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For William L. Dahut, MD, a Career of Service in Oncology

In this installment of the Living a Full Life series, Guest Editor Jame Abraham, MD, FACP, spoke with William L. Dahut, MD, who is currently serving as Chief Scientific Officer for the American Cancer Society (ACS). In this role, Dr. Dahut manages all pieces of the organization’s discovery work,...

leukemia

Richter Transformation Remains Challenging, but Better Treatments Are on the Horizon

Richter transformation, usually a diffuse large B-cell lymphoma developing in a person with CLL, remains a challenging entity, but novel regimens look promising, as described at the 2022 Pan Pacific Lymphoma Conference by Matthew S. Davids, MD, MMSc, Associate Professor of Medicine at Harvard...

kidney cancer

Negative Phase III Trials May Dampen Enthusiasm for Immunotherapy in the Adjuvant Setting in Kidney Cancer

Three negative phase III trials presented at the European Society for Medical Oncology (ESMO) Congress 2022 may dampen enthusiasm for immunotherapy as adjuvant therapy for renal cell carcinoma (RCC). None of the three trials—CheckMate 914, IMmotion010, and PROSPER—met its primary endpoint.1-3 The...

issues in oncology

A Call for Creativity: The Shades of Gray in Delivery of Goal-Concordant Care

I continue to be struck by the creativity of medical oncologists. The reimagining of dosing, duration, or regimen composition to respond to patient symptoms or preferences is like a master chef in the kitchen. Although standardization has, with good reason, become the paragon, delivering...

breast cancer

Why Are Young Adult Women Developing Later-Stage, More Aggressive Breast Cancer Than Older Women?

It has been well documented that breast cancer is the most common malignancy in adolescent and young adult (AYA) women aged 15 to 39 years, accounting for 30% of cancers among this population.1 In addition, 5.6% of all invasive breast cancers occur in AYA women.1 A presentation by Rebecca H....

Expert Point of View: Natasha Leighl, MD

“Platinum-ineligible patients are typically excluded from clinical trials, yet they represent the majority of patients that we diagnose and treat—patients with poor performance status and comorbidities,” said invited discussant Natasha Leighl, MD, of the Princess Margaret Cancer Centre, Toronto....

lung cancer

IPSOS Trial: Platinum-Ineligible Patients With NSCLC May Gain Survival Benefit From Atezolizumab Therapy

In platinum-ineligible patients with advanced non–small cell lung cancer (NSCLC), first-line treatment with the PD-L1 checkpoint inhibitor atezolizumab improved overall survival by an absolute value of about 1 month but almost doubled the rate of 2-year overall survival compared with chemotherapy...

hepatobiliary cancer
immunotherapy

FDA Approves Tremelimumab Plus Durvalumab for Adult Patients With Unresectable HCC

On October 21, the U.S. Food and Drug Administration (FDA) approved tremelimumab (Imjudo) in combination with durvalumab (Imfinzi) for the treatment of adult patients with unresectable hepatocellular carcinoma (HCC), the most common type of liver cancer. The novel dose and schedule of the...

supportive care
pain management

Prophylactic Radiation for Asymptomatic Bone Metastases May Reduce Pain and Extend Survival

Treating high-risk, asymptomatic bone metastases with radiation may reduce painful complications and hospitalizations and possibly extend overall survival in people whose cancer has spread to multiple sites, a phase II clinical trial suggests. Results of the multicenter, randomized trial were...

prostate cancer

PCS5 Trial: Long-Term Outcomes of Moderately Shortened Radiation Course for High-Risk Prostate Cancer

A randomized study has confirmed that patients with high-risk prostate cancer can be treated with 5 vs 8 weeks of radiation therapy. The phase III clinical trial is the first to confirm the safety and efficacy of a moderately shortened course of radiation exclusively for patients with high-risk...

issues in oncology

Small First-in-Human Trial Investigates FLASH Proton Radiotherapy for Patients With Bone Metastases

FLASH radiation treatment—which delivers therapeutic doses of radiation in a fraction of a second—may be a potential treatment for tough-to-kill tumors, a first-in-human study in a small number of people with bone cancer suggests. The technology, previously tested in animals, was shown to be as...

hepatobiliary cancer

Adding SBRT to Sorafenib May Improve Survival and Time to Disease Progression in Patients With Advanced HCC

Adding stereotactic body radiation therapy (SBRT) to systemic therapy with sorafenib for patients with advanced hepatocellular carcinoma (HCC) may extend overall survival and delay tumor progression without compromising patients’ quality of life, findings from the randomized phase III NRG...

issues in oncology

Incidence of Cutaneous Adverse Events With Adjuvant PI3K Inhibitor Therapy

In a systematic review and meta-analysis reported in JAMA Oncology, Jfri et al identified risk for cutaneous adverse events among patients with cancer receiving adjuvant phosphoinositide 3-kinase (PI3K) inhibitor therapy. Study Details The analysis included 15 phase II or III randomized controlled...

issues in oncology
covid-19

Effect of Goals-of-Care Program for Inpatients at a Comprehensive Cancer Center During the COVID-19 Pandemic

As reported in the Journal of Clinical Oncology by David Hui, MD, MSc, and colleagues, an interdisciplinary goals-of-care program instituted at The University of Texas MD Anderson Cancer Center in response to anticipated COVID-19–related increases in need for intensive care unit (ICU) use resulted ...

gynecologic cancers

Hair-Straightening Chemicals May Be Associated With Higher Uterine Cancer Risk

Individuals who reported using chemical hair-straightening products may be at greater risk for uterine cancer compared to those who did not report using these products, according to a new study published by Chang et al in the Journal of the National Cancer Institute (JNCI). The researchers found no ...

issues in oncology

ACS CAN Survey: Female Patients With Cancer Report Less Satisfaction, More Challenges With Cancer Care

Female patients with cancer were less satisfied with the quality of their cancer care than male patients with cancer, according to the results of a survey conducted by the Survivor Views program of the American Cancer Society Cancer Action Network (ACS CAN). In addition, female patients were more...

breast cancer
supportive care

Silicone-Based Polyurethane Film May Reduce Acute Radiation Dermatitis in Patients With Breast Cancer

Mepitel Film—a silicone-based polyurethane film dressing—may be beneficial in reducing skin toxicities caused by radiation treatment, according to data presented during the October 2022 session of the ASCO Plenary Series by Chow et al (Abstract 390226). Results of the phase III trial showed the...

breast cancer

No Benefit for Adjuvant Palbociclib in Stage IIA Breast Cancer: Analysis From the PALLAS Trial

In a preplanned analysis of the PALLAS trial, the addition of adjuvant palbociclib to standard endocrine therapy did not improve outcomes over endocrine therapy alone in patients with stage IIA breast cancer. Palbociclib offered no additional benefit in terms of invasive disease–free survival (the...

colorectal cancer

Timely Surveillance With Chest Imaging May Benefit Patients With Metastatic Colorectal Cancer

Patients with colorectal cancer who have certain clinical characteristics may benefit from more frequent chest imaging to help identify and target cancer that has metastasized to the lungs, according to a new study presented at the 2022 Scientific Forum of the American College of Surgeons Clinical...

solid tumors

Single-Dose Carboplatin Plus Involved-Node Radiotherapy in Stage IIA/IIB Seminoma

In a Swiss/German phase II trial (SAKK 01/10) reported in The Lancet Oncology, Papachristofilou et al found that a single dose of carboplatin followed by involved-node radiotherapy narrowly missed the target 3-year progression-free survival rate in patients with stage IIA or IIB seminoma.  As...

lung cancer
immunotherapy

First-Line Nivolumab/Ipilimumab vs Chemotherapy in Metastatic NSCLC Without EGFR or ALK Alterations: 5-Year Survival

As reported in the Journal of Clinical Oncology by Julie R. Brahmer, MD, MSc, FASCO, and colleagues, a 5-year analysis of the phase III CheckMate 227 trial showed improvement in overall survival with first-line nivolumab/ipilimumab vs platinum-doublet chemotherapy, at ≥ 3 years after cessation of...

survivorship
cost of care

Financial Hardship Among Adult Survivors of Childhood Cancer After Implementation of the Affordable Care Act

In an analysis from the Childhood Cancer Survivor Study reported in the Journal of Clinical Oncology, Nathan et al found that adult survivors of childhood cancer were more likely to report financial hardship than siblings without cancer in the era following implementation of the Affordable Care...

breast cancer

David Cescon, MD, PhD, Comments on the MONALEESA Analyses

David Cescon, MD, PhD, Clinician Scientist at the Princess Margaret Cancer Centre in Toronto, Canada, was the invited discussant of the two MONALEESA analyses.1,2 He noted that the most recent overall survival analysis, presented at the European Society for Medical Oncology (ESMO) Congress 2021,...

breast cancer

MONALEESA Analyses Show Widespread Benefit for Ribociclib in Hormone Receptor–Positive, HER2-Negative Breast Cancer

Further analyses of the ­MONALEESA metastatic breast cancer trials have shown that the benefit of ribociclib plus endocrine therapy in the first-line setting extends to most intrinsic molecular subtypes and is consistent across multiple subgroups. The studies were presented at the 2021 San Antonio...

Expert Point of View: Mafalda Oliveira, MD, PhD

Invited discussant of the MONALEESA-3 trial, Mafalda Oliveira, MD, PhD, of Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology, Barcelona, commented: “I totally agree with the authors when they say these results are ‘impressive.’” Among all the phase III trials evaluating...

breast cancer

MONALEESA-3: Ribociclib Plus Fulvestrant Improves Overall Survival Over Fulvestrant Alone in the First-Line Setting

In an updated analysis of the phase III MONALEESA-3 trial, which included postmenopausal patients with hormone receptor–positive, HER2-negative advanced or metastatic breast cancer, first-line treatment with ribociclib plus fulvestrant added nearly 16 months of overall survival time vs fulvestrant...

breast cancer
immunotherapy

TROPiCS-02 Sacituzumab Govitecan Effective in Hormone Receptor–Positive, HER2-Negative Metastatic Breast Cancer

For advanced breast cancer that is hormone receptor–positive and HER2-negative, sacituzumab govitecan-hziy significantly reduced the risk of disease progression by 34% over physician’s choice of treatment, based on the results of the phase III TROPiCS-02 trial.1 The heavily pretreated patients in...

breast cancer

Breast Cancer 2021–2022 Almanac

The past year has seen an unprecedented number of practice-changing advances across all three major breast cancer subtypes. For patients with early-stage triple-negative breast cancer, neoadjuvant chemotherapy plus pembrolizumab firmly entered the standard of care based on improvements in...

breast cancer

PALOMA-2: No Overall Survival Benefit Reported With Palbociclib/Letrozole in Advanced Breast Cancer

The final overall survival analysis of the phase III PALOMA-2 trial has shown no significant benefit for palbociclib given with letrozole, vs letrozole and placebo, as a first-line treatment in hormone receptor–positive, HER2-negative metastatic breast cancer.1 The results were reported at the 2022 ...

breast cancer
immunotherapy

T-DXd Improves Progression-Free Survival vs T-DM1 in Metastatic HER2-Positive Breast Cancer

As reported in The New England Journal of Medicine by Javier Cortés, MD, PhD, of the International Breast Cancer Center, Barcelona, and colleagues, the phase III DESTINY-Breast03 trial has shown significantly prolonged progression-free survival with fam-trastuzumab deruxtecan-nxki (T-DXd) vs...

Expert Point of View: Mafalda Oliveira, MD, PhD

The invited discussant of the TUXEDO-1 trial1 was Mafalda Oliveira, MD, PhD, of Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology, Barcelona. Dr. Oliveira noted that 40% of the 15 patients in TUXEDO-1 had symptomatic disease, and 60% had central nervous system metastases...

breast cancer
immunotherapy

T-DXd Shows Efficacy Against Active Brain Metastases in HER2-Positive Breast Cancer

In the single-center phase II TUXEDO-1 trial of patients with advanced HER2-positive breast cancer, fam-trastuzumab-deruxtecan-nxki (T-DXd) showed efficacy in patients with active brain metastases, yielding intracranial responses in 73.3% of the population and a median progression-free survival of...

breast cancer
immunotherapy

DESTINY-Breast04 Trial: T-DXd Significantly Improves Survival in Patients With HER2-Low Metastatic Breast Cancer

The antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) doubled progression-free survival compared with chemotherapy alone in patients with “HER2-low” metastatic breast cancer—ie, patients with low levels of HER2 expression. The agent also extended overall survival for patients with low ...

breast cancer
immunotherapy

Expert Point of View: Debu Tripathy, MD, and Hope S. Rugo, MD, FASCO

The ASCO Post asked Debu Tripathy, MD, Professor and Chair of Medical Breast Oncology at The University of Texas MD Anderson Cancer Center, Houston, and Hope S. Rugo, MD, FASCO, Professor of Medicine, Director of Breast Oncology and Clinical Trials Education at the University of California San...

breast cancer
immunotherapy

Datopotamab Deruxtecan Shows Activity in Advanced Triple-Negative Breast Cancer

Datopotamab deruxtecan, an antibody-drug conjugate directed against trophoblast cell surface antigen-2 (Trop-2), is showing promise as a treatment for relapsed or refractory advanced triple-negative breast cancer, according to early findings from the phase I TROPION-PanTumor01 trial presented...

breast cancer
immunotherapy

Addition of Pembrolizumab to Chemotherapy Improves Event-Free Survival in Triple-Negative Breast Cancer

As reported in The New England Journal of Medicine by Peter Schmid, MD, PhD, of Barts Cancer Institute, Queen Mary University of London, and colleagues, a preplanned interim analysis of the phase III KEYNOTE-522 trial has shown improved event-free survival with the addition of pembrolizumab to...

Expert Point of View: Mafalda Oliveira, MD, PhD

The invited discussant of the BEGONIA trial,1 Mafalda Oliveira, MD, PhD, of Vall d’Hebron University Hospital and Vall d’Hebron Institute of Oncology, Barcelona, called the activity of the combination of durvalumab and datopotamab deruxtecan (Dato-DXd) “notable,” with a 74% response rate overall,...

breast cancer
immunotherapy

BEGONIA Trial Reports Activity With Datopotamab Deruxtecan Plus Durvalumab in Triple-Negative Breast Cancer

Preliminary results of the basket BEGONIA trial showed that the antibody-drug conjugate datopotamab deruxtecan (Dato-DXd), paired with the immune checkpoint inhibitor durvalumab, has strong activity in advanced or metastatic triple-negative breast cancer among patients not biomarker-selected for...

Expert Point of View: Amy Tiersten, MD and Carlos L. Arteaga, MD

Amy Tiersten, MD, Professor of Medicine, Hematology, and Medical Oncology, Icahn School of Medicine at Mount Sinai, and Carlos L. Arteaga, MD, Director of the Simmons Comprehensive Cancer Center and Associate Dean of Oncology at The University of Texas Southwestern Medical Center, Dallas,...

breast cancer

PADA-1 Trial: With Early Identification of ESR1 Mutation, Switch to Fulvestrant in Metastatic Breast Cancer

Switching from an aromatase inhibitor to fulvestrant upon early identification of the ESR1 mutation in plasma—before disease progression—doubled progression-free survival in the phase III PADA-1 trial, presented at the 2021 San Antonio Breast Cancer Symposium.1 “PADA-1 is the first trial to...

breast cancer
genomics/genetics
immunotherapy

Dual Checkpoint Inhibitor Therapy Elicits Responses in Highly Mutated Breast Cancer

Patients with advanced HER2-negative metastatic breast cancer and high tumor mutational burden achieved responses—often durable—from treatment with the immunotherapy doublet of nivolumab and ipilimumab, according to results of the phase II NIMBUS trial reported at the 2021 San Antonio Breast Cancer ...

breast cancer
genomics/genetics

Expert Point of View: Mark E. Robson, MD

“OlympiA is clearly a practice-changing trial, and olaparib should be offered to patients meeting the entry criteria for the study,” said Mark E. Robson, MD, Chief of the Breast Medicine Service at Memorial Sloan Kettering Cancer Center, New York. Dr. Robson was invited to discuss the findings of...

breast cancer
genomics/genetics

OlympiA Trial: Adjuvant Olaparib Significantly Improves Overall Survival in Germline BRCA-Mutated Breast Cancer

The OlympiA trial of adjuvant olaparib in patients with HER2-negative, high-risk ­early-stage breast cancer and BRCA1 and BRCA2 mutations has now demonstrated a significant overall survival benefit, reducing the risk of death over placebo by 32% and yielding an absolute improvement of 3.8% at 3...

breast cancer

Strides Are Being Made in the Treatment of Brain Metastases From Breast Cancer

New drugs for HER2-positive breast cancer are able to overcome some of the obstacles that have made brain metastases challenging to treat, according to Mark Pegram, MD, the Susy Yuan-Huey Hung Professor of Oncology at Stanford University School of Medicine in California, who described the promising ...

breast cancer

EMERALD Trial: Oral Selective Estrogen Receptor Degrader as Second- or Third-Line Therapy for Advanced Breast Cancer

Use of the first investigational oral selective estrogen receptor degrader (SERD) elacestrant significantly reduced the risk of death or disease progression and lengthened progression-free survival compared with standard-of-care endocrine therapy with fulvestrant or an aromatase inhibitor in...

breast cancer

Aditya Bardia, MD, MPH, Comments on Findings From monarchE

The invited discussant of monarchE,1 Aditya Bardia, MD, MPH, Director, Breast Cancer Research, and Associate Professor of Medicine, Harvard Medical School, commented: “Based on a hazard ratio of 0.69 for invasive disease–free survival, the results are statistically significant and clinically...

breast cancer

Long-Term Follow-up of monarchE: Benefit of Abemaciclib Plus Endocrine Therapy Maintained in Early High-Risk Breast Cancer

Longer-term follow-up of the global phase III monarchE trial showed an increasing benefit for adding abemaciclib to endocrine therapy in the adjuvant treatment of early high-risk hormone receptor–positive, HER2-negative breast cancer, regardless of Ki67 index. The latest findings were reported at a ...

hepatobiliary cancer

Neoadjuvant Intensity-Modulated Radiotherapy in Centrally Located Hepatocellular Carcinoma

In a Chinese single-center phase II trial reported in JAMA Surgery, Wu et al found neoadjuvant intensity-modulated radiotherapy (IMRT) followed by hepatectomy could be an effective treatment option in patients with centrally located hepatocellular carcinoma. Study Details In the study, 38 patients...

skin cancer
immunotherapy

Mediterranean Diet May Improve Immunotherapy Response Rates and Progression-Free Survival in Advanced Melanoma, New Study Suggests

Following a Mediterranean diet rich in fiber, monounsaturated fatty acids, and polyphenols may be associated with improved immunotherapy response rates and progression-free survival in patients with advanced melanoma, according to a recent study presented at the United European Gastroenterology...

pancreatic cancer

Study Analyzes Postimaging Diagnoses of Pancreatic Cancer

Computed tomography (CT) and magnetic resonance imaging (MRI) scans may miss the detection of some pancreatic cancer tumors, narrowing the window for life-saving curative surgery, according to new research presented at the United European Gastroenterology (UEG) Week 2022 (Abstract OP192).  The...

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