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integrative oncology

Reishi Mushroom

Scientific name: Ganoderma lucidum Common names: Ling zhi, lin zi, mushroom of immortality Overview A fungus, reishi mushroom is an important component of the traditional medical systems of China, Japan, Korea, and other Asian countries. It is used to increase energy, stimulate the immune system,...

multiple myeloma

Lenalidomide Acts in Myeloma by Degrading Lymphoid Transcription Factors IKZF1 and IKZF3

The mechanism of action of lenalidomide (Revlimid) in multiple myeloma and other B-cell neoplasms remains largely uncharacterized. In a study reported in Science, Krönke and colleagues identified one of the effects of lenalidomide in this setting. Use of quantitative proteomics showed that...

health-care policy

The FDA’s Bad Ad Program

INSIDE THE BLACK BOX is an occasional column providing insight into the FDA and its policies and procedures. In this installment, Robert Dean, MBA, Director, and Michael Sauers, Deputy Director, of Division II in the FDA’s Office of Prescription Drug Promotion discuss the FDA’s Bad Ad program. The...

prostate cancer

Does ‘Specialist Bias’ Contribute to Overtreatment of Prostate Cancer?

Specialist bias, in which specialists recommend the therapy that they are capable of delivering, is thought to influence the treatment of patients with localized prostate cancer and to contribute to overtreatment of men with limited life expectancy,” Ayal A. Aizer, MD, MPH, and colleagues, from the ...

lung cancer

Decision Time for Lung Cancer Screening in High‑Risk Populations

For decades, dedicated members of the oncology community have fought to increase the nation’s focus on lung cancer prevention and treatment. Although smoking cessation initiatives have reduced cigarette consumption, lung cancer 5-year survival has remained stagnant at 15%, lagging far below most...

breast cancer

Study Shows Pathologic Complete Response to Neoadjuvant Therapy for Breast Cancer of Prognostic Value but Not for Use as Surrogate for Survival

Pathologic complete response to neoadjuvant therapy has been proposed as a surrogate endpoint for long-term clinical benefit in breast cancer. The U.S. Food and Drug Administration (FDA) established the international Collaborative Trials in Neoadjuvant Breast Cancer (CTNeoBC) working group to...

supportive care
issues in oncology

Accidental Extravasation of Chemotherapy

Accidental extravasation of chemotherapy is a rare but feared complication of cancer treatment. Risk factors for extravasation include medication-related factors (such as the vesicant properties of the compound, or the volume, concentration, and duration of the infusion), patient-related factors...

issues in oncology

Informed Consent: Not Just About Blood Tests and Procedures Anymore

On February 24, the Institute of Medicine National Cancer Policy Forum convened a workshop, “Contemporary Issues in Human Subjects Protection in Cancer Research,” in Washington, DC. In his introduction to the workshop, Steven Piantadosi, MD, PhD, Director, Samuel Oschin Cancer Institute,...

issues in oncology
health-care policy

ASCO Signs Joint Open Letter to End Tobacco Sales

ASCO has joined 26 of the nation’s leading public health and medical organizations in signing a joint letter calling on drug stores and other retailers to end the sale of cigarettes and other tobacco products. The open letter came just weeks after CVS Caremark announced it would stop selling...

health-care policy

ASCO Calls for Clear Guidance on Tobacco Cessation Benefits in the Affordable Care Act

ASCO has signed a joint letter to U.S. Department of Health and Human Services Secretary Kathleen Sebelius asking for clear and comprehensive guidance on the tobacco cessation benefit in the Affordable Care Act regulations. In the letter, the organizations applaud the Department of Health and Human ...

Become a Cornerstone of the Conquer Cancer Foundation

Have you given any thought to the legacy you would like to leave? For many of you, your professional legacy will include the patients you have cared for, the research you have conducted, the students you have mentored, and the lives you have touched in the world of cancer care. You also have your...

pain management

Individualized Care Key to Cancer Pain Management at Sidney Kimmel Comprehensive Cancer Center

Learning about the particulars of each cancer patient’s pain and treating each case uniquely is the key to keeping pain manageable. That is the goal of the Duffey Pain and Palliative Care Program at The Sidney Kimmel Comprehensive Cancer Center in Baltimore. The team consists of physicians, nurse...

cost of care
health-care policy

American College of Radiology Issues Statement on Budgetary Efforts to Curtail Imaging and Radiation Oncology Self-Referral

The American College of Radiology (ACR) recently issued a statement applauding steps to reign in medical imaging and radiation oncology self-referral included in the President’s fiscal year 2015 budget. However, prior authorization for imaging services, also included in the FY2015 budget, is...

issues in oncology

Electronic Cigarette Use and Smoking Among Adolescents

Use of e-cigarettes does not discourage, and may encourage, conventional cigarette use among U.S. adolescents.” This was the conclusion of a cross-sectional analysis of survey data from a representative sample of middle and high school students who completed the National Youth Tobacco Survey (NYTS) ...

thyroid cancer

Thyroid Cancer On the Rise: Is It Clinically Meaningful?

According to data from the Surveillance, Epidemiology, and End Results (SEER) program, rates for new cases of thyroid cancer in the United States have been rising on average 6.4% each year over the past 10 years, and death rates have been rising on average 0.9% each year over the same period. The...

prostate cancer

Long-Term Complications of Prostate Cancer Treatment May Have Been Underappreciated

The recent study by Nam et al in The Lancet Oncology—reviewed in this issue of The ASCO Post—provides a fresh perspective on complications other than incontinence or erectile dysfunction that commonly arise after primary treatment of localized prostate cancer.1 The authors conducted a...

colorectal cancer

Will Colorectal Cancer Surveillance Change Based on the Results of the FACS Trial?

Colorectal cancer is a common malignancy that will impact 1.4 million individuals globally each year.1 Approximately 70% to 75% of patients will present with locally advanced disease. For patients with stage III colon cancer, adjuvant chemotherapy is commonly offered, whereas chemotherapy for those ...

lymphoma

‘Double-Hit’ Lymphomas a Challenge for the Oncologist

"Double-hit” lymphomas remain challenging tumors, and the best means of treatment remains somewhat elusive, according to studies presented at the 2013 American Society of Hematology (ASH) Annual Meeting in New Orleans, and experts who commented on these findings. “We still don’t have a standard of...

bladder cancer

Bladder Cancer Patient With Rare Genetic Mutations Shows Exceptional Response to Everolimus/Pazopanib Combination

A patient with advanced bladder cancer experienced a complete response for 14 months to the drug combination everolimus (Afinitor) and pazopanib (Votrient) in a phase I trial, and genomic profiling of his tumor revealed two alterations that may have caused this exceptional response, according to a...

kidney cancer

A Conversation With Arie Belldegrun, MD, FACS, and Allan Pantuck, MD, MS, FACS

Cancer Immunotherapy What is the role of immunotherapy in the treatment of metastatic renal cell carcinoma? The harnessing of the immune system as an effective treatment for cancer was recently selected by the journal Science as the top scientific Breakthrough of the Year for 2013.1 With this...

kidney cancer

A Conversation With David I. Quinn, MBBS, PhD, FRACP

First-Line Therapy Please describe current medical oncology approaches to first-line therapy for metastatic renal cell carcinoma. The current first-line therapy for most patients with good- to intermediate-risk metastatic renal cell carcinoma is a vascular endothelial growth factor (VEGF) receptor...

breast cancer

SSO-ASTRO Margin Guideline: Why Now and What Does It Mean?

Although breast-conserving therapy has been a standard practice for more than 20 years, controversy still exists over what constitutes the appropriate margin of normal breast tissue around a tumor that minimizes local recurrence while maintaining a good cosmetic outcome. Surveys of surgeons1 and...

breast cancer

SSO-ASTRO Consensus Guideline on Margins for Breast-Conserving Surgery in Stage I/II Invasive Breast Cancer

The Society of Surgical Oncology (SSO) and American Society for Radiation Oncology (ASTRO) formed a multidisciplinary expert panel in 2013 to examine the relationship between surgical margin width and ipsilateral breast tumor recurrence and develop guidelines on margins for breast-conserving...

survivorship

Identifying One Main Provider and Involving Oncology Specialist Are Key to High-Quality Rating for Follow-up Care

Long-term cancer survivors are more likely to rate their follow-up care as high-quality when one main provider is identified and an oncology specialist is involved, according to results of a population-based cross-sectional study among adult survivors of breast, prostate, colorectal, endometrial,...

gynecologic cancers

Desensitization Protocols May Allow Reintroduction of Chemotherapeutic Agents After Hypersensitivity Reactions

Hypersensitivity reactions to chemotherapeutic agents used to treat ovarian cancer are “increasingly common and can greatly limit their use,” according to an article published in the Journal of the National Comprehensive Cancer Network. “Drug desensitization has emerged as a safe and effective way...

Bringing the Humanistic Approach to Palliative Care: From Diagnosis and Throughout Disease Course

For much of her career in oncology, Teresa A. Gilewski, MD, has sought to bridge the science of medicine with the humanistic aspect of care. She has created the Art of Medicine lecture series at Memorial Sloan Kettering Cancer Center in New York, where she is a medical oncologist on the Breast...

American Psychosocial Oncology Society Launches Psychosocial Distress Program

In February, the American Psychosocial Oncology Society (APOS) held its 11th Annual Conference in Tampa, Florida, and it marked a number of firsts. With over 500 registrants and more than 300 abstracts presented over the 3-day program, this was the largest APOS event to date. The theme of this...

Expert Point of View: Joyce F. Liu, MD, MPH, of Dana-Farber Cancer Institute, and Stephen A. Cannistra, MD

In an editorial accompanying publication of the AURELIA study results, Joyce F. Liu, MD, MPH, of Dana-Farber Cancer Institute, and Stephen A. Cannistra, MD, of Beth Israel Deaconess Medical Center, Boston, considered the implications of the benefits observed in the trial and limitations in...

ASCO Rolls Out Support for Changes in Maintenance of Certification Requirements

Big changes came to the American Board of Internal Medicine’s (ABIM) Maintenance of Certification (MOC) program requirements in 2014. As of January 1, all diplomates, including “grandfathers” (or those certified before 1990 who are “board-certified for life”), must actively participate in MOC...

Enhance Your ASCO Annual Meeting Experience With Attendee Resources

At the end of the month, more than 25,000 oncology professionals from around the world will meet in Chicago for the 2014 ASCO Annual Meeting. Will you be joining this global community? As you’re beginning to consider what to pack for your trip, keep in mind that you have a host of electronic...

gynecologic cancers

High-Risk Uterine Cancers Found in BRCA1 Mutation Carriers Who Had Preventive Oophorectomy but Not Hysterectomy

Prophylactic surgery to remove the ovaries and fallopian tubes is advised for women who carry BRCA mutations to reduce the risk of breast and ovarian cancer. This procedure, referred to as risk-reducing salpingo-oophorectomy, typically does not require a hysterectomy. However, a new study presented ...

hepatobiliary cancer

Ethiodized Oil Approved for Imaging of Hepatocellular Carcinoma Tumors

The U.S. Food and Drug Administration has approved ethiodized oil injection (Lipiodol) for selective hepatic intra-arterial use for imaging tumors in adults with known hepatocellular carcinoma. The agent received orphan drug designation for management of patients with known hepatocellular carcinoma ...

NCCN Receives $2 Million in Research Funding to Study Nintedanib in Colorectal and Lung Cancers

The National Comprehensive Cancer Network® (NCCN®) Oncology Research Program (ORP) has announced it has been awarded a $2 million grant from Boehringer Ingelheim Pharmaceuticals, Inc. to develop a program to scientifically evaluate and define the safety and clinical effectiveness of the...

sarcoma

Surgery Plus Radiation Offers Mixed Results in Soft-Tissue Sarcoma

Adjuvant radiation following surgery for soft-tissue sarcomas of the extremities did not lead to a survival benefit and seemed to be associated with some degree of long-term limb complications, according to a presentation at the 2014 Society of Surgical Oncology (SSO) Cancer Symposium in Phoenix.1...

skin cancer

Patients With Thin Melanoma Benefit From Sentinel Lymph Node Biopsy

Sentinel node status is “the most powerful predictor” of melanoma-specific survival in patients with thin melanoma, according to a presentation at the 2014 Society of Surgical Oncology (SSO) Cancer Symposium in Phoenix.1 As a result, sentinel lymph node biopsy should be considered in patients with...

Expert Point of View: Mario Sznol, MD

Mario Sznol, MD, of Yale Cancer Center, New Haven, Connecticut, was formal discussant of the MK-3475 presentations at the American Association for Cancer Research (AACR) Annual Meeting. He alluded to all the factors that complicate assays of PD-L1: the disparate nature of the assays themselves, the ...

skin cancer

PD-L1 Studied as Biomarker for Anti–PD-1 Immunotherapy

The anti–PD-1 inhibitor MK-3475 (formerly lambrolizumab) is in late-stage trials for advanced melanoma and is also being studied in other malignancies, including non–small cell lung cancer (NSCLC). An important aspect of Merck’s development program for MK-3475, as well as for other anti–PD-1 agents ...

multiple myeloma

Maintenance Therapy in Multiple Myeloma

In 2012, three randomized placebo-controlled trials reported a significant prolongation of progression-free survival with lenalidomide (Revlimid) as maintenance therapy for multiple myeloma.1-3 Two of these trials tested lenalidomide maintenance after stem cell transplantation, and one investigated ...

Questions Answered About Uridine Triacetate

Q. What is uridine triacetate? A. It is an investigational, orally active prodrug of uridine currently under development as an antidote to overexposure of fluorouracil (5-FU). Although not yet approved by the U.S. Food and Drug Administration, it has been shown to be effective in treating patients...

Collaborative Exchange: Leucovorin and Glucarpidase

The panel discussed the rationale behind the continued use of leucovorin in conjunction with glucarpidase. Dr. Campen: We continue with leucovorin to provide a full basis for recovery of the cells. One important thing to know is that leucovorin should be given separately from glucarpidase because...

Collaborative Exchange: Indications and Dosing

Indications and Dosing of Methotrexate and 5-FU Dr. Campen: The interesting thing about methotrexate is that it has been used for such a long time. You would think there would be a specific dose that would be considered “high dose,” but high dose is actually quite variable. [Dosage] depends on the...

CE Activity Instructions

CE is available on May 1, 2014 and expires on May 1, 2015. A continuing education activity for physicians, physician assistants, nurse practitioners, nurses, pharmacists, and other allied health professionals specializing in the field of oncology. This activity is supported by an unrestricted...

breast cancer

ASCO Issues Two New Guidelines on Treating Patients With Advanced, HER2-Positive Breast Cancer

ASCO recently issued two clinical practice guidelines on treating women with advanced, HER2-positive breast cancer. The first guideline lists the appropriate systemic therapies for women newly diagnosed with advanced disease and those whose early-stage disease progressed to advanced cancer. The...

prostate cancer

Tadalafil Did Not Prevent Erectile Dysfunction Among Men Receiving Radiotherapy

Daily use of tadalafil (Cialis) did not improve erectile function compared to placebo or prevent erectile dysfunction among men undergoing radiotherapy for prostate cancer, according to results of a stratified, placebo-controlled, double-blind, parallel-group study with 1:1 randomization at 76...

Don’t Always Expect Questions From Patients About Prognosis

Although most patients want to know about the potential outcome of their disease and whether treatment is likely to have a significant impact on it, the information needs of patients and how best to fulfill those needs are very variable, Walter F. Baile, MD, told The ASCO Post. Dr. Baile is...

issues in oncology

Breaking Bad News Badly Can Add to Upset

When the prognosis is poor, breaking the bad news badly can exacerbate the distress experienced by cancer patients and their families. A lack of sensitivity to patient and family emotions and not being attuned to how individual patients would prefer to be informed about their prognoses can result...

ASCO’s Visionary Founders

On April 9, 1964, seven physicians—Jane Cooke Wright, MD, FASCO; Arnoldus Goudsmit, MD, PhD; Fred J. Ansfield, MD, FASCO; Harry F. Bisel, MD, FASCO; Herman H. Freckman, MD, FASCO; Robert W. Talley, MD, FASCO; and William Wilson, MD, FASCO—met for lunch at the Edgewater Beach Hotel in Chicago. They...

The Consequence Is Cure

My Presidency was the first year that the Annual Meeting hit 10,000 attendees, which at the time we thought was a huge number—it seemed that we’d hit the ceiling. It was about 9 years after we published the results from our study of combination chemotherapy (MOPP) in the treatment of advanced...

Multidisciplinary Interactions

As my Presidency gradually fades into the past, it is sobering to reminisce on how exciting it was. ASCO is a great organization with an amazing staff and a solid mission. Chairing the Board meetings was clearly a highlight of my Presidency because of the vast talent and collective wisdom that is...

SIDEBAR: FDA-Approved Drugs to Use as Single Agents or in Combination Chemotherapy

2014 Ceritinib for the treatment of patients with anaplastic lymphoma kinase (ALK)-positive, metastatic NSCLC with disease progression on or who are intolerant to crizotinib; mercaptopurine as a 20 mg/mL oral suspension for the treatment of acute lymphoblastic leukemia as part of a combination...

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