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cost of care

Is Precision Oncology an Unsustainable Promise?

Despite the promise of precision oncology, the cost-effectiveness of targeted treatments remains open to debate. According to Aakash Desai, MD, MPH, there is an urgent need for drug-pricing reform, given the average expenditure of Medicare Part D. An analysis of the Medicare database presented...

breast cancer
global cancer care

Urbanization in Bangladesh: The Prevalence of Breast Cancer Brings Unique Challenges

The number of deaths related to breast cancer are increasing at an alarming pace worldwide. According to a World Health Organization (WHO) 2020 report, approximately 2,088,849 new cases and 627,000 deaths related to breast cancer occurred in 2018.1 More than 55% of these deaths occurred in low- to ...

leukemia

Noninferior Progression-Free Survival and Reduced Cardiovascular Toxicity With Acalabrutinib vs Ibrutinib in Previously Treated CLL

As reported in the Journal of Clinical Oncology by John C. Byrd, MD, of The Ohio State University Comprehensive Cancer Center, and colleagues, the phase III ELEVATE-RR trial has shown noninferior progression-free survival with the more-selective Bruton’s tyrosine kinase (BTK) inhibitor...

lung cancer

Pretreatment Levels of Circulating Tumor DNA May Predict Long-Term Survival in NSCLC

Pretreatment circulating tumor DNA (ctDNA) levels in patients with non–small cell lung cancer (NSCLC) appear to be a more accurate predictor of long-term survival than classic survival surrogates, according to research presented during the International Association for the Study of Lung Cancer...

IASLC Presents WCLC 2021 Lectureship Awards to International Array of Lung Cancer Researchers

The International association for the Study of Lung Cancer (IASLC), at its 2021 World Conference on Lung Cancer (WCLC), presented awards to clinicians and researchers who made significant contributions to the treatment of patients with lung cancer. The awards represent many major categories of lung ...

skin cancer
genomics/genetics
immunotherapy

SECOMBIT Trial Evaluates Optimal Treatment Sequencing in BRAF-Mutated Melanoma

Patients with untreated, metastatic BRAF-mutated melanoma may benefit from receiving immunotherapy first, moving to targeted therapy in the second line, data from the updated overall survival analysis of the randomized, phase II SECOMBIT trial suggest.1 The study aimed to define the optimal...

Expert Point of View: Barbara Pistilli, MD

Barbara Pistilli, MD, of the Breast Cancer Group at Gustave Roussy Cancer Center, Villejuif, France, said the results of the TULIP trial, showing the progression-free survival benefit for vic-trastuzumab duocarmazine (SYD985), help to establish antibody-drug conjugates as key components of the...

breast cancer
immunotherapy

Another Antibody-Drug Conjugate Enters the Metastatic Breast Cancer Landscape

In the global phase III TULIP trial in metastatic HER2-positive breast cancer, treatment with the antibody-drug conjugate vic-trastuzumab duocarmazine (SYD985) significantly improved progression-free survival in comparison with standard chemotherapy in previously treated patients, making this a new ...

bladder cancer

Neoadjuvant dd-MVAC Improves Local Control and Progression-Free Survival in Patients With Muscle-Invasive Bladder Cancer

The VESPER phase III trial answers some key questions regarding the optimal management of muscle-invasive bladder cancer. The study found that the neoadjuvant regimen of dose-dense methotrexate, vinblastine, doxorubicin, and cisplatin (dd-MVAC) was superior to standard gemcitabine/cisplatin in...

sarcoma

Risk-Based Treatment of Pediatric and Young Adult Synovial Sarcoma

In a report from the Children’s Oncology Group ARST0332 study published in the Journal of Clinical Oncology, Venkatamani et al found that risk-based treatment of pediatric and young adult patients with synovial sarcoma produced favorable outcomes in those with nonmetastatic disease. Outcomes in...

breast cancer

Development of a Breast Cancer Risk Prediction Model for Black Women in the United States

As reported in the Journal of Clinical Oncology, Julie R. Palmer, ScD, and colleagues have developed and validated a risk prediction model for invasive breast cancer in Black women in the United States. Study Details For the development of the model, breast cancer relative and attributable risks...

Expert Point of View: Melinda L. Telli, MD

The invited discussant of GeparNuevo,1 Melinda L. Telli, MD, Associate Professor of Medicine at Stanford University School of Medicine, Director of the Breast Cancer Program at the Stanford Cancer Institute, and Associate Director of the Stanford Women’s Cancer Center, welcomed the additional data...

Expert Point of View: Giuseppe Curigliano, MD, PhD

Invited discussant Giuseppe Curigliano, MD, PhD, Associate Professor of Medical Oncology at the University of Milan, Italy, and Head of the Division of Early Drug Development at the European Institute of Oncology, said the “clear” findings of KEYNOTE-5221 are “practice-changing.” However, the ideal ...

breast cancer

Early Triple-Negative Breast Cancer: Are Checkpoint Inhibitors Ready for Neoadjuvant or Adjuvant Use?

Recent clinical trials have been encouraging for the neoadjuvant or adjuvant use of immune checkpoint inhibitors in triple-negative breast cancer, but is this approach ready for the clinic? This question was addressed at the 38th Miami Breast Cancer Conference, held virtually this year, by Adam M....

breast cancer

Novel HER2-Targeted Therapies Pose Sequencing Challenges

With three new HER2-targeted therapies approved over the past year or two alone, the treatment landscape for patients with metastatic breast cancer has become increasingly crowded. In the third-line setting and beyond, there are now at least eight HER2-targeted agents approved by the U.S. Food and...

breast cancer

Expert Point of View: C. Kent Osborne, MD

C. Kent Osborne, MD, Founding Director of the Dan L. Duncan Comprehensive Cancer Center and the Dudley and Tina Sharp Chair for Cancer Research, Baylor College of Medicine, Houston, said in a press briefing that the results of the study were clear, but the explanation for the findings is less so....

breast cancer

Expert Point of View: C. Kent Osborne, MD, and Ruth M. O’Regan, MD

Commentary for monarchE and PENELOPE-B was provided by C. Kent Osborne, MD, and Ruth M. O’Regan, MD, respectively. Dr. Osborne is Professor of Medicine, Hematology, and Oncology and the Dudley and Tina Sharp Chair for Cancer Research at Baylor College of Medicine, as well as Founding Director of...

breast cancer

Beyond CDK4/6 Inhibitors in Metastatic Breast Cancer: What’s Next?

Because of their well-established efficacy, inhibitors of cyclin-dependent kinases 4 and 6 (CDK4/6) are the standard of care in the treatment of hormone receptor–positive, HER2-negative metastatic breast cancer. The question now is this: After disease progresses on a CDK4/6 inhibitor and endocrine...

breast cancer

Breast Cancer 2020–2021 Almanac

The past decade has seen an explosion of novel agents for breast cancer across subtypes. Although each new advance improves therapeutic options for patients, it also brings forth a challenging question: Who needs what treatment? Not all cancers are created equally, and similarly not all patients...

breast cancer

Reduction in Ipsilateral Recurrence Risk With Radiotherapy vs Observation After Lumpectomy for Good-Risk DCIS

In an analysis of long-term outcomes from the phase III NRG/RTOG 9804 trial reported in the Journal of Clinical Oncology, Beryl McCormick, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that whole-breast irradiation vs observation was associated with a reduced risk of all and...

skin cancer
immunotherapy

Adjuvant Pembrolizumab Shows Efficacy in High-Risk Stage II Melanoma in Adults and Children Older Than 12

Adjuvant pembrolizumab reduced the risk of recurrence in adults and children older than age 12 with high-risk stage II (AJCC 8th edition, stage IIB/IIC) melanoma vs placebo, according to a late-breaking interim analysis of the phase III KEYNOTE-716 trial, presented during the European Society for...

gynecologic cancers
immunotherapy

Study Shows Pembrolizumab Plus Chemotherapy Improves Survival in Advanced Cervical Cancer

The addition of pembrolizumab to chemotherapy prolonged survival in recurrent, persistent, or metastatic cervical cancer, according to the results of the first interim analysis of the ­KEYNOTE-826 trial, presented at a Presidential Symposium during the European Society for Medical Oncology (ESMO)...

lung cancer
immunotherapy

Expert Point of View: Ichiro Yoshino, MD, PhD

Ichiro Yoshino, MD, PhD, Professor and Chairman of the Department of General Thoracic Surgery, Chiba University Graduate School of Medicine, Japan, reviewed the finer details of the IMpower010 exploratory analysis.1 He maintained that atezolizumab’s benefit does, indeed, seem to favor some patient...

lung cancer
immunotherapy

IMpower010: Benefits Observed With Atezolizumab Regardless of Stage, Type of Prior Treatment

In an exploratory analysis of the pivotal phase III IMpower010 trial in stage II–IIIA non–small cell lung cancer (NSCLC), continued treatment with the monoclonal antibody atezolizumab after surgery and chemotherapy improved disease-free survival regardless of the type of surgery or chemotherapy...

breast cancer
immunotherapy

Expert Point of View: Shanu Modi, MD

Shanu Modi, MD, of the Breast Medicine Service at Memorial Sloan Kettering Cancer Center, New York, called the DESTINY-Breast03 results,1 which showed a highly significant benefit for fam-trastuzumab deruxtecan-nxki (T-DXd) over trastuzumab emtansine (T-DM1), “unprecedented.” She suggested they...

breast cancer
immunotherapy

DESTINY Breast03 Trial Supports Second-Line Use of T-DXd in Metastatic HER2-Positive Breast Cancer

The antibody-drug conjugate fam-trastuzumab deruxtecan-nxki (T-DXd) may become a new option as a second-line treatment of patients with HER2-positive unresectable or metastatic breast cancer, based on results from the global phase III DESTINY-Breast03 trial. These findings were presented by Javier...

pancreatic cancer

Study Finds Some Pancreatic Cancer Trial Eligibility Criteria Disproportionately Exclude Black Patients

Although lack of clinical trial participation is associated with worse survival outcomes in some malignancies, data show that Black patients with cancer represent just 7.3% of participants—and only 4.5% for such cancers as multiple myeloma—in cancer clinical trials, compared with 84.2% for White...

lung cancer
immunotherapy

Maintenance Durvalumab: Increased Utilization May Improve Outcomes in NSCLC

Maintenance durvalumab, the standard-of-care treatment for patients with unresectable stage III non–small cell lung cancer (NSCLC), remains significantly underutilized, according to data presented at the International Association for the Study of Lung Cancer (IASLC) 2021 World Conference on Lung...

lymphoma
immunotherapy

Tackling a Growing Need: Options After CAR T-Cell Therapy for Lymphoma

For aggressive B-cell lymphomas, chimeric antigen receptor (CAR) T-cell therapy saves lives, but relapse remains common, and a second-line standard of care is lacking. During the 2021 Pan Pacific Lymphoma Conference, Grzegorz (Greg) S. Nowakowski, MD, Professor of Medicine and Oncology, Lymphoma...

prostate cancer

Adding Value to Clinical Decision-Making in Nonmetastatic Castration-Resistant Prostate Cancer

Several recent investigations have led to the U.S. Food and Drug Administration (FDA) approval of novel antiandrogens to treat nonmetastatic castration-resistant prostate cancer. Yet, this work has not addressed the treatment of nonmetastatic hormone-sensitive biochemically recurrent prostate...

colorectal cancer
genomics/genetics

Adavosertib for Patients With TP53- and RAS-Mutant Metastatic Colorectal Cancer

As reported in the Journal of Clinical Oncology by Seligmann et al, the phase II FOCUS4-C trial has shown activity of the WEE1 kinase inhibitor adavosertib in patients with TP53- and RAS-mutant metastatic colorectal cancer with disease control after first-line chemotherapy. As state by the...

lung cancer

Classifying EGFR Mutations by Structure and Function May Help to Match Patients With NSCLC to More Effective Treatments

Researchers have discovered that grouping EGFR mutations by structure and function provides an accurate framework to match patients with non–small cell lung cancer (NSCLC) to the right drugs. The findings, published by Robichaux et al in Nature, identify four subgroups of mutations and introduce a...

colorectal cancer

Capecitabine Maintenance After First-Line Therapy for Metastatic Colorectal Cancer

In the FOCUS4-N trial reported in the Journal of Clinical Oncology, Adams et al found that capecitabine maintenance improved progression-free—but not overall—survival vs active monitoring in patients with stable disease or objective response after first-line therapy for metastatic colorectal...

hepatobiliary cancer

Ivosidenib for Previously Treated IDH1-Mutant Advanced or Metastatic Cholangiocarcinoma

On August 25, 2021, ivosidenib was approved for adults with previously treated, locally advanced or metastatic cholangiocarcinoma with an IDH1 mutation, as detected by a U.S. Food and Drug Administration (FDA)-approved test.1 The FDA simultaneously approved the Oncomine Dx Target Test as a...

lymphoma
geriatric oncology

Older Adults With Primary CNS Lymphoma: Treatment Opportunities and Challenges

The ASCO Post is pleased to present the Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib, Desai, and DeAngelis explore the treatment of older patients with primary central nervous system lymphoma (PCNSL), which pose...

integrative oncology

Kombucha

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, Yen Nien Hou, PharmD, DipIOM, LAc, and Jyothirmai Gubili, MS, focus on...

global cancer care
covid-19

Building a ‘Better Normal’ of Oncology Care to Strengthen Global Health Security After the COVID-19 Pandemic

During the opening session of the 2021 ASCO Annual Meeting, Julio Frenk, MD, PhD, MPH, President of the University of Miami, gave a riveting presentation in which he described the devastating effects of the global COVID-19 pandemic on patients with cancer as well as on fragile and fragmented...

hematologic malignancies

Myeloma Trial Updates: Focus on High-Risk Patients and Measurable Residual Disease Negativity

Newly diagnosed patients with multiple myeloma deemed at high risk for disease progression may achieve sustained measurable residual disease (MRD) negativity with newer regimens and transplantation, and this may translate into longer progression-free survival. That’s the key take-away message from...

skin cancer

Adoptive Cell Therapy May Soon Be Available for Patients With Melanoma

Oncologists who treat patients with melanoma will need to become familiar with another immunotherapy approach. For refractory metastatic disease, adoptive cell therapy is on the horizon. “Adoptive cell therapy will offer additional hope for our patients with melanoma. We’ll likely be seeing this...

solid tumors
hematologic malignancies

ASCO 2021: Roundup of Studies You May Have Missed

As ASCO Annual Meeting attendees know by now, clinicians don’t have to be at McCormick Place to hear practice-changing findings and forward-looking advances in the field of oncology. Interesting content was no exception at the 2021 conference, so in addition to covering the biggest news from the...

immunotherapy
lymphoma

Lymphoid Malignancies: What’s Next for Antibody-Drug Conjugates?

Antibody-drug conjugates are improving outcomes of patients with lymphoma, often those who have exhausted treatment options after chimeric antigen receptor (CAR) T-cell therapy. Four available antibody-drug conjugates are in the clinic, with brentuximab vedotin moving into the front-line...

lymphoma

Putting Radiotherapy to Best Use With CAR T-Cell Therapy in Lymphoma

The integration of radiation therapy into chimeric antigen receptor (CAR) T-cell therapy may improve outcomes for patients with relapsed or refractory lymphoma, according to Charles A. Enke, MD, Professor and the Bill Bures and Jerry Pabst Chair in Radiation Oncology at the Fred and Pamela Buffett...

lymphoma

Bispecific Antibodies Find a Place in B-Cell Lymphoma Treatment

In relapsed or refractory B-cell lymphomas, bispecific T-cell engager antibodies are finding a place in the treatment algorithm, said Christopher Flowers, MD, MS, FASCO, Professor and Chair of the Department of Lymphoma/Myeloma at The University of Texas MD Anderson Cancer Center, Houston. At the...

issues in oncology

Overcoming the Disparities in Cancer Survival Among AYA Minority Patients

Although the National Cancer Institute (NCI) has identified adolescents and young adults (AYAs) with cancer as a distinct patient population from children and older adults with the disease, research into the diagnosis, treatment, and survivorship specific to this patient population has not kept...

colorectal cancer

Association of Skeletal Muscle Area and Adiposity Measures With Inflammation and Outcomes in Nonmetastatic Colon Cancer

In a study reported in JAMA Network Open, Fleming et al found that low skeletal muscle area and high visceral-to-total fat ratio were associated with increased expression of proinflammatory cytokines and VEGF as well as worse 5-year outcomes in patients with nonmetastatic colon cancer. Study...

gynecologic cancers
immunotherapy

Novel Treatments Show Activity in Advanced Cervical Cancer

The treatment of recurrent or metastatic cervical cancer has not changed much in recent years, but according to preliminary trials presented at the European Society for Medical Oncology (ESMO) Virtual Congress 2020, checkpoint inhibitors and antibody-drug conjugates may become new options. In the...

gynecologic cancers

With the Exception of Cervical Cancer, HPV-Associated Cancers Are on the Rise, Especially in Older Adults

Although the incidence of cervical cancer has decreased 1.03% a year over the past 17 years in the United States, likely due to screening or vaccination, other human papillomavirus (HPV)-associated cancers are increasing in both men and women, according to a study by Cheng-I Liao, MD, currently of...

gynecologic cancers

5-Year Follow-up of SOLO-1: Sustained Benefit for Maintenance Olaparib in Ovarian Cancer

In the 5-year follow-up of the pivotal SOLO-1 trial in women with newly diagnosed advanced ovarian cancer and a BRCA1/2 mutation, maintenance treatment with olaparib led to a more than doubling in progression-free survival, according to a presentation at the Society of Gynecologic Oncology (SGO)...

gynecologic cancers

Expert Point of View: Kunle Odunsi, MD, PhD, and Lilian T. Gien, MD, MSc

Comments on the OUTBACK trial were provided by invited discussant Kunle Odunsi, MD, PhD, Professor of Obstetrics and Gynecology, Dean for Oncology, and Director of the University of Chicago Medicine Comprehensive Cancer Center. Lilian T. Gien, MD, MSc, Associate Professor of Oncology at the...

gynecologic cancers
immunotherapy

Gynecologic Cancers 2020–2021 Almanac

The past year has been a remarkable and noteworthy time with much exciting progress made in gynecologic cancers, despite the underlying presence of the COVID-19 pandemic. Several key studies were presented in 2020–2021 that detailed the results of novel therapies for our patients with cervical,...

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