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global cancer care

Cancer on the Global Stage: Incidence and Cancer-Related Mortality in Cambodia

The ASCO Post is pleased to continue this occasional special focus on the worldwide cancer burden. In this issue, we feature a close look at the cancer incidence and mortality rates in Cambodia. The aim of this special feature is to highlight the global cancer burden for various countries of the...

Penn Medicine Receives $4.9 Million Grant to Improve Uptake of Cancer Care Best Practices

Although extensive research has suggested ways to ensure that patients receive evidence-based cancer care, putting these solutions into widespread practice can be a complex, challenging, and inefficient process. Now, a new grant awarded to the Perelman School of Medicine at the University of...

David A. Karnofsky’s Early Contributions to Cancer Research Helped Establish Oncology as a Medical Discipline

For nearly 30 years, from the time he was a young resident at the Collis P. Huntington Memorial Hospital for Cancer Research of Harvard University, until his death from lung cancer on August 31, 1969, David A. Karnofsky, MD, dedicated himself to the pursuit of scientific excellence and the...

multiple myeloma

How to Treat Patients With Multiple Myeloma Cost-Effectively Without Compromising Outcome

The dramatic advances in the diagnosis and treatment of multiple myeloma over the past 20 years have resulted in significant improvements in overall survival, with 5-year relative survival rates now around 50% and more than 60% for patients younger than age 70.1 The proteasome inhibitors...

cost of care

How the First International Summit on Interventional Pharmacoeconomics Is Sparking Discussion on Reducing Cancer Costs

Three years ago, former Chief Executive Officer of ASCO, Allen S. Lichter, MD, Laurence H. Baker, DO, Professor in the Departments of Internal Medicine and Pharmacology at the University of Michigan Medical School in Ann Arbor; Leonard Saltz, MD, a gastrointestinal oncologist at Memorial Sloan...

leukemia
lymphoma

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 tre atment of 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 studies where...

leukemia
lymphoma

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 the investigator’s choice of...

skin cancer

Addition of Atezolizumab to Vemurafenib/Cobimetinib in Unresectable Advanced BRAF V600–Mutant Melanoma

As reported inThe Lancet by Ralf Gutzmer, MD, of Medizinische Hochschule Hannover, Germany, and colleagues, the phase III IMspire150 trial has shown that the addition of atezolizumab to BRAF and MEK inhibitor therapy with vemurafenib and cobimetinib improved progression-free survival in the...

Raymond N. DuBois, MD, PhD, Named Director, MUSC Hollings Cancer Center

The Medical University of South Carolina (MUSC) President David J. Cole, MD, FACS, has announced the appointment of MUSC College of Medicine Dean Raymond N. DuBois, MD, PhD, to the additional role as Director of the MUSC Hollings Cancer Center. Dr. DuBois has headed the College of Medicine for more ...

lymphoma
immunotherapy

Tafasitamab-cxix in the Treatment of Diffuse 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 July 31, 2020, tafasitamab-cxix, a CD19-directed...

covid-19

Repurposing Drugs for the Treatment of COVID-19

A vaccine for COVID-19 is currently the Holy Grail, but even if an effective vaccine were developed on a fast-track timetable, it may be effective in only a percentage of people, judging by existing flu vaccines, which show efficacy rates of approximately 45% and vary year by year. Until we have a...

gastrointestinal cancer

Switch Control Inhibitor for GISTs Harboring Drug-Resistance Mutations: The INVICTUS Trial

In May 2020, the U.S. Food and Drug Administration (FDA) approved ripretinib for patients who have received prior treatment with three or more kinase inhibitors, including imatinib, for advanced gastrointestinal stromal tumors (GIST). The approval was largely based on the findings of the...

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 M. ...

health-care policy

Past CMS and FDA Head Discusses Challenges in U.S. Health-Care Policy and Possible Solutions

As evidenced at this year’s ASCO20 Virtual Scientific Program, oncology science, technology, and clinical practice are evolving at a rapid pace, bringing new challenges to the efficient and ethical practice of cancer care at all levels. To shed light on some of the large-scale public health and...

prostate cancer

Rucaparib in Metastatic Castration-Resistant Prostate Cancer With Deleterious BRCA Alterations

As reported in the Journal of Clinical Oncology by Abida and colleagues, the phase II TRITON2 trial has shown that rucaparib produces durable responses in patients with metastatic castration-resistant prostate cancer with deleterious BRCA1 or BRCA2 alterations. The trial supported the May 2020...

multiple myeloma
immunotherapy

FDA Approves Daratumumab Plus Carfilzomib and Dexamethasone for Relapsed or Refractory Multiple Myeloma

On August 20, the U.S. Food and Drug Administration (FDA) approved daratumumab (Darzalex) in combination with carfilzomib (Kyprolis) and dexamethasone (DKd) for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three previous lines of therapy....

pancreatic cancer

ASCO Updates Metastatic Pancreatic Cancer Guideline

ASCO has released an update to its Metastatic Pancreatic Cancer Guideline that includes recommendations for second-line treatment, including early biomarker testing for actionable genomic alterations.1 Last updated in 2018, this new version was triggered by novel evidence related to targeted...

leukemia

Sorafenib Maintenance After Stem Cell Transplant in FLT3-ITD–Positive Acute Myeloid Leukemia

In a Chinese phase III trial reported in The Lancet Oncology, Xuan et al found that sorafenib maintenance after allogeneic hematopoietic stem cell transplantation significantly reduced the risk of relapse vs no maintenance therapy in patients with FLT3–internal tandem duplication (ITD)–positive...

solid tumors

Tumor Mutational Burden and the Future of Complex Biomarkers

The development of complex biomarkers such as tumor mutational burden (TMB) has enabled clinicians to identify patients more likely to respond to treatment of a variety of cancers, leading to more accurate diagnoses and improved outcomes. Differences in testing assays, however, have produced...

breast cancer
genomics/genetics

Three Novel Genetic Variants Linked to Male Breast Cancer Discovered

Scientists have newly discovered three genetic changes that increase the risk of breast cancer in men. These findings were published by Maguire et al in the Journal of the National Cancer Institute. The researchers identified three common variations in DNA that predispose men to developing breast...

colorectal cancer
genomics/genetics

Molecular Testing in Metastatic Colorectal Cancer: Understanding How, When, and What to Profile

“In line with the emergence of targeted therapies, molecular biomarker testing in metastatic colorectal cancer has evolved over the past decade,” noted Jeanne Tie, MD, MBChB, FRACP, who acknowledged there is confusion about the best ways to use molecular testing in the clinic. Dr. Tie, who is...

gynecologic cancers

Genomic Analysis of Cervical Cancer in Ugandan Patients

Nineteen of the 20 nations with the highest cervical cancer death rates are in sub-Saharan Africa. Now an international team has published the first comprehensive genomic study of cervical cancers in sub-Saharan Africa, with a focus on tumors from 212 Ugandan patients with cervical cancer. Their...

breast cancer
immunotherapy

Activity of Olaparib and Durvalumab in Germline BRCA-Mutated Metastatic Breast Cancer

As reported in The Lancet Oncology by Susan M. Domchek, MD, and colleagues, the combination of olaparib and durvalumab showed activity in a cohort of patients with germline BRCA-mutated, HER2-negative metastatic breast cancer enrolled in a phase I/II basket study (MEDIOLA). Study Details In the...

breast cancer
immunotherapy

Balancing Efficacy and Safety of Targeted Therapy in Breast Cancer Care

Novel targeted therapies have increased the likelihood of cure and prolonged survival in many patients with advanced breast cancer (Table 1), but these new agents also carry toxicity profiles that vary greatly from those of traditional chemotherapy. During the ASCO20 Virtual Education Program,...

hepatobiliary cancer
immunotherapy

Novel Tremelimumab/Durvalumab Regimen Active in Advanced Hepatocelluar Carcinoma

A single priming dose of tremelimumab and durvalumab, followed by monthly durvalumab, showed clinical activity in a predominantly second-line advanced hepatocellular carcinoma population, in a study reported at the ESMO World Congress on Gastrointestinal Cancer Virtual 2020.1 In a study of 332...

lung cancer
genomics/genetics
gynecologic cancers
leukemia
lymphoma

FDA Pipeline: Approval for First Liquid Biopsy Next-Generation Sequencing Companion Diagnostic; Designations in Ovarian Cancer, Leukemia, and Lymphoma

Recently, the U.S. Food and Drug Administration (FDA) approved the first liquid biopsy companion diagnostic that also uses next-generation sequencing technology to identify patients with non–small cell lung cancer (NSCLC) and specific types of EGFR mutations. The FDA also granted Fast Track...

Providing Aid for Patients With Cancer Affected by the Beirut Explosion

The explosion of 2,750 metric tons of ammonium nitrate near the port of Beirut, Lebanon, on August 4 leveled whole sections of the city. The blast killed at least 200 people, injured more than 6,000, and left hundreds of thousands homeless. The blast also severely damaged Beirut’s already fragile...

Expert Point of View: Taimur Sher, MBBS, MD

Taimur Sher, MBBS, MD, Associate Professor of Medicine, Hematology and Medical Oncology Consultant, and Director of the Multi-Specialty Amyloidosis Group at the Mayo Clinic in Jacksonville, Florida, told The ASCO Post that shutting down the source of amyloidogenic light-chain production—the...

lung cancer

Study Suggests Drop in Non–Small Cell Lung Cancer Mortality Rates Due to Treatment Advances, Reduction in Incidence

A study by researchers at the National Cancer Institute investigating mortality trends in lung cancer by subtype has found that population-level mortality from individuals with non–small cell lung cancer (NSCLC) fell sharply from 2013 to 2016, and that survival after diagnosis improved...

bladder cancer
immunotherapy

First-Line Atezolizumab Plus Platinum-Based Chemotherapy vs Chemotherapy Alone in Advanced Urothelial Cancer

As reported in The Lancet by Matthew D. Galsky, MD, of Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, and colleagues, the phase III IMvigor130 trial has shown prolonged progression-free survival with first-line atezolizumab plus platinum-based chemotherapy vs...

Expert Point of View: Toni K. Choueiri, MD

At the Genitourinary Highlights session of the ASCO20 Virtual Scientific Program, Toni K. Choueiri, MD, Director of the Lank Center for Genitourinary Oncology at Dana-Farber Cancer Institute, Boston, put the findings from KEYNOTE-426 into perspective. “This is an important update. The initial...

kidney cancer

Study Supports Pembrolizumab Plus Axitinib in Previously Untreated Advanced Renal Cell Carcinoma

Extended analysis of the phase III KEYNOTE-426 study upholds pembrolizumab plus axitinib as a preferred front-line regimen over sunitinib in patients with advanced sporadic renal cell carcinoma.1 These updated results were presented during the ASCO20 Virtual Scientific Program by Elizabeth R....

Expert Point of View: Philip J. Saylor, MD

Philip J. Saylor, MD, Attending Physician at Massachusetts General Hospital and Assistant Professor at Harvard Medical School, Boston, commented on this study. “The results presented are clearly exciting and cause us to look forward to a likely phase III study of this strategy. The high response...

kidney cancer
immunotherapy

Salvage Nivolumab Plus Ipilimumab After Prior Immune Checkpoint Inhibitor Therapy in Patients With Metastatic Renal Cell Carcinoma

In a study reported in the Journal of Clinical Oncology,1 Anita Gul, MD, of the Cleveland Clinic Taussig Cancer Institute, and colleagues found that salvage therapy with nivolumab/ipilimumab was capable of producing a response after prior PD-1 pathway inhibitor therapy in some patients with...

kidney cancer
immunotherapy

First-Line Combination Treatments Improve Outcomes vs Sunitinib in Advanced Renal Cell Carcinoma

Two recently reported phase III trials have shown the benefits of combination therapy vs sunitinib in the first-line treatment of advanced renal cell carcinoma. As reported in The New England Journal of Medicine by Brian I. Rini, MD, of Cleveland Clinic Taussig Cancer Institute, and colleagues, the ...

kidney cancer
immunotherapy

Immune Checkpoint Inhibitor Rechallenge in Metastatic Renal Cell Carcinoma

In a study presented during the ASCO20 Virtual Scientific Program1 and published as a brief report in JAMA Oncology,2 Praful Ravi, MB, BChir, of the Dana-Farber Cancer Institute, Boston, and colleagues found that rechallenge with immune checkpoint inhibitor therapy was capable of producing...

prostate cancer

Addition of Apalutamide to Androgen-Deprivation Therapy in Metastatic Castration-Sensitive Prostate Cancer

As reported in The New England Journal of Medicine by Kim N. Chi, MD, of BC Cancer and Vancouver Prostate Centre, and colleagues, the first analysis of the phase III TITAN trial has shown that the addition of apalutamide to androgen-deprivation therapy improved radiographic progression-free and...

prostate cancer

Nonmetastatic Castration-Resistant Prostate Cancer

Nonmetastatic castration-resistant prostate cancer arises in the subset of men with biochemically recurrent disease (ie, rising prostate-specific antigen [PSA] level after definitive therapy in the absence of metastases) who develop PSA progression after chronic exposure to androgen-deprivation...

prostate cancer

Phase III Study of AR Antagonist in Nonmetastatic Castration-Resistant Prostate Cancer

In the phase III ARAMIS trial reported in The New England Journal of Medicine,1 Karim Fizazi, MD, PhD, of the Institut Gustave Roussy, Universite Paris-Sud, Villejuif, France, and colleagues found that the androgen-receptor (AR) antagonist darolutamide significantly prolonged metastasis-free...

prostate cancer

Final Analysis of the ARAMIS Trial in Men With Nonmetastatic Castration-Resistant Prostate Cancer

A year ago, initial results from the double-blind, multicenter, randomized phase III ARAMIS clinical trial evaluating the efficacy and safety of darolutamide, a structurally unique androgen-receptor antagonist, in men with nonmetastatic castration-resistant prostate cancer, were published in The...

prostate cancer

In Biochemically Recurrent Prostate Cancer, PSMA-Targeted PET/CT Imaging May Be Useful

Positron-emission tomography/computed tomography (PET/CT) imaging with the prostate-specific membrane antigen (PSMA)-targeted radiotracer fluorine F-18 DCFPyL (PyL) successfully identified areas of occult metastasis in men with biochemically recurrent metastatic castration-resistant prostate...

prostate cancer
kidney cancer
bladder cancer
immunotherapy

Genitourinary Oncology Highlights 2019–2020 Almanac

Over the past year, we have seen significant advances in the treatment of prostate, kidney, and urothelial cancers that will benefit patients now and in the future. We have learned about the final results of important clinical trials across multiple genitourinary cancers disease states leading to...

skin cancer
immunotherapy

Pembrolizumab Monotherapy as First-Line Treatment for Patients With Unresectable Cutaneous Squamous Cell Carcinoma

In the French phase II CARSKIN trial reported in the Journal of Clinical Oncology, Maubec et al found that pembrolizumab monotherapy produced durable responses in the first-line treatment of unresectable cutaneous squamous cell carcinoma. Study Details In the multicenter trial, 39 patients (primary ...

CMS, CMMI Announce Flexibilities for Oncology Practices Impacted by COVID-19

The Centers for Medicare & Medicaid Services (CMS) recently announced flexibilities for clinicians participating in the 2020 Quality Payment Program (QPP) Merit-based Incentive Payment System (MIPS) who have been impacted by the COVID-19 Public Health Emergency (PHE). Affected clinicians may...

lung cancer

Having Cancer Has Not Affected Me in Any Negative Way

I have witnessed much sickness and death over my 35-year career as a medical oncologist. During the early years of my career, I had difficulty dealing with the sickness and death I witnessed on a regular basis. As a result, with help from the Hindu scripture of Bhagavad Gita, I have trained my...

issues in oncology

Physicians, New Drugs, and Pharma

The U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) have approved record numbers of new cancer drugs recently. This is extraordinarily good news for physicians, patients, and drug companies, but it raises important questions as to how effective these drugs are, whether...

covid-19

NCI Funds Studies of Impact of Telehealth and Telemedicine Capacity for Rural Patients Amid COVID-19 Pandemic

The National Cancer Institute (NCI) has awarded the Sidney Kimmel Cancer Center–Jefferson Health (SKCC) a supplemental grant (P30) to study the role of telehealth in delivering cancer care during the COVID-19 pandemic. The project will evaluate the impact of telehealth on health outcomes, patient...

Flossie Wong-Staal, PhD, Molecular Biologist Who Uncovered the Secrets of Human Immunodeficiency Virus, Dies at 73

The origin of the human immunodeficiency virus (HIV) has been traced back to Kinshasa, in the Democratic Republic of Congo, around 1920, when the virus crossed species from chimpanzees to humans. It wasn’t until the 1980s that epidemiologic data began to sum up the number of people who were...

cns cancers

A Pioneering Neurosurgeon Shares Hard-Earned Wisdom Gained Along the Road From the Segregated South

For this installment of the Living a Full Life series, guest editor Jame Abraham, MD, spoke with noted neurosurgeon Keith L. Black, MD, Chair of Cedars-Sinai Medical Center’s Department of Neurosurgery and Director of the Maxine Dunitz Neurosurgical Institute. During his career, Dr. Black has...

leukemia
immunotherapy

Gemtuzumab Ozogamicin in Pediatric Patients With Newly Diagnosed CD33-Positive AML

On June 16, 2020, the indication of gemtuzumab ozogamicin (Mylotarg) for newly diagnosed CD33-positive acute myeloid leukemia (AML) was extended to include pediatric patients aged 1 month and older.1,2 Supporting Efficacy Data Approval was supported by findings from the phase III AAML0531 trial...

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