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immunotherapy
gastrointestinal cancer

Study Shows Limited Antitumor Activity of Pembrolizumab in Neuroendocrine Tumors

Neuroendocrine tumors appear resistant to single-agent immunotherapy, according to the results of the KEYNOTE-028 trial of pembrolizumab. “Pembrolizumab monotherapy showed limited antitumor activity but a manageable safety profile in patients with previously treated, advanced neuroendocrine...

prostate cancer

ARAMIS Trial Reports Darolutamide Improves Outcomes in High-Risk Nonmetastatic Prostate Cancer

Darolutamide—an investigational androgen receptor inhibitor—significantly improved metastasis-free survival in men with high-risk nonmetastatic castration-resistant prostate cancer vs placebo in the large phase III ARAMIS trial.1 Men treated with darolutamide had a median metastasis-free survival...

prostate cancer

Radioligand Therapy Achieves Responses in Metastatic Prostate Cancer

In a prospective, single-center, single-arm phase II trial reported at the 2019 Genitourinary Cancers Symposium, a novel approach using a tumor-specific radioligand therapy that binds to prostate-specific membrane antigen (PSMA) (lutetium-177 PSMA-617 -[LuPSMA]) achieved responses in a majority of...

issues in oncology

10 Patient-Centered Principles for More Conservative Cancer Diagnosis

Although diagnostic errors date back to antiquity, in recent years, they have begun to receive attention as an important patient safety issue. This culminated in the National Academy of Medicine’s 2015 landmark report, which concluded that most people in the United States would experience at...

pancreatic cancer

Mutations in DNA Damage Repair Predict Benefit With Platinum Agents in Pancreatic Cancer

Patients with advanced pancreatic cancer who have homologous repair damage response mutations may derive considerable benefit from treatment with platinum agents, according to an analysis of patients in the Know Your Tumor Program presented by Michael Pishvaian, MD, PhD, of Georgetown University,...

kidney cancer

Pembrolizumab/Axitinib Combination Improves Outcomes vs Sunitinib in Kidney Cancer

The checkpoint inhibitor pembrolizumab plus the vascular endothelial growth factor (VEGF) tyrosine kinase inhibitor axitinib significantly improved overall survival, progression-free survival, and objective response rates vs sunitinib as first-line therapy for clear cell metastatic renal cell...

solid tumors
immunotherapy

2019 ASCO-SITC: Combined Targeting of TIM-3 and PD-L1 Immune Checkpoint Pathways in Advanced Relapsed or Refractory Solid Tumors

A phase Ia/Ib trial was launched in order to evaluate the safety of LY3321367, an anti–T-cell immunoglobulin domain and mucin domain–containing molecule-3 (TIM-3) antibody, administered alone or in combination with LY3300054, an anti-programmed death ligand 1 (PD-L1) antibody, in...

lung cancer

Stereotactic Ablative vs Standard Radiotherapy in Inoperable Stage I NSCLC

In the phase III TROG 09.02 CHISEL trial reported in The Lancet Oncology, Ball et al found that stereotactic ablative body radiotherapy improved local disease control vs standard radiotherapy in peripherally located, inoperable stage I non–small cell lung cancer (NSCLC). The open-label trial ...

breast cancer
immunotherapy

2019 ASCO-SITC: Combination Immunotherapy for Breast Cancer With Trastuzumab and a HER2-Targeted Vaccine

After preclinical findings showed shared activity between trastuzumab and HER2-targeted vaccines, researchers evaluated adjvuant nelipepimut-S plus granulocyte-macrophage colony-stimulating factor (GM-CSF) with trastuzumab compared to trastuzumab with GM-CSF alone in patients with HER2...

solid tumors
immunotherapy

TAT 2019: Use of the Lung Immune Prognostic Index in Stratifying Outcomes in Patients Treated With Immune Checkpoint Inhibitors

The Lung Immune Prognostic Index (LIPI) calculated prior to the initiation of treatment may be used to stratify patients with diverse tumor types into groups that significantly associate with outcome following immune checkpoint inhibitor therapy, according to a retrospective study presented at the...

issues in oncology
immunotherapy

TAT 2019: Barriers to Clinical Trial Access for Adolescents vs Young Adults With Cancer

Compared to young adults, adolescents with the same types of cancer have far less access to immunotherapy and/or targeted therapies, according to findings presented at the TAT 2019–International Congress on Targeted Anticancer Therapies in Paris. In addition, young adults could be included in ...

breast cancer

Sacituzumab Govitecan-hziy in Heavily Pretreated, Metastatic Triple-Negative Breast Cancer

In a phase I/II trial reported in The New England Journal of Medicine, Bardia et al found durable responses with the antibody-drug conjugate sacituzumab govitecan-hziy in patients with heavily pretreated, metastatic triple-negative breast cancer. The monoclonal antibody sacituzumab targets the...

prostate cancer

Addition of Radium-223 to Abiraterone Acetate and Prednisone or Prednisolone in Metastatic Castration-Resistant Prostate Cancer

In the phase III ERA 223 trial reported in The Lancet Oncology, Smith et al found that the addition of radium-223 to abiraterone acetate and prednisone or prednisolone did not improve symptomatic skeletal event-free survival and was associated with increased risk of fracture in patients with...

colorectal cancer
issues in oncology

AACR 2019: Survey Finds Young-Onset Colorectal Cancer Is Often Misdiagnosed, Treated at Later Stages

A recent study by the American Cancer Society (ACS) has found that while colorectal cancer incidence in the United States is rapidly declining overall, colorectal cancer rates are increasing among young adults. According to the study, compared with adults born in the 1950s, those born in the 1990s...

lung cancer

AACR 2019: Liquid Biopsy–Based Test May Be Reliable in Identifying Treatment for Non–Small Cell Lung Cancer

The number of guideline-recommended biomarkers to be assessed in patients with newly diagnosed, metastatic non–small cell lung cancer (NSCLC) is increasing. These biomarkers include both predictive targets—including EGFR, ALK, ROS1, BRAF, RET, MET, and ERBB2—and prognostic...

gynecologic cancers

Decline in Rates for HPV16/18-Positive Cervical Precancers Since Introduction of the HPV Vaccine

According to the World Health Organization, approximately 70% of cervical cancers worldwide are caused by the human papillomavirus (HPV) types 16 and 18. In 2006, the HPV vaccine was introduced in the United States to prevent HPV-associated morbidity and mortality. A study analyzing data on the...

breast cancer
immunotherapy

Addition of Pembrolizumab to Trastuzumab in PD-L1–Positive, Trastuzumab-Resistant, HER2-Positive Breast Cancer

In the phase II portion of a phase Ib/II trial reported in The Lancet Oncology, Loi et al found evidence of activity of pembrolizumab plus trastuzumab in programmed cell death protein ligand 1 (PD-L1)-positive, trastuzumab-resistant, HER2-positive advanced breast cancer. Study Details In the...

prostate cancer

Addition of Docetaxel to Hormone Therapy in High-Risk Prostate Cancer With Rising PSA Levels

In a French phase III trial reported in JAMA Oncology, Oudard et al found that the addition of docetaxel to androgen-deprivation therapy (ADT) did not improve prostate-specific antigen (PSA) progression-free survival in men with high-risk prostate cancer with rising PSA after primary local therapy. ...

First-Line Ibrutinib/Rituximab Combination Shows Benefit for Younger Patients With CLL

FIRST-LINE therapy with the combination of ibrutinib and rituximab reduced disease progression by two-thirds compared with standard chemotherapy using fludarabine, cyclophosphamide, and rituximab (FCR) in younger patients with chronic lymphocytic leukemia (CLL), according to the late-breaking...

Large Single-Arm Trial of Hydroxyurea for Sickle Cell Anemia in Sub-Saharan Africa

THE LARGEST PROSPECTIVE trial of hydroxyurea for sickle cell anemia has shown that this treatment is feasible, accepted, well tolerated, and safe for children living in sub-Saharan Africa. Hydroxyurea has long been the standard of care for treating children with sickle cell anemia in developed...

Expert Point of View: Mrinal Patnaik, MBBS, and David P. Steensma, MD

Mrinal S. Patnaik, MBBS, Associate Professor of Internal Medicine and Oncology and a consultant in hematology at the Mayo Clinic, Rochester, commented on the MEDALIST trial for The ASCO Post. “Given its unique mode of action, relative ease of administration, and excellent tolerability,...

Luspatercept May Reduce the Need for Transfusion in Lower-Risk Myelodysplastic Syndromes

IN THE RANDOMIZED, double-blind, phase III MEDALIST trial, the experimental drug luspatercept significantly reduced the need for frequent red blood cell transfusions in patients with lower-risk myelodysplastic syndromes (MDS) and ring sideroblasts. With luspatercept, 37.8% of patients remained...

Front-Line Ibrutinib Improves Progression-Free Survival in Older Patients With Chronic Lymphocytic Leukemia

IN A PHASE III TRIAL reported during the Plenary Session at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition and published in The New England Journal of Medicine, single-agent ibrutinib and ibrutinib/rituximab were associated with superior progression-free survival vs...

hematologic malignancies

Conference Highlights From the 2018 American Society of Hematology Annual Meeting & Exposition

In sunny San Diego, the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition welcomed nearly 30,000 attendees who were eager to present, learn, network, and cheer the joint achievements of many researchers. The packed meeting was filled with important information from...

lung cancer
immunotherapy

Pembrolizumab in Combination With Chemotherapy in First-Line Treatment of Metastatic Squamous NSCLC

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On October 30, 2018, pembrolizumab in combination with...

head and neck cancer
immunotherapy

In Era of Immunotherapy, Radiation Therapy May Become Essential Component of Systemic Treatments of Cancer

“IN THIS era of immunotherapy, it is highly possible, and potentially probable, that radiation therapy may become not just a form of locoregional and palliative treatment, but an essential component of our systemic treatments of cancer,” according to Zachary S. Morris, MD, PhD, Vice-Chair,...

head and neck cancer
immunotherapy
symptom management

Immunotherapy for Head and Neck Cancer Expands, but Concerns Persist About Patient Selection and Toxicities

SOME PATIENTS with advanced head and neck cancer may achieve durable responses with immunotherapy, and recent trial results suggest first-line immunotherapy may increase survival among patients with recurrent or metastatic disease. However, concerns remain about selecting patients most likely to...

lymphoma
immunotherapy

Update on FDA-Approved CAR T-Cell Products

AXICABTAGENE CILOLEUCEL (also known as CAR19) is an anti-CD19 chimeric antigen receptor (CAR) T-cell product approved by U.S. Food and Drug Administration to treat selected hematologic malignancies.1 To appreciate the clinical trial findings summarized here, from selected abstracts presented at the ...

lymphoma
leukemia
immunotherapy

Update on FDA-Approved CAR T-Cell Products

TISAGENLECLEUCEL IS an anti-CD19 chimeric antigen receptor (CAR) T-cell product approved by U.S. Food and Drug Administration to treat selected hematologic malignancies.1,2 To appreciate the clinical trial findings summarized here, from selected abstracts presented at the 2018 American Society of...

leukemia
myelodysplastic syndromes
lymphoma
multiple myeloma
immunotherapy

Highlights From the 2018 ASH Annual Meeting & Exposition

TO ADD to our ongoing coverage of the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition, we bring readers of The ASCO Post these summaries of an assortment of interesting studies. They focus on novel therapies under investigation in the treatment of acute lymphoblastic...

breast cancer

Prognostic Value of Disseminated Tumor Cells in Early Breast Cancer

IN THE PADDY TRIAL, involving more than 10,000 women with early invasive breast cancer, the presence of disseminated tumor cells at diagnosis or primary surgery was an independent prognostic factor for overall, disease-free, and distant disease–free survival. The study findings were presented at...

breast cancer

SABCS Presentations Offer New Data on Biomarkers and Novel Treatment Approaches in Early and Metastatic Breast Cancers

REPORTERS FOR The ASCO Post captured the following summaries of noteworthy studies presented at the 2018 San Antonio Breast Cancer Symposium. In HER2-Negative Metastatic Disease, CTCs Frequently HER2-Positive ALMOST HALF of all patients with HER2-negative metastatic breast cancer have circulating...

hepatobiliary cancer

BRAF/MEK Targeting May Yield Benefit in Treating Biliary Tract Cancer

ROUTINE TESTING for BRAF V600E mutations in patients with biliary tract cancer may prove to be a good idea, based on the findings of a phase II study in which treatment with dabrafenib plus trametinib showed activity.1 The results suggest there may be a benefit to testing patients with biliary...

colorectal cancer
immunotherapy

Expert Point of View: Michael J. Overman, MD

INVITED STUDY discussant Michael J. Overman, MD, Professor of Gastrointestinal Medical Oncology at The University of Texas MD Anderson Cancer Center, Houston, is a co-investigator on CheckMate 142, which led to the approval of another immunotherapy doublet—nivolumab plus ipilimumab—in patients...

colorectal cancer
immunotherapy

Durvalumab and Tremelimumab Combination Active in Refractory Microsatellite-Stable Colorectal Cancer

THE COMBINATION of durvalumab and tremelimumab prolonged median overall survival by 2.5 months compared with best supportive care alone in patients with advanced treatment-refractory colorectal cancer. These findings, which are from the randomized phase II Canadian Cancer Trials Group (CCTG) CO.26...

issues in oncology
survivorship

How to Improve Care for Young Sexual and Gender Minority Cancer Survivors

IN 2017, ASCO issued its recommendations for addressing the oncology care needs of sexual and gender minority cancer survivors and the unique challenges they face.1 There are myriad reasons for cancer disparities in this population compared to heterosexual cisgender cancer survivors, including...

issues in oncology
health-care policy

‘Curve 2’ and Oncology: What Those in Charge Don’t Understand … or Ignore

THERE IS little doubt that the U.S. health-care system is under assault from many directions.1 It is clear that the costs of health management are no longer sustainable, and the United States has one of the highest per capita health costs among the 36 member nations of the Organisation for...

pancreatic cancer

Emerging Role for Neoadjuvant Treatment of Resectable Pancreatic Cancer

SEVERAL STUDIES presented at the 2019 Gastrointestinal Cancers Symposium evaluated the benefits of neoadjuvant treatment in patients with pancreatic cancer—and in patients deemed fully resectable, not just “borderline” resectable.1-3 Although the standard of care for resectable pancreatic ductal...

hematologic malignancies

Crizanlizumab Improves Prevention of Vaso-occlusive Crises in Patients With Sickle Cell Disease

For the first time in more than 20 years, patients with sickle cell disease may have another treatment option to reduce painful vaso-occlusive crises, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Results of the phase II, randomized,...

hematologic malignancies

Direct Oral Anticoagulants Show Reduced Risk of Venous Thromboembolism in Patients With Cancer

Results of a recent study suggest that direct oral anticoagulants can reduce the risk of thromboembolism in patients with cancer who are starting a new systemic therapy regimen, without significantly increasing the risk of major bleeding. Data presented at the 2018 ASH Annual Meeting &...

hematologic malignancies

Pilot Study Tests Novel Approach to Gene Therapy for Sickle Cell Disease

Initial findings from a first-in-human trial have provided proof of principle for a groundbreaking approach to gene therapy for sickle cell disease, according to data presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition.1 Early results of genetic targeting of...

hematologic malignancies

Low-Dose Rituximab Effective for Acquired Thrombotic Thrombocytopenic Purpura With Severe ADAMTS13 Deficiency

The results of a recent pilot study suggest that low-dose rituximab provides similar efficacy to standard-dose rituximab for the treatment of acquired thrombotic thrombocytopenic purpura (TTP), a finding that could point to potential cost savings for patients in the nonlymphoma setting. According...

hematologic malignancies
multiple myeloma

Daratumumab, Lenalidomide, and Dexamethasone in Patients With Newly Diagnosed Multiple Myeloma: Outcomes From the MAIA Trial

In patients with newly diagnosed multiple myeloma who are not eligible for stem cell transplantation, the addition of daratumumab to lenalidomide and dexamethasone significantly reduced the risk of death or disease progression by 44%, according to a late-breaking abstract presentation by Thierry...

solid tumors
leukemia
lung cancer
lymphoma

FDA Pipeline: Priority Reviews in Solid Tumors and Lymphoma; Plus an sNDA in Acute Myeloid Leukemia

Over the past week, the U.S. Food and Drug Administration (FDA) granted multiple Priority Reviews and accepted a supplemental new drug application: Priority Review for Entrectinib in NTRK Fusion–Positive Solid Tumors and Metastatic, ROS1-Positive NSCLC This week, the FDA accepted new drug...

issues in oncology

Former JAMA Editor Offers Perspective on Challenges Past and Present in American Health Care

BOOKMARK Title: Severed Trust: Why American Medicine Hasn’t Been FixedAuthor: George D. Lundberg, MD, With James StaceyPublisher: Basic BooksPublication date: March 2001Price: $28.00, hardcover, 336 pages Pathologist George D. Lundberg, MD, served as Editor-in-Chief of The Journal of the American...

kidney cancer
immunotherapy

2019 GU Cancers Symposium: First-Line Pembrolizumab Plus Axitinib vs Sunitinib in Advanced Renal Cell Carcinoma

As reported at the 2019 Genitourinary Cancers Symposium (Abstract 543) and in The New England Journal of Medicine, Rini et al found significant benefits in overall and progression-free survival with the combination of pembrolizumab plus axitinib vs sunitinib in the first-line treatment of advanced...

lung cancer

No Survival Benefit With Avelumab vs Docetaxel in Platinum-Treated, Advanced, PD-L1–Positive NSCLC

As reported in The Lancet Oncology by Fabrice Barlesi, MD, and colleagues, the phase III JAVELIN Lung 200 trial has shown no overall survival benefit with avelumab vs docetaxel in patients with platinum pretreated programmed cell death ligand 1 (PD-L1)–positive advanced non–small cell lung cancer ...

hematologic malignancies
multiple myeloma

Cancer Has Given Me the Life I Was Meant to Live

The first symptom of my multiple myeloma appeared 6 months before I received the official diagnosis. I began having some discomfort, not pain exactly, in my right hip, and developed a pronounced limp. I had recently left my medical practice to launch Global Girls Global Women, a nonprofit...

breast cancer

Increased Risk of Bone Loss Extends to Younger Women Treated for Breast Cancer

Younger women who have been treated for breast cancer have a higher risk for osteopenia and osteoporosis than do their cancer-free peers, and that risk seems to rise when treatment involves chemotherapy plus hormone therapy or aromatase inhibitors alone. Researchers from Johns Hopkins Bloomberg...

Norman E. Sharpless, MD: From Director of a Comprehensive Cancer Center to Director of the NCI

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic. In this installment of the Living a Full Life series of articles, guest editor Jame Abraham, MD, FACP, interviewed Norman E. ...

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