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issues in oncology

Medical Preparedness for Nuclear Disaster

ROBERT PETER GALE, MD, PhD, DSc (hc), was on the faculty of the University of California, Los Angeles, School of Medicine for 20 years and has served as Chairman of the Scientific Advisory Committee of the Center for International Blood and Marrow Transplant Research. In 1986, he was asked by the...

hepatobiliary cancer
immunotherapy

FDA Grants Breakthrough Therapy Designation for Atezolizumab/Bevacizumab Combination as First-Line Treatment for Advanced or Metastatic HCC

The U.S. Food and Drug Administration (FDA) recently granted Breakthrough Therapy designation for atezolizumab (Tecentriq) in combination with bevacizumab (Avastin) as a first-line treatment for people with advanced or metastatic hepatocellular carcinoma (HCC), the most common form of liver...

solid tumors
breast cancer

Oral Taxane Shows Strong Activity and Good Tolerability in Metastatic Breast Cancer

As first-line treatment for metastatic breast cancer, the oral taxane tesetaxel produced a 45% confirmed response rate and was well tolerated, producing little alopecia or neuropathy, according to Andrew D. Seidman, MD, and colleagues from several cancer centers. Dr. Seidman, of Memorial Sloan...

Excerpt From the 2018 ASCO Presidential Address: ‘Delivering Discoveries: Expanding the Reach of Precision Medicine’

In my area of research, lung cancer, precision medicine is indeed transforming the treatment of this disease and has important implications for other cancers and for the future of our patients with cancer. Today’s achievement of being able to systematically identify genomic changes that can be...

cns cancers

Surgery Followed by Salvage Stereotactic Radiosurgery vs Whole-Brain Radiotherapy for Four or Fewer Brain Metastases

In a Japanese phase III noninferiority trial (JCOG0504) reported in the Journal of Clinical Oncology, Kayama et al found that salvage stereotactic radiosurgery (SRS) was noninferior to whole brain radiation therapy (WBRT) for survival in patients with 1 to 4 resected brain metastases. In the...

integrative oncology

Green Tea

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. Gary Deng, MD, PhD, and Jyothirmai Gubili, MS, present information on the potential health benefits ...

lymphoma
immunotherapy

2018 ASCO: Lenalidomide Plus Rituximab vs Rituximab Plus Chemotherapy in Previously Untreated Follicular Lymphoma

Results from RELEVANCE, a phase III, randomized, open-label, international clinical study conducted in partnership with the Lymphoma Academic Research Organisation (LYSARC), were presented by Fowler et al at the 2018 ASCO Annual Meeting (Abstract 7005). This study evaluated the investigational...

leukemia

FDA Grants Priority Review to Gilteritinib for the Treatment of Relapsed or Refractory FLT3 Mutation–Positive AML

The U.S. Food and Drug Administration (FDA) has accepted, with Priority Review, a new drug application (NDA) for gilteritinib for the treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) and a mutation in the FLT3 gene, as detected by an FDA-approved test....

lung cancer

Valued Mentors and a Link Between Science and Medicine Paved the Road to Oncology for Alice Tsang Shaw, MD, PhD

Lung cancer expert Alice Tsang Shaw, MD, PhD, was born and reared in Gaithersburg, a small suburb located to the northwest of Washington, DC. Both her parents were chemists, and during high school, Dr. Shaw had a keen interest in science, particularly biology, yet the thought of pursuing a career...

lymphoma

Pioneering Researcher and Oncologist Volker S. Diehl, MD, Helped Unlock the ‘Black Box’ of Hodgkin Lymphoma

Volker S. Diehl, MD, the internationally renowned hematologist and researcher, was born in Berlin, Germany, on February 28, 1938—arguably one of the most tumultuous periods in world history. Germany had just invaded Austria, signaling the dark intentions of the Third Reich. In 1943, the air raids...

A Lifetime of Accomplishments in Oncology Brings Knighthood to Sir Murray F. Brennan, MD, FACS

Sir Murray F. Brennan, MD, FACS, was born on April 2, 1940, in Auckland, New Zealand, which lies on and around an isthmus surrounded by the sparkling azure waters of the Hauraki Gulf. “I was born at the beginning of World War II. Fortunately, my father was too old to be drafted into the army. I...

issues in oncology
cost of care
immunotherapy

Weighing the Cost and Value of CAR T-Cell Therapy

This past year’s approval by the U.S. Food and Drug Administration (FDA) of two chimeric antigen receptor (CAR) T-cell therapies heralded a new era in both effective cancer treatments and the most expensive cancer drugs ever. Tisagenlecleucel (Kymriah) was initially approved for the treatment of...

leukemia

Clearance of Somatic Mutations at Remission and Outcomes in AML

In a study reported in the Journal of Clinical Oncology, Morita et al found that clearance of somatic mutations at complete remission—particularly those in nonpreleukemic genes—was associated with improved outcomes in previously untreated patients with acute myeloid leukemia (AML)....

solid tumors
kidney cancer

Combined Immune Checkpoint and VEGF Inhibition as First-Line Therapy in Advanced Clear Cell Kidney Cancer

In a dose-finding, dose-expansion phase Ib trial (JAVELIN Renal 100) reported in The Lancet Oncology, Toni K. Choueiri, MD, of Dana-Farber Cancer Institute and Brigham and Women’s Hospital, and colleagues determined the maximum tolerated dose of the immune checkpoint inhibitor avelumab (Bavencio)...

lymphoma
immunotherapy

FDA Expands Tisagenlecleucel Approval to Include Relapsed or Refractory Large B-Cell Lymphoma

On May 1, the U.S. Food and Drug Administration (FDA) approved tisagenlecleucel (Kymriah) suspension for intravenous infusion for the treatment of adult patients with relapsed or refractory large B-cell lymphoma—including diffuse large B-cell lymphoma (DLBCL), high-grade B-cell lymphoma, and...

lung cancer

Crizotinib in East Asian Patients With ROS1-Positive Advanced NSCLC

In a phase II study reported in the Journal of Clinical Oncology, Wu et al found that crizotinib (Xalkori) was highly active in East Asian patients with ROS1-positive advanced non­–small cell lung cancer (NSCLC). Study Details In the study, 127 patients from 37 sites in China, Japan,...

breast cancer
immunotherapy

Potent Anti-HER2 Agents on the Horizon

THANKS TO the efficacy of five approved anti-HER2 agents, patients with HER2-positive breast cancer have overall survival numbers that are as good as, or better than, their HER2-negative counterparts. With the next generation of anti-HER2 therapies in clinical trials, these outcomes may become even ...

colorectal cancer

Modified XELIRI vs FOLFIRI as Second-Line Treatment for Metastatic Colorectal Cancer

In an Asian phase III noninferiority trial (AXEPT) reported in The Lancet Oncology, Xu et al found that modified XELIRI (mXELIRI, capecitabine plus irinotecan) was noninferior in overall survival vs standard FOLFIRI (leucovorin, fluorouracil, and irinotecan), both given with or without bevacizumab...

hepatobiliary cancer

Lenvatinib Mesylate Approved in Japan for Unresectable HCC

On March 23, the multiple-receptor tyrosine kinase inhibitor lenvatinib mesylate (Lenvima) was approved in Japan for unresectable hepatocellular carcinoma (HCC). This is the first approval worldwide of lenvatinib mesylate for the indication of unresectable HCC and the first new systemic therapy to...

issues in oncology
global cancer care

ASCO International: 2017 Year in Review

In late 2016, ASCO announced further expansion of its robust portfolio of international programs, and significant progress toward this expansion was achieved in 2017.  All of these accomplishments reflect the hard work and commitment of many ASCO member volunteers, ASCO staff, and organizations...

kidney cancer
immunotherapy

Activity of Combined Immune Checkpoint and VEGF Inhibition as First-Line Therapy in Advanced Clear Cell RCC

In the dose-finding, dose-expansion phase Ib JAVELIN Renal 100 trial reported in The Lancet Oncology, Choueiri et al identified the maximum tolerated dose of the immune checkpoint inhibitor avelumab (Bavencio) in combination with the vascular endothelial growth factor inhibitor axitinib...

hepatobiliary cancer

In Unresectable Liver Cancer, Progression-Free Survival Doubled When Sorafenib Added to TACE

SORAFENIB (Nexavar) added to transarterial chemoembolization (TACE) doubled the median progression-free survival over TACE alone in patients with unresectable hepatocellular carcinoma, Japanese investigators reported at the 2018 Gastrointestinal Cancers Symposium.1 The results of the randomized,...

colorectal cancer

Small Study Evaluates Treatment Sequencing in Patients With Metastatic Colorectal Cancer

THE OPTIMAL treatment sequence for two approved agents in metastatic colorectal cancer may be regorafenib (Stivarga) before cetuximab (Erbitux), according to results from the small randomized Japanese REVERCE trial presented at the 2018 Gastrointestinal Cancers Symposium.1 Giving regorafenib...

symptom management

Dexamethasone-Sparing Antiemetic Regimen in Patients Receiving Highly Emetogenic Chemotherapy

In a Japanese phase III noninferiority trial reported in the Journal of Clinical Oncology, Ito et al found that dexamethasone could be spared on days 2 and 3 in an antiemetic regimen including the neurokinin-1 (NK1) receptor antagonist aprepitant and palonosetron in patients receiving highly...

lung cancer

FDA Grants Priority Review to Lorlatinib in ALK-Positive NSCLC

On February 12, the U.S. Food and Drug Administration (FDA) accepted and granted Priority Review to Pfizer’s new drug application for lorlatinib. The Prescription Drug User Fee Act goal date for a decision by the FDA is in August 2018. Lorlatinib is an investigational, anaplastic lymphoma...

gynecologic cancers

FDA Grants Premarket Approval to New HPV Assay

On February 14, Becton, Dickinson and Company (BD) announced it had received premarket approval from the U.S. Food and Drug Administration (FDA) for the BD Onclarity human papillomavirus (HPV) assay. The test detects 14 types of high-risk HPV from specimens collected for cervical cancer screening...

global cancer care

CONCORD-3: Global Surveillance of Cancer Survival Trends, 2000–2014

In an article in The Lancet, Allemani et al reported findings from the CONCORD program for global surveillance of cancer survival trends updated through 2014 (CONCORD-3).   Study Details CONCORD-3 includes data on 37.5 million patients diagnosed with cancer between 2000 and 2014 from...

hematologic malignancies
lymphoma

Mogamulizumab in Cutaneous T-Cell Lymphoma

The anti-CCR4 monoclonal antibody mogamulizumab may answer an unmet need in providing an effective treatment of cutaneous T-cell lymphoma. In the phase III MAVORIC trial reported at the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition, treatment with mogamulizumab was...

lymphoma
immunotherapy

FDA Accepts sBLA, Grants Priority Review for Tisagenlecleucel in Adults With DLBCL

Today, the U.S. Food and Drug Administration (FDA) accepted for Priority Review a supplemental Biologics License Application (sBLA) for tisagenlecleucel (Kymriah) suspension for intravenous infusion (formerly CTL019) for the treatment of adult patients with relapsed or refractory diffuse large...

solid tumors
lung cancer

Durvalumab Therapy Improves Outcomes in Patients With Unresectable Stage III NSCLC

The PACIFIC study showed that the addition of the programmed cell death ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) following chemoradiotherapy for patients with unresectable stage III non–small cell lung cancer (NSCLC) dramatically improved progression-free survival compared with placebo....

gastroesophageal cancer

Immunotherapy in Advanced Esophageal Carcinoma

As reported in the Journal of Clinical Oncology by Doi et al, pembrolizumab (Keytruda) showed activity in patients with previously treated advanced esophageal carcinoma in the phase Ib multicohort KEYNOTE-028 study. Study Details In the study, eligible patients with squamous cell carcinoma or...

colorectal cancer

ESMO Asia 2017: AXEPT Trial: New Second-Line Therapy for Metastatic Colorectal Cancer Is Effective and Safe

A randomized trial in 650 patients has confirmed the safety and efficacy of a new second-line treatment for metastatic colorectal cancer, researchers reported at the European Society for Medical Oncology (ESMO) Asia 2017 Congress (Abstract LBA3_PR). Oral fluorinated pyrimidines have been...

gastrointestinal cancer

Adding Targeted Agent to Chemotherapy in Second-Line Treatment of Advanced Gastric Cancer

In the Asian phase III GOLD trial reported in The Lancet Oncology, Bang et al found that the addition of olaparib (Lynparza) to paclitaxel did not significantly improve overall survival among patients with previously treated advanced gastric cancer, including those with...

breast cancer

10-Year Follow-up on Adjuvant Therapy in Postmenopausal Early Breast Cancer

The 10-year follow-up of the phase III TEAM trial has shown that exemestane alone and sequential tamoxifen/exemestane provide similar outcomes as adjuvant endocrine therapy in postmenopausal women with hormone receptor–positive early breast cancer. The findings were reported in The Lancet Oncology ...

lung cancer

Dacomitinib Prolongs Progression-Free Survival vs Gefitinib in First-Line Treatment of EGFR-Mutant NSCLC

THE PHASE III ARCHER 1050 trial has shown superior progression-free survival with the second-generation irreversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor dacomitinib vs gefitinib (Iressa) in the first-line treatment of advanced EGFR-mutant non–small-cell lung cancer...

pancreatic cancer

Resectable Pancreatic Cancer: Neoadjuvant or Adjuvant Therapy?

For potentially curable treatment of resectable pancreatic cancer, adjuvant therapy remains the standard “for now,” but evidence is growing that neoadjuvant therapy may be more beneficial, at least in certain patient subsets, according to Thomas Seufferlein, MD, PhD, Professor of Medicine at the...

gastrointestinal cancer

Anti–PD-1 Agents Gaining Momentum in Gastric Cancer

In updates of two important studies in metastatic gastric cancer reported at the European Society for Medical Oncology (ESMO) 2017 Congress, nivolumab -(Opdivo) and pembrolizumab (Keytruda) demonstrated activity—but to varying degrees and with some nuances. “Anti-PD [programmed cell death protein]...

lung cancer

Tumor Mutation Burden Shows Promise as a Response Biomarker in Small Cell Lung Cancer

Patients with small cell lung cancer (SCLC) and a high tumor mutation burden had a near doubling in response rate and 1-year overall survival when ipilimumab (Yervoy) was combined with nivolumab (Opdivo), vs nivolumab alone, new findings from CheckMate 032 have shown. Regardless of the treatment...

lung cancer

Residual Tumor ‘Uncertain’ Classification Validated in Non–Small Cell Lung Cancer

After surgical resection of non–small cell lung cancer (NSCLC), investigators from the International Association for the Study of Lung Cancer (IASLC) have validated outcomes for tumors deemed to be of “uncertain” residual tumor status (ie, R[un]). “The residual tumor (R) classification reflects the ...

lung cancer

Treatment Based on BRCA1 Expression Did Not Improve Survival in NSCLC

IN PATIENTS with early-stage non–small cell lung cancer (NSCLC), the use of expression of BRCA1 failed as an approach to customize chemotherapy, investigators from the Spanish Lung Cancer Cooperative Group reported at the 2017 International Association for the Study of Lung Cancer (IASLC) World...

lung cancer

IASLC 2017: Exercise Interventions in Advanced Lung Cancer Patients Led to Increased Functionality

Physical exercise and psychosocial interventions in patients with advanced-stage lung cancer improved functional capacity, which may be linked to quality-of-life benefits. Morten Quist, PT, PhD, MSc, of the University of Copenhagen, presented these findings at the International Association for the...

lung cancer

IASLC 2017: Community Engagement Interventions May Reduce Disparities in Lung Cancer Outcomes Among Minorities

Community-based interventions implemented in minority community sites resulted in changes in participants’ knowledge, attitudes, and beliefs about cancer, as well as perceived benefits and self-efficacy measures regarding lung cancer screening. Lovoria Williams, PhD, APRN-BC, FAANP, of...

lung cancer

IASLC 2017: Non–Small Cell Lung Cancer Survival Rates Higher Among Patients Treated at Academic Centers

As non–small cell lung cancer (NSCLC) survival rates have increased over time, new research sheds light on how NSCLC outcomes are significantly influenced by the type of treatment facility where patients undergo care. Bhagirathbhai Dholaria, MD, of the Moffitt Cancer Center, presented these...

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...

lung cancer

IASLC 2017: First-Line Pembrolizumab Increases Overall Survival vs Chemotherapy in Metastatic NSCLC With High Levels of PD-L1

Updated overall survival findings from the phase III KEYNOTE-024 trial evaluating pembrolizumab (Keytruda) as a first-line monotherapy in patients with non–small cell lung cancer (NSCLC) whose tumors express high levels of programmed cell death ligand 1 (PD-L1) were presented at the...

lung cancer

IASLC 2017: IASLC Releases New Atlas of EGFR Testing

The International Association for the Study of Lung Cancer (IASLC) released its Atlas of EGFR Testing in Lung Cancer at the IASLC 18th World Conference on Lung Cancer (WCLC) in Yokohama, Japan. The EGFR Atlas provides health-care professionals with information on EGFR testing processes and...

lung cancer

IASLC 2017: Treatment Based on BRCA1 Level Does Not Increase Survival of Stage II/III NSCLC Node-Positive Resected Patients

New research shows that treating stage II and III non–small cell lung cancer (NSCLC) node-positive resected patients with customized chemotherapy based on their specific BRCA1 expression levels, as opposed to providing the standard treatment, did not increase overall survival rates among...

lung cancer

IASLC 2017: Biopsy Specimen Found to Be Reliable for Evaluating DLL3 Expression in Small Cell Lung Cancer

Small cell lung cancer (SCLC) biopsy specimens were found to be reliable material for evaluating DLL3 expression, and high levels of DLL3 in SCLC are correlated with poor survival trends. Researchers from Guangdong General Hospital and Guangdong Academy of Medical Sciences in China presented...

lung cancer

IASLC 2017: REVEL Trial Subgroup Analysis Further Clarifies Outcomes With Ramucirumab Plus Docetaxel in Advanced Non–Small Cell Lung Cancer

New subgroup analysis from the phase III REVEL trial of ramucirumab (Cyramza) in advanced non–small cell lung cancer (NSCLC) was presented at the International Association for the Study of Lung Cancer (IASLC) 18th World Conference on Lung Cancer in Yokohama, Japan. Specifically, these...

lung cancer

IASLC 2017: Research Confirms IASLC Characterization of Uncertain R Status With Prognosis Between R0 and R1

The findings of a recent study confirm the International Association for the Study of Lung Cancer (IASLC)’s proposed criteria for uncertain resection margin status, R(un), in residual tumor (R) classification. John Edwards, PhD, MBChB, of the University of Sheffield in the United Kingdom,...

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