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How Medical Oncology Came to Be

For many, the way things are when you learn about them is assumed to be the way things have always been. For example, antibiotics are wonderful—but if you were practicing medicine when penicillin was discovered, it would have seemed like a miracle. For most of us, there have always been chemical...

issues in oncology

Establishing a Health Equity Report Card to Eradicate Disparities in Cancer Care

Although enormous progress over the past 50 years in every aspect of cancer care, including prevention, screening, chemotherapy, targeted therapy, surgery, radiation therapy, and supportive care, has resulted in increases in lives saved—from 3 million in 1971 to 16.9 million in 2019—the burden of...

breast cancer
immunotherapy

Peter Schmid, MD, PhD, on Early-Stage Triple-Negative Breast Cancer: Neoadjuvant Treatment With Pembrolizumab and Chemotherapy

Peter Schmid, MD, PhD, of Barts Cancer Institute, discusses phase III findings from KEYNOTE-522, in which researchers found a generally consistent event-free survival benefit among patients with early-stage high-risk triple-negative breast cancer who were treated with neoadjuvant pembrolizumab plus ...

breast cancer

Elacestrant May Improve Outcomes for Postmenopausal Patients With Progressive ER-Positive HER2-Negative Metastatic Breast Cancer

The investigational oral selective estrogen receptor degrader (SERD) elacestrant significantly decreased the risk of death or disease progression and increased progression-free survival compared with standard-of-care endocrine monotherapy in the second- or third-line setting  for postmenopausal...

breast cancer

Elacestrant May Improve Outcomes for Postmenopausal Patients With Progressive ER-Positive HER2-Negative Metastatic Breast Cancer

The investigational oral selective estrogen receptor degrader (SERD) elacestrant significantly decreased the risk of death or disease progression and increased progression-free survival compared with standard-of-care endocrine therapy for postmenopausal patients with estrogen receptor...

breast cancer
immunotherapy

Single-Cell Spatial Analysis May Help to Predict Response to Neoadjuvant Atezolizumab in Patients With Triple-Negative Breast Cancer

A next-generation technology that allows the study of protein expression at the single-cell level and the location of the cells within the tumor microenvironment was feasible and provided information on the benefit of adding the immune checkpoint inhibitor atezolizumab to chemotherapy as...

issues in oncology
covid-19

Telemedicine Use Among U.S. Patients With Newly Diagnosed Cancer: Impact of Socioeconomic Status

In a study reported in a research letter in JAMA Oncology, Katz et al found that higher socioeconomic status was associated with greater use of telemedicine among patients with newly diagnosed cancers in the United States between January and August 2020. As stated by the investigators, “The...

covid-19

COVID-19 Infection After SARS–CoV-2 Messenger RNA Vaccination in Patients With Cancer

In a study reported in JAMA Oncology, Wu et al found that vaccination with SARS–CoV-2 messenger RNA vaccines reduced the incidence of COVID-19 infection vs no vaccination in Veterans Affairs (VA) patients with cancer. Vaccine effectiveness varied according to time between last systemic therapy and...

breast cancer
genomics/genetics

Molecular Tumor Profiling May Improve Treatment Matching for Patients With Metastatic Breast Cancer

The use of multigene sequencing and SNP array as a therapeutic decision tool improved the outcomes of patients with metastatic breast cancer if the patients carried alterations classified in the I/II tiers of the ESMO Scale for Clinical Actionability of Molecular Targets (ESCAT), according to...

breast cancer

I-SPY2 Study Finds Tumor Biology Is a More Significant Factor Than Race in Predicting Response to Breast Cancer Treatment

Data analysis from the I-SPY2 clinical trial found that among women with high-risk breast cancer, race did not significantly affect several key measures of breast cancer treatment outcomes, including pathologic complete response (pCR) and event-free survival. The study, which is being presented by...

breast cancer
supportive care
symptom management

Study Examines Rates of Lymphedema in Black and White Patients With Breast Cancer

Black women had a 3.85-fold increased risk of developing lymphedema following treatment for breast cancer compared to White women, according to the results from a study by Barrio et al being presented at the 2021 San Antonio Breast Cancer Symposium (Abstract GS4-01). In addition, the researchers...

multiple myeloma
covid-19

Fully Vaccinated Patients With Multiple Myeloma: Rates of SARS–CoV-2 Breakthrough Infection and Hospitalization

In a U.S. cohort study reported in JAMA Network Open, Wang et al found that fully vaccinated patients with multiple myeloma were at increased risk of breakthrough SARS–CoV-2 infection, and that those with breakthrough infection were more likely to be hospitalized vs fully vaccinated persons without ...

Expert Point of View: Adam M. Brufsky, MD, PhD

Adam M. Brufsky, MD, PhD, Professor of Medicine at the University of Pittsburgh School of Medicine and Co-Director of the Comprehensive Breast Cancer Center, commented on the KEYNOTE-355 final analysis1 for The ASCO Post. “We now have a drug with full approval of the U.S. Food and Drug...

breast cancer
immunotherapy

KEYNOTE-355 Final Analysis Reveals Survival Benefit With Pembrolizumab in Triple-Negative Breast Cancer

The final overall survival results from the KEYNOTE-355 study showed a statistically significant 27% reduction in the risk of death for patients with metastatic triple-negative breast cancer whose tumors were strongly positive for PD-L1, defined as a combined positive score (CPS) of at least 10 and ...

multiple myeloma
covid-19

COVID-19 Vaccination: Patients With Multiple Myeloma May Lack T-Cell Response

Patients with multiple myeloma lacking an antibody response to COVID-19 vaccination may also fail to mount a T-cell response, researchers from the Icahn School of Medicine at Mount Sinai have reported. This scenario seemed to be most common among patients actively treated with anti-CD38 and...

gynecologic cancers

Addition of Cytoreductive Surgery to Platinum-Based Chemotherapy in Relapsed Ovarian Cancer

In a European Network of Gynecologic Oncology Trialists–Gynecologic Cancer Intergroup trial (DESKTOP III) reported in The New England Journal of Medicine, Philipp Harter, MD, PhD, and colleagues found that the addition of cytoreductive surgery to platinum-based chemotherapy improved overall...

solid tumors
covid-19

Response to Third Dose of SARS–CoV-2 BNT162b2 mRNA Vaccine in Patients With Solid Tumors Undergoing Active Treatment

In a single-institution Israeli study reported in a research letter in JAMA Oncology, Rottenberg et al found that a booster dose of the SARS–CoV-2 BNT162b2 mRNA resulted in increased spike protein antibody titers in patients with solid tumors undergoing active treatment. Study Details The study...

hematologic malignancies
issues in oncology
genomics/genetics

Association of Donor Clonal Hematopoiesis With Outcomes in Hematopoietic Stem Cell Transplant Recipients

In a study reported in the Journal of Clinical Oncology, Gibson et al identified significant associations of donor clonal hematopoiesis with outcomes in patients undergoing allogeneic hematopoietic stem cell transplantation (HCT). As stated by the investigators, “Clonal hematopoiesis can be...

skin cancer
immunotherapy

Vidutolimad Plus Pembrolizumab in PD-1 Refractory Melanoma

The addition of vidutolimod to pembrolizumab could help overcome resistance to immune checkpoint inhibition in patients with metastatic or unresectable cutaneous melanoma, according to data presented by John M. Kirkwood, MD, and colleagues at the Society for Immunotherapy of Cancer (SITC) 2021...

skin cancer
immunotherapy

Sotigalimab Plus Nivolumab in Anti–PD-1/PD-L1–Refractory Melanoma

Immune checkpoint inhibitors have revolutionized the treatment of metastatic melanoma, but a significant number of patients still fail to respond to anti–PD-1 therapy. The novel combination of sotigalimab, an anti-CD40 monoclonal antibody, and the PD-1 inhibitor nivolumab could help address this...

gynecologic cancers
immunotherapy

Study Examines Safety and Efficacy of Retifanlimab in Recurrent MSI-H/dMMR Endometrial Cancer

The novel PD-1 inhibitor retifanlimab appears to be safe and effective in patients with pretreated, recurrent microsatellite instability–high (MSI-H) or deficient mismatch repair (dMMR) endometrial cancer, according to according to data presented by Berton-Rigaud et al at the Society for...

hepatobiliary cancer
immunotherapy

Novel Vaccine Platform Plus Pembrolizumab May Boost Immune Response in Advanced HCC

A novel vaccine platform administered in combination with pembrolizumab appears to be safe and effective in patients with advanced hepatocellular carcinoma (HCC), according to data presented by Mark Yarchoan, MD, and colleagues at the Society for Immunotherapy of Cancer (SITC) 2021 Annual Meeting...

leukemia
immunotherapy

Next-Generation Sequencing of Bone Marrow DNA to Predict Relapse Following CAR T-Cell Therapy in Patients With ALL

Next-generation sequencing of bone marrow samples from pediatric and young adult patients with acute lymphoblastic leukemia (ALL) treated with tisagenlecleucel was more accurate in predicting relapse than flow cytometry and monitoring of B-cell aplasia, according to the results from a study by...

palliative care

Managing Illness Expectations in Patients With Advanced Cancer

In a study reported in JCO Oncology Practice, Sigler et al found that an oncology nurse–led primary palliative care intervention known as CONNECT did not increase realistic illness expectations among patients with advanced cancer. Study Details The study involved adults with advanced solid tumors...

breast cancer

To Elect or Forgo Radiation Therapy: An Informed Decision for Patients With Breast Cancer

Advances in treating breast cancer “increasingly create opportunities to consider where radiation therapy might safely be omitted,” Reshma Jagsi, MD, DPhil, told participants at the 2021 Lynn Sage Breast Cancer Symposium.1 “But, I would encourage us,” she continued, “not to assume that women who...

skin cancer
immunotherapy
genomics/genetics

Keith T. Flaherty, MD, on Results From the DREAMseq Trial

Invited discussant of the phase III DREAMseq trial, Keith T. Flaherty, MD, said the findings still leave room for nuanced decision-making.1 Dr. Flaherty is Professor of Medicine at Harvard and Director of the Henri and Belinda Termeer Center for Targeted Therapy at the Massachusetts General...

skin cancer
immunotherapy
genomics/genetics

DREAMseq Trial: In Advanced Melanoma With BRAF Mutations, Start With Immunotherapy

 In the treatment of patients with advanced melanoma containing BRAF mutations, initial treatment with an immunotherapy combination achieved superior overall survival compared with targeted therapy in the phase III DREAMseq trial, also known as the ECOG-ACRIN EA6134 trial. The results were reported ...

covid-19

Effect of the COVID-19 Pandemic on Cancer Imaging

Significant decreases in computed tomography (CT) imaging for cancer persisted even after the peak of the COVID-19 pandemic in 2020—delaying diagnosis and treatment and raising the possibility of more advanced cancers and poorer outcomes for patients, according to a study presented at the...

breast cancer

Study Examines the Effect of Breast MRI on Short-Term Quality of Life in Women With DCIS

In a substudy of the ECOG-ACRIN E4112 cohort trial reported in JAMA Network Open, Fazeli et al found that approximately half of women with ductal carcinoma in situ (DCIS) undergoing magnetic resonance imaging (MRI) for pretreatment planning experienced fear or anxiety before and during the...

leukemia

COG AAML1331 Trial: Arsenic Trioxide and All-Trans Retinoic Acid in Pediatric Patients With APL

As reported in JAMA Oncology by Kutny et al, the Children’s Oncology Group (COG) AAML1331 trial has shown that treatment with arsenic trioxide and all-trans retinoic acid (ATRA) with no maintenance therapy produced high event-free and overall survival rates in pediatric patients with acute...

lung cancer
immunotherapy

Immunomodulatory Effects of Neoadjuvant Nivolumab, Chemotherapy in NSCLC

The immunomodulatory effects of neoadjuvant immune-based treatments for non–small cell lung cancer (NSCLC) are becoming clearer, in part due to data presented by Schmidt et al at the Society for Immunotherapy of Cancer (SITC) 2021 Annual Meeting (Abstract 962). The first integrated analysis of...

pancreatic cancer
immunotherapy

Neoadjuvant Chemoradiation Plus Pembrolizumab Shows No Effect on Tumor-Infiltrating Lymphocytes in Pancreatic Cancer

The addition of the checkpoint inhibitor pembrolizumab to neoadjuvant chemoradiation  has failed to overcome the immunosuppressive microenvironment of pancreatic cancer, according to data presented by Osama E. Rahma, MD, and colleagues at the Society for Immunotherapy of Cancer (SITC) 2021 Annual...

breast cancer
immunotherapy

Eftilagimod Alpha Plus Paclitaxel May Improve Survival in HR-Positive, HER2-Negative Metastatic Breast Cancer: AIPAC Trial

The addition of the LAG-3 protein eftilagimod alpha to paclitaxel led to a significant improvement in overall survival in younger patients with hormone receptor (HR)-positive, HER2-negative metastatic breast cancer, according to data presented by Hans Wildiers, MD, and colleagues at the Society for ...

multiple myeloma

FDA Approves Triplet Therapy for Previously Treated Patients With Relapsed or Refractory Multiple Myeloma

On November 30, the U.S. Food and Drug Administration (FDA) approved daratumumab and hyaluronidase-fihj (Darzalex Faspro) in combination with carfilzomib (Kyprolis) plus dexamethasone for adult patients with relapsed or refractory multiple myeloma who have received one to three prior lines of...

breast cancer

Aditya Bardia, MD, MPH, Comments on Findings From monarchE

The invited discussant of monarchE,1 Aditya Bardia, MD, MPH, Director, Breast Cancer Research, and Associate Professor of Medicine, Harvard Medical School, commented: “Based on a hazard ratio of 0.69 for invasive disease–free survival, the results are statistically significant and clinically...

breast cancer

Long-Term Follow-up of monarchE: Benefit of Abemaciclib Plus Endocrine Therapy Maintained in Early High-Risk Breast Cancer

Longer-term follow-up of the global phase III monarchE trial showed an increasing benefit for adding abemaciclib to endocrine therapy in the adjuvant treatment of early high-risk hormone receptor–positive, HER2-negative breast cancer, regardless of Ki67 index. The latest findings were reported at a ...

lymphoma

High Response Rate With Venetoclax in Previously Treated Patients With Waldenström’s Macroglobulinemia

In a phase II study reported in the Journal of Clinical Oncology, Castillo et al found that venetoclax produced a high major response rate in previously treated patients with Waldenström’s macroglobulinemia. As stated by the investigators, “BCL2 is overexpressed and confers prosurvival signaling in ...

genomics/genetics

Cancer Incidence and Patterns in Individuals With Pathogenic/Likely Pathogenic Germline TP53 Variants

In an observational cohort study reported in The Lancet Oncology, de Andrade et al identified cancer incidence and patterns in individuals meeting criteria for Li-Fraumeni syndrome on the basis of presence of pathogenic or likely pathogenic germline TP53 variants. As stated by the investigators,...

immunotherapy
covid-19

Response to SARS–CoV-2 mRNA Vaccination in Patients With B-Cell Depletion Associated With CAR T-Cell Therapy

In a small single-institution study reported in a research letter in JAMA Oncology, Parvathaneni et al found that SARS–CoV-2 mRNA vaccination produced antibody responses in nearly half—and CD4 T-cell responses in more than half—of patients with B-cell depletion due to treatment with...

prostate cancer

Does Yoga Improve Quality of Life in Men With Prostate Cancer?

A diagnosis of prostate cancer may translate to approximately a 30% increase in the incidence of depression and anxiety, a fourfold higher risk of heart attack, and a twofold higher risk of suicide. A study published by Kaushik et al in Prostate Cancer and Prostatic Diseases aimed to evaluate the...

breast cancer

Phase II Breast Cancer Trial: Large Declines in Ki67 Index Seen With Oral Selective Estrogen Receptor Degrader

In the phase II coopERA Breast Cancer trial, which evaluated two endocrine neoadjuvant therapies in estrogen receptor–positive, HER2-negative early breast cancer, the oral selective estrogen receptor degrader giredestrant led to a greater reduction in Ki67 level—a measure of cancer cell...

gynecologic cancers

FDA Approves Pafolacianine to Help Identify Ovarian Cancer Lesions

On November 29, the U.S. Food and Drug Administration (FDA) approved pafolacianine (Cytalux), a targeted fluorescent imaging agent intended to assist surgeons in identifying ovarian cancer lesions. The drug, which is indicated for use in adult patients with ovarian cancer and is administered in the ...

leukemia
immunotherapy

Impact of Prior Blinatumomab Exposure on CD19-Targeted CAR T-Cell Therapy Outcomes in Pediatric Patients With B-Cell ALL

In a study reported in the Journal of Clinical Oncology, Myers et al found that lack of response to prior blinatumomab treatment was associated with poorer outcomes with CD19-targeted chimeric antigen receptor (CAR) T-cell therapy (CD19-CAR) in children and young adults with relapsed or refractory...

integrative oncology

Addressing the Global Challenges of Cancer Prevention and Treatment

Nearly 20 million people around the world were diagnosed with cancer in 2020, with 10 million losing their lives to this devastating disease. We highlight here the salient points from our article published in CA: A Cancer Journal for Clinicians,1 which describes the major themes and...

prostate cancer

Study Examines Treatment-Related Regret Among Men With Localized Prostate Cancer

In a prospective cohort study (CEASAR) reported in JAMA Oncology, Wallis et al found that patient expectations of treatment efficacy and adverse effects were associated with treatment-related regret at 5 years after diagnosis in men with localized prostate cancer. As stated by the investigators,...

skin cancer
immunotherapy

Impact of Time of Day of Immune Checkpoint Inhibitor Infusion on Overall Survival in Patients With Metastatic Melanoma

In a single-institution study reported in The Lancet Oncology, Qian et al found that the administration of immune checkpoint inhibitors after 4:30 PM was associated with poorer overall survival vs infusion earlier in the day in patients with metastatic melanoma. As stated by the investigators, “The ...

FDA Approves Maribavir for Posttransplant CMV

On November 23, the U.S. Food and Drug Administration (FDA) approved the antiviral maribavir (Livtencity) for adult and pediatric patients aged 12 years and older (and weighing at least 35 kg) with posttransplant cytomegalovirus (CMV) infection or disease that is not responsive (with or without...

lymphoma
issues in oncology

Possible Impact of Nurse Navigation Program in Achieving Equitable Care and Outcomes in Minority vs White Patients

In a single-institution study reported in Cancer, Bei Hu, MD, of the Department of Hematologic Oncology and Blood Disorders, Levine Cancer Institute/Atrium Health in Charlotte, and colleagues found that use of a dedicated nurse navigation program contributed to redressing the recognized inequities...

American Cancer Society and Flatiron Health Announce Recipients of Real-World Data Impact Award

The American Cancer Society (ACS) and Flatiron Health recently presented the 2021 Real-World Data Impact Awards, which will support research into health disparities among patients with advanced pancreatic and breast cancers. This year marks the third year of the joint grant-making program, under...

Passionate About Surgical Oncology, Masakazu Toi, MD, PhD, Is a Leader in Japanese Clinical Trials

In this installment of the Living a Full Life series, guest editor Jame Abraham, MD, spoke with Masakazu Toi, MD, PhD, a clinical breast cancer expert who is keen on research that translates basic science into clinical study. He is involved in various innovative research projects on the development ...

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