Studies examining ongoing controversies in the field of clinical oncology were released
at a press briefing of the 45th Annual Meeting of the American Society of Clinical Oncology (ASCO).
“There are many ongoing debates in cancer research and care, and the best care for our patients is not always
clear-cut,” said Julie Gralow, MD, an associate professor in the oncology division of the University of
Washington School of Medicine and moderator of the press briefing. “The studies presented today shed light
on ongoing controversies in the field, and on the challenges physicians face when launching clinical trials,
evaluating trial results, advising patients on screening, and determining the most appropriate treatment.”
Studies highlighted in the press briefing include:
• Lung cancer screening: The effectiveness of lung cancer screening in reducing death rates has been
widely debated in recent years. A new study finds that lung cancer screening using low-dose
computed tomography results in a high rate of false positives (33 percent after two screenings) and
significant follow-up testing, data that should help people at high risk for the disease, make informed
decisions about screening.
• Impact of common antidepressants on tamoxifen effectiveness: Hot flashes are a common side-effect
of tamoxifen treatment to prevent breast cancer recurrence, and are often managed with the
antidepressant drugs Paxil and Prozac. Two new studies report differing results about whether these
antidepressants have an adverse impact on the effectiveness of tamoxifen. Additional research is
needed to resolve these differences, though women may want to consider alternative antidepressants
in the meantime.
• Treatment of breast cancer micrometastases: Not all women with breast cancer undergo surgery to
remove all of the axillary (underarm) lymph nodes upon detection of tiny micrometastases in the
lymph node nearest the tumor (the “sentinel” node), given a lack of conclusive data to date
demonstrating the effectiveness of such treatment. However, a new study finds significantly higher
rates of cancer recurrence among women with micrometastases who do not undergo axillary lymph
node dissection, supporting routine use of the procedure to prevent the return of cancer.
• Patient accrual in clinical trials: Low rates of patient enrollment in cancer clinical trials have been an
ongoing challenge in cancer research, with just five percent of cancer patients participating. A new
analysis of federally-funded cancer trials finds that a full 40 percent of trials examined did not meet their
enrollment goals, threatening their ability to report statistically significant results. The study found that the
longer a trial takes to develop, the less likely it is to meefinding ways to shorten clinical trial development time.
