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leukemia

Moxetumomab Pasudotox-tdfk for Relapsed or Refractory Hairy Cell Leukemia

ON SEPTEMBER 13, 2018, moxetumomab pasudotox-tdfk (Lumoxiti), a CD22-directed cytotoxin, was approved for the treatment of adult patients with relapsed or refractory hairy cell leukemia who received at least two prior systemic therapies, including with a purine nucleoside analog.1,2 Supporting...

skin cancer

Encorafenib and Binimetinib: A New Benchmark in Metastatic Melanoma Therapy?

IN JULY 2018, the U.S. Food and Drug Administration (FDA) approved the combination of the oral BRAF inhibitor encorafenib (Braftovi) and the oral MEK inhibitor binimetinib (Mektovi) for BRAF V600E– or V600K– positive metastatic melanoma. The FDA approval was based on the results of the COLUMBUS...

skin cancer

Encorafenib Plus Binimetinib vs Vemurafenib in Advanced BRAF-Mutant Melanoma

AS REPORTED in The Lancet Oncology by Reinhard Dummer, MD, of the University Hospital Zurich Skin Cancer Center, and colleagues, the phase III COLUMBUS trial has shown a significant improvement in overall survival with the combination of the BRAF inhibitor encorafenib (Braftovi) and the MEK...

leukemia
lymphoma

Duvelisib for Relapsed or Refractory CLL/SLL and for Relapsed or Refractory Follicular Lymphoma

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 September 24, 2018, duvelisib (Copiktra) was granted...

bladder cancer
immunotherapy

Bladder Cancer: Strategies to Address Checkpoint Inhibitor Failure

CHECKPOINT INHIBITORS have rapidly become the standard of care as second-line treatment, and in some patients first-line treatment, of advanced bladder cancer. However, the majority of patients do not respond and eventually experience disease progression; these patients will need subsequent...

prostate cancer

Shedding Light on Mechanisms of Resistance to Treatment of Metastatic Castration-Resistant Prostate Cancer

ONE OF the pressing issues in metastatic castration-resistant prostate cancer is the development of resistance to therapies directed at the androgen receptor (AR), such as enzalutamide (Xtandi) and abiraterone acetate (Zytiga). Research is ongoing to identify mechanisms of resistance in the hope of ...

breast cancer

Management of HER2-Positive Breast Cancer: Business as Usual?

MANAGEMENT OF HER2-positive breast cancer changed after the introduction of trastuzumab (Herceptin), the first anti-HER2 therapy to be approved by the U.S. Food and Drug Administration (FDA) for this type of cancer. Recent studies have more clearly defined the role of pertuzumab (Perjeta) and...

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,...

breast cancer

HDAC Inhibitor May Overcome Endocrine Resistance in Advanced Breast Cancer

EPIGENETIC CHANGES are associated with the development of cancer, and epigenetic therapy is an attractive strategy for targeting the tumor microenvironment. One approach targeted to epigenetic changes is using histone deacetylase (HDAC) inhibition, which has antitumorigenic effects including growth ...

colorectal cancer
immunotherapy

Expert Point of View: Julien Taieb, MD

JULIEN TAIEB, MD, Professor of Medicine at Paris Descartes University in France, said the MODUL cohort was based on a clear rationale for adding atezolizumab (Tecentriq) to bevacizumab (Avastin) in the metastatic colorectal cancer setting. In immunodeficient mice, the combination of an...

colorectal cancer
immunotherapy

No Benefit for Atezolizumab Plus Standard of Care for Maintenance in Colorectal Cancer Subset

ADDING ATEZOLIZUMAB (Tecentriq) to a fluoropyrimidine plus bevacizumab (Avastin) did not improve outcomes for patients with BRAF wild-type metastatic colorectal cancer enrolled in the umbrella MODUL trial.1 “Despite activity in other, immune-responsive tumor types, there was no improvement in...

skin cancer
immunotherapy

Expert Point of View: Reinhard Dummer, MD

KEYNOTE-022’S invited discussant, Reinhard Dummer, MD, Professor of Dermatologic Oncology at the University Hospital Zurich Skin Cancer Center in Switzerland, told attendees, “We’ve been waiting for this small prospective randomized phase II trial, and the initial results appear very promising.”...

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 ...

prostate cancer

Expert Point of View: Joaquin Mateo, MD, PhD

FORMAL DISCUSSANT Joaquin Mateo, MD, PhD, of the Prostate Cancer Translational Research Group, Vall d’Hebron Institute of Oncology, Barcelona, said that the TRITON2 findings were encouraging, although still preliminary. “We should interpret these results with caution, because this interim analysis ...

prostate cancer

PARP Inhibitor Active in BRCA1/2-Mutated Metastatic Castration-Resistant Prostate Cancer

THE SEARCH for biomarkers in prostate cancer has proved frustrating, partly due to the complexity of the disease and its heterogeneity. A preliminary analysis of a phase II (TRITON2) study suggests that rucaparib (Rubraca), a poly (ADP-ribose) polymerase (PARP) inhibitor, may be active in men with...

kidney cancer

Expert Point of View: Manuela Schmidinger, MD

“TARGETED AGENTS were a breakthrough in the treatment of renal cell carcinoma, and immunotherapy also works well, improving survival. In the past 2 years, combining a checkpoint inhibitor with targeted agents appears to work even better, and multiple combination trials are underway. The outcomes...

kidney cancer

Progress Made in Identifying Gene-Signature Biomarkers in Renal Cell Carcinoma

A NEW ANALYSIS of the phase III IMmotion151 trial identified gene signatures in renal cell carcinoma that correlate with improved progression-free survival in patients treated with atezolizumab (Tecentriq) plus bevacizumab (Avastin) vs sunitinib (Sutent). These findings were presented at the...

skin cancer

Expert Point of View: Cara Haymaker, PhD

CARA HAYMAKER, PhD, of MD Anderson Cancer Center, said the researchers have made a “crucial” discovery: adoptive cellular therapy can be expanded beyond academic centers and be “taken to the masses.” Tumor-infiltrating lymphocytes can now be manufactured and shipped to patients treated at centers...

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 ...

Antonio Omuro, MD, Named Neuro-Oncology Chief at Smilow Cancer Hospital

ANTONIO OMURO, MD, a clinician and researcher with expertise in brain tumors, has been appointed Chief of Neuro-Oncology and a leader for the Brain Tumor Program at Smilow Cancer Hospital. “We are so fortunate to have recruited Dr. Omuro to lead our efforts in Brain Tumors and other nervous...

cns cancers

Expert Point of View: Christina I. Tsien, MD

DISCUSSANT OF the NRG-CC001 trial, Christina I. Tsien, MD, Professor of Radiation Oncology at Washington University School of Medicine, St. Louis, underscored the importance of this research, noting that cognitive impairment affects nearly 50% of patients who undergo whole-brain radiation therapy. ...

cns cancers

Hippocampus-Sparing Whole-Brain Radiotherapy and Neurocognitive Function in Patients With Brain Metastases

ANALYSIS OF a phase III trial has confirmed that conformal avoidance of the hippocampal dentate gyrus using intensity-modulated radiotherapy during whole-brain radiotherapy for brain metastases preserves neurocognitive function and improves patient-reported symptom burden while achieving similar...

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...

lung cancer

Expert Point of View: Catherine C. Park, MD, FASTRO

DISCUSSANT OF the abstract, Catherine C. Park, MD, FASTRO, Professor and Chair of the Department of Radiation Oncology at the University of California, San Francisco, expressed excitement about this study’s results, which suggest the possibility of curing patients with stage IV disease. “We’re...

lung cancer

Local Consolidative Therapy Associated With Survival Benefit for Some With Oligometastatic NSCLC

FOR A SUBSET of patients with stage IV lung cancer, aggressive treatment may improve overall survival, according to data presented at the 2018 Annual Meeting of the American Society for Radiation Oncology (ASTRO).1 The results of the phase II study showed that with long-term follow-up, local...

lymphoma

Expert Point of View: Laurie H. Sehn, MD

LAURIE H. SEHN, MD, Chair, Lymphoma Tumour Group, BC Cancer Agency, Vancouver, British Columbia, Canada, said these results are not unexpected and support de-escalation in selected patients. “The FLYER trial evaluates treatment with four cycles compared with six cycles of cyclophosphamide,...

lymphoma

De-escalation of Chemotherapy in Favorable-Risk Diffuse Large B-Cell Lymphoma

THE REGIMEN of four cycles of rituximab (Rituxan)/cyclophosphamide, doxorubicin, vincristine, prednisone (R-CHOP) plus two cycles of rituximab was noninferior to that of six cycles of R-CHOP in younger patients with favorable-risk diffuse large B-cell lymphoma (DLBCL), according to the results of...

immunotherapy

Expert Point of View: Aung Naing, MD, FACP

AT THE 2018 Society for Immunotherapy of Cancer (SITC) Annual Meeting, Aung Naing, MD, FACP, of the Department of Investigational Cancer Therapeutics at The University of Texas MD Anderson Cancer Center, Houston, commented on studies evaluating novel drugs to be combined with programmed cell death ...

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 ...

issues in oncology

Should Oncologists Recommend Cannabis?

A RECENT survey of 400 clinical oncologists found that 80% discuss the use of medical cannabis with their patients, and although nearly 50% recommend it, fewer than 30% consider themselves knowledgeable enough to make such recommendations.1 Oncologists are perhaps among the most evidence-demanding ...

leukemia
geriatric oncology

Expert Point of View: Susan M. O’Brien, MD

THE STUDY’S discussant, Susan M. O’Brien, MD, Associate Director for Clinical Science, Chao Family Comprehensive Cancer Center, University of California Irvine Health, said the results of the Alliance North American Intergroup Study A041202—demonstrating that ibrutinib (Imbruvica) is more...

leukemia
geriatric oncology

Ibrutinib vs Standard of Care in Front-Line Treatment of Older Patients With Chronic Lymphocytic Leukemia

IBRUTINIB (IMBRUVICA) as a front-line agent proved superior to standard-of-care chemoimmunotherapy for chronic lymphocytic leukemia (CLL) in older patients in A041202, an Alliance-led National Clinical Trials Network study.1 At a follow-up of 38 months, the median progression-free survival was not ...

breast cancer

Shanu Modi, MD, on Low HER2-Expressing Breast Cancer: Updated Trial Findings

Shanu Modi, MD, of Memorial Sloan Kettering Cancer Center, discusses study findings from a large phase I study on trastuzumab deruxtecan in patients with low HER2-expressing breast cancer (Abstract P6-17-02).

breast cancer
immunotherapy

Hope S. Rugo, MD, on Immunotherapy for Breast Cancer: Expert Perspective

Hope S. Rugo, MD, of the University of California, San Francisco, summarizes a spotlight session she chaired, which included discussion of new immunotherapy drug combinations, predictive factors, and the immune microenvironment.

breast cancer

Monica Morrow, MD, on View From the Trenches: What Will You do on Monday Morning?

Monica Morrow, MD, of Memorial Sloan Kettering Cancer Center reviews lessons learned from top abstracts, including how to tailor the extent of local therapy to minimize morbidity, the diminishing role of axillary lymph node dissection, long-term sequelae of breast surgical procedures, and the need...

breast cancer

Shom Goel, MD, PhD, on Breast Cancer: Impact of CDK4/6 Inhibitors on Immunity

Shom Goel, MD, PhD, of the Dana-Farber Cancer Institute, discusses preclinical data that suggest CDK4/6 inhibitors not only stop the growth of breast cancer cells, but also enhance antitumor immunity, a phenomenon that might help improve outcomes for people with advanced disease.

breast cancer
immunotherapy

Roisin M. Connolly, MD, on Breast Cancer Treatment Advances in 2018: Expert Perspective

Roisin M. Connolly, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, discusses clinical trials during the past year on studies on CDK and PI3K inhibitors in estrogen receptor–positive breast cancer and immune checkpoint agents in triple-negative breast cancer.

issues in oncology
breast cancer

Reshma Jagsi, MD, DPhil, and Rachel A. Freedman, MD, MPH, on Over- and Undertreatment: Getting It Right

Reshma Jagsi, MD, DPhil, of the University of Michigan, and Rachel A. Freedman, MD, MPH, of Dana-Farber Cancer Institute, discuss the twin challenges of overtreating people with cancer and the missed opportunities and dangers of undertreatment.

breast cancer
issues in oncology

Kathy S. Albain, MD, on Breast Cancer, Ethnicity, and Clinical Outcomes: Results From the TAILORx Trial

Kathy S. Albain, MD, of Loyola University Stritch School of Medicine, discusses study findings on race, ethnicity, and patient outcomes in hormone receptor–positive, HER2-negative, node-negative breast cancer (Abstract GS4-07).

breast cancer
geriatric oncology

Allison Magnuson, DO, on Older Patients With Breast Cancer: A New Tool to Help Guide Treatment Decisions

Allison Magnuson, DO, of the University of Rochester Strong Memorial Hospital, discusses the development of a chemotherapy toxicity risk score that is associated with dose reduction as well as reduced respiratory distress and fewer hospitalizations (Abstract GS6-04).

breast cancer
issues in oncology

Roberto A. Leon-Ferre, MD, on Decreasing Hot Flashes: Results From an ACCRU Trial

Roberto A. Leon-Ferre, MD, of the Mayo Clinic, discusses study findings on the effectiveness of oxybutynin in decreasing the frequency and severity of hot flashes (Abstract GS6-01).

breast cancer
genomics/genetics

Dejan Juric, MD, on Advanced Breast Cancer: Results From the SOLAR-1 Trial

Dejan Juric, MD, of Massachusetts General Hospital, discusses phase III study findings on liquid biopsy–based assessment of PIK3CA mutational status and the combination of the selective PI3K-alpha inhibitor alpelisib plus fulvestrant in the treatment of advanced breast cancer (Abstract GS3-08).

breast cancer
issues in oncology

Laura S. Dominici, MD, on Young Women With Breast Cancer: Local Therapy and Quality of Life

Laura S. Dominici, MD, of the Dana-Farber Cancer Institute, discusses the lower quality-of-life scores seen after unilateral or bilateral mastectomy compared with breast-conserving surgery in women younger than age 40 who are treated for breast cancer (Abstract GS6-05).

breast cancer
genomics/genetics

Judy E. Garber, MD, on Cancer Genetics: Updates for Breast Cancer Care

Judy E. Garber, MD, of the Dana-Farber Cancer Institute, summarizes a special session she moderated, which included discussion of polygenic risk scores, genetic testing in diverse populations, and what to do when presented with moderate-penetrance mutations.

breast cancer
issues in oncology

Shoshana M. Rosenberg, ScD, on Quality of Life and the Impact of Breast Cancer Surgery

Shoshana M. Rosenberg, ScD, of Dana-Farber Cancer Institute, discusses her study findings on the lower quality of life associated with mastectomy, and the need for intervention and timely referrals to supportive resources, especially for underserved populations (Abstract GS6-04).

breast cancer

Harold J. Burstein, MD, PhD, and Daniel F. Hayes, MD, on Breast Cancer With Positive Lymph Nodes: Treatment Controversy

Harold J. Burstein, MD, PhD, of the Dana-Farber Cancer Institute, and Daniel F. Hayes, MD, of the University of Michigan Rogel Cancer Center debate whether all women with breast cancer and positive lymph nodes should receive chemotherapy.

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breast cancer
survivorship
symptom management

SABCS 2018: Oxybutynin for the Management of Hot Flashes in Women Unable to Receive Hormone Replacement Treatment

Treatment with oxybutynin helped reduce the frequency and intensity of hot flashes for women who could not take hormone replacement therapy, including breast cancer survivors, according to the results of a trial presented at the 2018 San Antonio Breast Cancer Symposium by Leon-Ferre et al (Abstract ...

breast cancer

SABCS 2018: SOLAR-1: Liquid Biopsies in Predicting Benefit of Alpelisib in PIK3CA-Mutant Breast Cancer

Liquid biopsy–based assessment of PIK3CA mutational status served as a better indicator of progression-free survival compared with analysis of tissue biopsy in patients with breast cancer enrolled in the phase III SOLAR-1 clinical trial, according to data presented by Juric et al at the 2018...

breast cancer

SABCS 2018: TAILORx Results Show Association Between Clinical Outcomes in Breast Cancer and Race

An analysis of the association between clinical outcomes and race in participants enrolled in the TAILORx trial found that even with equivalent treatments among women with hormone receptor–positive, HER2-negative breast cancer, black women had worse clinical outcomes than white women, despite ...

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