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genomics/genetics
colorectal cancer
lung cancer

Mechanisms of Acquired Resistance to KRAS G12C Inhibition in Patients With Cancer

In a study reported in The New England Journal of Medicine, Awad et al identified potential mechanisms of acquired resistance to the KRAS G12C inhibitor adagrasib in patients receiving the agent for treatment of KRAS G12C–mutant cancers. As noted by the investigators, clinical trials of the KRAS...

colorectal cancer
immunotherapy

Addition of Pembrolizumab to Chemoradiotherapy in Total Neoadjuvant Therapy for Locally Advanced Rectal Cancer

As reported in JAMA Oncology by Osama E. Rahma, MD, and colleagues, initial results of the phase II NRG-GI002 trial showed no improvement in mean neoadjuvant rectal score with the addition of pembrolizumab to chemoradiotherapy in total neoadjuvant therapy for patients with locally advanced rectal...

cns cancers

Oncolytic Adenovirus for Malignant Glioma: Feasibility and Safety

In a first-in-human phase I trial reported in The Lancet Oncology, Fares et al found that neural stem cell delivery of an oncolytic adenovirus (NSC-CRAd-S-pk7) was safe and feasible in patients with newly diagnosed malignant glioma, with immunologic and histopathologic findings supporting continued ...

gastroesophageal cancer
gastrointestinal cancer

International Esodata Study Group Model for Predicting 90-Day Mortality After Esophagectomy

In a retrospective analysis reported by researchers from the International Esodata Study Group (IESG) in JAMA Surgery, D’Journo et al developed a model for predicting risk of 90-day mortality following esophagectomy for patients with esophageal or gastroesophageal junction cancer. As stated by the...

immunotherapy
skin cancer

FDA Approves Expanded Indication for Pembrolizumab in Locally Advanced Cutaneous Squamous Cell Carcinoma

On July 6, the U.S. Food and Drug Administration (FDA) approved an expanded label for pembrolizumab, an anti–PD-1 agent, as monotherapy for patients with locally advanced cutaneous squamous cell carcinoma that is not curable by surgery or radiation. This approval is based on data from the second...

covid-19

Study Suggests Substantial Delays in Diagnosis and Treatment for Cancer During the COVID-19 Pandemic

A new study has found evidence of the adverse effects the COVID-19 pandemic had on cancer detection and surgical treatments. The study, published by Robin Yabroff, PhD, MBA, and colleagues in JNCI: The Journal of the National Cancer Institute, found a 10.2% decline in real-time electronic pathology ...

gynecologic cancers

Predicting Chemotherapy Resistance in Patients With Gestational Trophoblastic Neoplasia

In a retrospective cohort study reported in The Lancet Oncology, Braga et al identified metastatic disease, choriocarcinoma histology, and higher pretreatment human chorionic gonadotropin concentration as independent predictors of resistance to single-agent chemotherapy in women with low-risk...

lymphoma

Recovery of Gonadal Function With PET-Adapted Regimen for Advanced Hodgkin Lymphoma

In a prospective analysis from the phase III Lymphoma Study Association AHL2011 trial reported in the Journal of Clinical Oncology, Demeestere et al found that patients with advanced Hodgkin lymphoma receiving a positron-emission tomography (PET)-adapted regimen had a reduced risk of gonadal...

leukemia
immunotherapy

Humanized CD19-Targeted CAR T-Cell Treatment in Patients With Relapsed or Refractory B-Cell ALL

In a pilot study reported by Myers et al in the Journal of Clinical Oncology, a humanized CD19-targeted chimeric antigen receptor (CAR) T-cell product developed by the investigators (huCART19) was found to produce durable remissions and prolonged CAR T-cell persistence in CAR-naive and CAR-exposed...

skin cancer
immunotherapy

Responses to Pembrolizumab and Ipilimumab After Anti–PD-1/L1 Failure in Advanced Melanoma

Despite new and effective treatments for melanoma with checkpoint inhibitors and targeted therapies, patients with metastatic melanoma who progress on frontline treatment generally do very poorly. “We really need to make sure we give these patients access to drugs that we know have some efficacy,”...

Assessment of Targeted Methylation-Based Multicancer Early Detection Test in Independent Validation Cohort

In a validation study reported in Annals of Oncology, Klein et al found that a targeted methylation-based multicancer early detection (MCED) assay using cell-free DNA (cfDNA) sequencing had high specificity for cancer signal detection and high accuracy in predicting cancer signal origin across a...

lymphoma

Second-Line Pembrolizumab Plus Chemotherapy Regimen for Relapsed or Refractory Classic Hodgkin Lymphoma

In a phase II trial reported in the Journal of Clinical Oncology, Alison J. Moskowitz, MD, and colleagues found that second-line therapy with pembrolizumab plus gemcitabine, vinorelbine, and liposomal doxorubicin (GVD) in relapsed or refractory classic Hodgkin lymphoma produced responses in all...

FDA Pipeline: Recent Designations in NSCLC, Leukemia, and Lymphoma

Recently, the U.S. Food and Drug Administration (FDA) issued regulatory decisions related to treatments for non–small cell lung cancer (NSCLC), acute leukemia, and mantle cell lymphoma. Breakthrough Therapy Designation for Adagrasib in Advanced NSCLC With KRAS G12C Mutation On June 24, 2021, the...

Phase III Trial Compares Induction Regimens in High-Risk Neuroblastoma

As reported in the Journal of Clinical Oncology by Garaventa et al, the phase III International Society of Pediatric Oncology European Neuroblastoma Group (SIOPEN) HR-NBL1.5 trial showed no significant differences in metastatic complete response rate or event-free survival with the Memorial Sloan...

issues in oncology

Despite Gains in Breast Cancer Survival, Black Women Continue to Experience Significant Mortality Disparities

Although breast cancer continues to be the most common cancer diagnosed in women in the United States, and remains the second-leading cause of cancer death, over the past several decades, the disease has affected Black and White women differently. According to the findings of a large retrospective...

FDA Approves Alternative to E coli–Derived Asparaginase for Leukemia and Lymphoma

On June 30, 2021, the U.S. Food and Drug Administration (FDA) approved asparaginase Erwinia chrysanthemi (recombinant)-rywn (Rylaze) as a component of a multiagent chemotherapeutic regimen for the treatment of acute lymphoblastic leukemia (ALL) and lymphoblastic lymphoma in adult and pediatric...

pancreatic cancer

Modified FOLFIRINOX Established as Preferred Neoadjuvant Treatment of Borderline Resectable Pancreatic Cancer

In the treatment of borderline resectable pancreatic ductal adenocarcinoma, the Alliance A021501 trial established neoadjuvant treatment with modified FOLFIRINOX (fluorouracil [5-FU], leucovorin, irinotecan, oxaliplatin) as a new benchmark. However, it failed to show the benefit of adding...

breast cancer

Personalizing Treatment of Early HER2-Positive Breast Cancer

With several pivotal trials providing evidence for the escalation and de-escalation of anti-HER2 therapy in certain early breast cancer scenarios, personalized treatment is possible. How can clinicians optimize treatment by applying the studies’ findings? Debu Tripathy, MD, Professor and Chair of...

issues in oncology
gynecologic cancers

Association Between Increased BMI and Endometrial Cancer Risk in Asian Women With Postmenopausal Bleeding

The link between obesity and the risk of endometrial cancer has been well documented. A recent study, however, showed that an even lower body mass index (BMI) than previously thought may be associated with an increased risk in Asian women with postmenopausal bleeding. The findings by Liu et al were ...

breast cancer
gynecologic cancers

Study Examines Impact of COVID-19 on Breast and Cervical Cancer Screening Programs

The total number of cancer screening tests received by women through the Centers for Disease Control and Prevention’s (CDC) National Breast and Cervical Cancer Early Detection Program (Early Detection Program) declined by 87% for breast cancer and 84% for cervical cancer during April 2020 as...

issues in oncology

Survey Finds COVID-19 Vaccine Hesitancy Among Many Adolescent and Young Adult Cancer Survivors

Despite recommendations from ASCO and other national organizations that cancer survivors, as well as patients on active treatment, receive the COVID-19 vaccine if they have no contraindications, a survey of adolescent and young adult cancer survivors finds many have vaccine hesitancy. According to...

prostate cancer

Immunotherapy May Be Effective for Subset of Patients With Prostate Cancer

In recent years, cancer immunotherapy has been effective in treating patients with immunogenic—or “hot”—tumors with increased levels of inflammation and the presence of immune cells in and around the tumors. Prostate cancer, however, is considered a “cold” tumor, with few immune cells recognizing...

genomics/genetics

Use of Germline Mutation Profiling in Patients With Advanced Cancers

In a study reported in the Journal of Clinical Oncology, Zsofia K. Stadler, MD, and colleagues found that germline mutation testing revealed therapeutically actionable variants in 8% of patients with recurrent or metastatic cancers, with 40% of them receiving directed treatment. As stated by the...

breast cancer

Beyond CDK4/6 Inhibitors in Metastatic Breast Cancer: What’s Next?

Because of their well-established efficacy, inhibitors of cyclin-dependent kinases 4 and 6 (CDK4/6) are the standard of care in the treatment of hormone receptor–positive, HER2-negative metastatic breast cancer. The question now is this: after disease progresses on a CDK4/6 inhibitor and endocrine...

breast cancer

Risk Factors for Early Discontinuation of Adjuvant Endocrine Therapy for Breast Cancer

In a post hoc analysis from the phase III TAILORx trial reported in JAMA Oncology, Yanez et al identified factors that may be associated with an increased and decreased likelihood of early discontinuation of adjuvant endocrine therapy for breast cancer. Study Details The TAILORx trial, conducted...

Addition of First-Line Camrelizumab to Gemcitabine/Cisplatin in Recurrent or Metastatic Nasopharyngeal Carcinoma

In an interim analysis of a Chinese phase III trial (CAPTAIN-1st) reported in The Lancet Oncology, Yang et al found that the addition of camrelizumab to gemcitabine and cisplatin significantly prolonged progression-free survival in the first-line treatment of recurrent or  metastatic nasopharyngeal ...

Are Patients With Primary Lung Cancer Detected by Low-Dose CT at Reduced Risk of Brain Metastases?

Patients with primary lung cancer detected using low-dose computed tomography (CT) screening may be at reduced risk for developing brain metastases after diagnosis, according to a study published in the Journal of Thoracic Oncology. The researchers, led by Summer Han, PhD, of Stanford University...

Effects of FOXR2 Expression in Neuroblastoma

In a study reported in the Journal of Clinical Oncology, Schmitt-Hoffner et al found that FOXR2 expression is associated with poorer survival in neuroblastoma, identifying a subgroup of patients in addition to those with MYCN-amplified tumors who are at risk of unfavorable outcomes. They found that ...

prostate cancer

VISION Trial: Lu-177–PSMA-617 Radioligand Therapy Prolongs Survival When Added to Standard of Care in Metastatic Castration-Resistant Prostate Cancer

As reported in The New England Journal of Medicine by Oliver Sartor, MD, and colleagues, the phase III VISION trial has shown prolonged progression-free and overall survival with lutetium-177–PSMA-617 (Lu-177–PSMA-617) radioligand therapy plus standard care vs standard care alone in previously...

supportive care

How to Talk With Teens and Young Adults About Their End-of-Life Goals

Although death rates for adolescent and young adults (AYAs) with cancer have been dropping 0.8% a year from 2009 to 2018, cancer remains a leading disease-related cause of death among this patient population. This year, the National Cancer Institute (NCI) estimates that 88,260 AYAs, defined by the...

colorectal cancer

Better Responses to Hepatic Arterial Infusion Therapy Among Patients With KRAS Wild-Type Metastatic Colorectal Cancer

Patients with colorectal cancer and unresectable liver metastases and KRAS wild-type disease experienced better responses to hepatic arterial infusion pump chemotherapy than did patients with KRAS mutations, a retrospective cohort study found. At a median follow-up of 14.6 months, “KRAS-positive...

lymphoma

PI3K Inhibition With Copanlisib Plus ­Rituximab in Relapsed Indolent Non-Hodgkin Lymphoma

Better understanding of the mechanism behind the malignant transformation of B cells has led to an explosion of “targeted” therapy. With the growing knowledge of the role of the B-cell receptor and its downstream kinases, it appeared that we were entering a new era in the management of patients...

issues in oncology
gynecologic cancers

Survey Finds Bullying, Sexual Harassment Not Uncommon for Women in Gynecologic Oncology

Female gynecologic oncologists have reported in a survey that having a department chair of the same gender is no buffer against gender harassment or discrimination in the workplace. The information comes from a survey of the “Women of Gynecologic Oncology” Facebook group and was reported in March...

Expert Point of View: Rui-Hua Xu, MD, PhD

David Cunningham, MD, Consultant Medical Oncologist, Head of the Gastrointestinal and Lymphoma Unit, and Director of Clinical Research at The Royal Marsden in London and Surrey in the United Kingdom, discussed CheckMate 6481 as well as the ESCORT-1st study of the PD-L1 inhibitor camrelizumab in...

Gauri Varadhachary, MD, Compassionate Leader, Caring and Brilliant Physician, Dies at 52

Gauri Varadhachary, MD, Clinical Professor in Gastrointestinal (GI) Medical Oncology at The University of Texas MD Anderson Cancer Center, died on June 5, 2021. She was 52. A member of the MD Anderson community for nearly 20 years, Dr. Varadhachary was remembered for her dedication to her patients, ...

breast cancer

Breast Cancer Has Taught Me Many Life Lessons

In 2016, 2 years before I was diagnosed with stage III estrogen and progesterone receptor–positive, HER2-negative, invasive ductal carcinoma in situ in my left breast, I had felt a mass in my right breast that turned out to be a benign fibroid. When I felt a mass in my left breast one morning while ...

issues in oncology
survivorship

Addressing Sexuality Challenges Throughout the Cancer Care Continuum

Multiple studies have shown that sexuality and intimacy problems are common among patients with cancer, often beginning at the time of diagnosis and persisting through the continuum of care into the survivorship setting. Although these problems have been well documented, many patients and survivors ...

multiple myeloma

Newly Diagnosed Multiple Myeloma

“Continuous improvement is better than delayed perfection.” —Mark Twain To complement The ASCO Post’s continued comprehensive coverage of the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on...

lymphoma
immunotherapy

Loncastuximab Tesirine-lpyl for Relapsed or Refractory Large B-Cell Lymphoma

On April 23, 2021, loncastuximab tesirine-lpyl, a CD19-directed antibody and alkylating agent conjugate, was granted accelerated approval for treatment of adult patients with relapsed or refractory large B-cell lymphoma after two or more lines of systemic therapy, including diffuse large B-cell...

Innovator in Treatment of Infectious Diseases, Francisco Marty, MD, Dies at 53

The Brigham and Women’s hospital community mourns the loss of Francisco Marty, MD, of the Division of Infectious Diseases, who died April 8, 2021, after a tragic accident while hiking in the Dominican Republic. He was 53. A member of the Brigham community for more than 20 years, Dr. Marty is...

gynecologic cancers

OUTBACK: No Benefit for Adjuvant Chemotherapy in Cervical Cancer

In women with locally advanced cervical cancer, adjuvant chemotherapy adds no benefit to standard cisplatin-based chemoradiation, results of the international phase III OUTBACK study have shown,1 as reported at the 2021 ASCO Annual Meeting by Linda R. Mileshkin, MD, Professor of Medical Oncology at ...

geriatric oncology

Do Community Oncologists Have Access to Geriatric Specialty Care for Older Patients?

As our population rapidly ages, the burden of cancer incidence increases accordingly, creating an urgent need for greater and more incisive research on the diagnosis, treatment, and survivorship issues for older adults with cancer. Given the numerous challenges faced by today’s busy oncologists, a...

Expert Point of View: Rana R. McKay, MD

Invited discussant of the KEYNOTE-564 trial, Rana R. McKay, MD, Associate Professor of Medicine and Urology at the University of California San Diego, offered these comments about these trial results. “This is a positive study, showing a 32% reduction in the risk of recurrence or death with...

kidney cancer
immunotherapy

KEYNOTE-564: Adjuvant Pembrolizumab Extends Disease-Free Survival in High-Risk Renal Cell Carcinoma

Adjuvant pembrolizumab following surgery significantly improved disease-free survival compared with placebo among patients with high-risk clear cell renal cell carcinoma (RCC), according to the international phase III KEYNOTE-564 study presented at the Plenary session during the 2021 ASCO Annual...

Whispers Over My Shoulder

When I interviewed for my current post as a first-time consultant in medical oncology in the United Kingdom, I was asked about my 5-year career plan. I remember some detail of my reply, but I don’t think it even remotely encompassed the depth of insight I would gain from the patients I’ve treated...

Mary Daly, MD, PhD, FACP, Receives NCCN’s 2021 Rodger Winn Award

The National Comprehensive Cancer Network (NCCN) recently presented Mary B. Daly, MD, PhD, FACP, Professor in the Department of Clinical Genetics and Director of the Risk Assessment Program at Fox Chase Cancer Center, with the Rodger Winn Award. The Rodger Winn Award is given annually to one NCCN...

global cancer care
covid-19

Harnessing a Worldwide Effort to Combat COVID-19 and Cancer

This past October, in a virtually held ceremony of the General Assembly of the Union for International Cancer Control (UICC), Anil K. D’Cruz, MBBS, MS, DNB, FRCS (Hon), Director of Oncology at Apollo Hospitals in Mumbai, Chennai, and Delhi, India, began his 2-year tenure as President of the global...

lung cancer

Sotorasib: Subgroup Analysis of Phase II Trial Shows Activity With Breakthrough KRAS Inhibitor in Lung Cancer

The breakthrough KRAS-specific inhibitor sotorasib achieved responses in patients with KRAS G12C–mutated non–small lung cancer (NSCLC) who had experienced disease progression on platinum-based chemotherapy, immunotherapy, or both treatments. The objective response rate was 37.1%, and responses...

colorectal cancer
genomics/genetics

How RAS Mutations in Early-Onset Colorectal Cancer May Impact Patient Survival

Although both incidence and mortality rates in colorectal cancer have been declining among people older than 65 by 3.3% and 3% annually, respectively, among individuals younger than age 50, the incidence rate has risen about 2% annually, and death rates have increased by 1.3% annually.1 Colorectal...

leukemia

Lessons From Pneumococcal Vaccine Responses in Patients With CLL in an Evolving Vaccine Landscape

The role of vaccines in mitigating the significant morbidity and mortality associated with infections in chronic lymphocytic leukemia (CLL) is a developing field of study, punctuated by the advent of novel therapeutic agents and pressing questions regarding the global SARS–CoV-2 vaccination...

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