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Pazopanib in Treatment of von Hippel-Lindau Disease

In a single-center phase II trial reported in The Lancet Oncology, Jonasch et al found evidence of activity of pazopanib in the treatment of patients with von Hippel-Lindau disease. Study Details The study involved 31 eligible adult patients with clinical manifestations of von Hippel-Lindau...

lung cancer

WCLC 2018: IMpower132: Atezolizumab Plus Carboplatin and Pemetrexed in Stage IV Nonsquamous NSCLC

Findings from the IMpower132 trial demonstrate that the use of the programmed cell death ligand 1 (PD-L1) inhibitor atezolizumab in combination with carboplatin plus pemetrexed as first-line therapy and pemetrexed as maintenance therapy improved progression-free survival in patients with stage IV...

cns cancers
issues in oncology

Factors in Endocrine Deficiency in Pediatric and Young Adult Patients Receiving Radiotherapy for Brain Tumors

In a study reported in the Journal of Clinical Oncology, Vatner et al identified factors associated with an increased risk of endocrine deficiency in pediatric and young adult patients receiving radiation therapy for brain tumors, including hypothalamus and pituitary radiation dose. Study Details ...

leukemia

Comparison of Methotrexate Intensification Regimens in Children and Young Adults With T-Cell ALL

As reported by Winter et al in the Journal of Clinical Oncology, findings in the Children’s Oncology Group (COG) AALL0434 trial indicate improved outcomes with a COG methotrexate intensification regimen vs a high-dose methotrexate intensification regimen in children and young adults with...

issues in oncology

First Large-Scale Survey of APPs in Oncology Shows Growing Role for Nurse Practitioners and Physician Assistants

Advanced practice providers (APPs) have increasingly become integral members of the oncology care delivery team, according to the first large-scale study of nurse practitioners (NPs) and physician assistants (PAs) in oncology. The study was conducted collaboratively by ASCO, the American Academy of ...

cns cancers
lung cancer

CNS Activity of First-Line Osimertinib in EGFR-Mutant Advanced NSCLC

In a subgroup analysis of the phase III FLAURA trial reported in the Journal of Clinical Oncology, Reungwetwattana et al found evidence of greater central nervous system (CNS) activity of osimertinib (Tagrisso) vs standard EGFR tyrosine kinase inhibitors in patients with previously untreated...

cns cancers
skin cancer
immunotherapy

Immunotherapy Combination in Melanoma Brain Metastases

In the phase II CheckMate 204 study reported in The New England Journal of Medicine, Tawbi et al found that combined nivolumab (Opdivo) and ipilimumab (Yervoy) produced a high rate of intracranial clinical benefit in patients with melanoma brain metastases. Study Details The study included 94...

cns cancers

Oncology Organizations Remember Senator John McCain

United States Senator from Arizona John McCain passed away on August 25 of the brain cancer glioblastoma multiforme (GBM). Numerous medical societies issued statements in light of his death, reprinted below. ASCO  ASCO President Monica M. Bertagnolli, MD, FACS, FASCO, issued the following...

cns cancers
issues in oncology

Memory Issues in Children With Medulloblastoma Undergoing Radiation Therapy

Children with certain types of brain tumors who undergo radiation treatment are less likely to recall the specifics of events they experienced after radiation than to remember pretreatment happenings, according to a Baylor University study comparing them to children with healthy brains. These...

issues in oncology

First Large-Scale Survey of Advanced Practice Providers in Oncology Shows Growing Role for Nurse Practitioners and Physician Assistants

Advanced practice providers (APPs) have increasingly become integral members of the oncology care delivery team, according to the first large-scale study of nurse practitioners (NPs) and physician assistants (PAs) in oncology published by Bruinooge et al in the Journal of Oncology Practice....

issues in oncology
cns cancers

A Firsthand Account of Cancer and Mental Illness

Brain tumors are among the most challenging clinical scenarios faced by the oncology community. Along with devastating physiologic damage, brain tumors often have a dramatic effect on the patient’s cognitive, neurologic, and psychological functions. However, the body of literature focusing on...

SMARTIE Initiative for Advanced Practitioners in Oncology Recognized by Alliance for Continuing Education

AN ONGOING educational initiative, the Study to Measure Advanced Practitioner Retention of Targeted Information and Education (SMARTIE), measures oncology learning and how it is used with advanced practitioners and their patients with cancer. The initiative, conducted by Harborside Medical...

cns cancers
immunotherapy

Bevacizumab and Temozolomide in First Recurrence of Glioma Without 1p/19q Codeletion

In a phase II trial funded by the European Organisation for Research and Treatment of Cancer and reported in The Lancet Oncology, van den Bent et al found no evidence of a survival benefit with the addition of bevacizumab (Avastin) to temozolomide in patients with a first recurrence of World Health ...

cns cancers
survivorship

Functional and Social Independence in Survivors of Pediatric CNS Tumors

In a report from the St. Jude Lifetime Cohort Study published in the Journal of Clinical Oncology, Brinkman et al found that 60% of adult survivors of pediatric central nervous system (CNS) tumors do not achieve full functional or social independence in adult life. In the study, functional and...

supportive care

Cannabinoids for Cancer Pain: Dangerous or Beneficial?

Cannabis has been used in health care for millennia, and its use has been well documented, albeit never definitively integrated into clinical practice. Recent societal changes and the increasing acceptance and availability of cannabis have reignited the medical and public debate around its role in...

lung cancer

CNS Activity of EGFR Tyrosine Kinase Inhibitor in T790M-Positive Advanced NSCLC

In a planned subgroup analysis of the phase III AURA3 trial reported in the Journal of Clinical Oncology, Wu et al found that the third-generation EGFR tyrosine kinase inhibitor osimertinib (Tagrisso) produced higher central nervous system (CNS) response rates vs platinum plus pemetrexed (Alimta)...

symptom management

Actively Recruiting Clinical Trials Focused on Neurotoxicities of Treatment

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on neurotoxicities of cancer treatment. These studies focus on the effects of chemotherapy on cognitive function, changes in resting state brain networks after stem cell...

cns cancers
lymphoma

Philip J. Bierman, MD, on DLBCL: Managing Patients at Risk of CNS Involvement and Systemic Disease

Philip J. Bierman, MD, of the University of Nebraska Medical Center, discusses how to identify and treat the 1% to 2% of patients with diffuse large B-cell lymphoma who have central nervous system involvement as well as systemic sites at the time of diagnosis.

cns cancers
issues in oncology

Pediatric CT Scans and Subsequent Malignancy Risk

A new study by Meulepas et al in the Journal of the National Cancer Institute suggests that computed tomography (CT) scans may increase the risk of brain tumors. The use of CT scans has increased dramatically over the past 2 decades. CT scans greatly improve diagnostic capabilities,...

cns cancers
skin cancer
immunotherapy

First-Line Treatment With Checkpoint Inhibitors in Patients With Melanoma Brain Metastases

An analysis of newly diagnosed patients with cutaneous melanoma brain metastases treated with checkpoint blockade immunotherapy has found the treatment was associated with an increase in median overall survival of 12.4 months compared with 5.2 months—a 1.4-fold improvement. The benefit was...

cns cancers

Intratumoral Recombinant Poliovirus in Grade IV Glioblastoma

In a study reported in The New England Journal of Medicine, Desjardins and colleagues found that convection-enhanced intratumoral delivery of a recombinant nonpathogenic polio–rhinovirus chimera (PVSRIPO) was not associated with neurovirulence in patients with recurrent grade IV glioma and...

cns cancers

Surgery Followed by Salvage Stereotactic Radiosurgery vs Whole-Brain Radiotherapy for Four or Fewer Brain Metastases

In a Japanese phase III noninferiority trial (JCOG0504) reported in the Journal of Clinical Oncology, Kayama et al found that salvage stereotactic radiosurgery (SRS) was noninferior to whole brain radiation therapy (WBRT) for survival in patients with 1 to 4 resected brain metastases. In the...

leukemia
immunotherapy

Outcomes of Tisagenlecleucel Therapy in Children and Young Adults With B-Cell Acute Lymphoblastic Leukemia

As reported in The New England Journal of Medicine by Shannon L. Maude, MD, PhD, of Perelman School of Medicine, University of Pennsylvania, Philadelphia, and colleagues, the phase II ELIANA trial has shown that the anti-CD19 chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel (Kymriah) ...

leukemia

Long-Term Outcomes With Dasatinib Plus Intensive Chemotherapy in Pediatric/Young Adult Ph-Positive ALL

In an analysis of the Children’s Oncology Group (COG) AALL0622 trial reported in the Journal of Clinical Oncology, Slayton et al found that adding dasatinib (Sprycel) to intensive chemotherapy produced good long-term outcomes in pediatric/young adult patients with newly diagnosed Philadelphia ...

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...

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 ...

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...

cns cancers

Durable Responses Observed With Novel Oncolytic Therapy in Recurrent Glioma

IN A PILOT study of recurrent glioma, 26% of patients treated with the optimal dose of vocimagene amiretroprepvec (aka Toca 511), a novel oncolytic virus therapy, achieved durable, long-term responses and remained alive 3 or more years later. This outcome far exceeded “historical benchmarks” for...

cns cancers

Characteristics of Long-Term Survivors of Diffuse Intrinsic Pontine Glioma

In a report from the diffuse intrinsic pontine glioma (DIPG) registries of the International and European Societies for Pediatric Oncology, published in the Journal of Clinical Oncology, Hoffman et al identified characteristics of long-term survivors among pediatric and young adult...

cns cancers
immunotherapy

Treating Pediatric Glioma With Bevacizumab and Standard Treatment

Children with nonbrainstem high-grade glioma could benefit from potentially life-extending treatment if genetic testing was used to personalize therapy as it is in many adults, new research published by Mackay et al in Cancer Cell reported.  Scientists analyzed the DNA of children taking an...

colorectal cancer
breast cancer
hepatobiliary cancer
lung cancer
kidney cancer
prostate cancer
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...

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