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Showing 1701 - 1750Regorafenib in Second-Line Setting for Hepatocellular Carcinoma: Balancing Benefit With Toxicity
During the past 40 years, hundreds of randomized trials testing treatments for advanced hepatocellular carcinoma have been published.1 Conventional systemic chemotherapy and radiotherapy lack survival advantages for these patients.1,2 In 2007, a phase III trial demonstrated survival benefits for...
Bright Future for Osimertinib in EGFR T790M–Positive Lung Cancer
The AURA3 study—reported by Mok and colleagues and reviewed in this issue of The ASCO Post—confirms the dramatic activity of osimertinib (Tagrisso) in patients with advanced epidermal growth factor receptor (EGFR)-mutant non–small cell lung cancer (NSCLC) and acquired resistance to prior EGFR...
Osimertinib Improves Progression-Free Survival vs Platinum/Pemetrexed in EGFR T790M–Positive NSCLC
In the phase III AURA3 trial reported in The New England Journal of Medicine by Tony S. Mok, MD, of the Chinese University of Hong Kong, and colleagues, osimertinib (Tagrisso) significantly improved progression-free survival vs platinum/pemetrexed (Alimta) among patients with epidermal growth...
Radiotherapy vs Temozolomide in Low-Grade Glioma: The Importance of Molecular Classification
The optimal treatment strategy for low-grade glioma has yet to be established, and practice patterns vary in regard to the timing of treatment, as well as the chosen treatment modality. It was against this backdrop, at a time when the benefits of radiation and chemotherapy remained uncertain but ...
Tailoring Treatment for Older Adults With Colorectal Cancer
Nearly 60% of colorectal cancer cases are diagnosed in patients ≥ 65 years, with a median age at diagnosis of 68 years,1 but this population makes up only 34% of clinical trial participants.2 In addition, the older adults enrolled on clinical trials are traditionally the most-fit older adults....
Exploring the Opportunities and Challenges of Seamless Drug Development
The traditional three-phase clinical trial process for testing new drugs does not necessarily make sense when it comes to targeted therapies, according to many experts, including regulators, academic researchers, industry chief executive officers, and patient advocates alike. Instead of three...
Exploring the Opportunities and Challenges of Seamless Drug Development
The traditional three-phase clinical trial process for testing new drugs does not necessarily make sense when it comes to targeted therapies, according to many experts, including regulators, academic researchers, industry chief executive officers, and patient advocates alike. Instead of three...
Many Cancer Survivors Find Online and Telephone Communication With Health-Care Professionals Beneficial
Researchers from the School of Health Sciences at the University of Surrey, Guildford, United Kingdom, have completed the first-ever systematic review of cancer survivors’ experience of online and telephone telehealth interventions in cancer care, according to a recent study reported by Anna Cox,...
Selected Abstracts From the 2016 ASH Annual Meeting
Here are several abstracts selected from the proceedings of this year’s American Society of Hematology (ASH) Annual Meeting & Exposition, highlighting newer therapeutics in high-grade, aggressive B-cell non-Hodgkin lymphomas (NHLs), including newly diagnosed as well as relapsed or refractory...
New Analysis of CheckMate 057: Search Continues for Predictors of Outcome With Nivolumab
Prognostic factors and tumor expression of programmed cell death ligand 1 (PD-L1) predict early mortality among patients with previously treated nonsquamous advanced non–small cell lung cancer (NSCLC) who receive nivolumab instead of docetaxel. But these features are not reliable for excluding...
Quality-of-Life Data From KEYNOTE-024: First-Line Pembrolizumab vs Chemotherapy in Advanced NSCLC
When used as first-line therapy for advanced non–small cell lung cancer (NSCLC), pembrolizumab (Keytruda) yields better health-related quality of life than platinum-based chemotherapy, suggest new data from the randomized phase III KEYNOTE-024 trial.1 After 15 weeks of treatment, changes in scores...
Clinical Trials Study the Role of Immunotherapy in the First-Line Setting of Non–Small Cell Lung Cancer
In 2016, the KEYNOTE-024 trial set the bar for first-line immunotherapy in non–small cell lung cancer (NSCLC). Trial results showed that pembrolizumab (Keytruda), an antibody to programmed cell death protein 1 (PD-1), reduced the risk of disease progression or death by 50% and the risk of death by...
Timing Is Everything
In 1959, my 5-year-old cousin, Kim, was diagnosed with acute lymphocytic leukemia (ALL). As an 8-year-old, I didn’t really understand what was happening to him, except that he had to go to the Riley Hospital for Children in Indianapolis, Indiana, for treatment. The haunting vision of his looking...
Understanding the Role of Immunotherapy for Lung Cancer: A Paradigm Shift for the Better
“Immunotherapy for lung cancer is a paradigm shift. I would never have thought when I started my career taking care of lung cancer patients in the mid 1990s that we’d now be substituting chemotherapy with an antibody immunotherapy in 2017. It’s incredible,” commented Roy S. Herbst, MD, PhD, Chief...
Study Finds Mutations in Myelodysplastic Syndrome Linked to Poorer Outcome After Stem Cell Transplantation
In a study reported in The New England Journal of Medicine, Lindsley et al found that a number of mutations present in patients with myelodysplastic syndrome (MDS) were associated with poorer clinical outcome after allogeneic hematopoietic stem cell transplantation (HSCT). Study Details The study ...
Telotristat Ethyl: A Novel Therapy for Carcinoid Syndrome—Not a Panacea but a Step in the Right Direction
The multihumoral manifestations of neuroendocrine tumors include diarrhea, cutaneous flushing, wheezing, and right-sided valvular heart disease.1 Serotonin, a biogenic amine and product of tryptophan metabolism,2 mediates several of these symptoms.3,4 Diarrhea is a cardinal and often disabling...
Liquid Biopsies Show Promise in Diffuse Large B-Cell Lymphoma
Technologic advances for detecting and analyzing cell-free circulating tumor DNA (ctDNA) from peripheral blood offer a precision method for monitoring diffuse large B-cell lymphoma (DLBCL). Although most patients with DLBCL are cured with initial therapy, those who are not cured have a poor...
Circulating Tumor DNA Profiling Identifies Clonal Evolution Patterns and Permits Classification of Tumor Subtypes in DLBCL
In a study reported in Science Translational Medicine, Florian Scherer, MD, David M. Kurtz, MD (Conquer Cancer Foundation Young Investigator), Aaron M. Newman, PhD, and colleagues from Stanford University found that analysis of circulating tumor DNA (ctDNA) permits identification of patterns of...
Expert Point of View: Fiona Blackhall, PhD, FRCP
“There has undoubtedly been extremely rapid progress made in establishing effective therapies for anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC) patients in less than a decade,” said Fiona Blackhall, PhD, FRCP, Chair of Thoracic Oncology and medical oncologist at the...
Adding Antiandrogen Therapy to Radiation Therapy in Recurrent Prostate Cancer
As reported in The New England Journal of Medicine by Shipley et al in the NRG Oncology Radiation Therapy Oncology Group (RTOG), the final analysis of the phase III RTOG 9601 trial showed that the addition of antiandrogen therapy with bicalutamide to radiation therapy significantly improves overall ...
Veliparib Improves Reponse but Not Progression-Free Survival in BRCA-Mutation Carriers
A randomized phase II study in women with metastatic breast cancer who have mutations in BRCA1 or BRCA2 evaluated the addition of the poly (ADP-ribose) polymerase (PARP) inhibitor veliparib to combination chemotherapy. The trial did not meet its primary endpoint.1 Hyo Sook Han, MD, of Moffitt...
Tumor-Infiltrating Lymphocytes Prognostic in the Metastatic and Neoadjuvant Breast Cancer Settings
Studies presented at the 2016 San Antonio Breast Cancer Symposium added to growing evidence that tumor-infiltrating lymphocytes are important prognostic factors in breast cancer. One investigation evaluated their impact in advanced HER2-positive breast cancer, finding a linear relationship between...
What Have We Got to Lose?
Tuesday morning was the regular time for the departmental meeting—an opportunity to discuss cases, troubleshoot, debrief, and expedite the necessary allied health referrals. As usual, patient cases were being discussed in alphabetical order of the attending oncologist. We were already three...
Vitamin D and Cancer: A Uniform Dose Is Unlikely to Fit All Patients
Technically, vitamin D is a secosteroid hormone, not a vitamin. Increasing evidence indicates that vitamin D exerts effects beyond calcium homeostasis. Importantly, for example, higher serum vitamin D levels are associated with better cancer outcomes, including survival.1-3 The protective effects...
Addressing Discrimination and Bias in Medical Education
“As a medical student, I often felt marginalized from my medical community. I have been told that my name is ‘not American,’ fallen prey to being confused for support staff such as a janitor (even while wearing my white coat) and been asked questions like, ‘Where are you really from?’ or ‘How old...
PARP Inhibitor Niraparib Yields ‘Unprecedented’ Results in Ovarian Cancer in Phase III Trial
The first phase III trial of an inhibitor of poly (ADP-ribose) polymerase (PARP) yielded unprecedented results in treating ovarian cancer. The trial was presented at the European Society for Medical Oncology (ESMO) in Copenhagen, Denmark, and electronically reported concurrently in The New England ...
Niraparib Maintenance Improves Progression-Free Survival in Platinum-Sensitive Recurrent Ovarian Cancer
In a phase III trial (ENGOT-OV16/NOVA) reported at the 2016 ESMO (European Society for Medical Oncology) Congress and in The New England Journal of Medicine by Mansoor R. Mirza, MD, of the Rigshospitalet–Copenhagen University Hospital, and colleagues, maintenance therapy with the PARP (poly...
Diamonds Are Forever, Tyrosine Kinase Inhibitors Are Not?
Sir Donald Munger: “You have been on holiday, I understand. Relaxing, I hope?” James Bond: “Oh, hardly relaxing, but most satisfying.” (Diamonds Are Forever) As tyrosine kinase inhibitors became the mainstay of therapy for patients with chronic myeloid leukemia (CML), our assumption has been that...
Falls in Older Patients With Cancer: Recognizing and Reducing the Risk
In older patients, a current or previous cancer diagnosis confers a 15% to 20% greater risk of suffering a fall.1 Defined as an “unexpected event in which the participant comes to rest on the ground, floor, or lower level,” a fall occurs in 30% to 50% of cancer patients 65 years of age or...
Nivolumab in Squamous Cell Carcinoma of the Head and Neck in CheckMate 141: Game Not Over
Most patients with squamous cell carcinoma of the head and neck present with locally advanced disease. With combined-modality approaches, the chance of cure ranges from < 50% to up to 80%, depending on the site, stage, and other risk factors, such as human papillomavirus (HPV) status. When...
Nivolumab Improves Overall Survival in Recurrent Platinum-Refractory Squamous Cell Carcinoma of the Head and Neck
In the phase III CheckMate 141 trial reported in The New England Journal of Medicine, Robert L. Ferris, MD, PhD, of the University of Pittsburgh Medical Center and Cancer Institute, and colleagues found that nivolumab (Opdivo) increased overall survival vs standard therapies in patients with...
Optimizing Access to Fertility Preservation Options
Ensuring that people with cancer understand how cancer treatment could affect their fertility and what options are available for preserving fertility were widely recognized as top priorities by attendees of the 2016 Oncofertility Conference in Chicago. As detailed at the conference, means of...
Expert Point of View: Philip McCarthy, MD
The ASCO Post asked Philip McCarthy, MD, Professor of Oncology and Internal Medicine at Roswell Park Cancer, Buffalo, and Director of the Blood and Marrow Transplant Center there, to comment on these study findings. He first addressed the need to study earlier intervention for smoldering ...
High Response Rates to Triplet Therapy in Smoldering Myeloma
High-risk patients with smoldering multiple myeloma responded to a regimen of elotuzumab (Empliciti), lenalidomide (Revlimid), and dexamethasone, in a multicenter phase II study led by Irene Ghobrial, MD, of Dana-Farber Cancer Institute, Boston.1 “The high response rates among this patient...
Pertuzumab, Trastuzumab, Plus Aromatase Inhibitor Beneficial in Metastatic Breast Cancer
In the phase II PERTAIN study of locally advanced or metastatic hormone receptor–positive, HER2-positive breast cancer patients, the addition of pertuzumab (Perjeta) to a regimen of trastuzumab (Herceptin) and an aromatase inhibitor in the first-line setting significantly improved progression-free ...
Osimertinib Significantly Improves Survival for Patients With Non–Small Cell Lung Cancer
For patients with epidermal growth factor receptor (EGFR) T790M–positive non–small cell lung cancer (NSCLC), osimertinib (Tagrisso) demonstrated clinically superior efficacy over pemetrexed (Alimta) plus a platinum agent, with a 70% reduction in the risk of disease progression, according to the...
What Precisely Is Precision Oncology—and Will It Work?
We know from chaos theory that even if you had a perfect model of the world, you’d need infinite precision in order to predict future events. —Nassim Nicholas Taleb The term “precision oncology” is used to describe diverse strategies in cancer medicine ranging from the use of targeted therapies...
Lu-177 Dotatate Improves Progression-Free Survival in Midgut Neuroendocrine Tumors
In a phase III trial (NETTER-1) reported in The New England Journal of Medicine, Strosberg et al found that the addition of the targeted radiotherapeutic agent lutetium Lu-177 dotatate to octreotide long-acting repeatable (LAR) (Sandostatin LAR) significantly improved progression-free...
Fear of Diagnostic Low-Dose Radiation Exposure May Be Overstated, Experts Assert
In an article published by Siegel et al in The Journal of Nuclear Medicine, researchers assert that exposure to medical radiation does not increase a person’s risk of getting cancer. The long-held belief that even low doses of radiation, such as those received in diagnostic imaging, increase...
Case Report of Regression of Glioblastoma After Chimeric Antigen Receptor T-Cell Therapy
In a brief report in The New England Journal of Medicine, Brown et al described regression of glioblastoma after chimeric antigen receptor (CAR) T-cell therapy. A 50-year-old patient with recurrent multifocal glioblastoma after tumor resection, radiation therapy, and temozolomide was treated with...
Colonoscopy Screening in Older Adults
A large population-based observational study by Xabier García-Albéniz, MD, PhD, of the Harvard T.H. Chan School of Public Health, and colleagues evaluating the effectiveness and safety of screening colonoscopy for the prevention of colorectal cancer in people aged 70 to 74 and 75 to 79 has found...
Study Suggests No Evidence for Screening Mammography Cutoff Age
An analysis of data from nearly 6 million screening mammograms found no evidence for a clear cutoff age to stop breast cancer screening. Screening mammography among women aged 75 years was associated with higher cancer detection and lower recall rates than among younger women in the study. These...
Co-occurrence of Cancer and Cognitive Impairment in Older Adults
The prevalence of both cancer and cognitive impairment increases with age.1-3 Based upon Surveillance, Epidemiology, and End Results (SEER)-Medicare studies, it is estimated that 3% to 7% of patients with cancer aged ≥ 65 also suffer from dementia, although the true prevalence of dementia in this...
Mutational Characteristics of Chemotherapy-Treated Bladder Urothelial Neoplasms
Radical cystectomy with urinary diversion is the standard of care for muscle invasive bladder cancer.1 Meta-analyses of prospective data have shown a 5% overall survival benefit at 5 years for those receiving neoadjuvant systemic chemotherapy prior to cystectomy.2,3 We currently know of two...
Confirmation or Transformation? The Case of Palbociclib in Hormone Receptor–Positive Metastatic Breast Cancer
Women with hormone receptor–positive metastatic breast cancer are witnessing an unprecedented time of success in the battle against their disease. Just in the past 12 months, a number of prospective, randomized, phase III studies were reported, with positive results indicating the value of...
Addition of Palbociclib to Letrozole in Previously Untreated Advanced Estrogen Receptor–Positive, HER2-Negative Breast Cancer
In the phase III PALOMA-2 trial reported in The New England Journal of Medicine, Richard S. Finn, MD, of the David Geffen School of Medicine at the University of California, Los Angeles, and colleagues found that the addition of palbociclib (Ibrance) to letrozole significantly improved...
Expert Point of View: Sergio A. Giralt, MD
Sergio A. Giralt, MD, Chief of the Adult Bone Marrow Transplant Service at Memorial Sloan Kettering Cancer Center, New York, and the Melvin Berlin Family Chair in Multiple Myeloma, commented on the findings of the StaMINA trial for The ASCO Post. He said the results of the largest randomized U.S....
Women in Oncology: Breaking Down Barriers and Looking to the Future
There has been no better time than the present for women in the field of oncology: Women at all stages of their careers are finding more opportunities and avenues to excel. At the time of the last ASCO workforce survey, women made up 28.4% of the oncologist workforce, and that proportion is rising...
T-Cell Transfer Therapy Targets Mutant KRAS in Metastatic Colorectal Cancer
In a case report in The New England Journal of Medicine, Tran et al at the National Cancer Institute describe response to adoptive transfer of ex vivo expanded tumor-infiltrating lymphocytes containing T cells targeting personalized cancer neoepitopes in a patient with lung metastases from...
Osimertinib Improves Progression-Free Survival vs Platinum/Pemetrexed in EGFR T790M–Positive NSCLC
In the phase III AURA3 trial reported in The New England Journal of Medicineby Mok et al, osimertinib (Tagrisso) significantly improved progression-free survival (PFS) vs platinum/pemetrexed (Alimta) among patients with epidermal growth factor receptor (EGFR) T790M–positive non–small...
