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Expert Point of View: Joshi J. Alumkal, MD

Invited discussant of the ACIS study, Joshi J. Alumkal, MD, leader of the Genitourinary Medical Oncology Section at the University of Michigan Rogel Cancer Center, noted that the toxicities were slightly higher with apalutamide plus abiraterone acetate/prednisone, including fatigue, hypertension,...

prostate cancer

Adding Apalutamide to Abiraterone/Prednisone Extends Radiographic Progression-Free but Not Overall Survival

The phase III ACIS trial met its primary endpoint at 6 months showing that apalutamide plus abiraterone acetate/prednisone (AAP) extended radiographic progression-free survival vs abiraterone acetate/prednisone alone in patients with chemotherapy-naive metastatic castration-resistant prostate...

kidney cancer

SWOG 1500: Cabozantinib Extends Progression-Free Survival vs Sunitinib in Metastatic Papillary Renal Cell Carcinoma

Cabozantinib achieved a statistically significant and clinically meaningful extension in progression-free survival compared with sunitinib in patients with metastatic papillary renal cell carcinoma, a relatively uncommon type of renal cell carcinoma, according to the randomized phase II SWOG 1500...

Expert Point of View: Richard K. Valicenti, MD

Invited discussant of the SAKK 09/10 trial, Richard K. Valicenti, MD, of the University of California, Davis, commented: “These results bring us closer to a more individualized approach than using PSA dynamics and conventional imaging. It does not appear that historic norms are sufficient to...

prostate cancer

Comparing Radiotherapy Regimens for Biochemically Recurrent Prostate Cancer After Radical Prostatectomy

A dose-intensified approach to salvage radiotherapy failed to show superiority to a conventional-dose strategy in patients with biochemically recurrent prostate cancer who had undergone radical prostatectomy, according to the phase III SAKK 09/10 trial presented at the 2021 Genitourinary Cancers...

prostate cancer

LuPSMA Outperforms Cabazitaxel for Metastatic Castration-Resistant Prostate Cancer in Phase II Trial

Following disease progression on docetaxel, prostate-specific membrane antigen (PSMA)-targeted radionuclide therapy reduced the risk of disease progression or death by 37% vs cabazitaxel in men with metastatic castration-resistant prostate cancer in the TheraP phase II trial reported at the 2021...

Expert Point of View: Arlene O. Siefker-Radtke, MD

“Now we know enfortumab vedotin-ejfv is here to stay in the armamentarium of treatment for advanced urothelial cancer,” said Arlene O. Siefker-Radtke, MD, of The University of Texas MD Anderson Cancer Center, during her discussion of both EV-301 and EV-201. “As we saw, overall survival was quite...

bladder cancer

EV-301 and EV-201 Trials: Enfortumab Vedotin-ejfv Improves Survival in Metastatic Urothelial Cancer

Enfortumab vedotin-ejfv continues to move the needle forward as a validated treatment option for advanced urothelial carcinoma. At the 2021 Genitourinary Cancers Symposium, results from the phase III EV-301 study1 and EV-201 Cohort 22 provided support for the use of this agent in both patients...

Physician-Patient Relationship: Sacred and Sacrosanct

There are many relationships we build at work in our entire lifetime. Some are good, a few are not, and many are somewhere in between. But of all the relationships we are fortunate enough to build, there is no relationship more valuable and gratifying than the one between a physician and a ...

immunotherapy
issues in oncology

Cardiovascular Risks Associated With Checkpoint Inhibitors and CAR T-Cell Therapy

In just a few years, immunotherapy has risen to become a pillar of cancer care, leading to significantly improved response rates and even cures in previously intractable diseases. Leveraging the immune system to treat cancer, however, also increases the potential for serious off-target effects....

Expert Point of View: Peter Schmid, MD, PhD

According to the invited discussant of UNIRAD,1Peter Schmid, MD, PhD, Lead of the Centre for Experimental Medicine at Barts Cancer Institute, Queen Mary University of London, it remains unclear whether or not everolimus plus hormone therapy is an effective adjuvant regimen for high-risk patients...

breast cancer

Distant Metastasis–Free Survival With Adjuvant vs No Adjuvant Chemotherapy According to Genomic and Clinical Risk in Early Breast Cancer

In an updated analysis of the European phase III MINDACT trial reported in The Lancet Oncology, Martine Piccart, MD, and colleagues found confirmatory evidence of the initial finding of a high rate of distant metastasis–free survival among patients with high–clinical-risk but low–genomic-risk...

breast cancer

No Benefit Found for Everolimus Plus Adjuvant Hormone Therapy in High-Risk Early-Stage Breast Cancer

Everolimus plus hormone therapy improves outcomes in the advanced disease setting but apparently not in the adjuvant setting, according to the results of the UNIRAD trial, presented as a part of the European Society for Medical Oncology (ESMO) Virtual Plenary program.1 “In the UNIRAD study, after...

kidney cancer

Lenvatinib/Pembrolizumab Combination Improves Outcomes vs Sunitinib in Renal Cell Carcinoma

The combination of lenvatinib plus pembrolizumab was superior to sunitinib for progression-free and overall survival as well as other key endpoints in patients with advanced clear cell renal cell carcinoma (RCC), according to results of the phase III CLEAR trial presented at the 2021 Genitourinary ...

covid-19

Rates of Seroconversion Among Patients With Cancer Infected With COVID-19

Most people with cancer who are infected with COVID-19 produce antibodies at a rate comparable to the rest of the population—but their ability to do so depends on the type of malignancy and the treatments they’ve received, according to a new study published by Thakkar et al in Nature Cancer. The...

hepatobiliary cancer
global cancer care

Study Establishes Global Burden of Gallbladder and Biliary Tract Cancer

Although cancers of the gallbladder or bile ducts are rare, their rates of occurrence are increasing. A recent study published by Ouyang et al in the journal Cancer provided details on the burden of gallbladder and biliary tract cancer across 195 countries and territories from 1990 to 2017....

bladder cancer
immunotherapy

Adjuvant Atezolizumab in Muscle-Invasive Urothelial Carcinoma: IMvigor010

As reported in The Lancet Oncology by Joaquim Bellmunt, MD, PhD, and colleagues, the phase III IMvigor010 trial showed no improvement in disease-free survival with adjuvant atezolizumab vs observation in patients with muscle-invasive urothelial carcinoma. Study Details In the open-label trial, 809...

bladder cancer

Nivolumab: First Adjuvant Immunotherapy to Show Survival Benefit in High-Risk Muscle-Invasive Urothelial Cancer

Adjuvant therapy with nivolumab, an anti–PD-1 immune checkpoint inhibitor, after radical surgery improved disease-free survival in high-risk muscle-invasive urothelial cancer regardless of PD-L1 status, according to the results of the CheckMate 274 randomized phase III trial presented at the 2021...

covid-19

Factors Associated With Severity of COVID-19 Infection in Patients With Cancer: Data From CCC19

Updated findings from a cohort of patients with cancer infected with COVID-19 included in the COVID-19 and Cancer Consortium (CCC19) were published by Petros Grivas, MD, PhD, and colleagues in Annals of Oncology. Authors identified factors associated with a more severe viral infection among...

gastrointestinal cancer

Outcomes of Complex Gastrointestinal Cancer Surgeries at Ranked vs Nonranked Hospitals

Patients whose procedures for gastrointestinal malignancies were performed by a surgical team at a hospital ranked as one of America’s “best” by U.S. News & World Report were nearly two and half times more likely to survive the operation than those who had the same procedure done at a nonranked ...

pancreatic cancer
genomics/genetics

Olaparib for Previously Treated Patients With Pancreatic Cancer and DDR Genetic Alterations Other Than BRCA Variants

Combined results of two parallel phase II studies reported in JAMA Oncology by Milind Javle, MD, and colleagues indicated that olaparib may have therapeutic value in previously treated patients with platinum-sensitive pancreatic ductal carcinoma with DNA damage repair (DDR) genetic alterations...

solid tumors

Analysis From the International Germ Cell Cancer Collaborative Group Update Consortium

In an analysis of a modern cohort of patients with metastatic seminoma reported in the Journal of Clinical Oncology, Beyer et al, members of the International Germ Cell Cancer Collaborative Group (IGCCCG) Update Consortium, found that progression-free and overall survival have improved compared...

colorectal cancer
genomics/genetics

KRAS Mutation Status May Predict Outcomes After Hepatic Arterial Infusion Pump Therapy for Unresectable Colorectal Liver Metastases

KRAS mutational status in patients with unresectable liver metastases from colorectal cancer predicts a worse response to hepatic arterial infusion (HAI) pump chemotherapy, according to research presented by Kolbeinsson et al at the Society of Surgical Oncology 2021 International Conference on...

gynecologic cancers
immunotherapy

Niraparib Plus Bevacizumab Shows Clinical Benefit in Patients With Advanced Ovarian Cancer

The addition of niraparib maintenance to first-line platinum-based chemotherapy with bevacizumab demonstrated clinical benefit in patients with advanced ovarian cancer, according to data from the OVARIO study presented by Melissa M. Hardesty, MD, MPH, during the Society of Gynecologic Oncology...

head and neck cancer

First-Line TPEx vs EXTREME Regimen for Recurrent or Metastatic Head and Neck Squamous Cell Carcinoma

In a phase II trial (GORTEC 2014-01 TPExtreme) reported in The Lancet Oncology, Joël Guigay, MD, and colleagues found that first-line TPEx (docetaxel/platinum/cetuximab) did not improve overall survival vs the standard-of-care EXTREME regimen (fluorouracil [5-FU]/platinum/cetuximab) in patients...

gynecologic cancers

Hormonal IUD May Be a Potential Nonsurgical Treatment for Early Endometrial Cancer or Precancer

An intrauterine device, or IUD, that releases the hormone levonorgestrel appears to be an effective treatment for endometrial precancer and early-stage endometrial cancer, according to new study results presented by Andreas Obermair, MD, at the Society of Gynecologic Oncology (SGO) 2021 Virtual...

gynecologic cancers

Maintenance Olaparib Yields Strong and Sustained Benefit in Ovarian Cancer

In the 5-year follow-up of the pivotal SOLO-1 trial in women with advanced ovarian cancer and a BRCA1/2 mutation, maintenance treatment with olaparib led to a doubling in progression-free survival. William H. Bradley, MD, presented these findings at the Society of Gynecologic Oncology (SGO) 2021...

gynecologic cancers

Phase III ARIEL4 Trial Confirms Benefit of Rucaparib in BRCA-Mutated Relapsed Ovarian Cancer

In patients with BRCA-mutated, advanced, relapsed ovarian cancer, treatment with the PARP (poly [ADP-ribose] polymerase) inhibitor rucaparib led to a significant improvement in progression-free survival compared with standard-of-care chemotherapy. These results from the international phase III...

gynecologic cancers

Frailty May Impact Surgical Outcomes in Patients With Ovarian Cancer

Frailty may be a better predictor of poor surgical outcomes in patients with ovarian cancer than age, according to two studies reported at the Society of Gynecologic Oncology (SGO) 2021 Virtual Annual Meeting on Women’s Cancer. Researchers found that frail patients are less likely to undergo...

gynecologic cancers
covid-19
immunotherapy

Recent Chemotherapy or Immunotherapy for Gynecologic Cancer Does Not Raise Risk of Death Due to COVID-19

Although some studies show that patients with cancer have a greater risk of health complications from COVID-19, a new study has found that recent chemotherapy or immunotherapy for gynecologic cancer does not raise the risk of hospitalization or death due to COVID-19. The study results were...

gynecologic cancers
genomics/genetics

PARP Inhibition Shows Efficacy in Ovarian Cancer Regardless of Number of Prior Lines of Chemotherapy, BRCA Mutation Status

Treatment with olaparib is safe and effective for patients with platinum-sensitive relapsed ovarian cancer, regardless of the number of prior lines of chemotherapy received and BRCA mutation status, according to data presented from the phase II LIGHT study by Karen A. Cadoo, MD, at the Society of...

gynecologic cancers
issues in oncology

Survey Reveals Workplace Bullying, Gender Discrimination, and Microaggressions Not Uncommon for Women Gynecologic Oncologists

In a survey of 250 female gynecologic oncologists, more than half reported experiencing instances of bullying, gender discrimination, or microaggressions. They also reported that having a female department chair provided no buffer against these forms of gender harassment or discrimination in the...

gynecologic cancers
immunotherapy

Pembrolizumab/Lenvatinib May Improve Survival in Advanced Endometrial Cancer

In the first report from the pivotal phase III KEYNOTE-775/Study 309 trial, the combination of lenvatinib and pembrolizumab significantly improved multiple outcomes compared to standard single-agent chemotherapy in patients with advanced, metastatic, or recurrent endometrial cancer that had...

breast cancer

DCIS Biologic Risk Signature May Predict Risk of Recurrence and Radiation Benefit After Breast-Conserving Surgery

Women with ductal carcinoma in situ (DCIS) and elevated decision scores had a significantly higher risk of ipsilateral breast events and a greater relative benefit from radiation therapy compared to women with lower decision scores, according to research presented by Mann et al at the Society of...

sarcoma

Predicting Survival in Patients With Extremity and Trunk Sarcomas in the United States

An examination of the online nomogram Sarculator demonstrated it is as effective at predicting overall survival of certain patients with sarcoma in the United States as it is in Europe, according to research presented by Voss et al at the Society of Surgical Oncology 2021 International Conference...

skin cancer
immunotherapy

Utilization and Survival Benefit of Adjuvant Immunotherapy for Resected High-Risk Stage II Melanoma

An observational study of 10,592 patients from the National Cancer Database with stage IIB/IIC melanoma who had undergone surgical resection demonstrated a significant survival advantage with immunotherapy. The research was presented by Wong et al at the Society of Surgical Oncology 2021...

issues in oncology

Association of Cardiovascular Risk Factors With Risk of Subsequent Cancer

In a study reported in JACC: CardioOncology, Emily S. Lau, MD, and colleagues found that the presence of cardiovascular disease risk factors was significantly associated with an increased risk of future cancer, although no increased risk was observed among individuals who had a history of...

gastroesophageal cancer

Hybrid Minimally Invasive vs Open Esophagectomy for Esophageal Cancer: 5-Year Outcomes

In long-term follow-up of the French phase III MIRO trial reported in JAMA Surgery, Nuytens et al found no significant difference in 5-year overall or disease-free survival with hybrid minimally invasive esophagectomy vs open esophagectomy in patients with esophageal cancer. In the multicenter...

lung cancer
immunotherapy

Immunotherapy Doublet as Maintenance Therapy for Extensive-Disease SCLC

As reported in the Journal of Clinical Oncology by Taofeek K. Owonikoko, MD, PhD, and colleagues, the phase III CheckMate 451 trial showed no improvement in overall survival with combined nivolumab and ipilimumab vs placebo as maintenance therapy for extensive-disease small cell lung cancer. Study ...

colorectal cancer
gastroesophageal cancer

Circulating Hybrid Cells May Help to Monitor Treatment Response in Patients With Rectal and Esophageal Cancers

An analysis of 58 peripheral blood specimens from patients with rectal and esophageal cancers demonstrated that circulating hybrid cells may be a novel, noninvasive biomarker with potential for monitoring treatment response and disease progression to help guide decisions for further therapy,...

lymphoma

Umbralisib for Relapsed or Refractory Indolent Non-Hodgkin Lymphoma

As reported in the Journal of Clinical Oncology by Nathan H. Fowler, MD, and colleagues, the phase IIb UNITY-NHL trial has shown that the dual PI3Kδ/casein kinase (CK) 1ε inhibitor umbralisib produced durable responses in patients with relapsed or refractory indolent non-Hodgkin lymphoma. The study ...

kidney cancer
lung cancer

FDA Pipeline: Priority Review for Kidney Cancer Treatment, Fast Track Designation for NSCLC Treatment

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review to the HIF-2α inhibitor belzutifan for the treatment of patients with von Hippel-Lindau (VHL) disease–associated renal cell carcinoma. The agency also granted Fast Track designation to poziotinib for the treatment of...

colorectal cancer

Using CT Colonography as a Noninvasive Colorectal Cancer Screening Test for Advanced Neoplasia

According to a report published by Pickhardt et al in the American Journal of Roentgenology (AJR), compared with multitarget stool DNA and fecal immunochemical tests, computed tomography (CT) colonography using a polyp size threshold ≥ 10 mm most effectively targeted advanced neoplasia—preserving...

leukemia
myelodysplastic syndromes
genomics/genetics

Whole-Genome Sequencing vs Cytogenetic Analysis in Myeloid Cancers

In a study reported in The New England Journal of Medicine, Duncavage et al found that whole-genome sequencing in patients with acute myeloid leukemia (AML) or myelodysplastic syndromes (MDS) provided rapid genomic profiling that improved diagnostic yield vs conventional cytogenetic analysis, as...

breast cancer
immunotherapy

Pembrolizumab vs Chemotherapy in Previously Treated Patients With Metastatic Triple-Negative Breast Cancer: KEYNOTE-119

As reported in The Lancet Oncology by Eric P. Winer, MD, FASCO, and colleagues, the phase III KEYNOTE-119 trial showed no significant improvement in overall survival with pembrolizumab vs investigator’s choice of chemotherapy in the second- or third-line treatment of metastatic triple-negative...

immunotherapy
genomics/genetics

High Tumor Mutational Burden Predicts Immunotherapy Response in Some—but Not All—Cancers

High tumor mutational burden (TMB) was useful for predicting clinical responses to immune checkpoint inhibitors only in a subset of cancer types, according to a study published by McGrail et al in Annals of Oncology. The findings suggest that TMB status may not be reliably used as a universal...

leukemia

Study Identifies Factors That May Lower the Risk of CNS Relapse in Pediatric Patients With ALL

Starting chemotherapy several days before the first lumbar puncture for diagnosis and treatment of acute lymphoblastic leukemia (ALL) may reduce the risk of central nervous system (CNS) relapse in children, according to a study published by Tang et al in the journal Blood. The research focused on...

gynecologic cancers

Secondary Cytoreduction Plus Chemotherapy vs Chemotherapy Alone in Relapsed Platinum-Sensitive Epithelial Ovarian Cancer

In a Chinese phase III trial (SOC-1) reported in The Lancet Oncology, Shi et al found that secondary cytoreduction followed by chemotherapy significantly prolonged progression-free survival vs chemotherapy alone in patients with platinum-sensitive relapsed epithelial ovarian cancer. No significant...

breast cancer
immunotherapy

Novel HER2-Targeted Therapies Pose Sequencing Challenges

With three new HER2-targeted therapies approved in the past 15 months alone, the treatment landscape for patients with metastatic breast cancer has become increasingly crowded. In the third-line setting and beyond, there are now at least eight HER2-targeted agents approved by the U.S. Food and Drug ...

kidney cancer
immunotherapy

CheckMate 9ER: First-Line Nivolumab Plus Cabozantinib vs Sunitinib for Advanced Renal Cell Carcinoma

As reported in The New England Journal of Medicine by Toni K. Choueiri, MD, and colleagues, the phase III CheckMate 9ER trial has shown that the combination of nivolumab and cabozantinib improved progression-free survival and overall survival vs sunitinib in first-line treatment of patients with...

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