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issues in oncology

IASLC Issues Statement on E-Cigarettes

There are currently no evidence-based guidelines to support the recommendation of e-cigarettes as a cessation tool to help patients stop smoking. In a recent article in the Journal of Thoracic Oncology,1 members of the International Association for the Study of Lung Cancer (IASLC) Tobacco Control...

prostate cancer

Delaying Androgen Deprivation Therapy May Not Compromise Survival in Men With Prostate Cancer and PSA-Only Relapse

In men with prostate cancer and a prostate-specific antigen (PSA)-only recurrence after curative surgery or radiation, delaying androgen deprivation therapy for at least 2 years or until clinical progression (ie, new symptoms, metastasis by imaging techniques or short PSA doubling time) did not...

breast cancer

ALTTO Trial Finds Dual Anti-HER2 Therapy No Better Than Trastuzumab Alone

The highly anticipated results from the phase III ALTTO trial show no additional benefit for adding lapatinib (Tykerb) to trastuzumab (Herceptin) in the adjuvant treatment of HER2-positive breast cancer.1 The results were presented at the 2014 ASCO Annual Meeting’s Plenary Session by Martine J....

SIDEBAR: How the MEDCAC Panelists Voted

Grading their responses on a 5-point scale, where 5 represented the highest level of confidence, Medicare Evidence Development & Coverage Advisory Committee (MEDCAC) members were asked the following questions: How confident are you that there is adequate evidence to determine if the benefits ...

Sharing 50 Years of Christmas: A Quality Metric?

A very pleasant 68-year-old woman was referred to my clinic with biopsy-proven liver metastasis from primary colon cancer. She was initially diagnosed with colon cancer, which was resected, and she then received chemotherapy. A suspicious liver lesion was biopsied in the adjuvant setting, which...

Leading Cancer Researcher and Public Health-Care Expert, Eddie Reed, MD, Dies

In a 2010 interview, Eddie Reed, MD, a pioneer in the molecular pharmacology of DNA-damaging anticancer agents and the clinical development of paclitaxel for ovarian cancer, was asked what lay ahead. Before answering, Dr. Reed first acknowledged the esteemed mentors who gave him their most precious ...

Focus on the Washington State Medical Oncology Society

The Washington State Medical Oncology Society (WSMOS) was formed in 1993 in response to the health-care reform legislation then being proposed by President Bill Clinton. “The law never passed, but it spurred the development of our Society, so some good came out of the law’s defeat,” said Vicky E....

Expect Questions From Patients

With the extensive media coverage of a study indicating that injections with the luteinizing hormone–releasing hormone (LHRH) agonist goserelin (Zoladex) may offer a new option for preserving fertility among women treated for breast cancer, physicians can expect questions from interested patients....

breast cancer

New Option for Preserving Fertility in Women Being Treated With Chemotherapy for Early-Stage Breast Cancer

One of the most reported studies emanating from the 2014 ASCO Annual Meeting involves the use of the luteinizing hormone–releasing hormone (LHRH) agonist goserelin (Zoladex) to reduce the risk of ovarian failure among women being treated with chemotherapy for early-stage breast cancer, and to...

issues in oncology

Genomic Confidence and Competence

As reported in the Journal of Clinical Oncology and reviewed in this issue of The ASCO Post, Stacy W. Gray, MD, AM, a medical oncologist at Dana-Farber Cancer Institute, Boston, and colleagues presented one of the first studies evaluating how academic oncologists perceive the incorporation of a...

issues in oncology

Physician Attitudes About Multiplex Tumor Genomic Testing: Variation in Projected Use and Confidence

It is a widely expressed belief that predictive multiplex somatic genomic testing represents the ability to transform cancer care by identifying targetable alterations in multiple cancer genes. Do oncologists share this belief? How do they intend to use such tests in practice? In a study reported...

cost of care
health-care policy

Cancer Care Under the Affordable Care Act

The problematic rollout of the Affordable Care Act’s website, HealthCare.gov, made good political theater, but while much of the heated discussion centered on the plan’s need to enroll “young invincibles,” America’s cancer care system and the older patients it serves were also affected by parts of...

pain management

Federal Pain Research Database Launched

The Interagency Pain Research Portfolio (IPRP), a database that provides information about pain research and training activities supported by the federal government, has been launched by six federal agencies. “This database will provide the public and the research community with an important tool...

Marie-Josée and Henry R. Kravis Foundation Provides $100 Million Gift to Support Precision Oncology Work at Memorial Sloan Kettering Cancer Center

Memorial Sloan Kettering Cancer Center has launched an initiative to improve cancer care and research through genomic analysis. The new program will reshape clinical trials and speed the translation of novel molecular discoveries into routine clinical practice. The Marie-Josée and Henry R. Kravis...

colorectal cancer

Colon Cancer Prevention: It’s All About Mindset and Minute Details

I would like to congratulate Corley and his colleagues for their seminal work on the association between adenoma detection rate and risk of colorectal cancer, advanced colorectal cancer, and colorectal cancer mortality. The impact of their findings—reported in The New England Journal of Medicine1...

breast cancer

A New Era in the Management of Advanced HER2-Positive Breast Cancer

Approximately 20% of all breast cancers are human epidermal growth factor receptor 2 (HER2)-positive. Prior to the era of HER2-targeted therapy, HER2-positive breast cancer was characterized by a poor prognosis.1,2 The development of the first HER2-targeted therapy, trastuzumab (Herceptin), led to...

issues in oncology

ASCO’s Patient Information Website, Cancer.Net, Undergoes Redesign

ASCO is committed to providing people with cancer and their caregivers with top quality educational information and resources to help them manage their cancer care, treatment, and survivorship. This ongoing commitment is best reflected in its patient-facing educational website, Cancer.Net...

Conquering Cancer With 2013 Career Development Award Recipient Rebecca A. Gardner, MD

Rebecca A. Gardner, MD is an Assistant Professor at the University of Washington and Attending Physician at Seattle Children’s Hospital. She received a 2013 Conquer Cancer Foundation of ASCO Career Development Award (CDA) for her project “Autologous T cells genetically modified to express a CD19...

head and neck cancer

FDA Approves Radioactive Diagnostic Imaging Agent to Help Determine the Extent of Head and Neck Cancer in the Body

The U.S. Food and Drug Administration has approved a new use for technetium 99m tilmanocept (Lymphoseek Injection), a radioactive diagnostic imaging agent used to help doctors determine the extent to which squamous cell carcinoma has spread in the body’s head and neck region. In 2013, tilmanocept...

colorectal cancer

Many Patients With Colorectal Cancer Fail to Receive Adjuvant Chemotherapy

Data from the National Cancer Data Bank (2010–2011) suggest that 30% of patients with colorectal cancer who are eligible for adjuvant chemotherapy fail to receive it, but their odds increase by 30% when surgery is performed by laparoscopy, rather than laparotomy.1 “In this large national database...

colorectal cancer

Colorectal Cancer Screening Poised for Change

New screening modalities and the customization of the screening population could soon change the way that screening for colorectal cancer is done. At Digestive Disease Week 2014, the largest gathering of gastrointestinal disease specialists in the world, researchers presented data suggesting that...

breast cancer

Preoperative Breast MRI: Does Higher Sensitivity Equal Better Outcomes?

Breast magnetic resonance imaging (MRI) is superior to more commonly used imaging modalities in preoperative breast cancer staging and should be a key element in routine workup. But despite its high sensitivity for catching cancers, breast MRI still does not deliver maximum value for the patient....

lung cancer

Lung-MAP Launches: First Precision Medicine Trial From National Clinical Trials Network

A public-private collaboration among the National Cancer Institute (NCI), SWOG Cancer Research, Friends of Cancer Research, the Foundation for the National Institutes of Health (FNIH), five pharmaceutical companies (Amgen, Genentech, Pfizer, AstraZeneca, and AstraZeneca’s global biologics R&D...

pancreatic cancer

Research Insights From the AACR Special Conference on Pancreatic Cancer

Pancreatic cancer still kills 40,000 Americans a year out of approximately 44,000 diagnosed. While advances in diagnosis and treatment are extending the lives of patients with other cancers, pancreatic ductal adenocarcinoma remains the second most lethal tumor (behind lung cancer). While a magic...

breast cancer

FDA Approves Magnetic Resonance Contrast Agent for Evaluation of Breast Cancer

The U.S. Food and Drug Administration has approved a new indication for gadobutrol (Gadavist) injection for intravenous use with magnetic resonance imaging (MRI) of the breast to assess the presence and extent of malignant breast disease. The approval is based on priority review of two multicenter...

Expert Point of View: Sherene Loi, MD PhD

Sherene Loi, MD PhD, Head of the Translational Breast Cancer Genomics Lab at the Peter McCallum Cancer Centre, Victoria, Australia, commented on the N9831 study presentation and referred to her group’s own work on tumor-infiltrating lymphocytes. These investigators have shown a positive association ...

breast cancer

Goserelin With Chemotherapy Prevents Early Menopause, Helps Preserve Fertility in Younger Women With Hormone Receptor–Negative Breast Cancer

The good news for younger women with hormone receptor–negative early breast cancer is that adding goserelin (Zoladex), a luteinizing hormone–releasing hormone (LHRH) agonist, to chemotherapy can prevent sudden menopause, better preserve ovarian function and fertility, and lead to successful...

Expert Point of View: Nasser H. Hanna, MD

Formal discussant of the study by Park et al, Nasser H. Hanna, MD, Associate Professor of Medicine at the Indiana University Simon Cancer Center, Indianapolis, said that the trial confirms the difficulty of giving consolidation therapy, since less than two-thirds of patients were able to get the...

Expert Point of View: Gregory A. Masters, MD, FASCO, Olatoyosi Odenike, MD, Lee Greenberger, PhD

It is impressive to see an overall survival benefit in chronic lymphocytic leukemia (CLL),” said Gregory A. Masters, MD, FASCO, who moderated an ASCO press conference where the RESONATE study data were discussed. “Patients treated with [ibrutinib] have a long survival. Ibrutinib can be an...

Expert Point of View: Steven J. O’Day, MD, Don S. Dizon, MD, Michael Birrer, MD, PhD

Steven J. O’Day, MD, Director, Clinical Research, Beverly Hills Cancer Center and Director, Los Angeles Skin Cancer Institute, Beverly Hills, California, commented on cervical cancer study by Hinrichs et al from the National Cancer Institute (NCI) during a press briefing at the ASCO Annual Meeting. ...

Expert Point of View: Cora N. Sternberg, MD, FACP

Despite the availability of hormonal therapy for the treatment of metastatic prostate cancer and the high response rates for these agents, most patients eventually experience progression to castration-resistant disease. “Multidisciplinary team approaches have contributed to the enormous progress...

Expert Point of View: Scott T. Tagawa, MD

Formal discussant Scott T. Tagawa, MD, Associate Professor of Clinical Medicine and Urology at Weill Cornell Medical College, New York, had the task of putting the three prostate cancer trials—PREVAIL, ELM-PC 4, and SWOG S0925—into context. “Since the approval of docetaxel, we have learned much...

prostate cancer

Updated Information on Prostate Cancer Drugs: Enzalutamide, Orteronel, and Cixutumumab

Three separate studies of treatments for prostate cancer reported at the 2014 ASCO Annual Meeting in Chicago showed excellent, intermediate, and disappointing results. An update of the previously reported PREVAIL trial (see March 1 issue of The ASCO Post, page 1) was overwhelmingly positive for the ...

colorectal cancer

Combined With Chemotherapy, Cetuximab and Bevacizumab Found Comparable for First-Line Metastatic Colorectal Cancer Treatment

Call it a draw: Cetuximab (Erbitux), an EGFR inhibitor,  and bevacizumab (Avastin), a VEGF inhibitor, confer comparable benefits as first-line treatment with chemotherapy for metastatic colorectal cancer, according to the phase III Cancer and Leukemia Group B (CALGB)/Southwest Oncology Group (SWOG) ...

Expert Point of View: Nancy E. Davidson, MD, and Claudine Isaacs, MD

This study provides key insights into the longstanding and vexing debate about optimal systemic therapy for these young women. We wonder about the role of tamoxifen, aromatase inhibitors, chemotherapy, and ancillary therapies like bisphosphonates,” said Nancy E. Davidson, MD, Director of the...

breast cancer

Exemestane/Ovarian Suppression Reduces Recurrence vs Tamoxifen/Ovarian Suppression in Premenopausal Breast Cancer

A joint analysis of two important phase III clinical trials—TEXT (Tamoxifen and Exemestane Trial) and SOFT (Suppression of Ovarian Function Trial)—showed that exemestane plus ovarian function suppression was superior to tamoxifen plus ovarian suppression in preventing recurrence in premenopausal...

head and neck cancer
issues in oncology

Limited Public Awareness of Head and Neck Cancers Raises Concerns About Prevention and Detection

Public awareness of head and neck cancer is limited, with the lack of awareness including the term head and neck cancer and common symptoms and risk factors, such as tobacco use and human papillomavirus (HPV), according to results of a cross-sectional online survey reported in JAMA...

breast cancer

Underuse of Trimodality Treatment for Patients With Inflammatory Breast Cancer Negatively Impacts Survival

Analysis of data for 10,197 women treated for nonmetastatic inflammatory breast cancer treated over a 12-year-period found that the use of trimodality treatment (chemotherapy, surgery, and radiation therapy) fluctuated annually between 58.4% and 73%. “Underutilization of trimodality therapy...

palliative care

Discontinuing Statins Near the End of Life Is Safe, Can Reduce Symptom Burden, and Is Generally Acceptable to Patients

Discontinuing statins for patients near the end of life is safe, saves money, spares patients from swallowing yet another pill and from the symptoms associated with statins, and is generally welcomed by patients. That last bit might come as a surprise to some physicians who worry that discontinuing ...

hematologic malignancies

Siltuximab for Multicentric Castleman’s Disease

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. On April 23, 2014, the anti–interleukin (IL)-6 monoclonal antibody...

ASTRO Names Three Radiation Oncologists as Recipients of Society’s 2014 Gold Medal

The American Society for Radiation Oncology (ASTRO) has announced the names of three recipients of the Society’s highest honor, the ASTRO Gold Medal. Mary K. Gospodarowicz, MD, FASTRO, Leonard L. ­Gunderson, MD, MS, FASTRO, and Nancy J. ­Tarbell, MD, FASTRO, will receive the ­ASTRO Gold Medal...

head and neck cancer

Diagnostic Imaging Agent Approved for Use in Patients With Head and Neck Cancer

The U.S. Food and Drug Administration (FDA) recently approved a new use for technetium 99m tilmanocept (Lymphoseek Injection), a radioactive diagnostic imaging agent used to help doctors determine the extent to which squamous cell carcinoma has spread in the body’s head and neck region. Earlier...

FDA Launches 'OpenFDA' Initiative to Ease Access to Public Health Data

The U.S. Food and Drug Administration (FDA) has launched openFDA, a new initiative designed to make it easier for web developers, researchers, and the public to access large, important public health datasets collected by the Agency. In alignment with the recent Presidential Executive Order on Open...

issues in oncology

UC Davis Comprehensive Cancer Center Tailors Pilot Program to Help Patients Adhere to Oral Chemotherapy

A University of California, Davis, Comprehensive Cancer Center program designed to better manage cancer patients taking oral chemotherapy drugs has demonstrated that one-on-one counseling, education, and monitoring can improve adherence to therapy. Issues in Adherence The rise in oral chemotherapy...

issues in oncology

ASCO Convenes Think Tank to Tackle Disparities in Cancer Care

Despite advances in cancer screening and in more effective therapies to treat the disease, which have led to improved outcomes and increased survival rates for millions of people with cancer, not every American is reaping the benefits of these advances. Disparities in health-care access, quality of ...

lung cancer

Lung Cancer Mutation Consortium Finds Oncogenic Drivers in Majority of Metastatic Lung Adenocarcinomas

The Lung Cancer Mutation Consortium (LCMC) was formed to test adenocarcinomas of the lung for 10 oncogenic drivers in order to enable clinicians to select targeted treatments and enroll patients into suitable clinical trials. As recently reported in JAMA by Mark G. Kris, MD, William and Joy Ruane...

colorectal cancer

Panitumumab Plus FOLFOX for KRAS Wild-Type Metastatic Colorectal 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. Panitumumab (Vectibix) was recently approved by the U.S. Food and...

breast cancer

ASCO Guideline for Management of Brain Metastases From  HER2-Positive Breast Cancer: An Important Framework

Brain metastases are a devastating complication of cancer, and occur in up to 50% of patients with advanced human epidermal growth factor 2 (HER2)-positive breast cancer. Management of brain metastases requires individualized coordination between the traditional treatment modalities for...

breast cancer

Ado-Trastuzumab Emtansine as a Late Treatment for HER2-Positive Metastatic Breast Cancer—Better and Less Toxic Than Physician’s Choice

TH3RESA is a randomized phase III open-label study, reported in The Lancet Oncology and summarized in this issue of The ASCO Post, which examined the activity of ado-trastuzumab emtansine (Kadcyla) in heavily pretreated HER2-positive metastatic breast cancer.1 Formerly known as T-DM1,...

breast cancer

Ado-Trastuzumab Emtansine Improves Progression-Free Survival vs Physician’s Choice in Advanced HER2-Positive Breast Cancer

There are few treatment options for breast cancer patients with progressive disease after two or more HER2-directed regimens for recurrent or metastatic disease. In the open-label phase III TH3RESA trial reported in The Lancet Oncology by Ian E. Krop, MD, PhD, of the Dana-Farber Cancer Institute,...

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