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global cancer care

Early Adopter of Breast Conservation, Surgical Oncologist Augusto Leon, MD, Reflects on Cancer Care in Chile

In this installment of the occasional department on Global Health-Care Equity, Guest Editor, Chandrakanth Are, MBBS, MBA, FRCS, FACS, spoke with Augusto Leon, MD, a surgical oncologist and Head of the Program of Cancer at Pontifical University of Chile, Santiago. Dr. Are is JL & CJ Varner...

global cancer care

Predicting Global Cancer Trends in 2021

Although we are just halfway through 2021, the outlook for improvements in global cancer trends looks grim. According to new estimates by the International Agency for Research on Cancer’s Global Cancer Observatory, the global cancer burden rose to 19.3 million cases and 10 million deaths in 2020...

breast cancer

ADAPT Trial: ‘Excellent’ Outcomes Reported With Neoadjuvant Dual HER2 Therapy in Breast Cancer

The first overall survival analysis of the WGS-ADAPT HER2+/HR– study, which evaluated neoadjuvant therapy in patients with hormone receptor–negative, HER2-positive disease, showed that treatment with pertuzumab and trastuzumab plus paclitaxel—or with the chemotherapy-free regimen of...

bladder cancer

Sacituzumab Govitecan-hziy: Welcome Addition to Advanced Urothelial Cancer Treatments, but Time to Figure Out Sequencing and Combinations

The results of Cohort 1 of the phase II trial TROPHY-U-01 (IMMU-132-06; ClinicalTrials.gov identifier NCT03547973), published in the Journal of Clinical Oncology by Tagawa et al and reviewed in this issue of The ASCO Post, led to the recent accelerated U.S. Food and Drug Administration (FDA)...

solid tumors

Enfortumab Vedotin Represents a Community of Work in Antibody-Drug Conjugates Targeting Cancer

The first known clinical trial report of an antibody-drug conjugate was a phase 0/I pharmacodynamic and safety study of a conjugate that targeted carcinoembryonic antigen and delivered a payload of vinca alkaloid in eight patients with ovarian or colorectal cancer.1 This work built on the work of...

bladder cancer

EV-301 Trial: Enfortumab Vedotin-ejfv Improves Overall Survival vs Chemotherapy in Previously Treated Advanced Urothelial Carcinoma

As reported in The New England Journal of Medicine by Thomas Powles, MD, of Barts Cancer Centre, Queen Mary University of London, and colleagues, a prespecified interim analysis of the phase III EV-301 trial has shown improved overall survival with the antibody-drug conjugate enfortumab...

multiple myeloma
covid-19

Study Finds Response to COVID-19 Vaccination Varies Widely in Patients With Multiple Myeloma

Patients with multiple myeloma had a wide variety of responses to COVID-19 vaccines—in some cases, no detectable response at all—pointing to the need for antibody testing and precautions for these patients after vaccination, according to a study published by Van Oekelen et al in Cancer Cell. Mount...

colorectal cancer

Is There a Link Between Use of Antibiotics and Early-Onset Colorectal Cancer?

Study findings presented by Perrott et al at the ESMO World Congress on Gastrointestinal Cancer (Abstract SO-25) showed that the use of antibiotics may be linked to colon tumor formation across all patient age groups, especially in those younger than 50 years. These results raise fresh concerns...

Annual Report to the Nation: Continued Decline in Cancer Death Rate

Overall cancer death rates continue to decline in men and women for all racial and ethnic groups in the United States, according to the latest Annual Report to the Nation on the Status of Cancer. During 2001 to 2018, declines in lung cancer death rates accelerated, and death rates for melanoma...

lymphoma
survivorship

Parenthood Status and Use of Assisted Reproductive Techniques in Younger Hodgkin Lymphoma Survivors

In a Danish population-based study reported in the Journal of Clinical Oncology, Øvlisen et al found that parenthood rates in younger Hodgkin lymphoma survivors who did not experience early relapse were similar to those in the general population, but that use of assisted reproductive techniques...

issues in oncology

Study Recommends Improvements for Cancer Care at Network Sites

New research published in JNCCN—Journal of the National Comprehensive Cancer Network assessed the quality of cancer care delivered through extended sites coordinated by some of the country’s largest cancer centers. The study was developed to implement strategies for disseminating discoveries and...

skin cancer
immunotherapy

Responses to Pembrolizumab and Ipilimumab After Anti–PD-1/L1 Failure in Advanced Melanoma

Despite new and effective treatments for melanoma with checkpoint inhibitors and targeted therapies, patients with metastatic melanoma who progress on frontline treatment generally do very poorly. “We really need to make sure we give these patients access to drugs that we know have some efficacy,”...

Efficiency of Virtual Care for Oncology Patients During the COVID-19 Pandemic

In a single-institution study reported in JCO Oncology Practice, Hsiehchen et al found that replacement of in-person with telehealth visits among patients with cancer initiating systemic therapy during the COVID-19 pandemic was not associated with poorer efficiency in components of oncology care or ...

Assessment of Targeted Methylation-Based Multicancer Early Detection Test in Independent Validation Cohort

In a validation study reported in Annals of Oncology, Klein et al found that a targeted methylation-based multicancer early detection (MCED) assay using cell-free DNA (cfDNA) sequencing had high specificity for cancer signal detection and high accuracy in predicting cancer signal origin across a...

leukemia

Effect of Myeloid Progenitor Cell Product on the Risk of Infection During Induction Chemotherapy for AML

In a phase II trial reported in the Journal of Clinical Oncology, Desai et al found that the addition of the myeloid progenitor cell product romyelocel-L to granulocyte colony-stimulating factor (G-CSF) reduced the incidence of infection and antimicrobial use vs G-CSF alone during induction...

breast cancer

Personalizing Treatment of Early HER2-Positive Breast Cancer

With several pivotal trials providing evidence for the escalation and de-escalation of anti-HER2 therapy in certain early breast cancer scenarios, personalized treatment is possible. How can clinicians optimize treatment by applying the studies’ findings? Debu Tripathy, MD, Professor and Chair of...

genomics/genetics

Use of Germline Mutation Profiling in Patients With Advanced Cancers

In a study reported in the Journal of Clinical Oncology, Zsofia K. Stadler, MD, and colleagues found that germline mutation testing revealed therapeutically actionable variants in 8% of patients with recurrent or metastatic cancers, with 40% of them receiving directed treatment. As stated by the...

breast cancer

Beyond CDK4/6 Inhibitors in Metastatic Breast Cancer: What’s Next?

Because of their well-established efficacy, inhibitors of cyclin-dependent kinases 4 and 6 (CDK4/6) are the standard of care in the treatment of hormone receptor–positive, HER2-negative metastatic breast cancer. The question now is this: after disease progresses on a CDK4/6 inhibitor and endocrine...

breast cancer

Risk Factors for Early Discontinuation of Adjuvant Endocrine Therapy for Breast Cancer

In a post hoc analysis from the phase III TAILORx trial reported in JAMA Oncology, Yanez et al identified factors that may be associated with an increased and decreased likelihood of early discontinuation of adjuvant endocrine therapy for breast cancer. Study Details The TAILORx trial, conducted...

breast cancer

Improving Screening of Dense Breasts With Newer MRI Technologies

Women with dense breasts are increasingly being screened with magnetic resonance imaging (MRI), which is clearly the best way to detect small cancers in this population, according to Elizabeth Morris, MD, FACR, FSBI, FISMRM, Professor and Chair of the Department of Radiology at the University of...

head and neck cancer

ASCO Releases Recommendations for Management of Salivary Gland Malignancies

Given the rarity of salivary gland malignancies—neoplasms that account for less than 1% to 5% of all head and neck cancers—limited evidence exists to support informed treatment guidance. The overall variability in the biologic behaviors of these neoplasms has further complicated clinical...

lymphoma

PI3K Inhibition With Copanlisib Plus ­Rituximab in Relapsed Indolent Non-Hodgkin Lymphoma

Better understanding of the mechanism behind the malignant transformation of B cells has led to an explosion of “targeted” therapy. With the growing knowledge of the role of the B-cell receptor and its downstream kinases, it appeared that we were entering a new era in the management of patients...

Expert Point of View: Kunle Odunsi, MD, PhD, and Lilian T. Gien, MD, MSc

Comments on the OUTBACK trial were provided by invited discussant Kunle Odunsi, MD, PhD, Professor of Obstetrics and Gynecology, Dean for Oncology, and Director of the University of Chicago Medicine Comprehensive Cancer Center. Lilian T. Gien, MD, MSc, Associate Professor of Oncology at the...

issues in oncology
survivorship

Addressing Sexuality Challenges Throughout the Cancer Care Continuum

Multiple studies have shown that sexuality and intimacy problems are common among patients with cancer, often beginning at the time of diagnosis and persisting through the continuum of care into the survivorship setting. Although these problems have been well documented, many patients and survivors ...

multiple myeloma

Newly Diagnosed Multiple Myeloma

“Continuous improvement is better than delayed perfection.” —Mark Twain To complement The ASCO Post’s continued comprehensive coverage of the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on...

lymphoma
immunotherapy

Loncastuximab Tesirine-lpyl for Relapsed or Refractory Large B-Cell Lymphoma

On April 23, 2021, loncastuximab tesirine-lpyl, a CD19-directed antibody and alkylating agent conjugate, was granted accelerated approval for treatment of adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including diffuse large B-cell...

Innovator in Treatment of Infectious Diseases, Francisco Marty, MD, Dies at 53

The Brigham and Women’s hospital community mourns the loss of Francisco Marty, MD, of the Division of Infectious Diseases, who died April 8, 2021, after a tragic accident while hiking in the Dominican Republic. He was 53. A member of the Brigham community for more than 20 years, Dr. Marty is...

gynecologic cancers

OUTBACK: No Benefit for Adjuvant Chemotherapy in Cervical Cancer

In women with locally advanced cervical cancer, adjuvant chemotherapy adds no benefit to standard cisplatin-based chemoradiation, results of the international phase III OUTBACK study have shown,1 as reported at the 2021 ASCO Annual Meeting by Linda R. Mileshkin, MD, Professor of Medical Oncology at ...

geriatric oncology

Do Community Oncologists Have Access to Geriatric Specialty Care for Older Patients?

As our population rapidly ages, the burden of cancer incidence increases accordingly, creating an urgent need for greater and more incisive research on the diagnosis, treatment, and survivorship issues for older adults with cancer. Given the numerous challenges faced by today’s busy oncologists, a...

global cancer care

Cancer in Morocco: Access to Innovative Treatments and Research Status

Morocco is an Arab country in North Africa. It covers 716,550 square kilometers and has a population of nearly 36 million. The median age is 29.3 years. Morocco’s estimated gross domestic product (GDP) in 2019 was $122 million. As of 2019, Morocco’s health budget was equivalent to 4.5% of the total ...

global cancer care
covid-19

Harnessing a Worldwide Effort to Combat COVID-19 and Cancer

This past October, in a virtually held ceremony of the General Assembly of the Union for International Cancer Control (UICC), Anil K. D’Cruz, MBBS, MS, DNB, FRCS (Hon), Director of Oncology at Apollo Hospitals in Mumbai, Chennai, and Delhi, India, began his 2-year tenure as President of the global...

leukemia

Lessons From Pneumococcal Vaccine Responses in Patients With CLL in an Evolving Vaccine Landscape

The role of vaccines in mitigating the significant morbidity and mortality associated with infections in chronic lymphocytic leukemia (CLL) is a developing field of study, punctuated by the advent of novel therapeutic agents and pressing questions regarding the global SARS–CoV-2 vaccination...

breast cancer

OlympiA Trial: Adjuvant Olaparib Extends Disease-Free Survival in BRCA-Mutated Early Breast Cancer

Adjuvant therapy with the PARP inhibitor olaparib for 1 year extended disease-free survival in patients with high-risk early-stage HER2-negative breast cancer with BRCA1/2 germline (inherited) mutations, according to a prespecified interim analysis of the phase III OlympiA trial presented at the...

hematologic malignancies
covid-19

Convalescent Plasma Therapy for Patients With Hematologic Cancers Hospitalized for COVID-19

In a retrospective cohort study reported in JAMA Oncology, Michael A. Thompson, MD, PhD, FASCO, and colleagues found that the use of convalescent plasma therapy was associated with improved 30-day mortality among patients with hematologic cancers hospitalized for COVID-19. Study Details The study...

pain management
supportive care

Stereotactic Body Radiotherapy vs Conventional External-Beam Radiotherapy for Pain Control of Spinal Metastases

In a Canadian/Australian phase II/III trial reported in The Lancet Oncology, Arjun Sahgal, MD, and colleagues found that stereotactic body radiotherapy (SBRT) produced a higher complete pain response rate vs conventional external-beam radiotherapy (EBRT) in patients with painful spinal metastases. ...

multiple myeloma
hematologic malignancies
gynecologic cancers
prostate cancer

FDA Pipeline: Priority Reviews in Multiple Myeloma, Cervical Cancer, Neutropenia, and Myelofibrosis

Over the past month, the U.S. Food and Drug Administration (FDA) has granted Priority Review to therapies for multiple myeloma, cervical cancer, chemotherapy-induced neutropenia, and myelofibrosis. The FDA also granted a number of Breakthrough Therapy designations, including those for treatments in ...

head and neck cancer

Adjuvant Metronomic Capecitabine for Locoregionally Advanced Nasopharyngeal Carcinoma

In a Chinese phase III study reported in The Lancet, Chen et al found that the use of adjuvant metronomic capecitabine improved failure-free survival vs observation after definitive chemoradiotherapy in patients with high-risk locoregionally advanced nasopharyngeal carcinoma. Study Details In the...

covid-19

ASCO/Friends of Cancer Research Joint Position Statement Encourages Enrollment of Patients With Cancer in COVID-19 Vaccine Studies

Individuals with cancer or a history of cancer should be eligible for clinical trials—including COVID-19 vaccine trials—unless there is safety justification for exclusion, ASCO and Friends of Cancer Research (Friends) asserted in a joint position statement released today. To date, clinical trials...

breast cancer

Testing of Lymph Nodes for Breast Cancer Recurrence After Neoadjuvant Chemotherapy

A study published by Sharp et al in The Breast Journal suggests that some patients with breast cancer may be able to forgo certain testing procedures after neoadjuvant chemotherapy without increasing their risk of cancer recurrence. Prior studies on detecting whether breast cancer has spread to...

multiple myeloma
immunotherapy

Addition of Isatuximab-irfc to Carfilzomib/Dexamethasone in Relapsed or Refractory Multiple Myeloma: IKEMA Trial

As reported in The Lancet by Philippe Moreau, MD, and colleagues, the phase III IKEMA trial has shown that the addition of the anti-CD38 antibody isatuximab-irfc to carfilzomib and dexamethasone resulted in significantly improved progression-free survival in patients with relapsed or refractory...

prostate cancer
issues in oncology

Peter C. Black, MD, on Prostate Cancer Health-Care Disparities: Expert Perspective

Peter C. Black, MD, of the Vancouver Prostate Centre, University of British Columbia, reviews three studies on early detection and treatment of Black patients with prostate cancer: a large-scale analysis of genomic profiling; the use of PSA screening; and integrating a patient-specific genomic...

breast cancer
symptom management

Survivors of Early-Stage Breast Cancer Face Broad Range of Symptoms and Concerns

Patients with early-stage breast cancer may be at low risk of dying of their disease, but they experience a high burden of physical and psychological symptoms long after their treatment has ended, according to data presented during the 2021 American Society of Breast Surgeons Annual Meeting.1...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Addition of First-Line Nivolumab to Chemotherapy in Advanced Gastric Cancers: CheckMate 649

As reported in The Lancet by Yelena Y. Janjigian, MD, and colleagues, the phase III CheckMate 649 trial has shown that the addition of first-line nivolumab to chemotherapy resulted in improved overall and progression-free survival among patients with advanced HER2-negative gastric, gastroesophageal ...

breast cancer
genomics/genetics

Effect of Polygenic Risk Score on Estimated Breast Cancer Risk Among Carriers of Pathogenic Variants in Predisposition Genes

In a study reported in the Journal of Clinical Oncology, Gao et al found that use of a polygenic risk score (PRS) modified the estimated risk of breast cancer among both carriers and noncarriers of established pathogenic variants in breast cancer predisposition genes. Study Details The study...

hematologic malignancies
immunotherapy

Efstathios Kastritis, MD, on Amyloidosis: Standard of Care Plus Daratumumab

Efstathios Kastritis, MD, of the University of Athens, discusses updated phase III results from the ANDROMEDA study of patients with newly diagnosed light chain amyloidosis. The trial further supports the use of daratumumab plus VCd (bortezomib, cyclophosphamide, and dexamethasone), which was shown ...

leukemia
lymphoma

Zanubrutinib vs Ibrutinib in Relapsed/Refractory CLL/SLL: ALPINE Trial

Zanubrutinib—a second-generation Bruton's tyrosine kinase (BTK) inhibitor—significantly improved response rates and delayed disease progression as compared to the standard of care, ibrutinib, in patients with relapsed or refractory chronic lymphocytic leukemia or small lymphocytic lymphoma...

breast cancer
genomics/genetics

ASCO Releases Rapid Guideline Recommendation Update for Patients With High-Risk, HER2-Negative, Germline BRCA–Mutated Breast Cancer

A new ASCO guideline update recommends offering 1 year of adjuvant olaparib to patients with high-risk, early-stage, HER2-negative breast cancer and germline BRCA mutations after completion of (neo)adjuvant chemotherapy and local treatment, including radiation. The recommendations update the 2020...

myelodysplastic syndromes

Reduced-Intensity Conditioning Allogeneic HCT Based on Donor Availability in Older Patients With Advanced Myelodysplastic Syndrome

In a study reported in the Journal of Clinical Oncology, Nakamura et al found that use of reduced-intensity conditioning allogeneic hematopoietic cell transplantation (HCT) in older patients with advanced myelodysplastic syndrome (MDS) with an available matched donor improved overall survival vs...

breast cancer

De-escalating Surgery for Women With Breast Cancer

From routine axillary lymph node dissection to sentinel lymph node surgery, the use of axillary surgery continues to evolve in breast cancer. Recently, surgical oncologists have begun to consider avoiding axillary surgery completely in patients with a low risk of node-positive disease as well as in ...

lung cancer

Trilaciclib to Reduce Chemotherapy-Induced Bone Marrow Suppression in Extensive-Stage Small Cell Lung Cancer

On February 12, 2021, the cyclin-dependent kinase 4/6 (CDK4/6) inhibitor trilaciclib was approved for use to decrease the incidence of chemotherapy-induced myelosuppression in adult patients when administered prior to a platinum/etoposide–containing regimen or topotecan-containing regimen for...

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