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breast cancer
immunotherapy

Challenge Moving Forward in Breast Cancer Treatment: To Show That New Approaches Change Outcomes

ADVANCES IN treating breast cancer over the past 20 years have brought us to the point where treatment can be confidently de-escalated for some patients, and immunotherapy and precision decision-making may change the way breast cancer is treated for others, William Gradishar MD, FASCO, told the...

symptom management
issues in oncology

Primary Prophylaxis With a Direct Oral Anticoagulation Agent Reduces Venous Thromboembolism Rate in Ambulatory Patients With Cancer

LATE-BREAKING results from the large, randomized, placebo-controlled CASSINI trial showed that primary prophylaxis with the direct oral anticoagulation agent rivaroxaban reduced the incidence of venous thromboembolism (VTE) as well as VTE-related deaths in high-risk patients with cancer who were...

breast cancer

Role of Adjuvant Capecitabine in Triple-Negative Breast Cancer

ADJUVANT CAPECITABINE added to standard neoadjuvant chemotherapy failed to significantly improve disease-free or overall survival in patients with early triple-negative breast cancer in the large phase III CIBOMA/2004-01_GEICAM/2003-11 (CIBOMA/GEICAM) trial.1 However, extended treatment with...

immunotherapy
lung cancer

PACIFIC Trial of Durvalumab Sets Standard in Stage III Unresectable NSCLC

IMMUNOTHERAPY HAS revolutionized the treatment of lung cancer over the past several years. Although lung cancer is associated with immunosuppression at baseline for most patients, the addition of immune checkpoint inhibitors can overcome that suppression and lead to antitumor immune responses....

immunotherapy
symptom management

Adoptive T-Cell Therapy for Progressive Multifocal Leukoencephalopathy

An emerging treatment known as adoptive T-cell therapy has proven effective in a phase II clinical trial for treating progressive multifocal leukoencephalopathy (PML), a rare and often fatal brain infection sometimes observed in patients with cancer and other diseases in which the immune system is...

supportive care
integrative oncology

Use of Valerian to Relieve Anxiety in Patients With Cancer

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. Eugenie Spiguel, MSN, ANP-BC, and Jyothirmai Gubili, MS, explore the use of valerian for...

hepatobiliary cancer

FDA Approves Cabozantinib in Previously Treated Hepatocellular Carcinoma

On January 14, the U.S. Food and Drug Administration (FDA) approved cabozantinib (Cabometyx) tablets for patients with hepatocellular carcinoma who have been previously treated with sorafenib. The FDA’s approval of this oral tyrosine kinase inhibitor was based on the results of the phase III...

hematologic malignancies
multiple myeloma

Novel Treatments in Newly Diagnosed Multiple Myeloma, Part 1

Here is an update on several different studies focusing on novel treatments for patients with newly diagnosed multiple myeloma presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. Featured therapeutics include daratumumab plus lenalidomide and dexamethasone, ...

issues in oncology
legislation
health-care policy

New Regulations Require Better Communication With Patients Who Have Disabilities and Limited English Proficiency

Ever since President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law on March 23, 2010, the nondiscrimination provision of the law, Section 1557, which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health ...

supportive care

Fecal Microbiota Transplantation May Help Restore Beneficial Bacteria in Patients With Cancer

Researchers have shown that autologous fecal microbiota transplantation may be a safe and effective way to help replenish beneficial gut bacteria in patients with cancer who require intense antibiotics during allogeneic hematopoietic stem cell transplantation. Their findings were published by Ying ...

gynecologic cancers

Welcome Questions About Cervical Cancer Treatment Options

TWO STUDIES reported in The New England Journal of Medicine1,2 showed that patients with early-stage cervical cancer had reduced disease-free and overall survival when treated with minimally invasive radical hysterectomy vs open or radical hysterectomy. The findings of these studies have been...

gynecologic cancers

Comparing Survival Outcomes With Minimally Invasive and Open Surgical Approaches to Early-Stage Cervical Cancer

MINIMALLY INVASIVE radical hysterectomy for women with early-stage cervical cancer has been associated with reduced rates of disease-free and overall survival in the phase III LACC randomized noninferiority trial comparing minimally invasive and open abdominal radical hysterectomy. The results...

symptom management

Clinician Survey to Explore Direct-Acting Oral Anticoagulants vs Low–Molecular-Weight Heparin in Cancer-Related VTE

Injectable low–molecular-weight heparin has long been considered the standard of care for treatment of venous thromboembolism (VTE) in patients with cancer. However, low–molecular-weight heparin is costly and often disliked by patients due to injection-related discomfort and bruising....

lung cancer
immunotherapy

Durvalumab Improves Overall Survival After Chemoradiotherapy in Unresectable, Stage III NSCLC

AS REPORTED in The New England Journal of Medicine by Scott J. Antonia, MD, PhD, of H. Lee Moffitt Cancer Center and Research Institute, and colleagues, the phase III PACIFIC trial has shown significantly improved overall survival, a coprimary endpoint, with the programmed cell death ligand 1...

lung cancer

Priority Review for Atezolizumab in Combination With Chemotherapy for Small Cell Lung Cancer

The U.S. Food and Drug Administration (FDA) accepted a supplemental biologics license application (sBLA) and granted Priority Review for atezolizumab (Tecentriq) in combination with carboplatin and etoposide for the first-line treatment of patients with extensive-stage small cell lung cancer. The...

Should I Have Lied?

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

immunotherapy
skin cancer

Optimal Duration of Checkpoint Inhibition in Melanoma Is No More Than 2 Years

For patients with advanced melanoma, the concept of treating to disease progression does not always apply. With many patients responding to checkpoint inhibition for years, when can treatment be safely discontinued? This important clinical question was addressed at the European Society for Medical...

gynecologic cancers

Minimally Invasive vs Open Abdominal Radical Hysterectomy in Early-Stage Cervical Cancer

TWO STUDIES recently reported in The New England Journal of Medicine indicate that minimally invasive radical hysterectomy is associated with poorer survival outcomes than open abdominal radical hysterectomy in women with early-stage cervical cancer. As reported by Pedro T. Ramirez, MD, of The...

breast cancer
supportive care

Has Scalp Cooling Reached the Level of Standard of Care?

Does evidence of the effectiveness and safety of scalp cooling to reduce hair loss among women being treated for breast cancer mean that scalp cooling is a new standard of care? “I would suggest that it is,” stated Mikel Ross, MSN, RN, AGNP-BC, of the Breast Medicine Service, Memorial Sloan...

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...

solid tumors

Larotrectinib for Solid Tumors With NTRK Gene Fusions

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. On November 26, 2018, larotrectinib (Vitrakvi) was...

global cancer care
hepatobiliary cancer

Controlling the Global Burden of Liver Cancer

The burden of mortality related to liver cancer is increasing worldwide. Prevention and control of viral hepatitis will be vital in combating this burden, but curbing the growing epidemic of obesity must also be seen as a key part of liver cancer prevention, according to Rosmawati Mohamed, MD, of...

Expert Point of View: Eric P. Winer, MD, and Jame Abraham, MD

Commenting on the findings of the KATHERINE trial were Eric P. Winer, MD, Director of the Breast Oncology Program in the Susan F. Smith Center for Women’s Cancers at Dana-Farber Cancer Institute and the Thompson Senior Investigator in Breast Cancer Research andProfessor of Medicine at Harvard...

breast cancer

KATHERINE Trial: Adjuvant T-DM1 Reduces Invasive Disease Risk by 50% vs Trastuzumab in HER2-Positive Early Breast Cancer

In patients with HER2-positive early breast cancer and residual disease after neoadjuvant chemotherapy, adjuvant treatment with trastuzumab emtansine (T-DM1; Kadcyla) reduced the risk of invasive disease by 50% over trastuzumab (Herceptin).1 The phase III KATHERINE study was presented at the 2018...

skin cancer

Encorafenib and Binimetinib: A New Benchmark in Metastatic Melanoma Therapy?

IN JULY 2018, the U.S. Food and Drug Administration (FDA) approved the combination of the oral BRAF inhibitor encorafenib (Braftovi) and the oral MEK inhibitor binimetinib (Mektovi) for BRAF V600E– or V600K– positive metastatic melanoma. The FDA approval was based on the results of the COLUMBUS...

prostate cancer

Shedding Light on Mechanisms of Resistance to Treatment of Metastatic Castration-Resistant Prostate Cancer

ONE OF the pressing issues in metastatic castration-resistant prostate cancer is the development of resistance to therapies directed at the androgen receptor (AR), such as enzalutamide (Xtandi) and abiraterone acetate (Zytiga). Research is ongoing to identify mechanisms of resistance in the hope of ...

breast cancer

Management of HER2-Positive Breast Cancer: Business as Usual?

MANAGEMENT OF HER2-positive breast cancer changed after the introduction of trastuzumab (Herceptin), the first anti-HER2 therapy to be approved by the U.S. Food and Drug Administration (FDA) for this type of cancer. Recent studies have more clearly defined the role of pertuzumab (Perjeta) and...

issues in oncology

Should Oncologists Recommend Cannabis?

A RECENT survey of 400 clinical oncologists found that 80% discuss the use of medical cannabis with their patients, and although nearly 50% recommend it, fewer than 30% consider themselves knowledgeable enough to make such recommendations.1 Oncologists are perhaps among the most evidence-demanding ...

leukemia
geriatric oncology

Expert Point of View: Susan M. O’Brien, MD

THE STUDY’S discussant, Susan M. O’Brien, MD, Associate Director for Clinical Science, Chao Family Comprehensive Cancer Center, University of California Irvine Health, said the results of the Alliance North American Intergroup Study A041202—demonstrating that ibrutinib (Imbruvica) is more...

lung cancer

Pembrolizumab With Chemotherapy for First-Line Treatment of Metastatic Nonsquamous NSCLC

On August 20, 2018, pembrolizumab (Keytruda) in combination with pemetrexed (Alimta) and platinum was granted regular approval as first-line treatment of patients with metastatic nonsquamous non–small cell lung cancer (NSCLC) with no epidermal growth factor receptor (EGFR) or anaplastic lymphoma...

supportive care
integrative oncology

Addressing Patient Expectations Regarding the Use of Alternative Therapies

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

Palliative Care Trailblazer, Charles von Gunten, MD, PhD, Shares Insights With Advanced Practitioners

“The data are in, and they are clear and convincing. Palliative care leads to better outcomes for patients. The major challenge now is to make it part of standard cancer care everywhere in the United States and then everywhere else in the world, said Charles von Gunten, MD, PhD, a medical...

supportive care
palliative care

Palliative Care in the Pediatric Oncology Setting

Cancer is the leading cause of disease-related childhood death. To better serve the special needs of this highly vulnerable patient population, pediatric palliative care teams use a personalized, holistic, and interdisciplinary approach tailored to relieve the physical, psychosocial, and spiritual ...

breast cancer

Talazoparib for Germline BRCA-Mutated HER2-Negative Advanced Breast Cancer

On October 16, 2018, the poly (ADP-ribose) polymerase (PARP) inhibitor talazoparib (Talzenna) was approved for the treatment of patients with deleterious or suspected deleterious germline BRCA-mutated, HER2-negative locally advanced or metastatic breast cancer.1,2 Patients must be selected for...

integrative oncology

Probiotics

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. Shelly Latte-Naor, MD, and Jyothirmai Gubili, MS, explore some of the beneficial effects attributed ...

issues in oncology

Electronic ‘Datarrhea’ and Wellness

THE INTRODUCTION of the electronic health record (EHR) was supposed to lead us to a utopian world for health-care delivery in America. The Patient Protection and Affordable Care Act, signed into law on March 23, 2010, promoted its implementation by providing financial incentives.1 The Centers for...

skin cancer

Cemiplimab-rwlc for Metastatic or Locally Advanced Cutaneous Squamous Cell Carcinoma

On September 28, 2018, cemiplimab-rwlc (Libtayo) was approved for the treatment of patients with metastatic cutaneous squamous cell carcinoma or locally advanced cutaneous squamous cell carcinoma who are not candidates for curative surgery or curative radiation.1 Supporting Efficacy Data Approval...

issues in oncology

Patients With Cancer in Rural America Remain Underserved

Despite growing national awareness of health-care inequities, the plight of rural Americans diagnosed with cancer has persistently remained inadequate. Speaking with The ASCO Post, Jan Probst, PhD, Professor at the Arnold School of Public Health, University of South Carolina, Columbia, noted, “We...

hematologic malignancies
leukemia

Duvelisib in Resistant Chronic Lymphocytic Leukemia: Expanding the Treatment Armamentarium

The phase III DUO trial, reported by Flinn et al and reviewed in this issue of The ASCO Post, has led to the U.S. Food and Drug Administration (FDA) approval of a novel B-cell receptor (BCR) kinase inhibitor, duvelisib (Copiktra), which targets phosphoinositide 3-kinase (PI3K)-δ/γ in patients...

hematologic malignancies

Ibrutinib Plus Rituximab in Adult Patients With Waldenström’s Macroglobulinemia

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. On August 27, 2018, ibrutinib (Imbruvica) was approved...

Steven A. Rosenberg, MD, PhD, Works to Unmask Cancer’s Achilles Heel

Steven A. Rosenberg, MD, PhD, knew from the start of his medical career that if treatments for cancer were to become curative, research in new therapies would have to move away from the mainstay one-size-fits-all approach of systemic chemotherapy to an innovative, personalized strategy that...

prostate cancer

ASTRO/ASCO/AUA Guideline for Early-Stage Prostate Cancer Supports Use of Hypofractionated Radiotherapy

Three prominent medical organizations have issued a new clinical guideline for physicians treating men with early-stage prostate cancer using external-beam radiation therapy (EBRT). Developed by a panel of experts from the American Society for Radiation Oncology (ASTRO), ASCO, and the American...

skin cancer
immunotherapy

Neoadjuvant Therapy With Reduced-Dose Immunotherapy for Stage III Melanoma

In patients with stage III melanoma, a reduced-dose neoadjuvant immunotherapy combination was well tolerated and led to high pathologic response rates, in the phase II OpACIN-neo trial presented at the European Society for Medical Oncology (ESMO) 2018 Congress.1 “Neoadjuvant ipilimumab (Yervoy) at...

prostate cancer

Treatment With Radium-223 Plus Abiraterone Not Advisable in Metastatic Prostate Cancer

The combination of radium-223 plus AAP (abiraterone acetate [Zytiga] and prednisone) was not superior to placebo plus AAP in the phase III ERA 223 trial, which enrolled men with asymptomatic bone-predominant metastatic castration-resistant prostate cancer.1 Patients treated with the combination had ...

kidney cancer
immunotherapy

Immunotherapy and Tyrosine Kinase Inhibitor Combination in Advanced Renal Cell Carcinoma

In the JAVELIN Renal 101 phase III study, the combination of the immune checkpoint inhibitor avelumab (Bavencio), a programmed death ligand-1 (PD-L1) blocking antibody, plus the tyrosine kinase inhibitor axitinib (Inlyta) significantly improved progression-free survival in previously untreated...

breast cancer

Impact of Palbociclib on Survival in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

Much anticipated overall survival data for palbociclib (Ibrance) plus fulvestrant (Faslodex) in advanced breast cancer were presented at the European Society for Medical Oncology (ESMO) 2018 Congress.1 Although overall survival in PALOMA-3 was not designed to detect a statistically significant...

hematologic malignancies

The WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Medeiros explore the recently updated World Health Organization (WHO) classification of hematopoietic and lymphoid tissue...

immunotherapy
lung cancer

Corticosteroids and Immunotherapy: Guilty or Guilt By Association?

FIRST-LINE TREATMENT options for advanced non–small cell lung cancer (NSCLC) include single- agent immunotherapy for patients with a programmed cell death ligand 1 (PD-L1) tumor proportion score of at least 50% or in combination with chemotherapy in unselected patients.1-3 Single immunotherapy is...

leukemia
lymphoma

Venetoclax for CLL or SLL With or Without 17p Deletion After Prior Therapy

On June 8, 2018, venetoclax (Venclexta) was granted regular approval for treatment of patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), with or without 17p deletion, who have received at least one prior therapy.1,2 Supporting Efficacy Data APPROVAL WAS BASED on ...

issues in oncology

Do Incident Learning Systems Prevent Medical Errors?

ACCORDING TO a study by Johns Hopkins, medical errors are the third leading cause of death in the United States.1 Lakshmi Santanam, PhD, tackled such sobering data at the 2018 ASCO Quality Care Symposium. “Incident learning systems are not just about medical errors or data; it’s kind of a first...

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