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issues in oncology

Relevance of the Hippocratic Oath in the 21st Century

On the face of it, the idea that a code of professional conduct dating to the ancient Iron Age could possibly retain any relevance in the current era of “Big Data,” religious and cultural pluralism, trillion-dollar government budgets, and nanotechnology seems preposterous. Yet the well-publicized...

Expert Point of View: Benjamin Movsas, MD

Benjamin Movsas, MD, Chair of Radiation Oncology at Henry Ford Hospital in Detroit, served as moderator at a press conference where the two SBRT studies by Timmerman et al and Ashworth et al were reported.1,2 Dr. Movsas said that SBRT is a promising approach, noting that the therapy facilitates...

leukemia

Obinutuzumab Could Have Synergistic Action With New Tyrosine Kinase Inhibitors

Final results from the phase I/II GAUGUIN study showed that obinutuzumab (Gazyva) monotherapy was active in patients with heavily pretreated relapsed or refractory chronic lymphocytic leukemia, European researchers reported in Blood. In phase II, median progression-free survival was 10.7 months and ...

Chemotherapy-Induced Immunosuppressive Myeloid Cells Inhibit Tumor Control via PD-1–PD-L1 Axis

In a study reported in Cancer Research, Ding and colleagues identified mechanisms by which cyclophosphamide induces suppressor cells that inhibit immune response and predispose to loss of tumor control. They found that cyclophosphamide treatment induces expansion of inflammatory monocytic myeloid...

issues in oncology

Professional Associations Collaborate to Launch Stereotactic Radiosurgery Patient Registry

The American Association of Neurological Surgeons (AANS) and the American Society for Radiation Oncology (ASTRO) are partnering to launch and support a national registry for stereotactic radiosurgery (SRS) treatments. The partnership was announced recently at the ASTRO Annual Meeting. The SRS...

solid tumors

Nearly 800 New Cancer Medicines and Vaccines in Development, PhRMA Reports

America’s biopharmaceutical research companies are currently developing nearly 800 new medicines and vaccines for cancer, according to a report released recently by the Pharmaceutical Research and Manufacturers of America (PhRMA).1 Perseverance Needed “In recent decades, we have seen great progress ...

$1 Million Raised in Honor of 40th Anniversary of Milestone

Gifts totaling $1 million in honor of the 40th anniversary of the cure for testicular cancer were recently announced at a celebration for the physician scientist who developed the treatment. Family, friends, colleagues, and men grateful for their lives gathered at the Indianapolis Museum of Art to...

solid tumors

Treating Testicular Cancer in 2014

Testicular cancer is one of oncology’s true success stories. It is a highly treatable disease, usually curable, that most often develops in young and middle-aged men. Despite the success in testicular cancer, there are still clinical challenges ranging from staging to optimum therapeutic...

head and neck cancer

No Benefit Seen for Cetuximab Added to Cisplatin and Accelerated Radiotherapy in Advanced Head and Neck Carcinoma

Use of cisplatin or cetuximab (Erbitux) with radiotherapy improves overall survival in stage III or IV head and neck carcinoma, and adding cetuximab to platinum therapy improves overall survival in metastatic disease. In the phase III Radiation Therapy Oncology Group (RTOG) 0522 trial reported in...

multiple myeloma

Experts Debate the Need for Upfront vs Late Stem Cell Transplant in Multiple Myeloma

With powerful new drugs capable of achieving sustained and deep remissions in multiple myeloma, the role of upfront stem cell transplantation is being questioned by experts, who debated the pros and cons at the National Comprehensive Cancer Network (NCCN) 9th Annual Congress on Hematologic...

breast cancer

Variety of Adjuvant Strategies Explored in HER2‑Positive and Other Breast Cancer Types

Adjuvant trastuzumab (Herceptin) was shown to be effective in patients with breast cancers ≤ 2 cm, regardless of estrogen receptor status, in a meta-analysis1 of five chemotherapy trials, but a “pressing question” remaining is whether T1a/b, N0 tumors warrant the use of adjuvant trastuzumab, Andrew ...

breast cancer

50 Years of Advancements in Treating Breast Cancer Have Led to Tumor-Centered Treatment Algorithm

Transformations in the treatment of early-stage breast cancer have shifted the therapeutic approach from a “stage-centered treatment algorithm” to a “tumor biology-centered treatment algorithm,” Priyanka Sharma, MD, Associate Professor of Medicine, University of Kansas School of Medicine, Kansas...

breast cancer

For Triple-Negative Breast Cancer, Adding Carboplatin to Anthracycline/Taxane Produces Benefit, but How Much?

Combination chemotherapy for triple-negative breast cancer is anthracycline- and taxane-based and has not really changed much in the past 10 years, but “we are starting to see emerging data with selective activity of platinum agents,” Priyanka ­Sharma, MD, told participants at the Best of ASCO...

Illumination and Innovation: Transforming Data Into Learning

"Illumination” is a provocative word, evoking as it does the banishment of the darkness of ignorance by the light of new knowledge. Today, we are benefiting from a steady stream of new knowledge about the molecular basis of cancer and the interaction between host and tumor immunology. The concept...

Despite Potential to Overwhelm, Surveys Still Essential Research Tool

The age of the Internet and worldwide connectivity has made it easier than ever to send out surveys to a wide audience quickly and easily. This ease of access can make surveys an affordable and readily available research tool for independent investigators, but it can also make surveys an...

thyroid cancer

Lenvatinib Receives Priority Review Designation for Advanced Thyroid Cancer

The U.S. Food and Drug Administration (FDA) has given Priority Review designation to the New Drug Application for lenvatinib mesylate as a treatment for progressive radioactive iodine–refractory differentiated thyroid cancer. Lenvatinib is an oral multiple receptor tyrosine kinase inhibitor with a...

issues in oncology

E-Cigarettes Unhelpful in Smoking Cessation Among Patients With Cancer

In a new study of patients with cancer who smoke, those using e-cigarettes in addition to traditional cigarettes were more nicotine-dependent and equally or less likely to have quit smoking traditional cigarettes than nonusers.1 The rising use of e-cigarettes has raised many questions among...

prostate cancer

Radiotherapy Should Be Added to Hormone Therapy in Node-Positive Prostate Cancer

Node-positive prostate cancer has typically been excluded from clinical trials, leaving oncologists with little evidence to guide management for this group of patients. A study presented at the European Society for Medical Oncology (ESMO) 2014 Congress sheds light on this issue, providing the...

solid tumors

Long-Term Results of COU-AA-302 Confirm Abiraterone Benefit

Final results of the COU-AA-302 trial continue to support the survival benefit of abiraterone acetate (Zytiga) in men with chemotherapy-naive metastatic castration-resistant prostate cancer, often referred to as the “predocetaxel space.” “The study met the overall survival endpoint and all...

lymphoma

FDA Approves Bortezomib Injection for Previously Untreated Patients With Mantle Cell Lymphoma

The U.S. Food and Drug Administration (FDA) has approved bortezomib (Velcade) injection for previously untreated patients with mantle cell lymphoma. This is the first treatment in the United States to be approved for use in previously untreated patients with mantle cell lymphoma. Bortezomib was...

skin cancer

Nivolumab Yields ‘Impressive’ Duration of Response as Late-Line Melanoma Treatment

Nivolumab yielded an “impressive” duration of response when used as second- or third-line treatment for patients with advanced melanoma, according to Jeffrey S. Weber, MD, of the Moffitt Cancer Center in Tampa, Florida, who presented preliminary results of a phase III trial at the European Society...

UCSF Study Finds $18 Billion Tobacco Toll in California, 2009

Smoking took an $18.1 billion toll in California in 2009—$487 for each resident—and was responsible for more than one in seven deaths in the state, more than from AIDS, influenza, diabetes, or many other causes, according to the first comprehensive analysis in more than a decade on the financial...

breast cancer

What Is the Real Risk of Breast Cancer Associated With Atypical Hyperplasia?

Women with atypical hyperplasia have an absolute risk of about 1% per year for developing breast cancer—a level of risk that has been underappreciated. Not enough is being done to protect these women, according to Lynn C. Hartmann, MD, Professor of Oncology at the Mayo Clinic in Rochester,...

issues in oncology

Partnering With Community Centers to Advance Oncology Care

Last fall, Richard R. Barakat, MD, FACS, the Ronald O. Perelman Chair in Gynecologic Surgery at Memorial Sloan Kettering Cancer Center, was named to the new position of Deputy Physician-in-Chief for the Memorial Sloan Kettering Regional Care Network and Cancer Alliance, a new initiative meant to...

leukemia

Linking Biology and Therapy in Chronic Lymphocytic Leukemia

Recent discoveries in biology, therapy, and (most importantly) the interplay between these two have led to groundbreaking advances in chronic lymphocytic leukemia (CLL). These advances underline the impact of the “translational” approach to cancer management in general. Standard of Care...

breast cancer

CLEOPATRA: Survival With Dual HER2 Blockade ‘Unprecedented’

In the final overall survival analysis of the phase III CLEOPATRA trial, HER2-positive metastatic breast cancer patients lived 15.7 months longer if they received pertuzumab (Perjeta) in addition to trastuzumab ­(Herceptin) and docetaxel, investigators reported at the European Society for Medical...

Dr. Conti Replies

Dr. Watson states that my assertion that physicians gain profit from the administration of chemotherapy in private practice is “absurd.” Recent reports from the Oncology Circle practices [a data-sharing collaborative of best-in-class oncology practices from across the country] suggest that current...

breast cancer

DNA Double-Strand Break Repair Genes and Oxidative Damage in Brain Metastasis of Breast Cancer

In a study reported in the Journal of the National Cancer Institute, Woditschka and colleagues identified a role for the DNA repair genes BARD1 and RAD51 and oxidative damage in brain metastases in breast cancer. The two genes were implicated in expression profiling of 23 matched resected brain...

Expect Questions About Pertuzumab for HER2-Positive Breast Cancer

The 56.5-month overall survival for women with HER2-positive metastatic breast cancer receiving first-line treatment with pertuzumab (Perjeta) in combination with trastuzumab (Herceptin) and docetaxel in the CLEOPATRA trial represents a 15.7-month survival advantage for those receiving pertuzumab...

breast cancer

Impressive Survival Data for Women With HER2-Positive Breast Cancer Increase First-Line Use of Pertuzumab/Trastuzumab

"Impressive,” “outstanding,” and “unprecedented” are among the terms used to describe the 56.5-month overall survival for women with HER2-positive metastatic breast cancer receiving first-line treatment with pertuzumab (Perjeta) in combination with trastuzumab (Herceptin) and docetaxel in the...

gastroesophageal cancer

Ramucirumab in Combination With Paclitaxel in Advanced Gastric or Gastroesophageal Junction Adenocarcinoma

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 November 5, 2014, ramucirumab (Cyramza) was approved for use...

issues in oncology

A Father and Son’s Journey Through Medicine

BOOKMARK Title: The Good Doctor: A Father, a Son, and the Evolution of Medical EthicsAuthor: Barron H. Lerner, MDPublisher: Beacon PressPublication date: May 13, 2014Price: $25.95; hardcover, 240 pages   One morning in 1996, an infectious disease specialist was making rounds when he and his team...

integrative oncology
pain management
symptom management

Acupuncture Treatment for Cancer Pain and Chemotherapy-Induced Peripheral Neuropathy

Acupuncture is a traditional Chinese medicine technique that involves inserting and manipulating filiform needles into specific points of the body to achieve a therapeutic effect. According to traditional Chinese medicine, disruptions in the flow of “vital energy” (qi) throughout the body are the...

colorectal cancer

Clinical Trials Actively Recruiting Patients With Colon or Rectal Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies of people with colon or rectal cancer in the newly diagnosed and metastatic settings. The studies include phase I, Ib, II, observational, and interventional trials investigating new drug...

2014 Ellen Stovall Award Presented to Giuliana Rancic, E! News Co-Anchor and Co-Host of The Fashion Police

As part of the Lilly Oncology On Canvas Art Competition, Lilly Oncology and the National Coalition for Cancer Survivorship created the Ellen Stovall Award in honor of Ellen Stovall, a tireless advocate for cancer survivors and former president and CEO of NCCS. The award recognizes those who use...

lung cancer

ASCO Endorses CAP/IASLC/AMP Guidelines for Molecular Testing of Patients With Non–Small Cell Lung Cancer

Personalized medicine is an established treatment concept for patients with advanced non–small cell lung cancer (NSCLC), and molecular characterization of tumors is crucial for choice of (first-line) therapy. As of right now, we have U.S. Food and Drug Administration (FDA)-approved drugs for two...

lung cancer

ASCO Endorses Guideline for Molecular Testing for Selecting Lung Cancer Patients for EGFR and ALK Inhibitor Treatment

ASCO has endorsed the recently developed joint College of American Pathologists (CAP), International Association for the Study of Lung Cancer (IASLC), and Association for Molecular Pathology (AMP) guideline on molecular testing for selection of patients with lung cancer for EGFR and ALK inhibitor...

skin cancer

BRAF/MEK Inhibition in BRAF-Mutant Advanced Melanoma

Preliminary evidence of efficacy for BRAF inhibitors as monotherapy in advanced melanoma first emerged in 2009.1 Phase II and III trials rapidly ensued for vemurafenib (Zelboraf) and dabrafenib (Tafinlar), leading to U.S. Food and Drug Administration (FDA) approval in 2011. As a result of melanoma...

issues in oncology
cost of care

Expert Panel Explores Cost, Value, and Patient-Centered Care in Cancer Treatment

In assessing a cancer treatment, cost and value are two key factors. So how, the moderator asked, do they enter into your everyday decisions? Tanisha Carino, PhD, Executive Vice President of Avalere Health, was speaking to a clinical oncologist, a patient advocate, a pharma executive, and a health...

head and neck cancer

Radiation Treatment for Facial Cancer, Boston, 1903

Diseases and cancers of the face were so visible and disfiguring that they were usually brought to the attention of a physician in their early stages. The effect and success produced by Finsen’s light therapy on lupus, eczema, psoriasis, other skin diseases and even infections, such as...

issues in oncology

Expert Panels Offer Five Proposals to Address Challenges in Regulating, Implementing Next-Generation Sequencing

At the third annual Blueprint for Drug/Diagnostic Co-Development forum, cohosted by Friends of Cancer Research in Washington, DC, and the Alexandria Center for Life Science in New York, two panels tackled considerations in simultaneous development of drugs and companion diagnostics. Friends of...

palliative care

Dying in America: Ensuring High-Quality Care at the End of Life

In September, the Institute of Medicine (IOM) released its report Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life. The report argues that the U.S. health-care system subjects patients to too many—and often futile—interventions near the end of life, often ...

multiple myeloma

High-Dose Melphalan, Early Stem Cell Transplant, and Lenalidomide Maintenance in Myeloma: One Size Still Does Not Fit All

In an important recent study by Dr. Antonio Palumbo and colleagues,1 reviewed in this issue of The ASCO Post (page 128), 273 patients aged ≤ 65 years were randomly assigned to early transplant or consolidation therapy using MPR (melphalan, prednisone, and lenalidomide [Revlimid]) after successful...

NIH Awards Aim to Improve Understanding of Cell Pathways, Development of New Therapies

Building on a successful 3-year pilot project, the National Institutes of Health (NIH) has awarded more than $64 million to six individuals at five research institutions to create a database of human cellular responses—the Library of Integrated Network-based Cellular Signatures (LINCS)....

supportive care

Fixed-Combination Netupitant/Palonosetron for Prevention of Chemotherapy-Induced Nausea and Vomiting

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 October 10, 2014, oral fixed-combination netupitant and...

gastroesophageal cancer

FDA Approves Ramucirumab in Combination With Paclitaxel for Advanced Gastric or Gastroesophageal Junction Adenocarcinoma

The U.S. Food and Drug Administration (FDA) has approved ramucirumab (Cyramza) for use in combination with paclitaxel for the treatment of patients with advanced gastric or gastroesophageal junction adenocarcinoma. Ramucirumab was approved in April 2014 as a single agent for the treatment of...

hematologic malignancies
solid tumors
issues in oncology

Top 10 Myths About FDA’s Office of Hematology and Oncology Products

INSIDE THE BLACK BOX is an occasional column providing insight into the U.S. Food and Drug Administration (FDA) and its policies and procedures. In this installment, FDA oncologists Gideon Blumenthal, MD, and Tatiana Prowell, MD, discuss 10 common myths about FDA’s Office of Hematology and Oncology ...

lymphoma

Bortezomib in Previously Untreated 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.   On October 9, 2014, bortezomib (Velcade) was granted approval for ...

skin cancer
cost of care

U.S. Skin Cancer Costs Rise From 2002 Through 2011

The costs associated with skin cancer increased five times as fast as treatments for other cancers between 2002 and 2011, according to a Centers for Disease Control and Prevention (CDC) study published online in the American Journal of Preventive Medicine.1 The average annual cost for skin cancer...

gynecologic cancers

Maintenance Therapy in Ovarian Cancer: What’s at Stake?

Maintenance therapy in ovarian cancer refers to a cohort of women achieving response to initial adjuvant chemotherapy who then go on to additional therapy in the hopes of extending time to recurrence or inducing a lasting remission. The concept is not new and retains its scientific and clinical...

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