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Lena E. Winestone, MD, MSHP, on Health-Care Disparities in Hematologic Cancers: Real-World Data
Lena E. Winestone, MD, MSHP, of the University of California, San Francisco and Benioff Children’s Hospital, reviews different aspects of bias in treatment delivery, including patient selection for clinical trials; racial and ethnic disparities in survival for indolent non-Hodgkin diffuse large...
Does Anticancer Therapy Impact Unplanned Hospital Care in Patients With NSCLC?
In a single-institution study reported in JCO Oncology Practice, Shah and Neal found that only a small proportion of unplanned hospital encounters were related to anticancer therapy among patients with non–small cell lung cancer (NSCLC), with almost one-quarter of such encounters being considered...
New Study Explores the Use of Focused Ultradeep DNA Sequencing to Quantify Skin Cancer Risk
Recent research has shed new light on the carcinogenic effect of exposure to ultraviolet (UV) radiation, laying the groundwork for improvements in skin cancer risk stratification and prevention. A study published by Lei Wei, PhD, and colleagues in Science Advances detailed a method to measure the...
Adjuvant Gefitinib vs Vinorelbine/Cisplatin in Stage II–IIIA EGFR-Mutant NSCLC: Final Overall Survival Analysis
As reported in the Journal of Clinical Oncology by Zhong et al, the final overall survival results of the phase III CTONG1104 trial indicated no significant advantage of adjuvant gefitinib vs vinorelbine/cisplatin in patients with EGFR-mutant stage II–IIIA (N1–2) non–small cell lung cancer ...
Feasibility Study of Radical Cystectomy vs Intravesical BCG for High-Grade, Non–Muscle Invasive Bladder Cancer
As reported in the Journal of Clinical Oncology by Catto et al, the BRAVO-Feasibility study showed that recruitment of patients with high-grade, non–muscle invasive bladder cancer into a randomized trial comparing radical cystectomy vs intravesical bacillus Calmette-Guérin (BCG) proved difficult,...
Nivolumab Indication in Small Cell Lung Cancer Withdrawn in U.S. Market
On December 29, Bristol Myers Squibb issued the following statement on nivolumab’s small cell lung cancer (SCLC) indication in the United States. In 2018, nivolumab was granted accelerated approval by the U.S. Food and Drug Administration (FDA) for the treatment of patients with SCLC whose disease...
Left Anterior Descending Coronary Artery Radiation Exposure, Cardiac Events, and Mortality in NSCLC
In a retrospective cohort analysis reported in JAMA Oncology, Atkins et al identified a volume (V, percent) of exposure of the left anterior descending (LAD) coronary artery to a radiation dose (V15 Gy ≥10%) that is an independent risk factor for major adverse cardiac events and all-cause mortality ...
Risk of COVID-19 Infection in Patients With Cancer: Effect of Time of Diagnosis and Race
In a study reported in JAMA Oncology, Wang et al found that patients with cancer were at a greater risk of being infected with COVID-19 and having worse outcomes vs patients without cancer. Risk was greatest among patients with a more recent diagnosis and was even further exacerbated among Black...
Reducing Disparities in Cancer Care for Sexual and Gender Minority Patients
Although efforts have been made by various medical societies, including ASCO, over the past decade to address the needs of sexual and gender minorities in the cancer care setting, research shows that lesbian, gay, bisexual, transgender, and queer/questioning (LGBTQ) patients continue to face...
Selected ASH Abstracts on Novel Treatments of Polycythemia Vera
To complement The ASCO Post’s continued comprehensive coverage of the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, here are three abstracts selected from the meeting proceedings focusing on novel therapies for polycythemia vera. For full details of these study...
FDA Approves Adjuvant Osimertinib for EGFR-Mutated NSCLC
On December 18, the U.S. Food and Drug Administration (FDA) approved osimertinib (Tagrisso) for adjuvant therapy after tumor resection in patients with non–small cell lung cancer (NSCLC) whose tumors have epidermal growth factor receptor (EGFR) exon 19 deletions or exon 21 L858R mutations, as...
Germline-Somatic Interactions in Advanced Urothelial Cancer and Their Role in Disease Progression
In a study reported in Nature Communications, Bishoy M. Faltas, MD, of the Department of Medicine, Division of Hematology and Medical Oncology, Weill Cornell Medicine, New York, and colleagues identified common germline-somatic variant interactions in advanced urothelial cancer, with these...
Life and Death Under COVID-19
Victoria was a 79-year-old woman living alone in a London suburb. Having no children of her own, she visited us regularly here in the United States. She was one of three sisters and my sister-in-law. I knew her for more than 50 years, and she always reminded me of Audrey Hepburn, both in looks and ...
Initial Therapy for Asymptomatic Follicular Lymphoma: Start With Watch and Wait or Rituximab
For patients with indolent follicular lymphoma, generally take a conservative approach to treatment unless the patient is symptomatic, advised John P. Leonard, MD, Executive Vice-Chair of Weill Department of Medicine at Weill-Cornell Medicine/NewYork-Presbyterian, New York.1 “Prognostic scores are...
2020 FDA Approvals of Drugs for Cancer Treatment
Over the past year (January to December 2020), the U.S. Food and Drug Administration (FDA) granted approval to several novel drugs and new indications for older therapeutic agents used in oncology and hematology. A brief review of new approvals appears here. For complete prescribing information for ...
Identifying Multiple Myeloma Prognostic Subgroups With Distinct Genetic and Clinical Features
Multiple myeloma is the second most common blood cancer, after non-Hodgkin lymphoma, diagnosed in the United States. In 2020, it is estimated that about 32,270 people will be diagnosed with the cancer, and despite advances in more effective treatments, nearly 13,000 will die of the disease.1...
Disparities in Socioeconomic Status, Treatment Complications, and Obesity Impact Outcomes in Minority Patients With AML
A study by Ivy Abraham, MD, of the University of Illinois at Chicago, and colleagues, investigated the contribution of structural violence, specifically neighborhood socioeconomic status, on the racial/ethnic differences in the survival of patients with acute myeloid leukemia (AML). They found that ...
FDA Approves Rituximab-arrx, a Biosimilar to Rituximab
On December 17, the U.S. Food and Drug Administration (FDA) approved rituximab-arrx (Riabni), a biosimilar to rituximab (Rituxan), for the treatment of adult patients with non-Hodgkin lymphoma, chronic lymphocytic leukemia, granulomatosis with polyangiitis (Wegener's granulomatosis), and...
Overcoming the Challenges of Addressing Race, Culture, and Structural Inequality in Medical Education
In 2017, a workgroup task force, made up of medical students and faculty at George Washington University, Texas Christian University, and the University of North Texas Health Science Center, conducted a literature review to identify best practices for teaching and learning about race and culture in ...
Association of Out-of-Pocket Costs for Tyrosine Kinase Inhibitors With Outcomes in Patients With EGFR- and ALK-Positive Advanced NSCLC
In a single-institution study reported in JCO Oncology Practice, Bernardo H.L. Goulart, MD, and colleagues found that higher out-of-pocket costs for tyrosine kinase inhibitors (TKIs) were associated with reduced adherence to and increased discontinuation of TKI therapy—as well as poorer overall...
ESMO Immuno-Oncology 2020: Sintilimab vs Docetaxel for Advanced Squamous NSCLC
Sintilimab provided superior clinical benefit compared to docetaxel in patients with previously treated, advanced and/or metastatic squamous non–small cell lung cancer (NSCLC), according to phase III study findings presented by Shi et al at the European Society for Medical Oncology (ESMO)...
Trends in AYA Cancer Incidence in the United States Over 4 Decades
Cancer cases in adolescents and young adults (AYAs) have risen by 30% during the past 4 decades, with rates of kidney cancer increasing at the greatest rate, according to findings published by Scott et al in JAMA Network Open. The team said further research into screening, diagnosis, and treatment...
ESMO Immuno-Oncology 2020: Does Pleural Effusion Affect Survival in Patients Treated With Immunotherapy for NSCLC?
Patients with non–small cell lung cancer (NSCLC) who have pleural effusion, especially those requiring pleural evacuation, experienced poorer survival when treated with immune checkpoint inhibitors, according to findings presented by Epaillard et al at the European Society for Medical Oncology...
Improved Outcomes With Neoadjuvant Paclitaxel Plus Trastuzumab/Lapatinib vs Paclitaxel/Trastuzumab in HER2-Positive Breast Cancer
In a 7-year follow-up of the phase III CALGB 40601/Alliance trial reported in the Journal of Clinical Oncology, Aranzazu Fernandez-Martinez, MD, of Lineberger Comprehensive Center, University of North Carolina, Chapel Hill, and colleagues found that neoadjuvant paclitaxel combined with a dual...
Meta-analysis Shows Superior Disease-Free and Overall Survival With Measurable Residual Disease Negativity in AML
In a systematic review and meta-analysis reported in JAMA Oncology, Nicholas J. Short, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, found that measurable residual disease (MRD) negativity is associated with superior disease-free and overall survival in patients with...
Progress Report on Checkpoint Inhibitors in Rare Tumors
Immune checkpoint inhibitors may prove to be effective in treating patients with two rare cancer types—leptomeningeal metastases and angiosarcoma, according to early-phase clinical trials reported at the 2020 Annual Meeting of the Society for Immunotherapy of Cancer (SITC), which was held virtually ...
Emerging Data on PARP Inhibition in Prostate Cancer
Prostate cancer has lagged behind other solid tumors with regard to molecularly targeted therapy and precision medicine, with no targeted therapies approved specifically in prostate cancer, but that has changed with the recent approval in 2020 of a PARP (poly [ADP-ribose] polymerase) inhibitor for...
Physician-Scientist Judah Folkman, MD, Faced Years of Skepticism Before His Theory of Angiogenesis Was Proven
That Moses Judah Folkman would buck tradition, breaking his family’s long line of rabbinical succession and pursuing a career in science and medicine instead, was evident from the time he was a young child. Born in Cleveland on February 24, 1933, the first child of Rabbi Jerome and Bessie Folkman, ...
Front-Line Nonchemotherapy Regimens May Improve Long-Term Outcomes in CLL
An assortment of agents has been approved in the United States for the first-line treatment of chronic lymphocytic leukemia (CLL), and all of them are effective, explained Richard Furman, MD, of Weill-Cornell Medical College, NewYork-Presbyterian Hospital, New York. In the modern era, most patients ...
Lung Cancer Progression-Free Survival With Immunotherapy Varies Significantly by Tumor-Mutation Subtype, Real-World Data Show
A real-world study of single-agent immune checkpoint inhibitors in driver-mutated non–small cell lung cancer (NSCLC) has demonstrated significant variation in progression-free survival between mutation subtypes, according to data presented during the International Association for the Study of Lung...
Early-Stage Lung Cancer: An Overview of the Clinical Trial Landscape
Although early-stage, resectable disease represents the best chance for meaningful long-term survival and cure for patients with lung cancer, there are still high rates of recurrence. According to Rajwanth Veluswamy, MD, MSCR, neoadjuvant and adjuvant treatments are needed to improve surgical...
Surgical Resection of Stage I Lung Cancer: Rating the Evidence of Benefit
A recent report from the U.S. Preventive Services Task Force (USPSTF) has undermined the evidentiary basis for the primary treatment of stage I non–small cell lung cancer (NSCLC) while rating the evidence for the benefit of screening as “high.”1 According to David F. Yankelevitz, MD, these...
Interference of Clonal Hematopoiesis in DNA Repair Genes With Prostate Cancer Plasma Cell-Free DNA Testing
In a study reported in JAMA Oncology, Jensen and colleagues found that clonal hematopoiesis of indeterminate potential (CHIP) involving DNA repair genes can interfere with prostate cancer plasma cell-free DNA testing used to determine eligibility for poly (ADP-ribose) polymerase (PARP) inhibitor...
Assessing the Progress Made in Global Cancer Care and Looking Toward the Future
In October 2020, Her Royal Highness Princess Dina Mired of Jordan ended her 2-year tenure as President of the Union for International Cancer Control (UICC), a global organization with more than 1,198 members from 172 countries and territories committed to reducing the cancer burden and...
ZUMA-5 Trial Finds Axicabtagene Ciloleucel Shows Activity in Patients With Indolent Non-Hodgkin Lymphoma
In the phase II ZUMA-5 trial, axicabtagene ciloleucel led to responses in 92% of patients with indolent non-Hodgkin lymphoma treated with the cellular immunotherapy. These findings were reported by Caron Jacobson, MD, MMSc, and colleagues at the 2020 American Society of Hematology (ASH) Annual...
ASH 2020: Multiple Myeloma Patient Similarity Network Identifies Prognostic Subgroups With Distinct Genetic and Clinical Features
An analysis by Bhalla et al of multiomics data from newly diagnosed patients with multiple myeloma has identified 3 main patient groups and 12 prognostic subgroups (as well as potential vulnerabilities in each subgroup) based on five data types generated from genomic and transcriptomic patient...
ASH 2020: Does Race Contribute to Poor Outcomes in Younger Black Patients Diagnosed With AML?
It has been well documented that, collectively, Black individuals have the highest death rate and shortest survival of any racial/ethnic group in the United States for most cancers. Black men also have the highest cancer incidence. Although the causes of these inequities are complex, a study by...
ASH 2020: Study Examines Impact of Neighborhood Socioeconomic Status on Outcomes in Minority Patients With AML
Studies show that non-Hispanic Black and Hispanic patients with acute myeloid leukemia (AML) have higher mortality rates than non-Hispanic White patients diagnosed with the disease, despite lower rates of incidence, more favorable genetics, and a younger age at disease onset. A study by Abraham et...
End-of-Life Care Among Commercially Insured Women Younger Than 65 With Metastatic Breast Cancer
In a study reported in JCO Oncology Practice, Ferrario et al found a sizable increase in end-of-life intensive care unit (ICU) admissions and a small but significant increase in emergency department visits over time among commercially insured women younger than age 65 with metastatic breast cancer...
Discordance Among Risk Models for Smoldering Multiple Myeloma
In a study reported as a research letter in JAMA Oncology, Hill et al found a low degree of concordance in risk categorization among commonly used smoldering multiple myeloma risk models. Study Details The study involved application of the Mayo Clinic Risk Stratification Model 2008, the Programa...
Effect of Fertility Preservation on Reproductive Outcomes in Patients After Breast Cancer
In a Swedish nationwide cohort study reported in JAMA Oncology, Marklund et al found that women who had undergone fertility preservation had a higher live birth rate, were more likely to use assisted reproductive technology, and had better overall survival after breast cancer than women who had not ...
First-Line Atezolizumab Improves Overall Survival vs Chemotherapy in Certain Patients With Metastatic NSCLC
As reported in The New England Journal of Medicine by Roy S. Herbst, MD, PhD, of Yale School of Medicine, and colleagues, the phase III IMpower110 trial has shown significantly prolonged overall survival with first-line atezolizumab vs platinum-based chemotherapy in metastatic non–small cell lung...
Racial Disparities in Treatment of Common Lung Cancer Persist Despite Gains
Lung cancer continues to be the most deadly solid cancer in the world, despite the fact that survival rates have been improving over the past decade. However, Black patients have worse outcomes and shorter lifespans after being diagnosed with lung cancer. A study published in the Journal of...
Understanding the Uniqueness of Cancer and Survival in Adolescents and Young Adults
Numerous studies over the past 4 decades have chronicled the lack of progress in improved outcomes for adolescents and young adults (AYAs)—defined by the National Cancer Institute as those ranging in age from 15 to 39—diagnosed with cancer compared with children and older adults diagnosed with the...
Expert Point of View: Howard (Jack) West, MD, and William R. Sellers, MD
Howard (Jack) West, MD, Associate Clinical Professor in Medical Oncology at City of Hope Comprehensive Cancer Center, Duarte, California, was impressed with the data from the KRYSTAL-1 trial. “It’s great to see new data on another entrant into the space for patients with KRAS G12C...
KRAS Inhibitor Adagrasib Shows Activity in Non–Small Cell Lung Cancer
Another novel oral KRAS inhibitor—adagrasib (MRTX849)—has shown promise in early clinical trials, according to investigators of the KRYSTAL-1 study who reported findings at the virtual 32nd EORTC-NCI-AACR Symposium on Molecular Targets and Cancer Therapeutics.1,2 The conference is jointly provided...
Phase III GEMSTONE-302 Trial Finds CS1001 Plus Platinum Chemotherapy Prolongs Progression-Free Survival in NSCLC
The addition of CS1001, an anti–PD-L1 monoclonal antibody, to platinum-based chemotherapy significantly prolonged progression-free survival vs chemotherapy in treatment-naive patients with advanced non–small cell lung cancer (NSCLC), according to phase III findings presented by Zhou et al at the...
Phase II Study Investigates Efficacy of Anlotinib in Radioiodine-Refractory Differentiated Thyroid Cancer
Patients with locally advanced or metastatic radioiodine-refractory differentiated thyroid carcinoma demonstrated a statistically significant progression-free survival benefit when treated with anlotinib, a novel tyrosine kinase inhibitor, vs placebo, as well as higher response rates, according to...
Nivolumab Plus Ipilimumab in First-Line NSCLC: Two New Indications, Many More Questions
In May 2020, the combination of nivolumab and ipilimumab was approved by the U.S. Food and Drug Administration (FDA) for two separate indications in the first-line setting of advanced non–small cell lung cancer (NSCLC). One was in metastatic NSCLC with tumors that have PD-L1 expression ≥ 1% with...
ESMO Asia 2020: Baseline Characteristics of Asian Patients Enrolled in the monarchE Trial
A comparison of baseline characteristics in patients with hormone receptor (HR)-positive, HER2-negative early breast cancer revealed that a higher proportion of patients enrolled from Asia had risk factors for disease recurrence than those enrolled from non-Asian countries, reported Jiang et al at...
