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Alexander Fleming Would Have Loved Our Success With Cancer Immunotherapy

THE UNIVERSITY of Edinburgh Medical School was established in 1726 during the Scottish Enlightenment. As one of the oldest medical schools in the English-speaking world, it is interesting to reflect on the seminal contributions made centuries ago by several alumni that are still relevant to the...

Howard A. ‘Skip’ Burris III, MD, FACP, FASCO, Elected ASCO President for 2019–2020 Term

Howard A. “Skip” Burris III, MD, FACP, FASCO, a long-time member and volunteer, has been elected to serve as the President of ASCO for the term beginning in June 2019. He will take office as President-Elect during the ASCO Annual Meeting in Chicago in June 2018. Additionally, five...

prostate cancer

Study Finds Racial Disparities in Treatment of Clinically Significant Prostate Cancer

In a study reported in the Journal of Oncology Practice, Bickell et al found underuse of treatment for clinically significant prostate cancer was infrequent among white and black patients at two New York City hospitals, but black men accounted for nearly all such underuse of treatment. As noted by...

lymphoma

CAR T-Cell Therapy in Refractory B-Cell Lymphomas

As reported at the recent American Society of Hematology Annual Meeting & Exposition and in The New England Journal of Medicine, Schuster et al found that chimeric antigen receptor (CAR) T-cell therapy produced responses in a high proportion of patients with B-cell lymphomas refractory to or...

gastroesophageal cancer
gastrointestinal cancer

Updated Data in KEYNOTE-061: Pembrolizumab in Previously Treated Gastric or Gastroesophageal Junction Adenocarcinoma

The phase III KEYNOTE-061 trial investigating pembrolizumab (Keytruda) as a second-line treatment for patients with advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma did not meet its primary endpoint of overall survival (OS) (hazard ratio [HR] = 0.82, 95% confidence interval [CI] = ...

gynecologic cancers

FDA Accepts sNDA for Rucaparib in Recurrent Epithelial Ovarian, Fallopian Tube, or Primary Peritoneal Cancer

On December 5, Clovis Oncology announced that the U.S. Food and Drug Administration (FDA) has accepted a supplemental New Drug Application (sNDA) for rucaparib (Rubraca) and granted Priority Review status to the application, with a Prescription Drug User Fee Act (PDUFA) date of April 6, 2018. In...

leukemia

ASH 2017: Dasatinib Plus Standard Chemotherapy Demonstrates 3-Year Survival Benefit in Pediatric Patients With Philadelphia Chromosome–Positive ALL

At the 59th American Society of Hematology (ASH) Annual Meeting & Exposition, Hunger et al presented data from the phase II CA180-372 study in pediatric patients with newly diagnosed Philadelphia chromosome–positive acute lymphoblastic leukemia (ALL) treated with dasatinib (Sprycel) added ...

solid tumors

Anti–PD-L1 Antibody in Advanced Urothelial Carcinoma After Platinum Failure

As reported in The Lancet Oncology by Patel et al, the anti–programmed cell death ligand 1 (PD-L1) antibody avelumab (Bavencio) produced durable responses in patients with locally advanced or metastatic urothelial carcinoma after failure of platinum-based therapy in two expansion cohorts of...

hematologic malignancies
symptom management

ASH 2017: Low–Molecular-Weight Heparin/Edoxaban vs Dalteparin for VTE Associated With Cancer

People with cancer face an increased risk for venous thromboembolism (VTE). Under current guidelines, cancer patients who develop VTE are prescribed low–molecular-weight heparin, an anticoagulant that must be injected under the skin daily for several months. While effective, this regimen can...

hematologic malignancies
symptom management

ASH 2017: Abatacept Nearly Eliminates Severe Acute GVHD After Hematopoietic Stem Cell Transplant

Results from a phase II clinical trial presented by Kean et al at the 59th American Society of Hematology (ASH) Annual Meeting (Abstract 212) show that the drug abatacept (Orencia) nearly eliminated life-threatening severe acute graft-versus-host disease (GVHD) in patients receiving hematopoietic...

multiple myeloma

ASH 2017: ALCYONE Trial: Adding Daratumumab to Bortezomib, Melphalan, and Prednisone in Multiple Myeloma

The first randomized trial to evaluate the use of a monoclonal antibody for treating newly diagnosed multiple myeloma showed that adding the drug daratumumab (Darzalex) to one of the standard treatment regimens reduced the likelihood of disease progression or death by 50%. The regimen also induced...

multiple myeloma

ASH 2017: Clinical Activity Seen With Anti-BCMA CAR T-Cell Therapy in Heavily Pretreated Multiple Myeloma

A one-time infusion of an investigational chimeric antigen receptor (CAR) T-cell therapy that targets a protein found on most multiple myeloma cells elicited an 86% overall response rate in 21 patients whose disease had come back or had not responded after a median of seven prior treatments,...

lymphoma

ASH 2017: JULIET Trial: 6-Month Analysis of Tisagenlecleucel in Relapsed/Refractory DLBCL Shows Sustained Responses

Six months after receiving a single dose of tisagenlecleucel, a chimeric antigen receptor (CAR) T-cell therapy that targets CD-19, high response rates persist among adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), according to findings reported by Schuster et al at...

lymphoma

ASH 2017: ZUMA-1: Responses to CAR T-Cell Therapy Still Strong After 1 Year in Patients With Refractory NHL

Among 108 patients with fast-growing and refractory aggressive non-Hodgkin lymphoma (NHL), more than half were still alive at least a year after receiving a single infusion of a CAR T-cell therapy called axicabtagene ciloleucel that targets the CD-19 protein frequently found on cancerous lymphoma...

leukemia

ASH 2017: CLARITY Trial: Combination Treatment With Two Targeted Agents Shows Promise in Previously Treated CLL

One-third of patients with previously treated chronic lymphocytic leukemia (CLL) had no detectable disease after 6 months of combination therapy with the targeted agents ibrutinib (Imbruvica) and venetoclax (Venclexta), with no increase in the occurrence of tumor-lysis syndrome, a serious treatment ...

FDA Announces Approval, CMS Proposes Coverage of Diagnostic Test for Cancer Biomarkers

On November 30, the U.S. Food and Drug Administration (FDA) approved CDx (F1CDx), a breakthrough-designated, next-generation sequencing–based in vitro diagnostic test that can detect genetic mutations in 324 genes and 2 genomic signatures in any solid tumor type. The Centers for Medicare &...

solid tumors
breast cancer

Partial-Breast and Reduced-Dose Radiotherapy After Breast-Conserving Surgery

The UK IMPORT LOW phase III trial has shown noninferiority in local relapse for partial-breast and reduced-dose vs standard whole-breast radiotherapy after breast-conserving surgery in early breast cancer. These study results were reported by Charlotte E. Coles, PhD, of the University of...

hematologic malignancies
leukemia

Asparaginase-Associated Pancreatitis in Childhood Acute Lymphoblastic Leukemia

An observational study reported in The Lancet Oncology by -Wolthers et al in the Ponte di Legno Toxicity Working Group identified characteristics and the course of asparaginase-associated pancreatitis in childhood acute lymphoblastic leukemia. Kjeld Schmiegelow, MD, of The University Hospital...

solid tumors
lung cancer

Living a Full Life With Stage IV Non–Small Cell Lung Cancer

The discovery of my non–small cell lung cancer (NCSLC) in 2005 was serendipitous and completely unexpected. A never smoker and physically active my whole life, the only hint something might be amiss was a slight tickle in my throat, which I’m not even sure was related to my cancer diagnosis. In...

hematologic malignancies

Untangling the Controversies of Hematopoietic Cell Transplantation

BOOKMARK Title: Hematopoietic Cell Transplants: Concepts, Controversies, and Future DirectionsEditors: Hillard M. Lazarus, MD; Robert Peter Gale, MD, PhD, DSc (hon), FACP; Armand Keating, MD, FRCP(C); Andrea Bacigalupo, MD; Reinhold Munker, MD; Kerry Atkinson, MBBS, MD, DTM&H, FRCP, FRACP; and...

hematologic malignancies
leukemia

Clinical Trials Actively Recruiting Patients With Pediatric Leukemia

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on pediatric leukemia. These studies highlight quality-of-life reporting; neutropenia management; combination chemotherapy; chimeric antigen receptor (CAR) T-cell therapy and some...

hematologic malignancies

Liposome-Encapsulated Daunorubicin and Cytarabine for AML Subtypes

On August 3, 2017, a liposome-encapsulated combination of daunorubicin and cytarabine (Vyxeos) was approved for treatment of adults with newly diagnosed therapy-related acute myeloid leukemia (AML) or AML with myelodysplasia-related changes.1,2 This is the first U.S. Food and Drug...

hematologic malignancies

Ibrutinib in Chronic Graft-vs-Host Disease

On August 2, 2017, ibrutinib (Imbruvica) was approved for treatment of adult patients with chronic graft-vs-host disease after failure of one or more lines of systemic therapy.1,2 This is the first U.S. Food and Drug Administration (FDA)-approved therapy for treatment of chronic graft-vs-host...

solid tumors

Future Directions for CAR T-Cell Therapy

Chimeric antigen receptor (CAR) T-cell therapy burst upon the scene as an innovative approach to the treatment of hematologic malignancies, mainly for patients who have exhausted all other treatment options. Recently two CAR T-cell products were approved by the U.S. Food and Drug Administration...

solid tumors
gynecologic cancers

Olaparib Tablets for Maintenance Treatment in Ovarian Cancer

On August 17, 2017, olaparib -(Lynparza) in tablet form was granted regular approval for maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy.1,2 Olaparib...

Seattle Translational Tumor Research Presents Precision-Medicine Grant Winners

Five cross-disciplinary research groups involving scientists from Fred Hutchinson Cancer Research Center, University of Washington School of Medicine, and Seattle Cancer Care Alliance have received $100,000 in awards from Fred Hutchinson Cancer Research Center–based Seattle Translational Tumor...

hematologic malignancies
lymphoma

Born in Chicago, Lymphoma Specialist Sonali M. Smith, MD, Never Left the Windy City

Nationally recognized lymphoma expert Sonali M. Smith, MD, was born and reared in Chicago to a mother who was a pediatrician and allergist, and a father who was an engineer. Her parents were first-generation immigrants from India who placed the value of education second to none. “I became used to...

breast cancer

SABCS 2017: SOLD Trial Data Support Current Standard 12-Month Adjuvant Trastuzumab for HER2-Positive Breast Cancer

Disease-free survival after 9 weeks of adjuvant trastuzumab (Herceptin) and standard chemotherapy was not comparable to disease-free survival after 12 months of adjuvant trastuzumab and standard chemotherapy for women with early-stage HER2-positive breast cancer, supporting the current...

solid tumors

Immunotherapy Has Indelibly Changed the Treatment Paradigm in Urothelial Carcinoma

Cisplatin-based combination chemotherapy is the preferred first-line therapy for metastatic urothelial cancer and the only treatment shown to improve survival in patients with previously untreated disease for many years. This chemotherapy also has proven to be beneficial in the neoadjuvant and...

solid tumors
lung cancer

Immunotherapy Plus Chemotherapy in Non–Small Cell Lung Cancer: Despite the Failure of Ipilimumab, Guarded Optimism Persists

Ipilimumab (Yervoy) is a fully human monoclonal antibody that inhibits cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) and was the first checkpoint inhibitor approved after showing survival benefit in metastatic melanoma.1 Indeed, in the first-line setting for metastatic melanoma, ipilimumab ...

breast cancer

Vered Stearns, MD, and Prudence A. Francis, MD, on ER+ Breast Cancer: Controversies in Adjuvant Treatment

Vered Stearns, MD, of Johns Hopkins University, and Prudence A. Francis, MD, of the Peter MacCallum Cancer Centre, discuss two key topics in adjuvant treatment: endocrine therapy for premenopausal women with ER+ breast cancer and finding the optimal duration of treatment.

supportive care

Intravenous Rolapitant for Chemotherapy-Induced Delayed Nausea and Vomiting

On October 25, 2017, intravenous (IV) rolapitant (Varubi) was approved for use in combination with other antiemetic agents in adults for the prevention of delayed nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including but not limited to highly...

supportive care
palliative care

Helping Patients With Advanced Disease Transition From Focused to Intrinsic Hope

While hope for a cure after a cancer diagnosis is a feeling both patients and oncologists rightly cling to during treatment, when too much emphasis is placed on this type of “focused” hope, it can make it more difficult for patients to face their mortality. Moreover, such a focus can deny patients ...

genomics/genetics
solid tumors
issues in oncology
breast cancer

National Cancer Institute Awards $12 Million for Breast Cancer Genetics Study

A large study headed by researchers at the Keck School of Medicine of the University of Southern California and two other institutions received $12 million in funding to examine why African American women seem to have more aggressive breast tumors and higher mortality rates from breast cancer than...

hematologic malignancies
leukemia

Dasatinib in Pediatric Patients With Chronic Myeloid Leukemia

On November 9, 2017, dasatinib (Sprycel) was granted regular approval for treatment of pediatric patients with Philadelphia chromosome–positive chronic myeloid leukemia (CML) in chronic phase.1,2 Supporting Efficacy Data Approval was based on findings among 97 pediatric patients with chronic-phase...

hematologic malignancies

Recent Study Findings in CAR T-Cell Therapy for Neoplastic Malignancies

Here is an update on two recent clinical trials focusing on chimeric antigen receptor (CAR) T-cell therapy for neoplastic malignancies. Highlighted are the findings from an early-phase study in refractory aggressive lymphoma and a study in chronic lymphocytic leukemia after failure of ibrutinib...

hematologic malignancies
lymphoma

Follicular Lymphoma: Is the Road to Cure Paved With Gallium?

The roadside along the path to curing follicular lymphoma is riddled with the debris of failed cytotoxic regimens. For decades, clinical trials unsuccessfully pitted various chemotherapy combinations against each other. It took but a single, noncytotoxic molecule, rituximab (Rituxan), to forever...

issues in oncology

Cancer and Obesity: Not Such a Linear Relationship

Obesity has been established as a strong risk factor for the development of cancer. African Americans and Hispanics are particularly at risk, and their access to health care is often poor. How do racial and ethnic disparities in the development of obesity as well as access to care intersect to...

Louis M. Weiner, MD, Appointed Director of MedStar Georgetown Cancer Institute

MedStar Health, the largest not-for-profit health-care system across Maryland and the Washington, DC, region, has named Louis M. Weiner, MD, as Director of its MedStar Georgetown Cancer Institute. Dr. Weiner will serve in this capacity while also remaining Director of Georgetown Lombardi...

supportive care
palliative care

‘Triple Threat’ Conditions May Predict Mortality in Patients With Cancer Presenting to Emergency Departments

Dyspnea, delirium, and poor performance—so-called “triple threat” conditions—are known to predict short survival in palliative care. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 however, the presence of at least two of these symptoms in patients...

issues in oncology
global cancer care

Launching Harmonized NCCN Guidelines for Sub-Saharan Africa

Cancer care in Sub-Saharan Africa, as in other low-resource settings, can be a challenge: The right medications and equipment may be in short supply, maintaining equipment can be a problem, basic chemotherapy drugs may be unaffordable, and patients may not see doctors until the cancer is advanced....

Seattle Children’s Hospital Opens CAR T-Cell Immunotherapy Trial in Pediatric Leukemia

Seattle Children’s Hospital has opened the first chimeric antigen receptor (CAR) T-cell immunotherapy trial in the United States for children and young adults with relapsed or refractory CD19- and CD22-positive acute lymphoblastic leukemia (ALL). With this more robust defense, researchers hope the...

solid tumors
lung cancer

Durvalumab Therapy Improves Outcomes in Patients With Unresectable Stage III NSCLC

The PACIFIC study showed that the addition of the programmed cell death ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) following chemoradiotherapy for patients with unresectable stage III non–small cell lung cancer (NSCLC) dramatically improved progression-free survival compared with placebo....

breast cancer

SABCS 2017: Temporary Ovarian Suppression With Hormone Analog May Preserve Fertility During Breast Cancer Chemotherapy

Meta-analysis of individual patient data from five randomized clinical trials provided a high level of evidence that treatment with a gonadotropin-releasing hormone analog (GnRHa) could safely and effectively protect ovarian function and potentially preserve fertility in premenopausal women...

hematologic malignancies
lymphoma
multiple myeloma

CAR T-Cell Therapy Makes Further Inroads in Lymphoma and Myeloma

With the recent U.S. Food and Drug Administration (FDA) approvals of two chimeric antigen receptor (CAR) T-cell products, this novel approach seems to be moving into the mainstream. The approvals were tisagenlecleucel (also known as CTL019; Kymriah) for the treatment of pediatric B-cell acute...

breast cancer
pain management

SABCS 2017: Acupuncture May Reduce Joint Pain Caused by Aromatase Inhibitor Treatment

Acupuncture significantly reduced joint pain for postmenopausal women with early-stage breast cancer receiving treatment with an aromatase inhibitor compared with both sham acupuncture and no treatment, according to data from the randomized, phase III SWOG S1200 trial presented by Hershman et al at ...

hematologic malignancies
multiple myeloma

Evidence-Based Support for Triplet Therapies in Multiple Myeloma

Over the past 15 years, multiple myeloma has garnered among the highest number of regulatory approvals by the U.S. Food and Drug Administration (FDA) for the management of all phases of the disease. This fast-expanding repertoire of treatment options has pushed the median survival of multiple...

issues in oncology
health-care policy

How ASCO’s New Initiatives Are Helping Oncologists Transition to MACRA

This year has been an important transitional period for oncology providers to start collecting their performance data to meet the requirements of the Quality Payment Program outlined in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA). The Quality Payment Program is a...

hematologic malignancies

ASCO Clinical Practice Guideline Update: Platelet Transfusion for Patients With Cancer

As reported in the Journal of Clinical Oncology by Charles A. Schiffer, MD, of Karmanos Cancer Institute, Wayne State University School of Medicine, and colleagues, ASCO has issued a clinical practice guideline update on platelet transfusions in patients with cancer. The updated guideline replaces ...

gastroesophageal cancer

Oral Microbiota Indicates Possible Link Between Periodontal Disease and Esophageal Cancer

An analysis of bacteria present in the mouth showed that some types of bacteria that lead to periodontal disease were associated with higher risk of esophageal cancer, according to a study published by Peters et al in Cancer Research. Esophageal cancer is the eighth most common cancer and the...

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