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cns cancers
immunotherapy

Bevacizumab in Recurrent Glioblastoma

On December 5, 2017, bevacizumab (Avastin) was granted regular approval for the treatment of recurrent glioblastoma in adults.1 Bevacizumab was granted accelerated approval in May 2009 for use in treating patients with glioblastoma who had disease progression on prior therapy. Supporting Efficacy...

legislation
health-care policy

Why Right-to-Try Laws Are Dangerous

Why wouldn’t you support a patient with a terminal illness the “right to try” any therapy that may save his or her life? The answer to this question—one engulfed in a political debate in Congress—seems simple. It is not. [Editor’s Note: On May 30, 2018, the President signed into law the Trickett...

cost of care

Use of Charity Assistance to Pay for Novel Oral Anticancer Agents

In a study reported in the Journal of Oncology Practice, Olszewski et al found that 36% of patients receiving novel oral anticancer agents in a Rhode Island academic research center received charity assistance to pay for treatment, including 47% of patients aged ≥ 65 years. Study Details The...

issues in oncology
gastrointestinal cancer

Rehospitalization Patterns After Gastrointestinal Cancer Hospitalizations

In a study reported in the Journal of Oncology Practice, Manzano et al found that unplanned rehospitalization within 30 days after gastrointestinal (GI) cancer hospitalization was more likely after medical vs surgical index hospitalizations among older patients. Some risk factors for...

sarcoma

Neoadjuvant Chemotherapy With or Without Regional Hyperthermia in Localized High-Risk Soft-Tissue Sarcoma

As reported in JAMA Oncology by Issels et al, long-term follow-up of the phase III EORTC 62961-ESHO 95 trial has shown improved outcomes with the addition of regional hyperthermia to neoadjuvant chemotherapy in patients with high-risk soft-tissue sarcoma. Study Details In the open-label trial,...

solid tumors

Larotrectinib in TRK Fusion–Positive Cancers in Adults and Children

In a study reported in The New England Journal of Medicine, Drilon et al found that the oral tropomyosin receptor kinase (TRK) inhibitor larotrectinib produced a high response rate and enduring responses in patients with TRK fusion–positive cancers. These fusions have been found to lead to...

hematologic malignancies
leukemia

Data Favoring Maintenance Therapy in Older Patients With AML Accumulate

The use of maintenance therapy in older patients with acute myeloid leukemia (AML) is theoretically sensible, but its clinical value remains uncertain. The phase III HOVON97 randomized study demonstrated that maintenance therapy with the hypomethylating agent azacitidine may improve disease-free...

leukemia

Guadecitabine in Treatment-Naive Older Patients With Acute Myeloid Leukemia

The results of a phase II trial have shown high activity of guadecitabine, a next-generation hypomethylating drug, in treatment-naive older patients with acute myeloid leukemia. The findings were reported in The Lancet Oncology by Hagop M. Kantarjian, MD, of The University of Texas MD Anderson...

multiple myeloma

Overall Survival With Carfilzomib vs Bortezomib in Relapsed or Refractory Multiple Myeloma

As reported by Meletios A. Dimopoulos, MD, of the National and Kapodistrian University of Athens, Alexandra Hospital, and colleagues in The Lancet Oncology, a prespecified interim analysis of the phase III ENDEAVOR trial has shown a significant overall survival benefit for carfilzomib (Kyprolis)...

breast cancer

Addition of Metronomic Chemotherapy to Dual Anti-HER2 Treatment in Older Patients With Metastatic Breast Cancer

In the phase II EORTC 75111-10114 trial reported in The Lancet Oncology, Wildiers et al found that the addition of metronomic oral cyclophosphamide to pertuzumab (Perjeta) and trastuzumab (Herceptin) improved progression-free survival in elderly or frail women with HER2-positive metastatic breast...

skin cancer

U.S. Incidence and Projected Rise of Merkel Cell Carcinoma

The number of U.S. cases of Merkel cell carcinoma is rising about six times faster than most other cancers, and at nearly twice the rate of melanoma. Paulson et al reported these findings in The Journal of the American Academy of Dermatology, which are based on research conducted at the University...

palliative care

Why Palliative Care Isn’t Just for Older Patients With Cancer

It is well established that adolescents and young adults (AYAs) with cancer—defined by the National Cancer Institute as those between the ages of 15 and 39 years—have not reaped a comparable survival benefit as either younger or older adult cancer survivors over the past 4 decades, despite...

skin cancer

Retrospective Analysis Suggests Obesity Associated With Longer Survival for Men With Metastatic Melanoma

OBESE PATIENTS with metastatic melanoma who are treated with targeted or immune therapies live significantly longer than those with a normal body mass index (BMI), according to a study published in The Lancet Oncology of 1,918 patients in 6 independent clinical cohorts.1  This effect—referred to as ...

head and neck cancer

ASCO Clinical Practice Guideline Update: Use of Larynx-Preservation Strategies in the Treatment of Laryngeal Cancer

AS REPORTED in the Journal of Clinical Oncology by Arlene A. Forastiere, MD, of The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, and colleagues, ASCO has issued a clinical practice guideline update on the use of larynx-preservation strategies in the treatment of laryngeal cancer.1...

hematologic malignancies
symptom management

EXPERT POINT OF VIEW: Robert Brodsky, MD

“THE RESULTS of these two trials are more similar than different. I think the best conclusion would be that we now have two trials with consistent results and can probably, in most cases, replace low–molecular-weight heparin with direct oral anticoagulants,” said Dr. Raskob, lead investigator of...

bladder cancer
immunotherapy

Long-Term Outcomes With PD-L1 Inhibition in Metastatic Urothelial Cancer

As reported by Petrylak et al in JAMA Oncology, long-term follow-up of patients in a phase I study expansion cohort indicated enduring clinical benefit and maintained tolerability of atezolizumab (Tecentriq) in patients with metastatic urothelial carcinoma.  Study Details The study involved...

breast cancer

Family History Increases Breast Cancer Risk, Even in Women Aged 65 and Older

A family history of breast cancer continues to significantly increase chances of developing invasive breast tumors in women aged 65 years and older, according to research published by Braithwaite et al in JAMA Internal Medicine. The findings could impact mammography screening decisions later in...

solid tumors
breast cancer

Ovarian Function Suppression During and After Chemotherapy Valid for Some Patients With Early Breast Cancer

Temporary ovarian suppression during chemotherapy as a means of preserving ovarian function and fertility in young women with early breast cancer is controversial. An eagerly awaited meta-analysis including individual patient data from five randomized controlled trials found that the use of...

solid tumors
breast cancer

Perioperative Aromatase Inhibitors: No Effect on Recurrence, but Ki67 Level Important

Updated analysis from the United Kingdom’s POETIC trial found no evidence that perioperative aromatase inhibitor therapy slows or prevents time to recurrence of breast cancer. However, the study did show that tumor Ki67 levels after 2 weeks of perioperative aromatase inhibitor therapy are...

solid tumors
breast cancer

SABCS Highlights Focus on Predicting Residual Tumor Burden, Therapy-Related Arm Morbidity, Lifestyle and Cancer Risk

We have covered many of the important presentations from the 2017 San Antonio Breast Cancer Symposium in the pages of The ASCO Post and in our online Evening News. Here are summaries of additional noteworthy studies presented at the meeting. We hope you will find them of interest. Predicting...

solid tumors

Cabozantinib Improves Survival in Advanced Hepatocellular Carcinoma

Patients with previously treated advanced hepatocellular carcinoma derived a survival benefit from cabozantinib (Cabometyx), in the phase III CELESTIAL trial.1 “Cabozantinib represents a new treatment option for patients with advanced hepatocellular carcinoma after prior systemic anticancer...

survivorship

2018 SURVIVORSHIP: Many Young Adult Cancer Survivors Forgo Follow-up Care After Cancer Treatment Ends

Despite survivorship guidelines from ASCO and other organizations regarding follow-up care after cancer treatment ends, follow-up care is generally lacking for adolescent and young adult (AYA) cancer survivors. Since AYA cancer survivors are at an increased risk for late effects from their cancer...

breast cancer
colorectal cancer
survivorship

2018 SURVIVORSHIP: Exercising During Chemotherapy for Breast or Colon Cancer Has Long-Term Benefits

A follow-up study to a randomized clinical trial reveals that exercising during adjuvant chemotherapy helps people engage in more physical activity years later. Four years later, people with breast or colon cancer who had participated in an 18-week exercise program while receiving chemotherapy...

survivorship

2018 SURVIVORSHIP: Web-Based Interventions Help Adolescents Stay Physically Active After Cancer Treatment

Survivors of childhood cancer are at increased risk for obesity and metabolic syndrome, which can lead to other serious health conditions, including heart disease, stroke, and diabetes. However, engaging in regular physical activity may help remediate these health issues in young survivors. A...

bladder cancer
immunotherapy

Avelumab Active in Advanced Urothelial Carcinoma After Platinum Failure

AS REPORTED in The Lancet Oncology by Manish R. Patel, MD, of Florida Cancer Specialists/Sarah Cannon Research Institute, and colleagues, the anti–programmed cell death ligand 1 (PD-L1) antibody avelumab (Bavencio) produced durable responses in patients with locally advanced or metastatic...

prostate cancer

Differentiating Cancerous Prostate Tissue From Benign Tissue

Using nuclear medicine, German researchers may have found a way to accurately differentiate cancerous tissue from healthy tissue in prostate cancer patients. The research is highlighted in findings published by Rahbar et al in The Journal of Nuclear Medicine. These new findings demonstrate that...

breast cancer

Adjuvant Zoledronic Acid in Early Breast Cancer: Is 5 Years Better?

THE PHASE III SUCCESS A trial, presented at the 2017 San Antonio Breast Cancer Symposium, found no benefit for extending the use of intravenous zoledronic acid from 2 years to 5 years.1  “At this time point, our study showed no difference in disease-free survival or overall survival between 5 years ...

breast cancer

EXPERT POINT OF VIEW: C. Kent Osborne, MD, and Joseph Sparano, MD

“ONCOLOGISTS WANT to find drugs that will delay the use of chemotherapy, and cyclin-dependent kinase (CDK) 4/6 inhibitors provide that. These agents work better than chemotherapy and with less toxicity,” said press conference moderator C. Kent Osborne, MD, Director of the Duncan Cancer Center at...

breast cancer

CDK 4/6 Inhibitors May Be Effective but More Toxic in Older Women

OLDER WOMEN with breast cancer derive benefit from treatment with cyclin-dependent kinase (CDK) 4/6 inhibitors as part of initial endocrine-based therapy for hormone receptor–positive, HER2-negative, metastatic breast cancer, according to a retrospective pooled subgroup analysis of women aged 70 or ...

hematologic malignancies
immunotherapy

Daratumumab Shows Efficacy in Amyloid Light-Chain Amyloidosis

DARATUMUMAB (DARZALEX) may be an effective treatment for systemic amyloid light-chain (AL) amyloidosis, according to phase II studies reported at the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition.1,2 While the cohorts were small and the arms uncontrolled, the findings...

gynecologic cancers

Prexasertib in Pretreated BRCA Wild-Type High-Grade Serous Ovarian Cancer

In a phase II study reported in The Lancet Oncology by Lee et al, the investigational cell-cycle checkpoint kinase 1 and 2 inhibitor prexasertib produced responses in women with recurrent BRCA wild-type high-grade serous ovarian cancer. In the study, 28 women with measureable disease enrolled...

multiple myeloma

For Patients Treated for Myeloma, Antibiotic Prophylaxis May Reduce Infections and Deaths

IN PATIENTS undergoing treatment of multiple myeloma, the prophylactic use of levofloxacin significantly reduced febrile episodes and deaths, without increasing healthcare-associated infections or carriage of key nosocomial pathogens, in a large multicenter study from the United Kingdom.1 The...

breast cancer

Nab-Paclitaxel vs Paclitaxel in Neoadjuvant Treatment of HER2-Negative Breast Cancer

In a European phase III trial (ETNA) reported in JAMA Oncology, Gianni et al found no significant difference in pathologic complete response rate with nab-paclitaxel (Abraxane) vs paclitaxel followed by an anthracycline regimen in neoadjuvant treatment for HER2-negative breast cancer. Study...

breast cancer

Scientific Statement From the American Heart Association Examines Intersection of Breast Cancer and Cardiovascular Disease

Patients with breast cancer may be at an increased risk of cardiovascular diseases, including heart failure, and may benefit from a treatment approach that weighs the benefits of specific therapies against potential damage to the heart, according to a new scientific statement from the American...

breast cancer

Combined Aerobic-Resistance Exercise Intervention in Overweight/Obese Survivors of Breast Cancer

In a study reported in the Journal of Clinical Oncology, Dieli-Conwright et al found that an aerobic and resistance intervention reduced metabolic syndrome factors and sarcopenic obesity among sedentary, overweight, or obese women with breast cancer. Study Details In the study, 100 women from...

solid tumors
breast cancer

I’m Not a Victim of Cancer

What I thought after feeling a large, hard lump—similar to the feel of a granola bar—in my left breast was that I probably pulled a muscle while playing with my two young children, ages 7 and 5. Cancer never entered my mind until I asked my husband to feel the lump, and he immediately said, with...

hematologic malignancies
multiple myeloma
immunotherapy

Daratumumab in Previously Treated Multiple Myeloma

  On June 16, 2017, daratumumab -(Darzalex) was approved for use in combination with pomalidomide (Pomalyst) and dexamethasone for treatment of patients with multiple myeloma who have received at least two prior therapies including lenalidomide (Revlimid) and a proteasome inhibitor.1,2 Supporting...

solid tumors
immunotherapy

Pembrolizumab in MSI-H or dMMR Solid Tumors: ‘First Tissue/Site-Agnostic’ Approval by FDA

  On May 23, 2017, pembrolizumab (Keytruda) was granted accelerated approval for treatment of adult and pediatric patients with unresectable or metastatic microsatellite instability–high (MSI-H) or mismatch repair deficient (dMMR) solid tumors progressing following prior treatment and who have no...

lung cancer

Posttreatment Mortality With Stereotactic Body Radiotherapy vs Surgery in NSCLC

In a study reported in the Journal of Clinical Oncology, Stokes and colleagues found lower posttreatment mortality rates with stereotactic body radiotherapy (SBRT) vs surgery in early-stage non–small cell lung cancer (NSCLC), with the difference in rates increasing as a function of age....

hematologic malignancies
leukemia

Enasidenib in IDH2-Mutant Relapsed or Refractory Acute Myeloid Leukemia

  On August 1, 2017, the IDH2 inhibitor enasidenib (Idhifa) was granted regular approval for treatment of adult patients with relapsed or refractory acute myeloid leukemia (AML) with an isocitrate dehydrogenase-2 (IDH2) mutation as detected by a U.S. Food and Drug Administration (FDA)-approved...

gynecologic cancers

Potential Effect of Excess Body Weight on Detection of Cervical Precancer

In a study reported in the Journal of Clinical Oncology, Clarke et al found that increasing body mass index (BMI) was associated with lower rates of cervical precancer diagnosis and higher rates of cervical cancer diagnosis. The investigators had hypothesized that increased body mass could decrease ...

breast cancer

Evaluating the Need for Biopsies During Follow-up Care in Early Breast Cancer

In an analysis of more than 120,000 women diagnosed with and treated for early-stage breast cancer, researchers from The University of Texas MD Anderson Cancer Center determined the rate of additional breast biopsies needed for these patients during their follow-up care. The findings, reported by...

gastrointestinal cancer

Incidence of Noncardia Gastric Cancer Increasing Among Americans Under 50

A type of cancer that occurs in the lower stomach has been increasing among some Americans under the age of 50, even though in the general population, the incidence of all stomach cancers has been declining for decades. These findings were published by Anderson et al in the Journal of the National...

prostate cancer

Obese Men May Have Higher Risk for Biochemical Recurrence Following Radical Prostatectomy

Among men with prostate cancer who underwent radical prostatectomy, those who were obese had a higher risk of biochemical recurrence, according to data presented at the American Association for Cancer Research (AACR) Special Conference on Obesity and Cancer: Mechanisms Underlying Etiology and...

issues in oncology

Obstetric and Neonatal Outcomes With Cancer Diagnosed During Pregnancy

As reported by de Haan et al in The Lancet Oncology, data from the International Network on Cancer, Infertility and Pregnancy (INCIP) registry indicate that use of chemotherapy during pregnancy has increased over a 20-year period, and that infants exposed to antenatal chemotherapy may be more...

breast cancer

Racial Differences in Breast Cancer 21-Gene Recurrence Scores

In a study reported in the Journal of Clinical Oncology, Holowatyj et al found that among women with hormone receptor–positive, HER2-negative, node-negative invasive breast cancer, non-Hispanic black women had higher 21-gene recurrence scores  at diagnosis vs non-Hispanic white women....

immunotherapy

CAR T-Cell Immunotherapy Named Advance of the Year in ASCO’s Clinical Cancer Advances 2018

A new and unique new way to treat cancer—chimeric antigen receptor (CAR) T-cell therapy—is poised to transform the outlook for children and adults with certain otherwise incurable cancers. ASCO named this type of adoptive-cell immunotherapy the Advance of the Year in its annual...

breast cancer
colorectal cancer

Two Genetic Mutations Implicated in Breast Cancer Emerge From Study of Lynch Syndrome

Researchers at Columbia University Irving Medical Center (CUIMC) and GeneDx, a genetic testing company, have identified two new genetic mutations associated with breast cancer: MSH6 and PMS2. The researchers’ study—published by Roberts et al in Genetics in Medicine—suggests that...

gynecologic cancers

Addition of Hyperthermic Intraperitoneal Chemotherapy to Cytoreductive Surgery in Advanced Ovarian Cancer

In a Dutch/Belgian phase III trial reported in The New England Journal of Medicine by van Driel et al, the addition of hyperthermic intraperitoneal chemotherapy to interval cytoreductive surgery following neoadjuvant chemotherapy was associated with significantly improved recurrence-free and...

multiple myeloma

Cardiovascular Adverse Events and Multiple Myeloma Treatment

In a systematic review and meta-analysis reported in JAMA Oncology, Waxman et al found that any-grade and grade ≥ 3 cardiovascular adverse events occurred in 18.1% and 8.2% of patients receiving carfilzomib (Kyprolis) for multiple myeloma in clinical trials. Study Details The study involved...

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