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breast cancer
genomics/genetics
immunotherapy

Dual Checkpoint Inhibitor Therapy Elicits Responses in Highly Mutated Breast Cancer

Patients with advanced HER2-negative metastatic breast cancer and high tumor mutational burden achieved responses—often durable—from treatment with the immunotherapy doublet of nivolumab and ipilimumab, according to results of the phase II NIMBUS trial reported at the 2021 San Antonio Breast Cancer ...

breast cancer
immunotherapy

Datopotamab Deruxtecan Shows Activity in Advanced Triple-Negative Breast Cancer

Datopotamab deruxtecan, an antibody-drug conjugate directed against trophoblast cell surface antigen-2 (Trop-2), is showing promise as a treatment for relapsed or refractory advanced triple-negative breast cancer, according to early findings from the phase I TROPION-PanTumor01 trial presented...

integrative oncology

Mindfulness in Pediatric and Adolescent Patients With Cancer

Guest Editor’s Note: Mindfulness has gained immense popularity in recent years. Growing evidence suggests the benefits of mindfulness-based practices, which include concentration meditation and guided imagery, for managing symptoms associated with cancer and its treatments. In this article,...

leukemia

Fixed-Duration Venetoclax Plus Ibrutinib Achieves Deep and Durable MRD Remissions in CLL

Two different trials presented at the 2021 American Society of Hematology (ASH) Annual Meeting & Exposition found that fixed-duration treatment with ibrutinib and venetoclax achieved deep and sustained undetectable measurable residual disease (MRD) status when used as first-line therapy for...

breast cancer

PALLAS Trial in Hormone Receptor–Positive, HER2-Negative Breast Cancer: Defining the Role of Adjuvant CDK4/6 Inhibition

Over the past 7 years, the introduction of combined endocrine therapy with cyclin-dependent kinase (CDK) 4/6 inhibitors resulted in a dramatic improvement in outcomes for patients with metastatic, hormone receptor–positive, HER2-negative breast cancer. Early attempts to modulate the cell cycle with ...

multiple myeloma

Continued Progression-Free Survival Benefit With Carfilzomib/Dexamethasone/Daratumumab vs Carfilzomib/Dexamethasone in Relapsed or Refractory Multiple Myeloma

In an updated analysis of the pivotal phase III CANDOR trial reported in The Lancet Oncology, Saad Z. Usmani, MD, of Levine Cancer Institute/Atrium Health, and colleagues found that the addition of daratumumab to carfilzomib and dexamethasone (KdD) continued to show a large progression-free...

pancreatic cancer

Neoadjuvant Chemoradiotherapy vs Upfront Surgery in Resectable and Borderline Resectable Pancreatic Cancer

As reported in the Journal of Clinical Oncology by Versteijne et al, long-term follow-up of the Dutch phase III PREOPANC trial has shown an overall survival benefit among patients receiving neoadjuvant chemoradiotherapy vs upfront surgery for resectable and borderline resectable pancreatic cancer;...

colorectal cancer

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

The combination of the BRAF inhibitor encorafenib with 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...

breast cancer

Pyrotinib and Capecitabine in HER2-Positive Breast Cancer With Brain Metastases

In the Chinese phase II PERMEATE trial reported in The Lancet Oncology, Yan et al found that the combination of the pan-HER receptor tyrosine kinase inhibitor pyrotinib plus capecitabine produced high intracranial response rates in women with HER2-positive breast cancer and brain metastases,...

pancreatic cancer
gastrointestinal cancer

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 ...

issues in oncology

Risk-Standardized Mortality Rates as Quality Proxy for Surgical Oncology

In a German study reported in the Journal of Clinical Oncology, Baum et al found that risk-standardized mortality rates may be a better-quality proxy for complex oncologic surgeries than hospital volume. As stated by the investigators, “Despite a long-known association between annual hospital...

lymphoma
immunotherapy

FDA Approves New Label Update for CAR T-Cell Therapy Axicabtagene Ciloleucel

On January 31, the FDA approved an update to the prescribing information for axicabtagene ciloleucel (Yescarta) to include use of prophylactic corticosteroids across all approved indications. Axicabtagene ciloleucel is now the first and only chimeric antigen receptor (CAR) T-cell therapy with...

gastroesophageal cancer
immunotherapy

Addition of Perioperative Trastuzumab to Neoadjuvant Chemoradiation for Patients With HER2-Overexpressing Esophageal Adenocarcinoma

As reported in The Lancet Oncology by Howard P. Safran, MD, and colleagues, the phase III NRG Oncology/RTOG-101 trial has shown no significant disease-free survival benefit with the addition of perioperative trastuzumab to neoadjuvant chemoradiation in previously untreated patients with...

gastrointestinal cancer

Similar Efficacy—but Better Tolerability—for Ripretinib vs Sunitinib in Previously Treated Patients With Advanced GIST

In the INTRIGUE trial, the tyrosine kinase inhibitor ripretinib was not superior to sunitinib in the second-line treatment of patients with advanced gastrointestinal stromal tumors (GIST); however, the agent was better tolerated. These findings were presented by Michael C. Heinrich, MD, FACP, and...

multiple myeloma
immunotherapy

Daratumumab/Hyaluronidase-fihj and Carfilzomib in Multiple Myeloma

On November 30, 2021, daratumu­mab/hyaluronidase-fihj and carfilzomib were approved for use in combination with dexamethasone for adults with relapsed or refractory multiple myeloma who had one to three prior lines of therapy.1,2 Supporting Efficacy Data Approval was based on findings in a cohort...

skin cancer
immunotherapy

Circadian Timing of Immune Checkpoint Inhibitors: Beyond Good Times and Bad Times

After almost a century of limited efficacy of cancer immunotherapy,1 the breakthrough happened in 2012 with the discovery of immune checkpoint inhibitors,2,3 leading to the 2018 Nobel Prize in Physiology or Medicine for James P. Allison and Tasuku Honjo. Yet about 40% of patients on immune...

skin cancer
immunotherapy

Metastatic Melanoma: Improved Overall Survival Reported With Immunotherapy Infusions Given Earlier in the Day

In a single-institution study reported in The Lancet Oncology, David C. Qian, MD, PhD, and Zachary S. Buchwald, MD, PhD, of Winship Cancer Institute of Emory University, Atlanta, and colleagues found that patients with metastatic melanoma who received at least 20% of immune checkpoint inhibitor...

lymphoma

POLARIX: Addition of Polatuzumab Vedotin-piiq to Standard of Care Significantly Reduces Progression of Diffuse Large B-Cell Lymphoma

As a first-line treatment of inter-mediate- or high-risk diffuse large B-cell lymphoma, the addition of the antibody-drug conjugate polatuzumab vedotin-piiq to standard-of-care therapy resulted in a 27% reduction in the relative risk of disease progression, relapse, or death, with a similar safety...

breast cancer

PADA-1 Trial: With Early Identification of ESR1 Mutation, Switch to Fulvestrant in Metastatic Breast Cancer

Switching from an aromatase inhibitor to fulvestrant upon early identification of the ESR1 mutation in plasma—before disease progression—doubled progression-free survival in the phase III PADA-1 trial, presented at the 2021 San Antonio Breast Cancer Symposium.1 “PADA-1 is the first trial to...

lymphoma

ZUMA-7: Axicabtagene Ciloleucel Quadruples Event-Free Survival in Large B-Cell Lymphoma

In the primary analysis of the phase III ZUMA-7 trial, examining second-line therapy for relapsed or refractory large B-cell lymphoma, the CAR T-cell therapy axicabtagene ciloleucel led to a fourfold increase in event-free survival over the standard of care. These findings were presented at the...

bladder cancer

Erdafitinib for Patients With Advanced Urothelial Carcinoma and FGFR Alterations

As reported in The Lancet Oncology by Arlene O. Siefker-Radtke, MD, and colleagues, the final analysis of the phase II BLC2001 trial has shown maintained activity of the pan-fibroblast growth factor receptor (FGFR) tyrosine kinase inhibitor erdafitinib in patients with locally advanced unresectable ...

myelodysplastic syndromes

PANTHER: No Significant Benefit for Pevonedistat Plus Azacitidine in Higher-Risk Myelodysplastic Syndrome

The phase III PANTHER trial, which evaluated pevonedistat plus azacitidine vs azacitidine alone in higher-risk myelodysplastic syndromes, chronic myelomonocytic leukemia, and low–blast count acute myeloid leukemia (AML), failed to meet its primary endpoint of event-free survival, though lessons...

breast cancer

Does Early Locoregional Therapy for the Primary Site Improve Survival in Newly Diagnosed Metastatic Breast Cancer?

In the phase III ECOG-ACRIN E2108 trial reported in the Journal of Clinical Oncology, Seema A. Khan, MD, MPH, and colleagues found no difference in overall survival with early locoregional therapy vs continued systemic therapy among women with newly diagnosed stage IV breast cancer and an intact...

leukemia

Inotuzumab Ozogamicin for Pediatric Patients With Relapsed or Refractory B-Cell ALL

In a phase II trial (Children’s Oncology Group AALL1621) reported in the Journal of Clinical Oncology, O’Brien et al found that inotuzumab ozogamicin produced a high response rate in children and adolescents with relapsed or refractory B-cell acute lymphoblastic leukemia (ALL). Study Details In the ...

breast cancer

Second-Line T-DXd Improves Progression-Free Survival Across HER2-Positive Metastatic Breast Cancer Subgroups

The antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) lengthened progression-free survival and improved objective response rate compared to the antibody-drug conjugate ado-trastuzumab emtansine (T-DM1) after trastuzumab and taxane therapy in women with HER2-positive metastatic breast...

kidney cancer
immunotherapy

Atezolizumab/Bevacizumab vs Sunitinib in Previously Untreated Patients With Metastatic RCC: Final Overall Survival Analysis of IMmotion151

As reported in JAMA Oncology by Robert J. Motzer, MD, and colleagues, the final overall survival analysis of the phase III IMmotion151 trial has shown no significant difference for atezolizumab plus bevacizumab vs sunitinib in previously untreated patients with metastatic renal cell carcinoma...

covid-19

Immunogenicity of COVID-19 BNT162b2 mRNA Vaccine Booster in Patients With Cancer Receiving Active Treatment

In an Israeli single-institution study reported in The Lancet Oncology, Ligumsky et al found that a booster dose of the SARS–CoV-2 Pfizer-BioNTech BNT162b2 mRNA vaccine given in August or September 2021 was immunogenic in patients receiving active cancer treatment. Antibody levels prior to and...

global cancer care

Study Examines Global Cancer Burden From 2010 to 2019

Cancer deaths rose to 10 million and new cases jumped to over 23 million globally in 2019, according to a new study from the Institute for Health Metrics and Evaluation (IHME) at the University of Washington School of Medicine published in JAMA Oncology. At the start of the decade in 2010, total...

multiple myeloma

MRD Response–Adapted Therapy in Patients Receiving Daratumumab, Carfilzomib, Lenalidomide, and Dexamethasone Plus AHCT for Newly Diagnosed Multiple Myeloma

In the phase II MASTER trial reported in the Journal of Clinical Oncology, Luciano J. Costa, MD, PhD, and colleagues found that daratumumab, carfilzomib, lenalidomide, and dexamethasone (Dara-KRd) induction; autologous hematopoietic cell transplantation (AHCT); and measurable residual disease (MRD) ...

lung cancer

Postoperative Radiotherapy for Patients With Completely Resected Stage IIIA NSCLC and N2 Involvement

In the European phase III Lung ART trial reported in The Lancet Oncology, Le Pechoux et al found that three-dimensional (3D) conformal postoperative radiotherapy (PORT) did not improve disease-free survival vs no PORT in patients with stage IIIA N2 non–small cell lung cancer (NSCLC) who had...

hematologic malignancies
supportive care

Calcineurin Inhibitor–Free Chronic Graft-vs-Host Disease Interventions in Myeloablative HCT for Hematologic Malignancies

As reported in the Journal of Clinical Oncology by Luznik et al, the phase III Blood and Marrow Transplant Clinical Trial Network 1301 trial has shown no improvement in the composite outcome of chronic graft-vs-host disease or relapse-free survival with calcineurin inhibitor–free regimens in...

multiple myeloma
immunotherapy

MAIA Trial: Daratumumab Added to Lenalidomide Plus Dexamethasone Improves Overall Survival in Transplant-Ineligible Multiple Myeloma

As reported in The Lancet Oncology by Thierry Facon, MD, of the Centre Hospitalier Universitaire de Lille, and colleagues, a prespecified interim analysis of overall survival in the pivotal phase III MAIA trial has shown a significant benefit with the addition of daratumumab to...

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-3121 are not mature enough to establish cabozantinib/atezolizumab as a new front-line option for advanced hepatocellular carcinoma...

solid tumors
hematologic malignancies

2021 FDA Approvals of Drugs for Cancer Treatment

Over the past year, the U.S. Food and Drug Administration (FDA) granted approval to many novel drugs and new indications for older therapeutic agents used in oncology and hematology. NOVEMBER Pafolacianine for Ovarian Cancer Lesions: On November 29, pafolacianine (Cytalux), an imaging drug,...

colorectal cancer

Solving the Conundrum of Young-Onset Colorectal Cancer

Although research so far has failed to uncover the root causes of the development of young-onset colorectal cancer, what is certain is that although colorectal cancer rates are declining in older adults, they are on a steady rise in people younger than age 50, especially those between the ages of...

multiple myeloma

CANDOR: Continued Progression-Free Survival Benefit With Carfilzomib, Dexamethasone, and Daratumumab vs Carfilzomib and Dexamethasone in Relapsed or Refractory Multiple Myeloma

In an updated analysis of the pivotal phase III CANDOR trial reported in The Lancet Oncology, Saad Z. Usmani, MD, and colleagues found that the addition of daratumumab to carfilzomib and dexamethasone (KdD) continued to show a large progression-free survival benefit in patients with relapsed or...

breast cancer
immunotherapy

Composite Biomarker Needed to Predict Benefit of Immunotherapy in Triple-Negative Breast Cancer

Although there is a biomarker that predicts response to the one approved immunotherapy agent for metastatic triple-negative breast cancer, “it is important to note there are no biomarkers of response to neoadjuvant immunotherapy in early-stage triple-negative breast cancer,” Elizabeth A....

lymphoma

POLARIX: Pola-R-CHP vs R-CHOP for Previously Untreated Patients With DLBCL

The POLARIX study found patients with diffuse large B-cell lymphoma (DLBCL) had a significantly higher likelihood of survival without disease progression 2 years after receiving a new drug combination known as pola-R-CHP (polatuzumab vedotin-piiq with rituximab, cyclophosphamide, doxorubicin, and...

covid-19

European OnCovid Registry Analysis of Time-Dependent COVID-19 Mortality in Patients With Cancer

As reported in JAMA Oncology by researchers from the OnCovid Study Group, an updated analysis of the European OnCovid registry indicated that mortality due to COVID-19 infection has decreased over time for patients with cancer during the pandemic. Study Details The study included real-world data on ...

hematologic malignancies
covid-19

ASH RC COVID-19 Registry for Hematology: Risk Factors for Hospitalization and Death Among Patients With Hematologic Malignancies Infected With COVID-19

Patients with blood cancers, particularly those with more advanced disease, are at increased risk for serious COVID-19 outcomes, including an elevated chance of severe illness or death from infection, according to an analysis of more than 1,000 patients in the ASH Research Collaborative (RC)...

leukemia

Brexucabtagene Autoleucel for Relapsed or Refractory B-Cell Precursor ALL

On October 1, 2021, the CD19-directed chimeric antigen receptor (CAR) T-cell therapy brexucabtagene autoleucel was approved for adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).1 The product is available only through a restricted program under a Risk Evaluation ...

Last Hug

“Good evening, doc; I wanted to check on you and update you on my mom” read the text message on a late Thursday afternoon. I recognized the sender; it was not uncommon for me to share my cell phone number with patients and their families. Having been a caretaker of my own parents’ medical needs, I...

lymphoma

Potential Impact of Nurse Navigation Program in Achieving Equitable Care and Outcomes in Patients With Aggressive Large B-Cell Lymphoma

In a single-institution study reported in the journal Cancer, and reviewed in the September 10, 2021, issue of The ASCO Post, Bei Hu, MD, and colleagues from Levine Cancer Institute/Atrium Health found that the use of a dedicated nurse navigation program aided in producing similar patterns of...

hematologic malignancies

Increased Risk of Early Cardiac Toxicity With Posttransplantation Cyclophosphamide in Allogeneic HSCT

In a French single-center retrospective cohort study reported in JACC: CardioOncology, Rémy Duléry, MD, of Saint-Antoine Hospital, Paris, and colleagues found that posttransplantation cyclophosphamide was associated with a significantly increased risk of early cardiac toxicity among patients...

skin cancer
immunotherapy

Long-Term Outcomes From CheckMate 067: Nivolumab/Ipilimumab, Nivolumab, or Ipilimumab in Advanced Melanoma

In a 6.5-year update of the phase III CheckMate 067 trial reported in the Journal of Clinical Oncology, Jedd D. Wolchok, MD, PhD, FASCO, and colleagues provided long-term overall survival as well as melanoma-specific survival findings among patients with advanced melanoma who received nivolumab...

kidney cancer

Pembrolizumab for Adjuvant Treatment of Renal Cell Carcinoma

On November 17, 2021, the immunotherapeutic agent pembrolizumab was granted approval for adjuvant treatment of patients with renal cell carcinoma at intermediate-high or high risk of recurrence following nephrectomy or nephrectomy and resection of metastatic lesions.1 Supporting Efficacy Data...

head and neck 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...

lung cancer

Low-Dose Computed Tomography: A Window Into Early Lung Disease?

Lung health in adults has traditionally been defined as the absence of disease, but it may be time to rethink this paradigm, according to Ravi Kalhan, MD, MS, Director of the Northwestern Asthma and Chronic Obstructive Pulmonary Disease (COPD) Program at Northwestern University Feinberg School of...

issues in oncology

Establishing a Health Equity Report Card to Eradicate Disparities in Cancer Care

Although enormous progress over the past 50 years in every aspect of cancer care, including prevention, screening, chemotherapy, targeted therapy, surgery, radiation therapy, and supportive care, has resulted in increases in lives saved—from 3 million in 1971 to 16.9 million in 2019—the burden of...

covid-19

COVID-19 Infection After SARS–CoV-2 Messenger RNA Vaccination in Patients With Cancer

In a study reported in JAMA Oncology, Wu et al found that vaccination with SARS–CoV-2 messenger RNA vaccines reduced the incidence of COVID-19 infection vs no vaccination in Veterans Affairs (VA) patients with cancer. Vaccine effectiveness varied according to time between last systemic therapy and...

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