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prostate cancer
issues in oncology

2019 GU Cancers Symposium: Study Evaluates Survival by Race in Metastatic Castration-Resistant Prostate Cancer

A large, retrospective study analyzing 5 years of data from the Veterans Health Administration (VHA) found that African American men with chemotherapy-naive, metastatic, castration-resistant prostate cancer who were treated with abiraterone acetate or enzalutamide lived 20% longer compared with...

prostate cancer

2019 GU Cancers Symposium: Small Trial of LuPSMA in PSMA-Positive, Metastatic, Castration-Resistant Prostate Cancer

A single-arm, phase II trial in men with prostate-specific membrane antigen (PSMA)-positive, metastatic, castration-resistant prostate cancer that progressed despite standard therapies found that a majority of men treated with a novel, targeted radiation therapy called lutetium-177 PSMA-617...

breast cancer

MRI and Assay Results May Influence Treatment of DCIS

In a prospective cohort clinical trial reported in JAMA Oncology, Lehman et al found that multiple factors, including magnetic resonance imaging (MRI) findings, played a role in conversion to mastectomy among women with ductal carcinoma in situ (DCIS) who were candidates for wide local excision...

lung cancer
pain management

Opioid Use Following Thoracoscopic Surgery in Early-Stage Lung Cancer

In a study reported in a research letter in JAMA Oncology, Stephanie Tuminello, MPH, and colleagues found that video-assisted thoracoscopic surgery (VATS) was less likely than open resection to be associated with long-term opioid use in patients undergoing surgery for early-stage lung cancer....

skin cancer
immunotherapy

Neoadjuvant Combination Checkpoint Blockade in Advanced Melanoma

Neoadjuvant combination checkpoint blockade showed activity among patients with high-risk stage III melanoma in a small study. However, a high incidence of side effects caused the trial to be closed early. These results were published by Rodabe N. Amaria, MD, Assistant Professor of Melanoma...

integrative oncology

Advancing the Science and Art of Integrative Oncology

In 2019, we will mark the 20th year of the establishment of the Integrative Medicine Service at Memorial Sloan Kettering Cancer Center (MSK), which helped lay the foundation for the emerging field of integrative oncology. Over the past 2 decades, academic cancer institutions, including The...

breast cancer

Breast Cancer Surgical Terminology Should Be Updated to Reflect Modern Medical Practice

BREAST CANCER is a microscopic disease, with most patients presenting with “localized” stage I to III disease, for which they are offered curative-intent surgery often accompanied by radiation therapy, chemotherapy, and hormonal therapy. More accurately, we now know that patients with localized...

lung cancer

Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC

IN A GLOBAL phase II study reported in The Lancet Oncology, Benjamin J. Solomon, MBBS, of Peter MacCallum Cancer Centre, Melbourne, and colleagues found that lorlatinib showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were...

colorectal cancer

Direct-to-Consumer Genetic Test on Hereditary Colorectal Cancer Syndrome Receives FDA Clearance

ON JANUARY 22, 2019, 23andMe received U.S. Food and Drug Administration (FDA) clearance for a genetic health risk report on the hereditary colorectal cancer syndrome MUTYH-associated polyposis. The clearance follows the FDA’s authorization for 23andMe’s BRCA1/BRCA2 (Selected Variants) Genetic...

lung cancer

Encourage Lung Cancer Screening to Prevent Early Deaths

Discussions of benefits and harms from screening of high-risk populations for lung cancer have missed the point. The National Lung Screening Trial (NLST) showed an early and statistically significant major benefit in all-cause mortality from computed tomography (CT) screening.1 Those referred for...

myelodysplastic syndromes

Novel Treatments of Myelodysplastic Syndromes

AS PART of The ASCO Post’s continued coverage of the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition, here is an update on seven different studies on new therapeutics in myelodysplastic syndromes (MDS). Among the treatments highlighted here are the erythroid maturation...

solid tumors
lymphoma
pancreatic cancer
symptom management

FDA Pipeline: Treatments for Tenosynovial Giant Cell Tumor and Pancreatic Cancer, Plus a Statement on Breast Implant–Associated Lymphoma

The U.S. Food and Drug Administration (FDA) recently granted the following designations and applications and also issued a statement: Priority Review for Pexidartinib in Tenosynovial Giant Cell Tumor The FDA has accepted a new drug application (NDA) and granted Priority Review for pexidartinib...

immunotherapy

Immunotherapy in Patients With HIV Infection and Advanced Cancer

A study published by Cook et al in JAMA Oncology focused on whether treatment with checkpoint inhibitors is both safe and effective in patients with advanced cancer who are also human immunodeficiency virus (HIV)-positive. Because checkpoint inhibitors manipulate the immune system, the concern has...

colorectal cancer

Do Certain Sedentary Behaviors Increase the Risk of Young-Onset Colorectal Cancer?

Although colorectal cancer rates in older adults have been decreasing in the United States since the mid-1980s, incidence rates for the cancer have been increasing among young and middle-aged adults, according to a study by the American Cancer Society (ACS). Based on the new data, in 2018, the ACS...

health-care policy
issues in oncology

More Than 60 Leading Health-Care Organizations Call on CMS to Maintain Coverage for Medically Necessary Cancer Testing

Leading health-care companies and organizations representing patients, providers, academic medical centers, laboratories, and diagnostic manufacturers urged the Centers for Medicare & Medicaid Services (CMS) to revise its interpretation of the National Coverage Determination (NCD) for...

immunotherapy

Machine Learning Identifies Multiple Underlying Factors Predicting Response to Immunotherapy

A research team is using a branch of artificial intelligence known as machine learning to better target immunotherapy to those who will benefit. In a recent study published by Leiserson et al in PLOS One, the team used data from a clinical trial of patients with bladder cancer to...

palliative care
issues in oncology

Site of Care May Affect Racial and Ethnic Minorities’ Access to Palliative Treatment

For patients at the end of life, palliative care can prolong survival and improve the quality of life for patients with a life-threatening illness and for their families—but studies have found that racial and ethnic minorities are less likely to receive end-of-life palliative care than...

gynecologic cancers

'Deep Learning'–Based Visual Evaluation for Cervical Cancer Screening

In an observational study reported in the Journal of the National Cancer Institute, Hu et al found that an automated 'deep learning'–based visual evaluation algorithm permitted identification of cervical precancer/cancer cases with greater accuracy than other screening methods. Study Details ...

supportive care
symptom management

FDA Approves Caplacizumab-yhdp for Acquired Thrombotic Thrombocytopenic Purpura

Today, the U.S. Food and Drug Administration approved caplacizumab-yhdp (Cablivi) injection, the first therapy specifically indicated, in combination with plasma exchange and immunosuppressive therapy, for the treatment of adult patients with acquired thrombotic thrombocytopenic purpura (aTTP), a...

skin cancer
immunotherapy

Real-World Treatment Impact of Newer Agents on Survival of Patients With Metastatic Melanoma

The approval of several new agents for metastatic melanoma in the past several years has led to changes in how the disease is treated and managed. Treatments such as the programmed cell death protein 1 (PD-1) inhibitors pembrolizumab, ipilimumab, and nivolumab; BRAF inhibitors; and MEK inhibitors...

solid tumors

Impact of Stereotactic Ablative Radiotherapy on Survival for Patients With Advanced Cancers

The first report from a phase II, multicenter clinical trial has found that a newer, more aggressive form of radiation therapy—stereotactic ablative radiation—can extend long-term survival for some patients with stage IV cancers, while maintaining their quality of life. The study was...

breast cancer

CYP2D6 Genotypes, Endoxifen Levels, and Clinical Outcome in Early-Stage Breast Cancer Treated With Adjuvant Tamoxifen

In a Dutch-Belgian study (CYPTAM) reported in the Journal of Clinical Oncology, Sanchez-Spitman et al found no associations between CYP2D6 genotypes or levels of endoxifen (active metabolite of tamoxifen) and clinical outcomes in patients receiving adjuvant tamoxifen for early-stage breast cancer....

gynecologic cancers
immunotherapy

Avelumab in Recurrent or Refractory Ovarian Cancer

In phase Ib results from the JAVELIN Solid Tumor Trial reported in JAMA Oncology, Disis et al found that avelumab produced durable responses in some patients with recurrent or refractory ovarian cancer. In the study, an expansion cohort of 125 women with advanced disease who had received...

skin cancer

HLA Mismatch and Skin Cancer Risk After Organ Transplant

Data on the risk factors for the development of skin cancer after a solid organ transplant are limited. In a retrospective cohort study, researchers sought to determine the relationship between human leukocyte antigen (HLA) mismatch and risk of skin cancer after transplant. Their findings were...

lung cancer

Clonal MET Amplification and Tyrosine Kinase Inhibitor Treatment Outcome in EGFR-Mutant NSCLC

In a Singaporean study reported in the Journal of Clinical Oncology, Lai et al found that tyrosine kinase inhibitor treatment outcome did not differ according to mesenchymal epithelial transition factor (MET)-high vs MET-low status in treatment-naive, EGFR-mutant non–small cell lung cancer...

prostate cancer

Quality of Life in Men Living With Advanced and Localized Prostate Cancer

In a population-based study reported in The Lancet Oncology, Downing et al found little difference in health-related quality of life (HRQOL) between men with advanced vs localized prostate cancer. Sexual function problems were common among all patients—and often not addressed—and use of ...

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...

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 ...

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, ...

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...

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...

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 ...

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...

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...

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

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...

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...

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