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issues in oncology

For Your Patients: An Expert Q&A on Cancer Disparities and Health Equity

Cancer does not affect all people equally. The phrase “cancer disparities” refers to the differences in the number of new cancer cases as well as differences in cancer outcomes that exist among different populations. Disparities more often negatively affect racial and ethnic minorities, poor...

leukemia
lymphoma

Final ASCEND Results Confirm Acalabrutinib as a Standard for Relapsed CLL

The Bruton’s tyrosine kinase (BTK) inhibitors have been one of the most exciting advances in the tre atment of chronic lymphocytic leukemia (CLL) and have led to the development of chemotherapy-free treatments for both treatment-naive as well as relapsed or refractory CLL based on studies where...

leukemia
lymphoma

Acalabrutinib Improves Progression-Free Survival vs Idelalisib Plus Rituximab or Bendamustine Plus Rituximab in Relapsed or Refractory CLL

As reported in the Journal of Clinical Oncology by Paolo Ghia, MD, PhD, of the Università Vita-Salute San Raffaele, Milan, Italy, and colleagues, the phase III ASCEND trial showed significantly prolonged progression-free survival with acalabrutinib monotherapy vs the investigator’s choice of...

skin cancer

Adding Immunotherapy to BRAF/MEK Inhibition in BRAF V600–Mutant Melanoma: First Step on the Journey

As investigators, we were always determined to find the drug to work with BRAF/MEK inhibitor combination therapy. It had come on like a storm and showed us that we could help even those with the most advanced metastatic melanoma, as long as it harbored the magical BRAF V600E mutation.1...

skin cancer
immunotherapy

Researchers Outline Need for Evaluation of Gene-Expression Profiling in Melanoma

A consensus statement published in JAMA Dermatology by an international group of melanoma researchers evaluated the use of prognostic gene-expression profile testing to guide clinical management of melanoma.1 The group cautioned against the routine use of currently available gene-expression...

hematologic malignancies

The WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that occasionally quizzes readers on issues in hematology. In this installment, Drs. Abutalib, Pemmaraju, and Medeiros highlight the clinically aggressive blastic plasmacytoid dendritic cell neoplasm. For each quiz...

lymphoma
immunotherapy

Tafasitamab-cxix in the Treatment of Diffuse Large B-Cell Lymphoma

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On July 31, 2020, tafasitamab-cxix, a CD19-directed...

covid-19

Repurposing Drugs for the Treatment of COVID-19

A vaccine for COVID-19 is currently the Holy Grail, but even if an effective vaccine were developed on a fast-track timetable, it may be effective in only a percentage of people, judging by existing flu vaccines, which show efficacy rates of approximately 45% and vary year by year. Until we have a...

gastrointestinal cancer

Switch Control Inhibitor for GISTs Harboring Drug-Resistance Mutations: The INVICTUS Trial

In May 2020, the U.S. Food and Drug Administration (FDA) approved ripretinib for patients who have received prior treatment with three or more kinase inhibitors, including imatinib, for advanced gastrointestinal stromal tumors (GIST). The approval was largely based on the findings of the...

gastrointestinal cancer

Ripretinib Improves Progression-Free Survival vs Placebo in Previously Treated Advanced GIST

As reported inThe Lancet Oncology by Jean-Yves Blay, MD, of Centre Léon Bérard, Lyon, France, and colleagues, the phase III INVICTUS trial has shown that the oral KIT and PDGFRα tyrosine kinase inhibitor ripretinib significantly prolonged progression-free survival vs placebo in patients with...

solid tumors

ASCO Provisional Clinical Update Offers New Recommendations for HBV Management in Patients With Cancer

Oncologists should consider screening all patients with cancer for the hepatitis B virus (HBV) prior to starting systemic anticancer therapy, with a focus on tests that use the hepatitis B surface antigen (HBsAg), hepatitis B core antibody (anti-HBc), total Ig or IgG, and antihepatitis B surface...

covid-19

Impact of Immune Checkpoint Inhibitors on COVID-19 in Patients With Cancer

In the time of COVID-19, there is much to learn about the intersection of coronavirus and cancer. One area of concern has been whether immunotherapies increase the risk of mortality in patients with cancer who also have COVID-19 infection. “To what extent immune checkpoint inhibition affects...

covid-19

Reevaluating the Delivery of Palliative Care in the Era of COVID-19

Palliative care services are so crucial to the well-being of patients with cancer that, in 2017, ASCO updated its clinical practice guideline on the integration of palliative care into standard oncology care.1 The updated guideline recommends that all patients with advanced cancer receive dedicated ...

Pet Therapy: How the Cat I Never Wanted Saved My Life

My husband and I adopted our cat, Franklin, on a cold November day. It was one of the last days Andrew felt well enough to leave the house to go anywhere other than to chemotherapy or a doctor’s appointment. Our news at these appointments had shifted toward the negative, with disease progression...

health-care policy

Past CMS and FDA Head Discusses Challenges in U.S. Health-Care Policy and Possible Solutions

As evidenced at this year’s ASCO20 Virtual Scientific Program, oncology science, technology, and clinical practice are evolving at a rapid pace, bringing new challenges to the efficient and ethical practice of cancer care at all levels. To shed light on some of the large-scale public health and...

prostate cancer

Rucaparib in Metastatic Castration-Resistant Prostate Cancer With Deleterious BRCA Alterations

As reported in the Journal of Clinical Oncology by Abida and colleagues, the phase II TRITON2 trial has shown that rucaparib produces durable responses in patients with metastatic castration-resistant prostate cancer with deleterious BRCA1 or BRCA2 alterations. The trial supported the May 2020...

multiple myeloma
immunotherapy

FDA Approves Daratumumab Plus Carfilzomib and Dexamethasone for Relapsed or Refractory Multiple Myeloma

On August 20, the U.S. Food and Drug Administration (FDA) approved daratumumab (Darzalex) in combination with carfilzomib (Kyprolis) and dexamethasone (DKd) for the treatment of adult patients with relapsed or refractory multiple myeloma who have received one to three previous lines of therapy....

pancreatic cancer

ASCO Updates Metastatic Pancreatic Cancer Guideline

ASCO has released an update to its Metastatic Pancreatic Cancer Guideline that includes recommendations for second-line treatment, including early biomarker testing for actionable genomic alterations.1 Last updated in 2018, this new version was triggered by novel evidence related to targeted...

immunotherapy
lung cancer
cns cancers
leukemia
lymphoma

FDA Pipeline: Priority Reviews for Immunotherapy Dose Regimen, Small Cell Lung Cancer; Fast Track Designations in Brain Cancer and Leukemia

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Reviews for a novel dosing regimen for durvalumab as well as for trilaciclib in small cell lung cancer; granted Fast Track designations to treatments for glioblastoma and B-cell acute lymphoblastic leukemia; and issued reports...

immunotherapy
kidney cancer

Link Between Gut Microbiome and Treatment Outcomes in Patients With Metastatic Kidney Cancer

Researchers have found that greater gut microbial diversity in patients with metastatic kidney cancer is associated with better treatment outcomes in those receiving immunotherapy. These findings were published by Salgia et al in European Urology. “We also reported the changes over time in the gut...

breast cancer
covid-19

Study Finds Treatment Delays for Patients With Breast Cancer Early in the COVID-19 Pandemic

The results of an online questionnaire of 609 breast cancer survivors in the United States suggest that nearly half of patients experienced delays in care during the early weeks of the COVID-19 pandemic. The study was published by Papautsky et al in the journal Breast Cancer Research and ...

covid-19

Updated Registry Data Confirm Higher COVID-19–Related Mortality in Patients With Cancer

“The distressing intersection of COVID-19 and cancer requires the use of large registries to acknowledge diversity,” stated Solange Peters, MD, PhD, President of the European Society for Medical Oncology (ESMO), in her keynote speech at the American Association for Cancer Research (AACR) Virtual...

neuroendocrine tumors

Characteristics of Neuroendocrine Carcinomas of the Gallbladder

In a Korean study reported in the American Journal of Surgical Pathology, Lee et al identified clinicopathologic and immunohistochemical characteristics of neuroendocrine carcinomas of the gallbladder. Study Details The study involved data from 34 patients with gallbladder neuroendocrine carcinomas ...

breast cancer

Hypofractionated vs Conventionally Fractionated Radiotherapy After Breast-Conserving Surgery in Women With Breast Cancer

In a Chinese phase III trial reported in the Journal of Clinical Oncology, Wang et al found that hypofractionated radiotherapy (HFRT) and conventionally fractionated radiotherapy (CFRT) following breast-conserving surgery were associated with similar low 5-year local recurrence rates in women with...

solid tumors

Tumor Mutational Burden and the Future of Complex Biomarkers

The development of complex biomarkers such as tumor mutational burden (TMB) has enabled clinicians to identify patients more likely to respond to treatment of a variety of cancers, leading to more accurate diagnoses and improved outcomes. Differences in testing assays, however, have produced...

breast cancer
genomics/genetics

Three Novel Genetic Variants Linked to Male Breast Cancer Discovered

Scientists have newly discovered three genetic changes that increase the risk of breast cancer in men. These findings were published by Maguire et al in the Journal of the National Cancer Institute. The researchers identified three common variations in DNA that predispose men to developing breast...

lung cancer
issues in oncology

Current Lung Cancer Screening Guidelines May Underselect Black Ever-Smokers

Public health screening guidelines for lung cancer followed by the U.S. Preventive Services Task Force (USPSTF) and the Centers for Medicare & Medicaid Services (CMS) undercount eligible Black individuals, according to a study by Mary Pasquinelli, DNP, FNP-BC, and colleagues in press at the...

leukemia

Addition of Venetoclax to Azacitidine in Previously Untreated Patients With AML Ineligible for Induction Therapy

In the phase III VIALE-A trial reported in The New England Journal of Medicine, Courtney D. DiNardo, MD, and colleagues found that venetoclax plus azacitidine significantly improved overall survival vs azacitidine alone in previously untreated patients with acute myeloid leukemia (AML) who were...

colorectal cancer
genomics/genetics

Molecular Testing in Metastatic Colorectal Cancer: Understanding How, When, and What to Profile

“In line with the emergence of targeted therapies, molecular biomarker testing in metastatic colorectal cancer has evolved over the past decade,” noted Jeanne Tie, MD, MBChB, FRACP, who acknowledged there is confusion about the best ways to use molecular testing in the clinic. Dr. Tie, who is...

ASCO Members Can Access Special Offer for PPE Through Project N95: Register by August 24

Project N95, a not-for-profit organization, is offering access to ASCO’s qualifying U.S. members who are having difficulty obtaining personal protective equipment (PPE) for their patients and staff. Qualifying ASCO members will be able to make a one-time bulk purchase of the following PPE...

lung cancer

Brigatinib vs Crizotinib in ALK Inhibitor–Naive Patients With ALK-Positive Advanced NSCLC

As reported in the Journal of Clinical Oncology by D. Ross Camidge, MD, PhD, and colleagues, a second prespecified interim analysis of the pivotal phase III ALTA-1L trial has shown maintained progression-free survival benefit with brigatinib vs crizotinib in ALK inhibitor–naive patients with...

breast cancer
immunotherapy

Activity of Olaparib and Durvalumab in Germline BRCA-Mutated Metastatic Breast Cancer

As reported in The Lancet Oncology by Susan M. Domchek, MD, and colleagues, the combination of olaparib and durvalumab showed activity in a cohort of patients with germline BRCA-mutated, HER2-negative metastatic breast cancer enrolled in a phase I/II basket study (MEDIOLA). Study Details In the...

issues in oncology
geriatric oncology

Aspirin May Accelerate the Progression of Advanced Cancers in Older Adults

Results from a recent clinical trial indicated that for older adults with advanced cancer, initiating aspirin treatment may increase their risk of disease progression and mortality. These findings were published by McNeil et al in the Journal of the National Cancer Institute. Study Background and...

survivorship

Study Finds Radiotherapy May Be Associated With Long-Term Impact on the Cardiovascular and Metabolic Health of Childhood Cancer Survivors

A study by Wilson et al investigating the impact of radiation therapy on adult survivors of pediatric abdominal and pelvic tumors has found that these survivors were significantly more likely to have insulin resistance, high levels of triglycerides, and low levels of high-density lipoproteins...

Expert Point of View: Amit Mahipal, MBBS, MPH

Amit Mahipal, MBBS, MPH, Consultant, Associate Professor of Oncology, Mayo College of Medicine, Rochester, put the findings for tremelimumab/durvalumab into context regarding other studies evaluating checkpoint inhibitors in advanced hepatocellular carcinoma. In the current study by Kelly et al, he ...

Expert Point of View: Taimur Sher, MBBS, MD

Taimur Sher, MBBS, MD, Associate Professor of Medicine, Hematology and Medical Oncology Consultant, and Director of the Multi-Specialty Amyloidosis Group at the Mayo Clinic in Jacksonville, Florida, told The ASCO Post that shutting down the source of amyloidogenic light-chain production—the...

immunotherapy

Subcutaneous Daratumumab Improves Outcomes for Patients With Light-Chain Amyloidosis, Study Finds

Patients with light-chain amyloidosis may soon have a new standard of care, according to data presented during the 25th European Hematology Association (EHA25) Virtual Annual Congress.1 Results of the phase III ANDROMEDA study have shown that adding subcutaneous daratumumab to the triplet...

prostate cancer

TITAN Trial: Apalutamide Adds to Options for Men With Metastatic Hormone-Sensitive Prostate Cancer

Androgen-deprivation therapy has been, and remains, the standard of care for patients with metastatic prostate cancer. Patients are often surprised to learn that was all we would do to control their disease and sometimes asked why they would not receive chemotherapy, as for other cancers. I would...

bladder cancer
immunotherapy

First-Line Atezolizumab Plus Platinum-Based Chemotherapy vs Chemotherapy Alone in Advanced Urothelial Cancer

As reported in The Lancet by Matthew D. Galsky, MD, of Icahn School of Medicine at Mount Sinai, Tisch Cancer Institute, New York, and colleagues, the phase III IMvigor130 trial has shown prolonged progression-free survival with first-line atezolizumab plus platinum-based chemotherapy vs...

bladder cancer
immunotherapy

Novel Indications and New Drugs for the Treatment of Bladder Cancer

Pembrolizumab: On January 8, 2020, pembrolizumab (Keytruda) was approved by the U.S. Food and Drug Administration (FDA) for bacillus Calmette-Guérin (BCG)-unresponsive, high-risk, non–muscle invasive bladder cancer with carcinoma in situ with or without papillary tumors who are ineligible for or...

bladder cancer
immunotherapy

Early Data Show Activity for Enfortumab Vedotin Plus Pembrolizumab in Advanced Bladder Cancer

It may be possible to use a platinum-free combination as first-line treatment for advanced or metastatic urothelial carcinoma in cisplatin-ineligible patients, if the results of the phase Ib/II EV-103 trial hold up. The combination of the newly approved antibody-drug conjugate (enfortumab vedotin)...

bladder cancer

Erdafitinib in FGFR-Altered Advanced Urothelial Carcinoma

As reported in The New England Journal of Medicine by Loriot et al, the fibroblast growth factor receptor 1-4 tyrosine kinase inhibitor erdafitinib showed activity in FGFR-altered advanced urothelial carcinoma.1 The study enrolled patients from sites in 14 countries between May 2015 and March 2018. ...

prostate cancer

Many Choices Now for Men With Metastatic Hormone-Sensitive Prostate Cancer: How to Decide?

Based on the recently published ENZAMET, ARCHES, and TITAN trials,1-3 we now have several choices of systemic combination therapies for men with metastatic hormone-sensitive prostate cancer. Today, men are faced with decisions of androgen-deprivation therapy alone or combinations with abiraterone,...

kidney cancer
immunotherapy

Novel Indications and New Drugs for the Treament of Patients With Renal Cell Carcinoma

Pembrolizumab Plus Axitinib: On April 19, 2019, pembrolizumab (Keytruda) was approved for use in combination with the small-molecule tyrosine kinase inhibitor axitinib (Inlyta) for the first-line treatment of patients with advanced renal cell carcinoma. Approval was based on findings in the phase...

kidney cancer
immunotherapy

Immune Checkpoint Inhibitor Rechallenge in Metastatic Renal Cell Carcinoma

In a study presented during the ASCO20 Virtual Scientific Program1 and published as a brief report in JAMA Oncology,2 Praful Ravi, MB, BChir, of the Dana-Farber Cancer Institute, Boston, and colleagues found that rechallenge with immune checkpoint inhibitor therapy was capable of producing...

prostate cancer

Nonmetastatic Castration-Resistant Prostate Cancer

Nonmetastatic castration-resistant prostate cancer arises in the subset of men with biochemically recurrent disease (ie, rising prostate-specific antigen [PSA] level after definitive therapy in the absence of metastases) who develop PSA progression after chronic exposure to androgen-deprivation...

prostate cancer

Phase III Study of AR Antagonist in Nonmetastatic Castration-Resistant Prostate Cancer

In the phase III ARAMIS trial reported in The New England Journal of Medicine,1 Karim Fizazi, MD, PhD, of the Institut Gustave Roussy, Universite Paris-Sud, Villejuif, France, and colleagues found that the androgen-receptor (AR) antagonist darolutamide significantly prolonged metastasis-free...

prostate cancer

Novel Indications and New Drugs for Castration-Resistant or Castrate-Sensitive Prostate Cancer

The past year has witnessed the U.S. Food and Drug Administration (FDA) approval of a number of drugs for treatment of patients with metastatic castrate-resistant prostate cancer or castrate-sensitive prostate cancer. Castrate-Resistant Prostate Cancer Olaparib: On May 19, 2020, olaparib...

prostate cancer

In Biochemically Recurrent Prostate Cancer, PSMA-Targeted PET/CT Imaging May Be Useful

Positron-emission tomography/computed tomography (PET/CT) imaging with the prostate-specific membrane antigen (PSMA)-targeted radiotracer fluorine F-18 DCFPyL (PyL) successfully identified areas of occult metastasis in men with biochemically recurrent metastatic castration-resistant prostate...

prostate cancer

Lutetium-177–Labeled PSMA-617 Improves PSA Response in First Analysis From TheraP Trial in Metastatic Prostate Cancer

Initial results of the randomized phase II TheraP trial showed that therapy directed to prostate-specific membrane antigen (PSMA) with lutetium-177–labeled PSMA-617 (LuPSMA) significantly improved prostate-specific antigen (PSA) response compared with cabazitaxel in men with metastatic...

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