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Has the Promise of Precision Medicine Been Oversold?

Recently, the term “personalized medicine” in oncology care has been overtaken by the more contemporary concept of “precision medicine.” According to the National Research Council of the National Academies of Science, Engineering, and Medicine, the newer terminology shifts the focus to improving...

genomics/genetics

Everolimus Tablets for Oral Suspension for Tuberous Sclerosis Complex–Associated Partial-Onset Seizures

On April 10, 2018, the U.S. Food and Drug Administration approved everolimus tablets for oral suspension (Afinitor Disperz) for the adjunctive treatment of adult and pediatric patients aged ≥ 2 years with tuberous sclerosis complex–associated partial-onset seizures.1,2 Tuberous sclerosis complex is ...

Overcoming Long-Term Health and Economic Impact of Cancer on Young Adult Survivors

A pair of studies showcased the potentially devastating long-term health and financial consequences cancer has on adult survivors of childhood cancer compared with other adults, as well as survival disparities based on health insurance status.1,2 Despite increasing survival rates among the more...

lung cancer
immunotherapy

Tony Mok, MD, on NSCLC: Targeted Treatment Update

Tony Mok, MD, of the Chinese University of Hong Kong, discusses two important studies in non–small cell lung cancer: FLAURA, which looked at the first-line activity of osimertinib and the mechanisms of resistance; and ALESIA, which examined crizotinib dosing.  

gynecologic cancers

ESMO 2018: SOLO-1: Olaparib Maintenance Extends Progression-Free Survival in BRCA1/2-Mutated Advanced Ovarian Cancer

Two-year maintenance therapy with olaparib (Lynparza), a poly ADP-ribose polymerase (PARP) inhibitor, led to a substantial improvement in progression-free survival (PFS) in newly diagnosed patients with advanced ovarian cancer and a BRCA1/2 mutation, results from the phase III SOLO-1 trial...

issues in oncology

Largest ASCO RCF Annual Meeting to Date Facilitated Meaningful Discussion on Conducting Clinical Trials

The ASCO Research Community Forum (RCF) 2018 Annual Meeting brought together 165 physician investigators and research staff from 34 states across the country—its largest meeting to date—to discuss contemporary challenges and develop creative solutions in conducting and managing clinical trials. The ...

solid tumors
head and neck cancer

The Sontag Foundation: Turning a Difficult Diagnosis Into Action to Benefit Patients With Brain Cancer

When Frederick B. Sontag’s wife, Susan, was diagnosed in 1994 with grade III astrocytoma, the couple was understandably overwhelmed to hear that her expected survival was 3 years. At that time, there were few organizations providing resources to patients with brain tumors and their families. While...

solid tumors
hepatobiliary cancer

Cabozantinib in Advanced Hepatocellular Cancer: Call for Revision of Practice Standards

As reported in The New England Journal of Medicine by Ghassan K. Abou-Alfa, MD, and colleagues, and reviewed in this issue of The ASCO Post, the phase III CELESTIAL trial has demonstrated that cabozantinib (Cabometyx) improved the median overall survival to 10.2 months in comparison to 8 months...

hepatobiliary cancer

Cabozantinib Improves Survival in Patients With Previously Treated Hepatocellular Carcinoma

As reported in The New England Journal of Medicine by Ghassan K. Abou‑Alfa, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the second interim analysis of the phase III CELESTIAL trial has shown a significant improvement in overall and progression-free survival with cabozantinib...

hematologic malignancies
lymphoma

Novel Treatment Approaches in Early Relapse of Follicular Lymphoma

“Patients with follicular lymphoma who relapse early after treatment are a minority of patients, fortunately, but they are clearly patients with a different disease,” according to Jonathon B. Cohen, MD, of Emory University School of Medicine. At Emory’s 2018 Debates and Didactics in Hematology and...

breast cancer

ESMO 2018: PALOMA-3: Palbociclib in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

Treatment with the cyclin-dependent kinase (CDK) 4/6 inhibitor palbociclib (Ibrance) achieved a clinically meaningful improvement in overall survival in patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer that has relapsed or ...

breast cancer

ESMO 2018: HDAC Inhibitor Therapy in Advanced Hormone Receptor–Positive Breast Cancer

A phase III trial presented by Jiang et al at the European Society for Medical Oncology (ESMO) 2018 Congress showed activity of histone deacetylase (HDAC) inhibitor therapy in advanced hormone receptor–positive breast cancer (Abstract 283O_PR). Endocrine therapies are the foundation of...

lung cancer
immunotherapy

Regardless of Taxane Used, Pembrolizumab Plus Chemotherapy Improves Survival in Squamous NSCLC

The addition of pembrolizumab (Keytruda) to a standard platinum doublet as first-line therapy improved overall and progression-free survival in patients with metastatic squamous non–small cell lung cancer (NSCLC), in the primary analysis of KEYNOTE-407.1,2 Furthermore, it did not seem to matter...

Expert Point of View: Chengxiang Ren, MD, PhD

Formal discussant, Shengxiang Ren, MD, PhD, of Shanghai Pulmonary Hospital, Tongji University, Shanghai, China, commented on the entrectinib study as well as two potent ROS1 inhibitors in development. “Both entrectinib and lorlatinib could be first-line agents for patients with brain metastases.”...

Expert Point of View: John K. Field, PhD, FRCP

“This wonderful result joins other landmark studies. The differential effect by gender is extremely important,” said formal discussant of the trial, John K. Field, PhD, FRCP, of the University of Liverpool, UK. “This study validates the management protocol and analysis of nodule volume and growth...

lung cancer

NELSON Trial: ‘Call to Action’ for Lung Cancer CT Screening of High-Risk Individuals

Results of the very large, randomized, population-based NELSON trial confirm the value of low-dose computed tomography (CT) screening in people at high risk for developing lung cancer. The protective value of screening was more pronounced in women than in men. These study findings were presented at ...

immunotherapy
lung cancer

Durvalumab Improves Overall Survival in Unresectable Stage III NSCLC

Several lung cancer trials have shown prolonged progression-free survival with checkpoint inhibitor therapy. For the first time, the phase III PACIFIC trial has found an overall survival benefit for the selective programmed cell death ligand 1 (PD-L1) checkpoint inhibitor durvalumab (Imfinzi) vs...

issues in oncology
global cancer care

Cancer Care in the Palestinian Territories

The global burden of cancer is huge and growing. In 2018, there will be > 18 million new cancer cases and 9.6 million deaths.1,2 Although several recent articles have reviewed cancer in developing countries, few have focused on the Palestinian territories. There are several reasons for that,...

How the Nobel Prize Could Spur More Cancer Advances

Even before James P. Allison, PhD, made an appearance at the Fourth International Cancer Immunotherapy Conference: Translating Science Into Survival in New York City, the excitement among attendees was palpable. Earlier that day, October 1, 2018, Dr. Allison and Tasuku Honjo, MD, PhD, of Kyoto...

lung cancer

Atezolizumab Plus Standard Chemotherapy Improves Progression-Free Survival in Stage IV NSCLC

The combination of atezolizumab (Tecentriq), a programmed cell death ligand 1 (PD-L1) inhibitor, plus carboplatin or cisplatin and pemetrexed (Alimta) as first-line therapy followed by pemetrexed plus atezolizumab maintenance therapy improved progression-free survival in patients with stage IV...

issues in oncology
gastroesophageal cancer
symptom management

ESMO 2018: Pooled Analysis of Influence of Sex on Chemotherapy Efficacy and Toxicity in Esophagogastric Cancer

In an analysis presented by Davidson et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract 619PD_PR), data were pooled from four UK randomized controlled clinical trials of first-line chemotherapy in esophagogastric cancer, finding significant differences in a...

hematologic malignancies
immunotherapy

Adoptive T-Cell Therapy for Progressive Multifocal Leukoencephalopathy

An emerging treatment known as adoptive T-cell therapy has proven effective in a phase II clinical trial for treating progressive multifocal leukoencephalopathy (PML), a rare and often fatal brain infection sometimes observed in patients with cancer and other diseases in which the immune...

hepatobiliary cancer

Regular Aspirin Use and Reduction in Risk for Hepatocellular Carcinoma

A pooled analysis of two large U.S. prospective cohort studies reported in JAMA Oncology by Simon et al indicates that regular use of aspirin is associated with a significant reduction in risk for hepatocellular carcinoma (HCC), with an apparent dose- and duration-dependent effect. Study Details...

lymphoma

Chemotherapy-Free Initial Treatment of Advanced Indolent Lymphoma

In an analysis of two Nordic Lymphoma Group trials with long-term follow up reported in the Journal of Clinical Oncology, Lockmer and colleagues found evidence that many patients receiving rituximab (Rituxan) as initial treatment for advanced indolent lymphoma may not require the addition of...

skin cancer
immunotherapy

Small Study of Neoadjuvant Combination Checkpoint Blockade in High-Risk Stage III Melanoma

Neoadjuvant combination checkpoint blockade showed activity among patients with high-risk stage III melanoma in a small study. However, a high incidence of side effects caused the trial to be closed early. These results were published by Amaria et al in Nature Medicine. The phase II...

breast cancer

Study Finds Deep Learning Can Distinguish Recalled-Benign Mammogram Images From Malignant and Negative Cases

Although digital mammography is effective in detecting early-stage breast cancer and in reducing mortality, high recall rates after a screening mammogram often result in unnecessary medical procedures, including breast biopsies, medical costs, and psychological stress for patients.   A...

leukemia
lymphoma

Duvelisib vs Ofatumumab in Relapsed or Refractory CLL/SLL

As reported in the journal Blood by Flinn et al, the phase III DUO trial has shown significantly prolonged progression-free survival with the phosphoinositide 3-kinase (PI3K)-δ,-γ inhibitor duvelisib (Copiktra) vs ofatumumab (Arzerra) in patients with relapsed or refractory chronic...

breast cancer
issues in oncology

Adherence to Endocrine Therapy for Breast Cancer in Black Women and White Women

In a study reported in the Journal of the National Cancer Institute, Wheeler et al found that black women reported nonadherence to endocrine therapy for breast cancer more often than white women, although no significant difference in discontinuation of treatment was observed. The study...

breast cancer
issues in oncology
survivorship

Cognitive Outcomes Among Older Survivors of Breast Cancer

In a study (Thinking and Living with Cancer) reported in the Journal of Clinical Oncology, Mandelblatt et al found that poorer cognitive function in older survivors of breast cancer was associated with chemotherapy, hormone therapy, and ApoE genotype. The ApoE ε4 allele has been associated...

Proton Therapy Leader, James D. Cox, MD, Dies at 80

THE ACCLAIMED radiation oncologist James D. Cox, MD, led MD Anderson’s Proton Therapy Center, an international center of excellence for proton therapy, research, and education, distinguished as the world’s first proton therapy facility located within a comprehensive cancer center. At the 2017...

Johns Hopkins Radiation Oncology Pioneer, Moody Wharam, Jr, MD, Dies at 77

MOODY WHARAM, JR, MD, Professor Emeritus of Radiation Oncology and Molecular Radiation Sciences and former Willard and Lillian Hackerman Professor of Radiation Oncology at the Johns Hopkins Kimmel Cancer Center, died on August 10 at the age of 77. Dr. Wharam specialized in the treatment of...

gynecologic cancers

Niraparib Maintenance Therapy in Recurrent Ovarian Cancer

In a study reported in The Lancet Oncology, Amit M. Oza, MD, of the Princess Margaret Cancer Centre, University Health Network, Toronto, and colleagues found that quality of life based on patient-reported outcomes was not worsened with niraparib (Zejula) maintenance vs placebo in the phase III...

breast cancer

Living a Purposeful Life Is My Revenge on Cancer

There is a lot of breast cancer in my family history. My mother was diagnosed with the disease at 44, and my paternal grandmother died of breast cancer when she was just 33, so I’ve always been diligent about performing breast self-exams— often weekly—to ensure that if I did get breast cancer, it...

survivorship

Getting Their Lives Back: Helping Survivors of Cancer to Move Forward

Thirteen years ago, Stephanie Koraleski, PhD, an oncology psychologist, and Kay Ryan, PhD, RN, a cardiac nurse and breast cancer survivor, in Omaha, brought together colleagues in the fields of clinical research, nursing, nutrition, mental health, physical therapy, pharmacy, and spirituality to...

breast cancer

An Early Love of Literature Gives Way to a Career in Breast Cancer Research for Jennifer K. Litton, MD

Breast cancer specialist Jennifer K. Litton, MD, was born and reared in Leominster, Massachusetts, a small city in the north central part of the state. “I went to parochial schools until seventh grade and then went on to high school in Worcester. Although I enjoyed science early on, I was...

solid tumors
issues in oncology

New Techniques in Intraoperative-Guided Imagery May Enhance Outcomes in Patients With Cancer

Primary treatment of most solid tumors includes surgical excision or radiation therapy, both of which require precise anatomic localization of the tumor as well as surrounding tissue and organs. If the targeting is too broad, unnecessary morbidity may occur to nearby structures, along with the...

hematologic malignancies
leukemia
lymphoma

FDA Approves Duvelisib for Adult Patients With Relapsed or Refractory Hematologic Malignancies

ON SEPTEMBER 24, 2018, the U.S. Food and Drug Administration (FDA) granted regular approval to duvelisib (Copiktra) for adults with relapsed or refractory chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL) after at least two prior therapies. Duvelisib also received accelerated...

ESMO Recognizes Tony S. Mok, MD, FRCPC, FASCO, With Lifetime Achievement Award

THE EUROPEAN SOCIETY for Medical Oncology (ESMO) has recognized Tony S. Mok, MD, FRCPC, FASCO, with the ESMO Lifetime Achievement Award for his contributions in lung cancer. Dr. Mok, who is a Li Shu Fan Medical Foundation Endowed Professor and Chairman of the Department of Clinical Oncology at the ...

immunotherapy

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

In a single-center phase II study reported in JAMA Oncology, Massarelli et al 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 HPV-specific T cells....

colorectal cancer
issues in oncology

Sex-Linked Differences in Cancer May Identify Specific Genetic Drivers, Predict Responses to Treatment

Analysis of male- and female-derived tumor samples revealed differences in prognostic biomarkers, genes that drive cancer, and in regulation of key pathways that may predict responses to treatment, according to results published in two studies in Cancer Research, one by Li et al and the other...

head and neck cancer
immunotherapy

DNA Vaccine Leads to Immune Responses in HPV-Related Head and Neck Cancer in Small Study

A therapeutic vaccine may boost antibodies and T cells, helping them infiltrate human papillomavirus (HPV)-related head and neck cancer tumors. Researchers from the Abramson Cancer Center of the University of Pennsylvania tested the immunotherapy approach in two groups of patients with...

breast cancer
immunotherapy

Long-Term Outcomes With Anti–PD-L1 Treatment in Metastatic Triple-Negative Breast Cancer

In a long-term follow-up of a phase I trial reported in JAMA Oncology, Emens et al found that single-agent atezolizumab (Tecentriq) produced enduring benefit in patients with metastatic triple-negative breast cancer after stable or responding disease and in first-line treatment. Study Details In...

lung cancer
immunotherapy

No Survival Benefit With Avelumab vs Docetaxel in Platinum-Treated, Advanced, PD-L1–Positive NSCLC

As reported in The Lancet Oncology by Barlesi et al, the phase III JAVELIN Lung 200 trial has shown no overall survival benefit with avelumab (Bavencio) vs docetaxel in patients with platinum pretreated programmed cell death ligand 1 (PD-L1)–positive advanced non–small cell lung cancer...

hematologic malignancies
multiple myeloma

Emerging Options and Sequencing Therapy in Relapsed Multiple Myeloma

Advances in the treatment of multiple myeloma have led to longer progression-free survival, but the majority of patients will still relapse despite newer treatments. A number of new drugs and combinations are under study in the hope of improving outcomes. “Multiple myeloma is a complex disease...

gynecologic cancers
immunotherapy

Addition of a CTLA-4–Targeted Therapy to a Checkpoint Inhibitor in Ovarian Cancer

An analysis of the NRG Oncology clinical trial NRG-GY003 suggests that adding ipilimumab (Yervoy), a monoclonal antibody that targets the protein receptor cytotoxic T-lymphocyte–associated protein 4 (CTLA-4), to a regimen with the checkpoint inhibitor nivolumab (Opdivo) could improve response ...

breast cancer

More to Learn About Using PARP Inhibitors for Advanced Breast Cancer With Germline BRCA Mutation

Germline mutations in the breast cancer–susceptibility genes 1 and 2 (BRCA1/2) increase the risk for cancer due to an inability to repair DNA double-strand breaks, and about 5% of patients with unselected breast cancer carry a germline BRCA mutation.1 These DNA repair–deficient tumors are...

lymphoma
issues in oncology

Ovarian Function After Response-Adapted Treatment in Younger Women With Advanced Hodgkin Lymphoma

In a secondary analysis of the UK phase III RATHL trial reported in The Lancet Oncology, Anderson et al found that ovarian function recovery was affected by age and type of response-adapted therapy in women receiving treatment for advanced Hodgkin lymphoma. The analysis included 67 eligible...

breast cancer

Talazoparib Improves Progression-Free Survival in Advanced Breast Cancer With Germline BRCA Mutation

As reported in The New England Journal of Medicine by Jennifer K. Litton, MD, of The University of Texas MD Anderson Cancer Center, and colleagues, the phase III EMBRACA trial has shown significantly improved progression-free survival with the poly (ADP-ribose) polymerase (PARP) inhibitor...

hematologic malignancies
lymphoma

Targeting CCR4 in Cutaneous T-Cell Lymphoma: The MAVORIC Trial

The C-C chemokine receptor 4 (CCR4) is predominantly expressed in type 2 helper T (Th2) cells and regulatory T (Treg) cells.1 Under physiologic conditions and in response to its ligands, CCL17 (TARC) and CCL22 (MDC), CCR4 promotes T-cell migration to the skin.2 Of note, CCR4 is highly expressed in...

hematologic malignancies
lymphoma

Mogamulizumab Improves Progression-Free Survival vs Vorinostat in Cutaneous T-Cell Lymphoma

As reported by Youn H. Kim, MD, of Stanford Cancer Institute, Stanford University School of Medicine, and colleagues in The Lancet Oncology, the phase III MAVORIC trial showed that the anti-C-C chemokine receptor 4 (CCR4) monoclonal antibody mogamulizumab (Poteligeo) significantly improved...

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