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William G. Wierda, MD, PhD, on Immunotherapy for Relapsed/Refractory CLL/SLL: Results From TRANSCEND CLL 004
William G. Wierda, MD, PhD, of The University of Texas MD Anderson Cancer Center, discusses the TRANSCEND CLL 004 trial, which studied the use of an experimental CD19-directed CAR T-cell product in heavily pretreated patients with chronic lymphocytic leukemia or small lymphocytic lymphoma (Abstract ...
NCCN Roundtable Tackles Issues With Innovative Immunotherapies
Immunotherapies are radically changing outcomes, but while helping patients, they are creating complexities surrounding their cost. At the 2019 Annual Conference of the National Comprehensive Cancer Network® (NCCN®), a roundtable of experts, including clinicians and payers, discussed how chimeric...
2019 NCCN Posters Explore Next-Generation Sequencing, Cancer Burden vs Funding, Cardiac Monitoring, and Scalp Cooling
Posters presented at the National Comprehensive Cancer Network® (NCCN®) Annual Conference continue to grow in number and in quality. The ASCO Post presents a few that we found interesting at the recent 2019 meeting. Next-Generation Sequencing Not Always Helpful in Practice The value of...
Targeted Brachytherapy May Improve Outcomes in Recurrent Brain Tumors
For recurrent, previously irradiated brain tumors, innovative treatment with surgically targeted brachytherapy yielded good local control and overall survival, as compared to historic controls, neurosurgeons reported at the 2019 Annual Scientific Meeting of the American Association of Neurological...
Expert Point of View: Marcie L. Riches, MD, MS
Marcie L. Riches, MD, MS, Director of Clinical Research and Data Quality and Bone Marrow Transplant Clinic Medical Director, and Clinical Associate Chief of Hematology/Oncology at the University of North Carolina at Chapel Hill, commented on the study of tabelecleucel for The ASCO Post. At the...
T-Cell Therapy for EBV-Associated Posttransplant Lymphoproliferative Disorder With CNS Involvement
An “off-the-shelf” allogeneic T-cell product, tabelecleucel, may effectively treat patients who develop Epstein-Barr virus (EBV)-associated posttransplant lymphoproliferative disorder with central nervous system (CNS) involvement, researchers from Memorial Sloan Kettering Cancer Center reported at...
NCCN Clinical Practice Guidelines in Oncology: 2019 Updates
In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®), covering eight tumor types. NCCN Guidelines are now published for more than 70 tumor types and topics. Some of the key updates for 2019 were presented...
Expert Point of View: Irene Ghobrial, MD, and Monica M. Bertagnolli, MD, FACS, FASCO
Irene Ghobrial, MD, of Dana-Farber Cancer Institute and Harvard Medical School, Boston, who has conducted seminal trials in smoldering myeloma, commented on the phase III E3A06 study. Asked by The ASCO Post whether E3A06 settles the issue of treating smoldering disease, Dr. Ghobrial responded,...
Evidence Builds for Treating Smoldering Myeloma
In patients with intermediate- to high-risk smoldering multiple myeloma, treatment with single-agent lenalidomide, vs observation, led to a 72% reduction in the risk of disease progression at 3 years.1 Results of the phase III E3A06 study were presented at a press briefing in advance of the 2019...
Postprogression Treatment of Estrogen Receptor–Positive Breast Cancer: Future Approaches
AT THE 2019 Miami Breast Cancer Conference, William J. Gradishar, MD, FASCO, presented a vision of the future in the treatment of advanced hormone receptor–positive breast cancer.1 The refinement of disease subsets, the development of agents targeting the PI3K/AKT/mTOR pathway, the use of novel...
Expert Point of View: Rafael Fonseca, MD
Rafael Fonseca, MD, the Getz Family Professor of Cancer and Chair of the Department of Medicine, Mayo Clinic in Arizona and an expert in minimal residual disease (MRD) in myeloma, commented on the PRIMeR study for The ASCO Post. The PRIMeR subanalysis of the STaMINA trial showed the prognostic...
PRIMeR Study Explores Meaning of Minimal Residual Disease in Myeloma
In a study that earned a Best Abstract Award at the 2019 Transplantation & Cellular Therapy (TCT) Meetings in Houston, minimal residual disease (MRD) negativity at 1 year after autologous hematopoietic cell transplant (HCT) and maintenance lenalidomide therapy was an independent prognostic...
Biomarkers Can Now Help Guide Treatment Selections in Breast Cancer
A growing list of biomarkers is beginning to drive targeted therapy in breast cancer, and clinicians can take advantage of these assays to make treatment selections, Debu Tripathy, MD, Professor of Medicine and Chair of Breast Medical Oncology at The University of Texas MD Anderson Cancer Center,...
Expert Point of View: High-Risk Smoldering Multiple Myeloma
IN SPITE of the high response rates and lack of progression to active disease with the regimens described at the 2018 American Society of Hematology Meeting & Exposition, several myeloma experts interviewed by The ASCO Post said the data do not yet move them to routinely intervene in high-risk...
Early Studies of Two Regimens Show Benefit in High-Risk Smoldering Multiple Myeloma
MORE DATA are in to support early intervention for high-risk smoldering multiple myeloma—an early, asymptomatic entity lacking the presence of CRAB criteria (elevated calcium, renal failure, anemia, bone lesions). The latest come from two phase II studies presented at the 2018 American Society of...
Expert Point of View: Joseph Mikhael, MD
PRESS BRIEFING moderator Joseph Mikhael, MD, Professor of Applied Cancer Research and Drug Discovery, Translational Genomics Research Institute, City of Hope Cancer Center in Phoenix, noted that traditional models are based on simplicity, and the scoring system contains few variables. “In an era...
New Model May Improve Prediction of Risk in Myelodysplastic Syndromes
A PERSONALIZED risk-prediction model for myelodysplastic syndromes (MDS) has been developed through the use of a machine-learning approach that analyzes genomic and clinical data for an individual patient. According to lead investigator Aziz Nazha, MD, of the Cleveland Clinic, the model provides...
Tale of Two FLT3 Inhibitors in AML: Gilteritinib and Quizartinib
Data supporting the use of FLT3 inhibitors in patients with acute myeloid leukemia (AML) were featured at the 2018 ASH Annual Meeting & Exposition. Gilteritinib was evaluated in combination with induction and consolidation as front-line therapy in newly diagnosed patients with AML,1 and...
Better Techniques Coming to Breast Cancer Screening
BREAST CANCER SCREENING is no longer “just mammography” but involves a growing list of ever more sophisticated techniques that are improving detection, according to Elizabeth Morris, MD, Professor of Radiology, the Larry Norton Chair, and Chief of the Breast Imaging Service at Memorial Sloan...
Advanced HER2-Positive Breast Cancer: All Eyes on These Novel Agents
NEW AGENTS for the treatment of advanced HER2-positive breast cancer should be coming soon to your clinic, according to Sara A. Hurvitz, MD, Director of the Breast Cancer Clinical Research Program and Associate Professor of Medicine at the David Geffen School of Medicine at the University of...
Expert Point of View: Christopher L. Hallemeier, MD, and Andrew S. Kennedy, MD
Christopher L. Hallemeier, MD, Associate Professor in Radiation Oncology at the Mayo Clinic, Rochester, and Andrew S. Kennedy, MD, Physician in Chief of Radiation Oncology at Sarah Cannon, Nashville, and Director of Radiation Oncology Research, Sarah Cannon Research Institute, commented on the...
Study Finds Shorter Treatment Course for Rectal Cancer May Actually Improve Outcomes
In patients with locally advanced rectal cancer, the delivery of all radiotherapy and chemotherapy neoadjuvantly—with a shorter course of radiation—may improve the chance of complete response and downstaging over conventional treatment, according to investigators from Washington University, St....
Expert Point of View: Kenneth Shain, MD, PhD
KENNETH SHAIN, MD, PhD, Director of the Myeloma Working Group at Moffitt Cancer Center, Tampa, Florida, told The ASCO Post that ixazomib is “an effective drug,” but he is not ready to use it as maintenance therapy. He noted that the TOURMALINE-MM3 trial did meet its primary endpoint—but not...
Maintenance Ixazomib Delays Disease Progression in Newly Diagnosed Myeloma
IN PATIENTS with newly diagnosed multiple myeloma who responded well to induction therapy and underwent transplant, 2 years of maintenance therapy with ixazomib led to a 38% improvement in progression-free survival compared with placebo, according to the results of the phase III TOURMALINE-MM3...
Expert Point of View: Ajay K. Nooka, MD, MPH
THE ASCO POST asked Ajay K. Nooka, MD, MPH, Associate Professor, Division of Bone Marrow Transplant at Winship Cancer Institute, Emory University, to comment on studies involving daratumumab. “After the phase III SWOG S0777 trial demonstrated a survival benefit with a 3-drug induction regimen...
ASH Reports Show Benefit of Adding Daratumumab to Initial Therapy in Multiple Myeloma
DARATUMUMAB APPEARS to be the “gift that keeps on giving” to the myeloma community. “It seems we can add daratumumab to almost anything and make the regimen better. It’s got good activity and a good safety profile,” said Kenneth Shain, MD, PhD, Director of the Myeloma Working Group at Moffitt...
American Society of Breast Surgeons Recommends Genetic Testing for Newly Diagnosed Patients With Breast Cancer
IN A MOVE that is a significant departure from current testing recommendations, the American Society of Breast Surgeons (ASBrS) recommends that genetic testing be available to all individuals newly diagnosed with breast cancer.1 The new recommendations expand on common restrictions by the National...
New Data in Colorectal, Neuroendocrine, Gastric, and Hepatocellular Cancers
THE ANNUAL GASTROINTESTINAL CANCERS SYMPOSIUM took place earlier this year in San Francisco. In addition to important studies captured in our past few issues, The ASCO Post here briefly summarizes additional interesting studies. Adjuvant Hyperthermic Intraperitoneal Chemotherapy in Colon Cancer...
Expert Point of View: Aditya Bardia, MD, MPH
Aditya Bardia, MD, MPH, Assistant Professor of Medicine at Harvard Medical School and Director of Precision Medicine at the Center for Breast Cancer, Massachusetts General Hospital, Boston, found the PALLET study noteworthy in light of heightened interest in cyclin-dependent kinase 4/6 (CDK4/6)...
Neoadjuvant Palbociclib Plus Letrozole Reduces Ki67 Levels
In the neoadjuvant setting, adding palbociclib to letrozole significantly enhanced the suppression of malignant cell proliferation, as measured by Ki67 levels, in patients with primary estrogen receptor–positive breast cancer but did not increase the clinical response rate over 14 weeks, according ...
Expert Point of View: Eleftherios (Terry) P. Mamounas, MD, William Sikov, MD, and Laura Esserman, MD
Several breast cancer experts said the findings of the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) meta-analysis and the AERAS study are in line with data emerging from other studies of extended treatment with aromatase inhibitors. All of these studies suggest that extended...
More Data Show Small Benefit From Extended Endocrine Therapy
Two studies presented at the 2018 San Antonio Breast Cancer Symposium validated a small benefit of extending adjuvant aromatase inhibitor therapy beyond thestandard 5 years for postmenopausal women with hormone receptor–positive breast cancer. In a meta-analysis of 24,912 patients from 12...
Expert Point of View: Parag J. Parikh, MD
Parag J. Parikh, MD, Director of Gastrointestinal Radiation Oncology, Henry Ford Cancer Institute, Detroit, commented that KEYNOTE-128 “unfortunately found a very low rate of response to single-agent pembrolizumab.” He said he would not use this approach in any patients with neuroendocrine tumors...
Study Shows Limited Antitumor Activity of Pembrolizumab in Neuroendocrine Tumors
Neuroendocrine tumors appear resistant to single-agent immunotherapy, according to the results of the KEYNOTE-028 trial of pembrolizumab. “Pembrolizumab monotherapy showed limited antitumor activity but a manageable safety profile in patients with previously treated, advanced neuroendocrine...
Expert Point of View: Allyson Ocean, MD
Allyson Ocean, MD, a medical oncologist and attending physician in gastrointestinal oncology at NewYork–Presbyterian Hospital/Weill Cornell Medical Center, commented on the Know Your Tumor study. “This study by Pishvaian et al highlights the importance of genomics in guiding treatment decisions in ...
Mutations in DNA Damage Repair Predict Benefit With Platinum Agents in Pancreatic Cancer
Patients with advanced pancreatic cancer who have homologous repair damage response mutations may derive considerable benefit from treatment with platinum agents, according to an analysis of patients in the Know Your Tumor Program presented by Michael Pishvaian, MD, PhD, of Georgetown University,...
Expert Point of View: Mrinal 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,...
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, 37.8% of patients remained...
Front-Line Ibrutinib Improves Progression-Free Survival in Older Patients With Chronic Lymphocytic Leukemia
IN A PHASE III TRIAL reported during the Plenary Session at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition and published in The New England Journal of Medicine, single-agent ibrutinib and ibrutinib/rituximab were associated with superior progression-free survival vs...
Highlights From the 2018 ASH Annual Meeting & Exposition
TO ADD to our ongoing coverage of the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition, we bring readers of The ASCO Post these summaries of an assortment of interesting studies. They focus on novel therapies under investigation in the treatment of acute lymphoblastic...
Expert Point of View: Carlos L. Arteaga, MD
CARLOS L. ARTEAGA, MD, Director of the Harold C. Simmons Comprehensive Cancer Center and Associate Dean of Oncology Programs at The University of Texas Southwestern Medical Center, Dallas, expressed some caution about the overall applicability of the findings of the PADDY trial. Primarily, he...
Prognostic Value of Disseminated Tumor Cells in Early Breast Cancer
IN THE PADDY TRIAL, involving more than 10,000 women with early invasive breast cancer, the presence of disseminated tumor cells at diagnosis or primary surgery was an independent prognostic factor for overall, disease-free, and distant disease–free survival. The study findings were presented at...
SABCS Presentations Offer New Data on Biomarkers and Novel Treatment Approaches in Early and Metastatic Breast Cancers
REPORTERS FOR The ASCO Post captured the following summaries of noteworthy studies presented at the 2018 San Antonio Breast Cancer Symposium. In HER2-Negative Metastatic Disease, CTCs Frequently HER2-Positive ALMOST HALF of all patients with HER2-negative metastatic breast cancer have circulating...
BRAF/MEK Targeting May Yield Benefit in Treating Biliary Tract Cancer
ROUTINE TESTING for BRAF V600E mutations in patients with biliary tract cancer may prove to be a good idea, based on the findings of a phase II study in which treatment with dabrafenib plus trametinib showed activity.1 The results suggest there may be a benefit to testing patients with biliary...
Expert Point of View: Michael J. Overman, MD
INVITED STUDY discussant Michael J. Overman, MD, Professor of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, is a co-investigator on CheckMate 142, which led to the approval of another immunotherapy doublet—nivolumab plus ipilimumab—in patients...
Durvalumab and Tremelimumab Combination Active in Refractory Microsatellite-Stable Colorectal Cancer
THE COMBINATION of durvalumab and tremelimumab prolonged median overall survival by 2.5 months compared with best supportive care alone in patients with advanced treatment-refractory colorectal cancer. These findings, which are from the randomized phase II Canadian Cancer Trials Group (CCTG) CO.26...
Emerging Role for Neoadjuvant Treatment of Resectable Pancreatic Cancer
SEVERAL STUDIES presented at the 2019 Gastrointestinal Cancers Symposium evaluated the benefits of neoadjuvant treatment in patients with pancreatic cancer—and in patients deemed fully resectable, not just “borderline” resectable.1-3 Although the standard of care for resectable pancreatic ductal...
Expert Point of View: Kenneth Shain, MD, PhD, and Vincent Rajkumar, MD
In interviews with The ASCO Post, Kenneth Shain, MD, PhD, Director of the Myeloma Working Group at Moffitt Cancer Center, Tampa, Florida, and Vincent Rajkumar, MD, Professor of Medicine at the Mayo Clinic in Rochester, Minnesota, commented on the findings of the MAIA trial. “The study shows that...
Daratumumab, Lenalidomide, and Dexamethasone in Patients With Newly Diagnosed Multiple Myeloma: Outcomes From the MAIA Trial
In patients with newly diagnosed multiple myeloma who are not eligible for stem cell transplantation, the addition of daratumumab to lenalidomide and dexamethasone significantly reduced the risk of death or disease progression by 44%, according to a late-breaking abstract presentation by Thierry...
Thomas Powles, MD, PhD, on Urothelial Carcinoma: Results From the RANGE Trial on Ramucirumab and Docetaxel
Thomas Powles, MD, PhD, of Queen Mary University of London, discusses phase III study findings on ramucirumab plus docetaxel vs placebo plus docetaxel in patients with advanced platinum-refractory urothelial carcinoma (Abstract 353).
