Miller on Oncology

 
 

  • Are Oncology Pathways 'Achieving the Goals We Promised'?   Dr Kathy Miller talks with Dr Robin Zon about ASCO's effort to assess clinical pathways programs, and whether pathways programs are transparent and evidence-based in their recommendations.
  • Clinical Pathways: Many Potential Benefits but 'More Work to Do'   Drs Miller and Zon discuss the current challenges associated with clinical pathways in oncology.
  • TAILORx Provides 'Clear Answer' for ER+ Breast Cancer   Lead investigator Joseph Sparano discusses the pivotal TAILORx trial presented at ASCO 2018. It's a 'great day for patients,' says Kathy Miller.
  • Long-Awaited TAILORx Results 'Will Impact Your Practice'   'Do not miss' the results of TAILORx this year at ASCO 2018, says Dr Kathy Miller, because they will likely affect management of ER-positive breast cancer.
  • 'False Hope' Over Immunotherapy? The Media's Misguided Effects   Dr Kathy Miller responds to a recent New York Times article documenting rare immunotherapy responses, which may lead to false hope among cancer patients and their families.
  • 'Cultural Change' in DCIS   Some think it's time to change how we talk about DCIS and to consider de-escalation of therapy. Drs Kathy Miller and Shelley Hwang discuss these hot topics and the COMET study at SABCS 2017.
  • Late Recurrence in ER- Positive Breast Cancer: Banking on Biomarkers   Evaluation of biomarkers after 5 years of standard therapy for hormone-positive breast cancer may help determine those at risk for recurrence and those who may need further endocrine therapy.
  • Will Immunotherapy Be a PANACEA for Breast Cancer?   Drs Kathy Miller and Sherene Loi discuss advances in immunotherapy for breast cancer, particularly in HER2-positive disease and TNBC.
  • For Low-Level HER2 Breast Cancer, Trastuzumab Is a No-Go   Although the study didn't turn out as hoped, NSABP B-47 will help inform the decision of whether patients with low-level HER2 breast cancer should receive trastuzumab.
  • Does Breast Cancer Risk REACT to Celecoxib?   Does this COX-2 inhibitor alter breast cancer risk? Dr Kathy Miller discusses the results of the REACT trial with its primary investigator, Dr Charles Coombes.
  • Hot Topics (and Hot Chilis): SABCS 2017   Dr Kathy Miller highlights potential practice-changing studies that she is looking forward to at SABCS 2017.
  • Two 'P' Words Top List of Hot Topics in Breast Cancer   Dr Kathy Miller points to PARP inhibitors and pertuzumab as highpoints of the breast cancer program at the upcoming ASCO meeting, including the plenary presentation of the OlympiAD trial.
  • Should High-Risk Breast Cancer Patients Go Back on an AI?   Drs Kathy Miller and Hyman Muss discuss implications of the MA-17R study on long-term AI therapy in breast cancer patients and what the study tells us about management of patients 65 or older.
  • Vitamin D: A New Intervention for Melanoma?   Does the association of low vitamin D levels and poor outcomes in melanoma patients point to supplementation as a potential intervention for melanoma?
  • Will Real-World 'Bias' of Big Data Improve Cancer Care?   Drs Kathy Miller and Peter Yu discuss how big data can complement the evidence derived from clinical trials, and why the 'bias' of big data is a valuable reflection of real-world practice.
  • Trastuzumab Biosimilar: An Understudy Waits in the Wings   Drs Miller and Rugo talk about the trastuzumab biosimilar and what it could mean for patient care worldwide, the lessons from a failed vaccine study, and a practice change that can prevent stomatitis.
  • Can Guidelines Spur Political Action in MBC?   Drs Cardoso and Miller discuss consensus guidelines that could improve care and median survival of metastatic breast cancer patients, if more clinicians worldwide were aware of them.
  • Breast Cancer: Big Questions Answered?   Dr Kathy Miller previews the top ASCO 2016 breast cancer studies, which may provide definitive answers about anthracyclines in HER2-negative BC and optimal duration for adjuvant aromatase inhibitors.
  • Bread Comas and Other Not-to-Miss Chicago Treats   Dr Kathy Miller shares her favorite Chicago pizzerias (the ones the locals want to keep secret) and other Chicago treats to enjoy during ASCO. Why not share your own Chicago guilty pleasures?
  • On Mother's Day, Let's Think About Our Patients   Dr Kathy Miller takes a moment to consider how cancer affects families, especially the children of cancer patients, and urges you to give a special hug to your patients who are mothers.
  • Big Data vs Breast Cancer Trials Raises Big Issues   Using big data in place of clinical trials to answer clinical questions may sound progressive. But judging from the results of a recent study, it raises big issues, says Dr Kathy Miller.
  • Ovarian Suppression in BC: Right or Wrong, Depending   Dr Kathy Miller asks ASCO guidelines author Dr Harold Burstein which early breast cancer patients should -- and should not -- receive ovarian suppression, and how best to manage its side effects.
  • Benefits of Additional Chemo in Residual Breast Cancer   Drs Kathy Miller and Bryan Schneider discuss the surprising CREATE-X findings, which show improved survival using more chemotherapy in triple-negative breast cancer patients with residual disease.
  • Out-of-Pocket Can Mean Cancer Meds Are Out   Drs Kathy Miller and Dawn Hershman discuss factors in adherence to cancer medications, including cost and side effects, and what clinicians can do to keep patients on their medications.
  • Not to Diss Denosumab, but More Data Needed in Breast Cancer   Is it time to jump on the bisphosphonate bandwagon? Drs Kathy Miller and George Sledge review the adjuvant use in breast cancer and discuss new data on denosumab to make sense of all the controversy.
  • From Bedside to Bench: A New Direction in Breast Cancer Research   Past AACR president Dr Carlos Arteaga describes translational studies and emerging therapies that are transforming the clinical practice of breast cancer.
  • Breast Cancer and Pregnancy: POSITIVE Study Welcome   Dr Kathy Miller discusses a study of outcomes among children born to women with cancer, and an ongoing study of stopping antiestrogen therapy for women with breast cancer who want to become pregnant.
  • Pembrolizumab Shows Durable Responses in TNBC   Single-agent PD-L1 antibodies in triple-negative breast cancer show exceptionally durable responses, raising hope for stronger responses with combination therapies, says Dr Hope Rugo from SABCS 2015.
  • Jury Still Out on Anthracyclines in HER2+ Breast Cancer   Dr Sara Tolaney highlights studies in HER2-positive breast cancer from SABCS 2015, including the less-than-definitive 10-year results of the BCIRG 006 study.
  • SABCS Promises 'Seismic Tremors' for Breast Cancer   Dr Kathy Miller previews several provocative and likely practice-changing studies to be presented at 2015 SABCS.
  • Oncologist Asks for Your Second Opinion   Dr Kathy Miller asks what you would do in a second-opinion workup to determine whether a breast cancer patient needs a change in management, and to compare it with the workup she actually received.
  • Money Talks: Solution to Soaring Costs of Cancer Drugs?   A panel of oncologists and patient advocates takes on the challenge of what to do about rising cancer care costs--and hits upon a solution both simple and challenging: talk to patients about money.
  • SHAVE a Big Plus in Breast Cancer   Dr Kathy Miller makes her top picks of breast cancer studies to watch at ASCO, noting trials in ER-positive and HER2-positive disease--and a small surgical study that may yield big benefits.
  • Is Patient’s 'Right to Try' Law All Wrong?   Indiana's new 'right to try' law, which allows terminally ill patients access to experimental drugs for compassionate use, offers nothing, but potential harm, says Dr Kathy Miller.
  • Pertuzumab and the Curious Case of Accelerated Registration   Drs Kathy Miller, Clifford Hudis, and George Sledge discuss the pros and cons of testing novel breast cancer treatments in the neoadjuvant setting, with special reference to pertuzumab.
  • Sorting Therapy Options in Locoregional Breast Cancer   Drs Richard Zellar and Kathy Miller, at SABCS 2014, discuss locoregional breast cancer therapies, including partial breast irradiation, surgery vs radiation of sentinel nodes, and DCIS scoring.
  • Weight Loss WINS in Breast Cancer   Women overweight when diagnosed with breast cancer have poorer outcomes. Drs Kathy Miller and Jennifer Ligibel discuss how to motivate patients to alter their lifestyles to lower their risk.
  • SABCS Wrap-up: Will TNT Quietly Change Practice?   Drs Kathy Miller and George Sledge review the surprises and intrigues of SABCS, from its start in 1977 to the best scientific and practice-changing studies presented in 2014.
  • HER2+ Therapy: Getting Less Toxic All the Time   Drs Kathy Miller and Clifford Hudis discuss at SABCS 2014 recent advances in HER2+ breast cancer, focusing on the growing interest in lowering the toxicity of therapy.
  • SOFT Yields Hard Data on Hormone Therapy   Drs Kathy Miller and Ann Partridge drill down on the practice-changing data from the SOFT trial, indicating which breast cancer patients should receive ovarian suppression.
  • TNT Refines Platinum Use in TNBC   Drs Kathy Miller and Andrew Tutt discuss the findings of the important TNT trial, which indicates the significance of knowing BRCA status in using platinums for triple-negative breast cancer.
  • SOFT Trial Landing at SABCS   Dr Kathy Miller's preview of SABCS 2014 spotlights key data in triple-negative, HER2+, and local-regional disease as well as the much-anticipated results from the SOFT trial.
  • BRCA Screening: Good Sense or Gattaca Rising?   Does population screening for BRCA mutations portend a eugenics future, as in 'Gattaca,' or a practical means to reduce the risk for breast and ovarian cancer? Dr. Kathy Miller weighs the issues.
  • Will Clinical Pathways Go the Way of the Dinosaur?   Dr. Kathy Miller contrasts standardization of therapy, as demonstrated by pathways, with the trend of individualizing care on the basis of genomics, and asks: Will pathways will lead to extinction?
  • 'Got It Right': Guidelines for HER2-Negative Breast Cancer   Dr. Kathy Miller says the ASCO guidelines for advanced HER2-negative breast cancer 'got it right,' focusing on HT, sequential chemo agents, and decisions made jointly by doctors and patients.
  • Is Fast MRI Better Than Mammography?   Dr. Kathy Miller reports on a study showing 'fast' MRI is faster, cheaper, and more accurate than conventional MRI, and is better than mammography for screening certain women for breast cancer.
  • ASCO President on the Triumph of the Open Mind   Dr. James Holland, president of ASCO in 1976-1977, talks to Dr. Kathy Miller about the early days of oncology, the society, and the humanist passion that is a driving force for both.
  • ASCO Presidents Survey 50 Years of Oncology   Three ASCO presidents chart the course of the Society -- and oncology as a whole -- over the past 50 years, from a tentative first meeting to a global influence for cancer research and practice.
  • Oncology and ASCO: A Family Affair   Drs. Erica Mayer and Robert Mayer, father and daughter oncologists and colleagues, talk about the bond created by their common work.
  • Results Flat in ALTTO Breast Cancer Trial   Drs. Kathy Miller and Karen Gelmon reflect on the major breast cancer data presented at ASCO 2014, and how they will influence practice.
  • Breast Cancer Preview: Critical Issues Resolved?   Dr. Kathy Miller sees a subspecialty in transition as she previews the breast cancer sessions at ASCO and highlights plenary studies that may resolve questions of critical importance to patients.
  • Prevention: Stop Cancer Before It Starts   Dr. Kathy Miller says prevention is the best way to improve cancer mortality and points out that cancer prevention should become the main focus of primary care practice.
  • The Hero Behind Dr. Larry Einhorn   Dr. Kathy Miller talks about John Cleland, who at age 23 with metastatic testis cancer enrolled in the first cisplatin-based trial in 1974, knowing that the investigational drug might offer him no benefit.
  • Breast Cancer Immunogenic: Who Knew? Drs. Kathy Miller and Christos Sotiriou have a candid discussion about tumor-infiltrating lymphocytes and their role in the prognosis and future treatment of breast cancer.
  • Finally! Data in Low-Risk HER2 Breast Cancer   Drs. Kathy Miller and Ian Krop talk about why a single-arm study in low-risk cancer is a huge advance for a population of understudied breast cancer patients.
  • 'Cutting Edge' in Local Breast Cancer Therapy Why has local therapy for breast cancer become more interesting, more complicated, and more important? Drs. Kathy Miller and Michael Dixon discuss the top studies in local therapy from SABCS 2013.
  • HOPE Gets the Breast Cancer Joint Rockin’ Exercise has many benefits for breast cancer survivors, including keeping them on their aromatase inhibitors. Drs. Kathy Miller and Jennifer Ligibel discuss results of the HOPE study from SABCS 2013.
  • Is Platinum the Silver Lining for TNBC? Drs. Kathy Miller and Hope Rugo discuss why platinum is a good option in triple-negative breast cancer, drawing from evidence presented at SABCS 2013.
  • The Whole Enchilada: What's Hot at SABCS 2013   Dr. Kathy Miller previews SABCS 2013, highlighting studies on platinum agents in triple-negative breast cancer, trends in local therapy, and whether CTC levels should guide therapy decisions.
  • Lifestyle Intervention: 5-Year Benefit in Prostate Cancer   A 3-month lifestyle intervention showed benefit at 5 years in men with low-risk prostate cancer, underscoring for Dr. Kathy Miller the importance of lifestyle in the lives of cancer patients.
  • Best Adjuvant Regimen for Early Breast Cancer   Reviewing available data, Dr. Kathy Miller gives her pick for the best adjuvant therapy regimen in early breast cancer -- one that provides efficacy at a lower cost and with less toxicity.
  • CIGNA Restricts Coverage of Genetic Testing   Dr. Kathy Miller reports on the potential harm that may come as a result of CIGNA's new policy that no genetic testing will be covered unless the patient first sees a genetic counselor.
  • Call It Cancer and Do Nothing? Untenable!   Cancer requires treatment, but what if low-risk lesions are no longer called cancer? Drs. Kathy Miller and Maurie Markman look at possible effects on screening, treatment, and public perception.
  • Larry Norton: From A to B in Breast Cancer   Drs. Kathy Miller and Larry Norton talk about breast cancer presentations at ASCO, from data on axillary radiation, aTTom, and adjuvant chemotherapy to BOLERO-3.
  • ASCO Plenary Session: Not Your Usual Suspects   Dr. Kathy Miller previews the exceptional studies to be presented at the ASCO plenary session, ranging from rare tumors of the brain and thyroid to a screening strategy that has global implications.
  • Angelina Jolie and the Power of the Informed Decision   Dr. Kathy Miller comments on the importance of genetic testing in women at high risk for breast cancer so that they can make personal, informed decisions about their care, as Angelina Jolie has done.
  • What Is 'Clinically Meaningful Benefit'?   An ASCO committee charged with defining 'clinically meaningful benefit' explored initial chemotherapy in patients with metastatic triple negative disease. Dr. Kathy Miller asks: Did we get it right?
  • Should States Be Setting Breast Screening Policy?   Indiana will soon pass legislation requiring that women undergoing mammography be notified of their breast density and its associated risk for cancer. Dr. Kathy Miller questions whether this is wise.
  • You Will Remember This Day   The FDA's approval of trastuzumab emtansine (T-DM1) for metastatic breast cancer, says Dr. Kathy Miller, marks a historic day in the fight against breast cancer.
  • Taking a Break After 100 Cycles of Bevacizumab   The last patient on the ECOG-2100 trial has stopped therapy after 100 cycles, and Dr. Kathy Miller reminds clinicians to treasure the exceptions for they can point the direction to new interventions.
  • SABCS Preview: Watch for Sentinel Node Studies   Dr. Kathy Miller highlights studies topping the bill at the 2012 San Antonio Breast Cancer Symposium, including 2 on the role of sentinel node surgery.
  • Delayed Nausea After Chemotherapy: 3 Questions Answered   Dr. Kathy Miller discusses a study on the prevention of delayed nausea in patients receiving chemotherapy, the results of which are instructive for improved management and cost savings.
  • Brave New World of Breast Cancer Therapy?   Dr. Kathy Miller reports on 2 high-profile genomic studies whose findings revolutionize concepts of sensitivity to therapy as well as acquired and intrinsic resistance.
  • Can Imaging Results Lead the Oncologist Astray?   Dr. Kathy Miller, who reports 2 cases of ER+ breast cancer in which radiology misidentified metastases, worries that oncologists are relying more on technology than on their own clinical savvy.
  • Between HIPAA and a Hard Place   Dr. Kathy Miller reports on an ethical dilemma: Should she violate HIPAA or let a terminally ill nurse return to work where his weakened capacity endangers himself and the patients under his care?
  • How Physicians Influence Patient Choices   The quality of information that physicians give patients affects their decisions, concludes Dr. Kathy Miller, who reports on a recent study in which a video helped patients to make end-of-life decisions.
  • Medicaid: Is Greater Access Worth It?   Given the Supreme Court's ACA ruling that will allow states to expand Medicaid coverage, the issue remains: Does greater access do good or harm -- and at what cost? Dr. Kathy Miller looks at a study that may provide answers.
  • Can Efficacy Be Derailed by Toxicity?   Dr. Kathy Miller discusses how treatment of patients with metastatic disease requires negotiation between the most effective and the most tolerable therapies, if durable PFS is to be achieved.
  • Plenary Session: 4 Critical Advances in Oncology   Dr. Kathy Miller previews the ASCO plenary session studies in breast cancer, prostate cancer, lymphoma, and oligodendroglioma, all 4 of which signal significant advances in science and treatment.
  • Early Reports on T-DM1 Breast Cancer Trial   Dr. Kathy Miller comments on early reports that a phase 3 trial of T-DM1 shows "substantially" increased survival in HER2-positive breast cancer patients.
  • Does Elevated Risk Require MRI?   Dr. Kathy Miller commends the American College of Radiology Imaging Network (ACRIN) for a recent study assessing the value of MRI in women at intermediate risk for breast cancer.
  • HER2-Positive Breast Cancer: The Next Testis Cancer?   With cure rates for HER2-positive breast cancer climbing, Dr. Kathy Miller says research may soon follow the direction taken in testis cancer: finding similar cure rates with less therapy and less toxicity.
  • How We Do Harm   Dr. Kathy Miller provides a short book review of Dr. Otis Brawley and Paul Goldberg's essential review of the US healthcare system.
  • Rebiopsy: Should New Finding Redirect Therapy?   If biopsy of metastatic breast cancer shows a phenotype that differs from that found at diagnosis, should the new finding redirect therapy? Dr. Kathy Miller gives her take on this complex issue.
  • Exercise: A Way to Outdistance Breast Cancer?   Dr. Kathy Miller reports on a study that shows that exercise can lessen the risk for breast cancer in sedentary postmenopausal women. Can exercise also improve breast cancer prognosis?
  • Must All DCIS Patients Undergo Radiation?   Dr. Kathy Miller reports on a new look at an old study that indicates how to identify DCIS patients at sufficiently low risk for local recurrence such that they do not need radiation after lumpectomy.
  • HER2-Positive Breast Cancer and Long Life   Dr. Kathy Miller takes another look at CLEOPATRA and predicts that dual HER2 blockade, when offered in the adjuvant setting, will make HER2+ breast cancer a disease patients can live with, for years.
  • Sniper Attacks in the War on Cancer   Drs. Kathy Miller and George Sledge talk about strategies, past and future, in the war on cancer.
  • Bevacizumab Gone: Where to From Here?   The FDA's withdrawal of bevacizumab for breast cancer prompts Dr. Kathy Miller to ask where we go from here for patients receiving benefit and for future studies in the metastatic setting.
  • SABCS Preview: New Data, Old Controversies   Dr. Kathy Miller previews studies to be presented at the San Antonio Breast Cancer Symposium, including the eagerly awaited CLEOPATRA trial.
  • Breast Cancer Prevention: The New Primary Care?   If primary care physicians treat hypertension to prevent heart attacks, reasons Dr. Kathy Miller, why shouldn’t they prescribe SERMs and AIs to at-risk patients to prevent breast cancer?
  • When Therapies Are Ineffective   Dr. Kathy Miller discusses the negative data on lapatinib from the ALTTO trial in HER2-positive breast cancer and questions how best to share information with patients on ineffective therapies.
  • Paradoxical Findings in Local Breast Cancer Therapy   Paradoxical findings from recent studies suggest that what have been considered equivalent therapies for local breast cancer may not be, as reported by Dr. Kathy Miller.
  • Objective Response Rates: No Such Thing   A study in the variability of tumor measurements on repeat CT scans suggests to Dr. Kathy Miller that objective response rates in clinical trials may be anything but.
  • Breast Cancer: New Data on Prevention and Treatment   Dr. Kathy Miller highlights what she expects to be the big news at ASCO in breast cancer, from prevention to metastatic disease.
  • ASCO® Plenary Session: 5 Practice-Changing Studies   Dr. Kathy Miller says that the plenary session, which features 5 studies that are certain to change practice, and the AACR/ASCO session with Nobel Prize winner Elizabeth Blackburn are not to be missed.
  • What It Takes to Beat Metastatic Disease   Dr. Kathy Miller reports on indisputable evidence for why oncologists should get tissue samples from patients with metastatic disease. If patients are willing to take this step, why aren’t oncologists?
  • Balancing Treatment Efficacy and Toxicity   Dr. Kathy Miller reports on 2 trials in which investigators examine how to maximize the benefit of treatment while minimizing its drawbacks.
  • ASCO: Early Bird Report   Dr. Kathy Miller reports that the breadth and depth of abstracts submitted to the ASCO Program Committee -- coupled with an easily navigated program -- will make this year's meeting a quality experience.
  • Are You as Smart as This Fourth Grader?   Dr. Kathy Miller wants to recruit to her staff a fourth-grade student who won top honors in a science fair for her discovery in regard to patients who receive chemotherapy.
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