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integrative oncology

Milk Thistle

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...

breast cancer

Clinical Trials Actively Recruiting Patients With Breast Cancer

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies for people with breast cancer. The studies include phase I and II, interventional, and observational trials evaluating new therapies; diagnostic tools; genetic counseling; the association ...

prostate cancer

Primary Androgen Deprivation Does Not Improve Long-Term Survival in Older Patients With Localized Prostate Cancer

Primary androgen-deprivation therapy has been widely used in localized prostate cancer, despite the absence of definitive evidence of benefit in early-stage disease. In a large population-based cohort study reported in JAMA Internal Medicine, Grace L. Lu-Yao, MPH, PhD, of Rutgers Cancer Institute...

lymphoma

Lympho-Sarcoma Treated by Radiation, Patient of Francis H. Williams, MD, Boston, 1902

One of the miracles produced by the x-ray was the relatively easy treatment of inoperable or disfiguring tumors. If not a cure, the results frequently gave the patients at least some time to look and feel normal. The young patient shown in these photographs had a remarkable response. Images such as ...

breast cancer

First Photographs of Breast Surgery, New York City, 1886

Antiseptic principles delivered the promise of safe surgery, while asepsis allowed safe major dissections and invasion of body cavities. The physicians who were using these techniques recognized the amazing difference in their surgical results and corresponding mortality rates and proselytized to...

100 Years of Progress in Oncology Treatment

In his powerful 2010 best-seller, The Emperor of All Maladies: A Biography of Cancer (Scribner), Siddhartha Mukherjee, MD, chronicles the evolution of cancer from the oldest known description of the disease written on a papyrus from about 1600 BC to the present day’s understanding of the biology of ...

issues in oncology

Choosing Wisely® Campaign Identifies Five Radiation Treatments Not for Routine Use

The American Society for Radiation Oncology (ASTRO) reported a second list of five radiation oncology treatments that should not be used routinely in clinical practice on day 1 of the Society’s 56th Annual Meeting.1 These five treatments should be discussed in depth with patients prior to being...

sarcoma

Treating Sarcomas in 2014

In 2014, about 15,000 people in the United States will be diagnosed with some form of sarcoma, and of those, approximately 5,000 adults and children are expected to die of the disease. Sarcomas are a heterogeneous group of mesenchymal malignancies that have historically been difficult to diagnose...

prostate cancer

Enzalutamide in Metastatic Castration-Resistant Prostate 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.   On September 10, 2014, the androgen receptor inhibitor...

supportive care

Improving Treatment of Depression in Patients With Cancer: The SMaRT Oncology-2 Trial

Clinical depression is highly prevalent, associated with significant morbidity, often underrecognized, and inadequately treated in cancer patients.  Professor Michael Sharpe and Jane Walker, PhD, and their colleagues’ seminal work on enhancing treatment of depression in cancer patients using a...

supportive care

Integrated Collaborative Care Program Highly Successful in Treating Major Depression in Patients With Cancer

In the Scottish SMaRT Oncology-2 study reported in The Lancet, Michael Sharpe, MD, and Jane Walker, PhD, of University of Oxford, United Kingdom, and colleagues found that an integrated collaborative treatment program for depression (“depression care for people with cancer”) was associated with...

cns cancers

CENTRIC Trial Shows No Benefit of Adding Cilengitide to Therapy in Glioblastoma With Methylated MGMT Promoter

In the phase III CENTRIC/European Organisation for Research and Treatment of Cancer (EORTC) 26071-22072 trial reported in The Lancet ­Oncology, Roger Stupp, MD, of University Hospital Zurich, and colleagues found that adding the selective αvβ3 and αvβ5 integrin inhibitor cilengitide to standard...

ASCO, AACR Urge FDA to Regulate All Tobacco Products—Including E-Cigarettes

ASCO and the American Association for Cancer Research (AACR) sent a joint letter to the U.S. Food and Drug Administration (FDA) urging the agency to regulate electronic cigarettes, cigars, and all other tobacco products and to strengthen the proposed regulations for newly deemed products. The...

New Series Features Interviews With Authors of JCO and JOP Research

Journal of Clinical Oncology (JCO) and Journal of Oncology Practice (JOP) “Exclusive Coverage” summaries, available on ASCO.org and ASCO Connection, are designed to provide quick insight and additional author perspectives on select recently published studies. Based on interviews conducted with the...

issues in oncology

Fellows’ Expectations of Work-Life Balance Not in Line With Realities of Practice

Oncology fellows just years away from entering the profession full time may have unrealistic expectations of their future career, according to data published recently in the Journal of Clinical Oncology. The study by Tait D. Shanafelt, MD, of the Mayo Clinic, Rochester, Minnesota, and colleagues...

lymphoma

ECOG E4402/RESORT Trial: When ‘Black and White’ Results Are Actually Gray

The results of the ECOG E4402/RESORT trial recently reported by Kahl and colleagues,1 and reviewed in this issue of The ASCO Post, provide interesting new information on the use of maintenance rituximab (Rituxan) vs retreatment with rituximab at progression in patients with low–tumor burden...

lymphoma

Time to Treatment Failure Similar With Rituximab Retreatment vs Maintenance in Low–Tumor Burden Follicular Lymphoma

Maintenance rituximab (Rituxan) has been shown to improve progression-free survival vs observation in low–tumor burden follicular lymphoma. In the Eastern Cooperative Oncology Group (ECOG) E4402 Trial ­(RESORT), reported in the Journal of Clinical Oncology, Brad S. Kahl, MD, of the University of...

kidney cancer

Advanced Robotic Technology Used to Remove Kidney Tumor in First-Time Outpatient Procedure

Keck Medical Center of the University of Southern California (USC) has become the first medical center in the world to use a new robotic technology in an outpatient procedure for a patient with kidney cancer. Urologic surgeons at the USC Institute of Urology, part of Keck Medicine of USC, used a...

skin cancer

First Approval of PD-1 Inhibitor: Pembrolizumab in Unresectable or Metastatic Melanoma

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 September 4, 2014, pembrolizumab (Keytruda) was granted...

issues in oncology

Exceptional Responders to Cancer Therapy Study Begins

The National Cancer Institute (NCI) recently launched “The Exceptional Responders Initiative,” a study to investigate the molecular factors of tumors associated with exceptional treatment responses of patients with cancer to drug therapies. Scientists will attempt to identify the molecular features ...

pain management

Despite Growing Awareness, the Global Crisis of Untreated Cancer Pain Persists

Each day, millions of patients with cancer around the world suffer unrelieved pain because they are denied morphine, the gold standard of cancer pain control. The World Health Organization has called access to morphine a human rights issue. Not surprisingly, the crisis in unrelieved cancer pain is...

supportive care

Life-Threatening Dermatologic Toxicity

A variety of life-threatening dermatologic adverse events may occur in association with cancer drug therapies. Here, we discuss the recognition and management of three types of such toxicities: type I hypersensitivity/anaphylaxis, Stevens-Johnson syndrome/toxic epidermal necrolysis, and drug rash...

global cancer care

NCI’s Center for Global Health Announces First Major Research Grants to Support Portable Technologies

The National Cancer Institute (NCI) Center for Global Health announced grants that will support the development and validation of low-cost, portable technologies. These technologies have the potential to improve early detection, diagnosis, and noninvasive or minimally invasive treatment of several...

gynecologic cancers

Call for Ideas for Ovarian Cancer Translational Research ‘Dream Team’ Grant

The American Association for Cancer Research (AACR) is accepting submissions of ideas for the Stand Up To Cancer–Ovarian Cancer Research Fund–Ovarian Cancer National Alliance–National Ovarian Cancer Coalition (SU2C-OCRF-­OCNA-NOCC) Translational Research Dream Team Grant that will offer up to $6...

breast cancer

Guidelines and Care: What Comes Next?

The goal of clinical, translational, and basic research is, in the end, the betterment of life on earth. Advances in basic and clinical science ultimately should lead to information that, in turn, enables clinicians to make better treatment decisions for individual patients in order to improve...

breast cancer

ASCO Clinical Practice Guideline: Chemotherapy and Targeted Therapy in Advanced HER2-Negative or HER2 Status–Unknown Breast Cancer

The American Society of Clinical Oncology has released a new clinical practice guideline on chemotherapy and targeted therapy for women with advanced HER2-negative or HER2 status–unknown breast cancer. The guideline is published in the Journal of Clinical Oncology.1 In formulating the consensus...

Expert Point of View: William M. Sikov, MD

At the Breast Cancer Symposium, William M. Sikov, MD, Associate Professor of Medicine at the Warren Alpert Medical School of Brown University, Providence, Rhode Island, gave a talk on the use of pathologic complete response in the clinic and summarized the CTNeoBC findings for The ASCO Post. “The...

breast cancer

CTNeoBC Analysis: Response to Neoadjuvant Chemotherapy Varies by Breast Tumor Subtype

Women who achieve a pathologic complete response (pCR) to neoadjuvant chemotherapy rarely have local or regional recurrence of breast cancer, but this largely depends on tumor subtype, which remained an independent predictor of locoregional recurrence when pathologic response was taken into account ...

breast cancer

Fertility Preservation Suggested With Triptorelin in Long-Term Study

Young women with early breast cancer may be more likely to resume menses and become pregnant when treated with a luteinizing hormone–releasing hormone (LH-RH) analog (also known as a gonadotropin-releasing hormone [GnRH] analog) along with chemotherapy, according to the final follow-up of...

breast cancer
survivorship

Testosterone/Anastrozole Implants Relieve Menopausal Symptoms in Breast Cancer Survivors

Subcutaneous implants containing testosterone in combination with a low dose of anastrozole can relieve menopausal symptoms in breast cancer survivors, according to research presented at the 2014 ASCO Breast Cancer Symposium.1 “Menopausal symptoms can be quite severe in breast cancer survivors in...

breast cancer

Pathologic Complete Response: Understanding the Subtleties

In the neoadjuvant treatment of breast cancer, the importance of achieving a pathologic complete response (pCR) varies substantially by breast cancer subtype. Patients are increasingly interested in this outcome, but it means different things to different patients, according to two breast cancer...

lung cancer

Managing Resistance to Targeted Agents: The Future of NSCLC Therapy

The bane of treating non–small cell lung cancer (NSCLC) patients with druggable mutations has been the development of resistance to targeted agents. New compounds are meeting the challenge of treating resistant disease, according to Fadlo R. Khuri, MD, FACP, Professor and Chair of Hematology and...

head and neck cancer

Lymphatic Mapping Agent Receives Orphan Drug Designation for Head and Neck Cancers

Navidea Biopharmaceuticals, Inc, recently announced that technetium 99m tilmanocept (Lymphoseek Injection) has been granted Orphan Drug Designation by the U.S. Food & Drug Administration (FDA) for use in sentinel lymph node detection in patients with cancer of the head and neck. The designation ...

lung cancer

Study in Survivors of NSCLC Reports Lower Risk of Developing Secondary Primary Lung Cancers in Never and Former Smokers vs Current Smokers

Survivors of non–small cell lung cancer (NSCLC) who never smoked or who are former smokers at the time of diagnosis have a lower risk of developing secondary primary lung cancers compared to those who are current smokers, suggesting that increased tobacco exposure is associated with a higher risk...

gastroesophageal cancer
palliative care

Radiation Alone Is as Effective as and Less Toxic Than Chemoradiation for Advanced Esophageal Cancer

Radiation therapy alone was found to be as effective as chemoradiation in reducing dysphagia associated with advanced esophageal cancer in the palliative setting and was less toxic, according to results of a multinational phase III trial called the Trans-Tasman Radiation Oncology Group (TROG) 03.01 ...

Expert Point of View: Kenneth B. Roberts, MD

This is a provocative study, showing unexpected differences in acute skin reactions with conventional fractionation vs hypofractionation. Some studies have failed to show differences in acute toxicities between these two types of radiation therapy,” said Kenneth B. Roberts, MD, Professor of...

lymphoma

Radiation Therapy Improves 10-Year Survival for Patients With Early Hodgkin Lymphoma, but Frequently Omitted in Treatment Plans

Adding consolidation radiation therapy to chemotherapy significantly improves 10-year survival in patients with stage I and II Hodgkin lymphoma, according to a large observational study based on the National Cancer Database (NCDB). Yet over that same 10-year period, radiation therapy use declined...

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...

lung cancer

Stereotactic Body Radiation Therapy Benefits Patients With Early-Stage Inoperable or Advanced Oligometastatic Lung Cancer

The door is open for expanded use of stereotactic body radiation therapy (SBRT) in patients with inoperable early-stage lung cancer and for patients with oligometastatic stage IV non-small cell lung cancer (NSCLC), according to results of two studies presented at the 56th Annual Meeting of the...

health-care policy
cost of care

Tough Questions About Health-Care Reform Put Economist in Hot Seat

Although diverse stakeholders agree that health reform is needed, there is little consensus on the specifics of that reform. Best of ASCO Seattle attendees put a number of pointed questions to health economist Rena Conti, PhD, of the University of Chicago, asking about thorny issues such as cost...

health-care policy

Health-Care Reform Is Changing the Oncology Landscape

Value-based health-care reform is happening. We have to get on board,” Rena Conti, PhD, a health economist at the University of Chicago, advised attendees of the Best of ASCO Seattle meeting. She discussed highlights from Annual Meeting sessions that addressed the impact of the Affordable Care Act...

Hippocratic Oath

I swear by Apollo the physician, and Asclepius, and Hygieia and Panacea and all the gods and goddesses as my witnesses, that, according to my ability and judgement, I will keep this Oath and this contract: To hold him who taught me this art equally dear to me as my parents, to be a partner in life...

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...

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