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Saad Z. Usmani, MD, on Carfilzomib, Dexamethasone, and Daratumumab for Relapsed or Refractory Myeloma
Saad Z. Usmani, MD, of the Levine Cancer Institute, discusses phase III study findings suggesting that the combination of carfilzomib/dexamethasone/daratumumab represents an efficacious new regimen for patients with relapsed or refractory disease, including those refractory to lenalidomide...
C. Ola Landgren, MD, PhD, on Carfilzomib, Lenalidomide, Dexamethasone, and Daratumumab for Newly Diagnosed Multiple Myeloma
C. Ola Landgren, MD, PhD, of Memorial Sloan Kettering Cancer Center, discusses phase II study findings that showed an 83% negative rate of minimal residual disease in newly diagnosed multiple myeloma treated weekly with 8 cycles of the quadruplet regimen of...
Mark Bustoros, MD, on Ixazomib/Lenalidomide/Dexamethasone for High-Risk Smoldering Multiple Myeloma
Mark Bustoros, MD, of Dana-Farber Cancer Institute, discusses phase II study results showing that the combination of ixazomib, lenalidomide, and dexamethasone is effective in patients with high-risk smoldering disease, with a high response rate, convenient schedule, and manageable toxicity. Longer...
An Early Interest in Biology and People Led to a Career in Oncology for Nina Shah, MD
Multiple myeloma expert Nina Shah, MD, was born and reared in the Northeast. During grade school, she developed a passion for science that would lead to an early decision to pursue a career in medicine. “My ninth-grade biology class really got me interested in human biology, and that’s when I...
First-Line Pembrolizumab Plus Axitinib for Advanced Renal Cell Carcinoma
On April 19, 2019, pembrolizumab was approved for use in combination with the small-molecule tyrosine kinase inhibitor axitinib for the first-line treatment of patients with advanced renal cell carcinoma.1,2 Supporting Efficacy Data Approval was based on findings in the open-label phase III...
I Do Not Have a Multiple Myeloma Precursor Condition. Why Not?
For the country, and for me personally, 2001 was a watershed year. In May, my mother died; the following month my brother, Dom, then 57, called to tell me he had just been diagnosed with multiple myeloma. Except for some fatigue Dom had complained about at our mother’s funeral, there were no...
Expert Point of View: Joshua Richter, MD
Joshua Richter, MD, Assistant Professor of Medicine, Hematology, and Medical Oncology at the Tisch Cancer Institute at Mount Sinai in New York, offered his thoughts on the CANDOR study, noting that the findings point to “a new and exciting treatment regimen for our patients with relapsed and...
Addition of Daratumumab Increases Benefit of Carfilzomib/Dexamethasone in Multiple Myeloma
In patients with relapsed or refractory multiple myeloma, the addition of daratumumab to carfilzomib plus dexamethasone improved multiple outcomes, compared with carfilzomib/dexamethasone alone, in the international phase III CANDOR trial.1 “Overall, carfilzomib/dexamethasone/daratumumab was...
Edward A. Stadtmauer, MD, on Advanced Multiple Myeloma and Sarcoma: First-in-Human Assessment of CRISPR-Edited T Cells
Edward A. Stadtmauer, MD, of the University of Pennsylvania Abramson Cancer Center, discusses phase I results of immune cells, modified with CRISPR/Cas9 technology, and infused in three patients (two with multiple myeloma and one with sarcoma). Researchers observed the cells expand and bind to...
ASH 2019: Is Autologous Hematopoietic Stem Cell Transplant Safe and Effective for Patients Aged 70 or Older With Multiple Myeloma?
Even though autologous hematopoietic stem cell transplantation (AHCT) is an effective treatment for multiple myeloma, only 4 out of 10 patients receive this therapy. A new study presented by Munshi et al at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 782) ...
ASH 2019: Dose-Climbing Trial of Dual-Target CAR T-Cell Therapy for Relapsed or Refractory Multiple Myeloma
More than three out of four patients with relapsed multiple myeloma, or myeloma that was refractory to at least two therapies, remained in remission 7 months after treatment with a novel chimeric antigen receptor (CAR) T-cell therapy targeting two proteins that are frequently found on myeloma...
ASH 2019: Phase Ib/II Study of BCMA-Directed CAR T-Cell Therapy for Pretreated Multiple Myeloma
Patients with multiple myeloma who had received a median of five prior therapies with refractory disease had a high response rate when treated with the investigational chimeric antigen receptor (CAR) T-cell therapy JNJ-4528, which targets B-cell maturation antigen (BCMA), a protein commonly found...
Role of Integrative Therapies for Patients With Colorectal Cancer
The ASCO Post’s Integrative Oncology series is intended to facilitate the availability of evidence-based information on integrative and complementary therapies sometimes used by patients with cancer. In this installment, Richard T. Lee, MD, describes the symptoms associated with colorectal cancer...
Use of an On-Site Touchscreen-Based Geriatric Assessment for Older Patients With Multiple Myeloma
In a study reported in the Journal of Oncology Practice, Nathwani et al found that the use of a tablet-based modified geriatric assessment during physician visits by older patients with multiple myeloma was feasible and provided physicians with information that influenced treatment decisions. Study ...
How the PROMISE Study Aims to Convert Multiple Myeloma Into a Preventable Cancer
In 2018, researchers from Dana-Farber Cancer Institute launched a large, ambitious screening study called (PROMISE; ClinicalTrials.gov identifier NCT03689595) to identify people with premalignant precursor conditions of multiple myeloma, to understand the molecular signs of progression to myeloma...
ICARIA-MM: Addition of Isatuximab to Pomalidomide/Dexamethasone in Relapsed and Refractory Multiple Myeloma
As reported in The Lancet by Michel Attal, MD, 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 progression-free survival in patients with relapsed and refractory...
Using the Nobel Prize to Champion Curiosity-Driven Research in Cancer
William G. Kaelin, Jr, MD, Sidney Farber Professor of Medicine and Howard Hughes Medical Institute Investigator at Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Harvard Medical School, admits that early in his research career, he and his late wife, Carolyn, would have fun...
A Diagnosis of Multiple Myeloma Taught Me to Live in the Moment
I was just 39 in 2015 when I was diagnosed with multiple myeloma. I have a wife and three young children whom I love, a challenging and fulfilling career, and I wasn’t ready to die. When I was first diagnosed, I met with a medical oncologist who had little experience treating this type of cancer....
Elotuzumab in Combination Therapy for Previously Treated Multiple Myeloma
In late 2018, elotuzumab was approved for use in combination with pomalidomide and dexamethasone for the treatment of adult patients with multiple myeloma who have received at least two prior therapies, including lenalidomide and a proteasome inhibitor.1 Supporting Efficacy Data Approval was based ...
Addressing the Obesity Epidemic and Barriers to Implementing Weight Management Programs for Cancer Survivors
Earlier this year, ASCO published the results of its new study on oncologists’ perceptions and practice behaviors regarding obesity, weight management, and related lifestyle factors in their patients both during and after cancer treatment.1 The findings from the online survey of 971 oncology...
FDA Office of Hematology Oncology Products Reorganized, Renamed Office of Oncologic Diseases
As part of modernization plans approved in September 2019, the U.S. Food and Drug Administration (FDA) office responsible for reviewing applications for new and existing cancer therapies has reorganized and been renamed. The Center for Drug Evaluation and Research (CDER) Office of Hematology and...
Selinexor/Dexamethasone in Refractory Multiple Myeloma: The STORM Has Arrived, but Does It Represent Climate Change?
The term “relapsed/refractory multiple myeloma” is often used to describe advanced myeloma that has progressed through primary or salvage therapy. The International Myeloma Working Group (IMWG) defined the term in 2011 as disease that is “nonresponsive while on salvage therapy or progresses...
Selinexor Plus Dexamethasone Studied in Triple-Class Refractory Multiple Myeloma
In a phase IIb study (STORM Part 2) reported in TheNew England Journal of Medicine, Ajai Chari, MD, of Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, and colleagues found that oral selinexor and dexamethasone were active in some patients with multiple myeloma refractory to prior...
Selinexor Plus Dexamethasone Studied in Triple-Class Refractory Multiple Myeloma
In a phase IIb study (STORM Part 2) reported in The New England Journal of Medicine, Ajai Chari, MD, of Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, and colleagues found that oral selinexor and dexamethasone were active in some patients with multiple myeloma refractory to prior...
Lenalidomide vs Observation in Asymptomatic Smoldering Multiple Myeloma
In a phase III trial reported in the Journal of Clinical Oncology, Sagar Lonial, MD, and colleagues found that lenalidomide significantly improved progression-free survival vs observation in patients with intermediate- or high-risk smoldering multiple myeloma. As noted by the investigators,...
How Clonal Hematopoiesis of Indeterminate Potential Increases the Risk of Heart Disease and Blood Cancers as People Age
Although stem cells throughout the body acquire genetic mutations over time, usually these alterations do not affect how the stem cells function or cause disease. However, recent research in clonal hematopoiesis and aging has found an association between clonal expansion of hematopoietic cells with ...
Fedratinib: Back From Development Limbo for the Treatment of Myeloproliferative Neoplasms
In September 2019, Dr. Claire Harrison and colleagues, myself among them, presented two new analyses regarding the use of the JAK2 and FLT3 inhibitor fedratinib in myelofibrosis at the Society of Hematologic Oncology (SOHO) Annual Meeting, with resulting publication in Clinical Lymphoma, Myeloma...
Addition of Durvalumab to Etoposide Plus Platinum Chemotherapy for Extensive-Stage SCLC
This week, we’ll review an interim analysis of the CASPIAN trial, which evaluated the addition of durvalumab to etoposide plus platinum chemotherapy for extensive-stage small cell lung cancer. Then, we’ll talk about two recently issued guidelines on screening for colorectal cancer. Lastly, we’ll...
Daratumumab Combination Therapy for Patients With Multiple Myeloma Who Are Eligible for Transplantation
On September 26, 2019, daratumu-mab (Darzalex) was approved in combination with bortezomib, thalidomide, and dexamethasone for the treatment of multiple myeloma in newly diagnosed adult patients eligible for autologous stem cell transplantation (ASCT).1,2 Supporting Efficacy Data Approval was based ...
FDA Office of Hematology Oncology Products Reorganizes, Renamed Office of Oncologic Diseases
As part of modernization plans approved in September 2019, the U.S. Food and Drug Administration (FDA) office responsible for reviewing applications for new and existing cancer therapies has reorganized and been renamed. The Center for Drug Evaluation and Research (CDER) Office of Hematology and...
Continuous Therapy for Multiple Myeloma Offers Survival Advantage, but Questions Remain
The number of approved agents in multiple myeloma has skyrocketed in recent years, leading to significant improvements in survival, but questions remain regarding the optimal duration of treatment. Although traditionally limited to a fixed number of cycles due to accumulating toxicity, novel agents ...
Levofloxacin Prophylaxis During Treatment of Newly Diagnosed Multiple Myeloma
In the phase III TEAMM trial reported in The Lancet Oncology, Drayson et al found that prophylactic treatment with levofloxacin during the first 12 weeks of multiple myeloma treatment in newly diagnosed patients was associated with a significant reduction in first febrile episodes or death from any ...
Pembrolizumab/Lenvatinib in Advanced Endometrial Carcinoma Without Microsatellite Instability–High or Mismatch Repair–Deficient Disease
On September 17, 2019, the combination of pembrolizumab plus lenvatinib was granted accelerated approval for the treatment of patients with advanced endometrial carcinoma that is not microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) and who have disease progression...
Study Finds Disparities in Treatment of African American and Hispanic Patients With Multiple Myeloma
African American and Hispanic patients with multiple myeloma generally start treatment with novel therapy significantly later than white patients, according to a study published by Ailawadhi et al in Blood Advances. The study found that, on average, it took about 3 months for white patients to...
Impact of Treating Facility, Provider Volume, and Patient-Sharing in the Treatment of Patients With Multiple Myeloma
A study published by Freeman et al in JNCCN—Journal of the National Comprehensive Cancer Network found that generally, providers with more experience treating multiple myeloma have better outcomes than those with more limited experience. Providers who saw the most cases were more likely to be...
Jorge J. Castillo, MD, on Evolution of Therapy for Relapsed/Refractory Multiple Myeloma
Jorge J. Castillo, MD, of Dana-Farber Cancer Institute, discusses the many advances in treating relapsed and/or refractory multiple myeloma, including novel immunomodulators, proteasome inhibitors, and monoclonal antibodies, as well as emerging treatments such as chimeric antigen receptor T-cell...
Nina Shah, MD: How Long Should Initial Treatment for Myeloma Last?
Nina Shah, MD, of the University of California, San Francisco, discusses the debate on fixed duration vs waiting until disease progression, a key question for clinicians treating patients with multiple myeloma.
FDA Approves Daratumumab Combination for Transplant-Eligible Patients With Multiple Myeloma
On September 26, 2019, the U.S. Food and Drug Administration approved daratumumab (Darzalex) in combination with bortezomib, thalidomide, and dexamethasone for newly diagnosed adult patients with multiple myeloma who are eligible for autologous stem cell transplant (ASCT). Efficacy was investigated ...
Benefit of Daratumumab Across Populations With Newly Diagnosed Multiple Myeloma
This week, we review a presentation on the benefit of daratumumab across populations with newly diagnosed multiple myeloma. We also talk about a study on racial disparities in colorectal cancer mortality. Lastly, we discuss the U.S. Food and Drug Administration’s recent approval of apalutamide in...
CMS Expands Coverage of CAR T-Cell Therapy for Medicare Beneficiaries
The Centers for Medicare & Medicaid Services (CMS) released a new national coverage determination (NCD) announcing that Medicare will now cover U.S. Food and Drug Administration (FDA)-approved chimeric antigen receptor T-cell (CAR T-cell) therapy for certain patients with cancer. As outlined in ...
Investigating the Inflammatory Mechanisms That May Be Causing Prostate Cancer in World Trade Center First Responders
The terrorist attacks on September 11, 2001*, on the World Trade Center in New York City resulted in the deaths of more than 2,700 people.1 Nearly 2 decades later, that number may soon be exceeded by the more than 2,000 deaths—and climbing—of first responders to the attack, including firefighters,...
Tailoring Upfront Daratumumab Treatment for Some Patients With Multiple Myeloma
The monoclonal antibody daratumumab has been widely embraced for the treatment of multiple myeloma, but for newly diagnosed patients, its benefit has been proved only in some patients, according to Craig Hofmeister, MD, MPH, Associate Professor of Medicine at the Winship Cancer Institute of Emory...
SOHO 2019: Melflufen for Patients With Late-Stage, Relapsed or Refractory Multiple Myeloma Refractory to Daratumumab and/or Pomalidomide
In a presentation of updated efficacy and safety data from the phase II HORIZON trial, Paul G. Richardson, MD, and colleagues found that melflufen, a lipophilic peptide-conjugated alkylator, showed activity in patients with late-stage relapsed or refractory multiple myeloma refractory to...
Benefits Reported With Addition of Isatuximab to Pomalidomide and Dexamethasone in Resistant Multiple Myeloma
In patients with relapsed or refractory multiple myeloma, isatuximab in combination with pomalidomide and low-dose dexamethasone nearly doubled progression-free survival when compared with pomalidomide and dexamethasone alone, with a manageable safety profile, according to data from a phase III...
FDA Pipeline: Breakthrough Therapy Designation in Lung Cancer, Orphan Drug Designations in Myeloma and Soft-Tissue Sarcoma
Recently, the U.S. Food and Drug Administration (FDA) granted Breakthrough Therapy designation to tepotinib for metastatic non–small cell lung cancer harboring MET exon 14 skipping alterations, and Orphan Drug designations to novel chimeric antigen receptor T-cell therapies in both multiple myeloma ...
Pembrolizumab in Advanced Esophageal Squamous Cell Cancer With PD-L1 Expression of CPS ≥ 10
On July 30, 2019, pembrolizumab was approved for the treatment of patients with recurrent locally advanced or metastatic squamous cell carcinoma of the esophagus whose tumors express programmed cell death ligand 1 (PD-L1; Combined Positive Score [CPS] ≥ 10), as determined by a U.S. Food and Drug...
Daratumumab-Based Therapy for Patients With Newly Diagnosed Multiple Myeloma Who Are Ineligible for Transplantation
On June 27, 2019, daratumumab was approved for use in combination with lenalidomide and dexamethasone for patients with newly diagnosed multiple myeloma who are ineligible for autologous stem cell transplantation.1,2 Supporting Efficacy Data Approval was based on findings in the open-label phase...
Lenalidomide for Previously Treated Follicular and Marginal Zone Lymphomas
On May 28, 2019, lenalidomide was approved for use in combination with a rituximab product for previously treated follicular lymphoma and previously treated marginal zone lymphoma.1,2 Supporting Efficacy Data Approval was based on the findings of two clinical trials: AUGMENT (ClinicalTrials.gov...
SITC Publishes First Clinical Immunotherapy Guidelines for Treatment of Head/Neck Squamous Cell Carcinoma
The Society for Immunotherapy of Cancer (SITC) has published the first clinical immunotherapy guidelines for squamous cell carcinoma of the head and neck, providing oncologists and other advanced practice providers with a clinical roadmap to treating this disease with immunotherapies approved in...
Light Intervention for Cancer-Related Fatigue, Depression, and Sleep Disturbance
GUEST EDITOR Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief of Integrative Medicine Service at Memorial Sloan Kettering Cancer Center, New York. Cancer and its treatments are associated with severe fatigue, depression, ...
