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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...

lymphoma
skin cancer
immunotherapy

15-ICML: Final Data From ALCANZA: Brentuximab Vedotin for CD30-Positive CTCL

Final analyses from the ALCANZA study, a phase III trial investigating brentuximab vedotin vs physician’s choice for the treatment of CD30-positive cutaneous T-cell lymphoma (CTCL), were presented by Horwitz et al at the 15th International Conference on Malignant Lymphoma (ICML; Abstract...

lung cancer
immunotherapy

Outcomes of Immune Checkpoint Inhibitor Treatment in Patients With Advanced NSCLC Receiving Baseline Corticosteroids

In a single-center study reported in the Journal of Clinical Oncology, Ricciuti et al found better outcomes with immune checkpoint inhibitor treatment among patients with advanced non–small cell lung cancer (NSCLC) receiving baseline prednisone equivalent of ≥ 10 mg daily for...

breast cancer
immunotherapy

Niraparib Plus Pembrolizumab in Advanced Triple-Negative Breast Cancer

In the phase II TOPACIO/KEYNOTE-162 trial reported in JAMA Oncology, Vinayak et al found evidence of activity of combined niraparib and pembrolizumab in a cohort of patients with advanced or metastatic triple-negative breast cancer, with higher response rates seen in patients with BRCA mutations or ...

gynecologic cancers

Does Adjuvant Chemoradiotherapy Extend Relapse-Free Survival in Stage III or IVA Endometrial Cancer?

In the phase III GOG 258 trial reported in The New England Journal of Medicine, Matei et al found that 6 months of adjuvant platinum-based chemotherapy plus radiation therapy did not improve relapse-free survival vs chemotherapy alone in stage III or IVA endometrial cancer. In the open-label...

head and neck cancer
immunotherapy

Synergistic Relationship Between Radiotherapy and Immunotherapy for Squamous Cell Carcinoma of the Head and Neck

Recent technologic improvements in radiotherapy now offer an unprecedented opportunity to enhance immune response, and going forward, may play a role in the definitive treatment of head and neck cancer, according to William Stokes, MD, Assistant Professor in the Department of Radiation Oncology at...

immunotherapy
head and neck cancer

Immune Therapies Emerging in Disease-Specific Treatment of HPV-Positive Head and Neck Cancer

Patients with human papillomavirus (HPV)-related head and neck cancer stand to benefit greatly from immunotherapy, according to Nabil F. Saba, MD, FACP, Director, Head and Neck Medical Oncology Program, Winship Cancer Institute of Emory University, Atlanta. He added, immunotherapy will likely play...

prostate cancer

Apalutamide Improves Survival Outcomes in Castration-Sensitive Metastatic Prostate Cancer in TITAN Trial

Adding apalutamide to androgen-deprivation therapy (ADT) significantly improved survival in men with metastatic castration-sensitive (also termed hormone-sensitive) prostate cancer, according to the results of the phase III TITAN trial, which were presented at the 2019 ASCO Annual Meeting and...

prostate cancer

ENZAMET Trial Shows Enzalutamide Improves Overall Survival in Hormone-Sensitive Metastatic Prostate Cancer

Agents that improve survival in metastatic castration-resistant prostate cancer when added to background androgen-deprivation therapy (ADT) are showing success in treating metastatic prostate cancer earlier while it is still hormone-sensitive. These agents include docetaxel (chemotherapy) and...

issues in oncology
legislation

Curbside Consults: New Liability Risks to Avoid When You Are Not a Patient’s Physician

Like most clinicians, oncologists often informally consult their colleagues, both asking questions and seeking suggestions on how best to care for their patients.1,2 These informal or “curbside” consults (sometimes called “sidewalk,” “elevator,” or “hallway” consults) are valuable, because the...

skin cancer

Performance of Machine-Learning Classifiers in the Diagnosis of Pigmented Skin Lesions

In a study conducted under the supervision of researchers from the MedUni Vienna, human experts competed against computer algorithms in diagnosing pigmented skin lesions. The algorithms achieved better results when diagnosing, but had decreased performance for out-of-distribution images. These...

leukemia
immunotherapy

EHA 2019: ASCEND Trial Compares Acalabrutinib vs Investigator’s Choice in Relapsed or Refractory CLL

The randomized, global, multicenter, open-label phase III ASCEND trial evaluated the efficacy and safety of acalabrutinib vs investigator’s choice of rituximab/idelalisib or rituximab/bendamustine in patients with relapsed or refractory chronic lymphocytic leukemia (CLL). Ghia et al presented ...

skin cancer

Neoadjuvant Dabrafenib/Trametinib in Stage IIIB/C, BRAF V600–Mutant Melanoma

In the single-center, phase II NeoCombi trial reported in The Lancet Oncology, Long et al found that neoadjuvant dabrafenib plus trametinib produced promising response rates in resectable, stage IIIB/C, BRAF V600–mutant melanoma. As noted by the investigators, adjuvant dabrafenib plus...

leukemia

QuANTUM-R: Quizartinib vs Salvage Chemotherapy in Relapsed or Refractory FLT3-ITD–Positive AML

In the phase III QuANTUM-R trial reported in The Lancet Oncology, Cortes et al found that the FLT3 inhibitor quizartinib produced a modest but significant improvement in overall survival vs salvage chemotherapy in relapsed or refractory FLT3 internal tandem duplication (FLT3-ITD)-positive acute...

prostate cancer

2019 ASCO: TOPARP-B Finds Olaparib Shows Efficacy in Men With BRCA-Mutant Prostate Cancer

The poly (ADP-ribose) polymerase (PARP) inhibitor olaparib may benefit some men with prostate cancer, according to findings from the phase II TOPARP-B trial presented by Mateo et al at the 2019 ASCO Annual Meeting (Abstract 5005).   Olaparib previously showed activity against 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

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 ...

issues in oncology

2019 ASCO: Survey Finds 'Knowledge Gap' in Molecular Profiling Among Oncologists

A questionnaire aimed at assessing how well community oncologists understand “molecular profiling” results from tumor specimens found that 69% of participants either said they didn't know the answers or they responded incorrectly. In six different clinical scenarios, the oncologists...

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...

gynecologic cancers
immunotherapy

2019 ASCO: Novel Immunotherapy for Recurrent, Metastatic, or Persistent Cervical Cancer

There is a high, unmet need for effective treatments for patients with recurrent, metastatic, or persistent cervical cancer—most patients are young, and survival rates are poor. Adoptive cell transfer using tumor-infiltrating lymphocytes (TILs) has demonstrated durable responses in some...

lymphoma
immunotherapy

Polatuzumab Vedotin and Immunochemotherapy in Previously Untreated Diffuse Large B-Cell Lymphoma

As reported in The Lancet Oncology, Tilly et al 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 previously...

FDA Oncology Drug Approvals Granted Between May 21, 2018 and May 14, 2019

Over the past year (May 2018–May 2019), the U.S. Food and Drug Administration (FDA) granted approval and accelerated approval to a number of new oncology drugs and biosimilars. Here we list the new FDA-approved labels and indications. AVELUMAB (BAVENCIO) and AXITINIB (INLYTA) has been approved as a ...

cns cancers

Rookie

His steps generated a low rumble that propagated through the floor like a tsunami, flowed up through my desk, and ended as tiny waves visible through the clear plastic of my water bottle. His custom Lucchese ostrich boots made a distinctive clicking sound as they rhythmically struck the tile floor, ...

pain management
health-care policy

Debating the Role of Opioids in the Management of Chronic Cancer Pain

Despite the increasing public awareness of the danger of the overuse of prescription opioids, drug overdose deaths continue to rise in the United States. According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2017, nearly 400,000 people died of an overdose involving...

integrative oncology

Capsaicin

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, Shelly Latte-Naor, MD, and Jyothirmai Gubili, MS, explore the use of...

multiple myeloma

OPTIMISMM: Addition of Pomalidomide to Bortezomib/Dexamethasone in Pretreated Relapsed or Refractory Multiple Myeloma

In the phase III OPTIMISMM trial, reported by Richardson et al 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 lenalidomide. Study Details...

breast cancer

FDA Approves T-DM1 for HER2-Positive Early Breast Cancer

On May 3, the U.S. Food and Drug Administration (FDA) approved ado-trastuzumab emtansine (T-DM1; Kadcyla) for the adjuvant treatment of patients with HER2-positive early breast cancer who have residual invasive disease after neoadjuvant taxane- and trastuzumab-based treatment. Patients should be...

prostate cancer

Enzalutamide Plus Androgen Deprivation Therapy in Metastatic Hormone-Sensitive Prostate Cancer

Adding enzalutamide to androgen-deprivation therapy (ADT) significantly prolonged radiographic progression-free survival in men with metastatic hormone-sensitive prostate cancer, reducing the risk of disease progression or death by 61% compared with ADT plus placebo, according to the results of the ...

kidney cancer

Retrospective Study Evaluates Cabozantinib in Advanced Non–Clear Cell Renal Cell Carcinoma

Cabozantinib, a kinase inhibitor, is approved in metastatic renal cell carcinoma on the basis of studies in clear cell histology. Its activity in non–clear cell renal cell carcinoma is poorly defined. In a retrospective cohort study, Nieves Martinez Chanzá, MD, and colleagues reported that...

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