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issues in oncology

AACR-NCI-EORTC: Rising Number of Seamless Clinical Trials in Oncology

The number of early-phase trials in oncology that adopted a seamless approach—as opposed to a traditional trial approach with defined phase I, II, and III plans—is rising, with data from the majority of them presented after 2014, according to a study presented by Barata et al at the...

colorectal cancer

AACR-NCI-EORTC: Colorectal Cancers May Mutate to Escape Immune System Detection

Whole-exome sequencing revealed that colorectal cancers with high mutational load (microsatellite instability–high, or MSI-H) predominantly use “immunoediting” to escape immune surveillance, while colorectal cancers with low mutational load (microsatellite stable, or MSS) use...

palliative care
leukemia

2017 ASCO Palliative Care: People With Leukemia and Their Oncologists Have Vastly Different Perceptions of Prognosis

A study of 100 people with acute myeloid leukemia (AML) receiving chemotherapy found that patient and physician perceptions of treatment risk and the likelihood of a cure varied widely. Overall, patients tended to overestimate both the risk of dying due to treatment and the likelihood of a cure....

palliative care

2017 ASCO Palliative Care: Resilience Intervention Improves Quality of Life for Adolescents and Young Adults With Cancer

Although a cancer diagnosis is daunting at any age, adolescents and young adults (AYAs) with the disease often face unique challenges and are at risk for poor psychosocial outcomes than older patients. A randomized study investigating whether a brief, age-appropriate, skills-based intervention...

skin cancer

Effectiveness of Sentinel Lymph Node Biopsy in Patients With Newly Diagnosed Melanoma

Research presented at the 9th World Congress of Melanoma supports the updated guideline recommendation that sentinel lymph node biopsy be performed in more patients newly diagnosed with melanoma, as it has the potential to save lives due to the information the procedure provides. This biopsy can...

multiple myeloma

Carfilzomib May Be a Strong Candidate for Salvage Therapy in Relapsed/Refractory Multiple Myeloma—but Questions Remain

WITH THE INCLUSION of proteasome inhibitors and immunomodulatory agents first into salvage and then as components of first-line, consolidation, and maintenance regimens, response rates, depth of response, and median progression-free and overall survival have all improved for patients suffering...

multiple myeloma

Carfilzomib Improves Overall Survival vs Bortezomib in Relapsed/Refractory Multiple Myeloma

AT A PRESPECIFIED interim analysis, the phase III ENDEAVOR trial has shown a significant overall survival benefit for carfilzomib (Kyprolis) vs bortezomib (Velcade) in patients with relapsed/refractory multiple myeloma, as reported by Meletios A. Dimopoulos, MD, of the National and Kapodistrian...

lung cancer

Phase III Trial Shows No Survival Benefit to Adding First-Line Ipilimumab to Chemotherapy in Advanced Squamous NSCLC

IN A PHASE III trial reported by Ramaswamy Govindan, MD, of Washington University School of Medicine, and colleagues in the Journal of Clinical Oncology, the addition of first-line ipilimumab (Yervoy) to paclitaxel/carboplatin did not improve overall survival in patients with advanced squamous...

skin cancer

Nivolumab/Ipilimumab in Patients With Advanced Melanoma Who Did or Did Not Discontinue Induction Treatment due to Adverse Events

IN A RETROSPECTIVE pooled analysis of the CheckMate 069 and 067 studies reported in the Journal of Clinical Oncology, Dirk Schadendorf, MD, of the University Hospital Essen and the German Cancer Consortium, and colleagues found little difference in the efficacy of combined nivolumab (Opdivo) and...

bladder cancer

Positive Early Data on Second-Line Ramucirumab/Docetaxel in Platinum-Refractory Advanced Urothelial Cancer

RAMUCIRUMAB (CYRAMZA) added to docetaxel improved progression-free survival and almost doubled the overall response rate compared with docetaxel alone in patients with advanced or metastatic urothelial cancer that has progressed on platinum-based chemotherapy. These results of the phase III RANGE...

colorectal cancer
issues in oncology

Could the Rising Rates of Colorectal Cancer in AYAs Be Linked to HPV Infection?

TWO STUDIES published this year examining the incidence of colorectal cancer in adolescents and young adults (AYAs) show an undeniable and sobering trend: Colorectal cancer rates are increasing in this age group, and younger people are dying of the cancer at slightly higher rates than in previous...

bladder cancer

Second-Line Pembrolizumab Extends Survival in Urothelial Cancer

PEMBROLIZUMAB (KEYTRUDA) extended survival by about 3 months in patients with advanced urothelial cancer whose disease progressed on platinum-based chemotherapy vs investigator’s choice of therapy, according to the mature results of the KEYNOTE-045 trial presented at the European Society for...

lung cancer

IASLC 2017: Poziotinib Yields High Response Rates in Patients With NSCLC With EGFR Exon 20 Insertion

A targeted therapy studied at The University of Texas MD Anderson Cancer Center has produced high response rates among patients with metastatic non–small cell lung cancer (NSCLC) that carries a highly treatment-resistant mutation. Preliminary results were presented at the International...

hematologic malignancies

Early Love of Science and Famous Mentor Paved the Way for Gwen L. Nichols, MD, in Hematologic Cancer

Nationally regarded leukemia and lymphoma specialist Gwen L. Nichols, MD, was born in the Bronx, New York, and when she became of school age, her parents moved to the upstate suburb of Chappaqua, where she grew up. Asked if there were any physicians in her family who might have influenced her...

2018 Integrative Oncology Scholars Program Accepting Applications

Applications are now open for a nationwide integrative oncology training program. The Integrative Oncology Scholars program brings together oncology professors in a free, year-long course. Designed for the full spectrum of oncology care professionals, the program equips oncologists, nurses,...

supportive care
integrative oncology

Melatonin

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, present information on...

lymphoma

PI3K Inhibition in Relapsed or Refractory Indolent Lymphoma

As reported in the Journal of Clinical Oncology by Dreyling et al, the phase II CHRONOS-1 trial has shown a high response rate and durable responses with the phosphatidylinositol 3-kinase (PI3K) inhibitor copanlisib (Aliqopa) in adults with relapsed or refractory indolent lymphoma who had received...

lung cancer

IASLC 2017: Lorlatinib in ALK-Positive and ROS1-Positive Advanced Non–Small Cell Lung Cancer

At the International Association for the Study of Lung Cancer (IASLC) 18th World Conference on Lung Cancer in Yokohama, Japan, Pfizer announced full results from the phase II clinical trial of the investigational, next-generation tyrosine kinase inhibitor lorlatinib. The agent exhibited clinically...

lung cancer

IASLC 2017: Brigatinib in ALK-Positive Non–Small Cell Lung Cancer

Data from the phase II ALTA clinical trial evaluating brigatinib (Alunbrig) in patients with locally advanced or metastatic anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC) who have disease progression on crizotinib were presented at the International...

lung cancer

IASLC 2017: Combination of Lurbinectedin and Doxorubicin in Relapsed Small Cell Lung Cancer

The final efficacy and safety data obtained from a phase I/II trial combining lurbinectedin (PM1183) with doxorubicin in relapsed small cell lung cancer were presented during a Research Perspectives oral session at the International Association for the Study of Lung Cancer (IASLC) 18th World...

skin cancer

Single-Center Study of Adjuvant Beta-Blocker Therapy for Cutaneous Melanoma

An Italian single-center prospective cohort study suggests that adjuvant treatment with the beta-blocker propranolol significantly reduces the risk of melanoma recurrence in patients with stage IB to IIIA cutaneous disease. The findings were reported in JAMA Oncology by De Giorgi et al. Preclinical ...

lymphoma

Maintenance Therapy After ASCT in Younger Patients With Mantle Cell Lymphoma

In a French phase III trial, maintenance rituximab (Rituxan) improved event-free survival vs observation after autologous stem cell transplantation (ASCT) in younger patints with mantle cell lymphoma. These findings were reported by Le Gouill et al in The New England Journal of Medicine. Study...

solid tumors

Incidence of Endocrine Dysfunction With Immune Checkpoint Inhibitors

In a systematic review and meta-analysis reported in JAMA Oncology, Barroso-Sousa et al evaluated the incidence of endocrine dysfunction in patients receiving currently approved immune checkpoint inhibitors for various advanced solid tumors. Patients who received combination therapy were found to...

bladder cancer

First-Line Immunotherapy for Cisplatin-Ineligible Patients With Advanced Urothelial Cancer

As reported in The Lancet Oncology by Balar et al, first-line pembrolizumab (Keytruda) produced durable responses in cisplatin-ineligible patients with locally advanced and unresectable or metastatic urothelial cancer in the phase II KEYNOTE-052 trial. The trial supported the accelerated approval...

breast cancer
symptom management

Cryotherapy for Preventing Chemotherapy-Induced Peripheral Neuropathy in Patients With Breast Cancer

A self-controlled clinical trial by Hanai et al investigating the efficacy of cryotherapy for the prevention of chemotherapy-induced peripheral neuropathy in patients with breast cancer treated with paclitaxel has found that cryotherapy resulted in a clinically and statistically significant...

issues in oncology

Cancers Associated With Overweight and Obesity Make Up 40% of Cancers Diagnosed in the United States

Overweight and obesity are associated with increased risk of 13 types of cancer—and these cancers account for about 40% of all cancers diagnosed in the United States in 2014—according to the latest Vital Signs report by the Centers for Disease Control and Prevention (CDC). Overall, the...

issues in oncology
breast cancer

Treating Breast Cancer During Pregnancy Calls for Careful Timing of Therapies and Sensitive Discussions With Patients

Breast cancer during pregnancy is relatively uncommon; however, it poses a significant clinical challenge to the patient and her multidisciplinary care team. To shed light on this difficult issue, The ASCO Post spoke with Carey K. Anders, MD, a medical oncologist and researcher at the University...

breast cancer

For Breast Cancer Specialist Ann H. Partridge, MD, MPH, Medicine Is a Family Tradition

Breast cancer specialist Ann H. Partridge, MD, MPH, was born in Manhasset, Long Island, and grew up several miles east in Muttontown, New York. Since tiny Muttontown didn’t have its own school system, Dr. Partridge went to high school in nearby Locust Valley, a town on Long Island’s North Shore,...

colorectal cancer

Nivolumab in MSI-H or dMMR Metastatic Colorectal Cancer

ON JULY 31, 2017, nivolumab (Opdivo) was granted accelerated approval for treatment of patients 12 years and older with DNA mismatch repair–deficient (dMMR) and microsatellite instability– high (MSI-H) metastatic colorectal cancer progressing following treatment with a fluoropyrimidine,...

colorectal cancer

Nivolumab in Advanced DNA Mismatch Repair–Deficient or Microsatellite Instability–High Colorectal Cancer

THE PHASE II CHECKMATE 142 TRIAL has shown that nivolumab (Opdivo) produces durable responses in previously treated recurrent or metastatic DNA mismatch repair–deficient (dMMR)/ microsatellite instability–high (MSI-H) colorectal cancer. These study findings were reported in The Lancet Oncology...

gynecologic cancers

Strong Showing for Rucaparib Maintenance Therapy for Platinum-Sensitive Ovarian Cancer

EVIDENCE CONTINUES to mount for the benefits of poly (ADP-ribose) polymerase (PARP) inhibition in ovarian cancer. Rucaparib (Rubraca) maintenance therapy after response to platinum-containing therapy significantly improved progression-free survival in patients with recurrent ovarian cancer compared ...

Journal of Clinical Oncology Literature Update

STAYING UP-TO-DATE in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology.  Sorafenib Dosing and Outcomes in Hepatocellular Cancer  IN A...

lung cancer

‘Clinically Meaningful’ Results With First-Line Osimertinib in EGFR–Positive NSCLC

OSIMERTINIB (TAGRISSO) showed encouraging results as first-line therapy for patients with epidermal growth factor receptor (EGFR)–mutated non–small-cell lung cancer (NSCLC) in the phase III FLAURA trial, according to results presented at the 2017 European Society for Medical Oncology (ESMO)...

lung cancer

‘Clinically Meaningful’ Results With First-Line Osimertinib in EGFR–Positive NSCLC

OSIMERTINIB (TAGRISSO) showed encouraging results as first-line therapy for patients with epidermal growth factor receptor (EGFR)–mutated non–small-cell lung cancer (NSCLC) in the phase III FLAURA trial, according to results presented at the 2017 European Society for Medical Oncology (ESMO)...

hepatobiliary cancer

FDA Accepts sNDA for Lenvatinib for the Treatment of Hepatocellular Carcinoma

On September 26, Eisai Inc announced the U.S. Food and Drug Administration (FDA) has accepted for review a supplemental New Drug Application (sNDA) for lenvatinib  (Lenvima) for potential use in the first-line treatment of patients with hepatocellular carcinoma. “Patients with...

kidney cancer

Nivolumab Plus Ipilimumab vs Sunitinib Alone as First-Line Therapy for Metastatic Renal Cell Carcinoma

A CHANGE IN PARADIGM may be on the horizon for the treatment of metastatic renal cell carcinoma. According to the results of CheckMate 214, the combination of ipilimumab (Yervoy) plus nivolumab (Opdivo) outperformed the standard of care—sunitinib (Sutent)—for first-line treatment, with improved...

breast cancer

Abemaciclib Plus Endocrine Therapy Extends Progression-Free Survival in First-Line Therapy for Advanced Breast Cancer

THE VALUE OF cyclin-dependent kinase 4/6 (CDK4/6) inhibitors in advanced breast cancer became ever more certain with the announcement of interim data from MONARCH 3, which evaluated abemaciclib in combination with endocrine therapy as first-line therapy for hormone receptor–positive/HER2-negative...

gastrointestinal cancer

Nivolumab Approved in Japan for Unresectable Advanced or Recurrent Gastric Cancer That Has Progressed After Chemotherapy

On September 22, Bristol-Myers Squibb Company announced that the Japanese Ministry of Health, Labor and Welfare (MHLW) approved nivolumab (Opdivo) for the treatment of unresectable advanced or recurrent gastric cancer which has progressed after chemotherapy. This approval was based on the phase III ...

skin cancer

Pooled Analysis Safety Profile of Combination Immunotherapy for Advanced Melanoma

In a retrospective study reported in the Journal of Clinical Oncology, Sznol et al have provided a pooled safety profile of combination nivolumab (Opdivo) and ipilimumab (Yervoy) treatment in patients with advanced melanoma. Study Details The study included data from 448 patients from a phase Ib...

gastrointestinal cancer

Addition of MET Inhibitor to First-Line Chemotherapy in Advanced Gastric Cancer

The phase III RILOMET-1 trial showed no survival benefit of adding the MET inhibitor rilotumumab to first-line epirubicin, cisplatin, and capecitabine in patients with advanced MET-positive gastric or gastroesophageal junction adenocarcinoma. These results were reported in The Lancet Oncology by...

solid tumors
skin cancer

Adjuvant Nivolumab vs Ipilimumab in Resected Stage III or IV Melanoma

The phase III Checkmate 238 trial has shown improved recurrence-free survival with adjuvant nivolumab (Opdivo) vs ipilimumab (Yervoy) in patients with resected advanced melanoma. The findings were reported by Jeffrey Weber and colleagues in The New England Journal of Medicine. Study Details In the ...

solid tumors
bladder cancer

Durvalumab in Advanced Urothelial Carcinoma Progressing After Platinum Therapy

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On May 1, 2017, durvalumab (Imfinzi) was granted...

issues in oncology

Increasing Racial and Ethnic Diversity in the Oncology Workforce

Although significant progress has been made in cancer incidence and mortality in the United States over the past 2 decades—the death rate fell 23% between 1991 and 20121—not everyone is benefiting equally. According to the American Cancer Society, blacks have the highest death rate and shortest...

solid tumors
breast cancer

Adjuvant Pertuzumab in HER2-Positive Breast Cancer: Value Yet to Be Demonstrated

The ASCO Post issue of June 25, 2017, did an excellent job of summarizing the results and controversy generated by the initial results of the APHINITY trial, reported at the 2017 ASCO Annual Meeting and published simultaneously online in The New England Journal of Medicine.1 With a median follow-up ...

kidney cancer

Adjuvant Therapy for Localized or Locally Advanced Renal Cell Carcinoma

As reported in the Journal of Clinical Oncology by Motzer et al, the phase III PROTECT trial showed no significant disease-free survival benefit for adjuvant pazopanib at 600 mg vs placebo after nephrectomy in patients with localized or locally advanced renal cell carcinoma at high risk of relapse. ...

gynecologic cancers

ASTRO 2017: IAEA Trial: Safety, Efficacy of High-Dose Brachytherapy Plus Pelvic Radiation for Cervical Cancer

Findings from a new multicenter, international clinical trial confirm the effectiveness of high-dose brachytherapy, or internal radiation therapy, for managing locally advanced cervical cancer. Tumor control was significantly better following four fractions of 7 Gy each than following two 9-Gy...

issues in oncology

ASTRO 2017: Urban Cancer Center Finds 75% of Its Patients With Depression Were Previously Undiagnosed

A new study of patients at an urban cancer center points to a potentially serious problem that may limit the impact of clinical cancer care—undiagnosed depression. Among the 40% of patients at the center who were diagnosed with depression, three in four had not previously been told they were ...

Heart Disease, Cancer, Leading Causes of Death due to Noncommunicable Diseases, Global Study Finds

The Global Burden of Disease Study, published in The Lancet, finds that of noncommunicable diseases, cancer is the second-leading cause of death globally.1 The report also finds that deaths from cancer increased more than 17% between 2006 and 2016. The Global Burden of Disease Study is a...

breast cancer

Trastuzumab-Based Regimens in Older Women With Early Breast Cancer

A comparative analysis of outcomes with two different trastuzumab (Herceptin)-based adjuvant regimens in older women with early HER2-positive breast cancer found little difference in safety and efficacy between treatments. The study was reported by Katherine E. Reeder-Hayes, MD, MBA, of the...

Stemming the Growing Cancer Crisis in Rural Appalachia

A pair of recent studies show a troubling trend: Despite a 20% decrease in cancer mortality rates nationwide over the past 2 decades,1 Americans living in rural regions of the United States are more likely to die of cancer than persons living in metropolitan areas of the country. An analysis of...

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