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Andrew Kneebone, MD, on an ANZUP Trial on Adjuvant vs Early Salvage Radiotherapy After Prostatectomy
Andrew Kneebone, MD, of Royal North Shore Hospital, discusses phase III study findings showing that at 5 years, biochemical control was similar between adjuvant and early salvage radiotherapies, the latter sparing half of the men potential side effects of radiotherapy without any significant...
Robert Olson, MD, on Quality-of-Life Outcomes After Stereotactic Ablative Radiotherapy vs Standard-of-Care Palliative Treatments
Robert Olson, MD, of the BC Cancer Centre for the North, discusses a secondary analysis of the SABR-COMET trial, which showed there was a small magnitude decline in quality of life in both arms of the study but no associated detriment with stereotactic ablative radiotherapy (Abstract 148).
Erica H. Bell, PhD, on Low-Grade Gliomas: Subgroup Analysis of the NRG Oncology/RTOG 9802 Trial
Erica H. Bell, PhD, of The Ohio State University, discusses phase III findings from a prognostic and predictive molecular subgroup analysis of radiotherapy vs radiotherapy plus procarbazine/lomustine/vincristine in high-risk low-grade gliomas (Abstract 161).
Michael J. LaRiviere, MD, on Non-Hodgkin Lymphoma: Induction Radiation Before CAR T-Cell Therapy for Resistant Disease
Michael J. LaRiviere, MD, of the University of Pennsylvania, discusses the safety and efficacy of an alternate radiation-based approach to using cytotoxic chemotherapy alone in preparation for CAR T-cell treatment (Abstract 135).
Sue Sun Yom, MD, PhD, on Oropharyngeal Cancer: Deintensifying Radiation Therapy Plus Chemotherapy
Sue Sun Yom, MD, PhD, of the University of California, San Francisco, discusses phase II results showing that swallowing-related quality of life after deintensified chemoradiation therapy may improve in patients with p16-positive, nonsmoking-associated, locoregionally advanced disease (Abstract...
Alejandra Méndez Romero, MD, PhD, on Liver Metastases: Dutch-Belgian Registry of Stereotactic Body Radiation
Alejandra Méndez Romero, MD, PhD, of Erasmus University Medical Center, discusses findings that show high local control rates with stereotactic body radiation for patients in this large published series, most of whom had colorectal cancer (Abstract 230).
David Routman, MD, on Oropharyngeal Squamous Cell Carcinoma and HPV Circulating Tumor DNA
David Routman, MD, of the Mayo Clinic, discusses his study findings showing that detectable human papillomavirus circulating tumor DNA in the postoperative setting may be linked to disease progression, which may help improve patient selection for treatment intensity (Abstract LBA5).
Daniel M. Trifiletti, MD, on Optimizing Whole-Brain Radiotherapy Dose and Fractionation for Patients With Brain Metastases
Daniel M. Trifiletti, MD, of the Mayo Clinic, discusses study findings showing that, between two different radiation doses (30 Gy/10 fractions vs 37.5 Gy/15 fractions), there was no difference in the time to cognitive failure, tumor control, or overall survival for patients with brain metastases...
Youssef Zeidan, MD, PhD, on HER2-Positive Breast Cancer: HERA Trial on Postmastectomy Radiation Therapy
Youssef Zeidan, MD, PhD, of the American University of Beirut Medical Center, discusses study findings showing that, in patients with one to three positive lymph nodes, postmastectomy radiation treatment decreased the risk of locoregional recurrence, particularly in estrogen receptor–positive...
Ryan Phillips, MD, PhD, on Oligometastatic Prostate Cancer: ORIOLE Trial on Observation vs Stereotactic Ablative Radiation
Ryan Phillips, MD, PhD, of Johns Hopkins Medical Institutions, discusses phase II findings suggesting that treatment with stereotactic ablative radiation significantly decreased the risk of disease progression at 6 months and increased progression-free survival (Abstract LBA3).
Justin Barnes, MS, on the Affordable Care Act and Risk of Suicide in Patients With Cancer
Justin Barnes, MS, of the St. Louis University School of Medicine, discusses his findings on the risk of suicide, which is higher in patients with cancer than in other adults but can be reduced by health policy interventions, including components of the Affordable Care Act (Abstract LBA9).
Steven H. Lin, MD, PhD, on Esophageal Cancer: Proton Beam vs Intensity-Modulated Radiation Therapy
Steven H. Lin, MD, PhD, of The University of Texas MD Anderson Cancer Center, discusses phase II findings that showed proton beam therapy improved total toxicity burden score with no difference in progression-free survival when compared with intensity-modulated radiation treatment (Abstract LBA2).
Tailoring Upfront Daratumumab Treatment for Some Patients With Multiple Myeloma
The monoclonal antibody daratumumab has been widely embraced for the treatment of multiple myeloma, but for newly diagnosed patients, its benefit has been proved only in some patients, according to Craig Hofmeister, MD, MPH, Associate Professor of Medicine at the Winship Cancer Institute of Emory...
SOHO 2019: Ivosidenib/Azacitidine for Newly Diagnosed AML
Findings from a phase Ib study of the combination of the mutant IDH1 inhibitor ivosidenib plus azacitidine for patients with IDH1-mutated, newly diagnosed acute myeloid leukemia (AML) ineligible for intensive treatment showed that the combination was well tolerated and produced more responses than...
Two Studies Show Variation in Effectiveness of Mammography Across Populations
Two recent studies showed varying degrees of the effectiveness of mammography in different populations. In a report published in Radiology, Gao et al showed that in men at high risk for breast cancer, screening mammography may be able to increase the rate of detection of early-stage disease....
Sorafenib Plus Transarterial Chemoembolization for Advanced Hepatocellular Carcinoma
During the past decade, scientists began to test whether the addition of transarterial chemoembolization (TACE) to treatment with sorafenib could increase survival in patients with advanced hepatocellular carcinoma. Scientists from Taiwan and Japan performed the first large, national-level,...
Adoption of Conservative Management of Prostate Cancer Among Urology Practices
In a study reported in the Journal of Oncology Practice, Modi et al found that the difference in the rates of use of conservative management of prostate cancer widened between lower-use and higher-use urology practices between 2014 and 2018. Study Details Use of a sample of Medicare claims...
Risk Model for Advanced Systemic Mastocytosis
As reported in the Journal of Clinical Oncology, Jawhar et al have developed a risk model for advanced systemic mastocytosis that differentiates low-, intermediate-, and high-risk disease. Study Details The study included 383 patients with advanced systemic mastocytosis from the German Registry on ...
Daniel E. Spratt, MD, on the Impact of Antiandrogen Treatment in Prostate Cancer: NRG Oncology/RTOG 9601 Trial
Daniel E. Spratt, MD, of the University of Michigan, discusses phase III study findings showing that 2 years of antiandrogen therapy increased cardiac and neurologic toxicities, as well as mortality from causes other than prostate cancer, in men with low levels of prostate-specific antigen after...
Andreas Rimner, MD, on the PACIFIC Trial: Durvalumab for Stage III NSCLC
Andreas Rimner, MD, of Memorial Sloan Kettering Cancer Center, discusses study findings showing that, for patients with stage III non–small cell lung cancer, durvalumab reduced the rate of and time to disease progression vs placebo and also reduced the number of new distant lesions (Abstract LBA6).
SOHO 2019: Melflufen for Patients With Late-Stage, Relapsed or Refractory Multiple Myeloma Refractory to Daratumumab and/or Pomalidomide
In a presentation of updated efficacy and safety data from the phase II HORIZON trial, Paul G. Richardson, MD, and colleagues found that melflufen, a lipophilic peptide-conjugated alkylator, showed activity in patients with late-stage relapsed or refractory multiple myeloma refractory to...
Cancer Survival, Incidence, and Mortality in Seven High-Income Countries From 1995–2014
As reported by Arnold and colleagues in The Lancet Oncology, the International Cancer Benchmarking Partnership Cancer Survival in High-Income Countries (SURVMARK-2) project has found general improvement in cancer survival between 1995 and 2014 in Australia, Canada, Denmark, Ireland, New Zealand,...
Final Results of a Phase III Trial of PET-Guided Treatment in Early-Stage Favorable Hodgkin Lymphoma
As reported in the Journal of Clinical Oncology by Fuchs et al, final results of the German Hodgkin Study Group phase III HD16 trial in early-stage favorable Hodgkin lymphoma indicate that combined modality therapy (CMT) is associated with better progression-free survival vs chemotherapy alone...
Patients With Metastatic Colorectal Cancer Carrying Class 3 BRAF Mutations May Respond to Anti-EGFR Therapy
Although between 8% and 12% of patients with metastatic colorectal cancer harbor a BRAF gene mutation, not all non-V600 BRAF alterations respond to EGFR antibody treatment, according to findings from a study by Yaeger et al published in Clinical Cancer Research. The study investigated whether...
Current Controversies in Lymphoma: From the Role of Liquid Biopsy to Ways to Improve Upon Standard Chemotherapy
Two topics that hematologists are currently grappling with were addressed at the 2019 Debates and Didactics Conference in Sea Island, Georgia, sponsored by Emory University Winship Cancer Institute, by Editor-in-Chief of The ASCO Post, James O. Armitage, MD, FASCO.1 They focus on the emerging role ...
Suboptimal Insurance Linked to Worse Survival Outcomes in Positive Clinical Trials
Findings from a recent SWOG study could cast doubt on the generalizability of treatment effects observed in positive clinical trials, especially among underinsured patients. According to data presented at the 2019 ASCO Quality Care Symposium,1 patients with Medicaid or no insurance had no observed...
Expert Point of View: Alex A. Adjei, MD, PhD
Alex A. Adjei, MD, PhD, of Mayo Clinic, Rochester, Minnesota, who was not involved in KEYNOTE-189 or KEYNOTE-021, provided some perspective on the exploratory analyses of tumor mutational burden from these and other studies. “Four studies at this meeting presented data on tumor mutational burden...
Tumor Mutational Burden Disappoints as Biomarker for Treatment Response in Exploratory Analyses of Nonsquamous NSCLC
Tumor mutational burden failed to prove effective as a biomarker for response to chemotherapy plus checkpoint inhibitor or chemotherapy alone as first-line treatment for nonsquamous non–small cell lung cancer (NSCLC) in two different exploratory analyses of KEYNOTE trials.1,2 In both analyses,...
Benefits Reported With Addition of Isatuximab to Pomalidomide and Dexamethasone in Resistant Multiple Myeloma
In patients with relapsed or refractory multiple myeloma, isatuximab in combination with pomalidomide and low-dose dexamethasone nearly doubled progression-free survival when compared with pomalidomide and dexamethasone alone, with a manageable safety profile, according to data from a phase III...
SOHO 2019: Asciminib/Imatinib in Patients With Previously Treated CML
In a phase I trial, the combination of the BCR-ABL1 inhibitor asciminib and the small-molecule kinase inhibitor imatinib showed preliminary efficacy, safety, and tolerability in patients with chronic myeloid leukemia (CML) resistant to or intolerant of treatment with two or more prior tyrosine...
Addition of Selective Internal Radiotherapy to Chemotherapy May Improve Resectability of Colorectal Cancer Liver Metastases
In a report published by Garlipp et al in the British Journal of Surgery, the addition of selective internal radiotherapy (SIRT) to modified FOLFOX6-based chemotherapy (mFOLFOX6; oxaliplatin/leucovorin/fluorouracil) improved the resectability of initially unresectable colorectal cancer liver...
AACR Cancer Progress Report 2019 Released
Today, the American Association for Cancer Research (AACR) released the AACR Cancer Progress Report 2019, which highlights how research largely supported by federal investments in the National Institutes of Health (NIH) is spurring improvements in public health and innovations across the spectrum...
FDA Approves Apalutamide for Metastatic Castration-Sensitive Prostate Cancer
On September 17, the U.S. Food and Drug Administration (FDA) approved apalutamide (Erleada) for patients with metastatic castration-sensitive prostate cancer. Apalutamide was initially approved by the FDA in 2018 for patients with nonmetastatic castration-resistant prostate cancer. TITAN Trial...
International Guidelines for Treatment and Prophylaxis of VTE in Patients With Cancer
The 2019 International Initiative on Thrombosis and Cancer (ITAC) has issued updated clinical practice guidelines for the treatment and prophylaxis of venous thromboembolism (VTE) in patients with cancer. They were published by Farge et al in The Lancet Oncology. The guidelines consist of...
POLE/POLD1 Mutations Across Cancer Types and Association With Immune Checkpoint Inhibitor Therapy Outcomes
In a research letter published in JAMA Oncology, Wang et al identified the frequency of mutations in DNA polymerase epsilon (POLE) and delta 1 (POLD1) genes across cancer types and found that these mutations were associated with better survival outcomes among patients receiving immune checkpoint...
ASTRO 2019: Patterns of Disease Progression in Patients With Unresectable Stage III NSCLC: Analysis of the PACIFIC Trial
Andreas Rimner, MD, of Memorial Sloan Kettering Cancer Center, presented an update of the landmark PACIFIC trial at the 61st Annual Meeting of the American Society for Radiation Oncology (ASTRO) (Abstract LBA-6). In earlier reports from the randomized phase III trial, Antonia et al had evaluated...
FDA Grants Approval to Lenvatinib/Pembrolizumab in Advanced Endometrial Cancer, Announces Project Orbis
The U.S. Food and Drug Administration (FDA) has announced Project Orbis, an initiative of the FDA Oncology Center of Excellence (OCE). Project Orbis provides a framework for concurrent submission and review of oncology drugs among its international partners. Under this project, the FDA, the...
Targeting an Important Tumor Vulnerability With Maintenance Olaparib in Germline BRCA-Mutated Pancreatic Cancer
In the POLO trial, which is discussed in this issue of The ASCO Post, Golan and colleagues evaluated the potential benefit of maintenance olaparib after disease stability or response to a minimum of 4 months of platinum-based chemotherapy in patients with metastatic pancreatic cancer and a...
POLO Trial: Maintenance Olaparib in Germline BRCA-Mutated Metastatic Pancreatic Cancer
As reported in TheNew England Journal of Medicine by Talia Golan, MD, of Sheba Medical Center, Tel Aviv University, and colleagues, the phase III POLO trial showed that maintenance treatment with the poly (ADP ribose) polymerase (PARP) inhibitor olaparib improved progression-free survival vs...
ASTRO 2019: Long-Term Hormone Therapy May Increase Other-Cause Mortality in Men With Prostate Cancer Receiving Early Salvage Radiotherapy
Findings from the randomized phase III NRG Oncology/RTOG 9601 trial were initially reported in 2017, and showed that the addition of 2 years of antiandrogen therapy to postsurgical radiation treatment for men with recurrent prostate cancer increased their long-term overall survival rate. That study ...
ASTRO 2019: Machine-Learning Model May Accurately Predict Radiation Side Effects in Patients With Head and Neck Cancers
A study by Reddy et al investigating the use of a machine-learning model to predict which patients with head and neck cancer being treated with radiation may experience significant weight loss, feeding tube placement, and unplanned hospitalization has found that the model accurately identified the...
Bevacizumab/Niraparib vs Niraparib Alone for Platinum-Sensitive Recurrent Ovarian Cancer
In the phase II NSGO-AVANOVA2/ENGOT-ov24 trial reported in The Lancet Oncology, Mansoor Raza Mirza, MD, and colleagues found that the combination of bevacizumab plus niraparib prolonged progression-free survival vs niraparib alone in women with platinum-sensitive recurrent ovarian cancer. Study...
Access to Cannabis Products for Patients With Cancer in a State With Restrictive Medical Marijuana Laws
Results of a survey reported by Singh et al in the Journal of Oncology Practice found that a population of primarily patients with cancer enrolled in Georgia’s medical marijuana program reported concerns about the legality of marijuana-related products and their ability to obtain the products. As...
FDA Issues Drug Safety Communication on Lung Inflammation Due to Treatment With CDK4/6 Inhibitors
On September 13, the U.S. Food and Drug Administration (FDA) issued a drug safety communication warning that palbociclib, ribociclib, and abemaciclib—used to treat some patients with advanced breast cancer—may cause rare but severe inflammation of the lungs. The agency approved new warnings about...
Conundrums in Managing Cancer-Associated Thrombosis
Although there may be a clear role for prophylactic anticoagulation in hospitalized patients and those undergoing surgery, indication for prophylactic anticoagulation for patients with cancer seen in the ambulatory setting has yet to emerge. Until clinical trial data on prophylactic...
ASTRO 2019: Effect of Closure of Women’s Health Clinics From 2010 to 2013 on Cervical Cancer Screening and Detection
Following the closure of nearly 100 women’s health clinics across the United States from 2010 to 2013, fewer women were screened for cervical cancer; more women were diagnosed with advanced stages of the disease; and disease mortality rates rose. Findings from a new analysis combining several...
ASTRO 2019: SBRT After Disease Progression on Immunotherapy Increases PFS in Patients With Metastatic NSCLC
Non–small cell lung cancer (NSCLC) accounts for the vast majority of all lung cancers—between 80% and 85% of those diagnosed in the United States—and is among the most deadly cancers for both men and women, exceeding the mortality rate of colon, breast, and pancreatic cancers combined. The results...
ASTRO 2019: ORIOLE Trial: Observation vs SABR for Oligometastatic Prostate Cancer
The randomized, phase II ORIOLE trial studying the efficacy of targeted high-dose radiation for men with oligometastatic prostate cancer has shown that stereotactic ablative radiation (SABR) is an effective and safe option for patients who wish to delay hormone-suppression therapy. Data from the...
Home-Based Exercise and Weight Loss Programs for Lymphedema Management in Overweight Breast Cancer Survivors
As reported in JAMA Oncology by Schmitz et al, the WISER Survivor trial showed no benefit of home-based exercise and weight loss programs on lymphedema outcomes vs facility-based lymphedema care among overweight breast cancer survivors. Study Details In the trial, 351 overweight breast cancer...
Single-Center Study of Human Herpesvirus 6B Detection in Bronchoalveolar Lavage Fluid After Hematopoietic Cell Transplantation
In a single-institution study reported in the Journal of Clinical Oncology, Hill et al found that detection of human herpesvirus 6B (HHV-6B) in bronchoalveolar lavage fluid was associated with increased mortality in recipients of allogeneic hematopoietic cell transplantation (HCT) with lower...
