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colorectal cancer
breast cancer
hepatobiliary cancer
lung cancer
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cns cancers
leukemia

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2018 Guidelines Updates

In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®) covering 8 tumor types. Guidelines are now published for more than 60 tumor types and topics. Some of the key updates were presented at NCCN’s 23rd...

cns cancers

Genetic Counseling and Testing for Patients With Medulloblastoma

Researchers have identified six genes that predispose carriers to develop medulloblastoma and have used the discovery to craft genetic counseling and screening guidelines. The study was published by Waszak et al in The Lancet Oncology. St. Jude Children’s Research Hospital,...

cns cancers

Early-Phase Trial of Carboxyamidotriazole Orotate and Temozolomide in Glioblastoma

In a phase Ib trial reported in the Journal of Clinical Oncology, Omuro et al found evidence of activity of carboxyamidotriazole orotate plus temozolomide in patients with recurrent anaplastic gliomas or glioblastoma and previously untreated glioblastoma. Carboxyamidotriazole orotate is an...

cns cancers

Updated NCCN Guidelines® for Newly Diagnosed Glioblastoma

THE NATIONAL COMPREHENSIVE Cancer Network (NCCN) has updated its Clinical Practice Guidelines in Oncology for Central Nervous System Cancers (NCCN Guidelines®) to recommend alternating electric field therapy (also known as tumor-treating fields, Optune) in combination with temozolomide as a...

cns cancers

A Clinician’s Guide to Treating Patients With Glioblastoma

Glioblastoma, a grade 4 astrocytoma, is the most common and most aggressive form of primary brain tumors in adults. The most recent guidance on molecular profiling, diagnostic and prognostic factors, and treatments for newly diagnosed and recurrent diseases was described in the Journal of Oncology ...

lung cancer

ELCC 2018: Alectinib Provides Longer Symptom Improvement Than Crizotinib in ALK-Positive Lung Cancer

Alectinib provides longer symptom improvement than crizotinib in <em>ALK</em>-positive non–small cell lung cancer (NSCLC), according to results from the ALEX trial presented by Pérol et al at the European Lung Cancer Congress (ELCC) in Geneva, Switzerland (Abstract...

cns cancers
skin cancer
immunotherapy

Nivolumab/Ipilimumab or Nivolumab Alone in Melanoma Brain Metastases

In an Australian phase II trial reported in The Lancet Oncology, Long et al found that the combination of nivolumab (Opdivo) and ipilimumab (Yervoy) and nivolumab alone showed intracranial activity in patients with melanoma brain metastases. Study Details In the open-label trial, 76 evaluable...

cns cancers

Genomic Copy Number Aberrations and Extremely Poor Survival in High-Risk Neuroblastoma

In a study reported in the Journal of the National Cancer Institute, Depuydt et al identified two genomic copy number aberrations associated with risk of extremely poor survival in patients with high-risk neuroblastoma. Study Details The international collaborative study included normalized...

cns cancers

We Need to Fill the Gap Between Pediatric and Adult Oncology Care

When I was 15, and just 6 weeks into my sophomore year in high school, I heard a loud sound similar to a gunshot in my head and minutes later I was engulfed in a grand mal seizure, now called tonic-clonic seizure, and rushed to the hospital. A magnetic resonance imaging (MRI) scan found a small...

lung cancer

Osimertinib Improves Progression-Free Survival vs Standard EGFR Inhibitors in EGFR-Mutant NSCLC

AS REPORTED in The New England Journal of Medicine by Jean-Charles Soria, MD, PhD, of Gustave Roussy Cancer Campus and University Paris-Sud, and colleagues, the phase III FLAURA trial has shown a significant progression-free survival benefit with the third-generation epidermal growth factor...

cns cancers
immunotherapy

Bevacizumab in Recurrent Glioblastoma

On December 5, 2017, bevacizumab (Avastin) was granted regular approval for the treatment of recurrent glioblastoma in adults.1 Bevacizumab was granted accelerated approval in May 2009 for use in treating patients with glioblastoma who had disease progression on prior therapy. Supporting Efficacy...

cns cancers

Does Treatment With Tumor-Treating Fields Plus Temozolomide Influence Quality of Life in Patients With Newly Diagnosed Glioblastoma?

A DETAILED quality-of-life analysis of the phase III EF-14 trial of tumor-treating fields (Optune) in combination with temozolomide for the treatment of newly diagnosed glioblastoma was published by Taphoorn et al in JAMA Oncology.1 This secondary endpoint analysis showed the addition of...

cns cancers
immunotherapy

Monoclonal Antibody Treatment in Newly Diagnosed Pediatric High-Grade Glioma

In a phase II study reported in the Journal of Clinical Oncology, Grill et al found that the addition of bevacizumab (Avastin) to radiotherapy plus temozolomide (RT + TMZ) did not improve event-free survival in pediatric patients with newly diagnosed high-grade glioma. Study Details In the...

cns cancers

Does Treatment With Tumor-Treating Fields Plus Temozolomide Influence Quality of Life in Patients With Newly Diagnosed Glioblastoma?

A detailed quality-of-life analysis of the phase III EF-14 trial of tumor-treating fields (Optune) in combination with temozolomide for the treatment of newly diagnosed glioblastoma was published by Taphoorn et al in JAMA Oncology. This secondary endpoint analysis demonstrated that the...

cns cancers

Addition of EGFR-Targeting Vaccine to Temozolomide in EGFRvIII-Expressing Glioblastoma

The phase III ACT IV study has shown no survival benefit of adding rindopepimut, a vaccine targeting the epidermal growth factor receptor (EGFR) deletion mutation EGFRvIII, to temozolomide in patients with newly diagnosed EGFRvIII-positive glioblastoma. These findings were reported in The Lancet...

cns cancers

Adjuvant Temozolomide in 1p/19q Non-codeleted Anaplastic Glioma

Interim results of the phase III CATNON trial (EORTC study 26053-22054) indicate a survival benefit of adjuvant temozolomide in 1p/19q non-codeleted anaplastic glioma. These findings were reported in The Lancet by Martin J. van den Bent, MD, of the Brain Tumour Centre at Erasmus MC Cancer...

cns cancers

Addition of Tumor-Treating Fields to Maintenance Temozolomide in Glioblastoma

Final results of a phase III trial reported by Stupp and colleagues in JAMA indicate that adding antimitotic treatment with tumor-treating fields to maintenance temozolomide is associated with improved progression-free and overall survival in patients with previously treated glioblastoma. The...

Alectinib in ALK-Positive Metastatic Non–Small Cell Lung Cancer

On November 6, 2017, alectinib (Alecensa) received regular approval for treatment of patients with anaplastic lymphoma kinase (ALK)-positive metastatic non–small cell lung cancer (NSCLC), as detected by a U.S. Food and Drug Administration–approved test.1,2 Supporting Efficacy Data Approval was...

St. John’s Wort

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies commonly used by patients with cancer. In this installment, Jun J. Mao, MD, MSCE, and Jyothirmai Gubili, MS, explore the role of St....

lung cancer

FDA Accepts sNDA for Osimertinib in First-Line Treatment of EGFR-Mutated NSCLC

On December 18, the U.S. Food and Drug Administration (FDA) accepted a supplemental New Drug Application (sNDA) for the use of osimertinib (Tagrisso)—a third-generation, irreversible epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor with clinical activity against central...

hematologic malignancies

Liposome-Encapsulated Daunorubicin and Cytarabine for AML Subtypes

On August 3, 2017, a liposome-encapsulated combination of daunorubicin and cytarabine (Vyxeos) was approved for treatment of adults with newly diagnosed therapy-related acute myeloid leukemia (AML) or AML with myelodysplasia-related changes.1,2 This is the first U.S. Food and Drug...

cns cancers

FDA Grants Bevacizumab Full Approval in Recurrent Glioblastoma

On December 5, the U.S. Food and Drug Administration (FDA) granted full approval of bevacizumab (Avastin) for the treatment of adults with recurrent glioblastoma that has progressed following prior therapy. Bevacizumab was previously granted provisional approval in this setting under the FDA's ...

cns cancers

Phase III Trial of Combination Therapy for Progressive Glioblastoma

In a phase III trial reported in The New England Journal of Medicine, Wick et al found that adding bevacizumab (Avastin) to lomustine at first disease progression did not improve overall survival in patients with progressive glioblastoma. Study Details In the trial, 437 patients with disease...

lung cancer

Comparison of EGFR Inhibitors in Untreated Advanced EGFR-Mutant NSCLC

As reported in The New England Journal of Medicine by Soria et al, the phase III FLAURA trial has shown a significant progression-free survival benefit with the third-generation epidermal growth factor receptor (EGFR) tyrosine kinase inhibitor (TKI) osimertinib (Tagrisso) vs standard EGFR TKIs in...

hematologic malignancies
breast cancer
lung cancer
lymphoma

FDA Approvals in November 2017: Novel Drugs, New Indications

THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) approved a number of novel drugs and new indications in November 2017. Several of them are listed here.  Fulvestrant/Abemaciclib Combination in Breast Cancer  ON NOVEMBER 15 , the FDA approved fulvestrant (Faslodex) in combination with abemaciclib...

cns cancers

Gene Therapy Shows Early Efficacy Against Recurrent Brain Cancer

MORE THAN A QUARTER of patients with recurrent high-grade glioma treated with the retroviral vector Toca 511 and the prodrug of the chemotherapy fluorouracil (5-FU), Toca FC, were alive more than 3 years after treatment, according to data from a subset of patients in a phase I clinical trial, Toca ...

hematologic malignancies
lymphoma

Axicabtagene Ciloleucel for Large B-Cell Lymphoma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On October 18, 2017, the chimeric antigen receptor (CAR)...

lung cancer

ESMO Asia 2017: Alectinib More Effective Than Crizotinib in Asian Patients With ALK-Positive NSCLC

A subanalysis of the phase III ALEX study has shown that alectinib (Alecensa) is more effective than the standard of care, crizotinib, in Asian patients with anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC), researchers reported at the European Society for Medical...

lung cancer

FDA Approves Alectinib for ALK-Positive Metastatic NSCLC

On November 6, 2017, the U.S. Food and Drug Administration (FDA) granted regular approval to alectinib (Alecensa) for treatment of patients with anaplastic lymphoma kinase (ALK)-positive metastatic non–small cell lung cancer (NSCLC), as detected by an FDA-approved test. In December 2015,...

lung cancer

Novel Tyrosine Kinase Inhibitor for ALK- or ROS1-Rearranged NSCLC

A phase I trial has shown that the ALK and ROS1 tyrosine kinase inhibitor lorlatinib is active in patients with advanced ALK- or ROS1-positive non–small cell lung cancer (NSCLC), including those with central nervous system (CNS) metastases and failure on at least two prior tyrosine kinase...

cns cancers

AACR-NCI-EORTC: Gene Therapy Shows Early Efficacy Against Recurrent Brain Cancer

More than a quarter of patients with recurrent high-grade glioma treated with the retroviral vector Toca 511 (vocimagene amiretrorepvec) combined with Toca FC (an extended-release formulation of fluorocytosine, a prodrug of fluorouracil [5-FU]) were alive more than 3 years after...

cns cancers
survivorship

Predicting Risk of Subsequent CNS Tumors in Survivors of Childhood Cancer

As reported in the Journal of Clinical Oncology, Wang et al have developed a model for predicting risk of subsequent central nervous system (CNS) tumors in survivors of childhood cancer. Study Details In the study, matched childhood cancer survivors with (n = 82) and without (n = 228) subsequent...

lung cancer

Expert Point of View: Luis Paz-Ares, MD

FORMAL DISCUSSANT of the ALEX and ALUR trials, Luis Paz-Ares, MD, Professor of Medicine at the Hospital Universitario 12 de Octubre, Madrid, said that the ALEX trial is “good news” for patients. “Importantly, 40% had baseline metastases. Disease progression was nicely controlled with alectinib...

lung cancer

Alectinib Yields Favorable Results in Phase&nbsp;III Trials of ALK-Positive NSCLC

RESULTS OF TWO separate phase III trials confirm the activity of alectinib (Alecensa) in the central nervous system (CNS) in patients with anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC). Results lend support for alectinib as the better first-line treatment option over...

lung cancer

‘Clinically Meaningful’ Results With First-Line Osimertinib in EGFR–Positive NSCLC

OSIMERTINIB (TAGRISSO) showed encouraging results as first-line therapy for patients with epidermal growth factor receptor (EGFR)–mutated non–small-cell lung cancer (NSCLC) in the phase III FLAURA trial, according to results presented at the 2017 European Society for Medical Oncology (ESMO)...

lung cancer

Expert Point of View: Tony Mok, MD, FASCO

“IN 2008, I presented the IPASS results. FLAURA has beaten me to the ground. The results exceeded expectations, and FLAURA is undoubtedly a positive study,” stated formal discussant Professor Tony Mok, MD, FASCO, Chair of Department of Clinical Oncology, the Chinese University of Hong Kong. “It is ...

lung cancer

‘Clinically Meaningful’ Results With First-Line Osimertinib in EGFR–Positive NSCLC

OSIMERTINIB (TAGRISSO) showed encouraging results as first-line therapy for patients with epidermal growth factor receptor (EGFR)–mutated non–small-cell lung cancer (NSCLC) in the phase III FLAURA trial, according to results presented at the 2017 European Society for Medical Oncology (ESMO)...

solid tumors
bladder cancer

Durvalumab in Advanced Urothelial Carcinoma Progressing After Platinum Therapy

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On May 1, 2017, durvalumab (Imfinzi) was granted...

survivorship

Cumulative Burden of Chronic Health Conditions in Childhood Cancer Survivors

In a report from the St Jude Lifetime Cohort Study published in The Lancet, Bhakta et al detailed the burden of lifetime chronic health conditions in survivors of childhood cancers. The report included retrospectively collected data on chronic health conditions in 5,522 patients treated for...

cns cancers

Small Steps Forward in Brain Tumor Therapy

SOME RECENT ADVANCES in the treatment of brain tumors are promising, but others are less so, according to Jeffrey J. Olson, MD, Professor of Neurosurgery at Emory University, Atlanta. At the 2017 Debates and Didactics in Hematology and Oncology Conference, held in Sea Island, Georgia, and...

cns cancers
gynecologic cancers
kidney cancer
lung cancer
gastroesophageal cancer

FDA Approves First Biosimilar for the Treatment of Cancer

The U.S. Food and Drug Administration today approved bevacizumab-awwb (Mvasi) as a biosimilar to bevacizumab (Avastin) for the treatment of multiple types of cancer. Bevacizumab-awwb is the first biosimilar approved in the U.S. for the treatment of cancer. “Bringing new biosimilars to...

lung cancer

ESMO 2017: ALEX and ALUR Trials: Alectinib Shows CNS Benefit in ALK-Positive NSCLC

Data from two separate phase III studies presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid show the particular central nervous system (CNS) activity of alectinib (Alecensa) in patients with advanced non–small cell lung cancer involving a mutation of the...

cns cancers

Dinutuximab vs Temsirolimus in Combination Therapy for Children With Resistant Neuroblastoma

A randomized phase II trial (Children’s Oncology Group [COG] ANBL1221) has resulted in the selection of dinutuximab (Unituxin) plus irinotecan/temozolomide as a regimen to be further evaluated in the treatment of pediatric patients with refractory or relapsed neuroblastoma. Study results were...

cns cancers

Zika Virus Shows Oncolytic Activity Against Glioblastoma Stem Cells in Preclinical Trial

Although Zika virus causes devastating damage to the brains of developing fetuses, it someday may prove to be an effective treatment for glioblastoma. New research from Washington University School of Medicine in St. Louis and the University of California San Diego School of Medicine showed that...

cns cancers

Addition of EGFR-Targeting Vaccine to Temozolomide in EGFRvIII-Expressing Glioblastoma

The phase III ACT IV study has shown no survival benefit of adding rindopepimut, a vaccine targeting the epidermal growth factor receptor (EGFR) deletion mutation EGFRvIII, to temozolomide in patients with newly diagnosed EGFRvIII-positive glioblastoma. These findings were reported by Weller et al...

cns cancers

Expect Questions About Glioblastoma Symptoms

WITH THE MANY NEWS REPORTS about Senator John McCain being diagnosed with glioblastoma, patients may be asking if symptoms such as headaches and vision or speech problems should signal the need for screening or diagnostic tests. “There has never been any suggestion that doing routine screening,...

cns cancers

‘Substantial Improvements’ in the Treatment of Glioblastoma

NEWS ARTICLES about Senator John McCain’s diagnosis of glioblastoma accurately describe glioblastoma as aggressive and having a poor prognosis. But as Walter J. Curran, Jr, MD, pointed out in one of those reports, “substantial improvements in surgical approaches” have enabled more patients to...

cns cancers

Adjuvant Temozolomide in 1p/19q Non-Codeleted Anaplastic Glioma

Interim results of the phase III CATNON trial (EORTC study 26053-22054) indicate a survival benefit of adjuvant temozolomide in 1p/19q non-codeleted anaplastic glioma. These findings were reported in The Lancet by van den Bent et al. Study Details In the open-label 2 x 2 factorial trial, 745...

cns cancers
survivorship

Study Maps Mutation That May Drive Meningioma Development in Childhood Cancer Survivors

Neuroscientists may have uncovered the genetic basis for why many long-term survivors of childhood cancer develop meningiomas, the most common adult brain tumor, decades after their treatment with cranial radiation. The findings, published by Agnihotri et al in Nature Communications, show that...

cns cancers

Vaccine-Chemotherapy Combination in Glioblastoma

Despite highly aggressive therapy that includes maximal tumor resection, high-dose radiation, and temozolomide chemotherapy, the prognosis for patients with newly diagnosed glioblastoma is dismal, with a median survival of less than 15 months, prompting researchers to study novel approaches to...

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