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Reflections on a Career in Hematology/Oncology

I am a retired 82-year-old Hematologist/Oncologist who reads The ASCO Post regularly. I am writing to share some brief thoughts with the authors of two articles in the February 10, 2020 issue. First, I would address the article, A Hopeful Look Ahead in Oncology, written by Dan L. Longo, MD, MACP....

NCI Awards $9.1 Million Grant to Cedars-Sinai for Research on Dietary Fat and Liver Metastasis

A scientific team has been awarded a $9.1 million grant by the National Cancer Institute to study liver metastasis. The co-lead investigators, Neil Bhowmick, PhD, Director of the Cancer Biology Program, and Shelly Lu, MD, Women’s Guild Chair in Gastroenterology and Director of the Division of...

Rush University Medical Center Earns National Center of Excellence for Pancreatic Cancer Designation

The National Pancreas Foundation has named Rush University Medical Center as a National Center of Excellence for Pancreatic Cancer, a designation given to hospitals that have demonstrated the multidisciplinary approach, social support, and advanced research resources needed to successfully treat...

lymphoma
solid tumors
hepatobiliary cancer

FDA Pipeline: Priority Review in DLBCL, Fast Track Designations in T-Cell Lymphoma and Adenoid Cystic Carcinoma

Over the past week, the U.S. Food and Drug Administration (FDA) granted Priority Review to a combination therapy in diffuse large B-cell lymphoma (DLBCL); gave Fast Track designations for treatments in T-cell lymphoma and adenoid cystic carcinoma; granted Orphan Drug designation to an agent for the ...

breast cancer

NSABP B-42 Trial 10-Year Update: Impact of Extended Letrozole on Disease-Free Survival

“In the 10-year analysis of the NSABP B-42 trial, the effect of extended treatment with 5 years of letrozole on disease-free survival persisted and reached statistical significance. There was no significant improvement in overall survival with letrozole, but letrozole continued to provide a...

lung cancer
immunotherapy

Concurrent Pembrolizumab and Chemoradiotherapy in Locally Advanced NSCLC

In a phase I trial reported in JAMA Oncology, Jabbour et al found that the use of pembrolizumab concurrently with chemoradiotherapy in advanced non–small cell lung cancer (NSCLC) was tolerable, and that progression-free survival with the combination therapy was 69.7% at 12 months. As stated by the...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Expert Point of View: Daniel V.T. Catenacci, MD

Daniel V.T. Catenacci, MD, Associate Professor of Medicine and Director of the Gastrointestinal Oncology Program at the University of Chicago, was the JAVELIN Gastric 100 study’s invited discussant. After offering an extensive background on the use of immunotherapy in gastric or gastroesophageal...

lung cancer
immunotherapy

Plasma-Based Tumor Mutational Burden May Predict Response to Immunotherapy in Patients With Metastatic NSCLC

Patients with non–small cell lung cancer (NSCLC) with higher measures of tumor mutations that show up in a blood test generally have a better clinical response to certain immunotherapy treatments than patients with a lower measure of mutations. A clinical trial showed that in cases where liquid...

lung cancer
immunotherapy

Long-Term Outcomes and Retreatment Outcomes With Immunotherapy in PD-L1–Positive Advanced NSCLC

As reported in the Journal of Clinical Oncology by Roy S. Herbst, MD, PhD, and colleagues, long-term follow-up of patients with previously treated advanced programmed cell death ligand 1 (PD-L1)-positive non–small cell lung cancer (NSCLC) in the KEYNOTE-010 trial has shown a continued survival...

lung cancer
head and neck cancer
gynecologic cancers
breast cancer

FDA Pipeline: Priority Review in Lung Cancer, Breakthrough Therapy Designation in Head and Neck Cancer, and More

This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to brigatinib for the treatment of ALK-positive lung cancer and Breakthrough Therapy designation to a potential first-in-class oral antagonist of inhibitors of apoptosis proteins for the treatment of head and neck...

breast cancer
issues in oncology

Are There Differences in Treatment and Outcomes for African American and White Women With Triple-Negative Breast Cancer?

In a study using Henry Ford Health System data reported in a research letter in JAMA Surgery, Chen et al found little difference in treatment and outcomes between African American and white women with nonmetastatic triple-negative breast cancer. Screen detection of disease was associated with...

lung cancer

Cancer Has Made Me the Person I Am, and I’m Grateful

The only clue that I was harboring a life-threatening cancer came as I was driving to a golf lesson in the fall of 2006, and I casually rubbed the left side of neck and felt a tiny bump. Although I wasn’t alarmed at the time, I did point out the mass to my primary care physician when I met with...

lung cancer
lymphoma
bladder cancer
head and neck cancer
gastroesophageal cancer
gastrointestinal cancer
immunotherapy

FDA Pipeline: Priority Reviews in Lung Cancers, Lymphoma

This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to treatments for non–small cell and small cell lung cancers, as well as for diffuse large-B cell lymphoma (DLBCL); Breakthrough Therapy designation to an antibody-drug conjugate for bladder cancer; and a double Fast...

Searching for Evidence-Based Reassurance Where None Could Be Found

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

lung cancer
immunotherapy

Patient-Reported Outcomes With Addition of Pembrolizumab vs Placebo to Pemetrexed/Platinum for Nonsquamous NSCLC

As reported in The Lancet Oncology by Marina C. Garassino, MD, and colleagues, global health status/quality of life was maintained or improved with the addition of pembrolizumab vs placebo to pemetrexed/platinum therapy for previously untreated metastatic nonsquamous non–small cell lung cancer...

breast cancer
genomics/genetics

Neoadjuvant Cisplatin for BRCA-Mutation Carriers: Pruning the Dead Branches

At the 2019 San Antonio Breast Cancer Symposium, Nadine Tung, MD, of Beth Israel Deaconess Medical Center, presented a multisite study called INFORM, run by the Translational Breast Cancer Research Consortium.1 It compared single-agent cisplatin with a “classic” combination of doxorubicin and...

geriatric oncology

Poster to Bedside: Geriatric Oncology Research Updates From 2019 ASCO Annual Meeting

Functional status impairment, limited mobility, comorbidities, polypharmacy, and other aging-related manifestations are common in older individuals. These conditions complicate the oncologic management of older adults, who are underrepresented in clinical trials, even though they form the majority ...

immunotherapy
bladder cancer

Pembrolizumab for BCG-Unresponsive, High-Risk Non–Muscle Invasive Bladder Cancer

On January 8, 2020, pembrolizumab was approved for treatment of patients with bacillus Calmette-Guérin (BCG)-unresponsive, high-risk, non–muscle invasive bladder cancer with carcinoma in situ with or without papillary tumors who are ineligible for or have elected not to undergo cystectomy.1,2...

immunotherapy
hematologic malignancies

Early Data Suggest Efficacy of Innovative CAR NK-Cell Therapy for B-Cell Malignancies

FT596, a novel off-the-shelf chimeric antigen receptor natural killer cell (CAR-NK) product, was as effective as existing CAR T-cell platforms in killing cancer cells in vivo, and the combination of FT596 plus rituximab killed lymphoma cancer cells that were no longer responding to CAR T-cell...

immunotherapy
lymphoma

Bispecific Antibody Shows Activity in Post–CAR T-Cell Therapy for Non-Hodgkin Lymphoma

Mosunetuzumab, an ­investigational ­bispecific antibody, demonstrated activity in preliminary studies of patients with non-Hodgkin lymphoma (NHL), including those who are refractory to or relapsed after third-line chimeric antigen receptor (CAR) T-cell therapy. With further study, mosunetuzumab,...

immunotherapy
lymphoma

Will Bispecific Antibodies Compete With CAR T-Cell Therapy in Lymphoma?

Are second-generation bispecific antibodies the next big thing in lymphoma? Studies of these drugs were among the highlights of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition. Years ago, the bispecific T-cell engager blinatumomab validated the concept of bispecific...

hematologic malignancies
leukemia
multiple myeloma
lymphoma
immunotherapy

Conference Highlights From the 2019 American Society of Hematology Annual Meeting & Exposition

More than 25,000 specialists in hematology from over 115 countries attended the 61st American Society of Hematology (ASH) Annual Meeting & Exposition held last December in Orlando. The conference featured a stunning array of 4,900 abstracts with impressive new data in the treatment of multiple...

lymphoma

Haploidentical Related Donor vs Unrelated Cord Blood Hematopoietic Cell Transplantation for Hodgkin and Non-Hodgkin Lymphomas

In a retrospective analysis reported in the Journal of Clinical Oncology, Fatobene et al found that nonmyeloablative haploidentical related donor cell transplantation was associated with better outcomes compared to unrelated cord blood hematopoietic transplantation in patients with Hodgkin and...

lung cancer

Osimertinib Plus Savolitinib for EGFR-Mutated, MET-Amplified NSCLC After Disease Progression on EGFR Tyrosine Kinase Inhibitors

As reported in The Lancet Oncology, Lecia V. Sequist, MD, and colleagues have found activity and an acceptable risk-benefit profile with the combination of the third-generation EGFR tyrosine kinase inhibitor osimertinib and the MET tyrosine kinase inhibitor savolitinib in patients with EGFR...

skin cancer

States With Highest Rates of Cutaneous Melanoma Due to Ultraviolet Exposure

A new study found a wide state-by-state variation in rates of melanoma caused by ultraviolet (UV) exposure, with highest rates in several states on the east and west coasts (including Hawaii), but also a few landlocked states (including Utah, Vermont, and Minnesota). The report, published by Islami ...

lung cancer
immunotherapy

ASCO/CCO Update Guideline for Selecting Systemic Treatment in Stage IV NSCLC Without Driver Mutations

ASCO and Cancer Care Ontario (CCO) have published an update to a joint guideline on systemic therapy for stage IV non–small cell lung cancer (NSCLC) without driver mutations.1 “The treatment of stage IV NSCLC has become increasingly more complicated, and, with the advent of immunotherapy and the...

lymphoma
lung cancer
gastrointestinal cancer
breast cancer
head and neck cancer
immunotherapy

FDA Pipeline: Priority Reviews in Lymphoma, Lung Cancer, GIST, and Breast Cancer

This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to agents in lymphoma, lung cancer, gastrointestinal stromal tumors, and breast cancer, and granted Fast Track designation to a first-in-class radioenhancer hafnium oxide nanoparticle in head and neck cancer. Priority...

hematologic malignancies
immunotherapy

Anti-CD19 CAR-NK Therapy in Relapsed or Refractory CD19-Positive Lymphoid Tumors

In a phase I/II trial reported in The New England Journal of Medicine, Liu et al found that anti-CD19 chimeric antigen receptor (CAR) natural killer (NK) cells produced rapid responses in patients with CD19-positive lymphoid tumors, without the toxicities associated with CAR T-cell therapy in this...

immunotherapy
symptom management

Immune-Related Adverse Events in Patients With Cancer Receiving Influenza Vaccination During Treatment With Pembrolizumab

In a study reported in JCO Oncology Practice, Failing et al found that influenza vaccination did not increase the incidence of immune-related adverse events among patients receiving pembrolizumab for various cancers. On multivariate analysis, influenza vaccination was associated with a...

breast cancer

Low-Fat Diets With Increased Vegetable, Fruit, and Grain Intake Linked to Reduced Risk of Breast Cancer Mortality in Postmenopausal Women

As reported in the Journal of Clinical Oncology by Rowan T. Chlebowski, MD, PhD, and colleagues, 20-year follow-up of the Women’s Health Initiative Dietary Modification trial has shown a maintained reduction in non–breast cancer-related mortality after breast cancer diagnosis and the emergence of a ...

lung cancer

Jarrett Failing, MD, on Human Leukocyte Antigen Expression in NSCLC With Brain Metastases

Jarrett Failing, MD, of the Mayo Clinic, discusses his study data, which show some agreement between the expression of human leukocyte antigens in primary non–small cell lung cancer with brain metastasis. His findings may have some bearing on resistance to immune checkpoint inhibitors (Abstract 43).

lung cancer
immunotherapy
symptom management

ASCO-SITC 2020: Low Incidence of Nivolumab-Induced Radiation Recall Pneumonitis Among Patients With NSCLC

A multicenter retrospective study investigating the incidence of pneumonitis and the incidence, risk factors, and clinical characteristics of radiation recall pneumonitis in patients with non–small cell lung cancer (NSCLC) who had received nivolumab found the incidence of radiation recall...

lymphoma
immunotherapy
geriatric oncology
cost of care

Real-World Data for CAR T-Cell Therapy Show Benefit in Older Patients With Lymphoma, Lower Subsequent Health-Care Costs

Once considered highly experimental, chimeric antigen receptor (CAR) T-cell therapy is now an established third-line treatment option for B-cell lymphomas and leukemias. CAR T-cell therapy has saved the lives of people who would otherwise have run out of treatment options. But the question is...

issues in oncology

Comparing Prescribing Habits in Academic and Nonacademic Oncology Settings

The art of oncology practice is tailored to the individual patient with cancer, and with the advent of highly personalized targeted therapies, patient outcomes have improved markedly over the past several decades. Although much of oncology practice is guideline- or protocol-driven, chemotherapy...

lung cancer

ASCO Guideline Addresses Surveillance of Lung Cancer After Curative-Intent Therapy

ASCO has released a new guideline providing recommendations to practicing clinicians on radiographic imaging and biomarker surveillance strategies after definitive, curative-intent therapy in patients with stage I to III non–small cell lung cancer or small cell lung cancer. These guideline...

CAR T-Cell Gene Therapy in Non-Hodgkin Lymphomas: Present and Future

To complement The ASCO Post’s continued comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel immunotherapies for patients with different types of non-Hodgkin...

Selected ASH Abstracts on Myelodysplastic Syndromes

To complement The ASCO Post’s continued comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapies for myelodysplastic syndromes (MDS), including the...

ASCO’s Inaugural Breakthrough Global Summit Showcased Evolving Technologies Poised to Revolutionize Cancer Care

Unlike ASCO’s Annual Meeting, symposia, and conferences, which highlight the current scientific advances in specific cancers and how they are improving cancer outcomes for the more than 18.1 million people worldwide diagnosed with cancer each year,1 ASCO Breakthrough: A Global Summit for Oncology...

lung cancer
thyroid cancer
myelodysplastic syndromes

FDA Pipeline: Priority Review Granted for Treatment in Lung and Thyroid Cancers

This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to a treatment for lung and thyroid cancers with a RET fusion or mutation; gave Breakthrough Therapy designation to a doublet therapy for TP53-mutated myelodysplastic syndromes; and issued an update to their...

lung cancer
immunotherapy

Pooled Analysis of Body Mass Index and Overall Survival With Immune Checkpoint Inhibitor Therapy in NSCLC

In a study reported in JAMA Oncology, Kichenadasse et al found that high body mass index was associated with improved overall survival in patients with advanced non–small cell lung cancer (NSCLC) treated with atezolizumab. As noted by the investigators, there are data showing that high BMI is...

prostate cancer
issues in oncology

Equal-Access Health-Care System for African American and White Men With Prostate Cancer

Among men with prostate cancer who received care from the U.S. Department of Veterans Affairs (VA) Health System, an equal-access health-care system, African American men did not have more advanced disease at the time of diagnosis or die earlier than white men, unlike trends seen in the greater...

issues in oncology

Are Patient-Reported Outcomes Predictive of Survival and Likelihood of Hospitalization?

In a study reported in JCO Oncology Practice, Kerrigan et al found that patient-reported outcomes (PROs), obtained by using the National Cancer Institute (NCI) Patient-Reported Outcomes Measurement Information System–Cancer (PROMIS-Ca) Bank, may be prognostic for outcomes in patients with advanced...

lymphoma
immunotherapy

CAR T-Cell Therapy Comes to Mantle Cell Lymphoma

Advanced mantle cell lymphoma appears to be a good target for chimeric antigen receptor (CAR) T-cell therapy. Treatment with KTE-X19, an anti-CD19 CAR T-cell product, led to unprecedented outcomes in patients with relapsed or refractory disease in the phase II ZUMA-2 study presented at the 2019 ASH ...

lung cancer

STS 2020: Intraoperative Molecular Imaging Technology Helps Surgeons to Detect NSCLC

A tumor-highlighting technology—OTL38—enhances the visualization of lung cancer tissue, providing surgeons with a significantly better chance of finding and removing more cancer than previously possible, according to a scientific presentation by Gangadharan et al at the Plenary Session of the 56th...

solid tumors
immunotherapy

Dual VEGF and PD-1 Inhibition in Advanced Solid Tumors

In a phase Ib/II trial reported in the Journal of Clinical Oncology, Taylor et al found the combination of the VEGF inhibitor lenvatinib and the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab showed activity across a range of advanced solid tumors. As stated by the authors, there is ...

geriatric oncology

How Real-World Data Can Help Contextualize New Treatments in Older Patients

Consider a patient who is referred for neoadjuvant therapy for stage IIIA, HER2-positive breast cancer. She is otherwise healthy, with no significant medical history, an Eastern Cooperative Oncology Group performance status of 0, unremarkable baseline labs, and a left-ventricular ejection fraction...

survivorship

AYA Cancer Survivors at Greater Risk of Inpatient Hospitalization

A population-based study investigating the risk of inpatient hospitalizations among adolescent and young adult (AYA) cancer survivors compared with their siblings and those in the general population found that the AYA survivors had nearly double the risk of being hospitalized than the matched...

multiple myeloma
prostate cancer
lung cancer
hepatobiliary cancer
immunotherapy

FDA Pipeline: Priority Reviews in Multiple Myeloma, Prostate Cancer

Over the past week, the U.S. Food and Drug Administration (FDA) granted Priority Review to treatments for multiple myeloma and prostate cancer; gave Fast Track designation to a targeted gene therapy for lung cancer; granted Orphan Drug designation to a combination therapy for hepatocellular...

Largest Single-Year Drop in Cancer Mortality Ever Reported: 2016–2017

The cancer death rate declined by 29% from 1991 to 2017, including a 2.2% drop from 2016 to 2017—the largest single-year drop in cancer mortality ever reported. These findings were reported in “Cancer Statistics, 2020,” the latest edition of the American Cancer Society’s annual report on cancer...

pancreatic cancer

Olaparib as Maintenance Therapy for Germline BRCA-Mutated Metastatic Pancreatic Adenocarcinoma

On December 27, 2019, the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib was approved for the maintenance treatment of adult patients with deleterious or suspected deleterious germline BRCA-mutated metastatic pancreatic adenocarcinoma, as detected by a U.S. Food and Drug Administration...

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