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multiple myeloma

Redefining What It Means to Have Precursor Myeloma

Studies have shown that all patients diagnosed with multiple myeloma had a preceding asymptomatic expansion of clonal plasma cells, clinically recognized as monoclonal gammopathy of undetermined significance or smoldering multiple myeloma. According to C. Ola Landgren, MD, PhD, Professor of...

Searching for Evidence-Based Reassurance Where None Could Be Found

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

breast cancer
genomics/genetics

Neoadjuvant Cisplatin for BRCA-Mutation Carriers: Pruning the Dead Branches

At the 2019 San Antonio Breast Cancer Symposium, Nadine Tung, MD, of Beth Israel Deaconess Medical Center, presented a multisite study called INFORM, run by the Translational Breast Cancer Research Consortium.1 It compared single-agent cisplatin with a “classic” combination of doxorubicin and...

issues in oncology

Using Machine Learning to Prompt Serious Illness Conversations

Despite research showing that among patients with cancer, early advance care planning conversations lead to care that is in alliance with patients’ goals and wishes, especially at the end of life,1 most patients die without having discussions about their treatment goals and end-of-life preferences ...

NCI’s James N. Kochenderfer, MD, Receives Clinical Research Achievement Award

James N. Kochenderfer, MD, Investigator in the Surgery Branch of the National Cancer Institute has been named a Top Ten Clinical Research Achievement Awardee by the Clinical Research Forum. Dr. Kochenderfer received the award for his research into the development of chimeric antigen receptor (CAR) ...

colorectal cancer

BEACON-CRC: Quality of Life May Be Well Maintained With Targeted Treatment

For patients with previously treated metastatic colorectal cancer harboring BRAF V600E mutations, the phase III BEACON-CRC study showed the benefit for combining two or three targeted agents vs the standard of care.1 The study has now also shown a benefit for the triplet and doublet in maintaining ...

lung cancer
immunotherapy

ASCO/CCO Update Guideline for Selecting Systemic Treatment in Stage IV NSCLC Without Driver Mutations

ASCO and Cancer Care Ontario (CCO) have published an update to a joint guideline on systemic therapy for stage IV non–small cell lung cancer (NSCLC) without driver mutations.1 “The treatment of stage IV NSCLC has become increasingly more complicated, and, with the advent of immunotherapy and the...

gynecologic cancers

Is There a Future Role for Secondary Cytoreductive Surgery in the Treatment of Recurrent Ovarian Cancer?

In a recent issue of The New England Journal of Medicine, Coleman et al released the results from the GOG-0213 trial, a multicenter, randomized prospective trial that compared secondary cytoreduction followed by chemotherapy with chemotherapy alone in women with platinum-sensitive recurrent ovarian ...

Addressing Symptom Control and Palliative Care Needs

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, Gabriel Lopez, MD, emphasizes the importance of effective communication and...

Doctoring in the Digital Age: Modern Stressors, Ancient Strategies to Cope

In my 45 years of practicing hematology/oncology at a major urban academic medical center, I have observed a sea change in daily practice that contributes to physician burnout. Although the emotional stresses of caring for seriously ill people play a part in physician burnout, I find the daily...

CAR T-Cell Gene Therapy in Non-Hodgkin Lymphomas: Present and Future

To complement The ASCO Post’s continued comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel immunotherapies for patients with different types of non-Hodgkin...

gynecologic cancers

Addition of Secondary Surgical Cytoreduction to Chemotherapy in Recurrent Platinum-Sensitive Ovarian Cancer

As reported in The New England Journal of Medicine by Robert L. Coleman, MD, of MD Anderson Cancer Center, and colleagues, the phase III trial Gynecologic Oncology Group (GOG)-0213 trial has shown no overall survival benefit with secondary surgical cytoreduction followed by chemotherapy with or...

geriatric oncology

How Real-World Data Can Help Contextualize New Treatments in Older Patients

Consider a patient who is referred for neoadjuvant therapy for stage IIIA, HER2-positive breast cancer. She is otherwise healthy, with no significant medical history, an Eastern Cooperative Oncology Group performance status of 0, unremarkable baseline labs, and a left-ventricular ejection fraction...

pancreatic cancer

‘Unprecedented’ Responses to Cisplatin/Gemcitabine in BRCA-Mutated Advanced Pancreatic Cancer

As first-line treatment of patients with pancreatic ductal adenocarcinoma and a germline BRCA/PALB2 mutation, cisplatin plus gemcitabine yielded high response rates and encouraging survival, establishing this doublet as a standard approach in this subset of patients, according to Eileen M....

breast cancer

APHINITY Update Supports Benefit of Pertuzumab-Based Triplet in Early HER2-Positive, Node-Positive Breast Cancer

Six-year follow-up of the APHINITY trial found a modest, but not statistically significant, overall survival benefit for the addition of pertuzumab to chemotherapy plus trastuzumab vs chemotherapy/trastuzumab as adjuvant therapy in patients with early HER2-positive breast cancer. The benefit was...

pancreatic cancer

Olaparib as Maintenance Therapy for Germline BRCA-Mutated Metastatic Pancreatic Adenocarcinoma

On December 27, 2019, the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib was approved for the maintenance treatment of adult patients with deleterious or suspected deleterious germline BRCA-mutated metastatic pancreatic adenocarcinoma, as detected by a U.S. Food and Drug Administration...

leukemia

ADMIRAL Trial: More Than Standard Chemotherapy Needed for FLT3-Mutant Advanced AML

The important ADMIRAL trial, reported by Perl et al in The New England Journal of Medicine1 and reviewed in this issue of The ASCO Post, shows the efficacy of a specific FLT3 inhibitor in patients with advanced acute myeloid leukemia (AML) and enhances the era of personalized medicine in leukemia. ...

breast cancer

Expert Point of View: Debra A. Patt, MD, MPH, MBA, FASCO, and C. Kent Osborne, MD, FASCO

Debra A. Patt, MD, MPH, MBA, FASCO, Clinical Professor at Dell Medical School at The University of Texas at Austin and Executive Vice President of Public Policy and Strategy Initiatives for Texas Oncology, told attendees in a symposium highlights talk, “We all identify and follow some patients who ...

breast cancer
immunotherapy

Fam-trastuzumab Deruxtecan-nxki for Previously Treated Unresectable or Metastatic HER2-Positive Breast Cancer

On December 20, 2019, the antibody-drug conjugate fam-trastuzumab deruxtecan-nxki was granted accelerated approval in the treatment of patients with unresectable or metastatic HER2-positive breast cancer who have received two or more prior anti–HER2-based regimens in the metastatic setting.1,2...

breast cancer

FDA Grants Breakthrough Therapy Designation to Tucatinib in Combination Therapy for HER2-Positive Breast Cancer

Seattle Genetics recently announced that the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation to tucatinib, in combination with trastuzumab and capecitabine, for the treatment of patients with locally advanced unresectable or metastatic HER2-positive breast...

breast cancer
immunotherapy

Tucatinib Combination Extends Survival in HER2-Positive Metastatic Breast Cancer, Including Patients With Brain Metastases

For patients with progressing HER2-positive metastatic breast cancer previously treated with trastuzumab, pertuzumab, and ado-trastuzumab emtansine (T-DM1), no single regimen is an established standard of care. More than 50% of these patients will develop brain metastasis, and thus far, treatments...

leukemia

Selected Abstracts on Novel Therapies for Chronic Myeloid Leukemia

To complement The ASCO Post’s comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic regimens for chronic myeloid leukemia (CML). For full details of...

leukemia

ADMIRAL Trial: Gilteritinib Improves Overall Survival in Relapsed or Refractory FLT3-Mutated AML

As reported in The New England Journal of Medicine by Alexander E. Perl, MD, of Abramson Cancer Center, University of Pennsylvania, and colleagues, the phase III ADMIRAL trial showed improved overall survival with the oral FMS-like tyrosine kinase 3 (FLT3) inhibitor gilteritinib vs salvage...

multiple myeloma

Taking a Reasonable Approach to Treating Newly Diagnosed Multiple Myeloma

Multiple myeloma is a malignancy characterized by clonal proliferation of terminally differentiated plasma cells within the bone marrow. Although it leads to a host of different issues within the body, overall survival has steadily improved in recent years. “This is largely because of better...

breast cancer

Novel Antibody-Drug Conjugate Shows Efficacy in Women With Pretreated, Metastatic HER2-Positive Breast Cancer

The novel antibody-drug conjugate [fam-] trastuzu­mab deruxtecan (T-DXd) achieved high response rates and durable responses in heavily pretreated patients with HER2-positive metastatic breast cancer, according to results of the phase II DESTINY-Breast 01 trial presented at the 2019 San Antonio...

lung cancer

Global Survey Shows Misperceptions About Lung Cancer Among the General Public

Only one in five people (22%) disagrees with the statement “generally, patients with lung cancer have caused their illness through their lifestyle choices and behaviors,” according to a global, omnibus survey conducted by Ipsos MORI and sponsored by the Lung Ambition Alliance. The results were...

skin cancer

Pembrolizumab in Adjuvant Treatment of Melanoma With Involvement of Lymph Nodes After Complete Resection

In early 2019, pembrolizumab was approved for the adjuvant treatment of patients with melanoma with involvement of lymph node(s) following complete resection.1,2 Supporting Efficacy Data Approval was based on findings in the double-blind EORTC 1325/KEYNOTE-054 trial (ClinicalTrials.gov identifier...

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.1 As stated by the investigators,...

supportive care

Coexisting With Cancer and Depression

Among the highlights at the 2019 Supportive Care in Oncology Symposium in October was the keynote address by Thomas J. Smith, MD, FACP, FASCO, FAAHPM, the Harry J. Duffey Family Professor of Palliative Medicine and Director of Palliative Medicine at Johns Hopkins Medicine and Professor of Oncology ...

head and neck cancer
immunotherapy

Immunotherapy for Head/Neck Squamous Cell Carcinoma: Questions Raised by KEYNOTE-048

There is a new first-line treatment option for patients with newly diagnosed, recurrent, or metastatic head and neck squamous cell carcinoma. As reported by Burtness et al in The Lancet, pembrolizumab improved overall survival vs the standard-of-care regimen of cetuximab and platinum-based...

lung cancer

Global Survey Shows Misperceptions About Lung Cancer Among the General Public

Only one in five people (22%) disagrees with the statement “generally, patients with lung cancer have caused their illness through their lifestyle choices and behaviors,” according to a global, omnibus survey conducted by Ipsos MORI and sponsored by the Lung Ambition Alliance. The results were...

immunotherapy

Antibiotics and Immune Checkpoint Blockade in Patients With Cancer: First Do No Harm

Despite the unprecedented improvement in clinical outcomes with the advent of immune checkpoint blockade for cancer,1,2 robust biomarkers for therapeutic success as well as novel strategies to increase their efficacy are urgently needed. In addition to exploring novel immune checkpoints and other...

kidney cancer

First-Line Pembrolizumab Plus Axitinib for Advanced Renal Cell Carcinoma

On April 19, 2019, pembrolizumab was approved for use in combination with the small-molecule tyrosine kinase inhibitor axitinib for the first-line treatment of patients with advanced renal cell carcinoma.1,2 Supporting Efficacy Data Approval was based on findings in the open-label phase III...

Mary Jo Turk, PhD, Named O. Ross McIntyre, MD, Professor at Dartmouth College

Mary Jo Turk, PhD, has been named the O. Ross McIntyre, MD, Professor at the Geisel School of Medicine at Dartmouth College. Professor of Microbiology and Immunology and Co-Director of the Immunology and Cancer Immunotherapy Program at Dartmouth’s Norris Cotton Cancer Center, Dr. Turk joined the...

solid tumors

The Light at the End of the Tunnel in Urothelial Cancer Is Not a Train: Enfortumab Vedotin and Other Developments

There is an urgent need to develop new drugs for the treatment of urothelial cancer. Chemotherapy was the only approved treatment in advanced disease for 40 years, which was associated with response rates of between 30% and 50% in the front-line setting.1-3 However, durable remissions were...

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...

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...

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...

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...

skin cancer
immunotherapy

Updated Data From Clinical Trials on Nivolumab/Ipilimumab in Advanced Melanoma

More than one out of two patients with metastatic melanoma treated with the combination of nivolumab plus ipilimu-mab is still alive after 5 years, according to the longest follow-up of patients receiving this combination. In two additional studies, the immunotherapy duet also proved to be active...

issues in oncology

A Call to Action for Oncology Clinicians to Help Patients ‘Move Through Cancer’

“There is clear evidence that patients are more likely to exercise if their oncologist tells them to do so,” reported representatives from 17 organizations participating in the Second Roundtable on Exercise and Cancer Prevention and Control. In an article published in CA: A Cancer Journal for...

lung cancer

Long-Term Survival With PD-1/PD-L1 Inhibitors in NSCLC

Although many commentaries on studies featured in The ASCO Post call for scrutiny of the fine points, this is not the case for the recent report by Antonia et al in The Lancet Oncology (reviewed in the current issue of The ASCO Post).1 This article serves as a well-deserved victory lap for the...

multiple myeloma

Elotuzumab in Combination Therapy for Previously Treated Multiple Myeloma

In late 2018, elotuzumab was approved for use in combination with pomalidomide and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least two prior therapies, including lenalidomide and a proteasome inhibitor.1 Supporting Efficacy Data Approval was based ...

issues in oncology
survivorship

Addressing the Obesity Epidemic and Barriers to Implementing Weight Management Programs for Cancer Survivors

Earlier this year, ASCO published the results of its new study on oncologists’ perceptions and practice behaviors regarding obesity, weight management, and related lifestyle factors in their patients both during and after cancer treatment.1 The findings from the online survey of 971 oncology...

prostate cancer

Apalutamide for Metastatic Castration-Sensitive Prostate Cancer

On September 17, 2019, apalutamide was approved for the treatment of patients with metastatic castration-sensitive prostate cancer.1,2 Supporting Efficacy Data The approval is based on overall survival and radiographic progression-free survival findings in the phase III double-blind TITAN trial.2,3 ...

National Comprehensive Cancer Network Oncology Research Program Supports Clinical Trial for Lung Cancer

The National Comprehensive Cancer Network (NCCN®) Oncology Research Program (ORP) has announced plans to support a phase II randomized trial for lung cancer patients. The study is titled, “TH-138: Phase II randomized trial of carboplatin + pemetrexed + bevacizumab, with or without atezolizumab in...

multiple myeloma

Selinexor/Dexamethasone in Refractory Multiple Myeloma: The STORM Has Arrived, but Does It Represent Climate Change?

The term “relapsed/refractory multiple myeloma” is often used to describe advanced myeloma that has progressed through primary or salvage therapy. The International Myeloma Working Group (IMWG) defined the term in 2011 as disease that is “nonresponsive while on salvage therapy or progresses...

hematologic malignancies
immunotherapy

Answers to Hematology Expert Review Questions

Question 1 Which of the following statements about cytokine-release syndrome and neurotoxicity after tisagenlecleucel infusion is correct? Correct answer: B. The median time to onset of cytokine-release syndrome is 3 days. Expert Perspective Following tisagenlecleucel infusion, cytokine-release...

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