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geriatric oncology

Surgical and Radiation Oncology in Elderly Patients With Cancer

As one might expect, the focus on older patients developed in surgical and radiation oncology at the same time as in medical oncology. As we have done in our overview of medical oncology, we may recognize a prehistory, past history, and present history in surgical and radiation geriatric oncology....

solid tumors

Activity of the KRAS G12C Inhibitor Sotorasib in KRAS G12C–Mutant Advanced Solid Tumors

As reported inThe New England Journal of Medicine by David S. Hong, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues, a phase I trial (CodeBreak 100) has shown activity of the oral KRAS G12C inhibitor sotorasib in heavily pretreated patients with KRAS G12C–mutant...

lung cancer

Capmatinib Active in Advanced NSCLC With MET Exon 14 Skipping Mutations

As reported inThe New England Journal of Medicine by Jürgen Wolf, MD, of the Center for Integrated Oncology, University Hospital Cologne and University of Cologne, and colleagues, the phase II GEOMETRY mono-1 trial has shown durable responses with the selective MET inhibitor capmatinib in patients...

Expert Point of View: Henrik Grönberg, MD

Formal discussant of the PROfound trial, Henrik Grönberg, MD, of the Karolinska Institute, Stockholm, agreed that this was a practice-changing trial for select patients. “The patient population is representative, but the problem is the control group, which included patients who experienced disease ...

prostate cancer

Olaparib Improves Outcomes in Metastatic Castration-Resistant Prostate Cancer With BRCA1/2 Alterations

The PARP inhibitor olaparib reduced the risk of death by 31% compared with a second hormonal treatment (enzalutamide or abiraterone) in men with metastatic castration-resistant prostate cancer characterized by BRCA1, BRCA2, or ATM mutations, in the final analysis of the phase III PROfound trial...

Emmanuelle Charpentier, PhD, and Jennifer A. Doudna, PhD, Honored With Nobel Prize in Chemistry 2020

On October 7, 2020, The Royal Swedish Academy of Sciences announced that the Nobel Prize in Chemistry 2020 would be awarded to Emmanuelle Charpentier, PhD, and Jennifer A. Doudna, PhD, “for the development of a method for genome editing,” the CRISPR/Cas9 genetic scissors. “There is enormous power...

breast cancer
immunotherapy

Sacituzumab Govitecan Yields Survival Benefit as Third-Line Treatment in Triple-Negative Breast Cancer: ASCENT Trial

Based on results from a phase I/II clinical trial, the antibody drug conjugate sacituzumab govitecan was recently granted accelerated approval in the treatment of patients with advanced triple-negative breast cancer, contingent on a larger study confirming its benefit. The confirmatory phase III...

covid-19

COVID-19, Cancer, and the Older Adult

An inspiring case series of fit patients aged 98 and older who recovered from hospitalization for COVID-19, published by Huang et al, reminds us that older age may not be a barrier to recovery.1 On behalf of the Cancer and Aging Research Group, we do not support “ageism” in the care of older...

Expert Point of View: Christine M. Lovly, MD, PhD

Lorlatinib was strategically designed to have activity against ALK and to be highly CNS-penetrant,” said formal discussant Christine M. Lovly, MD, PhD, of Vanderbilt Ingram Cancer Center, Nashville. “We look forward to seeing more data from this trial. Alectinib had a progression-free survival of...

lung cancer

Lorlatinib Improves Outcomes Over Crizotinib in First-Line Setting of ALK-Positive NSCLC: CROWN Trial

Lorlatinib significantly improved progression-free survival compared with crizotinib in the first-line treatment of patients with advanced ALK-positive non–small cell lung cancer (NSCLC), according to a planned interim analysis of the phase III CROWN trial presented at the European Society for...

skin cancer

Small Case Study Explores Novel Approach to Neoadjuvant Therapy for Skin Cancer

Skin cancers are the most common malignancy in the United States and worldwide. Between 1994 and 2014, the diagnosis and treatment of melanoma and nonmelanoma skin cancers in the United States increased by 77%.1 The cost of treating melanoma and nonmelanoma skin cancers to the health-care system...

neuroendocrine tumors

Surufatinib in Advanced Pancreatic Neuroendocrine Tumors

As reported in The Lancet Oncology by Xu et al, the Chinese phase III SANET-p trial has shown significantly improved progression-free survival with surufatinib vs placebo in patients with advanced pancreatic neuroendocrine tumors. Surufatinib is a novel small-molecule inhibitor that targets...

prostate cancer

Adjuvant vs Salvage Radiotherapy Plus Short-Term ADT After Radical Prostatectomy for Localized Prostate Cancer

As reported in The Lancet Oncology by Sargos et al, the French phase III GETUG-AFU 17 trial has shown no event-free survival benefit for adjuvant radiotherapy vs salvage radiotherapy—both with short-term androgen-deprivation therapy (ADT)—after radical prostatectomy in men with localized prostate...

gynecologic cancers
immunotherapy

Addition of Bevacizumab to Paclitaxel in Relapsed Ovarian Sex Cord–Stromal Tumors

In the phase II ALIENOR trial reported in JAMA Oncology, Isabelle Ray-Coquard, MD, and colleagues found that the addition of bevacizumab to paclitaxel did not improve the 6-month progression-free rate among women with relapsed ovarian sex cord–stromal tumors. Study Details The study, performed in...

multiple myeloma

Ixazomib Maintenance in Newly Diagnosed Patients With Multiple Myeloma Not Undergoing Stem Cell Transplant: TOURMALINE-MM4 Trial

As reported in the Journal of Clinical Oncology by Meletios A. Dimopoulos, MD, and colleagues, the phase III TOURMALINE-MM4 trial has shown that postinduction maintenance with ixazomib prolonged progression-free survival vs placebo in patients with newly diagnosed multiple myeloma not undergoing...

leukemia
geriatric oncology

FDA Approves Venetoclax Combination Regimen for Certain Adult Patients With AML

On October 16, the U.S. Food and Drug Administration (FDA) granted regular approval to venetoclax (Venclexta) in combination with azacitidine, decitabine, or low-dose cytarabine for newly diagnosed acute myeloid leukemia (AML) in adults age 75 or older or who have comorbidities precluding intensive ...

lung cancer
immunotherapy

Addition of Cetuximab to Afatinib in First-Line Treatment of EGFR-Mutant NSCLC

As reported in the Journal of Clinical Oncology by Sarah B. Goldberg, MD, MPH, and colleagues, final results of the phase II SWOG S1403 trial show no progression-free survival benefit with afatinib plus cetuximab vs afatinib alone in the first-line treatment of EGFR-mutant advanced non–small cell...

gastroesophageal cancer
immunotherapy

KEYNOTE-181 Trial: Second-Line Pembrolizumab vs Chemotherapy in Advanced Esophageal Cancer

As reported in the Journal of Clinical Oncology by Takashi Kojima, MD, and colleagues, the phase III KEYNOTE-181 trial has shown that second-line pembrolizumab improved overall survival vs investigator’s choice of chemotherapy in patients with advanced or metastatic esophageal cancer with a PD-L1...

gynecologic cancers

Swedish Study of HPV Vaccination and Risk of Invasive Cervical Cancer

In a study reported in The New England Journal of Medicine, Lei et al found that receipt of the quadrivalent human papillomavirus (HPV) vaccine among girls and young women was associated with a substantial reduction in the risk of invasive cervical cancer. As stated by the investigators, “The...

breast cancer
symptom management

Can Routine Scans Help Predict Which Patients With Breast Cancer May Be at Risk for Heart Disease?

Automated analysis of the routine scans of patients with breast cancer may help to predict which women have a greater risk of developing cardiovascular disease, according to research presented by Gal et al at the 12th European Breast Cancer Conference (Abstract 7). Women who have been treated for...

prostate cancer

Biochemical Progression-Free Survival With Adjuvant vs Salvage Radiotherapy After Radical Prostatectomy: RADICALS-RT Trial

As reported in The Lancet by Christopher C. Parker, MD, and colleagues, initial findings in the phase III RADICALS-RT trial have shown no biochemical progression-free survival benefit and no difference in freedom from nonprotocol hormone therapy with adjuvant radiotherapy vs salvage radiotherapy...

prostate cancer
supportive care

New Study Finds Low Rates of Bone Mineral Density Testing in Men Treated With ADT for Prostate Cancer

A report published by Hu et al in JNCCN—Journal of the National Comprehensive Cancer Network found the rate of bone mineral density testing in people with prostate cancer undergoing androgen-deprivation therapy (ADT) has improved in recent years, but remains low. ADT is considered a cornerstone of...

bladder cancer

Nab-paclitaxel vs Paclitaxel in Platinum-Refractory Metastatic Urothelial Cancer

In a phase II trial reported in JAMA Oncology, Srikala S. Sridhar, MD, MSc, FRCPC, and colleagues found no difference in progression-free survival with nab-paclitaxel vs paclitaxel in patients with platinum-refractory metastatic urothelial cancer. Study Details In the investigator-initiated...

Conquer Cancer Offers New Research Grants Targeting Diversity in Research, Underserved Patients

The oncology workforce struggles with adequate representation of racial and ethnic minorities, with only 2.3% of practicing oncologists self-identifying as Black or African American and 5.8% of practicing oncologists self-identifying as Hispanic.1 Conquer Cancer, the ASCO Foundation® is offering a...

Art of Oncology: On the Page and in a Podcast, Personal Reflections From Oncologists Are a Fitting Companion Amid the COVID-19 Pandemic

The well-loved Art of Oncology section of the Journal of Clinical Oncology (JCO) and its pioneering podcast are both resonating as never before, as cancer specialists are prompted into deeper reflections about the poignant moments that give life meaning by the COVID-19 pandemic. JCO’s Art of...

Dana-Farber Opens Clinical Trial to Evaluate Simple Blood Test for Many Types of Cancer

Recent advances such as immune, cellular, and targeted therapies have provided new and effective means to treat a variety of cancers. Despite this considerable progress, cancer caught in its earliest stages remains the most curable. That is why Dana-Farber Cancer Institute is opening a new clinical ...

breast cancer

Addition of Veliparib to Carboplatin/Paclitaxel in BRCA-Mutated Advanced Breast Cancer

As reported in The Lancet Oncology by Véronique Diéras, MD, of the Institut Curie, Paris, and Centre Eugène Marquis, Rennes, and colleagues, the phase III BROCADE3 trial has shown a significant improvement in progression-free survival with the addition of the poly (ADP-ribose) polymerase (PARP)...

issues in oncology
breast cancer
colorectal cancer
lung cancer
genomics/genetics
multiple myeloma
pancreatic cancer

Trends to Watch in Early-Onset Cancer Among Young Adults

Although cancer incidence and mortality rates for all cancers combined are considerably lower in younger adults than older adults, a disturbing pattern is beginning to emerge in the development of early-onset cancers, typically diagnosed in older patients, occurring in younger adults. The rising...

lung cancer

Pralsetinib for NSCLC With RET Gene Fusions

On September 4, 2020, pralsetinib (Gavreto) was granted accelerated approval by the U.S. Food and Drug Administration (FDA) for treatment of adults with metastatic RET fusion–positive non–small cell lung cancer (NSCLC) as detected by an FDA-approved test.1,2 The FDA simultaneously approved the...

A Leader in Drug Development, Patricia Keegan, MD, Reflects on Making a Difference in Cancer Care

In this installment of the Living a Full Life series, guest editor Jame Abraham, MD, spoke with Patricia Keegan, MD, who served at the U.S. Food and Drug Administration (FDA) for 30 years, most recently as Acting Associate Director of Medical Policy at the Oncology Center for Excellence (OCE)....

prostate cancer

Rucaparib Produces Durable Responses in Previously Treated Metastatic Castration-Resistant Prostate Cancer

As reported in the Journal of Clinical Oncology by Wassim Abida, MD, PhD, of Memorial Sloan Kettering Cancer Center, and colleagues, the phase II TRITON2 trial has shown that the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib produced durable responses in patients with previously treated...

breast cancer
pain management

Eliminating Routine Opioids While Maintaining Pain Control for Women Undergoing Lumpectomy or Excisional Biopsy

Changing from routinely prescribing opioids for patients who were having a lumpectomy or excisional biopsy to instead routinely prescribing nonsteroidal anti-inflammatory drugs [NSAIDs] resulted in a sharply decreased opioid prescription rate with “no difference in the proportion of patients...

gastrointestinal cancer
immunotherapy

Expert Point of View: Elizabeth Smyth, MD

The overall survival benefit for PD-L1 CPS ≥ 5 tumors in CheckMate 649 is a game-changer. An oxaliplatin doublet plus chemotherapy should become a standard of care for these patients,” according to Elizabeth Smyth, MD, an oncology consultant at Cambridge University Hospital NHS Foundation Trust in...

multiple myeloma
immunotherapy

Carfilzomib and Daratumumab With Dexamethasone for Relapsed or Refractory Multiple Myeloma

On August 20, 2020, carfilzomib and daratumumab were approved for use in combination with dexamethasone for treatment of adults with relapsed or refractory multiple myeloma who have received one to three lines of therapy.1-3 Supporting Efficacy Data Approval was based on findings in two clinical...

lung cancer

Study Questions Role of Routine Postoperative Radiotherapy in NSCLC With Mediastinal Nodes

The Lung ART trial was designed to demonstrate whether there is any benefit to the routine use of modern mediastinal postoperative radiotherapy in patients with non–small cell lung cancer (NSCLC) stage IIIA N2 (ie, patients with mediastinal nodal involvement) following complete resection and neo...

kidney cancer
immunotherapy

First-Line Nivolumab Plus Cabozantinib Improves Outcomes vs Sunitinib in Advanced Renal Cell Carcinoma

The combination of nivolumab plus cabozantinib was found to be superior to the former standard, sunitinib, in the first-line treatment of advanced or metastatic renal cell carcinoma, according to the results of the phase III CheckMate 9ER trial reported at the European Society for Medical Oncology...

issues in oncology
gynecologic cancers
colorectal cancer
covid-19

A Primary Care Physician Explores Barriers to Cancer Prevention and Clinical Trial Accrual

To accelerate progress in the survival rates of people with cancer in the United States and to reduce cancer disparities across the entire spectrum of cancer from diagnosis to survivorship, there needs to be increased access to cancer screening and prevention programs. To shed light on this...

breast cancer

Expert Point of View: George W. Sledge, Jr, MD

The results of monarchE were discussed by George W. Sledge, Jr, MD, Professor of Medicine and Chief of Oncology at Stanford University Medical Center, who offered some possibilities as to why its results were positive and those for palbociclib, in the phase III PALLAS trial, were “resoundingly...

breast cancer

Phase III NALA Trial Meets Primary Endpoint in Previously Treated HER2-Positive Breast Cancer

As reported in the Journal of Clinical Oncology by Cristina Saura, MD, of Vall d’Hebron University Hospital, Barcelona, and colleagues, the phase III NALA trial has shown significantly prolonged progression-free survival with the irreversible pan-HER tyrosine kinase inhibitor neratinib plus...

immunotherapy

City of Hope Scientists Explore Combination Immunotherapy for Solid Tumors

City of Hope scientists have combined two immunotherapies—an oncolytic virus and chimeric antigen receptor (CAR) T-cell therapy—to target solid tumors that are otherwise difficult to treat with CAR T-cell therapy alone, according to a recent study in Science Translational Medicine.1 In preclinical...

breast cancer

Tucatinib Combination Extends Survival in HER2-Positive Metastatic Breast Cancer, Including Patients With Brain Metastases

For patients with progressing HER2-positive metastatic breast cancer previously treated with trastuzumab, pertuzumab, and ado-trastuzumab emtansine (T-DM1), no single regimen is an established standard of care. More than 50% of these patients will develop brain metastasis, and thus far, treatments...

Chemistry of Caring: Timeless Lessons From Oncology Fellowship

As a high school student growing up in St Petersburg, Russia, I was so obsessed with chemistry that I begged my professor for extra problems to complete after school. When I rode the bus home on cold winter evenings, I traced chemical reactions with my finger in the frost on the window. By the...

Emmanuelle Charpentier, PhD, and Jennifer A. Doudna, PhD, Honored With Nobel Prize in Chemistry 2020

On October 7, 2020, The Royal Swedish Academy of Sciences announced that the Nobel Prize in Chemistry 2020 would be awarded to Emmanuelle Charpentier, PhD, and Jennifer A. Doudna, PhD, “for the development of a method for genome editing,” the CRISPR/Cas9 genetic scissors. “There is enormous power...

prostate cancer

Meta-analysis of Adjuvant vs Early Salvage Radiotherapy in Localized and Locally Advanced Prostate Cancer

In a systematic review and meta-analysis reported in The Lancet, Claire L. Vale, PhD, and colleagues found that immediate adjuvant radiotherapy did not improve event-free survival vs early salvage radiotherapy in men with intermediate-risk or high-risk localized or locally advanced prostate cancer...

bladder cancer
immunotherapy

Avelumab Maintenance Therapy in Advanced or Metastatic Urothelial Carcinoma

In the phase III JAVELIN Bladder 100 trial reported in The New England Journal of Medicine, Thomas Powles, MD, PhD, and colleagues found that maintenance treatment with avelumab plus best supportive care significantly improved overall survival vs best supportive care alone among patients whose...

lung cancer
immunotherapy

First-Line Atezolizumab vs Chemotherapy in PD-L1–Positive Metastatic NSCLC: IMpower110

As reported in The New England Journal of Medicine by Roy S. Herbst, MD, PhD, and colleagues, the phase III IMpower110 trial has shown significantly prolonged overall survival with first-line atezolizumab vs platinum-based chemotherapy in patients with metastatic non–small cell lung cancer (NSCLC)...

breast cancer

Neratinib in Previously TreatedHER2-Positive Metastatic Breast Cancer: Point of View From the NALA Trial

Neratinib is an oral pan-HER tyrosine kinase inhibitor that is approved by the U.S. Food and Drug Administration (FDA) for two indications. The first is as adjuvant treatment of early-stage HER2-positive breast cancer following adjuvant trastuzumab therapy. The second is in combination with...

breast cancer
immunotherapy

Expert Point of View: Lisa A. Carey, MD

Invited study discussant Lisa A. Carey, MD, the Richardson and Marilyn Jacobs Preyer Distinguished Professor in Breast Cancer Research and Deputy Director of Clinical Sciences at the University of North Carolina-Chapel Hill, framed her remarks as a tale of two trials. Dr. Carey asked these...

breast cancer
geriatric oncology

Adjuvant Trastuzumab With or Without Chemotherapy for Older Patients With HER2-Positive Early Breast Cancer

In the Japanese RESPECT trial reported in the Journal of Clinical Oncology, Sawaki et al found that noninferiority of adjuvant trastuzumab alone vs with chemotherapy was not shown for disease-free survival among women with HER2-positive breast cancer between the ages of 70 and 80 years. However, a...

gastrointestinal cancer

Long-Term Outcomes With Neoadjuvant Therapy Followed by Surgery in Rectal Adenocarcinoma: Focus on Pathologic Response

For patients with rectal adenocarcinoma treated with neoadjuvant therapy followed by operative resection, “achieving a pathologic complete response is associated with excellent long-term disease-free and overall survival,” according to the results of a study reported by Naomi M. Sell, MD, MHS, of...

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