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cns cancers

Addition of Tumor-Treating Fields to Maintenance Temozolomide in Glioblastoma

The final results of a phase III trial reported by Roger Stupp, MD, of the Robert H. Lurie Comprehensive Cancer Center of Northwestern University, and colleagues in JAMA indicate that adding antimitotic treatment with tumor-treating fields to maintenance temozolomide is associated with improved...

gynecologic cancers

FDA Grants Priority Review to Expanded Use of Gardasil 9 in Women and Men Aged 27 to 45 for the Prevention of Certain HPV-Related Cancers and Diseases

On June 13, the U.S. Food and Drug Administration (FDA) accepted for review a new supplemental biologics license application (sBLA) for recombinant human papillomavirus (HPV) 9-valent vaccine (Gardasil  9). The application is seeking approval for an expanded age...

leukemia

Suboptimal Use of Initial Chemotherapy in Newly Diagnosed AML

In a study of National Cancer Database data reported in Blood Advances, Bhatt et al found that 25% of patients with newly diagnosed acute myeloid leukemia (AML) did not receive initial chemotherapy, despite evidence that chemotherapy is associated with a survival benefit and improvement in symptoms ...

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 ...

breast cancer

AJCC Breast Cancer Staging System More Clinically Relevant

THE RECENTLY issued 8th revision to the American Joint Committee on Cancer (AJCC) Breast Cancer Staging System incorporates tumor biology and prognostic stage groups and thus has become more accurate and clinically relevant, according to two speakers at the 2018 Miami Breast Cancer Conference.1,2...

leukemia

Activity of Ivosidenib in IDH1-Mutated Relapsed or Refractory Acute Myeloid Leukemia

As reported at the 2018 ASCO Annual Meeting and in The New England Journal of Medicine by DiNardo et al, early-phase testing has shown activity of ivosidenib, an oral small-molecule inhibitor of mutant IDH1, in patients with IDH1-mutated relapsed or refractory acute myeloid leukemia (AML). IDH1...

solid tumors
prostate cancer

ASCO Clinical Practice Guideline: Optimizing Anticancer Therapy in Metastatic Non-castrate Prostate Cancer

As reported in the Journal of Clinical Oncology by Michael J. Morris, MD, of Memorial Sloan Kettering Cancer Center and Weill Cornell Medicine, and colleagues, ASCO has released a clinical practice guideline on optimizing anticancer therapy in men with metastatic non-castrate prostate cancer.1 To ...

Expert Point of View: Naiyer Rizvi, MD

“In CheckMate 227, the benefit of nivolumab [Opdivo] plus ipilimumab [Yervoy] was the same in tumor mutational burden–high patients whether or not they were programmed cell death ligand 1 (PD-L1)–high or –low,” said formal discussant of this paper, Naiyer Rizvi, MD, Director of Thoracic Oncology...

solid tumors
lung cancer

Nivolumab Plus Ipilimumab Improves Progression-Free Survival in NSCLC With High Tumor Mutational Burden

The combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) improved progression-free survival compared with chemotherapy as first-line treatment for patients with advanced non–small cell lung cancer (NSCLC) and a high tumor mutational burden irrespective of programmed cell death ligand 1...

solid tumors
gastrointestinal cancer

Optimizing Biologics in Metastatic Colon Cancer

Biologics are credited with increasing median overall survival in colorectal cancer to approximately 30 months. Their optimal use was discussed by Axel Grothey, MD, Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, in an article he coauthored for the Journal of Oncology Practice 1...

hematologic malignancies
leukemia

Phase I Study Shows Safety, Efficacy of Ivosidenib in Acute Myeloid Leukemia

Ivosidenib, an isocitrate dehydrogenase-1 (IDH1) inhibitor, yielded durable and molecular remissions in some patients with IDH1-mutated advanced relapsed or refractory acute myeloid leukemia (AML). At a dose of 500 mg/d, ivosidenib was associated with a low frequency of grade 3 or higher...

solid tumors
head and neck cancer

Esomeprazole With Aspirin in Patients With Barrett’s Esophagus

An updated analysis of a randomized phase III trial showed that taking a high dose of esomeprazole with low-dose aspirin for at least 7 years may moderately reduce the risk of developing high-grade dysplasia or esophageal cancer and may delay death from any cause in people with Barrett’s esophagus. ...

solid tumors
gastrointestinal cancer
colorectal cancer

Less Is More: No Benefit Reported for Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer

With a growing emphasis on value in cancer care, some types of resource-intensive therapies may need to be reconsidered. One such treatment may be hyperthermic intraperitoneal chemotherapy, which showed no benefit during surgery for colorectal cancer confined to the peritoneum in the PRODIGE 7...

breast cancer
immunotherapy

Priming the Immune System: Neoadjuvant Durvalumab Plus Chemotherapy May Be Beneficial in Triple-Negative Breast Cancer

The addition of durvalumab -(Imfinzi) to anthracycline/taxane-based chemotherapy had encouraging results as neoadjuvant therapy for early triple-negative breast cancer in the randomized phase II GeparNuevo study presented at the 2018 ASCO Annual Meeting.1 The results were positive in a subgroup of...

Expert Point of View: Daniel George, MD, Robert J. Motzer, MD, and Paul Russo, MD

Formal discussant of the CARMENA trial, Daniel George, MD, of Duke University Medical Center, Durham, North Carolina, had reservations about the broad application of these results. “CARMENA was designed to reassess the value and role of nephrectomy in patients who present with metastatic renal...

leukemia

EHA 2018: Single-Agent Quizartinib vs Chemotherapy in Relapsed or Refractory AML

Results from the phase III QuANTUM-R study of single-agent quizartinib in relapsed or refractory acute myeloid leukemia (AML) were presented by Cortes et al at the 23rd Annual Congress of the European Hematology Association (EHA) (Abstract LB2600). Study Findings QuANTUM-R study results showed...

multiple myeloma

EHA 2018: Elotuzumab Plus Pomalidomide and Low-Dose Dexamethasone vs Pomalidomide/Dexamethasone Alone in Relapsed or Refractory Multiple Myeloma

The ELOQUENT-3 trial, an international phase II study evaluating the addition of elotuzumab (Empliciti) to pomalidomide (Pomalyst) and low-dose dexamethasone in patients with relapsed/refractory multiple myeloma, achieved its primary endpoint, showing a statistically significant and clinically...

breast cancer
survivorship

Low-Fat Dietary Intervention and Overall Survival After Breast Cancer Diagnosis

In an analysis from the Women’s Health Initiative (WHI) trial reported in JAMA Oncology, Chlebowski et al found that overall survival after the diagnosis of incident breast cancer was improved in women in the reduced-fat dietary intervention group vs control group, reflecting reduced...

lung cancer

Prophylactic Cranial Irradiation in Stage III NSCLC

In a Dutch phase III trial reported in the Journal of Clinical Oncology, De Ruysscher et al found that prophylactic cranial irradiation (PCI) prevented symptomatic brain metastases vs observation in patients with stage III non–small cell lung cancer (NSCLC) receiving treatment with curative...

colorectal cancer

Surveillance Intensity Not Associated With Earlier Detection of Recurrence or Improved Survival in Patients With Colorectal Cancer

A national retrospective study led by researchers at The University of Texas MD Anderson Cancer Center found no association between intensity of posttreatment surveillance and detection of recurrence or overall survival (OS) in patients with stage I, II, or III colorectal cancer. Published by...

symptom management

Rivaroxaban vs Dalteparin in Patients With Venous Thromboembolism

In a UK pilot trial (SELECT-D) reported in the Journal of Clinical Oncology, Young et al found that the oral factor Xa inhibitor rivaroxaban was associated with a lower rate of recurrent venous thromboembolism (VTE) but a higher rate of clinically relevant nonmajor bleeding compared with the...

cns cancers

Risk-Adapted Treatment for Young Children With Medulloblastoma

In a phase II trial (SJYC07) reported in The Lancet Oncology, Robinson et al found that risk-adapted treatment did not improve event-free survival in young children with medulloblastoma. Analysis by methylation status showed superior outcome in the sonic hedgehog (SHH) subgroup. Study Details The ...

gynecologic cancers
pain management

Study Evaluates Effect of Restrictive Opioid Protocol After Gynecologic Surgery

THE NUMBER of opioids prescribed after surgery for gynecologic cancer decreased significantly after implementation of an ultra-restrictive opioid prescription protocol, with no apparent negative effect on patient satisfaction or pain, according to research presented by Jaron Mark, MD, and...

gynecologic cancers

Clinical Findings Predict Early Treatment Discontinuation in Patients Receiving Immunotherapy for Ovarian Cancer

PRETREATMENT CLINICAL findings may predict early treatment discontinuation in patients with ovarian cancer receiving checkpoint blockade immunotherapy agents. Data presented by MD candidate Julia L. Boland at the 2018 Society of Gynecologic Oncology Annual Meeting on Women’s Cancer revealed that...

lung cancer
symptom management
cns cancers

Quick Takes From Original Research Presented at the 2018 NCCN Annual Conference

THE QUANTITY of original research presented at the National Comprehensive Cancer Network® (NCCN®) Annual Conference has been growing, and at the 2018 meeting, 121 researchers presented their work. The ASCO Post captured some of the findings for this report.  Blood Markers Correlate With Anti–PD-1...

pancreatic cancer

Using Neoadjuvant Therapy to Reduce Early Recurrences, Increase Survival in Patients With Pancreatic Cancer

USE OF THE FOLFIRINOX regimen (fluorouracil, leucovorin, irinotecan, and oxaliplatin) was associated with a 4.9-month improvement in overall survival compared to gemcitabine/ nab-paclitaxel (Abraxane) in the neoadjuvant treatment of resectable and borderline-resectable pancreatic head...

breast cancer

Expert Point of View: Carla S. Fisher, MD

CARLA S. FISHER, MD, Associate Professor of Surgery at Indiana University School of Medicine, Indianapolis, underscored the importance of these data in informing treatment decisions given the difficult trade-off patients can face.  “By analyzing a large group of patients treated in the modern era, ...

breast cancer

Recurrence Rates After Lumpectomy Significantly Improved in Patients Receiving ‘Modern-Era’ Therapy

A STUDY OF local recurrence rates following lumpectomy has shown significant improvement in patients receiving modern, multimodal therapies, suggesting breast-conserving surgery may be an option for more patients with breast cancer, according to data presented at the 2018 American Society of Breast ...

lung cancer

Despite USPSTF Recommendations, Majority of Heavy Smokers Not Screened for Lung Cancer

AN ANALYSIS of 1,800 lung cancer screening sites nationwide found that only 1.9% of more than 7 million eligible current and former heavy smokers were screened for lung cancer in 2016, despite U.S. Preventive Services Task Force (USPSTF) and ASCO screening recommendations. Results from this...

lung cancer

Expert Point of View: John Heymach, MD, PhD, and Leena Gandhi, MD

“THIS STUDY represents a true milestone in the field of lung cancer. For the first time, the vast majority of patients with non–small cell lung cancer (NSCLC) can receive immunotherapy with pembrolizumab (Keytruda),” said ASCO expert John Heymach, MD, PhD, of MD Anderson Cancer Center, Houston,...

lung cancer

Immunotherapy Benefits Survival, Improves Safety, vs Platinum-Based Chemotherapy for PD-L1–Expressing NSCLC

IMMUNOTHERAPY WITH pembrolizumab (Keytruda) improved overall survival compared with investigator’s choice of platinum-based chemotherapy as first-line treatment for patients with advanced non–small cell lung cancer (NSCLC) in the KEYNOTE-042 trial. Median overall survival was improved by 4 to 8...

lymphoma
leukemia

Adherence to Oral Anticancer Treatment: Priorities in Lymphoma and CLL

ADVANCES IN cancer treatment have been nothing short of breathtaking in recent years. Among the most important has been the advent of effective oral therapies, marking a significant change in the way many patients receive treatment and in the oversight required by the cancer care team. As with...

breast cancer

TAILORx: Endocrine Therapy Alone Is Sufficient for Most Patients With ‘Intermediate-Risk’ Breast Cancer

THE HIGHLY ANTICIPATED results of the phase III TAILORx study are in—and they indicate that the vast majority of patients with “intermediate-risk” early-stage breast cancer can forgo chemotherapy.  “Our study shows that chemotherapy may be avoided in about 70% of women with hormone...

When Patients Are Open to Lifestyle Changes: Take Advantage of ‘Unique Window of Opportunity'

Colon cancer survivors who followed guidelines for healthy eating, maintaining a healthy weight, and staying physically active had higher 5-year survival rates than those who did not adhere to those guidelines, according to a study among 992 patients treated with stage III colon cancer.1 The 5-year ...

solid tumors
colorectal cancer

Following Guidelines for Healthy Eating and Physical Activity May Improve Survival in Patients Treated for Colon Cancer

Following guidelines for proper nutrition, maintaining a healthy weight, and staying physically active may improve survival among patients treated for colon cancer, according to the results of a study with nearly 1,000 patients followed for a median of 7 years.1 “The study suggests that if...

ASCO Supports NCI-Designated Cancer Centers’ Goal of Eliminating HPV-Related Cancers

ASCO has endorsed a statement by the 70 National Cancer Institute (NCI)-designated cancer centers calling for increased human papillomavirus (HPV) vaccination and screening to eliminate HPV-related cancers. The full uptake of the vaccine and screening could prevent 12,000 cervical cancers and...

hematologic malignancies
lymphoma

Hematopoietic Cell Transplantation for Follicular Lymphoma

Many patients with follicular lymphoma relapse within 2 years of initial therapy, and for a number of these individuals, hematopoietic cell transplantation is a good treatment option. Transplant, however, both autologous and allogeneic, is vastly underutilized in these patients, according to Mehdi ...

solid tumors
skin cancer

Durable Complete Responses After Discontinuation of Pembrolizumab in Metastatic Melanoma

As reported in the Journal of Clinical Oncology by Caroline Robert, MD, PhD, of Institut Gustave Roussy, Villejuif, France, and colleagues, a high proportion of patients with metastatic melanoma achieving a complete response on pembrolizumab (Keytruda) in the phase Ib KEYNOTE-001 trial maintained...

colorectal cancer

Validation of the Consensus Immunoscore for Classification of Colon Cancer

As reported in The Lancet by Pagès et al, an international collaboration has validated the consensus Immunoscore for colon cancer as a predictive tool for recurrence of disease. Study Details An international consortium of 14 centers in 13 countries, led by the Society for Immunotherapy of ...

multiple myeloma
immunotherapy

2018 ASCO: Pomalidomide, Bortezomib, and Low-Dose Dexamethasone in Relapsed or Refractory Multiple Myeloma

For patients with multiple myeloma who have been treated with lenalidome (Revlimid) but have relapsed and not responded to other therapy, a three-drug combination can significantly extend the time in which the disease is held in check. The findings of the phase III OPTIMISMM trial were presented by ...

prostate cancer

Lutetium-177–PSMA-617 Radionuclide Treatment for Previously Treated Metastatic Castration-Resistant Prostate Cancer

In an Australian investigator-initiated single-center phase II study reported in The Lancet Oncology, Hofman et al found that treatment with a radiolabeled small molecule that binds to prostate-specific membrane antigen (PSMA), lutetium-177 (177Lu)–PSMA-617, produced a high response rate ...

breast cancer

2018 ASCO: Aromatase Inhibitor Plus Ovarian Suppression Yields Benefit in High-Risk Premenopausal Patients With Breast Cancer

Premenopausal women with hormone receptor (HR)­–positive, HER2-negative breast cancer and a high risk of recurrence who are treated with an aromatase inhibitor plus ovarian function suppression may gain a 10% to 15% improvement in freedom from distant recurrence at 8 years, according to a ...

gastroesophageal cancer

2018 ASCO: Esomeprazole With Aspirin Offers Moderate Benefits in Patients With Barrett’s Esophagus

An updated analysis of a randomized phase III trial showed that taking a high dose of the acid-reducing medicine esomeprazole with low-dose aspirin for at least 7 years can moderately reduce the risk of developing high-grade dysplasia or esophageal cancer and delay death from any cause in people...

colorectal cancer

2018 ASCO: Hyperthermic Intraperitoneal Chemotherapy Does Not Add Benefit in Patients With Advanced Colorectal Cancer

A randomized phase III clinical trial showed that people with advanced colorectal cancer may not need a frequently considered component of treatment—heated chemotherapy delivered to the abdomen during surgery. There was no difference in survival between patients with metastases in the abdomen ...

lung cancer
issues in oncology

Danh Pham, MD: Lung Cancer Screening Rates Still Too Low

Danh Pham, MD, of the James Graham Brown Cancer Center, University of Louisville, discusses his findings using a registry on the low rates of screening with low-dose computed tomography, despite its potential to prevent thousands of lung cancer deaths each year (Abstract 6504).

sarcoma

Gianni Bisogno, MD, on Rhabdomyosarcoma: Results From the European Paediatric Soft Tissue Sarcoma Study Group

Gianni Bisogno, MD, of the University Hospital of Padova, discusses study findings on maintenance low-dose chemotherapy in patients with high-risk rhabdomyosarcoma (Abstract LBA2).

breast cancer

2018 ASCO: TAILORx: Most Women With Early-Stage Breast Cancer Can Forgo Chemotherapy When Guided by a Diagnostic Test

The federally funded, phase III TAILORx clinical trial showed that most women with hormone receptor (HR)–positive, HER2-negative, axillary node–negative early-stage breast cancer and a mid-range score on a 21-tumor gene expression assay (Oncotype DX® Breast Recurrence Score) do not...

sarcoma

2018 ASCO: Low-Dose Maintenance Chemotherapy in Rhabdomyosarcoma

A new chemotherapy strategy seems to improve cure rates for children with rhabdomyosarcoma who are at high risk for cancer recurrence. In a randomized phase III clinical trial, adding 6 months of low-dose maintenance chemotherapy after initial treatment increased the 5-year overall survival rate...

lung cancer

2018 ASCO: Blood Test Shows Potential as a Detection Tool for Early-Stage Lung Cancer

An initial report from the large, ongoing Circulating Cell-Free Genome Atlas (CCGA) study provides preliminary evidence that a blood test may be able to detect early-stage lung cancer. This is one of the first studies to explore blood tests analyzing free-floating or cell-free DNA as a tool for the ...

lung cancer
immunotherapy

2018 ASCO: IMpower 131 Studies Addition of Atezolizumab to Chemotherapy in Advanced Squamous NSCLC

Initial findings from a randomized phase III clinical trial showed that patients with advanced squamous non–small cell lung cancer (NSCLC) benefit more from initial treatment with the programmed cell death ligand 1 (PD-L1)-targeted immunotherapy atezolizumab (Tecentriq) and chemotherapy than...

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