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Showing 1151 - 1200Expert Point of View: Stuart A. Grossman, MD, and Deborah Schrag, MD
Formal discussant of this trial Stuart A. Grossman, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, commented that the trial did not include a best standard-of-care arm. The pivotal trial defined optimal radiotherapy as 60 Gy over 6 weeks, but this...
Chemoradiotherapy Improves Survival in Patients Over Age 65 With Glioblastoma: A New Standard Option?
The combination of short-course radiotherapy and temozolomide followed by maintenance with temozolomide significantly improved survival compared with short-course radiotherapy alone in newly diagnosed elderly patients with glioblastoma, according to the results of a global cooperative group trial...
Expert Point of View: Harold J. Burstein, MD, and Ian Smith, MD
“There is a tremendous interest in longer aromatase inhibitor therapy. The Oxford Overview data, presented at ASCO, show the substantial risk of recurrence in years 5 to 15, despite an initial 5 years of adjuvant endocrine treatment. “Women with lower-risk breast cancer will be less inclined to...
Additional 5 Years of Letrozole May Benefit Some Postmenopausal Women With Early-Stage Breast Cancer
Five years of aromatase inhibitor as upfront therapy or after tamoxifen is the current standard of care for postmenopausal women with early hormone receptor–positive breast cancer. A new trial suggests that extending aromatase inhibitor therapy with letrozole for an additional 5 years may improve...
Expert Point of View: Louis M. Weiner, MD
“These gene fusions that drive malignant processes in certain cancers are good targets for cancer therapy. These targets can be potentially disabled [by targeted therapy],” said Louis M. Weiner, MD, Director of the Georgetown Lombardi Comprehensive Cancer Center in Washington, DC, who moderated a ...
Gene Rearrangements: Attractive Targets in a Variety of Cancers
Entrectinib, a potent investigational tyrosine kinase inhibitor, exhibited promising clinical activity in a pooled analysis of two phase I trials of patients with solid metastatic tumors that harbored any of five specific genetic rearrangements involving NTRK1, NTRK2, NTRK3, ROS1, or ALK....
Expert Point of View: Mayer Fishman, MD, PhD
“This was a difficult study to conduct. It required 13 centers in 8 countries over 3 years to recruit these patients—that’s about 1 patient per site per year,” said Mayer Fishman, MD, PhD, of Moffitt Cancer Center in Tampa, Florida. “It’s an important study, because these patients are typically...
Crizotinib Active in Orphan Kidney Malignancy
Crizotinib (Xalkori) achieved overall and durable responses in advanced inoperable papillary renal cell carcinoma type 1 characterized by somatic MET mutations, according to an investigator-initiated trial conducted by the European Organization for Research and Treatment of Cancer (EORTC).1 “To...
Highlights From the 2016 AACR Annual Meeting
This year’s Annual Meeting of the American Association for Cancer Research (AACR) featured outstanding research in the field of cancer, as well as an inspiring talk by Vice President Joe Biden (see the May 10 issue of The ASCO Post). Here are some summaries of studies that warrant attention; they...
NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2016 Guidelines
In 1996, the National Comprehensive Cancer Network (NCCN®) published its first set of Clinical Practice Guidelines in Oncology® (NCCN Guidelines®), covering eight tumor types. The NCCN Guidelines® are now published for more than 60 tumor types and topics. Some of the key updates for 2016 were...
Expert Point of View: Padmanee Sharma, MD, PhD
“When we treat our patients, overall survival is the gold standard. We are all waiting for phase III overall survival data from CheckMate 067,” said formal discussant Padmanee Sharma, MD, PhD, Professor; Scientific Director of the Immunotherapy Platform; and Co-Director of the Parker Institute for ...
Durable Benefit With Immunotherapy Combination in Advanced Melanoma
With the recent explosion in immunotherapies for advanced melanoma and other tumors, all eyes are on how best to sequence or combine these therapies. Initial reports of overall survival from the phase II randomized CheckMate 069 trial suggest that the combination of ipilimumab (Yervoy, an...
Pembrolizumab Survival Benefit Proves Durable in Patients With Advanced Melanoma
With new immunotherapies available for the treatment of advanced melanoma, an important question is how best to combine and sequence them. Long-term follow-up from the KEYNOTE-001 trial suggests that pembrolizumab (Keytruda) can improve survival in newly diagnosed patients and in those treated...
Expert Point of View: Mark Pegram, MD & Martine Piccart, MD, PhD
Formal discussant of the ado-trastuzumab emtansine plus pertuzumab trial, Mark Pegram, MD, Director of the Breast Cancer Program at Stanford Women’s Cancer Center and Co-Director of Stanford’s Molecular Therapeutics Program, Stanford, California, said that I-SPY 2 has several strengths. They...
Ado-Trastuzumab Emtansine Plus Pertuzumab: Promising Neoadjuvant Results for HER2-Positive Breast Cancer From the I-SPY 2 Trial
The combination of ado-trastuzumab emtansine (Kadcyla) plus pertuzumab (Perjeta) is a worthy combination to pursue in phase III studies as neoadjuvant therapy for HER2-positive invasive breast cancer, according to findings in the I-SPY 2 trial presented at the 2016 Annual Meeting of the American...
Expert Point of View: Lillian L. Siu, MD, FASCO
“This is an important study,” said formal discussant Lillian L. Siu, MD, FASCO, Professor, University of Toronto Cancer Care Ontario Research Chair and medical oncologist at Princess Margaret Cancer Centre Drug Development Program in Toronto, Ontario, Canada. “No new drugs have been approved by the ...
Nivolumab: New Standard of Care for Progressive Head and Neck Cancer After Platinum Therapy
Squamous cell carcinoma of the head and neck that progresses after platinum-based therapy has a dismal prognosis, and there is no effective standard of care. No treatment has improved survival for this patient population, but that may be about to change. Nivolumab (Opdivo), an anti–PD-1 (programmed ...
Making the Moonshot Initiative a Reality
Excitement was high on the last day of the 2016 Annual Meeting of the American Association for Cancer Research (AACR) in anticipation of Vice President Joseph R. Biden’s remarks related to the Moonshot Initiative to accelerate progress in cancer research. The Secret Service made elaborate...
Expert Point of View: Jedd D. Wolchok, MD, PhD
“We are at a fortunate time to have multiple routes to ‘lifetime’ (T-cell) memory (including ipilimumab [Yervoy] and nivolumab [Opdivo]),” said Jedd D. Wolchok, MD, PhD, of Memorial Sloan Kettering Cancer Center, New York, who was the formal discussant of the CA909-003 trial at the American...
One-Third of Patients With Advanced Melanoma Survive at Least 5 Years After Nivolumab Treatment
The news is good from the longest follow-up survival study of patients with advanced melanoma who were treated with the anti–programmed cell death protein 1 (PD-1) agent nivolumab (Opdivo).1 Thirty-four percent of patients who received the drug in a phase I trial (CA909-003) were alive 5 years...
Expert Point of View: Carlos Arteaga, MD
Carlos Arteaga, MD, of Vanderbilt-Ingram Cancer Center, Nashville, Tennessee, said, “Breast-conserving therapy is the right thing to do. This study will not change current practice guidelines. Mastectomy is generally reserved for larger tumors and those with multifocal disease. The study just...
Study Shows Breast-Conserving Therapy Beats Mastectomy, but Questions Remain
Breast-conserving therapy (lumpectomy plus radiation therapy) appears to improve 10-year overall survival for women with early breast cancer compared with mastectomy, according to a very large population-based study from the Netherlands.1 However, the study raises more questions than it answers,...
Expert Point of View: C. Kent Osborne, MD
“We used to consider HER2-positive breast cancer one of the more aggressive forms of the disease. Now we have treatments based on HER2 expression that have dramatically altered the course of the disease for many patients,” said C. Kent Osborne, MD, who moderated the press conference where these...
Role of Ado-Trastuzumab Emtansine in Metastatic Breast Cancer Solidified
Ado-trastuzumab emtansine (formerly T-DM1; Kadcyla) improved overall survival compared with treatment of physician’s choice of therapy for patients with pretreated HER2-positive metastatic breast cancer, according to the phase III TH3RESA trial.1 Patients enrolled in the trial had previously been...
Expert Point of View: Daniel Hamstra, MD
Formal discussant of these trials Daniel Hamstra, MD, of Texas Center for Proton Therapy, Irving, offered his perspective. With increased doses of radiation using additional conventional fractions, tumor control is improved, but the risk of damage to normal tissue is increased. Hypofractionation is ...
Hypofractionation Is Ready for Prime Time in Prostate Cancer, but Will It Be Adopted?
Separate phase III trials presented at the 2016 Genitourinary Cancers Symposium demonstrated that modest hypofractionated radiotherapy is noninferior to conventional radiotherapy for men with intermediate- and low-risk prostate cancer and should be considered a new standard of care.1,2 However, it...
Expert Point of View: Elizabeth Plimack, MD
The Egyptian study presented by Brian Baumann, MD, of the University of Pennsylvania, Philadelphia, was a “valiant effort” to determine whether sequential adjuvant chemotherapy added to adjuvant radiation would improve disease-free survival, said formal discussant of this trial Elizabeth Plimack,...
Adjuvant Chemoradiotherapy in Locally Advanced Bladder Cancer: Hint of Benefit That Needs Confirmation
Adjuvant sequential chemotherapy plus radiation therapy and adjuvant radiation therapy alone significantly improved local tumor control compared with adjuvant chemotherapy alone in locally advanced bladder cancer but the improvement in disease-free survival (3-year disease-free survival of 68% vs...
Genomic, Molecular Differences in Tumor Biology May Explain Inferior Survival in African Americans With Kidney Cancer
African Americans who develop metastatic renal cell carcinoma have had worse survival historically than whites. With the advent of targeted therapy, the hope is that the gap in survival would be narrowed. However, a new study has shown that survival for African Americans with metastatic renal cell...
Active Holistic Surveillance May Prevent Unnecessary Biopsies in Low- and Low/Intermediate-Risk Prostate Cancer
The use of prostate-specific antigen (PSA) screening has led to a dramatic rise in the number of men diagnosed with low-grade prostate cancer. Active surveillance is recommended to manage patients with favorable-risk, low-grade prostate cancer, with the goal of avoiding overtreatment of these...
Expert Point of View: Oliver Sartor, MD
“This platform has no selection bias. Phlebotomy samples are drawn at key decision points. We begin to see that heterogeneity of circulating tumor cells predicted for shorter progression and survival times with selected androgen receptor–directed therapies. We need to study this prospectively,”...
New Technology to Characterize Circulating Tumor Cells Suggests Better Treatment Decision-Making in Prostate Cancer
An early study showed that an experimental blood test (ie, “liquid biopsy”) that characterizes the phenotype and genomic characteristics of circulating tumor cells appears to have utility in personalizing treatment decisions for individual men with advanced prostate cancer.1 The assay—developed and ...
Expert Point of View: C. Kent Osborne, MD
These data will help us personalize treatment for our patients. We still don’t know which women with a favorable cancer like ductal carcinoma in situ are most likely to progress. This is an unmet need,” said C. Kent Osborne, MD, Director of the Dan L. Duncan Cancer Center at Baylor College of...
Tamoxifen or Anastrozole for Ductal Carcinoma in Situ?
Ductal carcinoma in situ is a relatively benign form of breast cancer (stage 0), yet up to 10% of women with ductal carcinoma in situ will have a recurrence within 10 years. At present, there is no way to identify which women will recur, so standard treatment is lumpectomy plus radiation therapy....
Expert Point of View: William Y. Kim, MD
Formal discussant of this trial William Y. Kim, MD, of the University of North Carolina’s Lineberger Comprehensive Cancer Center, Chapel Hill, commented on the fact that the IMvigor study had a substantial number of patients compared with other phase II trials in bladder cancer. “This trial was not ...
Atezolizumab in Urothelial Cancer: Ushering in a New Standard of Care
Atezolizumab achieved excellent results in a cohort of patients with platinum-resistant urothelial cancer enrolled in a large phase II trial known as IMvigor 210.1 Overall response rates were greatly improved over those with historical controls, and responses were durable. Although expression of...
Expert Point of View: Christian K. Kollmannsberger, MD
Commenting on both of these studies, Christian K. Kollmannsberger, MD, of the British Columbia Cancer Center, Vancouver, Canada, said: “These studies suggest a more personalized approach to testicular cancer. Clearly, we need to do better than traditional risk factors used to guide therapy for...
Improved Outcomes in Patients With Germ Cell Testicular Tumors in the Modern Era
Although patients with poor-risk metastatic testicular germ cell tumors continue to have less favorable outcomes, the bar has been raised by contemporary treatment. There is still room for improvement in managing metastatic testicular germ cell tumors, especially in poor-risk patients, but if...
Two Contenders for Second-Line Treatment of Advanced Renal Cell Carcinoma
Options for second-line therapy of advanced/metastatic renal cell carcinoma are expanding. Updates from the CheckMate 025 and METEOR trials presented at the 2016 Genitourinary Cancers Symposium solidify the value of both nivolumab (Opdivo, an immune checkpoint inhibitor) and cabozantinib...
Expert Point of View: Marcela V. Maus, MD, PhD
Investigators are looking at biomarkers to predict the probability of cytokine-release syndrome [in patients receiving chimeric antigen receptor–modified T-cell (CAR-T) therapy] so that they can intervene early. This study [from the University of Pennsylvania] identified two biomarkers that appear...
Blood Test Can Predict High-Risk Cancers in Patients Treated With CAR-T
Dramatic advances have been made in using genetically engineered chimeric antigen receptor–modified T cells (CAR-T) with anti-CD19 specificity to treat highly refractory hematologic malignancies. The highest complete remission rates have been achieved in patients with relapsed or refractory acute...
Immunotherapy for Breast Cancer: Early Lackluster Study Results yet Promise Remains
Immunotherapy is at the forefront of exciting new approaches to cancer, with excellent and long-lasting responses in metastatic melanoma and non–small cell lung cancer (NSCLC) and several immunotherapy agents now approved for those malignancies by the U.S. Food and Drug Administration (FDA). The...
Expert Point of View: Lisa Carey, MD
For the most part, the cardiotoxicity with trastuzumab appears to be largely reversible, unlike anthracyclines, which cause permanent cardiac damage,” said Lisa Carey, MD, Distinguished Professor at the UNC Lineberger Breast Center, Chapel Hill, North Carolina. “In this small study, they saw no...
Prophylactic Beta-Blocker Preserves Left-Ventricular Function in Patients Receiving Trastuzumab
The beta-blocker bisoprolol was able to prevent trastuzumab (Herceptin)-associated declines in left-ventricular ejection fraction, whereas the effect of the angiotensin-converting–enzyme (ACE) inhibitor perindopril was less robust. Use of bisoprolol reduced dose interruptions for trastuzumab due to ...
Expert Point of View: Kevin S. Hughes, MD
This study confirms that what is important is a negative margin, not the margin size,” said Kevin S. Hughes, MD, a breast surgeon who is Co-Director of the Avon Comprehensive Breast Evaluation Center at Massachusetts General Hospital, Boston. “This is a confirmatory study of the consensus...
Surgical Margin Width Not Related to Breast Cancer Recurrence
The width of the surgical margin doesn’t matter, as long as the margin is negative, according to a large study of breast-conserving surgery in patients with invasive breast cancer. The risk of ipsilateral breast tumor recurrence was similar for wide negative margins (2–4 mm) or narrow negative...
Expert Point of View: Mark Crowther, MD
Commenting on the AALL03N1 study, press conference moderator Mark Crowther, MD, of McMaster University, Hamilton, Ontario, Canada, said: “This study is extremely important. We have many presentations on new and novel therapies that are expensive, complex, and revolutionary. But if patients don’t...
Self-Reports Overestimate Mercaptopurine Intake in Childhood Acute Lymphoblastic Leukemia
Mercaptopurine is critical for maintaining remission in childhood acute lymphoblastic leukemia (ALL). However, a study has shown that overreporting of intake is common, and self-reports of intake are not as reliable as electronic reporting.1 About 86% of parents and children overreported the number ...
Expert Point of View: George Daley, MD, PhD, and David Williams, MD
Press briefing moderator George Daley, MD, PhD, of Boston Children’s Hospital, was enthusiastic about these results, despite the small number of patients treated in studies of CAR-T cells thus far. Most of the results have been in a positive direction, he noted. “It is remarkably exciting to see...
New Use for CAR-T Cells Post Transplantation
The approach of using genetically engineered chimeric antigen receptor (CAR)-T cells has received much attention for treating leukemias, where it has achieved spectacular long-lasting complete remissions in some patients with no other treatment options. CAR-T cells are also being studied in...
