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issues in oncology
covid-19

How Telemedicine Is Impacting Oncology Care During the COVID-19 Pandemic

The expansion of telemedicine has been one of the most important developments during the COVID-19 pandemic. Here, we discuss some of the legal and ethical dimensions of expanding telemedicine services in oncology practices. As Royce et al discussed in a recent JAMA Oncology article, Congress...

geriatric oncology

Surgical and Radiation Oncology in Elderly Patients With Cancer

As one might expect, the focus on older patients developed in surgical and radiation oncology at the same time as in medical oncology. As we have done in our overview of medical oncology, we may recognize a prehistory, past history, and present history in surgical and radiation geriatric oncology....

geriatric oncology

Cancer in Older Adults: The History of Geriatric Oncology, Part 2: 1990–2020

In part 1 of this three-part article, which was published in the October 10, 2020, issue of The ASCO Post, we chronicled the progress made in geriatric oncology up to the decade of the 1990s, which saw an explosion of research activity in the study of aging and cancer. In part 2, we review the...

FDA Awards Six Grants to Fund New Clinical Trials of Medical Products for Treatment of Rare Diseases

The U.S. Food and Drug Administration (FDA) announced it has awarded six new clinical trial research grants to principal investigators from academia and industry, totaling more than $16 million over the next 4 years. These grants, awarded through the Congressionally funded Orphan Products Grants...

Expert Point of View: Chiara Cremolini, MD, PhD

The KEYNOTE-177 invited discussant, Chiara Cremolini, MD, PhD, of the University of Pisa, Italy, welcomed the patient-reported outcomes of the study, noting that such data are frequently missing. “Unfortunately, quality of life is an often-disregarded issue in colorectal cancer clinical trials,”...

colorectal cancer

First-Line Pembrolizumab in Metastatic Colorectal Cancer: Quality of Life Also Improved

In KEYNOTE-177, the anti–PD-L1 antibody pembrolizumab reduced the risk of disease progression by 40% vs chemotherapy in a targeted subset of previously untreated patients with metastatic colorectal cancer. Now, in terms of health-related quality of life, pembrolizumab is also the clear favorite,...

lymphoma

The WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Syed Ali Abutalib and L. Jeffrey Medeiros explore the updated World Health Organization (WHO) classification of hematopoietic and lymphoid tissue...

solid tumors

Activity of the KRAS G12C Inhibitor Sotorasib in KRAS G12C–Mutant Advanced Solid Tumors

As reported inThe New England Journal of Medicine by David S. Hong, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues, a phase I trial (CodeBreak 100) has shown activity of the oral KRAS G12C inhibitor sotorasib in heavily pretreated patients with KRAS G12C–mutant...

UICC Launches New Program at the Start of Breast Cancer Awareness Month

As the cancer community marks Breast Cancer Awareness Month this October, the Union for International Cancer Control (UICC) is starting a new 5-year program aimed at accelerating progress in breast cancer control. “While the incidence of breast cancer is generally higher in more developed regions, ...

lung cancer

Capmatinib Active in Advanced NSCLC With MET Exon 14 Skipping Mutations

As reported inThe New England Journal of Medicine by Jürgen Wolf, MD, of the Center for Integrated Oncology, University Hospital Cologne and University of Cologne, and colleagues, the phase II GEOMETRY mono-1 trial has shown durable responses with the selective MET inhibitor capmatinib in patients...

Thinking Out of the Box to Advance the Management of Chronic Graft-vs-Host Disease

Over the past decade, the field of allogeneic hematopoietic cell transplantation has made great strides, evolving into a curative procedure for blood cancers that once were almost always fatal. However, chronic graft-vs-host disease, whose biologic etiology remains unclear, continues to be the...

prostate cancer

Ipatasertib/Abiraterone Combination Shows Potential in Metastatic Castration-Resistant Prostate Cancer With PTEN Loss

Ipatasertib plus abiraterone plus prednisone achieved significantly superior radiographic progression–free survival and antitumor activity compared with placebo plus abiraterone plus prednisonein patients with metastatic castration-resistant prostate cancer and PTEN loss, according to the results...

Florida Surgeon Steven D. Wexner, MD, FACS, Elected Vice-Chair of Board of Regents of American College of Surgeons

Steven D. Wexner, MD, PhD (Hon), FACS, FRCS (Eng), FRCS (Ed), FRCSI (Hon), Hon FRCS (Glasg), was recently elected Vice-Chair of the Board of Regents of the American College of Surgeons (ACS) during the College’s virtual Clinical Congress 2020, held October 3–7. Dr. Wexner is Chair of the...

prostate cancer

Olaparib Improves Outcomes in Metastatic Castration-Resistant Prostate Cancer With BRCA1/2 Alterations

The PARP inhibitor olaparib reduced the risk of death by 31% compared with a second hormonal treatment (enzalutamide or abiraterone) in men with metastatic castration-resistant prostate cancer characterized by BRCA1, BRCA2, or ATM mutations, in the final analysis of the phase III PROfound trial...

solid tumors

Early-Phase Study Reports Progress in Targeting KRAS-Mutated Tumors With Sotorasib

Although KRAS is one of the most frequently mutated oncogenes in human cancers, an almost 4-decade long search for drugs that hit this target has been elusive—until now. Sotorasib (formerly called AMG-510), a small-molecule inhibitor of the KRAS G12C mutation, demonstrated clinical activity and...

lung cancer

EMPOWER-Lung 1 Trial: Cemiplimab Improves Survival Over Chemotherapy in Advanced NSCLC

The European Society for Medical Oncology (ESMO) Virtual Congress 2020 presented several abstracts with good news for patients with lung cancer. Long-term follow-up of immunotherapies showed excellent survival, a promising new ALK inhibitor improved outcomes compared with the standard of care, the...

bladder cancer
immunotherapy

Co-Leader of Immunotherapy Trial Reflects on ‘Practice-Changing’ Results in Advanced Bladder and Other Urinary Tract Cancers

In a large, randomized clinical trial, researchers evaluated the immunotherapy drug avelumab for patients with advanced urothelial cancer. The findings of the trial, called the JAVELIN Bladder 100 study, are “very exciting,” even “practice-changing,” said the trial’s co-leader, Petros Grivas, MD,...

head and neck cancer

Novel IAP Blocker Plus Chemoradiotherapy Improved Outcomes in Head and Neck Cancer Trial

Xevinapant, an investigational inhibitor of apoptosis proteins (IAP) blocker, prolonged overall survival when added to standard chemoradiotherapy for locally advanced head and neck squamous cell carcinoma, according to an updated analysis of a randomized, placebo-controlled phase II study presented ...

breast cancer
immunotherapy

Sacituzumab Govitecan Yields Survival Benefit as Third-Line Treatment in Triple-Negative Breast Cancer: ASCENT Trial

Based on results from a phase I/II clinical trial, the antibody drug conjugate sacituzumab govitecan was recently granted accelerated approval in the treatment of patients with advanced triple-negative breast cancer, contingent on a larger study confirming its benefit. The confirmatory phase III...

covid-19

COVID-19, Cancer, and the Older Adult

An inspiring case series of fit patients aged 98 and older who recovered from hospitalization for COVID-19, published by Huang et al, reminds us that older age may not be a barrier to recovery.1 On behalf of the Cancer and Aging Research Group, we do not support “ageism” in the care of older...

breast cancer

Should Body Mass Index Guide the Choice of Chemotherapy in Patients With Breast Cancer?

The rate of obesity is rising dramatically in the United States and Europe, with more than 60% of women in the United States1,2 and 50% of women in Europe3 classified as overweight or obese based on their body mass index (BMI). Obesity is associated with an increased risk of hormone...

Expert Point of View: Christine M. Lovly, MD, PhD

Lorlatinib was strategically designed to have activity against ALK and to be highly CNS-penetrant,” said formal discussant Christine M. Lovly, MD, PhD, of Vanderbilt Ingram Cancer Center, Nashville. “We look forward to seeing more data from this trial. Alectinib had a progression-free survival of...

lung cancer

Lorlatinib Improves Outcomes Over Crizotinib in First-Line Setting of ALK-Positive NSCLC: CROWN Trial

Lorlatinib significantly improved progression-free survival compared with crizotinib in the first-line treatment of patients with advanced ALK-positive non–small cell lung cancer (NSCLC), according to a planned interim analysis of the phase III CROWN trial presented at the European Society for...

skin cancer

Small Case Study Explores Novel Approach to Neoadjuvant Therapy for Skin Cancer

Skin cancers are the most common malignancy in the United States and worldwide. Between 1994 and 2014, the diagnosis and treatment of melanoma and nonmelanoma skin cancers in the United States increased by 77%.1 The cost of treating melanoma and nonmelanoma skin cancers to the health-care system...

neuroendocrine tumors

Surufatinib in Advanced Pancreatic Neuroendocrine Tumors

As reported in The Lancet Oncology by Xu et al, the Chinese phase III SANET-p trial has shown significantly improved progression-free survival with surufatinib vs placebo in patients with advanced pancreatic neuroendocrine tumors. Surufatinib is a novel small-molecule inhibitor that targets...

prostate cancer

Adjuvant vs Salvage Radiotherapy Plus Short-Term ADT After Radical Prostatectomy for Localized Prostate Cancer

As reported in The Lancet Oncology by Sargos et al, the French phase III GETUG-AFU 17 trial has shown no event-free survival benefit for adjuvant radiotherapy vs salvage radiotherapy—both with short-term androgen-deprivation therapy (ADT)—after radical prostatectomy in men with localized prostate...

gynecologic cancers
immunotherapy

Addition of Bevacizumab to Paclitaxel in Relapsed Ovarian Sex Cord–Stromal Tumors

In the phase II ALIENOR trial reported in JAMA Oncology, Isabelle Ray-Coquard, MD, and colleagues found that the addition of bevacizumab to paclitaxel did not improve the 6-month progression-free rate among women with relapsed ovarian sex cord–stromal tumors. Study Details The study, performed in...

gynecologic cancers
immunotherapy

Camrelizumab Plus Apatinib in Previously Treated Patients With Advanced Cervical Cancer

In the Chinese phase II CLAP study reported in the Journal of Clinical Oncology, Lan et al found that the combination of the anti–PD-1 antibody camrelizumab and the VEGFR inhibitor apatinib produced high response rates in previously treated women with advanced cervical cancer. Study Details The...

issues in oncology
covid-19

Advanced Practitioner Leadership in Times of Crisis

In 2020, health-care providers from all disciplines are facing challenges never before encountered in the modern era of medicine. Advanced practitioners (APs) are playing critical roles in developing protocols, managing health-care teams, and delivering hands-on patient care. JADPRO Live, the...

breast cancer

Are Delays in Breast Cancer Treatment as Harmful as Commonly Thought?

Delays in the treatment of breast cancer matter, but not as much “as we and our patients typically assume,” Richard J. Bleicher, MD, FACS, informed participants at the 22nd Annual Lynn Sage Breast Cancer Symposium.1 Some of these delays are unavoidable and others are tradeoffs that must be made to...

bladder cancer
immunotherapy

Neoadjuvant Dual Checkpoint Blockade in Certain Patients With Localized Bladder Cancer

Neoadjuvant combination therapy with the anti–CTLA-4 therapy tremelimumab and the anti–PD-1 therapy durvalumab was well tolerated and showed early signs of activity in patients ineligible to receive cisplatin-based chemotherapy, all of whom had tumors with high-risk features that are associated...

cns cancers

Hypofractionated Stereotactic Radiotherapy to the Resection Cavity in Patients With Brain Metastases

In a multi-institutional cohort study reported in JAMA Oncology, Eitz et al found that hypofractionated stereotactic radiotherapy (HSRT) to the resection cavity in patients with brain metastases appears to be associated with an “excellent risk-benefit profile.” As stated by the investigators, “For...

kidney cancer

Adjuvant Sorafenib vs Placebo in Patients With Kidney Cancer at Intermediate or High Risk of Relapse

In the phase III SORCE trial reported in the Journal of Clinical Oncology, Eisen et al found no benefit of sorafenib vs placebo as adjuvant therapy in patients with renal cell carcinoma at intermediate or high risk of disease recurrence. Study Details The double-blind trial included 1,711 patients...

lymphoma

Study Finds Combined HDAC and mTOR Inhibition May Improve Outcomes in Patients With Relapsed or Refractory Hodgkin Lymphoma

Results from a nonrandomized, dose-escalation phase I clinical trial investigating the histone deacetylase (HDAC) inhibitor vorinostat in combination with the mTOR inhibitors sirolimus or everolimus found the combination therapies showed activity in heavily pretreated patients with relapsed or...

Expert Point of View: Rodabe N. Amaria, MD

The value of adjuvant therapy for patients with resected stage III or IV melanoma—in the form of pembrolizumab and nivolumab—continues to be observed after approximately 4 years from the start of therapy, according to Rodabe N. Amaria, MD, Associate Professor of Melanoma Medical Oncology at The...

skin cancer

Long-Term Benefit of Adjuvant Immunotherapy Sustained in Stage III or IV Melanoma

The benefit of anti–PD-1 antibodies in the adjuvant treatment of patients with stage III or stage IV melanoma continues to be observed at around 4 years for both pembrolizumab and nivolumab, according to updates of pivotal trials presented at the European Society for Medical Oncology (ESMO) Virtual ...

multiple myeloma

Ixazomib Maintenance in Newly Diagnosed Patients With Multiple Myeloma Not Undergoing Stem Cell Transplant: TOURMALINE-MM4 Trial

As reported in the Journal of Clinical Oncology by Meletios A. Dimopoulos, MD, and colleagues, the phase III TOURMALINE-MM4 trial has shown that postinduction maintenance with ixazomib prolonged progression-free survival vs placebo in patients with newly diagnosed multiple myeloma not undergoing...

lymphoma

Tazemetostat in Relapsed or Refractory Follicular Lymphoma

In a phase II trial reported in The Lancet Oncology, Franck Morschhauser, MD, and colleagues found that the oral EZH2 inhibitor tazemetostat produced durable responses in patients with relapsed or refractory follicular lymphoma with or without an EZH2 mutation. As noted by the investigators,...

colorectal cancer

Addition of Oxaliplatin to Preoperative Capecitabine-Based Chemoradiation and Adjuvant Capecitabine in Locally Advanced Rectal Cancer

As reported in the Journal of Clinical Oncology by Schmoll et al, the phase III PETACC 6 trial has shown no benefit of the addition of preoperative and adjuvant oxaliplatin to preoperative capecitabine-based chemoradiation and adjuvant capecitabine in patients undergoing total mesorectal excision...

skin cancer

COMBI-i Trial: No Statistical Benefit to Adding Spartalizumab to Dabrafenib/Trametinib in Melanoma

Patients with unresectable or metastatic melanoma harboring BRAF V600 mutations did not benefit from the addition of the anti–PD-1 antibody spartalizumab to dabrafenib and trametinib in the COMBI-i trial, which was presented at the European Society for Medical Oncology (ESMO) Virtual Congress...

bladder cancer

Urine-Based Liquid Biopsy May Perform Similarly to Urine Cytology in Detecting Urothelial Carcinoma

Analysis of DNA copy number variants in the cells exfoliated in urine showed improved sensitivity and similar specificity in detecting urothelial carcinoma compared to urine cytology, according to results published by Zeng et al in Clinical Cancer Research. “Urine cytology, which is widely used to...

hematologic malignancies
immunotherapy

Long-Term Follow-up of Anti-CD19 CAR T-Cell Therapy in Relapsed B-Cell Malignancies

As reported in the Journal of Clinical Oncology by Cappell et al, long-term follow-up of a National Cancer Institute phase I trial has shown that anti-CD19 chimeric antigen receptor (CAR) T-cell therapy for various relapsed B-cell malignancies produced responses lasting 3 years or longer in half of ...

lymphoma
immunotherapy

FDA Extends the Approval of Pembrolizumab for Patients With Classical Hodgkin Lymphoma

On October 14, the U.S. Food and Drug Administration (FDA) extended the approval of pembrolizumab (Keytruda) for the following indications:   Adult patients with relapsed or refractory classical Hodgkin lymphoma Pediatric patients with refractory classical Hodgkin lymphoma or classical Hodgkin...

sarcoma

Tazemetostat in Patients With Advanced Epithelioid Sarcoma and Loss of INI1/SMARCB1

As reported in The Lancet Oncology by Mrinal Gounder, MD, and colleagues, findings in a cohort of a phase II basket trial showed that the oral EZH2 inhibitor tazemetostat produced durable responses in some patients with advanced epithelioid sarcoma with loss of INI1 or SMARCB1 (the gene encoding...

lung cancer
immunotherapy

Addition of Cetuximab to Afatinib in First-Line Treatment of EGFR-Mutant NSCLC

As reported in the Journal of Clinical Oncology by Sarah B. Goldberg, MD, MPH, and colleagues, final results of the phase II SWOG S1403 trial show no progression-free survival benefit with afatinib plus cetuximab vs afatinib alone in the first-line treatment of EGFR-mutant advanced non–small cell...

skin cancer

ASCO’s Policy Statement on Skin Cancer Prevention Focuses on Four Key Areas to Reduce Incidence and Save Lives

The increasing incidence rates of skin cancer in the United States are staggering. It is the most common cancer diagnosed in the country, and current estimates show that about 9,500 Americans are diagnosed with skin cancer every day. Over the course of a year, more than 3 million people are...

breast cancer
immunotherapy

Addition of Atezolizumab to T-DM1 in Previously Treated Patients With HER2-Positive Advanced Breast Cancer

In the phase II KATE2 trial reported in The Lancet Oncology, Leisha A. Emens, MD, and colleagues found that the addition of atezolizumab to ado-trastuzumab emtansine (T-DM1) did not improve progression-free survival in patients with advanced HER2-positive breast cancer progressing after previous...

breast cancer

Clinical Challenges of Managing Breast Cancer Brain Metastases

“Breast cancer brain metastases are a clinical challenge that are only increasing in incidence and are a consequence of advanced breast cancers, largely HER2-positive and triple-negative,” according to Carey K. Anders, MD, Professor of Medicine and Medical Director of the Duke Brain and Spine...

gastroesophageal cancer
immunotherapy

KEYNOTE-181 Trial: Second-Line Pembrolizumab vs Chemotherapy in Advanced Esophageal Cancer

As reported in the Journal of Clinical Oncology by Takashi Kojima, MD, and colleagues, the phase III KEYNOTE-181 trial has shown that second-line pembrolizumab improved overall survival vs investigator’s choice of chemotherapy in patients with advanced or metastatic esophageal cancer with a PD-L1...

leukemia

Prognostic Model for Outcomes With Ibrutinib Treatment for Chronic Lymphocytic Leukemia

As reported in the Journal of Clinical Oncology, Ahn et al developed a four-factor model that identified risk groups for poorer outcomes among patients treated with ibrutinib for chronic lymphocytic leukemia. Study Details Patients treated with ibrutinib in phase II and III trials constituted the...

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