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FDA Approves Voxelotor for Sickle Cell Disease

On November 25, the U.S. Food and Drug Administration (FDA) granted accelerated approval to voxelotor (Oxbryta) for adults and pediatric patients 12 years of age and older with sickle cell disease. “[Voxelotor] is an inhibitor of deoxygenated sickle hemoglobin polymerization, which is the central...

ASH Recognized Choosing Wisely Champions at 2019 Annual Meeting & Exposition

The American Society of Hematology (ASH) recognized three Choosing Wisely® Champions, practitioners working to tackle the overuse of hematology tests and treatments, at its 2019 Annual Meeting & Exposition in Orlando: Stephen L. Wang, MD, of Kaiser Permanente Santa Clara Medical Center, Santa...

Expert Point of View: Angela Lamarca, MD, PhD, Ian Chau, MD, and Per Pfeiffer, MD, PhD

Angela Lamarca, MD, PhD, of the Christie NHS Foundation Trust, Manchester, United Kingdom, served as European Society for Medical Oncology (ESMO) commentator for the ClarIDHy trial in a press briefing held during the ESMO Congress 2019. Dr. Lamarca acknowledged, “The reported median...

hepatobiliary cancer

ClarIDHy and FIGHT-202 Trials Show Positive Results in the Treatment of Patients With Biliary Tract Cancer

Two studies reported at the European Society for Medical Oncology (ESMO) Congress 2019—ClarIDHy and FIGHT-202—demonstrated clinical benefits with novel molecularly targeted agents in the treatment of advanced cholangiocarcinoma. Currently, first-line treatment for locally advanced or metastatic...

Databases: Where Math Meets Medicine

About 4 decades ago, as a young physician, I observed that most surgeons were numerator doctors; they remembered their successes and their failures, but they did not remember the frequency of either. There was no denominator. Worse, the approach to any specific surgical problem was always the...

lung cancer

Ramucirumab Plus Erlotinib Improves Progression-Free Survival in Previously Untreated EGFR-Mutated Advanced NSCLC

As reported in The Lancet Oncology by Kazuhiko Nakagawa, MD, of the Department of Medical Oncology, Kindai University Faculty of Medicine, Osaka, and colleagues, the phase III RELAY trial has shown that the addition of the VEGFR2 inhibitor ramucirumab to the EGFR inhibitor erlotinib improved...

Expert Point of View: Joshua Richter, MD

Joshua Richter, MD, Assistant Professor of Medicine, Hematology, and Medical Oncology at the Tisch Cancer Institute at Mount Sinai in New York, offered his thoughts on the CANDOR study, noting that the findings point to “a new and exciting treatment regimen for our patients with relapsed and...

multiple myeloma

Addition of Daratumumab Increases Benefit of Carfilzomib/Dexamethasone in Multiple Myeloma

In patients with relapsed or refractory multiple myeloma, the addition of daratumumab to carfilzomib plus dexamethasone improved multiple outcomes, compared with carfilzomib/dexamethasone alone, in the international phase III CANDOR trial.1 “Overall, carfilzomib/dexamethasone/daratumumab was...

leukemia
genomics/genetics

ASH 2019: Genomic Features of AML in Patients Aged 60 or Older May Predict Stem Cell Transplant Outcome

For older patients with acute myeloid leukemia (AML), the prospects for success of a stem cell transplant can often be predicted based on the particular set of leukemic genetic characteristics, according to results presented by Murdock et al at the 2019 American Society of Hematology (ASH) Annual...

multiple myeloma
sarcoma
immunotherapy

Edward A. Stadtmauer, MD, on Advanced Multiple Myeloma and Sarcoma: First-in-Human Assessment of CRISPR-Edited T Cells

Edward A. Stadtmauer, MD, of the University of Pennsylvania Abramson Cancer Center, discusses phase I results of immune cells, modified with CRISPR/Cas9 technology, and infused in three patients (two with multiple myeloma and one with sarcoma). Researchers observed the cells expand and bind to...

leukemia

Tait D. Shanafelt, MD, on CLL in Younger Patients: Comparing Ibrutinib and Rituximab With FCR

Tait D. Shanafelt, MD, of Stanford University, discusses extended follow-up data that show ibrutinib plus rituximab improved clinical outcomes vs the standard therapy of fludarabine/cyclophosphamide/ rituximab in younger patients with previously untreated chronic lymphocytic leukemia (Abstract 33).

leukemia

Mhairi Copland, PhD, MB BChir, on Blast Phase CML: A Possible Treatment Advance

Mhairi Copland, PhD, MB BChir, of the University of Glasgow, discusses results of a study on the combination of ponatinib and fludarabine, cytarabine, idarubicin, and G-CSF for patients with blast phase chronic myeloid leukemia, a rare complication with a poor outcome (Abstract 497).

leukemia

Nitin Jain, MD, on First-Line Ibrutinib Plus Venetoclax in CLL

Nitin Jain, MD, of The University of Texas MD Anderson Cancer Center, discusses findings from two studies showing that the combination of ibrutinib and venetoclax is an effective chemotherapy-free oral regimen for patients with high-risk, previously untreated chronic lymphocytic leukemia (Abstract...

lymphoma

Loretta J. Nastoupil, MD, on Follicular Lymphoma: Trial Results With Obinutuzumab/Lenalidomide

Loretta J. Nastoupil, MD, of The University of Texas MD Anderson Cancer Center, discusses phase II study findings that showed obinutuzumab in combination with lenalidomide for patients with previously untreated, high tumor burden follicular lymphoma was associated with improved outcomes (Abstract...

myelodysplastic syndromes
leukemia

Mikkael A. Sekeres, MD, on Newly Diagnosed Hematologic Malignancies: Early Trial Findings on Glasdegib Plus Azacitidine

Mikkael A. Sekeres, MD, of the Cleveland Clinic, discusses results of a phase Ib study of glasdegib in combination with azacitidine, which showed activity in patients with untreated myelodysplastic syndromes, acute myeloid leukemia, and chronic myelomonocytic leukemia who are ineligible for...

immunotherapy
lymphoma
geriatric oncology

ASH 2019: CAR T-Cell Therapy Shows Activity, Reduces Health-Care Utilization in Older Patients With DLBCL

A new analysis of Medicare claims data presented by  Kilgore et al at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 793) has provided the first real-world evidence using claims data available after the approval of autologous anti-CD19 chimeric antigen...

multiple myeloma
geriatric oncology

ASH 2019: Is Autologous Hematopoietic Stem Cell Transplant Safe and Effective for Patients Aged 70 or Older With Multiple Myeloma?

Even though autologous hematopoietic stem cell transplantation (AHCT) is an effective treatment for multiple myeloma, only 4 out of 10 patients receive this therapy. A new study presented by Munshi et al at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 782) ...

leukemia
issues in oncology

ASH 2019: Lower Area-Based Income and Educational Attainment Associated With Poorer Survival Among Pediatric Patients With AML

Children from lower-income neighborhoods were 2.4 times more likely to die during treatment for acute myeloid leukemia (AML) than children from middle- and high-income neighborhoods, according to findings from a study that analyzed nearly 1,500 clinical trial participants. While previous research...

hematologic malignancies

ASH 2019: Early-Phase Study of Venetoclax in Reduced-Intensity Transplant Conditioning Regimen for Patients With High-Risk Myeloid Malignancies

For patients with high-risk myeloid malignancies undergoing allogeneic hematopoietic stem cell transplant, adding the BCL-2 inhibitor venetoclax to a reduced-intensity drug regimen prior to transplant is safe and does not impair the ability of the donor cells to engraft. The phase I study was...

multiple myeloma
immunotherapy

ASH 2019: Dose-Climbing Trial of Dual-Target CAR T-Cell Therapy for Relapsed or Refractory Multiple Myeloma

More than three out of four patients with relapsed multiple myeloma, or myeloma that was refractory to at least two therapies, remained in remission 7 months after treatment with a novel chimeric antigen receptor (CAR) T-cell therapy targeting two proteins that are frequently found on myeloma...

multiple myeloma
immunotherapy

ASH 2019: Phase Ib/II Study of BCMA-Directed CAR T-Cell Therapy for Pretreated Multiple Myeloma

Patients with multiple myeloma who had received a median of five prior therapies with refractory disease had a high response rate when treated with the investigational chimeric antigen receptor (CAR) T-cell therapy JNJ-4528, which targets B-cell maturation antigen (BCMA), a protein commonly found...

hematologic malignancies
immunotherapy

ASH 2019: CAR-NK Therapy for B-Cell Malignancies Shows Activity in Preclinical Studies

Preclinical studies have provided the first evidence that cellular immunotherapy for B-cell cancers could ultimately become an off-the-shelf product, capable of being uniformly manufactured in large quantities. The product—FT596—is among the first cellular immunotherapies to be based on...

immunotherapy
lymphoma

ASH 2019: Early Data Signal Potential for Bispecific Antibody in Non-Hodgkin Lymphoma

The investigational bispecific antibody mosunetuzumab is showing activity in preliminary studies of patients with non-Hodgkin lymphoma (NHL), including those who are refractory to or relapsed after third-line chimeric antigen receptor (CAR) T-cell therapy. If preliminary findings are validated by...

breast cancer

Hair Dye and Chemical Straightener Use May Increase Breast Cancer Risk

Scientists at the National Institutes of Health (NIH) found that women who use permanent hair dye and chemical hair straighteners may have a higher risk of developing breast cancer than women who don’t use these products. The study, published by Eberle et al in the International Journal of Cancer,...

breast cancer
immunotherapy

Promising New Treatments for Triple-Negative Breast Cancer: Immunotherapy and Other Targeted Therapies

Clinical trials continue to demonstrate that combining immunotherapy with chemotherapy and other targeted therapies can improve survival for patients with triple-negative breast cancer, according to results presented at the 21st Annual Lynn Sage Breast Cancer Symposium in Chicago. Nearly 700...

pain management

Multidimensional Palliative Care: Fewer Opioids, More Pain Control in Patients With Advanced Cancer

For opioid-tolerant patients with advanced cancer experiencing pain, relief does not necessarily have to come from a higher dose of opioids, according to findings presented at the 2019 Supportive Care in Oncology Symposium.1 The results of a retrospective analysis of 300 patients with advanced...

prostate cancer

Is Nonmetastatic Castration-Resistant Prostate Cancer a Valid Disease Category?

Does nonmetastatic castration-resistant prostate cancer really exist? Although it is considered a disease category, it turns out that the definition depends on the type of imaging used. Many patients with castration-resistant prostate cancer who were categorized as “nonmetastatic” on conventional...

solid tumors
lymphoma
immunotherapy

Atezolizumab for Pediatric and Young Adult Patients With Previously Treated Solid Tumors or Lymphomas

In a phase I/II study reported in The Lancet Oncology, Geoerger et al found little activity of atezolizumab alone in pediatric and young adult patients with relapsed or refractory malignancies (including solid tumors, non-Hodgkin lymphoma, and Hodgkin lymphoma) with known or expected programmed...

issues in oncology

Factors Associated With Prolonged Grief Symptom Levels in Parents of Children Who Have Died of Cancer

In a Swedish study reported in the Journal of Clinical Oncology, Pohlkamp et al identified factors associated with levels of prolonged grief symptoms in parents of children who have died of cancer, with factors being found to differ between mothers and fathers. As stated by the investigators,...

breast cancer

Breast-Conserving Surgery and Partial-Breast Reirradiation in Patients With Ipsilateral Disease Recurrence

Findings from the phase II NRG Oncology/RTOG 1014 trial, reported in JAMA Oncology by Arthur et al, showed that partial-breast reirradiation after second lumpectomy for recurrence of ipsilateral breast cancer following previous whole-breast irradiation was an effective treatment approach and could...

colorectal cancer

Role of Integrative Therapies for Patients With Colorectal Cancer

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. In this installment, Richard T. Lee, MD, describes the symptoms associated with colorectal cancer...

Expert Point of View: Mafalda Oliveira, MD, PhD

Invited study discussant, Mafalda Oliveira, MD, PhD, of Vall d’Hebron University Hospital in Barcelona, said the phase II G1T28-04 study was “a ‘negative’ trial with clinically ‘positive’ results: an improved toxicity profile and overall survival benefit…. Despite the statistically negative...

Sequence of Therapies for Metastatic Castration-Resistant Prostate Cancer

We’ll start with a trial focused on the sequence of therapies for metastatic, castration-resistant prostate cancer. Then, we’ll move on to an abstract presented at a recent American Heart Association meeting about the link between increased cardiovascular disease risk and increased cancer risk....

breast cancer

‘Unexpected’ Survival Benefit With Trilaciclib Plus Chemotherapy in Triple-Negative Breast Cancer

An unanticipated result of a randomized phase II study was the improvement in overall survival achieved with the investigational CDK4/6 inhibitor trilaciclib in women with metastatic triple-negative breast cancer. The drug was not being evaluated for its anticancer effects, but rather as a means of ...

lung cancer
immunotherapy

FDA Approves Atezolizumab in Combination With Chemotherapy for First-Line Treatment of Metastatic Nonsquamous NSCLC

On December 4, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) in combination with chemotherapy (nab-paclitaxel and carboplatin) for the first-line treatment of adults with metastatic nonsquamous non–small cell lung cancer (NSCLC) with no EGFR or ALK genomic tumor...

lung cancer
immunotherapy

Does Adding Pembrolizumab or Placebo to Chemotherapy for Patients With Metastatic Squamous NSCLC Improve Quality of Life?

In a health-related quality of life analysis from the phase III KEYNOTE-407 trial reported in the Journal of Clinical Oncology, Mazières et al found that the patients with metastatic squamous non–small cell lung cancer (NSCLC) who received pembrolizumab in addition to chemotherapy had better...

breast cancer

FDA Approves FoundationOne CDx as a Companion Diagnostic for Alpelisib/Fulvestrant Treatment in Breast Cancer

On December 4, the U.S. Food and Drug Administration (FDA) approved FoundationOne CDx to be used as a companion diagnostic for alpelisib in combination with fulvestrant for the treatment of postmenopausal female patients as well as male patients with hormone receptor (HR)-positive, HER2-negative,...

prostate cancer

RSNA 2019: MRI-Guided Ultrasound Treatment for Localized Prostate Cancer

A novel magnetic resonance imaging (MRI)-guided procedure that uses therapeutic ultrasound may effectively treat prostate cancer with minimal side effects, according to a new study presented at the 2019 annual meeting of the Radiological Society of North America (RSNA) (Abstract SSC07-07)....

skin cancer

RSNA 2019: High-Dose Brachytherapy for Older Patients With Nonmelanoma Skin Cancer

High-dose brachytherapy for elderly patients with nonmelanoma skin cancer produces excellent cure rates and cosmetic outcomes, according to a new study presented at the 2019 annual meeting of the Radiological Society of North America (RSNA) (Abstract SSM24-02). “For elderly patients [with...

multiple myeloma
geriatric oncology

Use of an On-Site Touchscreen-Based Geriatric Assessment for Older Patients With Multiple Myeloma

In a study reported in the Journal of Oncology Practice, Nathwani et al found that the use of a tablet-based modified geriatric assessment during physician visits by older patients with multiple myeloma was feasible and provided physicians with information that influenced treatment decisions. Study ...

colorectal cancer

Meta-Analysis of Overall Survival With Laparoscopic vs Open Resection for Colorectal Liver Metastases

In an individual patient-level meta-analysis reported in the Annals of Surgery, Syn et al found that laparoscopic resection vs open surgery was associated with significantly improved overall survival as treatment for colorectal liver metastases. Study Details The meta-analysis included data from...

bladder cancer

Does the Addition of Ramucirumab to Docetaxel Improve Overall Survival in Previously Treated Urothelial Carcinoma?

As reported in The Lancet Oncology by Daniel P. Petrylak, MD, and colleagues, the phase III RANGE trial has shown no significant improvement in overall survival with the addition of ramucirumab to docetaxel in patients with locally advanced or metastatic urothelial carcinoma previously treated with ...

supportive care

Checkpoint Inhibitor Pneumonitis: A Pulmonologist’s Perspective

Oncologists have become accustomed to seeing pneumonitis associated with immune checkpoint inhibitor treatment in non–small cell lung cancer (NSCLC), requiring intervention by pulmonologists in the management of severe cases. At CHEST 2019, the annual meeting of the American College of Chest...

prostate cancer

Biomarker-Driven Treatment Selection for Prostate and Other Genitourinary Cancers

As the Nobel Laureate Bob Dylan wrote, “The times they are a-changin’.” Heather Cheng, MD, PhD, Associate Professor, University of Washington, Associate Member, Fred Hutchinson Cancer Research Center, and Director, Seattle Cancer Care Alliance, Prostate Cancer Genetics Clinic, quoted this line in...

kidney cancer
immunotherapy

Immunotherapy Strategies in Renal Cell Carcinoma: Present and Future

Immunotherapy with checkpoint inhibitors is now considered a standard of care for the front-line treatment of advanced renal cell carcinoma. Despite better outcomes with these agents, there is still room for improvement. At the 2019 Chemotherapy Foundation Symposium, Robert J. Motzer, MD, of...

breast cancer

Emerging Alternatives in the Third-Line Setting for Metastatic HER2-Positive Breast Cancer

In the post-trastuzumab era, a number of U.S. Food and Drug Administration (FDA)-approved targeted agents for metastatic HER2-positive breast cancer are available, but there is no preferred option for third-line treatment and beyond. At the 2019 Chemotherapy Foundation Symposium, Shanu Modi, MD,...

cns cancers

Quality of Life and Neurocognitive Function in Patients With Gliomas Treated With Temozolomide-Based Chemoradiotherapy

A secondary analysis of the phase II NRG-RTOG 0424 trial—which initially reported a 73.1% 3-year overall survival rate—has shown a decline in neurocognitive function for half of the trial participants with high-risk, low-grade gliomas up to a year after receiving concurrent chemoradiotherapy with...

Cardiovascular Disease Risk May Be Associated With Cancer Risk

People with risk factors for cardiovascular diseases (determined by traditional risk, 10-year artherosclerotic cardiovascular disease risk score, and biomarkers) were also at higher risk for developing cancer compared to people with lower cardiovascular disease risk, according to research presented ...

breast cancer

Associations of Onctotype DX Breast Recurrence Score With Mortality Prediction and Difference Between Sexes

A study comparing the prognostic value of the Oncotype DX Breast Recurrence Score in male and female patients with early-stage estrogen receptor (ER)-positive breast cancer has found that the score is associated with mortality in male patients at a much lower threshold than female patients. The...

breast cancer

Swedish Population Study of Risk-Adapted Screening Starting Ages for Relatives of Patients With Breast Cancer

In a study reported in JAMA Oncology, Mukama et al identified risk-adapted screening starting ages for relatives of patients with breast cancer according to the number of affected first-degree and second-degree relatives and the age at diagnosis of affected relatives. Study Details The nationwide...

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