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breast cancer

Can Breast Cancer Surgery Be Eliminated in ‘Exceptional Responders’ to Neoadjuvant Therapy?

Can patients with breast cancer who achieve an “exceptional response” to neoadjuvant therapy safely forgo surgery? That is a question being seriously explored in multinational trials. “We’ve known for a long time that we can eliminate disease in many patients if they have chemosensitive tumors....

sarcoma
skin cancer
cns cancers

Early Signs of Activity With Immunotherapies in Low-Incidence Cancers

Immunotherapy is showing promise for patients with rare cancers, offering new treatment opportunities and clinical trials to those with previously limited options. At the 2020 ASCO-SITC Clinical Immuno-Oncology Symposium, presenters discussed the use of immunotherapy in three low-incidence cancers: ...

skin cancer
immunotherapy

Novel Treatment Strategies Under Study in Advanced Melanoma

Several novel strategies for the treatment of patients with stage III or IV melanoma showed promise in studies presented at the 2020 ASCO-SITC Clinical Immuno-Oncology Symposium.1,2 Vaccine for High-Risk Patients After Resection A tumor lysate, particle-loaded, dendritic cell (TLPLDC) vaccine was...

skin cancer
immunotherapy

New Guideline on Systemic Therapy for Melanoma Tackles Rapid Developments in Treatment Options

Systemic treatment of melanoma has changed rapidly since the introduction of ipilimumab in 2011. Newer therapies approved for melanoma since that time include immunotherapy, targeted therapy for mutation-bearing tumors, and injectional therapy for cutaneous or palpable lesions. ASCO has released...

gynecologic cancers

PARP Inhibitors in Maintenance Treatment for Advanced Ovarian Cancer

Based on multiple phase III prospective trials, there is evidence that both PARP inhibitors and antiangiogenic therapies such as bevacizumab provide benefit when utilized in a maintenance strategy in the first-line treatment of advanced epithelial ovarian cancer (GOG 218, ICON7, SOLO-1, PRIMA,...

covid-19
palliative care

Prioritizing Patients With Metastatic Disease for Palliative Radiotherapy

In anticipation of how the COVID-19 pandemic might impact oncology care as the coronavirus spread across New York City, radiation oncologists with expertise in the management of metastatic disease and inpatient oncologic emergencies at Memorial Sloan Kettering Cancer Center (MSK) met in late winter ...

gynecologic cancers
immunotherapy

FDA Approves Olaparib Plus Bevacizumab as Maintenance Treatment for Ovarian, Fallopian Tube, or Primary Peritoneal Cancers

On May 8, 2020, the U.S. Food and Drug Administration (FDA) expanded the indication of olaparib (Lynparza) to include its combination with bevacizumab for first-line maintenance treatment of adult patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in...

solid tumors
immunotherapy

Chemoimmunotherapy for Pediatric Refractory or Relapsed Neuroblastoma

In an expansion of a Children’s Oncology Group trial reported in the Journal of Clinical Oncology, Mody et al found that the combination of irinotecan, temozolomide, the anti–disialoganglioside GD2 antibody dinutuximab, and granulocyte-macrophage colony-stimulating factor (I/T/DIN/GM-CSF) showed...

leukemia
supportive care

Benefit of Increased Dietary Antioxidants During Induction Therapy for Pediatric ALL

In a study reported in the Journal of Clinical Oncology, Ladas et al found that increased dietary intake of antioxidants was associated with reduced risk for bacterial infection and grade ≥ 3 mucositis during induction therapy in pediatric patients with acute lymphoblastic leukemia (ALL). Study...

gynecologic cancers

Advanced Ovarian Cancer: Use of Neoadjuvant Chemotherapy Increasing Along With Survival

The use of neoadjuvant chemotherapy for advanced ovarian cancer may not have the negative impact on survival feared by many gynecologic oncologists. In fact, according to a pair of studies that were to have been presented at the Society of Gynecologic Oncology (SGO) 2020 Annual Meeting on Women’s...

hepatobiliary cancer
immunotherapy

Nivolumab for Advanced Refractory Biliary Tract Cancer

In a phase II trial reported in JAMA Oncology, Kim et al found that nivolumab showed antitumor activity in patients with advanced refractory biliary tract cancer. As noted by the investigators, there currently is no established second-line systemic treatment for biliary tract cancer. Study Details...

leukemia
covid-19

Laura C. Michaelis, MD: In My Experience Question 3

lymphoma
covid-19

Mehdi Hamadani, MD: In My Experience Question 3

During the COVID-19 pandemic, would you still recommend immediate upfront autologous transplant in patients with T-cell non-Hodgkin lymphoma? Recorded April 21, 2020.

bladder cancer

Chemoablation of Low-Grade Upper Tract Urothelial Cancer With Mitomycin-Containing Reverse Thermal Gel

In the single-arm phase III OLYMPUS trial reported in The Lancet Oncology, Kleinmann et al found that primary chemoablation of low-grade upper tract urothelial carcinoma using a mitomycin-containing reverse thermal gel (UGN-101) resulted in disease eradication in more than half of patients. As...

leukemia

Dexrazoxane, Cardiac Function, and Treatment Outcomes in Pediatric AML

In a study reported in the Journal of Clinical Oncology, Getz et al found that use of dexrazoxane was associated with preservation of cardiac function in pediatric patients receiving front-line treatment for acute myeloid leukemia (AML) and resulted in no adverse effects on treatment outcomes. As...

breast cancer

FAST-Forward Trial: Long-Term Outcomes With Adjuvant Hypofractionated Radiotherapy for 1 vs 3 Weeks in Early Breast Cancer

As reported in The Lancet by Brunt et al, 5-year findings from the phase III FAST-Forward trial indicated that adjuvant radiotherapy with 26 Gy in 5 fractions over 1 week was noninferior to 40 Gy in 15 fractions over 3 weeks in preventing local tumor relapse in women with early-stage breast ...

skin cancer
immunotherapy

AACR 2020: Triplet Regimen Improves Progression-Free Survival in Advanced Melanoma in IMspire150 Trial

The addition of the checkpoint inhibitor atezolizumab to two targeted therapies (the BRAF inhibitor vemurafenib and the MEK inhibitor cobimetinib) as initial therapy improved outcomes compared with the two targeted therapies plus placebo in patients with newly diagnosed BRAF V600E/K–mutant advanced ...

colorectal cancer
covid-19

Treating Colorectal Cancer in the Time of COVID-19

The treatment of colorectal cancer has always been something of an art—but never more so than during the COVID-19 pandemic. The ASCO Post asked three experts in this malignancy to share their concerns and their approaches to achieving good patient outcomes while minimizing the risk of COVID-19...

hepatobiliary cancer
immunotherapy

AACR 2020: Atezolizumab Alone or in Combination With Cobimetinib for Biliary Tract Cancer

A randomized multicenter study of a combination of immunotherapy with a targeted therapy improved cancer control for some patients with biliary tract cancer, according to research presented by Yarchoan et al at the American Association for Cancer Research (AACR) Virtual Annual Meeting (Abstract...

neuroendocrine tumors
issues in oncology

Issues With Travel Faced by Patients Undergoing Lu-177 Dotatate Radiation Therapy

A team of researchers and patient advocates have addressed the challenges related to traveling after receiving radiation therapy involving Lu-177 dotatate in a study published by Kendi et al in The Journal of Nuclear Medicine. Due to the residual radiation activity of Lu-177 dotatate, some patients ...

breast cancer
immunotherapy

Abemaciclib/Fulvestrant/Trastuzumab for Patients With Previously Treated HR-Positive, HER2-Positive Advanced Breast Cancer

In the phase II monarcHER trial reported in The Lancet Oncology, Sara M. Tolaney, MD, and colleagues found that the combination of abemaciclib, fulvestrant, and trastuzumab prolonged progression-free survival vs trastuzumab plus standard-of-care chemotherapy in patients with previously treated...

colorectal cancer
gastrointestinal cancer
immunotherapy

Regorafenib Plus Nivolumab in Advanced Gastric and Colorectal Cancers

In a Japanese phase Ib/dose-expansion trial reported in the Journal of Clinical Oncology, Fukuoka et al found that the combination of regorafenib and nivolumab showed activity in patients with previously treated gastric cancer and colorectal cancer with microsatellite stable/mismatch...

prostate cancer

PROfound Trial: Olaparib for Patients With Metastatic Castration-Resistant Prostate Cancer and Homologous Recombination Repair Gene Alterations

In a phase III trial reported in The New England Journal of Medicine, Johann de Bono, MB, ChB, PhD, and colleagues found that olaparib significantly improved progression-free survival vs hormonal therapy in patients with metastatic castration-resistant prostate cancer who had alterations in the...

immunotherapy
skin cancer

Neoadjuvant Nivolumab for Resectable Merkel Cell Carcinoma

As reported in the Journal of Clinical Oncology by Suzanne L. Topalian, MD, and colleagues, neoadjuvant treatment with nivolumab was found to produce pathologic complete response in approximately half of patients with resectable Merkel cell carcinoma enrolled in the phase I/II CheckMate 358 trial....

multiple myeloma
covid-19

Saad Z. Usmani, MD: In My Experience Question 3

Because of the COVID-19 pandemic, has your management strategy changed for post-transplant consolidation and maintenance therapy in patients with multiple myeloma? Recorded April 24, 2020.

immunotherapy
covid-19

Negotiating the Obstacles to Conducting Clinical Trials of Immunotherapy During the Coronavirus Pandemic

Coronavirus disease 2019 (COVID-19) is perhaps the biggest challenge health-care systems have ever had to face. As part of a series of interviews The ASCO Post is conducting with oncologists, we talked with Charles G. Drake, MD, PhD, about the impact of COVID-19 on his practice and on the conduct...

covid-19

On the Shoulders of Giants

Before the dawn of the modern antibiotic era and amid the chaos of World War II, future Professor of Radiology and Founding Dean of two American medical colleges, Dr. George T. Harrell,* penned what could now be argued was far too bold a statement. As the opening lines of his nonrandomized study...

multiple myeloma
immunotherapy

FDA Approves Daratumumab and Hyaluronidase-fihj in Multiple Myeloma

On May 1, the U.S. Food and Drug Administration (FDA) approved daratumumab and hyaluronidase-fihj (Darzalex Faspro) for adult patients with newly diagnosed, relapsed, or refractory multiple myeloma. This new product allows for subcutaneous dosing of daratumumab. Daratumumab and hyaluronidase-fihj...

leukemia
pancreatic cancer
neuroendocrine tumors
lung cancer
gynecologic cancers
lymphoma

FDA Pipeline: Priority Review in AML, Fast Track Designations for Pancreatic Cancer and Neuroendocrine Tumors

Over the past 2 weeks, the U.S. Food and Drug Administration (FDA) granted Priority Review to a treatment for acute myeloid leukemia (AML); Fast Track designations for agents in pancreatic cancer and pancreatic/nonpancreatic neuroendocrine tumors; approvals for companion diagnostic tests;...

breast cancer

Avoiding Use of Prophylactic Peg-filgrastim During Paclitaxel Treatment in Dose-Dense Chemotherapy for Breast Cancer

In a phase II study reported in the Journal of Clinical Oncology, Vaz-Luis et al found that the use of a prespecified algorithm enabled the avoidance of routine peg-filgrastim prophylaxis during the paclitaxel portion of neoadjuvant or adjuvant treatment with dose-dense...

breast cancer
immunotherapy

AACR 2020: I-SPY2 Trial: Durvalumab/Olaparib/Paclitaxel ‘Graduates’ in HER2-Negative Breast Cancer

The I-SPY2 trial found that the combination of the checkpoint inhibitor durvalumab, the PARP inhibitor olaparib, and the taxane paclitaxel followed by doxorubicin/cyclophosphamide as neoadjuvant therapy improved pathologic complete responses vs paclitaxel followed by doxorubicin/cyclophosphamide...

covid-19

Allocating Ventilators in Times of Crisis: A Brave New World

The unprecedented COVID-19 crisis has challenged us, as a society, to evaluate our core values and philosophy. Ventilators, a precious and limited commodity, are now in short supply. Humanity is at a precipice, and we physicians are facing an ethical dilemma, how best to allocate ventilators, and, ...

covid-19

New Research Highlights Risk of Thromboembolic Complications in Patients With COVID-19

A special report published by Oudkerk et al in the journal Radiology outlined strategies for the prevention, diagnosis, and treatment of thromboembolic complications in patients with COVID-19. Based on recent reports that demonstrated a strong association between elevated D-dimer levels and poor...

covid-19
multiple myeloma

Managing Multiple Myeloma During the COVID-19 Pandemic

In dealing with coronavirus disease 2019 (COVID-19), some oncologists are modifying conventional treatment regimens to limit patients’ visits to infusion centers and providers’ offices. The ASCO Post asked C. Ola Landgren, MD, PhD, Chief of the Myeloma Service at Memorial Sloan Kettering Cancer...

gynecologic cancers
immunotherapy

Nivolumab/Ipilimumab vs Nivolumab Alone in Recurrent or Persistent Ovarian Cancer

In a phase II NRG Oncology trial (NRG GY003) reported in the Journal of Clinical Oncology, Dmitriy Zamarin, MD, PhD, and colleagues found that the addition of ipilimumab to nivolumab improved objective response rate and progression-free survival in women with persistent or recurrent epithelial...

immunotherapy

FDA Approves New Pembrolizumab Dosing Regimen

On April 28, the U.S. Food and Drug Administration (FDA) granted accelerated approval to a new dosing regimen for pembrolizumab (Keytruda)—400 mg every 6 weeks—across all currently approved adult indications, in addition to the current 200 mg every 3 weeks dosing regimen. The approval was based on...

issues in oncology

AACR 2020: Study Finds Vape Shops Are Mostly Concentrated in Low-Resource, Minority Communities

An analysis investigating the socioecologic context of tobacco and vape shops in Los Angeles has found that vape shops are more likely to be concentrated in low-resource communities. The communities also tended to have higher concentrations of minority residents and fewer tobacco and vaping sales...

skin cancer

AACR 2020: Continuous vs Intermittent Dabrafenib/Trametinib Dosing in Patients With BRAF-Mutated Melanoma

A randomized clinical trial offers evidence that a combination of two targeted melanoma drugs, when given continuously, improves progression-free survival when compared with intermittent treatment, according to study results presented by Algazi et al at the American Association for Cancer Research...

covid-19

Hypercoagulability in Critically Ill Patients With COVID-19: Where Do We Stand?

“Life is short, art long, opportunity fleeting, experience treacherous, judgment difficult.” ―Hippocrates 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 and Connors...

multiple myeloma

Long-Term Outcomes With Triplet Induction and Risk-Adapted Maintenance Therapy for Newly Diagnosed Multiple Myeloma

As reported by Joseph et al in the Journal of Clinical Oncology, follow-up in a large cohort of patients with newly diagnosed multiple myeloma indicates good long-term outcomes with consecutive treatment with lenalidomide/bortezomib/dexamethasone (RVD) induction therapy and risk-adapted maintenance ...

breast cancer

AACR 2020: Final Overall Survival Results From the Phase III EMBRACA Trial

New data from the phase III EMBRACA trial showed the poly (ADP-ribose) polymerase (PARP) inhibitor talazoparib did not produce a statistically significant overall survival benefit for patients with locally advanced or metastatic HER2-negative germline BRCA­-mutated breast cancer. Most patients...

multiple myeloma
immunotherapy

Isatuximab-irfc for Previously Treated Multiple Myeloma

On March 2, 2020, the CD-38-directed cytolytic antibody isatuximab-irfc (Sarclisa) was approved for use in combination with pomalidomide and dexamethasone for adult patients with multiple myeloma who have received at least two prior therapies including lenalidomide and a proteasome inhibitor.1,2...

covid-19

FDA Accelerates Development of Novel Therapies for COVID-19

The U.S. Food and Drug Administration (FDA) has implemented a program to expedite the development of potentially safe and effective life-saving treatments. The program, known as the Coronavirus Treatment Acceleration Program (CTAP), is using every tool at the agency’s disposal to bring new...

Adapting Adjuvant Endocrine Therapy by Patient Age and Risk

The individualization and optimization of adjuvant endocrine therapy for breast cancer are important and not always simple. Guidance on this issue was offered at the 2020 Miami Breast Cancer Conference by Joyce O’Shaughnessy, MD, the Celebrating Woman Chair in Breast Cancer Research at Baylor...

immunotherapy
solid tumors

PD-1 Inhibition in Mismatch Repair–Deficient/Microsatellite Instability–High Cancers Other Than Colorectal Cancer

Mismatch repair (MMR)-deficiency and consequently high DNA microsatellite instability (MSI-H) are associated with high tumor mutational burden. A high mutational load increases the potential number of neoantigens that can be presented by the tumor cell and recognized by host lymphocytes. Detection...

immunotherapy
solid tumors

NCI-MATCH Subprotocol Finds Nivolumab Active in Mismatch Repair–Deficient Cancers Other Than Colorectal Cancer

In a study (NCI-MATCH trial subprotocol, arm Z1D) reported in the Journal of Clinical Oncology, Nilofer S. Azad, MD, of Johns Hopkins Medicine Sidney Kimmel Comprehensive Cancer, and colleagues found that nivolumab was active in mismatch repair (MMR)-deficient noncolorectal cancers.1 As stated by...

multiple myeloma
immunotherapy

Addition of Isatuximab to Pomalidomide and Dexamethasone in Relapsed and Refractory Multiple Myeloma

As reported in The Lancet by Michel Attal, MD, of the Institut Universitaire du Cancer Toulouse Oncopole, France, and colleagues, the phase III ICARIA-MM trial has shown that the addition of the CD38-targeted antibody isatuximab to pomalidomide and low-dose dexamethasone significantly improved...

hematologic malignancies

Gut Bacterial Diversity: A Marker or Driver of Outcomes After Hematopoietic Cell Transplantation?

Previous single-center studies have linked the gut microbiota (via stool sample analysis) to outcomes after hematopoietic cell transplantation (HCT), such as overall mortality, transplant-related mortality, graft-vs-host disease, and graft-vs-host–related mortality.1-4 Although intriguing, these...

lymphoma

Selected ASH Abstracts on Novel Treatments for Non-Hodgkin Lymphomas

To complement The ASCO Post’s continued comprehensive coverage of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition, here are several abstracts selected from the meeting proceedings focusing on novel therapies for patients with non-Hodgkin lymphomas (NHLs). For full...

genomics/genetics

How CRISPR-Cas9 Gene Editing May Improve the Effectiveness of Cellular Therapeutics in Patients With Cancer

The results from the first in-human phase I clinical trial in the United States evaluating CRISPR-Cas9–edited T cells in patients with advanced cancer has shown that the therapy is both feasible and safe, representing a big step forward in the potential of using gene editing to boost the natural...

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