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issues in oncology
colorectal cancer

Can a Culturally Tailored Education Program Improve Colorectal Cancer Awareness and Screening?

People who received information from the Screen to Save program, a culturally tailored initiative from the National Cancer Institute (NCI) Center to Reduce Cancer Health Disparities (CRCHD), increased their knowledge of colorectal cancer and indicated willingness to adopt potentially preventive...

Financial Support Available to Providers During COVID-19 Pandemic

The Coronavirus Aid, Relief, and Economic Security (CARES) Act and new guidance from the Centers for Medicare & Medicaid Services (CMS) both contain provisions to provide financial support to qualified providers. ASCO strongly encourages providers to immediately begin meticulously documenting...

integrative oncology

Yoga for Pediatric and Adolescent Patients With Cancer

The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. Despite significant improvements reported in survival rates, symptom management in pediatric...

lung cancer
immunotherapy

Durvalumab Plus Chemotherapy for Extensive-Stage Small Cell Lung Cancer

On March 27, 2020, durvalumab (Imfinzi) was approved for use in combination with etoposide and either carboplatin or cisplatin as first-line treatment of patients with extensive-stage small cell lung cancer.1,2 Supporting Efficacy Data Approval was based on the findings of the open-label phase III ...

Grace and Forgiveness

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

colorectal cancer
immunotherapy

Encorafenib Combined With Cetuximab in Previously Treated BRAF V600E–Mutant Metastatic Colorectal Cancer

On April 8, 2020, encorafenib was approved for use in combination with cetuximab for the treatment of previously treated adult patients with metastatic colorectal cancer with a BRAF V600E mutation detected by a U.S. Food and Drug Administration (FDA)-approved test.1,2 Encorafenib is not indicated...

issues in oncology

Understanding Patient-Reported Outcomes in Cancer Trials: A Beginner’s Guide

Patient-reported outcomes are measures used in clinical trials to capture aspects of a patient’s health condition, reported directly by the patient, without introduction of bias from third parties. They are distinct from the physical toxicities reported by clinicians1 and are collected using a...

hematologic malignancies
leukemia
lymphoma
multiple myeloma
myelodysplastic syndromes
immunotherapy

Highlights From ASH 2019 Included New Data in Leukemia, Lymphoma, Myeloma, and Myelodysplastic Syndromes

The 2019 American Society of Hematology (ASH) Annual Meeting & Exposition featured a cornucopia of sessions. It was impossible to attend all the lectures, symposia, oral presentations, poster presentations, and special events because many were concurrent. Below, we have selected some...

breast cancer
immunotherapy

Pooled Analysis Supports Benefit of Dual HER2-Targeted Therapy, but Questions Remain

In the treatment of HER2-positive early breast cancer, patients who receive dual HER2-targeted therapy in both the neoadjuvant and adjuvant settings are less likely to experience recurrence than those who received dual therapy only as neoadjuvant treatment, according to a pooled analysis of...

breast cancer
immunotherapy

KEYNOTE-522: A Biomarker Resource for PD-1 Inhibition in Early Triple-Negative Breast Cancer

In the phase III KEYNOTE-522 trial reported in The New England Journal of Medicine and reviewed in this issue of The ASCO Post, Schmid et al1 found that the addition of pembrolizumab to neoadjuvant chemotherapy in stage II or III triple-negative breast cancer significantly improved the pathologic...

breast cancer
immunotherapy

Neoadjuvant and Adjuvant Pembrolizumab Improves Outcomes in Early Triple-Negative Breast Cancer

As reported in The New England Journal of Medicine by Peter Schmid, MD, PhD, of Barts Cancer Institute, Queen Mary University of London, and colleagues, analyses in the phase III KEYNOTE-522 trial have shown that the addition of pembrolizumab to neoadjuvant chemotherapy and the use of adjuvant...

breast cancer

Studies Show Circulating Tumor Material May Predict Outcomes After Neoadjuvant Therapy for Breast Cancer

In early triple-negative breast cancer, the presence of circulating tumor DNA (ctDNA) and circulating tumor cells after neoadjuvant chemotherapy may enable risk stratification of patients for disease recurrence and may predict outcomes, according to a preplanned correlative analysis of the phase II ...

hematologic malignancies
lymphoma
immunotherapy

Bispecific Antibodies Poised to Impact Treatment of Lymphoma and Other Blood Cancers

Studies of second-generation bispecific antibodies were among the highlights of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition. The bispecific T-cell engager blinatumomab was the first such agent to be approved by the U.S. Food and Drug Administration (FDA) in...

issues in oncology

Actively Recruiting Clinical Trials Studying Cancer Prevention Measures

This Clinical Trials Resource Guide lists actively recruiting clinical trials evaluating strategies to improve cancer prevention measures, mostly through increased rates of screening. Some of the following trials also address cancer prevention through improving knowledge of tumor biomarkers,...

lung cancer
immunotherapy

Addition of Pembrolizumab to Docetaxel for Previously Treated Immunotherapy-Naive Patients With Advanced Lung Cancer

In the single-institution phase II PROLUNG trial reported in JAMA Oncology, Oscar Arrieta, MD, and Christian Rolfo, MD, PhD, and colleagues found that the addition of pembrolizumab to docetaxel improved objective response rates and progression-free survival in immunotherapy-naive patients with...

gynecologic cancers

Addition of Olaparib to Bevacizumab Maintenance in Advanced Ovarian Cancer: PAOLA-1 Trial

As reported in The New England Journal of Medicine by Isabelle Ray‑Coquard, MD, PhD, of the Centre Leon Berard, University Claude Bernard Lyon 1 and Groupe d’Investigateurs Nationaux pour l’Etude des Cancers Ovariens (GINECO), Paris, and colleagues, the phase III PAOLA-1 trial has shown a...

breast cancer
genomics/genetics

Joint Guideline Sheds Light on Management of Hereditary Breast Cancer

As germline genetic testing becomes more widespread among patients with breast cancer, recommendations for the appropriate management of patients with hereditary breast cancer are needed. Until now, no ASCO guideline has addressed the management of hereditary breast cancer, even for carriers of...

breast cancer

Vascular Imaging for Detection of Breast Cancer: Best of Two Worlds?

For breast imaging, contrast-enhanced mammography, which uses the anatomic imaging of a mammogram in addition to imaging neovascularity, can offer the overall screening capability of standard mammography and the sensitivity of magnetic resonance imaging (MRI) at a fraction of the cost of MRI,...

breast cancer

Can Breast Cancer Surgery Be Eliminated in ‘Exceptional Responders’ to Neoadjuvant Therapy?

Can patients with breast cancer who achieve an “exceptional response” to neoadjuvant therapy safely forgo surgery? That is a question being seriously explored in multinational trials. “We’ve known for a long time that we can eliminate disease in many patients if they have chemosensitive tumors....

sarcoma
skin cancer
cns cancers

Early Signs of Activity With Immunotherapies in Low-Incidence Cancers

Immunotherapy is showing promise for patients with rare cancers, offering new treatment opportunities and clinical trials to those with previously limited options. At the 2020 ASCO-SITC Clinical Immuno-Oncology Symposium, presenters discussed the use of immunotherapy in three low-incidence cancers: ...

skin cancer
immunotherapy

Novel Treatment Strategies Under Study in Advanced Melanoma

Several novel strategies for the treatment of patients with stage III or IV melanoma showed promise in studies presented at the 2020 ASCO-SITC Clinical Immuno-Oncology Symposium.1,2 Vaccine for High-Risk Patients After Resection A tumor lysate, particle-loaded, dendritic cell (TLPLDC) vaccine was...

skin cancer
immunotherapy

New Guideline on Systemic Therapy for Melanoma Tackles Rapid Developments in Treatment Options

Systemic treatment of melanoma has changed rapidly since the introduction of ipilimumab in 2011. Newer therapies approved for melanoma since that time include immunotherapy, targeted therapy for mutation-bearing tumors, and injectional therapy for cutaneous or palpable lesions. ASCO has released...

gynecologic cancers

PARP Inhibitors in Maintenance Treatment for Advanced Ovarian Cancer

Based on multiple phase III prospective trials, there is evidence that both PARP inhibitors and antiangiogenic therapies such as bevacizumab provide benefit when utilized in a maintenance strategy in the first-line treatment of advanced epithelial ovarian cancer (GOG 218, ICON7, SOLO-1, PRIMA,...

covid-19
palliative care

Prioritizing Patients With Metastatic Disease for Palliative Radiotherapy

In anticipation of how the COVID-19 pandemic might impact oncology care as the coronavirus spread across New York City, radiation oncologists with expertise in the management of metastatic disease and inpatient oncologic emergencies at Memorial Sloan Kettering Cancer Center (MSK) met in late winter ...

gynecologic cancers
immunotherapy

FDA Approves Olaparib Plus Bevacizumab as Maintenance Treatment for Ovarian, Fallopian Tube, or Primary Peritoneal Cancers

On May 8, 2020, the U.S. Food and Drug Administration (FDA) expanded the indication of olaparib (Lynparza) to include its combination with bevacizumab for first-line maintenance treatment of adult patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in...

solid tumors
immunotherapy

Chemoimmunotherapy for Pediatric Refractory or Relapsed Neuroblastoma

In an expansion of a Children’s Oncology Group trial reported in the Journal of Clinical Oncology, Mody et al found that the combination of irinotecan, temozolomide, the anti–disialoganglioside GD2 antibody dinutuximab, and granulocyte-macrophage colony-stimulating factor (I/T/DIN/GM-CSF) showed...

leukemia
supportive care

Benefit of Increased Dietary Antioxidants During Induction Therapy for Pediatric ALL

In a study reported in the Journal of Clinical Oncology, Ladas et al found that increased dietary intake of antioxidants was associated with reduced risk for bacterial infection and grade ≥ 3 mucositis during induction therapy in pediatric patients with acute lymphoblastic leukemia (ALL). Study...

gynecologic cancers

Advanced Ovarian Cancer: Use of Neoadjuvant Chemotherapy Increasing Along With Survival

The use of neoadjuvant chemotherapy for advanced ovarian cancer may not have the negative impact on survival feared by many gynecologic oncologists. In fact, according to a pair of studies that were to have been presented at the Society of Gynecologic Oncology (SGO) 2020 Annual Meeting on Women’s...

hepatobiliary cancer
immunotherapy

Nivolumab for Advanced Refractory Biliary Tract Cancer

In a phase II trial reported in JAMA Oncology, Kim et al found that nivolumab showed antitumor activity in patients with advanced refractory biliary tract cancer. As noted by the investigators, there currently is no established second-line systemic treatment for biliary tract cancer. Study Details...

leukemia
covid-19

Laura C. Michaelis, MD: In My Experience Question 3

lymphoma
covid-19

Mehdi Hamadani, MD: In My Experience Question 3

During the COVID-19 pandemic, would you still recommend immediate upfront autologous transplant in patients with T-cell non-Hodgkin lymphoma? Recorded April 21, 2020.

bladder cancer

Chemoablation of Low-Grade Upper Tract Urothelial Cancer With Mitomycin-Containing Reverse Thermal Gel

In the single-arm phase III OLYMPUS trial reported in The Lancet Oncology, Kleinmann et al found that primary chemoablation of low-grade upper tract urothelial carcinoma using a mitomycin-containing reverse thermal gel (UGN-101) resulted in disease eradication in more than half of patients. As...

leukemia

Dexrazoxane, Cardiac Function, and Treatment Outcomes in Pediatric AML

In a study reported in the Journal of Clinical Oncology, Getz et al found that use of dexrazoxane was associated with preservation of cardiac function in pediatric patients receiving front-line treatment for acute myeloid leukemia (AML) and resulted in no adverse effects on treatment outcomes. As...

breast cancer

FAST-Forward Trial: Long-Term Outcomes With Adjuvant Hypofractionated Radiotherapy for 1 vs 3 Weeks in Early Breast Cancer

As reported in The Lancet by Brunt et al, 5-year findings from the phase III FAST-Forward trial indicated that adjuvant radiotherapy with 26 Gy in 5 fractions over 1 week was noninferior to 40 Gy in 15 fractions over 3 weeks in preventing local tumor relapse in women with early-stage breast ...

skin cancer
immunotherapy

AACR 2020: Triplet Regimen Improves Progression-Free Survival in Advanced Melanoma in IMspire150 Trial

The addition of the checkpoint inhibitor atezolizumab to two targeted therapies (the BRAF inhibitor vemurafenib and the MEK inhibitor cobimetinib) as initial therapy improved outcomes compared with the two targeted therapies plus placebo in patients with newly diagnosed BRAF V600E/K–mutant advanced ...

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. The ASCO Post asked three experts in this malignancy to share their concerns and their approaches to achieving good patient outcomes while minimizing the risk of COVID-19...

hepatobiliary cancer
immunotherapy

AACR 2020: Atezolizumab Alone or in Combination With Cobimetinib for Biliary Tract Cancer

A randomized multicenter study of a combination of immunotherapy with a targeted therapy improved cancer control for some patients with biliary tract cancer, according to research presented by Yarchoan et al at the American Association for Cancer Research (AACR) Virtual Annual Meeting (Abstract...

neuroendocrine tumors
issues in oncology

Issues With Travel Faced by Patients Undergoing Lu-177 Dotatate Radiation Therapy

A team of researchers and patient advocates have addressed the challenges related to traveling after receiving radiation therapy involving Lu-177 dotatate in a study published by Kendi et al in The Journal of Nuclear Medicine. Due to the residual radiation activity of Lu-177 dotatate, some patients ...

breast cancer
immunotherapy

Abemaciclib/Fulvestrant/Trastuzumab for Patients With Previously Treated HR-Positive, HER2-Positive Advanced Breast Cancer

In the phase II monarcHER trial reported in The Lancet Oncology, Sara M. Tolaney, MD, and colleagues found that the combination of abemaciclib, fulvestrant, and trastuzumab prolonged progression-free survival vs trastuzumab plus standard-of-care chemotherapy in patients with previously treated...

colorectal cancer
gastrointestinal cancer
immunotherapy

Regorafenib Plus Nivolumab in Advanced Gastric and Colorectal Cancers

In a Japanese phase Ib/dose-expansion trial reported in the Journal of Clinical Oncology, Fukuoka et al found that the combination of regorafenib and nivolumab showed activity in patients with previously treated gastric cancer and colorectal cancer with microsatellite stable/mismatch...

prostate cancer

PROfound Trial: Olaparib for Patients With Metastatic Castration-Resistant Prostate Cancer and Homologous Recombination Repair Gene Alterations

In a phase III trial reported in The New England Journal of Medicine, Johann de Bono, MB, ChB, PhD, and colleagues found that olaparib significantly improved progression-free survival vs hormonal therapy in patients with metastatic castration-resistant prostate cancer who had alterations in the...

immunotherapy
skin cancer

Neoadjuvant Nivolumab for Resectable Merkel Cell Carcinoma

As reported in the Journal of Clinical Oncology by Suzanne L. Topalian, MD, and colleagues, neoadjuvant treatment with nivolumab was found to produce pathologic complete response in approximately half of patients with resectable Merkel cell carcinoma enrolled in the phase I/II CheckMate 358 trial....

multiple myeloma
covid-19

Saad Z. Usmani, MD: In My Experience Question 3

Because of the COVID-19 pandemic, has your management strategy changed for post-transplant consolidation and maintenance therapy in patients with multiple myeloma? Recorded April 24, 2020.

immunotherapy
covid-19

Negotiating the Obstacles to Conducting Clinical Trials of Immunotherapy During the Coronavirus Pandemic

Coronavirus disease 2019 (COVID-19) is perhaps the biggest challenge health-care systems have ever had to face. As part of a series of interviews The ASCO Post is conducting with oncologists, we talked with Charles G. Drake, MD, PhD, about the impact of COVID-19 on his practice and on the conduct...

covid-19

On the Shoulders of Giants

Before the dawn of the modern antibiotic era and amid the chaos of World War II, future Professor of Radiology and Founding Dean of two American medical colleges, Dr. George T. Harrell,* penned what could now be argued was far too bold a statement. As the opening lines of his nonrandomized study...

multiple myeloma
immunotherapy

FDA Approves Daratumumab and Hyaluronidase-fihj in Multiple Myeloma

On May 1, the U.S. Food and Drug Administration (FDA) approved daratumumab and hyaluronidase-fihj (Darzalex Faspro) for adult patients with newly diagnosed, relapsed, or refractory multiple myeloma. This new product allows for subcutaneous dosing of daratumumab. Daratumumab and hyaluronidase-fihj...

leukemia
pancreatic cancer
neuroendocrine tumors
lung cancer
gynecologic cancers
lymphoma

FDA Pipeline: Priority Review in AML, Fast Track Designations for Pancreatic Cancer and Neuroendocrine Tumors

Over the past 2 weeks, the U.S. Food and Drug Administration (FDA) granted Priority Review to a treatment for acute myeloid leukemia (AML); Fast Track designations for agents in pancreatic cancer and pancreatic/nonpancreatic neuroendocrine tumors; approvals for companion diagnostic tests;...

breast cancer

Avoiding Use of Prophylactic Peg-filgrastim During Paclitaxel Treatment in Dose-Dense Chemotherapy for Breast Cancer

In a phase II study reported in the Journal of Clinical Oncology, Vaz-Luis et al found that the use of a prespecified algorithm enabled the avoidance of routine peg-filgrastim prophylaxis during the paclitaxel portion of neoadjuvant or adjuvant treatment with dose-dense...

breast cancer
immunotherapy

AACR 2020: I-SPY2 Trial: Durvalumab/Olaparib/Paclitaxel ‘Graduates’ in HER2-Negative Breast Cancer

The I-SPY2 trial found that the combination of the checkpoint inhibitor durvalumab, the PARP inhibitor olaparib, and the taxane paclitaxel followed by doxorubicin/cyclophosphamide as neoadjuvant therapy improved pathologic complete responses vs paclitaxel followed by doxorubicin/cyclophosphamide...

covid-19

Allocating Ventilators in Times of Crisis: A Brave New World

The unprecedented COVID-19 crisis has challenged us, as a society, to evaluate our core values and philosophy. Ventilators, a precious and limited commodity, are now in short supply. Humanity is at a precipice, and we physicians are facing an ethical dilemma, how best to allocate ventilators, and, ...

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