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solid tumors
issues in oncology

Cancer at Baseline Screening in Patients With Li-Fraumeni Syndrome

In a new study from the National Cancer Institute (NCI), researchers found a higher-than-expected prevalence of cancer at baseline screening in individuals with Li-Fraumeni syndrome, a rare inherited disorder that leads to a higher risk of developing certain cancers. The research demonstrates...

lung cancer

Alectinib: A New Standard for First-Line Therapy of ALK-Rearranged NSCLC?

ANAPLASTIC LYMPHOMA KINASE (ALK) was first identified in anaplastic large cell lymphoma. The ALK gene itself is not oncogenic, but it can become oncogenic by at least three mechanisms: by forming a fusion gene with a number of other partner genes, by copy number gain, or by mutations in the gene....

Sai Yendamuri, MD, FACS, Receives 2017 Brompton Prize

SAI YENDAMURI, MD, FACS, Chair of the Department of Thoracic Surgery at Roswell Park Cancer Institute, received the prestigious Brompton Prize at a recent international gathering of thoracic surgeons. The award, given by the European Society of Thoracic Surgeons, is for the year’s best thoracic...

lung cancer

Sacituzumab Govitecan in Metastatic NSCLC

As reported by Rebecca Suk Heist, MD, MPH, of Massachusetts General Hospital, and colleagues in the Journal of Clinical Oncology, the antibody-drug conjugate sacituzumab govitecan showed activity in patients with previously treated metastatic non–small cell lung cancer (NSCLC). Sacituzumab targets ...

lung cancer

FDA Grants Alectinib Priority Review for Initial Treatment of ALK-Positive Lung Cancer

Today, the U.S. Food and Drug Administration (FDA) accepted Genentech’s supplemental New Drug Application (sNDA) and granted Priority Review for alectinib (Alecensa) as a first-line treatment for people with anaplastic lymphoma kinase (ALK)-positive, locally advanced, or metastatic...

lung cancer

Osimertinib Improves Progression-Free Survival for EGFR-Positive NSCLC in the Phase III FLAURA Trial

On July 27, it was announced that the phase III FLAURA trial showed a statistically significant and clinically meaningful progression-free survival benefit with osimertinib (Tagrisso) compared to current first-line standard-of-care treatment (erlotinib [Tarceva] or gefitinib [Iressa]) in previously ...

health-care policy

FDA Announces Comprehensive Regulatory Plan to Shift Trajectory of Tobacco-Related Disease, Death

On July 28, the U.S. Food and Drug Administration (FDA) announced a new comprehensive plan for tobacco and nicotine regulation that will serve as a multiyear roadmap to better protect children and significantly reduce tobacco-related disease and death. The approach places nicotine and the issue of...

breast cancer

One Size May Not Fit All: Thoughts on the New Adjuvant Bisphosphonate Guideline for Early-Stage Breast Cancer

The oncology community has now conducted several prospectively designed, hypothesis-driven randomized clinical trials among women with breast cancer to address this question: Do adjuvant bisphosphonates decrease the risk of breast cancer bone metastases and other recurrence? A meta-analysis1 by...

genomics/genetics

Convergence of Precision Medicine and Immuno-oncology

“THE CONVERGENCE of two very hot and interesting topics—precision medicine and immuno-oncology”—is being advanced by next-generation sequencing, Douglas B. Johnson, MD, MSCI, made clear at the inaugural OncoSET Symposium: Emerging Approaches to Precision Medicine,” sponsored by the Robert H. Lurie ...

sarcoma
cns cancers
lymphoma
survivorship

In Case You Missed It: Short Takes on Current Cancer Research

MOST ONCOLOGISTS are familiar with the findings of the plenary sessions featured at the 2017 ASCO Annual Meeting, with topics ranging from the duration of adjuvant oxaliplatin-based therapy in stage III colon cancer to patient-reported outcomes for symptom monitoring during routine cancer...

issues in oncology
solid tumors

FDA’s First Site-Agnostic Drug Approval Marks a Paradigm Shift in Regulatory Criteria

IN MAY, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for patients with solid tumors that have the microsatellite instability–high (MSI-H) or mismatch repair deficient (dMMR) biomarker, which disrupts the ability of cells to repair DNA. The...

issues in oncology

Tissue Specimens in Clinical Trials: A Double-Edged Sword

AN INCREASING number of clinical trials require the submission of tissue specimens, either from archived specimens or increasingly from fresh biopsies taken after enrollment into the trial. These specimens can be either mandatory, required to determine whether a given patient has the required...

breast cancer

A New Triumvirate in Estrogen Receptor–Positive Metastatic Breast Cancer

THE BODY OF EVIDENCE supporting the use of cell-cycle inhibitors in combination with endocrine therapy for estrogen receptor–positive metastatic breast cancer now has another agent in the spotlight. The phase III MONARCH 2 trial—reported at the 2017 ASCO Annual Meeting and by Sledge et al in the...

lung cancer

FDA Grants Durvalumab Breakthrough Therapy Designation for Patients With Locally Advanced Unresectable NSCLC

On July 31, AstraZeneca and MedImmune (AstraZeneca’s global biologics research and development arm) announced that the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy designation for durvalumab (Imfinzi) for the treatment of patients with locally advanced,...

lung cancer

Initial Progression-Free Survival Results From the MYSTIC Trial in Stage IV NSCLC

On July 27, researchers announced the progression-free survival (PFS) results for the phase III MYSTIC trial, a randomized, open-label, multicenter, global trial of durvalumab (Imfinzi) monotherapy or durvalumab in combination with tremelimumab vs platinum-based standard-of-care chemotherapy in...

solid tumors

NCI-COG Pediatric MATCH Trial to Test Targeted Drugs in Childhood Cancers

Today, investigators at the National Cancer Institute (NCI) and the Children’s Oncology Group (COG) announced the opening of enrollment for a unique precision medicine clinical trial. NCI-COG Pediatric Molecular Analysis for Therapy Choice (Pediatric MATCH) is a nationwide trial to explore...

lung cancer

Concurrent Chemotherapy, Proton Therapy May Improve Survival in Patients With Advanced Lung Cancer

For patients with advanced, inoperable stage III lung cancer, concurrent chemotherapy and proton-beam radiotherapy offers improved survival compared to historical data for standard of care, according to a new study from The University of Texas MD Anderson Cancer Center. The research, published by...

breast cancer

Neoadjuvant Ado-trastuzumab Emtansine vs Trastuzumab in Early HER2-Positive, HR-Positive Breast Cancer

A West German Study Group phase II trial, reported by Harbeck et al in the Journal of Clinical Oncology, has shown a higher pathologic complete response rate with neoadjuvant ado-trastuzumab emtansine (formerly known as T-DM1; Kadcyla) with or without endocrine therapy vs trastuzumab (Herceptin)...

head and neck cancer

Pembrolizumab and Cetuximab-Treated Head and Neck Cancer: Activity Confirmed But No Surprises

WITH THE RECENT efficacy findings, improvements in survival, and resultant U.S. Food and Drug Administration (FDA) approvals of programmed cell death protein 1 (PD-1) immune checkpoint inhibitors across multiple solid tumor indications, the publication of yet another positive trial adds to the...

bladder cancer

Pembrolizumab in Second-Line Therapy for Advanced Urothelial Carcinoma

THE TREATMENT OF metastatic urothelial carcinoma experienced a long period of stagnation until the recognition that targeting the programmed cell death protein 1 (PD-1) pathway could yield deep and durable responses.1-3 Cisplatin-based combination chemotherapy has been the reference standard for...

breast cancer
cns cancers

Breast Cancer and Brain Metastases: Whole-Brain Radiotherapy May Not Be the Answer

FOR PATIENTS WITH BREAST CANCER who have metastases to the central nervous system (CNS), clinicians should think twice before administering whole-brain radiotherapy, according to Kimberly Blackwell, MD, Professor of Medicine and Assistant Professor of Radiation Oncology at Duke University Medical...

supportive care

Are Wearable Physical Activity Monitors Coming of Age in Oncology?

COMMERCIALLY AVAILABLE wearable physical activity monitors have been making their way into clinical research in recent years; however, most studies on these devices have been related to non-cancer conditions including obesity, depression, and physical activity. Their application in the field of...

symptom management

Radiation Therapy for Spinal Cord Compression: One Treatment Is Sufficient

SPINAL CORD COMPRESSION associated with metastatic cancer can be effectively treated with a single dose of radiotherapy, according to the results of a phase III British study that showed multiple radiotherapy doses to be no better than one treatment.1  Up to 10% of all patients with cancer will...

health-care policy

Maintaining Predictable Increases in NIH Funding for Cancer Research

CONGRESS RECENTLY passed its fiscal year (FY) 2017 spending bill, which contains an additional $2 billion for the National Institutes of Health (NIH). This marks the first time in more than a dozen years that Congress funded back-to-back increases for the NIH, demonstrating the bipartisan...

Edus H. Warren, MD, PhD, Named Leader of Fred Hutch Global Oncology Program

Immunotherapy researcher and oncologist Edus H. Warren, MD, PhD, has been selected to lead the Fred Hutchinson Cancer Research Center (Fred Hutch) program in Global Oncology in its effort to transform cancer care in sub-Saharan Africa, China, and other regions by providing greater access to the...

supportive care
palliative care

Advance Care Planning: Ensuring Patients’ End-of-Life Wishes Are Honored

When Amy Berman, BSN, LHD (aged 58), stood in front of the mirror to perform a routine breast self-exam and saw redness and dimpling on her right breast, she feared they were the telltale signs of inflammatory breast cancer. “I have never self-diagnosed myself before, but I had recently read an...

solid tumors
issues in oncology

ASTRO Updates Insurance Coverage Recommendations for Proton Therapy

The American Society for Radiation Oncology (ASTRO) has issued an update to its recommendations for medical insurance coverage regarding the use of proton beam therapy to treat cancer. The updated Proton Beam Therapy Model Policy provides guidance to payers on clinical indications that are...

Impact of Health Insurance and Sociodemographic Status on Survival for AYAs With Cancer

According to the National Cancer Institute, cancer is the leading cause of disease-related death among adolescents and young adults (AYAs) between the ages of 15 and 39. And although cancer survival among this age group is more than 80%, AYAs have not experienced the same improvements in relative...

lung cancer

FDA Approves First Companion Diagnostic Test to Simultaneously Screen for Multiple NSCLC Therapies

On June 22, the U.S. Food and Drug Administration (FDA) granted premarket approval to Thermo Fisher Scientific for the first next-generation sequencing–based test that simultaneously screens tumor samples for biomarkers associated with three FDA-approved therapies for non–small cell...

pancreatic cancer

Has a New Standard Really Been Established for the Adjuvant Treatment of Pancreatic Cancer?

THE PAST YEAR has undoubtedly been a disappointing one as far as clinical advances in pancreatic cancer go. No fewer than five high-profile randomized phase II or III trials in this setting reported negative results in 2016, ranging from next-generation cytotoxic agents1 to novel immunotherapeutic ...

geriatric oncology

Preparing for Future Challenges in Geriatric Surgical Oncology

In the past decade, advances in surgical oncology have been echoed in the field of geriatric oncology. The current literature regarding older people with cancer includes mainly retrospective cohort studies, focusing on alternatives to radical surgery in comorbid patients. More recently, work has...

issues in oncology
survivorship

Second Cancers May Be Deadlier in Child, Adolescent, and Young Adult Patients

Second cancers in children and adolescents and young adults (AYAs) are far deadlier than they are in older adults and may partially account for the relatively poor outcomes of cancer patients between the ages of 15 and 39 overall, a new study by researchers at the University of California, Davis...

hematologic malignancies

Autologous and Allogeneic Hematopoietic Cell Transplantation

HERE ARE SEVERAL ABSTRACTS selected from the proceedings of the 2016 American Society of Hematology (ASH) Annual Meeting & Exposition, highlighting clinical trials on autologous and allogeneic hematopoietic cell transplantation for various hematologic malignancies. Additional selected...

breast cancer

Potent PARP Inhibitor Moves Ahead in BRCA-Mutated Breast Cancer

TALAZOPARIB, a novel inhibitor of poly (ADP-ribose) polymerase (PARP), showed encouraging efficacy in breast cancer patients with BRCA1/2 mutations in the phase II ABRAZO trial, presented at the 2017 ASCO Annual Meeting by Nicholas C. Turner, MD, of the Royal Marsden Hospital and The Institute of...

lung cancer

Retreatment With Checkpoint Inhibitors May Be Feasible for Some Patients With NSCLC

INCREASING NUMBERS of patients are being treated with checkpoint inhibitors, and about one-quarter to one-third will develop immune-related adverse events. One question on the minds of oncologists is can these patients be safely re-treated once their adverse events resolve?  One of the first...

lung cancer

Expert Point of View: John Heymach, MD

"TO PUT THESE RESULTS into context, currently we have three approved epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors for EGFR-positive non–small cell lung cancer (NSCLC): gefitinib (Iressa), erlotinib (Tarceva), and afatinib (Gilotrif). Not many studies have compared these drugs ...

lung cancer

Dacomitinib Outperforms Gefitinib in EGFR-Positive NSCLC

DACOMITINIB, a second-generation epidermal growth factor receptor (EGFR)-targeted tyrosine kinase inhibitor, outperformed gefitinib (Iressa) as first-line treatment for EGFR-positive advanced non–small cell lung cancer (NSCLC) in the phase III ARCHER 1050 study.1 Dacomitinib improved...

issues in oncology

Annual Report to the Nation: Cancer Death Rates Continue to Decline

Overall cancer death rates continue to decrease in men, women, and children for all major racial and ethnic groups, according to the latest Annual Report to the Nation on the Status of Cancer, 1975–2014, published by Jemal et al in the Journal of the National Cancer Institute.1 The report finds...

colorectal cancer

FDA Approves Panitumumab for Use in Wild-Type RAS Metastatic Colorectal Cancer

On June 30, 2017, the U.S. Food and Drug Administration (FDA) approved the supplemental Biologics License Application (sBLA) for panitumumab (Vectibix) for patients with wild-type RAS (defined as wild-type in both KRAS and NRAS as determined by an FDA-approved test for this use) metastatic...

leukemia

Idelalisib in Resistant CLL: Benefit Shown, Questions Remain

As reported in The Lancet Oncology by Dr. Andrew Zelenetz and colleagues and reviewed in this issue of The ASCO Post, an international phase III trial in 416 patients with refractory or recurrent chronic lymphocytic leukemia (CLL) addressed the benefit of adding the first-in-class phosphoinositide...

hematologic malignancies
leukemia
lymphoma
myelodysplastic syndromes

FDA Allows Marketing of Test to Aid in the Detection of Certain Leukemias and Lymphomas

On June 29, the U.S. Food and Drug Administration (FDA) allowed marketing of ClearLLab Reagents (T1, T2, B1, B2, M), the first agency-authorized test for use with flow cytometry to aid in the detection of several leukemias and lymphomas, including chronic leukemia, acute leukemia, non-Hodgkin...

lung cancer

European Commission Expands Use of Ceritinib for First-Line Use in ALK-Positive Advanced NSCLC

On June 29, the European Commission approved expanding the use of ceritinib (Zykadia) to include the first-line treatment of patients with advanced non–small cell lung cancer (NSCLC) whose tumors are anaplastic lymphoma kinase (ALK)–positive. Approval follows a positive opinion granted...

lung cancer

First-Line Nivolumab vs Chemotherapy in Advanced NSCLC With PD-L1 Expression ≥ 5%

As reported by Carbone et al in The New England Journal of Medicine, the phase III CheckMate 026 trial has shown no progression-free survival benefit for first-line nivolumab (Opdivo) vs platinum-based chemotherapy in patients with recurrent or stage IV non–small cell lung cancer with...

lymphoma

EHA 2017: The DYNAMO Study: Duvelisib in Double-Refractory Follicular Lymphoma and Small Lymphocytic Lymphoma

Long-term follow-up data from the DYNAMO study, which met its primary endpoint of overall response rate (ORR; P = .0001) at the final analysis, was presented at the 22nd Congress of the European Hematology Association (EHA) (Abstracts S777, E1130).  DYNAMO is a phase II clinical study...

lung cancer

FDA Grants Regular Approval to Dabrafenib and Trametinib Combination for Metastatic NSCLC With BRAF V600E Mutation

On June 22, 2017, the U.S. Food and Drug Administration granted regular approvals to dabrafenib (Tafinlar) and trametinib (Mekinist) administered in combination for patients with metastatic non–small cell lung cancer (NSCLC) with BRAF V600E mutation as detected by an FDA-approved test. These ...

lung cancer

Atezolizumab as First-Line or Subsequent Treatment in PD-L1–Selected Advanced NSCLC

In the phase II BIRCH trial, atezolizumab (Tecentriq) was found to produce higher response rates as first-line or subsequent therapy in patients with advanced non–small cell lung cancer (NSCLC) with higher levels of programmed cell death ligand 1 (PD-L1) expression. Study findings were...

lung cancer

Expert Point of View: John V. Heymach, MD, PhD

“This is a watershed moment in the treatment of anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC). Often studies show only incremental improvements with a new treatment. This is different. Alectinib [Alecensa] shows a dramatic increase in efficacy that is also accompanied ...

colorectal cancer

ASCP/CAP/AMP/ASCO Colorectal Cancer Biomarker Guideline: A Clinician's Perspective

The joint American Society for Clinical Pathology (ASCP), College of American Pathologists (CAP), Association for Molecular Pathology (AMP), and ASCO guideline reported by Sepulveda et al, and reviewed in this issue of The ASCO Post, represents a collaboration of three pathology societies and ASCO ...

lung cancer

Alectinib vs Crizotinib in First-Line Treatment of ALK-Positive NSCLC

In 2011, crizotinib (Xalkori) became the first effective targeted therapy for anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC). Now data from a phase III trial show that alectinib (Alecensa), a second-generation ALK inhibitor, outperformed crizotinib, the current...

leukemia

Newer Approaches With CAR T Cells Explored in CLL

Chimeric antigen receptor (CAR) T-cell therapy is a hot area of research and development in hematologic malignancies and, more recently, some solid tumors. Results have been particularly good in acute lymphocytic leukemia, and one or more CAR T-cell products may be getting close to approval by the ...

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