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symptom management

How to Measure the Impact of Dermatologic and Mucosal Adverse Events on Symptom Burden and Quality of Life

Targeted anticancer therapies like epidermal growth factor receptor (EGFR) inhibitors, multitargeted tyrosine kinase inhibitors (mTKIs), and mammalian target of rapamycin (mTOR) inhibitors frequently result in dermatologic adverse events and mucosal adverse events, or, taken together, mucocutaneous ...

issues in oncology

Patient-Reported Outcomes, a Central Component to Value and Rapid-Learning Systems

With the passage of the Patient Protection and Affordable Care Act in 2010, value became the operative word in assessing the success of health care, from outcomes to cost. To drive more value, the Affordable Care Act seeks to implement initiatives such as comparative effectiveness research that...

Expert Point of View: Daniel F. Hayes, MD, FASCO

Daniel F. Hayes, MD, FASCO, the Stuart B. Padnos Professor of Breast Cancer Research at the University of Michigan, Ann Arbor, wrote an accompanying editorial on the value of these newly developed omics-related criteria.1 Dr. Hayes pointed out that since the cloning of the human genome, there has...

issues in oncology

Sharing Treatment Decision-Making With Patients: Where’s the Evidence of Value?

Though certainly not new to oncologists, “shared decision-making” between doctors and patients is receiving increased attention in the medical community today. While it’s an idea with merit, Steven J. Katz, MD, MPH, a specialist in quality care issues, maintains that expectations about the...

With the Goal of Curing Cancer, Ezra M. Greenspan, MD, Helped Usher in the Modern Era of Chemotherapy

Two events in Ezra M. Greenspan’s early adult life convinced him to pursue a career in medicine: the death of a college friend from pneumonia when the two were students at Cornell University College of Arts and Sciences and his own bout with the disease soon after. Saved by a local physician who...

prostate cancer

Inhibition of LAT Transporters and Leucine Uptake: A Step Forward for Therapeutic Strategies in Prostate Cancer  

The seminal study by Wang and colleagues reported in the Journal of the National Cancer Institute1 and reviewed in this issue of The ASCO Post suggests a potential new therapeutic option in the treatment of advanced prostate cancer. The authors draw attention to the reliance of cancer cells on...

ASCO Honors New Group of Members With FASCO Distinction

Formerly called the ASCO Statesman Award, the Fellow of the American Society of Clinical Oncology (FASCO) distinction recognizes ASCO members for their extraordinary volunteer service, dedication, and commitment to ASCO. Their efforts benefit ASCO, the specialty of oncology, and, most importantly,...

issues in oncology

ESMO Releases Position Paper on Med-Oncs' Role in Cancer Care

A new position statement from the European Society for Medical Oncology (ESMO) reports that medical oncologists have a vital role to play in cancer care.1 According to the position statement, medical oncologists are specialist cancer physicians trained to provide treatment with drugs, spanning from ...

lung cancer

Lung Cancer Screening Facts

The U.S. Preventive Services Task Force has posted a supplemental fact sheet for clinicians on its final recommendation statement on screening for lung cancer.1 This resource is meant to help health-care professionals talk about lung cancer screening with their patients and determine if screening...

Corrections to Note

In the January 15, 2014, issue of The ASCO Post, three errors occurred. These errors have since been corrected and revised versions of the articles may be viewed online at ASCOPost.com or via the QR code here. The errors were as follows below. Trastuzumab Dosing In the article “HER2-Positive...

integrative oncology

Kava

Kava Scientific Name: Piper methysticum Common Names: Kava-kava, kawa, kavain, rauschpfeffer, intoxicating long pepper, tonga, yagona, and yaqona. Overview Kava, a perennial shrub indigenous to the Hawaiian Islands and the Pacific Rim, is known for its relaxant effects and used for social and...

breast cancer

Switching Chemotherapy Based on Elevated Circulating Tumor Cells Does Not Change Outcome in Metastatic Breast Cancer

Elevated circulating tumor cells were prognostic for survival but did not pan out as a marker for switching after one cycle of chemotherapy in patients with metastatic breast cancer. The phase III Southwest Oncology Group (SWOG) S0500 clinical trial, presented at the 2013 San Antonio Breast Cancer...

City of Hope’s New Chief Scientific Officer and Cancer Center Director Reflects on His Career Path and the Future of Cancer Care

City of Hope in Duarte, California, has named Steven T. Rosen, MD, as its first Provost and Chief Scientific Officer. Dr. Rosen will guide the scientific direction of the center’s medical research, treatment, and education. He will also assume directorship of the comprehensive cancer institute,...

breast cancer

Overdiagnosis of Breast Cancer: New Research Directions

Currently, one of the most challenging problems in oncology is to accurately predict whether neoplastic lesions detected by screening tests will progress. The focus on developing ever-more sensitive cancer screening tests has produced the clinical dilemma of overdiagnosis. Overdiagnosis occurs when ...

breast cancer

The Canadian National Breast Screening Trial Had So Many Flaws That Its Results Should Not Be Used to Guide Screening Recommendations

If a randomized, controlled trial of therapy for breast cancer was submitted for publication in which 1. The drug being tested was old and ineffective, and 2. prior to randomization, the women underwent a clinical breast examination and the study coordinators knew who had the largest cancers, and...

breast cancer

Flaws in CNBSS Are Vast, Impact on Screening Recommendations Is Nil

The recent report from the Canadian National Breast Screening Study (CNBSS)—published in BMJ and reviewed in The ASCO Post, early release online—concluded that annual mammography in women aged 40 to 59 does not result in a reduction in mortality from breast cancer beyond that of physical...

Expert Point of View: Michael J. Morris, MD, and Maha H. Hussain, MD, FACP, FASCO

Commenting on the ALSYMPCA follow-up study presented at the Genitourinary Cancers Symposium, Michael J. Morris, MD, a medical oncologist at Memorial Sloan Kettering Cancer Center, New York, said that radium-223 was a very effective and safe drug, but its actual target and mechanism of action are...

issues in oncology

Task Force Recommends Against Beta-Carotene or Vitamin E Supplements for Primary Cancer Prevention

The U.S. Preventive Services Task Force (USPSTF) recommends against the use of beta-carotene or vitamin E supplementation for the primary prevention of cancer or cardiovascular disease, according to an updated recommendation statement published in the Annals of Internal Medicine. “The USPSTF found...

gastrointestinal cancer

Ongoing Clinical Trials Actively Recruiting Patients With Gastrointestinal Cancers

This Clinical Trials Resource Guide is meant to increase awareness of currently recruiting NCI- or academic institution–sponsored clinical studies for your patients with gastrointestinal cancers. All of the studies are listed on the National Institutes of Health website at ClinicalTrials.gov, and...

breast cancer

National Program to Screen Ashkenazi Women in Israel for BRCA Mutations Is Being Explored

Citing a World Health Organization report that lists Israel as having one of the highest rates of breast cancer in the world, The New York Times reported on a proposed screening program to identify women with BRCA1 and BRCA2 mutations.1 “A number of influential geneticists and cancer doctors from...

colorectal cancer

Colorectal Cancer Screening: Quality Measures Should Focus on Patient Benefit Over Age Alone, Study Reports

Screening for colorectal cancer based on age alone may contribute to both underuse and overuse of colonoscopy, sigmoidoscopy, and fecal occult blood testing among older people, according to a study by investigators at the University of Michigan and the Veterans Affairs Center for Clinical...

breast cancer

Breast Reconstruction Has Increased Over Time but Varies Widely by Region

Analysis of data from 20,560 women undergoing mastectomy for breast cancer found that breast reconstruction use “increased from 46% in 1998 to 63% in 2007 (P< .001), with increased use of implants and decreased use of autologous techniques over time (P < .001),” according to a report...

prostate cancer

Prostate Cancer Study Showing Increased Survival for Younger Men Undergoing Prostatectomy Not Expected to Increase Surgeries

Extended follow-up in the Scandinavian Prostate Cancer Group Study Number 4 (SPCG4), reported recently in The New England Journal of Medicine,1 found that men with early-stage prostate cancer, particularly those under 65 years old, who were treated with radical prostatectomy had increased survival...

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...

NCI Awards for Extramural/Intramural Research

Three of the 10 projects recently awarded grants by the National Institutes of Health (see page 73) focused on cancer research. These include the following: Grant No. 1 U01 CA18303001 Title: Therapeutic Elimination of Stem Cells for Relapsed Pediatric AML Extramural Investigators: Drs. Yang Liu,...

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,...

breast cancer

Targeting Cancer Stem Cells in Breast Cancer: A Potential Clinical Strategy

Preclinical models have suggested that cancer stem cells play a role in tumor recurrence and metastasis following adjuvant therapy, and Max S. Wicha, MD, and his research team are deciphering the mechanisms by which this might happen. A true understanding of cancer stem cells will have important...

breast cancer

Overdiagnosis of Breast Cancer: New Research Directions

Currently, one of the most challenging problems in oncology is to accurately predict whether neoplastic lesions detected by screening tests will progress. The focus on developing ever-more sensitive cancer screening tests has produced the clinical dilemma of overdiagnosis. Overdiagnosis occurs when ...

breast cancer

The Canadian National Breast Screening Trial Had So Many Flaws That Its Results Should Not Be Used to Guide Screening Recommendations

If a randomized, controlled trial of therapy for breast cancer was submitted for publication in which 1. The drug being tested was old and ineffective, and 2. prior to randomization, the women underwent a clinical breast examination and the study coordinators knew who had the largest cancers, and...

breast cancer

Flaws in CNBSS Are Vast, Impact on Screening Recommendations Is Nil

The recent report from the Canadian National Breast Screening Study (CNBSS)—published in BMJ and reviewed in this issue of The ASCO Post—concluded that annual mammography in women aged 40 to 59 does not result in a reduction in mortality from breast cancer beyond that of physical examination alone...

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...

lymphoma

Ongoing Clinical Trials Actively Recruiting Patients With Hodgkin Lymphomas

The information in this Clinical Trials Resource Guide includes details of actively recruiting clinical studies of patients with Hodgkin lymphomas, including patients with human immunodeficiency virus–associated and Epstein-Barr virus–positive Hodgkin lymphoma. Two of the studies are also...

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...

breast cancer

PALOMA-1 Trial Finds Palbociclib/Letrozole Doubles Progression-Free Survival in Metastatic Breast Cancer

First-line treatment with the combination of palbociclib plus letrozole extended progression-free survival by approximately 50% in patients with metastatic estrogen receptor–positive, HER2-negative breast cancer, according to final results of the PALOMA-1 trial, a randomized phase II study...

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...

global cancer care

American Society of Clinical Oncology Honors Researchers, Patient Advocates, and Leaders of the Global Oncology Community

Leaders in cancer care will be recognized as part of the American Society of Clinical Oncology Special Awards Program at the 2014 ASCO Annual Meeting. The Special Awards recognize the dedication and significant contributions of researchers, patient advocates, and leaders of the global oncology...

breast cancer

Lymphedema Lingers Long After Sentinel Lymph Node Dissection for Early Breast Cancer

Patients with early-stage breast cancer who underwent sentinel lymph node dissection experienced lymphedema with increasing incidence over time, according to a presentation at the 2014 Society of Surgical Oncology (SSO) Cancer Symposium in Phoenix.1 In women who took part in the American College of ...

breast cancer
colorectal cancer
lung cancer
prostate cancer
skin cancer
leukemia
lymphoma
multiple myeloma
survivorship

NCCN Clinical Practice Guidelines in Oncology: 2014 Updates

At the 19th Annual Conference of the National Comprehensive Cancer Network (NCCN), held recently in Hollywood, Florida, NCCN Panel members presented updates for several tumor types, briefly summarized here. For a more complete description of all updates, visit www.nccn.org. Breast Cancer Guidelines ...

integrative oncology

St. John's Wort

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...

issues in oncology

Randomized Trials vs Meta-analyses: Which Is the Better Bet?

Two surgical oncology experts who squared off in a “Great Debate” at the 2014 Society of Surgical Oncology (SSO) Annual Cancer Symposium in Phoenix. Heidi Nelson, MD, Professor of Surgery at the Mayo Clinic in Rochester, Minnesota, argued for the superiority of randomized controlled trials in...

breast cancer

Margin Reassessment in Breast-Conservation Therapy

Significant progress has been made in local-regional and systemic treatments of breast cancer. Most patients currently diagnosed with breast cancer in the United States are diagnosed with early-stage disease and achieve excellent outcomes with breast-conservation therapy. Indeed, outcomes have...

breast cancer

ASCO Endorses SSO/ASTRO Guideline on Margins for Breast-Conserving Surgery With Whole-Breast Irradiation in Stage I/II Breast Cancer

As reported in the Journal of Clinical Oncology,1 ASCO has endorsed the recently published Society of Surgical Oncology (SSO) and American Society for Radiation Oncology (ASTRO) consensus guideline on margins for breast-conserving surgery with whole-breast irradiation in stage I and II invasive...

survivorship

Study Calls for Revisiting Guidelines for Screening Childhood Cancer Survivors at Risk of Congestive Heart Failure

One of the first studies to analyze the effectiveness of screening survivors of childhood cancer for early signs of impending congestive heart failure found improved health outcomes but suggests that less frequent screening than currently recommended may yield similar clinical benefit. The...

colorectal cancer

Surveillance After Colon Cancer Surgery: Too Much of a Good Thing?

Finding salvageable colon cancer recurrence is akin to finding a needle in a haystack, rendering routine patient surveillance of little value. But finding that needle offers an opportunity for treating recurrent disease early, which makes surveillance worthwhile. These were the opposing views...

colorectal cancer
geriatric oncology

Colorectal Cancer Screening Recommended Past Age 75 for Previously Unscreened Patients

Colorectal cancer screening is cost-effective and “should be considered well beyond age 75 years” for individuals not previously screened, according to a computer simulation study published in the Annals of Internal Medicine. The researchers noted that while the U.S. Preventive Services Task Force...

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...

breast cancer

Issues in the Management of the Axilla in Patients With Breast Cancer

For the past 40 years the story of breast cancer surgery in general, and for the past 20 years the management of the axilla in particular, has been one of increasing conservatism. To give our readers insight into the current and future direction of axillary management, The ASCO Post spoke with...

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