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kidney cancer
immunotherapy

Cabozantinib Plus Nivolumab in Advanced Non–Clear Cell Renal Cell Carcinoma

In a single-institution phase II study reported in the Journal of Clinical Oncology, Chung-Han Lee, MD, PhD, and colleagues found that the combination of cabozantinib and nivolumab was active in patients with advanced non–clear cell renal cell carcinoma (RCC) variants, particularly those with...

survivorship

Transportation Barriers to Health Care Among Cancer Survivors in the United States

In a study reported in a research letter in JAMA Oncology, Changchuan Jiang, MD, MPH, and colleagues found that U.S. cancer survivors were more likely to report delays in health care due to transportation barriers than persons without a history of cancer, with the difference driven by barriers...

hepatobiliary cancer

Long-Term Survival Outcomes With Adjuvant Capecitabine in Biliary Tract Cancer

As reported in the Journal of Clinical Oncology by Bridgewater et al, long-term follow-up of the phase III BILCAP study has shown a continued survival benefit with adjuvant capecitabine therapy in patients with curatively resected biliary tract cancer. In the multicenter trial, 447 patients with...

breast cancer

Emerging Endocrine Therapies for the Management of Breast Cancer

Novel hormonal therapies for breast cancer could provide additional therapeutic options for patients with hormone receptor–positive breast cancer. The emerging landscape for these new agents was described at the 2022 Miami Breast Cancer Conference, sponsored by PER, by Aditya Bardia, MD, MPH,...

covid-19

Study Finds Black Patients With Cancer Diagnosed With COVID-19 Have Worse Outcomes Than White Patients

Black patients with cancer experienced significantly worse outcomes after a COVID-19 diagnosis than non-Hispanic White patients, according to findings published by Fu et al in JAMA Network Open. Investigators from the COVID-19 and Cancer Consortium (CCC19) studied the electronic health records of...

skin cancer

Thickness-Specific Incidence of Cutaneous Melanoma in the United States

In a population-based cohort study reported in JAMA Oncology, Chen et al found that the incidence of overall cutaneous melanoma and thinner tumors was stable in the United States from 2010 to 2018, with an increased incidence of the thickest (T4) melanomas being observed. Lower socioeconomic status ...

lymphoma
covid-19

Third COVID-19 Vaccine Dose May Improve Immune Response in Patients With Lymphoma

New research has found that the weakened immune systems of patients with lymphoma may improve after they receive a third COVID-19 vaccination. Patients with lymphoma have defects in their immune system that restrict its response to vaccination; despite this, a study published by Lim et al in Nature ...

colorectal cancer

Risk of Colorectal Cancer May Be Linked to Cumulative Time With Excess Body Weight

In a German study reported in JAMA Oncology, Li et al found that assessment of risk of colorectal cancer based on cumulative lifetime excess weight may be more accurate than risk indicated by single body mass index (BMI) measurements. As stated by the investigators, “Excess weight is associated...

immunotherapy
sarcoma

PD-1 Inhibition in Patients With Classic or Endemic Kaposi Sarcoma

In a French phase II study reported in The Lancet Oncology, Delyon et al found that pembrolizumab produced a high response rate in patients with classic or endemic Kaposi sarcoma with progressive cutaneous extension requiring systemic treatment. As stated by the investigators, “Although the...

colorectal cancer

Short-Term Radiotherapy Plus Preoperative Chemotherapy vs Long-Term Chemoradiotherapy for Locally Advanced Rectal Cancer

In the Chinese phase III STELLAR trial reported in the Journal of Clinical Oncology, Jin et al found that preoperative short-term radiotherapy followed by chemotherapy was not inferior in 3-year disease-free survival vs a standard schedule of long-term chemoradiotherapy in patients with locally...

FDA Approvals in Prostate and Endometrial Cancers

In this week’s episode, we are discussing two recent FDA approvals—one for prostate cancer, and the other for endometrial cancer. The radioconjugate lutetium Lu-177 vipivotide tetraxetan was approved for the treatment of adult patients with prostate-specific membrane antigen–positive metastatic...

genomics/genetics

Results From MAPPYACTS Trial Show the Feasibility and Benefit of Molecular Profiling at Cancer Recurrence in Pediatric Patients

Despite advances in treatment for pediatric patients, cancer remains the primary cause of disease-related mortality in children and adolescents. Data from the international clinical trial MAPPYACTS, which aims to define tumor molecular profiles in pediatric patients with recurrent/refractory...

symptom management

Concordance in Symptomatic Adverse Event Reporting by Children, Clinicians, and Caregivers

In a study reported in the Journal of Clinical Oncology, David R. Freyer, DO, MS, and colleagues found that clinicians consistently undergraded—and caregivers frequently overgraded—the severity of adverse events experienced by children with cancer. Study Details The study included 438...

bladder cancer
immunotherapy

Study Evaluates Response-Based Immunotherapy Strategy in Patients With Advanced Urothelial Carcinoma

In a phase II study (TITAN-TCC) reported in the Journal of Clinical Oncology, Grimm et al found that a nivolumab/ipilimumab boost in patients with advanced urothelial cancer who did not respond to nivolumab monotherapy alone increased objective response rates, with the benefit being greatest in...

geriatric oncology

Oncologists’ Use of Geriatric Assessment Instruments in Older Patients With Cancer

In a study of a population of predominantly community-based oncologists reported in JCO Oncology Practice, Ajeet Gajra, MD, and colleagues found that a majority of oncologists surveyed did not use a formal geriatric assessment instrument to assist in treatment decisions for older patients with...

lung cancer

Guideline-Concordant Surgery and Adjuvant Chemotherapy for Early-Stage NSCLC

In a retrospective cohort study reported in JAMA Oncology, Kenneth L. Kehl, MD, MPH, and colleagues found that only a slight majority of patients with early-stage non–small cell lung cancer (NSCLC) who were enrolled in a U.S. screening study (ALCHEMIST) received guideline-recommended adequate lymph ...

global cancer care

How ASCO, ECO, and WHO Are Marshalling Resources to Provide Care for Ukrainian Civilians and Refugees With Cancer

Since Russia invaded Ukraine on February 24, the number of attacks on health-care facilities continues to mount. According to the World Health Organization (WHO), as of March 16, there have been 43 attacks on health facilities, including 34 attacks that have directly impacted health facilities and...

pancreatic cancer
genomics/genetics

Expert Point of View: E. Gabriela Chiorean, MD

The invited discussant of the CodeBreaK 100 data, E. Gabriela Chiorean, MD, Professor of Medicine at the University of Washington and Fred Hutchinson Cancer Research Center, and Clinical Director of the Gastrointestinal Medical Oncology program at Seattle Cancer Care Alliance, found the efficacy of ...

pancreatic cancer
genomics/genetics

CodeBreaK 100: Sotorasib Shows Activity in KRAS G12C–Mutated Pancreatic Cancer

Promising activity in metastatic pancreatic cancer was shown by sotorasib, an inhibitor of the KRAS G12C mutation, in the phase I/II CodeBreaK 100 study presented by John H. Strickler, MD, Associate Professor of Medicine at Duke University Medical Center, Durham, North Carolina, during the February ...

pancreatic cancer
genomics/genetics

Expert Point of View: Mandana Kamgar, MD, MPH

The ASCO Post invited Mandana Kamgar, MD, MPH, Assistant Professor of Medicine at the Medical College of Wisconsin, LaBahn Pancreatic Cancer Program, Milwaukee, to comment on the KRYSTAL-1 trial. “The KRYSTAL-1 study in totality is a multiphase and multiarm ongoing study exploring the role of...

pancreatic cancer
genomics/genetics

KRYSTAL-1: Adagrasib Controls Disease in Gastrointestinal Malignancies Beyond Colorectal Cancer

A disease control rate of 100% was achieved in gastrointestinal cancers treated with the KRAS G12C inhibitor adagrasib in the phase II KRYSTAL-1 trial, presented at the 2022 ASCO Gastrointestinal Cancers Symposium.1 The population included primarily those with pancreatic cancer; other noncolorectal ...

hepatobiliary cancer
immunotherapy

Expert Point of View: Anthony El-Khoueiry, MD

Anthony El-Khoueiry, MD, Member of the Section of Gastrointestinal Cancers, Director of the phase I program, and Associate Professor of Clinical Medicine at the Keck School of Medicine of the University of Southern California and USC Norris Comprehensive Cancer Center, said the findings of the...

hepatobiliary cancer
immunotherapy

HIMALAYA Trial: First-Line Tremelimumab Plus Durvalumab Improves Overall Survival in Unresectable Hepatocellular Carcinoma

Patients with advanced, unresectable hepatocellular carcinoma may be gaining another first-line treatment option. In the global phase III HIMALAYA trial, a single priming dose of tremelimumab plus regular-interval durvalumab significantly improved overall survival, according to Ghassan K....

hepatobiliary cancer
immunotherapy

Expert Point of View: Ian Chau, MD

Invited discussant Ian Chau, MD, Consultant Medical Oncologist at The Royal Marsden Hospital in London and Surrey in the United Kingdom, said the findings from COSMIC-312 are not mature enough to establish cabozantinib/atezolizumab as a new front-line option for advanced hepatocellular carcinoma...

hepatobiliary cancer
immunotherapy

COSMIC-312: Cabozantinib Plus Atezolizumab Improves Progression-Free Survival in Advanced Hepatocellular Carcinoma

The phase III COSMIC-312 study has met its primary endpoint, showing a significant improvement in progression-free survival with cabozantinib plus atezolizumab compared with sorafenib in treatment-naive hepatocellular carcinoma (HCC), investigators reported at a European Society for Medical...

hepatobiliary cancer
immunotherapy

Expert Point of View: Chris Verslype, MD, PhD

The invited discussant of the RATIONALE 208 trial, Chris Verslype, MD, PhD, Professor of Medicine at University Hospitals Leuven in Belgium, said tislelizumab is an “active and safe” investigational PD-1 antibody, “comparable to other PD-1 agents.” In particular, he noted, the results of RATIONALE...

hepatobiliary cancer
immunotherapy

RATIONALE 208: ‘Durable Clinical Activity’ Reported With Tislelizumab in Advanced Liver Cancer

With the investigational checkpoint inhibitor tislelizumab, durable responses were achieved by some patients with previously treated advanced hepatocellular carcinoma, regardless of the number of prior lines of therapy, in the phase II RATIONALE 208 trial. These findings were presented during the...

hepatobiliary cancer
immunotherapy

Expert Point of View: Nilofer Azad, MD

Nilofer Azad, MD, Professor of Oncology at Johns Hopkins University School of Medicine and Co-Director of Cancer Genetics and Epigenetics at the Sidney Kimmel Comprehensive Cancer Center, Baltimore, was invited to discuss the results of the phase III TOPAZ-1 study, which found an overall survival...

hepatobiliary cancer
immunotherapy

TOPAZ-1: Overall Survival Prolonged With First-Line Immunotherapy Plus Chemotherapy in Biliary Tract Cancer

For the first time, a phase III study has shown an overall survival benefit for upfront treatment using immunotherapy plus chemotherapy in advanced biliary tract cancer. In the TOPAZ-1 trial, the addition of the anti–PD-L1 agent durvalumab to gemcitabine plus cisplatin significantly improved...

hepatobiliary cancer

Ivosidenib vs Placebo for Previously Treated Advanced IDH1-Mutated Cholangiocarcinoma: Final Overall Survival Analysis of the ClarIDHy Trial

As reported in JAMA Oncology by Andrew X. Zhu, MD, PhD, and colleagues, the final overall survival analysis of the pivotal phase III ClarIDHy trial showed prolonged overall survival with ivosidenib vs placebo in previously treated patients with unresectable or metastatic cholangiocarcinoma and an...

gastroesophageal cancer

Adjuvant Nivolumab Improves Disease-Free Survival vs Placebo in Resected Esophageal or Gastroesophageal Junction Cancer After Neoadjuvant Chemoradiotherapy

As reported in The New England Journal of Medicine by Ronan J. Kelly, MB BCh, MBA, of The Charles A. Sammons Cancer Center at Baylor University Medical Center, and colleagues, an interim analysis of the phase III CheckMate 577 trial has shown a significant improvement in disease-free survival with ...

Expert Point of View: Gabriel A. Brooks, MPH, MD

Gabriel A. Brooks, MPH, MD, Associate Professor of Medicine, Norris Cotton Cancer Center at Dartmouth-Hitchcock Medical Center, was invited to discuss the results of the ACCENT/IDEA database analysis of early treatment discontinuation in stage III colon cancer. Although the results confirm the...

colorectal cancer

Adjuvant Therapy for Colon Cancer: Impact of Stopping Treatment Early

For patients with stage III colon cancer, early discontinuation of adjuvant chemotherapy leads to worse outcomes—but early discontinuation of oxaliplatin did not. These findings, which came from an analysis of the large ACCENT and IDEA clinical trials databases, were presented at the 2022 ASCO...

Expert Point of View: Rona Yaeger, MD

Rona Yaeger, MD, Assistant Attending Physician at Memorial Sloan Kettering Cancer Center, New York, offered her thoughts on the findings of Morris et al for the combination regimen of encorafenib, cetuximab, and nivolumab in microsatellite-stable BRAF V600E–mutated metastatic colorectal cancer...

colorectal cancer

High Response Rate Seen With Nivolumab Added to Encorafenib and Cetuximab in BRAF V600E–Mutated Metastatic Colorectal Cancer

The combination of encorafenib, cetuximab, and nivolumab produced responses in 50% of patients and disease control in 96% of patients with microsatellite-stable BRAF V600E–mutated metastatic colorectal cancer in a phase I/II trial reported at the 2022 ASCO Gastrointestinal Cancers Symposium. The...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

KEYNOTE-811: Pembrolizumab Plus Trastuzumab and Chemotherapy in Previously Untreated Advanced HER2-Positive Gastric Adenocarcinoma

As reported in Nature by Yelena Y. Janjigian, MD, of the Gastrointestinal Oncology Service at Memorial Sloan Kettering Cancer Center, and colleagues, the first interim analysis of the phase III KEYNOTE-811 trial has shown a significantly higher objective response rate with the addition of...

colorectal cancer
hepatobiliary cancer
gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Recent FDA Approvals in Gastrointestinal Cancer

Over the past year, the U.S. Food and Drug Administration granted approval to several novel drugs and new indications for older therapeutic agents used in gastrointestinal oncology. Cetuximab Plus Encorafenib On September 28, 2021, cetuximab (Erbitux) was approved in combination with encorafenib...

Expert Point of View: Benoit Rousseau, MD, PhD

Benoit Rousseau, MD, PhD, of Memorial Sloan Kettering Cancer Center, New York, called the findings of the phase II GERCOR NIPICOL trial “interesting and convincing.” Long-term follow-up showed the 3-year progression-free survival rate to be 70% after 1 total year of treatment with nivolumab plus...

gastroesophageal cancer
immunotherapy

Expert Point of View: Samuel J. Klempner, MD

Samuel J. Klempner, MD, Associate Professor at Massachusetts General Hospital and Harvard Medical School, commented on the NEONIPIGA study for The ASCO Post. “This study was the first prospective data set to show what many have suspected—that neoadjuvant immune checkpoint blockade would lead to a...

colorectal cancer

NIPICOL Trial: Promising Outcomes With Shorter Duration of Checkpoint Inhibition in Metastatic Colorectal Cancer

The phase II GERCOR NIPICOL study evaluated 1 year of treatment with nivolumab plus ipilimumab in patients with chemotherapy-resistant metastatic colorectal cancer whose tumors were microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR). With this shortened treatment duration,...

colorectal cancer

Sotorasib in Previously Treated Patients With KRAS G12C–Mutant Colorectal Cancer

In a prespecified analysis of the phase II CodeBreaK100 trial reported in The Lancet Oncology, Marwan Fakih, MD, and colleagues found that the KRAS G12C protein inhibitor sotorasib showed modest activity in patients with previously treated KRAS G12C–mutant colorectal cancer.1 Study Details The...

gastroesophageal cancer
immunotherapy

Neoadjuvant Checkpoint Inhibitor Doublet Yields Complete Responses in Gastroesophageal Cancers

In patients with resectable microsatellite instability–high (MSI-H)/mismatch repair–deficient (dMMR) gastric and gastroesophageal junction adenocarcinoma, dual checkpoint inhibition with ipilimumab and nivolumab given as neoadjuvant therapy led to a pathologic complete response rate of 58.6%,...

gastroesophageal cancer
immunotherapy

Adding Pembrolizumab to Chemotherapy Improves Overall and Progression-Free Survival in First-Line Treatment of Advanced Esophageal Cancer

As reported in The Lancet by Jong-Mu Sun, MD, of Samsung Medical Center, Sungkyunkwan University, Seoul, and colleagues, an interim analysis in the phase III KEYNOTE-590 trial has shown that the addition of first-line pembrolizumab to chemotherapy resulted in improved overall and progression-free...

Expert Point of View: Elena Élez, MD, PhD

Invited discussant of the two studies, Elena Élez, MD, PhD, of the Colon Cancer Program, Vall d’Hebron Institute of Oncology, Barcelona, Spain, discussed the challenge of treating BRAF-mutant colorectal cancer and what the new data bring to that effort. Dr. Élez noted: “BRAF V600E–mutant...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Adding First-Line Nivolumab to Chemotherapy Improves Survival in Gastric, Gastroesophageal Junction, and Esophageal Adenocarcinomas

As reported in The Lancet by Yelena Y. Janjigian, MD, of the Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, and colleagues, the phase III CheckMate 649 trial has shown that the addition of first-line nivolumab to chemotherapy resulted in improved overall and...

colorectal cancer

BRAF-Mutant Colorectal Cancer: Latest Findings for Targeted Treatment

The phase II ANCHOR CRC study, the largest prospective study of BRAF inhibitor–based therapy as first-line treatment of metastatic colorectal cancer, has met its primary endpoint, with 47.8% of patients with metastatic colorectal cancer responding to first-line treatment with encorafenib,...

colorectal cancer

Addition of Neoadjuvant FOLFIRINOX to Preoperative Chemoradiotherapy in Locally Advanced Rectal Cancer

As reported in The Lancet Oncology by Thierry Conroy, MD, and colleagues, the French phase III UNICANCER-PRODIGE 23 trial has shown that intensification of preoperative therapy with FOLFIRINOX (oxaliplatin, irinotecan, leucovorin, fluorouracil [5-FU]) prior to chemoradiotherapy resulted in...

solid tumors

Gastrointestinal Oncology 2021–2022 Almanac

The past year has seen unprecedented progress across the spectrum of gastrointestinal malignances, including the advancement of immunotherapy and targeted molecular agents and the refinement of adjuvant therapy using novel as well as existing therapies. Three themes emerging from these reports are: ...

solid tumors

New ASCO-SNO Guideline Addresses Treatment Recommendations Tailored to Glioma Subtypes

Reflecting recent significant classification changes and new data on the use of biomarkers to inform treatment for central nervous system tumors, a new guideline offers oncologists up-to-date recommendations for managing gliomas in adults with neurologic cancer.1 “Over the past decade, there have...

issues in oncology

Most Favored Nation Model’s Withdrawal Complete; ASCO Applauds Decision Preserving Access to Care

On December 29, 2021, the Centers for Medicare & Medicaid Services (CMS) issued a final rule rescinding the Most Favored Nation (MFN) model. MFN was originally proposed in November 2020 and scheduled to be implemented on January 1, 2021. ASCO and other groups strenuously opposed what would have ...

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