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issues in oncology

What About Sharing Clinical Data?

IN RESPONSE to a question during the Lurie Cancer Center OncoSET Symposium about sharing clinical data, Warren Kibbe, PhD, Acting Deputy Director of the National Cancer Institute, acknowledged “it is still very problematic,” but “there is an opportunity for meaningful use.” He said that the...

solid tumors
genomics/genetics
hematologic malignancies

Update on NCI Projects Aimed at Advancing Precision Medicine

“PRECISION MEDICINE will lead to fundamental understanding of the complex interplay among genetics, epigenetics, nutrition, environment and clinical presentation, and direct effective, evidence-based prevention and treatment. We can’t measure all that all at once right now, but we are starting to...

breast cancer

Potent PARP Inhibitor Moves Ahead in BRCA-Mutated Breast Cancer

TALAZOPARIB, a novel inhibitor of poly (ADP-ribose) polymerase (PARP), showed encouraging efficacy in breast cancer patients with BRCA1/2 mutations in the phase II ABRAZO trial, presented at the 2017 ASCO Annual Meeting by Nicholas C. Turner, MD, of the Royal Marsden Hospital and The Institute of...

lung cancer

Retreatment With Checkpoint Inhibitors May Be Feasible for Some Patients With NSCLC

INCREASING NUMBERS of patients are being treated with checkpoint inhibitors, and about one-quarter to one-third will develop immune-related adverse events. One question on the minds of oncologists is can these patients be safely re-treated once their adverse events resolve?  One of the first...

lung cancer

Dacomitinib Outperforms Gefitinib in EGFR-Positive NSCLC

DACOMITINIB, a second-generation epidermal growth factor receptor (EGFR)-targeted tyrosine kinase inhibitor, outperformed gefitinib (Iressa) as first-line treatment for EGFR-positive advanced non–small cell lung cancer (NSCLC) in the phase III ARCHER 1050 study.1 Dacomitinib improved...

leukemia

Blinatumomab in B-Precursor Acute Lymphoblastic Leukemia

In a phase II trial reported in the Journal of Clinical Oncology, Giovanni Martinelli, MD, of S. Orsola University Hospital, Bologna, and colleagues found that blinatumomab (Blincyto) produced complete responses in patients with relapsed/refractory Philadelphia chromosome–positive B-precursor...

Cancer Survivor Publishes Book for Children About Cancer

A book aimed at helping young families understand cancer, Hair to the Queen! is now available on Amazon. Written by first-time author Tamara B. Rodriguez and illustrated by Carole A. Smith, the book empowers adults to discuss cancer with children in a simple and compassionate way. Hair to the...

kidney cancer

Atezolizumab/Bevacizumab Moves Forward in Metastatic Renal Cell Carcinoma

THE COMBINATION of atezolizumab (Tecentriq) plus bevacizumab (Avastin) showed promising results as first-line treatment of patients with metastatic renal cell carcinoma, according to a phase II trial called IMmotion 150. Based on these results, the phase III IMmotion 151 trial is comparing...

issues in oncology

Annual Report to the Nation: Cancer Death Rates Continue to Decline

Overall cancer death rates continue to decrease in men, women, and children for all major racial and ethnic groups, according to the latest Annual Report to the Nation on the Status of Cancer, 1975–2014, published by Jemal et al in the Journal of the National Cancer Institute.1 The report finds...

leukemia

Ublituximab/Ibrutinib Beneficial in Patients With Chronic Lymphocytic Leukemia

The addition of ublituximab (a glycoengineered anti-CD20 antibody) to ibrutinib (Imbruvica) improved response rates, depth of response, and led to quicker resolution of ibrutinib-associated lymphocytosis in patients with high-risk chronic lymphocytic leukemia (CLL) in the phase III GENUINE trial,...

multiple myeloma

CAR T-Cell Therapy in Multiple Myeloma Yields 100% Response Rate

Chinese investigators reported that 100% of patients with relapsed or refractory multiple myeloma responded to autologous chimeric antigen receptor (CAR) T-cell therapy, and 14 of 19 (74%) who were followed for a median of 4 months achieved a stringent complete response and have not recurred.1...

cost of care

The Emperor’s New Clothes: Biosimilars and Cost in Oncology

Biosimilars are biologic products similar to the parent (branded) molecule in structure and function—such as erythropoietin and filgrastim (Neupogen).1 To truly bend the cost curve, we want to see a dramatic economic savings achieved as oncology biosimilars for rituximab (Rituxan), trastuzumab...

myelodysplastic syndromes

High-Risk Mutations Predict Poor Outcomes for Patients With Myelodysplastic Syndromes Undergoing Transplantation

Although several treatment options are available for patients with myelodysplastic syndromes (MDS), hematopoietic stem cell transplantation (HSCT) remains the only curative therapy.1 The risks of complications and death from transplantation can be substantial. Determining which patients may...

multiple myeloma

FDA Approves Daratumumab in Combination With Pomalidomide and Dexamethasone for Relapsed or Refractory Multiple Myeloma

The U.S. Food and Drug Administration (FDA) has approved the use of the monoclonal antibody daratumumab -(Darzalex) in combination with pomalidomide (Pomalyst) and dexamethasone for the treatment of patients with multiple myeloma who have received at least two prior therapies including lenalidomide ...

breast cancer

Scalp Cooling to Prevent Chemotherapy-Induced Alopecia: Is It Now Ready for Prime Time?

In oncology, sometimes we forget about the small, everyday things that can significantly impact a patient’s life. When patients are explained the side effects of chemotherapy and chemotherapy-induced alopecia, most women will cry or become visibly upset. When a woman loses her hair, it represents...

breast cancer

Two Studies Show Scalp Cooling Reduces Hair Loss in Women Receiving Chemotherapy for Breast Cancer

An interim analysis of the SCALP trial, reported in JAMA by Julie Nangia, MD, of Baylor College of Medicine, and colleagues, showed that use of a scalp-cooling device significantly reduced hair loss in women receiving chemotherapy for stage I or II breast cancer compared with no scalp cooling.1 The ...

leukemia

Adding Midostaurin to Chemotherapy in Newly Diagnosed Acute Myeloid Leukemia With FLT3 Mutation

In a phase III trial (Cancer and Leukemia Group B 10603 [RATIFY]/Alliance) reported in The New England Journal of Medicine, Stone et al found that the addition of midostaurin (Rydapt) to standard chemotherapy improved overall survival in patients with newly diagnosed acute myeloid leukemia with...

colorectal cancer

ESMO World GI 2017: Right-Sided Colorectal Tumors: An Internal Radiation Advantage

For patients with colorectal cancer that has metastasized to the liver, having a primary tumor on the left side as opposed to the right side of the colon is known to be a significant advantage in terms of treatment response. But a new study, presented by van Hazel et al at the European Society for...

gastrointestinal cancer

ESMO World GI 2017: Study Explores Association of Mediterranean Diet Components With Advanced Colorectal Polyps

The benefits of a Mediterranean diet are well known when it comes to colorectal protection, but it’s hard to know specifically what elements of the diet are the healthiest. Now a new study, presented by Fliss Isakov et al at the ESMO 19th World Congress on Gastrointestinal Cancer, suggests...

pancreatic cancer

ESMO World GI 2017: Pegilodecakin Plus FOLFOX in Advanced Pancreatic Cancer

Clinical data on an investigational immuno-oncology drug pegilodecakin (PEGylated human interleukin-10, also known as AM0010) was presented by Hecht et al at the ESMO 19th World Congress on Gastrointestinal Cancer in Barcelona, Spain (Abstract O-004). Pegilodecakin is being evaluated in an ongoing...

health-care policy

FDA Takes Steps to Increase Drug Competition to Improve Patient Access

On June 27, the U.S. Food and Drug Administration (FDA) took two new, important steps to increase competition in the market for prescription drugs and facilitate entry of lower-cost alternatives. The agency published a list of off-patent, off-exclusivity branded drugs without approved generics, and ...

leukemia

EHA 2017: Half of Chronic-Phase Philadelphia Chromosome–Positive CML Patients Stay in Treatment-Free Remission 2 Years After Stopping Nilotinib

New data from two clinical trials—ENESTfreedom and ENESTop—demonstrates that approximately half of adult patients with Philadelphia chromosome–positive chronic myeloid leukemia (CML) in the chronic phase, were able to maintain treatment-free remission after stopping treatment with ...

multiple myeloma

EHA 2017: Ixazomib Plus Lenalidomide/Dexamethasone in Newly Diagnosed Multiple Myeloma With No Stem Cell Transplant, Followed by Maintenance Ixazomib

Data from two phase I/II clinical trials evaluating ixazomib (Ninlaro) in patients with newly diagnosed multiple myeloma was presented at the 2017 European Hematology Association (EHA) Annual Meeting (Abstracts S408, S780). Both studies evaluated ixazomib plus lenalidomide (Revlimid) and...

multiple myeloma

FDA Approves Daratumumab in Combination With Pomalidomide and Dexamethasone for Relapsed or Refractory Multiple Myeloma

The U.S. Food and Drug Administration (FDA) has approved the use of the monoclonal antibody daratumumab (Darzalex) in combination with pomalidomide (Pomalyst) and dexamethasone for the treatment of patients with multiple myeloma who have received at least two prior therapies including lenalidomide...

breast cancer

Positive Results for APHINITY, but Value of Benefit of Dual HER2 Blockade Questioned

The results of the long-awaited APHINITY trial are in, and although the phase III study met its primary endpoint, it failed to establish dual HER2 blockade as the optimal adjuvant treatment for early HER2-positive breast cancer. After 3 years of follow-up, the addition of pertuzumab (Perjeta) to...

leukemia
lymphoma

FDA Approves Rituximab Plus Hyaluronidase Combination for Treatment of Certain Hematologic Malignancies

On June 22, 2017, the U.S. Food and Drug Administration granted regular approval to the combination of rituximab and hyaluronidase human (Rituxan Hycela) for adult patients with follicular lymphoma, diffuse large B-cell lymphoma, and chronic lymphocytic leukemia. The approval provides a...

neuroendocrine tumors

Major Breakthrough in Development of Systemic Targeted Therapy for Midgut Neuroendocrine Tumors

This issue of The ASCO Post discusses a recent trial reported by Strosberg et al in The New England Journal of Medicine that is the first phase III randomized international multicenter clinical trial evaluating lutetium Lu-177 dotatate as a peptide receptor radionuclide therapy in midgut...

colorectal cancer

ASCP/CAP/AMP/ASCO Guideline on Molecular Biomarkers in Colorectal Cancer

As reported in the Journal of Clinical Oncology by Antonia R. Sepulveda, MD, PhD, of Columbia University, and colleagues, a joint guideline on the use of molecular biomarkers for evaluation of colorectal cancer has been developed by an expert panel from the American Society for Clinical Pathology...

genomics/genetics

Identifying Genetic Basis for Extraordinary Clinical Responses May Accelerate Development of New Therapies

Accelerating the discovery of targeted cancer therapies requires defining the targets present in individual tumors, and there are two main ways to do this, David B. Solit, MD, told participants at the inaugural OncoSET Symposium: Emerging Approaches to Precision Medicine in Chicago.1 The...

solid tumors

Novel Tropomyosin Receptor Kinase Inhibitor Yields High Response Rates Across Tumor Types

Larotrectinib, an oral inhibitor of tropomyosin receptor kinase, showed “striking” activity in adult and pediatric patients with the genetic aberrations known as tropomyosin receptor kinase (TRK) fusion, researchers reported at the 2017 ASCO Annual Meeting.1 Of 55 patients treated with...

breast cancer

Expert Point of View: Richard S. Finn, MD and Ingrid A. Mayer, MD

Richard S. Finn, MD, of the David Geffen School of Medicine at UCLA, Los Angeles, commented on MONARCH 2 and the field of cyclin-dependent kinase 4/6 (CDK4/6) inhibition in general in an interview with The ASCO Post. “MONARCH 2 is confirmatory for the role of CDK4/6 inhibition in estrogen...

breast cancer

Abemaciclib Plus Fulvestrant Delays Breast Cancer Progression in MONARCH 2

In the treatment of metastatic estrogen receptor–positive breast cancer, a highly significant 45% reduction in progression was achieved with abemaciclib, combined with fulvestrant (Faslodex), in the global phase III MONARCH 2 trial, reported at the 2017 ASCO Annual Meeting by George W. Sledge, MD,...

breast cancer

Olaparib Improves Progression-Free Survival in BRCA-Associated Breast Cancer

The PARP INHIBITOR olaparib (Lynparza) improved progression-free survival in women with HER2-negative metastatic breast cancer that was either hormone receptor–positive or triple-negative in patients who had a germline BRCA mutation.1,2 These results of the international, randomized, open-label,...

prostate cancer

Expert Point of View: Sumanta Pal, MD

LATITUDE Trial ASCO expert Sumanta Pal, MD, of the City of Hope Comprehensive Cancer Center in Duarte, California, commented on the LATITUDE trial at a press conference. “In 2014, docetaxel added to hormonal therapy showed an improved survival benefit in two trials—CHAARTED and STAMPEDE. It was no ...

prostate cancer

Two Studies Show Abiraterone Plus Prednisolone/Prednisone Added to Standard Hormone Therapy Improves Survival in Advanced Prostate Cancer

The addition of abiraterone acetate (Zytiga) plus prednisolone/prednisone to standard androgen-deprivation therapy improves survival in men starting treatment for locally advanced or metastatic, hormone--naive prostate cancer, according to the results of two potentially practice-changing studies...

colorectal cancer

Expert Point of View: Cathy Eng, MD, FACP and Alfred Neugut, MD, PhD

Cathy Eng, MD, FACP, the Sophie Caroline Steves Distinguished Professor in Cancer Research at The University of Texas MD Anderson Cancer Center, Houston, said the trial demonstrates “the challenge of analyzing six individually conducted studies in a pooled analysis.”  The study’s “potential...

breast cancer

Cancer Gave Me the Impetus to Lose Weight

Fifteen years ago, my internist advised me to lose weight. But after seeing the yo-yo effects of dieting on friends and colleagues, I knew I would find the process of losing weight and gaining it back frustrating, so I ignored my physician’s advice. It wasn’t until I was diagnosed late this past...

breast cancer

Renowned Breast Cancer Researcher, Angela Hartley Brodie, PhD, Dies at 82

Angela Hartley Brodie, PhD, Professor Emeritus in the Department of Pharmacology at the University of Maryland School of Medicine, and an internationally recognized scientist whose groundbreaking cancer research is considered among the greatest advances in treating breast cancer, passed away on...

breast cancer

Growing Use of Molecular Pathology May Help Avoid Overtreatment of Early Breast Cancer

The emerging field of molecular pathology focuses on the study and diagnosis of disease through the examination of genes and gene activity within organs and tissues. This information has transformed our thinking about the biologic diversity of breast cancers and has enhanced our treatment...

issues in oncology

Incorporating the ‘Goals of Medicine’ With the ‘Goals of Care’

In both inpatient and outpatient medical settings, the physician-patient communication process can become more difficult as a disease progresses. Conflicts due to a misunderstanding of therapeutic goals and/or a patient’s values can slowly arise over time among patients, their surrogates, and...

breast cancer

Monica Morrow, MD, Tumbled Gender Barriers to Build a Career in Surgical Oncology

Breast cancer surgeon Monica Morrow, MD, came from a town in the far northeast reaches of suburban Philadelphia. “I guess because there were only two girls in our family, I was the son my father never had, and he reared me that way. When we were playing catch, if I missed the ball and got hit in...

leukemia

Using a Pediatric Treatment Approach to Improve Outcomes for Young Adults With ALL

Three years ago, early results from the U.S. Intergroup C10403 trial,1 which evaluated the effectiveness of treating adolescent and young adults (AYAs) with acute lymphoblastic leukemia (ALL) using an intensive pediatric regimen, showed significant improvement in event-free and overall survival...

supportive care

Brief Psychological Interventions Positively Affect Cancer Patients’ Well-Being

Three separate brief psychological interventions aimed at helping cancer patients cope with distress have shown improvements in quality of life and well-being across the continuum of cancer care. The interventions were studied—respectively—in newly diagnosed cancer patients, survivors after cancer...

lymphoma

ICML 2017: 3-Year Follow-up Showed Fourfold Progression-Free Survival Benefit With Ibrutinib vs Temsirolimus at First Relapse in Mantle Cell Lymphoma

Three-year follow-up data from the phase III RAY study in patients with relapsed or refractory mantle cell lymphoma were presented at the 14th International Conference on Malignant Lymphoma (ICML) in Lugano, Switzerland. These results demonstrated that the subset of patients treated with ibrutinib...

lymphoma

ICML 2017: Data From the TRANSCEND Trial of JCAR017 in Relapsed and Refractory Aggressive B-Cell Non-Hodgkin Lymphoma

Data from the TRANSCEND trial of JCAR017 in relapsed and refractory aggressive B-cell non-Hodgkin lymphoma (NHL) was presented at the 2017 International Conference on Malignant Lymphoma (ICML) in Lugano, Switzerland. JCAR017 is Juno Therapeutics’ investigative chimeric antigen receptor (CAR) ...

leukemia

ICML 2017: Phase III GENUINE Trial: Ublituximab Plus Ibrutinib in High-Risk CLL

Data was recently presented from the phase III GENUINE trial of ublituximab, a novel glycoengineered anti–CD20 monoclonal antibody, in combination with ibrutinib (Imbruvica), a Bruton tyrosine kinase (BTK) inhibitor, for the treatment of high-risk chronic lymphocytic leukemia (CLL), at the...

leukemia
lymphoma

ICML 2017: Triplet Combination of Umbralisib, Ublituximab, and Ibrutinib in CLL/SLL/NHL

Data from the chemotherapy-free triple combination of umbralisib, an oral, next generation PI3K delta inhibitor; ublituximab, a novel glycoengineered anti-CD20 monoclonal antibody; and ibrutinib (Imbruvica) in patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL) and...

solid tumors

SNMMI 2017: Combining PRRT With a PARP Inhibitor May Slow Neuroendocrine Tumor Growth

Patients with neuroendocrine tumors may experience fewer symptoms and survive longer by undergoing peptide-receptor radionuclide therapy (PRRT) combined with a drug that makes tumor cells more sensitive to radiation therapy, said researchers at the 2017 Annual Meeting of the Society of Nuclear...

lung cancer

Ceritinib vs Chemotherapy in Previously Treated ALK-Rearranged NSCLC

The phase III ASCEND-5 trial has shown a significant improvement in progression-free survival with ceritinib (Zykadia) vs chemotherapy in advanced ALK-rearranged non–small cell lung cancer (NSCLC) previously treated with crizotinib (Xalkori) and chemotherapy. Trial results were reported in...

multiple myeloma

FDA Approves Daratumumab in Combination With Pomalidomide and Dexamethasone for Relapsed or Refractory Multiple Myeloma

The U.S. Food and Drug Administration (FDA) has approved the use of daratumumab (Darzalex) in combination with pomalidomide (Pomalyst) and dexamethasone for the treatment of patients with multiple myeloma who have received at least two prior therapies including lenalidomide (Revlimid) and a...

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