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palliative care

Palliative Care: Let’s Use the Tools We Already Have

Clinicians and researchers in the field of palliative and supportive care are enjoying the recognition the field is now receiving and expecting the future to be ripe with opportunity. But one thought leader in this specialty had a suggestion for attendees at the 2016 Palliative Care in Oncology...

symptom management
palliative care

Pearls for Managing Immune-Related Toxicities

With checkpoint inhibitors in frequent use, clinicians strive daily to balance the efficacy and toxicity of these treatments. At the 2016 Palliative Care in Oncology Symposium, Lynn M. Schuchter, MD, FASCO, the C. Willard Professor of Hematology-Oncology at the University of Pennsylvania,...

issues in oncology
palliative care

Immunotherapy Brings Unique Challenges for Clinicians

The advent of immunotherapies has created a number of interesting challenges for oncology providers. At the 2016 Palliative Care in Oncology Symposium, specialists in the field tackled these issues. “There is a lot of newness to how we approach patient care with immunotherapies on board,” said...

lung cancer

Lung Cancer Specialist Shares Clinical Pearls for Managing Stage IIIA Non–Small Cell Lung Cancer

Clinicians face a number of questions in evaluating and treating patients with stage IIIA non–small cell lung cancer (NSCLC). One expert in the field, Rafael Santana-Davila, MD, reviewed key issues in managing this disease in the Journal of Oncology Practice (JOP). The ASCO Post asked Dr....

lymphoma

Novel Agents on the Horizon in Lymphoma

Attendees at the 2016 Pan Pacific Lymphoma Conference held July 18–22 in Koloa, Hawaii, got a peek at early data for a number of novel agents in the treatment of various lymphoma subtypes. The ASCO Post captured these findings. Denintuzumab Mafodotin in Diffuse Large B-Cell Lymphoma Denintuzumab...

lymphoma

Routine PET Surveillance Discouraged in Large Cell Lymphoma

There is no role for routine imaging as a means of following patients with large cell lymphoma, according to Bruce D. Cheson, MD, Deputy Chief of Hematology-Oncology and Professor of Medicine at Georgetown University Hospital, Lombardi Comprehensive Cancer Center, Washington, DC. “Routine...

Expert Point of View: Julie ­Margenthaler, MD

The moderator of the press briefing, Julie ­Margenthaler, MD, of Washington University, St. Louis, maintained there are few contraindications for nipple-sparing mastectomy. “I reiterate Dr. Jakub’s view. I agree it’s absolutely safe for BRCA-positive patients,” she declared. The contraindications, ...

breast cancer

Nipple-Sparing Mastectomy Shown to Be Safe—and Increasingly Preferred

Prophylactic mastectomy that preserves a woman’s nipple is oncologically safe in patients with deleterious BRCA mutations, according to the largest study yet to evaluate this approach in this high-risk population. “In more than 500 risk-reducing nipple-sparing mastectomies in 348 deleterious...

skin cancer

Management of Merkel Cell Carcinoma

A recent report regarding pembrolizumab (Keytruda) for advanced Merkel cell carcinoma ushered in a more optimistic era in the treatment of this rare but often lethal skin cancer.1 The ASCO Post spoke with one of the field’s leaders, Paul Nghiem, MD, PhD—the first author of the study—about the...

hematologic malignancies
leukemia
lymphoma
multiple myeloma

Roundup of Selected Abstracts in Multiple Myeloma, Acute and Chronic Leukemia, and Advanced Lymphoma

In June 2016, the European Hematology Association Congress convened in Copenhagen, Denmark. The educational and scientific program highlighted state-of-the-art clinical practice and the latest findings in hematology research. The ASCO Post brings its readers brief summaries of some of the important ...

lymphoma

For High-Grade and Aggressive Non-Hodgkin Lymphomas, Treat Adults Like Children

Outcomes for adults with high-grade and aggressive non-Hodgkin lymphomas (NHLs) appear to be better when these patients are treated with pediatric-inspired protocols, according to Mitchell S. Cairo, MD, Chief of the Division of Pediatric Hematology, Oncology and Stem Cell Transplantation, Maria...

lymphoma

Early Relapse in Follicular Lymphoma: Clinical Trial Data May Guide Management Decisions

Approximately 20% of patients with follicular lymphoma will relapse within 2 years of diagnosis. Although the optimal management of these patients has not been established, clinicians may be guided by data from recent clinical trials, according to Nathan H. Fowler, MD, Associate Professor and...

lymphoma

Understanding Double-Hit Lymphomas and Optimizing Management

Double-hit lymphomas are a challenging subset of high-grade B-cell lymphomas, previously characterized histologically as diffuse large B-cell lymphoma or B-cell lymphoma unclassifiable with intermediate features between diffuse large B-cell lymphoma and Burkitt lymphoma. Expert guidance in their...

lymphoma

Outcomes With Rituximab in DLBCL: Does Gender Matter?

For diffuse large B-cell lymphoma, does the dose of rituximab (Rituxan) matter? Are there patient characteristics that determine outcomes as well as the optimal dose? These questions were explored at the 2016 Pan Pacific Lymphoma Conference by Matthew A. Lunning, DO, Assistant Professor of...

lymphoma

Combination Obinutuzumab Regimen Active in Aggressive Diffuse Large B-Cell Lymphoma

In a small phase Ib/II study, 100% of patients with newly diagnosed diffuse large B-cell lymphoma evaluated thus far responded to treatment with obinutuzumab (Gazyva), lenalidomide (Revlimid), and CHOP (cyclophosphamide, doxorubicin, vincristine, prednisone), investigators from the University of...

lymphoma

Novel Approaches Harness the Microenvironment Against Hodgkin Lymphoma

In the treatment of classical Hodgkin lymphoma, antibodies targeting programmed cell death protein 1 (PD-1) are just the beginning, according to Stephen M. Ansell, MD, PhD, Professor of Medicine and Chair of the Lymphoma Group at the Mayo Clinic, Rochester, Minnesota.1 Speaking at the 2016 Pan...

leukemia

New Upfront Treatment Algorithm Emerges for Chronic Lymphocytic Leukemia

According to Susan M. O’Brien, MD, an expert in the treatment of chronic lymphocytic leukemia (CLL), novel agents and new data on patient subsets have led to a new upfront treatment algorithm for this malignancy. Speaking at the 2016 Pan Pacific Lymphoma Conference in Koloa, Hawaii, Dr. O’Brien...

Expert Point of View: Amir T. Fathi, MD

Amir T. Fathi, MD, an oncologist at the Massachusetts General Hospital Cancer Center and Assistant Professor of Medicine at Harvard Medical School, Boston, commented on the INO-VATE ALL trial for The ASCO Post. “It has been a fairly exciting time for patients with acute lymphoblastic leukemia...

leukemia

Inotuzumab Ozogamicin Shows Clear Benefit in Acute Lymphoblastic Leukemia

In patients with relapsed/refractory acute lymphoblastic leukemia (ALL), the antibody-drug conjugate inotuzumab ozogamicin produced significantly more complete remissions and was a better bridge to transplant than treatment by physician’s choice, according to the final results of a phase III trial...

lymphoma

CAR T-Cell Therapy Promising in Non-Hodgkin Lymphoma

Research conducted at the Fred Hutchinson Cancer Research Center, Seattle, is moving the field of chimeric antigen receptor (CAR) T-cell therapy forward in the treatment of B-cell malignancies. At the 2016 Pan Pacific Lymphoma Conference in Koloa, Hawaii, David G. Maloney, MD, PhD, Professor of...

cost of care

ASCO Plenary Studies: Assessing the ‘Value’ of New Treatments

At the 2016 ASCO Annual Meeting, studies presented at the Plenary Session gave attendees new treatment strategies to employ back home. But in the emerging push to contain the cost of new cancer treatments, do the four interventions fit within the new “value framework” for oncology? Deborah Schrag, ...

breast cancer

The Metastatic Breast Cancer Project: Direct-to-Patient Research Initiative

A nationwide project is enlisting patients with breast cancer to share their tumor samples and clinical information. Launched in October 2015, the Metastatic Breast Cancer (MBC) Project has enrolled more than 2,000 patients from all 50 states and is yielding information that will be shared with...

breast cancer

Quick Takes on Promising New Approaches to Treating Breast Cancer

At the 2016 ASCO Annual Meeting, researchers reported encouraging results for several new drugs and treatment strategies for breast cancer. The ASCO Post brings you brief summaries of a select few. Abemaciclib Trial The cyclin-dependent kinase 4/6 (CDK4/6) inhibitor abemaciclib produced responses...

Expert Point of View: Isabelle Ray-Coquard, MD, PhD

Isabelle Ray-Coquard, MD, PhD, of the Centre Leon Berard, Claude Bernard, and Professor at Claude Bernard University Lyon, France, was the study’s formal discussant. She noted the “great benefits” provided by hormonal therapy in terms of progression-free survival and, in the subset with no...

gynecologic cancers

Benefit Strongly Suggested With Hormonal Maintenance in Low-Grade Serous Carcinoma

In patients with low-grade serous carcinoma, maintenance hormonal therapy reduced the risk of recurrence by 77%, compared with surveillance, in a retrospective cohort from The University of Texas MD Anderson Cancer Center. The study was reported by David Marc Gershenson, MD, at the 2016 ASCO...

Expert Point of View: Sunil Verma, MD

Sunil Verma, MD, Professor and Head of the Department of Oncology and Medical Director of the Tom Baker Cancer Centre of the University of Calgary in Canada, was the study’s formal discussant. He cited several limitations of the study: It was an open-label study, was initially a phase II study but ...

breast cancer

PHEREXA: Benefit for Second-Line Pertuzumab Questionable

In the second-line metastatic breast cancer setting, the addition of pertuzumab (Perjeta) to trastuzumab (Herceptin)/capecitabine did not significantly improve progression-free survival, results of the phase III ­PHEREXA trial showed.1 This is the first randomized trial to evaluate the efficacy of ...

breast cancer

Results of Two Practice-Changing Breast Cancer Trials Upheld

Results of two pivotal breast cancer trials reported at the 2016 ASCO Annual Meeting confirmed the practice-changing findings that resulted from earlier findings. PALOMA-2 The phase III PALOMA-2 trial confirmed results from the smaller, open-label phase II PALOMA-1 trial that led to the U.S. Food...

Expert Point of View: David Reardon, MD

“Adjuvant temozolomide does represent a new standard of care for 1p/19q-intact anaplastic glioma patients,” according to David Reardon, MD, Clinical Director at the Dana-Farber Center for Neuro-Oncology and the study’s formal discussant at the 2016 ASCO Annual Meeting. “We see a significant...

cns cancers

New Standard of Care Emerges for Anaplastic Glioma Without 1p/19q Codeletion

Adjuvant temozolomide, after radiotherapy, improves overall survival in patients with grade 3 anaplastic glioma without 1p/19q codeletion, according to a phase III EORTC (European Organization for Research and Treatment of Cancer) study presented at the 2016 ASCO Annual Meeting.1 “We were...

Expert Point of View: Elizabeth Mittendorf, MD, PhD

The discussant of these studies was Elizabeth Mittendorf, MD, PhD, Associate Professor of Breast Surgical Oncology at the University of Texas MD Anderson Cancer Center, Houston. Dr. Mittendorf noted that approximately 3% of U.S. breast cancer patients present with de novo stage IV disease. For...

breast cancer

Mixed Results With Resection of Primary Tumor in Stage IV Breast Cancer

For de novo stage IV breast cancer, does resection of the primary tumor improve outcomes? Two studies presented at the 2016 ASCO Annual Meeting reached different conclusions. A prospective randomized study conducted in Turkey concluded there is a survival benefit at 5 years,1 whereas a U.S....

Expert Point of View: Stephen K.L. Chia, MD

Stephen K.L. Chia, MD, of the British Columbia Cancer Agency, Vancouver, discussed two of these neoadjuvant breast cancer studies at the ASCO Annual Meeting. In the current landscape for neoadjuvant therapy in HER2-positive disease, said Dr. Chia, the NeoSphere, ­TRYPHAENA, KRISTINE, and I-SPY 2...

breast cancer

Pertuzumab-Containing Regimens Compared for Neoadjuvant Treatment in Early Breast Cancer

In patients with HER2-positive early breast cancer, pathologic complete response rates after neoadjuvant therapy were higher with docetaxel plus carboplatin plus trastuzumab (Herceptin) plus pertuzumab (Perjeta), or TCH+P, than with ado-trastuzumab emtansine (Kadcyla) plus pertuzumab, or T-DM1+P,...

Expert Point of View: Nancy E. Davidson, MD

Nancy E. Davidson, MD, the Hillman Professor of Oncology and Director of the University of Pittsburgh Cancer Institute in Philadelphia, was the Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) study’s formal discussant. With this analysis, she noted, the EBCTCG has “reinforced the long...

breast cancer

EBCTCG Analysis Identifies Recurrence Risk by Tumor Subgroup in Estrogen Receptor–Positive Breast Cancer

The risk of recurrence in estrogen receptor–positive breast cancer is known to continue after 5 years, but just how much is that risk once endocrine therapy is stopped? The Early Breast Cancer Trialists’ Collaborative Group (EBCTCG) has concluded it is “appreciable,” with distant recurrences...

Expert Point of View: Samir Gupta, MD

Samir Gupta, MD, Associate Professor of Medicine at the University of California San Diego, who has led trials of colorectal cancer screening, commented on this study for The ASCO Post. Although there are approximately 138,000 new colorectal cancer diagnoses a year in the United States, only...

colorectal cancer

Young-Onset Colorectal Cancer Diagnoses Rising

Colorectal cancer is being increasingly diagnosed in persons younger than age 50, the age at which colorectal cancer screening is usually initiated. According to Elie Sutton, MD, of Mount Sinai West Hospital in New York, a review of cases in the National Cancer Data Base revealed that between...

Expert Point of View: Peter C. Enzinger, MD

Not so FAST? The study discussant Peter C. Enzinger, MD, Director of the Center for Esophageal and Gastric Cancer at Dana-Farber/Brigham and Women’s Cancer Center, Boston, viewed the findings of the FAST trial as promising but voiced several considerations, as did Gulam A. Manji, MD, PhD,...

gastrointestinal cancer
gastroesophageal cancer

First-in-Class Antibody Reduces Gastric Cancer Recurrence

A novel immunotherapy agent, the first in its class, reduced disease progression by more than 50% when added to standard chemotherapy for patients with advanced gastric cancer, according to results from an international phase II trial presented at the 2016 ASCO Annual Meeting.1 The drug, IMAB362,...

solid tumors

‘Liquid Biopsy’ Stacks Up Well to Tissue Biopsy in Detecting Tumor-Specific Mutations

So-called liquid biopsy identified cancer mutations in 85% of all advanced tumors, in the largest-ever evaluation of circulating tumor DNA (ctDNA) in the blood.1 In 49% of the cases, these biomarkers were associated with an approved targeted drug, Philip C. Mack, PhD, reported at the 2016 ASCO...

Expert Point of View: Tiffany A. Traina, MD, and Larry Norton, MD

Study discussant Tiffany A. Traina, MD, Clinical Director of the Breast Medicine Service and Associate Attending at Memorial Sloan Kettering Cancer Center and Assistant Professor of Medicine at Weill Cornell Medicine, commented, “The overall trial results demonstrate that not only is docetaxel...

breast cancer

Joint Analysis Confirms Benefit of Anthracyclines for High-Risk Early-Stage Breast Cancer

For the treatment of high-risk, HER2-negative early-stage breast cancer, anthracyclines were confirmed as beneficial in a joint analysis of the Anthracyclines in Early Breast Cancer (ABC) trials. Presented at the 2016 ASCO Annual Meeting, the joint analysis of the ABC trials validated taxane plus...

Expert Point of View: Dominique Valteau-Couanet, MD, PhD

Study discussant Dominique Valteau-Couanet, MD, PhD, of the Gustave Roussy in France, said the study was “an important step” in research, by showing “Cy-THIO/mCEM [tandem autologous stem cell transplant (ASCT) with cyclophosphamide/thiotepa followed by a modified regimen of...

cns cancers

For High-Risk Neuroblastoma, Two Transplants May Be Better Than One

In children with high-risk neuroblastoma, tandem autologous stem cell transplant (ASCT) improved event-free survival rates in the ANBL0532 trial from the Children’s Oncology Group. The study was presented at the plenary session of the 2016 ASCO Annual Meeting by Julie R. Park, MD, of Seattle...

Breast Density Legislation: An Opportunity for Better Risk Assessment

Dense breasts are not an automatic indication for additional imaging. Instead, breast density generally provides an opportunity for improved risk assessment, according to Kevin Hughes, MD, of Massachusetts General Hospital, Boston. “More than 20 states have mandated that women be informed of...

It Started With Twitter: ASBrS Immediate Past-President, Deanna Attai, MD, Spearheads Patient-Centered Care

Breast surgeon Deanna Attai, MD, is a virtual mighty mouse as a spokesperson for her professional organization, the American Society of Breast Surgeons (ASBrS). She is as big on ideas as she is petite in stature and for actively tweeting on medical topics (@DrAttai). Assistant Clinical Professor...

pancreatic cancer

Adjuvant Chemotherapy Improves Survival in Pancreatic Cancer

An adjuvant chemotherapy regimen improved overall survival in early-stage pancreatic cancer patients, in the large phase III European ESPAC-4 study reported at the 2016 ASCO Annual Meeting.1 The combination of gemcitabine and capecitabine almost doubled the 5-year survival rate, compared to...

Expert Point of View: Paul G. Richardson, MD

Study discussant Paul G. Richardson, MD, the RJ Corman Professor of Medicine at Harvard Medical School and the Jerome Lipper Multiple Myeloma Chair at Dana-Farber Cancer Institute, Boston, commented, “The evolving role of monoclonal antibodies in multiple myeloma has been worth the wait. You can...

multiple myeloma

Daratumumab Hits the Mark in Early Relapsed Multiple Myeloma

For relapsed or refractory multiple myeloma, daratumumab (Darzalex), combined with bortezomib (Velcade) and dexamethasone, reduced relapses by 61% in the phase III CASTOR study reported at the 2016 ASCO Annual Meeting.1 “The results are unprecedented in a randomized study comparing a novel...

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