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immunotherapy
symptom management

Adoptive T-Cell Therapy for Progressive Multifocal Leukoencephalopathy

An emerging treatment known as adoptive T-cell therapy has proven effective in a phase II clinical trial for treating progressive multifocal leukoencephalopathy (PML), a rare and often fatal brain infection sometimes observed in patients with cancer and other diseases in which the immune system is...

supportive care
integrative oncology

Use of Valerian to Relieve Anxiety in 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 sometimes used by patients with cancer. Eugenie Spiguel, MSN, ANP-BC, and Jyothirmai Gubili, MS, explore the use of valerian for...

27% Drop in Overall U.S. Cancer Mortality Rate From 1991 to 2016

A steady 25-year decline has resulted in a 27% drop in the overall cancer death rate in the United States between 1991 and 2016. The data come from “Cancer Statistics, 2019,” the American Cancer Society’s annual report on cancer rates and trends. The report was published by Siegel et al in CA: A...

hematologic malignancies
multiple myeloma

Novel Treatments in Newly Diagnosed Multiple Myeloma, Part 1

Here is an update on several different studies focusing on novel treatments for patients with newly diagnosed multiple myeloma presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. Featured therapeutics include daratumumab plus lenalidomide and dexamethasone, ...

issues in oncology
legislation
health-care policy

New Regulations Require Better Communication With Patients Who Have Disabilities and Limited English Proficiency

Ever since President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law on March 23, 2010, the nondiscrimination provision of the law, Section 1557, which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health ...

palliative care
issues in oncology

Impact of Survival Predictions on Aggressive End-of-Life Care Among Patients With Metastatic Cancer

In a single-institution study reported in the Journal of Oncology Practice, Sborov et al found that inaccurate prediction of life expectancy can be associated with greater likelihood of aggressive end-of-life care among patients with metastatic cancer receiving palliative radiation therapy. Study...

issues in oncology
global cancer care

Patient Navigation Program Reduces Time to Treatment in Patients With Cancer

Global Cancer Institute recently announced the results of its Patient Navigation Program in Mexico City. The average time to referral before the program’s inception was 5 months, but the implementation of patient navigators reduced that average to 7 days. These findings were published by ...

issues in oncology
symptom management

Incidence of Acute Kidney Injury in Patients Receiving Systemic Therapy for Cancer

In a Canadian population–based cohort study reported in the Journal of the National Cancer Institute, Kitchlu et al found that acute kidney injury (AKI) is common in patients receiving systemic therapy for newly diagnosed cancer and has increased in incidence in recent years. Study Details...

issues in oncology

27% Drop in Overall U.S. Cancer Mortality Rate From 1991 to 2016

A steady 25-year decline has resulted in a 27% drop in the overall cancer death rate in the United States between 1991 and 2016. The data come from “Cancer Statistics, 2019,” the American Cancer Society’s annual report on cancer rates and trends. The report was published in CA: A...

gynecologic cancers

Maintenance Olaparib in Newly Diagnosed Advanced Ovarian Cancer

As reported in The New England Journal of Medicine by Moore et al, the phase III SOLO-1 trial has shown that maintenance with olaparib, following complete or partial response to platinum-based chemotherapy, significantly prolonged progression-free survival vs placebo in...

lung cancer

Transformation of EGFR-Mutant NSCLC to SCLC

In a study reported in the Journal of Clinical Oncology, Marcoux et al provided further evidence that EGFR-mutant non–small cell lung cancer (NSCLC) can undergo transformation to small cell lung cancer (SCLC) and identified factors associated with such transformation. It has been estimated...

multiple myeloma

I Welcome Being the Face of Multiple Myeloma

Thirteen years ago, at age 34, I was healthy and enjoying life. I went to the gym almost daily, and when I wasn’t at the gym, I was shooting hoops with my friends. During a gym workout while on a family vacation, I suddenly felt excruciating pain in my left shoulder and thought I must have strained ...

immunotherapy

Immune Checkpoint Blockade and Tumor-Specific Vaccine for Incurable HPV16-Related Cancer

In a single-center phase II study reported in JAMA Oncology, Erminia Massarelli, MD, and colleagues found combining tumor-specific vaccine and nivolumab (Opdivo) showed evidence of activity in incurable human papillomavirus (HPV) 16–related cancer. The therapeutic vaccine, ISA 101, induces...

hematologic malignancies

Study Findings on Myeloproliferative Neoplasms Including Systemic Mastocytosis

HERE IS AN UPDATE on six different studies featured at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. Topics focused on novel treatments for myelofibrosis, polycythemia vera and essential thrombocythemia, as well as systemic mastocytosis. Myelofibrosis ABSTRACT...

lung cancer

Lorlatinib in Second- or Third-Line Treatment of ALK-Positive Metastatic Non–Small Cell Lung Cancer

On November 2, 2018, lorlatinib (Lorbrena) was granted accelerated approval for the treatment of patients with ALK-positive metastatic non–small cell lung cancer (NSCLC) whose disease has progressed on crizotinib (Xalkori) and at least one other ALK inhibitor for metastatic disease or whose disease ...

lung cancer
immunotherapy

Durvalumab Improves Overall Survival After Chemoradiotherapy in Unresectable, Stage III NSCLC

AS REPORTED in The New England Journal of Medicine by Scott J. Antonia, MD, PhD, of H. Lee Moffitt Cancer Center and Research Institute, and colleagues, the phase III PACIFIC trial has shown significantly improved overall survival, a coprimary endpoint, with the programmed cell death ligand 1...

Should I Have Lied?

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,...

gynecologic cancers

Minimally Invasive vs Open Abdominal Radical Hysterectomy in Early-Stage Cervical Cancer

TWO STUDIES recently reported in The New England Journal of Medicine indicate that minimally invasive radical hysterectomy is associated with poorer survival outcomes than open abdominal radical hysterectomy in women with early-stage cervical cancer. As reported by Pedro T. Ramirez, MD, of The...

leukemia

Nuclear Excision Repair as a Possible Predictor of Early Relapse in Pediatric ALL

Researchers recently discovered that by testing the level of nucleotide excision repair (NER) gene expression, pediatric oncologists may be able to determine the likelihood of early relapse (less than 3 years) in patients with acute lymphoblastic leukemia (ALL). These findings were published by...

issues in oncology
health-care policy
legislation
cost of care

Will the Trump Administration’s Plan to Reduce Cancer Drug Prices Work?

High drug prices are the number one health-care concern of many Americans. The average price of a cancer drug rose from less than $10,000/yr before 2000 to more than $170,000/yr in 2017.1-3 Between 1995 and 2013, the launch price of cancer drugs increased by 10% to 12% every year, and the average...

issues in oncology
symptom management

Apixaban Thromboprophylaxis in Patients With Cancer

In the Canadian phase III AVERT trial reported in The New England Journal of Medicine, Carrier et al found that the oral factor Xa inhibitor apixaban reduced the risk of venous thromboembolism vs placebo among intermediate- to high-risk ambulatory patients with cancer starting chemotherapy but was...

lung cancer

SELECT Trial: Adjuvant Erlotinib in Resected EGFR-Mutant NSCLC

In a phase II trial reported in the Journal of Clinical Oncology, Pennell et al found that adjuvant erlotinib (Tarceva) improved disease-free survival over historical controls in patients with resected EGFR-mutant non­–small cell lung cancer (NSCLC).  In the study, 100 patients with ...

breast cancer

Expert Point of View: Rebecca Dent, MD, and Suzette Delaloge, MD, MSc

FORMAL DISCUSSANT of the ACE trial, Rebecca Dent, MD, of the National Cancer Center in Singapore, commented that the phase II ENCORE 301 study provided proof of concept that a histone deacetylase (HDAC) inhibitor can reprogram epigenetic changes.1 In that randomized, double-blind,...

skin cancer
immunotherapy

Pembrolizumab Triplet Shows Activity in BRAF-Mutant Melanoma

AS FIRST-LINE treatment of advanced BRAF-mutant melanoma, pembrolizumab (Keytruda) added to dabrafenib (Tafinlar) and trametinib (Mekinist) produced a nonsignificant improvement in progression-free survival. It also increased the rate of grade 3 to 5 treatment-related adverse events in the phase II ...

skin cancer

Using Tumor‑Infiltrating Lymphocytes to Treat Metastatic Melanoma

STEVEN A. ROSENBERG, MD, PhD, Chief of Surgery at the National Cancer Institute (NCI), began his pioneering research in adoptive cell transfer using interleukin (IL)-2 in the mid-1970s. His IL-2 studies were among the clinical trials that led to the first U.S. Food and Drug Administration approval ...

solid tumors

Stereotactic Ablative Radiotherapy May Improve Outcomes in Some Patients With Oligometastatic Tumors

IN PATIENTS with a controlled primary tumor and up to 5 oligometastatic lesions, delivering stereotactic ablative radiotherapy was associated with a 13-month improvement in overall survival when compared with palliative standard-of-care treatments alone (41 months vs 28 months; P = .09).1...

immunotherapy

Beyond Checkpoint Inhibitors: Novel Immunotherapy Combinations With Antitumor Activity

THE 2018 Society for Immunotherapy of Cancer (SITC) Annual Meeting hosted a meeting of the minds of the world’s premier cancer immunologists. In addition to the cutting-edge laboratory science explored and presented at the meeting, numerous phase I clinical trials and a few phase II studies offered ...

breast cancer
solid tumors
lung cancer

A Diagnosis of Li-Fraumeni Syndrome Has Focused My Life Direction

Despite the fact that I had to have open heart surgery at age 7 to fix a congenital heart defect and then more surgery, chemotherapy, and radiation therapy to treat a diagnosis of rhabdomyosarcoma a year later, I never felt like I was a sick kid. Children don’t have the existential worries about...

Denial’s Many Faces

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,...

hepatobiliary cancer

Lenvatinib in Unresectable Hepatocellular Carcinoma

On August 16, 2018, lenvatinib (Lenvima) was approved for the first-line treatment of patients with unresectable hepatocellular carcinoma.1,2 Supporting Efficacy Data Approval was based on the findings of a phase III open-label noninferiority trial (REFLECT), in which 954 patients with previously...

lymphoma
immunotherapy

ASH 2018: Updated Analysis of JULIET Trial: Tisagenlecleucel in Relapsed or Refractory DLBCL

In an update to the global JULIET clinical trial, the chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel (Kymriah) led to long-lasting remissions in patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). The most recent results from the trial were presented by...

multiple myeloma

ELOQUENT-3: Addition of Elotuzumab to Pomalidomide and Dexamethasone in Previously Treated Multiple Myeloma

As reported in The New England Journal of Medicine by Dimopoulos et al, the phase II ELOQUENT-3 trial has shown that the addition of elotuzumab (Empliciti) to pomalidomide (Pomalyst) and dexamethasone significantly prolonged progression-free survival in patients with relapsed and/or refractory...

leukemia

Causes of Inferior Outcomes in AYAs With Leukemia

Despite survival gains for children diagnosed with acute lymphoblastic leukemia (ALL), adolescents and young adults (AYAs)— those between the ages of 15 and 39— diagnosed with the disease have seen only modest improvements in survival. A study by Julie A. Wolfson, MD, MSHS, Assistant Professor and ...

issues in oncology
breast cancer
genomics/genetics

Obligation to Evaluate Racial/Ethnic Features That May Affect Outcomes for Patients With Breast Cancer

"WE ABSOLUTELY have an obligation to evaluate all of the features describing our patients with cancer when we are trying to figure out why some patients do better than others,” Lisa A. Newman, MD, MPH, reminded the nearly 700 participants at the 2018 Lynn Sage Breast Cancer Symposium, hosted by...

integrative oncology

Probiotics

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. Shelly Latte-Naor, MD, and Jyothirmai Gubili, MS, explore some of the beneficial effects attributed ...

At Sea

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,...

issues in oncology
immunotherapy

The Abscopal Effect: A Reemerging Field of Interest

For the past 50 years or more, oncologists have designed their treatment plans around the three pillars: surgery, chemotherapy, and radiation. Now, with a series of recent successes, immunotherapy is rapidly reemerging as the fourth pillar in the oncologic armamentarium. Despite major advancements...

lung cancer

Dacomitinib for Metastatic EGFR-Mutant NSCLC

On September 27, 2018, dacomitinib (Vizimpro) received approval for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R substitution mutations, as detected by a test approved by the...

hematologic malignancies

Ibrutinib Plus Rituximab in Adult Patients With Waldenström’s Macroglobulinemia

In the Clinic provides overviews of novel 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 August 27, 2018, ibrutinib (Imbruvica) was approved...

gynecologic cancers

Study Identifies Suitable Partner for Bevacizumab in Recurrent Ovarian Cancer

For patients with recurrent ovarian cancer who receive platinum-based retreatment, the more suitable partner for bevacizumab (Avastin) may be carboplatin plus pegylated liposomal doxorubicin, rather than carboplatin and gemcitabine, according to the results of a phase III ENGOT/GCIG Intergroup...

prostate cancer

Treatment With Radium-223 Plus Abiraterone Not Advisable in Metastatic Prostate Cancer

The combination of radium-223 plus AAP (abiraterone acetate [Zytiga] and prednisone) was not superior to placebo plus AAP in the phase III ERA 223 trial, which enrolled men with asymptomatic bone-predominant metastatic castration-resistant prostate cancer.1 Patients treated with the combination had ...

lung cancer

Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC

In a global phase II study reported in The Lancet Oncology, Solomon et al found that lorlatinib (Lorbrena) showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were treatment-naive or who had received crizotinib (Xalkori)...

hematologic malignancies

The WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

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 Medeiros explore the recently updated World Health Organization (WHO) classification of hematopoietic and lymphoid tissue...

bladder cancer
immunotherapy

Pembrolizumab Shows Antitumor Activity in Non–Muscle Invasive Bladder Cancer

THE ANTI–PROGRAMMED cell death protein 1 (anti–PD-1) checkpoint inhibitor pembrolizumab (Keytruda) was found to have antitumor activity in patients with high-risk non–muscle invasive bladder cancer who were nonresponsive to bacillus Calmette-Guérin (BCG), according to the preliminary results of the ...

bladder cancer
immunotherapy

PURE-01 Trial: Neoadjuvant Immunotherapy in Muscle-Invasive Bladder Carcinoma

In the Italian phase II PURE-01 trial reported in the Journal of Clinical Oncology, Necchi et al found that neoadjuvant pembrolizumab (Keytruda) before radical cystectomy in muscle-invasive bladder carcinoma produced complete pathologic response (pT0) in 42% of patients, with pT0 being more common...

hematologic malignancies
leukemia

Nilotinib for Pediatric Patients With Philadelphia Chromosome–Positive CML in Chronic Phase

Earlier in 2018, nilotinib (Tasigna) was approved for the treatment of pediatric patients aged ≥ 1 year with newly diagnosed Philadelphia chromosome–positive chronic myeloid leukemia in chronic phase (CML-CP) or Philadelphia chromosome–positive CML-CP resistant or intolerant to prior tyrosine...

solid tumors
breast cancer

The Persephone Trial Reconsidered

The Persephone presentation by Helena Margaret Earl, MBBS, PhD, got a lot of publicity after a pre–ASCO Annual Meeting press release, suggesting that 6 months of adjuvant trastuzumab (Herceptin) is enough. The advice of experts has been that the evidence is inconclusive, but I have not heard a...

lymphoma

Risk Factors for Higher-Grade Transformation in Marginal Zone Lymphoma

In a single-institution study reported in the Journal of Clinical Oncology, Alderuccio et al found that not achieving complete remission (CR) after initial treatment, elevated lactate dehydrogenase (LDH), and more than four nodal sites at marginal zone lymphoma diagnosis are predictive of...

solid tumors

2018 ASTRO: SABR-COMET: Stereotactic Ablative Radiation Therapy for Oligometastatic Tumors

In the first randomized, phase II clinical trial of its kind, researchers have shown that an aggressive form of high-precision radiation therapy can increase survival in patients with oligometastatic tumors. These findings were presented by Palma et al in the plenary session at the 60th Annual ...

Philip J. DiSaia, MD, Former President, Society of Gynecologic Oncology, American Board of Obstetrics & Gynecology, Dies at 81

The grandson of Italian immigrants, Philip J. DiSaia was born on August 14, 1937, in Providence, Rhode Island. He earned his Bachelor’s in Science at Brown University and his MD at Tufts University. Upon the advice of his mentor in medical school, Dr. DiSaia obtained 2 years of general surgery...

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