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pain management
health-care policy

Debating the Role of Opioids in the Management of Chronic Cancer Pain

Despite the increasing public awareness of the danger of the overuse of prescription opioids, drug overdose deaths continue to rise in the United States. According to the Centers for Disease Control and Prevention (CDC), from 1999 to 2017, nearly 400,000 people died of an overdose involving...

Otis W. Brawley, MD, MACP, FASCO: Doctor, Policy Advocate, Writer, and Champion of the Underserved

  In this installment of Living a Full Life, guest editor Jame Abraham, MD, FACP, spoke with Otis W. Brawley, MD, MACP, FASCO, a global leader in cancer research and health disparities. Dr. Brawley, who served as Chief Medical and Scientific Officer for the American Cancer Society (ACS) and...

prostate cancer

New Radiation Options for Localized Prostate Cancer May Improve Patient Outcomes

External-beam radiation therapy (EBRT) is a standard treatment option for men with localized prostate cancer and confers long-term prostate cancer control outcomes equal to radical prostatectomy. Technologic advances in imaging and computing during the past 20 years have led to a number of...

lung cancer

FDA Expands Pembrolizumab Indication for NSCLC in First-Line Setting

On April 14, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) for the first-line treatment of patients with stage III non–small cell lung cancer (NSCLC) who are not candidates for surgical resection or definitive chemoradiation, or those with metastatic NSCLC....

hematologic malignancies
lymphoma

Combination Immunotherapy With Lenalidomide Plus Rituximab in Indolent NHL: Time to Replace Rituximab Monotherapy?

With increasing knowledge on the key role of the tumor microenvironment in lymphomagenesis, treatments for indolent B-cell lymphoma, especially follicular lymphoma, are mechanistically moving toward a more immunomodulatory approach. Chemotherapy-free regimens are an attractive alternative to...

hematologic malignancies
lymphoma

AUGMENT Trial: Addition of Lenalidomide to Rituximab in Relapsed or Refractory Indolent Lymphoma

In the phase III AUGMENT trial, reported in the Journal of Clinical Oncology, John P. Leonard, MD, of Meyer Cancer Center, Weill Cornell Medicine and NewYork-Presbyterian Hospital, and colleagues found that the addition of lenalidomide to rituximab significantly prolonged progression-free survival...

hematologic malignancies

Prolonged Exposure to Ibrutinib May Increase Effectiveness of CAR T-Cell Therapy in Patients With CLL

Chimeric antigen receptor (CAR) T-cell therapy has shown remarkable efficacy in the treatment of certain hematologic malignancies, including several types of large B-cell non-Hodgkin lymphomas (NHLs) and acute lymphoblastic leukemia (ALL). The U.S. Food and Drug Administration (FDA) has approved...

Researchers Supported by Conquer Cancer, the ASCO Foundation, Earn Spot in Clinical Cancer Advances 2019

The work of nine researchers who have previously received funding from Conquer Cancer is featured in ASCO’s Clinical Cancer Advances 2019. Visit CONQUER.ORG/CCA for more details. In two separate trials, Conquer Cancer–supported investigators produced research results that improved treatment for...

Expert Point of View: David Gandara, MD

“MYSTIC is the second phase III trial to compare a first-line immune checkpoint inhibitor with platinum that failed to meet the primary endpoint. However, both MYSTIC and CheckMate 026 identified patients who benefited from an immune checkpoint inhibitor based on tumor mutational burden,”...

lung cancer

Evidence Mounts for Tumor Mutational Burden as Biomarker of Immune Checkpoint Inhibitor Benefit in NSCLC

The search for biomarkers to identify patients who are likely to respond to immunotherapy continues. According to biomarker tissue and blood analysis of patients enrolled in the phase III MYSTIC trial, high tumor mutational burden in both tissue and blood identified patients with non–small cell...

kidney cancer

Retrospective Study Evaluates Cabozantinib in Advanced Non–Clear Cell Renal Cell Carcinoma

Cabozantinib, a kinase inhibitor, is approved in metastatic renal cell carcinoma on the basis of studies in clear cell histology. Its activity in non–clear cell renal cell carcinoma is poorly defined. In a retrospective cohort study, Nieves Martinez Chanzá, MD, and colleagues reported that...

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...

kidney cancer
immunotherapy

Expert Point of View: Tracy Rose, MD, MPH

THE FORMAL DISCUSSANT of the KEYNOTE-427 trial, Tracy Rose, MD, MPH, of the University of North Carolina, Chapel Hill, told listeners: “I think pembrolizumab should now be considered an option for non–clear cell kidney cancer. Response rates, however, remain inferior to those seen in clear cell...

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 ...

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...

solid tumors

2019 ASCO: Nearly One-Quarter of Participants in the Pediatric MATCH Trial Have an Actionable Molecular Alteration

A study investigating the frequency of targetable molecular alterations in pediatric cancer among patients enrolled in the National Cancer Institute–Children’s Oncology Group Pediatric Molecular Analysis for Therapy Choice (MATCH) trial has found that about one-quarter of patients with...

breast cancer
lung cancer
skin cancer

Lifetime Risk of Brain Metastases in Elderly Survivors of Breast, Lung, and Skin Cancers

Elderly survivors of breast cancer, lung cancer, and melanoma face risk of brain metastasis later in life, and may require extra surveillance in the years following initial cancer treatment, according to results of a study published by Ascha et al in Cancer Epidemiology, Biomarkers, &...

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...

breast cancer
solid tumors

FDA Pipeline: Designations in Triple-Negative Breast Cancer, ctDNA Detection

This week, the U.S. Food and Drug Administration (FDA) granted a Fast Track designation to a treatment for CCR5-positive metastatic triple-negative breast cancer; granted Breakthrough Device designation to a test for the postsurgical detection and quantification of circulating tumor DNA (ctDNA);...

lung cancer
immunotherapy

Association Between Clinical Outcomes and Patient Characteristics/Genomic Profiles in Lung Cancer

As reported in JAMA, Singal et al used a clinicogenomic database in routine clinical practice to identify associations between treatment outcomes and patient characteristics or tumor genomic profiles in the setting of non–small cell lung cancer (NSCLC). The study cohort of 4,064 patients...

lung cancer
issues in oncology

Survey Finds Rates of Physician-Patient Discussions About Lung Cancer Screening Are Declining

A study examining trends in patient-reported physician-patient discussions about lung cancer screening and the association of these discussions with smokers’ attempts to quit and intent to quit has found that discussions about screening have declined since 2012. Moreover, they were not...

issues in oncology

How Hepatitis C Virus Screening May Improve Survival in Patients With Cancer

In 2013, the Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommended that all people born between 1945 and 1965 undergo one-time screening for the hepatitis C virus (HCV), because the rates of HCV infection are markedly higher for baby...

lung cancer

Local Consolidative Therapy Linked to Survival Benefit in Oligometastatic Non–Small Cell Lung Cancer

A retrospective analysis of nearly 200 patients treated with local consolidative therapy for oligometastatic non–small cell lung cancer (NSCLC) has found improved overall survival associated with aggressive consolidation.1 According to data presented at the 2019 Multidisciplinary Thoracic Cancers...

lung cancer

Erlotinib Plus Bevacizumab vs Erlotinib Alone in EGFR-Positive, Advanced Nonsquamous NSCLC

In an interim analysis of the phase III NEJ026 trial reported in The Lancet Oncology, Saito et al found that the addition of bevacizumab to erlotinib improved progression-free survival in patients with EGFR-positive, nonsquamous non–small cell lung cancer (NSCLC). In the open-label...

leukemia

Intermittent vs Intensive PEG-Asparaginase in Pediatric Acute Lymphoblastic Leukemia

In a Scandinavian study reported in the Journal of Clinical Oncology, Albertsen et al found that use of intermittent vs intensive pegylated (PEG)-asparaginase was associated with similar efficacy and reduced asparaginase-related toxicity in pediatric acute lymphoblastic leukemia (ALL). The study...

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...

lung cancer

Online Tool May Improve Guideline Concordance for Patients With Lung Cancer

An online tool that allows patients to input their clinical and pathologic features as well as explore treatment options in a structured manner based on National Comprehensive Cancer Network® Clinical Practice Guidelines in Oncology (NCCN Guidelines) may help drive smoking cessation and testing for ...

Expert Point of View: Kristin Higgins, MD

The discussant of the abstract on repeat positron-emission tomography (PET) and/or computed tomography (CT) scans prior to chemoradiation in locally advanced non–small cell lung cancer, Kristin Higgins, MD, emphasized the importance of timing of imaging when staging patients and the need for...

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...

lung cancer

Mitigating Frailty and Sarcopenia to Improve Treatment Outcomes in Lung Cancer

Frailty and sarcopenia are common conditions among patients with lung cancer and are linked with decreased survival as well as increased surgical complications, chemotherapy toxicity, and cost of care. If a survey of oncologists at the 2019 Multidisciplinary Thoracic Cancers Symposium is any...

Expert Point of View: Aaron S. Mansfield, MD

The discussant of the STELLAR trial abstract, Aaron S. Mansfield, MD, a translational scientist at the Mayo Clinic in Rochester, called the survival outcomes “very promising” for a trial that included a relatively large population of patients with the more aggressive sarcomatoid variant of...

solid tumors

Tumor-Treating Fields Plus Chemotherapy Improved Survival in Unresectable Malignant Pleural Mesothelioma

The addition of tumor-treating fields to standard-of-care chemotherapy has been found to be safe and effective in the treatment of unresectable malignant pleural mesothelioma. Data presented at the 2019 Multidisciplinary Thoracic Cancers Symposium showed that patients receiving the combination of...

issues in oncology
lung cancer

Shared Decision-Making in Lung Cancer Screening: Whence? Whither?

We read with interest a recent article published on ASCOPost.com, which summarized a paper on the role of shared decision-making in lung cancer screening.1,2 The summary and original report highlight a mandate by the Centers for Medicare & Medicaid Services (CMS) that bears careful...

immunotherapy

The Microbiome: The Next Target in Cancer Therapy

With the recent breakthroughs in immunotherapy, treatments that modulate the immune system are now being used across numerous cancer types and across the spectrum of disease with significant success, but not all patients achieve objective responses. There is still a critical need to better...

gynecologic cancers

Cervical Cancer Subtype Rising in Some Populations

A new study reports that a type of cervical cancer that is less amenable to detection by Papanicolaou (Pap) testing is increasing in several subpopulations of women, pointing to the growing importance of human papillomavirus (HPV) testing and vaccination. The study was published by Islami ...

lung cancer

Deep-Learning Model May Improve Predictions of Survival and Specific Outcomes in Lung Cancer

A study by Xu et al in Clinical Cancer Research evaluating deep-learning networks that analyze time-series computed tomography (CT) images of patients with locally advanced NSCLC has found these networks can integrate imaging scans at multiple time points to improve clinical outcome...

lung cancer
immunotherapy

KEYNOTE-042: Pembrolizumab vs Chemotherapy in Previously Untreated Locally Advanced or Metastatic NSCLC With PD-L1 Expression ≥ 1%

As reported in The Lancet by Mok et al, the KEYNOTE-042 trial has shown an improvement in overall survival with pembrolizumab vs standard chemotherapy in previously untreated patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) without a sensitizing EGFR mutation or ...

solid tumors

NRG1 Gene Fusions Detected at Low Incidence Across Multiple Tumor Types

A consortium of researchers have completed an analysis of a new gene fusion they believe is responsible for the development of a wide spectrum of cancer types. According to the investigators, their studies show that errant gene fusions in neuregulin-1, or NRG1, which are present in about...

issues in oncology
integrative oncology

Complementary and Alternative Medicine Use in Patients With Cancer

In a recent study focusing on patients with cancer and cancer survivors, one-third of patient participants reported use of complementary and alternative medicines such as meditation, yoga, acupuncture, herbal medicine, and supplements. These findings were published by Sanford et al in JAMA...

lung cancer

Five-Fraction SBRT for Centrally Located, Inoperable NSCLC

In the phase I/II NRG Oncology/RTOG 0813 study reported in the Journal of Clinical Oncology, Bezjak et al found that five-fraction stereotactic body radiotherapy (SBRT) was associated with relatively low rates of serious treatment-related toxicity and good outcomes in patients with centrally...

gynecologic cancers

Niraparib in Late-Line Treatment of Ovarian Cancer

In the phase II QUADRA trial reported in The Lancet Oncology, Moore et al found that the poly(ADP-ribose) polymerase (PARP) inhibitor niraparib was active in fourth- or later-line treatment of ovarian cancer, particularly in patients with homologous recombination deficiency (HRD)-positive,...

lung cancer
immunotherapy

FDA Expands Pembrolizumab Indication for NSCLC in First-Line Setting

Today, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) for the first-line treatment of patients with stage III non–small cell lung cancer (NSCLC) who are not candidates for surgical resection or definitive chemoradiation, or those with metastatic NSCLC....

lung cancer
issues in oncology
immunotherapy

ELCC 2019: Immunotherapy in Elderly Patients With Advanced NSCLC

Two studies reported at the European Lung Cancer Congress (ELCC) 2019 provided new insights on the efficacy and safety of immunotherapy in elderly patients with advanced non–­small cell lung cancer (NSCLC). Although around half of all people newly diagnosed with NSCLC are elderly (Pallis ...

lymphoma

Addition of Ibrutinib to R-CHOP in Non–Germinal Center B-Cell DLBCL

In the phase III PHOENIX trial reported in the Journal of Clinical Oncology, Younes et al found that the addition of ibrutinib to R-CHOP (rituximab plus cyclophosphamide, doxorubicin, vincristine, and prednisone) did not improve outcomes in patients with untreated non–germinal center B-cell...

immunotherapy

The Future of Immunotherapy: Building on Checkpoint Blockade

THE EMERGENCE of anticancer agents that block immune checkpoints has transformed the field of oncology, leading to durable responses and improvements in overall survival in melanoma, renal cell carcinoma, head/neck squamous cell carcinoma, urothelial bladder cancer, and non–small cell lung cancer....

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