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issues in oncology

Characteristics of FDA-Designated Breakthrough and Nonbreakthrough Cancer Drugs

In a study reported in the Journal of Clinical Oncology, Hwang et al found little difference in the efficacy and safety of U.S. Food and Drug Administration (FDA)-designated breakthrough vs nonbreakthrough cancer drugs and found that breakthrough drugs were not more likely to represent a novel...

survivorship

Infection-Associated Late Mortality in Childhood Cancer Survivors Undergoing Splenectomy or Splenic Radiation

In a report from the Childhood Cancer Survivor Study published in the Journal of Clinical Oncology, Weil et al found that splenectomy and splenic radiation significantly increased the risk of infection-related late mortality among 5-year survivors of childhood cancer. Study Details The study...

gynecologic cancers

Positive Results From QUADRA Trial of Niraparib in Ovarian Cancer

Tesaro recently announced results from the QUADRA study, which was designed to assess the clinical benefit of niraparib (Zejula) treatment in heavily pretreated patients with ovarian cancer. Results successfully achieved the prespecified primary endpoint and demonstrated niraparib monotherapy...

skin cancer
immunotherapy

FDA Approves Dabrafenib Plus Trametinib for Adjuvant Treatment of Melanoma With BRAF V600E or V600K Mutations

On April 30, 2018, the U.S. Food and Drug Administration (FDA) granted regular approval to dabrafenib (Tafinlar) and trametinib (Mekinist) in combination for the adjuvant treatment of patients with melanoma with BRAF V600E or V600K mutations (as detected by an FDA-approved test) and involvement of...

solid tumors
hematologic malignancies

Update Regarding Tazemetostat Clinical Program

On April 23, Epizyme, Inc, announced that U.S.-based enrollment of new patients into tazemetostat clinical trials is temporarily on hold. Following a safety report of a pediatric patient who developed a secondary lymphoma, the U.S. Food and Drug Administration (FDA) issued a partial clinical hold...

bladder cancer

Results From Phase III RANGE Study of Ramucirumab in Advanced or Metastatic Urothelial Cancer

Eli Lilly and Company recently announced additional results from its global, randomized, double-blind, placebo-controlled phase III RANGE trial evaluating ramucirumab (Cyramza) in combination with docetaxel in patients with locally advanced or unresectable or metastatic urothelial carcinoma whose...

breast cancer

Many Economic Evaluations of Oncotype DX May Have Misleading Conclusions

Research from the Yale School of Public Health has found that the majority of published papers analyzing the cost-effectiveness of a widely used test for breast cancer used a study design that can increase bias. These findings were published by Wang et al in the Journal of Clinical Oncology....

colorectal cancer

Survival Analysis for Adjuvant Chemotherapy vs Observation After Pathologic Complete Response and Resection in Rectal Cancer

In a propensity-score matching analysis reported in JAMA Oncology, Polanco et al found that adjuvant chemotherapy was associated with a survival benefit vs observation among patients with locally advanced rectal cancer who underwent resection after pathologic complete response following neoadjuvant ...

prostate cancer

Concordance of Non–Low-Risk Prostate Cancer Among Brother Pairs

In a Swedish study reported in the Journal of Clinical Oncology, Jansson et al identified an increased risk of non–low-risk prostate cancer among men with prostate cancer who had with brothers diagnosed with non–low-risk disease. Study Details The study involved 4,262 pairs of...

kidney cancer

Results From AREN0533: Treating Higher-Risk Favorable-Histology Wilms Tumor

In a report from the Children’s Oncology Group AREN0533 study published in Journal of Clinical Oncology, Dix et al found improved survival outcomes with a modified approach to treatment of favorable-histology Wilms tumor with lung metastases. Study Details The National Wilms Tumor Study...

prostate cancer

ESTRO 37: Ultrahypofractionated Radiotherapy for Prostate Cancer Is Safe and Effective

Radiotherapy given in high doses over a shorter period of time is safe and effective for patients with prostate cancer, according to research from a phase III trial presented at the European Society for Radiotherapy & Oncology (ESTRO) 37 Conference (Abstract OC-0599). The...

lung cancer

ESTRO 37: Handgrip Strength Test May Be a Good Indicator of Survival in Patients With NSCLC

A simple test of handgrip strength may be a good indicator of short- and long-term survival in patients with stage I non–small cell lung cancer (NSCLC), according to new findings presented at the European Society for Radiotherapy & Oncology (ESTRO) 37 Conference (Abstract PV0041)....

lung cancer

ESTRO 37: Elderly Patients With NSCLC May Be Less Likely to Benefit From Concurrent Chemoradiotherapy

An analysis of elderly patients with non–small cell lung cancer (NSCLC) treated in a phase II trial of radiotherapy combined with chemotherapy has shown that they were less likely to benefit than younger patients if the two treatments were given at the same time. These findings were presented ...

gynecologic cancers

ESTRO 37: Brachytherapy for Patients With Cervical Cancer Does Not Increase Risk of Ureteral Stricture

A rare but potentially serious complication following radiation treatment for cervical cancer is a narrowing of the tube that takes urine from the kidneys to the bladder (the ureter), which can lead to kidney damage and sometimes life-threatening infections. This is called ureteral stricture and,...

prostate cancer

Long-Term Outcomes of Adjuvant Treatment in High-Risk Prostate Cancer

As reported by Hussain et al in the Journal of Clinical Oncology, long-term follow-up of the phase III SWOG S9921 trial showed that the addition of adjuvant mitoxantrone and prednisone (MP) to androgen-deprivation therapy (ADT) did not improve survival and increased death from other malignancies in ...

breast cancer

Family History and Contralateral Breast Cancer Risk in Young Women

In an update from the WECARE (Women’s Environmental Cancer and Radiation Epidemiology) study reported in the Journal of Clinical Oncology, Reiner et al found that women with invasive breast cancer are at increased risk of contralateral breast cancer even in the absence of deleterious...

skin cancer
immunotherapy

Immune-Related Toxicity With Combination Immunotherapy for Melanoma

As reported in JAMA Oncology by Alexander N. Shoushtari, MD, of the Memorial Sloan Kettering Cancer Center, and colleagues, a single-center experience has shown a very high rate of clinically significant immune-related adverse events with nivolumab (Opdivo) plus ipilimumab (Yervoy) for advanced...

skin cancer
immunotherapy

Pembrolizumab vs Ipilimumab in Advanced Melanoma

The final overall survival analysis of the phase III KEYNOTE-006 trial showed maintained superiority of pembrolizumab (Keytruda) vs ipilimumab (Yervoy) in advanced melanoma. The results were reported by Jacob Schachter, MD, of the Ella Lemelbaum Institute for Melanoma, Sheba Medical Center, Tel...

integrative oncology

Massage Therapy for Patients With Cancer

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Ting Bao, MD, DABMA, MS, reviews the current data on the use of massage to...

solid tumors

Morbidity in Testicular Cancer Survivors Treated With Standard Cisplatin-Based Chemotherapy

In a study reported in the Journal of Clinical Oncology, Kerns et al found that approximately 20% of testicular cancer survivors treated with cisplatin-based regimens had high cumulative burden of morbidity (CBM) scores and identified factors associated with risk for increased morbidity. Study...

multiple myeloma

Updated International Myeloma Working Group Criteria: Diagnostic Challenges

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Landgren review the underlying data that shaped the updated International Myeloma Working Group (IMWG) diagnostic criteria for...

Study Finds Sigmoidoscopy Screening Reduces Colon Cancer Risk in Men but Not Women

The U.S. Preventive Services Task Force recommends several screening tests for colorectal cancer (CRC) in adults aged 50 to 75, including fecal occult blood testing, sigmoidoscopy, or colonoscopy. According to the American Cancer Society, in 2017, there were an estimated 95,520 cases ...

gastroesophageal cancer
gastrointestinal cancer

Postoperative Chemotherapy vs Chemoradiotherapy in Resectable Gastric Cancer

In the Scandinavian phase III CRITICS trial reported in The Lancet Oncology, Cats et al found no benefit of postoperative chemoradiotherapy vs chemotherapy among patients with gastric cancer who had received neoadjuvant chemotherapy. Compliance with postoperative regimens was poor in both groups....

kidney cancer

Update on ATLAS Trial of Axitinib as Adjuvant Treatment for Patients at High Risk of Renal Cell Carcinoma Recurrence After Surgery

Pfizer recently announced that the independent data monitoring committee for the phase III ATLAS trial, which is evaluating axitinib (Inlyta) as adjuvant therapy for patients at high risk of recurrent renal cell carcinoma (RCC) after nephrectomy, recommended stopping the trial at a planned interim...

lung cancer

FDA Approves Osimertinib for First-Line Treatment of Metastatic NSCLC With Most Common EGFR Mutations

On April 18, the U.S. Food and Drug Administration (FDA) approved osimertinib (Tagrisso) for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R mutations, as...

colorectal cancer

Following Nutrition and Exercise Guidelines May Prolong Survival in Stage III Colon Cancer

A diet high in whole grains, fruits, and vegetables—along with exercise and maintaining a healthy body weight—can improve the 5-year survival rate for patients with stage III colorectal cancer, according to a new report published by Van Blarigan et al in JAMA Oncology. The findings...

lung cancer
immunotherapy

Pembrolizumab Monotherapy in NSCLC Meets Primary Endpoint in Phase III KEYNOTE-042 Study

On April 9, the phase III KEYNOTE-042 trial evaluating pembrolizumab (Keytruda) as monotherapy for the first-line treatment of locally advanced or metastatic non–small cell lung cancer (NSCLC, including nonsquamous or squamous histologies) met its primary endpoint of overall survival (OS). An ...

symptom management

Use of Indwelling Pleural Catheter for Outpatient Talc Administration in Treatment of Malignant Pleural Effusion

In a UK study reported in The New England Journal of Medicine, Bhatnagar et al found that outpatient talc vs placebo administration via indwelling pleural catheter was associated with a higher rate of pleurodesis in patients with malignant pleural effusion. Study Details In the study, a target of ...

lung cancer

Crizotinib in East Asian Patients With ROS1-Positive Advanced NSCLC

In a phase II study reported in the Journal of Clinical Oncology, Wu et al found that crizotinib (Xalkori) was highly active in East Asian patients with ROS1-positive advanced non­–small cell lung cancer (NSCLC). Study Details In the study, 127 patients from 37 sites in China, Japan,...

lung cancer
immunotherapy

AACR 2018: Pilot Study of Neoadjuvant Nivolumab in Resectable NSCLC

In a pilot study reported at the 2018 American Association for Cancer Research (AACR) Annual Meeting (Abstract CT079) and in The New England Journal of Medicine by Forde et al, neoadjuvant nivolumab therapy was found to be feasible and active in patients with resectable non–small cell lung...

lymphoma
immunotherapy

Axicabtagene Ciloleucel CAR T-Cell Therapy Active in Refractory Large B-Cell Lymphoma

As reported at the 2017 American Society of Hematology (ASH) Meeting & Exposition and in The New England Journal of Medicine by Sattva S. Neelapu, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, a phase II trial has shown high activity of autologous anti-CD19 chimeric...

issues in oncology
immunotherapy

AACR 2018: Boosting T-Cell Memory May Result in Longer-Lasting Responses in Patients Treated With Checkpoint Blockade Immunotherapies

Some T cells have excellent memories. These subtypes—known as memory T cells—may explain why some immunotherapies are more effective than others and could potentially lead to researchers designing more effective studies using combination checkpoint blockade treatments, according to...

lung cancer

AACR 2018: New Liquid Biopsy–Based Cancer Model Reveals Data on Chemoresistance in SCLC

Small cell lung cancer (SCLC) accounts for 14% of all lung cancers and is often rapidly resistant to chemotherapy, resulting in poor clinical outcomes. Treatment has changed little for decades, but a study at The University of Texas MD Anderson Cancer Center offers a potential explanation for...

skin cancer
immunotherapy

AACR 2018: Adjuvant Pembrolizumab in High-Risk Stage III Melanoma

As reported at the 2018 American Association for Cancer Research (AACR) Annual Meeting (Abstract CT001) and in The New England Journal of Medicine by Eggermont et al, the phase III EORTC 1325/KEYNOTE 054 trial has shown that adjuvant pembrolizumab (Keytruda) significantly prolonged recurrence-free...

hematologic malignancies

FDA Approves Fostamatinib Disodium Hexahydrate for Chronic Immune Thrombocytopenia in Adult Patients

On April 17, the U.S. Food and Drug Administration (FDA) approved fostamatinib disodium hexahydrate (Tavalisse) for the treatment of thrombocytopenia in adult patients with chronic immune thrombocytopenia who have had an insufficient response to a previous treatment. Fostamatinib is an oral spleen ...

issues in oncology
global cancer care

An Inspiring Experience at Cancer Control for Primary Care Course in Bhutan

I’ll admit it. When I was first asked if I would chair the Cancer Control for Primary Care (CCPC) Course in Bhutan, I immediately exclaimed yes... and then sheepishly went to look up where exactly Bhutan was on a map. For the uninitiated, Bhutan is a country nestled between India and Tibet in the...

cns cancers

A Clinician’s Guide to Treating Patients With Glioblastoma

Glioblastoma, a grade 4 astrocytoma, is the most common and most aggressive form of primary brain tumors in adults. The most recent guidance on molecular profiling, diagnostic and prognostic factors, and treatments for newly diagnosed and recurrent diseases was described in the Journal of Oncology ...

A Career Based on Service: Both Medical and Military

For this installment in the Living a Full Life series of articles, Edith Peterson Mitchell, MD, was interviewed by Guest Editor Jame Abraham, MD, FACP. Dr. Mitchell is Clinical Professor of Medicine and Medical Oncology in the Division of Medical Oncology at Thomas Jefferson University as well as ...

hematologic malignancies
leukemia
immunotherapy

Fine-Tuning Treatment in Myeloma and Leukemia

It is a difficult task to include every notable presentation from the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition. In addition to our more comprehensive coverage of the news from that meeting over the past several issues, below are summaries of additional key...

breast cancer

Modest Weight Loss Reduces Breast Cancer Risk

Evidence of the numerous health benefits of weight loss continues to mount, and the hope is that doctors and patients are listening. A large observational study presented at the 2017 San Antonio Breast Cancer Symposium showed that weight loss of more than 5% is associated with a significantly lower ...

lung cancer
immunotherapy

AACR 2018: KEYNOTE-189: Addition of Pembrolizumab to Chemotherapy in Metastatic NSCLC

As reported at the American Association for Cancer Research (AACR) Meeting (Abstract CT075) in the The New England Journal of Medicine by Gandhi et al, the first interim analysis of the phase III KEYNOTE-189 trial has shown significant improvement in overall and progression-free survival with the...

Expert Point of View: C. Kent Osborne, MD

C. Kent Osborne, MD, Director of the Dan L. Duncan Cancer Center at Baylor College of Medicine, Houston, and moderator of a press conference where the EMBRACA findings were presented, shared his thoughts on the study. While a few months’ improvement in the risk of disease progression may seem...

lung cancer
immunotherapy

AACR 2018: CheckMate 227: Nivolumab/Ipilimumab vs Chemotherapy in NSCLC With High Tumor Mutational Burden Analysis

As reported at the 2018 American Association for Cancer Research (AACR) Meeting (Abstract CT077) and in The New England Journal of Medicine by Hellmann et al, an analysis from the phase III CheckMate 227 trial has shown that the combination of nivolumab (Opdivo) plus ipilimumab (Yervoy)...

breast cancer

Talazoparib Reduces Risk of Disease Progression in BRCA-Mutated Breast Cancer

In patients with BRCA-positive advanced breast cancer, talazoparib reduced the risk of disease progression or death by 46% vs chemotherapy, according to the phase III EMBRACA trial presented at the 2017 San Antonio Breast Cancer Symposium.1 “We are very pleased that the EMBRACA trial—the largest...

survivorship
issues in oncology

Meeting the Challenges of Providing Long-Term Psychosocial Care for Cancer Survivors

Focusing on the first year after a cancer diagnosis is necessary, but not sufficient, for delivering care to cancer survivors, according to Deborah Mayer, PhD, RN, Director of Cancer Survivorship at the UNC Lineberger Comprehensive Cancer Center at the University of North Carolina at Chapel Hill....

bladder cancer
immunotherapy

Health-Related Quality-of-Life Analysis of Anti–PD-1 Therapy vs Chemotherapy in Advanced Urothelial Cancer

As reported by Vaughn et al in the Journal of Clinical Oncology, a health-related quality-of-life analysis from the phase III KEYNOTE-045 trial in previously treated advanced urothelial cancer showed that patients treated with the anti–programmed cell death protein 1 immunotherapy...

pancreatic cancer

AACR 2018: Short-Acting Calcium Channel Blockers Associated With Increased Risk of Pancreatic Cancer in Postmenopausal Women

Calcium channel blockers (CCBs)—specifically the short-acting form of CCBs, which are prescribed to treat high blood pressure—were associated with an increased risk of pancreatic cancer in postmenopausal women, according to a study presented at the American Assocation for Cancer...

solid tumors
immunotherapy

AACR 2018: Dual Inhibition of IDO1 and PD-L1 Safe in Patients With Advanced Solid Tumors

Treatment combining the IDO1 inhibitor epacadostat and the programmed cell death ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) was found to be safe in patients with advanced solid tumors, with safety data similar to treatment with durvalumab alone, according to data presented from the ongoing...

issues in oncology
survivorship

Efforts to Make Tobacco Cessation in Cancer Survivors Standard Practice

It is well established that smoking increases the risk for developing cancer, but when it comes to tobacco cessation in the cancer survivor population, should oncologists be stepping in, and what resources should they be using? Graham W. Warren, MD, PhD, posed these questions to the audience at the ...

skin cancer
immunotherapy

AACR 2018: TLR9 Agonist CMP-001/Pembrolizumab Combination Shows Early Efficacy in Patients With Metastatic Melanoma Resistant to Anti–PD-1

A combination of CMP-001, an intratumoral Toll-like receptor 9 (TLR9) agonist, and pembrolizumab (Keytruda) was well tolerated and had clinical activity in patients with metastatic melanoma resistant to programmed cell death protein 1 (PD-1) checkpoint inhibition, according to preliminary data...

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