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immunotherapy
skin cancer

Study Finds Immune-Related Adverse Events Herald Benefit With Adjuvant Pembrolizumab in Melanoma

In the EORTC 1325/KEYNOTE-054 trial of adjuvant pembrolizumab in patients with stage III melanoma, recurrences were reduced by 44% in the immunotherapy arm, vs placebo, but this benefit increased to a 63% reduction in risk among patients developing an immune-related adverse event on treatment.1...

hematologic malignancies
leukemia

Active Regimen for High-Risk and Older Patients With Previously Untreated Chronic Lymphocytic Leukemia

In a single-center phase II trial reported in The New England Journal of Medicine, Nitin Jain, MD, and colleagues found that the combination of ibrutinib and venetoclax was highly active in previously untreated high-risk and older patients with chronic lymphocytic leukemia (CLL).  In the study, 80 ...

issues in oncology

Physicians and the Threat of Nuclear War

The Hippocratic Oath calls on physicians to “use treatment to help the sick according to my ability and judgment,” but not all versions of the oath call on us to prevent disease. Here we urge our colleagues to acknowledge that additional mandate and renew their commitment to preventing what could ...

Emergency Medicine Doctor Reflects on 5 Decades of Career Experiences

BOOKMARK Title: Patient Care: Death and Life in the Emergency RoomAuthor: Paul Seward, MDPublisher: CatapultPublication Date: July 2018Price: $22.95, hardcover, 240 page The history of emergency medicine residency training is interlaced with the impetus for specialty status in emergency medicine,...

hematologic malignancies
multiple myeloma

FDA Approves Daratumumab in Combination With Lenalidomide and Dexamethasone for Newly Diagnosed Multiple Myeloma

On June 27, the U.S. Food and Drug Administration (FDA) approved daratumumab (Darzalex) in combination with lenalidomide and dexamethasone for the treatment of patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant (ASCT). The application received...

supportive care

Integrative Medicine in Pediatric and Adolescent Patients With Cancer

GUEST EDITOR Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief of Integrative Medicine Service at Memorial Sloan Kettering Cancer Center, New York. The ASCO Post’s Integrative Oncology series is intended to facilitate the...

integrative oncology

Chaga Mushroom

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, Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, explore the current...

immunotherapy
lung cancer

Combination Immunotherapy and Inhibitors of DNA Damage Repair in the Treatment of Small Cell Lung Cancer

Unlike non–small cell lung cancer (NSCLC), which has seen a paradigm shift in treatment modalities with the discovery of genetic signatures (including EGFR mutations) that are responsive to targeted drugs, systemic treatment of small cell lung cancer (SCLC) has remained largely unchanged for over...

pancreatic cancer

APACT Trial: Nab-paclitaxel/Gemcitabine vs Gemcitabine Alone in Adjuvant Treatment of Pancreatic Cancer

The largest adjuvant trial in pancreatic adenocarcinoma, the global phase III APACT trial, evaluated the combination of adjuvant nab-paclitaxel/gemcitabine vs gemcitabine monotherapy in patients with resected pancreatic cancer. Results of the study were reported by Margaret A. Tempero, MD, of the...

colorectal cancer

IDEA Collaboration Turns to Duration of Adjuvant Treatment in Stage II Colon Cancer

The findings of the landmark IDEA trial in stage III colorectal cancer, presented at the 2017 ASCO Annual Meeting and subsequently published in The New England Journal of Medicine,1 were upheld by a subsequent analysis by the same group, the International Duration Evaluation of Adjuvant...

breast cancer

NALA Trial: Neratinib Plus Capecitabine Shows Benefit in Metastatic Breast Cancer

In the global phase III NALA trial, treatment of metastatic HER2-positive breast cancer with neratinib plus capecitabine significantly improved progression-free survival, delayed the time to intervention for central nervous system disease, and showed a trend toward improved overall survival vs...

breast cancer

Clinical Risk Enhances Utility of TAILORx Findings in Young Women With Breast Cancer

Clinical risk factors add prognostic information that complements the 21-gene recurrence score, according to a new analysis from the landmark TAILORx trial.1,2 The integration of clinical risk with the recurrence score provides greater precision in determining recurrence risk and guiding the use of ...

breast cancer

CLEOPATRA End-of-Study Analysis in Metastatic Breast Cancer: 37% Alive at 8 Years

The end-of-study analysis of the landmark CLEOPATRA trial shows that 37% of patients with HER2-positive metastatic breast cancer are still alive at 8 years, according to principal investigator Sandra M. Swain, MD, FACP, FASCO, Associate Dean for Research Development at Georgetown University Medical ...

issues in oncology

Accelerated Approval Program: For the Benefit of Patients

A DIAGNOSIS of any life-threatening cancer or other serious illness has always been a world-shaking event for those touched by significant disease, and most of us have known—or will know—the frustration, helplessness, and desperate sense of urgency provoked by the words, “The disease is worsening,...

head and neck cancer
immunotherapy

Synergistic Relationship Between Radiotherapy and Immunotherapy for Squamous Cell Carcinoma of the Head and Neck

Recent technologic improvements in radiotherapy now offer an unprecedented opportunity to enhance immune response, and going forward, may play a role in the definitive treatment of head and neck cancer, according to William Stokes, MD, Assistant Professor in the Department of Radiation Oncology at...

leukemia
immunotherapy

Fixed-Duration Venetoclax Plus Obinutuzumab as First-Line Treatment in Older Patients With CLL Who Have Comorbidities

A fixed-duration regimen of venetoclax plus obinutuzumab demonstrated superior progression-free survival, complete response rates, and minimal residual disease (MRD) negativity compared with chlorambucil plus obinutuzumab as first-line therapy for older patients with chronic lymphocytic leukemia...

prostate cancer

Apalutamide Improves Survival Outcomes in Castration-Sensitive Metastatic Prostate Cancer in TITAN Trial

Adding apalutamide to androgen-deprivation therapy (ADT) significantly improved survival in men with metastatic castration-sensitive (also termed hormone-sensitive) prostate cancer, according to the results of the phase III TITAN trial, which were presented at the 2019 ASCO Annual Meeting and...

pancreatic cancer

POLO Trial Shows Maintenance Olaparib Improves Progression-Free Survival in Metastatic Pancreatic Cancer

In patients with metastatic pancreatic cancer and germline mutations in BRCA1 or BRCA2, maintenance therapy with olaparib doubled the time to disease progression and the proportion of patients who were progression-free at 2 years, in the phase III POLO trial.1 “Maintenance olaparib provided a...

prostate cancer

ENZAMET Trial Shows Enzalutamide Improves Overall Survival in Hormone-Sensitive Metastatic Prostate Cancer

Agents that improve survival in metastatic castration-resistant prostate cancer when added to background androgen-deprivation therapy (ADT) are showing success in treating metastatic prostate cancer earlier while it is still hormone-sensitive. These agents include docetaxel (chemotherapy) and...

issues in oncology
legislation

Curbside Consults: New Liability Risks to Avoid When You Are Not a Patient’s Physician

Like most clinicians, oncologists often informally consult their colleagues, both asking questions and seeking suggestions on how best to care for their patients.1,2 These informal or “curbside” consults (sometimes called “sidewalk,” “elevator,” or “hallway” consults) are valuable, because the...

prostate cancer

Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer: Delaying Overt Metastatic Disease Is a Major Advance

Nonmetastatic (M0) castration-resistant prostate cancer arises in the subset of men with biochemically recurrent disease (ie, rising prostate-specific antigen [PSA] level after definitive therapy in the absence of metastases) who develop PSA progression after chronic exposure to...

prostate cancer

ARAMIS Trial: Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer

In a phase III ARAMIS trial reported in The New England Journal of Medicine, Karim Fizazi, MD, of the Institut Gustave Roussy, Universite Paris-Sud, Villejuif, France, and colleagues found that the androgen-receptor antagonist darolutamide significantly prolonged metastasis-free survival vs placebo ...

hepatobiliary cancer
gynecologic cancers

Aspirin Use and Cancer Prevention: Long-Term Data Needed on Benefits and Risks

In addition to its well-known cardioprotective benefits, aspirin has a substantial body of observational, preclinical, and clinical evidence supporting its efficacy in preventing cancer, most strongly for colorectal cancer.1 The strength of this evidence led the U.S. Preventive Services Task...

Expert Point of View: Kristin Higgins, MD

The discussant of the abstract on the use of prophylactic cranial irradiation in patients with extensive-stage small-cell lung cancer (SCLC), Kristin Higgins, MD, underscored the marked shift in practice patterns in the United States. However, she noted that many questions remain concerning...

lung cancer

Survey Finds Prophylactic Cranial Irradiation Use in Decline for Extensive-Stage Small Cell Lung Cancer

Delivery of prophylactic cranial irradiation to patients with extensive-stage small cell lung cancer (SCLC) has declined significantly since the publication of a study by Takahashi et al, according to a recent survey of academic radiation oncologists.1 Data presented at the 2019 Multidisciplinary...

immunotherapy
head and neck cancer

Head and Neck Cancer Immunotherapy in Locally Advanced Disease: Clinical Trial Updates

Programmed cell death protein 1 (PD-1) inhibitors are approved for the second-line treatment of head and neck cancer and likely will be soon in the first-line treatment of locally advanced disease. According to Robert L. Ferris, MD, PhD, developments in immunotherapy for this population should be...

immunotherapy
lung cancer

KEYNOTE-001 Shows Long-Term Survival Benefit With Pembrolizumab in Advanced NSCLC

Before the introduction of immunotherapy with checkpoint inhibitors, the 5-year life expectancy for patients with advanced non–small cell lung cancer (NSCLC) was 5.5%. This dismal outlook has changed. Treatment with the immune checkpoint inhibitor pembrolizumab dramatically improved overall...

issues in oncology

How Have We Got It So Wrong?

The past 20 years have seen an unprecedented increase in the development of effective drugs for the management of cancer. The advent of immunotherapy offers even the promise of cure for some previously highly resistant diseases. The science is brilliant, the need is ever increasing—but the cost is ...

Expert Point of View: Harold Burstein, MD, PhD, FASCO, and Jame Abraham, MD, FACP

Harold Burstein, MD, PhD, FASCO, Associate Professor of Medicine at Dana-Farber Cancer Institute, Boston, and Jame Abraham, MD, FACP, Director of the Breast Oncology Program at Taussig Cancer Institute and Co-Director of the Cleveland Clinic Comprehensive Breast Cancer Program, commented on what...

breast cancer

MONALEESA-7 Shows Overall Survival Benefit for Ribociclib/Endocrine Therapy

The first statistically significant overall survival benefit has been shown for a cyclin-dependent kinase (CDK) 4/6 inhibitor plus endocrine therapy as first-line treatment of advanced breast cancer. The results are from the phase III MONALEESA-7 trial, which evaluated ribociclib plus endocrine...

A Lifetime Dedicated to Patients With Lung Cancer

Former ASCO President Paul Bunn, Jr, MD, FASCO, was born at the New York Hospital, the second oldest hospital in New York City and the third oldest in the nation. He grew up in DeWitt, New York, an eastern suburb of Syracuse, and went through the public-school system graduating from...

breast cancer

Fulvestrant/Anastrozole in Metastatic Breast Cancer

As reported in The New England Journal of Medicine by Rita S. Mehta, MD, and colleagues, the final overall survival results of the phase III SWOG S0226 trial show that the addition of first-line fulvestrant to anastrozole was associated with improved overall survival in postmenopausal women with...

breast cancer

ACP Issues Guidance for Breast Screening in Average-Risk Women

AVERAGE-RISK women between the ages of 50 and 74 who have no symptoms of breast cancer should undergo breast cancer screening with mammography every other year, the American College of Physicians (ACP) has recommended in a new evidence-based guidance statement published by Qaseem et al in Annals of ...

integrative oncology

Capsaicin

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, Shelly Latte-Naor, MD, and Jyothirmai Gubili, MS, explore the use of...

global cancer care

Uniting the Global Cancer Community to Reduce Deaths From Noncommunicable Diseases

It has been well documented that noncommunicable diseases, including cancer, cardiovascular disease, and diabetes, now pose the greatest health threat to people living in low- and middle-income countries, surpassing infectious diseases like HIV/AIDS as the leading cause of death and disability.1...

issues in oncology
cost of care
survivorship

How Cancer Affects Adolescents and Young Adults

The statistics are alarming: according to the National Cancer Institute (NCI), about 70,000 adolescents and young adults (AYAs) are diagnosed with cancer each year1—a recent report by the University of California put that figure at 87,000.2 Although overall cancer survival rates continue to improve ...

hematologic malignancies
lymphoma

Combination Immunotherapy With Lenalidomide Plus Rituximab in Indolent NHL: Time to Replace Rituximab Monotherapy?

With increasing knowledge on the key role of the tumor microenvironment in lymphomagenesis, treatments for indolent B-cell lymphoma, especially follicular lymphoma, are mechanistically moving toward a more immunomodulatory approach. Chemotherapy-free regimens are an attractive alternative to...

hematologic malignancies

Prolonged Exposure to Ibrutinib May Increase Effectiveness of CAR T-Cell Therapy in Patients With CLL

Chimeric antigen receptor (CAR) T-cell therapy has shown remarkable efficacy in the treatment of certain hematologic malignancies, including several types of large B-cell non-Hodgkin lymphomas (NHLs) and acute lymphoblastic leukemia (ALL). The U.S. Food and Drug Administration (FDA) has approved...

colorectal cancer

ASCO Guideline Recommends Shorter-Course Adjuvant Chemotherapy for Some Patients With Stage III Colon Cancer

In a clinical practice guideline released April 15, an ASCO Expert Panel outlined the latest recommendations for the duration of adjuvant chemotherapy with a fluoropyrimidine and oxaliplatin for patients with completely resected stage III colon cancer.1 New recommendations were based on the results ...

breast cancer

Trastuzumab Emtansine in Treatment of Residual Breast Cancer After Neoadjuvant Therapy: Who Will Benefit?

The discovery of trastuzumab has been revolutionary in the treatment of HER2-positive breast cancer, both in the metastatic and early-stage settings.1-6 This cannot be disputed. In the early-stage setting, the addition of trastuzumab to standard chemotherapy has led to a 50% gain in...

breast cancer

Adjuvant Trastuzumab Emtansine vs Standard Trastuzumab in Residual HER2-Positive Breast Cancer After Neoadjuvant Therapy

In the phase III KATHERINE trial reported in The New England Journal of Medicine,1Gunter von Minckwitz, MD, of the German Breast Group, Neu-Isenburg, and colleagues found that adjuvant treatment with the antibody-drug conjugate trastuzumab emtansine (T-DM1) improved invasive disease–free survival...

kidney cancer

Expert Point of View: Daniel George, MD

The CARMENA trial presented at the 2018 ASCO Annual Meeting, published simultaneously in The New England Journal of Medicine,1,2 and reported in this supplement to The ASCO Post, evaluated the role of nephrectomy in patients with metastatic renal cell carcinoma. Formal discussant of the trial,...

pancreatic cancer
genomics/genetics

ASCO Clinical Opinion Recommends Germline Testing for All Patients With Pancreatic Cancer

The recently released ASCO Clinical Practice Provisional Clinical Opinion on Evaluating Susceptibility to Pancreatic Cancer highlights the importance of emerging data indicating a relatively high rate of germline mutations in pancreatic cancer.1 Recent studies have demonstrated that up to 1 in 10...

kidney cancer
immunotherapy

Front-Line Therapy in Advanced Renal Cell Carcinoma: Developing a New Standard

THE FRONT-LINE systemic treatment landscape for metastatic renal cell carcinoma has undergone tremendous movement over the past several years. A better understanding of the current management paradigm for therapy-naive patients warrants a reflection of historic landmark clinical trials that have...

kidney cancer
immunotherapy

First-Line Therapy for Advanced Kidney Cancer: Combination Treatment vs Sunitinib

  TWO RECENTLY reported phase III trials have shown the benefits of combination therapy vs sunitinib in the first-line treatment of advanced renal cell carcinoma. As reported in The New England Journal of Medicine by Brian I. Rini, MD, of Cleveland Clinic Taussig Cancer Institute, and colleagues,...

bladder cancer
kidney cancer
prostate cancer

A Year in Review

The past year has seen groundbreaking advances in the treatment of genitourinary (GU) cancers, which in some cases are resulting in altering the standard of care for patients with renal cell carcinoma, prostate cancer, and urothelial carcinoma. Some of the biggest changes that have occurred are for ...

hematologic malignancies

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...

kidney cancer
immunotherapy

Front-Line Therapy in Advanced Renal Cell Carcinoma: Developing a New Standard

THE FRONT-LINE systemic treatment landscape for metastatic renal cell carcinoma has undergone tremendous movement over the past several years. A better understanding of the current management paradigm for therapy-naive patients warrants a reflection of historic landmark clinical trials that have...

issues in oncology

Harnessing the Power of Twitter for Clinical Trial Enrollment and Success

CLINICAL TRIALS are vital for advancing cancer care for our patients. Each trial represents an unanswered problem for which researchers are committed to solving. Designing, funding, recruiting, and completing a trial are tremendous undertakings for each researcher, physician, patient, and...

immunotherapy
skin cancer

Neoadjuvant Immunotherapy Associated With Improved Outcomes in Patients With Locally Advanced Melanoma

ACCORDING TO DATA from a small prospective study presented at the 2019 Society of Surgical Oncology Annual Cancer Symposium,1 neoadjuvant immunotherapy significantly prolonged relapse-free survival vs adjuvant immunotherapy in patients with stage III or oligometastatic stage IV melanoma intended...

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