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Expert Point of View: Barbara Pistilli, MD

Barbara Pistilli, MD, of the Breast Cancer Group at Gustave Roussy Cancer Center, Villejuif, France, said the results of the TULIP trial, showing the progression-free survival benefit for vic-trastuzumab duocarmazine (SYD985), help to establish antibody-drug conjugates as key components of the...

breast cancer
immunotherapy

Another Antibody-Drug Conjugate Enters the Metastatic Breast Cancer Landscape

In the global phase III TULIP trial in metastatic HER2-positive breast cancer, treatment with the antibody-drug conjugate vic-trastuzumab duocarmazine (SYD985) significantly improved progression-free survival in comparison with standard chemotherapy in previously treated patients, making this a new ...

Expert Point of View: Enrique Grande, MD

Invited discussant Enrique Grande, MD, of the Medical Oncology Department at MD Anderson Cancer Center Madrid, said that the VESPER trial should really be regarded as a neoadjuvant trial, since 88% of the patients enrolled were treated in the neoadjuvant setting. He focused the rest of his remarks ...

bladder cancer

Neoadjuvant dd-MVAC Improves Local Control and Progression-Free Survival in Patients With Muscle-Invasive Bladder Cancer

The VESPER phase III trial answers some key questions regarding the optimal management of muscle-invasive bladder cancer. The study found that the neoadjuvant regimen of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) was superior to standard gemcitabine/cisplatin in...

cns cancers
immunotherapy

Two Studies Examine the Efficacy of Immunotherapy for Leptomeningeal Carcinomatosis

Two new studies published in Nature Communications indicate that immunotherapy may benefit people with leptomeningeal carcinomatosis, a rare but serious complication of cancer that has spread to the brain and/or spinal cord.  Approximately 5% to 8% of all patients with cancer develop leptomeningeal ...

issues in oncology

National Cancer Act and Lung Cancer Screening: An Example of Intended Impact

The National Cancer Act of 1971 established a national priority to address the widely shared dread of a cancer diagnosis. The goal of the National Cancer Act was to strengthen the National Cancer Institute (NCI) to more effectively carry out the national effort against cancer. After the Act was...

leukemia

BTK Inhibition in CLL: An Embarrassment of Riches

Chronic lymphocytic leukemia (CLL) is a B-cell lymphoproliferative disorder defined by a specific phenotype and the presence of more than 5,000 clonal B cells in the peripheral blood.1 In the absence of this number of circulating cells, its soft-tissue/bone-marrow counterpart is semantically...

Expert Point of View: Gonzalo Gomez-Abuin, MD, and Gabriel N. Hortobagyi, MD, MACP, FASCO

The invited discussant of the MONALESSA-2 trial was Gonzalo Gomez-Abuin, MD, a medical oncologist who is Head of the Clinical Research Unit at Hospital Alemán in Buenos Aires. According to Dr. Gomez-Abuin, phase III trials of three different CDK4/6 inhibitors—ribociclib, palbociclib, and...

breast cancer

MONALEESA-2: Overall Survival Benefit With First-Line Ribociclib Plus Letrozole

Ribociclib plus hormonal therapy in the first-line setting boosted overall survival by more than 1 year, vs hormone therapy alone, in postmenopausal women with hormone receptor–positive HER2-negative advanced breast cancer, according to the latest findings from the MONALEESA-2 trial, reported at...

multiple myeloma
immunotherapy

Overall Survival in the MAIA Trial: Daratumumab, Lenalidomide, and Dexamethasone for Newly Diagnosed Transplant-Ineligible Patients With Multiple Myeloma

As reported in The Lancet Oncology by Thierry Facon, MD, and colleagues, an interim analysis of overall survival in the pivotal phase III MAIA trial has shown a significant benefit with the addition of daratumumab to lenalidomide/dexamethasone in newly diagnosed, transplant-ineligible patients with ...

hepatobiliary cancer

Addition of Liposomal Irinotecan to Fluorouracil and Leucovorin as Second-Line Treatment for Metastatic Biliary Tract Cancer

In a Korean phase IIb trial (NIFTY) reported in The Lancet Oncology, Yoo et al found that the addition of liposomal irinotecan to fluorouracil/leucovorin improved progression-free survival as a second-line treatment for patients with metastatic biliary tract cancer whose disease had progressed on...

sarcoma

Activity of Nab-sirolimus in Malignant Perivascular Epithelioid Cell Tumors

In the phase II AMPECT trial reported in the Journal of Clinical Oncology, Wagner et al found that the mTOR inhibitor nab-sirolimus produced a substantial rate of durable responses and a high disease control rate in patients with malignant perivascular epithelioid cell tumors. As stated by the...

hematologic malignancies
covid-19

Patients With Hematologic Malignancies: How Robust Is Their Immunity to SARS–CoV-2?

A large study from the United Kingdom has taken a deep dive into SARS–CoV-2 in the setting of cancer, yielding both concerning and encouraging findings about natural and vaccine-induced immunity. The study was presented at the Presidential Symposium during the European Society for Medical Oncology...

gynecologic cancers
genomics/genetics

Relationship Between Preexisting TP53 CHIP Variants and Risk of Secondary Myeloid Neoplasms in High-Grade Ovarian Cancer

In a study reported in JAMA Oncology, Kwan et al found that preexisting TP53 clonal hematopoiesis of indeterminate potential (CHIP) variants were associated with increased risk of secondary myeloid neoplasms in patients receiving poly (ADP-ribose) polymerase (PARP) inhibitor therapy with rucaparib...

lung cancer
genomics/genetics

Mobocertinib for Platinum-Pretreated Patients With EGFR Exon 20 Insertion–Positive Metastatic NSCLC

In a phase I/II trial reported in JAMA Oncology, Caicun Zhou, PhD, MD, and colleagues found that mobocertinib, a first-in-class oral kinase inhibitor, produced durable responses in platinum-pretreated patients with EGFR exon 20 insertion–positive metastatic non–small cell lung cancer (NSCLC).  The...

colorectal cancer
immunotherapy

Nivolumab/Low-Dose Ipilimumab Produces Responses in Patients With MSI-H/dMMR Metastatic Colorectal Cancer

As reported in the Journal of Clinical Oncology by Heinz-Josef Lenz, MD, and colleagues, in the phase II CheckMate 142 trial, first-line treatment with nivolumab plus low-dose ipilimumab produced a high rate of durable responses in a cohort of patients who had received no prior treatment for...

gynecologic cancers

PARP Rechallenge Slows Ovarian Cancer Progression in Platinum-Sensitive Disease

Rechallenge with the poly (ADP-­ribose) polymerase (PARP) inhibitor olaparib in patients with platinum-sensitive ovarian cancer led to significant improvement in progression-free survival, in patients with either BRCA1/2-mutated or nonmutated (ie, wild-type) disease compared with placebo, according ...

colorectal cancer

Primary Tumor Resection Followed by Systemic Treatment vs Systemic Treatment Alone in Metastatic Colorectal Cancer: 60-Day Mortality

As reported in JAMA Surgery by van der Kruijssen et al, 60-day post–random assignment mortality results in the Danish/Dutch phase III CAIRO4 trial showed higher rates of mortality in patients with metastatic colorectal cancer who received primary tumor resection plus systemic treatment vs those...

breast cancer

First-Line Fulvestrant/Palbociclib vs Letrozole/Palbociclib for Endocrine-Sensitive, HR-Positive, HER2-Negative Advanced Breast Cancer

In the phase II PARSIFAL trial reported in JAMA Oncology, Antonio Llombart-Cussac, MD, and colleagues found that the combination of fulvestrant plus palbociclib did not improve progression-free survival vs letrozole plus palbociclib in women with advanced endocrine-sensitive, hormone receptor...

breast cancer
global cancer care

Global Analysis of National Health System Characteristics and Breast Cancer Mortality and Stage at Diagnosis

In a global population-based study reported in The Lancet Oncology, Duggan et al identified national health system characteristics associated with reduced breast cancer mortality, including higher Universal Health Coverage Service Coverage Index (UHC Index) rating and increased number of public...

leukemia

Ibrutinib vs Placebo Following Achievement of Undetectable MRD With First-Line Ibrutinib/Venetoclax in CLL

As reported in the Journal of Clinical Oncology by William G. Wierda, MD, PhD, and colleagues, findings in the measurable residual disease (MRD) cohort of the phase II CAPTIVATE study indicated a high disease-free survival rate with placebo and no significant benefit of continued ibrutinib in...

cns cancers

DM-CHOC-PEN May Improve Outcomes for Adolescents and Young Adults With Central Nervous System Tumors

In a phase II clinical trial, the drug 4-demethyl-4-cholesteryloxycarbonylpenclomedine (DM-CHOC-PEN) improved survival for some adolescent and young adult patients with cancers involving the central nervous system, according to results presented by Morgan et al at the AACR-NCI-EORTC Virtual...

head and neck cancer

Abiraterone for Castration-Resistant, Androgen Receptor–Expressing Salivary Gland Cancer

In an Italian single-institution phase II trial reported in the Journal of Clinical Oncology, Locati et al found that abiraterone acetate showed activity in patients with androgen deprivation therapy (ADT)-resistant, androgen receptor (AR)-overexpressing salivary gland carcinoma. As stated by the...

lymphoma

Final Analysis of iNNOVATE: Addition of Ibrutinib to Rituximab for Waldenström’s Macroglobulinemia

As reported in the Journal of Clinical Oncology by Buske et al, the final analysis of the pivotal phase III iNNOVATE trial has shown a continued progression-free survival benefit with the addition of ibrutinib to rituximab in patients with Waldenström’s macroglobulinemia after 50 months of...

breast cancer

Nodal Recurrence With Sentinel Node Biopsy Alone Following Neoadjuvant Chemotherapy for Node-Positive Breast Cancer

In a single-center cohort study reported in JAMA Oncology, Barrio et al evaluated nodal recurrence rates in patients with clinically node-negative breast cancer following neoadjuvant chemotherapy for biopsy-proven node-positive disease. The investigators found an extremely low incidence of nodal...

issues in oncology

Study Examines Potential Link Between Cancer and Physical Inactivity

A new report finds that more than 46,000 cancer cases annually in the United States could be prevented if Americans met the 5 hours per week of moderate-intensity activity recommended in the American Cancer Society’s physical activity guidelines. Recent findings published by Minihan et al in the...

lung cancer
immunotherapy

FDA Approves Atezolizumab as Adjuvant Treatment for NSCLC

On October 15, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) for adjuvant treatment following resection and platinum-based chemotherapy in patients with stage II to IIIA non–small cell lung cancer (NSCLC) whose tumors have PD-L1 expression on ≥ 1% of tumor cells, as...

lung cancer
genomics/genetics

Genomic Profiling of Lung Adenocarcinoma in Never-Smokers vs Smokers

In a study reported in the Journal of Clinical Oncology, Devarakonda et al found that never-smokers with lung adenocarcinoma had a high frequency of RTK/RAS/RAF pathway driver alterations—similar to smokers with lung adenocarcinoma—but also harbored a significantly higher total frequency of...

genomics/genetics

Characteristics of Genomically Targeted Single-Patient Use Requests for Pediatric Cancers

In a study reported in the Journal of Clinical Oncology, Sabnis et al analyzed characteristics of genomically targeted single-patient use requests for investigational agents for the treatment of pediatric cancers. These requests were made from pediatric cancer programs over a 5-year period. As...

issues in oncology
covid-19

AACR Cancer Progress Report 2021 Showcases 50 Years of Advances in Cancer Research and Treatment

The AACR Cancer Progress Report 2021 celebrates the gains made in cancer research since the National Cancer Act was signed into law on December 23, 1971. The report also recognizes the negative impact the COVID-19 pandemic has had on cancer research and patient care, the disproportionate toll both...

issues in oncology

Risk of Cancer in Children With Fanconi Anemia and Ataxia-Telangiectasia

In a German nationwide register-based cohort study reported in the Journal of Clinical Oncology, Dutzmann et al found that risk of developing cancer by age 18 exceeded 10% in children with Fanconi anemia or ataxia-telangiectasia. Study Details The study involved data on 421 patients with Fanconi...

breast cancer

Is Baseline Brain White Matter Microstructure Associated With Cognitive Decline After Chemotherapy for Breast Cancer?

In a Dutch study reported in the Journal of Clinical Oncology, de Ruiter et al found that white matter microstructure at baseline was associated with cognitive decline after chemotherapy for breast cancer. Study Details The study included 49 patients with breast cancer who received...

gynecologic cancers
immunotherapy

FDA Approves Pembrolizumab Combination for the First-Line Treatment of Cervical Cancer

On October 13, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) in combination with chemotherapy, with or without bevacizumab, for patients with persistent, recurrent, or metastatic cervical cancer whose tumors express PD-L1 (combined positive score [CPS] ≥ 1), as...

breast cancer

Recent FDA Approvals in Breast Cancer

In the past year, the U.S. Food and Drug Administration (FDA) approved five treatment options for patients with breast cancer, which are summarized herein. Abemaciclib Combination On October 12, 2021, the FDA approved abemaciclib (Verzenio) with endocrine therapy (tamoxifen or an aromatase...

breast cancer

KEYNOTE-355: Pembrolizumab Plus Chemotherapy Improves Progression-Free Survival in PD-L1–Enriched Advanced Triple-Negative Breast Cancer

Pembrolizumab plus chemotherapy improved progression-free survival vs chemotherapy alone as first-line treatment of advanced or metastatic triple-negative breast cancer, according to the results of KEYNOTE-355.1 Progression-free survival was significantly improved with pembrolizumab plus...

Expert Point of View: Melinda L. Telli, MD

EA1131 study discussant, Melinda L. Telli, MD, Associate Professor of Medicine at Stanford University, Director of the Breast Cancer Program at the Stanford Cancer Institute, and Associate Director of the Stanford Women’s Cancer Center, commented: “At this point, capecitabine remains preferred as...

breast cancer

EA1131 Trial: Platinum Not Equal to Capecitabine for Residual Disease in Triple-Negative Breast Cancer

In patients with triple-negative breast cancer who have residual disease after neoadjuvant chemotherapy, adjuvant capecitabine remains the standard of care. In the multicenter randomized noninferiority EA1131 trial, which included primarily basal tumors, noninferiority of adjuvant platinum over...

breast cancer

Sacituzumab Govitecan-hziy Improves Survival vs Single-Agent Chemotherapy in Metastatic Triple-Negative Breast Cancer

As reported in The New England Journal of Medicine by Aditya Bardia, MD, of the Division of Medical Oncology, Massachusetts General Hospital Cancer Center, and colleagues, the phase III ASCENT trial has shown prolonged progression-free and overall survival with the Trop-2–directed antibody-drug...

Expert Point of View: Melinda L. Telli, MD

The invited discussant of GeparNuevo,1 Melinda L. Telli, MD, Associate Professor of Medicine at Stanford University School of Medicine, Director of the Breast Cancer Program at the Stanford Cancer Institute, and Associate Director of the Stanford Women’s Cancer Center, welcomed the additional data...

breast cancer

Neoadjuvant Durvalumab Improves Long-Term Outcomes in the GeparNuevo Trial

In the phase II GeparNuevo trial, patients with early triple-negative breast cancer receiving the PD-L1 inhibitor durvalumab in addition to chemotherapy as neoadjuvant therapy saw improvements in long-term outcomes. The results were presented at the 2021 ASCO Annual Meeting by Sibylle Loibl, MD,...

Expert Point of View: Giuseppe Curigliano, MD, PhD

Invited discussant Giuseppe Curigliano, MD, PhD, Associate Professor of Medical Oncology at the University of Milan, Italy, and Head of the Division of Early Drug Development at the European Institute of Oncology, said the “clear” findings of KEYNOTE-5221 are “practice-changing.” However, the ideal ...

breast cancer

KEYNOTE-522: Neoadjuvant Pembrolizumab Improves Event-Free Survival in Triple-Negative Breast Cancer

The latest analysis of the phase III KEYNOTE-522 trial demonstrated significant improvements in clinical outcomes with pembrolizumab plus chemotherapy vs chemotherapy alone as a neoadjuvant/adjuvant treatment of triple-negative breast cancer.1 This is the first large, randomized, phase III trial to ...

breast cancer

Early Triple-Negative Breast Cancer: Are Checkpoint Inhibitors Ready for Neoadjuvant or Adjuvant Use?

Recent clinical trials have been encouraging for the neoadjuvant or adjuvant use of immune checkpoint inhibitors in triple-negative breast cancer, but is this approach ready for the clinic? This question was addressed at the 38th Miami Breast Cancer Conference, held virtually this year, by Adam M....

breast cancer

Margetuximab-cmkb Plus Chemotherapy Prolongs Progression-Free Survival in Heavily Pretreated HER2 Positive Breast Cancer

As reported in JAMA Oncology by Hope S. Rugo, MD, of the University of California San Francisco Helen Diller Family Comprehensive Cancer Center, and colleagues, the phase III SOPHIA trial has shown significantly prolonged progression-free survival with margetuximab-cmkb plus chemotherapy vs...

breast cancer

ADAPT Trial: ‘Excellent’ Outcomes Reported With Neoadjuvant Dual HER2 Therapy in Breast Cancer

The first overall survival analysis of the WGS-ADAPT HER2+/HR– study, which evaluated neoadjuvant therapy in patients with hormone receptor–negative, HER2-positive disease, showed that treatment with pertuzumab and trastuzumab plus paclitaxel—or with the chemotherapy-free regimen of...

Expert Point of View: Evandro de Azambuja, MD, PhD

Invited discussant of the Short-HER trial, Evandro de Azambuja, MD, PhD, Head of the Medical Support Team at the Institut Jules Bordet, Brussels, acknowledged the good outcomes in low- and intermediate-risk patients treated with either a short or long duration of trastuzumab but said 1 year of the...

breast cancer

Long-Term Analysis of Short-HER Trial of Adjuvant Trastuzumab

Long-term analysis of the Short-HER trial showed that 9 weeks of adjuvant trastuzumab conveyed benefits comparable to a 1-year course in patients with early HER2-positive breast cancer deemed to be at low or intermediate risk for recurrence. High-risk patients, however, derived considerably more...

breast cancer

Novel HER2-Targeted Therapies Pose Sequencing Challenges

With three new HER2-targeted therapies approved over the past year or two alone, the treatment landscape for patients with metastatic breast cancer has become increasingly crowded. In the third-line setting and beyond, there are now at least eight HER2-targeted agents approved by the U.S. Food and...

breast cancer

RxPONDER: Many Postmenopausal Patients With Node-Positive Breast Cancer Can Avoid Chemotherapy

The SWOG S1007 RxPONDER trial evaluated the benefit of chemotherapy in women with early-stage hormone receptor–positive, HER2-negative breast cancer and node-positive disease.1 The data showed that many postmenopausal women can skip adjuvant chemotherapy, based on a 46% reduction in the risk of...

breast cancer

Expert Point of View: C. Kent Osborne, MD, and Ruth M. O’Regan, MD

Commentary for monarchE and PENELOPE-B was provided by C. Kent Osborne, MD, and Ruth M. O’Regan, MD, respectively. Dr. Osborne is Professor of Medicine, Hematology, and Oncology and the Dudley and Tina Sharp Chair for Cancer Research at Baylor College of Medicine, as well as Founding Director of...

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