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issues in oncology

Pediatric Hematologist/Oncologist Yoram Unguru, MD, MS, MA, Explains the Economic Origins of Drug Shortages and Other Ethical Issues

Improvements in protocol-driven clinical trials and supportive care for children and adolescents with cancer have markedly reduced mortality rates over the past 5 decades. Yet, along with clinical advances, oncologists and their young patients with cancer face a host of ethical issues, made more...

breast cancer
covid-19

Increased Time to Breast Cancer Surgery May Not Impact Overall Survival for Patients With Early-Stage Disease

A new study published by Minami et al in the Journal of the American College of Surgeons found that longer time from diagnosis to surgical treatment did not lower overall survival in women with early-stage breast cancer. These findings may be reassuring for women with early-stage breast cancer who...

gynecologic cancers
immunotherapy

Avelumab for Patients With Gestational Trophoblastic Tumors Resistant to Single-Agent Chemotherapy

In the French phase II TROPHIMMUN trial reported in the Journal of Clinical Oncology, Benoit You, MD, PhD, and colleagues found that avelumab normalized human chorionic gonadotropin (hCG) levels in approximately half of women with gestational trophoblastic tumors resistant to single-agent...

kidney cancer
lung cancer
myelodysplastic syndromes
solid tumors
skin cancer
lymphoma
pancreatic cancer
breast cancer
immunotherapy

FDA Pipeline: Designations in Kidney and Lung Cancers, Myelodysplastic Syndromes, and More

Over the past few weeks, the U.S. Food and Drug Administration (FDA) has issued designations and accepted applications for novel agents, as well as approved companion diagnostics. We summarize these regulatory movements below. Breakthrough Therapy Designation for MK-6482 in von Hippel-Lindau...

hepatobiliary cancer
immunotherapy

Combination Immunotherapy in Advanced Biliary Tract Cancers

In a subgroup analysis of an Australian phase II trial reported in JAMA Oncology, Klein et al found that the combination of nivolumab and ipilimumab was active in patients with advanced biliary tract cancers. Study Details The phase II trial is enrolling patients with advanced rare cancers. The...

lymphoma
immunotherapy

Anti-CD30 CAR T-Cell Therapy for Patients With Relapsed or Refractory Hodgkin Lymphoma

In a pooled analysis of two parallel single-center phase I/II studies reported in the Journal of Clinical Oncology, Ramos et al found that anti-CD30 chimeric antigen receptor (CAR) T-cell therapy produced responses in a high proportion of patients with relapsed or refractory Hodgkin lymphoma. As...

pancreatic cancer

Addition of Pegvorhyaluronidase Alfa to Nab-paclitaxel and Gemcitabine in Hyaluronan-High Metastatic Pancreatic Cancer

In the phase III HALO 109-301 trial reported in the Journal of Clinical Oncology, Eric Van Cutsem, MD, PhD, and colleagues found that the addition of pegvorhyaluronidase alfa (PEGPH20) to nab-paclitaxel plus gemcitabine (AG) did not improve overall survival or progression-free survival in patients...

supportive care
immunotherapy

ASCO Guideline Supports Continued Use of Dexamethasone for Patients Receiving Checkpoint Inhibitors and Emetogenic Chemotherapy

The ASCO guideline on the use of antiemetics has been updated to include new anticancer agents, antiemetics, and regimens.1 The guideline also addresses a growing concern among some oncologists that corticosteroids and their immunosuppressive abilities could potentially compromise the efficacy of...

myelodysplastic syndromes
genomics/genetics

Role of TP53 Mutations on Disease Severity in Myelodysplastic Syndromes

Considered the “guardian of the genome,” TP53 is the most commonly mutated gene in patients with cancer. TP53's normal function is to detect DNA damage and prevent cells from passing this damage on to daughter cells. When TP53 is mutated, the protein made from this gene, called p53, can no longer...

lung cancer

Pyrotinib for Pretreated Patients With HER2-Mutated Advanced NSCLC

In a Chinese phase II trial reported in the Journal of Clinical Oncology, Zhou et al found that pyrotinib produced durable responses in patients with HER2-mutated advanced non–small cell lung cancer (NSCLC) who had received prior platinum-based chemotherapy.   Study Details The multicenter study...

breast cancer

NALA Trial: Neratinib/Capecitabine vs Lapatinib/Capecitabine for Pretreated Patients With HER2-Positive Metastatic Breast Cancer

As reported in the Journal of Clinical Oncology by Cristina Saura, MD, and colleagues, the phase III NALA trial has shown significantly prolonged progression-free survival with neratinib/capecitabine vs lapatinib/capecitabine in patients with HER2-positive metastatic breast cancer who had received...

leukemia

Sorafenib Maintenance After Allogeneic HCT in Patients With FLT3-ITD–Positive AML

In the German-Austrian phase II SORMAIN trial reported in the Journal of Clinical Oncology, Burchert et al found that maintenance treatment with sorafenib vs placebo was associated with significantly prolonged relapse-free survival after allogeneic hematopoietic stem cell transplantation (HCT) in...

Comparison of Two Combination Treatments in Localized Pancreatic Cancer

This week, we’ll discuss a study that compared two combination treatments for previously untreated patients with localized pancreatic cancer. Then, we’ll explore whether a longer-established diagnosis of cancer is associated with higher risk of severe COVID-19 infection or death from the virus....

multiple myeloma
genomics/genetics

Analysis of Deep Whole-Genome Sequencing in Patients With Multiple Myeloma Identifies Superior Outcome Subgroup

In a study of genome-wide somatic alterations in multiple myeloma reported in the Journal of Clinical Oncology, Samur et al identified a subgroup of patients with superior outcomes who are not adequately identified by traditional risk markers. The study involved analysis of deep whole-genome...

colorectal cancer

Does Periodontal Disease Increase the Risk of Colorectal Cancer?

Periodontal disease was associated with an increased risk of two precursors of colorectal cancer, according to results of a study published by Lo et al in Cancer Prevention Research. “Periodontal disease is prevalent among adults, with periodontitis affecting more than 40% of the U.S. population,”...

gynecologic cancers

American Cancer Society Updates Guideline for Cervical Cancer Screening

An updated cervical cancer screening guideline from the American Cancer Society released today has called for less—and more simplified—screening. The guideline was published by Fontham et al in CA: A Cancer Journal for Clinicians. The updated guideline recommends that individuals with a cervix...

gastrointestinal cancer

First-Line S-1 Plus Leucovorin and Oxaliplatin vs S-1 Plus Cisplatin in Advanced Gastric Cancer

As reported in The Lancet Oncology by Kang et al, the Japanese-Korean phase III SOLAR trial showed that oral tegafur/gimeracil/oteracil, a combination known as S-1, plus leucovorin and oxaliplatin was associated with a modest but significant improvement in overall survival vs S-1 plus cisplatin in...

issues in oncology

Study Finds Lack of Parental Intent to Initiate and Complete HPV Vaccination in the United States

Study results documenting parental hesitancy to begin and complete their child's human papillomavirus (HPV) vaccine series were published by Sonawane et al in The Lancet Public Health. The Centers for Disease Control and Prevention recommends a two-dose HPV vaccination regimen for children if the...

lymphoma

Outcomes With PET-Directed Therapy for Limited-Stage DLBCL

As reported in the Journal of Clinical Oncology by Daniel O. Persky, MD, and colleagues, the phase II Intergroup National Clinical Trials Network Study S1001 has shown good outcomes with positron-emission tomography (PET)-directed therapy in patients with limited-stage diffuse large B-cell lymphoma ...

lung cancer
immunotherapy

Anti-TIGIT Antibody Plus Atezolizumab Move Forward in Advanced NSCLC

Tiragolumab, an anti-TIGIT antibody, plus the PD-L1 inhibitor atezolizumab exhibited early clinical activity and was tolerated in patients with advanced solid tumors, including those with metastatic non–small cell lung cancer (NSCLC) that was PD-L1–positive and untreated with prior checkpoint...

covid-19

Are Patients With a Longer-Established Diagnosis of Cancer at Higher Risk for More Severe Infection or Death From COVID-19?

According to research published by Russell et al in Frontiers in Oncology, patients with a longer-established diagnosis of cancer are at increased risk for more severe infection with COVID-19, as well as death from the virus. Patients of Asian ethnicity or who were receiving palliative treatment...

issues in oncology
survivorship

Risk of Chronic Comorbidities Among Survivors of Adolescent and Young Adult Cancer

In a retrospective cohort study reported in the Journal of Clinical Oncology, Chao et al found that survivors of adolescent and young adult (AYA) cancer were at increased risk of numerous chronic comorbidities vs the general population.   Study Details The study involved data from 6,778 ≥ 2-year...

lung cancer
genomics/genetics

Treatment of KRAS G12C Mutation

Drs. Ramalingam, Brahmer, and Wakelee review the role of KRAS G12C mutation in lung cancer, which is found is 13% of all non–small cell lung cancer. They highlight two investigational therapies, AMG 510 and MRTX 849, and discuss recently presented data.

Expert Point of View: Philip A. Philip, MD, PhD, FRCP

The study’s invited discussant, Philip A. Philip, MD, PhD, FRCP, Professor of Oncology, Pharmacology, and Medicine and the Kathryn Cramer Endowed Chair in Cancer Research at Karmanos Cancer Institute, Wayne State University School of Medicine, Detroit, asked whether another triplet regimen was...

pancreatic cancer

First-Line Liposomal Irinotecan–Containing Regimen Studied in Advanced Pancreatic Cancer

In patients with newly diagnosed locally advanced or metastatic pancreatic adenocarcinoma, treatment with liposomal irinotecan plus fluorouracil (5-FU), leucovorin, and oxaliplatin (NALIRIFOX) resulted in a median progression-free survival of 9.2 months and a median overall survival of 12.6 months, ...

The Wake

The ASCO Post is pleased to reproduce installments of the “Art of Oncology,” as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

Prominent Surgeon and Teacher LaSalle D. Leffall, Jr, MD, Promotes Hard Work and Education to Overcome Boundaries

LaSalle D. Leffall, Jr, MD, the Charles R. Drew Professor of Surgery at Howard University College of Medicine in Washington, DC, died on May 25, 2019, at the age of 89. The ASCO Post paid tribute to Dr. Leffall in its July 10, 2019, issue. Here, as part of our 10-Year Anniversary Series, we...

lung cancer

Lurbinectedin in Previously Treated Metastatic Small Cell Lung Cancer

On June 15, 2020, the alkylating drug lurbinectedin was granted accelerated approval for treatment of adult patients with metastatic small cell lung cancer (SCLC) with disease progression during or after platinum-based chemotherapy.1,2 Supporting Efficacy Data Accelerated approval was based on...

lymphoma
immunotherapy

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

Minard-Colin et al recently reported for the European Intergroup for Childhood Non-Hodgkin Lymphoma/Children’s Oncology Group (EICNHL/COG) 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...

lymphoma
immunotherapy

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 The New 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...

Fox Chase Cancer Center Welcomes Two New Staff Members

Fox Chase Cancer Center, part of the Philadelphia-based Temple University Health System, recently announced two new additions to its staff. Shazia K. Nakhoda, MD, a graduate of the Fox Chase–Temple Hematology/Oncology Fellowship Program, joins the center’s Department of Hematology/Oncology in the...

Expert Point of View: Marcus Noel, MD, and Susan Tsai, MD, MHS

Marcus Noel, MD, Associate Professor of Medicine at Lombardi Comprehensive Cancer Center and MedStar Georgetown University Hospital, Washington, DC, included SWOG S1505 in the presentation of the Gastrointestinal Cancer Highlights during the ASCO20 Virtual Scientific Program. Susan Tsai, MD, MHS, ...

pancreatic cancer

SWOG S1505 Trial Evaluates Neoadjuvant Regimens in Pancreatic Cancer

The much-anticipated SWOG S1505 trial has failed to show that one preoperative regimen is better than another in resectable pancreatic cancer.1 “Perioperative modified FOLFIRINOX and gemcitabine/nab-paclitaxel appear to have similar efficacy, with acceptable safety and resectability rates,”...

Expert Point of View: Erika Hamilton, MD, and Nikhil Wagle, MD

Erika Hamilton, MD, Director of the Breast Cancer and Gynecologic Cancer Research Program, Sarah Cannon Research Institute at Tennessee Oncology, Nashville, who gave the Metastatic Breast Cancer Highlights presentation, and Nikhil Wagle, MD, Assistant Professor of Medicine, Harvard Medical...

covid-19

Two Cohort Studies Identify Risk Factors for Mortality in Patients With Cancer and COVID-19

Two studies recently reported in The Lancet have identified risk factors for mortality among patients with cancer and COVID-19.1,2 As reported by Lennard Y.W. Lee, DPhil, of the Institute of Cancer and Genomic Sciences, University of Birmingham, and colleagues,1 a UK prospective cohort study...

breast cancer

When Paired With Palbociclib, Fulvestrant and Letrozole Yield Comparable Results in PARSIFAL Trial

When paired with palbociclib in the first-line treatment of metastatic breast cancer, fulvestrant and letrozole performed comparably, with no statistical superiority in progression-free or overall survival shown for either endocrine agent, in the phase II PARSIFAL study presented during the ASCO20...

covid-19
solid tumors
hematologic malignancies

In Case You Missed It: Quick Takes on Novel Therapies for Solid and Hematologic Malignancies

Because of the COVID-19 pandemic, oncology providers from around the world had to forgo their annual trip to McCormick Place—but the show did go on. We all realized important research can still be presented, clinicians and fellow researchers will still listen, and ASCO presentations will still...

breast cancer

Double PIK3CA Mutations and Response Benefit in Breast Cancer

Patients who have breast cancers with double PIK3CA mutations seem to have a more robust response to PI3Kα inhibitors than those with a single PIK3CA mutation, based on an analysis of the phase III SANDPIPER trial, which tested taselisib plus fulvestrant, according to a presentation during the 2020 ...

skin cancer
immunotherapy

Small Study Evaluates Neoadjuvant vs Adjuvant Nivolumab Plus Ipilimumab in Stage III Melanoma

The neoadjuvant combination of nivolumab and ipilimumab yielded a continued benefit in relapse-free survival vs adjuvant use of the same combination therapy in 20 patients with stage III macroscopic melanoma. This finding is based on 3-year follow-up results of the phase Ib OpACIN trial, presented...

lung cancer
immunotherapy

Can Radiomics Predict Survival in Patients With NSCLC Receiving Immunotherapy?

Immunotherapy with immune checkpoint inhibitors has made great strides in the treatment of many cancers, but only between 25% and 50% of patients respond with clinical benefit, and these agents come with adverse events and high price tags. Thus, preselection of patients who are likely to respond to ...

lymphoma

Monumental Progress in the Treatment of Diffuse Large B-Cell Lymphoma

Some monuments are difficult to topple. At least that was the case dating back to 1976, when investigators from the Southwest Oncology Group demonstrated the importance of doxorubicin in the treatment of patients with a group of lymphoid malignancies then referred to as diffuse aggressive...

covid-19

The Need for Solid Data During a Global Pandemic

The rapid outbreak of COVID-19 disease on a global scale found the community of clinicians and scientists largely unprepared to face the devastating effects of the pandemic. The stress on health-care systems revealed their weaknesses and brought about associated financial crises. Defining the...

breast cancer
immunotherapy

T-DM1 in Patients With HER2-Positive Breast Cancer and Brain Metastases: KAMILLA Trial

An exploratory subgroup analysis of the KAMILLA trial represents the largest reported cohort of patients with HER2-positive breast cancer and brain metastases treated with the anti-HER2 antibody-drug conjugate ado-trastuzumab emtansine, or T-DM1, in a prospective setting. Researchers observed...

covid-19

Updated CCC19 Data Offer Insights on Treatment for Patients With Cancer and COVID-19 Infection

Newly released data on treatment outcomes of patients with cancer infected with COVID-19 revealed a racial disparity in access to remdesivir, an antiviral drug that has been shown to shorten hospital stays, and increased mortality associated with dexamethasone, a steroid that has had the opposite...

pancreatic cancer

First-Line FOLFIRINOX vs Gemcitabine/Nab-paclitaxel for Localized Pancreatic Cancer

In a single-institution retrospective study reported in JAMA Surgery, Perri et al found that first-line FOLFIRINOX (fluorouracil, leucovorin, irinotecan, and oxaliplatin) was associated with a higher response rate and subsequent pancreatectomy vs gemcitabine plus nab-paclitaxel in patients with...

breast cancer
genomics/genetics

Effect of Breast Cancer Pathway Implementation on Rate of Referrals for Genetic Counseling and Testing

In a study reported in JCO Oncology Practice, Stephanie L. Graff, MD, and colleagues found that patients with breast cancer seen by a physician with training in using an established pathway for genetic counseling and testing referral were more frequently referred for such services vs patients seen...

prostate cancer
issues in oncology

EAU Virtual: EUPROMS Study Investigates Effect of Prostate Cancer Treatment on Quality of Life

Findings from the first international prostate cancer quality-of-life study showed that significant numbers of men treated for the disease are struggling with continence and sexual problems after treatment. Results suggest that any treatment apart from active surveillance may negatively affect...

gastrointestinal cancer

Avapritinib in Advanced PDGFRA D842V–Mutant Gastrointestinal Stromal Tumors

As reported in The Lancet Oncology by Heinrich et al, the phase I NAVIGATOR trial showed that the PDGFRA and KIT kinase inhibitor avapritinib produced a response in patients with PDGFRA D842V–mutant gastrointestinal stromal tumors (GIST).   The study supported the January 2020 approval of...

gastroesophageal cancer
immunotherapy

Margetuximab/Pembrolizumab for Previously Treated Patients With HER2-Positive Advanced Gastroesophageal Adenocarcinoma

In a phase Ib/II trial reported in The Lancet Oncology, Daniel V.T. Catenacci, MD, and colleagues found that the combination of margetuximab and the anti–PD-1 therapy pembrolizumab showed evidence of activity in patients with previously treated HER2-positive gastroesophageal adenocarcinoma. As...

hepatobiliary cancer
immunotherapy

Phase Ib Trial of Atezolizumab With or Without Bevacizumab in Patients With Unresectable Hepatocellular Carcinoma

The combination of atezolizumab and bevacizumab was recently approved by the U.S. Food and Drug Administration for the treatment of unresectable or metastatic hepatocellular carcinoma on the basis of findings from the phase III IMbrave150 trial, which showed superior overall and progression-free...

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