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hematologic malignancies

Recent Clinical Trials in Hematopoietic Cell Transplantation Setting for Hematologic Malignancies

Here is a brief look at the study findings and clinical implications of several recent and important clinical trials in neoplastic hematology. Attention is focused on hematopoietic cell transplantation in a variety of hematologic malignancies, with investigations addressing the role of maintenance ...

survivorship
lymphoma

Life After Treatment: Managing Lymphoma Survivors

According to Surveillance, Epidemiology, and End Results (SEER) data, patients with Hodgkin lymphoma and non-Hodgkin lymphoma (NHL) have 5-year survival rates of 86% and 71%, respectively.1 Although the increased number of survivors is welcome proof of the success of new treatment regimens, it also ...

multiple myeloma

Management of Newly Diagnosed Multiple Myeloma in Transplant-Eligible Patients

The treatment paradigm for multiple myeloma has changed dramatically in the past decade with the availability of several efficacious agents in various drug classes. At the National Comprehensive Cancer Network® (NCCN®) 13th Annual Congress: Hematologic Malignancies™, Shaji K. Kumar, MD, Professor...

leukemia

Immunotherapeutic Approaches for B-Cell Acute Lymphocytic Leukemia

New therapeutic agents for acute lymphocytic leukemia (ALL) have led to dramatic improvement in remission rates, but questions concerning the proper sequencing and combination of these agents remain. At the National Comprehensive Cancer Network® (NCCN®) 13th Annual Congress: Hematologic...

2017 Palliative Care in Oncology Symposium

The 2017 Palliative Care in Oncology Symposium took place October 27–28 in San Diego. Photos shown here, from left to right, as follows: 1. Eduardo Bruera, MD, of The University of Texas MD Anderson Cancer Center leads a group of attendees on a poster walk and discussion; 2. Charles Loprinzi, MD,...

supportive care
palliative care

How Effective Communication Is Integral to Patient-Centered Care

Communicating effectively with patients with advanced cancer not only helps patients and their family members successfully transition to palliative and end-of-life care, it can prevent physicians from experiencing professional burnout, according to Robert M. Arnold, MD, Distinguished Service...

First ESMO Award for Immuno-Oncology Presented to Laurence Zitvogel, MD, PhD

The European Society for Medical Oncology (ESMO) has granted the newly established ESMO Award for Immuno-Oncology to Laurence Zitvogel, MD, PhD, for her innovating and internationally recognized achievements in the field. Dr. Zitvogel is Professor of Immunobiology at the University of Paris XI...

head and neck cancer

EXPERT POINT OF VIEW: Sandrine Faivre, MD, PhD

Commenting on these study results, formal discussant Sandrine Faivre, MD, PhD, of Bichat-Beaujon University Hospitals Paris Nord Val de Seine, Paris, France, said: “It is a challenge to identify patients who we should allow to remain on immune checkpoint inhibitor treatment. In KEYNOTE-040, the...

head and neck cancer

Pembrolizumab Benefits Patients With Recurrent Metastatic Head and Neck Cancer, Mainly High PD-L1–Expressing Tumors

Pembrolizumab (Keytruda) may be a better choice than standard of care for patients with recurrent or metastatic head and neck squamous cell carcinoma, especially those whose tumors express programmed cell death ligand 1 (PD-L1) in 50% or more of cells, suggest results of the phase III KEYNOTE-040...

pancreatic cancer

Resectable Pancreatic Cancer: Neoadjuvant or Adjuvant Therapy?

For potentially curable treatment of resectable pancreatic cancer, adjuvant therapy remains the standard “for now,” but evidence is growing that neoadjuvant therapy may be more beneficial, at least in certain patient subsets, according to Thomas Seufferlein, MD, PhD, Professor of Medicine at the...

breast cancer
gynecologic cancers

More Data From ESMO 2017

In GEICAM 2006-10, the addition of fulvestrant at 250 mg/d to anastrozole did not improve 5-year disease-free survival over anastrozole alone (91.0% vs 90.8%).  “Immune induction” with chemotherapy or radiotherapy appeared to enhance response to nivolumab in women with metastatic triple-negative...

breast cancer
gynecologic cancers

International Trials Reveal New Findings in the Management of Breast and Ovarian Cancers

The European Society for Medical Oncology (ESMO) 2017 Congress, held in Madrid, featured important news including at least seven practice-changing or potentially practice-changing trials, which are covered in recent issues of The ASCO Post. Here we present additional highlights of studies in breast ...

gastrointestinal cancer

Quick Takes on Studies in Noncolorectal Gastrointestinal Cancers

In this roundup, The ASCO Post offers a glance at key findings from studies in noncolorectal gastrointestinal malignancies presented at the European Society for Medical Oncology (ESMO) 2017 Congress from investigators around the world. Docetaxel-Based Triplet in Gastric Cancer The superiority of...

lymphoma

FDA Approves Novel Therapies for Lymphoma Indications

IN OCTOBER, the U.S. Food and Drug Administration (FDA) approved two novel agents for lymphoma indications: -acalabrutinib (Calquence), a kinase inhibitor, for the treatment of adults with mantle cell lymphoma who have received at least one prior therapy; and axicabtagene ciloleucel (Yescarta), a...

gastrointestinal cancer

EXPERT POINT OF VIEW: Eric Van Cutsem, MD, PhD

Invited discussant Eric Van Cutsem, MD, PhD, of University Hospitals Leuven, Belgium, commented that both ATTRACTION-02 and KEYNOTE-059 suggest that anti-PD [programmed cell death protein] antibodies have activity in advanced gastric cancer, but their findings differed with regard to the impact of ...

gastrointestinal cancer

Anti–PD-1 Agents Gaining Momentum in Gastric Cancer

In updates of two important studies in metastatic gastric cancer reported at the European Society for Medical Oncology (ESMO) 2017 Congress, nivolumab -(Opdivo) and pembrolizumab (Keytruda) demonstrated activity—but to varying degrees and with some nuances. “Anti-PD [programmed cell death protein]...

lung cancer

In Patients With Non–Small Cell Lung Cancer, Tumor Mutation Load Emerging as Biomarker for Immunotherapy

Tumor mutation burden is emerging as a biomarker for selecting non–small cell lung cancer (NSCLC) patients for immunotherapy, according to Naiyer Rizvi, MD, the Price Family Chair of Clinical Translational Medicine, Professor of Medicine, and Director of Thoracic Oncology at Columbia University,...

lung cancer

EXPERT POINT OF VIEW: Balazs Halmos, MD

The study’s invited discussant, Balazs Halmos, MD, Director of Thoracic Oncology and Clinical Cancer Genomics at Montefiore Medical Center and Albert Einstein College of Medicine, New York, called tumor mutation burden a “highly promising” biomarker of response to immune checkpoint inhibitors....

lung cancer

Tumor Mutation Burden Shows Promise as a Response Biomarker in Small Cell Lung Cancer

Patients with small cell lung cancer (SCLC) and a high tumor mutation burden had a near doubling in response rate and 1-year overall survival when ipilimumab (Yervoy) was combined with nivolumab (Opdivo), vs nivolumab alone, new findings from CheckMate 032 have shown. Regardless of the treatment...

lung cancer

No Additional Benefit Found for Routine, Early Palliative Care in Mesothelioma

Early routine specialist palliative care for patients recently diagnosed with malignant pleural mesothelioma did not impact quality of life, an international multicenter study has found.1 “Regular early specialist palliative care for patients was not associated with improved quality of life, as...

lung cancer

EXPERT POINT OF VIEW: Kemp Kernstine, MD, PhD

The study’s invited discussant Kemp Kernstine, MD, PhD, the Robert Tucker Hayes Foundation Distinguished Chair in Cardiothoracic Surgery at The University of Texas Southwestern Medical Center, Dallas, welcomed the findings, but expressed some concerns about the study. To begin, of a database of...

lung cancer

Residual Tumor ‘Uncertain’ Classification Validated in Non–Small Cell Lung Cancer

After surgical resection of non–small cell lung cancer (NSCLC), investigators from the International Association for the Study of Lung Cancer (IASLC) have validated outcomes for tumors deemed to be of “uncertain” residual tumor status (ie, R[un]). “The residual tumor (R) classification reflects the ...

breast cancer

Model Emphasizes Long-Term Risks of Ovarian Ablation Plus Aromatase Inhibitor

“At Microphone 1” is an occasional column written by Steven E. Vogl, MD, of Bronx, New York. When he’s not in his clinic, Dr. Vogl can generally be found at major oncology meetings and often at the microphone, where he stands ready with critical questions for presenters of new data. Here Dr. Vogl...

leukemia

MicroRNA Expression–Based Risk Model for Pediatric Acute Myeloid Leukemia

As reported in the Journal of Clinical Oncology, Lim et al have identified a microRNA expression–based risk model associated with event-free survival in pediatric acute myeloid leukemia (AML). The study involved comprehensive miRNA sequencing of 1,362 pediatric AML samples, consisting of...

solid tumors

Factors Associated With Outcome in Pediatric Adrenocortical Tumors

In a St. Jude Adrenocortical Tumor Registry and Children’s Oncology Group study reported in the Journal of Clinical Oncology, Pinto et al found that a positive Ki67 labeling index was associated with a poorer outcome in children with adrenocortical tumors independent of germline TP53 mutation ...

lung cancer

Novel Tyrosine Kinase Inhibitor for ALK- or ROS1-Rearranged NSCLC

A phase I trial has shown that the ALK and ROS1 tyrosine kinase inhibitor lorlatinib is active in patients with advanced ALK- or ROS1-positive non–small cell lung cancer (NSCLC), including those with central nervous system (CNS) metastases and failure on at least two prior tyrosine kinase...

lung cancer

CHEST 2017: American College of Chest Physicians Unveils New Lung Cancer Screening Guidelines

Low-dose computed tomography (CT) screening for lung cancer has become standard practice, mostly due to the results of the National Lung Screening Trial. Related evidence continues to evolve, informing the benefits and risks of low-dose CT in clinical practice. Mazzone et al presented new ...

lung cancer

CHEST 2017: Gender, Language, and Treatment Setting as Barriers in Screening and Patient Care in Lung Cancer

Two new studies from CHEST 2017, held recently in Toronto, reveal disparities in lung cancer screening and care that may impact detection as well as mortality and survival rates in the disease. Risk Status and Screening The first study from Lahey Hospital and Medical Center in Burlington,...

multiple myeloma

ENDEAVOR Trial Endeavors to Make Case for Carfilzomib: Despite Survival Advantage, Should We Be Surprised?

LOCATION! LOCATION! LOCATION! That’s what home buyers are frequently cautioned about before purchasing a property. For trialists, and more importantly, practicing oncologists, a study’s design, akin to a property’s location, must be taken into account prior to buying into the results and changing ...

lung cancer

EXPERT POINT OF VIEW: Joan H. Schiller, MD

JOAN H. SCHILLER, MD, Deputy Director of Inova Schar Cancer Institute in Fairfax, Virginia, pointed out that no one particular chemotherapy regimen has been shown to improve overall survival vs other standard regimens. “So if we can’t identify one best chemotherapy, what else can we do to make...

lung cancer

Treatment Based on BRCA1 Expression Did Not Improve Survival in NSCLC

IN PATIENTS with early-stage non–small cell lung cancer (NSCLC), the use of expression of BRCA1 failed as an approach to customize chemotherapy, investigators from the Spanish Lung Cancer Cooperative Group reported at the 2017 International Association for the Study of Lung Cancer (IASLC) World...

issues in oncology

Changes in Uninsured Status Among Nonelderly Cancer Patients Under the Affordable Care Act

In a research letter in JAMA Oncology, Soni et al reported reductions in the proportion of nonelderly adult cancer patients who were uninsured between 2010 and 2013 vs 2014, after institution of the Affordable Care Act (ACA). Study Details The study used data from the Surveillance, Epidemiology,...

head and neck cancer

ASCO Endorses ASTRO Guideline on Radiation Therapy for Oropharyngeal Squamous Cell Carcinoma

As reported in the Journal of Clinical Oncology by Harry Quon, MD, of Johns Hopkins University School of Medicine, and colleagues, ASCO has endorsed the recently published American Society for Radiation Oncology (ASTRO) evidence-based clinical practice guideline on radiation therapy for...

multiple myeloma

Results From Phase III ARROW Study of Once-Weekly Carfilzomib in Relapsed/Refractory Multiple Myeloma

On October 23, topline results of the phase III ARROW trial were announced, showing carfilzomib (Kyprolis) administered once weekly at 70 mg/m2 with dexamethasone allowed relapsed and refractory multiple myeloma patients to live 3.6 months longer without their disease worsening than...

skin cancer

Adjuvant Dabrafenib/Trametinib Combination Granted FDA Breakthrough Therapy Designation for Stage III Melanoma With BRAF V600 Mutation

On October 23, Novartis announced that the U.S. Food and Drug Administration (FDA) has granted Breakthrough Therapy designation for dabrafenib (Tafinlar) in combination with trametinib (Mekinist) for the adjuvant treatment of patients with stage III melanoma with a BRAF V600 mutation following...

lung cancer

PanCan Risk Model for Lung Cancer Screening

Results of the Pan-Canadian Early Detection of Lung Cancer (PanCan) study, reported in The Lancet Oncology by Tammemagi et al, indicate that the PanCan risk model is effective in identifying persons found to have early-stage lung cancer on low-dose computed tomography (CT) screening. Study Details ...

breast cancer

Complications and Patient Satisfaction After Breast Reconstruction in Women Receiving Radiotherapy

In a prospective cohort study reported by Jagsi et al in the Journal of the National Cancer Institute, autologous reconstruction was associated with fewer complications and greater patient satisfaction vs implant approaches in women receiving postmastectomy radiotherapy. Study Details The...

survivorship

New Persistent Opioid Use After Curative-Intent Cancer Surgery

A study reported by Lee et al in the Journal of Clinical Oncology indicates that approximately 10% of patients undergoing curative-intent surgery for cancer become new persistent opioid users. Study Details The study involved data from 68,463 patients from a national data set of insurance claims...

hepatobiliary cancer

The Liver Meeting: Daily Aspirin May Reduce Risk for Hepatitis B Virus–Related Liver Cancer

A new study presented at The Liver Meeting, held by the American Association for the Study of Liver Diseases, found that daily aspirin therapy was significantly associated with a reduced risk in hepatitis B virus (HBV)–related liver cancer (Abstract 223). According to AASLD’s...

hepatobiliary cancer

The Liver Meeting: Direct-Acting Antiviral Medications as Hepatitis C Treatment May Reduce Risk of Liver Cancer

A new study presented at The Liver Meeting—held by the American Association for the Study of Liver Diseases—found that eradication of the hepatitis C virus induced by direct-acting antiviral medications is associated with a 71% reduction in the risk of liver cancer (Abstract 142)....

pain management

Jeremy Hirst, MD, on My Patient Needs Opiates and Benzodiazepines: What Should I Do?

Jeremy Hirst, MD, of the University of California, San Diego, offers concrete advice on assessing the need for these medications, using them safely, and knowing when to deprescribe them.

survivorship

Long-Term Survivors of Childhood Cancer Prone to ‘Job Lock’ due to Worries About Losing Health Insurance

The results of a national cancer survey reveal a significant number of childhood cancer survivors are worried about keeping their health insurance, to the point of letting it affect their career decisions. The findings were published by Kirchhoff et al in JAMA Oncology. Anne Kirchhoff, PhD,...

prostate cancer

HSD3B1 Genotype and Outcomes With ADT After Radiotherapy for Localized Prostate Cancer

In a study reported in JAMA Oncology, Hearn et al found that the presence of the HSD3B1 (1245C) allele was associated with more rapid development of metastases in patients receiving androgen-deprivation therapy for biochemical recurrence after primary radiation therapy for localized prostate...

lymphoma

Final Results of German Trial of PET-Guided Treatment in Advanced Hodgkin Lymphoma

Final results of the German Hodgkin Study Group phase III HD18 trial, reported in The Lancet by Borchmann et al, showed no benefit of adding rituximab (Rituxan) to escalated BEACOPP (eBEACOPP; bleomycin, etoposide, doxorubicin, cyclophosphamide, vincristine, procarbazine, and prednisone) in...

breast cancer

ASCO/CCO Focused Guideline Update on Role of Bone-Modifying Agents in Metastatic Breast Cancer

As reported by Catherine Van Poznak, MD, of the University of Michigan, Ann Arbor, and colleagues in the Journal of Clinical Oncology, ASCO and Cancer Care Ontario (CCO) have collaborated in providing a focused update for the ASCO clinical practice guideline on the role of bone-modifying agents in...

breast cancer

ASHG 2017: Quantifying Breast Cancer Risk Based on Rare Variants and Background Risk

Rare variants combined with background genetic risk factors may account for many unexplained cases of familial breast cancer, and knowing the specific genes involved could inform choice of prevention and treatment strategies, according to findings presented in a plenary session at the American...

supportive care

Abby R. Rosenberg, MD, on Promoting Resilience in Young Cancer Patients: Results From the PRISM Trial

Abby R. Rosenberg, MD, of Seattle Children’s Hospital, discusses study findings on a skills-based intervention that helped teens and young adults with cancer manage stress to improve their quality of life and reduce distress (Abstract 176).

palliative care

Areej El-Jawahri, MD, on A Revolutionary Plan for End-of-Life Care

Areej El-Jawahri, MD, of Massachusetts General Hospital, discusses a video tool that helps overcome communication barriers so that patients can make more informed decisions for end-of-life care and their preferences are respected.

issues in oncology
palliative care

Sandip Patel, MD, on Immunotherapy: New Developments and Toxicity Challenges

Sandip Patel, MD, of the University of California, San Diego, discusses diagnosing and managing immune-related adverse events from immune checkpoint blockade and the toxicities of these treatments.

palliative care

Jamie Jacobs, PhD, on Early Integrated Palliative Care: The Positive Effects

Jamie Jacobs, PhD, of Massachusetts General Hospital Cancer Center, discusses study results that showed integrating oncology and palliative care early in the course of treatment helps people with incurable lung and gastrointestinal cancers cope better and have an improved quality of life and less...

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