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How will Obama foot the bill for his proposed health-care reform initiative, which is projected to cost at least $1 trillion? Cancer care could suffer more cuts.

Music is a powerful tool that can evoke latent emotions, induce a range of emotional states, and enhance communication. It also offers a creative, lyrical, and symbolic means of addressing spiritual needs, and is increasingly used in end-of-life care.

A phase III trial comparing R–CHOP14 and R–CHOP21 for the treatment of patients with newly diagnosed diffuse large B–cell non–Hodgkin's lymphoma D. Cunningham, P. Smith, P. Mouncey, et al Methods: Patients were randomized to either 8 cycles of standard R–CHOP21 or 6 cycles of R–CHOP14 (+ G–CSF) with 2 additional cycles of single–agent rituximab (Rituxan). Patients were stratified by age (≤ 60 vs > 60), World Health Organization performance status (0–1 vs 2), and LDH (lactate dehydrogenase) level (normal vs raised). The primary endpoint was overall survival. Among 1,080 patients (median age 61 years), IPI (International Prognostic Index) scores of ≥ 4 were found in 17% of R–CHOP21 patients and in 15% of the R–CHOP14 arm. Stage 3/4 disease was reported in 63%/62% of patients in the R–CHOP21/R–CHOP14 arms, B symptoms in 44%/47%, and bulky disease in 51%/48%, respectively. Results: Reported grade 3/4 toxicities in the R–CHOP21 and R–CHOP14 arms were neutropenia 57%/31%, thrombocytopenia 5%/9%, infection 22%/17%, cardiac symptoms 1%/2%, nausea and vomiting 8%/8%, and mucositis 2%/3%. The radiologic complete response rates (CR/CRu [unconfirmed]) were 63% in the R–CHOP21 arm (49%/14%) and 58% (40%/18%) in the R–CHOP14 arm (P = .183). With a median follow–up of 17 months, there have been 150 deaths (14%). Conclusions: Response rates with 6 x R–CHOP14 (+2xR) are no better than with 8 x R–CHOP21. There are no differences among prognostic subgroups (including IPI). Acute toxicity levels are comparable. Final analysis will be performed when 330 deaths have occurred.

Methods: Among 63 chemotherapy-naive and 138 pretreated FL patients receiving 4 weekly rituximab (Rituxan) doses, those responding or with stable disease were randomized to observation (n = 78) or to consolidation with 4 additional rituximab doses at 2-month intervals (n = 73).

Benefit of rituximab combined to ACVBP (R-ACVBP) over ACVBP in 209 poor- risk DLBCL patients treated with up-front consolidative autotransplantation: A GELA phase II trial (LNH 2003-3)

A phase III study of VMPT versus VMP in newly diagnosed elderly myeloma patients

R-ICE versus R-DHAP in relapsed patients with CD20 diffuse large B-cell lymphoma followed by autologous stem cell transplantation: CORAL study

Idiotype vaccine therapy (BiovaxID) in follicular lymphoma in first complete remission: Phase III clinical trial results

Complete remissions with weekly dosing of SGN-35, a novel antibody-drug conjugate targeting CD30, in a phase I dose-escalation study in patients with relapsed or refractory Hodgkin lymphoma or systemic anaplastic large cell lymphoma

Activity of ofatumumab, a novel CD20 mAb, and prior rituximab exposure in patients with fludarabine- and alemtuzumab-refractory or bulky fludarabine-refractory chronic lymphocytic leukemia

Pooled analyses of two international, multicenter clinical studies of romidepsin in 167 patients with cutaneous T-cell lymphoma (CTCL)

In spite of significant advances in the understanding and treatment of hematologic malignancies over the past 5 years or so, these cancers remain challenges for clinicians. We always await the results of studies presented at the annual meeting of the American Society of Clinical Oncology (ASCO), hoping that they will be practice–changing for us and life–altering for our patients. This year, at the 45th ASCO in Orlando, we instead heard results that further refined or validated the treatment approaches we often take.

Studies presented at this year’s ASCO annual meeting gave us a glimpse of the future, which looks promising with regard to improved treatments for the major hematologic malignancies. Several new compounds are in preliminary trials and others are on the fast track to approval, offering some very new options for attacking a variety of these cancers.

Newly appointed FDA commissioner, Margaret A. Hamburg, MD, has created a task force to study how to make the agency's processes more transparent. When it comes to cancer drugs, she's got a tough road ahead.

President Obama wants to push forward his health-care reform initiative this year. Republicans have expressed strong reservations about the plan and its express-train timetable, but they do not enough clout on the Hill to stop it.

A psychoanalyst describes her intimate psychosocial care with a dying patient. But her musings on caring for the terminally ill leave out one crucial thing--pain relief.

The recent decision by CMS to deny coverage for CT colonography in colorectal cancer screening has been seen by some as a favorable trend toward using evidence-based medicine to make more cost-effective coverage decisions. With the Medicare hospital insurance trust fund projected to become insolvent by 2017, perhaps the agency is responding to the impending fiscal realities.

A novel drug that targets an important protein receptor that supports B-cell lymphoma cells produced significant responses in non-Hodgkin’s lymphoma patients who had failed prior therapies. Results from the phase II trial of fostamatinib disodium in 68 heavily pretreated relapsed and refractory B-cell NHL patients revealed that the treatment has significant promise and should undergo further clinical testing, according to lead investigator Jonathan W. Friedberg, MD, of the James P. Wilmot Cancer Center at the University of Rochester in New York.

Recipients of the 2009 ASCO Special Awards have been announced. Clara D. Bloomfield, MD, (left) will be given the David A. Karnofsky Memorial Award; the Science of Oncology Award will go to Bert Vogelstein, MD; Olufunmilayo Olopade, MBBS, will receive the ASCO-American Cancer Society Award; the B.J. Kennedy Award for Scientific Excellence in Geriatric Oncology will be given to Martine Extermann, MD, PhD; the Pediatric Oncology Award will be presented to William E. Evans, PharmD, and Mary V. Relling, PharmD; John H. Glick, MD, will take home the Distinguished Achievement Award; Diane S. Blum, MSW, is the recipient of Partners in Progress Award; Richard Pazdur, MD, will be given the Special Recognition Award.

As comparative effectiveness research matures from a political buzz phrase to a decision-making process, leaders in the oncology community are concerned about the effect this latest government initiative might have on community practices that already feel overregulated.

One of the most discussed elements of President Obama's health-care reform is the the initiative to launch comparative effectiveness research. The administration contends that CER is about enhancing the quality of care by choosing more effective clinical options. Pharma is worried that comparative effectiveness code for cost-effectiveness, and oncologists are concerned that CER could effect the autonomy of their clinical decision making.

New biologics are improving the treatment of advanced colorectal cancer, but their optimal integration into practice remains unclear, and the question of how aggressive treatment should be is still open ended.

ASCO has issued policy recommendations designed to eliminate existing disparities between minorities and whites, and between those with and without health insurance. “Disparities in Cancer Care” comes as the incidence of cancer is projected to increase significantly in the next 20 years, a situation that could be catastrophic if not dealt with sooner rather than later.

A call center in India takes a customer service inquiry from Idaho; an Australian doctor reads an emergency x-ray for a U.S. patient; a professor in Moscow delivers a lecture via satellite to UK-based students-these examples of “going global” no longer seem so novel. Cancer clinical trials are also crossing international datelines. Between 2005 and 2006, international clinical trials initiated in the Asia-Pacific region increased by 50%, while major research initiatives-once the stronghold of U.S. institutions-are now run by EU-based investigators.

Imaging with MR and/or PET/CT can help physicians figure out appropriate treatment for cervical cancer patients as well as prevent unnecessary therapy, according to a new study.

V. Craig Jordan, OBE, PhD, DSc, will become the scientific director for the cancer center and vice chairman of the department of oncology at Georgetown University Medical Center and the Lombardi Comprehensive Cancer Center.

Elekta has promised $1 million to the Radiation Oncology Institute, a campaign spearheaded by the American Society for Radiation Oncology to raise awareness of radiation therapy.

Varian gains more worldwide sites for RapidArc system

ORLANDO, Fla.-ASCO has awarded $10,000 grants to five state projects. The recipients will be recognized at the State Affiliates’ Reception at ASCO 2009.