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Expert Point of View: Martin Reck, MD, PhD

Martin Reck, MD, PhD, Head of Thoracic Oncology at the Hospital Grosshansdorf in Germany, discussed the anti–PD-1 abstracts at the ASCO Annual Meeting. “We have seen tremendous results for immunotherapies for the reactivation of the immune system in patients with advanced melanoma. The question...

lung cancer

Strong Showing for Anti–PD-1 Agents in Non–Small Cell Lung Cancer

Monoclonal antibodies targeting the programmed death receptor-1 (PD-1) pathway are expected to answer an unmet need in non–small cell lung cancer (NSCLC). With first-line platinum-doublets, 1-year overall survival is 30% to 50%, and while treatments targeting sensitizing mutations are more...

skin cancer

Long-Term Follow-up of Phase I Nivolumab Trial

In the longest follow-up to date of any programmed death (PD)-1 receptor inhibitor in previously treated advanced melanoma, one-third of patients are demonstrating durable responses to the investigational agent nivolumab, and in some cases, these persist following discontinuation of the drug,...

skin cancer

Ipilimumab Reduces Recurrences as Adjuvant Treatment of Melanoma

Ipilimumab (Yervoy) has transformed the treatment of metastatic melanoma, producing long-term responses in about 20% of patients. A phase III study has now evaluated its impact in the adjuvant setting, and the results are a bit less striking. Primary Endpoint The European Organisation for Research...

Expert Point of View: Jeffrey S. Weber, MD, PhD

Jeffrey S. Weber, MD, PhD, Director of the Donald A. Adam Comprehensive Melanoma Research Center at the Moffitt Cancer Center and Research Institute in Tampa, Florida, formally discussed the prembrolizumab study at the ASCO Annual Meeting. He called the response rate and the ongoing responses...

skin cancer

'Impressive' Outcomes Achieved With Pembrolizumab in Advanced Melanoma

The latest bit of good news for the programmed death receptor-1 (PD-1)–targeting antibodies in advanced melanoma comes for pembrolizumab (MK-3475). While the results came from only a phase I study, they were among those chosen for presentation at an ASCO press briefing during the Annual Meeting....

lung cancer

Lung-MAP Trial Debuts—Other Personalized Studies Will Follow

Oncologists now have a means of bringing personalized medicine to advanced squamous cell carcinoma, and it involves a biomarker-driven clinical trial that maximizes the chance of successful treatment and new drug approvals. Lung-MAP (Lung Cancer Master Protocol) is a unique concept in which the...

cost of care

Federally Funded Trials Praised—and Underfunded

All four studies presented at the 2014 ASCO Annual Meeting Plenary Session were at least partially funded by federal dollars, bringing long overdue attention to the value of federally supported cancer research. Perhaps because of this high visibility, ASCO leaders took to the soapbox to sound the...

thyroid cancer

Impressive Delay in Thyroid Cancer Progression Achieved With Lenvatinib

The investigational tyrosine kinase inhibitor lenvatinib reduced disease progression by 79%, as compared to placebo, in patients with metastatic differentiated thyroid cancer that is refractory to radioactive iodine in the phase III SELECT trial. These findings were presented at the 2014 ASCO...

Expert Point of View: Carmen J. Allegra, MD

Carmen J. Allegra, MD, Professor of Medicine and Chief of Hematology/Oncology at the University of Florida, Gainesville, who discussed the findings at the ASCO Annual Meeting, said the study upholds what has become the practice of many oncologists—to use adjuvant FOLFOX...

colorectal cancer

Benefit Confirmed for Adjuvant Oxaliplatin in Rectal Cancer

Patients with curatively resected rectal cancer are more likely to be disease-free at 3 years after treatment with an oxaliplatin-containing regimen than with fluorouracil (5-FU)/leucovorin, Korean investigators of the phase II multicenter ADORE trial reported at the ASCO Annual Meeting.1 Study...

Expert Point of View: Axel Hauschild, MD

Axel Hauschild, MD, Professor of Dermatology at the University Hospital Schleswig-Holstein, Campus Kiel, in Germany, discussed the evolving utility of intralesional approaches to melanoma in the ASCO Poster Highlights session. In general, he maintained that the overall and complete response rates...

skin cancer

Intralesional Injections Trigger Immune Responses in Melanoma

The emerging approach to treating metastatic melanoma is a full-throttle effort to stimulate an immune response. One of the components of this strategy could be intralesional injections, according to studies presented at the 2014 ASCO Annual Meeting. T-VEC Oncolytic Immunotherapy Talimogene...

Expert Point of View: Philip McCarthy, MD

Melphalan, prednisone, and thalidomide (Thalomid), or MPT, was a widely accepted regimen in newly diagnosed multiple myeloma when the E1A06 trial was launched, noted Philip McCarthy, MD, Director of the Blood and Marrow Transplant Program at the Roswell Park Cancer Institute, Buffalo, New York....

multiple myeloma

Multiple Myeloma Studies Explore Roles of Panobinostat in Relapsed/Refractory Disease and Thalidomide Compared to Lenalidomide as Part of Initial Therapy

At the 2014 ASCO Annual Meeting, one phase III trial confirmed the promise of a novel agent in advanced multiple myeloma, while another cooperative group trial returned some rather surprising results in newly diagnosed myeloma patients. Panobinostat Doubles Response, Prolongs Remission The phase...

issues in oncology
cost of care

Stakeholders Are Uniting Around Value in Cancer Care

Judging from its visibility at the 2014 ASCO Annual Meeting, the concept of “value” in cancer care has reached critical mass. “ASCO is leading this difficult discussion on value in cancer care. This had to happen,” said ­Clifford A. Hudis, MD, FACP, Immediate Past President of ASCO and Chief of the ...

Expert Point of View: Howard A. Fine, MD and Martin J. van den Bent, MD

Session moderator Howard A. Fine, MD, the Anne Murnick Cogan and David H. Cogan Professor of Oncology and Director of the Brain Tumor Center at New York University Cancer Institute, shared his enthusiasm over the findings of the RTOG 9802 study. “I don’t know of any other tumor type where the...

cns cancers

Considerable Extension of Survival Achieved With Conventional Treatment in Grade 2 Glioma

Long-term results from the Radiation Therapy Oncology Group (RTOG) 9802 study in high-risk grade 2 gliomas were presented at the 2014 ASCO Annual Meeting. The study’s mature analysis showed a 41% reduction in mortality at 5 years with combination radiation therapy followed by six cycles of PCV...

supportive care

NEPA for Chemotherapy-Induced Nausea and Vomiting: Key Endpoints and Additional Analyses Show Strong Efficacy

For the prevention of chemotherapy-induced nausea and vomiting, NEPA, a novel combination of a neurokinin-1 (NK1) receptor antagonist and the 5-HT3 receptor antagonist palonosetron (Aloxi), has been studied in three pivotal trials that were recently published in the Annals of Oncology.1-3 Further...

head and neck cancer
supportive care

Mucositis Remains a Challenge in Head and Neck Cancer

Chemoradiotherapy for head and neck cancer requires intensive supportive care by a knowledgeable and proactive multidisciplinary team, according to Avraham Eisbruch, MD, Professor of Radiation Oncology at the University of Michigan, Ann Arbor. “Aggressive chemoradiotherapy has improved the cure...

breast cancer

Tackling the Heterogeneity of Triple-Negative Breast Cancer

Triple-negative breast cancer is now recognized as a very complex subtype for which one treatment will not be applicable to all, according to Mohammad Jahanzeb, MD, Professor of Clinical Medicine at the University of Miami and Director of the UM Sylvester Deerfield Campus, who gave an update on...

lung cancer
sarcoma
head and neck cancer
kidney cancer

New Research Presented in Wilms Tumor, Pediatric Sarcoma, Head and Neck Cancer, and Non–Small Cell Lung Cancer

In the past few months, numerous presentations from this year’s ASCO Annual Meeting have been covered in depth in the pages of The ASCO Post and online at ASCOPost.com. The brief summaries below capture additional important highlights that have not been covered thus far. We hope you will find them...

Expert Point of View: Melinda L. Telli, MD

The potential of individualizing systemic treatment based on BRCA1/2 status has not yet been realized. BRCA1/2 germline status currently does not factor into systemic therapy decisions,” said Melinda L. Telli, MD, of Standard University School of Medicine, Palo Alto, California, who discussed the...

triple-negative

Studies Assess Response to Platinum Therapy in Triple-Negative Breast Cancer

Studies in triple-negative breast cancer presented at the 2014 ASCO Annual Meeting sought to determine predictors of response to platinum agents. One identified a subset of responders to neoadjuvant chemotherapy, but prediction proved more elusive in metastatic disease. Neoadjuvant Carboplatin The...

Expert Point of View: Lauren C. Harshman, MD

In her discussion of the renal cell carcinoma studies at the ASCO Annual Meeting, Lauren C. Harshman, MD, Assistant Professor of Medical Oncology at Dana-Farber Cancer Institute, Boston, suggested, “Given the plateau in efficacy with current treatments, there is space and need for agents with new...

kidney cancer

Anti–PD-1 Agent Shows Activity in Renal Cell Carcinoma

Renal cell carcinoma can be added to the growing list of tumors that respond to programmed death (PD)-1 immune checkpoint inhibitors, according to the results of the CheckMate trials, presented at the 2014 ASCO Annual Meeting. The phase II CheckMate-010 trial evaluated three doses of nivolumab as a ...

leukemia

Program Offers Unique Intervention for Acute Promyelocytic Leukemia

If Anand P. Jillella, MD, has his way, no future patient with acute promyelocytic leukemia (APL) will experience a delay in treatment or lack for an expert consult—and few, if any, will die of this condition. Mortality from APL is much higher than most oncologists think, especially during the first ...

leukemia

Emerging Approaches in Acute Myeloid Leukemia

With the emergence of molecular diagnostics and new therapeutics, the treatment of acute myeloid leukemia (AML) is entering a new era. Hugo F. Fernandez, MD, Associate Chief of Blood and Marrow Transplantation at Moffitt Cancer Center in Tampa, Florida, spoke with The ASCO Post about how he...

issues in oncology

Quest for Targeted Therapeutic ‘Cocktails’ Hits Roadblocks

The use of cutting-edge technology and bioinformatics to inform clinical decision-making in oncology is still a ways off, according to Mark Pegram, MD, the Susy Yuan-Huey Hung Professor of Oncology and Director of the Stanford Breast Oncology Program, Stanford University, Palo Alto, California. At...

lung cancer

Targeting KRAS Mutations in Lung Cancer: No Longer Impossible

The KRAS mutation has long been considered “undruggable,” but new approaches in drug development may change this. The end result could be effective new treatment options for KRAS-mutated non–small cell lung cancer (NSCLC), according to David R. Gandara, MD, who described the emerging findings at...

lung cancer

Stereotactic Body Radiation Therapy an Effective Option for Early-Stage Lung Cancer Patients

Stereotactic body radiation therapy (SBRT) is safe and effective in early-stage non–small cell lung cancer (NSCLC), as it confers local control in 90% or more patients with T1 disease, according to Roy Decker, MD, PhD, Associate Professor in the Department of Therapeutic Radiology at Yale Cancer...

lung cancer

Hsp90 Inhibitors May Soon Transition Into Clinic

Inhibitors of heat shock protein 90 (Hsp90) look promising for the treatment of advanced non–small cell lung cancer (NSCLC) and have the advantage of not needing a specific mutation to target, said Suresh S. Ramalingam, MD, Professor and Chief of Medical Oncology at the Winship Cancer Institute of...

lung cancer

In Advanced Lung Cancer, Targeted Combinations Are Still Works in Progress

For the treatment of advanced non–small cell lung cancer (NSCLC), combinations of targeted agents are of great research interest but have not yet been shown to improve outcomes. Single-agent treatment with tyrosine kinase inhibitors, therefore, remains the standard of care for patients with...

lung cancer

Can Metastatic Lung Cancer Be Cured?

Don’t expect metastatic lung cancer to be cured any time soon, says Paul A. Bunn, Jr, MD, Professor and James Dudley Chair in Cancer Research at the University of Colorado School of Medicine, Denver. “You have to be disease-free for some length of time in order to be cured, which is our goal,” he...

pancreatic cancer

Early Study Finds BRCA-Mutated Pancreatic Cancer Responds to PARP Inhibition Trio

Two-thirds of patients with advanced pancreatic adenocarcinoma who harbored BRCA mutations responded to the combination of veliparib, cisplatin, and gemcitabine in a phase IB trial that is paving the way for future studies of novel poly(ADP-ribose) polymerases (PARP) inhibitors in this challenging...

Expert Point of View: William M. Sikov, MD

At the Breast Cancer Symposium, William M. Sikov, MD, Associate Professor of Medicine at the Warren Alpert Medical School of Brown University, Providence, Rhode Island, gave a talk on the use of pathologic complete response in the clinic and summarized the CTNeoBC findings for The ASCO Post. “The...

breast cancer

CTNeoBC Analysis: Response to Neoadjuvant Chemotherapy Varies by Breast Tumor Subtype

Women who achieve a pathologic complete response (pCR) to neoadjuvant chemotherapy rarely have local or regional recurrence of breast cancer, but this largely depends on tumor subtype, which remained an independent predictor of locoregional recurrence when pathologic response was taken into account ...

breast cancer

Fertility Preservation Suggested With Triptorelin in Long-Term Study

Young women with early breast cancer may be more likely to resume menses and become pregnant when treated with a luteinizing hormone–releasing hormone (LH-RH) analog (also known as a gonadotropin-releasing hormone [GnRH] analog) along with chemotherapy, according to the final follow-up of...

Menopause Rating Scale

The Menopause Rating Scale is a questionnaire evaluating the severity of 11 symptom categories related to menopause on a scale from 0 (no symptoms) to 4 (extremely severe). These include such symptoms as hot flashes, heart discomfort, trouble sleeping, depressive feelings, irritability, sexual...

breast cancer
survivorship

Testosterone/Anastrozole Implants Relieve Menopausal Symptoms in Breast Cancer Survivors

Subcutaneous implants containing testosterone in combination with a low dose of anastrozole can relieve menopausal symptoms in breast cancer survivors, according to research presented at the 2014 ASCO Breast Cancer Symposium.1 “Menopausal symptoms can be quite severe in breast cancer survivors in...

breast cancer

With Breast-Conserving Surgery, Margin Status Not a Factor in Recurrence

In a chart review of 754 early-stage breast cancer patients undergoing breast-conserving surgery, margin status did not impact risk of locoregional recurrence or breast cancer-specific survival, though it did predict for overall survival, as did numerous other factors. Tumor biology remained the...

breast cancer

In Ductal Carcinoma in Situ, Margin Status Need Not Dictate Reexcision

A study of 252 patients with ductal carcinoma in situ raises questions regarding the need to reexcise close margins.1 The findings were presented at a poster session during the 2014 Breast Cancer Symposium by Rachel Gentile, BS, of the Medical College of Wisconsin. The researchers evaluated data...

Expert Point of View: Harold Burstein, MD

Harold Burstein, MD, Associate Professor of Medicine at Dana-Farber Cancer Institute, Boston, spoke to The ASCO Post about the multidisciplinary discussion of margin assessment during the 2014 Breast Cancer Symposium. Should Oncologists Be Concerned? “There is a real art to being a good...

breast cancer

How Accurate Is the Pathologic Assessment of the Partial Mastectomy Specimen?

The pathologic evaluation of lumpectomy margins is “fraught with problems and pitfalls,” said Stuart J. Schnitt, MD, Director of Anatomic Pathology at Beth Israel Deaconess Medical Center and Professor of Pathology at Harvard Medical School, Boston, who was part of a multidisciplinary discussion of ...

breast cancer

Pathologic Complete Response: Understanding the Subtleties

In the neoadjuvant treatment of breast cancer, the importance of achieving a pathologic complete response (pCR) varies substantially by breast cancer subtype. Patients are increasingly interested in this outcome, but it means different things to different patients, according to two breast cancer...

lung cancer

Managing Resistance to Targeted Agents: The Future of NSCLC Therapy

The bane of treating non–small cell lung cancer (NSCLC) patients with druggable mutations has been the development of resistance to targeted agents. New compounds are meeting the challenge of treating resistant disease, according to Fadlo R. Khuri, MD, FACP, Professor and Chair of Hematology and...

Expert Point of View: Ignacio Melero, MD, PhD

As discussant of the nivolumab paper presented by Weber et al at the ESMO Presidential Symposium, Ignacio Melero, MD, PhD, of the Universidad de Navarra in Spain, said “We are presented today with very exciting clinical data. The only disappointment is that the survival data are not mature.” Dr....

skin cancer

Nivolumab Yields ‘Impressive’ Duration of Response as Late-Line Melanoma Treatment

Nivolumab yielded an “impressive” duration of response when used as second- or third-line treatment for patients with advanced melanoma, according to Jeffrey S. Weber, MD, of the Moffitt Cancer Center in Tampa, Florida, who presented preliminary results of a phase III trial at the European Society...

Expert Point of View: Christian Blank, MD, PhD

Oncologists are now “in the luxury position of having two highly potent agents to treat BRAF V600–mutated melanoma,” noted Christian Blank, MD, PhD, Group Leader of Immunology at The Netherlands Cancer Institute, Amsterdam, who discussed the two papers at the ESMO 2014 Presidential Symposium....

skin cancer

BRAF/MEK Inhibitor Combinations Impressive in Melanoma Trials

For advanced/metastatic melanoma patients with BRAF mutations, two pathway inhibitors are better than one, according to studies presented at the European Society for Medical Oncology (ESMO) 2014 Congress that demonstrated improved progression-free and overall survival for regimens combining a BRAF...

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