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head and neck cancer
immunotherapy

Pembrolizumab in First-Line Treatment of Head/Neck Squamous Cell Carcinoma

On June 10, 2019, pembrolizumab was approved for the first-line treatment of patients with metastatic or unresectable recurrent head and neck squamous cell carcinoma.1,2 Pembrolizumab was approved for use in combination with platinum and fluorouracil (5-FU) for all patients and as a single agent...

immunotherapy
multiple myeloma

Daratumumab-Based Therapy for Patients With Newly Diagnosed Multiple Myeloma Who Are Ineligible for Transplantation

On June 27, 2019, daratumumab was approved for use in combination with lenalidomide and dexamethasone for patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplantation.1,2 Supporting Efficacy Data Approval was based on findings in the open-label phase...

lymphoma

Lenalidomide for Previously Treated Follicular and Marginal Zone Lymphomas

On May 28, 2019, lenalidomide was approved for use in combination with a rituximab product for previously treated follicular lymphoma and previously treated marginal zone lymphoma.1,2 Supporting Efficacy Data Approval was based on the findings of two clinical trials: AUGMENT (ClinicalTrials.gov...

colorectal cancer

Physical Activity Level and Outcomes in Metastatic Colorectal Cancer

A prospective cohort study within the phase III Cancer and Leukemia Group B (Alliance)/SWOG 80405 trial found that increased physical activity at baseline was associated with nonsignificant improvement in overall survival, a significant improvement in progression-free survival, and a reduced risk...

hepatobiliary cancer

Real-Time ctDNA Evaluation in Patients With Hepatocellular Carcinoma

In a study published in the Journal of Gastrointestinal Oncology, Mody et al described results from patients with hepatocellular carcinoma undergoing circulating tumor DNA (ctDNA) testing in a real-time clinical context. The authors wrote, “[ctDNA assessment] holds incredible promise for early...

skin cancer

Stage IV Melanoma: What Current Role Should Surgery Play?

Advanced melanoma has become a different entity in the era of immunotherapy and targeted agents. Considering the potential for good outcomes from systemic therapy in advanced disease, has the role of surgery changed? Should it be offered up front or limited to patients with oligometastatic ...

First-Line Nivolumab and Ipilimumab vs Sunitinib in Advanced Renal Cell Carcinoma

This week, we’ll be talking about an extended follow-up of a phase III trial that investigated first-line nivolumab and ipilimumab vs sunitinib in advanced renal cell carcinoma. Then we’ll go over a research letter that identified strong predictors of response to immune checkpoint inhibitor...

breast cancer

Neoadjuvant Talazoparib for Operable BRCA-Mutated Breast Cancer

In a study reported in the Journal of Clinical Oncology, Jennifer K. Litton, MD, and colleagues found that 6 months of neoadjuvant talazoparib therapy resulted in a high rate of residual cancer burden (RCB) of 0 (pathologic complete response) in patients with stage I–III breast cancer with germline ...

multiple myeloma

Is It Time to Intervene in Smoldering Myeloma?

Early intervention in smoldering multiple myeloma prevents progression to symptomatic disease and should be strongly considered for patients meeting new criteria for high risk, according to Sagar Lonial, MD, Professor and Chair of Hematology and Medical Oncology and the Anne and Bernard Gray...

issues in oncology

2019 Quality Care: Socioeconomic Deprivation and Outcomes in Cancer Clinical Trials

In a study to be presented by Unger et al at the 2019 ASCO Quality Care Symposium, researchers found patients living in socioeconomically deprived areas were more likely to experience worse survival in cancer clinical trials, even after adjustments for race and insurance (Abstract 162). Methods...

prostate cancer

TITAN Trial: Apalutamide Adds to Options for Men With Metastatic Hormone-Sensitive Prostate Cancer

Androgen-deprivation therapy has been, and remains, the standard of care for patients with metastatic prostate cancer. Patients are often surprised to know that was all we would do to control their disease and sometimes asked why they would not get chemotherapy, as for other cancers. I would take...

prostate cancer

Addition of Apalutamide to Androgen-Deprivation Therapy in Metastatic Castration-Sensitive Prostate Cancer

As reported in The New England Journal of Medicine by Kim N. Chi, MD, of BC Cancer and Vancouver Prostate Centre, and colleagues, the first analysis of the phase III TITAN trial has shown that the addition of apalutamide to androgen-deprivation therapy improved radiographic progression-free and...

supportive care
symptom management

Study Explores Efficacy of Lower-Dose Olanzapine in Combination With Standard Antiemetic Regimen

Olanzapine at a 5-mg dose, when combined with aprepitant, palonosetron, and dexamethasone, significantly reduced the risk of delayed nausea and vomiting in patients receiving cisplatin-based chemotherapy, according to new research. The study investigators believe this approach may be considered a...

prostate cancer

Many Choices Now for Men With Metastatic Hormone-Sensitive Prostate Cancer: How to Decide?

Based on the recently published ENZAMET, ARCHES, and TITAN trials,1-3 we now have several choices of systemic combination therapies for men with metastatic hormone-sensitive prostate cancer; the ENZAMET trial is reviewed in this issue of The ASCO Post. In 2019, men are now faced with decisions of...

prostate cancer

Enzalutamide Improves Survival vs Standard First-Line Treatment in Hormone-Sensitive Metastatic Prostate Cancer

As reported in The New England Journal of Medicine by Ian D. Davis, MBBS, PhD, FRACP, FAChPM, of Monash University and Eastern Health in Melbourne, and colleagues, the phase III ENZAMET trial has shown that the androgen receptor inhibitor enzalutamide improved progression-free and overall survival ...

kidney cancer
immunotherapy

Extended Follow-up of CheckMate 214: Nivolumab/Ipilimumab vs Sunitinib as First-Line Treatment for Advanced RCC

As reported in The Lancet Oncology by Robert J. Motzer, MD, and colleagues, extended follow-up of the phase III CheckMate 214 trial has shown a maintained survival benefit for first-line nivolumab/ipilimumab vs sunitinib in patients with previously untreated intermediate- or poor-risk advanced...

immunotherapy
skin cancer

Phase Ib Trial of Toripalimab/Axitinib in Asian Patients With Advanced Mucosal Melanoma

In a Chinese phase Ib study reported in the Journal of Clinical Oncology, Sheng et al reported activity with the combination of the anti–programmed cell death protein 1 (PD-1) agent toripalimab plus axitinib in patients with metastatic mucosal melanoma. As stated by the investigators, whereas...

kidney cancer
prostate cancer
immunotherapy

Novel Treatments Under Study in Renal Cell Carcinoma and Prostate Cancer

There were numerous notable presentations at the 2019 Genitourinary Cancers Symposium, many of which were covered in The ASCO Post over the past few months. To add to our continued coverage of this meeting, here are some highlights from studies focusing on novel therapeutics in renal cell carcinoma ...

prostate cancer

Darolutamide for Nonmetastatic Castration-Resistant Prostate Cancer

On July 30, 2019, darolutamide was approved for the treatment of patients with nonmetastatic castration-resistant prostate cancer.1,2 Approval was based on findings in the double-blind phase III ARAMIS trial (ClinicalTrials.gov identifier NCT02200614), in which 1,509 patients were randomly assigned ...

kidney cancer
prostate cancer
immunotherapy

Novel Treatments Under Study in Renal Cell Carcinoma and Prostate Cancer

There were numerous notable presentations at the 2019 Genitourinary Cancers Symposium, many of which were covered in The ASCO Post over the past few months. To add to our continued coverage of this meeting, here are some highlights from studies focusing on novel therapeutics in renal cell carcinoma ...

issues in oncology
geriatric oncology

Polypharmacy Associated With Functional Decline in Older Patients With Advanced Cancer

Polypharmacy (ie, the concurrent use of eight or more medications) and potentially inappropriate medications may be associated with functional impairment in older adults with advanced cancer, according to research presented by ­Mostafa Mohamed, MBBCh, at the Multinational Association of Supportive...

lung cancer
immunotherapy

Optimal First-Line Therapy for Stage IV Non–Small Cell Lung Cancer: Immunotherapy Alone or With Chemotherapy?

Recent studies in non–small cell lung cancer (NSCLC) have shown benefit for combining checkpoint inhibitors with chemotherapy. Should combinations, therefore, be the first choice for treating patients with newly diagnosed stage IV disease? Two lung cancer experts debated this point at the 2019...

solid tumors

Exploratory Analysis Shows DNA Methylation Assay Highly Specific for Cancer Detection

A cell-free DNA test based on the presence of DNA methylation has proven highly specific as a multicancer detection test and appears especially good at detecting high-risk malignancies. In most cases, it can also accurately pinpoint the tumor’s tissue of origin, researchers reported at the 2019...

lymphoma
prostate cancer

FDA Pipeline: Priority Reviews in Prostate Cancer, Mantle Cell Lymphoma

This week, the U.S. Food and Drug Administration (FDA) accepted new drug applications for enzalutamide in metastatic hormone-sensitive prostate cancer and zanubrutinib in relapsed or refractory mantle cell lymphoma, and granted both applications Priority Review. Priority Review for Enzalutamide in ...

lung cancer

Addition of Pemetrexed/Carboplatin to Gefitinib in Advanced EGFR-Mutant NSCLC

In an Indian single-center phase III trial reported in the Journal of Clinical Oncology, Noronha et al found that the addition of pemetrexed/carboplatin to gefitinib improved progression-free and overall survival in first-line treatment of advanced EGFR-mutant non–small cell lung cancer...

gynecologic cancers

Adjuvant Chemoradiotherapy vs Radiotherapy Alone in High-Risk Endometrial Cancer

As reported in The Lancet Oncology by Stephanie de Boer, MD, and colleagues, a post hoc updated survival analysis of the phase III PORTEC-3 trial has shown a significant overall survival benefit of adjuvant chemoradiotherapy vs radiotherapy alone in women with high-risk endometrial cancer. A...

Pexidartinib for Tenosynovial Giant Cell Tumor

On August 2, the oral colony-stimulating factor 1 receptor inhibitor pexidartinib was approved for treatment of adult patients with symptomatic tenosynovial giant cell tumor associated with severe morbidity or functional limitations and not amenable to improvement with surgery.1,2 It is the first...

ASTRO Elects Four New Officers to Board of Directors

The members of the American Society for Radiation Oncology (ASTRO) have elected four new officers to ASTRO’s Board of Directors. Laura Dawson, MD, FASTRO, will begin her term as President-Elect in September during ASTRO’s 61st Annual Meeting in Chicago. Neha Vapiwala, MD, was elected as ASTRO’s new ...

An Early Decision to Become an Oncologist

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic.   For this installment of the Living a Full Life series, Guest Editor Jame Abraham, MD, FACP, spoke with Gilberto de Lima...

lung cancer

Atezolizumab Plus Chemotherapy and Bevacizumab in First-Line Treatment of Metastatic Lung Cancer

In late 2018, atezolizumab was approved for use in combination with bevacizumab, paclitaxel, and carboplatin for the first-line treatment of patients with metastatic nonsquamous non–small cell lung cancer (NSCLC) with no EGFR or ALK genomic tumor aberration.1,2 Supporting Efficacy Data Approval was ...

breast cancer

Total Cumulative Chemotherapy Dose and Survival in Breast Cancer

Physicians should attempt to maintain full doses of chemotherapy, especially early in the course of treatment, for patients with intermediate- or high-risk breast cancer, according to research published by Veitch et al in JNCCN—Journal of the National Comprehensive Cancer Network. The...

breast cancer

Neoadjuvant Letrozole Plus Taselisib or Placebo in Postmenopausal Women With ER-Positive, HER2-Negative Early Breast Cancer

In the phase II LORELEI trial reported in The Lancet Oncology, Saura et al found that the addition of the phosphatidylinositol-3 kinase (PI3K) inhibitor taselisib to neoadjuvant letrozole improved objective response rates but not pathologic complete response rates in women with estrogen receptor...

lung cancer
immunotherapy

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

In an analysis reported in The Lancet Oncology, Antonia et al identified long-term survival rates with nivolumab therapy in patients with previously treated advanced non–small cell lung cancer (NSCLC). The pooled analysis included data from the CheckMate 017, 057, 063, and 003 trials, each...

colorectal cancer

Does Exercise Improve Outcomes in Patients With Metastatic Colorectal Cancer?

Patients with metastatic colorectal cancer who engaged in moderate exercise while undergoing chemotherapy tended to have delayed progression of their disease and fewer severe side effects from treatment, according to the results of a new study published by Guercio et al in the Journal of Clinical...

leukemia
prostate cancer
gastrointestinal cancer

FDA Pipeline: Designation in CLL, New Drug Application in GIST, New Prostate Ablation System Receives 510(k) Clearance

Recently, the U.S. Food and Drug Administration granted Breakthrough Therapy designation to acalabrutinib in chronic lymphocytic leukemia (CLL), accepted a new drug application for avapritinib in some types of gastrointestinal stromal tumors (GIST), and granted 501(k) clearance to market the...

breast cancer
survivorship

Adiposity Distribution and Risk for Cardiovascular Disease Among Breast Cancer Survivors

In a study reported in the Journal of Clinical Oncology, Cespedes Feliciano et al found that increased visceral and intramuscular adiposity were associated with increased risk of cardiovascular disease among breast cancer survivors, independent of baseline risk factors and cancer treatment. Study...

issues in oncology

Age Disparities Among Patients in Cancer Clinical Trials and Patients With Cancer in the General Population

In a study reported in JAMA Oncology, Ludmir et al found that the median age of patients with common cancers enrolled in clinical trials was substantially lower than the median age of patients with the same cancers in the general population. Age disparity was greater in industry-funded trials....

cns cancers

Response- and Biology-Based Therapy for Pediatric Intermediate-Risk Neuroblastoma

As reported in the Journal of Clinical Oncology by Twist et al, use of reduced therapy for subsets of pediatric patients with intermediate-risk neuroblastoma in the Children’s Oncology Group (COG) study ANBL0531 did not affect the excellent overall survival rates observed in prior COG studies ...

skin cancer
immunotherapy

Addition of IDO1 Inhibitor to Immunotherapy in Melanoma

As reported in The Lancet Oncology by Georgina V. Long, PhD, and colleagues, the phase III ECHO-301/KEYNOTE-252 trial showed no improvement in progression-free or overall survival with the addition of the IDO1 inhibitor epacadostat to pembrolizumab in unresectable stage III or stage IV melanoma....

rituxan
dacogen
imbruvica
venclexta

Highlights in Geriatric Hematology From the ASH Annual Meeting & Exposition

GUEST EDITOR Geriatrics for the Oncologist is guest edited by Stuart M. Lichtman, MD, FACP, FASCO, and developed in collaboration with the International Society of Geriatric Oncology (SIOG). Dr. Lichtman is an Attending Physician at Memorial Sloan Kettering Cancer Center, Commack, New York, and...

Leading City of Hope Hematologists Appointed to New Positions

Larry Kwak, MD, PhD, has been appointed the Deputy Director of City of Hope’s Hematologic Malignancies and Stem Cell Transplantation Institute. Tanya Siddiqi, MD, Associate Clinical Professor in City of Hope’s Department of Hematology & Hematopoietic Cell Transplantation, has been appointed...

hematologic malignancies
lymphoma

Treatment Update on Selected Non-Hodgkin Lymphomas

As part of The ASCO Post’s coverage of the 2019 ASCO Annual Meeting, featured here are four abstracts from different clinical trials evaluating newer treatments for Waldenström’s macroglobulinemia and T-cell lymphomas. Waldenström’s Macroglobulinemia ABSTRACT 7509: Outcomes with bendamustine plus ...

lung cancer
immunotherapy

Maintenance Bevacizumab, Pemetrexed, or Both in Advanced Nonsquamous NSCLC

In the phase III ECOG-ACRIN 5508 trial, reported in the Journal of Clinical Oncology by Ramalingam et al, maintenance pemetrexed or bevacizumab was associated with no significant improvement in overall survival vs the bevacizumab control group alone, and was associated with greater toxicity in...

lung cancer

Atezolizumab Combined With Chemotherapy in First-Line Extensive-Stage Small Cell Lung Cancer

On March 18, 2019, atezolizumab was approved for use in combination with carboplatin and etoposide in the first-line treatment of adult patients with extensive-stage small cell lung cance (SCLC).1,2 Supporting Efficacy Data Approval was based on findings in the phase III double-blind IMpower133...

symptom management
supportive care

Novel Therapeutics on the Horizon for Treating Chemotherapy-Induced Peripheral Neuropathy

Chemotherapy-induced peripheral neuropathy is a major clinical problem, and better therapies are needed for both its treatment and prevention. According to Charles Loprinzi, MD, a medical oncologist at the Mayo Clinic in Rochester, Minnesota, to devise better preventive and treatment approaches,...

breast cancer
kidney cancer
sarcoma
lymphoma
multiple myeloma

Notable Presentations at ASCO 2019 Included Studies in Sarcoma, Lymphoma, Myeloma, and Breast and Kidney Cancers

The 2019 ASCO Annual Meeting featured a wealth of presentations on important topics. In addition to our regular news coverage of the meeting, we present below some highlights of other studies that add to our knowledge base for treatment of various cancers. Olaratumab in Soft-Tissue Sarcoma...

breast cancer
cost of care

How Treatment Costs Affect Decisions for Breast Cancer Surgery

In a study reported in the Journal of Oncology Practice, Greenup et al found that cancer treatment costs influenced women’s decisions on breast cancer surgery. Researchers reported many women, even at the highest income levels, said that costs were higher than expected, and that most women...

mektovi
erbitux
braftovi

BEACON CRC: Encorafenib/Binimetinib/Cetuximab Improves Survival in BRAF V600E–Mutated Metastatic Colorectal Cancer

The three-drug combination of encorafenib (a BRAF inhibitor), binimetinib (a MEK inhibitor), and cetuximab (an EGFR inhibitor) significantly improved overall survival in patients with BRAF-mutated metastatic colorectal cancer, according to the results of the phase III BEACON CRC clinical trial....

leukemia
immunotherapy

Ibrutinib/Rituximab vs Standard Chemoimmunotherapy in Previously Untreated CLL

In an interim analysis of the phase III E1912 trial reported in The New England Journal of Medicine, Shanafelt et al found that ibrutinib/rituximab improved progression-free and overall survival vs standard chemoimmunotherapy in patients 70 years old or younger with previously untreated chronic...

solid tumors
skin cancer
immunotherapy

FDA Pipeline: Breakthrough Therapy for Melanoma, Investigational New Drug for Advanced Solid Tumors

This week, the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy designation to bempegaldesleukin in combination with nivolumab for advanced melanoma and cleared an investigational new drug application for a phase I trial of SB 11285 in advanced solid tumors. Breakthrough...

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