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lung cancer

Pembrolizumab Safe and Effective in Patients With NSCLC, Especially in Those With Tumors Showing High Levels of PD-L1 Expression

Add lung cancer to the growing list of cancers that may derive benefit from immunotherapy. The KEYNOTE-001 trial found that pembrolizumab (Keytruda) achieved durable responses in a proportion of patients with non–small cell lung cancer (NSCLC) and high levels of expression of the protein PD-L1...

skin cancer
breast cancer
multiple myeloma
leukemia
colorectal cancer
prostate cancer
pancreatic cancer

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2015 Updates

For 2 decades, the NCCN Guidelines® have been recognized as the standard of cancer care in the United States, combining evidence, experience, and choice, so that multidisciplinary cancer treatment teams—including patients—are empowered to make informed decisions about cancer care,” said Robert W....

issues in oncology

Illumination and Innovation: Transforming Data Into Learning

The ASCO Annual Meeting is our Society’s premier event and without a doubt one that is highly anticipated by the oncology world. The success of the meeting stems from the desire to share with each other our data and the knowledge we have gleaned from those data over the course of the past year. The ...

Global Leader in Drug Development John L. Marshall, MD, Calls for a Smarter War on Cancer

John L. Marshall, MD, a global leader in the research and treatment of gastrointestinal cancers, grew up in Lexington, Kentucky, in a family that put high value on education. As a young boy, science was already on his mind; he enjoyed the explorative nature that chemistry and biology offered....

leukemia

First-Line Imatinib With Early Switch to Nilotinib May Be Preferable to First-Line Use of More Potent Agents in CML

Using imatinib to treat chronic-phase chronic myeloid leukemia (CP-CML) first line, with selective switching to nilotinib (Tasigna) “leads to excellent molecular response and survival” and “may be preferable to universal first-line use of more potent agents, considering efficacy, toxicity, and...

colorectal cancer

Another Angiogenesis Inhibitor Shows Benefit in Metastatic Colorectal Cancer, but Where Do We Go Next?

The phase III RAISE trial—reported by Tabernero and colleagues in The Lancet Oncology1 and reviewed in this issue of The ASCO Post—demonstrated that ramucirumab ­(Cyramza), a fully human IgG1 monoclonal antibody to the vascular endothelial growth factor receptor 2 (VEGFR2) extracellular domain, in...

skin cancer

The Promise of Immune Checkpoint Inhibition: Changing the Therapeutic Landscape for Melanoma and Other Malignancies

The past 3 years have witnessed transformative changes in the way that solid tumors and hematologic malignancies are approached, in almost every instance now including consideration of some form of immunomodulation in the first- or later-line therapeutic setting. The greatest success has occurred...

issues in oncology

New ASCO Journal to Focus on Cancer in Resource-Constrained Countries

Internationally renowned oncologist David Kerr, MD, DSc, will serve as founding Editor-in-Chief of the new ASCO publication, Journal of Global Oncology (JGO). JGO will be the first journal focused exclusively on cancer research, treatment, and care delivery in middle- and low-resource countries...

lung cancer

Outcomes of the CUSTOM ‘Basket’ Trial of Molecular Profiling and Targeted Therapy in Advanced Thoracic Malignancies

In the phase II CUSTOM trial reported in the Journal of Clinical Oncology, Ariel Lopez-Chavez, MD, Anish Thomas, MD, and colleagues performed molecular profiling of tumors in patients with advanced non–small cell lung cancer (NSCLC), small cell lung cancer (SCLC), or thymic malignancies and...

gynecologic cancers

What Is the Future of Intraperitoneal Treatment in Advanced Ovarian Cancer?

An analysis of Gynecologic Oncology Group (GOG) studies recently reported in the Journal of Clinical Oncology by Tewari and colleagues and reviewed in this issue of The ASCO Post showed a survival benefit of intraperitoneal chemotherapy vs intravenous chemotherapy over long-term follow-up in women...

prostate cancer

Studies Evaluate Effectiveness of Active Surveillance in Prostate Cancer Patients

Active surveillance has become a viable option for many men with low-risk prostate cancer who choose not to undergo active treatment such as surgery or radiotherapy. Four studies evaluating the effectiveness, trends, and other considerations for active surveillance in managing prostate cancer were...

prostate cancer

New Studies Call for Smarter Approach to Prostate Cancer Screening

Prostate cancer is one of the most common cancers in American men, yet controversy over the utilization and frequency of prostate-specific antigen (PSA) screening methods remains, due to the overdiagnosis and overtreatment of men with low-grade, less-aggressive forms of the disease. At the 110th...

kidney cancer

Intensified Therapy Improves Survival in Wilms Tumor Patients With Rare Genetic Abnormality

Data from two phase III studies led by the Children’s Oncology Group show that augmenting or intensifying therapy for children with high-risk Wilms tumor improved relapse-free survival. These children are deemed to be at high risk due to a specific chromosomal abnormality that confers worse...

head and neck cancer

Clinically Meaningful Preliminary Results With Pembrolizumab in Recurrent Head and Neck Cancer

Pembrolizumab (Keytruda) is making inroads into head and neck cancer, with encouraging results in heavily pre-treated patients with recurrent or metastatic squamous cell carcinoma of the head and neck, according to a report on the expansion-cohort ­KEYNOTE-012 study presented at the 2015 ASCO...

lung cancer

Second-Line Nivolumab Therapy Improves Survival in Patients With Nonsquamous Non–Small Cell Lung Cancer

Anti–programmed cell death protein 1 (PD-1) immunotherapy with nivolumab (Opdivo) extended survival in patients with the most common form of lung cancer—nonsquamous non–small cell lung cancer (NSCLC). Patients whose disease progressed on standard platinum doublet therapy who were treated with...

issues in oncology

Redefining Cancer

The ability to interrogate cancer cells at the genomic, proteomic, immunologic, and metabolomic levels will transform oncology care from one that relies mainly on trial-and-error treatment strategies based on the anatomy of the tumor to one that is more precisely based on the tumor’s molecular...

leukemia

Ibrutinib Plus Bendamustine/Rituximab Called a New Standard in Patients With Previously Treated CLL

The addition of ibrutinib (Imbruvica) to standard therapy with bendamustine (Treanda)/rituximab (Rituxan) significantly reduced the risk of disease progression or death and overall response rates compared with bendamustine/rituximab alone in previously treated chronic lymphocytic leukemia...

supportive care

Two Factors Predict for Recurrent Venous Thromboembolism in Patients With Cancer

Patients with cancer who develop venous thromboembolism are at high risk of such obstructive disease recurring despite adequate anticoagulation. A prespecified analysis of the CATCH trial identified two major predictors of recurrence: venous compression by the tumor and a diagnosis of hepatobiliary ...

Expert Point of View: Lynn Schuchter, MD, and Vernon Sondak, MD

Lynn Schuchter, MD, of the University of Pennsylvania, Philadelphia, a designated ASCO expert, commented at the press briefing that the results might apply to a select group of patients concerned about lymphedema but not yet to the broader population. “I would say that this is a really important...

Expert Point of View: Hisham Mehanna, PhD

Formal discussant Hisham Mehanna, PhD, Chief of Head and Neck Surgery and Director of Head and Neck Studies and Education at the University of Birmingham, United Kingdom, congratulated Dr. D’Cruz on conducting an ambitious and difficult trial. “Like all studies, it has flaws, but the study has...

issues in oncology

Agreement on High-Value Screening for Five Common Cancers

Finding agreement on high-value cancer screening among organizations publishing screening guidelines, the American College of Physicians (ACP) issued advice listing the least-intensive screening strategies that all the organizations recommend—as well as strategies not recommended—for five common...

issues in oncology
health-care policy

Translating Study Recommendations Into Medicare Coverage

Lung cancer doggedly remains the leading cause of cancer-related death in the United States. This grim mortality figure is due, in part, to a lack of early detection methods; more than half of all lung cancers have metastasized at the time of diagnosis. For decades, lung cancer advocates lobbied...

lung cancer

Pembrolizumab in Advanced NSCLC: The Promise of Immune Checkpoint Inhibitors

Drugs targeting the immune-checkpoint pathways have shown promising activity in non–small cell lung cancer (NSCLC). In a recent article in The New England Journal of Medicine, Garon and colleagues reported the results of the KEYNOTE-001 clinical trial evaluating single-agent pembrolizumab...

kidney cancer

16-Gene Assay Recurrence Score Predicts Recurrence After Surgery for Localized Renal Cell Carcinoma

In a study reported in The Lancet Oncology, Brian Rini, MD, of the Cleveland Clinic Taussig Cancer Institute, and colleagues developed a 16-gene assay and recurrence score that predicted postoperative outcome in patients with stage I to III clear cell renal cell carcinoma.1 Development Phase In the ...

breast cancer
issues in oncology

Assessing and Improving Imaging Interpretation in Breast Cancer Screening

The quality of mammography images has markedly improved over the past few decades. However, the quality of the interpretation of mammograms remains variable. That said, more than 38 million mammograms are performed annually in the United States. So said Diana Buist, PhD, Senior Scientific...

Expert Point of View: Lloyd Damon, MD

Lloyd Damon, MD, Professor of Medicine at the University of California, San Francisco, discussed the study and noted that although ruxolitinib (Jakafi) is associated with a fair amount of anemia and thrombocytopenia, pacritinib did not increase these conditions in PERSIST-1. In fact, treatment was...

hematologic malignancies

Pacritinib for Myelofibrosis: Effective in Patients With Thrombocytopenia

An emerging JAK inhibitor, pacritinib, appears not only effective in a broad population of patients with myelofibrosis but also among a subset with very low platelet counts, investigators from the global phase III PERSIST-1 trial reported at the 2015 ASCO Annual Meeting.1 “There is a huge unmet...

Expert Point of View: Anees B. ­Chagpar, MD

“This is an important study. We’ve known for some time that the aromatase inhibitors tend to be better than tamoxifen for postmenopausal women with hormonally sensitive invasive breast cancer. The NSABP B-35 trial asked the same question in ductal carcinoma in situ. These data, which now follow...

Expert Point of View: Shanu Modi, MD

Study discussant Shanu Modi, MD, of Memorial Sloan Kettering Cancer Center, New York, commented, “Neither T-DM1 [Kadcyla] nor T-DM1 plus pertuzumab [Perjeta] proved to be superior to the old standard of care, taxane plus trastuzumab [Herceptin]. MARIANNE was a valiant trial, but THP (taxane,...

thyroid cancer

Thyroid Cancer Rarely Diagnosed in Those With Asymptomatic, Benign Nodules

A prospective, multicenter, observational study involving 992 consecutive patients with one to four asymptomatic, sonographically or cytologically benign thyroid nodules found that “the majority of nodules exhibited no significant size change during 5 years of follow-up or actually decreased in...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia

Question 1: In this case, what is the most appropriate next best test? Correct Answer: B. Peripheral blood smear examination. Expert Perspective In the appropriate clinical setting, information obtained from a carefully examined peripheral blood smear film is indispensable. The peripheral blood...

hematologic malignancies

Microangiopathic Hemolytic Anemia and Thrombocytopenia

The ASCO Post is pleased to present Hematology Expert Review, an occasional feature that includes a case report detailing a particular hematologic condition followed by questions. Answers to each question with expert commentary can be found in the sidebar. In this installment, we present the case...

Laura van’t Veer, PhD, Receives European Inventor Award 2015

Laura van’t Veer, PhD, Co-leader of the University of California San Francisco Helen Diller Family Comprehensive Cancer Center (HDFCCC) Breast Oncology Program, and her team at the Netherlands Cancer Institute were awarded the European Inventor Award for the invention of a gene-based tissue test,...

ASCO, Conquer Cancer Foundation Congratulate 2015 Grant and Award Recipients

The Conquer Cancer Foundation of ASCO presented more than $6.7 million in grants and awards to more than 200 promising oncology researchers at the 2015 ASCO Annual Meeting. The Conquer Cancer Foundation and ASCO congratulate the recipients on their contributions to the field of oncology and offer...

Expert Point of View: Daniel G. Coit, MD

Daniel G. Coit, MD, of Memorial Sloan Kettering Cancer Center, New York, and Chair of the National Comprehensive Cancer Network (NCCN) Melanoma Guidelines Panel, discussed the findings reported by Lewin et al at the ASCO Annual Meeting. “This is a small retrospective study examining a prospective...

leukemia
myelodysplastic syndromes

Advancing Classification and Risk Stratification for Leukemia and Myelodysplastic Syndromes

Refinements in the classification and risk stratification for leukemia and myelodysplastic syndromes were reported by three different investigators at the 2015 ASCO Annual Meeting. The first study showed that leukemia stem cell phenotypes are associated with outcomes in acute myeloid leukemia...

cns cancers

New Concept for Brain Tumors: Tumor Treating Fields

A novel treatment modality that applies electric forces to brain tumors via scalp electrodes improved outcomes in a study reported at the 2015 ASCO Annual Meeting.1 In the first report of the full dataset, tumor treating fields significantly and consistently prolonged both progression-free...

Expert Point of View: Keith T. Flaherty, MD

Keith T. Flaherty, MD, Associate Professor of Medicine, Harvard Medical School, and Director of the Termeer Center for Targeted Therapy, Boston, was interviewed by The ASCO Post for his thoughts on the findings from Atreya and colleagues. He believes the study’s outcomes are sufficient for...

Expert Point of View: Kenneth Yu, MD, MSc

Kenneth Yu, MD, MSc, of Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, called investigational ­PEGPH20 “a very promising tumor microenvironment-targeted approach” that appears to be well tolerated. “The results are preliminary but there appears to be a biomarker ...

pancreatic cancer

Novel Enzyme Improves Outcomes in Subset of Patients With Pancreatic Cancer

Patients with stage IV pancreatic cancer who received a novel enzyme along with standard chemotherapy experienced a doubling in progression-free survival, compared to those given chemotherapy alone, in a study presented at the 2015 ASCO Annual Meeting.1 Response rates and median duration of...

Expert Point of View: Noah Hahn, MD

Commenting on the pembrolizumab (Keytruda) phase Ib study, Noah Hahn, MD, of Johns Hopkins Sidney Kimmel Cancer Center, Baltimore, called the overall response rate of 28% with pembrolizumab “pretty impressive. Nearly two-thirds of patients had some response or tumor reduction, and overall survival...

bladder cancer

Immunotherapy Marches On, Making Headway in Advanced Urothelial Bladder Cancer

Two immunotherapy agents show promise in preliminary studies of advanced urothelial bladder cancer: the anti–PD-1 (programmed cell death protein 1) antibody pembrolizumab (Keytruda) and the anti–PD-L1 (programmed cell death ligand 1) antibody atezolizumab. Separate phase I studies of each drug...

hepatobiliary cancer

More Than One-Third of Those Diagnosed With Hepatocellular Carcinoma as Outpatients Have Diagnostic Delays of 3 or More Months

Nearly 20% of patients with hepatocellular carcinoma “wait more than 3 months from presentation to diagnosis, which can contribute to interval tumor growth,” Nishant Patel, MD, and colleagues concluded in the Journal of the National Comprehensive Cancer Network. They based their conclusions on a...

issues in oncology

American College of Physicians Releases High Value Care Screening Advice for Five Common Cancers

In a paper published in Annals of Internal Medicine1, the American College of Physicians (ACP) issued advice for screening average risk adults without symptoms for five common cancers: breast, colorectal, ovarian, prostate, and cervical. In a companion piece also published in Annals2, ACP outlined...

Blame

The following essay by Karen J. Krag, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Stan Winokur, MD, and Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. It is easier ...

issues in oncology
palliative care

Using Gene Analytics to Identify Patients at Risk for Treatment Toxicity

Genomic applications are now an accepted part of oncologic science and practice. Differences in gene expression have been used to understand and predict tumor behaviors and response to treatment. And now it seems likely that genomics may also play a pivotal role in guiding treatment preferences by...

prostate cancer

Magnetic Resonance Imaging/Ultrasound Fusion: A Promising Technology for Image-Guided Prostate Biopsy

An elegant study by Siddiqui et al1—reviewed in this issue of The ASCO Post—offers compelling evidence for the diagnostic utility of “targeted” prostate biopsy using multiparametric magnetic resonance imaging (MRI) data fused with ultrasound images. The technique involves first performing a...

prostate cancer

Magnetic Resonance Imaging/Ultrasound Fusion–Guided Biopsy Improves Detection of High-Risk Prostate Cancer

In a study reported in JAMA, M. Minhaj Siddiqui, MD, currently of the University of Maryland School of Medicine, and colleagues found that targeted magnetic resonance imaging (MRI)/ultrasound fusion–guided prostate biopsy increased diagnosis of high-risk prostate cancer and reduced detection of...

cost of care

The Value Proposition in Oncology: ASCO Session Weighs Points of View

The value proposition in health care is often represented with the following equation: Value = Outcomes/Cost. The simplicity of this equation, however, belies the complexity of its parts, which are the contributions of multiple stakeholders with unique perspectives. A session presented at the 2015...

cns cancers

Glioblastoma: Novel Immunotherapy Approaches Generate Responses and Excitement

Checkpoint inhibitors were major attention grabbers at the 2015 ASCO Annual Meeting, but studies suggested there are other encouraging means of harnessing the immune system in the treatment of glioblastoma. EGFRvIII-Targeted Vaccine David A. Reardon, MD, Clinical Director of the Center for...

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