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Expert Point of View: Aditya Bardia, MD

These results are promising. The fact that there were two patients with a complete response caught my eye. This is very exciting in metastatic triple-negative breast cancer. These were heavily pretreated patients; 85% had more than four lines of prior therapy,” said Aditya Bardia, MD, a breast...

breast cancer

Anti–PD-L1 Agent Shows Activity in Early Study of Triple-Negative Breast Cancer

An investigational immunotherapy called MPDL3280A showed encouraging and durable clinical activity in heavily pretreated patients with metastatic triple-negative breast cancer, in an early study presented at the 2015 Annual Meeting of the American Association of Cancer Research (AACR).1 Responses...

prostate cancer

Studies Evaluate Effectiveness of Active Surveillance in Prostate Cancer Patients

Active surveillance has become a viable option for many men with low-risk prostate cancer who choose not to undergo active treatment such as surgery or radiotherapy. Four studies evaluating the effectiveness, trends, and other considerations for active surveillance in managing prostate cancer were...

kidney cancer

Intensified Therapy Improves Survival in Wilms Tumor Patients With Rare Genetic Abnormality

Data from two phase III studies led by the Children’s Oncology Group show that augmenting or intensifying therapy for children with high-risk Wilms tumor improved relapse-free survival. These children are deemed to be at high risk due to a specific chromosomal abnormality that confers worse...

cns cancers

Whole-Brain Radiation: Risks Outweigh Benefits for Limited Brain Metastases

New data from a phase III ­Alliance trial weighs in on a longstanding debate in the treatment of brain metastases: Should whole-brain radiation therapy be added to stereotactic radiosurgery? The study found that although whole-brain radiation therapy improved local tumor control in patients with...

head and neck cancer

Clinically Meaningful Preliminary Results With Pembrolizumab in Recurrent Head and Neck Cancer

Pembrolizumab (Keytruda) is making inroads into head and neck cancer, with encouraging results in heavily pre-treated patients with recurrent or metastatic squamous cell carcinoma of the head and neck, according to a report on the expansion-cohort ­KEYNOTE-012 study presented at the 2015 ASCO...

lung cancer

Second-Line Nivolumab Therapy Improves Survival in Patients With Nonsquamous Non–Small Cell Lung Cancer

Anti–programmed cell death protein 1 (PD-1) immunotherapy with nivolumab (Opdivo) extended survival in patients with the most common form of lung cancer—nonsquamous non–small cell lung cancer (NSCLC). Patients whose disease progressed on standard platinum doublet therapy who were treated with...

colorectal cancer

Mismatch Repair Deficiency Predicts Benefit With Pembrolizumab in Colorectal Cancer

A genetic marker to predict response to anti–PD-1 (anti-programmed cell death protein 1) antibodies may have emerged in colorectal cancer, a tumor type that is a newcomer to the anti–PD-1 ballgame. In a phase II study of colorectal cancer patients treated with pembrolizumab (Keytruda), the presence ...

Expert Point of View: Michael B. Atkins, MD

Michael B. Atkins, MD, Deputy Director, Lombardi Cancer Center of Georgetown University, Washington, DC, discussed CheckMate 067 at the Plenary Session. Pending overall survival data, he concluded, “Nivolumab and nivolumab plus ipilimumab are superior to ipilimumab. These treatments (along with...

skin cancer

CheckMate 067: Dual Checkpoint Blockade Proves Effective in Advanced Melanoma

In advanced melanoma, combination treatment with nivolumab (Opdivo) and ipilimumab (Yervoy) more than doubled the median progression-free survival time over ipilimumab alone in the CheckMate 067 trial. That said, single-agent nivolumab proved almost as powerful in patients expressing the programmed ...

leukemia

Patients With Relapsed/Refractory CLL That Progresses Early on Ibrutinib Have Poor Outcomes

Most patients with relapsed/refractory chronic lymphocytic leukemia (CLL) who discontinued ibrutinib (Imbruvica) early “were difficult to treat and had poor outcomes,” according to a study of patients enrolled in four different clinical trials of ibrutinib, with or without rituximab (Rituxan), at...

lymphoma

Carpe Diem

My life as a cancer survivor and an oncologist has taught me the importance of living every day to the fullest. Sometimes we all need a little reminding to appreciate life to the fullest. When I think of my former patient, Marc, that is what comes to mind. When I was a senior in high school, I was...

issues in oncology

Redefining Cancer

The ability to interrogate cancer cells at the genomic, proteomic, immunologic, and metabolomic levels will transform oncology care from one that relies mainly on trial-and-error treatment strategies based on the anatomy of the tumor to one that is more precisely based on the tumor’s molecular...

issues in oncology

Deciphering the Genetic Variability of Cancer to Advance Precision Oncology Care

In 2014, Memorial Sloan Kettering Cancer Center (MSKCC) in New York opened the Marie-Josée and Henry R. Kravis Center for Molecular Oncology with the sole purpose of expediting the translation of novel molecular discoveries into clinical innovations to turn the goal of precision oncology care into...

Expert Point of View: Ian Tannock, MD, PhD, DSc

Formal discussant of this trial Ian Tannock, MD, PhD, DSc, of Princess Margaret Cancer Centre and University of Toronto, Canada, took issue with the design of RTOG 0521. He questioned the use of one-sided P values instead of conventional two-sided P values, noting that overall survival would have...

leukemia

Ibrutinib Plus Bendamustine/Rituximab Called a New Standard in Patients With Previously Treated CLL

The addition of ibrutinib (Imbruvica) to standard therapy with bendamustine (Treanda)/rituximab (Rituxan) significantly reduced the risk of disease progression or death and overall response rates compared with bendamustine/rituximab alone in previously treated chronic lymphocytic leukemia...

supportive care

Two Factors Predict for Recurrent Venous Thromboembolism in Patients With Cancer

Patients with cancer who develop venous thromboembolism are at high risk of such obstructive disease recurring despite adequate anticoagulation. A prespecified analysis of the CATCH trial identified two major predictors of recurrence: venous compression by the tumor and a diagnosis of hepatobiliary ...

sarcoma

Eribulin Improves Overall Survival in Difficult-to-Treat Sarcoma Types

Eribulin (Halaven), a cytotoxic agent approved for advanced/metastatic breast cancer, may improve overall survival for patients with two common and difficult-to-treat forms of advanced/metastatic sarcoma, investigators reported at the 2015 ASCO Annual Meeting.1 Eribulin is a microtubule inhibitor...

Expert Point of View: George Somlo, MD, FACP

This is a significant study. About 30% of patients who undergo breast-conserving surgery or partial mastectomy are likely to have positive margins. Optimal treatment is to remove the entire tumor surgically and then follow with radiation. Standard practice requires reexcision for positive margins,” ...

breast cancer

Routine Resection of Cavity Shave Margins Halved Reexcision Rates in Breast Cancer

Taking additional tissue circumferentially around the cavity left by partial mastectomy (“cavity shave margins”) cut the rate of positive margins by nearly 50% and the rate of reexcision for margin clearance by more than 50% compared with standard partial mastectomy with or without the surgeon...

multiple myeloma

Single-Agent Daratumumab Activity Deemed ‘Remarkable’ in Refractory Multiple Myeloma

Heavily pretreated patients with multiple myeloma achieved rapid, durable, and deepening responses to the anti-CD38 monoclonal antibody daratumumab, in a phase II study presented at the 2015 ASCO Annual Meeting.1 “Daratumumab showed remarkable single-agent activity in heavily pretreated and...

cost of care

ASCO Releases Details of Its Conceptual Framework for Assessing Value in Cancer Care

Defining and ensuring the delivery of high-value oncology care has been one of ASCO’s major goals for more than a decade. In 2007, ASCO formed the Task Force on the Cost of Cancer Care, now called the Value in Cancer Care Task Force, to identify the drivers of the increasing costs of oncology care...

Noted Pediatric Oncologist, Robert J. Arceci, MD, PhD, Dies

Over the past 50 years, great strides have been made in diagnosis, treatment, and survival of childhood cancer. In the 1960s, the probability of survival for a child with cancer was less than 25%, whereas today it may exceed 80%. This incredible cancer success story has been made possible by the...

Clara D. Bloomfield, MD, FASCO: Never One to Back Down From a Challenge

Clara D. Bloomfield, MD, FASCO, always sat in the front row at school. She grew up during a rigidly paternalist period in American society, and her early feminist leanings were brushed aside as grade-school adventures. The medical school lecture room of the 1960s was a male-dominated culture, and...

lung cancer

PD-1 Inhibitor Pembrolizumab Active in Advanced NSCLC: Outcomes Better With Higher PD-L1 Expression

In the phase I KEYNOTE-001 trial reported in The New England Journal of Medicine,1 Edward B. Garon, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues found that the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab (Keytruda)...

kidney cancer

Predicting Recurrence After Surgery in Renal Cell Carcinoma: 16-Gene Assay Recurrence Score Ushers in New Era

In a study reported in The Lancet Oncology and reviewed in this issue of The ASCO Post, Brian Rini, MD, of the Cleveland Clinic Taussig Cancer Institute, and colleagues showed that a 16-gene assay recurrence score could predict postoperative outcome in patients with stage I to III clear cell renal...

skin cancer

Oncolytic Immunotherapy in Melanoma: It’s Not All About PD-1

The benefit from immune-directed therapies in patients with advanced melanoma is not limited to the exploding field of checkpoint inhibitors. According to Robert Andtbacka, MD, Associate Professor of Surgical Oncology, at the Huntsman Cancer Institute at the University of Utah, Salt Lake City,...

cns cancers

Poliovirus for Glioblastoma Grabs National Attention

Researchers at The Preston Robert Tisch Brain Tumor Center at Duke University are being barraged by patients wishing to enroll in their clinical trial of an engineered poliovirus for recurrent glioblastoma. This comes as a result of a CBS 60 Minutes interview with lead researcher Matthias...

cost of care

Cost of Immunotherapy Projected to Top $1 Million per Patient per Year

If new immunotherapy combinations were administered to the half a million Americans dying of cancer each year, the nation’s price tag for treating them—for just 1 year—could top $174 billion, according to projections by Leonard Saltz, MD, Chief of Gastrointestinal Oncology and Chair of the Pharmacy ...

kidney cancer

Lenvatinib/Everolimus: Robust Combination in Metastatic Renal Cell Carcinoma

The combination of lenvatinib (Lenvima) plus everolimus (Afinitor) significantly extended progression-free survival compared with everolimus alone in metastatic renal cell carcinoma, according to a randomized phase II trial.1 Median progression-free survival for patients who received the...

Expert Point of View: Anees B. ­Chagpar, MD

“This is an important study. We’ve known for some time that the aromatase inhibitors tend to be better than tamoxifen for postmenopausal women with hormonally sensitive invasive breast cancer. The NSABP B-35 trial asked the same question in ductal carcinoma in situ. These data, which now follow...

breast cancer

Anastrozole and Tamoxifen: Both Options for Ductal Carcinoma in Situ

Anastrozole was found to be at least as safe and effective as tamoxifen in preventing breast cancer recurrence in women with ductal carcinoma in situ, in the large NSABP B-35/SWOG-35 study.1 Among all women in the trial, however, the 10-year breast cancer–free interval rates were higher in women...

issues in oncology

How CancerLinQ™ Can Benefit People Living With Cancer

As a regular readers of The ASCO Post know, ASCO is developing an exciting new health information learning system called CancerLinQ™, which will exponentially enlarge our understanding of cancer therapy far beyond what we’ve achieved with our system of clinical trials. Cancer clinical trials have...

Expert Point of View: Michael P. Link, MD

“We have had remarkable success in treating patients with cancer. Millions of survivors are a testament to this success. But the ‘cost of cure’ borne by our patients is substantial in terms of diminished quality and quantity of life,” commented the formal discussant of the study ­Michael P. Link,...

thyroid cancer

Thyroid Cancer Rarely Diagnosed in Those With Asymptomatic, Benign Nodules

A prospective, multicenter, observational study involving 992 consecutive patients with one to four asymptomatic, sonographically or cytologically benign thyroid nodules found that “the majority of nodules exhibited no significant size change during 5 years of follow-up or actually decreased in...

Preeminent Cancer Researcher Brian E. Henderson, MD, Dies

Brian E. Henderson, MD, began his medical path as a researcher in virology, and as a young scientist, he ventured to Africa as part of a Centers for Disease Control team to study yellow fever. The better part of his esteemed medical career, however, was as one of the world’s most respected...

breast cancer

My Faith Helped Me Choose a Way Forward With Cancer

I've been fortunate to be strong and healthy for most of my life. In fact, there is no history of any serious illness in my family, which is why I was so unprepared to hear the words “You have breast cancer” 5 years ago. Not only was the diagnosis foreign to me, I had no idea what chemotherapy and...

Expect Questions About Preventing Melanoma

A recent report from the Centers for Disease Control and Prevention (CDC) stated that the incidence of melanoma “doubled between 1982 and 2011, but comprehensive skin cancer prevention programs could prevent 20% of new cases between 2020 and 2030.”1,2 That report should serve to increase interest...

skin cancer

Capitalizing on Increased Interest in Skin Cancer During Summer to Reeducate People About Sunscreens and ‘Smart Sun Strategies’

Amid the encouraging studies reported at the 2015 ASCO Annual Meeting about advances in the treatment of melanoma was a troubling finding about the incidence of melanoma increasing. An analysis of data from nine Surveillance, Epidemiology, and End Results (SEER) registries found that the incidence...

skin cancer

Adjuvant Ipilimumab in High-Risk Stage III Melanoma: Encouraging Study Results Yet Questions Remain

Ipilimumab (Yervoy) is a fully human monoclonal antibody that blocks the negative T-cell regulator cytotoxic T-lymphocyte antigen 4 (CTLA-4) and has improved overall survival for patients with unresectable or metastatic melanoma in two phase III studies.1,2 Based upon these results, ipilimumab was...

Memorial Sloan Kettering Cancer Center Receives Gift of $150 Million From David H. Koch

Memorial Sloan Kettering Cancer Center (MSK) announced that it has received the largest gift in its history, a commitment of $150 million, from long-time MSK board member David H. Koch. This unprecedented contribution will fund a state-of-the-art outpatient medical facility to be known as The David ...

symptom management

2015 Palliative Care in Oncology Symposium to Highlight the Science of Symptom Management

For the past few decades, ASCO has led efforts to integrate palliative care into all phases of cancer treatment. Through numerous educational programs, advocacy efforts, and most recently, the first annual Palliative Care in Oncology Symposium, ASCO has championed the idea that palliative care,...

lung cancer

ASCO Endorses ASTRO Guideline on Definitive and Adjuvant Radiotherapy in Locally Advanced NSCLC

As reported in the Journal of Clinical Oncology by Andrea Bezjak, MD, of Princess Margaret Cancer Center, Toronto, and colleagues,1 ASCO has recently endorsed the American Society for Radiation Oncology (ASTRO) evidence-based guideline on external-beam radiotherapy for patients with locally...

lung cancer

Progress in the Treatment of Patients With EGFR-Mutated NSCLC

Approximately 10% to 15% of patients with advanced non–small cell lung (NSCLC) cancer have mutations in the epidermal growth factor receptor (EGFR) in tumor cells. Specific therapies to inhibit the activity of EGFR-mutated NSCLC have now been clearly shown to improve response rate and...

lung cancer

Early-Phase Studies Show Activity of Novel EGFR Inhibitors Rociletinib and AZD9291 in T790M-Positive NSCLC

Two early-phase studies have shown that the novel epidermal growth factor receptor (EGFR) inhibitors rociletinib and AZD9291 exhibit high activity in non–small cell lung cancer (NSCLC) patients with the EGFR T790M mutation who had progressed on prior EGFR inhibitor therapy.1,2 The T790M mutation...

Cyrus Ghajar, PhD, Receives $4.1 Million From Department of Defense

Cyrus Ghajar, PhD, a metastatic breast cancer researcher at Fred Hutchinson Cancer Research Center, has received a $4.1 million Department of Defense Breast Cancer Research Program (BCRP) “Era of Hope” Scholar Award. The Department of Defense’s BCRP is the second biggest funder of breast cancer...

skin cancer

PET/CT Detects Asymptomatic Melanoma Recurrences

In monitoring patients with melanoma at high risk for relapse, surveillance imaging with 18F-fluorodeoxyglucose–positron-emission tomography (FDG-PET)/computed tomography (CT) can detect asymptomatic metastases and thus facilitate early treatment, according to Australian investigators who presented ...

leukemia
myelodysplastic syndromes

Advancing Classification and Risk Stratification for Leukemia and Myelodysplastic Syndromes

Refinements in the classification and risk stratification for leukemia and myelodysplastic syndromes were reported by three different investigators at the 2015 ASCO Annual Meeting. The first study showed that leukemia stem cell phenotypes are associated with outcomes in acute myeloid leukemia...

Expert Point of View: Keith T. Flaherty, MD

Keith T. Flaherty, MD, Associate Professor of Medicine, Harvard Medical School, and Director of the Termeer Center for Targeted Therapy, Boston, was interviewed by The ASCO Post for his thoughts on the findings from Atreya and colleagues. He believes the study’s outcomes are sufficient for...

colorectal cancer

Triple Inhibition May Cripple BRAF-Mutated Colorectal Cancer

Triplet therapy that inhibits the BRAF, MEK, and EGFR pathways appears promising in BRAF-mutated colorectal cancer, a malignancy that typically does not respond to BRAF inhibition alone.1 At the 2015 ASCO Annual Meeting, Chloe Evelyn Atreya, MD, of the University of California, San Francisco,...

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