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kidney cancer
immunotherapy

ESMO 2018: JAVELIN Renal 101: Avelumab Plus Axitinib in Previously Untreated Renal Cell Carcinoma

A combination of the immune checkpoint blocker avelumab (Bavencio) plus the tyrosine kinase inhibitor axitinib (Inlyta) improved progression-free survival (PFS) in previously untreated patients with advanced renal cell carcinoma (RCC) in the phase III JAVELIN Renal 101 study, according to results...

gynecologic cancers

ESMO 2018: SOLO-1: Olaparib Maintenance Extends Progression-Free Survival in BRCA1/2-Mutated Advanced Ovarian Cancer

Two-year maintenance therapy with olaparib (Lynparza), a poly ADP-ribose polymerase (PARP) inhibitor, led to a substantial improvement in progression-free survival (PFS) in newly diagnosed patients with advanced ovarian cancer and a BRCA1/2 mutation, results from the phase III SOLO-1 trial...

genomics/genetics

Arul Chinnaiyan, MD, PhD, Granted NCI Award to Investigate Cancer Genomics

Arul Chinnaiyan, MD, PhD, of the University of Michigan Rogel Cancer Center, has received an Outstanding Investigator Award from the National Cancer Institute (NCI) that provides $6.5 million in funding over 7 years. The grant will fund research to create new bioinformatics resources and identify...

solid tumors
hepatobiliary cancer

Cabozantinib in Advanced Hepatocellular Cancer: Call for Revision of Practice Standards

As reported in The New England Journal of Medicine by Ghassan K. Abou-Alfa, MD, and colleagues, and reviewed in this issue of The ASCO Post, the phase III CELESTIAL trial has demonstrated that cabozantinib (Cabometyx) improved the median overall survival to 10.2 months in comparison to 8 months...

hematologic malignancies
lymphoma

Novel Treatment Approaches in Early Relapse of Follicular Lymphoma

“Patients with follicular lymphoma who relapse early after treatment are a minority of patients, fortunately, but they are clearly patients with a different disease,” according to Jonathon B. Cohen, MD, of Emory University School of Medicine. At Emory’s 2018 Debates and Didactics in Hematology and...

breast cancer

ESMO 2018: SOLAR-1: Alpelisib in Patients With PIK3CA-Mutated HR-Positive, HER2-Negative Advanced Breast Cancer

Targeting a common mutation in patients with hormone receptor (HR)–positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer with the alpha-specific phosphatidylinositol-3-kinase (PI3K) inhibitor alpelisib improved progression-free survival, according to...

breast cancer

ESMO 2018: PALOMA-3: Palbociclib in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

Treatment with the cyclin-dependent kinase (CDK) 4/6 inhibitor palbociclib (Ibrance) achieved a clinically meaningful improvement in overall survival in patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer that has relapsed or ...

breast cancer
immunotherapy

ESMO 2018: IMpassion 130: Atezolizumab Plus Nab-Paclitaxel in Metastatic Triple-Negative Breast Cancer

A combination of immunotherapy and chemotherapy improves survival in some patients with metastatic triple-negative breast cancer, according to late-breaking results from the IMpassion130 trial reported by Schmid et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract...

breast cancer

ESMO 2018: HDAC Inhibitor Therapy in Advanced Hormone Receptor–Positive Breast Cancer

A phase III trial presented by Jiang et al at the European Society for Medical Oncology (ESMO) 2018 Congress showed activity of histone deacetylase (HDAC) inhibitor therapy in advanced hormone receptor–positive breast cancer (Abstract 283O_PR). Endocrine therapies are the foundation of...

lung cancer
immunotherapy

Regardless of Taxane Used, Pembrolizumab Plus Chemotherapy Improves Survival in Squamous NSCLC

The addition of pembrolizumab (Keytruda) to a standard platinum doublet as first-line therapy improved overall and progression-free survival in patients with metastatic squamous non–small cell lung cancer (NSCLC), in the primary analysis of KEYNOTE-407.1,2 Furthermore, it did not seem to matter...

How the Nobel Prize Could Spur More Cancer Advances

Even before James P. Allison, PhD, made an appearance at the Fourth International Cancer Immunotherapy Conference: Translating Science Into Survival in New York City, the excitement among attendees was palpable. Earlier that day, October 1, 2018, Dr. Allison and Tasuku Honjo, MD, PhD, of Kyoto...

palliative care
lung cancer
issues in oncology
cost of care

ICU Admissions During Terminal Hospitalizations in Patients With Stage IV Lung Cancer

In a study reported in the Journal of Oncology Practice, Mrad et al found an increase in the proportion of patients with stage IV lung cancer admitted to the intensive care unit (ICU) during terminal hospitalization between 1998 and 2014. A large increase in palliative care contacts also occurred,...

breast cancer

FDA Approves Talazoparib for Deleterious Germline BRCA-Mutated HER2-Negative Locally Advanced or Metastatic Breast Cancer

On October 16, 2018, the U.S. Food and Drug Administration (FDA) approved talazoparib (Talzenna), a poly (ADP-ribose) polymerase (PARP) inhibitor, for patients with deleterious or suspected deleterious germline BRCA-mutated (gBRCAm), HER2-negative locally advanced or metastatic breast cancer....

lung cancer

FDA Approves Dacomitinib for Metastatic Non–Small Cell Lung Cancer

ON SEPTEMBER 27, 2018, the U.S. Food and Drug Administration (FDA) approved dacomitinib tablets (Vizimpro) for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R substitution...

lymphoma
skin cancer

Results From ECHELON-2: Brentuximab Vedotin in CD30-Expressing Peripheral T-Cell Lymphoma

The phase III ECHELON-2 clinical trial has met its primary endpoint, demonstrating a statistically significant improvement in progression-free survival (PFS) with brentuximab vedotin (Adcetris) in combination with CHP (cyclophosphamide, doxorubicin, prednisone) vs CHOP (cyclophosphamide,...

hematologic malignancies
multiple myeloma

Emerging Options and Sequencing Therapy in Relapsed Multiple Myeloma

Advances in the treatment of multiple myeloma have led to longer progression-free survival, but the majority of patients will still relapse despite newer treatments. A number of new drugs and combinations are under study in the hope of improving outcomes. “Multiple myeloma is a complex disease...

breast cancer

More to Learn About Using PARP Inhibitors for Advanced Breast Cancer With Germline BRCA Mutation

Germline mutations in the breast cancer–susceptibility genes 1 and 2 (BRCA1/2) increase the risk for cancer due to an inability to repair DNA double-strand breaks, and about 5% of patients with unselected breast cancer carry a germline BRCA mutation.1 These DNA repair–deficient tumors are...

thyroid cancer

Lauren P. Wallner, PhD, MPH, on Thyroid Cancer: Reducing Overtreatment With Radioactive Iodine

Lauren P. Wallner, PhD, MPH, of the University of Michigan, discusses her findings from a population-based study, which showed that many patients believe they had no choice about whether or not to receive radioactive iodine, even though it often does not improve survival. There is a need, she says, ...

hematologic malignancies
lymphoma

Targeting CCR4 in Cutaneous T-Cell Lymphoma: The MAVORIC Trial

The C-C chemokine receptor 4 (CCR4) is predominantly expressed in type 2 helper T (Th2) cells and regulatory T (Treg) cells.1 Under physiologic conditions and in response to its ligands, CCL17 (TARC) and CCL22 (MDC), CCR4 promotes T-cell migration to the skin.2 Of note, CCR4 is highly expressed in...

lung cancer

Durvalumab Improves Overall Survival in Stage III NSCLC

The phase III PACIFIC trial showed significantly improved overall survival with durvalumab (Imfinzi) vs placebo after chemoradiotherapy in patients with unresectable stage III non–small cell lung cancer (NSCLC). Scott J. Antonia, MD, of the Moffitt Cancer Center, Tampa, Florida, reported these...

hematologic malignancies
lymphoma

The Relevance of the RELEVANCE Trial in Follicular Lymphoma

We have seen remarkable progress in the outcomes of patients with advanced-stage follicular lymphoma over the past 2 decades.1 Recent manuscripts and presentations describing long-term follow-up of randomized trials comparing various chemotherapy platforms (all combined with anti-CD20 antibodies)...

multiple myeloma

FDA Approves Once-Weekly Carfilzomib in Combination With Dexamethasone for Relapsed or Refractory Multiple Myeloma

Today, the U.S. Food and Drug Administration (FDA) approved a supplemental new drug application (sNDA) to expand the prescribing information for carfilzomib (Kyprolis) to include a once-weekly dosing option in combination with dexamethasone (once-weekly Kd70) for patients with relapsed or...

lung cancer

FDA Approves Dacomitinib for Metastatic Non–Small Cell Lung Cancer

On September 27, 2018, the U.S. Food and Drug Administration (FDA) approved dacomitinib tablets (Vizimpro) for the first-line treatment of patients with metastatic non–small cell lung cancer (NSCLC) with epidermal growth factor receptor (EGFR) exon 19 deletion or exon 21 L858R substitution...

lung cancer

WCLC 2018: NELSON Study: CT Screening for Early Lung Cancer Reduces Lung Cancer Mortality

Findings from the NELSON study demonstrate that the use of computed tomography (CT) screening among asymptomatic men at high risk for lung cancer led to a 26% (95% confidence interval [CI] = 9%–41%) reduction in lung cancer deaths at 10 years of study follow-up (at 86% compliance). In the...

leukemia

Jerald P. Radich, MD, on Chronic-Phase CML: Optimizing Tyrosine Kinase Inhibitor Therapy

Jerald P. Radich, MD, of the Fred Hutchinson Cancer Research Center, discusses the best strategies for sequencing tyrosine kinase inhibitor therapy for chronic myeloid leukemia and treatment-free remission.

issues in oncology
pain management

2018 Quality Care: Opioid Deaths Are 10 Times Less Likely to Occur in Patients With Cancer Compared to the General Population

According to the U.S. Department of Health and Human Services, in 2016, over 42,000 Americans died from opioid overdose, making the epidemic a top public health concern. Although opioids are commonly used for cancer-associated pain, the risks for overdose in patients with cancer were unknown. A...

issues in oncology
cost of care

2018 Quality Care: Older Patients With Advanced Cancer Experiencing Financial Difficulties Have Worse Quality of Life and Mental Health

Older patients with advanced cancer experiencing financial toxicity due to the cost of their treatment have higher rates of severe anxiety and depression and poorer quality of life than patients who do not experience financial hardship. In addition, for those patients having financial difficulty,...

legislation
pain management

New Laws Limiting Opioid Prescriptions Create Undue Barriers for Patients With Cancer and Cancer Survivors

Among other policy responses to the growing opioid epidemic, many states have enacted legislation that limits the duration or amount of opioid prescriptions issued by physicians. Although, it is clear we need strong measures to mitigate widespread overuse and misuse of opioids. These...

gastrointestinal cancer
colorectal cancer

Maintenance Therapy for Metastatic Colorectal Cancer: Benefit Seen With Panitumumab Combination

Although the optimal approach to maintenance is not definitive in patients with metastatic colorectal cancer who have undergone chemotherapy-based induction with anti–endothelial growth factor receptor (EGFR) agents, the phase II VALENTINO trial showed that anti-EGFR maintenance therapy with...

issues in oncology

An Invitation to Be Quiet No Longer

My male colleagues sometimes broach the topic of #MeToo or sexual harassment in medicine by saying how uncomfortable it makes them. Ah, yes. How uncomfortable the sexual harassment I  have faced for years makes you. I casually bring up microaggressions—subtle verbal or nonverbal slights against...

solid tumors
breast cancer

Treatment of Triple-Negative Breast Cancer With BRCA1/2 Mutations: More to Learn From Ongoing Trials

The treatment of triple-negative breast cancer remains a clinical challenge with no single validated target, though numerous pathways are druggable and are being investigated. In the subset of BRCA-mutated triple-negative breast cancer, the approval of the first poly (ADP-ribose) polymerase (PARP)...

solid tumors
hepatobiliary cancer

Cabozantinib in Second-Line Treatment of Advanced Hepatocellular Carcinoma

Compared with placebo, cabozantinib (Cabometyx) significantly improved overall survival and progression-free survival in patients with advanced hepatocellular carcinoma who were previously treated with sorafenib (Nexavar), with no new safety signals, according to data from the phase III CELESTIAL ...

issues in oncology

Bleeding in Patients Treated With Anticoagulants and Potential Cancers

Bleeding in patients treated with anticoagulants may indicate an increased probability of cancer, according to late-breaking results from the COMPASS trial presented at the 2018 European Society of Cardiology Congress. Principal investigator John Eikelboom, MD, of the Population Health Research...

Three Immunotherapy Researchers Receive 2018 Albany Medical Center Prize

THREE SCIENTISTS whose work in immuno-oncology has led to a revolutionary way to treat cancer have been announced as the recipients of the 2018 Albany Medical Center Prize in Medicine and Biomedical Research. The awardees were chosen to receive the 2018 Albany Prize for their research in...

skin cancer

No Improvement in Survival Reported With Epacadostat Plus Pembrolizumab in Advanced Melanoma

IN PATIENTS with unresectable or metastatic melanoma, adding epacadostat to pembrolizumab (Keytruda) did not result in greater clinical benefit over pembrolizumab alone, according to data from the phase III ECHO-301/KEYNOTE-252 study. These results were originally presented at the 2018 ASCO Annual...

hepatobiliary cancer
lung cancer
bladder cancer

Recent Drug Approvals and Revisions in Prescribing Information

THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) issued the following approvals and prescribing information revisions in August 2018. Lenvatinib Approved for Unresectable Hepatocellular Carcinoma THE FDA approved lenvatinib (Lenvima) for the first-line treatment of patients with unresectable...

head and neck cancer

Adding Nimotuzumab to Chemoradiation Improved Survival in Locally Advanced Head and Neck Cancer

IN PATIENTS with locally advanced squamous cell carcinoma of the head and neck, nimotuzumab—a humanized monoclonal antibody against the epidermal growth factor receptor—in combination with cisplatin and radiotherapy was superior to cisplatin and radiotherapy alone in improving progression-free...

hematologic malignancies

FDA Approves First Nonchemotherapy Combination Regimen for Patients With Waldenström’s Macroglobulinemia

ON AUGUST 27, 2018, the U.S. Food and Drug Administration (FDA) approved the combination of ibrutinib (Imbruvica) and rituximab (Rituxan) for patients with Waldenström’s macroglobulinemia. The recent approval expands the label for ibrutinib in Waldenström’s macroglobulinemia beyond its current...

lymphoma

Clarifying the Complexity of Genomic Testing in Non-Hodgkin Lymphoma

AS MORE is learned about the genomic landscape in non-Hodgkin lymphoma, clinicians are grappling with how to apply this information in the clinic. At the 2018 Pan Pacific Lymphoma Conference, Andrew D. Zelenetz, MD, PhD, helped them understand this emerging area.1 Dr. Zelenetz is Professor of...

head and neck cancer

Prediction of Survival and Disease Control in HPV-Negative Head and Neck Cancer Using Molecular Markers

A new method may predict the course of human papillomavirus (HPV)-negative head and neck cancer after radiochemotherapy. According to findings published by Hess et al in Clinical Cancer Research, five microRNAs (miRNAs) may be able to provide the decisive data. Squamous cell carcinomas of the head ...

supportive care
integrative oncology

Coriolus versicolor

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. Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, present information on the potential...

issues in oncology

Cancer May Be Linked to Poor Prognosis in Patients With Broken Heart Syndrome

Cancer may be linked to an increased risk of death and prehospitalization in patients with broken heart syndrome, according to research presented by Santoro et al at the 2018 European Society of Cardiology Congress. Study author Francesco Santoro, MD, of the University of Foggia, Italy, said, ...

multiple myeloma
immunotherapy

FDA Accepts sBLA for Elotuzumab Plus Pomalidomide and Low-Dose Dexamethasone in Patients With Relapsed or Refractory Multiple Myeloma

The U.S. Food and Drug Administration (FDA) recently accepted a supplemental biologics license application (sBLA) for elotuzumab (Empliciti) in combination with pomalidomide (Pomalyst) and low-dose dexamethasone for the treatment of patients with relapsed or refractory multiple myeloma who...

lymphoma

ctDNA and Treatment Outcome in Diffuse Large B-Cell Lymphoma

In a study reported in the Journal of Clinical Oncology, Kurtz et al found that baseline circulating tumor DNA (ctDNA) and molecular response to treatment were independent predictors of treatment outcome in diffuse large B-cell lymphoma. Study Details The association of ctDNA with treatment...

lymphoma
immunotherapy

FDA Approves Ibrutinib Plus Rituximab for Waldenström’s Macroglobulinemia

The U.S. Food and Drug Administration (FDA) has approved ibrutinib (Imbruvica) plus rituximab (Rituxan) for the treatment of adult patients with Waldenström's macroglobulinemia (WM). With this approval, the ibrutinib prescribing information now includes combination use with rituximab,...

issues in oncology

Focus on the Empire State Hematology & Oncology Society

The Empire State Hematology & Oncology Society (ESHOS), a State Affiliate of ASCO, was formed in January 2017 as a merger of three separate hematology and oncology professional organizations in New York. Stuart P. Feldman, MD, of the New York State Society of Medical Oncologists &...

lung cancer
immunotherapy

FDA Approves Pembrolizumab in Combination With Chemotherapy for First-Line Treatment of Metastatic Nonsquamous NSCLC

Today, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) in combination with pemetrexed (Alimta) and platinum as first-line treatment of patients with metastatic, nonsquamous non–small cell lung cancer with no EGFR or ALK genomic tumor aberrations. Pembrolizumab...

breast cancer

Breast Reconstruction: ‘A Process Not a Procedure’ With Potential Short- and Long-Term Complications

The complication rate among women who underwent postmastectomy breast reconstruction was 32.9% at 2 years postoperatively, and women undergoing autologous reconstruction “had significantly higher odds of developing any complication compared with those undergoing expander-implant reconstruction,”...

hepatobiliary cancer

FDA Approves Lenvatinib for Unresectable Hepatocellular Carcinoma

Today, the U.S. Food and Drug Administration (FDA) approved lenvatinib capsules (Lenvima) for first-line treatment of patients with unresectable hepatocellular carcinoma (HCC). REFLECT Trial Approval was based on the international, multicenter, randomized, open-label, noninferiority REFLECT trial ...

issues in oncology

Stakeholders Agree: ‘Value’ in Cancer Care Depends on Perspective

In a roundtable discussion moderated by Clifford Goodman, PhD, of The Lewin Group, Falls Church, Virginia, representatives of the patient advocacy community, public and private payers, large and small clinics, and the pharmaceutical industry did not always see eye to eye on what “value” means nor ...

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