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issues in oncology
gynecologic cancers
global cancer care

Barriers to Cervical Cancer Screening Among HIV-Infected Women in Tanzania

Population screening programs and the advent of human papillomavirus (HPV) vaccination have made cervical cancer largely a preventable disease. Despite these advances, ­cervical cancer remains a leading cause of cancer death for ­women in low- and middle-income countries. A recent study identified...

integrative oncology

Capsaicin

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. In this installment, Shelly Latte-Naor, MD, and Jyothirmai Gubili, MS, explore the use of...

breast cancer
global cancer care

Ghanaian Oncologist Yehoda M. Martei, MD, Seeks Ways to Improve Outcomes in the Developing World

Breast cancer remains the most commonly diagnosed cancer among women globally. Due to a lack of early interventions, most women in low- and middle-income countries have advanced disease at the time of diagnosis, conferring a grim prognosis. Yehoda M. Martei, MD, of the Department of Medicine,...

global cancer care

Measuring the Burden of Global Cancer as a Tool for Policymakers

The Global Burden of Disease Study was initiated in 1990, commissioned by the World Bank. At that time, the study was conducted mainly by researchers at Harvard and the World Health Organization (WHO). Since then the study has gone through many iterations to its present structure, which is a...

global cancer care
issues in oncology

St. Jude Children’s Research Hospital and WHO Join Forces to Improve Childhood Cancer Survival Worldwide

A report by the International Agency for Research on Cancer (IARC) based on data from more than 100 cancer registries in 68 countries shows that from 2001 to 2010, the occurrence of childhood cancer worldwide was 13% more common than in the 1980s.1 In addition, the report’s findings showcase stark...

multiple myeloma

OPTIMISMM: Addition of Pomalidomide to Bortezomib/Dexamethasone in Pretreated Relapsed or Refractory Multiple Myeloma

In the phase III OPTIMISMM trial, reported by Richardson et al in The Lancet Oncology, researchers found that the addition of pomalidomide to bortezomib/dexamethasone improved progression-free survival in relapsed or refractory multiple myeloma previously treated with lenalidomide. Study Details...

solid tumors

Erythropoiesis-Stimulating Agents Recommended for Some Patients With Cancer and Anemia

ASCO and the American Society of Hematology (ASH) have released an update to existing guidelines for use of erythropoiesis-stimulating agents to manage anemia in patients with cancer.1 “The current update aims to increase awareness of recent developments regarding the use of...

breast cancer

Study Finds Timing of Therapy Does Not Influence Outcomes in HER2-Positive Breast Cancer

The sequencing of trastuzumab administration with chemotherapy in the neoadjuvant setting seems to have no effect on outcomes for patients with HER2-positive breast cancer, according to data presented at the 2019 Society of Surgical Oncology Annual Cancer Symposium.1 The results of a phase III...

breast cancer

Adjuvant Trastuzumab Emtansine vs Standard Trastuzumab in Residual HER2-Positive Breast Cancer After Neoadjuvant Therapy

In the phase III KATHERINE trial reported in The New England Journal of Medicine,1Gunter von Minckwitz, MD, of the German Breast Group, Neu-Isenburg, and colleagues found that adjuvant treatment with the antibody-drug conjugate trastuzumab emtansine (T-DM1) improved invasive disease–free survival...

bladder cancer
immunotherapy

Lenvatinib Plus Pembrolizumab Shows Activity in Advanced Urothelial Cancer

THE COMBINATION of lenvatinib plus pembrolizumab has demonstrated antitumor activity in patients with advanced urothelial cancer, including patients receiving later-line treatment. Results of a phase Ib/II trial showed an objective response rate of 25% and a median progression-free survival of 5.4...

bladder cancer

Sacituzumab Govitecan Shows Activity in Heavily Pretreated Bladder Cancer

PRELIMINARY EVIDENCE suggests that the antibody-drug conjugate sacituzumab govitecan is active in patients previously treated with chemotherapy or checkpoint inhibitor therapy for metastatic urothelial cancer. These results from a phase I/II basket study of this agent were presented at the 2019...

prostate cancer

LATITUDE Trial in Newly Diagnosed, Metastatic Prostate Cancer: Final Overall Survival Analysis

As reported in The Lancet Oncology by Karim Fizazi, MD, PhD, and colleagues, the final overall survival analysis in the phase III LATITUDE trial has shown a significant benefit with the addition of abiraterone acetate plus prednisone to androgen deprivation therapy (ADT) in newly diagnosed,...

kidney cancer

Cytoreductive Nephrectomy in Patients With Metastatic RCC Treated With Sunitinib

In a trial with a modified primary endpoint due to slow accrual reported in JAMA Oncology,1 Axel Bex, MD, PhD, and colleagues found that deferred cytoreductive nephrectomy after sunitinib did not improve the 28-week progression-free rate vs immediate nephrectomy followed by sunitinib in patients...

pancreatic cancer

Study Shows Rucaparib Active as Maintenance Therapy in Pancreatic Cancer

The poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib holds promise as maintenance therapy for advanced, platinum-sensitive, BRCA- or PALB2-mutated pancreatic cancer, according to an interim analysis of an ongoing phase II clinical trial presented at the 2019 Annual Meeting of the American...

kidney cancer

TIVO-3: Tivozanib vs Sorafenib in Refractory Advanced Renal Cell Carcinoma

The TIVO-3 trial was conducted to confirm progression-free survival results from the TIVO-1 trial, which found an improvement in median progression-free survival in patients with metastatic renal cell carcinoma treated with tivozanib vs sorafenib. Findings from TIVO-3 were presented by Rini et al...

kidney cancer
immunotherapy

First-Line Therapy for Advanced Kidney Cancer: Combination Treatment vs Sunitinib

  TWO RECENTLY reported phase III trials have shown the benefits of combination therapy vs sunitinib in the first-line treatment of advanced renal cell carcinoma. As reported in The New England Journal of Medicine by Brian I. Rini, MD, of Cleveland Clinic Taussig Cancer Institute, and colleagues,...

immunotherapy
breast cancer
lung cancer
prostate cancer
kidney cancer
bladder cancer
colorectal cancer
pancreatic cancer
sarcoma
leukemia
skin cancer
head and neck cancer

NCCN Clinical Practice Guidelines in Oncology: 2019 Updates

In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®), covering eight tumor types. NCCN Guidelines are now published for more than 70 tumor types and topics. Some of the key updates for 2019 were presented...

gastrointestinal cancer

Study Finds Less Chemotherapy Noninferior to More in Frail and Elderly Patients With Advanced Gastroesophageal Cancer

A large randomized trial has found that frail and elderly patients with advanced gastroesophageal cancer may be safely and successfully treated with dose-reduced chemotherapy. In the GO2 phase III trial, low doses of oxaliplatin/capecitabine performed similarly to intermediate and high doses of the ...

kidney cancer
immunotherapy

KEYNOTE-427: Pembrolizumab Shows Activity in Advanced Non–Clear Cell Kidney Cancer

IMMUNOTHERAPY WITH the checkpoint inhibitor pembrolizumab may prove to be an effective option for patients with advanced non–clear cell renal cell carcinoma, according to results in cohort B of the KEYNOTE-427 trial, presented at the 2019 Genitourinary Cancers Symposium.1 Kidney cancers with a...

bladder cancer
kidney cancer
prostate cancer

A Year in Review

The past year has seen groundbreaking advances in the treatment of genitourinary (GU) cancers, which in some cases are resulting in altering the standard of care for patients with renal cell carcinoma, prostate cancer, and urothelial carcinoma. Some of the biggest changes that have occurred are for ...

breast cancer
gastroesophageal cancer
gastrointestinal cancer

Trastuzumab Deruxtecan in Advanced HER2-Positive Gastric and Breast Cancers

Two phase I studies reported in The Lancet Oncology indicate activity of the antibody-drug conjugate trastuzumab deruxtecan in advanced HER2-positive gastric cancer and advanced HER2-positive breast cancer previously treated with trastuzumab emtansine (T-DM1). Trastuzumab deruxtecan (DS-8201a) is a ...

lung cancer

Long-Term Results With Local Consolidative Therapy vs Maintenance Therapy or Observation in Oligometastatic NSCLC

In long-term follow-up of a phase II study reported in the Journal of Clinical Oncology, Gomez et al confirmed superior outcomes with local consolidative therapy vs maintenance therapy or observation in patients with oligometastatic non–small cell lung cancer (NSCLC). In the open-label,...

cns cancers
solid tumors
leukemia
multiple myeloma
sarcoma

FDA Pipeline: Designations in Myeloma, Adenoid Cystic Carcinoma, and Kaposi Sarcoma, Plus ODAC Votes

This week, the U.S. Food and Drug Administration granted designations in relapsed or refractory multiple myeloma, adenoid cystic carcinoma, and Kaposi sarcoma; and the FDA’s Oncologic Drugs Advisory Committee (ODAC) held votes on treatments for tenosynovial giant cell tumor and acute...

gastroesophageal cancer

2019 ASCO: Reduced Chemotherapy Dosages in Elderly Patients With Advanced Gastroesophageal Cancer

A phase III randomized clinical study evaluating the optimum dose of a combination chemotherapy regimen of oxaliplatin and capecitabine in the treatment of advanced gastroesophageal cancer in frail and elderly patients has found that the patients prescribed the lowest dose tested experienced less...

multiple myeloma

2019 ASCO: Lenalidomide May Reduce the Risk of Smoldering Multiple Myeloma Progressing to Active Disease

A phase III randomized trial (E3A06) by Lonial et al testing the effect of single-agent lenalidomide vs observation in patients with intermediate- or high-risk smoldering multiple myeloma has found that lenalidomide significantly reduces the risk of smoldering multiple myeloma progressing to active ...

pancreatic cancer
immunotherapy

Study Finds Immune Enrichment Improves Outcomes in Pancreatic Cancer With Activated but Not Normal Stroma

ALTHOUGH IMMUNOTHERAPIES have had limited success in pancreatic cancer to date, findings from a molecular analysis of the tumor microenvironment suggest that certain subtypes may be more responsive to treatment. According to data presented at the 2019 Society of Surgical Oncology Annual Cancer...

immunotherapy
lung cancer

Pembrolizumab as Third-Line Option for Extensive-Stage Small Cell Lung Cancer

USE OF the anti–programmed cell death protein 1 (anti–PD-1) checkpoint inhibitor pembrolizumab after two or more prior lines of therapy led to responses in patients with advanced small cell lung cancer (SCLC) in a pooled analysis of two clinical trials: phase Ib KEYNOTE-028 and phase II...

breast cancer
pancreatic cancer
sarcoma
immunotherapy
issues in oncology

AACR Study Presentations Include New Data in Breast and Prostate Cancers, Sarcoma, and High-Risk Individuals

THE 2019 American Association for Cancer Research (AACR) Annual Meeting was held March 29 to April 3 in Atlanta. In addition to our regular coverage of news stories from the meeting, here are some brief highlights of additional noteworthy studies. Stage IV HER2-Positive Breast Cancer: Surgery or No ...

lymphoma

Umbralisib: Potential Option for Relapsed or Refractory Marginal Zone Lymphoma

UMBRALISIB—an investigational PI3K-delta inhibitor—produced impressive results as monotherapy in patients with relapsed or refractory marginal zone lymphoma, according to an interim analysis of the phase II UNITY-NHL trial presented at the 2019 American Association for Cancer Research (AACR) Annual ...

lung cancer

Expert Point of View: Roy S. Herbst, MD, PhD

FORMAL STUDY discussant, Roy S. Herbst, MD, PhD, Chief of Medical Oncology at the Yale Cancer Center, New Haven, Connecticut, stated that the findings of the TATTON analyses are “compelling,” and the combination of osimertinib plus savolitinib can be considered a “win,” although randomized trials...

lung cancer

Osimertinib Plus Savolitinib in Advanced NSCLC Driven by MET Resistance

THE ADDITION of the MET inhibitor savolitinib to the EGFR inhibitor osimertinib led to activity in patients with MET-amplified, EGFR-mutated non–small lung cancer (NSCLC) with acquired resistance to previous therapies, according to interim results from two expansion cohorts of a phase Ib clinical...

issues in oncology

WINTHER Trial: Genomic and Transcriptomic Profiling May Translate to New Therapeutic Options for Patients With Advanced Cancer

Published by Rodon et al in Nature Medicine, results of the WINTHER study showed that RNA profiling together with DNA testing matches more patients with advanced cancer to personalized therapies than DNA profiling for tumor mutations alone. The WINTHER trial aimed to...

breast cancer
prostate cancer
symptom management

ESTRO 38: REQUITE Project Finds Predictive Biomarkers for Late Radiotherapy Toxicity

The latest results from the REQUITE project, which aimed to discover what makes patients more likely to experience adverse effects after radiotherapy, have shown that a combination of biologic markers and certain genetic changes can predict radiation sensitivity. In addition, the international team ...

cns cancers

ESTRO 38: What Type of Radiotherapy May Best Preserve Cognitive Function in Pediatric Patients With Brain Tumors?

A comparison of three types of radiotherapy for pediatric brain tumors suggests that a type of proton therapy called pencil-beam scanning (PBS) offers the best hope of preserving cognitive functions. The study, presented by Toussaint et al at ESTRO 38, the annual congress of the European Society...

solid tumors
leukemia
prostate cancer
pain management

FDA Pipeline: Applications and Designations in Prostate Cancer, Leukemia, and HER2-Positive Cancers

In the past 2 weeks, the U.S. Food and Drug Administration (FDA) accepted a new drug application and granted Priority Review for a prostate cancer treatment, granted Orphan Drug designation to a treatment for acute lymphoblastic leukemia, accepted an investigational new drug application for a...

lymphoma

ESTRO 38: Radiotherapy After ABVD May Improve Survival in Advanced Hodgkin Lymphoma

Patients with advanced Hodgkin lymphoma with bulky lesions at the time of diagnosis may benefit from radiotherapy after chemotherapy, according to late-breaking results presented by Ricardi et al at ESTRO 38, the annual congress of the European Society for Radiotherapy & Oncology...

breast cancer

ESTRO 38: Long-Term Results of Adjuvant Radiotherapy Plus Antihormonal Treatment in Hormone Receptor–Positive Breast Cancer

Women with early-stage, low-risk, hormone receptor–positive breast cancer may be less likely to experience disease recurrence if they have radiotherapy after surgery as well as antihormonal treatment, according to results from a trial that has followed 869 women for 10 years. These findings...

colorectal cancer
immunotherapy

IMblaze370: Atezolizumab With or Without Cobimetinib vs Regorafenib in Previously Treated Advanced Colorectal Cancer

In the phase III IMblaze370 trial reported in The Lancet Oncology, Eng et al found no survival benefit with third-line atezolizumab with or without cobimetinib vs regorafenib in patients with locally advanced or metastatic colorectal cancer. Study Details The open-label trial included 363...

issues in oncology

Physician Identity and Physician Wellness Are Inextricably Linked

Imagine a 70-year-old patient who is scheduled for a pancreaticoduodenectomy. On the morning of surgery, the patient is checked in at the front desk by the “data-entry provider.” The patient is taken to the preoperative area, where the appropriate formalities are completed by multiple “bedside-care ...

leukemia

Long-Term Follow-up: Addition of Idelalisib to Rituximab in Relapsed Chronic Lymphocytic Leukemia

In an article published in the Journal of Clinical Oncology, Sharman et al provided long-term findings of a phase III trial that examined the addition of idelalisib to rituximab in relapsed chronic lymphocytic leukemia (CLL), including findings from an extension phase of idelalisib monotherapy. The ...

kidney cancer

First-Line Combination Treatments Improve Outcomes vs Sunitinib in Advanced Renal Cell Carcinoma

Two recently reported phase III trials have shown the benefits of combination therapy vs sunitinib in the first-line treatment in advanced renal cell carcinoma. As reported in The New England Journal of Medicine by Brian I. Rini, MD, of Cleveland Clinic Taussig Cancer Institute, and colleagues, the ...

prostate cancer

Final Overall Survival Analysis of the LATITUDE Trial in Newly Diagnosed, High-Risk, Metastatic, Castration-Sensitive Prostate Cancer

As reported in The Lancet Oncology by Fizazi et al, the final overall survival analysis in the phase III LATITUDE trial has shown a significant benefit with the addition of abiraterone acetate plus prednisone to androgen deprivation therapy (ADT) in newly diagnosed, high-risk, metastatic, ...

hepatobiliary cancer

Ramucirumab After Sorafenib in Advanced Hepatocellular Carcinoma: An Efficacious Therapy With Applicability Challenges

In the 2 years since the U.S. Food and Drug Administration’s (FDA) approval of regorafenib in the treatment of patients with sorafenib-refractory advanced hepatocellular carcinoma, we oncologists have witnessed a veritable avalanche of newly approved medicines for the treatment of advanced...

hepatobiliary cancer

Ramucirumab in Sorafenib-Pretreated Patients With Advanced Hepatocellular Carcinoma

In the phase III REACH-2 trial reported in The Lancet Oncology, Andrew X. Zhu, MD, of Harvard Medical School and Massachusetts General Hospital, and colleagues found that ramucirumab improved overall and progression-free survival vs placebo in patients with advanced hepatocellular carcinoma and...

issues in oncology

Rising Rates of Six Obesity-Related Cancers Among Younger Adults

PHYSICIANS SHOULD routinely assess the body mass index (BMI) of their patients and offer counseling and/or referrals to a nutritionist or dietician to patients with a BMI of > 30 kg/m2, Ahmedin Jemal, DVM, PhD, told The ASCO Post. Those actions plus community-level policies designed to increase...

lung cancer

Role of Repeat PET/CT Scans in Ensuring Accuracy of Staging of Locally Advanced NSCLC

Findings from a new study highlight the importance of timing in initial staging positron-emission tomography (PET) and/or computed tomography (CT) scans for patients with locally advanced non–small cell lung cancer (NSCLC) receiving chemoradiation therapy.1 According to data presented at the 2019...

breast cancer
cost of care

Does Oncotype DX–Guided Treatment Reduce Initial Costs of Breast Cancer Care?

A new study suggests that Oncotype DX–guided treatment could reduce the cost for the first year of breast cancer care in the United States by about $50 million (about 2% of the overall costs in the first year). These findings were published by Mariotto et al in the Journal of the...

Well-Deserved Attention on Lung Cancer Screening

SCREENING FOR LUNG CANCER among high-risk groups deserves the attention that Steven E. Vogl, MD, brought to it in his column At Microphone 1 in the February 10 issue of The ASCO Post. Subspecialist oncologists are not always attuned to the needs of their patients outside of their own specialty.1...

myelodysplastic syndromes

Early Studies of Two Regimens Show Benefit in High-Risk Smoldering Multiple Myeloma

MORE DATA are in to support early intervention for high-risk smoldering multiple myeloma—an early, asymptomatic entity lacking the presence of CRAB criteria (elevated calcium, renal failure, anemia, bone lesions). The latest come from two phase II studies presented at the 2018 American Society of...

solid tumors

SABR-COMET: Stereotactic Ablative Radiotherapy vs Standard Palliative Treatment in Oligometastatic Cancers

Results of the phase II SABR-COMET trial reported by Palma et al in The Lancet indicate that stereotactic ablative radiotherapy (SABR) was associated with improved survival vs standard palliative treatment in patients with oligometastatic cancers, although it was also associated with...

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