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Refocusing Doctor-Patient Conversations

BOOKMARK Title: What Patients Say, What Doctors HearAuthor: Danielle Ofri, MDPublisher: Beacon PressPublication date: February 2017Price: $24.95, hardcover, 288 pages Despite our scientific and medical advances, the single most important diagnostic tool is the doctor-patient conversation, which is ...

The Serendipitous Road to Drug Development

BOOKMARK Title: The Drug Hunters: The Improbable Quest to Discover New MedicinesAuthors: Donald R. Kirsch, PhD, and Ogi Ogas, PhDPublisher: Arcade PublishingPublication date: January 2017Price: $24.99, hardcover, 328 pages Only about 1 in 100 drug discovery projects initiated by the pharmaceutical ...

leukemia

Clofarabine-Based Consolidation in Younger Patients With AML

In a French randomized phase II trial reported in the Journal of Clinical Oncology, Thomas et al found that clofarabine-based consolidation may provide improved relapse-free survival vs conventional high-dose cytarabine in postremission treatment in younger patients with acute myeloid leukemia...

breast cancer

Anthracyclines in HER2-Negative Breast Cancer

As reported by Joanne L. Blum, MD, PhD, of Baylor University Medical Center, Texas Oncology, and colleagues in the Journal of Clinical Oncology, the efficacy analysis of the combined adjuvant Anthracyclines in Early Breast Cancer (ABC) Trials showed better invasive disease-free survival with taxane ...

Fred & Pamela Buffett Cancer Center Dedicated at UNMC

The University of Nebraska Medical Center (UNMC) and its clinical partner, Nebraska Medicine, has officially dedicated the new Fred & Pamela Buffett Cancer Center in Omaha. Joe Biden, the former two-term Vice President who headed a national Cancer Moonshot Task Force, served as keynote speaker...

prostate cancer

Ipilimumab vs Placebo in Metastatic Chemotherapy-Naive, Castration-Resistant Prostate Cancer Without Visceral Metastases

In the phase III CA184-095trial reported in the Journal of Clinical Oncology, Tomasz M. Beer, MD, FACP, of the Knight Cancer Institute, Oregon Health and Science University, and colleagues found that ipilimumab (Yervoy) did not increase overall survival vs placebo in men with asymptomatic or...

prostate cancer

Androgen Blockade and Salvage ­Radiation Therapy in Prostate Cancer: Cautious Optimism Amid Unanswered Questions

The recent report of results of RTOG 9601 by Shipley et al in The New England Journal of Medicine1—reviewed in this issue of The ASCO Post—strongly supports the variably used practice of adding “androgen blockade” to salvage radiation therapy in men with a rising prostate-specific antigen (PSA)...

prostate cancer

Survival Benefit of Adding Antiandrogen Therapy to Radiation in Recurrent Prostate Cancer: Final Results of RTOG 9601

As reported in The New England Journal of Medicine by W.U. Shipley, MD, of Massachusetts General Hospital and Harvard Medical School, and colleagues in the NRG Oncology Radiation Therapy Oncology Group (RTOG), the final analysis of the phase III RTOG 9601 trial shows that the addition of...

lung cancer

Atezolizumab: Another Therapeutic Option for Patients With Previously Treated Non–Small Cell Lung Cancer

The OAK study—recently reported by Rittmeyer and colleagues and reviewed in this issue of The ASCO Post—is the first study to show patients with previously treated non–small cell lung cancer (NSCLC) treated with a humanized antibody (atezolizumab, Tecentriq) directed against the programmed cell...

lung cancer

Atezolizumab Improves Overall Survival vs Docetaxel in Previously Treated Non–Small Cell Lung Cancer

In the phase III OAK trial reported in The Lancet by Achim Rittmeyer, MD, of Lungenfachklinik Immenhausen, Germany, and colleagues, treatment with the anti–programmed cell death ligand 1 (PD-L1) antibody atezolizumab (Tecentriq) improved overall survival vs docetaxel in previously treated non–small ...

multiple myeloma

Autologous Transplantation for Myeloma: Don’t Change the Winning Team

Over the past 20 years, the Intergroupe Francophone du Myelome (IFM) and Dr. Michel Attal have pioneered the use of autologous hematopoietic cell transplantation (AHCT) for multiple myeloma in a series of randomized studies. Notable studies include comparisons of planned upfront AHCT vs...

multiple myeloma

Lenalidomide, Bortezomib, and Dexamethasone With or Without Transplantation in Younger Myeloma Patients

In the French phase III IFM 2009 trial reported in The New England Journal of Medicine by Michel Attal, MD, of the Institut Universitaire du Cancer de Toulouse-Oncopole, and colleagues, consolidation treatment with lenalidomide (Revlimid), bortezomib (Velcade), and dexamethasone (RVD) was...

Brian Wolpin, MD, MPH, Named Director of Gastrointestinal Cancer Center at Dana-Farber

Brian Wolpin, MD, MPH, has been named the new Director of the Gastrointestinal Cancer Center at Dana-Farber Cancer Institute. Dr. Wolpin is Associate Professor of Medicine at Harvard Medical School and was appointed earlier this year as the Robert T. and Judith B. Hale Chair in Pancreatic Cancer...

cns cancers

Combinations of Novel Treatment Approaches Continue to Make Progress in Overcoming Challenges of Pediatric Brain Tumors

Nearly 2,500 children in the United States are diagnosed with brain tumors each year, making these malignancies among the most common solid tumors in children and adolescents. Despite advances over the past few decades, the treatment of brain tumors remains one of the most challenging clinical...

geriatric oncology
global cancer care

Geriatric Oncology: A Multidisciplinary Approach in a Global Environment

Geriatrics for the Oncologist is guest edited by Stuart M. Lichtman, MD, FACP, FASCO, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Dr. Lichtman is an Attending Physician at Memorial Sloan Kettering Cancer Center, Commack, New York, and Professor of...

lung cancer

Combination Therapy With Pembrolizumab in Metastatic Nonsquamous NSCLC

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.  On May 10, 2017, pembrolizumab (Keytruda) was granted accelerated...

lung cancer

FDA Broadens Ceritinib Indication

On May 26, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to ceritinib (Zykadia), a kinase inhibitor for patients with metastatic non–small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)-positive as detected by an FDA-approved test. In April...

multiple myeloma

Selected Novel Agents in Development for Multiple Myeloma

Here are several abstracts selected from the proceedings of the 2016 America Society of Hematology (ASH) Annual Meeting & Exposition, highlighting newer therapeutics for the development for patients with relapsed or refractory multiple myeloma. For full details of these study abstracts, visit...

breast cancer

Targeting the Androgen Receptor in Breast Cancer

One of the most active areas of research in breast cancer involves the targeting of the androgen receptor. Trials underway for androgen receptor antagonists and modulators, alone and in various combinations of available agents and novel therapies, are yielding encouraging early results. At the 2017 ...

breast cancer

Expert Point of View: Michael Berry, MD

Michael Berry, MD, a breast surgeon who is Director of the Margaret West Comprehensive Breast Center at The West Cancer Center, Memphis, told the The ASCO Post that these findings “echo what surgeons already know,” which is that lymphedema is a result of multiple insults to the axilla. But one...

breast cancer
symptom management

Lymphedema Risk: It’s Not Just About the Surgery

In a study from the Mayo Clinic, Rochester, Minnesota, the risk of lymphedema in a population-based breast cancer cohort was related to multimodality therapy and not axillary surgery alone, investigators reported at the American Society of Breast Surgeons (ASBrS) Annual Meeting.1 “Most patients...

head and neck cancer
survivorship

Optimizing Quality of Life in Head and Neck Cancer Survivors

Head and neck cancer can take away a patient’s “right to feel human,” and its impact on physical appearance, physical functioning, and general quality of life can be devastating, according to Merry Sebelik, MD, Associate Professor of Head and Neck Surgery at Emory University in Atlanta. At a...

head and neck cancer

Targeted Therapy in the Age of Immunotherapy in Head and Neck Cancer

The impact of targeted therapies in head and neck cancer has been limited, but we can strategize to integrate the development of targeted and immunotherapeutic agents, according to Christine H. Chung, MD, Senior Member and Chair in the Department of Head and Neck-Endocrine Oncology at Moffitt...

head and neck cancer

New Horizons in Immunotherapy for Head and Neck Cancer

Immunotherapy is a new treatment paradigm in recurrent metastatic head and neck cancer, according to Nabil F. Saba, MD. At a symposium hosted by the Winship Cancer Institute and Emory University—Updates in the Management of Head and Neck Cancer—Dr. Saba discussed current research and new...

hematologic malignancies
leukemia

Idelalisib Toxicities Appear to Be Immune-Related

Phosphoinositide 3-kinase (PI3K) inhibitors represent a highly active class of drug for the treatment of chronic lymphocytic leukemia (CLL). Idelalisib (Zydelig), a PI3K-delta inhibitor and the first PI3K inhibitor to be approved by the U.S. Food and Drug Administration (FDA) for CLL, has...

leukemia

Venetoclax Achieves Durable and Deep Remissions in CLL

Preliminary study results suggest that venetoclax (Venclexta) plus rituximab (Rituxan) is a highly active combination in relapsed/refractory chronic lymphocytic leukemia (CLL), achieving durable responses and minimal residual disease negativity in previously treated patients. “The results of our...

solid tumors
colorectal cancer

FDA Approves Pembrolizumab for First Tissue/Site-Agnostic Indication

On May 23, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for adult and pediatric patients with unresectable or metastatic, microsatellite instability–high (MSI-H) or mismatch repair deficient (dMMR) solid tumors that have progressed...

colorectal cancer

Expert Point of View: Manish Shah, MD and Daniel F. Hayes, MD, FACP, FASCO

Manish Shah, MD, Director of Gastrointestinal Oncology at NewYork-Presbyterian and Weill Cornell Medicine, was impressed with the findings of the two subanalyses of CALGB 89803.  “The study found a 46% reduction in the risk of recurrence with two servings of tree nuts a week, and that’s more than ...

colorectal cancer

Tree Nut Consumption May Improve Outcomes in Stage III Colon Cancer

Tree nut consumption, as well as a generally healthy lifestyle, significantly reduced the risk of cancer recurrence and death in patients with stage III colon cancer treated in the Cancer and Leukemia Group B (CALGB) 89803 trial, researchers reported at the 2017 ASCO Annual Meeting. Two subanalyses ...

breast cancer

ASCO 2017: I-SPY 2 Trial: Combination of Pembrolizumab Plus Standard Neoadjuvant Therapy in High-Risk Breast Cancer

At the 2017 ASCO Annual Meeting, results were presented from the phase II I-SPY 2 trial investigating pembrolizumab (Keytruda) in combination with standard therapy (paclitaxel followed by doxorubicin and cyclophosphamide) as a neoadjuvant treatment for patients with locally advanced triple-negative ...

pain management

FDA Requests Removal of Oxymorphone Hydrochloride for Risks Related to Abuse

On June 8,the U.S. Food and Drug Administration (FDA) requested that Endo Pharmaceuticals remove its opioid pain medication, reformulated oxymorphone hydrochloride (Opana ER), from the market. After careful consideration, the agency is seeking removal based on its concern that the benefits of the...

hematologic malignancies

ASCO 2017: Ibrutinib Plus Cellular Therapy CTL119 May Lead to Complete Remissions in CLL

Combining the kinase inhibitor ibrutinib (Imbruvica) with an investigational personalized cellular therapy known as CTL119 can lead to complete remission in patients with high-risk chronic lymphocytic leukemia (CLL), according to new research from the Perelman School of Medicine at the University...

lung cancer

ALEX Trial: Alectinib vs Crizotinib in Untreated Advanced ALK-Positive NSCLC

As reported at the recent ASCO Annual Meeting and in The New England Journal of Medicine by Peters et al, the phase III ALEX trial has shown improvement in progression-free survival with alectinib (Alecensa) vs crizotinib (Xalkori) in the first-line treatment of advanced ALK-positive...

skin cancer

ASCO 2017: Higher Gut Bacteria Diversity Tied to Slower Metastatic Melanoma Progression

The blend of bacteria in the digestive tract of metastatic melanoma patients is associated with disease progression or delay in patients treated with immunotherapy, reported Wargo et al at the 2017 ASCO Annual Meeting (Abstract 3008). Their study of fecal samples from 105 patients treated with...

bladder cancer

European Commission Approves Nivolumab for Previously Treated, Locally Advanced, Unresectable or Metastatic Urothelial Cancer

On June 2, the European Commission (EC) approved nivolumab (Opdivo) for the treatment of locally advanced unresectable or metastatic urothelial carcinoma in adults after failure of prior platinum-containing therapy. This makes nivolumab the first immuno-oncology agent approved in the European Union ...

lung cancer

Adjuvant Gefitinib Delays Recurrence in EGFR-Positive NSCLC

Adjuvant therapy with gefitinib (Iressa), an epidermal growth factor receptor (EGFR)-targeted agent, was more successful at preventing recurrence than standard-of-care chemotherapy, in a phase III study of patients with EGFR-positive non–small cell lung cancer (NSCLC).1 Gefitinib extended...

pancreatic cancer

ASCO 2017: Adding PEGPH20 to Standard Treatment in Metastatic Pancreatic Cancer May Delay Disease Progression

By adding an experimental drug to a standard chemotherapy regimen, a subset of patients with metastatic pancreatic cancer had a significantly longer period before the cancer progressed as compared with those who received the standard treatment, according to a phase II clinical trial led by an...

cost of care

ASCO 2017: Implementing Cost Transparency in Oncology

Being transparent about the cost of cancer treatments with patients has been increasingly recommended to help minimize financial harm and improve care, but what's preventing or derailing those conversations is less understood. New findings from Penn Medicine that identified several barriers and key ...

issues in oncology
cost of care
symptom management

ASCO 2017: Many Emergency Department Visits Among Patients With Cancer Appear Preventable

Among patients with cancer, as many as 53% of emergency department visits that do not require admission could be avoided with better symptom management and greater availability of outpatient care tailored to their needs, according to a new study from Fred Hutchinson Cancer...

colorectal cancer

ASCO 2017: Impact of Patient Age on Molecular Alterations in Colorectal Tumors

Younger patients with colon cancer appear to have more than three times as many mutations in their tumors as older patients, which could lead to more effective treatment decisions, according to researchers at Georgetown Lombardi Comprehensive Cancer Center. In a new study, they found that tumor...

solid tumors
lymphoma
multiple myeloma

ASCO's TAPUR Study Continues Its Expansion of Sites, Participants, and Collaborators

ASCO’s Targeted Agent and Profiling Utilization Registry (TAPUR) Study continues to expand and now has more than 300 participants enrolled on study drug, more than 100 sites, new partnerships, and a revised protocol to lower the age of eligibility. “We are very pleased with the...

gynecologic cancers

Tumor Microvessel Density and Outcome With Bevacizumab in Ovarian Cancer

A retrospective biomarker analysis of the phase III GOG-0218 trial indicated a higher tumor microvessel density was associated with progression-free and overall survival benefit with bevacizumab (Avastin) vs placebo plus front-line chemotherapy in patients with ovarian cancer. These findings were...

cns cancers

Dinutuximab vs Temsirolimus in Combination Therapy for Children With Refractory or Relapsed Neuroblastoma

A randomized phase II trial (Children’s Oncology Group [COG] ANBL1221) has resulted in the selection of dinutuximab (Unituxin) plus irinotecan/temozolomide as a regimen to be further evaluated in the treatment of pediatric patients with refractory or relapsed neuroblastoma. Study results were ...

prostate cancer

T2:ERG and PCA3 RNA Urinary Testing for Detecting Aggressive Prostate Cancer

Combined testing for urinary PCA3 and TMPRSS2:ERG (T2:ERG) RNA may increase accuracy in identifying the risk for aggressive early prostate cancer, according to a study reported in JAMA Oncology by Sanda et al in the EDRN-PCA3 Study Group. Study Details The study involved 516 development cohort...

lung cancer

Effect of Previous Radiotherapy on Outcome With Pembrolizumab in NSCLC

In a single-site experience reported in The Lancet Oncology by Shaverdian et al, patients with advanced non–small cell lung cancer (NSCLC) in the phase I KEYNOTE-001 trial of pembrolizumab (Keytruda) were found to have better outcomes if they had received prior radiotherapy. Study Details...

lung cancer

ASCO 2017: Research Suggests Possible New Treatment for EGFR-Positive Lung Cancer

Findings from a phase III clinical trial point to a potential new treatment for patients newly diagnosed with advanced, epidermal growth factor receptor (EGFR)-positive non–small cell lung cancer (NSCLC). Compared to the EGFR inhibitor gefitinib (Iressa), one of the standard targeted...

lung cancer

ASCO 2017: Early Research Suggests First Immunotherapy for Mesothelioma on the Horizon

Malignant pleural mesothelioma is a rare cancer, but its incidence has been rising. This cancer is usually associated with asbestos exposure, and patients have a median life expectancy of only 13 to 15 months. All patients relapse despite initial chemotherapy, more than 50% of them within 6 months...

multiple myeloma

ASCO 2017: BCMA-Specific CAR T-Cell Therapy Sends Relapsed/Refractory Multiple Myeloma Into Lasting Remission in an Early Trial

In an early clinical trial, 33 out of 35 (94%) patients had clinical remission of multiple myeloma upon receiving immunotherapy with chimeric antigen receptor (CAR) T cells targeting B-cell maturation protein, or BCMA. Most patients had only mild side effects. The study was presented by Fan et al...

lung cancer

ASCO 2017: ALEX Study: Alectinib Halts Lung Cancer Growth More Than a Year Longer Than Crizotinib

Findings from a phase III clinical trial point to a more effective initial treatment for patients with ALK-positive non–small cell lung cancer (NSCLC). Compared to the current standard of care, crizotinib (Xalkori), the newer ALK inhibitor alectinib (Alecensa) halted cancer growth for a...

breast cancer

OlympiAD Trial: Olaparib in Metastatic Breast Cancer With Germline BRCA Mutation

As reported in the Plenary Session at the 2017 ASCO Annual Meeting and in The New England Journal of Medicine by Robson et al, the phase III OlympiAD trial showed that the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib (Lynparza) prolonged progression-free survival vs standard therapy in...

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