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COVID-19: Infection Rate Among Patients Undergoing Anticancer Therapy and Its Effect on Cancer Clinical Trials

As COVID-19 infection rates again spike around the nation, this week, we’re looking at two recent studies focused on COVID-19 and cancer. The first describes the rate of infection with the virus among asymptomatic patients with cancer undergoing active treatment for their solid tumors. The second...

leukemia

Final ASCEND Results Confirm Acalabrutinib as a Standard for Relapsed CLL

The Bruton’s tyrosine kinase (BTK) inhibitors have been one of the most exciting advances in the treatment of patients with chronic lymphocytic leukemia (CLL) and have led to the development of chemotherapy-free treatments for both treatment-naive as well as relapsed or refractory CLL based on...

leukemia
immunotherapy

Acalabrutinib Improves Progression-Free Survival vs Idelalisib Plus Rituximab or Bendamustine Plus Rituximab in Relapsed or Refractory CLL

As reported in the Journal of Clinical Oncology by Paolo Ghia, MD, PhD, of the Università Vita-Salute San Raffaele, Milan, Italy, and colleagues, the phase III ASCEND trial showed significantly prolonged progression-free survival with acalabrutinib monotherapy vs investigator’s choice of either...

multiple myeloma
immunotherapy

Support Builds for Anti-BCMA CAR T-Cell Therapy in Multiple Myeloma

Based on early results in clinical trials, interest in the use of chimeric antigen receptor (CAR) T-cell therapy in multiple myeloma has been high, especially for products targeting B-cell maturation antigen (BCMA). During the ASCO20 Virtual Scientific Program, further support for CAR T-cell...

multiple myeloma
immunotherapy

Responses Achieved With Belantamab Mafodotin in Relapsed or Refractory Myeloma

The antibody-drug conjugate belantamab mafodotin yielded responses as a single agent and in combination with bortezomib and dexamethasone in the treatment of relapsed or refractory multiple myeloma, according to two reports from the DREAMM team at the ASCO20 Virtual Scientific Program.1,2 In the...

leukemia
lymphoma
multiple myeloma
immunotherapy

Novel Therapies and New Indications for Use in Treatment of Hematologic Malignancies

Daratumumab and hyaluronidase-fihj: On May 1, 2020, the FDA approved daratumumab and hyaluronidase-fihj (Darzalex) for adult patients with newly diagnosed or relapsed or refractory multiple myeloma. Ibrutinib: On April 21, 2020, the FDA expanded the indication of ibrutinib (Imbruvica) to include...

multiple myeloma
immunotherapy

Novel Treatment Approaches on the Horizon in Multiple Myeloma

Clinicians who treat multiple myeloma can anticipate a host of new treatments: melflufen, cereblon E3 ligase modulators (CELMoDs), antibody-drug conjugates, bispecific antibodies, and chimeric antigen receptor (CAR) T-cell therapies. Kenneth C. Anderson, MD, FASCO, Director of the Jerome Lipper...

leukemia
lymphoma
multiple myeloma
immunotherapy

Novel Therapies and New Indications for Use in Treatment of Hematologic Malignancies

Venetoclax: On October 16, 2020, the U.S. Food and Drug Administration (FDA) approved venetoclax (Venclexta) in combination with azacitidine, decitabine, or low-dose cytarabine for newly diagnosed acute myeloid leukemia (AML) in adults aged 75 or older. See page 32 for more on this approval....

hematologic malignancies
multiple myeloma
lymphoma
leukemia
immunotherapy

Hematologic Oncology Highlights 2019–2020 Almanac

The past year has seen remarkable advances in the treatment of leukemia, lymphoma, and multiple myeloma, which combined account for 9.9% of the estimated 1,806,590 new cases of cancer diagnosed in the United States and an estimated 56,840 cancer-related deaths.1 Novel therapies are providing...

breast cancer
legislation

Study Finds Medicaid Expansion in Louisiana Increased Early-Stage Breast Cancer Diagnosis and Access to Treatment

A study by Quyen D. Chu, MD, MBA, FACS, and colleagues published in the journal Cancer investigated how expansion of the Medicaid provision in the the Patient Protection and Affordable Care Act (ACA) affected breast cancer care in Louisiana. The state is the third poorest in the country and has one ...

issues in oncology

Does Supplementation With Vitamin D Reduce the Risk of Developing Advanced Cancer?

The Vitamin D and Omega-3 Trial (VITAL), which was completed in 2018, found that vitamin D did not reduce overall incidence of cancer, but it hinted at a decreased risk of cancer deaths. Now, in a secondary analysis of VITAL, a research team focused on the connection between taking vitamin D...

multiple myeloma

Association of FDG Uptake According to Deauville Criteria With Survival Outcomes in Newly Diagnosed Multiple Myeloma

In an analysis reported in the Journal of Clinical Oncology, Zamagni et al found that fluorodeoxyglucose F-18 (FDG) uptake of less than 4 on the Deauville scale in bone marrow and focal lesions on pre–maintenance therapy FDG positron-emission tomography/computed tomography (PET/CT) scans was...

lymphoma

Study Results With PET-Directed Therapy for Limited-Stage DLBCL

As reported in the Journal of Clinical Oncology by Daniel O. Persky, MD, of the University of Arizona Cancer Center, Tucson, and colleagues, the phase II Intergroup National Clinical Trials Network Study S1001 has shown good outcomes with positron-emission tomography (PET)-directed therapy in...

hematologic malignancies

Bispecific Antibodies Poised to Impact Treatment of Lymphoma and Other Blood Cancers

Studies of second-generation bispecific antibodies were among the highlights of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition. The bispecific T-cell engager blinatumomab was the first such agent to be approved by the U.S. Food and Drug Administration (FDA) in...

lymphoma

Chemotherapy-Free Approaches in Follicular and Mantle Cell Lymphomas

As chemotherapy and chemoimmunotherapy regimens reach their maximal impact in follicular lymphoma and mantle cell lymphoma, clinicians are turning to chemotherapy-free approaches to achieve better control, less toxicity, and (hopefully) a cure. During the ASCO20 Virtual Education Program, Sonali...

lymphoma

Newer Therapeutic Approaches Improving Outcomes in Hodgkin Lymphoma

At the 2020 Debates and didactics in Hematology and Oncology Virtual Conference, sponsored by Emory University School of Medicine and Winship Cancer Institute, Pamela Allen, MD, Assistant Professor of Medicine at Emory, described recent trials on therapeutic approaches that are informative on this ...

lymphoma

Role of Rituximab in Treatment of Children and Adolescents With Mature B-Cell Non-Hodgkin Lymphoma

The European Intergroup for Childhood Non-Hodgkin Lymphoma/Children’s Oncology Group (EICNHL/COG) recently reported a significant improvement in event-free survival among children and adolescents (aged 6 months to 18 years) with high-risk mature B-cell non-Hodgkin lymphoma (B-NHL) following the...

lymphoma

Addition of Rituximab to Standard Chemotherapy Improves Event-Free and Overall Survival in Children With High-Risk, Mature B-Cell Non-Hodgkin Lymphoma

In a European Intergroup for Childhood Non-Hodgkin Lymphoma/Children’s Oncology Group phase III trial, reported in TheNew England Journal of Medicine, -Véronique Minard-Colin, MD, PhD, of Gustave Roussy, Université Paris-Saclay, Villejuif, France, and colleagues found that the addition of rituximab ...

leukemia

Venetoclax Combination in Newly Diagnosed AML

On October 16, 2020, the U.S. Food and Drug Administration (FDA) granted regular approval to venetoclax (Venclexta) in combination with azacitidine, decitabine, or low-dose cytarabine for newly diagnosed acute myeloid leukemia (AML) in adults aged 75 or older or who have comorbidities precluding...

leukemia

Optimizing the Treatment of Adults With Acute Lymphoblastic Leukemia

In the treatment of adults with acute lymphoblastic leukemia (ALL), use of newer antibodies and de-intensification of chemotherapy have greatly improved outcomes, according to Hagop Kantarjian, MD, FASCO, who has been very involved in much of the research in ALL treatment. Dr. Kantarjian, Professor ...

breast cancer
gynecologic cancers
genomics/genetics

Screening Younger Women for Variants Linked to Breast and Ovarian Cancers May Be Cost-Effective

Population-wide screening for genetic variants linked to hereditary breast and ovarian cancers may be cost-effective in women between the ages of 20 and 35, according to a study published by Guzauskas et al in JAMA Network Open. However, screening for older women was not cost-effective, the...

breast cancer
genomics/genetics

Paclitaxel Plus Trastuzumab With or Without Lapatinib in HER2-Positive Breast Cancer: Long-Term Follow-up and Genomic Analysis

In a 7-year follow-up of the phase III CALGB 40601/Alliance neoadjuvant trial reported in the Journal of Clinical Oncology, Fernandez-Martinez et al found that paclitaxel combined with trastuzumab/lapatinib was associated with improved survival outcomes vs paclitaxel/trastuzumab in women with...

leukemia

Addition of Venetoclax to Bortezomib/Dexamethasone in Relapsed or Refractory Multiple Myeloma: BELLINI Trial

As reported in The Lancet Oncology by Shaji K. Kumar, MD, and colleagues, the phase III BELLINI trial has shown that the addition of venetoclax to bortezomib/dexamethasone significantly prolonged progression-free survival in patients with relapsed or refractory multiple myeloma but was associated...

leukemia

Ivosidenib Plus Azacitidine in Newly Diagnosed IDH1-Mutant Acute Myeloid Leukemia

In a phase Ib study reported in the Journal of Clinical Oncology, Courtney D. DiNardo, MD, and colleagues found that the combination of ivosidenib and azacitidine produced a high response rate in patients with newly diagnosed isocitrate dehydrogenase 1 (IDH1)-mutant acute myeloid leukemia...

solid tumors

Genetic Variants Linked to Bevacizumab-Induced Adverse Effects

Two common genetic variants appear to be linked to toxicity induced by bevacizumab, researchers reported at the 32nd European Organisation for Research and Treatment of Cancer (EORTC)–National Cancer Institute (NCI)–American Association for Cancer Research (AACR) Symposium on Molecular Targets and...

symptom management

Ask Patients With Advanced Cancer About Fatigue: The Answer May Reveal Survival Odds

Fatigue could be an important baseline stratification factor for cancer treatment, according to data presented during the 2020 ASCO Quality Care Symposium.1 An analysis of four SWOG treatment trials has found an association between patient fatigue and outcomes in advanced cancer. Data from the...

breast cancer

Addition of Indoximod to Taxane Chemotherapy in First-Line Treatment of HER2-Negative Metastatic Breast Cancer

In a phase II trial reported in JAMA Oncology, Mariotti et al found that the addition of the indoleamine 2,3-dioxygenase 1 (IDO1) pathway inhibitor indoximod to a taxane did not improve progression-free survival in first-line treatment of patients with metastatic HER2-negative breast cancer. As...

covid-19

Serial COVID-19 Screening in Asymptomatic Patients Receiving Treatment for Cancer

In a United Arab Emirates single-institution study reported as a research letter in JAMA Oncology, Al-Shamsi et al found a high rate of COVID-19 infection among asymptomatic patients with solid tumors undergoing cancer treatment. Study Details The study included 109 patients receiving treatment for ...

legislation
breast cancer
colorectal cancer
lung cancer

Medicaid Expansion Associated With Decreased Mortality in Patients With Newly Diagnosed Breast, Colorectal, and Lung Cancers

In states that have expanded Medicaid availability as part of the Affordable Care Act (ACA), mortality rates for three major types of cancer are significantly lower than in states that have not expanded their Medicaid, according to findings from a new study published by Miranda B. Lam, MD, MBA, and ...

solid tumors

Stereo X-Ray of Stomach Cancer

The text and photograph here are excerpted from a four-volume series of books titled Oncology: Tumors & Treatment, A Photographic History, The X-Ray Era 1901–1915 by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. Photograph courtesy of Stanley B. Burns, MD, and The Burns Archive. A few...

breast cancer

Beyond BROCADE3: Just the Beginning for Veliparib-Based Therapy in Advanced BRCA-Mutated Breast Cancer

As recently reported in The Lancet Oncology and reviewed in the October 10, 2020, issue of The ASCO Post, the phase III BROCADE3 trial has shown that the addition of veliparib to carboplatin and paclitaxel improved progression-free survival in previously treated BRCA-mutated advanced breast...

bladder cancer
immunotherapy

DANUBE Trial Reports No Survival Benefit With First-Line Durvalumab in Metastatic Urothelial Carcinoma

As reported in The Lancet Oncology by Thomas Powles, MD, of Barts Cancer Institute, Queen Mary University of London, and colleagues, the phase III DANUBE trial showed that durvalumab monotherapy did not prolong overall survival vs standard chemotherapy in previously untreated patients with...

A Doctor Shares His Rich Life in Medicine and Cancer Research

“What am I doing here? This question kept running through my mind as the incoming freshman medical students at the University of Chicago assembled for the first time.” The person asking the introspective question was Marvin Stone, fresh out of college, recently married to his wife, Jill, and now a...

An Emergency Room Physician Explores Her Own Healing Through a Life of Medical Service

Medical memoir dramas, especially those centered in the emergency room (ER), are often met with the anticipation of top-rated medical shows portrayed on TV, in which there is nonstop blood-and-guts action and sizzling tensions between shouting doctors and nurses. In her recently published memoir,...

Three New Transatlantic Research Teams to Study Difficult-to-Treat Childhood Cancers

Although remarkable progress has been made in advancing pediatric cancer research, critical unmet needs remain, especially for more aggressive cancers such as neuroblastomas and Ewing sarcoma. The Stand Up To Cancer–Cancer Research UK Pediatric Cancer New Discoveries Challenge has awarded three...

breast cancer

PALOMA-3 Exploratory Analysis: Who Benefits Most From Palbociclib?

The phase III PALOMA-3 trial significantly reduced the risk of disease progression by 50% in patients with hormone receptor–positive/HER2-negative advanced breast cancer, but the improvement in overall survival did not reach statistical significance.1 An exploratory subgroup analysis has now shown...

pancreatic cancer

Pancreatic Adenocarcinoma: Leveraging Molecular Data to Drive Clinical Advances

With the worst 5-year overall survival of all cancers and the second-leading cause of cancer death, pancreatic adenocarcinoma remains a dismal prognosis for the vast majority of patients. However, more accurate tumor staging and better understanding of distinct molecular subgroups have started to...

issues in oncology
supportive care

Reducing Emergency Department Visits: Better Patient Outreach May Improve Care, Treatment Costs

Identifying patients at risk for adverse outcomes and intervening with intensive clinical services may improve cancer care while saving billions of dollars in avoidable emergency department (ED) visits. And, in fact, cancer centers may already have all the information they need to do so, according...

issues in oncology
cost of care

Medical Financial Hardship: Pervasive and Possibly Linked to Mortality Among Patients With Cancer

Reducing the financial impact of cancer diagnosis and treatment may save not only bank accounts but lives as well, according to recent data. Two separate survey studies presented during the 2020 ASCO Quality Care Symposium have highlighted the pervasiveness and deadliness of financial toxicity,...

After Leaving His Home in Syria to Train Abroad, an Oncologist Makes a Tough Decision to Return

For this installment of the Living a Full Life series, guest editor Jame Abraham, MD, FACP, spoke with Nedal Estfan, MD, a noted Syrian oncologist who was at the forefront of his county’s earliest efforts to establish a national cancer care system during a time of political and military turmoil....

leukemia

Chronic Lymphocytic Leukemia: New Treatments Achieve Deeper Remissions

At the National Comprehensive Cancer Network® (NCCN®) 2020 Virtual Congress: Hematologic Malignancies, William Wierda, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston, reviewed current data on chronic lymphocytic leukemia (CLL), including promising new combinations of modern...

lung cancer

Fragment Analysis as a MET Exon 14 Screening Strategy in NSCLC Tumors

Comparison of two techniques used in screening non–small cell lung cancer (NSCLC) tumor samples demonstrated that fragment analysis could detect large MET exon 14 skipping deletions that were missed by next-generation sequencing, according to findings presented at the Molecular Analysis for...

lymphoma
immunotherapy

Do All Patients With Refractory Diffuse Large B-Cell Lymphoma Need CAR T-Cell Therapy?

Chimeric antigen receptor (CAR) T-cell therapy has made great strides in treating patients with relapsed or refractory diffuse large-B cell lymphoma (DLBCL) and refractory mantle cell lymphoma (MCL), but there may be newer strategies that can produce equivalent outcomes, and not all patients with...

prostate cancer

No Biochemical Progression-Free Survival Benefit With Adjuvant vs Salvage Radiotherapy After Radical Prostatectomy for Prostate Cancer

As reported in The Lancet by Christopher C. Parker, MD, of Royal Marsden NHS Foundation Trust, Sutton, United Kingdom, and colleagues, initial findings in the phase III RADICALS-RT trial have shown no biochemical progression-free survival benefit with adjuvant radiotherapy vs a policy of salvage...

issues in oncology
covid-19

Results From ASCO’s 2020 National Cancer Opinions Survey

As in past years, the results from ASCO’s 2020 National Cancer Opinions Survey showed a startling dichotomy in the perceptions of Americans on a variety of health-care issues. As expected, the two major events this year, the COVID-19 pandemic and a national reckoning over racial injustice,...

breast cancer
geriatric oncology

Surgery Improves Survival in Older Women With Early Estrogen Receptor–Positive Breast Cancer

Older women with estrogen receptor–positive breast cancer have poorer survival than younger women, but this gap might be closed by offering surgery to women over age 70 who are fit and have resectable tumors. According to a study presented at the 12th European Breast Cancer Conference (EBCC 12),...

Expert Point of View: Tim Price, MBBS, DHthSc

The invited discussant of PRODIGE 13 was Tim Price, MBBS, DHthSc, Professor at the University of Adelaide, Australia, senior consultant medical oncologist, and Director of Medical Oncology and Clinical Cancer Research at the Queen Elizabeth Hospital. As he reminded listeners, the current ASCO...

colorectal cancer

After Surgery for Colorectal Cancer, Intensive Monitoring of Little Benefit: PRODIGE 13

Is intensive monitoring of patients after curative colorectal cancer resection warranted? Not necessarily, according to the findings of PRODIGE 13, reported at the European Society for Medical Oncology (ESMO) Virtual Congress 2020.1 “After curative surgery, the addition of CEA [carcinoembryonic...

breast cancer
immunotherapy

First-Line Pembrolizumab Delays Disease Progression in PD-L1–Expressing Metastatic Triple-Negative Breast Cancer

In the phase III KEYNOTE-355 trial, pembrolizumab combined with several chemotherapy partners yielded a statistically significant and clinically meaningful improvement in progression-free survival vs chemotherapy alone in patients with previously untreated locally advanced or metastatic...

covid-19

UK-Based Study Finds Evidence of COVID-19 Infection, Antibody Presence in Oncology Health-Care Staff

A study of oncology staff carried out immediately after the spring peak of the COVID-19 pandemic in the United Kingdom indicated that many had been infected with the coronavirus, including those who did not show any symptoms. The study—presented by Favara et al at the NCRI (National Cancer Research ...

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