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lung cancer
immunotherapy

FDA Approves Atezolizumab in Combination With Chemotherapy for First-Line Treatment of Metastatic Nonsquamous NSCLC

On December 4, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) in combination with chemotherapy (nab-paclitaxel and carboplatin) for the first-line treatment of adults with metastatic nonsquamous non–small cell lung cancer (NSCLC) with no EGFR or ALK genomic tumor...

lung cancer
immunotherapy

Does Adding Pembrolizumab or Placebo to Chemotherapy for Patients With Metastatic Squamous NSCLC Improve Quality of Life?

In a health-related quality of life analysis from the phase III KEYNOTE-407 trial reported in the Journal of Clinical Oncology, Mazières et al found that the patients with metastatic squamous non–small cell lung cancer (NSCLC) who received pembrolizumab in addition to chemotherapy had better...

bladder cancer

Does the Addition of Ramucirumab to Docetaxel Improve Overall Survival in Previously Treated Urothelial Carcinoma?

As reported in The Lancet Oncology by Daniel P. Petrylak, MD, and colleagues, the phase III RANGE trial has shown no significant improvement in overall survival with the addition of ramucirumab to docetaxel in patients with locally advanced or metastatic urothelial carcinoma previously treated with ...

supportive care

Checkpoint Inhibitor Pneumonitis: A Pulmonologist’s Perspective

Oncologists have become accustomed to seeing pneumonitis associated with immune checkpoint inhibitor treatment in non–small cell lung cancer (NSCLC), requiring intervention by pulmonologists in the management of severe cases. At CHEST 2019, the annual meeting of the American College of Chest...

prostate cancer

Biomarker-Driven Treatment Selection for Prostate and Other Genitourinary Cancers

As the Nobel Laureate Bob Dylan wrote, “The times they are a-changin’.” Heather Cheng, MD, PhD, Associate Professor, University of Washington, Associate Member, Fred Hutchinson Cancer Research Center, and Director, Seattle Cancer Care Alliance, Prostate Cancer Genetics Clinic, quoted this line in...

kidney cancer
immunotherapy

Immunotherapy Strategies in Renal Cell Carcinoma: Present and Future

Immunotherapy with checkpoint inhibitors is now considered a standard of care for the front-line treatment of advanced renal cell carcinoma. Despite better outcomes with these agents, there is still room for improvement. At the 2019 Chemotherapy Foundation Symposium, Robert J. Motzer, MD, of...

breast cancer

Emerging Alternatives in the Third-Line Setting for Metastatic HER2-Positive Breast Cancer

In the post-trastuzumab era, a number of U.S. Food and Drug Administration (FDA)-approved targeted agents for metastatic HER2-positive breast cancer are available, but there is no preferred option for third-line treatment and beyond. At the 2019 Chemotherapy Foundation Symposium, Shanu Modi, MD,...

gynecologic cancers

Secondary Surgical Cytoreduction Plus Chemotherapy vs Chemotherapy Alone in Recurrent Platinum-Sensitive Ovarian Cancer

In the phase III trial Gynecologic Oncology Group (GOG)-0213 trial, reported in The New England Journal of Medicine by Robert L. Coleman, MD, and colleagues, no overall survival benefit was found for secondary surgical cytoreduction followed by chemotherapy vs chemotherapy alone in women with...

multiple myeloma
immunotherapy

ICARIA-MM: Addition of Isatuximab to Pomalidomide/Dexamethasone in Relapsed and Refractory Multiple Myeloma

As reported in The Lancet by Michel Attal, MD, and colleagues, the phase III ICARIA-MM trial has shown that the addition of the CD38-targeted antibody isatuximab to pomalidomide and low-dose dexamethasone significantly improved progression-free survival in patients with relapsed and refractory...

breast cancer

ESMO Asia 2019: Trastuzumab Biosimilar HLX02 Shows Activity in HER2-Positive Metastatic Breast Cancer

The trastuzumab biosimilar HLX02—manufactured in China—achieved a similar overall response rate to reference trastuzumab in women with HER2-positive recurrent or previously untreated metastatic breast cancer, according to a large, randomized phase III study reported by Xu et al at the European...

hepatobiliary cancer
immunotherapy

ESMO Asia 2019: Combination of Atezolizumab and Bevacizumab for Unresectable Hepatocellular Carcinoma

Combination therapy with the programmed cell death ligand 1 inhibitor atezolizumab and the VEGF inhibitor bevacizumab significantly improved overall and progression-free survival in patients with unresectable hepatocellular carcinoma (HCC) compared to sorafenib, according to findings from the phase ...

skin cancer
immunotherapy

Updated Data From Clinical Trials on Nivolumab/Ipilimumab in Advanced Melanoma

More than one out of two patients with metastatic melanoma treated with the combination of nivolumab plus ipilimu-mab is still alive after 5 years, according to the longest follow-up of patients receiving this combination. In two additional studies, the immunotherapy duet also proved to be active...

ASCO Statement Says FDA Should Implement Proposed Rule for Graphic Labels on Cigarette Packs and Ads

ASCO submitted comments to the U.S. Food and Drug Administration (FDA) applauding its proposed rule to implement the use of new graphic warning labels on cigarette packaging and advertisements. The comments were sent in a letter from 2019–2020 ASCO President Howard A. Burris III, MD, FACP, FASCO, ...

breast cancer

When to Consider Local Therapy for Stage IV Breast Cancer

Local therapy for stage IV breast cancer has not been proven to increase overall survival, yet there are some cases where local therapy could be considered outside a clinical trial. For patients with intact asymptomatic primary tumors, local therapy could be offered if distant disease is well...

gastroesophageal cancer
gastrointestinal cancer

Trifluridine/Tipiracil in Recurrent, Metastatic Gastric or Gastroesophageal Junction Adenocarcinoma

Early in 2019, trifluridine/tipiracil tablets were approved for the treatment of adult patients with metastatic gastric or gastroesophageal junction adenocarcinoma previously treated with at least two prior lines of chemotherapy that included a fluoropyrimidine; a platinum; either a taxane or...

immunotherapy
lung cancer

Analysis of 4-Year Survival With Nivolumab in Patients Previously Treated for Advanced NSCLC

In an analysis reported in The Lancet Oncology, Scott J. Antonia, MD, PhD, of Duke Cancer Institute, and colleagues identified long-term survival rates with nivolumab therapy in patients with previously treated advanced non–small cell lung cancer (NSCLC), including comparative outcomes vs...

Expert Point of View: Charles L. Loprinzi, MD

Charles L. Loprinzi, MD, Regis Professor of Breast Cancer Oncology at the Mayo Clinic, in Rochester, Minnesota, discussed the abstract on oncology massage to treat chemotherapy-induced peripheral neuropathy. He said that although massage therapy shows promise for this patient population, its...

lung cancer

Final Overall Survival Results of IMpower131 Trial in Advanced Squamous NSCLC

In patients with stage IV squamous non–small cell lung cancer (NSCLC), those with high programmed cell death ligand 1 (PD-L1) expression treated with atezolizumab and chemotherapy experienced longer overall survival rates than those treated with chemotherapy alone. For those participants without...

neuroendocrine tumors
lung cancer

Novel Therapies for Small Cell Lung Cancer and Neuroendocrine Tumors

Here is a glimpse at updated clinical trial data on newer therapies under study for the small cell lung cancer (SCLC) and advanced extrapancreatic neuroendocrine tumors. IMpower133 and ALTER: Novel Therapies for SCLC The treatment of small cell lung cancer has seen little progress in recent years,...

Expert Point of View: Ian Chau, MD

The invited discussant for the ATTRACTION-3 study was Ian Chau, MD, Consultant Medical Oncologist at The Royal Marsden Hospital, London and Surrey, United Kingdom. Dr. Chau first congratulated the investigators for successfully conducting a randomized phase III trial in metastatic esophageal...

head and neck cancer

Nivolumab vs Chemotherapy in Advanced Esophageal Cancer

Nivolumab improved overall survival compared with chemotherapy in previously treated patients with esophageal squamous cell carcinoma in the final analysis of the phase III ATTRACTION-3 study. The data were presented at the European Society for Medical Oncology (ESMO) Congress 2019 Presidential...

Award Winners Named for 2019 San Antonio Breast Cancer Symposium

The San Antonio Breast Cancer Symposium (SABCS) and the American Association for Cancer Research (AACR) will honor two renowned researchers for their work in breast cancer at the 2019 SABCS, to be held December 10–14 in San Antonio. Myles Brown, MD, is the recipient of the 2019 AACR Distinguished ...

Expert Point of View: Arndt Vogel, MD and Angela Lamarca, MD, PhD

Arndt Vogel, MD, of Hannover Medical School in Germany, who served as discussant of the two studies of immunotherapy in hepatocellular carcinoma, said the findings point to a promising future in the treatment of this malignancy. He commented that the responses observed with nivolumab in CheckMate...

immunotherapy
hepatobiliary cancer

‘Clinically Meaningful’ Outcomes Seen in Two Studies of First-Line Immunotherapy for Hepatocellular Carcinoma

In the first-line treatment of advanced hepatocellular carcinoma, checkpoint inhibitors led to favorable outcomes in studies reported at the European Society for Medical Oncology (ESMO) Congress 2019—though one study was technically negative. The current first-line standard of care for unresectable ...

prostate cancer

Apalutamide for Metastatic Castration-Sensitive Prostate Cancer

On September 17, 2019, apalutamide was approved for the treatment of patients with metastatic castration-sensitive prostate cancer.1,2 Supporting Efficacy Data The approval is based on overall survival and radiographic progression-free survival findings in the phase III double-blind TITAN trial.2,3 ...

gastrointestinal cancer

Pivotal Study Reports Positive Findings in Fourth-Line Setting for Advanced GIST

In a late-breaking, oral presentation at the European Society for Medical Oncology (ESMO) 2019 Congress, Margaret von Mehren, MD, presented results from INVICTUS, a pivotal phase III clinical study of ripretinib in patients with advanced gastrointestinal stromal tumor (GIST).1 Ripretinib is an...

gastrointestinal cancer

Circulating Tumor DNA: A Prognostic Marker in Stage III Colon Cancer?

Circulating tumor DNA in the blood could serve as a marker of prognosis in patients with colon cancer receiving adjuvant oxaliplatin, according to a subanalysis of the IDEA trial, presented at the European Society for Medical Oncology (ESMO) Congress 2019.1 After 2 years of adjuvant...

multiple myeloma

Selinexor/Dexamethasone in Refractory Multiple Myeloma: The STORM Has Arrived, but Does It Represent Climate Change?

The term “relapsed/refractory multiple myeloma” is often used to describe advanced myeloma that has progressed through primary or salvage therapy. The International Myeloma Working Group (IMWG) defined the term in 2011 as disease that is “nonresponsive while on salvage therapy or progresses...

global cancer care

Challenging the Global Community to Deliver Equitable Cancer Care for All

For Her Royal Highness Princess Dina Mired of Jordan, ensuring that every patient with cancer receives high-quality care is not an abstract goal—it is personal. Princess Dina saw firsthand the life-and-death differences that access to state-of-the-art oncology care makes in a patient’s life when...

lung cancer
immunotherapy

Nivolumab/Ipilimumab: Another First-Line Option for Advanced NSCLC

The combination of nivolumab and ipilimumab improved overall survival compared with chemotherapy as first-line therapy for patients with advanced non–small cell lung cancer (NSCLC) and programmed cell death ligand 1 (PD-L1) expression of at least 1%, according to the results of CheckMate 227....

head and neck cancer
immunotherapy

Pembrolizumab With or Without Chemotherapy vs Cetuximab Plus Chemotherapy in Recurrent or Metastatic HNSCC

As reported in The Lancet by Barbara Burtness, MD, and colleagues, the phase III KEYNOTE-048 trial has shown improved overall survival with first-line pembrolizumab plus chemotherapy vs cetuximab plus chemotherapy among patients with recurrent or metastatic squamous cell carcinoma of the head and...

leukemia
lymphoma

FDA Approves Acalabrutinib for CLL/SLL as Part of Project Orbis

On November 21, as part of Project Orbis—a collaboration with the Australian Therapeutic Goods Administration (TGA) and Health Canada—the U.S. Food and Drug Administration (FDA) granted supplemental approval to acalabrutinib (Calquence) for the treatment of adults with chronic lymphocytic leukemia...

lung cancer

What Is the Best Palliation for End-Stage Lung Cancer?

Patients with advanced lung cancer can experience burdensome symptoms at the end of life. Pulmonologists can alleviate some of this suffering, but it’s a balancing act between doing too much and not enough, according to specialists who spoke at CHEST 2019, the annual meeting of the American College ...

lung cancer

Gefitinib Alone vs Gefitinib Plus Chemotherapy in EGFR-Mutated Metastatic NSCLC

In the Japanese phase III NEJ009 trial reported in the Journal of Clinical Oncology, Hosomi et al found that the addition of first-line gefitinib to carboplatin/pemetrexed improved progression-free survival vs gefitinib alone in patients with EGFR-mutated metastatic non–small cell lung cancer...

multiple myeloma

Selinexor Plus Dexamethasone Studied in Triple-Class Refractory Multiple Myeloma

In a phase IIb study (STORM Part 2) reported in TheNew England Journal of Medicine, Ajai Chari, MD, of Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, and colleagues found that oral selinexor and dexamethasone were active in some patients with multiple myeloma refractory to prior...

colorectal cancer

Targeted Triplet Therapy Improved Overall Survival in BRAF-Mutated Colorectal Cancer

For patients with metastatic colorectal cancer harboring BRAF V600E mutations, three drugs seem to be better than two, the most recent analysis of the phase III BEACON CRC study has shown.1 The results, presented at the 2019 European Society for Medical Oncology (ESMO) Congress, were concurrently...

issues in oncology

Presenting Symptoms and Cancer Stage at Diagnosis

In a population-based study reported in The Lancet Oncology, Koo et al found that presenting symptoms of cancer were mostly associated with stage earlier than stage IV, suggesting a benefit of symptom awareness campaigns based on common symptoms. As stated by the investigators, “Early diagnosis...

gynecologic cancers
immunotherapy

Nivolumab Plus Bevacizumab in Relapsed Ovarian Cancer

In a phase II trial reported in JAMA Oncology, Liu et al found evidence of the activity of combined nivolumab and bevacizumab in relapsed ovarian cancer, with activity appearing to be greater in platinum-sensitive disease. Study Details In the trial, 38 women with relapsed epithelial ovarian cancer ...

skin cancer

5-Year Efficacy Outcomes With Dabrafenib Plus Trametinib in BRAF-Mutated Metastatic Melanoma

As reported in The New England Journal of Medicine by Caroline Robert, MD, PhD, of the Institut Gustave Roussy and Paris-Sud-Paris-Saclay University, Villejuif, and colleagues, the long-term follow-up of the phase III COMBI-d and COMBI-v trials has shown a pooled 5-year overall survival rate of 34% ...

prostate cancer
breast cancer
bladder cancer
pancreatic cancer
kidney cancer
thyroid cancer
gynecologic cancers
immunotherapy

ESMO Congress 2019: Quick Takes From Key Clinical Trials

The ESMO Congress continues to grow as a pivotal platform for research in clinical oncology. At the ESMO Congress 2019, important findings were showcased in more than 2,200 studies, including 93 late-breaking abstracts. The ASCO Post summarized much of that news in separate articles over several...

lung cancer
neuroendocrine tumors
immunotherapy

Novel Therapies for Small Cell Lung Cancer and Neuroendocrine Tumors

Here is a glimpse at updated clinical trial data on newer therapies under study for the small cell lung cancer (SCLC) and advanced extrapancreatic neuroendocrine tumors. IMpower133 and ALTER: Novel Therapies for SCLC The treatment of small cell lung cancer has seen little progress in recent years, ...

gastrointestinal cancer

Pivotal Phase III Study Evaluates Investigational TKI in Fourth-Line Setting for Advanced GIST

In a late-breaking, oral presentation at the ESMO Congress 2019, Margaret von Mehren, MD, presented results from ­INVICTUS, a pivotal phase III clinical trial of ripretinib in patients with advanced gastrointestinal stromal tumor (GIST).1 Ripretinib is an investigational tyrosine kinase inhibitor...

hepatobiliary cancer

Targeted Treatment Advances in Cholangiocarcinoma

For one of the rarest and most aggressive of tumors—cholangiocarcinoma—two novel molecularly targeted agents yielded encouraging outcomes in advanced disease in studies reported at the European Society for Medical Oncology (ESMO) Congress 2019. In the phase III ClarIDHy trial, the risk of disease...

prostate cancer

Expert Point of View: Eleni Efstathiou, MD

Formal study discussant Eleni Efstathiou, MD, of MD Anderson Cancer Center, Houston, commented on results of the PROfound trial at the ESMO Congress 2019. “This is the first phase III targeted therapy trial to deliver a positive outcome in metastatic castration-resistant prostate cancer,” she...

prostate cancer

Phase III PROfound Study Evaluates Olaparib in Setting of Metastatic, Castration-Resistant Prostate Cancer

Treatment with the poly (ADP-ribose) polymerase (PARP) inhibitor olaparib delayed disease progression and appears to improve survival, compared with newer hormonal agents in men with pretreated metastatic castration-resistant prostate cancer and homologous recombinant repair (HRR) genetic...

multiple myeloma

Selinexor Plus Dexamethasone Studied in Triple-Class Refractory Multiple Myeloma

In a phase IIb study (STORM Part 2) reported in The New England Journal of Medicine, Ajai Chari, MD, of Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, and colleagues found that oral selinexor and dexamethasone were active in some patients with multiple myeloma refractory to prior...

multiple myeloma

Lenalidomide vs Observation in Asymptomatic Smoldering Multiple Myeloma

In a phase III trial reported in the Journal of Clinical Oncology, Sagar Lonial, MD, and colleagues found that lenalidomide significantly improved progression-free survival vs observation in patients with intermediate- or high-risk smoldering multiple myeloma. As noted by the investigators,...

lung cancer
immunotherapy

CheckMate 227: Nivolumab Plus Ipilimumab Presents Another Option in First-Line Treatment of Advanced Non–Small Cell Lung Cancer

The combination of nivolumab and ipilimumab improved overall survival compared with chemotherapy as first-line therapy for patients with advanced non–small cell lung cancer (NSCLC) and programmed cell death ligand 1 (PD-L1) expression of at least 1%, according to the results of CheckMate 227....

lung cancer

Osimertinib Improves Overall Survival vs Gefitinib, Erlotinib in Advanced EGFR-Mutated Non–Small Cell Lung Cancer: FLAURA Phase III Trial

The third-generation tyrosine kinase inhibitor osimertinib extended overall survival compared with the older tyrosine kinase inhibitors gefitinib and erlotinib in patients with EGFR-mutated advanced non–small cell lung cancer (NSCLC), according to late-breaking final overall survival results of the ...

gynecologic cancers

Phase III Trials Suggest Paradigm Shift With PARP Inhibitors in Ovarian Cancer

At the ESMO Congress 2019, ovarian cancer was a topic of heightened interest, particularly due to findings reported in several important phase III studies of PARP inhibitors in front-line maintenance therapy for patients with newly diagnosed advanced disease—and not just those with BRCA mutations....

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