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lymphoma

15-ICML: ROBUST Trial Examines Efficacy of Lenalidomide/R-CHOP in Previously Untreated ABC-Type DLBCL

The ROBUST trial compared the addition of lenalidomide to R-CHOP (rituximab plus cyclophosphamide/doxorubicin/vincristine/prednisone) vs placebo/R-CHOP in previously untreated, prospectively selected, CD20-positive patients with activated B-cell­–like (ABC)-type diffuse large B-cell...

lymphoma

15-ICML: Genotyping of ctDNA in Classical Hodgkin Lymphoma

An abstract presented by Camus et al at the 15th International Conference on Malignant Lymphoma (ICML; Abstract 138) found that targeted genotyping of circulating tumor DNA (ctDNA) in classical Hodgkin lymphoma at diagnosis “may help to assess early treatment response in complement to...

breast cancer

Final Analysis of the PHARE Trial: 6 Months vs 12 Months of Adjuvant Trastuzumab in HER2-Positive Breast Cancer

In the French phase III PHARE trial reported in The Lancet, Pivot et al found that noninferiority of 6 months vs 12 months of adjuvant trastuzumab combined with standard chemotherapy could not be demonstrated for disease-free survival in HER2-positive early breast cancer. An earlier interim...

breast cancer
immunotherapy

Niraparib Plus Pembrolizumab in Advanced Triple-Negative Breast Cancer

In the phase II TOPACIO/KEYNOTE-162 trial reported in JAMA Oncology, Vinayak et al found evidence of activity of combined niraparib and pembrolizumab in a cohort of patients with advanced or metastatic triple-negative breast cancer, with higher response rates seen in patients with BRCA mutations or ...

lymphoma
immunotherapy

15-ICML: Post Hoc Analysis of MAVORIC Study: Mogamulizumab in Patients With Previously Treated Cutaneous T-Cell Lymphoma

The MAVORIC study—presented by Scarisbrick et al at the 15th International Conference on Malignant Lymphoma (ICML; Abstract 034)—examined the efficacy of mogamulizumab, a monoclonal antibody that targets the CC chemokine receptor 4 (CCR4), in patients with previously treated mycosis...

issues in oncology

Transition to Outpatient Infusional EPOCH-Based Chemotherapy at a Safety Net Hospital

In a report published in the Journal of Oncology Practice, Keshvani et al found that transitioning from inpatient to outpatient ambulatory infusional EPOCH (etoposide, prednisone, vincristine, cyclophosphamide, and doxorubicin)-based chemotherapy in patients with lymphoma at a safety net hospital...

gynecologic cancers

Does Adjuvant Chemoradiotherapy Extend Relapse-Free Survival in Stage III or IVA Endometrial Cancer?

In the phase III GOG 258 trial reported in The New England Journal of Medicine, Matei et al found that 6 months of adjuvant platinum-based chemotherapy plus radiation therapy did not improve relapse-free survival vs chemotherapy alone in stage III or IVA endometrial cancer. In the open-label...

issues in oncology

Accelerated Approval Program: For the Benefit of Patients

A DIAGNOSIS of any life-threatening cancer or other serious illness has always been a world-shaking event for those touched by significant disease, and most of us have known—or will know—the frustration, helplessness, and desperate sense of urgency provoked by the words, “The disease is worsening,...

head and neck cancer

Noninferiority Trial Establishes Chemoradiotherapy Regimen as ‘First Standard of Care for HPV-Positive Oral Cancer’

A noninferiority phase III trial, previously reported in The Lancet, has established the standard of care in human papillomavirus (HPV)-related oral cancer, according to Andy M. Trotti, MD, a radiation oncologist at Moffitt Cancer Center in Tampa, Florida. Data from the NRG Oncology RTOG 1016 trial ...

head and neck cancer
immunotherapy

Synergistic Relationship Between Radiotherapy and Immunotherapy for Squamous Cell Carcinoma of the Head and Neck

Recent technologic improvements in radiotherapy now offer an unprecedented opportunity to enhance immune response, and going forward, may play a role in the definitive treatment of head and neck cancer, according to William Stokes, MD, Assistant Professor in the Department of Radiation Oncology at...

issues in oncology

ASCO Launches Task Force to Address the Cancer Care Gap in Rural America

Despite progress being made in cancer survivorship—there are currently nearly 17 million cancer survivors in the United States1—not everyone is benefiting equally, especially those patients living in rural communities across America. According to “The State of Oncology Practice in America, 2018:...

cns cancers
immunotherapy

Update on Early-Stage Studies of Novel Treatments in Glioblastoma

Outcomes are typically grim for patients with recurrent glioblastoma multiforme. At the 2019 Annual Scientific Meeting of the American Association of Neurological Surgeons (AANS), three early-stage studies hinted at ways that standard treatments might be made more effective. Metronomic Dosing of...

head and neck cancer

Improved Survival Shown With First-Line Pembrolizumab in Advanced Head and Neck Cancer

In the final analysis of KEYNOTE-048, first-line pembrolizumab monotherapy led to a significant improvement in overall survival, vs standard chemotherapy with targeted therapy (EXTREME regimen), in patients with recurrent or metastatic head and neck squamous cell carcinoma expressing programmed...

prostate cancer

Two Studies Question the Role of Continuous LHRH Antagonists in Metastatic Castration‑Resistant Prostate Cancer

In the field of prostate cancer, the use of androgen-deprivation therapy (ADT) in men with metastatic castration-resistant prostate cancer is received wisdom. When experts are asked why ADT is continued once the disease has figured out how to evade hormone suppression, the answer invariably is...

leukemia
immunotherapy

Fixed-Duration Venetoclax Plus Obinutuzumab as First-Line Treatment in Older Patients With CLL Who Have Comorbidities

A fixed-duration regimen of venetoclax plus obinutuzumab demonstrated superior progression-free survival, complete response rates, and minimal residual disease (MRD) negativity compared with chlorambucil plus obinutuzumab as first-line therapy for older patients with chronic lymphocytic leukemia...

prostate cancer

Apalutamide Improves Survival Outcomes in Castration-Sensitive Metastatic Prostate Cancer in TITAN Trial

Adding apalutamide to androgen-deprivation therapy (ADT) significantly improved survival in men with metastatic castration-sensitive (also termed hormone-sensitive) prostate cancer, according to the results of the phase III TITAN trial, which were presented at the 2019 ASCO Annual Meeting and...

head and neck cancer
immunotherapy

FDA Approves Pembrolizumab for the First-Line Treatment of Head and Neck Squamous Cell Carcinoma

On June 10, the U.S. Food and Drug Administration (FDA) approved the anti–programmed cell death protein 1 immunotherapy pembrolizumab (Keytruda) for the first-line treatment of patients with metastatic or unresectable recurrent head and neck squamous cell carcinoma. Pembrolizumab was approved for...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

KEYNOTE-062: Pembrolizumab Is a New First-Line Option in Gastric/Gastroesophageal Junction Cancer

KEYNOTE-062, a study of first-line treatment in patients with advanced gastric or gastroesophageal junction adenocarcinoma, found pembrolizumab to be noninferior to chemotherapy and perhaps better than chemotherapy in a subgroup of patients. The results were reported at the 2019 ASCO Annual Meeting ...

pancreatic cancer

POLO Trial Shows Maintenance Olaparib Improves Progression-Free Survival in Metastatic Pancreatic Cancer

In patients with metastatic pancreatic cancer and germline mutations in BRCA1 or BRCA2, maintenance therapy with olaparib doubled the time to disease progression and the proportion of patients who were progression-free at 2 years, in the phase III POLO trial.1 “Maintenance olaparib provided a...

issues in oncology
colorectal cancer

Solving the Mystery of Why Colorectal Cancer Is on the Rise in Young Adults

Excluding skin cancer, colorectal cancer is the third most prevalent and lethal cancer among both men and women in the United States.1 Although the risk of developing colorectal cancer increases with age—more than 90% of cases occur in people aged 50 or older2—recent research shows that the...

prostate cancer

Chemotherapy and/or Hormonal Agents: Differing Perspectives

WHEN ASKED which treatment to start with—docetaxel or enzalutamide, Dr. Sweeney said, “Patients fit for chemotherapy with high-volume disease can receive chemotherapy [docetaxel] and come back to these newer hormonal treatments or start with anyone of the hormonal options. Choosing among the newer...

prostate cancer

ENZAMET Trial Shows Enzalutamide Improves Overall Survival in Hormone-Sensitive Metastatic Prostate Cancer

Agents that improve survival in metastatic castration-resistant prostate cancer when added to background androgen-deprivation therapy (ADT) are showing success in treating metastatic prostate cancer earlier while it is still hormone-sensitive. These agents include docetaxel (chemotherapy) and...

breast cancer

Evidence Lacking That Denosumab Alters the Course of Breast Cancer

I am writing to provide personal context to my column on adjuvant denosumab or bisphosphonates for resected breast cancer, which appears on page 52 in this issue of The ASCO Post. I have been upset since 2013 that adjuvant zoledronate has been recommended for women with breast cancer onset after...

hematologic malignancies
lymphoma

Transitioning From Healthy Physician to Patient With Cancer

As you probably already know, physicians do not make the best patients. When I began experiencing the early signs of Hodgkin lymphoma, in 2007, including a persistent cough, unusual fatigue, and pruritus, I self-diagnosed allergic rhinitis and began treatment with intranasal corticosteroids....

breast cancer

Denosumab Prevents Neither Breast Cancer Relapse Nor Death

The recently published report of Austrian Breast and Colorectal Cancer Study Group’s Study 18 (ABCSG-18)1 for the secondary endpoint of disease-free survival suggests that denosumab given in a low dose of 60 mg subcutaneously every 6 months during aromatase inhibitor adjuvant therapy is...

issues in oncology
legislation

Curbside Consults: New Liability Risks to Avoid When You Are Not a Patient’s Physician

Like most clinicians, oncologists often informally consult their colleagues, both asking questions and seeking suggestions on how best to care for their patients.1,2 These informal or “curbside” consults (sometimes called “sidewalk,” “elevator,” or “hallway” consults) are valuable, because the...

prostate cancer

Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer: Delaying Overt Metastatic Disease Is a Major Advance

Nonmetastatic (M0) castration-resistant prostate cancer arises in the subset of men with biochemically recurrent disease (ie, rising prostate-specific antigen [PSA] level after definitive therapy in the absence of metastases) who develop PSA progression after chronic exposure to...

prostate cancer

ARAMIS Trial: Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer

In a phase III ARAMIS trial reported in The New England Journal of Medicine, Karim Fizazi, MD, of the Institut Gustave Roussy, Universite Paris-Sud, Villejuif, France, and colleagues found that the androgen-receptor antagonist darolutamide significantly prolonged metastasis-free survival vs placebo ...

skin cancer
immunotherapy

Comparison of Combination Dosing Schedules of Neoadjuvant Ipilimumab/Nivolumab in Macroscopic Stage III Melanoma

In the phase II OpACIN-neo study reported in The Lancet Oncology, Rozeman et al identified a promising dosing schedule for neoadjuvant ipilimumab/nivolumab in macroscopic stage III melanoma. Study Design The trial included 86 evaluable patients with resectable stage III melanoma involving the...

multiple myeloma

Are Cardiac Events During Proteasome Inhibitor Therapy for Relapsed Multiple Myeloma Common?

In a study reported in the Journal of Clinical Oncology, Cornell et al found that cardiovascular adverse events are common in patients receiving proteasome inhibitor therapy for relapsed multiple myeloma and are associated with poorer outcome. The prospective observational study involved 95...

head and neck cancer

Immune Response to HPV16-Driven Tumorigenesis May Be Detectable Before Clinical Diagnosis of Oropharyngeal Squamous Cell Carcinoma

An international group of researchers has found that antibodies to the human papillomavirus type 16 (HPV16) may develop in the body between 6 to 40 years prior to a clinical diagnosis of oropharyngeal squamous cell carcinoma, and their presence indicates a strong increased risk of the disease....

issues in oncology
survivorship

Study Finds Primary Care Providers Are Engaged in Cancer Survivorship Care but Report Barriers to Optimal Care Delivery

A new study published by McDonough et al in the Journal of Oncology Practice found that while primary care physicians are often involved in cancer survivorship care, many do not feel adequately prepared for key components of it. The study shared the results of a survey of 117...

skin cancer

Performance of Machine-Learning Classifiers in the Diagnosis of Pigmented Skin Lesions

In a study conducted under the supervision of researchers from the MedUni Vienna, human experts competed against computer algorithms in diagnosing pigmented skin lesions. The algorithms achieved better results when diagnosing, but had decreased performance for out-of-distribution images. These...

lymphoma
immunotherapy

Rate and Outcome of Late Relapses in Patients With DLBCL Treated With Immunochemotherapy

In a study reported in the Journal of Clinical Oncology, Wang et al identified the rates and outcomes of relapses of diffuse large B-cell lymphoma (DLBCL) in patients who had achieved 24-month event-free survival (EFS) after immunochemotherapy.   Study Details The study involved 1,324...

leukemia

Association of Antibodies With Pegaspargase Allergic Reactions and Failure of Rechallenge in Pediatric ALL

In a study reported in the Journal of Clinical Oncology, Liu et al determined the frequency of allergic reactions and consequences of development of antibodies to pegaspargase (PEG-ASP) among pediatric patients with newly diagnosed acute lymphoblastic leukemia (ALL).    As noted by the...

breast cancer

PERSEPHONE: 4-Year Disease-Free Survival With 6 vs 12 Months of Adjuvant Trastuzumab for HER2-Positive Breast Cancer

The 4-year disease-free survival results of the UK phase III PERSEPHONE trial, reported by Earl et al in The Lancet, found that 6 months of adjuvant trastuzumab was noninferior to 12 months when given with chemotherapy in HER2-positive early breast cancer. Study Details The open-label trial...

What We Remember: From D-Day to Cancer Care

I RECENTLY returned from Normandy, France, where my wife and I attended events honoring the 75th Anniversary of D-Day and the millions, including close friends and family, who fought and died in the Second World War. My wife and a journalist from Los Angeles laid a wreath on Omaha Beach in honor of ...

leukemia
immunotherapy

EHA 2019: ASCEND Trial Compares Acalabrutinib vs Investigator’s Choice in Relapsed or Refractory CLL

The randomized, global, multicenter, open-label phase III ASCEND trial evaluated the efficacy and safety of acalabrutinib vs investigator’s choice of rituximab/idelalisib or rituximab/bendamustine in patients with relapsed or refractory chronic lymphocytic leukemia (CLL). Ghia et al presented ...

multiple myeloma

EHA 2019: BELLINI Trial Evaluates Addition of Venetoclax to Bortezomib/Dexamethasone in Relapsed or Refractory Multiple Myeloma

The phase III BELLINI trial—reported by Kumar et al at the 24th Annual Congress of the European Hematology Association (EHA; Abstract LB2601) investigated the efficacy and safety of venetoclax/bortezomib/dexamethasone vs bortezomib/dexamethasone in patients with relapsed or refractory...

head and neck cancer

Dose De-escalation in Adjuvant Chemoradiotherapy for HPV-Associated Oropharyngeal Squamous Cell Carcinoma

In a phase II study reported in the Journal of Clinical Oncology, Ma et al found that aggressive radiotherapy dose de-escalation in adjuvant chemoradiotherapy for human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma was associated with disease control rates comparable to...

sarcoma

Cediranib in Alveolar Soft-Part Sarcoma

In the phase II CASPS trial reported in The Lancet Oncology, Judson et al found evidence of activity of cediranib in alveolar soft-part sarcoma. In the double-blind trial, 48 patients from 12 sites in the United Kingdom, Spain, and Australia were randomly assigned 2:1 between July 2011 and July...

multiple myeloma
immunotherapy

EHA 2019: CASSIOPEIA Trial Examines Addition of Daratumumab to Standard Treatment Before and After ASCT in Multiple Myeloma

In the phase III CASSIOPEIA trial, reported in The Lancet and presented at the 24th Annual Congress of the European Hematology Association (EHA; Abstract S145) by Moreau et al, daratumumab plus bortezomib/thalidomide/dexamethasone (D-VTd) given before and after autologous stem cell transplantation...

lung cancer

FDA Expands Indications for Pembrolizumab to Include Metastatic SCLC With Disease Progression on or After Other Therapies

On June 17, the U.S. Food and Drug Administration (FDA) granted accelerated approval to the anti–programmed cell death protein 1 (PD-1) therapy pembrolizumab (Keytruda) as monotherapy for the treatment of patients with metastatic small cell lung cancer (SCLC) with disease...

skin cancer

Neoadjuvant Dabrafenib/Trametinib in Stage IIIB/C, BRAF V600–Mutant Melanoma

In the single-center, phase II NeoCombi trial reported in The Lancet Oncology, Long et al found that neoadjuvant dabrafenib plus trametinib produced promising response rates in resectable, stage IIIB/C, BRAF V600–mutant melanoma. As noted by the investigators, adjuvant dabrafenib plus...

breast cancer
immunotherapy

2019 ASCO: 3-Year Outcomes in the KRISTINE Trial on Neoadjuvant Trastuzumab Emtansine Plus Pertuzumab in HER2-Positive Breast Cancer

As reported at the 2019 ASCO Annual Meeting (Abstract 500) and in the Journal of Clinical Oncology by Hurvitz et al, 3-year outcomes in the phase III KRISTINE trial showed that neoadjuvant trastuzumab emtansine (T-DM1) plus pertuzumab was associated with increased risk of event-free survival events ...

leukemia

QuANTUM-R: Quizartinib vs Salvage Chemotherapy in Relapsed or Refractory FLT3-ITD–Positive AML

In the phase III QuANTUM-R trial reported in The Lancet Oncology, Cortes et al found that the FLT3 inhibitor quizartinib produced a modest but significant improvement in overall survival vs salvage chemotherapy in relapsed or refractory FLT3 internal tandem duplication (FLT3-ITD)-positive acute...

breast cancer
immunotherapy

TONIC: PD-1 Blockade in Metastatic Triple-Negative Breast Cancer

Clinical and translational data from the TONIC trial, published in a research letter by Voorwerk et al in Nature Medicine, indicated that short-term doxorubicin and cisplatin may induce a more favorable tumor microenvironment and increase the likelihood of response to programmed cell death protein...

issues in oncology
survivorship

U.S. Cancer Survivors Numbered Nearly 17 Million at the Start of 2019

There were more than 16.9 million Americans with a history of cancer on January 1, 2019, and that number is projected to reach more than 22.1 million by 2030 based on the growth and aging of the population alone, according to estimates from Cancer Treatment and Survivorship Statistics, 2019....

lung cancer
immunotherapy

KEYNOTE-001: 5-Year Overall Survival With Pembrolizumab in Advanced NSCLC

Long-term follow-up of the phase I KEYNOTE-001 study reported in the Journal of Clinical Oncology by Garon et al showed that pembrolizumab monotherapy was associated with an estimated 5-year overall survival of 23.2% for treatment-naive patients and 15.5% for previously treated patients with...

prostate cancer

Toxicity With Prostate-Only vs Prostate and Pelvic Lymph Node Intensity-Modulated Radiation Therapy

In a UK national population-based study reported in the Journal of Clinical Oncology, Parry et al found virtually no difference in gastrointestinal or genitourinary toxicity associated with prostate-only (PO-IMRT) vs prostate and pelvic lymph node intensity-modulated radiation therapy (PPLN-IMRT)...

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