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pain management

CDC Issues Clarification on Guideline for Prescribing Opioids for Chronic Pain

ASCO, the American Society of Hematology (ASH), and the National Comprehensive Cancer Network® (NCCN®) recently acknowledged receipt of a key clarification1 from the Centers for Disease Control and Prevention (CDC) on prescribing opioids to manage pain from certain conditions. The clarification...

breast cancer

Postprogression Treatment of Estrogen Receptor–Positive Breast Cancer: Future Approaches

AT THE 2019 Miami Breast Cancer Conference, William J. Gradishar, MD, FASCO, presented a vision of the future in the treatment of advanced hormone receptor–positive breast cancer.1 The refinement of disease subsets, the development of agents targeting the PI3K/AKT/mTOR pathway, the use of novel...

immunotherapy
lung cancer

Pembrolizumab as Third-Line Option for Extensive-Stage Small Cell Lung Cancer

USE OF the anti–programmed cell death protein 1 (anti–PD-1) checkpoint inhibitor pembrolizumab after two or more prior lines of therapy led to responses in patients with advanced small cell lung cancer (SCLC) in a pooled analysis of two clinical trials: phase Ib KEYNOTE-028 and phase II...

breast cancer
pancreatic cancer
sarcoma
immunotherapy
issues in oncology

AACR Study Presentations Include New Data in Breast and Prostate Cancers, Sarcoma, and High-Risk Individuals

THE 2019 American Association for Cancer Research (AACR) Annual Meeting was held March 29 to April 3 in Atlanta. In addition to our regular coverage of news stories from the meeting, here are some brief highlights of additional noteworthy studies. Stage IV HER2-Positive Breast Cancer: Surgery or No ...

lymphoma

Umbralisib: Potential Option for Relapsed or Refractory Marginal Zone Lymphoma

UMBRALISIB—an investigational PI3K-delta inhibitor—produced impressive results as monotherapy in patients with relapsed or refractory marginal zone lymphoma, according to an interim analysis of the phase II UNITY-NHL trial presented at the 2019 American Association for Cancer Research (AACR) Annual ...

neuroendocrine tumors
immunotherapy

Dual-Immunotherapy Approach Shows Efficacy in High-Grade Neuroendocrine Tumors

COMBINING TWO established immunotherapy agents achieved tumor shrinkage in rare, aggressive, extrapancreatic high-grade neuroendocrine tumors, according to the results of SWOG S1609, a phase II clinical basket trial also known as DART (Dual Anti– CLTA-4 and Anti–PD-1 Blockade in Rare Tumors). The...

lung cancer

Osimertinib Plus Savolitinib in Advanced NSCLC Driven by MET Resistance

THE ADDITION of the MET inhibitor savolitinib to the EGFR inhibitor osimertinib led to activity in patients with MET-amplified, EGFR-mutated non–small lung cancer (NSCLC) with acquired resistance to previous therapies, according to interim results from two expansion cohorts of a phase Ib clinical...

kidney cancer
immunotherapy

Front-Line Therapy in Advanced Renal Cell Carcinoma: Developing a New Standard

THE FRONT-LINE systemic treatment landscape for metastatic renal cell carcinoma has undergone tremendous movement over the past several years. A better understanding of the current management paradigm for therapy-naive patients warrants a reflection of historic landmark clinical trials that have...

issues in oncology

Harnessing the Power of Twitter for Clinical Trial Enrollment and Success

CLINICAL TRIALS are vital for advancing cancer care for our patients. Each trial represents an unanswered problem for which researchers are committed to solving. Designing, funding, recruiting, and completing a trial are tremendous undertakings for each researcher, physician, patient, and...

immunotherapy
skin cancer

Neoadjuvant Immunotherapy Associated With Improved Outcomes in Patients With Locally Advanced Melanoma

ACCORDING TO DATA from a small prospective study presented at the 2019 Society of Surgical Oncology Annual Cancer Symposium,1 neoadjuvant immunotherapy significantly prolonged relapse-free survival vs adjuvant immunotherapy in patients with stage III or oligometastatic stage IV melanoma intended...

breast cancer
solid tumors

FDA Pipeline: Designations in Triple-Negative Breast Cancer, ctDNA Detection

This week, the U.S. Food and Drug Administration (FDA) granted a Fast Track designation to a treatment for CCR5-positive metastatic triple-negative breast cancer; granted Breakthrough Device designation to a test for the postsurgical detection and quantification of circulating tumor DNA (ctDNA);...

solid tumors

PRRT Shows Long-Term Effectiveness in Malignant Neuroendocrine Tumors

A 12-year retrospective clinical study of patients who received peptide receptor radionuclide therapy (PRRT) for malignant neuroendocrine tumors demonstrated the long-term effectiveness of this treatment, which also allows patients to maintain a high quality of life. The study was published by...

multiple myeloma
immunotherapy

Anti-BCMA CAR T-Cell Therapy in Relapsed or Refractory Multiple Myeloma

In a phase I trial reported in The New England Journal of Medicine, Raje et al found that bb2121, a chimeric antigen receptor (CAR) T-cell therapy targeting B-cell maturation antigen (BCMA), was safe in heavily pretreated patients with relapsed or refractory multiple myeloma. Investigators reported ...

skin cancer
immunotherapy

PD-1 Inhibitor–Associated Cutaneous Toxicity and Clinical Outcomes in Advanced Melanoma

In a research letter published in JAMA Oncology, Quach et al found that cutaneous toxicities related to anti–programmed cell death protein 1 (PD-1) treatment—specifically, vitiligo and rash—were associated with improved clinical outcomes in advanced melanoma. Study Details The...

pain management

Single-Fraction Stereotactic vs Multifraction Radiotherapy for Pain Relief in Predominantly Nonspinal Bone Metastases

In a single-center phase II trial reported in JAMA Oncology, Nguyen et al found that single-fraction stereotactic body radiotherapy (SBRT) was associated with improved pain relief vs conventional multifraction radiotherapy in patients with mostly nonspinal bone metastases. In the noninferiority...

breast cancer

Final Analysis of the HannaH Trial: Perioperative Subcutaneous vs Intravenous Trastuzumab in HER2-Positive Early Breast Cancer

As reported in JAMA Oncology by Jackisch et al, the final analysis of the phase III HannaH trial indicated comparable efficacy and safety of perioperative subcutaneous (SC) vs intravenous (IV) trastuzumab in ERBB2 (HER2)-positive early breast cancer. Earlier reports from the trial showed similar...

symptom management
immunotherapy

Treatment-Related Adverse Events With PD-1/PD-L1 Inhibitors in Clinical Trials

In a systematic review and meta-analysis reported in JAMA Oncology, Wang et al characterized treatment-related adverse event profiles associated with monotherapy use of programmed cell death protein 1 (PD-1) and programmed cell death ligand 1 (PD-L1) inhibitors in clinical trials. Study Details...

gynecologic cancers
immunotherapy

GOG-252: Intravenous vs Intraperitoneal Chemotherapy in Advanced Ovarian Carcinoma

In the phase III NRG Oncology/Gynecologic Oncology Group (GOG)-252 study reported in the Journal of Clinical Oncology, Walker et al found no progression-free survival benefit of postsurgical intraperitoneal (IP) chemotherapy vs intravenous (IV) chemotherapy, each combined with bevacizumab, in...

bladder cancer

AUA 2019: OLYMPUS Trial Assesses Mitomycin Gel in Low-Grade Upper Tract Urothelial Carcinoma

Findings from a secondary analysis of the phase III OLYMPUS trial were presented by Kleinmann et al during the Plenary Session at the 2019 American Urological Association (AUA) Annual Meeting (Abstract LBA-16). Results showed that instillation of UGN-101, an investigational formulation of mitomycin ...

breast cancer
symptom management

ASBrS 2019: Bioimpedance Spectroscopy for Surveillance of Breast Cancer–Related Lymphedema

Surveillance of women at risk for breast cancer–related lymphedema using bioimpedance spectroscopy was more effective in preventing lymphedema progression than traditional arm circumference measurement when each was combined with immediate compression therapy. These were the results of an...

breast cancer

FDA Approves Ado-Trastuzumab Emtansine for HER2-Positive Early Breast Cancer

On May 3, the U.S. Food and Drug Administration (FDA) approved ado-trastuzumab emtansine (T-DM1; Kadcyla) for the adjuvant treatment of patients with HER2-positive early breast cancer who have residual invasive disease after neoadjuvant taxane- and trastuzumab-based treatment. Patients should be...

cns cancers

ESTRO 38: What Type of Radiotherapy May Best Preserve Cognitive Function in Pediatric Patients With Brain Tumors?

A comparison of three types of radiotherapy for pediatric brain tumors suggests that a type of proton therapy called pencil-beam scanning (PBS) offers the best hope of preserving cognitive functions. The study, presented by Toussaint et al at ESTRO 38, the annual congress of the European Society...

prostate cancer

ESTRO 38: High–Dose Rate Brachytherapy in Localized Prostate Cancer

A single high dose of radiation that can be delivered directly to a treatment site within a few minutes is a safe and effective technique for treating men with localized, low-risk prostate cancer, according to a study presented by Tharmalingam et al at ESTRO 38, the annual congress of the ...

lymphoma

ESTRO 38: Radiotherapy After ABVD May Improve Survival in Advanced Hodgkin Lymphoma

Patients with advanced Hodgkin lymphoma with bulky lesions at the time of diagnosis may benefit from radiotherapy after chemotherapy, according to late-breaking results presented by Ricardi et al at ESTRO 38, the annual congress of the European Society for Radiotherapy & Oncology...

breast cancer

ESTRO 38: Long-Term Results of Adjuvant Radiotherapy Plus Antihormonal Treatment in Hormone Receptor–Positive Breast Cancer

Women with early-stage, low-risk, hormone receptor–positive breast cancer may be less likely to experience disease recurrence if they have radiotherapy after surgery as well as antihormonal treatment, according to results from a trial that has followed 869 women for 10 years. These findings...

gynecologic cancers

Adjuvant Pelvic Radiation Therapy vs Vaginal Brachytherapy Plus Chemotherapy in Endometrial Cancer

As reported in the Journal of Clinical Oncology by Randall et al, the phase III Gynecologic Oncology Group (GOG)-0249 trial showed similar outcomes with adjuvant pelvic radiation therapy vs vaginal brachytherapy plus paclitaxel/carboplatin in high-intermediate and high-risk early-stage endometrial...

colorectal cancer
immunotherapy

IMblaze370: Atezolizumab With or Without Cobimetinib vs Regorafenib in Previously Treated Advanced Colorectal Cancer

In the phase III IMblaze370 trial reported in The Lancet Oncology, Eng et al found no survival benefit with third-line atezolizumab with or without cobimetinib vs regorafenib in patients with locally advanced or metastatic colorectal cancer. Study Details The open-label trial included 363...

solid tumors
hepatobiliary cancer

Adjuvant Capecitabine After Resection for Biliary Tract Cancer

In the phase III BILCAP trial reported in The Lancet Oncology, John N. Primrose, FMedSci, and colleagues found evidence that adjuvant capecitabine may improve overall survival vs observation following surgery for patients with resected biliary tract cancer.  The open-label study included 447...

solid tumors
kidney cancer

Hope and Fear Are Two Constants in the Lives of Patients With Cancer

A year and a half ago, when I was 33, the thought of having a life-threatening disease was unimaginable. In hindsight, the weight loss I began experiencing in the fall of 2017 should have raised concern because I’ve always had to be mindful of my diet if I wanted to lose weight. But denial can be a ...

Hematologist Francesco Lo Coco, MD, Dies in Rome at 63

Hematologist Francesco Lo Coco, MD, known for his research accomplishments in both acute myeloid leukemia (AML) and acute promyelocytic leukemia (APL), died in Rome on March 3, 2019. He was 63. After graduating from the Medical School in Pisa, he moved to La Sapienza University of Rome in 1981....

issues in oncology

Physician Identity and Physician Wellness Are Inextricably Linked

Imagine a 70-year-old patient who is scheduled for a pancreaticoduodenectomy. On the morning of surgery, the patient is checked in at the front desk by the “data-entry provider.” The patient is taken to the preoperative area, where the appropriate formalities are completed by multiple “bedside-care ...

hepatobiliary cancer

Minimal Adjuvant Chemotherapy for Pediatric Hepatoblastoma Resected at Diagnosis

In an analysis from the Children’s Oncology Group phase III AHEP0731 trial reported in The Lancet Oncology, Katzenstein et al found that minimal adjuvant chemotherapy with two cycles of cisplatin, fluorouracil, and vincristine was associated with disease control in pediatric patients with...

leukemia

Long-Term Follow-up: Addition of Idelalisib to Rituximab in Relapsed Chronic Lymphocytic Leukemia

In an article published in the Journal of Clinical Oncology, Sharman et al provided long-term findings of a phase III trial that examined the addition of idelalisib to rituximab in relapsed chronic lymphocytic leukemia (CLL), including findings from an extension phase of idelalisib monotherapy. The ...

issues in oncology

How Hepatitis C Virus Screening May Improve Survival in Patients With Cancer

In 2013, the Centers for Disease Control and Prevention (CDC) and the U.S. Preventive Services Task Force (USPSTF) recommended that all people born between 1945 and 1965 undergo one-time screening for the hepatitis C virus (HCV), because the rates of HCV infection are markedly higher for baby...

kidney cancer

First-Line Combination Treatments Improve Outcomes vs Sunitinib in Advanced Renal Cell Carcinoma

Two recently reported phase III trials have shown the benefits of combination therapy vs sunitinib in the first-line treatment in advanced renal cell carcinoma. As reported in The New England Journal of Medicine by Brian I. Rini, MD, of Cleveland Clinic Taussig Cancer Institute, and colleagues, the ...

hematologic malignancies

The WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

GUEST EDITORS Dr. Abutalib is Assistant Director, Hematology and Hematopoietic Cell Transplantation Director, Hematopoietic Cell Transplant Apheresis Service, Cancer Treatment Centers of America, Zion, Illinois, Editor-in-Chief, Advances in Cell & Gene Therapy. Dr. Medeiros is Professor and...

breast cancer

ESMO Breast Cancer 2019: Outcomes in Younger Patients With Breast Cancer

Breast cancer in young women is characterized by more aggressive biologic features as compared to older patients, but outcomes are good when guideline-recommended treatments are given. European Society for Medical Oncology (ESMO) spokesperson Matteo Lambertini, MD, PhD, of IRCCS Policlinico San...

lung cancer

Local Consolidative Therapy Linked to Survival Benefit in Oligometastatic Non–Small Cell Lung Cancer

A retrospective analysis of nearly 200 patients treated with local consolidative therapy for oligometastatic non–small cell lung cancer (NSCLC) has found improved overall survival associated with aggressive consolidation.1 According to data presented at the 2019 Multidisciplinary Thoracic Cancers...

prostate cancer

Final Overall Survival Analysis of the LATITUDE Trial in Newly Diagnosed, High-Risk, Metastatic, Castration-Sensitive Prostate Cancer

As reported in The Lancet Oncology by Fizazi et al, the final overall survival analysis in the phase III LATITUDE trial has shown a significant benefit with the addition of abiraterone acetate plus prednisone to androgen deprivation therapy (ADT) in newly diagnosed, high-risk, metastatic, ...

sarcoma

Phase II Study of Regorafenib in Metastatic Osteosarcoma

As reported in the Journal of Clinical Oncology by Davis et al, outcomes in the osteosarcoma cohort of the phase II SARC024 trial indicated a progression-free survival benefit with regorafenib vs placebo in previously treated metastatic osteosarcoma. Study Details The randomized...

lung cancer

Erlotinib Plus Bevacizumab vs Erlotinib Alone in EGFR-Positive, Advanced Nonsquamous NSCLC

In an interim analysis of the phase III NEJ026 trial reported in The Lancet Oncology, Saito et al found that the addition of bevacizumab to erlotinib improved progression-free survival in patients with EGFR-positive, nonsquamous non–small cell lung cancer (NSCLC). In the open-label...

hematologic malignancies
lymphoma

Risk Model for Disease Progression in Asymptomatic Waldenström’s Macroglobulinemia

In a study reported in the Journal of Clinical Oncology, Bustoros et al developed a model for predicting risk of progression from asymptomatic Waldenström’s macroglobulinemia to symptomatic disease requiring treatment. The study involved 439 patients with asymptomatic...

hepatobiliary cancer

Addition of Nab-paclitaxel to Gemcitabine and Cisplatin in Advanced Biliary Tract Cancers

In a phase II trial reported in JAMA Oncology, Shroff and colleagues found that the addition of nab-paclitaxel to standard gemcitabine and cisplatin resulted in promising outcomes in patients with unresectable locally advanced or metastatic biliary tract cancers. The study included 60 patients...

leukemia

Intermittent vs Intensive PEG-Asparaginase in Pediatric Acute Lymphoblastic Leukemia

In a Scandinavian study reported in the Journal of Clinical Oncology, Albertsen et al found that use of intermittent vs intensive pegylated (PEG)-asparaginase was associated with similar efficacy and reduced asparaginase-related toxicity in pediatric acute lymphoblastic leukemia (ALL). The study...

2019 ASCO Annual Meeting Global Health Track

ASCO Annual Meeting attendees with an interest in global health will find a deep portfolio of relevant sessions in the 2019 program. A preliminary list of global health–related sessions is below; visit am.asco.org or check the 2019 iPlanner for the most updated program information, including...

hepatobiliary cancer

Ramucirumab After Sorafenib in Advanced Hepatocellular Carcinoma: An Efficacious Therapy With Applicability Challenges

In the 2 years since the U.S. Food and Drug Administration’s (FDA) approval of regorafenib in the treatment of patients with sorafenib-refractory advanced hepatocellular carcinoma, we oncologists have witnessed a veritable avalanche of newly approved medicines for the treatment of advanced...

hepatobiliary cancer

Ramucirumab in Sorafenib-Pretreated Patients With Advanced Hepatocellular Carcinoma

In the phase III REACH-2 trial reported in The Lancet Oncology, Andrew X. Zhu, MD, of Harvard Medical School and Massachusetts General Hospital, and colleagues found that ramucirumab improved overall and progression-free survival vs placebo in patients with advanced hepatocellular carcinoma and...

gastrointestinal cancer
colorectal cancer

New ASCO Guidelines on Early Detection and Treatment of Colorectal Cancer in Resource-Stratified Settings

ASCO has approved two new resource-stratified guidelines aimed at improving the early detection and treatment of colorectal cancer in all resource settings. The guidelines are a continuation of ASCO’s efforts to provide evidence-based recommendations for the management of malignancies applicable...

hematologic malignancies

PRIMeR Study Explores Meaning of Minimal Residual Disease in Myeloma

In a study that earned a Best Abstract Award at the 2019 Transplantation & Cellular Therapy (TCT) Meetings in Houston, minimal residual disease (MRD) negativity at 1 year after autologous hematopoietic cell transplant (HCT) and maintenance lenalidomide therapy was an independent prognostic...

breast cancer

Biomarkers Can Now Help Guide Treatment Selections in Breast Cancer

A growing list of biomarkers is beginning to drive targeted therapy in breast cancer, and clinicians can take advantage of these assays to make treatment selections, Debu Tripathy, MD, Professor of Medicine and Chair of Breast Medical Oncology at The University of Texas MD Anderson Cancer Center,...

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