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hematologic malignancies
lymphoma

Outcomes in Waldenström’s Macroglobulinemia Improved With Ibrutinib Plus Rituximab

In patients with Waldenström’s macroglobulinemia, the risk of disease progression was reduced by 80% with the combination of ibrutinib (Imbruvica) and rituximab (Rituxan) over rituximab alone, in the international phase III iNNOVATE trial, reported at the 2018 ASCO Annual Meeting1 and...

Expert Point of View: Daniel George, MD, Robert J. Motzer, MD, and Paul Russo, MD

Formal discussant of the CARMENA trial, Daniel George, MD, of Duke University Medical Center, Durham, North Carolina, had reservations about the broad application of these results. “CARMENA was designed to reassess the value and role of nephrectomy in patients who present with metastatic renal...

solid tumors
kidney cancer

Nephrectomy May Be Avoided in Some Patients With Advanced Renal Cell Carcinoma

In the modern era of targeted therapy, some patients with metastatic renal cell carcinoma may be able to forgo nephrectomy and be treated with sunitinib (Sutent) alone, according to results of the phase III CARMENA trial reported during the Plenary Session at the 2018 ASCO Annual Meeting.1 The...

hematologic malignancies
leukemia

Minimal Residual Disease Testing in AML: Still a Shifting Target

Testing for minimal residual disease (MRD) has become an established part of the management of acute lymphoblastic leukemia (ALL), but in acute myeloid leukemia (AML), the technology still warrants validation. To address issues and set new standards, the European LeukemiaNet Working Party recently ...

lung cancer

Early Evidence of Neoadjuvant PD-1 Blockade in Non–Small Cell Lung Cancer

A NOVEL APPROACH using two doses of nivolumab (Opdivo) prior to surgery achieved major pathologic responses in 45% of patients with resectable stages I to IIIA non–small cell lung cancer (NSCLC), according to the results of a small Stand Up 2 Cancer–Cancer Research Institute Dream Team study...

breast cancer

TAILORx: Endocrine Therapy Alone Is Sufficient for Most Patients With ‘Intermediate-Risk’ Breast Cancer

THE HIGHLY ANTICIPATED results of the phase III TAILORx study are in—and they indicate that the vast majority of patients with “intermediate-risk” early-stage breast cancer can forgo chemotherapy.  “Our study shows that chemotherapy may be avoided in about 70% of women with hormone...

solid tumors
issues in oncology
geriatric oncology

Does Warfarin Have Anticancer Potential in Persons Older Than Age 50?

A Norwegian population–based cohort study indicated that the use of warfarin was associated with a reduced risk of cancer overall and site-specific cancers among patients aged > 50 years. The findings were reported in JAMA Internal Medicine by Haaland et al. As noted by the investigators,...

solid tumors
issues in oncology
survivorship
breast cancer

Tai Chi for the Treatment of Insomnia in Breast Cancer Survivors

Underrecognized and inadequately managed, insomnia is a significant burden for many cancer survivors. Often persistent over several years following diagnosis and treatment, sleep problems negatively affect quality of life and elevate the risk of depression and anxiety. In this installment of The...

solid tumors
skin cancer
head and neck cancer

Dabrafenib Plus Trametinib for Thyroid Cancer, Melanoma With BRAF Mutations

On May 4, 2018, dabrafenib (Tafinlar) and trametinib (Mekinist) in combination was granted approval for treatment of patients with locally advanced or metastatic anaplastic thyroid cancer with BRAF V600E mutation and no satisfactory locoregional treatment options.1-3 Dabrafenib is not indicated for ...

solid tumors
kidney cancer

Nivolumab Plus Ipilimumab in Advanced Renal Cell Carcinoma: A Shift in the Treatment Paradigm

For over a decade, vascular endothelial growth factor (VEGF) tyrosine kinase inhibitors have been the standard first-line agents in the management of patients with advanced or metastatic clear cell renal cell carcinoma.1-3 Historically, phase III trials of first-line VEGF therapies included...

solid tumors
kidney cancer

CheckMate 214: Nivolumab Plus Ipilimumab Improves Survival vs Sunitinib in Advanced Renal Cell Cancer

As reported in The New England Journal of Medicine by Robert J. Motzer, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the phase III CheckMate 214 trial has shown an overall survival advantage with nivolumab (Opdivo) plus ipilimumab (Yervoy) vs sunitinib (Sutent) in patients with...

issues in oncology

ASCO Launches Its Education Scholars Program

Education is such an integral part of ASCO’s strategic plan to reduce the burden of cancer for all patients, it is incorporated into the Society’s mission statement to “conquer cancer through research, education, and promotion of the highest patient care.” In 2017, ASCO’s Board of Directors voted...

breast cancer

Hormonal Contraception and Breast Cancer Risk

As reported in The New England Journal of Medicine by Lina S. Mørch, PhD, of the University of Copenhagen, and colleagues, a Danish study has shown that the risk of breast cancer is increased in hormonal contraception users vs nonusers, with the absolute increase in risk being small.  The study...

supportive care
integrative oncology

Supporting Patients During and After Cancer Treatment: Evidence-Informed Approach to Lifestyle and Behavior Change

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. In this installment, Lorenzo Cohen, PhD, and Alison Jefferies, BA, MEd, summarize research...

leukemia

Molecular Minimal Residual Disease Detection Shows Further Promise in Acute Myeloid Leukemia

Extended next-generation sequencing genomic profiling in acute myeloid leukemia (AML) has revealed remarkable heterogeneity and molecular complexity of the disease and provided critical insights into the genetic mechanisms underpinning of preleukemic and leukemic pathogenesis.1,2 Despite...

leukemia

Targeted Sequencing Detection of Molecular Minimal Residual Disease and Prognosis in Acute Myeloid Leukemia

In a study reported in The New England Journal of Medicine, Mojca Jongen-Lavrencic, MD, PhD, of Erasmus MC Cancer Institute, and colleagues found that molecular minimal residual disease identified by next-generation sequencing during complete remission was associated with an increased risk of...

gynecologic cancers

How a Recent Study Heats up the Debate Over Intraperitoneal Chemotherapy in Newly Diagnosed Advanced Ovarian Cancer

Based on pharmacokinetic and preclinical data, there appears to be a biologic advantage to the use of intraperitoneal chemotherapy in treating some malignancies confined to the abdomen. Since most ovarian, fallopian tube, and peritoneal cancers present and recur in the peritoneal cavity, this...

gynecologic cancers

Adding Hyperthermic Intraperitoneal Chemotherapy to Cytoreductive Surgery Improves Outcomes in Advanced Ovarian Cancer

In a Dutch/Belgian phase III trial reported in The New England Journal of Medicine by Willemien J. van Driel, MD, PhD, of the Netherlands Cancer Institute, and colleagues, the addition of hyperthermic intraperitoneal chemotherapy (aka HIPEC) to interval cytoreductive surgery following neoadjuvant...

prostate cancer

Role of MRI in Detection of Clinically Significant Prostate Cancer: ‘Practice-Affirming’ Results From The PRECISION Trial

Simultaneously presented at the 2018 European Association of Urology meeting and published in The New England Journal of Medicine, the PRECISION trial will go down as a landmark study for solidifying the role of magnetic resonance imaging (MRI) in prostate cancer diagnosis.1 This trial provides...

prostate cancer

MRI-Targeted vs Standard Biopsy in Prostate Cancer Diagnosis: The PRECISION Trial

In the international PRECISION trial reported in The New England Journal of Medicine, Veeru Kasivisvanathan, MRCS, of University College London, and colleagues found that magnetic resonance imaging (MRI)-targeted biopsy resulted in a significantly higher rate of diagnosis of clinically significant ...

lymphoma
immunotherapy

Brentuximab Vedotin in Previously Untreated Stage III or IV Classical Hodgkin Lymphoma

On March 20, 2018, brentuximab vedotin (Adcetris) was approved for the treatment of adult patients with previously untreated stage III or IV classical Hodgkin lymphoma in combination with chemotherapy.1,2 Supporting Efficacy Data Approval was based on the findings of the open-label phase III...

issues in oncology
cost of care
immunotherapy

Weighing the Cost and Value of CAR T-Cell Therapy

This past year’s approval by the U.S. Food and Drug Administration (FDA) of two chimeric antigen receptor (CAR) T-cell therapies heralded a new era in both effective cancer treatments and the most expensive cancer drugs ever. Tisagenlecleucel (Kymriah) was initially approved for the treatment of...

multiple myeloma
immunotherapy

FDA Approves Daratumumab/VMP Combination for Newly Diagnosed Multiple Myeloma

On May 7, the U.S. Food and Drug Administration(FDA) approved daratumumab (Darzalex) in combination with bortezomib (Velcade), a proteasome inhibitor; melphalan, an alkylating agent; and prednisone—VMP—for the treatment of patients with newly diagnosed multiple myeloma who are ineligible for...

issues in oncology

Here’s How ASCO Is Joining With Other Organizations to Reduce Obesity and Cancer Rates

GUEST EDITOR Prevention in Oncology is guest edited by Jennifer A. Ligibel, MD, Chair of ASCO’s Energy Balance Working Group and a member of ASCO’s Cancer Survivorship and Cancer Prevention Committees. Dr. Ligibel is Director of the Leonard P. Zakim Center for Integrative Therapies at Dana-Farber...

solid tumors
breast cancer

Endocrine Therapy: An Important Treatment Limited by Major Challenges

“Endocrine therapy remains the most effective and least toxic treatment for breast cancer, but we have many problems to solve. And there will have to be many different solutions,” according to George W. Sledge, MD, FASCO, Professor of Medicine and Chief of the Division of Oncology at Stanford...

Expert Point of View: William M. Sikov, MD and Sunil Verma, MD

The ASCO Post obtained comments about the Persephone trial results from two breast cancer experts. William M. Sikov, MD, is Associate Director of Clinical Research at the Program in Women’s Oncology at Women and Infants Hospital of Rhode Island and Associate Professor of Medicine and of...

lung cancer

Researchers Identify Most Accurate Risk-Prediction Models for Lung Cancer Screening in Ever-Smokers

Recent lung cancer screening guidelines from the National Comprehensive Cancer Network(®) permit the use of risk models to refer ever-smokers for screening. However, different models select different screening populations and the performance of each model in selecting ever-smokers is...

issues in oncology

Now More Than Ever, the Oncology Pharmacist Can Play a Variety of Roles on the Health-Care Team

Susannah E. Koontz, PharmD, BCOP, FHOPA, is a consultant for clinical pharmacy services, research, and education in the areas of pediatric hematology/oncology, stem cell transplantation, and cellular therapy. She has held positions at the Children’s Cancer Hospital at The University of Texas MD...

health-care policy

COA Practice Impact Report Details Consolidation, Shift of Cancer Care System Into Hospital Setting

THE COMMUNITY ONCOLOGY Alliance (COA) has released the 2018 Community Oncology Practice Impact Report,1 which tracks data on the changing landscape of cancer care in the United States. It details a decade-long trend of closure and consolidation in the U.S. cancer system that has resulted in a...

skin cancer

Updated ASCO/SSO Guideline on Sentinel Lymph Node Biopsy in Melanoma: Addressing Fundamental Clinical Questions

Dr. Thompson is Professor of Melanoma and Surgical Oncology, Sydney Medical School, The University of Sydney, and Senior Surgeon, Melanoma Institute Australia, Sydney. IN THE MID-1990s, the surgical management of patients presenting with primary cutaneous melanomas changed forever when the...

skin cancer

Sentinel Lymph Node Biopsy and Management of Regional Lymph Nodes in Melanoma: ASCO/SSO Clinical Practice Guideline Update

AS REPORTED IN the Journal of Clinical Oncology by Sandra L. Wong, MD, of Dartmouth-Hitchcock Medical Center, and colleagues, ASCO and the Society of Surgical Oncology (SSO) have issued an update to the ASCO/SSO clinical practice guideline on sentinel lymph node biopsy and management of regional...

head and neck cancer

Circulating Tumor DNA May Guide Treatment Intensity in Advanced HPV-Associated Head and Neck Cancers

A MULTI-INSTITUTIONAL analysis of circulating tumor DNA extracted from the plasma of patients has shown that human papillomavirus type 16 (HPV16) DNA is detectable in the majority of cases of favorable-risk HPV-associated oropharyngeal squamous cell carcinoma and may be a clinically useful...

skin cancer
immunotherapy

Adjuvant Pembrolizumab Improves Relapse-Free Survival in High-Risk Stage III Melanoma

ADJUVANT THERAPY with pembrolizumab (Keytruda) significantly prolonged recurrence-free survival compared with placebo for patients with resected high-risk stage III melanoma, according to the results of the EORTC 1325/KEYNOTE-054 trial.1 Patients who received pembrolizumab had a 43% reduction in...

leukemia
genomics/genetics

Minimal Residual Disease in Acute Myeloid Leukemia: Mutation Matters

A RECENT article in The New England Journal of Medicine explored the nuances of minimal/measurable residual disease testing after induction treatment of acute myeloid leukemia (AML)1 and David P. Steensma, MD, and Benjamin L. Ebert, MD, PhD, of Dana-Farber Cancer Institute and Harvard Medical...

lung cancer
immunotherapy

Pembrolizumab Plus Standard Chemotherapy Improves Survival in Newly Diagnosed Metastatic Non–Small Cell Lung Cancer

ADDING THE IMMUNE checkpoint inhibitor pembrolizumab (Keytruda) to standard chemotherapy with pemetrexed (Alimta) and a platinum as first-line therapy was superior to chemotherapy alone in the KEYNOTE-189 trial.1 Induction and maintenance therapies with the new triplet therapy improved overall...

solid tumors
skin cancer

FDA Approves Drug Combination for Adjuvant Treatment of BRAF V600–Mutant Melanoma

On April 30, 2018, the U.S. Food and Drug Administration (FDA) approved dabrafenib (Tafinlar) in combination with trametinib (Mekinist) for the adjuvant treatment of patients with melanoma with BRAF V600E or V600K mutations, as detected by an FDA-approved test, and lymph node involvement following...

supportive care
integrative oncology

Chamomile

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Jun J. Mao, MD, MSCE, and Jyothirmai Gubili, MS, focus attention on chamomile ...

issues in oncology
legislation

Decision Aids Reflect Patients’ Values and Preferences for Care: So Why Aren’t More Oncologists Using Them?

Overwhelming evidence shows that patient decision aids, such as educational booklets, videos, or Web-based tools that take into account patients’ values and personal preferences, hold enormous promise for improving the informed consent process. Patient decision aids both reduce unwanted medical...

skin cancer
immunotherapy

Nivolumab in Adjuvant Treatment of Melanoma

On December 20, 2017, nivolumab (Opdivo) was granted regular approval for adjuvant treatment of patients with melanoma with lymph node involvement or metastatic disease who have undergone complete resection.1,2 Nivolumab was previously approved for the treatment of patients with unresectable or...

solid tumors
prostate cancer

Should We Treat Rising PSA in Men With Castrate Androgen Levels?

In rapid succession, the SPARTAN study results were presented at the 2018 Genitourinary Cancers Symposium, the data were published in The New England Journal of Medicine,1 and the drug apalutamide -(Erleada) was approved by the U.S. Food and Drug Administration (FDA) for men with previously...

supportive care
palliative care

Using Video Decision-Support Tools to Facilitate End-of-Life Discussions With Patients

GUEST EDITOR Addressing the evolving needs of cancer survivors at various stages of their illness and care, Palliative Care in Oncology is guest edited by Jamie H. Von Roenn, MD. Dr. Von Roenn is ASCO’s Vice President of Education, Science, and Professional Development. Research shows that...

lung cancer
prostate cancer

By 2030, Prostate and Lung Cancers Are Expected to Be the Most Common Cancer Types Among HIV-Infected Adults

While effective antiretroviral therapy, which suppresses HIV replication and improves immune function, has resulted in increased longevity for people living with HIV and reduced the risk of certain cancers, including Kaposi sarcoma and non-Hodgkin lymphoma, other cancers are expected to become more ...

integrative oncology

Massage Therapy for 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 commonly used by patients with cancer. In this installment, Ting Bao, MD, DABMA, MS, reviews the current data on the use of massage to...

multiple myeloma

Updated International Myeloma Working Group Criteria: Diagnostic Challenges

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 Landgren review the underlying data that shaped the updated International Myeloma Working Group (IMWG) diagnostic criteria for...

lymphoma
immunotherapy

Axicabtagene Ciloleucel CAR T-Cell Therapy Active in Refractory Large B-Cell Lymphoma

As reported at the 2017 American Society of Hematology (ASH) Meeting & Exposition and in The New England Journal of Medicine by Sattva S. Neelapu, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, a phase II trial has shown high activity of autologous anti-CD19 chimeric...

solid tumors
lung cancer
issues in oncology

Enormous Cost of Failure to Screen Heavy Smokers for Lung Nodules

In 2011 the American College of Radiology Imaging Network (ACRIN) group published its publicly funded study of three annual screening chest computed tomography (CT) scans among heavy smokers aged 55 to 74.1 The results remain the first and only screening study for any cancer demonstrating a...

hematologic malignancies
lymphoma
immunotherapy

Promise and Challenges of CAR T-Cell Therapy for Diffuse Large B-Cell Lymphoma: ZUMA-1 Trial Results

Advancing therapeutics and augmenting curability in diffuse large B-cell lymphoma (DLBCL) have been very challenging. Although many novel approaches have offered promise and continue to be developed, we have not yet identified a clearly superior approach to R-CHOP (rituximab [Rituxan],...

breast cancer
immunotherapy

2018 Treatment Algorithm for Metastatic HER2-Positive Breast Cancer

How should clinicians position anti-HER2 agents and also incorporate endocrine therapies in the treatment of metastatic HER2-positive breast cancer? At the 2018 Miami Breast Cancer Conference, this question was explored by Sunil Verma, MD, Medical Director of the Tom Baker Cancer Center and...

issues in oncology

How to Respond to a Patient’s Discriminatory Request for a Different Clinician

Some patients may make discriminatory requests for a different clinician for their health care.1-5 These individuals may want to avoid treatment with clinicians of a certain race, religion, gender, sexual orientation, or national origin. Oncologists are not exempt from this type of patient...

lymphoma
immunotherapy

Is CAR T-Cell Therapy Setting a New Standard of Care in Lymphoma?

Data presented at the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition on the longer-term follow-up analysis of results from the ZUMA-1 trial investigating the effectiveness of axicabtagene ciloleucel (Yescarta) in patients with refractory non-Hodgkin lymphoma (NHL) showed...

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