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issues in oncology
survivorship

Late Mortality and Chronic Health Conditions in Long-Term Survivors of AYA Cancers

A retrospective analysis from the Childhood Cancer Survivor Study, reported in The Lancet Oncology by Eugene Suh, MD, and colleagues, showed that as with survivors of childhood cancers, survivors of adolescent and young adult (AYA) cancers are at increased risk of earlier mortality and chronic...

breast cancer

Using Antioxidants and Other Supplements With Chemotherapy May Increase Risk of Breast Cancer Recurrence and Mortality

Using antioxidants and other dietary supplements before and during adjuvant chemotherapy for breast cancer may increase the risk of recurrence and “to a lesser extent, death,” according to an analysis of dietary and nutritional data from a phase III trial, published in the Journal of Clinical...

lung cancer

Cancer Has Made Me the Person I Am, and I’m Grateful

The only clue that I was harboring a life-threatening cancer came as I was driving to a golf lesson in the fall of 2006, and I casually rubbed the left side of neck and felt a tiny bump. Although I wasn’t alarmed at the time, I did point out the mass to my primary care physician when I met with...

lung cancer
lymphoma
bladder cancer
head and neck cancer
gastroesophageal cancer
gastrointestinal cancer
immunotherapy

FDA Pipeline: Priority Reviews in Lung Cancers, Lymphoma

This week, the U.S. Food and Drug Administration (FDA) granted Priority Review to treatments for non–small cell and small cell lung cancers, as well as for diffuse large-B cell lymphoma (DLBCL); Breakthrough Therapy designation to an antibody-drug conjugate for bladder cancer; and a double Fast...

Searching for Evidence-Based Reassurance Where None Could Be Found

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

lymphoma
immunotherapy

Quality of Life With Tisagenlecleucel Therapy for Relapsed or Refractory DLBCL

Adult patients with diffuse large B-cell lymphoma (DLBCL) whose disease was effectively treated with the chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel showed sustained and clinically meaningful improvement in a variety of self-reported quality-of-life measures, according to...

skin cancer
immunotherapy

Long-Term Outcomes With PD-1 Inhibitor Treatment and Response to Retreatment in Advanced Melanoma

In a single-center study reported in the Journal of Clinical Oncology, Allison Betof Warner, MD, PhD, and colleagues found that approximately three-quarters of patients with advanced melanoma achieving a complete response on programmed cell death protein 1 (PD-1) inhibitor therapy were alive...

breast cancer
genomics/genetics

Neoadjuvant Cisplatin for BRCA-Mutation Carriers: Pruning the Dead Branches

At the 2019 San Antonio Breast Cancer Symposium, Nadine Tung, MD, of Beth Israel Deaconess Medical Center, presented a multisite study called INFORM, run by the Translational Breast Cancer Research Consortium.1 It compared single-agent cisplatin with a “classic” combination of doxorubicin and...

breast cancer

Postmenopausal Estrogen and Risk of Breast Cancer: What Is the Real Story?

I am responding to an article in the January 25, 2020, issue of The ASCO Post on the conclusion of the 19-year follow-up on the Women’s Health Initiative (WHI) presented by Rowan T. Chlebowski, MD, PhD, at the 2019 San Antonio Breast Cancer Symposium: Postmenopausal estrogen administration does not ...

issues in oncology

Using Machine Learning to Prompt Serious Illness Conversations

Despite research showing that among patients with cancer, early advance care planning conversations lead to care that is in alliance with patients’ goals and wishes, especially at the end of life,1 most patients die without having discussions about their treatment goals and end-of-life preferences ...

immunotherapy

Strong Activity Shown for Lisocabtagene Maraleucel CAR T-Cell Therapy in Aggressive Large B-Cell Lymphoma

Another CD19-directed chimeric antigen receptor (CAR) T-cell therapy may be poised to enter the marketplace for aggressive relapsed or refractory large B-cell lymphoma, based on a high rate of rapid and durable complete responses achieved with lisocabtagene maraleucel. The phase I TRANSCEND NHL...

geriatric oncology

Poster to Bedside: Geriatric Oncology Research Updates From 2019 ASCO Annual Meeting

Functional status impairment, limited mobility, comorbidities, polypharmacy, and other aging-related manifestations are common in older individuals. These conditions complicate the oncologic management of older adults, who are underrepresented in clinical trials, even though they form the majority ...

immunotherapy
bladder cancer

Pembrolizumab for BCG-Unresponsive, High-Risk Non–Muscle Invasive Bladder Cancer

On January 8, 2020, pembrolizumab was approved for treatment of patients with bacillus Calmette-Guérin (BCG)-unresponsive, high-risk, non–muscle invasive bladder cancer with carcinoma in situ with or without papillary tumors who are ineligible for or have elected not to undergo cystectomy.1,2...

colorectal cancer
immunotherapy

Data From Colorectal Cancer Cohorts of TAPUR Study Presented

Positive findings from three Targeted Agent and Profiling Utilization Registry (TAPUR) study cohorts on the potential benefit of molecularly targeted drugs in patients with advanced colorectal cancer were presented at the 2020 Gastrointestinal Cancers Symposium.1-3 The TAPUR study is the first...

leukemia
lymphoma
multiple myeloma
immunotherapy

Highlights From ASH 2019 Included New Data in Leukemia, Lymphoma, and Multiple Myeloma

The ASH 2019 Annual Meeting & Exposition featured countless important sessions and lectures. It would be impossible to attend all the symposia, oral presentations, poster presentations, and special events. Below, we have selected some presentation highlights to supplement our coverage of the...

immunotherapy
leukemia

Pivotal Trial Evaluates Second-Generation BTK Inhibitor Alone and in Combination With Obinutuzumab for First-Line Treatment of CLL

The second-generation Bruton’s tyrosine kinase (BTK) inhibitor acalabrutinib, alone, or in combination with obinutuzumab significantly improved progression-free survival compared with a standard combination of obinutuzumab/chlorambucil in treatment-naive patients with chronic lympocytic leukemia...

leukemia

Bruton’s Tyrosine Kinase Inhibitor Yields High Overall Response Rates in del(17p) CLL and SLL

In findings of the SEQUOIA trial and updated results of the AU-003 trial,1,2 zanubrutinib, a Bruton’s tyrosine inhibitor (BTK), was shown to produce high overall response rates for patients with chronic lymphocytic leukemia (CLL) and small lymphocytic lymphoma (SLL), even in the presence of...

immunotherapy
multiple myeloma

Next-Generation BCMA-Targeted CAR T-Cell Therapies for Relapsed or Refractory Multiple Myeloma Explored in Early-Phase Trials

Two novel dual-target chimeric antigen receptor (CAR) T-cell strategies are yielding early and durable responses for patients with relapsed or refractory multiple myeloma, as well as potentially less cytokine-release syndrome and neurotoxicity compared with first-generation CAR T-cell products,...

immunotherapy
lymphoma

Combination Brentuximab Vedotin, Nivolumab Explored in First-Line, Salvage Therapies for Patients With Hodgkin Lymphoma

Two separate studies are investigating brentuximab vedotin plus nivolumab combination therapy for adults with Hodgkin lymphoma: one as first-line therapy and another as salvage therapy for relapsed/refractory classic disease, according to data presented at the 2019 Annual Meeting & Exposition...

immunotherapy
lymphoma

Bispecific Antibody Shows Activity in Post–CAR T-Cell Therapy for Non-Hodgkin Lymphoma

Mosunetuzumab, an ­investigational ­bispecific antibody, demonstrated activity in preliminary studies of patients with non-Hodgkin lymphoma (NHL), including those who are refractory to or relapsed after third-line chimeric antigen receptor (CAR) T-cell therapy. With further study, mosunetuzumab,...

immunotherapy
leukemia

Expert Point of View: Howard J. Weinstein, MD, and Robert A. Brodsky, MD

Commenting on the Children’s Oncology Group AALL1331 study, Howard J. Weinstein, MD, Chief of Pediatric Hematology­Oncology at Massachusetts General Hospital for Children and Harvard Medical School in Boston, said: “These are very promising results for children, adolescents, and young adults who...

immunotherapy
leukemia

Blinatumomab Post-reinduction Consolidation Improves Event-Free, Overall Survival vs Chemotherapy in Young Patients With B-Cell ALL

Among children, adolescents, and young adults with B-cell acute lymphoblastic leukemia (ALL), the bispecific T-cell engager blinatumomab improved event-free survival and overall survival, compared with standard chemotherapy, as post-reinduction consolidation therapy at first relapse prior to...

immunotherapy
lymphoma

Will Bispecific Antibodies Compete With CAR T-Cell Therapy in Lymphoma?

Are second-generation bispecific antibodies the next big thing in lymphoma? Studies of these drugs were among the highlights of the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition. Years ago, the bispecific T-cell engager blinatumomab validated the concept of bispecific...

hematologic malignancies
leukemia
multiple myeloma
lymphoma
immunotherapy

Conference Highlights From the 2019 American Society of Hematology Annual Meeting & Exposition

More than 25,000 specialists in hematology from over 115 countries attended the 61st American Society of Hematology (ASH) Annual Meeting & Exposition held last December in Orlando. The conference featured a stunning array of 4,900 abstracts with impressive new data in the treatment of multiple...

prostate cancer
symptom management
pain management

Hannah L. Rush, MBChB, on Prostate Cancer: Comparing Quality of Life in Patients Receiving Docetaxel or Abiraterone

Hannah L. Rush, MBChB, of the Clinical Trials Unit at University College London, discusses an analysis of the STAMPEDE trial, which showed that patients treated with abiraterone had higher scores in global quality of life as well as in the physical, social, and role function domains and lower...

prostate cancer
immunotherapy

Neeraj Agarwal, MD, on Castration-Resistant Prostate Cancer: Results From the COSMIC-021 Study of Cabozantinib and Atezolizumab

Neeraj Agarwal, MD, of the University of Utah Huntsman Cancer Institute, discusses trial findings that showed the combination of cabozantinib and atezolizumab had a tolerable safety profile and showed activity in men with metastatic disease. Further evaluation of cabozantinib and atezolizumab is...

breast cancer
immunotherapy

No Improved Pathologic Complete Response With Atezolizumab in Early Triple-Negative Breast Cancer

The addition of the checkpoint inhibitor atezolizumab to chemotherapy with carboplatin and nab-paclitaxel failed to significantly improve pathologic complete response rates compared with chemotherapy alone in patients with early high-risk, locally advanced triple-negative breast cancer. According...

gynecologic cancers

Proteomic Analysis of Endometrial Cancer

A comprehensive molecular study of endometrial cancer published by Dou et al in Cell has further defined the contributions of key genes and proteins to the disease. The overview suggests new treatment approaches that could be tailored for each patient, as well as potential biologic targets for...

prostate cancer

HSD3B1 Genotype and Its Effect on Castration Resistance and Overall Survival in Prostate Cancer

As reported in JAMA Oncology, Nima Sharifi, MD, and colleagues have found that the adrenal-permissive HSD3B1 genotype is associated with earlier onset of castration resistance and poorer overall survival in men with low-volume metastatic prostate cancer. As noted by the investigators, the...

lung cancer

Osimertinib Plus Savolitinib for EGFR-Mutated, MET-Amplified NSCLC After Disease Progression on EGFR Tyrosine Kinase Inhibitors

As reported in The Lancet Oncology, Lecia V. Sequist, MD, and colleagues have found activity and an acceptable risk-benefit profile with the combination of the third-generation EGFR tyrosine kinase inhibitor osimertinib and the MET tyrosine kinase inhibitor savolitinib in patients with EGFR...

skin cancer

States With Highest Rates of Cutaneous Melanoma Due to Ultraviolet Exposure

A new study found a wide state-by-state variation in rates of melanoma caused by ultraviolet (UV) exposure, with highest rates in several states on the east and west coasts (including Hawaii), but also a few landlocked states (including Utah, Vermont, and Minnesota). The report, published by Islami ...

pancreatic cancer

Expert Point of View: Andrea Wang-Gillam, MD, PhD

Andrea Wang-Gillam, MD, PhD, Clinical Director of the GI Oncology Program and Director of Developmental Therapeutics at Washington University in St. Louis, was the invited discussant of SEQUOIA and HALO 109-301. She tried to make sense of the two negative studies of pegylated agents in advanced...

pancreatic cancer

Two Novel Pegylated Agents Fail in Metastatic Pancreatic Cancer

Two novel treatments once thought to hold promise in the treatment of metastatic pancreatic cancer have not proved to be effective in phase III trials, investigators reported at the 2020 Gastrointestinal Cancers Symposium. When combined with standard chemotherapy, a pegylated form of human...

gynecologic cancers

Cervical Cancer Recurrence: Open vs Minimally Invasive Radical Hysterectomy

A multi-institutional retrospective study reported in the Journal of Clinical Oncology by Shitanshu Uppal, MBBS, and colleagues showed that minimally invasive radical hysterectomy was associated with a higher risk of disease recurrence vs open abdominal hysterectomy in women undergoing surgery for...

colorectal cancer
immunotherapy

Perioperative Chemotherapy With or Without Cetuximab in Patients With Resectable Colorectal Cancer Liver Metastases

As reported in The Lancet Oncology by Bridgewater et al, the phase III New EPOC trial has shown that the addition of perioperative cetuximab to chemotherapy was associated with significantly poorer overall survival in patients with KRAS wild-type resectable colorectal cancer liver metastases. An...

breast cancer
immunotherapy

Addition of Pembrolizumab to Neoadjuvant Chemotherapy in Early-Stage HER2-Negative Breast Cancer

As reported in JAMA Oncology by Rita Nanda, MD, and colleagues, findings from the ongoing phase II I-SPY 2 trial indicated that the addition of pembrolizumab to standard neoadjuvant chemotherapy improved pathologic complete response rates in patients with high-risk stage II/III HER2-negative breast ...

prostate cancer

2020 GU Cancers Symposium: Talazoparib for Pretreated Patients With Metastatic Castration-Resistant Prostate Cancer

According to results from a phase II trial presented by Johann S. de Bono, MD, PhD, and colleagues at the 2020 Genitourinary (GU) Cancers Symposium (Abstract 119), treatment with the poly (ADP-ribose) polymerase (PARP) inhibitor talazoparib showed antitumor activity in patients with metastatic...

hematologic malignancies
immunotherapy

Anti-CD19 CAR-NK Therapy in Relapsed or Refractory CD19-Positive Lymphoid Tumors

In a phase I/II trial reported in The New England Journal of Medicine, Liu et al found that anti-CD19 chimeric antigen receptor (CAR) natural killer (NK) cells produced rapid responses in patients with CD19-positive lymphoid tumors, without the toxicities associated with CAR T-cell therapy in this...

bladder cancer
kidney cancer
prostate cancer
issues in oncology

2020 GU Cancers Symposium: Fear of Recurrence, Patients’ Prognostic Understanding Examined in Genitourinary Cancers

In studies to be presented at the 2020 Genitourinary Cancers Symposium (Abstracts 649 and 665), researchers examined the prevalence of fear of cancer recurrence in patients with renal cell carcinoma and evaluated the prognostic understanding patients with genitourinary cancer possess of their...

lymphoma
immunotherapy

Expert Point of View: Edmund K. Waller, MD, PhD

Edmund K. Waller, MD, PhD, Professor, Departments of Medicine, Pathology, and Hematology and Medical Oncology at Emory University School of Medicine and Medical Director, Center for Stem Cell Processing and Apheresis at Emory, said he was not surprised to learn that bridging therapy was associated...

lymphoma
immunotherapy

Study Finds ‘Bridge’ to CAR T-Cell Therapy May Be Detrimental to Survival

The use of bridging therapy before treatment with axicabtagene ciloleucel was associated with worse overall survival in univariate, multivariate, and propensity score–matched analyses performed on data from the U.S. Lymphoma CAR T Consortium, investigators reported at the 2019 American Society of...

kidney cancer

2020 GU Cancers Symposium: Oral HIF2A Inhibitor for Advanced Clear Cell Renal Cell Carcinoma

A novel, first-in-class, small molecule, hypoxia-inducible factor 2 alpha (HIF2A) inhibitor showed single-agent activity in heavily pretreated patients with metastatic clear cell renal cell carcinoma. These results from a phase I/II study will be presented by Toni Choueiri, MD, and colleagues at...

survivorship

Therapy-Associated Polyposis in Survivors of Childhood Cancer

A report published by Biller et al in Cancer Prevention Research provides new details about a recently discovered condition in which childhood cancer survivors develop numerous colorectal polyps, despite not having a hereditary susceptibility to the condition. The condition—known as...

head and neck cancer

Plasma Circulating Tumor HPV DNA for the Detection of Recurrent HPV-Associated Oropharyngeal Cancer

In a study reported in the Journal of Clinical Oncology, Bhishamjit S. Chera, MD, and colleagues found that surveillance for circulating tumor human papillomavirus (HPV) DNA was accurate in identifying disease recurrence in patients with curatively treated HPV-associated oropharyngeal squamous cell ...

gynecologic cancers
immunotherapy

Christopher B. Cole, MD, PhD, on Ovarian Cancer: First-in-Human Study of Interferon-Activated Autologous Monocytes

Christopher B. Cole, MD, PhD, of the National Cancer Institute, discusses findings from a phase I study of intraperitoneal monocytes activated by interferons alpha and gamma in patients with ovarian cancer. Two of 11 patients had a partial response and 5 of 11 had stable disease; ongoing efforts...

immunotherapy
symptom management
skin cancer

Kevin Tyan on Colitis Induced by Immune Checkpoint Inhibitors: Potential Preventive Strategy

Kevin Tyan, of Kinnos, and currently a medical school student at Harvard University, discusses his study findings, which showed that patients with melanoma who are treated with immunotherapy had a significantly lower risk of developing colitis if they also took vitamin D ( Abstract 89).

gastroesophageal cancer

PANGEA Trial Shows Personalized Antibody Selection May Improve Outcomes in Gastroesophageal Cancer

A personalized approach to selecting antibody therapy for patients with newly diagnosed stage IV gastroesophageal adenocarcinoma resulted in a 1-year overall survival rate of 66% and a median overall survival of 16.4 months in the PANGEA study (see Table 1).1 The study used a novel clinical...

leukemia

Dengue Virus Infection May Increase Risk of Developing Leukemia

Compared to individuals without a history of dengue virus infection, those previously infected with the virus had over twice the risk of developing leukemia, with the highest risk occurring between 3 and 6 years after infection. The results of a study conducted in Taiwan were published by Chien et...

bladder cancer

Enfortumab Vedotin in Metastatic Urothelial Carcinoma

In the phase I EV-101 trial reported in the Journal of Clinical Oncology, Rosenberg et al found that the antibody-drug conjugate enfortumab vedotin had no maximum tolerated dose and was active in patients with metastatic urothelial carcinoma at the dose selected for phase II evaluation. The agent...

A Hopeful Look Ahead in Oncology

“They’re all charlatans,” my professor assured me when, in medical school in the mid-1970s, I expressed an interest in oncology. The treatment of cancer with drugs, despite popular but inaccurate descriptions of its history, began in 1944 when Goodman and Gilman at Yale conducted contract research...

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