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immunotherapy
multiple myeloma

Multiple Myeloma Pipeline Filled With CAR T-Cell Therapies

The burgeoning pipeline of chimeric antigen receptor (CAR) T-cell therapies targeting B-cell maturation antigen (BCMA) in multiple myeloma was on full display at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. A bispecific antibody also made its debut in this busy...

breast cancer

Small Differences Found in Breast Cancer Recurrence With Partial-Breast vs Whole-Breast Irradiation

Partial-breast irradiation delivered over 5 to 10 days did not meet noninferiority criteria compared with whole-breast irradiation given over 5 to 7 weeks, according to 10-year results of the large NRG (NSABP B-39/RTOG 0413) trial presented at the 2018 San Antonio Breast Cancer Symposium.1 However, ...

hepatobiliary cancer

Ramucirumab in Sorafenib-Pretreated Patients With Advanced HCC and Increased α-Fetoprotein

In the phase III REACH-2 trial reported in The Lancet Oncology, Zhu et al found that ramucirumab improved overall and progression-free survival vs placebo in patients with advanced hepatocellular carcinoma (HCC) and increased α-fetoprotein levels who had previously received sorafenib. Study...

lung cancer
immunotherapy

Nivolumab or Nivolumab Plus Ipilimumab in Relapsed Malignant Pleural Mesothelioma

In a French phase II trial reported in The Lancet Oncology, Scherpereel et al found evidence of activity with nivolumab or the combination of nivolumab plus ipilimumab in patients with relapsed malignant pleural mesothelioma. Study Details In the open-label, noncomparative trial, 125 patients...

lung cancer
immunotherapy

Avelumab in Previously Treated Advanced Unresectable Mesothelioma

In a phase Ib trial reported in JAMA Oncology, Hassan et al found that the anti–programmed cell death ligand 1 antibody avelumab produced durable responses and a high rate of disease control in some patients with advanced unresectable mesothelioma progressing after platinum and pemetrexed...

leukemia
lymphoma

FDA Approves Ibrutinib in Combination With Obinutuzumab in Treatment-Naive CLL/SLL

Today, the U.S. Food and Drug Administration (FDA) approved ibrutinib (Imbruvica), a Bruton's tyrosine kinase inhibitor, in combination with obinutuzumab in treatment-naive patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). This is the first approval of a...

leukemia
myelodysplastic syndromes

Combination Azacitidine and Lenalidomide as Salvage Therapy for Relapsed AML After Allogeneic Stem Cell Transplantation

In a phase I trial reported in the Journal of Clinical Oncology, Craddock et al found evidence that the sequential combination of azacitidine and lenalidomide may be an effective salvage therapy in patients with acute myeloid leukemia (AML) relapsing after allogeneic stem cell transplantation...

colorectal cancer

Polymorphisms in Pattern Recognition Receptors as Predictors of Oxaliplatin Benefit in Colorectal Cancer

In a study reported in the Journal of the National Cancer Institute, Gray et al found that constitutional loss of function single-nucleotide polymorphisms in the pattern recognition receptors FPR1, TLR3, and TLR4 were not associated with preferential benefit of oxaliplatin in colorectal cancer. As...

Georgia Society of Clinical Oncology, Other Medical Associations Win Concessions in CVS/Aetna Merger

THE GEORGIA SOCIETY of Clinical Oncology (GASCO), in partnership with the Medical Association of Georgia, the Georgia Pharmacy Association, and Georgia Watch, worked with the Georgia Office of the Insurance Commissioner to secure what is described as “significant, one-of-a-kind concessions” from...

leukemia

Use of Isocitrate Dehydrogenase Inhibitors in Induction Therapy for Newly Diagnosed AML

IN AN OPEN-LABEL phase I study of 153 patients newly diagnosed with acute myeloid leukemia (AML) and mutations in isocitrate dehydrogenase-1 (IDH1) or IDH2, treatment with standard chemotherapy plus the oral IDH inhibitors ivosidenib and enasidenib led to high response rates and possibly impressive ...

leukemia

BEAT AML Umbrella Trial: Bringing Personalized Medicine to Acute Myeloid Leukemia

THE MULTIARM, multicollaborative BEAT AML umbrella trial demonstrated the feasibility of using next-generation sequencing to assign treatment tailored to individual genomics of elderly patients with acute myeloid leukemia (AML) within 7 days. This may prove to be a major advance, since typically...

breast cancer
symptom management

Oxybutynin: A Novel Option for Managing Hot Flashes?

OXYBUTYNIN, AN ANTICHOLINERGIC drug approved for the treatment of overactive bladder, reduced the frequency and intensity of hot flashes in women who were suffering frequent hot flashes, including breast cancer survivors who were receiving tamoxifen or aromatase inhibitors. These results of the...

immunotherapy
lung cancer

PACIFIC Trial of Durvalumab Sets Standard in Stage III Unresectable NSCLC

IMMUNOTHERAPY HAS revolutionized the treatment of lung cancer over the past several years. Although lung cancer is associated with immunosuppression at baseline for most patients, the addition of immune checkpoint inhibitors can overcome that suppression and lead to antitumor immune responses....

issues in oncology
global cancer care

Patient Navigation Program Reduces Time to Cancer Treatment

The 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 Yanin...

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,...

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