of five top clinical guidelines for rectal cancer and you will get a different answer, according to a new study by researchers at the University of Michigan Comprehensive Cancer Center. Their findings were published online in the journal...

multiple myeloma

HDAC Inhibitors and Triple Therapy in Relapsed Myeloma

The use of histone deacetylase (HDAC) inhibitors as human cancer therapy has focused on the impact of these agents on epigenetic regulation and gene transcription. However, the use of HDAC inhibitors in myeloma may be working through a different mechanism. Specifically, HDAC6 is known to regulate...

gynecologic cancers

Cancer-Killing Virus Plus Chemotherapy Studied in Recurrent Ovarian Cancer

In 6 out of 10 cases, ovarian cancer is diagnosed when the disease is advanced and 5-year survival is only 27%. A new study suggests that a cancer-killing virus combined with a chemotherapy drug might safely and effectively treat advanced or recurrent forms of the disease. Researchers at The Ohio...

issues in oncology

Focused Ultrasound, a Young Technology, Begins to Grow

In the United States, it’s been a good 2 years for focused ultrasound. The technology, which uses multiple, intersecting ultrasound beams to treat cancer and other diseases, completed its first successful U.S. phase III oncology trial—to alleviate the pain of bone metastases—and received approval...

gynecologic cancers

With New Innovator Award, Biomedical Engineer to Study How Ovarian Cancer Spreads

With approximately 22,000 diagnoses annually in the United States, ovarian cancer isn’t among the most commonly occurring cancers. Yet, the mortality rate for women who have ovarian cancer hovers above 60%. For Pamela Kreeger, PhD, a University of Wisconsin–Madison Assistant Professor of Biomedical ...

prostate cancer

From ‘Clinical Judgment’ to Evidence-Based Medicine: Thoughts on the  ASCO/CCO Guideline in Metastatic Castration-Resistant Prostate Cancer

We are witnessing unprecedented progress in the development of therapy for patients with metastatic castration-resistant prostate cancer. The U.S. Food and Drug Administration (FDA) has issued 13 approvals since 1996 for agents that have demonstrated an impact on overall survival, pain, or...

prostate cancer

Systemic Therapy in Men With Metastatic Castration-Resistant Prostate Cancer: ASCO/CCO Clinical Practice Guideline

The ASCO Clinical Practice Guidelines Committee and the Cancer Care Ontario (CCO) program in evidence-based care have released a clinical practice guideline on systemic therapy in men with metastatic castration-resistant prostate cancer. The guideline was published in the Journal of Clinical...

colorectal cancer

Sigmoidoscopy or Colonoscopy for Colorectal Cancer Screening: Is It Still the Question?

Mortality from colorectal cancer remains a public-health concern, being the second leading cause of cancer-related death for men and women combined. The major preventive measure for colorectal cancer is to screen for and remove adenomatous polyps. Average-risk individuals (ie, those who do not have ...

issues in oncology

New Imaging Technique Identifies Receptors for Targeted Cancer Therapy

Dartmouth researchers have developed a fluorescence imaging technique that can more accurately identify receptors for targeted cancer therapies without a tissue biopsy. They report on their findings in a recently published article in Cancer Research.1 “Protein overexpression is a hallmark of...

global cancer care

The Harvard Global Equity Initiative: From Research to Policy

The Harvard Global Equity Initiative is a research program at Harvard University that is dedicated to promoting equitable global development, with a strong emphasis on health-care issues. This initiative brings together scholars, policymakers, advocates, and practitioners from around the world to...

issues in oncology

Power Behind ‘Master’ Gene for Cancer Discovered

A study at The University of Texas MD Anderson Cancer Center, Houston, led by Mong-Hong Lee, PhD, Professor of Molecular and Cellular Oncology, has demonstrated the significance of CSN6 in regulating Myc which may well open up a new pathway for treating and killing tumors. The study results are...

hematologic malignancies

CAR T-Cell Therapy in Cancer: Driving Toward the Clinic

Chimeric antigen receptor (CAR) T-cell therapy represents a novel and promising therapeutic advance in cancer.1,2 It constitutes a form of personalized therapy that harnesses adoptive cell transfer through genetic engineering of autologous T cells. The initial step in this therapeutic paradigm...

leukemia

CD19-Directed CAR T Cells Produce Sustained Remission in Relapsed/Refractory Acute Lymphoblastic Leukemia

In a study reported in The New England Journal of Medicine, Shannon L. Maude, MD, PhD, of Children’s Hospital of Philadelphia, and Noelle Frey, MD, of the Perelman School of Medicine, University of Pennsylvania, and colleagues reported achieving sustained remissions in children and adults with...

Impact of Tumor Boards on Cancer Care

A large observational study suggested that weekly tumor board participation by oncologists improves survival in advanced lung and colorectal cancers, increases participation in clinical trials, and leads to greater use of guideline-based curative care for early non–small cell lung cancer. This is...

colorectal cancer
lung cancer

Tumor Board Participation Associated With Improved Survival in Stage IV Lung and Colorectal Cancers

A large, population-based, observational study suggests that participation in weekly tumor boards can improve outcomes in oncologic care. Specifically, oncologist participation in weekly tumor board meetings was associated with improved survival in patients with stage IV small cell lung cancer and...

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