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head and neck cancer

I Refuse to Let Cancer Win

My battle with cancer started with a simple sore throat in June 2005. Despite two rounds of an antibiotic to clear up the problem, within 2 months my throat hurt so much I couldn’t swallow, and a mysterious lump had suddenly appeared on my tongue. By the end of August, I was diagnosed with stage...

lymphoma

Two Cycles of Chemotherapy plus Involved-field Radiation Improves Tumor Control in Early Unfavorable Disease

Final analysis of the German Hodgkin Study Group (GHSG) HD14 trial concluded that intensified chemotherapy with two cycles of escalated BEACOPP (bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine [Matulane], and prednisone) followed by two cycles of ABVD (doxorubicin,...

SIDEBAR: Drug Development in the Era of Personalized Medicine

Advances in understanding cancer on a molecular level and the identification of subgroups of cancer patients with rare diseases are expected to have an effect on drug development and supply. “The vision of what cancer care will be like in the future is this very precise personalized care, where...

issues in oncology
health-care policy

Update on Oncology Drug Shortage: Better for Now, But Permanent Solutions Must Address Underlying Issues

Over the past few years, drug shortages in the United States have been on the rise, involving hundreds of agents, many of which are lifesaving medications for patients with cancer. In recent months, the FDA has taken steps to alleviate some of the most critical oncology drug shortages. “We should...

Scott M. Lippman, MD, Named New Director of UC San Diego Moores Cancer Center

Scott M. Lippman, MD, has been named Director of Moores Cancer Center at the University of California, San Diego, effective May 1, 2012. Dr. Lippman was previously Chair of Thoracic/Head and Neck Medical Oncology at The University of Texas MD Anderson Cancer Center, in Houston. “As the new...

Oncology Professionals and Leaders to be Honored at ASCO Annual Meeting

ASCO is recognizing researchers, patient advocates, and leaders of the global oncology community through its Special Awards Program at this year’s Annual Meeting in Chicago. Recipients of ASCO’s special awards collectively represent significant strides in cancer treatment and leadership in the...

issues in oncology

Novel Initiative to Address Oncology Drug Crisis

Much has been written about the oncology drug shortage crisis in the United States. In the spirit of being part of the solution to that problem, a group of oncologists has formed the Citizen’s Oncology Foundation (COF). The goal of the start-up not-for-profit association is two-pronged: to find...

symptom management

Oral Rivaroxaban Is Noninferior to Standard Anticoagulant Therapy in Acute Pulmonary Embolism

Thromboembolic disease is common in patients with cancer and increases risk of mortality. Recent studies showed that the oral factor Xa inhibitor rivaroxaban (Xarelto) was as effective and safe as standard anticoagulant therapy in treating deep-vein thrombosis, with superior efficacy of rivaroxaban ...

lung cancer
geriatric oncology

Canadian Registry Study of Adjuvant Therapy for NSCLC Shows Increased Use in Elderly Patients and Improved Survival

Cisplatin-based adjuvant therapy is recommended for patients with resected stage II–IIIA non–small cell lung cancer (NSCLC). There have been no trials of adjuvant therapy in elderly patients with NSCLC, who constitute a large part of the NSCLC population. A number of analyses indicate that older...

bladder cancer

Chemoradiation with Fluorouracil and Mitomycin Reduces Recurrence of Muscle-invasive Bladder Cancer

Radiotherapy is an alternative to surgery in muscle-invasive bladder cancer, particularly in less-fit patients. However, it is associated with high rates of incomplete response or recurrence, with salvage surgery often being required. Although synchronous chemoradiotherapy has improved local...

colorectal cancer

More New Data Support Use of Daily Aspirin to Prevent Cancers

Three new studies have added data to the growing evidence that low-dose, daily aspirin helps prevent colorectal cancer and other malignancies and may be useful in preventing metastases as well.1-3 Coming on the heels of other recent studies, the results appear to strengthen the case for using...

lung cancer
prostate cancer
issues in oncology

JAMA Highlights New Comparative Effectiveness Studies

A recent press briefing moderated by Phil B. Fontanarosa, MD, MBA, Executive Editor, JAMA, presented new findings on comparative effectiveness research, and two of the studies discussed focused on cancer. Dr. Fontanarosa started by defining comparative effectiveness research, which gained...

ASCO Past President Highlights QOPI® Efforts to Improve Care in Michigan

ASCO’s Quality Oncology Practice Initiative (QOPI®) can be used to assess the quality of care in a statewide consortium of oncology practices and ultimately can lead to better care for patients with cancer, said ASCO Past President Douglas W. Blayney, MD, at a recent briefing on cancer care value...

Conquer Cancer Foundation Board Member Tom Roberts Cites Need to Grow Research Capacity as Opportunity for Discovery Accelerates

Thomas G. Roberts, MD, dedicates a shelf in his home to memories of patients—photographs, notes, expressions of gratitude, traces of lives linked with his through cancer treatment. He looks at it every day, he says, and the memories inform his mission. “In oncology, you become part of people’s...

thyroid cancer

Vandetanib: New Drug for Unresectable Medullary Thyroid 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 The oral kinase inhibitor vandetanib (Caprelsa) was...

lung cancer

Study Reports on New Potential Biomarker of Response in Lung Cancer Chemoprevention Studies

MiRNAs, negative post-transcriptional regulators of gene expression, are involved in bronchial carcinogenesis from the very early steps of this process. Endobronchial histology is currently considered as the best intermediate endpoint for chemoprevention studies. However, no intermediate biomarker...

lung cancer

New Genetic Signature May Help Identify Risk of Relapse in Patients with Completely Resected Early Non–Small Cell Lung Cancer

A new genetic signature identified by Spanish researchers may provide robust and objective information about which patients with completely resected early stage non-small cell lung cancer are at low or high risk of relapse following surgery, according to Florentino Hernando, MD, who presented the...

global cancer care

Cancer Care in India: Complex Challenges in a Populous Nation

With 1.22 billion people, India is the second most populous country in the world. Experts project that cancer incidence in India will increase by more than two-thirds over the next 20 years, to approximately 1.7 million new cases per year. Due to a range of economic and social issues, most of...

leukemia

Progress in Treating Chronic Lymphocytic Leukemia Has Led to Across-the-board Improvements in Survival

Four decades ago, Kanti R. Rai, MD, was determined to figure out why some of his patients with chronic lymphocytic leukemia (CLL) died within 2 years after their diagnosis, while others lived for 20 or even 30 years. At the time, Dr. Rai was a young scientist doing research in leukemia at...

prostate cancer
issues in oncology

Study Shows Continued Benefit of PSA Screening in Reducing Prostate Cancer Mortality

Studies assessing the effect of prostate-specific antigen (PSA) testing on prostate cancer mortality have produced conflicting results, and recommendations regarding PSA screening vary among authorities. The recently published 11-year follow-up of the European Randomized Study of Screening for...

Immunotherapy Clinical Trials Show Benefits for Patients with Advanced Cancers

Immunotherapeutic approaches, including vaccines, a monoclonal antibody, and a combination of low-dose interleukin (IL)-2 (Proleukin) and retinoic acid, are showing some success in clinical trials investigating the prevention of breast cancer recurrence in women at high risk, the treatment of...

issues in oncology
health-care policy

Maintenance of Certification in Medical Oncology

It is said that time is perhaps the most treasured asset we have. If you are a practicing oncologist, everyone wants more and more of your time, and I’m not referring to patients. Rather, there is an increasing proliferation of folks who want to make sure we’re doing a good job, and they are...

health-care policy

ASCO Issues New Guideline on Chemotherapy Dosing for Obese Patients

In April, ASCO released a new clinical practice guideline on the appropriate dosing of chemotherapy drugs given to obese adult patients with cancer. The result of an analysis by a panel of experts assembled by ASCO, the guideline calls for the use of a patient's actual body weight when calculating...

gynecologic cancers

Scoring System Based on DNA Repair Pathways Predicts Outcomes and Response to Platinum Therapy

A potentially important tool to identify patients with advanced-stage ovarian cancer likely to benefit from platinum-based chemotherapy and redirect those with poor predicted outcomes to alternative treatments was developed using gene-expression data and validated in two independent datasets. While ...

lymphoma

Panobinostat Produces Objective Responses in Patients Refractory to Autologous Transplant

Panobinostat produced objective responses in 27% and tumor reductions in 74% of 129 patients enrolled in “the largest, prospective, multicenter, international trial conducted in heavily pretreated patients” with Hodgkin lymphoma who relapsed or were refractory to autologous stem cell...

thyroid cancer

Low-dose Radioiodine as Effective as High-dose in Thyroid Ablation

Two studies in The New England Journal of Medicine found that low-dose radioiodine is as effective as a high-dose strategy in treating patients with thyroid cancer and that recombinant human thyrotropin (thyrotropin alfa [Thyrogen]) and thyroid hormone withdrawal had similar efficacy in preparing...

symptom management

Surviving the Aftermath of Cancer

With medical information now just a click away, it’s difficult to imagine a time before the Internet existed, when finding answers to questions about serious diseases was nearly impossible. When I was diagnosed with liposarcoma 33 years ago, there was only one oncologist in my hometown of Tyler,...

breast cancer
issues in oncology
supportive care
palliative care

Studies Report Findings in Patient-centered Care

New studies highlighting findings that will lead to improvements in the patient experience and identifying potential risks for development of cancers in the future were reported at a press briefing held during the 2012 ASCO Annual Meeting in Chicago. “In this era of sophisticated research advances, ...

SIDEBAR: Expect Questions from Your Patients

“Our study provides critical interim companion data to awaited randomized trials and may help clinicians and patients quantify the risk-benefit ratio of brachytherapy compared with standard therapy,” Benjamin D. Smith, MD, said of a study comparing lumpectomy and either whole-breast irradiation or...

breast cancer

Will Study Showing Increased Complications Compared to Whole-breast Irradiation Put the Brakes on Brachytherapy?

In the News focuses on media reports that your patients may have questions about at their next visit. This continuing column will provide summaries of articles in the popular press that may prompt such questions, as well as comments from colleagues in the field. Older women treated for invasive...

What You Need to Know About Glucarpidase Injection for Toxic Methotrexate Levels in Renal Impairment

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 In January 2012, glucarpidase injection (Voraxaze) was...

prostate cancer

Denosumab Delays Time to First Bone Metastasis in Men with Castration-resistant Prostate Cancer

Denosumab (Xgeva) significantly delayed time to first bone metastases among men with nonmetastatic castration-resistant prostate cancer enrolled in a phase III randomized, placebo-controlled trial. The time to first bone metastasis was 33.2 months among the 716 patients randomly assigned to receive ...

SIDEBAR: Photodynamic Therapy for Cancer

Photodynamic therapy is a two-step treatment that includes a photosensitizing agent and a light source. In the first step, the photosensitizing agent (porfimer sodium) is injected into the bloodstream and absorbed by all cells. Over 24 to 48 hours, the drug is concentrated in cancer cells. In the...

gastrointestinal cancer

Strong Biomarker Candidates for Predicting Clinical Response to Bevacizumab

Plasma vascular endothelial growth factor A (VEGF-A) and tumor neuropilin-1 “are strong biomarker candidates for predicting clinical outcome in patients with advanced gastric cancer” after treatment with bevacizumab (Avastin). This was the conclusion of a mandatory biomarker program following up on ...

hematologic malignancies
multiple myeloma

Multiple Myeloma Research Foundation Initiatives Are Leading to More Effective Targeted Treatment

In 1996, at just 37, the last thing Kathy Giusti expected to hear was that she had the fatal blood cancer multiple myeloma. An executive at Searle Pharmaceuticals and the mother of an 18-month-old daughter, Giusti was told she probably had 3 years to live. At the time, treatments for the disease...

ASCO Participates in Two FDA Meetings on Improving Clinical Trials

ASCO recently took part in two public meetings at the U.S. Food and Drug Administration (FDA) that had the broad goal of improving clinical trials and, ultimately, treatment for cancer patients. Then ASCO President Michael P. Link, MD, served as a panelist on a workshop sponsored by FDA and ASCO,...

Markers in Cancer 2012, to be Held October 11–13, Will Seek to Move the Field of Biomarkers to the Next Phase

There are hundreds and hundreds of papers published on biomarkers in cancer each year, but very few make it over the hurdles necessary to be used in actual patient care, said James L. Abbruzzese, MD, Chair of the Department of Gastrointestinal Medical Oncology at the University of Texas MD Anderson ...

lung cancer

Study Validates Prognostic Role of Tumor Lymphocytic Infiltration in Resectable Non–Small Cell Lung Cancer

The benefit from platinum-based adjuvant chemotherapy in non–small cell lung cancer (NSCLC) was demonstrated in four randomized trials (International Adjuvant Lung Cancer Trial [IALT], Canadian JBR.10 trial, Cancer and Leukemia Group B [­CALGB] 9633 trial, and Adjuvant Navelbine International...

breast cancer

Postsurgical Local Breast Cancer Therapies Compared in Two Large Studies

A study presented at the 13th Annual Meeting of the American Society of Breast Surgeons suggested that accelerated partial-breast irradiation (APBI) using brachytherapy might control the tumor bed better than whole-breast irradiation (WBI), while another study suggested that radiofrequency ablation ...

hematologic malignancies
multiple myeloma

Maintenance Lenalidomide Improves Progression-free Survival and Time to Progression in Patients with Multiple Myeloma

Three phase III, double-blind, multicenter, randomized studies showed that lenalidomide (Revlimid) maintenance therapy for patients with multiple myeloma significantly improved progression-free survival or time to progression, the primary endpoints of the studies published in The New England...

At More than a Century Old, American Association for Cancer Research Continues to Evolve

Margaret Foti, PhD, MD (hc), has been Chief Executive Officer of the American Association for Cancer Research (AACR) since 1982, and has been instrumental in launching some of the most seminal efforts of the cancer research organization. Over the past 4 years, she has helped spearhead the AACR’s...

survivorship

Better Information Needed for Primary Care Providers Who Treat Cancer Survivors

Many primary care providers are unaware of the late effects of chemotherapy, according to survey results presented at the ASCO Annual Meeting.1 For three out of four commonly used chemotherapy agents, medical oncologists performed well on the survey, but 29% to 38% of medical oncologists were...

skin cancer

Dual BRAF and MEK Inhibition Is Active in Advanced Melanoma

In advanced melanoma, combination therapy with two investigational drugs—one targeting BRAF and the other the MEK pathway—achieved a median progression-free survival of 7.4 months, which rose to 10.8 months in patients who were optimally dosed, reported Jeffrey S. Weber, MD, PhD, Director of the...

solid tumors
prostate cancer

Encouraging Results with Neoadjuvant Therapy for High-risk Prostate Cancer

Use of the CYP17 inhibitor ­abiraterone acetate (Zytiga) in combination with leuprolide and prednisone prior to radical prostatectomy achieved pathologic complete response or near complete response in one-third of men with high-risk, localized prostate cancer. Abiraterone is FDA-approved for...

lymphoma

Radiotherapy in Early-stage Hodgkin Lymphoma

The treatment of patients with Hodgkin lymphoma is one of the major success stories in medical oncology. Depending on clinical stage, clinical risk factors, and the treatment given, 60% to 90% of all patients can be cured of their malignancy long-term. Hodgkin lymphoma survivors represent one of...

breast cancer
multiple myeloma
issues in oncology

Decoding the Genetic Blueprint of Cancer Cells: Findings in Multiple Myeloma and Breast Cancer

Advances in next-generation DNA sequencing technologies are allowing scientists to decipher the whole genome or whole exome (ie, the coding region of the genome) of cancer specimens more quickly and inexpensively than ever before. And the results are revealing genes that had not previously been...

When It Comes to Scientific Exploration, Renowned Clinical Investigator Lets the Work Guide His Path

Internationally renowned clinical investigator Daniel D. Von Hoff, MD, FACP, attended grade school in a one-room schoolhouse on the rural outskirts of Oshkosh, Wisconsin. Polio was a scourge at the time, and Dr. Von Hoff recalled lining up with his skittish classmates to get the newly developed...

New ASCO President Reflects on Value of Mentorship and Addressing Health-care Disparities

Sandra M. Swain, MD, Medical Director of the Washington Cancer Institute at the MedStar Washington Hospital Center in Washington, DC, and ASCO President for the 2012 to 2013 term, is a leading authority on breast cancer treatment with a global reputation in cutting-edge clinical research. The...

Dana-Farber Researcher’s Work with Partners in Health Brings Quality Cancer Care to Rwanda

Lawrence N. Shulman, MD, Chief Medical Officer at Dana-Farber Cancer Institute, grew up in New York City. A product of the public school system, Dr. Shulman entered Syracuse University as a history major, only to realize that studying the past, although important, wasn’t for him. “I wanted a field...

Trailblazing Oncologist Had Instrumental Role in France’s War on Cancer

David Khayat, MD, PhD, Chair of the Department of Medical Oncology at the Pitié-Salpêtrière Hospital in Paris, was inspired to become an oncologist by an episode that could have been ripped from the pages of one of his best-selling novels. At the age of 18, Dr. Khayat was the witness at his best...

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