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Expert Point of View: Hanna K. Sanoff, MD, MPH

Study discussant Hanna K. Sanoff, MD, MPH, of the University of North Carolina Lineberger Comprehensive Center, summarized the key results of VISNU-1: first, survival is shorter for patients with high circulating tumor cell (CTC) count; second, the incremental benefit from FOLFOXIRI (fluorouracil...

colorectal cancer
immunotherapy

Targeting FOLFOXIRI Plus Bevacizumab to a Metastatic Colorectal Cancer Subset

In a population of patients with metastatic colorectal cancer deemed to be at high risk by the presence of circulating tumor cells (CTCs), first-line treatment with FOLFOXIRI plus bevacizumab improved progression-free survival by about 3 months, compared with modified FOLFOX plus bevacizumab,...

lung cancer

Advances in Targeted Therapy for Non–Small Cell Lung Cancer

Targeted therapies for non–small cell lung cancer (NSCLC) are a hotbed of investigation. Two new targeted therapies are promising for patients with lung tumors that are either EGFR exon 20 insertions or RET-rearranged. At the 2019 ASCO Annual Meeting, attendees heard early data on therapies...

breast cancer

NALA Trial: Neratinib Plus Capecitabine Shows Benefit in Metastatic Breast Cancer

In the global phase III NALA trial, treatment of metastatic HER2-positive breast cancer with neratinib plus capecitabine significantly improved progression-free survival, delayed the time to intervention for central nervous system disease, and showed a trend toward improved overall survival vs...

breast cancer

Clinical Risk Enhances Utility of TAILORx Findings in Young Women With Breast Cancer

Clinical risk factors add prognostic information that complements the 21-gene recurrence score, according to a new analysis from the landmark TAILORx trial.1,2 The integration of clinical risk with the recurrence score provides greater precision in determining recurrence risk and guiding the use of ...

solid tumors

Presence of Teratoma and Disease-Related Death in Advanced Germ Cell Tumors

In a single-center retrospective analysis reported in the Journal of Clinical Oncology, Funt et al found that the presence of teratoma in advanced nonseminomatous germ cell tumors was associated with a greater risk for disease-related death. The study was a retrospective review of primary tumor...

hematologic malignancies
multiple myeloma

IMWG Consensus Recommendations on Imaging in Monoclonal Plasma Disorders

Just as newer drugs have significantly improved outcomes for patients with multiple myeloma in the past decade, newer imaging techniques are upgrading detection of the disease, leading to earlier treatment, but standards to help guide clinicians on the optimal use of advanced imaging have lagged...

breast cancer

Breast Cancer Screening With Addition of MRI to Mammography in Women With Familial Risk

The Dutch FaMRIsc study, reported in The Lancet Oncology by Saadatmand et al, found that the addition of screening magnetic resonance imaging (MRI) to mammography resulted in identification of more breast cancers—and identification at an earlier stage—vs mammography alone among women...

issues in oncology

Transition to Outpatient Infusional EPOCH-Based Chemotherapy at a Safety Net Hospital

In a report published in the Journal of Oncology Practice, Keshvani et al found that transitioning from inpatient to outpatient ambulatory infusional EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin)-based chemotherapy in patients with lymphoma at a safety net hospital...

gynecologic cancers

Does Adjuvant Chemoradiotherapy Extend Relapse-Free Survival in Stage III or IVA Endometrial Cancer?

In the phase III GOG 258 trial reported in The New England Journal of Medicine, Matei et al found that 6 months of adjuvant platinum-based chemotherapy plus radiation therapy did not improve relapse-free survival vs chemotherapy alone in stage III or IVA endometrial cancer. In the open-label...

cns cancers
immunotherapy

Update on Early-Stage Studies of Novel Treatments in Glioblastoma

Outcomes are typically grim for patients with recurrent glioblastoma multiforme. At the 2019 Annual Scientific Meeting of the American Association of Neurological Surgeons (AANS), three early-stage studies hinted at ways that standard treatments might be made more effective. Metronomic Dosing of...

prostate cancer

Apalutamide Improves Survival Outcomes in Castration-Sensitive Metastatic Prostate Cancer in TITAN Trial

Adding apalutamide to androgen-deprivation therapy (ADT) significantly improved survival in men with metastatic castration-sensitive (also termed hormone-sensitive) prostate cancer, according to the results of the phase III TITAN trial, which were presented at the 2019 ASCO Annual Meeting and...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Expert Point of View: Ian Chau, MD

IAN CHAU, MD, a consultant medical oncologist at the Gastrointestinal and Lymphoma Units of The Royal Marsden NHS Foundation Trust in London and Surrey, United Kingdom, was the invited discussant of KEYNOTE-062. In an interview with The ASCO Post, he first commented that although single-agent...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

KEYNOTE-062: Pembrolizumab Is a New First-Line Option in Gastric/Gastroesophageal Junction Cancer

KEYNOTE-062, a study of first-line treatment in patients with advanced gastric or gastroesophageal junction adenocarcinoma, found pembrolizumab to be noninferior to chemotherapy and perhaps better than chemotherapy in a subgroup of patients. The results were reported at the 2019 ASCO Annual Meeting ...

prostate cancer

Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer: Delaying Overt Metastatic Disease Is a Major Advance

Nonmetastatic (M0) castration-resistant prostate cancer arises in the subset of men with biochemically recurrent disease (ie, rising prostate-specific antigen [PSA] level after definitive therapy in the absence of metastases) who develop PSA progression after chronic exposure to...

prostate cancer

ARAMIS Trial: Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer

In a phase III ARAMIS trial reported in The New England Journal of Medicine, Karim Fizazi, MD, of the Institut Gustave Roussy, Universite Paris-Sud, Villejuif, France, and colleagues found that the androgen-receptor antagonist darolutamide significantly prolonged metastasis-free survival vs placebo ...

skin cancer
immunotherapy

Comparison of Combination Dosing Schedules of Neoadjuvant Ipilimumab/Nivolumab in Macroscopic Stage III Melanoma

In the phase II OpACIN-neo study reported in The Lancet Oncology, Rozeman et al identified a promising dosing schedule for neoadjuvant ipilimumab/nivolumab in macroscopic stage III melanoma. Study Design The trial included 86 evaluable patients with resectable stage III melanoma involving the...

head and neck cancer

Immune Response to HPV16-Driven Tumorigenesis May Be Detectable Before Clinical Diagnosis of Oropharyngeal Squamous Cell Carcinoma

An international group of researchers has found that antibodies to the human papillomavirus type 16 (HPV16) may develop in the body between 6 to 40 years prior to a clinical diagnosis of oropharyngeal squamous cell carcinoma, and their presence indicates a strong increased risk of the disease....

issues in oncology

AACR Environmental Carcinogenesis: Silicone-Based Wristbands for Detection of Occupational Environmental Exposures for Firefighters

First responders such as paramedics and firefighters may be exposed to hazardous occupational environmental exposures, but linking these exposures to conditions such as cancers is difficult due to the latency period of disease, magnitude of potential exposure, and potential interactions of...

colorectal cancer
issues in oncology

AACR Environmental Carcinogenesis: Lowering Exposure to Nitrates in Drinking Water May Reduce U.S. Cancer Cases

Nitrate levels in water resources have increased in many areas of the world, largely due to the use of inorganic fertilizer and animal manure in agricultural areas. Research has shown that the risk of specific cancers and birth defects may be increased when nitrate is ingested under conditions that ...

leukemia

Association of Antibodies With Pegaspargase Allergic Reactions and Failure of Rechallenge in Pediatric ALL

In a study reported in the Journal of Clinical Oncology, Liu et al determined the frequency of allergic reactions and consequences of development of antibodies to pegaspargase (PEG-ASP) among pediatric patients with newly diagnosed acute lymphoblastic leukemia (ALL).    As noted by the...

breast cancer

PERSEPHONE: 4-Year Disease-Free Survival With 6 vs 12 Months of Adjuvant Trastuzumab for HER2-Positive Breast Cancer

The 4-year disease-free survival results of the UK phase III PERSEPHONE trial, reported by Earl et al in The Lancet, found that 6 months of adjuvant trastuzumab was noninferior to 12 months when given with chemotherapy in HER2-positive early breast cancer. Study Details The open-label trial...

leukemia
immunotherapy

EHA 2019: ASCEND Trial Compares Acalabrutinib vs Investigator’s Choice in Relapsed or Refractory CLL

The randomized, global, multicenter, open-label phase III ASCEND trial evaluated the efficacy and safety of acalabrutinib vs investigator’s choice of rituximab/idelalisib or rituximab/bendamustine in patients with relapsed or refractory chronic lymphocytic leukemia (CLL). Ghia et al presented ...

leukemia

EHA 2019: CLL12 Trial Investigates Ibrutinib in Previously Untreated, Asymptomatic Early-Stage CLL

At the 24th Annual Congress of the European Hematology Association (EHA), Langerbeins et al presented findings from the phase III CLL12 trial, which evaluated whether ibrutinib prolongs event-free survival in patients with previously untreated, Binet stage A chronic lymphocytic leukemia (CLL)...

multiple myeloma

EHA 2019: BELLINI Trial Evaluates Addition of Venetoclax to Bortezomib/Dexamethasone in Relapsed or Refractory Multiple Myeloma

The phase III BELLINI trial—reported by Kumar et al at the 24th Annual Congress of the European Hematology Association (EHA; Abstract LB2601) investigated the efficacy and safety of venetoclax/bortezomib/dexamethasone vs bortezomib/dexamethasone in patients with relapsed or refractory...

sarcoma

Cediranib in Alveolar Soft-Part Sarcoma

In the phase II CASPS trial reported in The Lancet Oncology, Judson et al found evidence of activity of cediranib in alveolar soft-part sarcoma. In the double-blind trial, 48 patients from 12 sites in the United Kingdom, Spain, and Australia were randomly assigned 2:1 between July 2011 and July...

hepatobiliary cancer
pancreatic cancer

Serum MicroRNAs for the Diagnosis of Pancreatic and Biliary Tract Cancers

Diagnosis of pancreatic and biliary tract cancers is complex and challenging due to the lack of symptoms and/or the difficulty of direct, invasive, and imaging-based methods of diagnosis. In an effort to develop better diagnostic markers for these diseases, Kim et al analyzed the genome-wide...

issues in oncology
survivorship

U.S. Cancer Survivors Numbered Nearly 17 Million at the Start of 2019

There were more than 16.9 million Americans with a history of cancer on January 1, 2019, and that number is projected to reach more than 22.1 million by 2030 based on the growth and aging of the population alone, according to estimates from Cancer Treatment and Survivorship Statistics, 2019....

issues in oncology

Survival Improvements for AYA Survivors Undermined by Late-Stage Diagnosis, Racial and Socioeconomic Disparities

The 2006 publication of the National Cancer Institute’s report Closing the Gap: Research and Care Imperatives for Adolescents and Young Adults With Cancer highlighted the lack of improvement in cancer survival among people between the ages of 15 and 39 compared to children and older adults...

breast cancer

2019 ASCO: New TAILORx Data Provide Treatment Guidance for Women Under 50 With Early Breast Cancer

New information about adjuvant therapy to prevent recurrence of breast cancer in women 50 years of age or younger has emerged from the Trial Assigning Individualized Options for Treatment (Rx), or TAILORx. An analysis of a prespecified secondary endpoint in this trial found that an assessment of a ...

kidney cancer

2019 ASCO: No Benefit From Pazopanib in Advanced Renal Cell Carcinoma After Metastasectomy

The E2810 trial was conducted to determine whether treatment with the oral drug pazopanib following surgery to remove further metastases in patients with advanced renal cell carcinoma would improve their disease-free survival. Results from the study—which showed that primary endpoint of...

breast cancer
colorectal cancer
health-care policy
issues in oncology

Medicaid Expansion and Colorectal Cancer Screening

A new study examining Medicaid expansion and cancer screening found that the five states and District of Columbia that first adopted Medicaid expansion saw larger increases in colorectal cancer screening than states that did not expand Medicaid. The study—published by Fedewa et al in...

issues in oncology

NCI Annual Report to the Nation on the Status of Cancer

The latest Annual Report to the Nation on the Status of Cancer finds that, for all cancer sites combined, cancer death rates continued to decline in men, women, and children in the United States from 1999 to 2016. Overall cancer incidence rates, or rates of new cancers, decreased in men from 2008...

From Leeches to Liquid Biopsy: Uncovering the Mysteries of Blood

BOOKMARK Title: Nine Pints: A Journey Through the Money, Medicine, and Mysteries of BloodAuthor: Rose GeorgePublisher: Metropolitan BooksPublication date: October 2018Price: $27.00, hardcover, 368 pages Blood has been mythologized and misunderstood since the earliest records of humankind and still ...

Scientist, Father of A Child With Autism Pushes Back on the Antivaccine Movement

BOOKMARK Title: Vaccines Did Not Cause Rachel’s Autism: My Journey as a Vaccine Scientist, Pediatrician, and Autism DadAuthor: Peter J. Hotez, MD, PhDPublisher: Johns Hopkins University PressPublication date: October 2018Price: $22.95, hardcover; 240 pages English physician Edward Jenner invented...

issues in oncology
health-care policy

Major Settlement Raises Questions About Evidence-Based Value in Cancer Care

An Oklahoma jury recently awarded $25.5 million to the widower of a 53-year-old woman diagnosed with stage IV nasopharyngeal cancer who was denied coverage for proton therapy by her health insurer, Aetna. The patient’s family subsequently raised $92,000 to cover her proton therapy at The University ...

bladder cancer
immunotherapy

Adverse Events and Outcomes in Patients Receiving Anti–PD-1/PD-L1 Antibody Treatment for Advanced Urothelial Cancer

In an analysis reported in the Journal of Clinical Oncology, Maher et al found that treatment-related adverse events of special interest and immune-mediated adverse events were more common among patients with advanced urothelial cancer with vs without response to anti–programmed cell death...

hematologic malignancies

Selected Abstracts From the 2019 ASCO Annual Meeting

To complement The ASCO Post’s comprehensive coverage of the 2019 ASCO Annual Meeting, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic regimens for plasma cell dyscrasias, particularly multiple myeloma. For full details of these study abstracts, visit ...

hepatobiliary cancer
gynecologic cancers

Aspirin Use and Cancer Prevention: Long-Term Data Needed on Benefits and Risks

In addition to its well-known cardioprotective benefits, aspirin has a substantial body of observational, preclinical, and clinical evidence supporting its efficacy in preventing cancer, most strongly for colorectal cancer.1 The strength of this evidence led the U.S. Preventive Services Task...

lung cancer

Survey Finds Prophylactic Cranial Irradiation Use in Decline for Extensive-Stage Small Cell Lung Cancer

Delivery of prophylactic cranial irradiation to patients with extensive-stage small cell lung cancer (SCLC) has declined significantly since the publication of a study by Takahashi et al, according to a recent survey of academic radiation oncologists.1 Data presented at the 2019 Multidisciplinary...

immunotherapy
lung cancer

KEYNOTE-001 Shows Long-Term Survival Benefit With Pembrolizumab in Advanced NSCLC

Before the introduction of immunotherapy with checkpoint inhibitors, the 5-year life expectancy for patients with advanced non–small cell lung cancer (NSCLC) was 5.5%. This dismal outlook has changed. Treatment with the immune checkpoint inhibitor pembrolizumab dramatically improved overall...

issues in oncology
health-care policy

ACA Increases Access to Health Care, Early Diagnosis, and Timely Treatment for Patients With Cancer

  The evidence is in: the Affordable Care Act (ACA) has enabled improved access to earlier diagnosis, earlier care, and reduced racial disparities in access to care for patients with cancer, according to two studies presented at the 2019 ASCO Annual Meeting. In states that adopted Medicaid...

pancreatic cancer

2019 ASCO: POLO: Maintenance Olaparib in Germline BRCA-Mutated Pancreatic Cancer

The randomized phase III POLO trial found that maintenance therapy with the poly (ADP-ribose) polymerase inhibitor olaparib significantly delayed the progression of metastatic pancreatic cancer in patients with germline BRCA gene mutations compared with placebo (median...

prostate cancer

2019 ASCO: TITAN Study Assesses Apalutamide vs Placebo During Androgen-Deprivation Therapy for Metastatic Castration-Sensitive Prostate Cancer

Results from the phase III TITAN trial, presented by Chi et al at the 2019 ASCO Annual Meeting (Abstract 5006), showed that the addition of apalutamide to androgen-deprivation therapy (ADT) improved radiographic progression-free and overall survival in patients with metastatic castration-sensitive...

New Data on Improving Access to Cancer Care, Advances in Precision Medicine Highlighted at 2019 ASCO Annual Meeting

As this special edition of The ASCO Post goes to press, more than 32,000 cancer experts from around the world have convened in Chicago to share the latest clinical cancer research impacting patient care at the 55th Annual Meeting of the American Society of Clinical Oncology (ASCO). Advances in...

Never Forgetting His Roots Helps Surgical Oncologist Better Connect With His Patients

  Raja M. Flores, MD, grew up in New York’s Meatpacking District, a rough West Side neighborhood, light years before its gentrification into a hip commercial area, home to the Whitney Museum of American Art, high-end designer clothing stores and chic bars, and a stretch of the High Line (an...

A Brilliant Career in Oncology Decided on a Coin Toss

Rajendra Achyut Badwe, MBBS, MS, was born and reared in the sprawling city of Mumbai, the most populous city in India. “My grandmother was a matron in an infectious disease hospital. At that time, smallpox was a serious issue, and the patient care challenges were momentous. She taught me the value...

lymphoma
immunotherapy

Polatuzumab Vedotin and Immunochemotherapy in Previously Untreated Diffuse Large B-Cell Lymphoma

As reported in The Lancet Oncology, Tilly et al found that the combination of polatuzumab vedotin, an antibody-drug conjugate targeting the CD79b component of the B-cell receptor, with immunochemotherapy showed high response rates in the phase II portion of a phase I/II study in previously...

issues in oncology
survivorship

Sexual Minority Cancer Survivors and Need for Improved Access to Care

Results from a study published early by Boehmer et al in Cancer point to the need for improved access to medical care for sexual minority cancer survivors—in particular, sexual minority women. In women who are sexual minority cancer survivors, poor access to care is more strongly related to...

breast cancer

FDA Approves Alpelisib in Combination With Fulvestrant for PIK3CA-Mutated, Hormone Receptor–Positive Advanced Breast Cancer

On May 24, the U.S. Food and Drug Administration (FDA) approved alpelisib (Piqray) tablets to be used in combination with the FDA-approved endocrine therapy fulvestrant to treat postmenopausal women, and men, with hormone receptor (HR)-positive, human epidermal growth factor receptor 2...

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