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Showing 151 - 200Atezolizumab Plus Vemurafenib/Cobimetinib for Patients With BRAF V600–Mutated Melanoma and CNS Metastases
In the phase II TRICOTEL study reported in The Lancet Oncology, Reinhard Dummer, MD, and colleagues found that the combination of atezolizumab plus vemurafenib and cobimetinib produced durable intracranial responses in patients with BRAF V600–mutated melanoma and central nervous system (CNS)...
T-DXd Shows High Intracranial Response Rate in Patients With Active Brain Metastases From HER2-Positive Breast Cancer
In the investigator-initiated, prospective, open-label, single-arm phase II TUXEDO-1 study conducted among patients with newly diagnosed or progressive brain metastases from HER2-positive breast cancer, the antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) yielded responses according...
Outcomes With Postconsolidation Dinutuximab-Based Immunotherapy for Neuroblastoma
In an analysis reported in the Journal of Clinical Oncology, Desai et al described outcomes with postconsolidation dinutuximab-based immunotherapy for high-risk neuroblastoma in a cohort of patients from the Children’s Oncology Group ANBL0032 trial following cessation of randomized treatment. Study ...
Proton Craniospinal Irradiation vs Photon Involved-Field Radiotherapy for Solid Tumor Leptomeningeal Metastasis
In an interim analysis of a single-institution phase II trial reported in the Journal of Clinical Oncology, Yang et al found that proton craniospinal irradiation (pCSI) improved central nervous system (CNS) progression-free survival vs standard-of-care photon involved-field radiotherapy (IFRT) in...
Consolidation Radiotherapy vs Autologous Stem Cell Transplantation for Primary CNS Lymphoma
As reported in the Journal of Clinical Oncology by Houillier et al, 8-year follow-up in the French phase II PRECIS trial has shown a maintained event-free survival benefit with autologous stem cell transplantation (ASCT) vs whole-brain radiotherapy (WBRT) as consolidation in patients aged ≤ 60...
Investigational Blood Test May Help Improve Diagnosis and Monitoring of Glioma
Researchers at Massachusetts General Hospital (MGH) who previously developed a blood test for mutations in a gene linked to gliomas have now applied their technology to detect additional mutations—in this case, in the gene that codes for the epidermal growth factor receptor (EGFR). The advance,...
COG Trial of Intensive Multimodality Therapy for Extraocular Retinoblastoma
As reported in the Journal of Clinical Oncology by Dunkel et al, the Children’s Oncology Group (COG) ARET0321 trial has shown high 1-year event-free survival rates with intensive multimodality therapy in patients with stage II, III, and IVa extraocular retinoblastoma. Study Details In the...
HER2-Positive Residual Disease
This is Part 4 of Updates in HER2-Positive Breast Cancer, a four-part video roundtable series. Scroll down to watch the other videos from this Roundtable. In this video, Drs. Carey K. Anders, Erika Hamilton, and Sara A. Hurvitz discuss the management of HER2-positive residual disease. The patient ...
Deciphering the Elusive Origin and Pathways of Brain Metastases
The effective treatment of patients with brain metastases is an unmet need because, until fairly recently, patients with brain metastases were excluded from clinical trials of systemic therapies. However, the emergence of molecular targeted therapies has allowed a new treatment approach in patients ...
New Antibody Therapy Shows Activity in Patients With Medulloblastoma
Effective and safe treatments are needed for medulloblastoma—the most common type of cancerous brain tumor in children—especially for patients whose cancer has spread to the spinal cord. A recent phase I clinical trial has generated promising results for a new blocking antibody therapy that targets ...
CLN-081 Shows Selective Activity in NSCLC With EGFR Exon 20 Insertions
CLN-081, a novel agent targeted to non–small cell lung cancer (NSCLC) cells harboring epidermal growth factor receptor (EGFR) exon 20 insertion mutations—ie, the addition of nucleotide base pairs in exon 20 of the EGFR gene, a known oncogenic driver event—holds promise, according to the results of...
Oncolytic Virus DNX-2401 for Newly Diagnosed Pediatric Patients With Diffuse Intrinsic Pontine Glioma
In a Spanish single-institution study reported in The New England Journal of Medicine, Pérez‑Larraya et al found that intratumoral infusion of the oncolytic adenovirus DNX-2401 followed by radiotherapy showed activity in newly diagnosed pediatric patients with diffuse intrinsic pontine glioma...
First-Line Radiotherapy With or Without Procarbazine, Lomustine, and Vincristine Chemotherapy for Anaplastic Oligodendroglial Tumors
As reported in the Journal of Clinical Oncology by Lassman et al, final survival reports from long-term follow-up of the phase III EORTC 26951 and RTOG 9402 studies show continued benefit of the addition of (neo)adjuvant procarbazine, lomustine, and vincristine to radiotherapy in patients with...
Strides Are Being Made in the Treatment of Brain Metastases From Breast Cancer
New drugs for HER2-positive breast cancer are able to overcome some of the obstacles that have made brain metastases challenging to treat, according to Mark Pegram, MD, the Susy Yuan-Huey Hung Professor of Oncology at Stanford University School of Medicine in California, who described the promising ...
Dual-Targeted Therapy Improves Outcomes vs Chemotherapy for Some Pediatric Patients With Low-Grade Glioma
The all-oral combination of dabrafenib plus trametinib—two targeted therapies—significantly improved the overall response rate vs standard-of-care chemotherapy with carboplatin plus vincristine in pediatric patients with BRAF V600 mutation–positive low-grade gliomas. The clinical benefit rate...
Intracranial Efficacy of Lorlatinib vs Crizotinib in ALK-Positive Advanced NSCLC
In a post hoc analysis from the phase III CROWN trial reported in the Journal of Clinical Oncology, Benjamin J. Solomon, MBBS, PhD, and colleagues found that progression-free survival and the risk of central nervous system (CNS) progression were improved with lorlatinib vs crizotinib in previously...
DESTINY-Breast03: Should Trastuzumab Deruxtecan Be the Preferred Second-Line Regimen in HER2-Positive Metastatic Breast Cancer?
Since the introduction of trastuzumab in the late 1990s, overall survival for patients with HER2-positive metastatic breast cancer has substantially improved. Median overall survival in the pivotal first-line trial was only 20.3 months in the chemotherapy arm, and 25.1 months in the...
Immunotherapy Combination in Newly Diagnosed Glioblastoma
A novel combination of two experimental cancer immunotherapy agents along with an immune checkpoint blocker elicited robust immune responses in patients with newly diagnosed glioblastoma brain tumors, according to a presentation of interim, 2-year follow-up clinical trial data given by David...
Dabrafenib Plus Trametinib Improve Overall Response Rates vs Standard-of-Care Chemotherapy in Pediatric Patients With Low-Grade Gliomas
The combination of two targeted therapies, the BRAF inhibitor dabrafenib and the MEK inhibitor trametinib, significantly increased the overall response rate compared to the standard-of-care chemotherapy combination of carboplatin plus vincristine in pediatric patients with BRAF V600...
Etirinotecan Pegol vs Physician’s Choice of Chemotherapy for Patients With Metastatic Breast Cancer and Brain Metastases
As reported in JAMA Oncology by Debu Tripathy, MD, and colleagues, the phase III ATTAIN trial has shown no difference in overall survival with etirinotecan pegol vs physician’s choice of chemotherapy for patients with metastatic breast cancer and brain metastases. As noted by the investigators,...
Neurologic and Survival Outcomes After Awake Craniotomy for Glioblastoma
In an analysis from the GLIOMAP study reported in The Lancet Oncology, Gerritsen et al found that awake craniotomy for glioblastoma in eloquent brain areas (essential areas for carrying out basic neurological functions) was associated with reduced risk of neurologic deficits and improved survival...
ASTRO Issues Clinical Guideline on Radiation Therapy for Brain Metastases
A new clinical guideline from the American Society for Radiation Oncology (ASTRO) provides guidance on the use of radiation therapy to treat patients with brain metastases. Evidence-based recommendations guide the multidisciplinary planning and delivery of advanced radiation therapy techniques to...
DESTINY-Lung01: Is Trastuzumab Deruxtecan the Answer for HER2-Mutant Lung Cancer?
The human epidermal growth factor (HER) family of receptors are a well-established therapeutic target. Indeed, seminal studies conducted nearly 2 decades ago identified a key association between activating mutations in the kinase domain of the epidermal growth factor receptor (EGFR, also known as...
Priscilla K. Brastianos, MD, on CNS Metastases: Understanding Their Evolution and the Clinical Implications
Priscilla K. Brastianos, MD, of Harvard Medical School and Massachusetts General Hospital, talks about her efforts to better understand how brain metastases evolve genomically and to test such agents as abemaciclib, paxalisib, and entrectinib, which may stop their growth. Palbociclib, a CDK...
Phase III Trials and Tribulations
Imagine this. You are a large pharmaceutical company that launches an international randomized phase III trial to assess whether one of your drugs improves the outcome of patients with a common type of cancer. The trial was solidly backed by preclinical evidence that the drug target was essential ...
Mihir Gupta, MD, and Ganesh M. Shankar, MD, PhD, Offer Commentary on the Use of ctDNA to Detect CNS Lymphoma
Mihir Gupta, MD, a neurosurgery resident at the University of California San Diego and postdoctoral fellow at Massachusetts General Hospital Department of Neurosurgery, and Ganesh M. Shankar, MD, PhD, Assistant Professor of Neurosurgery, Massachusetts General Hospital and Harvard Medical School,...
Noninvasive Diagnosis of CNS Lymphoma Possible Through ctDNA
Circulating tumor DNA (ctDNA) is readily detectable in the plasma and cerebrospinal fluid of patients with central nervous system (CNS) lymphoma and is a strong prognostic biomarker for outcomes, a team of researchers from Germany and Stanford University reported at the 2021 American Society of...
CAR T-Cell Therapy as Second-Line Treatment in Large B-Cell Lymphomas
“The mind is not a vessel to be filled but a fire to be kindled.” —Plutarch About 30% to 40% of patients with newly diagnosed diffuse large B-cell lymphoma (DLBCL) experience relapse, and 10% are refractory to the...
New Guideline Offers Most Comprehensive Summary to Date of Therapies for Brain Metastases
In an effort to synthesize findings from multiple guidelines on various management approaches for brain metastases, ASCO, the Society for Neuro-Oncology (SNO), and the American Society for Radiation Oncology (ASTRO) spearheaded the development of a novel publication to inform and update physician...
T-DXd for Previously Treated Patients With Metastatic HER2-Mutant NSCLC
In the phase II DESTINY-Lung01 trial reported in The New England Journal of Medicine, Bob T. Li, MD, PhD, MPH, and colleagues found that fam-trastuzumab deruxtecan-nxki (T-DXd) showed durable activity in patients with metastatic HER2-mutant non–small cell lung cancer (NSCLC) refractory to standard...
Is There an Association Between Maternal Hormonal Contraception Use and Risk of CNS Tumors in Children?
In a Danish nationwide cohort study reported in JAMA, Hargreave et al found no association between maternal hormonal contraception use and risk of central nervous system (CNS) tumors in children. As stated by the investigators, “The incidence of CNS tumors in children appears to be increasing, yet...
Does Armodafinil Improve Cancer-Related Fatigue in Patients With High-Grade Glioma?
In a phase III trial reported in JAMA Oncology, Porter et al found that armodafinil, a psychostimulant, did not improve cancer-related fatigue vs placebo in adult patients with high-grade glioma. As stated by the investigators, “Nearly 96% of patients with high-grade glioma report...
Dabrafenib Plus Trametinib in BRAF V600E–Mutant High- and Low-Grade Glioma
In an interim analysis of a phase II basket trial (ROAR) reported in The Lancet Oncology, Patrick Y. Wen, MD, and colleagues found that the combination of dabrafenib and trametinib produced responses in adult patients with recurrent or progressive BRAF V600E–mutant high-grade and low-grade glioma. ...
T-DXd Makes Inroads in the Treatment of HER2-Mutant NSCLC
Previously treated patients with HER2-positive non–small cell lung cancer (NSCLC) achieved encouraging response rates and duration of response to the antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) in the phase II DESTINY-Lung01 trial. These results were reported at the European...
Brain Substructure–Informed Radiotherapy Planning May Improve Neurocognitive Outcomes in Pediatric Patients With Medulloblastoma
In an analysis from the single-institution phase III SJMB03 trial reported in the Journal of Clinical Oncology, Acharya et al found that increasing radiation doses to the corpus callosum, frontal white matter, and hippocampus were associated with neurocognitive impairment in pediatric patients...
Erin Murphy, MD, on Low-Grade Glioma: Neurocognitive Function Following Treatment
Erin Murphy, MD, of Cleveland Clinic, discusses new data that show no apparent difference in cognitive performance up to 2 years post-treatment among adults with low-grade glioma who were treated with concurrent radiotherapy and temozolomide (Abstract 3258).
Integrated Molecular-Morphologic Risk Predictor for Recurrence of Meningioma
In a study reported in the Journal of Clinical Oncology, Maas et al developed a novel integrated molecular-morphologic risk classification score that improved prediction of disease recurrence in patients with meningioma. Study Details The study involved DNA methylation, copy-number, and mutation...
Diana D. Shi, MD, on IDH-Mutant Gliomas: De Novo Pyrmidine Synthesis Inhibitor Under Study
Diana D. Shi, MD, of Dana-Farber Cancer Institute and Brigham and Women’s Cancer Center, discusses studies being planned and already underway to test BAY 2402234, a de novo pyrimidine synthesis inhibitor that possibly could be used clinically to target IDH-mutant gliomas and may act as a...
Two Studies Examine the Efficacy of Immunotherapy for Leptomeningeal Carcinomatosis
Two new studies published in Nature Communications indicate that immunotherapy may benefit people with leptomeningeal carcinomatosis, a rare but serious complication of cancer that has spread to the brain and/or spinal cord. Approximately 5% to 8% of all patients with cancer develop leptomeningeal ...
DM-CHOC-PEN May Improve Outcomes for Adolescents and Young Adults With Central Nervous System Tumors
In a phase II clinical trial, the drug 4-demethyl-4-cholesteryloxycarbonylpenclomedine (DM-CHOC-PEN) improved survival for some adolescent and young adult patients with cancers involving the central nervous system, according to results presented by Morgan et al at the AACR-NCI-EORTC Virtual...
Novel HER2-Targeted Therapies Pose Sequencing Challenges
With three new HER2-targeted therapies approved over the past year or two alone, the treatment landscape for patients with metastatic breast cancer has become increasingly crowded. In the third-line setting and beyond, there are now at least eight HER2-targeted agents approved by the U.S. Food and...
Factors Associated With Risk of Hearing Loss in Pediatric Patients Receiving Radiation and Chemotherapy
In a single-institution cohort study reported in the Journal of Clinical Oncology, Keilty et al identified factors associated with an increased risk of hearing loss in pediatric patients receiving radiation therapy and chemotherapy for central nervous system and head and neck tumors. The study...
DA-EPOCH-R for Children and Adolescents With Newly Diagnosed Primary Mediastinal B-Cell Lymphoma
In a phase II trial reported in the Journal of Clinical Oncology, Burke et al found that dose-adjusted etoposide, doxorubicin, and cyclophosphamide with vincristine and prednisone plus rituximab (DA-EPOCH-R) did not improve event-free survival vs historical controls in children and adolescents with ...
Older Adults With Primary CNS Lymphoma: Treatment Opportunities and Challenges
The ASCO Post is pleased to present the Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib, Desai, and DeAngelis explore the treatment of older patients with primary central nervous system lymphoma (PCNSL), which pose...
Belzutifan for Cancers Associated With von Hippel-Lindau Disease
On August 13, 2021, belzutifan, a hypoxia-inducible factor inhibitor, was approved for treatment of adults with von Hippel-Lindau (VHL) disease who require therapy for associated renal cell carcinoma, central nervous system (CNS) hemangioblastomas, or pancreatic neuroendocrine tumors but do not...
Highlights From the 2021 ASCO Annual Meeting
Despite the ongoing challenges of the COVID-19 pandemic, the practice-changing studies presented at the 2021 ASCO Annual Meeting clarified the continuing momentum in the oncology community to improve the lives of our patients. Immunotherapy demonstrated efficacy in cancers where it had not been...
Assumptions, Data … and More Questions!
I read with great interest the results from the phase II ZUMA-12 study of axicabtagene ciloleucel, presented during the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition.1 But the results raised several questions for me. Axicabtagene ciloleucel, an autologous anti-CD19...
Cross-Sectional Survey Reveals Disparities in Care of Patients With Brain Metastases
A cross-sectional survey of patients, caregivers, and physicians on the diagnosis and treatment of brain metastases, conducted by the American Brain Tumor Association (ABTA) as part of its Metastatic Brain Tumor Initiative, revealed disparities in practice patterns and communication around...
ALK Fusion–Positive High-Grade Glioma: Response to Lorlatinib in a Single Pediatric Case
In a letter to the editor published in The New England Journal of Medicine, Bagchi et al describe the course of treatment in a 3-year-old child with an intracranial tumor and his response to therapy with the kinase inhibitor lorlatinib. Key Points Magnetic resonance imaging (MRI) of the head in a...
Report Aims to Assess Contemporary Burden of Brain Tumors in the United States
A new study found that incidence rates for malignant brain and other central nervous system (CNS) tumors declined by 0.8% annually during 2008 through 2017 in the United States for all ages combined. The decline was driven by trends in adults, whereas rates have slightly increased by 0.5% to 0.7%...
