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Selected Abstracts From the 2016 ASH Annual Meeting

Here are several abstracts selected from the proceedings of this year’s American Society of Hematology (ASH) Annual Meeting & Exposition, highlighting newer therapeutics in high-grade, aggressive B-cell non-Hodgkin lymphomas (NHLs), including newly diagnosed as well as relapsed or refractory...

lung cancer

New Analysis of CheckMate 057: Search Continues for Predictors of Outcome With Nivolumab

Prognostic factors and tumor expression of programmed cell death ligand 1 (PD-L1) predict early mortality among patients with previously treated nonsquamous advanced non–small cell lung cancer (NSCLC) who receive nivolumab instead of docetaxel. But these features are not reliable for excluding...

neuroendocrine tumors

Expert Point of View: Vincent J. Picozzi, MD

Vincent J. Picozzi, MD, a pancreatic cancer specialist at Virginia Mason Hospital in Seattle, commented on the findings by Chan et al presented at the 2017 Gastrointestinal Cancers Symposium. Dr. Picozzi first acknowledged that there is a strong biologic rationale for evaluating cabozantinib...

hepatobiliary cancer

Novel Bridge to Liver Transplant May Improve Upon Standard of Care

For hepatocellular carcinoma patients awaiting a liver transplant, locoregional treatment as a “bridge” is a standard strategy for reducing tumor progression. The most common approach is transarterial chemoembolization, but a study from a large-volume liver transplant center questions whether it...

lung cancer

Expert Point of View: Edward B. Garon, MD

“There are several possible ways to move first-line immunotherapy for non–small cell lung cancer (NSCLC) forward, according to invited discussant Edward B. Garon, MD, Director of Thoracic Oncology at the David Geffen School of Medicine at the University of California, Los Angeles. “We could expand...

colorectal cancer

Expert Point of View: Philip B. Paty, MD

Philip B. Paty, MD, a surgical oncologist at Memorial Sloan Kettering Cancer Center, New York, commented on the findings for The ASCO Post. Dr. Paty is leading studies of surveillance at his own institution, which is not part of the International Watch & Wait Database. Consistency of Outcomes...

survivorship
health-care policy

Timing Is Everything

In 1959, my 5-year-old cousin, Kim, was diagnosed with acute lymphocytic leukemia (ALL). As an 8-year-old, I didn’t really understand what was happening to him, except that he had to go to the Riley Hospital for Children in Indianapolis, Indiana, for treatment. The haunting vision of his looking...

lung cancer

Understanding the Role of Immunotherapy for Lung Cancer: A Paradigm Shift for the Better

“Immunotherapy for lung cancer is a paradigm shift. I would never have thought when I started my career taking care of lung cancer patients in the mid 1990s that we’d now be substituting chemotherapy with an antibody immunotherapy in 2017. It’s incredible,” commented Roy S. Herbst, MD, PhD, Chief...

pain management

Combating Untreated Cancer-Related Pain

The problem of pain management facing clinicians today is twofold: how to ensure safe and effective treatment for patients with cancer in chronic pain, while avoiding the overuse of opioid medications and the potential for substance use disorder and diversion. According to the American Cancer...

colorectal cancer

CheckMate 142 Update: Prolonged Disease Control With Nivolumab in Deficient Mismatch Repair Colorectal Cancer

With 6 additional months of follow-up since the initial presentation of results, in the phase II CheckMate 142 trial, 74% of heavily pretreated patients with metastatic colorectal microsatellite instability–high (MSI-H) cancers are alive after single-agent treatment with nivolumab (Opdivo).1...

lung cancer

Never Smokers Account for Increased Proportion of Non–Small Cell Lung Cancer Cases

In a retrospective study in three U.S. institutions reported in the Journal of the National Cancer Institute, Pelosof et al found that never smokers accounted for an increasing proportion of cases of non–small cell lung cancer (NSCLC) during the period from 1990 to 2013. The study used data...

lung cancer

Gefitinib or Erlotinib vs Chemotherapy in EGFR-Mutant Advanced Non–Small Cell Lung Cancer

In an individual patient data meta-analysis reported in the Journal of the National Cancer Institute, Lee et al found no difference in overall survival for first-line treatment with the first-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors gefitinib (Iressa) or...

skin cancer

Intermittent Vismodegib Regimens in Patients With Multiple Basal Cell Carcinomas

In a phase II trial reported in The Lancet Oncology, Dréno et al found that two long-term intermittent vismodegib (Erivedge) dosing regimens provided a similar reduction in the number of clinically significant basal cell carcinomas among patients with multiple lesions. Study Details In the ...

kidney cancer

2017 GU Cancers Symposium: In Advanced Kidney Cancer, Antibiotic Use Lowers Efficacy of Immunotherapy

A new retrospective analysis suggests that immunotherapy may be less effective in patients who receive antibiotics less than a month before starting treatment. In the study, cancer worsened more quickly in such patients than in those who did not receive antibiotics (with median progression-free...

kidney cancer

2017 GU Cancers Symposium: Some Patients With Renal Cell Carcinoma Experience Long-Term Tumor Control Even After Stopping Immunotherapy Early

Early findings from a new study appear to challenge the current standard practice for immune checkpoint inhibitor therapy—continuing treatment until cancer worsens. Among patients with advanced kidney cancer who stopped programmed cell death protein 1/programmed cell death ligand 1...

breast cancer

Patients With Breast Cancer With Dense Breast Tissue More Likely to Develop Contralateral Disease

Patients with breast cancer with dense breast tissue have almost a twofold increased risk of developing disease in the contralateral breast, according to new research from The University of Texas MD Anderson Cancer Center. The study, published by Brewster et al in the journal Cancer, is among the...

head and neck cancer

Adding Buparlisib to Paclitaxel in Platinum-Pretreated Squamous Cell Carcinoma of the Head and Neck

In the phase II BERIL-1 trial reported in The Lancet Oncology, Soulières et al found that adding the pan-PI3K (phosphatidylinositol 3-kinase) inhibitor buparlisib to paclitaxel improved outcomes in patients with platinum-pretreated recurrent metastatic squamous cell carcinoma of the head and ...

survivorship

Cancer Survivors Find Online and Telephone Communication With Health-Care Professionals Beneficial

Researchers from the School of Health Sciences at the University of Surrey have completed the first-ever systematic review of cancer survivors’ experience of online and telephone telehealth interventions in cancer care, a new study by Cox et al in the Journal of Medical Internet...

leukemia

Adding Idelalisib to Bendamustine/Rituximab in Relapsed or Refractory Chronic Lymphocytic Leukemia

As reported by Zelenetz et al in The Lancet Oncology, an interim analysis of a phase III trial has shown the superiority of adding the phosphoinositide-3-kinase δ inhibitor idelalisib (Zydelig) to bendamustine/rituximab (Rituxan) in patients with relapsed or refractory chronic lymphocytic...

neuroendocrine tumors

Telotristat Ethyl: A Novel Therapy for Carcinoid Syndrome—Not a Panacea but a Step in the Right Direction

The multihumoral manifestations of neuroendocrine tumors include diarrhea, cutaneous flushing, wheezing, and right-sided valvular heart disease.1 Serotonin, a biogenic amine and product of tryptophan metabolism,2 mediates several of these symptoms.3,4 Diarrhea is a cardinal and often disabling...

neuroendocrine tumors

Telotristat Ethyl Reduces Frequency of Bowel Movements in Patients With Metastatic Neuroendocrine Tumors and Carcinoid Syndrome

In the phase III TELESTAR trial reported in the Journal of Clinical ­Oncology by Matthew H. Kulke, MD, of Dana-Farber Cancer Institute, and colleagues, telotristat ethyl, an investigational tryptophan hydroxylase inhibitor, significantly reduced the frequency of bowel movements in patients with...

lung cancer

ASCEND-4 Study Shows 45% Reduction in Risk of Disease Progression for NSCLC Patients on First-Line Ceritinib

Compared to chemotherapy, the use of first-line ceritinib (Zykadia) resulted in a statistically significant and clinically meaningful improvement in median progression-free survival, with an estimated 45% reduction in disease progression risk, as well as significant improvements in quality of...

bladder cancer

Nivolumab in Metastatic Urothelial Carcinoma After Platinum Therapy

As reported in The Lancet Oncology by Sharma et al, the phase II CheckMate 275 trial has shown nivolumab (Opdivo) to produce durable responses in patients with metastatic urothelial cancer who had received at least one prior platinum-based regimen. The study supported the recent accelerated...

From Azerbaijan to America: An IDEA Recipient’s Experience

Cancer takes away millions of lives every year, and in low- and middle-income countries, the high cancer mortality rate can often be attributed to scarce means and a shortage of trained professionals. Hoping to contribute my best in the fight against this disease, I chose to become an oncologist in ...

myelodysplastic syndromes

Early Success Reported With Two New Agents for High-Risk Myelodysplastic Syndromes

At the 2016 American Society for Hematology (ASH) Annual Meeting & Exposition, researchers reported early success with two new experimental agents for high-risk myelodysplastic syndromes—enasidenib (also known as AG-221), a potent oral inhibitor of the isocitrate dehydrogenase 2 (IDH2) enzyme,...

lymphoma

Studies Advance the Use of PD-1 Blockade in Classical Hodgkin Lymphoma

Classical Hodgkin lymphoma is one of the malignancies most susceptible to treatment with monoclonal antibodies targeting the programmed cell death protein (PD-1). Nivolumab (Opdivo) has been approved by the U.S. Food and Drug Administration (FDA) for use in patients with relapsed/refractory...

breast cancer

Expert Point of View: Virginia Kaklamani, MD, and Melinda L. Telli, MD

Moderator of the press conference on this study, Virginia Kaklamani, MD, of the University of Texas Health Science Center at San Antonio, agreed that an improvement in response is important. “If you are a patient with symptoms, such as a cough from lung metastases, and I give you a combination...

breast cancer
symptom management

Randomized Trial Demonstrates Benefit of Scalp-Cooling in Prevention of Chemotherapy-Induced Hair Loss

A scalp-cooling device was found safe and effective in preventing chemotherapy-induced hair loss in women undergoing adjuvant treatment for breast cancer in an interim analysis of the first prospective, randomized trial of a modern scalp-cooling system. The study was presented at the 2016 San...

cost of care

The Cost of a Patient’s Last Ride

It was a call from a referring physician who wanted the patient to be transferred to our major academic center. The patient had a history of a lethal malignancy in a very advanced stage. The patient was already outside the bell curve, for she had survived far longer than expected for a malignancy...

colorectal cancer

Dual Inhibition Proves Effective for BRAF-Mutated Colorectal Tumors

In patients with metastatic colorectal cancer who have mutations in BRAF V600, the addition of the BRAF inhibitor vemurafenib (Zelboraf) to cetuximab ­(Erbitux) and irinotecan significantly improved progression-free survival, results of the phase II Southwest Oncology Group (SWOG) 1406 trial have...

skin cancer

ECCO 2017: Melanoma Death Rates Will Fall by 2050, but Number of Deaths Will Increase

By 2050, the death rates from malignant melanoma will have decreased from their current levels, but the numbers of people dying from the disease will have increased due to the aging of populations. However, if new treatments for the deadly skin cancer prove to be effective, the numbers of deaths...

lung cancer

Phase III Trial Finds First-Line Ceritinib Improves PFS vs Platinum-Based Chemotherapy in ALK-Rearranged NSCLC

In a phase III trial (ASCEND-4) reported in The Lancet, Soria et al found that ceritinib (Zykadia) improved progression-free survival vs platinum-based chemotherapy in first-line treatment of advanced ALK-rearranged non–small cell lung cancer (NSCLC). Ceritinib is a next-generation selective...

breast cancer

ECCO 2017: Some Patients With Early-Stage Breast Cancer May Benefit More From Breast-Conserving Therapy Than Mastectomy

Breast-conserving therapy (breast-conserving surgery combined with radiation therapy) may be superior to mastectomy in certain patients with breast cancer, according to results from the largest study on this topic to date, presented at the 2017 European Cancer Congress (Abstract 4LBA). Although...

breast cancer

ECCO 2017: Low Cause-Specific Mortality in Women Over 50 Treated for Ductal Carcinoma in Situ

Women over 50 who have been treated for ductal carcinoma in situ (DCIS) are more likely to be alive 10 years later than women in the general population, according to new research presented by Elshof et al at the 2017 European Cancer Congress (ECCO) (Abstract 173). DCIS differs from breast cancer...

lymphoma

Low Loss of Residual Lifetime for Patients With DLBCL in Remission Who Were Event-Free 24 Months After Treatment

In a Danish population–based study reported in the Journal of Clinical Oncology, Jakobsen et al found that patients with diffuse large B-cell lymphoma (DLBCL) in first remission and event-free at 24 months after treatment have a low loss of residual lifetime compared with the general...

sarcoma

Regorafenib in Advanced Nonadipocytic Soft-Tissue Sarcoma

Mir et al found that regorafenib (Stivarga) was active in patients with advanced nonadipocytic soft-tissue sarcoma previously treated with an anthracycline, according to a French-Austrian phase II trial reported in The Lancet Oncology. Regorafenib, a kinase inhibitor, should be evaluated further in ...

gynecologic cancers

Rucaparib in Previously Treated BRCA Mutation–Associated Ovarian Cancer

On December 19, 2016, rucaparib (Rubraca) was granted accelerated approval for the treatment of patients with deleterious BRCA mutation–associated (germline or somatic) advanced ovarian cancer who have received two or more prior chemotherapy regimens.1,2 The U.S. Food and Drug Administration (FDA) ...

pain management

FDA Approves Extended-Release Morphine Product Formulated With Abuse-Deterrent Properties

On January 9, the U.S. Food and Drug Administration (FDA) ap­proved morphine sulfate extended-­release tablets with abuse-deterrent properties (Arymo ER), a C-II drug for the management of pain severe enough to require daily, around-the-clock, long-term opioid treatment and for which alternative...

hematologic malignancies
symptom management

Ibrutinib: A Potential Option for Chronic Graft-vs-Host Disease?

Currently, there is no U.S. Food and Drug Administration (FDA)-approved therapy for chronic graft-vs-host disease—a life-threatening consequence of stem cell or bone marrow transplant—that has not responded to corticosteroids, but this may be about to change. Ibrutinib (Imbruvica) achieved...

head and neck cancer

Vanderbilt Study to Explore Lymphedema Self-Care for Head and Neck Cancer Survivors

Vanderbilt University School of Nursing Assistant Professor Jie Deng, PhD, RN, has been awarded a $789,000 research scholar grant by the American Cancer Society to develop and test a self-care program for head and neck cancer survivors diagnosed with secondary lymphedema/fibrosis....

gynecologic cancers

Niraparib Maintenance Improves Progression-Free Survival in Platinum-Sensitive Recurrent Ovarian Cancer

In a phase III trial (ENGOT-OV16/NOVA) reported at the 2016 ESMO (European Society for Medical Oncology) Congress and in The New England Journal of Medicine by Mansoor R. ­Mirza, MD, of the Rigshospitalet–Copenhagen University Hospital, and colleagues, maintenance therapy with the PARP (poly...

leukemia

Safety of Stopping Imatinib in CML With Undetectable Minimal Residual Disease for at Least 2 Years

As reported in the Journal of Clinical Oncology by Gabriel Etienne, MD, PhD, of the Institut Bergonié, Bordeaux, and colleagues, long-term follow-up in the French Stop Imatinib (STIM1) study indicates that imatinib can be safely stopped in patients with chronic myeloid leukemia (CML) with...

head and neck cancer

Nivolumab Improves Overall Survival in Recurrent Platinum-Refractory Squamous Cell Carcinoma of the Head and Neck

In the phase III CheckMate 141 trial reported in The New England Journal of Medicine, Robert L. Ferris, MD, PhD, of the University of Pittsburgh Medical Center and Cancer Institute, and colleagues found that nivolumab (Opdivo) increased overall survival vs standard therapies in patients with...

lymphoma

Brentuximab Vedotin Plus Nivolumab Highly Active in Relapsed Classical Hodgkin Lymphoma

Response rates of 90% to 100% were achieved in early studies evaluating the combination of brentuximab vedotin (Adcetris) and nivolumab (Opdivo) in relapsed or refractory classical Hodgkin lymphoma. The findings were presented at the 2016 American Society of Hematology (ASH) Annual Meeting &...

lymphoma

CAR T-Cell Therapy KTE-C19 Appears Successful in Aggressive B-Cell Lymphoma

Chimeric antigen receptor (CAR) T-cell therapy continues to have impressive showings in patients with aggressive hematologic malignancies and no other good treatment options. Interim results of the pivotal phase II ZUMA-1 trial, the first multicenter trial of the experimental CAR T-cell therapy...

breast cancer

Selected Abstracts From the 2016 San Antonio Breast Cancer Symposium

Each year, The ASCO Post asks Jame Abraham, MD, Director of the Breast Oncology Program at Taussig Cancer Institute and Co-Director of the Cleveland Clinic Comprehensive Breast Cancer Program, to give his picks for the most important research presented at the San Antonio Breast Cancer Symposium....

breast cancer

Pertuzumab, Trastuzumab, Plus Aromatase Inhibitor Beneficial in Metastatic Breast Cancer

In the phase II PERTAIN study of locally advanced or metastatic hormone receptor–positive, HER2-positive breast cancer patients, the addition of pertuzumab (Perjeta) to a regimen of trastuzumab (Herceptin) and an aromatase inhibitor in the first-line setting significantly improved progression-free ...

gastroesophageal cancer
gastrointestinal cancer

2017 GI Cancers Symposium: Nivolumab Demonstrated Efficacy and Improved Survival in Patients With Previously Treated Advanced Gastric Cancer

Results of the ONO-4538-12 trial demonstrated that nivolumab (Opdivo) significantly reduced the risk of death by 37% (hazard ratio [HR] = 0.63; P < .0001) in patients with previously treated advanced gastric cancer refractory to or intolerant of standard therapy, a condition without current ...

breast cancer

Novel Antibody-Drug Conjugate Targets Triple-Negative Breast Cancer

The antibody-drug conjugate sacituzumab govitecan (IMMU-132) produced high objective response rates, many of them quite durable, in a multicenter study of heavily pretreated patients with metastatic triple-negative breast cancer, presented at the 2016 San Antonio Breast Cancer Symposium.1 Trop-2 is ...

leukemia

Lenalidomide Maintenance Extends Progression-Free Survival in CLL

Lenalidomide (Revlimid), a cornerstone of therapy for multiple myeloma in the modern era, is making headway as maintenance therapy in chronic lymphocytic leukemia (CLL). Separate phase III studies presented at the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition showed...

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