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immunotherapy
multiple myeloma

Daratumumab-Based Therapy for Patients With Newly Diagnosed Multiple Myeloma Who Are Ineligible for Transplantation

On June 27, 2019, daratumumab was approved for use in combination with lenalidomide and dexamethasone for patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplantation.1,2 Supporting Efficacy Data Approval was based on findings in the open-label phase...

lymphoma

Lenalidomide for Previously Treated Follicular and Marginal Zone Lymphomas

On May 28, 2019, lenalidomide was approved for use in combination with a rituximab product for previously treated follicular lymphoma and previously treated marginal zone lymphoma.1,2 Supporting Efficacy Data Approval was based on the findings of two clinical trials: AUGMENT (ClinicalTrials.gov...

health-care policy

2020 Fee Schedule Proposal Outlines E&M Code and MIPS Changes

On July 29, the Centers for Medicare & Medicaid Services (CMS) released its proposed rule for the 2020 Medicare Physician Fee Schedule (MPFS) and other changes to Medicare Part B payment policies, including proposals related to the Quality Payment Program (QPP). At the same time, CMS released...

lymphoma

Update on FDA-Approved CAR T-Cell Gene Therapy for B-Cell Lymphomas

On October 18, 2017, the U.S. Food and Drug Administration (FDA) granted approval to axicabtagene ciloleucel for the treatment of adult patients with relapsed or refractory large B-cell lymphoma. Specifically, this treatment can be used after two or more lines of systemic therapy for diffuse...

breast cancer
survivorship

Pregnancy Appears Safe After Treatment for Breast Cancer in Patients With BRCA Mutations

Pregnancy after breast cancer appears to be safe in patients with germline BRCA mutations—and particularly among those with BRCA1 mutations—according to new research. Limited data are available on the safety of pregnancy and reproductive outcomes in patients with breast cancer and BRCA mutations,...

issues in oncology

New Report Finds Cancer Drugs Account for Over a Quarter of All New Drug Approvals in the United States

Cancer drugs currently account for 27% of all new drug approvals in the United States since 2010—an increase from the 4% share they occupied in the 1980s, a newly completed analysis summarized in the most recent issue of the Tufts CSDD Impact Report. From 1980 through 2018, the U.S. Food and Drug...

supportive care
symptom management

Study Explores Efficacy of Lower-Dose Olanzapine in Combination With Standard Antiemetic Regimen

Olanzapine at a 5-mg dose, when combined with aprepitant, palonosetron, and dexamethasone, significantly reduced the risk of delayed nausea and vomiting in patients receiving cisplatin-based chemotherapy, according to new research. The study investigators believe this approach may be considered a...

prostate cancer

Enzalutamide Improves Survival vs Standard First-Line Treatment in Hormone-Sensitive Metastatic Prostate Cancer

As reported in The New England Journal of Medicine by Ian D. Davis, MBBS, PhD, FRACP, FAChPM, of Monash University and Eastern Health in Melbourne, and colleagues, the phase III ENZAMET trial has shown that the androgen receptor inhibitor enzalutamide improved progression-free and overall survival ...

kidney cancer
immunotherapy

Extended Follow-up of CheckMate 214: Nivolumab/Ipilimumab vs Sunitinib as First-Line Treatment for Advanced RCC

As reported in The Lancet Oncology by Robert J. Motzer, MD, and colleagues, extended follow-up of the phase III CheckMate 214 trial has shown a maintained survival benefit for first-line nivolumab/ipilimumab vs sunitinib in patients with previously untreated intermediate- or poor-risk advanced...

solid tumors

FDA Clears Next-Generation Scalp-Cooling Device

ON JUNE 27, 2019, the U.S. Food and Drug Administration (FDA) granted clearance of the DigniCap Delta scalp-cooling system to Dignitana, for use by health-care providers in the United States. The device is a fourth generation of the DigniCap scalp-cooling system. It is indicated to reduce the...

kidney cancer
prostate cancer
immunotherapy

Novel Treatments Under Study in Renal Cell Carcinoma and Prostate Cancer

There were numerous notable presentations at the 2019 Genitourinary Cancers Symposium, many of which were covered in The ASCO Post over the past few months. To add to our continued coverage of this meeting, here are some highlights from studies focusing on novel therapeutics in renal cell carcinoma ...

kidney cancer
prostate cancer
immunotherapy

Novel Treatments Under Study in Renal Cell Carcinoma and Prostate Cancer

There were numerous notable presentations at the 2019 Genitourinary Cancers Symposium, many of which were covered in The ASCO Post over the past few months. To add to our continued coverage of this meeting, here are some highlights from studies focusing on novel therapeutics in renal cell carcinoma ...

multiple myeloma

Selinexor in Relapsed or Refractory Multiple Myeloma

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. On July 3, 2019, the oral nuclear export...

solid tumors

FDA Clears Next-Generation Scalp-Cooling Device

ON JUNE 27, 2019, the U.S. Food and Drug Administration (FDA) granted clearance of the DigniCap Delta scalp-cooling system to Dignitana, for use by health-care providers in the United States. The device is a fourth generation of the DigniCap scalp-cooling system. It is indicated to reduce the...

lymphoma
prostate cancer

FDA Pipeline: Priority Reviews in Prostate Cancer, Mantle Cell Lymphoma

This week, the U.S. Food and Drug Administration (FDA) accepted new drug applications for enzalutamide in metastatic hormone-sensitive prostate cancer and zanubrutinib in relapsed or refractory mantle cell lymphoma, and granted both applications Priority Review. Priority Review for Enzalutamide in ...

survivorship
supportive care
integrative oncology

Healthy Lifestyle for Young Adult Cancer Survivors

GUEST EDITOR Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief of Integrative Medicine Service at Memorial Sloan Kettering Cancer Center, New York.   The survival rates of adolescent and young adults with cancer have risen ...

colorectal cancer

Does Exercise Improve Outcomes in Patients With Metastatic Colorectal Cancer?

Patients with metastatic colorectal cancer who engaged in moderate exercise while undergoing chemotherapy tended to have delayed progression of their disease and fewer severe side effects from treatment, according to the results of a new study published by Guercio et al in the Journal of Clinical...

solid tumors

Relapse of Nonseminomatous Germ Cell Tumors During Active Surveillance

In a single-institution study reported in the Journal of Clinical Oncology, Hamilton et al found that relapses of clinical stage I nonseminomatous germ cell tumors (NSGCT) during postorchiectomy active surveillance most frequently occurred in the retroperitoneum and were cured by single-modality...

solid tumors

Pazopanib or Methotrexate/Vinblastine in Progressive Desmoid Tumors

In the French Sarcoma Group noncomparative phase II DESMOPAZ trial reported in The Lancet Oncology, Toulmonde et al found that the oral vascular endothelial growth factor (VEGF) receptor inhibitor pazopanib was active in adult patients with progressive desmoid tumors. As noted by the investigators, ...

lymphoma

Early Trial of IPH4102 in Cutaneous T-Cell Lymphoma

In a phase I trial reported in The Lancet Oncology, Martine Bagot, MD, and colleagues found that IPH4102—a first-in-class monoclonal antibody targeting KIR3DL2—was safe and showed activity in patients with relapsed or refractory cutaneous T-cell lymphoma, particularly those with Sézary syndrome....

integrative oncology

Echinacea

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, Yen Nien Hou, PharmD, DipIOM, LAc, explores the potential health benefits of...

Out of the Mouths of Babes: A Physician Discusses Her Cancer Diagnosis With Her Two Young Children

  In medical school, I learned a five-step model on how to deliver bad news to a patient. I still fall back on this method, time and again, in my primary care clinic; I have even used it when giving really tough feedback to a learner who is struggling in some aspect of performance. But I honestly...

hematologic malignancies
lymphoma

Treatment Update on Selected Non-Hodgkin Lymphomas

As part of The ASCO Post’s coverage of the 2019 ASCO Annual Meeting, featured here are four abstracts from different clinical trials evaluating newer treatments for Waldenström’s macroglobulinemia and T-cell lymphomas. Waldenström’s Macroglobulinemia ABSTRACT 7509: Outcomes with bendamustine plus ...

breast cancer
kidney cancer
sarcoma
lymphoma
multiple myeloma

Notable Presentations at ASCO 2019 Included Studies in Sarcoma, Lymphoma, Myeloma, and Breast and Kidney Cancers

The 2019 ASCO Annual Meeting featured a wealth of presentations on important topics. In addition to our regular news coverage of the meeting, we present below some highlights of other studies that add to our knowledge base for treatment of various cancers. Olaratumab in Soft-Tissue Sarcoma...

breast cancer
cost of care

How Treatment Costs Affect Decisions for Breast Cancer Surgery

In a study reported in the Journal of Oncology Practice, Greenup et al found that cancer treatment costs influenced women’s decisions on breast cancer surgery. Researchers reported many women, even at the highest income levels, said that costs were higher than expected, and that most women...

solid tumors
immunotherapy

Tumor-Associated Antigen Cytotoxic T Cells in Relapsed or Refractory Solid Tumors

In a phase I trial reported in the Journal of Clinical Oncology, Hont et al found that treatment of relapsed or refractory solid tumors with ex vivo expanded autologous multiantigen-associated specific cytotoxic T cells—or, tumor-associated antigen cytotoxic T cells—was safe and showed...

head and neck cancer
immunotherapy

Palbociclib Plus Cetuximab in Platinum- and Cetuximab-Resistant HPV-Unrelated Head and Neck Cancer

In a phase II study reported in The Lancet Oncology, Adkins et al found that the combination of the cyclin-dependent kinase 4/6 (CDK4/6) inhibitor palbociclib and the EGFR inhibitor cetuximab showed activity in patients with either platinum- or cetuximab-resistant human papillomavirus...

sarcoma

Pazopanib in Advanced Extraskeletal Myxoid Chondrosarcoma

Findings from a cohort of a phase II study reported by Stacchiotti et al in The Lancet Oncology indicated activity of the antiangiogenic agent pazopanib in advanced extraskeletal myxoid chondrosarcoma. As noted by the investigators, this rare sarcoma has low sensitivity to cytotoxic chemotherapy,...

lung cancer
immunotherapy

Pembrolizumab After Stereotactic Body Radiotherapy in Advanced NSCLC

In a Dutch phase II study reported in JAMA Oncology, Theelen et al found that although use of stereotactic body radiotherapy prior to pembrolizumab increased the objective response rate vs pembrolizumab alone in metastatic non–small cell lung cancer (NSCLC), the difference did not meet study...

issues in oncology

Parental Treatment Refusals: What Your Responsibilities Are When Mom and Dad Decline Cancer Treatment for a Child

In April 2019, a 3-year-old boy, Noah McAdams, missed the third round of chemotherapy for his acute lymphoblastic leukemia. His parents wanted instead to focus on alternative remedies of cannabidiol oil, alkaline water, mushroom tea, and herbal extracts. The sheriff was summoned; Noah’s parents...

lung cancer

Two Investigational Agents Demonstrate Safety, Efficacy in Lung Cancer

A handful of investigational drugs in early-phase trials always create a buzz at ASCO Annual Meetings. Two that garnered attention this year, and could eventually change outcomes in the clinic, are the first-in-class KRAS inhibitor AMG 510 and the ROS1 inhibitor repotrectinib. Should late-phase...

breast cancer

Is Heterogeneity Within HER2-Positive Tumors Clinically Relevant?

Breast cancers that display heterogeneity of HER2 expression may represent a distinct subset of HER2-positive breast cancer that is associated with lower rates of pathologic complete response, according to a phase II study from Dana-Farber Cancer Institute. This trial evaluated HER2 heterogeneity...

issues in oncology

No Man Is an Island: Reflections From an ASCO IDEA Recipient

IT WAS a chilly Chicago morning, and I was sitting at the lobby of my hotel when I saw a smiling gentleman cheerfully waving at me from his car. It was Lawrence H. Einhorn, MD, picking me up for our drive to Indiana. I was one of the recipients of the ASCO International Development and Education...

hematologic malignancies
multiple myeloma

FDA Approves Daratumumab in Combination With Lenalidomide and Dexamethasone for Newly Diagnosed Multiple Myeloma

On June 27, the U.S. Food and Drug Administration (FDA) approved daratumumab (Darzalex) in combination with lenalidomide and dexamethasone for the treatment of patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplant (ASCT). The application received...

supportive care

Integrative Medicine in Pediatric and Adolescent Patients With Cancer

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

Laughter in Oncology Is More Common Than You Think

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,...

skin cancer

Family History of Melanoma May Increase Risk for Nonmelanoma Skin Cancers

A study by Wei et al in the Journal of the American Academy of Dermatology has found that individuals with a first-degree relative with a history of melanoma are at an increased risk for melanomas and keratinocyte cancers such as squamous cell carcinoma and basal cell carcinoma. Methods...

leukemia

CLARITY: Ibrutinib Plus Venetoclax in Relapsed or Refractory Chronic Lymphocytic Leukemia

In the phase II CLARITY trial reported in the Journal of Clinical Oncology, Hillmen et al found that the combination of ibrutinib and venetoclax resulted in high rates of minimal residual disease eradication in patients with relapsed or refractory chronic lymphocytic leukemia (CLL). In the...

lung cancer
issues in oncology

Poorer Outcomes for Patients With Lung Cancer Undergoing Radiotherapy During Disaster-Level Hurricanes

Patients who experienced a disaster-level hurricance during radiotherapy for lung cancer had worse overall survival than those who completed treatment in normal circumstances, with longer disaster declarations associated with increasingly worse survival. These findings come from a...

lung cancer
gastroesophageal cancer
bladder cancer
gastrointestinal cancer
immunotherapy

Ramucirumab Plus Pembrolizumab in Previously Treated Advanced Gastroesophageal Cancer, NSCLC, and Urothelial Carcinoma

Results from a phase IB trial expansion stage reported in The Lancet Oncology by Herbst et al showed the combination of ramucirumab plus pembrolizumab had manageable toxicity and antitumor activity in previously treated advanced gastroesophageal cancer, non–small cell lung cancer (NSCLC), and ...

issues in oncology

Fragility Analysis of Phase III Trials Supporting FDA Approval of Anticancer Drugs

In an analysis reported in The Lancet Oncology, Del Paggio and Tannock found that many phase III trials supporting U.S. Food and Drug Administration (FDA) approval of anticancer drugs have a low fragility index—a measure of how many people in a study would have had to have a different outcome ...

immunotherapy
lymphoma

Combination Therapy With Immunochemotherapy and an Antibody-Drug Conjugate in DLBCL

As reported in The Lancet Oncology, Hervé Tilly, MD, and colleagues found that the combination of polatuzumab vedotin, an antibody-drug conjugate targeting the CD79b component of the B-cell receptor, with immunochemotherapy showed high response rates in the phase II portion of a phase I/II study in ...

multiple myeloma

Effect of Bortezomib/Dexamethasone Plus Pomalidomide on Progression-Free Survival in Multiple Myeloma Pretreated With Lenalidomide

In the phase III OPTIMISMM trial, reported by Paul G. Richardson, MD, and colleagues in The Lancet Oncology, researchers found that the addition of pomalidomide to bortezomib/dexamethasone improved progression-free survival in relapsed or refractory multiple myeloma previously treated with...

integrative oncology

Chaga Mushroom

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, Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, explore the current...

The Bomb

I sit paralyzed at my desk. Everyone else has left the clinic. I can hear the sound of the broom in the hall as the after-hours cleaning begins. No phones ring, no patients hurry to appointments, no chatter lingers in the air. The silence is oppressive, the air is heavy, and the distance from my...

lymphoma
skin cancer

Anti-KIR3DL2 Monoclonal Antibody for Relapsed or Refractory Cutaneous T-Cell Lymphoma

In a phase I trial reported in The Lancet Oncology, Bagot et al found that IPH4102—a first-in-class monoclonal antibody targeting KIR3DL2—was safe and showed activity in patients with relapsed or refractory cutaneous T-cell lymphoma, particularly those with Sézary syndrome....

bladder cancer
immunotherapy

Enfortumab Vedotin After Checkpoint Inhibition in Metastatic Urothelial Cancer

A phase II study found that treatment with the antibody-drug conjugate enfortumab vedotin achieved responses in 44% of patients with locally advanced or metastatic urothelial cancer previously treated with platinum chemotherapy and a checkpoint inhibitor. This is a noteworthy study because it...

gastrointestinal cancer

Study Shows Benefit With Pazopanib in Treatment of Carcinoid Tumors

Pazopanib significantly improved progression-free survival by 47% in patients with progressive carcinoid tumors, in a prospective randomized phase II trial presented at the 2019 ASCO Annual Meeting.1 “With these results, Alliance A021202 becomes the first randomized study to show that the vascular...

gastrointestinal cancer

Study Supports Neoadjuvant Chemotherapy in Operable Colon Cancer

For patients with operable colon cancer, neoadjuvant chemotherapy resulted in numerous benefits in the FOxTROT trial but did not reach target significance for the primary endpoint. The study was presented at the 2019 ASCO Annual Meeting by Matthew T. Seymour, MD, of the University of Leeds School...

breast cancer

NALA Trial: Neratinib Plus Capecitabine Shows Benefit in Metastatic Breast Cancer

In the global phase III NALA trial, treatment of metastatic HER2-positive breast cancer with neratinib plus capecitabine significantly improved progression-free survival, delayed the time to intervention for central nervous system disease, and showed a trend toward improved overall survival vs...

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