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Study Sheds Light on Need for Optimal Dosing Standards for Patients With Metastatic Cancer

A new study, published recently in JCO Oncology Practice, found that oncologists have different perspectives on how to select starting doses for patients with metastatic cancer.1 The study shared findings from a 2021 international survey of 367 medical oncologists who treat patients with metastatic ...

prostate cancer

ASCO Treatment Guidance for Metastatic Castration-Resistant Prostate Cancer Updated to Include LuPSMA

An updated ASCO guideline recommends lutetium-177–labeled PSMA-617 (LuPSMA), a targeted radioligand therapy, for patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer who have been treated with one prior line of androgen receptor pathway...

skin cancer
immunotherapy

Expert Point of View: Ignacio Melero, MD, PhD

Ignacio Melero, MD, PhD, Professor of Immunology and Co-Director of the Department of Immunology and Immunotherapy at the Clinica Universidad de Navarra in Spain, was the invited discussant of the M14TIL study. He noted that a 50% relative reduction in the risk of disease progression is impressive...

skin cancer
immunotherapy

Prolonging Remission in Anti–PD-1 Refractory Melanoma With Tumor-Infiltrating Lymphocyte Therapy

For the first time in a multicenter randomized trial, T-cell therapy has been shown to improve outcomes in a solid tumor. In the phase III M14TIL trial, first-line or second-line treatment with tumor-infiltrating lymphocytes (TIL) led to a 50% reduction in disease progression or death from advanced ...

breast cancer

Expert Point of View: Meritxell Bellet Ezquerra, MD, PhD, and Sung-Bae Kim, MD, PhD

The MONARCH 3 study’s invited discussant, Meritxell Bellet Ezquerra, MD, PhD, a senior researcher at the Vall d’Hebron Institute of Oncology in Barcelona, commented: “The second interim analysis for overall survival in MONARCH 31 indicates a positive trend, which was also observed for the subgroup...

cost of care

Multilayered Approach to Financial Toxicity Solutions for Patients With Cancer and Their Families

With out-of-pocket costs of cancer care exceeding $21 billion in 2019, financial toxicity among patients and their families in the United States has become too prevalent to ignore. In fact, more than 50% of working-age survivors now report at least one material, psychological, or behavioral domain...

HPV Vaccine ‘Works Astonishingly Well’

The human papillomavirus (HPV) vaccine “works astonishingly well. It really prevents the kind of infections that cause cancer,” commented Ruanne Barnabas, MBChB, MSc, DPhil, MD, PhD, in an interview with The ASCO Post. “Other viral infections are difficult to protect against, or there might be...

gynecologic cancers
global cancer care

Global Effort to Eliminate Cervical Cancer: HPV Vaccinations Are Steadily Increasing in the United States, but Barriers Still Exist

To achieve its goal of eliminating cervical cancer, the World Health Organization (WHO) is calling on all countries “to reach and maintain an incidence rate of below 4 per 100,000 women.” Doing so would depend on the following: A total of 90% of girls being fully vaccinated against human...

leukemia

The Evolving Role of PI3K Inhibitors in Double-Refractory CLL

The treatment paradigm for chronic lymphocytic leukemia (CLL) continues to evolve in the first-line setting and beyond, with the availability of Bruton’s tyrosine kinase (BTK) inhibitors, the BCL2 inhibitor venetoclax, and novel combinations of these agents with anti-CD20 monoclonal antibodies....

leukemia

With Newer Therapies, AML Diagnosis and Prognosis Evolve

For many years, treatment options for acute myeloid leukemia (AML) were limited mainly to the 7 + 3 regimen. However, more recently, a mini-explosion of AML therapies aimed at newly identified genetic targets makes discussions about treatment of this disease much more complicated. In fact, these...

lymphoma
immunotherapy

High-Dose Chemotherapy and Stem Cell Transplant vs CAR T-Cell Therapy for Resistant DLBCL

Which is the preferred second-line treatment option for patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL): high-dose chemotherapy and autologous stem cell transplantation (ASCT) or chimeric antigen receptor (CAR) T-cell therapy? This was the subject of a debate at the...

issues in oncology

New Directions for Cancer Care: Major Trends in U.S. Health Policy

The pace of cancer drug development may have accelerated over the past decade, but so too has the cost of care, which threatens to limit access for a large percentage of Americans in the decade to come. During the keynote lecture at the 2022 ASCO Quality Care Symposium, Ezekiel J. Emanuel, MD, PhD, ...

pain management

Integrative Approaches to Managing Pain in Patients With Cancer: SIO-ASCO Guideline

Pain is highly prevalent in people with cancer throughout the disease trajectory. Often persisting for years after initial diagnosis and undertreated, it is associated with poor functional, mental, and cancer-related outcomes.1 Consequently, the need for effective pain management strategies has...

lung cancer
genomics/genetics

Sotorasib: A New Standard of Care for Second- or Third-Line Treatment of KRAS G12C–Mutated NSCLC?

The KRAS G12C inhibitor sotorasib doubled the rate of progression-free survival at 12 months and reduced the risk of disease progression or death by 34% compared with standard second-line docetaxel for patients with previously treated non–small cell lung cancer (NSCLC) and KRAS G12C mutations....

breast cancer

Study Finds Nearly Half of Black Women With Metastatic Breast Cancer Never Receive Information About Clinical Trial Participation

When Stephanie L. Walker, RN, was diagnosed with metastatic breast cancer in 2015, she was not given information about an appropriate clinical trial or help navigating her way through the financial difficulties she was having after a stroke from complications of the cancer forced her to leave her...

issues in oncology

How to Advance Antiracist Approaches to Patient Engagement in AYA Oncology and Research

Among the topics discussed at the 4th Global Adolescent and Young Adult Cancer Congress held online in December 2021 was the urgent need for clinicians, researchers, and advocates in adolescent and young adult (AYA) oncology to join forces to eradicate racist approaches to patient engagement in...

leukemia

Newly Diagnosed AML: Induction to Maintenance

When it is dark enough, you can see the stars.” —Ralph Waldo Emerson Low-intensity therapy for older or unfit patients with acute myeloid leukemia (AML) was introduced in the early 2000s in the form of low-dose cytarabine or hypomethylation therapy (azacitidine or decitabine). Recent studies...

lymphoma

‘TRANSFORMING’ Our Thinking About Second-Line Therapy for High-Risk Large B-Cell Lymphoma: Bring in the CARs

As reported in The Lancet by Kamdar et al,1 and summarized in this issue of The ASCO Post, the international phase III TRANSFORM trial was completed in 184 patients with primary refractory or early (≤ 12 months) relapsed large B-cell lymphoma (LBCL). Patients were randomly assigned to receive...

sarcoma

Shorter Course of Hypofractionated Radiation Therapy Yields Comparable Results to Conventional Radiotherapy for Patients With Nonmetastatic Soft-Tissue Sarcoma

Patients with nonmetastatic soft-tissue sarcoma who need preoperative radiation therapy can safely receive hypofractionated treatment for 3 weeks instead of 5 weeks, with comparable tumor control and no increased risk of major complications in wound healing, according to a new study published by...

head and neck cancer
survivorship

Some Head and Neck Cancer Survivors May Be at Greater Risk for Long-Term Gastrostomy Tube Use

A small subset of patients who have undergone treatment for head and neck cancer may require a gastrostomy tube many years into survivorship, according to a new study published by Galloway et al in the International Journal of Radiation Oncology, Biology, and Physics. The findings were also...

genomics/genetics

Phase I Trial Shows Experimental Mini-Protein May Be Able to Inhibit the Cancer-Driving MYC Gene

Researchers have found that a new drug may be able to target—and for the first time, inhibit—the function of the MYC gene. Until now, no other drug has been able to do this safely and effectively, according to findings from a phase I clinical trial published by Garralda et al in the European...

head and neck cancer
immunotherapy

Indian Trial Explores Addition of Low-Dose Nivolumab to Chemotherapy in Advanced Head and Neck Cancer

In an Indian single-center phase III trial reported in the Journal of Clinical Oncology, Vijay Patil, MBBS, MD, DM, and colleagues found that the addition of low-dose nivolumab to triple metronomic chemotherapy significantly improved overall survival in patients with newly diagnosed or recurrent...

prostate cancer

Sequencing of Short-Duration ADT With Radiotherapy in Nonmetastatic Prostate Cancer

In a pooled analysis (SANDSTORM) reported in the Journal of Clinical Oncology, Ma et al found that concurrent/adjuvant short-term androgen-deprivation therapy (ADT) with prostate-only radiotherapy (PORT) was associated with better outcomes in multiple measures vs neoadjuvant/concurrent ADT with...

lymphoma

PET-Adapted Therapy for Bulky Stage I/II Classical Hodgkin Lymphoma

As reported in the Journal of Clinical Oncology by Ann S. LaCasce, MD, MMSc, and colleagues, the phase II CALGB 50801/Alliance trial has shown that a positron-emission tomography (PET)-adapted treatment strategy allowed many patients with bulky stage I/II classical Hodgkin lymphoma to avoid...

breast cancer

Avoidance of Surgery in Patients With Invasive Breast Cancer and Exceptional Response to Neoadjuvant Systemic Therapy

In a phase II trial reported in The Lancet Oncology, Henry Kuerer, MD, PhD, FACS, and colleagues found radiotherapy alone among women with triple-negative or HER2-positive invasive breast cancer who had pathologic complete response on percutaneous image-guided, vacuum-assisted core biopsy (VACB)...

lung cancer
genomics/genetics

Repotrectinib for ROS1-Positive NSCLC Examined in Phase I/II TRIDENT-1 Trial

Early trials of the targeted oral drug repotrectinib discovered that it may help treat patients with a certain type of non–small cell lung cancer (NSCLC), according to a new study published by Cho et al in the European Journal of Cancer. The results of the TRIDENT-1 trial—presented at the 34th...

lung cancer

Preliminary Results From ARROS-1 Phase I Clinical Trial Suggest That NVL-520 May Be Well Tolerated and Active in NSCLC

Preliminary data from a phase I clinical trial of the ROS1 inhibitor NVL-520 to treat patients with non–small cell lung cancer (NSCLC) and other solid tumors suggested that it may have the potential to both halt tumor growth by inhibiting a cancer-causing gene change and reach cancer cells within...

hematologic malignancies

Cell-Free DNA Profiling in Patients With Advanced Cancers May Lead to Early Detection of Myeloid Malignancies

Researchers have found that an incidental finding of clonal hematopoiesis in liquid biopsies can be used to trigger hematologic tests to assess the risk of developing myeloid malignancies, according to a new study published by Tagliamento et al in the European Journal of Cancer. The findings were...

genomics/genetics
solid tumors

Sequential Dosing of Olaparib and Adavosertib in Patients With Advanced Tumors

Olaparib and adavosertib can be safely used to treat patients with cancers that are driven by certain mutations occurring in response to DNA damage if they are given in sequence rather than concurrently, according to a novel study published by Yap et al in the European Journal of Cancer. The...

genomics/genetics
cns cancers

Researchers Identify Specific Mutations in the BRAF Gene That May Affect Response to Treatment and Survival in Adult Brain Cancers

Researchers have identified a range of genetic mutations in gliomas that may help them understand how different mutations in the BRAF gene interact with other gene mutations—and which ones are more susceptible to targeted treatments in adults—according to a new study published by Schreck et al in...

Expert Point of View: Glenn J. Hanna, MD and Sherene Loi, MD, PhD

The ASCO Post asked for comment from Glenn J. Hanna, MD, Director of the Center for Salivary and Rare Head and Neck Cancers, Dana-Farber Cancer Institute, and Assistant Professor of Medicine at Harvard Medical School. Dr. Hanna said it is important to put the findings of KEYNOTE-4121 into context...

head and neck cancer

Pembrolizumab Plus Chemoradiation Therapy Falls Short in Locally Advanced Head and Neck Cancer

Pembrolizumab plus chemoradiation therapy failed to demonstrate a statistically significant improvement in event-free survival vs chemoradiation therapy alone in patients with locally advanced head and neck squamous cell carcinoma, but favorable numerical trends were demonstrated, according to...

solid tumors

DeFi Trial: Novel Gamma Secretase Inhibitor Halts Progression of Desmoid Tumors

Patients with rare desmoid tumors may finally have an effective treatment. A first-in-class gamma secretase inhibitor, nirogacestat, led to an improvement in progression-free survival in the phase III DeFi trial. The results were presented during the Presidential Symposium at the European Society...

skin cancer
immunotherapy

SWOG S1801: Addition of Neoadjuvant Pembrolizumab to Adjuvant Pembrolizumab Yields Benefits in High-Risk Resectable Melanoma

In resectable stage III to IV melanoma, three cycles of neoadjuvant pembrolizumab followed by adjuvant pembrolizumab was significantly more beneficial than adjuvant pembrolizumab alone, based on the results of the phase II SWOG S1801 trial presented in a Presidential Symposium at the European...

Expert Point of View: Robin Kate Kelley, MD

Robin Kate Kelley, MD, Professor of Clinical Medicine at the University of California, San Francisco, was invited to discuss the results of LEAP-002.1 She said the main take-away is that lenvatinib monotherapy is active as a preferred first-line agent for fit patients who have contraindications to ...

hepatobiliary cancer

Lenvatinib Plus Pembrolizumab in Hepatocellular Carcinoma: LEAP-002 Fails to Meet Co-primary Endpoints

The highly anticipated final analysis of the phase III LEAP-002 trial failed to meet expectations, as first-line treatment with lenvatinib plus pembrolizumab did not significantly improve outcomes in unresectable advanced hepatocellular carcinoma. Both progression-free survival and overall survival ...

Expert Point of View: James Larkin, PhD and Andrea Cercek, MD

Invited discussant James Larkin, PhD, a clinical researcher at the Royal Marsden Hospital, London, commented on the findings from NICHE-2.1 “These striking data are consistent with the recent report in locally advanced mismatch repair–deficient [dMMR] rectal cancer from Memorial Sloan Kettering.2...

colorectal cancer

NICHE-2: ‘Unprecedented’ Waterfall Plot Achieved With Neoadjuvant Immunotherapy in dMMR Colon Cancer

Treatment with neoadjuvant immunotherapy in colon cancer resulted in major pathologic responses in 95% of patients, NICHE-2 investigators reported at the European Society for Medical Oncology (ESMO) Congress 2022.1 Additionally, after 4 weeks of nivolumab plus ipilimumab, 67% of patients with...

Expert Point of View: Bernard Escudier, MD and Brian I. Rini, MD

To put the CheckMate 914, IMmotion010, and PROSPER trials into context, The ASCO Post spoke with Bernard Escudier, MD, former Chair of the Genitourinary Group of the Institut Gustave Roussy, Villejuif, France. In general, Dr. Escudier believes that studies to date are not robust enough to justify...

kidney cancer

Negative Phase III Trials May Dampen Enthusiasm for Immunotherapy in the Adjuvant Setting in Kidney Cancer

Three negative phase III trials presented at the European Society for Medical Oncology (ESMO) Congress 2022 may dampen enthusiasm for immunotherapy as adjuvant therapy for renal cell carcinoma (RCC). None of the three trials—CheckMate 914, IMmotion010, and PROSPER—met its primary endpoint.1-3 The...

Expert Point of View: Sumanta K. Pal, MD, FASCO

“Hats off to the investigators for the first comparison of triplet to doublet in advanced renal cell carcinoma. This is also the first results using a contemporary control group. The study met its primary endpoint,” said Sumanta K. Pal, MD, FASCO, Co-Director of the Kidney Cancer Program, City of...

kidney cancer
immunotherapy

COSMIC-313: Triplet Therapy Is Active in Renal Cell Carcinoma, but Toxicities Pose a Challenge

The addition of cabozantinib to nivolumab plus ipilimumab prolonged progression-free survival in untreated intermediate-risk patients with advanced renal cell carcinoma (RCC), according to the first results of the phase III COSMIC-313 trial. These findings were presented as a Presidential Symposium ...

Expert Point of View: Natasha Leighl, MD

“Platinum-ineligible patients are typically excluded from clinical trials, yet they represent the majority of patients that we diagnose and treat—patients with poor performance status and comorbidities,” said invited discussant Natasha Leighl, MD, of the Princess Margaret Cancer Centre, Toronto....

lung cancer

IPSOS Trial: Platinum-Ineligible Patients With NSCLC May Gain Survival Benefit From Atezolizumab Therapy

In platinum-ineligible patients with advanced non–small cell lung cancer (NSCLC), first-line treatment with the PD-L1 checkpoint inhibitor atezolizumab improved overall survival by an absolute value of about 1 month but almost doubled the rate of 2-year overall survival compared with chemotherapy...

lung cancer

Sotorasib: A New Standard of Care for Second- or Third-Line Treatment of KRAS G12C–Mutated NSCLC?

The KRAS G12C inhibitor sotorasib doubled the rate of progression-free survival at 12 months and reduced the risk of disease progression or death by 34% compared with standard second-line docetaxel for patients with previously treated non–small cell lung cancer (NSCLC) and KRAS G12C mutations....

colorectal cancer

The NordICC Trial: The Devil Is in the Details

Colorectal cancer ranks third among cancer deaths in both men and women in the United States, with an estimated 106,000 new cases and 52,000 deaths anticipated in 2022.1 Colorectal cancer rates have declined by approximately 2% per year from 2014 to 2018 in people over the age of 50 years, which is ...

solid tumors

Highlights From the ESMO Congress 2022

At this year’s European Society for Medical Oncology (ESMO) Congress, we experienced an eagerly awaited return to normality (or almost), and the quality of the science on display was anything but disappointing: from molecular medicine to treatment de-escalation, from early cancer detection and...

gynecologic cancers
immunotherapy

Researchers Discover Differences in Response to Pembrolizumab Among Patients With Endometrial Cancer

Researchers discovered a differential clinical response to pembrolizumab in patients with Lynch-like (mutated) vs methylated microsatellite instability–high endometrial cancer, outlining characteristics of patients who may derive benefit from immune checkpoint blockade antibodies, according to new...

prostate cancer

PSA Screening Rates and Incidence of Metastatic Prostate Cancer at VHA Facilities

In a retrospective cohort study reported in JAMA Oncology, Bryant et al found that prostate-specific antigen (PSA) screening rates at Veterans Health Administration (VHA) facilities declined between 2005 and 2019—and that diagnoses of metastatic prostate cancer increased over the same time period....

genomics/genetics

Genomic Microsatellite Signature Assay to Identify Germline MMRD in Patients With CMMRD

In an analysis reported in the Journal of Clinical Oncology, Chung et al described the performance of a newly developed assay using genomic microsatellite signatures (LOGIC; low-pass genomic instability characterization) in detecting germline mismatch repair deficiency (MMRD) in patients with the...

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