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Showing 8901 - 8950Spanning 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 ...
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, ...
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...
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 ...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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...
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 ...
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...
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...
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...
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...
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...
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...
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...
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...
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 ...
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...
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...
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...
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...
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...
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...
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...
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 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 ...
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...
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...
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...
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...
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...
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...
