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solid tumors
issues in oncology

2018 ASTRO: Phase I Trial of SBRT for Oligometastatic Disease With Multiple Metastases

The phase I NRG Oncology clinical trial BR001 tested the hypothesis that stereotactic body radiotherapy (SBRT) could be used safely in patients with oligometastatic disease characterized by multiple metastases. Results from the trial indicate that using SBRT is safe as treatment for patients with 2 ...

solid tumors
issues in oncology

Fluoropyrimidine DPYD Genotype–Guided Dosing in Patients With Cancer

In a Dutch study reported in The Lancet Oncology, Henricks et al found that DPYD genotype–guided dosing reduced the frequency of severe fluoropyrimidine toxicity in patients with cancer. Increased fluoropyrimidine toxicity is associated with reduced activity of the metabolic...

lung cancer

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

On October 30, 2018, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) in combination with carboplatin and either paclitaxel or nanoparticle albumin-bound (nab)-paclitaxel (Abraxane) as first-line treatment of metastatic squamous non–small cell lung...

lymphoma

Final Overall Survival Results for First-Line VR-CAP vs R-CHOP in Transplantation-Ineligible Mantle Cell Lymphoma

In an analysis reported in The Lancet Oncology by Robak et al, bortezomib, rituximab [Rituxan], cyclophosphamide, doxorubicin, and prednisone (VR-CAP) significantly prolonged overall survival vs rituximab, cyclophosphamide, doxorubicin, vincristine, and prednisone (R-CHOP) in a phase III trial ...

colorectal cancer
immunotherapy

ESMO 2018: Small Study of Preoperative Nivolumab Plus Ipilimumab in dMMR Colon Cancer

Neoadjuvant treatment with a combination of the immune checkpoint inhibitors nivolumab (Opdivo) and ipilimumab (Yervoy) achieved major pathological responses in mismatch repair­–deficient (dMMR) early-stage colon cancers, according to results reported by Chalabi et al at the European...

breast cancer

ESMO 2018: HOBOE-2: Zoledronic Acid in Premenopausal Hormone Receptor–Positive Early Breast Cancer

Adjuvant treatment with zoledronic acid, plus hormonal therapy with the aromatase inhibitor letrozole, significantly increases disease-free survival compared to tamoxifen in premenopausal women with hormone receptor–positive early breast cancer, according to results reported by Perrone et al...

skin cancer
immunotherapy

ESMO 2018: CheckMate 067: 4-Year Follow-up of Nivolumab Plus Ipilimumab in Advanced Melanoma

As reported in The Lancet Oncology and at the European Society for Medical Oncology 2018 Congress by Hodi et al, the 4-year follow-up of the phase III CheckMate 067 trial has shown a continued overall survival benefit with first-line nivolumab (Opdivo) plus ipilimumab (Yervoy) or nivolumab alone vs ...

prostate cancer

2018 ASTRO: SPPORT Trial: ADT With or Without Pelvic Lymph Node Radiation in Prostate Cancer

The first report of a large international clinical trial shows that, for men who show signs of prostate cancer after surgical removal of their prostates, extending radiation therapy to the pelvic lymph nodes combined with adding short-term androgen-deprivation therapy (ADT) to standard treatment...

lung cancer

2018 ASTRO: Overall Survival With Local Consolidative Therapy in Oligometastatic NSCLC

Adding radiation therapy or surgery to systemic therapy for patients with stage IV lung cancer whose cancer has spread to a limited number of sites can significantly extend overall survival, according to new results from a multicenter, randomized, controlled phase II study. The findings were...

head and neck cancer

2018 ASTRO: Liquid Biopsy in HPV-Associated Oral Cancer Surveillance

A highly sensitive blood test that detects minute traces of cancer-specific DNA has been shown to accurately determine whether patients with human papillomavirus (HPV)-related oropharyngeal squamous cell carcinoma (OPSCC) are free from cancer following radiation therapy. Findings were presented by...

breast cancer

2018 ASTRO: Radiation After Breast-Conserving Surgery in 'Good-Risk' DCIS

A subset of patients with low-risk breast cancer is highly unlikely to see cancer return following breast conservation surgery, but can lower that risk even further with radiation therapy, finds a new long-term clinical trial report. These 12-year follow-up data from the only prospective,...

prostate cancer

Long-Term Results of Sequence of Hormonal Therapy Plus Whole-Pelvic or Prostate-Alone Radiotherapy in Prostate Cancer

In long-term follow-up of the phase III NRG/RTOG 9413 study reported in The Lancet Oncology by Roach et al, neoadjuvant hormonal therapy (NHT) plus whole-pelvic radiotherapy (WPRT) and prostate-only radiotherapy (PORT) plus adjuvant hormonal therapy (AHT) were associated with the highest rates of...

breast cancer

2018 ASTRO: FAST Trial Finds Long-Term Side Effects Similar for Once-Weekly and Conventional Breast Radiation Therapies

In a 10-year study of women who received radiation therapy to treat early-stage breast cancer, those receiving fewer, larger individual radiation doses experienced similarly low rates of late-onset side effects as those undergoing conventional radiation therapy. Findings from the...

head and neck cancer

2018 ASTRO: Combined Radiation and Cisplatin in HPV-Related Head and Neck Cancer

A phase III trial has determined that cisplatin chemotherapy combined with radiation therapy showed high amounts of activity in human papillomavirus (HPV)-related head and neck cancer. Findings from NRG-RTOG 1016 were presented by Trotti et al the 60th Annual Meeting of the American Society for...

prostate cancer
issues in oncology

2018 ASTRO: Radiation Therapy Outcomes in African American Patients With Prostate Cancer

A new analysis of genetic data from a large prospective registry and clinical data from several randomized trials indicates that African American patients may have comparatively higher cure rates when treated with radiation therapy than Caucasian patients. The study, which is the first report...

head and neck cancer

ESMO 2018: Cetuximab vs Cisplatin in Patients With HPV-Positive Oropharyngeal Cancer Receiving Radiotherapy

Patients with human papillomavirus (HPV)-positive throat cancer responded better to chemoradiotherapy than to cetuximab (Erbitux) with radiotherapy, according to late-breaking research reported by Mehanna et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract LBA9_PR)....

Germline Mutations in Cancer Susceptibility Genes in Patients With Advanced Renal Cell Carcinoma

In a study reported in JAMA Oncology, Maria I. Carlo, MD, of the Department of Medicine, Memorial Sloan Kettering Cancer, and colleagues found a high prevalence of germline mutations in cancer susceptibility genes in patients with advanced renal cell carcinoma (RCC). In this cohort study,...

Sunitinib vs Nephrectomy Followed by Sunitinib in Metastatic Renal Cell Carcinoma

In an interim analysis of the French phase III noninferiority Carmena trial reported in The New England Journal of Medicine, Arnaud Méjean, MD, PhD, of the Hôpital Européen Georges Pompidou, and colleagues found that sunitinib alone was not inferior in overall survival vs nephrectomy followed by...

Many Patients With Early-Stage Follicular Lymphoma May Not Receive Guideline-Recommended Radiation Therapy

Radiation therapy for early-stage follicular lymphoma “is underused,” Joanna C. Yang, MD, MPH, and Joachim Yahalom, MD, declared in a recent editorial in the Journal of Clinical Oncology.1 This underuse of radiation therapy can result in overtreatment with systemic therapies or overconfidence in...

Exercise Therapy for Symptom Management and Treatment in Patients With 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. Although physical activity is associated with many positive outcomes in the general population,...

Humbled by Challenges, Renowned Hematologist Kanti R. Rai, MD, Recalls a Rich Career

For this installment of the Living a Full Life series, guest editor, Jame Abraham, MD, interviewed Kanti R. Rai, MD, Professor of Medicine at the Karches Center for Oncology Research, Feinstein Institute for Medical Research, Manhasset; Professor of Medicine at Zucker School of Medicine at...

I’m Not Dying of Cancer: I’m Living With Cancer

I’m a psychiatrist, so I don’t say this lightly: receiving a diagnosis of stage IV gastric adenocarcinoma made me insane. I had remembered the horrible deaths due to abdominal cancer I had seen during my medical training and was terrified that would be my fate as well. I knew from looking at the...

Has the Promise of Precision Medicine Been Oversold?

Recently, the term “personalized medicine” in oncology care has been overtaken by the more contemporary concept of “precision medicine.” According to the National Research Council of the National Academies of Science, Engineering, and Medicine, the newer terminology shifts the focus to improving...

genomics/genetics

Everolimus Tablets for Oral Suspension for Tuberous Sclerosis Complex–Associated Partial-Onset Seizures

On April 10, 2018, the U.S. Food and Drug Administration approved everolimus tablets for oral suspension (Afinitor Disperz) for the adjunctive treatment of adult and pediatric patients aged ≥ 2 years with tuberous sclerosis complex–associated partial-onset seizures.1,2 Tuberous sclerosis complex is ...

Overcoming Long-Term Health and Economic Impact of Cancer on Young Adult Survivors

A pair of studies showcased the potentially devastating long-term health and financial consequences cancer has on adult survivors of childhood cancer compared with other adults, as well as survival disparities based on health insurance status.1,2 Despite increasing survival rates among the more...

lung cancer

Activity of Antibody-Drug Conjugate Telisotuzumab Vedotin in c-Met–Positive Advanced NSCLC

In a phase I study reported in the Journal of Clinical Oncology, Strickler et al found evidence of activity of the antibody-drug conjugate telisotuzumab vedotin in non–small cell lung cancer (NSCLC) overexpressing c-Met. The agent combines the anti–c-Met monoclonal antibody...

prostate cancer

ESMO 2018: Survival Results From STAMPEDE: Local Radiotherapy in Newly Diagnosed Metastatic Prostate Cancer With Low Disease Burden

Radiotherapy to the prostate improved overall survival in men newly diagnosed with metastatic prostate cancer who have a low metastatic disease burden, but not in those with higher burden of disease, according to results from a preplanned analysis of a large comparison study reported by Parker et...

kidney cancer
immunotherapy

ESMO 2018: JAVELIN Renal 101: Avelumab Plus Axitinib in Previously Untreated Renal Cell Carcinoma

A combination of the immune checkpoint blocker avelumab (Bavencio) plus the tyrosine kinase inhibitor axitinib (Inlyta) improved progression-free survival (PFS) in previously untreated patients with advanced renal cell carcinoma (RCC) in the phase III JAVELIN Renal 101 study, according to results...

gynecologic cancers

ESMO 2018: SOLO-1: Olaparib Maintenance Extends Progression-Free Survival in BRCA1/2-Mutated Advanced Ovarian Cancer

Two-year maintenance therapy with olaparib (Lynparza), a poly ADP-ribose polymerase (PARP) inhibitor, led to a substantial improvement in progression-free survival (PFS) in newly diagnosed patients with advanced ovarian cancer and a BRCA1/2 mutation, results from the phase III SOLO-1 trial...

solid tumors
head and neck cancer

The Sontag Foundation: Turning a Difficult Diagnosis Into Action to Benefit Patients With Brain Cancer

When Frederick B. Sontag’s wife, Susan, was diagnosed in 1994 with grade III astrocytoma, the couple was understandably overwhelmed to hear that her expected survival was 3 years. At that time, there were few organizations providing resources to patients with brain tumors and their families. While...

issues in oncology

Cancer Policy Priorities Highlighted During 2018 ASCO Advocacy Summit

More than 100 ASCO volunteers from across the country came to Capitol Hill on September 25–26 for the 2018 ASCO Advocacy Summit, where they urged Congress to act on major policy priorities to support cancer research and ensure access to high-quality care for the millions of people in the United...

issues in oncology

Quality Improvement: Worth the Effort but Not Always Easy to Execute

According to Kaveh Shojania, MD, the keynote speaker at the 2018 ASCO Quality Care Symposium, dedicated quality improvement work can help repair a fragmented health-care delivery system, but it’s challenging, and there are multiple things that can go wrong during the process.1 “I’ve developed this ...

FDA Awards Research Grants in Development of Treatments of Rare Diseases, Cancers

The U.S. Food and Drug Administration (FDA) has announced that it has awarded 12 new clinical trial research grants totaling more than $18 million over the next 4 years to enhance the development of medical products for patients with rare diseases. These new grants were awarded to principal...

solid tumors
hepatobiliary cancer

Cabozantinib in Advanced Hepatocellular Cancer: Call for Revision of Practice Standards

As reported in The New England Journal of Medicine by Ghassan K. Abou-Alfa, MD, and colleagues, and reviewed in this issue of The ASCO Post, the phase III CELESTIAL trial has demonstrated that cabozantinib (Cabometyx) improved the median overall survival to 10.2 months in comparison to 8 months...

hepatobiliary cancer

Cabozantinib Improves Survival in Patients With Previously Treated Hepatocellular Carcinoma

As reported in The New England Journal of Medicine by Ghassan K. Abou‑Alfa, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the second interim analysis of the phase III CELESTIAL trial has shown a significant improvement in overall and progression-free survival with cabozantinib...

solid tumors
kidney cancer

Nivolumab Plus Ipilimumab in Intermediate- or Poor-Risk Advanced Renal Cell Carcinoma

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 April 16, 2018, nivolumab (Opdivo) and ipilimumab...

hematologic malignancies
lymphoma

Novel Treatment Approaches in Early Relapse of Follicular Lymphoma

“Patients with follicular lymphoma who relapse early after treatment are a minority of patients, fortunately, but they are clearly patients with a different disease,” according to Jonathon B. Cohen, MD, of Emory University School of Medicine. At Emory’s 2018 Debates and Didactics in Hematology and...

breast cancer

ESMO 2018: SOLAR-1: Alpelisib in Patients With PIK3CA-Mutated HR-Positive, HER2-Negative Advanced Breast Cancer

Targeting a common mutation in patients with hormone receptor (HR)–positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer with the alpha-specific phosphatidylinositol-3-kinase (PI3K) inhibitor alpelisib improved progression-free survival, according to...

breast cancer

ESMO 2018: PALOMA-3: Palbociclib in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

Treatment with the cyclin-dependent kinase (CDK) 4/6 inhibitor palbociclib (Ibrance) achieved a clinically meaningful improvement in overall survival in patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative advanced breast cancer that has relapsed or ...

breast cancer
immunotherapy

ESMO 2018: IMpassion 130: Atezolizumab Plus Nab-Paclitaxel in Metastatic Triple-Negative Breast Cancer

A combination of immunotherapy and chemotherapy improves survival in some patients with metastatic triple-negative breast cancer, according to late-breaking results from the IMpassion130 trial reported by Schmid et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract...

leukemia

Current Treatment Landscape of Relapsed or Refractory Chronic Lymphocytic Leukemia

Novel agents such as ibrutinib (Imbruvica), idelalisib (Zydelig), and venetoclax (Venclexta) have transformed the treatment of chronic lymphocytic leukemia (CLL) and are increasingly used to treat the disease. The optimal sequencing of these agents is not clear in relapsed or refractory disease,...

lung cancer
immunotherapy

Regardless of Taxane Used, Pembrolizumab Plus Chemotherapy Improves Survival in Squamous NSCLC

The addition of pembrolizumab (Keytruda) to a standard platinum doublet as first-line therapy improved overall and progression-free survival in patients with metastatic squamous non–small cell lung cancer (NSCLC), in the primary analysis of KEYNOTE-407.1,2 Furthermore, it did not seem to matter...

lung cancer

Entrectinib Shows Activity in ROS1-Positive NSCLC

Although ROS1-mutated lung cancer accounts for about 1% to 2% of all non–small cell lung cancers (NSCLCs), it is an important druggable oncogene, and new data show that it can be successfully targeted for clinical gain. In a pooled analysis of phase I and II trials in patients with ROS1-positive...

lung cancer

NELSON Trial: ‘Call to Action’ for Lung Cancer CT Screening of High-Risk Individuals

Results of the very large, randomized, population-based NELSON trial confirm the value of low-dose computed tomography (CT) screening in people at high risk for developing lung cancer. The protective value of screening was more pronounced in women than in men. These study findings were presented at ...

Expert Point of View: Everett Vokes, MD

“PACIFIC is a positive trial, with a 32% improvement in survival, and maintenance durvalumab is a new standard of care,” stated formal discussant Everett Vokes, MD, Chair of the Department of Medicine at the University of Chicago and a pioneer in the concurrent use of chemotherapy and radiotherapy ...

immunotherapy
lung cancer

Durvalumab Improves Overall Survival in Unresectable Stage III NSCLC

Several lung cancer trials have shown prolonged progression-free survival with checkpoint inhibitor therapy. For the first time, the phase III PACIFIC trial has found an overall survival benefit for the selective programmed cell death ligand 1 (PD-L1) checkpoint inhibitor durvalumab (Imfinzi) vs...

issues in oncology
global cancer care

Cancer Care in the Palestinian Territories

The global burden of cancer is huge and growing. In 2018, there will be > 18 million new cancer cases and 9.6 million deaths.1,2 Although several recent articles have reviewed cancer in developing countries, few have focused on the Palestinian territories. There are several reasons for that,...

How the Nobel Prize Could Spur More Cancer Advances

Even before James P. Allison, PhD, made an appearance at the Fourth International Cancer Immunotherapy Conference: Translating Science Into Survival in New York City, the excitement among attendees was palpable. Earlier that day, October 1, 2018, Dr. Allison and Tasuku Honjo, MD, PhD, of Kyoto...

lung cancer

Atezolizumab Plus Standard Chemotherapy Improves Progression-Free Survival in Stage IV NSCLC

The combination of atezolizumab (Tecentriq), a programmed cell death ligand 1 (PD-L1) inhibitor, plus carboplatin or cisplatin and pemetrexed (Alimta) as first-line therapy followed by pemetrexed plus atezolizumab maintenance therapy improved progression-free survival in patients with stage IV...

issues in oncology
cost of care

ESMO 2018: Variations Between European Countries in Time to Reimbursement Decisions for New Cancer Treatments Approved by the EMA

Some European countries take more than twice as long as others to reach health technology assessment (HTA) decisions to reimburse new cancer treatments following their approval by the European Medicines Agency (EMA). The average decision time is longer than 1 year in some countries, according to a...

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