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From Leeches to Liquid Biopsy: Uncovering the Mysteries of Blood

BOOKMARK Title: Nine Pints: A Journey Through the Money, Medicine, and Mysteries of BloodAuthor: Rose GeorgePublisher: Metropolitan BooksPublication date: October 2018Price: $27.00, hardcover, 368 pages Blood has been mythologized and misunderstood since the earliest records of humankind and still ...

Scientist, Father of A Child With Autism Pushes Back on the Antivaccine Movement

BOOKMARK Title: Vaccines Did Not Cause Rachel’s Autism: My Journey as a Vaccine Scientist, Pediatrician, and Autism DadAuthor: Peter J. Hotez, MD, PhDPublisher: Johns Hopkins University PressPublication date: October 2018Price: $22.95, hardcover; 240 pages English physician Edward Jenner invented...

issues in oncology
health-care policy

Major Settlement Raises Questions About Evidence-Based Value in Cancer Care

An Oklahoma jury recently awarded $25.5 million to the widower of a 53-year-old woman diagnosed with stage IV nasopharyngeal cancer who was denied coverage for proton therapy by her health insurer, Aetna. The patient’s family subsequently raised $92,000 to cover her proton therapy at The University ...

multiple myeloma

Cytogenetic Prognostic Index for Survival in Multiple Myeloma

In a study reported in the Journal of Clinical Oncology, Perrot et al identified a cytogenetic prognostic index predictive of survival in patients with newly diagnosed multiple myeloma. Study Details The study involved data from 1,635 patients in four trials conducted by the Intergroupe...

bladder cancer
immunotherapy

Adverse Events and Outcomes in Patients Receiving Anti–PD-1/PD-L1 Antibody Treatment for Advanced Urothelial Cancer

In an analysis reported in the Journal of Clinical Oncology, Maher et al found that treatment-related adverse events of special interest and immune-mediated adverse events were more common among patients with advanced urothelial cancer with vs without response to anti–programmed cell death...

hematologic malignancies

Selected Abstracts From the 2019 ASCO Annual Meeting

To complement The ASCO Post’s comprehensive coverage of the 2019 ASCO Annual Meeting, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic regimens for plasma cell dyscrasias, particularly multiple myeloma. For full details of these study abstracts, visit ...

lymphoma
multiple myeloma
prostate cancer
immunotherapy

FDA Pipeline: Reviews and Designations in Multiple Myeloma, Lymphoma, Prostate Cancer

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review for daratumumab in combination with a triplet therapy in multiple myeloma, Breakthrough Therapy designation to copanlisib for marginal zone lymphoma, and Fast Track designation for ARV-110 in metastatic...

hematologic malignancies

Ibrutinib in Combination With Obinutuzumab in Treatment-Naive CLL/SLL

In the Clinic provides overviews of novel hematology and oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. Early in 2019, ibrutinib was approved for...

lung cancer
immunotherapy

2019 ASCO: NEOSTAR: Neoadjuvant Nivolumab Plus Ipilimumab in Early-Stage, Resectable NSCLC

Neoadjuvant treatment with nivolumab plus ipilimumab resulted in an overall major pathologic response rate of 33% of treated patients with early-stage, resectable non–small cell lung cancer (NSCLC). With these results, the combination immunotherapy met the prespecified trial...

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...

gynecologic cancers
hepatobiliary cancer

Regular Aspirin Use and Risk of Hepatocellular Carcinoma and Epithelial Ovarian Cancer

Data from two large U.S. prospective cohort studies indicate the benefits of regular aspirin use in preventing hepatocellular carcinoma and epithelial ovarian cancer. As reported by Tracey G. Simon, MD, MPH, of Massachusetts General Hospital, Harvard Medical School, and colleagues, in JAMA...

2019 Integra Connect Golf Classic Raises More Than $1 Million for Conquer Cancer®, the ASCO Foundation

Conquer Cancer Board Member Raj Mantena, RPh, Founder and Chief Executive Officer of Integra Connect™, recently organized and sponsored the second Integra Connect Golf Classic and a dinner benefitting Conquer Cancer. More than $1 million was raised at the 2-day event, which took place March 31 and...

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...

Expert Point of View: Jeffrey S. Falk, MD

Jeffrey S. Falk, MD, a surgical oncologist at the Ascension Saint John Hospital in Grosse Pointe Woods, Michigan, commented on these studies of same-day mastectomy and home recovery programs: “The impetus behind these two significant quality-improvement studies was to allow patients to recover...

breast cancer

Studies Report Early Success With Same-Day Mastectomy and Home Recovery Programs

Patients can safely recover from mastectomy at home, according to two studies reported at the 2019 American Society of Breast Surgeons Annual Meeting.1,2 The studies examined outcomes after implementation of comprehensive postmastectomy surgical home recovery programs, showing that they...

breast cancer

Nipple-Sparing Mastectomy May Be Suitable for Growing Number of Well-Selected Patients

As nipple-sparing mastectomy gains favor, it is being performed on a broader spectrum of patients once considered off limits by surgeons. A Mayo Clinic study in a contemporary cohort found no increase in complication rates or decrease in reconstruction success with this surgical approach.1 “We...

breast cancer
supportive care

Using Bioimpedance Spectroscopy to Prevent Progression of Lymphedema

Surveillance of women at risk for breast cancer–related lymphedema using bioimpedance spectroscopy was more effective in preventing lymphedema progression than traditional measurement of arm circumference, when each is combined with immediate compression therapy. These findings came from the...

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...

lung cancer

Pembrolizumab Improves Survival vs Chemotherapy in Previously Untreated Advanced NSCLC With PD-L1 Expression ≥ 1%

As reported in The Lancet by Tony S.K. Mok, MD, of Chinese University of Hong Kong, and colleagues, the KEYNOTE-042 trial has shown an improvement in overall survival with pembrolizumab vs standard chemotherapy in previously untreated patients with locally advanced or metastatic non–small cell lung ...

Ruxolitinib Approved for Acute Graft-vs-Host Disease

On May 24, the U.S. Food and Drug Administration (FDA) approved ruxolitinib (Jakafi) for steroid-refractory acute graft-vs-host disease (GVHD) in adult and pediatric patients 12 years and older. Approval was based on the REACH1 trial/Study INCB 18424-271, an open-label, single-arm, multicenter...

head and neck cancer

NovoTTF-100L System in Combination With Chemotherapy Approved for Malignant Pleural Mesothelioma

On May 23, the U.S. Food and Drug Administration (FDA) approved the NovoTTF-100L System in combination with pemetrexed plus platinum-based chemotherapy for the first-line treatment of unresectable locally advanced or metastatic malignant pleural mesothelioma. NovoTTF-100L is a noninvasive,...

breast cancer

Alpelisib Plus Fulvestrant Approved for PIK3CA-Mutated Breast Cancer

On May 24, the U.S. Food and Drug Administration (FDA) approved the PIK3CA inhibitor alpelisib (Piqray) tablets to be used in combination with the FDA-approved endocrine therapy fulvestrant to treat postmenopausal women and men with hormone receptor–positive, HER2-negative, PIK3CA-mutated, advanced ...

genomics/genetics

Two Pediatric Trials Find Targets for Treatment-Refractory Cancers

An interim analysis of the large Pediatric MATCH trial found that 24% of children and young adolescents with cancers refractory to current treatments had been assigned to treatment with investigational targeted study agents based on genetic alterations detected in their tumors,1 which is more than...

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: Yousuf Zafar, MD

At the Plenary Session, formal discussant of Dr. Davidoff’s study, Yousuf Zafar, MD, of Duke Cancer Institute, Durham, North Carolina, gave an impassioned talk about the need to address racial disparities in cancer care. “This is a nontraditional study to be selected for the ASCO Plenary Session....

issues in oncology
health-care policy

ACA Increases Access to Health Care, Early Diagnosis, and Timely Treatment for Patients With Cancer

  The evidence is in: the Affordable Care Act (ACA) has enabled improved access to earlier diagnosis, earlier care, and reduced racial disparities in access to care for patients with cancer, according to two studies presented at the 2019 ASCO Annual Meeting. In states that adopted Medicaid...

solid tumors
issues in oncology

2019 ASCO: Study Finds Proton Therapy Reduces Adverse Events, Results in Similar Survival vs Photon Therapy

In a trial presented by Baumann et al at the 2019 ASCO Annual Meeting (Abstract 6521), patients with locally advanced cancer treated with proton chemoradiotherapy instead of traditional photon chemoradiotherapy were at a lower risk of experiencing side effects. However, cure rates were almost...

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...

cns cancers

Activity of Selumetinib in Pediatric Pilocytic Astrocytoma and Low-Grade Glioma

In a phase II trial reported in The Lancet Oncology, Fangusaro et al found that the MEK1/2 inhibitor selumetinib was active in pediatric patients with recurrent, refractory, or progressive pilocytic astrocytoma with common BRAF aberrations and neurofibromatosis type 1...

leukemia

First-Line Ibrutinib and Venetoclax for High-Risk and Older Patients With Previously Untreated CLL

In a single-center phase II trial reported in The New England Journal of Medicine, Jain et al 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 patients...

pain management

2019 ASCO: Pain Management Program for Patients Undergoing Robotic Urologic Surgery

A specialized pain management program for patients who underwent robotic surgery for urologic cancers resulted in 8% of patients going home with narcotics after discharge, compared to 100% who would have received them without this enhanced recovery protocol. The group of patients...

lymphoma
immunotherapy

2019 ASCO: Rituximab, Lenalidomide, and Ibrutinib Prior to Chemotherapy in DLBCL

Results of the phase II Smart Start trial revealed that combination targeted therapy consisting of rituximab, lenalidomide, and ibrutinib had an 84.6% overall response rate (ORR) and 38.5% complete response rate (CRR) when given prior to any chemotherapy for newly diagnosed patients with a...

sarcoma

SARC024: Regorafenib in Metastatic Osteosarcoma

In the phase II SARC024 trial in sarcoma subtypes reported in the Journal of Clinical Oncology, Davis and colleagues found that regorafenib improved progression-free survival vs placebo in the cohort of patients with metastatic osteosarcoma. The double-blind study included 42 patients from 12 U.S. ...

gastrointestinal cancer

Does Adding HIPEC to Cytoreductive Surgery Improve Outcomes in Patients With Gastric Cancer and Peritoneal Metastases?

In a propensity score analysis reported in the Journal of Clinical Oncology, Bonnot et al found that the addition of hyperthermic intraperitoneal chemotherapy (HIPEC) to cytoreductive surgery improved outcomes among patients with gastric cancer with peritoneal metastases. The study included 277...

breast cancer

2019 ASCO: Partial- vs Whole-Breast Irradiation in Early-Stage Breast Cancer

Partial-breast irradiation produces similar long-term survival rates and risk for recurrence compared with whole-breast irradiation for many women with low-risk, early-stage breast cancer, according to new data from the NRG Oncology/NSABP B-39/RTOG 0413 trial. Results were presented by Ganz et al...

prostate cancer

Active Surveillance/Watchful Waiting for Black Patients With Low-Risk Prostate Cancer

In a study reported in a letter to the editor in The New England Journal of Medicine, Butler et al found that the proportion of black patients with low-risk prostate cancer undergoing active surveillance remained lower than that among nonblack patients, despite increased use of the strategy in both ...

lung cancer
immunotherapy

IMpower130: Addition of First-Line Atezolizumab to Chemotherapy in Metastatic Nonsquamous NSCLC

As reported in The Lancet Oncology by West et al, the phase III IMpower130 trial found that the addition of atezolizumab to carboplatin plus nab-paclitaxel significantly improved overall and progression-free survival in first-line treatment of stage IV nonsquamous non–small cell lung cancer...

solid tumors

Brian C. Baumann, MD, on Locally Advanced Cancer: Proton vs Photon Therapy

Brian C. Baumann, MD, of Washington University School of Medicine, discusses study findings that showed, for adults with locally advanced cancer across five different disease sites, proton chemoradiotherapy was associated with significantly reduced acute adverse events, with no difference in...

breast cancer

Patricia A. Ganz, MD, on Breast Cancer: Whole- vs Partial-Breast Irradiation

Patricia A. Ganz, MD, of NRG Oncology and Jonsson Comprehensive Cancer Center at UCLA, discusses the NRG/NSABP phase III findings, which showed that partial-breast irradiation was more convenient and resulted in less fatigue but slightly poorer cosmesis at 36 months in patients who did not receive...

issues in oncology

2019 ASCO: Sexual Harassment and Gender Disparities: Survey of Gynecologic Oncologists

A recent survey of U.S.-based physician members of the Society of Gynecologic Oncology found that 64% of respondents experienced sexual harassment in training or practice; among women, the rate was 71% and among men, it was 51%. Only 10% reported the incident(s) to officials. In addition, women...

bladder cancer
immunotherapy

2019 ASCO: Enfortumab Vedotin Shows Activity in Previously Treated, Locally Advanced or Metastatic Urothelial Cancer

The single-arm, phase II EV-201 trial showed treatment with enfortumab vedotin—an agent targeting Nectin-4, a protein found in 97% of urothelial cancers—produced responses in 44% of patients with locally advanced or metastatic forms of urothelial cancer. Patients had previously been...

colorectal cancer

2019 ASCO: OSLO-COMET: Laparoscopic vs Open Resection for Colorectal Cancer Liver Metastases

The randomized Norwegian OSLO-COMET trial found that laparoscopic surgery did not change chances of survival compared to open resection to remove metastases that had spread to the liver in patients with colorectal cancer. Overall, patients lived more than 6.5 years after surgery, regardless of...

lung cancer
issues in oncology

2019 ASCO: Expansion of Clinical Trial Inclusion Criteria in Patients With Advanced NSCLC

A study that examined 10,500 health records of patients with advanced non–small cell lung cancer from ASCO’s CancerLinQ database found that the use of expanded clinical trial inclusion criteria—as proposed by ASCO and Friends of Cancer Research in 2017—would nearly double...

lung cancer

Hirotsugu Kenmotsu, MD, on Nonsquamous Non–Small Cell Lung Cancer: Pemetrexed Plus Cisplatin vs Vinorelbine Plus Cisplatin

Hirotsugu Kenmotsu, MD, of Shizuoka Cancer Center, discusses the phase III JIPANG trial findings, which showed that pemetrexed plus cisplatin was not superior to vinorelbine plus cisplatin in terms of recurrence-free survival for patients with completely resected nonsquamous non–small cell lung...

pancreatic cancer

2019 ASCO: POLO: Maintenance Olaparib in Germline BRCA-Mutated Pancreatic Cancer

The randomized phase III POLO trial found that maintenance therapy with the poly (ADP-ribose) polymerase inhibitor olaparib significantly delayed the progression of metastatic pancreatic cancer in patients with germline BRCA gene mutations compared with placebo (median...

prostate cancer

2019 ASCO: ENZAMET: Addition of Enzalutamide to Standard of Care in Metastatic Hormone-Sensitive Prostate Cancer

An interim analysis of the international, randomized phase III ENZAMET trial found that 80% of men with metastatic hormone-sensitive prostate cancer who received the nonsteroidal antiandrogen agent enzalutamide along with standard-of-care treatment were alive after 3 years, compared with 72% of men ...

health-care policy
issues in oncology

2019 ASCO: Medicaid Expansion and Time to Treatment in African American Patients Compared to White Patients With Cancer

Previous racial disparities in timely cancer treatment between African American and white patients were reduced in states where Medicaid access was expanded under the Affordable Care Act (ACA), according to a new analysis of electronic health records from for 30,000 patients. The study, based on...

multiple myeloma
issues in oncology

2019 ASCO: Does Insurance Status Impact Survival in Patients With Multiple Myeloma?

A new study analyzing demographic statistics from the National Cancer Database presented by Chamoun et al at the 2019 ASCO Annual Meeting (Abstract LBA107) identified multiple socioeconomic factors—including private insurance, living in a regionally higher-income area, and receiving treatment ...

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