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issues in oncology

Clinical Cancer Advances 2019: ASCO Names Advance of the Year, Debuts Research Priorities for the Cancer Community

In the release of its annual report on progress against cancer, Clinical Cancer Advances 2019, ASCO recognized progress in treating rare cancers as the Advance of the Year. The report catalogs a year’s worth of remarkable research advancements, reinforces the need for continued federal research...

Expert Point of View: Steven Gore, MD, Eyten Stein, MD, and Elihu H. Estey, MD

In discussions after these presentations, several points were made by several experts. To begin, Steven Gore, MD, Director of Hematologic Malignancies at Yale Medical School, called the study of venetoclax plus 10-day decitabine “very important,” but he raised the issue of appropriate dosing. He...

leukemia

Data Mount for Venetoclax as Add-on Therapy in Acute Myeloid Leukemia

The benefit of adding venetoclax to a hypomethylating agent or low-dose cytarabine in the front-line treatment of acute myeloid leukemia (AML) was evident from a number of studies reported at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition (see Table 1). For elderly...

Expert Point of View: Ravi Vij, MD and Saad Usmani, MD

Ravi Vij, MD, Professor of Medicine at Washington University School of Medicine, St. Louis, and Saad Usmani, MD, Director of Plasma Cell Disorders at Levine Cancer Institute, Charlotte, North Carolina, spoke to The ASCO Post about the studies presented on chimeric antigen receptor (CAR) T-cell...

immunotherapy
multiple myeloma

Multiple Myeloma Pipeline Filled With CAR T-Cell Therapies

The burgeoning pipeline of chimeric antigen receptor (CAR) T-cell therapies targeting B-cell maturation antigen (BCMA) in multiple myeloma was on full display at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. A bispecific antibody also made its debut in this busy...

Expert Point of View: Mrinal S. Patnaik, MBBS and David P. Steensma, MD

Mrinal S. Patnaik, MBBS, Associate Professor of Internal Medicine and Oncology and a consultant in hematology at the Mayo Clinic, Rochester, commented on the MEDALIST trial for The ASCO Post. “Given its unique mode of action, relative ease of administration, and excellent tolerability,...

supportive care
hematologic malignancies

Luspatercept May Reduce the Need for Transfusion in Lower-Risk Myelodysplastic Syndromes

In the randomized, double-blind, phase III MEDALIST trial, the experimental drug luspatercept significantly reduced the need for frequent red blood cell transfusions in patients with lower-risk myelodysplastic syndromes (MDS) and ring sideroblasts. With luspatercept, 37.9% remained transfusion-free ...

Expert Point of View: Virginia Kaklamani, MD and Wendy A. Woodward, MD

At a press conference held during the 2018 San Antonio Breast Cancer Symposium, moderator Virginia Kaklamani, MD, said that partial-breast irradiation is underutilized in the United States for women with breast cancer. Dr. Kaklamani is Professor of Medicine at The University of Texas at San...

breast cancer

Small Differences Found in Breast Cancer Recurrence With Partial-Breast vs Whole-Breast Irradiation

Partial-breast irradiation delivered over 5 to 10 days did not meet noninferiority criteria compared with whole-breast irradiation given over 5 to 7 weeks, according to 10-year results of the large NRG (NSABP B-39/RTOG 0413) trial presented at the 2018 San Antonio Breast Cancer Symposium.1 However, ...

lung cancer

Genomic Classification of Lung Cancers Diagnosed in Patients From Appalachian Kentucky

Squamous cell carcinoma of the lung represents approximately one-quarter (26.4%) of all lung cancers diagnosed in Appalachian Kentucky, where death from lung cancer is higher than the national average. Researchers sought to characterize genetic alterations specifically found in lung squamous cell...

pancreatic cancer

Enhancing Patient Outcomes After Whipple Procedure

Pancreaticoduodenectomy, or the Whipple procedure, is one of the most complex abdominal surgeries, and is commonly prescribed as a first line of therapy for cancer located within the pancreatic head. Investigators reported that following a 5-day accelerated recovery pathway after surgery helped to...

breast cancer

Selected Abstracts From the San Antonio Breast Cancer Symposium

Each year, The ASCO Post asks Jame Abraham, MD, FACP, Director of the Breast Oncology Program at Taussig Cancer Institute and Professor of Medicine at the Cleveland Clinic Lerner College of Medicine, to offer his picks for the most important research presented at the 2018 San Antonio Breast Cancer ...

sarcoma

Clinical Significance of Indeterminate Pulmonary Nodules at Diagnosis in Pediatric Rhabdomyosarcoma

In a study reported in the Journal of Clinical Oncology, Vaarwerk et al found that presence of indeterminate pulmonary nodules at diagnosis of pediatric rhabdomyosarcoma did not adversely affect treatment outcome in otherwise localized disease. The study involved 316 patients from the European...

issues in oncology
global cancer care

World Cancer Day 2019: Emphasis on Early Detection

World Cancer Day 2019—February 4—highlights the need for urgent action to increase early-stage cancer detection, screening, and diagnosis to significantly improve patients’ chances of survival. Taking place with the theme of “I Am and I Will,” World Cancer...

hepatobiliary cancer

Ramucirumab in Sorafenib-Pretreated Patients With Advanced HCC and Increased α-Fetoprotein

In the phase III REACH-2 trial reported in The Lancet Oncology, Zhu et al found that ramucirumab improved overall and progression-free survival vs placebo in patients with advanced hepatocellular carcinoma (HCC) and increased α-fetoprotein levels who had previously received sorafenib. Study...

Expert Point of View: Harry H. Yoon, MD

Harry H. Yoon, MD, Associate Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, the invited discussant of the study presented by Janjigan et al, commented on the strong rationale for combining an anti-HER2 agent, anti–programmed cell death protein 1 (PD-1) agent, and chemotherapy....

immunotherapy
gastrointestinal cancer

First-Line Trastuzumab Plus Pembrolizumab Shows Efficacy in Patients With Metastatic Esophagogastric Cancer

When added to first-line chemotherapy in patients with untreated metastatic HER2-positive esophageal, gastroesophageal junction, and gastric adenocarcinoma, the combination of pembrolizumab and trastuzumab produced responses in 87% of patients, with 100% of patients experiencing disease control and ...

Expert Point of View: Martine Extermann, MD, PhD

As invited discussant of the GAMMA-1 trial, Martine Extermann, MD, PhD, of Moffitt Cancer Center and Research Institute, Tampa, Florida, first commented on the “teaser” in the findings—the potential for benefit of andecaliximab in older patients. “The drug works better in older patients. As a...

gastrointestinal cancer
head and neck cancer

Andecaliximab in Untreated Gastric or Gastroesophageal Junction Cancer

The large phase III GAMMA-1 trial failed to replicate the encouraging findings from a previous smaller study of andecaliximab plus chemotherapy in untreated HER2-negative gastric or gastroesophageal junction adenocarcinoma, according to Manish A. Shah, MD, of Weill Cornell Medicine/New York...

issues in oncology

Essential Elements of an Effective Clinical Trials System: Business and Mission

Clinical trials aimed to improve health and quality of life are the cornerstone of progress in medicine. Support comes from academic medical centers, philanthropy, the National Institutes of Health (NIH), industry, or combinations thereof. Clinical trials need to be hypothesis-driven and address...

lung cancer

Progress With ALK Inhibitors: When Will We Consider ALK-Positive Lung Cancer a ‘Chronic Disease’?

As reported by Solomon et al in The Lancet Oncology1 and reviewed in this issue of The ASCO Post, results from a global phase II study of the third-generation ALK inhibitor lorlatinib showed a high overall response rate and high intracranial response rate for patients with advanced ALK-positive...

Expert Point of View: Harry H. Yoon, MD

KEYNOTE-181’s invited discussant, Harry H. Yoon, MD, Associate Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, said the findings have a “potentially immediate clinical impact” for second-line treatment of esophageal cancer, including esophageal squamous cell carcinoma and Siewert...

head and neck cancer

KEYNOTE-181: Pembrolizumab vs Chemotherapy in Second-Line Treatment of Advanced Esophageal Cancer

In the global phase III KEYNOTE-181 trial, pembrolizumab as second-line therapy for advanced esophageal cancer did not improve overall survival in the whole population, vs chemotherapy, but did improve survival for patients with strong expression of programmed cell death ligand 1 (PD-L1),...

lung cancer
immunotherapy

Lung-MAP Precision Medicine Trial Expands

The Lung Cancer Master Protocol (Lung-MAP), the first precision medicine trial in lung cancer supported by the National Cancer Institute (NCI), is undergoing a major expansion to include patients with all non–small cell lung cancers (NSCLCs). The trial previously tested treatments for people ...

skin cancer
immunotherapy

How Effective Is Talimogene Laherparepvec Injection in Metastatic Melanoma?

Injection of a genetically modified virus that induces the body’s own immune cells to attack metastatic melanoma effectively treated almost 40% of patients with tumors that could not be surgically removed, according to findings published by Louie et al in the Journal of the American...

multiple myeloma

Trial of Autologous Transplantation, Consolidation, and Maintenance Therapy in Multiple Myeloma

In a phase III trial reported in the Journal of Clinical Oncology, Stadtmauer and colleagues found that second autologous hematopoietic cell transplantation (AHCT) or RVD (lenalidomide, bortezomib, dexamethasone) consolidation as post-AHCT interventions did not improve outcomes vs single...

lung cancer
immunotherapy

Nivolumab or Nivolumab Plus Ipilimumab in Relapsed Malignant Pleural Mesothelioma

In a French phase II trial reported in The Lancet Oncology, Scherpereel et al found evidence of activity with nivolumab or the combination of nivolumab plus ipilimumab in patients with relapsed malignant pleural mesothelioma. Study Details In the open-label, noncomparative trial, 125 patients...

leukemia

Treatment Outcomes for Children With Hypodiploid Acute Lymphoblastic Leukemia

In a retrospective study reported in the Journal of Clinical Oncology, Pui et al found that minimal residual disease (MRD)-negative status, high hypodiploidy with 44 chromosomes, and MRD-stratified treatment were associated with improved outcomes among children treated for newly diagnosed...

gynecologic cancers

HPV Testing Using Self-Collected vs Clinician-Collected Samples for the Detection of Cervical Intraepithelial Neoplasia

In a Dutch study (IMPROVE) reported in The Lancet Oncology, Polman et al found that human papillomavirus (HPV) testing with a clinically validated polymerase chain reaction (PCR)–based assay had similar accuracy using self-collected vs clinician-collected samples in detecting cervical...

lung cancer
immunotherapy

Avelumab in Previously Treated Advanced Unresectable Mesothelioma

In a phase Ib trial reported in JAMA Oncology, Hassan et al found that the anti–programmed cell death ligand 1 antibody avelumab produced durable responses and a high rate of disease control in some patients with advanced unresectable mesothelioma progressing after platinum and pemetrexed...

lung cancer

FDA Expands Pemetrexed Label With Combination of Pembrolizumab and Platinum Chemotherapy for the First-Line Treatment of Metastatic Nonsquamous NSCLC

Today, the U.S. Food and Drug Administration (FDA) granted approval for a new indication for pemetrexed (Alimta) for injection in combination with pembrolizumab (Keytruda) and platinum chemotherapy for the first-line treatment of patients with metastatic nonsquamous non–small cell...

solid tumors
issues in oncology
legislation

ASCO Clinical Cancer Advances 2019 Names Advance of the Year: Progress in Treating Rare Cancers

Over the past year, major research advances provided new treatment options for patients with rare, difficult-to-treat cancers. In recognition of these achievements, ASCO named “Progress in Treating Rare Cancers” as the Advance of the Year. To continue the forward momentum, ASCO also...

lung cancer
lymphoma
skin cancer

FDA Pipeline: Updates on Treatments in NSCLC and Lymphomas, Plus New Dosimetry Software

The U.S. Food and Drug Administration (FDA) recently granted the following application, designations, and clearance: sBLA for Atezolizumab Plus Chemotherapy for First-Line Treatment of Metastatic, Nonsquamous NSCLC On January 17, the FDA accepted a supplemental biologics license application...

gastroesophageal cancer

Effectiveness of EsophaCap Tool in the Diagnosis of Barrett’s Esophagus

Barrett’s esophagus is the only known precursor of esophageal adenocarcinoma. Although endoscopy and biopsy are standard methods for diagnosing Barrett’s esophagus, their high cost and risk limit their use as a screening modality. Researchers sought to develop a screening method based...

issues in oncology

Prevalence of Infection With HBV, HBC, and HIV in Patients With Newly Diagnosed Cancer

In a prospective cohort study reported in JAMA Oncology, Ramsey et al identified the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection in patients with newly diagnosed cancer and found that a substantial proportion were unaware of...

solid tumors
hematologic malignancies

Standard Site-Specific Therapy Based on Gene-Expression Profiling vs Empirical Chemotherapy for Cancer of Unknown Primary

In a Japanese phase II trial reported in the Journal of Clinical Oncology, Hayashi et al found that standard site-specific treatment based on gene-expression profiling was not associated with better outcomes vs empirical paclitaxel and carboplatin in patients with cancer of unknown primary site....

breast cancer
issues in oncology

Racial Differences in Time to Breast Cancer Surgery and Survival in the U.S. Military Health System

In a retrospective cohort study reported in JAMA Surgery, Eaglehouse et al found that time to breast cancer surgery was delayed for non-Hispanic black vs non-Hispanic white women in the Military Health System but that this difference did not account for poorer overall survival in non-Hispanic black ...

breast cancer
cost of care

Cost-Effectiveness Analysis of Gene-Expression Profiling Assay in Breast Cancer

A new report published by Wang et al in JNCCN—Journal of the National Comprehensive Cancer Network found that using Oncotype DX—the most commonly used test for predicting the benefit of adjuvant chemotherapy to reduce the risk of disease recurrence—is not...

issues in oncology
survivorship
cost of care

Cancer Survivors and Medical Financial Hardship

New research indicates that cancer survivors carry greater financial burdens related to medical debt payments and bills compared with individuals without a cancer history, with the greatest hardships in younger survivors. Published by Zheng et al in Cancer, the study also found that among...

prostate cancer

Long-Term Effects of Finasteride vs Placebo on Prostate Cancer Mortality

In a letter to the editor of The New England Journal of Medicine, Goodman et al reported a long-term follow-up of the Prostate Cancer Prevention Trial indicating that finasteride treatment was not associated with an increased risk of death from prostate cancer. Study Details As previously...

colorectal cancer

Watch-and-Wait Strategy for Rectal Cancer With Complete Clinical Response After Neoadjuvant Therapy

In a single-center retrospective case series analysis reported in JAMA Oncology, Smith et al found that a watch-and-wait approach was associated with a high rate of rectal preservation and pelvic tumor control in patients with rectal cancer with complete clinical response to neoadjuvant therapy,...

lymphoma
skin cancer

2018 Update of WHO-EORTC Classification of Primary Cutaneous Lymphomas

As reported by Willemze and colleagues in Blood, the World Health Organization (WHO) and the European Organisation for Research and Treatment of Cancer (EORTC) have released a 2018 update of their classification of primary cutaneous lymphomas. As noted by the authors, “Primary cutaneous...

leukemia
lymphoma

FDA Approves Ibrutinib in Combination With Obinutuzumab in Treatment-Naive CLL/SLL

Today, the U.S. Food and Drug Administration (FDA) approved ibrutinib (Imbruvica), a Bruton's tyrosine kinase inhibitor, in combination with obinutuzumab in treatment-naive patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). This is the first approval of a...

skin cancer

Surgical Factors Contributing to Invasive Squamous Cell Carcinoma Recurrence

Invasive squamous cell carcinoma (SCC) is typically treated surgically, with guidelines in place recommending surgical margins for excision based on the SCC being classified as low or high risk. Researchers undertook a study to examine recurrence rates of SCC after surgical excision, taking into...

sarcoma
immunotherapy

Results Reported From the Phase III ANNOUNCE Trial of Olaratumab in Soft-Tissue Sarcoma

The recently reported results of ANNOUNCE, the phase III study of olaratumab in combination with doxorubicin in patients with advanced or metastatic soft-tissue sarcoma, did not confirm the clinical benefit of olaratumab in combination with doxorubicin as compared to doxorubicin, a...

leukemia
myelodysplastic syndromes

Combination Azacitidine and Lenalidomide as Salvage Therapy for Relapsed AML After Allogeneic Stem Cell Transplantation

In a phase I trial reported in the Journal of Clinical Oncology, Craddock et al found evidence that the sequential combination of azacitidine and lenalidomide may be an effective salvage therapy in patients with acute myeloid leukemia (AML) relapsing after allogeneic stem cell transplantation...

breast cancer

Short-Term Safety Outcomes in Mastectomy and Immediate Implant-Based Breast Reconstruction

In a prospective cohort study reported in The Lancet Oncology, Potter et al found that complications following immediate implant-based breast reconstruction—with or without mesh—were higher than considered acceptable by UK national standards. As noted by the investigators, the study was ...

colorectal cancer

Polymorphisms in Pattern Recognition Receptors as Predictors of Oxaliplatin Benefit in Colorectal Cancer

In a study reported in the Journal of the National Cancer Institute, Gray et al found that constitutional loss of function single-nucleotide polymorphisms in the pattern recognition receptors FPR1, TLR3, and TLR4 were not associated with preferential benefit of oxaliplatin in colorectal cancer. As...

gastrointestinal cancer

Rongbo Lin, MD, on Gastric Cancer: Results From the FNF-004 Trial

Rongbo Lin, MD, of Fujian Cancer Hospital, discusses phase II study findings on FOLFOX alone vs paclitaxel plus FOLFOX vs intraperitoneal paclitaxel plus FOLFOX as a first-line treatment in advanced gastric cancer (Abstract 6).

Oncology Pioneer V. Shanta, MD, Has Long Championed Access to Quality Cancer Care

In this installment of the Living a Full Life series, guest editor Jame Abraham, MD, interviewed V. Shanta, MD, an internationally renowned oncologist and Chairperson of the Cancer Institute in Adyar, Chennai, India. Dr. Shanta has been with the Institute since 1955, holding several positions...

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