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Expert Point of View: Sunil Verma, MD

Sunil Verma, MD, Professor and Head of the Department of Oncology and Medical Director of the Tom Baker Cancer Centre of the University of Calgary in Canada, was the study’s formal discussant. He cited several limitations of the study: It was an open-label study, was initially a phase II study but ...

breast cancer

PHEREXA: Benefit for Second-Line Pertuzumab Questionable

In the second-line metastatic breast cancer setting, the addition of pertuzumab (Perjeta) to trastuzumab (Herceptin)/capecitabine did not significantly improve progression-free survival, results of the phase III ­PHEREXA trial showed.1 This is the first randomized trial to evaluate the efficacy of ...

Expert Point of View: Marc S. Ernstoff, MD

The field of studies of combination immunotherapies is exploding, and “the future looks bright, with currently 71 trials of combination therapy in melanoma,” said formal discussant of these trials Marc S. Ernstoff, MD, of Roswell Park Cancer Institute, Buffalo, New York. “We now know that...

skin cancer

Studies Suggest Bright Future for Combination Immunotherapy in Advanced Melanoma, but Questions Remain

Two studies presented at the 2016 ASCO Annual Meeting focused on the use of combination immunotherapy in the treatment of patients with advanced melanoma. Updated results from the phase III CheckMate 067 trial centered on the combination of nivolumab (Opdivo) plus ipilimu­mab (Yervoy) compared...

breast cancer

Results of Two Practice-Changing Breast Cancer Trials Upheld

Results of two pivotal breast cancer trials reported at the 2016 ASCO Annual Meeting confirmed the practice-changing findings that resulted from earlier findings. PALOMA-2 The phase III PALOMA-2 trial confirmed results from the smaller, open-label phase II PALOMA-1 trial that led to the U.S. Food...

solid tumors
issues in oncology

Weight Loss in Overweight and Obese People May Lower Levels of Certain Proteins Linked to Cancer

A new study investigating the effects of dietary weight loss and exercise on circulating levels of certain angiogenesis-related proteins, including vascular endothelial growth factor (VEGF), plasminogen activator inhibitor-1 (PAI-1), and pigment epithelium-derived factor (PEDF), in postmenopausal...

colorectal cancer

World GI 2016: Anti–Interleukin-1 Alpha Antibody MABp1 Improves Outcomes Significantly Over Placebo in Advanced Colorectal Cancer

A novel anti–interleukin-1 alpha antibody has shown a significant impact on symptoms and a high level of safety and tolerability in patients with advanced colorectal cancer, according to phase III data presented by Hickish et al at ESMO’s 18th World Congress on Gastrointestinal Cancer...

gastrointestinal cancer

World GI 2016: Chemoradiotherapy After Surgery for Gastric Cancer Shows Similar Outcomes to Postoperative Chemotherapy

Postoperative treatment intensification with chemoradiotherapy does not achieve better outcomes compared to postoperative chemotherapy in patients with gastric cancer who have already undergone preoperative chemotherapy, according to phase III data presented by Verheij et al at the ESMO 18th World...

breast cancer
survivorship
supportive care

Managing Upper Extremity Dysfunction in Breast Cancer Survivors

With an increased number of breast cancer survivors and patients with metastatic disease living longer, it is imperative for oncology care providers to manage issues of new and chronic upper extremity dysfunction as a result of the malignancy itself or its treatment. As one of my patients...

Regarding Beau

Like most pediatric hematologists/oncologists, my career has been a journey, hoping to discover ways to improve the outcomes for children and adolescents with cancer. I have been blessed to work with outstanding colleagues in the United States and throughout the world. And of equal importance, I...

bladder cancer

Atezolizumab Promising in Cisplatin-Ineligible Metastatic Bladder Cancer

Atezolizumab (Tecentriq), an anti–programmed cell death ligand 1 (PD-L1) inhibitor, achieved durable responses as first-line treatment in cisplatin-ineligible patients with metastatic urothelial carcinoma in a primary analysis of a phase II trial. These data represent an unmet need, because...

cns cancers

New Standard of Care Emerges for Anaplastic Glioma Without 1p/19q Codeletion

Adjuvant temozolomide, after radiotherapy, improves overall survival in patients with grade 3 anaplastic glioma without 1p/19q codeletion, according to a phase III EORTC (European Organization for Research and Treatment of Cancer) study presented at the 2016 ASCO Annual Meeting.1 “We were...

breast cancer

Mixed Results With Resection of Primary Tumor in Stage IV Breast Cancer

For de novo stage IV breast cancer, does resection of the primary tumor improve outcomes? Two studies presented at the 2016 ASCO Annual Meeting reached different conclusions. A prospective randomized study conducted in Turkey concluded there is a survival benefit at 5 years,1 whereas a U.S....

breast cancer

Pertuzumab-Containing Regimens Compared for Neoadjuvant Treatment in Early Breast Cancer

In patients with HER2-positive early breast cancer, pathologic complete response rates after neoadjuvant therapy were higher with docetaxel plus carboplatin plus trastuzumab (Herceptin) plus pertuzumab (Perjeta), or TCH+P, than with ado-trastuzumab emtansine (Kadcyla) plus pertuzumab, or T-DM1+P,...

lung cancer

Combination of Nivolumab and Ipilimumab Moves Forward in NSCLC

How best to combine new immunotherapies is a burning question in oncology. A new study in the CheckMate series suggests that nivolumab (Opdivo) and ipilimumab (Yervoy) can be safely and effectively combined as first-line treatment of advanced non–small cell lung cancer (NSCLC),1 but further study...

head and neck cancer

Clinical Trials Actively Recruiting Patients With Ocular Cancer

Phase 0 Study Title: Use of Definity® Contrast Agent for Ultrasound of Intraocular Tumors Study Type: Interventional/single-group assignment Study Sponsor and Collaborators: Emory University Purpose: To determine if microbubbles may be used as a contrast agent to help image tumors in the eye. In...

ASCO Endows Young Investigator Award in Honor of Society Founder Jane Cooke Wright, MD

For the first time in ASCO’s history, the Society has endowed its own Young Investigator Award (YIA), illustrating its continued commitment to investing in the future of cancer research. Ongoing support of this kind will ensure that the Conquer Cancer Foundation (CCF), ASCO’s philanthropic arm, is...

multiple myeloma

Ixazomib: A Relevant Addition to Myeloma Therapy

In 2015, four new drugs were approved for the treatment of multiple myeloma by the U.S. Food and Drug Administration: panobinostat (Farydak), daratumumab (Darzalex), elotuzumab (Empliciti), and ixazomib (Ninlaro). Of them, the first three are drugs with unique new targets, whereas ixazomib is the...

Expert Point of View: Peter C. Enzinger, MD

Not so FAST? The study discussant Peter C. Enzinger, MD, Director of the Center for Esophageal and Gastric Cancer at Dana-Farber/Brigham and Women’s Cancer Center, Boston, viewed the findings of the FAST trial as promising but voiced several considerations, as did Gulam A. Manji, MD, PhD,...

gastrointestinal cancer
gastroesophageal cancer

First-in-Class Antibody Reduces Gastric Cancer Recurrence

A novel immunotherapy agent, the first in its class, reduced disease progression by more than 50% when added to standard chemotherapy for patients with advanced gastric cancer, according to results from an international phase II trial presented at the 2016 ASCO Annual Meeting.1 The drug, IMAB362,...

lung cancer

Once-Daily Radiation (66 Gy) Appears No Better Than Twice-Daily Radiation (45 Gy) for Small Cell Lung Cancer

A schedule of once-daily radiation therapy (66 Gy) was no better than a twice-daily schedule (45 Gy) for optimization of chemoradiotherapy in patients with limited-stage small cell lung cancer (SCLC), according to the eagerly anticipated results of the phase III ­CONVERT trial, presented at the...

gynecologic cancers

In the Neoadjuvant Era, Intraperitoneal Chemotherapy Is of Benefit in Advanced Ovarian Cancer

The role of intraperitoneal (IP) chemotherapy in the treatment of advanced ovarian cancer has been debated for a long time. According to a new study presented at the 2016 ASCO Annual Meeting, a combination of IP and intravenous (IV) chemotherapy appears more effective than IV chemotherapy alone in...

breast cancer

Trastuzumab Biosimilar Shows Efficacy and Safety Comparable to Reference Product in Phase III HERITAGE Trial

A new biosimilar version of the monoclonal antibody trastuzu­mab (Herceptin) is getting close to the finish line in the race to develop biosimilars in oncology. The new antibody, MYL-1401O, demonstrated comparable efficacy and safety compared with trastuzumab as front-line treatment of women with...

breast cancer

Joint Analysis Confirms Benefit of Anthracyclines for High-Risk Early-Stage Breast Cancer

For the treatment of high-risk, HER2-negative early-stage breast cancer, anthracyclines were confirmed as beneficial in a joint analysis of the Anthracyclines in Early Breast Cancer (ABC) trials. Presented at the 2016 ASCO Annual Meeting, the joint analysis of the ABC trials validated taxane plus...

cost of care
issues in oncology

ASCO Releases the Updated Version of Its Value Framework

Last June, ASCO published its initial concept for a value framework in the Journal of Clinical Oncology (JCO).1 The framework, developed by ­ASCO’s Value in Cancer Care Task Force, is designed to provide a standardized approach to assist physicians and patients in assessing the “value” of a new...

cns cancers

For High-Risk Neuroblastoma, Two Transplants May Be Better Than One

In children with high-risk neuroblastoma, tandem autologous stem cell transplant (ASCT) improved event-free survival rates in the ANBL0532 trial from the Children’s Oncology Group. The study was presented at the plenary session of the 2016 ASCO Annual Meeting by Julie R. Park, MD, of Seattle...

hematologic malignancies
leukemia

Study Finds Inotuzumab Ozogamicin Improves Outcomes vs Standard Therapy in Relapsed/Refractory ALL

In a phase III trial reported in The New England Journal of Medicine, Kantarjian et al found that treatment with the antibody-drug conjugate inotuzumab ozogamicin resulted in a greater complete remission rate and improved overall survival vs standard therapy in patients with relapsed/refractory...

Breast Density Legislation: An Opportunity for Better Risk Assessment

Dense breasts are not an automatic indication for additional imaging. Instead, breast density generally provides an opportunity for improved risk assessment, according to Kevin Hughes, MD, of Massachusetts General Hospital, Boston. “More than 20 states have mandated that women be informed of...

The Importance of Listening to Patients

My experience with cancer, or more accurately, cancers, is complicated. In 2002, after returning from a medical mission to Honduras, I noticed a bean-sized lymph node above my left clavicle. As an oncology-certified nurse, I knew not to ignore any unusual nodules that pop up on the body and asked...

multiple myeloma

SIRIUS Trial Heralds a New Era of Promise in Treating Resistant Myeloma

Multiple myeloma cells uniformly overexpress CD38.1 Daratumumab (Darzalex), a CD38-targeting human IgG1 kappa monoclonal antibody, has been evaluated in a series of phase I/II trials involving patients with relapsed or relapsed and refractory myeloma who have received at least two or more prior...

breast cancer

PALOMA-3 Trial in HER2-Negative Metastatic Breast Cancer: Challenge of Moving Beyond Estrogen Receptor Positivity

Hormone receptor–positive breast cancer represents the largest therapeutic subgroup of the disease. The development of endocrine therapies has shaped the treatment paradigm for both advanced- and early-stage disease for decades.1 Still, despite their significant impact, advanced breast cancer...

skin cancer

Anti–PD-1 Inhibitor Gains Foothold in Merkel Cell Carcinoma

Immunotherapy marches on! One of the latest frontiers for checkpoint inhibitors is the treatment of Merkel cell carcinoma, a rare but aggressive type of cancer. First-line therapy with pembrolizumab (Keytruda)—an anti–PD-1 (programmed cell death protein 1) inhibitor—achieved an objective response...

cns cancers

Combined-Modality Therapy for Low-Grade Gliomas: Balancing Toxicity, Delivery Logistics, and Survival Benefit

Low-grade gliomas account for 15% of all primary brain tumors and represent a heterogeneous group of glial neoplasms. Although these tumors have been termed low-grade, this is a misnomer, especially for some grade II gliomas, which may exhibit a more aggressive behavior and variable natural...

breast cancer

Ovarian Suppression in Premenopausal Women With Estrogen Receptor–Positive Breast Cancer

Oophorectomy was the first proposed form of endocrine therapy for women with breast cancer. Over 100 years ago, Thomas Nunn reported a relationship between menopause and regression of breast cancer.1 This incited interest in the induction of menopause as an anticancer therapy, and in 1986, a...

lymphoma

Nivolumab in Classical Hodgkin Lymphoma

On May 17, 2016, nivolumab (Opdivo) was granted accelerated approval for treatment of patients with classical Hodgkin lymphoma that has relapsed or progressed after autologous hematopoietic stem cell transplantation and post-transplantation brentuximab vedotin (Adcetris).1,2 Continued approval for ...

bladder cancer

PD-L1 Inhibitor Atezolizumab for Locally Advanced or Metastatic Urothelial Carcinoma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs.On May 18, 2016, the PD-L1 (programmed cell death ligand 1)...

bladder cancer

Atezolizumab in Platinum-Treated Advanced Urothelial Carcinoma: A New Standard of Care?

Compared with a historic control rate, a phase II study of the programmed cell death ligand 1 (PD-L1) inhibitor atezolizumab (Tecentriq) has demonstrated clinically meaningful responses in patients with urothelial carcinoma who progressed after platinum-based chemotherapy.1 Hailed as a “major...

pancreatic cancer

Adjuvant Chemotherapy Improves Survival in Pancreatic Cancer

An adjuvant chemotherapy regimen improved overall survival in early-stage pancreatic cancer patients, in the large phase III European ESPAC-4 study reported at the 2016 ASCO Annual Meeting.1 The combination of gemcitabine and capecitabine almost doubled the 5-year survival rate, compared to...

Expert Point of View: Stuart A. Grossman, MD, and Deborah Schrag, MD

Formal discussant of this trial Stuart A. Grossman, MD, of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, commented that the trial did not include a best standard-of-care arm. The pivotal trial defined optimal radiotherapy as 60 Gy over 6 weeks, but this...

cns cancers

Chemoradiotherapy Improves Survival in Patients Over Age 65 With Glioblastoma: A New Standard Option?

The combination of short-course radiotherapy and temozolomide followed by maintenance with temozolomide significantly improved survival compared with short-course radiotherapy alone in newly diagnosed elderly patients with glioblastoma, according to the results of a global cooperative group trial...

multiple myeloma

The ENDEAVOR Trial: A Case Study in the Interpretation of Modern Cancer Trials

It can be easy to miss the forest for the trees in the interpretation of clinical trials. In particular, trials for the treatment of cancer are exceedingly complex, with long lists of inclusion and exclusion criteria, designs with hidden biases, drugs with unpronounceable names (if not cumbersome...

multiple myeloma

Daratumumab Hits the Mark in Early Relapsed Multiple Myeloma

For relapsed or refractory multiple myeloma, daratumumab (Darzalex), combined with bortezomib (Velcade) and dexamethasone, reduced relapses by 61% in the phase III CASTOR study reported at the 2016 ASCO Annual Meeting.1 “The results are unprecedented in a randomized study comparing a novel...

ASCO 2016: Local Consolidative Therapy Improves Progression-Free Survival in Patients With Oligometastatic NSCLC vs Standard Chemotherapy

Lung cancer patients with oligometastases, defined as three or fewer sites of metastasis, may benefit from aggressive local therapy, surgery, or radiation, after standard chemotherapy, according to research led by The University of Texas MD Anderson Cancer Center. If validated in larger studies,...

gastrointestinal cancer

ASCO 2016: Novel Antibody Significantly Improves Survival in Patients With Advanced Gastric Cancer

Findings from the European phase II FAST study showed that the novel, first-in-class antibody IMAB362 can significantly extend median survival when added to standard chemotherapy (13.2 vs 8.4 months) for patients with advanced gastric cancer. This therapy targets a protein called claudin-18 splice...

bladder cancer

ASCO 2016: Atezolizumab Benefits Patients With Advanced Bladder Cancer

The anti–programmed cell death ligand 1 (PD-L1) immunotherapy atezolizumab (Tecentriq) is effective in patients with previously untreated advanced bladder cancer who are not eligible for the standard treatment with cisplatin. According to a nonrandomized phase II trial, atezolizumab shrank...

lung cancer

ASCO 2016: New Antibody-Drug Conjugate Shows Early Promise in Small Cell Lung Cancer

Early findings from a first-in-human clinical trial showed that the antibody-drug conjugate rovalpituzumab tesirine (Rova-T) shows promising efficacy against recurrent small cell lung cancer (SCLC). The treatment, which combines a novel anti-DLL3 antibody with a powerful anticancer agent, halted...

kidney cancer

FDA Approves Lenvatinib in Combination With Everolimus in Advanced Renal Cell Carcinoma

On May 13, 2016, the U.S. Food and Drug Administration (FDA) approved lenvatinib capsules (Lenvima) in combination with everolimus (Afinitor) for the treatment of advanced renal cell carcinoma following one prior antiangiogenic therapy. Lenvatinib was first approved in 2015 for the treatment of...

bladder cancer

Atezolizumab in Previously Treated Advanced Urothelial Carcinoma

The recent study by Rosenberg et al in The Lancet—summarized in this issue of The ASCO Post—is a very important paper in the field of bladder cancer therapy.1 It is the first phase II trial in metastatic transitional cell carcinoma that demonstrates the single-agent activity of the...

bladder cancer

Anti–PD-L1 Antibody Atezolizumab Active in Previously Treated Advanced Urothelial Carcinoma

In a phase II trial reported in The Lancet, Jonathan E. Rosenberg, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that the anti–PD-L1 (programmed cell death ligand 1) antibody atezolizumab produced durable responses in a marked proportion of patients with previously treated...

breast cancer

ExteNET Trial of Neratinib: One Size Does Not Fit All in HER2-Positive Breast Cancer

Neratinib is an oral anti-HER2 tyrosine kinase inhibitor that has shown promising activity in the treatment of HER2-positive metastatic breast cancer.1 It differs from monoclonal antibodies such as trastuzumab (Herceptin) because, as a small molecule, neratinib blocks the ATP binding site on the...

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