Clinical Cancer Advances 2013: Annual Report on Progress Against Cancer From the American Society of Clinical Oncology

Abstract

Since its founding in 1964, the American Society of Clinical Oncology (ASCO) has been committed to improving cancer outcomes through research and the delivery of quality care. Research is the bedrock of discovering better treatments--providing hope to the millions of individuals who face a cancer diagnosis each year. The studies featured in "Clinical Cancer Advances 2013: Annual Report on Progress Against Cancer From the American Society of Clinical Oncology" represent the invaluable contributions of thousands of patients who participate in clinical trials and the scientists who conduct basic and clinical research. The insights described in this report, such as how cancers hide from the immune system and why cancers may become resistant to targeted drugs, enable us to envision a future in which cancer will be even more controllable and preventable. The scientific process is thoughtful, deliberate, and sometimes slow, but each advance, while helping patients, now also points toward new research questions and unexplored opportunities. Both dramatic and subtle breakthroughs occur so that progress against cancer typically builds over many years. Success requires vision, persistence, and a long-term commitment to supporting cancer research and training. Our nation's longstanding investment in federally funded cancer research has contributed significantly to a growing array of effective new treatments and a much deeper understanding of the drivers of cancer. But despite this progress, our position as a world leader in advancing medical knowledge and our ability to attract the most promising and talented investigators are now threatened by an acute problem: Federal funding for cancer research has steadily eroded over the past decade, and only 15% of the ever-shrinking budget is actually spent on clinical trials. This dismal reality threatens the pace of progress against cancer and undermines our ability to address the continuing needs of our patients. Despite this extremely challenging economic environment, we continue to make progress. Maintaining and accelerating that progress require that we keep our eyes on the future and pursue a path that builds on the stunning successes of the past. We must continue to show our policymakers the successes in cancer survival and quality of life (QOL) they have enabled, emphasizing the need to sustain our national investment in the remarkably productive US cancer research enterprise. We must also look to innovative methods for transforming how we care for-and learn from-patients with cancer. Consider, for example, that fewer than 5% of adult patients with cancer currently participate in clinical trials. What if we were able to draw lessons from the other 95%? This possibility led ASCO this year to launch CancerLinQ, a groundbreaking health information technology initiative that will provide physicians with access to vast quantities of clinical data about real-world patients and help achieve higher quality, higher value cancer care. As you read the following pages, I hope our collect...

MANAGEMENT OF ENDOCRINE DISEASE: Acromegaly and cancer: an old debate revisited

“…Most studies include small numbers of individuals, with no statistical power to adjust the data for confounding factors, such as age and gender. The comparison between older and more recent series is challenging, as both cancer incidence in the general population and life expectancy in patients with acromegaly have dramatically changed over the past few decades, influencing the prevalence of disease-associated morbidities (2,29). In addition, population-based cancer registries and epidemiology may vary from site to site (29).…”

“…The comparison between older and more recent series is challenging, as both cancer incidence in the general population and life expectancy in patients with acromegaly have dramatically changed over the past few decades, influencing the prevalence of disease-associated morbidities (2,29). In addition, population-based cancer registries and epidemiology may vary from site to site (29). Finally, another source of biases is the heterogeneity of comparative control populations used in the studies, which have varied from data published in literature to hospitalized non-acromegaly patients, matched controls, or the general population.…”

Appropriate use of tumour biomarkers for treatment with innovative drugs: A retrospective study

“…Overall, it was observed that EGFR determination was requested at different stages of NSCLC history, confirming that, at the time of this monitoring survey, different approaches to NSCLC were possible. Nearly two-thirds of all patients with lung adenocarcinoma harbour at least one mutation in known lung cancer driver genes, and patients whose treatment is targeted specifically to those drivers show improved survival (19). Thus, close monitoring of biological determinations, their timing and the subsequent choice of treatment may be required to optimise therapeutic appropriateness and cost-effectiveness.…”

A Prospective Observational Study to Examine the Relationship between Quality of Life and Adverse Events of First-line Chemotherapy Plus Cetuximab in Patients with KRAS Wild-type Unresectable Metastatic Colorectal Cancer: QUACK Trial

“…Therefore, for patients with never resectable CRC who are asymptomatic or without imminent symptoms and at limited risk for rapid deterioration, the aim of therapy is to prevent tumour progression and prolong life while maintaining quality of life (QoL) (8). Importantly, incorporating the patient's perspective, including their values and priorities about treatment can assure personalized and appropriate shared decision making because those patients require information not only related to survival estimated, but also regarding HRQoL in the treatment (10,11). In the CRYSTAL study, the administration of FOLFIRI plus cetuximab was associated with significantly more severe skin toxicity (19.7 vs. 0.2%), including acne-like rash, dry skin, paronychia, infusion-related reactions (2.5 vs. 0%) and diarrhoea (15.7 vs. 10.5%) than administration of FOLFIRI alone (12).…”