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breast cancer
genomics/genetics

Novel Selective Estrogen Receptor Degraders in Advanced Breast Cancer: Use of Elacestrant in the Phase III EMERALD Trial

Endocrine therapy is the foundation of first-line therapy in most patients with hormone receptor–positive, HER2-negative metastatic breast cancer. Many of these patients respond to endocrine therapy but eventually become resistant to it through both intrinsic and acquired resistance mechanisms....

supportive care

SIO-ASCO Guideline Proposes Evidence-Based Approaches to Pain Management Incorporating Integrative Medicine Interventions

The Society for Integrative Oncology (SIO) and ASCO have released a guideline that appraises the evidence to support incorporating integrative medicine approaches into managing pain in adults with cancer.1 The guideline builds upon existing ASCO guidelines on pain management, the growing body of...

For William L. Dahut, MD, a Career of Service in Oncology

In this installment of the Living a Full Life series, Guest Editor Jame Abraham, MD, FACP, spoke with William L. Dahut, MD, who is currently serving as Chief Scientific Officer for the American Cancer Society (ACS). In this role, Dr. Dahut manages all pieces of the organization’s discovery work,...

leukemia

Richter Transformation Remains Challenging, but Better Treatments Are on the Horizon

Richter transformation, usually a diffuse large B-cell lymphoma developing in a person with CLL, remains a challenging entity, but novel regimens look promising, as described at the 2022 Pan Pacific Lymphoma Conference by Matthew S. Davids, MD, MMSc, Associate Professor of Medicine at Harvard...

kidney cancer

Negative Phase III Trials May Dampen Enthusiasm for Immunotherapy in the Adjuvant Setting in Kidney Cancer

Three negative phase III trials presented at the European Society for Medical Oncology (ESMO) Congress 2022 may dampen enthusiasm for immunotherapy as adjuvant therapy for renal cell carcinoma (RCC). None of the three trials—CheckMate 914, IMmotion010, and PROSPER—met its primary endpoint.1-3 The...

lung cancer

IPSOS Trial: Platinum-Ineligible Patients With NSCLC May Gain Survival Benefit From Atezolizumab Therapy

In platinum-ineligible patients with advanced non–small cell lung cancer (NSCLC), first-line treatment with the PD-L1 checkpoint inhibitor atezolizumab improved overall survival by an absolute value of about 1 month but almost doubled the rate of 2-year overall survival compared with chemotherapy...

breast cancer

Breast Cancer 2021–2022 Almanac

The past year has seen an unprecedented number of practice-changing advances across all three major breast cancer subtypes. For patients with early-stage triple-negative breast cancer, neoadjuvant chemotherapy plus pembrolizumab firmly entered the standard of care based on improvements in...

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
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...

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 ...

breast cancer
immunotherapy

Addition of Pembrolizumab to Chemotherapy Improves Event-Free Survival in Triple-Negative Breast Cancer

As reported in The New England Journal of Medicine by Peter Schmid, MD, PhD, of Barts Cancer Institute, Queen Mary University of London, and colleagues, a preplanned interim analysis of the phase III KEYNOTE-522 trial has shown improved event-free survival with the addition of pembrolizumab to...

breast cancer
genomics/genetics

Expert Point of View: Mark E. Robson, MD

“OlympiA is clearly a practice-changing trial, and olaparib should be offered to patients meeting the entry criteria for the study,” said Mark E. Robson, MD, Chief of the Breast Medicine Service at Memorial Sloan Kettering Cancer Center, New York. Dr. Robson was invited to discuss the findings of...

breast cancer
genomics/genetics

OlympiA Trial: Adjuvant Olaparib Significantly Improves Overall Survival in Germline BRCA-Mutated Breast Cancer

The OlympiA trial of adjuvant olaparib in patients with HER2-negative, high-risk ­early-stage breast cancer and BRCA1 and BRCA2 mutations has now demonstrated a significant overall survival benefit, reducing the risk of death over placebo by 32% and yielding an absolute improvement of 3.8% at 3...

colorectal cancer

NICHE-2: ‘Unprecedented’ Waterfall Plot Achieved With Neoadjuvant Immunotherapy in dMMR Colon Cancer

Treatment with neoadjuvant immunotherapy in colon cancer resulted in major pathologic responses in 95% of patients, NICHE-2 investigators reported at the European Society for Medical Oncology (ESMO) Congress 2022.1 Additionally, after 4 weeks of nivolumab plus ipilimumab, 67% of patients with...

issues in oncology
breast cancer

ASCO Treatment Guidelines for HER2-Negative Metastatic Breast Cancer Updated to Reflect New Trastuzumab Deruxtecan Data

Just 1 month after the DESTINY-Breast04 data were presented at the 2022 ASCO Annual Meeting Plenary Session,1 an ASCO expert panel released updated guidance that endorses the adoption of the antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) into clinical practice for patients with...

lymphoma

Managing Lymphomas in the Future: Some Bright Spots Are Emerging

Although standard therapies may provide long-lasting remissions for many patients with various subtypes of lymphoma, there is a critical need for new strategies for the sizable high-risk subset. At the 2022 Pan Pacific Lymphoma Conference, four experts in the field described future therapies for...

skin cancer
immunotherapy

Expert Point of View: Alexander M.M. Eggermont, MD; Omid Hamid, MD; and James Larkin, PhD

The results of SWOG S18011 were met with enthusiasm by attendees at the Presidential Symposium of the European Society for Medical Oncology (ESMO) Congress 2022. The ASCO Post captured the thoughts of several melanoma experts, who had somewhat different ideas about the immediate clinical...

global cancer care

The Development of Geriatric Oncology in France: An Outside View

With the aging of the world population, geriatric oncology is becoming a mainstay. Over the past year in The ASCO Post, we published a couple of articles on the history of oncology, including one on the history of geriatric oncology in the United States and Europe. Our goal was to promote a...

lung cancer

Real-World Experience With Durvalumab at the Mayo Clinic Mirrors PACIFIC Trial Findings

Concurrent chemoradiation therapy followed by durvalumab has become the standard of care in patients with unresectable, locally advanced non–small cell lung cancer (NSCLC), based on the PACIFIC trial.1 However, clinical trials have predetermined inclusion and exclusion criteria, and they evaluate...

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...

Expert Point of View: Benjamin Besse, MD, PhD

Discussant of the IMpower010 abstract, Benjamin Besse, MD, PhD, Professor and Head of Clinical Research at Institute Gustave Roussy, Villejuif, France, said there is enough evidence to use adjuvant immunotherapy in stage II–IIIA resected non–small cell lung cancer (NSCLC), calling the increased...

integrative oncology

Exercise Therapy Across the Cancer Care Continuum

Guest Editor’s Note: Several studies have shown that regular physical activity helps to reduce the symptom burden and improve disease-related outcomes in patients with cancer. In this article, Jessica M. Scott, PhD, and Neil M. Iyengar, MD, summarize the current evidence surrounding exercise...

lymphoma
immunotherapy

Changing the Algorithm for Relapsed or Refractory Large B-Cell Lymphomas

Despite a significant potential for cure, relapsed and refractory large B-cell lymphomas (LBCL) comprise the most common cause of lymphoma-related mortality. Sequential relapses reflect the limits of repeated exposure to chemotherapy, even when delivered at high doses. More than 30 years ago,...

issues in oncology

Diversify Cancer Clinical Trials With New Recruitment and Retention Resources

ASCO and the Association of Community Cancer Centers (ACCC) jointly released two resources to help research sites increase racial and ethnic equity, diversity, and inclusion (EDI) in cancer clinical trials. The Just ASK™ Increasing Diversity in Cancer Clinical Research: An ACCC-ASCO Training...

lymphoma

Axicabtagene Ciloleucel Improves Event-Free Survival vs Standard Care in Second-Line Treatment for Large B-Cell Lymphoma

As reported in The New England Journal of Medicine by Frederick L. Locke, MD, of the Department of Blood and Marrow Transplant and Cellular Immunotherapy, H. Lee Moffitt Cancer Center, Tampa, Florida, and colleagues, the phase III ZUMA-7 trial in large B-cell lymphoma has shown improved event-free...

Expert Point of View: Benjamin Besse, MD, PhD

Discussant of the IMpower010 abstract, Benjamin Besse, MD, PhD, Professor and Head of Clinical Research at Institute Gustave Roussy, Villejuif, France, said there is enough evidence to use adjuvant immunotherapy in stage II–IIIA resected non–small cell lung cancer (NSCLC), calling the increased...

issues in oncology

What the Supreme Court’s Abortion Decision Means for Patients With Cancer and Their Clinicians

On June 24, 2022, the Supreme Court ruled in Dobbs v Jackson Women’s Health Organization (Dobbs)1 and overturned Roe v Wade and Planned Parenthood v Casey, which recognized a federal constitutional right to end a pregnancy up to the point of viability. This decision opened the door for states to...

lung cancer
immunotherapy

'Real-World' Experience With Durvalumab at the Mayo Clinic Mirrors PACIFIC Findings

Concurrent chemoradiation followed by durvalumab has become the standard of care in patients with unresectable, locally advanced non–small cell lung cancer (NSCLC), based on the PACIFIC trial.1 But clinical trials have predetermined inclusion and exclusion criteria, and they evaluate selective...

multiple myeloma

Bispecific Antibodies and the Dawn of a New Era in Treatment of Multiple Myeloma

“I think the biggest innovations of the 21st century will be at the intersection of biology and technology. A new era is beginning!”  —Steve Jobs Relapsed and refractory multiple myeloma remains a treatment challenge. Promising responses have been demonstrated with bispecific antibodies, with a...

breast cancer

ASCO Updated Guideline of Biomarkers in Metastatic Breast Cancer Supports PIK3CA, BRCA1/2, PD-L1 Testing

ASCO has issued a new practice guideline update on the use of biomarkers in the management of metastatic breast cancer.1 The updated guideline revisits recommendations from the 2015 guideline and addresses topics that have emerged since then in the move toward personalized medicine in metastatic...

head and neck cancer

Head and Neck Cancer 2021–2022 Almanac

Head and neck cancer is the seventh most common cancer in the world, with 1.1 million new diagnoses reported annually.1 In the United States, the incidence of oral and pharyngeal cancers is over 54,000 cases per year, resulting in over 11,000 yearly deaths.2 Although smoking and alcohol consumption ...

integrative oncology

Dong Quai

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, Ting Bao, MD, DABMA, MS, and Jyothirmai Gubili, MS, focus on the herb dong...

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 ...

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