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Excerpt From the 2018 ASCO Presidential Address: ‘Delivering Discoveries: Expanding the Reach of Precision Medicine’

In my area of research, lung cancer, precision medicine is indeed transforming the treatment of this disease and has important implications for other cancers and for the future of our patients with cancer. Today’s achievement of being able to systematically identify genomic changes that can be...

solid tumors
survivorship

Testicular Cancer Survivors and Adequate Screening for Long-Term Heart Disease

TESTICULAR CANCER is among the most common cancers in young men. The majority of patients are cured of their disease, but a newly published study shows many remain at risk for later complications from chemotherapy or other treatments. The study, published by Mohammad Abu Zaid, MD, Assistant...

A Humble Beginning Built on Commitment: The Life and Times of Lee S. Schwartzberg, MD, FACP

  In this edition of the Living a Full Life series, guest editor Jame Abraham, MD, interviewed medical oncologist Lee S. Schwartzberg, MD, FACP, Executive Director at the West Cancer Center, Memphis. Dr. Schwartzberg’s major research interests are new therapeutic approaches to breast cancer,...

skin cancer
immunotherapy

Treatment Beyond Disease Progression in Melanoma: Challenge Centers on Knowing Who May Benefit

Dr. Weiss is Assistant Professor (Medical Oncology), Developmental Therapeutics, Melanoma Program, Yale Cancer Center. Dr. Sznol is Professor of Medicine (Medical Oncology); Co-Director, Cancer Immunology Program, Yale Cancer Center Co-Director, Yale SPORE in Skin Cancer, New Haven, Connecticut.  ...

skin cancer
immunotherapy

Outcomes in Patients With Melanoma Treated With Anti–PD-1 Antibody Beyond Disease Progression

A POOLED analysis by the U.S. Food and Drug Administration (FDA) has shown a benefit of treatment beyond disease progression on Response Evaluation Criteria in Solid Tumors (RECIST) in some patients receiving anti–programmed cell death protein 1 (anti–PD-1) antibodies for unresectable or...

skin cancer
immunotherapy

Early Data Suggest TLR9 Agonist May Combat PD-1 Resistance in Advanced Melanoma

COMBINING CMP-001, a Toll-like receptor 9 (TLR9) agonist, plus pembrolizumab (Keytruda) appears to overcome resistance to anti–programmed cell death protein 1 (anti–PD-1) therapy, according to a preliminary phase Ib study.1 Adding CMP-001 to pembrolizumab was well tolerated, with antitumor efficacy ...

multiple myeloma
immunotherapy

CAR T-Cell Therapy: Updated Data Remain Favorable in Heavily Pretreated Patients With Myeloma

IN AN UPDATE of a phase I trial, a heavily pretreated population of patients with multiple myeloma continued to respond to the chimeric antigen receptor (CAR) T-cell therapy bb2121.1 The results presented at the 2018 ASCO Annual Meeting confirmed previous findings for bb2121 in the dose-escalation...

breast cancer

Study of PI3K Inhibitor Added to Fulvestrant in Advanced Breast Cancer Affirms Proof-of-Principle

IN PATIENTS with advanced breast cancer harboring a PIK3CA mutation, the addition of the PI3 kinase (PI3K) inhibitor taselisib to endocrine therapy with fulvestrant (Faslodex) significantly improved progression-free survival compared with fulvestrant alone, in the international phase III SANDPIPER...

lung cancer
immunotherapy

More Evidence of Benefit With Immunotherapy and Chemotherapy in Nonsquamous Non–Small Cell Lung Cancer

ATEZOLIZUMAB (TECENTRIQ) plus bevacizumab (Avastin) plus a platinum doublet (ABCP) improved overall survival by 22% compared with bevacizumab plus a platinum doublet (BCP) in patients with advanced wild-type (without an identified mutation) nonsquamous non–small cell lung cancer (NSCLC), according...

lymphoma

Chemotherapy-Free Regimen Comparable to Rituximab-Chemotherapy as Front-Line Therapy for Follicular Lymphoma

IN PATIENTS with previously untreated advanced follicular lymphoma, the chemotherapy-free combination of rituximab (Rituxan) plus lenalidomide (Revlimid), the so-called R-squared (R2) regimen, yielded outcomes as good as those in patients who received standard rituximab-chemotherapy, in the interim ...

sarcoma

With European Protocol, Maintenance Therapy Improved 5-Year Survival in Rhabdomyosarcoma

THE ADDITION OF 6 months of maintenance chemotherapy in the treatment of rhabdomyosarcoma improved 5-year survival by 13%, in the European RMS2005 Maintenance study reported at the 2018 ASCO Annual Meeting.1 “At the end of this long, not-easy study, we concluded that maintenance is an effective and ...

leukemia

Ibrutinib Plus Venetoclax in CLL: High MRD-Negativity Rates, Reduced Risk for Tumor-Lysis Syndrome

A REGIMEN COMBINING ibrutinib (Imbruvica) and venetoclax (Venclexta) in previously untreated patients with chronic lymphocytic leukemia (CLL) greatly reduced the risk of venetoclax-associated tumor-lysis syndrome and led to promising rates of undetectable minimal residual disease (MRD) in the phase ...

breast cancer

Pooled Study Analysis Explores the Use of CDK4/6 Inhibitors in Metastatic Breast Cancer

RESEARCH TO DATE has not been able to identify a subgroup of patients with estrogen receptor–positive HER2-negative metastatic breast cancer who do not derive benefit from the addition of inhibitors of cyclin-dependent kinases 4/6 (CDK4/6) to endocrine therapy, according to a study by the U.S. Food ...

issues in oncology

With Compassion Toward None, With Technology for All?

Imagine health care in the not too distant future…  JOHN IS GOING about his usual Saturday at home, when his health-care–enabled smart watch alerts him to a sudden rise in his heart rate. As he is wondering about the reason, he feels a sharp pain in his left lower quadrant. The tachycardia...

lung cancer
immunotherapy

KEYNOTE-407: Pembrolizumab Plus Chemotherapy Benefits Response, Survival in Squamous NSCLC

THE COMBINATION of pembrolizumab (Keytruda) plus platinum-based chemotherapy improved overall survival, response rates, and duration of response in patients with advanced squamous cell non–small cell lung cancer (NSCLC) compared with chemotherapy alone irrespective of programmed cell death ligand 1 ...

breast cancer
skin cancer

Flight Attendants May Be at Increased Risk of Breast, Skin Cancers

Flight attendants showed an elevated incidence of several types of cancer compared with the general population, according to findings published by McNeely et al in Environmental Health. “Our findings of higher rates of several cancers among flight attendants is striking given the low rates...

survivorship

Many Childhood Cancer Survivors Not Concerned About Their Future Health

A research team led by a St. Jude Children’s Research Hospital epidemiologist has conducted the largest analysis to date of how adult survivors of childhood cancer view their health risk. The scientists found that a surprisingly high number of survivors showed a lack of concern for their...

cns cancers

Surgery Followed by Salvage Stereotactic Radiosurgery vs Whole-Brain Radiotherapy for Four or Fewer Brain Metastases

In a Japanese phase III noninferiority trial (JCOG0504) reported in the Journal of Clinical Oncology, Kayama et al found that salvage stereotactic radiosurgery (SRS) was noninferior to whole brain radiation therapy (WBRT) for survival in patients with 1 to 4 resected brain metastases. In the...

Lessons in the Chill of Early Morning

The following essay by Sushil Bhardwaj, MD, is adapted, with permission, from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and...

prostate cancer
immunotherapy

Apalutamide in Nonmetastatic Castration-Resistant Prostate Cancer

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Earlier this year, apalutamide (Erleada) was approved for ...

solid tumors
lung cancer
issues in oncology
supportive care

Racial/Ethnic Disparities in End-of-Life Care Among Patients With Lung Cancer

Significant disparities in the quality of end-of-life lung cancer care were found among racial/ethnic minorities, with higher odds of experiencing potentially preventable medical encounters during end of life as compared with non-Hispanic whites. These findings were published by Siddharth Karanth, ...

solid tumors
prostate cancer

Oxybutynin for Androgen Deprivation–Associated Hot Flashes in Prostate Cancer

In a letter to the editor of The New England Journal of Medicine, Thomas J. Smith, MD, of Johns Hopkins Sidney Kimmel Comprehensive Cancer Center, Baltimore, and colleagues described the successful use of oxybutynin to treat hot flashes in a patient receiving androgen-deprivation therapy (ADT) for ...

A Conversation With the Author: Mark Scholz, MD

To dig a bit deeper into some of the issues touched upon in the new book, The Key to Prostate Cancer: 30 Experts Explain 15 Stages of Prostate Cancer, The ASCO Post recently spoke with the author, Mark Scholz, MD. Dr. Scholz is a medical oncologist who exclusively treats men with prostate cancer....

solid tumors
prostate cancer

A Medical Oncologist Urges Men to Keep Their Prostates

With the development of the prostate-specific antigen (PSA) test in the early 1990s, the urology community advocated for population screening of all men of a certain age, igniting a heated argument about the test’s clinical value vs potential harms that has not abated to this day. Moreover, from...

issues in oncology
cost of care

Expensive Cancer Drugs Don’t Work if Patients Can’t Afford Them

Eight years ago, I was having a series of colds I couldn’t shake and pain that radiated throughout my back. Still, my symptoms weren’t concerning until, on Halloween morning in 2010, I stepped out of bed and fell to the floor in excruciating pain, unable to move. A visit to the emergency room and a ...

sarcoma

Addition of Dose-Intensified Doxorubicin to Standard Chemotherapy in Rhabdomyosarcoma

As reported by Bisogno et al in The Lancet Oncology, a phase III trial (EpSSG RMS 2005) has shown no benefit of adding doxorubicin to standard IVA (ifosfamide, vincristine, dactinomycin) in 3-year event-free survival among patients with high-risk rhabdomyosarcoma. Study Details In the open-label...

integrative oncology
supportive care

Mindfulness in Cancer Care: Hype or Help?

GUEST EDITOR Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief, Integrative Medicine Service, Memorial Sloan Kettering Cancer Center, New York.   “Mindfulness” has gained significant popularity in the lay press in recent...

issues in oncology
survivorship

Raising Awareness of the Financial Impact of Cancer on Young Adult Survivors

GUEST EDITOR Adolescent and Young Adult Oncology explores the unique physical, psychosocial, social, emotional, sexual, and financial challenges adolescents and young adults with cancer face. The column is guest edited by Brandon Hayes-Lattin, MD, FACP, Associate Professor of Medicine and Medical...

leukemia
immunotherapy

Outcomes of Tisagenlecleucel Therapy in Children and Young Adults With B-Cell Acute Lymphoblastic Leukemia

As reported in The New England Journal of Medicine by Shannon L. Maude, MD, PhD, of Perelman School of Medicine, University of Pennsylvania, Philadelphia, and colleagues, the phase II ELIANA trial has shown that the anti-CD19 chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel (Kymriah) ...

head and neck cancer

Addition of Concurrent Chemotherapy to EGFR Inhibitor and Radiotherapy in Locally Advanced Head and Neck Carcinoma

As reported in the Journal of Clinical Oncology by Tao et al, the phase III GORTEC (Groupe Oncologie Radiothèrapie Tête et Cou) 2007-01 trial has shown improved progression-free survival with the addition of concurrent chemotherapy to cetuximab (Erbitux) and radiotherapy (RT) in...

lung cancer

Addition of Veliparib to Temozolomide in Recurrent Small Cell Lung Cancer

In a phase II trial reported in the Journal of Clinical Oncology, Pietanza et al found no benefit of adding the PARP inhibitor veliparib to temozolomide (Temodar) in recurrent platinum-sensitive or platinum-refractory small cell lung cancer. Benefit was observed with the combination in the subgroup ...

breast cancer

Addition of Panitumumab to Neoadjuvant Chemotherapy in Primary HER2-Negative Inflammatory Breast Cancer

In a single-center phase II study reported in JAMA Oncology, Matsuda et al found that adding the EGFR inhibitor panitumumab (Vectibix) to neoadjuvant chemotherapy produced high pathologic complete response (pCR) rates in patients with primary triple-negative inflammatory breast cancer. Study...

skin cancer

Educational Interventions Decrease Sunburns Among Operators of Heavy Equipment

The implementation of educational interventions among heavy equipment operators, or operating engineers, in Michigan significantly increased the use of sunscreen and decreased the number of sunburns, reported Duffy et al in Cancer Epidemiology, Biomarkers & Prevention. “The rates of...

colorectal cancer

Colon Cancer Surgery and Resource Availability at Hospitals on Weekends and Holidays

The likelihood of severe complications after emergency colon cancer surgery is significantly higher over the weekend, according to a study published by Huijts et al in JNCCN – Journal of the National Comprehensive Cancer Network. The research was led by Perla Marang-van de Mheen, PhD, of the...

breast cancer
immunotherapy

Trastuzumab Biosimilar vs Reference Trastuzumab in HER2-Positive Early Breast Cancer

In the phase III LILAC equivalence trial reported in The Lancet Oncology, von Minckwitz et al found similar efficacy and safety with the trastuzumab biosimilar ABP 980 vs reference trastuzumab (Herceptin) in HER2-positive early breast cancer. On local review, the risk difference and risk ratio (RR) ...

lung cancer

ERBB Mutations and Outcomes With Afatinib and Erlotinib in Squamous NSCLC

In an analysis of the LUX-Lung 8 trial in squamous non–small cell lung cancer (NSCLC) reported in JAMA Oncology, Goss et al found that outcomes among patients treated with afatinib (Gilotrif) were better for those with vs without ERBB mutations. The LUX-Lung 8 trial showed that afatinib was...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Second-Line Pembrolizumab vs Paclitaxel in Advanced Gastric or Gastroesophageal Junction Cancer

As reported in The Lancet by Shitara et al, the phase III KEYNOTE-061 trial showed no significant overall survival benefit with pembrolizumab vs paclitaxel in patients with advanced gastric or gastroesophageal junction cancer progressing on platinum-fluoropyrimidine treatment with programmed cell...

colorectal cancer
survivorship

Dietary Insulin Load and Risk of Disease Recurrence in Stage III Colon Cancer

New research led by Dana-Farber Cancer Institute investigators suggests that patients treated for nonmetastatic colon cancer may sharply reduce the risk that the disease will return by following a diet low in carbohydrates and other foods that raise insulin levels. In a study published by...

issues in oncology
survivorship

Genetic Risk for Subsequent Neoplasms in Long-Term Survivors of Childhood Cancer

In a study reported in the Journal of Clinical Oncology, Wang et al found that germline pathogenic/likely pathogenic mutations significantly contributed to the risk of subsequent neoplasms in long-term survivors of childhood cancers. Study Details The study involved whole-genome sequencing on...

breast cancer

Addition of Ribociclib to Fulvestrant Improves Progression-Free Survival in HR-Positive, HER2-Negative Advanced Breast Cancer

As reported by Slamon and colleagues in the Journal of Clinical Oncology, the phase III MONALEESA-3 trial has shown significant improvement in progression-free survival with the addition of the CDK4/6 inhibitor ribociclib (Kisqali) to fulvestrant (Faslodex) in hormone receptor (HR)-positive,...

multiple myeloma

CAR T Cells Targeting B-Cell Maturation Antigen in Poor-Prognosis Relapsed Multiple Myeloma

In a first-in-human study reported in the Journal of Clinical Oncology, Brudno et al found that chimeric antigen receptor (CAR) autologous T cells targeting B-cell maturation antigen (BCMA) produced responses in patients with poor-prognosis relapsed multiple myeloma. Study Details The current...

lymphoma
immunotherapy

Outcomes by Chemotherapy Backbone for Obinutuzumab vs Rituximab in Previously Untreated Follicular Lymphoma

In an analysis of the GALLIUM trial reported in the Journal of Clinical Oncology, Hiddemann and colleagues found that obinutuzumab (Gazyva) appeared to provide consistent progression-free survival benefit vs rituximab (Rituxan) in previously untreated follicular lymphoma, irrespective of which...

lung cancer
immunotherapy

FDA Expands Approval of Pembrolizumab for First-Line Treatment of NSCLC

The U.S. Food and Drug Administration (FDA) recently granted accelerated approval to the immune checkpoint inhibitor pembrolizumab (Keytruda) for use in combination with chemotherapy as a first-line treatment for patients with metastatic non–small cell lung cancer (NSCLC). KEYNOTE-021 This...

leukemia

Quizartinib in Relapsed or Refractory AML

In a phase II trial reported in The Lancet Oncology, Cortes et al found that the next-generation FLT3 inhibitor quizartinib had good activity in patients with relapsed or refractory acute myeloid leukemia (AML), with greater activity in patients with FLT3-ITD mutations. Study Details The study...

breast cancer

Long-Term Results of Adjuvant Endocrine Therapy in Premenopausal Breast Cancer

In an analysis of long-term outcomes in the SOFT and TEXT trials reported at the 2018 ASCO Annual Meeting and in The New England Journal of Medicine, Francis et al found that the addition of ovarian suppression to adjuvant tamoxifen significantly improved 8-year rates of disease-free and overall...

Inside Story on the Genesis of Teen Cancer America

THANK YOU for publishing the excellent article “We Need to Fill the Gap Between Pediatric and Adult Oncology Care” by Sarah Stream (as told to Jo Cavallo) in the March 25, 2018, issue of The ASCO Post. Sarah’s story and her connection to Teen Cancer America actually go much deeper than she reported ...

gynecologic cancers
lymphoma

Pembrolizumab Receives FDA Approval for Relapsed or Refractory Primary Mediastinal Large B-Cell Lymphoma, Advanced Cervical Cancer

THE U.S. FOOD and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for the treatment of adult and pediatric patients with refractory primary mediastinal large B-cell lymphoma or who have relapsed after two or more prior lines of therapy on June 13, 2018. The newest ...

prostate cancer

Bipolar Androgen Therapy After Disease Progression in Metastatic Castration-Resistant Prostate Cancer

In a single-center phase II study reported in The Lancet Oncology, Teply et al found that bipolar androgen therapy can induce prostate-specific antigen (PSA) response and resensitization to enzalutamide (Xtandi) in men with metastatic castration-resistant prostate cancer whose disease progressed on ...

cns cancers

Addition of Tumor-Treating Fields to Maintenance Temozolomide in Glioblastoma

The final results of a phase III trial reported by Roger Stupp, MD, of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, and colleagues in JAMA indicate that adding antimitotic treatment with tumor-treating fields to maintenance temozolomide is associated with improved...

lymphoma

I’m Proud to Have Contributed to the FDA Approval of CAR T-Cell Therapy

When I was diagnosed with diffuse large B-cell lymphoma (DLBCL) in 2013, I used to joke that if I had to get cancer, this wasn’t a bad one to have. At just 32, I was otherwise healthy, and my prognosis for a cure was good, according to my oncologist. So I felt confident that once I underwent...

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