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lung cancer

New Guideline Updates Address Stage IV Non–Small Cell Lung Cancer With and Without Driver Alterations

Two ASCO guideline updates provide new evidence-based recommendations for the systemic treatment of stage IV non–small cell lung cancer (NSCLC) with and without driver alterations.1,2 Among several other updates, these new guidelines add the ALK and ROS1 inhibitor lorlatinib and the PD-L1 immune...

breast cancer

APHINITY Trial in Patients With HER2-Positive Early Breast Cancer: Update at 8 Years

Updated results from the adjuvant APHINITY trial in HER2-positive early breast cancer, now with a median follow-up of 8.4 years, confirmed the benefit of adding pertuzumab to trastuzumab plus chemotherapy in preventing invasive disease recurrences, but as yet no statistically significant overall...

pancreatic cancer

Sequencing Therapies May Improve Overall Survival in Metastatic Pancreatic Cancer

In the first-line treatment of metastatic pancreatic cancer, the sequencing of nab-paclitaxel plus gemcitabine with FOLFOX (fluorouracil, leucovorin, oxaliplatin) resulted in a significant improvement in overall survival at 12 months and in all other efficacy endpoints as compared with the standard ...

lung cancer
immunotherapy

Real-World Evidence Confirms Survival Benefit of Durvalumab in Locally Advanced Non–Small Cell Lung Cancer

In locally advanced non–small cell lung cancer (NSCLC), immunotherapy consolidation with the PD-L1 inhibitor durvalumab improved overall survival in the PACIFIC trial,1 thus leading to its use after chemoradiotherapy as a standard of care. Real-world evidence of durvalumab’s effect on overall and...

His Grandmother’s Death Inspires a Career in Oncology for Manmeet S. Ahluwalia, MD, MBA

In this installment of Living a Full Life, Guest Editor Jame Abraham, MD, spoke with Manmeet S. Ahluwalia, MD, MBA, Deputy Director, Chief Scientific Officer, and Chief of Solid Tumor Medical Oncology at Miami Cancer Institute, where his research focuses on the development of new therapies for...

Expert Point of View: Rebecca A. Dent, MD

The invited discussant of the DS8201-A-U105 trial, Rebecca A. Dent, MD, Head of the Department of Medical Oncology, Senior Consultant, and Chief of the Breast Medical Oncology Service at the National Cancer Center Singapore, said the results were reassuring in terms of safety and may pave the way...

breast cancer

Nivolumab Plus T-DXd Under Study in HER2-Expressing Metastatic Breast Cancer

In the phase Ib DS8201-A-U105 trial, the addition of the PD-1 inhibitor nivolumab to the antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) did not appear to improve outcomes over T-DXd alone (based on historical controls). However, it did establish the safety of the combination,...

solid tumors
immunotherapy

Immunotherapy for Gastrointestinal Malignancies: Is It Ready for Prime Time?

In less than a decade, immunotherapy has reshaped the treatment landscape of cancer, but some histologies tend to be more responsive to this modality than others. During the Society of Surgical Oncology 2022 International Conference on Surgical Care, Yuman Fong, MD, of the City of Hope Medical...

Expert Point of View: Claudine Isaacs, MD

The invited discussant of PALOMA-2 was Claudine Isaacs, MD, Professor of Medicine and Oncology at Lombardi Comprehensive Cancer Center, Georgetown University, Washington, DC. Dr. Isaacs examined the findings in context of the MONALEESA trials, which showed an overall survival benefit with...

breast cancer

PALOMA-2: No Overall Survival Benefit Reported With Palbociclib/Letrozole in Advanced Breast Cancer

The final overall survival analysis of the phase III PALOMA-2 trial has shown no significant benefit for palbociclib given with letrozole, vs letrozole and placebo, as a first-line treatment in hormone receptor–positive, HER2-negative metastatic breast cancer.1 The results were reported at the 2022 ...

breast cancer

ASCO Guideline Update Supports New Second- and Third-Line Treatments for HER2-Positive Breast Cancer

ASCO has issued a new practice guideline update on the use of systemic therapy for HER2-positive breast cancer, just 4 years after the previous practice guideline update was released in 2018.1,2 This latest update reviews results from multiple clinical trials published between 2016 and 2021 that...

issues in oncology
cost of care

Medical Costs and Clinical Value: Playing the Long Game

Even as soaring medical costs strain public and private budgets around the world, patients yearn for therapeutic breakthroughs. Game-changing cancer treatments, emerging antiviral agents, and mRNA vaccines are powerful reminders of medical technology’s potential. But insurance premiums and...

breast cancer

Changing the Natural History of ER-Positive, HER2-Negative Breast Cancer With the Introduction of CDK4/6 Inhibition

It has been 14 years since a collaboration between the University of California, Los Angeles (UCLA) and Pfizer identified a unique role for cyclin-dependent kinase 4/6 (CDK4/6) inhibitors in estrogen receptor (ER)-positive human cell line models and demonstrated that these agents act...

kidney cancer

Adjuvant Everolimus Narrowly Misses Statistical Significance in RCC, Except for Very High–Risk Patients

In the phase III EVEREST trial, adjuvant everolimus improved median recurrence-free survival in patients with resected renal cell carcinoma (RCC), but this finding failed to be statistically significant in the total study population of 1,499 patients, according to a prespecified boundary. However,...

global cancer care

Two Early-Career Cancer Researchers From Africa Aim to Make a Difference and Never Give Up

In countries with a high income, research in oncology is sponsored by funding agencies and industry, which has meaningfully improved survival outcomes of patients with cancer. In contrast, the African continent is disadvantaged in all aspects of human development, particularly in the fields of...

breast cancer

Addition of Ribociclib to Letrozole Improves Survival in Women With HR-Positive, HER2-Negative Advanced Breast Cancer

As reported in The New England Journal of Medicine by Gabriel N. Hortobagyi, MD, of the Department of Breast Medical Oncology, MD Anderson Cancer Center, Houston, and colleagues, the protocol-specified final overall survival analysis of the phase III MONALEESA-2 trial has shown a significant...

integrative oncology

Affirming Health Equity: A Model for Integrative Health Care

Guest Editor’s Note: Despite the increasing use of complementary modalities that include mind-body therapies and natural products, significant disparities exist in integrative health care. Contributing factors include access to care and affordability. In this installment of The ASCO Post’s...

cns cancers
genomics/genetics

Deciphering the Elusive Origin and Pathways of Brain Metastases

The effective treatment of patients with brain metastases is an unmet need because, until fairly recently, patients with brain metastases were excluded from clinical trials of systemic therapies. However, the emergence of molecular targeted therapies has allowed a new treatment approach in patients ...

prostate cancer

LuPSMA Improves Progression-Free Survival vs Cabazitaxel in PSMA-Positive Metastatic Castration-Resistant Prostate Cancer

Lutetium-177–labeled PSMA-617 (LuPSMA; lutetium Lu 177 vipivotide tetraxetan) achieved longer progression-free survival with fewer toxicities compared with cabazitaxel in patients with prostate-specific membrane antigen (PSMA)-positive metastatic castration-resistant prostate cancer whose disease...

multiple myeloma

Responses to Teclistamab Reported in Early-Phase Trial of Highly Refractory Multiple Myeloma

In patients with multiple myeloma exposed or refractory to three standard therapies, treatment with the bispecific antibody teclistamab produced strong and durable responses in the phase I/II MajesTEC-1 study.1 The results of weekly subcutaneous dosing of teclistamab in 165 patients were presented...

issues in oncology

History of Radiation Oncology in the United States

Part 1 of this two-part report described the beginnings of radiation oncology in the United States, including many of the field’s early pioneers and the rise of associated professional societies. In part 2, we will consider the advances in technology and biology that are the foundation of modern...

skin cancer

ASCO Guideline Update for Systemic Melanoma Therapy Addresses New Treatment Option for Uveal Melanoma

A rapid update to the ASCO guideline on systemic therapy for melanoma adds a new recommendation for the treatment of patients with metastatic uveal melanoma.1 The update follows the January 2022 U.S. Food and Drug Administration (FDA) approval of tebentafusp-tebn for patients with previously...

breast cancer

ASCO Guideline Update Aims to Improve Patient Outcomes for HER2-Positive Breast Cancer With Brain Metastases

Rapid developments over the past decade in the treatment of patients with advanced HER2-positive breast cancer may lead to better outcomes and improved quality of life for patients with brain metastases, according to findings incorporated into a new ASCO guideline update.1 “The difference this...

colorectal cancer

Circulating Tumor DNA–Guided Approach to Treating Stage II Colon Cancer

The use of postoperative circulating tumor DNA (ctDNA) in stage II colon cancer spared many patients the need for adjuvant chemotherapy without compromising recurrence-free survival, according to the phase II DYNAMIC study.1 “The strategy of using ctDNA results to inform treatment almost halved...

leukemia

Phase III Trial Reports Quizartinib Doubles Overall Survival in FLT3-ITD–Positive AML

A new treatment option has doubled overall survival for a difficult-to-treat subset of patients with acute myeloid leukemia (AML), according to data presented during the Presidential Symposium at the European Hematology Association (EHA) 2022 Congress in Vienna.1 Findings from the phase III...

Expert Point of View: Joseph Mikhael, MD, MEd

Invited discussant of the ­DETERMINATION trial, Joseph Mikhael, MD, MEd, Professor of Applied Cancer Research and Drug Discovery at the Translational Genomics Research Institute, City of Hope Cancer Center, described the many implications of the important findings for DETERMINATION and offered some ...

hematologic malignancies

Early Transplant With Triplet Therapy May Delay Progression of Myeloma, but Individualized Approach Recommended

In the phase III DETERMINATION trial, progression-free survival was significantly improved with triplet induction therapy and early transplantation in newly diagnosed patients with multiple myeloma, but overall survival at 5 years was similar to the nontransplant approach.1 The findings were...

issues in oncology

History of Radiation Oncology in the United States

Radiation therapy has long been one of the three pillars of cancer therapy—surgery, chemotherapy, and radiotherapy—only recently joined by what is widely considered a fourth pillar, immunotherapy. In part 1 of this two-part report, we trace the beginnings of radiation oncology in the United...

gynecologic cancers

ARIEL4 Confirms Rucaparib’s Efficacy in Recurrent, BRCA-Mutated Ovarian Cancer: Does It Tell Us Anything New?

In March 2022, Kristeleit et al reported the results of the ARIEL4 trial1 of rucaparib in relapsed BRCA-mutant ovarian cancer in The Lancet Oncology (summarized in this issue of The ASCO Post) and are to be congratulated on this accomplishment. This report, along with the almost simultaneous...

global cancer care
cardio-oncology

Cancer and War in Ukraine: How the World Can Help Win This Battle

In Ukraine, with a population of about 44 million, there are more than 1.3 million patients with cancer. Approximately 160,000 new cases of cancer are diagnosed each year.1 In almost every region, there are local cancer centers; specialized oncologic centers are located in large cities. In Kyiv,...

colorectal cancer
immunotherapy

Expert Point of View: Kimmie Ng, MD, MPH

The study’s invited discussant was Kimmie Ng, MD, MPH, Associate Professor of Medicine at Harvard Medical School and Co-Director of the Colon and Rectal Cancer Center at Dana-Farber Cancer Institute, Boston. “Neoadjuvant dostarlimab-gxly for 6 months represents a promising new treatment for...

colorectal cancer
immunotherapy

100% Complete Response Rate in 14 Patients With Rectal Cancer Treated With Neoadjuvant Dostarlimab-gxly

In a study of 18 patients with locally advanced mismatch repair–deficient (dMMR) rectal cancer, 6 months of neoadjuvant treatment with the anti–PD-1 agent dostarlimab-gxly alone led to clinical complete responses in 100% of the study’s first 14 patients.1 These results were presented at the 2022...

breast cancer
immunotherapy

DESTINY-Breast04 Trial: T-DXd Significantly Improves Survival in Patients With HER2-Low Metastatic Breast Cancer

The antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) doubled progression-free survival compared with chemotherapy alone in patients with “HER2-low” metastatic breast cancer—ie, patients with low levels of HER2 expression. The agent also extended overall survival for patients with low ...

covid-19

Looking Back at Telemedicine During the COVID-19 Era: Lessons Learned and Disparities Identified

Telemedicine stepped up to the plate when the COVID-19 pandemic swept the globe. Oncology providers—and practitioners in all specialties—had to rapidly adapt to a telemedicine format when face-to-face visits were severely limited. This scenario had its benefits for both patients and providers (and...

breast cancer

ASCO Refines Guidance on Using Biomarkers for Adjuvant Endocrine and Chemotherapy in Early-Stage Breast Cancer

A new ASCO guideline update provides further recommendations on the use of biomarkers to guide decision-making on adjuvant endocrine therapy and chemotherapy in patients with early-stage breast cancer.1 The update includes clarification of the use of certain genomic tests, based on age or...

integrative oncology

Traditional Chinese Medicine Herbal Formula Ma Zi Ren Wan for Constipation

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. In this installment, Eugenie Spiguel, MSN, ANP-BS, and Jyothirmai Gubili, MS, focus on Ma Zi Ren...

Cemiplimab-rwlc Following Platinum-Based Chemotherapy in Recurrent or Metastatic Cervical Cancer: Clinical Implications

It is estimated that globally, more than 600,000 women per year are diagnosed with cervical cancer, and more than 300,000 die annually of the disease.1 Many women continue to be diagnosed with cervical cancer at an advanced stage, with a high risk of recurrence. To date, the most effective...

gynecologic cancers
immunotherapy

Cemiplimab-rwlc Improves Overall Survival vs Chemotherapy in Recurrent Cervical Cancer After First-Line Platinum-Based Chemotherapy

As reported in The New England Journal of Medicine by Krishnansu S. Tewari, MD, of the Division of Gynecologic Oncology, University of California, Irvine, and colleagues, the phase III ­EMPOWER-Cervical1/GOG-3016/ENGOT-cx9 trial has shown improved overall survival with cemiplimab-rwlc vs...

breast cancer
immunotherapy

DESTINY-Breast03: Should Trastuzumab Deruxtecan Be the Preferred Second-Line Regimen in HER2-Positive Metastatic Breast Cancer?

Since the introduction of trastuzumab in the late 1990s, overall survival for patients with HER2-positive metastatic breast cancer has substantially improved. Median overall survival in the pivotal first-line trial was only 20.3 months in the chemotherapy arm, and 25.1 months in the...

breast cancer
immunotherapy

T-DXd Improves Progression-Free Survival vs T-DM1 in Metastatic HER2-Positive Breast Cancer

As reported in The New England Journal of Medicine by Javier Cortés, MD, PhD, of the International Breast Cancer Center, Barcelona, and colleagues, the phase III DESTINY-Breast03 trial has shown significantly prolonged progression-free survival with fam-trastuzumab deruxtecan-nxki (T-DXd) vs...

A Community Practitioner and Policy Advocate Who Stresses Holistic, Patient-Centered Care

Community practices have long been a keystone of our nation’s oncology care delivery system by allowing patients with cancer to receive specialized treatment near their homes and places of business. Innovative clinicians in the community setting are also leading efforts to create a more efficient...

Navigating Difficult Waters: A Cancer Journey

In the summer of 2017, while visiting Normandy, 64-year-old Mark’s right testis became enlarged and tender. His initial workup identified a large testicular Leydig cell tumor with adverse pathologic features; computed tomography showed no evidence of metastasis.1,2 His medical history was otherwise ...

A Personal Cancer Journey Shifts a Career in the Arts to a Career in Radiation Oncology

It is safe to assume that most oncologists take a fairly straight career path, beginning with the decision to become a doctor. Along the educational journey from medical school to fellowship, an event or mentor usually incites the passion to pursue the challenging field of oncology. Although Fumiko ...

multiple myeloma

Multiple Myeloma: Treatment Conundrums

The availability of numerous new agents for treating multiple myeloma has created some “conundrums” for clinicians, said Sergio Giralt, MD, Deputy Head of the Division of Hematologic Malignancies at Memorial Sloan Kettering Cancer Center and the Melvin Berlin Family Chair in Myeloma Research and...

issues in oncology

Incidental Respiratory Disease Found in Low-Dose CT Screens: Challenges and Opportunities

A retrospective analysis of the National Lung Screening Trial (NLST) by Pinsky et al, summarized in the April 25, 2022, issue of The ASCO Post, found high rates of incidental respiratory abnormalities on low-dose computed tomography (CT) examinations.1 Specifically, the findings of emphysema and...

breast cancer
immunotherapy

ASCO Guideline Rapid Update Addresses the Use of Neoadjuvant Pembrolizumab in High-Risk Early-Stage Triple-Negative Breast Cancer

A rapid update to the ASCO Guideline on neoadjuvant therapy for breast cancer adds a recommendation on the use of pembrolizumab in patients with high-risk early-stage triple-negative breast cancer.1 The update follows a recent analysis from the randomized phase III KEYNOTE-522 trial that showed a...

lung cancer
immunotherapy

CheckMate 816: Neoadjuvant Nivolumab Plus Chemotherapy Improves Event-Free Survival Over Chemotherapy Alone in Resectable NSCLC

The combination of neoadjuvant nivolu­mab plus chemotherapy achieved statistically significant and clinically meaningful improvement in event-free survival vs chemotherapy alone (P = .005) in patients with resectable non–small cell lung cancer (NSCLC, stage IB–IIIA), according to the results of the ...

lung cancer

Long-Term Overall Survival in Unresectable Stage III NSCLC With Consolidation Durvalumab in the PACIFIC Trial: Translation to Real-World Outcomes?

Lung cancer mortality rates have declined by more than 50% in men since 1990 and more than 30% in women since 2002. These declines in mortality are largely due to increases in smoking cessation. However, in recent years, clinical treatment advances, such as targeted therapies and immunotherapy,...

gastroesophageal cancer
immunotherapy

PD-1 Inhibition in First-Line Treatment of Advanced Esophageal Squamous Cell Carcinoma: More to Come on New Paradigm

Esophageal cancer is associated with significant morbidity and mortality worldwide, with more than 600,000 new cases and 540,000 deaths in 2020. The squamous cell histology comprises nearly 90% of cases globally, despite its steady decline in the United States over the past 40 years. Historically,...

lung cancer

5-Year Survival Outcomes With Consolidation Durvalumab After Chemoradiotherapy in Unresectable Stage III NSCLC

As reported in the Journal of Clinical Oncology by David R. Spigel, MD, of Sarah Cannon Research Institute/Tennessee Oncology, and colleagues, long-term follow-up of the phase III PACIFIC trial has shown maintained progression-free and overall survival benefits with consolidation durvalumab (a...

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