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multiple myeloma

Single-Agent Daratumumab Activity Deemed ‘Remarkable’ in Refractory Multiple Myeloma

Heavily pretreated patients with multiple myeloma achieved rapid, durable, and deepening responses to the anti-CD38 monoclonal antibody daratumumab, in a phase II study presented at the 2015 ASCO Annual Meeting.1 “Daratumumab showed remarkable single-agent activity in heavily pretreated and...

skin cancer

Oncolytic Immunotherapy in Melanoma: It’s Not All About PD-1

The benefit from immune-directed therapies in patients with advanced melanoma is not limited to the exploding field of checkpoint inhibitors. According to Robert Andtbacka, MD, Associate Professor of Surgical Oncology, at the Huntsman Cancer Institute at the University of Utah, Salt Lake City,...

cns cancers

Poliovirus for Glioblastoma Grabs National Attention

Researchers at The Preston Robert Tisch Brain Tumor Center at Duke University are being barraged by patients wishing to enroll in their clinical trial of an engineered poliovirus for recurrent glioblastoma. This comes as a result of a CBS 60 Minutes interview with lead researcher Matthias...

cost of care

Cost of Immunotherapy Projected to Top $1 Million per Patient per Year

If new immunotherapy combinations were administered to the half a million Americans dying of cancer each year, the nation’s price tag for treating them—for just 1 year—could top $174 billion, according to projections by Leonard Saltz, MD, Chief of Gastrointestinal Oncology and Chair of the Pharmacy ...

cns cancers

Investigators Update PVS-RIPO Data in Glioblastoma

At the 2015 ASCO Annual Meeting, Annick Desjardins, MD, Associate Professor of Neurology at Duke University Medical Center, presented a brief update on the ongoing study of oncolytic PVS-RIPO in glioblastoma, which now includes 24 patients.1 The median age of enrolled patients is 57, most have a...

Expert Point of View: Lloyd Damon, MD

Lloyd Damon, MD, Professor of Medicine at the University of California, San Francisco, discussed the study and noted that although ruxolitinib (Jakafi) is associated with a fair amount of anemia and thrombocytopenia, pacritinib did not increase these conditions in PERSIST-1. In fact, treatment was...

hematologic malignancies

Pacritinib for Myelofibrosis: Effective in Patients With Thrombocytopenia

An emerging JAK inhibitor, pacritinib, appears not only effective in a broad population of patients with myelofibrosis but also among a subset with very low platelet counts, investigators from the global phase III PERSIST-1 trial reported at the 2015 ASCO Annual Meeting.1 “There is a huge unmet...

Expert Point of View: Shanu Modi, MD

Study discussant Shanu Modi, MD, of Memorial Sloan Kettering Cancer Center, New York, commented, “Neither T-DM1 [Kadcyla] nor T-DM1 plus pertuzumab [Perjeta] proved to be superior to the old standard of care, taxane plus trastuzumab [Herceptin]. MARIANNE was a valiant trial, but THP (taxane,...

breast cancer

Ado-Trastuzumab Emtansine Fails to Replace Standard of Care in First-Line Metastatic Breast Cancer

Results are now in for the phase III MARIANNE trial. Although ado-trastuzumab emtansine (formerly known as T-DM1, Kadcyla) proved noninferior to trastuzumab (Herceptin) plus a taxane in the first-line metastatic breast cancer setting, it performed no better than the standard of care.1 “T-DM1 and...

Expert Point of View: Michael P. Link, MD

“We have had remarkable success in treating patients with cancer. Millions of survivors are a testament to this success. But the ‘cost of cure’ borne by our patients is substantial in terms of diminished quality and quantity of life,” commented the formal discussant of the study ­Michael P. Link,...

survivorship

Survivors of Childhood Cancer Living Longer, Largely Due to Treatment Improvements

Survivors of childhood cancers can expect longer lives than their peers of 30 years ago. Improvements in the care of children with cancer have reduced the long-term mortality rate, according to an analysis of 34,000 participants in the Childhood Cancer Survivor Study.1 Cumulative all-cause late...

issues in oncology

Precision Medicine Trials Bring Targeted Treatments to More Patients

At the 2015 ASCO Annual Meeting, both ASCO and the National Cancer Institute (NCI) unveiled details of new precision medicine trials that will greatly expand the number of patients with cancer who are benefiting from targeted agents. The trials will match a patient’s tumor molecular profile with an ...

Expert Point of View: Daniel G. Coit, MD

Daniel G. Coit, MD, of Memorial Sloan Kettering Cancer Center, New York, and Chair of the National Comprehensive Cancer Network (NCCN) Melanoma Guidelines Panel, discussed the findings reported by Lewin et al at the ASCO Annual Meeting. “This is a small retrospective study examining a prospective...

skin cancer

PET/CT Detects Asymptomatic Melanoma Recurrences

In monitoring patients with melanoma at high risk for relapse, surveillance imaging with 18F-fluorodeoxyglucose–positron-emission tomography (FDG-PET)/computed tomography (CT) can detect asymptomatic metastases and thus facilitate early treatment, according to Australian investigators who presented ...

Expert Point of View: Martin J. van den Bent, MD

Commenting on the EF14 study was Martin J. van den Bent, MD, of The Brain Tumor Center at Erasmus MC Cancer Institute in Rotterdam, The Netherlands, who was reticent to predict that tumor treating fields will become a standard of care. He noted that 57% of patients are still alive; therefore, the...

cns cancers

New Concept for Brain Tumors: Tumor Treating Fields

A novel treatment modality that applies electric forces to brain tumors via scalp electrodes improved outcomes in a study reported at the 2015 ASCO Annual Meeting.1 In the first report of the full dataset, tumor treating fields significantly and consistently prolonged both progression-free...

Expert Point of View: Keith T. Flaherty, MD

Keith T. Flaherty, MD, Associate Professor of Medicine, Harvard Medical School, and Director of the Termeer Center for Targeted Therapy, Boston, was interviewed by The ASCO Post for his thoughts on the findings from Atreya and colleagues. He believes the study’s outcomes are sufficient for...

colorectal cancer

Triple Inhibition May Cripple BRAF-Mutated Colorectal Cancer

Triplet therapy that inhibits the BRAF, MEK, and EGFR pathways appears promising in BRAF-mutated colorectal cancer, a malignancy that typically does not respond to BRAF inhibition alone.1 At the 2015 ASCO Annual Meeting, Chloe Evelyn Atreya, MD, of the University of California, San Francisco,...

Expert Point of View: Kenneth Yu, MD, MSc

Kenneth Yu, MD, MSc, of Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, called investigational ­PEGPH20 “a very promising tumor microenvironment-targeted approach” that appears to be well tolerated. “The results are preliminary but there appears to be a biomarker ...

pancreatic cancer

Novel Enzyme Improves Outcomes in Subset of Patients With Pancreatic Cancer

Patients with stage IV pancreatic cancer who received a novel enzyme along with standard chemotherapy experienced a doubling in progression-free survival, compared to those given chemotherapy alone, in a study presented at the 2015 ASCO Annual Meeting.1 Response rates and median duration of...

Expert Point of View: Jeffrey L. Wolf, MD

Jeffrey L. Wolf, MD, Director of the Myeloma Program at the University of California, San Francisco, formally discussed the ENDEAVOR study at the ASCO Annual Meeting. He commented that the “doubling” in progression-free survival is “impressive” and said that “time will tell if this difference...

multiple myeloma

Carfilzomib/Dexamethasone Doubles Progression-Free Survival vs Bortezomib/Dexamethasone in Patients With Relapsed Multiple Myeloma

In the first head-to-head study comparing two proteasome inhibitors in relapsed multiple myeloma, carfilzomib (Kyprolis)/dexamethasone provided a doubling in progression-free survival, compared with bortezomib (Velcade)/dexamethasone.1 Results of the phase III ENDEAVOR trial of the two regimens in...

cost of care

ESMO’s Magnitude of Clinical Benefit Scale Brings Unbiased Perspective to Cancer Drugs’ Worth

An anticancer therapy may be hailed as a breakthrough in some corners, whereas its value may be hotly contested in others. In an effort to bring clear, unbiased perspective to new expensive therapies, the European Society for Medical Oncology (ESMO) has created a valuable tool for oncologists,...

cns cancers

Glioblastoma: Novel Immunotherapy Approaches Generate Responses and Excitement

Checkpoint inhibitors were major attention grabbers at the 2015 ASCO Annual Meeting, but studies suggested there are other encouraging means of harnessing the immune system in the treatment of glioblastoma. EGFRvIII-Targeted Vaccine David A. Reardon, MD, Clinical Director of the Center for...

Expert Point of View: Peter B. Bach, MD, MAPP, and Leonard Saltz, MD

Peter B. Bach, MD, MAPP, Director of the Center for Health Policy and Outcomes at Memorial Sloan Kettering Cancer Center (Memorial), New York, discussed Dr. Schrag’s study at the ASCO Health Services Research and Quality of Care session. “Dr. Schrag’s analysis could have been ‘back of the...

colorectal cancer

Bevacizumab More Cost-Effective Than Cetuximab in Metastatic Colorectal Cancer

The landmark CALGB/SWOG 80405 trial concluded that bevacizumab (Avastin) and cetuximab (Erbitux) provide comparable benefit in the treatment of metastatic colorectal cancer. However, in terms of cost, bevacizumab was recently declared the winner. In an economic analysis presented at the 2015 ASCO...

issues in oncology

Access to Cancer Medicines Not Uniform Across Europe

Access to cancer medicines—including some old standbys—is inconsistent across Europe, depriving many patients of treatments that are the standard of care elsewhere,1 according to Alexandru E. Eniu, MD, PhD, Chair of the European Society for Medical Oncology (ESMO) Emerging Countries Committee and...

Resilient New Orleans: 10 Years After Katrina

It’s been 10 years since floodwaters washed away lives in New Orleans—for most, figuratively or temporarily, but for more than 1,800, literally. We who call this place home all lost something—homes, possessions, jobs, pets, loved ones, our sanity. Mold and muck marked our days for a long time, but...

solid tumors

State-of-the-Art Management of Germ Cell Tumors Produces High Cure Rates

Pasquale W. Benedetto, MD, the Leonard M. Miller Professor of Medicine at the University of Miami/Sylvester Comprehensive Cancer Center, recently spoke at the 2015 New Orleans Summer Cancer Meeting about his approach to diagnosing and treating germ cell tumors in men.1 The ASCO Post was there to...

issues in oncology

Emerging Technology Will Help Tackle Tumor Complexity

Emerging laboratory technology will be “moving the bar forward” in terms of molecular markers, genomics, and gene-expression profiling, with the potential for huge payoffs to oncologists and patients, according to Mark Pegram, MD, the Susy Yuan-Huey Hung Professor of Medicine at Stanford School of...

breast cancer

Genetic Testing in Breast Cancer Offers Much Information but Poses Challenges in Interpretation

For breast cancer patients with robust family histories, medical oncologists should be testing not only for BRCA1/2 mutations, but also for large duplications and deletions as well as for PALB2 mutations. “These [findings] have proven utility in testing breast cancer patients,” said Louise E....

colorectal cancer
hepatobiliary cancer

Colorectal Liver Metastases: Thumbs Up for Radiofrequency Ablation, Jury Still Out for Selective Internal Radiotherapy

Two “firsts” in studies of colorectal liver metastases were highlighted at the 2015 ASCO Annual Meeting: the first prospective randomized trial to evaluate radiofrequency ablation plus chemotherapy1 and the first large randomized phase III trial to study liver-directed selective internal radiation...

lymphoma

Indolent Lymphoma: A More Complex Malignancy Than Once Thought

With a growing number of options for follicular lymphoma, clinicians may wonder whether there is one best regimen. James O. Armitage, MD, FACP, FRCP, Professor of Medicine at the University of Nebraska, Omaha—and Editor-in-Chief of The ASCO Post—tackled this question and offered recommendations at...

lung cancer
issues in oncology

Positioning Targeted and Immunotherapy-Based Approaches in Lung Cancer

With immunotherapy changing the face of lung cancer, is there still a place for targeted therapy? Two experts from Emory University debated this issue at the 2015 Debates and Didactics in Hematology and Oncology Conference held in Sea Island, Georgia. Fadlo Khuri, MD, was recently named President...

Expert Point of View: James Jett, MD, and Martin J. ­Edelman, MD

James Jett, MD, of National Jewish Health in Denver, moderated the press briefing where the study results were presented and called MAPS a “landmark study” that could change the standard of care in this malignancy. Martin J. ­Edelman, MD, Professor of Medicine at the University of Maryland,...

lung cancer

Bevacizumab Plus Standard Chemotherapy Improves Survival in Mesothelioma

The standard of care for malignant pleural mesothelioma may be poised for change, judging by results from a study by the French Cooperative Thoracic Intergroup. The addition of bevacizumab (Avastin) in the first-line setting to the current standard of care, pemetrexed (Alimta)/cisplatin, improved...

head and neck cancer

HPV-Positive Head and Neck Cancer: When Can Chemotherapy Be Omitted?

Are there patients with locally advanced squamous cell carcinoma of the head and neck associated with human papillomavirus (HPV) for whom chemotherapy can be omitted? Experts debated this question at the 2015 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia,...

lymphoma

Mantle Cell Lymphoma: Is Transplantation Still Necessary?

Autologous stem cell transplantation has played a critical role in the treatment of mantle cell lymphoma, but in the age of novel treatments, is it always warranted? Two experts in the field explored the question at the 2015 Debates and Didactics in Hematology and Oncology Conference sponsored by...

Dr. Cohen’s Approach to Managing Double-hit Lymphoma

All patients with aggressive non Hodgkin lymphoma should be evaluated for MYC and BCL2/6 gene expression, if possible, by fluorescent in situ hybridization and immunohistochemistry. Several intensive treatment regimens are available. Dr. Cohen favors dose-adjusted R-EPOCH for patients with...

lymphoma

Double-Hit Lymphoma: Many Treatment Strategies, No Standard of Care

"Double-hit lymphoma” represents a challenging malignancy without a standard-of-care treatment, although outcomes for some patients are better than was once believed, according to Jonathon B. ­Cohen, MD, Assistant Professor of Hematology and Medical Oncology at Emory University, Atlanta. Dr. Cohen...

Expert Point of View: Glenwood Goss, MD, FRCPC, FCPSA

Glenwood Goss, MD, FRCPC, FCPSA, Professor of Medicine and Director of Clinical and Translational Research at the Ottawa Hospital Cancer Centre and University of Ottawa, Canada, formally discussed the findings. He noted that this combination in advanced melanoma showed “limited progression-free...

lung cancer

First-Line Nivolumab/Ipilimumab Combination in Non–Small Cell Lung Cancer Shown to Be Tolerable

For advanced non–small cell lung cancer (NSCLC), first-line treatment with combined immune checkpoint blockade—in novel doses and schedules—was associated with deep and durable responses, encouraging progression-free survival, and much better tolerability than has been previously observed with...

Expert Point of View: Solange Peters, MD, PhD

Solange Peters, MD, PhD, of the Lausanne University Hospital, Switzerland, put these updates in context of what is known about programmed cell death protein 1 (PD-1) antibodies in non–small cell lung cancer (NSCLC), concluding that nivolumab (Opdivo) is “one of the best options” for...

lung cancer

Nivolumab in Lung Cancer Supported by Updated Trial Data

For the treatment of advanced squamous non–small cell lung cancer (NSCLC), the programmed cell death protein 1 (PD-1) antibody nivolumab (Opdivo) continues to show results in key trials that now report 18-month data. The updates were reported at the 16th World Conference on Lung Cancer in Denver,...

lung cancer

Lung Cancer Rates Doubling Among Nonsmokers

Lung cancer is becoming an equal-opportunity malignancy—with rates rising among never-smokers, especially females, according to studies presented at the 16th World Conference on Lung Cancer in Denver. British investigators reported that in one large tertiary medical center, the proportion of...

Expert Point of View: Martin Reck, MD, PhD

Martin Reck, MD, PhD, of the Department of Thoracic Oncology at the Lung Clinic Grosshansdorf in Germany, discussed the studies. In pretreated patients, he said, “We have seen confirmed efficacy” [for AZD9291] and “impressive activity.” In the first-line setting, its efficacy is still being...

lung cancer

AZD9291 Updates Encouraging for Treatment-Resistant NSCLC

At the 16th World Conference on Lung Cancer, several studies showed consistent activity with the investigational third-generation inhibitor AZD9291 in patients with advanced non–small cell lung cancer (NSCLC) that is resistant to epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors....

Expert Point of View: Robert Pirker, MD

Robert Pirker, MD, Professor of Medicine and Program Director for Lung Cancer at the Medical University of Vienna, Austria, discussed the findings at the “Top Abstracts” session of the 16th World Conference on Lung Cancer. Based on these results and the findings of similar studies, Dr. Pirker...

lung cancer

EGFR Gene Copy Number as Biomarker for Antibody Treatment in Squamous Cell NSCLC

Two studies presented at the 16th World Conference on Lung Cancer suggest that high expression of the epidermal growth factor receptor (EGFR), or gene copy number, may indicate potential benefit from EGFR antibodies in squamous cell non–small cell lung cancer (NSCLC). The studies were presented by...

issues in oncology

Delays in Drug Approval Are Deadly, Highlighting the Need for Improved Regulatory Efficiency

Researchers have determined just how many lives are lost when effective investigational drugs are not approved in a timely manner. These delays in the process of anticancer drug approvals result in thousands of premature deaths each year, according to an analysis presented at the 16th World...

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