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pancreatic cancer

An Integrated Framework for Improving Outcomes in Pancreatic Cancer

Drawing on several lines of ongoing research, David A. Tuveson, MD, PhD, has created a theoretical framework to consider while developing clinical trials in pancreatic cancer. In his keynote lecture at the 2020 American Association for Cancer Research (AACR) Special Conference on Pancreatic Cancer, ...

bladder cancer
immunotherapy

Checkpoint Inhibitor and Chemotherapy Combinations Fail to Move Bar as First-Line Therapy for Advanced Urothelial Cancer

Two different phase III studies found that combining an anti–PD-1/PD-L1 checkpoint inhibitor (pembrolizumab in KEYNOTE-361) with platinum-based chemotherapy or with another checkpoint inhibitor (the anti–CTLA-4 antibody tremelimumab in DANUBE) failed to significantly improve overall or...

lymphoma

Outcomes With Second-Line Therapy After Relapse in Patients With Early-Stage, Favorable, Classical Hodgkin Lymphoma

In an analysis of two German Hodgkin Study Group trials reported in the Journal of Clinical Oncology, Bröckelmann et al found that second-line treatment with conventional polychemotherapy resulted in similar second progression–free survival (progression-free survival-2) durations vs high-dose...

breast cancer
immunotherapy

Effect of Early Trastuzumab Interruption on Recurrence-Free Survival in HER2-Positive Breast Cancer

In a single-center analysis reported in a research letter in JAMA Oncology, Copeland-Halperin et al found that early trastuzumab interruption and interruption resulting in a cumulative trastuzumab dose ≤ 56 mg/kg were associated with significantly poorer recurrence-free survival in patients with...

pancreatic cancer

New Maintenance Therapies in Metastatic Pancreatic Cancer Aim to End Perpetual Chemotherapy

The advent of effective combination chemotherapies has changed the treatment landscape for metastatic pancreatic cancer, extending median survival and leading to durable responses in a subset of patients. However, perpetual chemotherapy is cumulatively toxic, leading to progressive bone marrow...

issues in oncology
solid tumors

SBRT for Multiple Lung Metastases: How Many Treatment Sessions Are Optimal?

Delivering stereotactic body radiation therapy (SBRT, also called stereotactic ablative radiotherapy) in either one or four treatment sessions led to similar outcomes in patients with up to three lung metastases in the randomized SAFRON II trial. The study, reported by Shankar Siva, PhD, and...

genomics/genetics

Next-Generation BRAF Inhibitor Shows Activity in Phase I/II Trial

A new drug designed to treat cancers in patients with an altered BRAF gene showed activity and had a favorable safety profile in an early-phase trial. These findings were presented by Janku et al at the 32nd EORTC-NCI-AACR Symposium on Molecular Targets and Cancer Therapeutics (Abstract LBA-05)....

prostate cancer

Paul Sargos, MD, on Prostate Cancer: Adjuvant or Early Salvage Radiotherapy Plus Androgen Deprivation

Paul Sargos, MD, of the Institut Bergonié, discusses phase III findings from the GETUG-AFU 17 study, which compared adjuvant vs early salvage radiotherapy, both combined with short-term androgen-deprivation therapy after radical prostatectomy for localized prostate cancer. Although lacking...

supportive care

Stereotactic Radiosurgery May Delay Cognitive Deterioration vs WBRT in Patients With Numerous Brain Metastases

Stereotactic radiosurgery (SRS) may represent a new standard of care for patients with four or more brain metastases, replacing whole-brain radiation therapy (WBRT) in this setting, according to a phase III study presented at the virtual 2020 American Society for Radiation Oncology (ASTRO) Annual...

genomics/genetics

Targeted Inhibitor of Mutant KRAS Gene Shows Activity in Early Trial

Adagrasib (MRTX849), a novel agent that targets a mutated form of the KRAS gene—the most commonly altered oncogene in human cancers, and one long considered “undruggable”—caused tumor shrinkage in most patients in a clinical trial, with manageable side effects, researchers reported at the 32nd...

SHP2 Inhibition May Counter Resistance Mechanisms in Lung Cancer

Recent preclinical research from The University of Texas MD Anderson Cancer Center and BridgeBio Pharma, an affiliate of Navire Pharma, found that the novel SHP2 inhibitor IACS-13909 may be able to overcome therapeutic resistance mechanisms in non–small cell lung cancer (NSCLC). The data, which...

colorectal cancer

Becoming Acquainted With Cancer

Editor’s Note: The ASCO Post learned of the death of Patrick Beauregard due to colorectal cancer on September 6, 2020.  Just weeks after my wedding in late summer of 2017, I had a sudden bout of abdominal pain so severe that it sent me to the emergency room. I was just 29 years old and in great...

Remembering Patrick H. Beauregard: ‘Selfless in His Efforts to Raise Awareness’ of Colorectal Cancer in Young Adults

The editors of The ASCO Post are sad to report the death of Patrick H. ­Beauregard on September 6, 2020. The cause was colorectal cancer. Diagnosed with stage IV disease in 2017 at the age of 29, Mr. Beauregard dedicated the last 3 years of his life to raising awareness of colorectal cancer in...

Early-Career ASCO Member and Breast Medical Oncologist, Tomas Lyons, MB BCh, BAO, MRCPI, Dies at 38

Tomas Lyons, MB BCh, BAO, MRCPI, a medical oncologist at the Evelyn H. Lauder Breast Center Memorial Sloan Kettering Cancer Center in New York, died suddenly on September 29 at the age of 38. During his career at Memorial Sloan Kettering (MSK), he was a celebrated collaborator on multidisciplinary ...

immunotherapy
skin cancer

Continued Benefit of First-Line Nivolumab vs Dacarbazine in Advanced BRAF Wild-Type Melanoma

The 5-year outcomes of the ­CheckMate 066 trial, reported in the Journal of Clinical Oncology by Caroline Robert, MD, PhD, of Gustave Roussy, Villejuif, France,and colleagues, show continued benefit of first-line nivolumab vs dacarbazine in advanced BRAF wild-type melanoma and support evidence that ...

breast cancer

Focus on Preventing Invasive Recurrence in Women With DCIS Does Not Sufficiently Address Breast Cancer Mortality

A study published recently by Giannakeas et al looked at the risk of death from breast cancer for women diagnosed with ductal carcinoma in situ (DCIS).1 The investigators anticipated that treatment would eliminate the risk of invasive ipsilateral recurrence and prevent subsequent mortality from...

Emily Whitehead, Early Recipient of CAR T-Cell Therapy for ALL, Celebrates 8 Years Cancer-Free

Among the success stories in the treatment of acute lymphoblastic leukemia (ALL) in children and young adults is the development of chimeric antigen receptor (CAR) T-cell therapy. The field of cellular immunotherapy was still in its infancy in 2012 when Emily Whitehead, then 7, became the first...

Personal Testimonial: CAR-modified T Cells in Adults 

Twelve adults with chronic lymphocytic leukemia (CLL) have been treated with CD19-targeted chimeric antigen receptor (CAR) T-cell therapy at the University of Pennsylvania in Philadelphia by Carl June, MD, Richard W. Vague Professor in Immunotherapy, and colleagues. These were all end-stage...

hematologic malignancies
leukemia

Preliminary Progress with Genetically Engineered T Cells in Treating Childhood ALL 

Two small phase I studies at separate centers demonstrated encouraging results in the treatment of children with acute lymphoblastic leukemia (ALL) using reinfused autologous genetically engineered T cells. Results of both studies were presented at the Annual Meeting of the American Association for ...

skin cancer

Recurrence-Free Survival Benefit Maintained With Adjuvant Nivolumab vs Ipilimumab in Stage IIIB–IIIC and IV Melanoma

As reported in The Lancet Oncology by Paolo A. Ascierto, MD, of the Istituto Nazionale Tumori IRCCS Fondazione Pascale, Naples, and colleagues, 4-year results of the CheckMate 238 trial show continued benefit of adjuvant nivolumab vs ipilimumab in recurrence-free survival and metastasis-free...

gynecologic cancers

The Gut, Our Choices, and Gynecologic Cancers: Investigating an Unlikely Trio

Disturbance of the gut microbial metabolism is thought to be the root cause of human diseases. Bacteria, viruses, and fungi affect their human hosts in numerous ways. There is evidence to support the theory that microbes, through their genetic makeup, gene products, and metabolites, play a role in...

issues in oncology

Pay-for-Performance Program to Reimburse Oncology Practices for Prescribing Evidence-Based Cancer Drugs

A pay-for-performance program that offers enhanced reimbursement to oncology practices for prescribing high-quality, evidence-based cancer drugs increased use of these drugs without significantly changing total spending on care, Penn Medicine researchers reported in a study published in the Journal ...

Daughter of an Orthopedic Surgeon, Abigail T. Berman, MD, Finds Radiation Oncology Intriguing

Radiation oncologist Abigail T. Berman, MD, was born and reared in Philadelphia, the daughter of an orthopedic surgeon whose passion for his work was an early influence on her decision to pursue a career in medicine. “My father absolutely adored his job and worked very hard, which inspired me to...

issues in oncology
covid-19

How Telemedicine Is Impacting Oncology Care During the COVID-19 Pandemic

The expansion of telemedicine has been one of the most important developments during the COVID-19 pandemic. Here, we discuss some of the legal and ethical dimensions of expanding telemedicine services in oncology practices. As Royce et al discussed in a recent JAMA Oncology article, Congress...

2020 NIH Director’s Early Independence Awards Announced

The National Institutes of Health (NIH) Director’s Early Independence Award, established in 2010, is part of the High-Risk, High-Reward Research program managed by the Common Fund. The award provides an opportunity for exceptional junior scientists to skip the traditional postdoc and start an...

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....

geriatric oncology

Cancer in Older Adults: The History of Geriatric Oncology, Part 2: 1990–2020

In part 1 of this three-part article, which was published in the October 10, 2020, issue of The ASCO Post, we chronicled the progress made in geriatric oncology up to the decade of the 1990s, which saw an explosion of research activity in the study of aging and cancer. In part 2, we review the...

Thinking Out of the Box to Advance the Management of Chronic Graft-vs-Host Disease

Over the past decade, the field of allogeneic hematopoietic cell transplantation has made great strides, evolving into a curative procedure for blood cancers that once were almost always fatal. However, chronic graft-vs-host disease, whose biologic etiology remains unclear, continues to be the...

Expert Point of View: Henrik Grönberg, MD

Formal discussant of the -IPATential150 trial, Henrik Grönberg, MD, Professor at Karolinska Institute, Stockholm, found the study results intriguing, especially in the PTEN-loss patients. “Biomarkers are the wave of the future,” he said. “The study population was compared with an adequately...

prostate cancer

Ipatasertib/Abiraterone Combination Shows Potential in Metastatic Castration-Resistant Prostate Cancer With PTEN Loss

Ipatasertib plus abiraterone plus prednisone achieved significantly superior radiographic progression–free survival and antitumor activity compared with placebo plus abiraterone plus prednisonein patients with metastatic castration-resistant prostate cancer and PTEN loss, according to the results...

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...

solid tumors

Early-Phase Study Reports Progress in Targeting KRAS-Mutated Tumors With Sotorasib

Although KRAS is one of the most frequently mutated oncogenes in human cancers, an almost 4-decade long search for drugs that hit this target has been elusive—until now. Sotorasib (formerly called AMG-510), a small-molecule inhibitor of the KRAS G12C mutation, demonstrated clinical activity and...

Expert Point of View: Fatima Cardoso, MD

The encouraging results of the phase III ASCENT trial suggest that sacituzumab govitecan has clearly earned a place in the treatment algorithm for advanced triple-negative breast cancer, said the study’s invited discussant, Fatima Cardoso, MD, Director of the Breast Unit at the Champalimaud...

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...

breast cancer

Should Body Mass Index Guide the Choice of Chemotherapy in Patients With Breast Cancer?

The rate of obesity is rising dramatically in the United States and Europe, with more than 60% of women in the United States1,2 and 50% of women in Europe3 classified as overweight or obese based on their body mass index (BMI). Obesity is associated with an increased risk of hormone...

lung cancer
kidney cancer
leukemia
solid tumors
gastroesophageal cancer
gastrointestinal cancer
pancreatic cancer
prostate cancer
genomics/genetics
immunotherapy

FDA Pipeline: Priority Reviews in EGFR-Mutant Lung Cancer, Advanced Renal Cell Carcinoma; Fast Track Designations in CLL and Solid Tumors

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to treatments for EGFR-mutant lung cancer and advanced renal cell carcinoma; granted Fast Track designation to agents in chronic lymphocytic leukemia (CLL) and locally advanced or metastatic solid tumors; and more....

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...

lung cancer
genomics/genetics

Do Patients With Early-Stage NSCLC Have a Higher Tumor Mutational Burden Than Those With More Advanced Disease?

The tumors of patients with stage I and II non–small cell lung cancer (NSCLC) demonstrated a generally higher tumor mutational burden and more often displayed the mutational signature associated with tobacco smoking than those of patients with more advanced disease, according to findings presented...

issues in oncology
covid-19

Advanced Practitioner Leadership in Times of Crisis

In 2020, health-care providers from all disciplines are facing challenges never before encountered in the modern era of medicine. Advanced practitioners (APs) are playing critical roles in developing protocols, managing health-care teams, and delivering hands-on patient care. JADPRO Live, the...

palliative care

Behavioral Nudges Combined With Machine Learning Mortality Estimates May Improve Rate of Advanced Cancer Care Conversations

An electronic nudge to clinicians—triggered by an algorithm that used machine-learning methods to flag patients with cancer who would most benefit from a conversation around end-of-life goals—tripled the rate of those discussions, according to a new prospective, randomized study of nearly 15,000...

bladder cancer
immunotherapy

Neoadjuvant Dual Checkpoint Blockade in Certain Patients With Localized Bladder Cancer

Neoadjuvant combination therapy with the anti–CTLA-4 therapy tremelimumab and the anti–PD-1 therapy durvalumab was well tolerated and showed early signs of activity in patients ineligible to receive cisplatin-based chemotherapy, all of whom had tumors with high-risk features that are associated...

breast cancer

Final Efficacy Results From the ExteNET Trial: Neratinib in Pretreated Patients With HR-Positive, HER2-Positive Early Breast Cancer

In an analysis from the phase III ExteNET trial reported in Clinical Breast Cancer, Arlene Chan, MD, and colleagues found significant improvements in efficacy outcomes with the administration of neratinib vs placebo starting at 1 year or sooner after neoadjuvant/adjuvant trastuzumab-based therapy...

cns cancers

Hypofractionated Stereotactic Radiotherapy to the Resection Cavity in Patients With Brain Metastases

In a multi-institutional cohort study reported in JAMA Oncology, Eitz et al found that hypofractionated stereotactic radiotherapy (HSRT) to the resection cavity in patients with brain metastases appears to be associated with an “excellent risk-benefit profile.” As stated by the investigators, “For...

lymphoma

Study Finds Combined HDAC and mTOR Inhibition May Improve Outcomes in Patients With Relapsed or Refractory Hodgkin Lymphoma

Results from a nonrandomized, dose-escalation phase I clinical trial investigating the histone deacetylase (HDAC) inhibitor vorinostat in combination with the mTOR inhibitors sirolimus or everolimus found the combination therapies showed activity in heavily pretreated patients with relapsed or...

prostate cancer

Adjuvant vs Early Salvage Radiotherapy After Radical Prostatectomy in High-Risk Prostate Cancer

In a phase III noninferiority trial (RAVES) reported in The Lancet Oncology, Kneebone et al found that salvage radiotherapy did not meet noninferiority criteria for biochemical progression vs adjuvant radiotherapy, but was associated with nearly identical biochemical control rates and reduced...

Expert Point of View: Rodabe N. Amaria, MD

The value of adjuvant therapy for patients with resected stage III or IV melanoma—in the form of pembrolizumab and nivolumab—continues to be observed after approximately 4 years from the start of therapy, according to Rodabe N. Amaria, MD, Associate Professor of Melanoma Medical Oncology at The...

breast cancer
issues in oncology

Limited English-Language Proficiency May Affect Frequency of Screening Mammograms

Limited English-language proficiency may be a risk factor for receiving screening mammograms less often, according to new study results using national data. These findings, concerning women age 40 and older living in the United States, were presented at the American College of Surgeons Clinical...

skin cancer

COMBI-i Trial: No Statistical Benefit to Adding Spartalizumab to Dabrafenib/Trametinib in Melanoma

Patients with unresectable or metastatic melanoma harboring BRAF V600 mutations did not benefit from the addition of the anti–PD-1 antibody spartalizumab to dabrafenib and trametinib in the COMBI-i trial, which was presented at the European Society for Medical Oncology (ESMO) Virtual Congress...

skin cancer

ASCO’s Policy Statement on Skin Cancer Prevention Focuses on Four Key Areas to Reduce Incidence and Save Lives

The increasing incidence rates of skin cancer in the United States are staggering. It is the most common cancer diagnosed in the country, and current estimates show that about 9,500 Americans are diagnosed with skin cancer every day. Over the course of a year, more than 3 million people are...

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