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Role of Physical Activity in Cancer Treatment and Survivorship

On October 16, 2019, an expert panel convened by the American College of Sports Medicine (ACSM)released updated guidance and recommendations on the role of physical activity and exercise in cancer prevention and survivorship. The panel was co-chaired by Kathryn Schmitz, PhD, MPH, of the Department...

Confirmation Hearing for FDA Commissioner Nominee Stephen Hahn, MD

On November 20, 2019, Stephen Hahn, MD, President Trump’s nominee to be the next Commissioner of the U.S. Food and Drug Administration (FDA), appeared before the Senate Health, Education, Labor, and Pension Committee and answered wide-ranging questions relating to the many important roles the...

gastrointestinal cancer

Pivotal Study Reports Positive Findings in Fourth-Line Setting for Advanced GIST

In a late-breaking, oral presentation at the European Society for Medical Oncology (ESMO) 2019 Congress, Margaret von Mehren, MD, presented results from INVICTUS, a pivotal phase III clinical study of ripretinib in patients with advanced gastrointestinal stromal tumor (GIST).1 Ripretinib is an...

City of Hope’s Michael Caligiuri, MD, Formally Appointed to Deana and Stave Campbell Physician-in-Chief Distinguished Chair

Michael A. Caligiuri, MD, President of City of Hope National Medical Center, in Duarte, California, has been appointed the Deana and Steve Campbell Physician-in-Chief Distinguished Chair in Honor of Alexandra Levine, MD. The position was created in honor of Dr. Levine, a City of Hope Professor of...

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...

gastrointestinal cancer

Circulating Tumor DNA: A Prognostic Marker in Stage III Colon Cancer?

Circulating tumor DNA in the blood could serve as a marker of prognosis in patients with colon cancer receiving adjuvant oxaliplatin, according to a subanalysis of the IDEA trial, presented at the European Society for Medical Oncology (ESMO) Congress 2019.1 After 2 years of adjuvant...

breast cancer

Breast Cancer Treatments Targeting Estrogen May Be Putting Patients at Risk for Long-Term Comorbidities

“The majority of breast cancers are hormone receptor–positive, and treatments that target the estrogen receptors are very effective, but they also cause havoc in many tissues that are dependent on estrogen for normal functioning. As a result, breast cancer survivors suffer from ongoing symptoms and ...

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...

breast cancer

ASCO Updates Breast Cancer Risk Reduction Guideline to Include Anastrozole

ASCO has updated a guideline on pharmacologic interventions for breast cancer risk reduction in postmenopausal women at increased risk of developing breast cancer.1 The original clinical practice recommendations for breast cancer risk reduction were published in 1999 and updated in 2002, 2009, and...

Prescribing Hope

“There is no medicine like hope, no incentive so great, and no tonic so powerful as expectation of something tomorrow.” –Orison Swett Marden I was informed that my patient, a 58-year-old man recently diagnosed with pancreatic cancer, and his wife were becoming impatient waiting for me in the exam...

global cancer care

Challenging the Global Community to Deliver Equitable Cancer Care for All

For Her Royal Highness Princess Dina Mired of Jordan, ensuring that every patient with cancer receives high-quality care is not an abstract goal—it is personal. Princess Dina saw firsthand the life-and-death differences that access to state-of-the-art oncology care makes in a patient’s life when...

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...

Friends of Cancer Research Launches ctDNA Pilot Project

Friends of Cancer Research (Friends) recently announced the launch of its latest project, ctMoniTR. This pilot project will aim to harmonize the use of circulating tumor DNA (ctDNA) to monitor treatment response in patients with cancer and test the feasibility of data comparison from different...

Project Socrates: An Educational Bridge From the FDA to the Public

OCE Insights is an occasional department developed for The ASCO Post by members of the Oncology Center of Excellence (OCE) at the U.S. Food and Drug Administration (FDA). In this installment, Jennifer J. Gao, MD, Acting Associate Director of Education in the OCE, and Richard Pazdur, MD, Director of ...

leukemia

Glasdegib in Older Patients With AML or Those With Comorbidities

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Late in 2018, the Hedgehog pathway inhibitor glasdegib...

Expert Point of View: Sanjay Popat, FRCP, PhD

Formal discussant of the CheckMate 227 trial, Sanjay Popat, FRCP, PhD, of the Royal Marsden Hospital, London, had some reservations about endorsing nivolumab/ipilimumab as a new standard of care, mainly related to toxicity. “The landscape of treating advanced non–small cell lung cancer has changed ...

lung cancer
immunotherapy

Nivolumab/Ipilimumab: Another First-Line Option for Advanced NSCLC

The combination of nivolumab and ipilimumab improved overall survival compared with chemotherapy as first-line therapy for patients with advanced non–small cell lung cancer (NSCLC) and programmed cell death ligand 1 (PD-L1) expression of at least 1%, according to the results of CheckMate 227....

lung cancer

2019 State of Lung Cancer Report Released

More Americans than ever are surviving lung cancer. While the disease remains the leading cause of cancer deaths among both women and men, over the past decade, the survival rate has increased. A new report from the American Lung Association—the 2019 State of Lung Cancer—examines this promising...

skin cancer

MicroRNA Panel Could Aid in the Detection of Uveal Melanoma

A blood test could soon become a monitoring tool for the early detection of uveal melanoma. Stark et al discovered markers in the blood that can differentiate between a benign mole and a melanoma, while also determining whether the cancer has metastasized, according to findings they published in...

issues in oncology

Mental Health Outcomes in Mothers and Siblings of Children With Cancer

In a Canadian study reported in the Journal of Clinical Oncology, van Warmerdam et al found that mothers and siblings of children with cancer were significantly more likely to have mental health–related outpatient health-care contacts than their general population counterparts. The study involved...

solid tumors

Machine Learning Algorithm for Genome-Derived Prediction of Tumor Type

In a study reported in JAMA Oncology, Penson et al developed a machine learning algorithmic classifier that may be successful in identifying tumor type and origin based on DNA-sequence data obtained at point of care. The study used machine learning to construct and train an algorithmic classifier...

immunotherapy

Characteristics of Metastatic Lesion Responses to PD-1 Inhibition

In a study reported in the Journal of Clinical Oncology, Osorio et al found that responses to programmed cell death protein 1 (PD-1) inhibitor therapy tended to be consistent across metastases and occur simultaneously in metastatic lesions of non–small cell lung cancer (NSCLC) and mismatch...

skin cancer

Long-Term Analysis of Vemurafenib/Cobimetinib in Patients With BRAF-Mutated Melanoma

A phase Ib study evaluating the safety and long-term benefit of combination treatment with the BRAF inhibitor vemurafenib plus the MEK1 inhibitor cobimetinib in patients with advanced BRAF V600E–mutated melanoma has found that nearly 40% of the patients experienced extended survival of 4 to 5 years ...

head and neck cancer
immunotherapy

Pembrolizumab With or Without Chemotherapy vs Cetuximab Plus Chemotherapy in Recurrent or Metastatic HNSCC

As reported in The Lancet by Barbara Burtness, MD, and colleagues, the phase III KEYNOTE-048 trial has shown improved overall survival with first-line pembrolizumab plus chemotherapy vs cetuximab plus chemotherapy among patients with recurrent or metastatic squamous cell carcinoma of the head and...

FDA Approves Givosiran for Acute Hepatic Porphyria

On November 20, the U.S. Food and Drug Administration (FDA) approved givosiran (Givlaari) for adults with acute hepatic porphyria, a genetic disorder resulting in the buildup of toxic porphyrin molecules which are formed during the production of heme. “This buildup can cause acute attacks, known...

lung cancer

What Is the Best Palliation for End-Stage Lung Cancer?

Patients with advanced lung cancer can experience burdensome symptoms at the end of life. Pulmonologists can alleviate some of this suffering, but it’s a balancing act between doing too much and not enough, according to specialists who spoke at CHEST 2019, the annual meeting of the American College ...

issues in oncology

Two Societies Issue Statements on E-Cigarettes

Today, the American Cancer Society (ACS) announced an update to the organization’s position on e-cigarettes, and the American Medical Association (AMA) called for a total ban on all e-cigarette and vaping products that do not meet U.S. Food and Drug Administration (FDA) approval as cessation ...

issues in oncology

Does Testosterone Replacement Therapy Benefit Young Male Cancer Survivors?

Young male cancer survivors may significantly benefit from testosterone replacement therapy—especially after testicular cancer. Research published by Walsh et al in PLOS Medicine looked at one of the most common late-onset side effects experienced by young male survivors—reduced levels of the male...

kidney cancer
immunotherapy

Atezolizumab/Bevacizumab in Metastatic Renal Cell Carcinoma With Variant Histology or Sarcomatoid Features

In a phase II trial reported in the Journal of Clinical Oncology, Toni K. Choueiri, MD, and colleagues found that the combination of atezolizumab and bevacizumab was active in metastatic renal cell carcinoma with variant histology and clear cell renal cell carcinoma with ≥ 20% sarcomatoid...

leukemia

Late Bone Marrow Relapse Risk Stratification in Pediatric Patients With B-Cell Acute Lymphoblastic Leukemia

In an analysis of the German ALL-REZ BFM 2002 trial, reported in the Journal of Clinical Oncology, Eckert et al found that postinduction minimal residual disease (MRD)-based treatment stratification resulted in “excellent survival” in pediatric patients with late relapse of B-cell precursor acute...

breast cancer

Expert Point of View: Charles L. Loprinzi, MD

Charles L. Loprinzi, MD, Regis Professor of Breast Cancer Oncology at the Mayo Clinic, Rochester, Minnesota, discussed this abstract on sexual health in women treated for breast cancer. Addressing patients’ questions, offering advice, and providing appropriate referrals should improve patient care, ...

breast cancer

Study Finds Sexual Health Issues Are a Concern Among Majority of Women With Breast Cancer

Endocrine therapy has been a lifesaver for women with estrogen receptor–positive breast cancer, but decreases in recurrence and cancer-related mortality have come with substantial side effects, according to data presented at the 2019 Supportive Care in Oncology Symposium.1 The results of a...

solid tumors
immunotherapy

Pembrolizumab in Noncolorectal MSI-H/dMMR Solid Tumors

As reported in the Journal of Clinical Oncology by Marabelle et al, the phase II KEYNOTE-158 trial has shown robust activity of pembrolizumab in patients with noncolorectal microsatellite instability­–high (MSI-H)/mismatch repair–deficient (dMMR) solid tumors. Findings in the study supported the...

hematologic malignancies

Outcomes With Haploidentical Stem Cell Transplantation Plus Cyclophosphamide in Adults With Hematologic Cancers

In a meta-analysis reported in JAMA Oncology, Gagelmann et al found that overall survival with haploidentical stem cell transplantation with post-transplantation cyclophosphamide was poorer vs matched related donor transplantation and similar vs matched unrelated donor transplantation in adult...

multiple myeloma

Selinexor Plus Dexamethasone Studied in Triple-Class Refractory Multiple Myeloma

In a phase IIb study (STORM Part 2) reported in TheNew England Journal of Medicine, Ajai Chari, MD, of Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, and colleagues found that oral selinexor and dexamethasone were active in some patients with multiple myeloma refractory to prior...

Expert Point of View: Alfredo Falcone, MD

The invited discussant of BEACON CRC, Alfredo Falcone, MD, of the Department of Oncology and Translational Medicine at the University of Pisa, Italy, commented: “The ‘story’ of BEACON represents a good example of the European Society for Medical Oncology Congress theme: Translating Science Into...

colorectal cancer

Targeted Triplet Therapy Improved Overall Survival in BRAF-Mutated Colorectal Cancer

For patients with metastatic colorectal cancer harboring BRAF V600E mutations, three drugs seem to be better than two, the most recent analysis of the phase III BEACON CRC study has shown.1 The results, presented at the 2019 European Society for Medical Oncology (ESMO) Congress, were concurrently...

gastrointestinal cancer

Maximizing Benefit in the Treatment of Immune-Mediated Colitis

Immune-related colitis is the second most common toxicity associated with checkpoint inhibitors, affecting up to 40% of patients. The ASCO Post interviewed Yinghong Wang, MD, PhD, Director of Medication-Induced Colitis and Enteritis, Director of Fecal Microbiota Transplantation, and Associate...

lymphoma

FDA Grants Accelerated Approval to Zanubrutinib for Pretreated Mantle Cell Lymphoma

On November 14, the U.S. Food and Drug Administration (FDA) granted accelerated approval to zanubrutinib (Brukinsa) for adult patients with mantle cell lymphoma who have received at least one prior therapy. “Mantle cell lymphoma usually responds well to initial treatment, but eventually returns or ...

geriatric oncology

Improving Communication With Older Patients Using Geriatric Assessment During Oncology Visits

In the COACH study, reported in JAMA Oncology, Supriya G. Mohile, MD, MS, and colleagues found that including geriatric assessment in oncology visits for older adults with advanced cancer improved patient and caregiver satisfaction with communication regarding aging-related concerns. Study Details...

lymphoma
immunotherapy

Polatuzumab Vedotin Plus Bendamustine/Rituximab for Transplantation-Ineligible Relapsed or Refractory DLBCL

In a phase Ib/II trial reported in the Journal of Clinical Oncology, Laurie H. Sehn, MD, MPH, and colleagues found that the addition of polatuzumab vedotin to bendamustine/rituximab improved response rate and progression-free and overall survival among transplantation-ineligible patients with...

issues in oncology

Presenting Symptoms and Cancer Stage at Diagnosis

In a population-based study reported in The Lancet Oncology, Koo et al found that presenting symptoms of cancer were mostly associated with stage earlier than stage IV, suggesting a benefit of symptom awareness campaigns based on common symptoms. As stated by the investigators, “Early diagnosis...

Expert Point of View: Eduardo Bruera, MD, FAAHPM

Eduardo Bruera, MD, FAAHPM, Chair of the Department of Palliative, Rehabilitation, and Integrative Medicine at The University of Texas MD Anderson Cancer Center, Houston, explained the rationale behind this treatment approach. “We know that the tumor mass and the tumor function talk to the brain...

gynecologic cancers
immunotherapy

Nivolumab Plus Bevacizumab in Relapsed Ovarian Cancer

In a phase II trial reported in JAMA Oncology, Liu et al found evidence of the activity of combined nivolumab and bevacizumab in relapsed ovarian cancer, with activity appearing to be greater in platinum-sensitive disease. Study Details In the trial, 38 women with relapsed epithelial ovarian cancer ...

symptom management

Dexamethasone Plus Exercise May Reduce Fatigue in Patients With Advanced Cancer

A novel treatment approach may help to alleviate one of the most common and debilitating symptoms associated with cancer and its treatments—fatigue. According to data presented at the 2019 Supportive Care in Oncology Symposium,1 the combination of short-course dexamethasone plus standardized...

skin cancer

Reflections on Long-Term Outcomes With BRAF/MEK Inhibition in Advanced Melanoma

For the treatment of BRAF V600-mutated advanced melanoma, we now have three BRAF/MEK inhibitor combinations that are approved by the U.S. Food and Drug Administration: dabrafenib/trametinib, vemurafenib/cobimetinib, and encorafenib/binimetinib. Although the toxicity profiles for these combinations ...

skin cancer

5-Year Efficacy Outcomes With Dabrafenib Plus Trametinib in BRAF-Mutated Metastatic Melanoma

As reported in The New England Journal of Medicine by Caroline Robert, MD, PhD, of the Institut Gustave Roussy and Paris-Sud-Paris-Saclay University, Villejuif, and colleagues, the long-term follow-up of the phase III COMBI-d and COMBI-v trials has shown a pooled 5-year overall survival rate of 34% ...

solid tumors

Long-Term Effects of Denosumab in Patients With Giant Cell Tumor of Bone

As reported by Chawla et al in The Lancet Oncology, long-term data from the final analysis of an international phase II study suggest that a favorable risk-benefit ratio is maintained over time with denosumab treatment of patients with giant cell tumor of bone. Benefit of denosumab was indicated in ...

prostate cancer
breast cancer
bladder cancer
pancreatic cancer
kidney cancer
thyroid cancer
gynecologic cancers
immunotherapy

ESMO Congress 2019: Quick Takes From Key Clinical Trials

The ESMO Congress continues to grow as a pivotal platform for research in clinical oncology. At the ESMO Congress 2019, important findings were showcased in more than 2,200 studies, including 93 late-breaking abstracts. The ASCO Post summarized much of that news in separate articles over several...

lung cancer
neuroendocrine tumors
immunotherapy

Novel Therapies for Small Cell Lung Cancer and Neuroendocrine Tumors

Here is a glimpse at updated clinical trial data on newer therapies under study for the small cell lung cancer (SCLC) and advanced extrapancreatic neuroendocrine tumors. IMpower133 and ALTER: Novel Therapies for SCLC The treatment of small cell lung cancer has seen little progress in recent years, ...

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