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issues in oncology
supportive care

Findings From ASCO’s Second National Cancer Opinion Survey

Despite a recent study showing that patients with cancer who chose alternative therapies over conventional cancer treatment have a higher risk of death, nearly 4 in 10 Americans believe cancer can be cured by alternative remedies alone, according to the results of ASCO’s 2018 National Cancer...

solid tumors
kidney cancer

Clinical Trial Commences on Personalized Vaccine in Kidney Cancer

Researchers at the Dana-Farber Cancer Institute in Boston are testing a first-of-its-kind personalized cancer vaccine combined with an immunotherapy drug, with the aim of improving outcomes for patients with kidney cancer who are at high risk of recurrence after surgery. A two-pronged approach to...

hepatobiliary cancer
immunotherapy

2019 GI Cancers Symposium: Nivolumab vs Nivolumab Plus Ipilimumab in Resectable Hepatocellular Carcinoma

Anti–programmed cell death protein 1 and anti–cytotoxic T-lymphocyte–associated protein 4 antibodies have shown activity in hepatocellular carcinoma. Based on these earlier findings, researchers sought to examine the safety, efficacy, and tolerability of perioperative treatment...

hematologic malignancies
multiple myeloma

Novel Treatments in Newly Diagnosed Multiple Myeloma, Part 1

Here is an update on several different studies focusing on novel treatments for patients with newly diagnosed multiple myeloma presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. Featured therapeutics include daratumumab plus lenalidomide and dexamethasone, ...

issues in oncology
legislation
health-care policy

New Regulations Require Better Communication With Patients Who Have Disabilities and Limited English Proficiency

Ever since President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law on March 23, 2010, the nondiscrimination provision of the law, Section 1557, which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health ...

ASCO and ESMO Publish Joint Assessment of Value Frameworks

ASCO and the European Society for Medical Oncology (ESMO) published a joint analysis comparing the results of both organizations’ value frameworks in ASCO’s Journal of Clinical Oncology.1 The analysis found that the frameworks produce comparable measures of the clinical benefits of new therapies in ...

gastrointestinal cancer

2019 GI Cancers Symposium: Safety, Efficacy of Trifluridine/Tipiracil in Metastatic Gastric Cancer With or Without Gastrectomy

In a poster session earlier today David Ilson, MD, of Memorial Sloan Kettering Cancer Center, and colleagues reported on a preplanned subgroup analysis of the double-blind phase III TAGS study looking at the safety and efficacy of the oral agent trifluridine/tipiracil (FTP/TPI) in heavily...

gastroesophageal cancer
gastrointestinal cancer

2019 GI Cancers Symposium: Addition of Andecaliximab to mFOLFOX6 in Treatment-Naive Advanced Gastric or GEJ Adenocarcinoma

A phase I/Ib study found that the addition of andecaliximab, a monoclonal antibody that inhibits matrix metalloproteinase 9, to modified fluorouracil (5-FU), leucovorin, and oxaliplatin (mFOLFOX6) showed activity in gastric and or gastroesophageal junction (GEJ) carcinoma. Based on these...

lymphoma
immunotherapy

Is There a Benefit to Adding Rituximab to Methotrexate-Based Chemotherapy in Primary CNS Lymphoma?

In a phase III trial (HOVON 105/ALLG NHL 24) reported in The Lancet Oncology, Bromberg et al found no significant benefit of the addition of rituximab to high-dose methotrexate-based chemotherapy in patients with newly diagnosed primary central nervous system (CNS) lymphoma. Study Details In the...

pancreatic cancer
immunotherapy

VISTA Checkpoint Implicated in Pancreatic Cancer Immunotherapy Resistance

Researchers have identified a new potential immunotherapy target in pancreatic cancer, which so far has been notoriously resistant to treatment with immune checkpoint blockade drugs effective against a variety of other cancers. A research team from The University of Texas MD Anderson ...

gastroesophageal cancer

Hybrid Minimally Invasive Esophagectomy vs Open Esophagectomy in Esophageal Cancer

In a French phase III trial reported in The New England Journal of Medicine, Mariette et al found that a hybrid minimally invasive surgical procedure was associated with reduced postoperative complications vs transthoracic open esophagectomy in patients with resectable cancer of the middle or lower ...

lymphoma
immunotherapy

Nivolumab in Relapsed or Refractory DLBCL Ineligible for or After Failure of Autologous Transplantation

In a phase II trial reported in the Journal of Clinical Oncology, Ansell et al found that nivolumab was associated with low response rates among patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL) who were ineligible for or experienced failure of autologous hematopoietic cell ...

hepatobiliary cancer
issues in oncology

Role of Donor Race in Liver Transplant Outcomes in African American Patients With Hepatocellular Carcinoma

Among African American adults undergoing liver transplant to treat hepatocellular carcinoma, patients whose organ donor was also African American lived significantly longer than those with a racially unmatched donor, report authors of a new study using national data. Their findings were published...

head and neck cancer

Response to Induction Chemotherapy and Outcomes With Definitive Chemoradiotherapy or Surgery in Sinonasal Undifferentiated Carcinoma

In a single-center experience reported in the Journal of Clinical Oncology, Amit et al found that among patients with sinonasal undifferentiated carcinoma with a favorable response to induction chemotherapy, disease-specific survival was better in those receiving definitive concurrent...

lung cancer
immunotherapy

Updated Survival Analysis of KEYNOTE-024: Pembrolizumab vs Platinum-Based Chemotherapy in Previously Untreated, Advanced NSCLC

As reported in the Journal of Clinical Oncology by Reck et al, an updated analysis of the phase III KEYNOTE-024 trial indicates continued overall survival benefit of first-line pembrolizumab vs platinum-based chemotherapy in patients with advanced non–small cell lung cancer (NSCLC) with a...

colorectal cancer
solid tumors
hematologic malignancies
pancreatic cancer
symptom management

FDA Pipeline: Designations for Treatments of Graft-vs-Host-Disease, Colorectal Cancer, Pancreatic Cancer, and More

The U.S. Food and Drug Administration (FDA) recently issued the following new designations and clearances: Fast Track Designation for Itolizumab for the Treatment of Acute Graft-vs-Host Disease The FDA granted Fast Track designation to itolizumab for the treatment of acute graft-vs-host ...

breast cancer
gynecologic cancers
issues in oncology

BRCA Exchange: Resource Aggregates Data on BRCA Variants

A global resource that includes data on thousands of inherited variants in the BRCA1 and BRCA2 genes is available to the public. The BRCA Exchange was created through the BRCA Challenge, a long-term demonstration project initiated by the Global Alliance for Genomics and...

head and neck cancer

Study Identifies Prognostic Biomarker in HPV-Related Head and Neck Cancers

A study investigating how to identify and treat patients with high- and low-risk human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma has demonstrated variations in HPV-related molecules among HPV-positive cases of the disease. Using their findings, the investigators developed a ...

cns cancers

Higher Incidence of Brain and CNS Tumors Among People Living in Appalachia

A recent study published by Ostrom et al in the Journal of Neuro-Oncology showed that compared to the rest of the United States, the Appalachian region has a 5% higher incidence of malignant primary brain tumors and other central nervous system (CNS) tumors, a higher mortality rate due to ...

breast cancer

Neoadjuvant Degarelix vs Triptorelin in Premenopausal Women Receiving Letrozole for Locally Advanced, Endocrine-Responsive Breast Cancer

In a phase II trial reported in the Journal of Clinical Oncology, Dellapasqua et al found that neoadjuvant treatment with the gonadotropin-releasing hormone (GnRH) antagonist degarelix was more effective than the GnRH agonist triptorelin in achieving ovarian function suppression (OFS) in...

cns cancers

Risk of Intracranial Malignancy After Stereotactic Radiosurgery for Nonmalignant Conditions

In a retrospective cohort study reported in The Lancet Oncology, Wolf et al found that patients undergoing Gamma Knife stereotactic radiosurgery for nonmalignant neurosurgical conditions did not appear to be at long-term increased risk of radiation-associated secondary intracranial malignancy or...

lymphoma

Analysis of Cause of Death in Patients With Follicular Lymphoma in the Rituximab Era

In a pooled analysis of French and U.S. follicular lymphoma cohorts reported in the Journal of Clinical Oncology, Sarkozy and colleagues found that lymphoma was the most common cause of death during the first decade of the rituximab era in treatment of the disease. The study involved data from...

head and neck cancer
issues in oncology

Facing Death: Having the Difficult Conversation With Your Patients

Michael Becker, a former CEO for two biotechnology companies, discusses his terminal head and neck cancer diagnosis and his message for oncologists: be proactive and, at the appropriate time, talk with your patients about death and dying. For more information about Michael Becker’s blog and his HPV ...

pancreatic cancer

Adjuvant FOLFIRINOX vs Gemcitabine in Pancreatic Cancer

In a phase III Canadian and French trial reported in The New England Journal of Medicine, Conroy and colleagues in the Canadian Cancer Trials Group and the Unicancer-GI–PRODIGE Group found that adjuvant modified FOLFIRINOX (fluorouracil, leucovorin, irinotecan, oxaliplatin) produced better...

hematologic malignancies

FDA Approves Ravulizumab-cwvz for Paroxysmal Nocturnal Hemoglobinuria

On December 21, 2018, the U.S. Food and Drug Administration (FDA) approved ravulizumab-cwvz (Ultomiris) for adult patients with paroxysmal nocturnal hemoglobinuria (PNH). PNH is a rare bone marrow failure disorder that manifests with hemolytic anemia, thrombosis, and peripheral blood cytopenias....

issues in oncology

ASCO and ESMO Publish Joint Assessment of Their Value Frameworks

TO BETTER UNDERSTAND the performance characteristics of ASCO’s Value Framework Net Health Benefit Score version 2 (ASCO-NHB v2)1 and the European Society for Medical Oncology’s (ESMO’s) Magnitude of Clinical Benefit Scale version 1.1 (ESMO-MCBS v1.1),2 ASCO and ESMO undertook a joint project to...

thyroid cancer

For Maria Papaleontiou, MD, Research Holds the Key to Improving Care of Patients With Thyroid Cancer

Maria Papaleontiou, MD, whose research interests focus on the complex issues surrounding the management of thyroid cancer and thyroid disease in general, was born on Cyprus, a small island nestled in the azure waters of the Mediterranean Sea. She recently spoke with The ASCO Post about her life and ...

immunotherapy

Immune Checkpoint Blockade and Tumor-Specific Vaccine for Incurable HPV16-Related Cancer

In a single-center phase II study reported in JAMA Oncology, Erminia Massarelli, MD, and colleagues found combining tumor-specific vaccine and nivolumab (Opdivo) showed evidence of activity in incurable human papillomavirus (HPV) 16–related cancer. The therapeutic vaccine, ISA 101, induces...

gynecologic cancers

Welcome Questions About Cervical Cancer Treatment Options

TWO STUDIES reported in The New England Journal of Medicine1,2 showed that patients with early-stage cervical cancer had reduced disease-free and overall survival when treated with minimally invasive radical hysterectomy vs open or radical hysterectomy. The findings of these studies have been...

hematologic malignancies
leukemia

Venetoclax in Combination Regimens for Older Patients With AML or Those With Comorbidities Precluding Intensive Induction

On November 21, 2018, venetoclax (Venclexta) was granted accelerated approval for use in combination with azacitidine or decitabine or low-dose cytarabine for the treatment of newly diagnosed acute myeloid leukemia (AML) in patients aged ≥ 75 years or who have comorbidities that preclude the use of ...

immunotherapy

Illustrating Genius

FOUR AND A HALF YEARS AGO, author Neil Canavan attended a scientific conference to learn what he could about the then-emerging field of immunotherapy for cancer. After a presentation by Zelig Eshhar, PhD, principal investigator in the Department of Immunology at the Weizmann Institute of Science...

FDA Announces New Updates to Expanded Access Program

The U.S. Food and Drug Administration (FDA) recently announced new changes to expand and update the Expanded Access (EA) program, which allows very ill patients access to experimental treatments outside of clinical trials. The most recent updates include: Clarifications on Safety Data: The FDA...

symptom management

Clinician Survey to Explore Direct-Acting Oral Anticoagulants vs Low–Molecular-Weight Heparin in Cancer-Related VTE

Injectable low–molecular-weight heparin has long been considered the standard of care for treatment of venous thromboembolism (VTE) in patients with cancer. However, low–molecular-weight heparin is costly and often disliked by patients due to injection-related discomfort and bruising....

hematologic malignancies

Study Findings on Myeloproliferative Neoplasms Including Systemic Mastocytosis

HERE IS AN UPDATE on six different studies featured at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. Topics focused on novel treatments for myelofibrosis, polycythemia vera and essential thrombocythemia, as well as systemic mastocytosis. Myelofibrosis ABSTRACT...

issues in oncology

How to Build a Clinical Trial Infrastructure in the Community Oncology Setting

HISTORICALLY, CLINICAL research has been viewed as an entity belonging to academic settings alone. With the advent of the Community Clinical Oncology Program (CCOP) in the 1980s and later with the Cancer Trials Support Unit, cancer clinical trials have begun to emerge in the community setting....

lung cancer

New Data Reported From International Studies of Lung Cancer Treatment

At the European Society for Medical Oncology (ESMO) 2018 Congress, important studies were presented for every cancer type. Here, The ASCO Post offers some snapshots of lung cancer studies that may inform approaches to treating this common cancer, which—despite the advances in recent years—remains...

Should I Have Lied?

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,...

immunotherapy
skin cancer

Optimal Duration of Checkpoint Inhibition in Melanoma Is No More Than 2 Years

For patients with advanced melanoma, the concept of treating to disease progression does not always apply. With many patients responding to checkpoint inhibition for years, when can treatment be safely discontinued? This important clinical question was addressed at the European Society for Medical...

gynecologic cancers

Minimally Invasive vs Open Abdominal Radical Hysterectomy in Early-Stage Cervical Cancer

TWO STUDIES recently reported in The New England Journal of Medicine indicate that minimally invasive radical hysterectomy is associated with poorer survival outcomes than open abdominal radical hysterectomy in women with early-stage cervical cancer. As reported by Pedro T. Ramirez, MD, of The...

head and neck cancer
immunotherapy

Pembrolizumab Plus Chemoradiotherapy in HPV-Positive Head and Neck Cancer

The addition of pembrolizumab (Keytruda) to a chemoradiotherapy regimen yielded complete response rates of 85% in patients with human papillomavirus (HPV)-positive advanced squamous cell carcinoma of the head and neck. These findings from a phase Ib study were presented at the 2018 Society for...

Researchers at The University of Texas at Dallas Receive Funding for Assorted Cancer Projects

MORE THAN $4.5 million in new funding from state and federal agencies will support cancer-related research over the next 5 years at The University of Texas at Dallas. Two projects related to brain cancer, each totaling $200,000 over 2 years, recently received High-Impact/High-Risk Research...

immunotherapy

Update on Immune Checkpoint Inhibitors

Checkpoint inhibitors have moved the field of immuno-oncology to the forefront of cancer treatment and research. However, these agents come with the risk of serious adverse events. To shed light on the toxicities associated with checkpoint inhibitors and other timely issues in the field of...

supportive care
palliative care

The Great Opioid Debate: Treating Cancer Pain Safely

As the number of opioid-related deaths continues to rise in the United States, stakeholders are struggling to make sense of the crisis. At the 2018 Palliative and Supportive Care in Oncology Symposium, two experts in the field, Charles F. von Gunten, MD, PhD, and Leslie J. Blackhall, MD,...

breast cancer
supportive care

Has Scalp Cooling Reached the Level of Standard of Care?

Does evidence of the effectiveness and safety of scalp cooling to reduce hair loss among women being treated for breast cancer mean that scalp cooling is a new standard of care? “I would suggest that it is,” stated Mikel Ross, MSN, RN, AGNP-BC, of the Breast Medicine Service, Memorial Sloan...

lung cancer
immunotherapy

ESMO Immuno-Oncology 2018: Second-Line Nivolumab vs Chemotherapy in SCLC

Treatment with nivolumab (Opdivo) did not improve response rates or survival over standard chemotherapy in patients with metastatic small cell lung cancer (SCLC) who relapsed following first-line treatment, according to findings presented by Reck et al at the European Society for Medical...

skin cancer
immunotherapy

ESMO Immuno-Oncology 2018: OpACIN Trial: Neoadjuvant Ipilimumab Plus Nivolumab in Stage III Melanoma

Updated data of the OpACIN study, which studied combined ipilimumab (Yervoy) plus nivolumab (Opdivo) administered as neoadjuvant or adjuvant therapy in patients with high-risk stage III melanoma, demonstrated high response rates upon neoadjuvant therapy and promising long-term clinical outcome,...

lung cancer
immunotherapy

ESMO Immuno-Oncology 2018: OAK Trial: Fast Progression in Patients With NSCLC Treated With Atezolizumab vs Chemotherapy

Overall survival (OS) was improved across all subgroups of patients with non–small cell lung cancer (NSCLC) who received atezolizumab (Tecentriq) compared with chemotherapy, including poor prognostic factors that were evaluated in an analysis of data from the OAK trial. Additionally, this...

breast cancer

Disease-Free Survival With Letrozole vs Placebo After Aromatase Inhibitor–Based Therapy in Postmenopausal Breast Cancer

As reported by Mamounas et al in The Lancet Oncology, the phase III NRG Oncology/NSABP B-42 trial has shown no disease-free survival benefit with 5 years of letrozole (Femara) vs placebo after 5 years of aromatase inhibitor–based therapy in women with hormone receptor–positive...

hematologic malignancies
immunotherapy

Combining a Checkpoint Inhibitor With CAR T-Cell Therapy May Augment Immune Response

Chimeric antigen receptor (CAR) T-cell therapy is a revolutionary approach to treating hematologic malignancies. As experience with this strategy is gained, researchers are learning more about how to optimize responses, especially in patients with “immune exhaustion,” who have a suboptimal initial...

hematologic malignancies
leukemia
immunotherapy

Early Studies of Ibrutinib Plus CAR T-Cell Combination in Chronic Lymphocytic Leukemia

Researchers are combining chimeric antigen receptor (CAR) T-cell therapy with ibrutinib (Imbruvica) as a means of augmenting and deepening responses in patients with relapsed or refractory chronic lymphocytic leukemia (CLL). Two pilot studies presented at the 2018 American Society of Hematology...

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