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immunotherapy
breast cancer
lung cancer
prostate cancer
kidney cancer
bladder cancer
colorectal cancer
pancreatic cancer
sarcoma
leukemia
skin cancer
head and neck cancer

NCCN Clinical Practice Guidelines in Oncology: 2019 Updates

In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®), covering eight tumor types. NCCN Guidelines are now published for more than 70 tumor types and topics. Some of the key updates for 2019 were presented...

kidney cancer
immunotherapy

Expert Point of View: Tracy Rose, MD, MPH

THE FORMAL DISCUSSANT of the KEYNOTE-427 trial, Tracy Rose, MD, MPH, of the University of North Carolina, Chapel Hill, told listeners: “I think pembrolizumab should now be considered an option for non–clear cell kidney cancer. Response rates, however, remain inferior to those seen in clear cell...

bladder cancer
kidney cancer
prostate cancer

A Year in Review

The past year has seen groundbreaking advances in the treatment of genitourinary (GU) cancers, which in some cases are resulting in altering the standard of care for patients with renal cell carcinoma, prostate cancer, and urothelial carcinoma. Some of the biggest changes that have occurred are for ...

Marking a Year of Learning From ASCO Members

This past year, I have traveled thousands of miles across the United States meeting with ASCO members and their patients, focusing on members who care for patients in particularly challenging settings. While I am not surprised by the extraordinary work our members are doing in every region of the...

Incoming ASCO President Sets His Sights on Conquering Cancer

For more than 3 decades, Howard A. “Skip” Burris III, MD, FACP, FASCO, has dedicated his medical career to researching the development of chemotherapies for breast cancer, including ado-trastuzumab emtansine, everolimus, and gemcitabine. In addition, he is credited with changing the standard of...

hematologic malignancies

Evidence Builds for Treating Smoldering Myeloma

In patients with intermediate- to high-risk smoldering multiple myeloma, treatment with single-agent lenalidomide, vs observation, led to a 72% reduction in the risk of disease progression at 3 years.1 Results of the phase III E3A06 study were presented at a press briefing in advance of the 2019...

issues in oncology

American Cancer Society Sets 2035 Cancer Mortality Reduction Goal

The American Cancer Society (ACS) has set a challenge goal to reduce overall cancer mortality 40% between 2015 and 2035—a goal set by applying favorable cancer mortality trends among college graduates to the population as a whole. A report on the goal was published by Ma et al in CA: A...

prostate cancer

ASTRO and AUA Announce Updates to Joint Clinical Guidance for Adjuvant and Salvage Radiotherapy After Prostatectomy

The American Society for Radiation Oncology (ASTRO) and the American Urological Association (AUA) recently announced updates to their joint clinical guideline on adjuvant and salvage radiotherapy after prostatectomy in patients with and without evidence of prostate cancer recurrence to include new...

issues in oncology

Control Arm Quality in Randomized Oncology Trials Leading to FDA Approval

In a study reported in JAMA Oncology, Hilal et al found that 17% of recent cancer drug approvals based on randomized controlled trials featured a suboptimal control arm. Study Details The study involved analysis of a total of 145 studies that led to 143 drug approvals between January 2013 and...

breast cancer

Sentinel Lymph Node Biopsy With or Without Use of Preoperative Lymphoscintigraphy in Early Breast Cancer

In a German/Swiss phase III trial (SenSzi [GBG80]) reported in the Journal of Clinical Oncology, Kuemmel et al found that preoperative lymphoscintigraphy was not associated with an increased number of histologically detected sentinel lymph nodes with sentinel lymph node biopsy in women with early...

hepatobiliary cancer

ARRS 2019: Percutaneous Liver Ablation Intervention vs Surgery for Hepatocellular Carcinoma

Compared to surgery, percutaneous liver ablation interventions in patients with hepatocellular carcinoma were associated with lower in-hospital mortality, length of hospital stay, and hospitalization costs, according to a study presented by Sodagari et al at the American Roentgen Ray Society...

pain management

CDC Issues Clarification on Guideline for Prescribing Opioids for Chronic Pain

ASCO, the American Society of Hematology (ASH), and the National Comprehensive Cancer Network® (NCCN®) recently acknowledged receipt of a key clarification1 from the Centers for Disease Control and Prevention (CDC) on prescribing opioids to manage pain from certain conditions. The clarification...

health-care policy
breast cancer

FDA Advances Policy Changes to Modernize Mammography Services

ON MARCH 27, 2019, the U.S. Food and Drug Administration (FDA) announced important new steps to modernize breast cancer screening and help empower patients with more information when they are considering important decisions regarding their breast health care. For the first time in more than 20...

breast cancer

Postprogression Treatment of Estrogen Receptor–Positive Breast Cancer: Future Approaches

AT THE 2019 Miami Breast Cancer Conference, William J. Gradishar, MD, FASCO, presented a vision of the future in the treatment of advanced hormone receptor–positive breast cancer.1 The refinement of disease subsets, the development of agents targeting the PI3K/AKT/mTOR pathway, the use of novel...

immunotherapy
lung cancer

Pembrolizumab as Third-Line Option for Extensive-Stage Small Cell Lung Cancer

USE OF the anti–programmed cell death protein 1 (anti–PD-1) checkpoint inhibitor pembrolizumab after two or more prior lines of therapy led to responses in patients with advanced small cell lung cancer (SCLC) in a pooled analysis of two clinical trials: phase Ib KEYNOTE-028 and phase II...

breast cancer
pancreatic cancer
sarcoma
immunotherapy
issues in oncology

AACR Study Presentations Include New Data in Breast and Prostate Cancers, Sarcoma, and High-Risk Individuals

THE 2019 American Association for Cancer Research (AACR) Annual Meeting was held March 29 to April 3 in Atlanta. In addition to our regular coverage of news stories from the meeting, here are some brief highlights of additional noteworthy studies. Stage IV HER2-Positive Breast Cancer: Surgery or No ...

lung cancer

Expert Point of View: Roy S. Herbst, MD, PhD

FORMAL STUDY discussant, Roy S. Herbst, MD, PhD, Chief of Medical Oncology at the Yale Cancer Center, New Haven, Connecticut, stated that the findings of the TATTON analyses are “compelling,” and the combination of osimertinib plus savolitinib can be considered a “win,” although randomized trials...

lung cancer

Osimertinib Plus Savolitinib in Advanced NSCLC Driven by MET Resistance

THE ADDITION of the MET inhibitor savolitinib to the EGFR inhibitor osimertinib led to activity in patients with MET-amplified, EGFR-mutated non–small lung cancer (NSCLC) with acquired resistance to previous therapies, according to interim results from two expansion cohorts of a phase Ib clinical...

issues in oncology

Harnessing the Power of Twitter for Clinical Trial Enrollment and Success

CLINICAL TRIALS are vital for advancing cancer care for our patients. Each trial represents an unanswered problem for which researchers are committed to solving. Designing, funding, recruiting, and completing a trial are tremendous undertakings for each researcher, physician, patient, and...

immunotherapy
skin cancer

Neoadjuvant Immunotherapy Associated With Improved Outcomes in Patients With Locally Advanced Melanoma

ACCORDING TO DATA from a small prospective study presented at the 2019 Society of Surgical Oncology Annual Cancer Symposium,1 neoadjuvant immunotherapy significantly prolonged relapse-free survival vs adjuvant immunotherapy in patients with stage III or oligometastatic stage IV melanoma intended...

breast cancer
solid tumors

FDA Pipeline: Designations in Triple-Negative Breast Cancer, ctDNA Detection

This week, the U.S. Food and Drug Administration (FDA) granted a Fast Track designation to a treatment for CCR5-positive metastatic triple-negative breast cancer; granted Breakthrough Device designation to a test for the postsurgical detection and quantification of circulating tumor DNA (ctDNA);...

head and neck cancer

Oropharyngeal Cancer Trends in White Men

In a study reported in the Journal of Clinical Oncology, Tota et al found that there has been a reduction in the increase of oropharyngeal cancer among young white men, with a high number of cases projected among older white men in coming years. As stated by the investigators, “Human...

breast cancer
pain management

ASBrS 2019: Opioid Management Program Reduces Post–Breast Surgery Narcotic Use

A breast surgery opioid prescription management program that analyzed current physician patterns and provided education and guidelines successfully reduced the volume of narcotics given postoperatively to patients at a large institution. These results were presented by Fan et al at the Annual...

symptom management
immunotherapy

Treatment-Related Adverse Events With PD-1/PD-L1 Inhibitors in Clinical Trials

In a systematic review and meta-analysis reported in JAMA Oncology, Wang et al characterized treatment-related adverse event profiles associated with monotherapy use of programmed cell death protein 1 (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors in clinical trials. Study Details...

prostate cancer

AUA 2019: Insights in Prostate Cancer Identification and Management

Prostate cancer diagnosis and treatment are ever-changing, with new research showcasing different ways to identify and manage patients with the disease. Three new abstracts—highlighting how beta-blockers may impact prostate cancer risk, the advantages and disadvantages of using magnetic...

breast cancer
prostate cancer
symptom management

ESTRO 38: REQUITE Project Finds Predictive Biomarkers for Late Radiotherapy Toxicity

The latest results from the REQUITE project, which aimed to discover what makes patients more likely to experience adverse effects after radiotherapy, have shown that a combination of biologic markers and certain genetic changes can predict radiation sensitivity. In addition, the international team ...

prostate cancer

ESTRO 38: High–Dose Rate Brachytherapy in Localized Prostate Cancer

A single high dose of radiation that can be delivered directly to a treatment site within a few minutes is a safe and effective technique for treating men with localized, low-risk prostate cancer, according to a study presented by Tharmalingam et al at ESTRO 38, the annual congress of the ...

solid tumors
leukemia
prostate cancer
pain management

FDA Pipeline: Applications and Designations in Prostate Cancer, Leukemia, and HER2-Positive Cancers

In the past 2 weeks, the U.S. Food and Drug Administration (FDA) accepted a new drug application and granted Priority Review for a prostate cancer treatment, granted Orphan Drug designation to a treatment for acute lymphoblastic leukemia, accepted an investigational new drug application for a...

gynecologic cancers
cost of care

Treat-and-Release Emergency Department Use by Patients With Gynecologic Cancers

In a study reported in the Journal of Oncology Practice, Albright et al found that treat-and-release emergency department use by patients with gynecologic cancers has increased in recent years, with an increase in total cost in this population but not in average visit cost. Visits and Costs...

leukemia

FDA Approves First-Line Ivosidenib for IDH1-Mutated AML

On May 2, the U.S. Food and Drug Administration (FDA) expanded its approval of ivosidenib (Tibsovo) to include newly diagnosed acute myeloid leukemia (AML) with a susceptible IDH1 mutation, as detected by an FDA-approved test, in patients who are at least 75 years old or who have comorbidities that ...

breast cancer

ESMO Breast Cancer 2019: Does Continuous Chemotherapy Benefit Patients With Advanced Breast Cancer?

Continuous chemotherapy showed greater benefit in patients with advanced breast cancer by both improving survival and maintaining quality of life compared to intermittent scheduling, according to analyses of the Stop&Go study presented by Erdkamp et al and Claessens et al at the European...

issues in oncology

Psychosocial Care Is a Critical Component of Value-Based Oncology

The ongoing dialogue regarding health-care payment reform that attempts to incentivize high-value care by linking reimbursement to quality rather than quantity has largely ignored the ultimate consumer/buyer—the patient. Yet, in the minds of clinicians, policymakers, and the public at large,...

solid tumors
hepatobiliary cancer

Adjuvant Capecitabine After Resection for Biliary Tract Cancer

In the phase III BILCAP trial reported in The Lancet Oncology, John N. Primrose, FMedSci, and colleagues found evidence that adjuvant capecitabine may improve overall survival vs observation following surgery for patients with resected biliary tract cancer.  The open-label study included 447...

Nobel Laureate and Pioneer in Molecular Biology, Sydney Brenner, MSc, MBBCh, DPhil, Dies at 92

Sydney Brenner, MSc, MBBCh, DPhil, died on April 6, 2019, at age 92, according to The Agency for Science, Technology and Research (A*STAR) in Singapore, where Dr. Brenner had served as a Senior Fellow. Dr. Brenner was conferred the Nobel Prize in Physiology or Medicine in 2002 for his pioneering...

issues in oncology

FDA Oncology Center of Excellence Issues Annual Report

The U.S. Food and Drug Administration (FDA) Oncology Center of Excellence (OCE) has issued its 2018 Annual Report,1 including updates on regulatory reviews and initiatives, OCE programs, guidances, and more. The OCE is tasked with clinical medical oncology reviews, irrespective of whether the...

solid tumors
bladder cancer

FDA Grants Accelerated Approval to Erdafitinib for Metastatic Urothelial Carcinoma

On April 15, the U.S. Food and Drug Administration (FDA) granted accelerated approval to erdafitinib (Balversa) for patients with locally advanced or metastatic urothelial carcinoma with susceptible FGFR3 or FGFR2 genetic alterations that has progressed during or following platinum-containing...

lung cancer

Local Consolidative Therapy Linked to Survival Benefit in Oligometastatic Non–Small Cell Lung Cancer

A retrospective analysis of nearly 200 patients treated with local consolidative therapy for oligometastatic non–small cell lung cancer (NSCLC) has found improved overall survival associated with aggressive consolidation.1 According to data presented at the 2019 Multidisciplinary Thoracic Cancers...

breast cancer
issues in oncology
global cancer care

ESMO Breast Cancer 2019: ONCOLLEGE-001: Global Survey of HER2 Testing

A global survey of HER2 testing has raised questions about how resources should be spent on potentially lifesaving HER2-targeted therapies for breast cancer, especially in lower-income countries. These results will be presented at the European Society for Medical Oncology (ESMO) Breast Cancer...

prostate cancer

Final Overall Survival Analysis of the LATITUDE Trial in Newly Diagnosed, High-Risk, Metastatic, Castration-Sensitive Prostate Cancer

As reported in The Lancet Oncology by Fizazi et al, the final overall survival analysis in the phase III LATITUDE trial has shown a significant benefit with the addition of abiraterone acetate plus prednisone to androgen deprivation therapy (ADT) in newly diagnosed, high-risk, metastatic, ...

colorectal cancer

Colon Cancer Proteogenomic Analysis May Uncover New Potential Treatments

A new study analyzing the entire set of genes and all the proteins produced by colon cancer tissues from patient samples has revealed a more comprehensive view of the tumor, pointing to novel cancer biologic mechanisms and possible new therapeutic strategies. This multidisciplinary and...

symptom management

New Biomarkers Associated With Cancer-Related Cognitive Impairment Identified

Cognitive impairment associated with cancer—also known as “chemobrain”—has gained recognition as a complication of the disease and its treatment. With this in mind, a research team started to investigate levels of biomarkers in relation to chemobrain to better understand its ...

leukemia

Intermittent vs Intensive PEG-Asparaginase in Pediatric Acute Lymphoblastic Leukemia

In a Scandinavian study reported in the Journal of Clinical Oncology, Albertsen et al found that use of intermittent vs intensive pegylated (PEG)-asparaginase was associated with similar efficacy and reduced asparaginase-related toxicity in pediatric acute lymphoblastic leukemia (ALL). The study...

hepatobiliary cancer

Ramucirumab After Sorafenib in Advanced Hepatocellular Carcinoma: An Efficacious Therapy With Applicability Challenges

In the 2 years since the U.S. Food and Drug Administration’s (FDA) approval of regorafenib in the treatment of patients with sorafenib-refractory advanced hepatocellular carcinoma, we oncologists have witnessed a veritable avalanche of newly approved medicines for the treatment of advanced...

hepatobiliary cancer

Ramucirumab in Sorafenib-Pretreated Patients With Advanced Hepatocellular Carcinoma

In the phase III REACH-2 trial reported in The Lancet Oncology, Andrew X. Zhu, MD, of Harvard Medical School and Massachusetts General Hospital, and colleagues found that ramucirumab improved overall and progression-free survival vs placebo in patients with advanced hepatocellular carcinoma and...

Expert Point of View: Rafael Fonseca, MD

Rafael Fonseca, MD, the Getz Family Professor of Cancer and Chair of the Department of Medicine, Mayo Clinic in Arizona and an expert in minimal residual disease (MRD) in myeloma, commented on the PRIMeR study for The ASCO Post. The PRIMeR subanalysis of the STaMINA trial showed the prognostic...

Ryan C. Fields, MD, Named Chief of Surgical Oncology at Washington University in St. Louis

Ryan C. Fields, MD, has been named Chief of the Section of Surgical Oncology at Washington University School of Medicine in St. Louis. Dr. Fields, who joined the faculty in 2011, is also Associate Professor of Surgery, Associate Program Director of the General Surgery Residency Program, and...

solid tumors
immunotherapy

Preliminary Results Show Activity for Mesothelin‑Directed CAR T-Cell Therapy in Malignant Mesothelioma

A phase I clinical trial showed encouraging results with chimeric antigen receptor (CAR) T-cell therapy targeted to the mesothelin protein in patients with mesothelin-associated malignant pleural solid tumors—primarily, malignant mesothelioma—that had progressed following standard platinum-based...

Expert Point of View: Charles B. Simone II, MD, and Aaron S. Mansfield, MD

In a press briefing before the 2019 Multidisciplinary Thoracic Cancers Symposium, Charles B. Simone II, MD, a radiation oncologist and Chief Medical Officer at the New York Proton Center, noted that although the National Comprehensive Cancer Network® (NCCN®) provides high-quality clinical...

lung cancer

Online Tool May Improve Guideline Concordance for Patients With Lung Cancer

An online tool that allows patients to input their clinical and pathologic features as well as explore treatment options in a structured manner based on National Comprehensive Cancer Network® Clinical Practice Guidelines in Oncology (NCCN Guidelines) may help drive smoking cessation and testing for ...

Expert Point of View: Kristin Higgins, MD

The discussant of the abstract on repeat positron-emission tomography (PET) and/or computed tomography (CT) scans prior to chemoradiation in locally advanced non–small cell lung cancer, Kristin Higgins, MD, emphasized the importance of timing of imaging when staging patients and the need for...

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