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issues in oncology

Inpatient Radiation Oncology Consult Model for Metastatic Cancer to Reduce Hospital Length of Stay

In a single-institution study reported in JCO Oncology Practice, Xu et al found that implementation of a novel inpatient radiation oncology consult service was associated with a significant increase in consults involving metastatic disease specialists, as well as a reduction in hospital length of...

gynecologic cancers

Overall Survival With Olaparib vs Placebo Maintenance in Patients With Platinum-Sensitive Relapsed Ovarian Cancer and BRCA1/2 Mutation

As reported in The Lancet Oncology by Andrés Poveda, MD, and colleagues, the phase III SOLO2/ENGOT-Ov21 trial has shown a large numeric but statistically nonsignificant improvement in the secondary endpoint of overall survival with olaparib tablet maintenance therapy vs placebo in patients with...

lung cancer
genomics/genetics

Patients With NSCLC and Driver Mutations May Be More Likely to Present With Brain Metastasis at Diagnosis

The incidence of brain metastasis at diagnosis in patients with non–small cell lung cancer (NSCLC) harboring driver mutations was high, according to findings presented by Rashkit et al at the European Lung Cancer Virtual Congress 2021 (Abstract 38P). However, these patients achieved treatment...

gastroesophageal cancer

Locally Advanced Esophageal Cancer: Neoadjuvant Chemoradiotherapy vs Chemotherapy Followed by Minimally Invasive Esophagectomy

In an early analysis from a Chinese phase III trial reported in JAMA Surgery, Wang et al found similar safety and improved histopathologic outcome among patients undergoing minimally invasive esophagectomy for locally advanced esophageal squamous cell carcinoma following neoadjuvant...

head and neck cancer
genomics/genetics

Tipifarnib for Patients With Advanced HRAS-Mutant Head and Neck Cancer and High Variant Allele Frequency

In a phase II trial reported in the Journal of Clinical Oncology, Ho et al found that tipifarnib produced a high response rate among patients with recurrent or metastatic head and neck squamous cell carcinoma with HRAS mutations and high variant allele frequency. As stated by the investigators,...

leukemia

Addition of Pegaspargase Intensification to Standard Low-Intensity Chemotherapy Backbone in Pediatric Low-Risk B-Cell ALL

In an analysis from the Children’s Oncology Group (COG) AALL0331 trial reported in the Journal of Clinical Oncology, Mattano et al found that the addition of pegaspargase intensification did not improve the high rate of continuous complete remission achieved with a standard COG low-intensity...

skin cancer
immunotherapy

Chronic Immune-Related Adverse Events Associated With Adjuvant Immunotherapy for Advanced Melanoma

In a retrospective cohort study reported in JAMA Oncology, Patrinely et al found that chronic immune-related adverse events occurred in a high proportion of patients receiving adjuvant PD-1–targeted therapy for high-risk resected melanoma and frequently persisted even during prolonged follow-up....

multiple myeloma
immunotherapy

FDA Approves Isatuximab-irfc Combination for Relapsed or Refractory Multiple Myeloma

On March 31, the U.S. Food and Drug Administration (FDA) approved isatuximab-irfc (Sarclisa) in combination with carfilzomib and dexamethasone for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three prior lines of therapy. IKEMA The efficacy...

breast cancer
immunotherapy

Does Adding Adjuvant Concurrent Trastuzumab to Radiotherapy After Lumpectomy for HER2-Positive DCIS Reduce Ipsilateral Recurrence?

As reported in the Journal of Clinical Oncology by Cobleigh et al, the phase III NRG Oncology/NSABP B-43 trial did not show a significant reduction in ipsilateral breast tumor recurrence with the addition of adjuvant concurrent trastuzumab to radiotherapy in women undergoing lumpectomy for...

lymphoma
immunotherapy

Pembrolizumab vs Brentuximab Vedotin in Relapsed or Refractory Classical Hodgkin Lymphoma: KEYNOTE-204 Trial

As reported in The Lancet Oncology by John Kuruvilla, MD, and colleagues, an interim analysis of the phase III KEYNOTE-204 trial has shown significantly improved progression-free survival with pembrolizumab vs brentuximab vedotin in patients with relapsed or refractory classical Hodgkin lymphoma....

integrative oncology
pain management
survivorship

Electroacupuncture and Auricular Acupuncture vs Usual Care for Chronic Musculoskeletal Pain in Cancer Survivors

In the PEACE study, reported in JAMA Oncology, Jun J. Mao, MD, MSCE, and colleagues found that both electroacupuncture and auricular acupuncture significantly reduced pain severity vs usual care in cancer survivors with chronic musculoskeletal pain. Noninferiority of auricular acupuncture to...

lung cancer
covid-19

Incidence of Brain Metastases in Patients Diagnosed With Stage IV NSCLC During the COVID-19 Pandemic

Computed tomography and/or magnetic resonance imaging demonstrated that 39% of patients diagnosed with stage IV non–small cell lung cancer (NSCLC) presented with de novo brain metastases during the COVID-19 pandemic. This percentage was higher than the historic rate of 25%, and many of these...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Adjuvant Nivolumab in Resected Esophageal or Gastroesophageal Junction Cancer Following Neoadjuvant Chemoradiation Therapy

Adjuvant nivolumab is the first therapy to provide a statistically significant and clinically meaningful improvement in disease-free survival in patients with resected esophageal and gastroesophageal junction cancer, according to research presented by Guillaume Piessen, MD, PhD, and colleagues at...

gynecologic cancers

WEE1 Inhibition in Patients With Recurrent Uterine Serous Carcinoma

In a single-institution phase II trial reported in the Journal of Clinical Oncology, Joyce F. Liu, MD, MPH, and colleagues found that the WEE1 inhibitor adavosertib produced durable responses in women with recurrent uterine serous carcinoma. The investigators stated, “Uterine serous carcinoma is a...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Expert Point of View: Rutika Mehta, MD, MPH

The FIGHT study’s invited discussant, Rutika Mehta, MD, MPH, a gastrointestinal oncologist at Moffitt Cancer Center, Tampa, Florida, noted the emergence of new biomarkers and their targeted agents in HER2-negative gastric or gastroesophageal junction cancer. Two important ones are FGFR2b—now...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Targeting FGFR2b With Bemarituzumab Plus Chemotherapy in Gastric or Gastroesophageal Junction Cancer

Gastric cancer appears to have a new druggable target: fibroblast growth factor receptor 2b (FGFR2b). Targeting FGFR2b with bemarituzumab plus chemotherapy led to clinically meaningful and statistically significant improvements in progression-free survival, overall survival, and response rate in...

gastrointestinal cancer
immunotherapy

Nivolumab Plus Chemotherapy: New Standard of Care in Advanced Gastric Cancer?

As first-line treatment for advanced gastric cancer, nivolumab plus chemotherapy leads to significantly improved progression-free and overall survival over chemotherapy alone, investigators reported during a Presidential Symposium of the European Society for Medical Oncology (ESMO) Virtual Congress ...

pancreatic cancer

New Maintenance Therapies in Metastatic Pancreatic Cancer Aim to End Perpetual Chemotherapy

The advent of effective combination chemotherapies has changed the treatment landscape for metastatic pancreatic cancer, extending median survival and leading to durable responses in a subset of patients. However, perpetual chemotherapy is cumulatively toxic, leading to progressive bone marrow...

pancreatic cancer

SWOG S1505 Trial Evaluates Neoadjuvant Regimens in Pancreatic Cancer

The much-anticipated SWOG S1505 trial has failed to show that one preoperative regimen is better than another in resectable pancreatic cancer.1 “Perioperative modified FOLFIRINOX and gemcitabine/nab-paclitaxel appear to have similar efficacy, with acceptable safety and resectability rates,”...

hepatobiliary cancer

Cholangiocarcinoma: Often Misdiagnosed, Always Impactful

A large survey of patients with cholangiocarcinoma indicates the toll this cancer takes on patients, even those with early-stage disease, as reported at the 2021 Gastrointestinal Cancers Symposium by Kristen Bibeau, PhD, MSPH, Head of Global Health Outcomes and Real-World Evidence Generation at...

hepatobiliary cancer

Novel CK2 Inhibitor Silmitasertib Shows Promise in Cholangiocarcinoma

A novel inhibitor of casein kinase 2 (CK2) has shown preliminary evidence of efficacy in patients with locally advanced or metastatic cholangiocarcinoma, according to a phase I/IIb study presented at the 2021 Gastrointestinal Cancers Symposium.1  Silmitasertib (CX-4945) is an oral small-molecule...

hepatobiliary cancer
genomics/genetics

In Cholangiocarcinoma, Does Chemotherapy Response Vary According to FGFR2 Status?

With inhibitors of fibroblast growth factor receptor 2 (FGFR2) fusion and other genetic alterations now in clinical trials for cholangiocarcinoma, there is interest in better understanding what FGFR2 genetic alterations mean for patients. In particular, little is known about the effects of FGFR2...

hepatobiliary cancer

FGFR2 Inhibitor Infigratinib Active in Chemotherapy-Refractory Cholangiocarcinoma

The novel targeted agent infigratinib (BGJ398) showed clinically meaningful activity against chemotherapy-refractory cholangiocarcinoma in patients with fibroblast growth factor receptor (FGFR2) fusions and rearrangements. The confirmed overall response rate was 23% (34% confirmed/unconfirmed), the ...

hepatobiliary cancer

ClarIDHy Trial: IDH1 Inhibitor Ivosidenib Improves Survival in Cholangiocarcinoma

Ivosidenib, an inhibitor of isocitrate dehydrogenase 1 (IDH1), improved overall survival by almost 3 months in previously treated patients with advanced IDH1-mutated cholangiocarcinoma, compared with placebo, researchers of the global phase III ClarIDHy trial reported at the 2021 Gastrointestinal...

hepatobiliary cancer
immunotherapy

IMbrave150: A New Standard of Care to Treat Hepatocellular Cancers?

In 2007, sorafenib became the first approved systemic therapy for hepatocellular cancers and the first agent to improve overall survival in these patients.1 In a similar multikinase inhibitor strategy, lenvatinib was found to be noninferior to sorafenib in overall survival in the same patient...

gastrointestinal cancer

IMbrave150 Trial: Atezolizumab Plus Bevacizumab Improves Survival in Unresectable Hepatocellular Carcinoma

As reported in The New England Journal of Medicine by Richard S. Finn, MD, of Jonsson Comprehensive Cancer Center, Geffen School of Medicine at the University of California, Los Angeles, and colleagues, the phase III IMbrave150 trial has shown that anti–PD-L1 plus anti-VEGF therapy with...

colorectal cancer

Solving the Mystery of Why Colorectal Cancer Is on the Rise in Young Adults

Excluding skin cancer, colorectal cancer is the third most prevalent and lethal cancer among both men and women in the United States.1 Although the risk of developing colorectal cancer increases with age—more than 90% of cases occur in people aged 50 or older2—recent research shows that the...

gastrointestinal cancer

Novel Therapies and New Indications for Use in the Treatment of Gastrointestinal Cancers

The past year has witnessed the U.S. Food and Drug Administration (FDA) approval of a number of novel drugs and new indications for treating patients with gastrointestinal malignancies. A summary of these approvals is provided herein. Nivolumab plus ipilimumab: On March 10, 2020, the FDA granted...

colorectal cancer

Molecular Testing in Metastatic Colorectal Cancer: Understanding How, When, and What to Profile

“In line with the emergence of targeted therapies, molecular biomarker testing in metastatic colorectal cancer has evolved over the past decade,” noted Jeanne Tie, MD, MBChB, FRACP, who acknowledged there is confusion about the best ways to use molecular testing in the clinic. Dr. Tie, who is...

Expert Point of View: Christopher Leigh Hallemeier, MD

The invited discussant for the RAPIDO and PRODIGE 23 trials, Christopher Leigh Hallemeier, MD, Associate Professor of Radiation Oncology at the Mayo Clinic, Rochester, noted the standard approach to locally advanced rectal cancer has been, for the past 2 decades, a long course of chemoradiotherapy ...

gastrointestinal cancer

Two Studies Validate Neoadjuvant Chemotherapy With Short-Course Radiotherapy or Long-Term Chemoradiotherapy in Locally Advanced Rectal Cancer

In the treatment of resectable, locally advanced rectal cancer, researchers are trying to identify the most effective chemotherapy regimens, the best radiotherapy approaches, and the optimal sequence of these modalities. Two phase III trials presented during the ASCO20 Virtual Scientific Program...

Expert Point of View: Autumn McRee, MD

DESTINY-CRC01 study discussant, Michael S. Lee, MD, Assistant Professor of Medicine, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill, called the findings “most promising” for the subsequent anti-HER2 treatment of HER2-positive metastatic colorectal cancer. The...

colorectal cancer

Fam-Trastuzumab Deruxtecan-nxki Shows Benefit in Refractory Colorectal Cancer

Having recently gained approval in metastatic breast cancer, fam-trastuzumab deruxtecan-nxki (T-DXd) is now proving its worth in metastatic colorectal cancer, according to results of the phase II DESTINY-CRC01 study in patients with HER2-positive disease.1 T-DXd is an antibody-drug conjugate...

colorectal cancer

KEYNOTE-177: New Analysis Confirms Benefit of Pembrolizumab vs Chemotherapy in Microsatellite Instability–High Advanced Colorectal Cancer

In an updated analysis of the pivotal phase III KEYNOTE-177 trial of pembrolizu-mab for microsatellite instability–high (MSI-H) metastatic colorectal cancer, the benefit of first-line pembrolizumab continued beyond disease progression on the subsequent line of treatment, despite a high crossover to ...

colorectal cancer
covid-19

Treating Colorectal Cancer in the Time of COVID-19

The treatment of colorectal cancer has always been something of an art—but never more so than during the COVID-19 pandemic. In the spring of 2020, The ASCO Post asked three experts in this malignancy to share their concerns and their approaches to achieving good patient outcomes while minimizing...

gastrointestinal cancer

Gastrointestinal Oncology Highlights 2020–2021 Almanac

Cancers of the digestive tract account for 338,090 new cases and 169,280 deaths annually in the United States. Although the overall mortality from these cancers is decreasing, this has been countered by an increase in the incidence of colorectal cancer in young adults. The rising incidence and poor ...

survivorship
supportive care

Inclusion of Surveillance Ejection Fraction in Predicting Risk of 10-Year Left-Ventricular Systolic Dysfunction in Survivors of Childhood Cancer

In a Dutch study reported in JACC: CardioOncology, Leerink et al found that the addition of ejection fraction measurement at the time of first surveillance echocardiogram improved prediction of 10-year risk of left-ventricular systolic dysfunction vs prediction based on cumulative anthracycline and ...

pancreatic cancer

Definitive Ablative Radiation Therapy in Inoperable Locally Advanced Pancreatic Cancer

In a single-institution study reported in JAMA Oncology, Reyngold et al found that definitive hypofractionated ablative radiation therapy following induction chemotherapy was associated with prolonged locoregional control and favorable survival in patients with inoperable locally advanced...

breast cancer
issues in oncology

Younger vs Older Women With Breast Cancer: Understanding the Differences

Younger women with breast cancer differ from their older counterparts in ways that should be appreciated by their clinicians, according to Ann H. Partridge, MD, MPH, FASCO, Vice Chair of Medical Oncology at Dana-Farber Cancer Institute and Professor of Medicine at Harvard Medical School. At PER’s...

Eleven Oncology Practices Receive Quality Certification From the Association for Clinical Oncology

The Association for Clinical Oncology congratulates the 11 practices that prioritized the quality of care they provide by achieving the Quality Oncology Practice Initiative (QOPI®) Certification in the second half of 2020. These practices have shown that they are committed to providing the...

breast cancer
genomics/genetics

Breast Cancer Susceptibility Genes: Putting the Pieces Together

With the widespread use of multigene panels for germline genetic testing, understanding the cancer risks associated with pathogenic or likely pathogenic variants (ie, mutations) has become increasingly necessary. To identify which genes are breast cancer susceptibility genes, population studies...

Health-Care Policy Expert Sybil R. Green, JD, RPh, MHA, Brings Wealth of Experience as ASCO’s First Diversity and Inclusion Officer

Sybil R. Green, JD, RPh, MHA, has been named Diversity and Inclusion Officer by ASCO. A health-care policy expert with experience in both corporate and nonprofit organizations, Ms. Green will guide ASCO’s internal and external initiatives aimed at achieving the Society’s equity, diversity, and...

health-care policy
global cancer care

Cancer Control in Egypt: Investing in Health

Egypt is a country of 1,010,408 km2 located on the northeast corner of Africa with a population exceeding 100 million. In 2018, there were about 134,632 new cancer cases and 89,042 cancer-related deaths in Egypt. Liver and breast cancers are the most common tumors in terms of incidence and...

lymphoma
immunotherapy

Challenges in Managing Hodgkin Lymphoma: Focus on Use of Brentuximab Vedotin

“I was taught that the way of progress was neither swift nor easy.” —Marie Curie To complement The ASCO Post’s continued comprehensive coverage of the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, here are two abstracts selected from the meeting proceedings focusing on...

global cancer care

Lydia Pace, MD, MPH: A Primary Care Physician on the Front Lines of Oncology, Both Nationally and Globally

Lydia Pace, MD, MPH, was inspired to a become a doctor by her grandfather, a general surgeon in New York City, who spoke effulgently of his career in medicine, and by her mother, a social worker who was equally passionate about her profession. A primary care physician, Dr. Pace developed an...

lung cancer
immunotherapy

Next Up in NSCLC: Antibody-Drug Conjugates

Antibody-drug conjugates directed against HER2, HER3, and trophoblast cell-surface antigen 2 (TROP2) are showing encouraging antitumor activity in advanced non–small cell lung cancer (NSCLC), according to research presented during the virtual edition of the International Association for the Study...

kidney cancer
immunotherapy

Nivolumab Plus Cabozantinib as First-Line Treatment of Advanced Renal Cell Carcinoma

On January 22, 2021, the U.S. Food and Drug Administration approved the combination of nivolumab and cabozantinib as first-line treatment for patients with advanced renal cell carcinoma.1-3 Supporting Efficacy Data Approval was based on the findings of the phase III, open-label CheckMate 9ER trial...

leukemia

Groundbreaking Cancer Researcher Brian J. Druker, MD, Shows No Signs of Slowing Down

For this installment of the Living a Full Life series, guest editor Jame Abraham, MD, spoke with physician-scientist Brian J. Druker, MD, Director of the Knight Cancer Institute at Oregon Health & Science University, Portland. In 2009, Dr. Druker won the Lasker-DeBakey Clinical Medical Research ...

lung cancer

ITACA Trial: No Survival Benefit for Tailoring Adjuvant Chemotherapy in NSCLC

Tailoring adjuvant chemotherapy based on the expression of two molecular markers did not lead to a survival advantage in patients with completely resected stage II to III non–small cell lung cancer (NSCLC) in the phase III ITACA trial. This result was presented during the virtual edition of the...

covid-19

Evidence-Based Strategy for Improving Access to Colorectal Cancer Screening for Diverse Populations

A novel strategy of combining a drive-by flu vaccination clinic with an opportunity for participants to use a take-home fecal immunochemical test (FIT) increased access to colorectal screening among Black Americans during the COVID-19 pandemic. Results related to access to colorectal cancer...

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