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cns cancers
colorectal cancer
gynecologic cancers
kidney cancer
lung cancer

FDA Approves Bevacizumab Biosimilar for Five Cancer Types

On June 28, the U.S. Food and Drug Administration (FDA) approved bevacizumab-bvzr (Zirabev), a biosimilar to bevacizumab (Avastin), for the treatment of five types of cancer: metastatic colorectal cancer; unresectable, locally advanced, recurrent, or metastatic nonsquamous non–small cell ...

cns cancers
immunotherapy

Update on Early-Stage Studies of Novel Treatments in Glioblastoma

Outcomes are typically grim for patients with recurrent glioblastoma multiforme. At the 2019 Annual Scientific Meeting of the American Association of Neurological Surgeons (AANS), three early-stage studies hinted at ways that standard treatments might be made more effective. Metronomic Dosing of...

cns cancers
lymphoma

Cytoreductive Surgery for Primary Central Nervous System Lymphoma

Through a systematic review of published studies, researchers report they have identified a distinct subtype of primary central nervous system (PCNS) lymphoma that should be considered for surgical removal, suggesting a major shift in how this type of tumor is evaluated and managed. These findings...

cns cancers
immunotherapy

2019 ASCO: Combination Therapy With SurVaxM in Newly Diagnosed Glioblastoma

Ahluwalia et al shared research results on SurVaxM at the 2019 ASCO Annual Meeting, reporting that combination therapy with the immunotherapy vaccine was more effective than standard therapy for nearly all patients with newly diagnosed glioblastoma in a phase II trial (Abstract 2016). SurVaxM...

cns cancers

2019 ASCO: Subgroups of Patients With Low-Grade Glioma May Benefit From PCV Chemotherapy Plus Radiotherapy

A recent, updated predictive analysis of the three World Health Organization (WHO)-defined molecular subgroups based on IDH mutation status and 1p/19q codeletion status represented in the high-risk treatment arms of a phase III trial found that both IDH-mutant subgroups may derive benefit ...

cns cancers

As My Outside World Became Smaller, My Family Focus Became Larger

As I write this, I think I’m making sense but am not 100% sure. My brain is a little scrambled after nearly 4 years of treatment for grade 4 glioblastoma multiforme, but I think the essence of my humor and humanity is still intact. When I experienced my first partial seizure while riding my...

cns cancers

Activity of Selumetinib in Pediatric Pilocytic Astrocytoma and Low-Grade Glioma

In a phase II trial reported in The Lancet Oncology, Fangusaro et al found that the MEK1/2 inhibitor selumetinib was active in pediatric patients with recurrent, refractory, or progressive pilocytic astrocytoma with common BRAF aberrations and neurofibromatosis type 1...

cns cancers

Manmeet S. Ahluwalia, MD, on Glioblastoma: Novel Cancer Vaccine With Standard Therapy

Manmeet S. Ahluwalia, MD, of the Taussig Center Institute, Cleveland Clinic, discusses phase II findings on the efficacy and immunogenicity of SurVaxM, a novel cancer vaccine targeting the tumor-specific antigen survivin in newly diagnosed glioblastoma (Abstract 2016).

cns cancers

Rookie

His steps generated a low rumble that propagated through the floor like a tsunami, flowed up through my desk, and ended as tiny waves visible through the clear plastic of my water bottle. His custom Lucchese ostrich boots made a distinctive clicking sound as they rhythmically struck the tile floor, ...

cns cancers

Targeted Brachytherapy May Improve Outcomes in Recurrent Brain Tumors

For recurrent, previously irradiated brain tumors, innovative treatment with surgically targeted brachytherapy yielded good local control and overall survival, as compared to historic controls, neurosurgeons reported at the 2019 Annual Scientific Meeting of the American Association of Neurological...

hematologic malignancies

T-Cell Therapy for EBV-Associated Posttransplant Lymphoproliferative Disorder With CNS Involvement

An “off-the-shelf” allogeneic T-cell product, tabelecleucel, may effectively treat patients who develop Epstein-Barr virus (EBV)-associated posttransplant lymphoproliferative disorder with central nervous system (CNS) involvement, researchers from Memorial Sloan Kettering Cancer Center reported at...

immunotherapy
breast cancer
lung cancer
prostate cancer
kidney cancer
bladder cancer
colorectal cancer
pancreatic cancer
sarcoma
leukemia
skin cancer
head and neck cancer

NCCN Clinical Practice Guidelines in Oncology: 2019 Updates

In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®), covering eight tumor types. NCCN Guidelines are now published for more than 70 tumor types and topics. Some of the key updates for 2019 were presented...

cns cancers
symptom management

Treatment-Related Ototoxicity and Reading Impairment in Pediatric Patients With Embryonal Brain Tumors

In a study reported in the Journal of Clinical Oncology, Olivier et al found that pediatric patients with severe sensorineural hearing loss associated with the treatment of embryonal brain tumors experienced greater reading difficulties over time. The study involved data from 260 children and...

cns cancers
solid tumors
leukemia
multiple myeloma
sarcoma

FDA Pipeline: Designations in Myeloma, Adenoid Cystic Carcinoma, and Kaposi Sarcoma, Plus ODAC Votes

This week, the U.S. Food and Drug Administration granted designations in relapsed or refractory multiple myeloma, adenoid cystic carcinoma, and Kaposi sarcoma; and the FDA’s Oncologic Drugs Advisory Committee (ODAC) held votes on treatments for tenosynovial giant cell tumor and acute...

cns cancers

2019 ASCO: Entrectinib in Children and Adolescents With Recurrent or Refractory Solid or Central Nervous System Tumors

A phase I/IB study evaluating the activity of entrectinib in children and adolescents with recurrent or refractory solid tumors, including central nervous system (CNS) tumors, has found that the agent produced responses in children with tumors harboring target aberrations...

cns cancers

ESTRO 38: What Type of Radiotherapy May Best Preserve Cognitive Function in Pediatric Patients With Brain Tumors?

A comparison of three types of radiotherapy for pediatric brain tumors suggests that a type of proton therapy called pencil-beam scanning (PBS) offers the best hope of preserving cognitive functions. The study, presented by Toussaint et al at ESTRO 38, the annual congress of the European Society...

breast cancer

Advanced HER2-Positive Breast Cancer: All Eyes on These Novel Agents

NEW AGENTS for the treatment of advanced HER2-positive breast cancer should be coming soon to your clinic, according to Sara A. Hurvitz, MD, Director of the Breast Cancer Clinical Research Program and Associate Professor of Medicine at the David Geffen School of Medicine at the University of...

issues in oncology
cns cancers

Fine-Tuning an ‘Airport Diagnosis’

HIS HEAD WAS DIFFERENT from those of the other people in line. He bore a matrix of white rows of circular patches on his shaved scalp like a wig. The patches were electrodes, connected by cords to a power supply in a satchel around his shoulder. I was able to make an instant and unfortunate...

cns cancers
leukemia
multiple myeloma

FDA Pipeline: Designations in Glioblastoma, Neurofibromatosis, Multiple Myeloma, and AML

This week, the U.S. Food and Drug Administration (FDA) granted designations for treatments for recurrent glioblastoma, neurofibromatosis type 1 and plexiform neurofibromas, multiple myeloma, and relapsed or refractory FLT3-ITD acute myeloid leukemia (AML). Fast Track Designation for Ad-RTS-hIL-12...

cns cancers

Pachymeningeal Seeding After Neurosurgical Resection in Patients With Brain Metastases

In a retrospective cohort study reported in JAMA Oncology, Cagney et al found that pachymeningeal seeding was fairly common after neurosurgical resection in patients with brain metastases treated with adjuvant stereotactic radiation. Study Details The study involved 1,188 consecutive patients...

breast cancer

Neratinib Plus Capecitabine Active Against HER2-Positive Breast Cancer Brain Metastases

In the phase II TBCRC 022 trial reported in the Journal of Clinical Oncology, Freedman et al found that the combination of neratinib and capecitabine was active against brain metastases in women with HER2-positive breast cancer. Modest activity of neratinib monotherapy had been found in previous...

cns cancers

Does Postoperative Conformal Radiotherapy Improve Survival in Pediatric Patients With Ependymoma?

Treatment with conformal radiation therapy immediately following surgery in children with ependymoma may greatly improve survival. The findings were published by Merchant et al in the Journal of Clinical Oncology. “Historically, children under the age of 3 with ependymoma have a worse...

cns cancers
survivorship

Late Morbidity and Mortality in Survivors of Medulloblastoma

In a report from the Childhood Cancer Survivor Study published in the Journal of Clinical Oncology, Salloum et al found that changes in medulloblastoma therapy over 3 decades that have improved survival have also increased risk for subsequent neoplasms and debilitating health conditions. As noted...

cns cancers

Addition of Lomustine to Temozolomide and Radiotherapy in Newly Diagnosed Glioblastoma With Methylated MGMT Promoter

In a German phase III trial (CeTeG/NOA–09) reported in The Lancet, Herrlinger et al found that the addition of adjuvant lomustine to temozolomide and radiotherapy improved overall survival in newly diagnosed glioblastoma with methylated MGMT promoter. The researchers noted that findings...

cns cancers
immunotherapy

Madhav V. Dhodapkar, MBBS, on Cancer Vaccines: Emerging Trends

Madhav V. Dhodapkar, MBBS, of Emory University, summarizes a session he co-chaired on emerging approaches for vaccines, personalized/neoantigen vaccines, and mutation-targeted immunotherapy for diffuse midline gliomas.

solid tumors
leukemia
lung cancer
lymphoma

FDA Pipeline: Priority Reviews in Solid Tumors and Lymphoma; Plus an sNDA in Acute Myeloid Leukemia

Over the past week, the U.S. Food and Drug Administration (FDA) granted multiple Priority Reviews and accepted a supplemental new drug application: Priority Review for Entrectinib in NTRK Fusion–Positive Solid Tumors and Metastatic, ROS1-Positive NSCLC This week, the FDA accepted new drug...

cns cancers

Buparlisib in PI3K Pathway–Activated Recurrent Glioblastoma

In a phase II trial reported in the Journal of Clinical Oncology, Wen et al found minimal activity of the phosphatidylinositol 3-kinase (PI3K) inhibitor buparlisib in patients with recurrent glioblastoma with PI3K pathway activation. The study included 2 cohorts. In cohort 1, 14 evaluable patients ...

cns cancers
issues in oncology

Implementation of a Hospital Pathway for Patients With a Newly Identified Single Brain Mass

In a study reported by Arrillaga-Romany et al in the Journal of Oncology Practice, a team at Massachusetts General Hospital found that implementation of a hospital pathway consisting of a dedicated admission protocol for patients with newly identified single brain masses and no history of cancer...

lung cancer

Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC

IN A GLOBAL phase II study reported in The Lancet Oncology, Benjamin J. Solomon, MBBS, of Peter MacCallum Cancer Centre, Melbourne, and colleagues found that lorlatinib showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were...

lung cancer

Progress With ALK Inhibitors: When Will We Consider ALK-Positive Lung Cancer a ‘Chronic Disease’?

As reported by Solomon et al in The Lancet Oncology1 and reviewed in this issue of The ASCO Post, results from a global phase II study of the third-generation ALK inhibitor lorlatinib showed a high overall response rate and high intracranial response rate for patients with advanced ALK-positive...

supportive care
integrative oncology

Use of Valerian to Relieve Anxiety in Patients With Cancer

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. Eugenie Spiguel, MSN, ANP-BC, and Jyothirmai Gubili, MS, explore the use of valerian for...

lymphoma
immunotherapy

Is There a Benefit to Adding Rituximab to Methotrexate-Based Chemotherapy in Primary CNS Lymphoma?

In a phase III trial (HOVON 105/ALLG NHL 24) reported in The Lancet Oncology, Bromberg et al found no significant benefit of the addition of rituximab to high-dose methotrexate-based chemotherapy in patients with newly diagnosed primary central nervous system (CNS) lymphoma. Study Details In the...

cns cancers

Higher Incidence of Brain and CNS Tumors Among People Living in Appalachia

A recent study published by Ostrom et al in the Journal of Neuro-Oncology showed that compared to the rest of the United States, the Appalachian region has a 5% higher incidence of malignant primary brain tumors and other central nervous system (CNS) tumors, a higher mortality rate due to ...

cns cancers

Risk of Intracranial Malignancy After Stereotactic Radiosurgery for Nonmalignant Conditions

In a retrospective cohort study reported in The Lancet Oncology, Wolf et al found that patients undergoing Gamma Knife stereotactic radiosurgery for nonmalignant neurosurgical conditions did not appear to be at long-term increased risk of radiation-associated secondary intracranial malignancy or...

lung cancer

Transformation of EGFR-Mutant NSCLC to SCLC

In a study reported in the Journal of Clinical Oncology, Marcoux et al provided further evidence that EGFR-mutant non–small cell lung cancer (NSCLC) can undergo transformation to small cell lung cancer (SCLC) and identified factors associated with such transformation. It has been estimated...

cns cancers

Regorafenib vs Lomustine in Relapsed Glioblastoma

In the Italian phase II REGOMA trial reported in The Lancet Oncology, Lombardi et al found that regorafenib was associated with improved overall survival vs lomustine in patients with relapsed glioblastoma. In the open-label trial, 119 patients from 10 Italian sites were randomly assigned between...

lung cancer

Lorlatinib in Second- or Third-Line Treatment of ALK-Positive Metastatic Non–Small Cell Lung Cancer

On November 2, 2018, lorlatinib (Lorbrena) was granted accelerated approval for the treatment of patients with ALK-positive metastatic non–small cell lung cancer (NSCLC) whose disease has progressed on crizotinib (Xalkori) and at least one other ALK inhibitor for metastatic disease or whose disease ...

lung cancer

New Data Reported From International Studies of Lung Cancer Treatment

At the European Society for Medical Oncology (ESMO) 2018 Congress, important studies were presented for every cancer type. Here, The ASCO Post offers some snapshots of lung cancer studies that may inform approaches to treating this common cancer, which—despite the advances in recent years—remains...

cns cancers

Expert Point of View: Christina I. Tsien, MD

DISCUSSANT OF the NRG-CC001 trial, Christina I. Tsien, MD, Professor of Radiation Oncology at Washington University School of Medicine, St. Louis, underscored the importance of this research, noting that cognitive impairment affects nearly 50% of patients who undergo whole-brain radiation therapy. ...

cns cancers

Hippocampus-Sparing Whole-Brain Radiotherapy and Neurocognitive Function in Patients With Brain Metastases

ANALYSIS OF a phase III trial has confirmed that conformal avoidance of the hippocampal dentate gyrus using intensity-modulated radiotherapy during whole-brain radiotherapy for brain metastases preserves neurocognitive function and improves patient-reported symptom burden while achieving similar...

breast cancer

Talazoparib for Germline BRCA-Mutated HER2-Negative Advanced Breast Cancer

On October 16, 2018, the poly (ADP-ribose) polymerase (PARP) inhibitor talazoparib (Talzenna) was approved for the treatment of patients with deleterious or suspected deleterious germline BRCA-mutated, HER2-negative locally advanced or metastatic breast cancer.1,2 Patients must be selected for...

cns cancers
immunotherapy

Addition of Interleukin-2 to Dinutuximab Beta in High-Risk Neuroblastoma

In an international phase III trial (HR-NBL1/SIOPEN) reported in The Lancet Oncology, Ladenstein et al found that the addition of interleukin (IL)-2 to dinutuximab beta did not improve event-free survival in children and young people with high-risk neuroblastoma. Study Details The current report...

lung cancer

Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC

In a global phase II study reported in The Lancet Oncology, Solomon et al found that lorlatinib (Lorbrena) showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were treatment-naive or who had received crizotinib (Xalkori)...

cns cancers

Molecular and Clinical Heterogeneity in Histologically Diagnosed CNS-PNET

As reported by Hwang et al in the Journal of Clinical Oncology, subsequent molecular profiling of histologically diagnosed central nervous system supratentorial primitive neuroectodermal tumors (CNS-PNET) in patients showed molecular and clinical heterogeneity that strongly affected prognosis. The ...

lung cancer

Brigatinib Improves Outcomes Over Crizotinib in ALK-Positive Non–Small Cell Lung Cancer

THE FIRST-LINE USE of brigatinib (Alunbrig) was superior to standard-of-care crizotinib (Xalkori) in patients with advanced anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC), according to the first report of the phase III ALTA-1L trial presented at the International...

cns cancers

Activity of Vemurafenib in BRAF V600–Mutant Gliomas

In a multicohort study (VE-BASKET study) in patients with BRAF V600–mutant nonmelanoma cancers in the Journal of Clinical Oncology, Kaley et al found evidence of activity of vemurafenib (Zelboraf) in gliomas that appeared to vary by glioma subtype.   Study Details In the study, 24...

cns cancers

2018 ASTRO: Impact of MGMT Gene Expression on Overall Survival in Patients With Anaplastic Glioma

A phase III trial revealed that elevated MGMT gene expression is independently associated with worse overall survival for patients with anaplastic grade III gliomas. These findings were presented by Fleming et al at the 60th Annual Meeting of the American Society for Radiation Oncology (ASTRO) and...

lung cancer

Entrectinib Shows Activity in ROS1-Positive NSCLC

Although ROS1-mutated lung cancer accounts for about 1% to 2% of all non–small cell lung cancers (NSCLCs), it is an important druggable oncogene, and new data show that it can be successfully targeted for clinical gain. In a pooled analysis of phase I and II trials in patients with ROS1-positive...

breast cancer

Talazoparib Improves Progression-Free Survival in Advanced Breast Cancer With Germline BRCA Mutation

As reported in The New England Journal of Medicine by Jennifer K. Litton, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, the phase III EMBRACA trial has shown significantly improved progression-free survival with the poly (ADP-ribose) polymerase (PARP) inhibitor...

lung cancer
issues in oncology

Health Resource Utilization and CNS Metastases in EGFR-Mutant Advanced NSCLC

In a single-center study reported in the Journal of Oncology Practice, Chooback et al found that central nervous system (CNS)  metastases are frequent in patients with EGFR-mutant advanced non­–small cell lung cancer (NSCLC) and are associated with increased health resource...

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