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issues in oncology

Checklists: Simple Tools That Enhance Quality

Evidence indicates that the use of surgical safety checklists results in marked improvements in patient outcomes. Unfortunately, their adoption in the field of medicine has largely been limited to equipment operations or parts of specific treatment algorithms. Yet they have tremendous potential to...

breast cancer
cost of care

Medicare Part D Low-Income Subsidy Program Improves Adherence to Hormone Therapy After Breast Cancer Surgery

Findings from a study of more than 23,000 women suggest that the Medicare Part D Extra Help program, which provides low-income subsidies for medications, improves adherence to hormone therapy after breast cancer surgery in all racial/ethnic groups and reduces racial/ethnic disparities. The study,...

health-care policy

ASCO Calls for Major Medicaid Reform to Improve Quality Cancer Care for Low-Income Americans

ASCO issued its new Policy Statement on Medicaid Reform on November 17, which calls for major changes to the program to ensure access to high-quality cancer care for all low-income individuals. The Society’s recommendations call for Medicaid expansion in all 50 states to close coverage gaps,...

breast cancer

Hormonal Therapy for Early Breast Cancer: Do We Learn From Past Mistakes?

Guidelines can be incorrect if they are not based on incontrovertible evidence. Such was the case with the National Cancer Institute (NCI) 1995 guidelines recommending 5 years of tamoxifen adjuvant therapy for stage I to III hormone receptor–positive breast cancer. With more definitive evidence,...

issues in oncology

CancerLinQ: Building a Data Infrastructure to Improve Quality and Reduce Cost

In November 2013, ASCO initiated the development of CancerLinQ, a learning health system designed to transform cancer care and improve outcomes. At this year’s Quality Care Symposium in Boston, ASCO President Peter Paul Yu, MD, FACP, FASCO, Director of Cancer Research at the Palo Alto Medical...

breast cancer

Optimizing HER2 Therapy in Early and Advanced Breast Cancers

Trastuzumab (Herceptin) has been the cornerstone of therapy for HER2-positive tumors, which comprise about 20% of all breast tumors. Additional therapies targeted to other HER2 pathways or other targets to be used in combination with trastuzumab are being explored in both the adjuvant and...

Vincent T. DeVita, Jr, Helped Usher in the Era of Chemotherapy, Turning Lethal Cancers Into Curable Ones

Although Vincent T. DeVita, Jr, MD, harbored fantasies as a young child of becoming an ice deliveryman when he grew up, his love of chemistry and biology, as well as admonitions from his mother, Isabel, “to become a doctor,” propelled him toward a career in medicine. Now, more than 6 decades later, ...

colorectal cancer

Small Risk-Adjusted Variation in Hospital Readmissions Following Colorectal Cancer Surgery

“Little risk-adjusted variation exists in hospital readmission rates after colorectal surgery,” according to an analysis of data from 44,822 patients who underwent colorectal resection for cancer at 1,401 U.S. hospitals between 1997 and 2002. “The use of readmission rates as a high-stakes quality...

colorectal cancer

Patients With Metastatic Colorectal Cancer Have Improved Outcome With FOLFOXIRI and Bevacizumab

Patients with untreated metastatic colorectal cancer who received ­FOLFOXIRI (folinic acid, fluorouracil, oxaliplatin, irintotecan) plus bevacizumab (Avastin) had improved survival compared with patients who received FOLFIRI (folinic acid, fluorouracil, irintotecan) plus bevacizumab in a phase III...

supportive care
lung cancer
symptom management

Appetite-Enhancing Agent Helps Patients Treated for NSCLC Gain Weight and Lean Body Mass and Feel Better

People have an image of stage III or IV lung cancer patients getting chemotherapy or chemoradiation, and they look terrible; they are losing weight. The fact is, when they respond, they can gain weight,” according to Philip Bonomi, MD, MS. He is the lead author of a phase III study showing that the ...

Additional Articles of Note

Adjuvant Bisphosphonates in Early Breast Cancer: Practice-Changing Findings January 15, 2014, Volume 5, Issue 1 Visit http://bit.ly/1rUM8CS HER2-Positive Breast Cancer Patients With Small Tumors Benefit From Low-Toxicity Regimen January 15, 2014, Volume 5, Issue 1 Visit http://bit.ly/1tA6UZ4...

Top 10 Articles From The ASCO Post in 2014

The following list presents those articles published in 2014 that were observed most often by visitors to ASCOPost.com, as measured by the number of views.a To view the full version of the articles listed below, visit ASCOPost.com and enter the URL provided below each entry. 1. Continuous...

integrative oncology

Aloe Vera

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...

issues in oncology

Second Annual JADPRO Live Conference Attracts 400 Advanced Practitioners in Oncology From Across the Nation

The second annual JADPRO Live: Transforming Oncology Practice was held October 30 to November 2 in Orlando, Florida. The conference drew nearly 400 nurse practitioners, physician assistants, clinical nurse specialists, advanced-degree nurses, hematology/oncology nurses, pharmacists, and...

hematologic malignancies

ASH Releases Second List for Choosing Wisely Campaign

The American Society of Hematology (ASH) has announced five additional commonly used tests, treatments, and procedures in hematology that physicians and patients should question in certain circumstances. The additional items join an initial list of five practices to question that the Society...

RSNA Awards Gold Medal to Three Leaders in Radiology

The Radiological Society of North America (RSNA) awarded the Gold Medal, the organization’s highest honor, to three individuals at the RSNA 100th Scientific Assembly and Annual Meeting: Gary J. Becker, MD, of Tucson; Allen S. Lichter, MD, FASCO, of Alexandria, Virginia; and Etta D. Pisano, MD, of...

breast cancer

FDA Guidance on the Use of Pathologic Complete Response in Development of New Treatments for High-Risk Early Breast Cancer Includes ASCO Suggestions

The U.S. Food and Drug Administration’s (FDA) final Guidance for Industry on Pathologic Complete Response in Neoadjuvant Treatment of High-Risk Early-Stage Breast Cancer incorporates two changes that ASCO had proposed in comments submitted to the agency on a draft guidance issued in 2012. The...

palliative care

Cancer Care Incomplete Without Palliative Care Integration

ASCO recognizes that an array of efforts are needed to fully integrate palliative care into the cancer care continuum, and the Society is committed to facilitating the integration of palliative cancer care into existing health-care systems worldwide in order to realize the vision of comprehensive...

colorectal cancer

Conquer Cancer Foundation and Michael’s Mission Work Together to Conquer Colorectal Cancer

"Nobody tells a 28 year old to get a colonoscopy.” It’s the sad but true reality that many young adults may be at risk for colorectal cancer. Unfortunately, many people, young adults in particular, are not aware of the risk factors and do not get screened early enough to catch the disease when it...

health-care policy

Policy Issues in Molecularly Targeted Therapy: The Science, the Money, the Applications

In the past decade, much new knowledge about the molecular underpinnings of cancer has accumulated, and the array of molecular aberrations in each individual tumor can be assessed through genomic sequencing and other tests. The rationale for and feasibility of developing molecularly targeted...

symptom management

Benefits of Exercise for Relieving Fatigue in Cancer Survivors

Fatigue is such a common—and ongoing—problem among cancer survivors, last spring, ASCO published a clinical practice guideline1 to address screening, assessment, and treatment approaches for the management of fatigue after patients have completed treatment. Among the strategies included in the...

leukemia

Racing Against Acute Lymphoblastic Leukemia: CTL019 Is a Fast CAR With Sustained Endurance

The long-term outcome for patients with relapsed or refractory acute lymphoblastic leukemia (ALL) is poor, with 5-year overall survival from first relapse being only approximately 10%.1,2 Patients with disease relapse following allogeneic transplant have the worse prognosis and are typically...

survivorship

ASCO Clinical Expert Statement on Cancer Survivorship Care Planning

Efforts at implementing survivorship care plans have met with limited success in oncology practice, in part due to the time required to complete them, the lack of role clarity, and the lack of reimbursement for time to complete the documents. In response, ASCO convened a Survivorship Care Planning...

lung cancer

Lung Cancer: Next Frontier for Immunotherapy

Immune checkpoint inhibitors, particularly PD-1 (programmed cell death-1) and PD-L1 (programmed death-ligand 1) inhibitors, are being studied extensively in lung cancer. These agents, alone and in combination, appear to have the potential to change the management of non–small cell lung cancer...

pancreatic cancer

Choice for Metastatic Pancreatic Cancer: FOLFIRINOX or Gemcitabine/Nab-Paclitaxel?

The choice between FOLFIRINOX (fluorouracil [5-FU], leucovorin, irinotecan, oxaliplatin) vs the combination of gemcitabine and nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) for first-line treatment of metastatic pancreatic cancer is not much of a contest, judging by a discussion of...

skin cancer

New Serologic Assay May Help Predict Recurrences in Merkel Cell Carcinoma

A new and inexpensive serologic assay may help to predict recurrences of Merkel cell carcinoma, according to Paul Nghiem, MD, PhD, the Michael Piepkorn Endowed Chair in Dermatology Research at the University of Washington, Seattle, who helped develop the test.1 Dr. Nghiem and other experts in...

skin cancer

Hedgehog Inhibitors Can Be Life-Altering in Patients With Advanced Basal Cell Carcinoma

What advanced basal cell carcinomas lack in frequency, they make up for in morbidity, and for these challenging patients, the hedgehog inhibitors have changed lives, according to experts at the 3rd Annual World Cutaneous Malignancies Congress, held recently in San Francisco. “The majority of basal...

Expert Point of View: Deborah Schrag, MD, MPH

Formal discussant of this abstract, Deborah Schrag, MD, MPH, Dana-Farber Cancer Institute, praised this effort. “Dr. Stuver’s abstract provides ample evidence of overuse of intensive care at the end of life. Patients and their families do not want to be in the hospital or emergency department at...

lung cancer

Revisiting Successes in Advanced NSCLC to Test Value in Earlier-Stage Disease

Some pretty good evidence suggests that chemotherapy that works in advanced disease probably works even better in early-stage disease,” said Fadlo R. Khuri, MD, Chair, Department of Hematology and Medical Oncology at Winship Cancer Institute in Atlanta, in summarizing results from ­trials of...

lung cancer

Lung Cancer Expert Offers Recommendations for Treating Toxicities Associated With Targeted Therapies

Clearly life as a thoracic oncologist has changed. Our paradigm for giving one-size-fits-all chemotherapy seems a bit dated, as we now are learning that there are multiple targets that we can treat effectively with the right drugs,” Jyoti D. Patel, MD, Associate Professor of Medicine at...

lung cancer
health-care policy

CMS Issues Preliminary Decision to Cover Annual Lung Cancer Screening

In a long-awaited decision, the Centers for Medicare & Medicaid Services (CMS) has issued a preliminary proposal to cover annual lung cancer screening with low-dose computed tomography for appropriate beneficiaries following counseling and a shared–decision-making visit with a qualified...

leukemia

Transplants for AML in First Remission: A Great Leap Forward, Sideways, or Backward?

“All great truths begin as blasphemies.” —George Bernard Shaw (Annajanksa, 1918)   Until about 15 years ago, persons with acute myelogenous leukemia (AML) were considered candidates to receive a blood cell or bone marrow allotransplant in first remission only if they had had an HLA-identical...

lymphoma

PD-1 Blockade Moves Into Hematology

The promise of the programmed death receptor-1 (PD-1) inhibitors seen in solid tumors, especially melanoma, may hold true for at least one hematologic malignancy, according to studies presented at the 56th American Society of Hematology (ASH) Annual Meeting and Exposition. At a press briefing, data ...

breast cancer

About 25% of Patients Who Undergo Breast-Conservation Surgery for Stage 0 to II Carcinoma Have Subsequent Surgery

“Approximately one-fourth of all patients who undergo initial breast-conservation surgery for breast cancer will have a subsequent operative intervention,” concluded a study published online by JAMA Surgery. “The rate of repeat surgeries varies by patient, tumor, and facility factors,” reported Lee ...

leukemia

Patients With Chronic Lymphocytic Leukemia Who Progress After Front-line Treatment May Be Candidates for Novel Noncytotoxic Therapies

Although patients who relapse within 3 years of front-line fludarabine, cyclophosphamide, and rituximab (Rituxan; FCR) therapy have poor survival when treated with conventional salvage regimens, these patients may be candidates for novel noncytotoxic therapies, according to an analysis of extended...

gynecologic cancers

Electro-Gynecology, Philadelphia, 1883

Through the Lens of Oncology History A Century of Progress The text and photographs on these pages represent the establishment of oncology as a viable medical specialty during the mid-1800s. The images and captions are excerpted from a four-volume series of books titled Oncology Tumors &...

issues in oncology
cost of care

MD Anderson, UnitedHealthcare Launch New Cancer Care Payment Model

The University of Texas MD Anderson Cancer Center and UnitedHealthcare have launched a pilot to explore a new cancer care payment model for head and neck cancers that focuses on quality patient care and outcomes. The collaboration is among the first using bundled payments in a large, comprehensive...

palliative care

Incorporating Physical Medicine and Rehabilitation Into Palliative Care

Although cancer rehabilitation has been a part of oncology clinical practice for several decades, it has largely gone unrecognized as an integral part of palliative medicine and survivorship care. Now, the role of physical medicine and rehabilitation in oncology care may increase as patients with...

issues in oncology

Smarter Trial Design Saves Money and Produces Better Drugs

The process of identifying a promising molecule and moving it from the laboratory through the highly complex series of clinical trials necessary to garner U.S. Food and Drug Administration (FDA) approval is a costly scientific gauntlet during which many new agents fail. New trial design,...

multiple myeloma

Cleveland Clinic Piloting ‘Adaptive Therapy’ Approach in Multiple Myeloma

For newly diagnosed multiple myeloma patients, Cleveland Clinic specialists believe two drugs may suffice for most patients, bucking the trend toward using triplets for all patients and reserving them for patients with insufficient response to two. They described a pilot study of their “carepath”...

NIH Recruits Three Lasker Clinical Research Scholars

National Institutes of Health (NIH) has selected three researchers as new Lasker Clinical Research Scholars as part of a joint initiative with the Albert and Mary Lasker Foundation to nurture the next generation of great clinical scientists. This highly competitive program provides talented...

leukemia

Victory for Pediatric Regimens in Adolescents and Young Adults With ALL

Long in the works, early results of the U.S. Intergroup C10403 trial clearly showed that treating acute lymphoblastic leukemia (ALL) in adolescents and young adults using a pediatric-inspired regimen improves event-free survival and overall survival and should be the backbone for future studies in...

breast cancer
global cancer care

Breast Health Global Initiative Tackles Third-World Health Care

Benjamin O. Anderson, MD, is the Director of the Breast Health Global Initiative (BHGI) and surgical oncologist and Director of the Breast Health Clinic at the University of Washington in Seattle. The ASCO Post recently spoke with Dr. Anderson about the conceptual framework of the...

prostate cancer

Physical Activity Improves Survival for Men With Localized Prostate Cancer

Among a large group of men with localized prostate cancer, those who engaged in higher levels of physical activity had lower rates of overall mortality and lower rates of prostate cancer-specific mortality, according to a study published in Cancer Epidemiology, Biomarkers & Prevention.1 “Our...

Appointments and Awards Announced at The Johns Hopkins Kimmel Cancer Center

The Johns Hopkins Sidney Kimmel Comprehensive Cancer Center in Baltimore recently announced new appointments and awards given to faculty. New Director of Thoracic Oncology Julie Brahmer, MD, a medical oncologist with expertise in the use of immunotherapies to treat lung cancer, has been named...

breast cancer

Complexities of Targeting HER2 in Estrogen Receptor–Positive Breast Cancers

The interactions between the estrogen receptor (ER) and HER2 pathways in breast cancers are clearly complex and remain incompletely understood. Historically, cancers that express both ER and HER2 were thought to be intrinsically resistant to endocrine therapy, likely due to HER2 being the dominant...

breast cancer

No Benefit of Adding Lapatinib to Fulvestrant in Hormone Receptor–Positive Advanced Breast Cancer

In a phase III trial (Cancer and Leukemia Group B [CALGB] 40302/Alliance) reported in the Journal of Clinical Oncology, Harold J. Burstein, MD, PhD, of Dana-Farber Cancer Institute, Boston, and colleagues found that the addition of the dual EGFR-HER2 inhibitor lapatinib (Tykerb) to endocrine...

lung cancer

Crizotinib in ROS1-Positive NSCLC: A Next Step Forward

Advances in the molecular characterization of non–small cell lung cancer (NSCLC) have led to the identification of molecularly defined distinct subsets of patients who derive benefit from targeted therapies. Currently, two such groups of agents have moved widely into clinical practice: epidermal...

head and neck cancer
lung cancer

Coupling Head and Neck Cancer Screening and Lung Cancer Scans Could Improve Early Detection, Survival

Adding head and neck cancer screenings to recommended lung cancer screenings would likely improve early detection and survival, according to a multidisciplinary team led by scientists affiliated with the University of Pittsburgh Cancer Institute (UPCI), a partner with the University of Pittsburgh...

skin cancer

Survival Benefits of Front-Line Treatment With Nivolumab for Advanced Melanoma Confirmed, Yet Questions Remain

As reported in this issue of The ASCO Post, Robert and colleagues recently published a phase III study comparing the anti–programmed death 1 (PD-1) antibody nivolumab with the standard melanoma chemotherapy dacarbazine in the front-line treatment of patients with advanced BRAF wild-type melanoma.1...

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