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Showing 1301 - 1350Atezolizumab Plus Chemotherapy Improves Outcomes in Small Cell Lung Cancer
ATEZOLIZUMAB (TECENTRIQ), an anti–program cell death ligand 1 (PD-L1) antibody, combined with carboplatin/ etoposide as first-line treatment for extensive-stage small-cell lung cancer (SCLC) improved overall and progression-free survival and may represent a new standard of care, according to...
Results Reported for Olaparib Maintenance in Ovarian Cancer
TWO-YEAR MAINTENANCE therapy with olaparib (Lynparza), a poly (ADP-ribose) polymerase inhibitor, achieved a significant improvement in progression-free survival in patients with newly diagnosed advanced ovarian cancer and a BRCA1 or BRCA2 mutation, according to results of the phase III SOLO-1...
Brigatinib Improves Outcomes Over Crizotinib in ALK-Positive Non–Small Cell Lung Cancer
THE FIRST-LINE USE of brigatinib (Alunbrig) was superior to standard-of-care crizotinib (Xalkori) in patients with advanced anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC), according to the first report of the phase III ALTA-1L trial presented at the International...
Immunotherapy Improves Survival in a Subset of Patients With Metastatic Triple-Negative Breast Cancer
IMMUNOTHERAPY APPEARS to be the new upfront standard of care for patients with metastatic triple-negative breast cancer, based on a late-breaking presentation at the European Society for Medical Oncology (ESMO) 2018 Congress1 and simultaneously published in The New England Journal of Medicine.2 In ...
IASLC Issues Statement on Lung Cancer Screening With Low-Dose Computed Tomography
The International Association for the Study of Lung Cancer (IASLC) recently issued a statement on lung cancer screening with low-dose computed tomography (CT) based on the results of the Dutch-Belgian NELSON lung cancer screening trial presented at the IASLC 19th World Conference on Lung Cancer...
Acupuncture for Joint Symptoms Caused by Aromatase Inhibitors
Arthralgia is a common and debilitating adverse effect experienced by patients with breast cancer who are being treated with aromatase inhibitors, often resulting in poor adherence. And premature treatment discontinuation can negatively impact disease-free and overall breast cancer survival....
The Persephone Trial Reconsidered
Persephone is a 4,088-patient trial that Helena Margaret Earl, MBBS, PhD, reported at the 2018 ASCO Annual Meeting as establishing that 6 months of trastuzumab (Herceptin) is not inferior to 12 months in 4-year survival without invasive or local regional recurrence or distant metastases. Dr. Earl...
The Persephone Trial Reconsidered
The Persephone presentation by Helena Margaret Earl, MBBS, PhD, got a lot of publicity after a pre–ASCO Annual Meeting press release, suggesting that 6 months of adjuvant trastuzumab (Herceptin) is enough. The advice of experts has been that the evidence is inconclusive, but I have not heard a...
Sunitinib vs Nephrectomy Followed by Sunitinib in Metastatic Renal Cell Carcinoma
In an interim analysis of the French phase III noninferiority Carmena trial reported in The New England Journal of Medicine, Arnaud Méjean, MD, PhD, of the Hôpital Européen Georges Pompidou, and colleagues found that sunitinib alone was not inferior in overall survival vs nephrectomy followed by...
Exercise Therapy for Symptom Management and Treatment 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. Although physical activity is associated with many positive outcomes in the general population,...
Overcoming Long-Term Health and Economic Impact of Cancer on Young Adult Survivors
A pair of studies showcased the potentially devastating long-term health and financial consequences cancer has on adult survivors of childhood cancer compared with other adults, as well as survival disparities based on health insurance status.1,2 Despite increasing survival rates among the more...
On the Frontier of Breast Cancer Research With Joyce A. O’Shaughnessy, MD
Nationally regarded breast cancer researcher and clinician Joyce A. O’Shaughnessy, MD, was born in upstate New York, just outside of Albany, where she attended grade school before her family moved to Beverly, Massachusetts, a suburban town 26 miles from Boston, where her family’s roots were....
Cabozantinib in Advanced Hepatocellular Cancer: Call for Revision of Practice Standards
As reported in The New England Journal of Medicine by Ghassan K. Abou-Alfa, MD, and colleagues, and reviewed in this issue of The ASCO Post, the phase III CELESTIAL trial has demonstrated that cabozantinib (Cabometyx) improved the median overall survival to 10.2 months in comparison to 8 months...
Cabozantinib Improves Survival in Patients With Previously Treated Hepatocellular Carcinoma
As reported in The New England Journal of Medicine by Ghassan K. Abou‑Alfa, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the second interim analysis of the phase III CELESTIAL trial has shown a significant improvement in overall and progression-free survival with cabozantinib...
Nivolumab Plus Ipilimumab in Intermediate- or Poor-Risk Advanced Renal Cell Carcinoma
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 April 16, 2018, nivolumab (Opdivo) and ipilimumab...
Current Treatment Landscape of Relapsed or Refractory Chronic Lymphocytic Leukemia
Novel agents such as ibrutinib (Imbruvica), idelalisib (Zydelig), and venetoclax (Venclexta) have transformed the treatment of chronic lymphocytic leukemia (CLL) and are increasingly used to treat the disease. The optimal sequencing of these agents is not clear in relapsed or refractory disease,...
Regardless of Taxane Used, Pembrolizumab Plus Chemotherapy Improves Survival in Squamous NSCLC
The addition of pembrolizumab (Keytruda) to a standard platinum doublet as first-line therapy improved overall and progression-free survival in patients with metastatic squamous non–small cell lung cancer (NSCLC), in the primary analysis of KEYNOTE-407.1,2 Furthermore, it did not seem to matter...
Entrectinib Shows Activity in ROS1-Positive NSCLC
Although ROS1-mutated lung cancer accounts for about 1% to 2% of all non–small cell lung cancers (NSCLCs), it is an important druggable oncogene, and new data show that it can be successfully targeted for clinical gain. In a pooled analysis of phase I and II trials in patients with ROS1-positive...
NELSON Trial: ‘Call to Action’ for Lung Cancer CT Screening of High-Risk Individuals
Results of the very large, randomized, population-based NELSON trial confirm the value of low-dose computed tomography (CT) screening in people at high risk for developing lung cancer. The protective value of screening was more pronounced in women than in men. These study findings were presented at ...
Durvalumab Improves Overall Survival in Unresectable Stage III NSCLC
Several lung cancer trials have shown prolonged progression-free survival with checkpoint inhibitor therapy. For the first time, the phase III PACIFIC trial has found an overall survival benefit for the selective programmed cell death ligand 1 (PD-L1) checkpoint inhibitor durvalumab (Imfinzi) vs...
An Early Love of Literature Gives Way to a Career in Breast Cancer Research for Jennifer K. Litton, MD
Breast cancer specialist Jennifer K. Litton, MD, was born and reared in Leominster, Massachusetts, a small city in the north central part of the state. “I went to parochial schools until seventh grade and then went on to high school in Worcester. Although I enjoyed science early on, I was...
Closing the Gender Divide in Preference for Palliative Care
Eight years ago, a survey of the preferences of Dutch patients with cancer for health care found that while gender was one aspect influencing how men and women approach cancer care, it was the most important, with men, generally, regarding most care aspects as less important than women. The study...
More to Learn About Using PARP Inhibitors for Advanced Breast Cancer With Germline BRCA Mutation
Germline mutations in the breast cancer–susceptibility genes 1 and 2 (BRCA1/2) increase the risk for cancer due to an inability to repair DNA double-strand breaks, and about 5% of patients with unselected breast cancer carry a germline BRCA mutation.1 These DNA repair–deficient tumors are...
Talazoparib Improves Progression-Free Survival in Advanced Breast Cancer With Germline BRCA Mutation
As reported in The New England Journal of Medicine by Jennifer K. Litton, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, the phase III EMBRACA trial has shown significantly improved progression-free survival with the poly (ADP-ribose) polymerase (PARP) inhibitor...
Rituximab/Lenalidomide vs Rituximab/Chemotherapy in Advanced Untreated Follicular Lymphoma
In the phase III RELEVANCE trial reported in The New England Journal of Medicine by Franck Morschhauser, MD, PhD, of The University of Lille, Centre Hospitalier Universitaire Lille, France, and colleagues, no difference in the complete response rate or interim progression-free survival was found...
Osimertinib in First-Line Treatment of EGFR-Mutant Metastatic NSCLC
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. In April 2018, osimertinib (Tagrisso) was approved for...
Strategies for Using Anticoagulation Therapy in Patients With Cancer
Although approximately 20% to 30% of patients with cancer will develop venous thromboembolism (VTE), clinicians continue to debate strategies for pharmacologic treatment and prevention.1 At the 2018 Debates and Didactics in Hematology and Oncology Conference, held on Sea Island, Georgia, Christine...
Neuroendocrine Tumors: New Data, New Options
Because neuroendocrine tumors are not one disease but a continuum of diseases, ranging from well-differentiated tumors to poorly differentiated and small cell tumors, treatment approaches can vary greatly. At the 2018 Debates and Didactics in Hematology and Oncology conference, held on Sea Island,...
Durvalumab Improves Overall Survival in Stage III NSCLC
The phase III PACIFIC trial showed significantly improved overall survival with durvalumab (Imfinzi) vs placebo after chemoradiotherapy in patients with unresectable stage III non–small cell lung cancer (NSCLC). Scott J. Antonia, MD, of the Moffitt Cancer Center, Tampa, Florida, reported these...
The Relevance of the RELEVANCE Trial in Follicular Lymphoma
We have seen remarkable progress in the outcomes of patients with advanced-stage follicular lymphoma over the past 2 decades.1 Recent manuscripts and presentations describing long-term follow-up of randomized trials comparing various chemotherapy platforms (all combined with anti-CD20 antibodies)...
Pertuzumab in Adjuvant Treatment of HER2-Positive Breast Cancer
AT THE END OF 2017, pertuzumab (Perjeta) was granted regular approval for use in combination with trastuzumab (Herceptin) and chemotherapy as adjuvant treatment of patients with HER2- positive early breast cancer at high risk of recurrence.1,2 Supporting Efficacy Data APPROVAL WAS BASED on...
Abiraterone Acetate Plus Prednisone in High-Risk Metastatic Castration-Sensitive Prostate Cancer
IN EARLY 2018, abiraterone acetate tablets (Yonsa, Zytiga) in combination with prednisone was approved for the treatment of metastatic high-risk castration-sensitive prostate cancer.1,2 Supporting Efficacy Data APPROVAL WAS BASED on findings from the phase III LATITUDE trial, in which 1,199...
Care for the Cancer Caregiver
Providing care to patients with cancer can be overwhelming, and caregivers are at risk for physical and psychological distress, which can negatively impact their own health. Over the past decade, supporting caregiver well-being has gained prominence as a national health-care issue. In this...
New Laws Limiting Opioid Prescriptions Create Undue Barriers for Patients With Cancer and Cancer Survivors
Among other policy responses to the growing opioid epidemic, many states have enacted legislation that limits the duration or amount of opioid prescriptions issued by physicians. Although, it is clear we need strong measures to mitigate widespread overuse and misuse of opioids. These...
CAR T-Cell Therapy for CLL
A pair of new studies from researchers at the Abramson Cancer Center of the University of Pennsylvania are shedding light on why patients with advanced chronic lymphocytic leukemia (CLL) respond or do not respond to chimeric antigen receptor (CAR) T-cell therapy. Although CAR T-cell therapy is...
An Invitation to Be Quiet No Longer
My male colleagues sometimes broach the topic of #MeToo or sexual harassment in medicine by saying how uncomfortable it makes them. Ah, yes. How uncomfortable the sexual harassment I have faced for years makes you. I casually bring up microaggressions—subtle verbal or nonverbal slights against...
Treatment of Triple-Negative Breast Cancer With BRCA1/2 Mutations: More to Learn From Ongoing Trials
The treatment of triple-negative breast cancer remains a clinical challenge with no single validated target, though numerous pathways are druggable and are being investigated. In the subset of BRCA-mutated triple-negative breast cancer, the approval of the first poly (ADP-ribose) polymerase (PARP)...
Cabozantinib in Second-Line Treatment of Advanced Hepatocellular Carcinoma
Compared with placebo, cabozantinib (Cabometyx) significantly improved overall survival and progression-free survival in patients with advanced hepatocellular carcinoma who were previously treated with sorafenib (Nexavar), with no new safety signals, according to data from the phase III CELESTIAL ...
Expanding the Use of Provider Orders for Life-Sustaining Treatment for Patients With Advanced Cancer
Patients with advanced cancer often get more aggressive treatment than they want because too few oncologists elicit their end-of-life treatment preferences.1,2 In response to this problem, leading associations, including ASCO3,4 and the Institute of Medicine,5 have called for more advance care...
FDA Approves First Nonchemotherapy Combination Regimen for Patients With Waldenström’s Macroglobulinemia
ON AUGUST 27, 2018, the U.S. Food and Drug Administration (FDA) approved the combination of ibrutinib (Imbruvica) and rituximab (Rituxan) for patients with Waldenström’s macroglobulinemia. The recent approval expands the label for ibrutinib in Waldenström’s macroglobulinemia beyond its current...
Treating Nonmetastatic Castration-Resistant Prostate Cancer: Implications of the PROSPER Trial
A MAN in his early 70s sits in our office. His general health is good, and he is feeling well. Yet he is deeply worried. Four years ago, when his prostate-specific antigen (PSA) level rapidly increased after radical prostatectomy and subsequent radiation therapy, he was started on...
Trametinib Treatment for Histiocytic Sarcoma With Activating MAP2K1 Mutation
In a letter to the editor in The New England Journal of Medicine, Mrinal M. Gounder, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues described the successful treatment of a patient with histiocytic sarcoma and an activating MAP2K1 (MEK1) mutation with the MAPK kinase 1 and...
Coriolus versicolor
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. Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, present information on the potential...
Improving the Lives of Patients With Cancer Is Richard L. Schilsky’s Lifelong Mission
In 2009, as Richard L. Schilsky, MD, FACP, FSCT, FASCO, was preparing his Presidential Address for that year’s ASCO Annual Meeting, he came across his 6th grade essay titled “My Ambition,” which foretold with eerie specificity the career path he would follow over the next 6 decades. In the paper,...
Ivosidenib for Relapsed or Refractory Acute Myeloid Leukemia
ON JULY 20, 2018, the U.S. Food and Drug Administration (FDA) approved ivosidenib (Tibsovo) for the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with a susceptible isocitrate dehydrogenase-1 (IDH1) mutation, as detected by an FDA-approved test.1,2 The FDA...
Daratumumab in Newly Diagnosed Transplant-Ineligible Multiple Myeloma
In May 2018, daratumumab (Darzalex) was approved for use in combination with VMP (bortezomib, melphalan, and prednisone) in the treatment of patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplantation.1 Supporting Efficacy Data Approval was based on...
Obesity and Cancer: Complex Interplay of Multiple Factors
The evolving concept that dietary fat plays an important role in the etiology of human cancer emerged more than 50 years ago. Ernst Wynder, MD, whose seminal epidemiologic work led to identifying smoking as a contributory cause of lung cancer, presented a paper in 1967 showing a decided correlation ...
Enzalutamide in Nonmetastatic Castration-Resistant Prostate Cancer
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 July 13, 2018, enzalutamide (Xtandi) was approved for...
Medical Marijuana: Research Not Anecdotes
For patients with cancer, marijuana may be valuable in controlling pain and chemotherapy-induced nausea and vomiting. Furthermore, it may have efficacy as an appetite stimulant. No randomized clinical trial has investigated the utility of whole-plant medical marijuana to alleviate these symptoms in ...
TAILORx: How to Apply This Landmark Study
TAILORx changes the configuration of the ball field and the shape of the ball in deciding which women will be recommended chemotherapy after resection of node-negative, hormone receptor–positive breast cancer. TAILORx was presented by Joseph Sparano, MD, at the 2018 ASCO Plenary Session and...
