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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...

cns cancers

Carboplatin Intensification for the Treatment of Pediatric High-Risk Medulloblastoma

In a Children’s Oncology Group (COG) phase III trial reported in JAMA Oncology, Leary et al found that the addition of carboplatin to radiotherapy in pediatric patients with newly diagnosed high-risk medulloblastoma improved event-free survival in the group 3 molecular subgroup but not in others....

breast cancer

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

The latest analysis of the pivotal 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...

multiple myeloma
immunotherapy

Surbhi Sidana, MD, Comments on CAR T-Cell Therapy and Bispecific Antibodies Targeting Myeloma

The session’s invited discussant Surbhi Sidana, MD, Assistant Professor of Medicine, Stanford University, said CAR T-cell therapy and bispecific antibodies targeting myeloma are emerging as potentially effective options for patients with highly refractory disease. For this population of triple...

multiple myeloma
immunotherapy

Bispecific Antibodies Advance in Relapsed or Refractory Multiple Myeloma

For the challenging population of patients with multiple myeloma who have become refractory to essentially all current treatments, new approaches are much needed. Early clinical trials data suggest bispecific antibodies may help meet this need, as suggested by studies presented at the 2021 ASCO...

breast cancer
covid-19

Incidence of Axillary Adenopathy in Screening or Diagnostic Mammography After COVID-19 Vaccination

In a single-center retrospective study reported in a research letter in JAMA Oncology, Robinson et al found a vaccine-related axillary adenopathy incidence rate of 3% among women undergoing screening or diagnostic mammography within 90 days of receipt of at least one dose of a COVID-19 vaccine....

issues in oncology

Association of Baseline Fatigue With Survival and Adverse Events in Patients With Advanced Cancer

In an analysis of four SWOG clinical trials of patients with advanced cancer reported in JCO Oncology Practice, Mo et al found that clinically significant fatigue at baseline was associated with poorer survival and increased risk of severe adverse events. Study Details The analysis included data...

gastrointestinal cancer
gastroesophageal cancer

Perioperative or Postoperative Oxaliplatin/S-1 vs Postoperative Oxaliplatin/Capecitabine for Locally Advanced Gastric Cancer

In the Chinese phase III RESOLVE trial reported in The Lancet Oncology, Zhang et al found that perioperative S-1/oxaliplatin was superior to—and adjuvant S-1/oxaliplatin was noninferior to—adjuvant capecitabine/oxaliplatin in terms of disease-free survival in patients undergoing D2 gastrectomy for...

breast cancer

Single-Agent Talazoparib Shows Activity in the Neoadjuvant Treatment of Triple-Negative Breast Cancer

For the neoadjuvant treatment of triple-negative breast cancer, the oral poly (ADP-ribose) polymerase (PARP) inhibitor talazoparib yielded promising pathologic complete response rates in the phase II single-arm NEOTALA trial presented at the 2021 ASCO Annual Meeting.1 Preoperative chemotherapy is...

issues in oncology
global cancer care

How Climate Change Is Impacting Cancer Care and What Can Be Done to Reduce Oncology’s Footprint on the Environment

Worldwide, the global average surface temperature has risen at a similar rate of 0.17°F per decade since 1901, with the warmest year on record occurring in 2016 and the second warmest occurring in 2020. However, according to NOAA, since the late 1970s, the United States has warmed faster than the...

solid tumors
hematologic malignancies

Complication Rates Among Central Venous Access Devices Compared

In the CAVA trial reported in The Lancet, Moss et al found that among central venous access devices used for the delivery of systemic anticancer therapy, totally implanted ports (PORTs) were associated with significantly reduced rates of complications compared with Hickman-type tunneled catheters...

pancreatic cancer

Comparison of First-Line Chemotherapy Strategies in Metastatic Pancreatic Cancer

In a French phase II trial (PANOPTIMOX-PRODIGE) reported in the Journal of Clinical Oncology, Dahan et al found that 4 months of FOLFIRINOX (fluorouracil, leucovorin, irinotecan, oxaliplatin) followed by leucovorin/fluorouracil maintenance was associated with favorable outcomes vs 6 months of...

lymphoma
global cancer care

Study Explores Cost-Effectiveness of CHOP Therapy for Patients With DLBCL in Sub-Saharan Africa

In a clinical trial conducted in Malawi, researchers found that combination chemotherapy with CHOP (cyclophosphamide, doxorubicin, vincristine, and prednisone) provided curative benefit compared to current standard-of-care therapy in people diagnosed with diffuse large B-cell lymphoma (DLBCL)—and...

breast cancer

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

“KAITLIN didnot meet its primary endpoint, either in the intent-to-treat or node-positive population,1 but in context with the APHINITY trial [1 year of adjuvant pertuzumab/trastuzumab plus chemotherapy],2 whose outcomes were similar at 3 years, you can appreciate that both arms did extremely...

breast cancer

KAITLIN Trial: No Subgroup Benefits More From T-DM1 Plus Chemotherapy for HER2-Positive Early Breast Cancer

In the phase III KAITLIN trial, replacing adjuvant taxane and trastuzumab with ado-trastuzumab emtansine (T-DM1) did not result in a significant improvement in invasive disease–free survival in the node-positive or intent-to-treat population of women with high-risk, HER2-positive early breast...

skin cancer
immunotherapy

Pembrolizumab Shows Durable Antitumor Activity in Both Locally Advanced and Recurrent/Metastatic Squamous Cell Carcinomas

The results of the second interim analysis of the KEYNOTE-629 study of pembrolizumab in cutaneous squamous cell carcinoma confirmed durable antitumor activity in both the locally advanced and the recurrent/metastatic settings. Adverse events with pembrolizumab were generally consistent with its...

geriatric oncology

Cancer vs Non–Cancer-Related Deaths Among Older Patients Selected for Surgical Treatment

In a Canadian population-based cohort study reported in JAMA Surgery, Chesney et al found that the 5-year rate of cancer-related deaths exceeded that of non–cancer-related deaths among patients aged 70 or older undergoing surgery for cancer.    Study Details The study used data from ICES (formerly...

prostate cancer
covid-19

Prostate Cancer Surgery Rates in Black vs White Men With Nonmetastatic Disease During the COVID-19 Pandemic

In a retrospective cohort study reported in JAMA Oncology, Bernstein et al found that prostatectomy rates during the initial wave of the COVID-19 pandemic were dramatically lower among Black men vs White men with previously untreated nonmetastatic prostate cancer. Study Details The study involved...

breast cancer
immunotherapy

FDA Approves Pembrolizumab in Combination for High-Risk, Early-Stage Triple-Negative Breast Cancer

On July 26, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) for high-risk, early-stage triple-negative breast cancer in combination with chemotherapy as a neoadjuvant treatment, and then continued as a single agent as adjuvant treatment after surgery. The FDA also...

immunotherapy
skin cancer

Benefits of Adjuvant Pembrolizumab in Melanoma Reinforced by EORTC 1325/KEYNOTE-054 Updates

Adjuvant anti–PD-1 antibody therapy is widely used for stage III melanoma, given the approvals of pembrolizumab and nivolumab. These approvals were based on significantly improved relapse-free survival in the CheckMate 238 trial of nivolumab compared with ipilimumab and the EORTC 1325/KEYNOTE-054...

skin cancer
immunotherapy

Adjuvant Pembrolizumab Improves Distant Metastasis–Free Survival in Resected High-Risk Stage III Melanoma

As reported in The Lancet Oncology by Alexander M.M. Eggermont, MD, of Princess Máxima Center, Utrecht, the Netherlands, and colleagues, the pivotal phase III EORTC 1325/KEYNOTE-054 trial has shown significant improvement in the secondary endpoint of distant metastasis–free survival, as well as...

lung cancer

Lorlatinib for Metastatic ALK-Positive NSCLC

On March 3, 2021, lorlatinib was granted regular approval for treatment of patients with metastatic non–small cell lung cancer (NSCLC) with ALK-positive tumors as detected by a U.S. Food and Drug Administration (FDA)-approved test.1,2 The FDA simultaneously approved the Ventana ALK (D5F3) CDx Assay ...

solid tumors
gastroesophageal cancer

Pembrolizumab Combined With Chemotherapy for Advanced Esophageal or Gastroesophageal Junction Carcinoma

On March 22, 2021, pembrolizumab was approved for use in combination with platinum- and fluoropyrimidine-based chemotherapy for patients with metastatic or locally advanced esophageal or gastroesophageal junction (tumors with epicenter 1 to 5 cm above the gastroesophageal junction) carcinoma who...

breast cancer

Breast Cancer in 2030: Predictions From a Breast Cancer Luminary

According to George W. Sledge, Jr, MD, FASCO, Professor of Medicine in the Division of Oncology at Stanford University Medical Center, by the beginning of the next decade, clinicians will be aided by the use of artificial intelligence (AI) in many facets of care and by the approval of a wave of new ...

Expert Point of View: Fabrice André, MD, PhD

Fabrice André, MD, PhD, Director of Research and Professor of Medical Oncology at Institut Gustave Roussy, Villejuif, France, commented on the two studies that used the MammaPrint 70-gene signature to identify patients for de-escalation or escalation of endocrine therapy.1,2 The push to...

breast cancer

MINDACT Trial Shows ‘Excellent’ Outcomes in Ultra-Low–Risk Breast Cancer

Patients with ultra-low–risk breast cancer, as classified by the MammaPrint 70-gene assay, had “excellent” long-term outcomes regardless of clinical risk or receipt of adjuvant therapy, a new analysis of the MINDACT trial has shown.1 In a separate study, a retrospective analysis of the National...

Public Comment on National Coverage Analysis of Screening for Lung Cancer With Low-Dose Computed Tomography

The following letter is adapted from comments made to the Centers for Medicare and Medicaid Services (CMS) by the American College of Radiology, the GO2 Foundation for Lung Cancer, and the Society of Thoracic Surgeons. “The American College of Radiology, the GO2 Foundation for Lung Cancer, and the...

breast cancer

I’m Alive by Sheer Force of Will—and a Lot of Luck

From the moment I felt a searing pain go through my right breast, I had a premonition that something was very wrong. Although I couldn’t feel anything unusual when I did a breast self-exam, I made an appointment with my gynecologist for a more thorough clinical breast exam and a mammogram. Because...

The Compelling Story of Cystic Fibrosis and the Dawn of Precision Medicine

Woe to the child who tastes salty from a kiss on the brow” was a forbidding prophecy from Medieval Europe, presaging unknown disease. Today, we know that salty skin is a telltale sign of cystic fibrosis in children, a disease that eluded medical identification until 1938, when an American...

prostate cancer

Bone-Protecting Agents Shown to Reduce Fracture Rate in Men With Metastatic Prostate Cancer

Prostate cancer experts have often stated it is important to add a bone-protecting agent for patients on treatment for metastatic castration-resistant prostate cancer. Recent evidence in support of this recommendation comes from a study presented during the 2021 ASCO Annual Meeting, confirming a...

kidney cancer

Tivozanib for Relapsed or Refractory Advanced Renal Cell Carcinoma

On March 10, 2021, the VEGF tyrosine kinase inhibitor tivozanib was approved for treatment of adults with relapsed or refractory advanced renal cell carcinoma following at least two prior systemic therapies.1,2 Supporting Efficacy Data Approval was based on findings in the open-label, phase III...

gynecologic cancers
immunotherapy

Dostarlimab-gxly for Mismatch Repair–Deficient Recurrent or Advanced Endometrial Cancer

On April 22, 2021, the PD-1 inhibitor dostarlimab-gxly was granted accelerated approval for treatment of adults with mismatch repair–deficient recurrent or advanced endometrial cancer, as determined by a U.S. Food and Drug Administration (FDA)-approved test, that has progressed on or following a...

integrative oncology

American Ginseng

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, Eugenie Spiguel, MSN, ANP-BC, and Jyothirmai Gubili, MS, focus on American...

Expert Point of View: Amit M. Oza, MD, MBBS

Invited discussant of the FORWARD II trial,1Amit M. Oza, MD, MBBS, concluded that bevacizumab and mirvetuximab soravtansine was a “very well tolerated and effective” combination with “encouraging activity,” even in patients previously treated with bevacizumab and weekly paclitaxel. Dr. Oza is Head ...

lymphoma
immunotherapy

Axicabtagene Ciloleucel for Relapsed or Refractory Follicular Lymphoma

On March 5, 2021, the CD19-directed genetically modified autologous T-cell immunotherapy axicabtagene ciloleucel was granted accelerated approval for treatment of adults with relapsed or refractory follicular lymphoma after two or more lines of systemic therapy.1,2 Axicabtagene ciloleucel is...

leukemia

B-Cell Acute Lymphoblastic Leukemia: Update on Clinical Trials

“Learning never exhausts the mind.” —Leonardo da Vinci To complement The ASCO Post’s continued comprehensive coverage of the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on treatments under study ...

gynecologic cancers

Early-Phase Trial Finds Mirvetuximab Soravtansine Plus Bevacizumab Active in Recurrent Ovarian Cancer

In patients with recurrent ovarian cancer, the antibody-drug conjugate mirvetuximab soravtansine, given with bevacizumab, showed antitumor activity leading to durable responses in platinum-agnostic patients with strong expression of folate receptor alpha (FRα), researchers reported at the 2021 ASCO ...

Expert Point of View: Kostas Stamatopoulos, MD, PhD

In the phase III GLOW trial, the all-oral regimen of fixed-duration ibrutinib plus venetoclax as first-line treatment for older or unfit patients with chronic lymphocytic leukemia (CLL) showed superior efficacy compared with chlorambucil and obinutuzumab.1Kostas Stamatopoulos, MD, PhD, of the...

Sukhmani K. Padda, MD, to Direct Thoracic Medical Oncology at Cedars-Sinai Cancer Center

Thoracic medical oncologist Sukhmani K. Padda, MD, was recently selected to direct Thoracic Medical Oncology at Cedars-Sinai Cancer Center in Los Angeles. Dr. Padda’s appointment, following a national search, reflects her breadth of experience as a clinician and researcher in the field of thoracic...

palliative care

Bringing Palliative Care to Native American Patients With Cancer

Native Americans are among the most underserved minority populations in the United States and are disproportionately affected by cancer. They have the lowest survival rates for nearly all types of cancer of any minority population and much higher rates of certain types of cancer, including lung,...

leukemia

Phase III GLOW Trial: Improved Outcomes With First-Line Ibrutinib Plus Venetoclax in Elderly Patients With CLL

Fixed-duration ibrutinib and venetoclax as a first-line treatment yielded superior outcomes compared with chlorambucil plus obinutuzumab in patients with chronic lymphocytic leukemia (CLL), based on the primary analysis of the phase III GLOW trial presented during the European Hematology...

issues in oncology

Bridging the Gender Gap in Oncology

Women account for a growing proportion of the oncology workforce. Multiple studies, however, show that women oncologists are underrepresented in leadership positions, may have significantly lower salaries than men, and may be subjected to discriminatory practices stimulated by a medical culture...

hematologic malignancies

Avapritinib for Advanced Systemic Mastocytosis

On June 16, 2021, avapritinib was approved for the treatment of adult patients with advanced systemic mastocytosis, including patients with aggressive systemic mastocytosis, systemic mastocytosis with an associated hematological neoplasm, and mast cell leukemia.1,2 Avapritinib is not recommended...

Expert Point of View: Philip McCarthy, MD

Commenting on the updated results of the MAIA trial1 for The ASCO Post was Philip McCarthy, MD, Professor of Oncology and Internal Medicine and Director of the Transplant and Cellular Therapy Center at Roswell Park Comprehensive Cancer Center, Buffalo, New York. Dr. McCarthy described how the...

lymphoma

Role of PI3K Inhibition in Indolent Lymphomas

As reported by Fowler et al in the Journal of Clinical Oncology1—and summarized in this issue of The ASCO Post—the international phase IIb UNITY-NHL trial of 208 patients with marginal zone lymphoma (MZL; n = 69), follicular lymphoma (FL; n = 117), and small lymphocytic lymphoma (SLL; n = 22)...

hematologic malignancies

MAIA Update: Overall Survival Benefit Reported With Daratumumab Plus Lenalidomide in Myeloma

In an updated analysis of the phase III MAIA trial, the addition of the monoclonal antibody daratumumab to the immunomodulatory agent lenalidomide and the corticosteroid dexamethasone (D-Rd) significantly improved overall survival over lenalidomide/dexamethasone alone in patients newly diagnosed...

lymphoma

Dual PI3Kδ/CK1ε Inhibitor Umbralisib in Relapsed or Refractory Indolent Non-Hodgkin Lymphoma

As reported in the Journal of Clinical Oncology by Nathan H. Fowler, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, a phase IIb trial (UNITY-NHL) has shown that the dual PI3Kδ/casein kinase (CK)1ε inhibitor umbralisib produced durable responses in patients with relapsed...

breast cancer

Factoring Fertility Preservation Into Breast Cancer Treatment

Breast cancer is the most commonly diagnosed cancer in women of reproductive age. Approximately 10% of breast cancers are diagnosed in this age group.1 Young age at diagnosis is an adverse prognostic factor, and most young women will be offered chemotherapy and/or endocrine therapy, both of which ...

gynecologic cancers

Addition of Adavosertib to Gemcitabine Improves Outcomes in High-Grade Serous Ovarian Cancer

In a phase II trial reported in The Lancet, Stephanie Lheureux, MD, of Princess Margaret Cancer Centre, Toronto, and colleagues, found that the addition of the oral Wee1 inhibitor adavosertib to gemcitabine significantly improved progression-free and overall survival in...

lung cancer
immunotherapy

Addition of Ipilimumab to Nivolumab in Previously Treated, Immunotherapy-Naive Patients With Stage IV Squamous NSCLC

As reported in JAMA Oncology by Scott N. Gettinger, MD, and colleagues, the phase III Lung Cancer Master Protocol S1400I trial showed no improvement in overall survival with the addition of ipilimumab to nivolumab in previously treated, immune checkpoint inhibitor–naive patients with stage IV...

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