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kidney cancer
immunotherapy

2019 GU Cancers Symposium: KEYNOTE-426: Pembrolizumab Plus Axitinib vs Sunitinib in Advanced Renal Cell Carcinoma

Results from the randomized, phase III KEYNOTE-426 clinical trial show that first-line therapy with a combination of pembrolizumab and axitinib extended both overall survival (OS) and progression-free survival (PFS) for patients with clear cell metastatic renal cell carcinoma compared with the...

breast cancer

MRI and Assay Results May Influence Treatment of DCIS

In a prospective cohort clinical trial reported in JAMA Oncology, Lehman et al found that multiple factors, including magnetic resonance imaging (MRI) findings, played a role in conversion to mastectomy among women with ductal carcinoma in situ (DCIS) who were candidates for wide local excision...

skin cancer
immunotherapy

Neoadjuvant Combination Checkpoint Blockade in Advanced Melanoma

Neoadjuvant combination checkpoint blockade showed activity among patients with high-risk stage III melanoma in a small study. However, a high incidence of side effects caused the trial to be closed early. These results were published by Rodabe N. Amaria, MD, Assistant Professor of Melanoma...

integrative oncology

Advancing the Science and Art of Integrative Oncology

In 2019, we will mark the 20th year of the establishment of the Integrative Medicine Service at Memorial Sloan Kettering Cancer Center (MSK), which helped lay the foundation for the emerging field of integrative oncology. Over the past 2 decades, academic cancer institutions, including The...

breast cancer

Breast Cancer Surgical Terminology Should Be Updated to Reflect Modern Medical Practice

BREAST CANCER is a microscopic disease, with most patients presenting with “localized” stage I to III disease, for which they are offered curative-intent surgery often accompanied by radiation therapy, chemotherapy, and hormonal therapy. More accurately, we now know that patients with localized...

lymphoma

Living My Best Life

Five years ago, I was living my dream life. I was under contract as a commentator on Fox News, which necessitated commuting weekly from my home in Los Angeles to New York, and was building a new home in Palm Springs with my partner, Matt Lashey. Not only was my career and personal life going well,...

lung cancer

Lorlatinib Shows Overall and Intracranial Activity in ALK-Positive NSCLC

IN A GLOBAL phase II study reported in The Lancet Oncology, Benjamin J. Solomon, MBBS, of Peter MacCallum Cancer Centre, Melbourne, and colleagues found that lorlatinib showed high overall and intracranial activity in patients with advanced ALK-positive non–small cell lung cancer (NSCLC) who were...

leukemia
lymphoma

FDA Approves Ibrutinib in Combination With Obinutuzumab in Treatment-Naive CLL/SLL

ON JANUARY 28, 2019, the U.S. Food and Drug Administration (FDA) approved ibrutinib (Imbruvica), a Bruton’s tyrosine kinase inhibitor, in combination with obinutuzumab in treatment-naive patients with chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL). This is the first approval of...

lung cancer

Encourage Lung Cancer Screening to Prevent Early Deaths

Discussions of benefits and harms from screening of high-risk populations for lung cancer have missed the point. The National Lung Screening Trial (NLST) showed an early and statistically significant major benefit in all-cause mortality from computed tomography (CT) screening.1 Those referred for...

myelodysplastic syndromes

Novel Treatments of Myelodysplastic Syndromes

AS PART of The ASCO Post’s continued coverage of the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition, here is an update on seven different studies on new therapeutics in myelodysplastic syndromes (MDS). Among the treatments highlighted here are the erythroid maturation...

integrative oncology

Integrative Oncology Scholars Program: Model for Evidence-Based Complementary Care

THE FIRST full year of educational training in the practice of complementary therapies is now underway at the University of Michigan in Ann Arbor through its Integrative Oncology Scholars Program, which launched in 2017. The program, which is supported through a 5-year grant from the National...

solid tumors
lymphoma
pancreatic cancer
symptom management

FDA Pipeline: Treatments for Tenosynovial Giant Cell Tumor and Pancreatic Cancer, Plus a Statement on Breast Implant–Associated Lymphoma

The U.S. Food and Drug Administration (FDA) recently granted the following designations and applications and also issued a statement: Priority Review for Pexidartinib in Tenosynovial Giant Cell Tumor The FDA has accepted a new drug application (NDA) and granted Priority Review for pexidartinib...

breast cancer

Postmastectomy Hypofractionated vs Conventionally Fractionated Radiotherapy for High-Risk Breast Cancer

In a Chinese, single-center, noninferiority phase III trial reported in The Lancet Oncology, Wang et al found that postmastectomy hypofractionated radiotherapy was noninferior to and associated with similar toxicities vs conventionally fractionated radiotherapy in patients with high-risk breast...

hematologic malignancies
symptom management

Letter to the Editor: Survey on DOACs in Cancer-Related Venous Thromboembolism

This letter is a follow-up to a report published previously in The ASCO Post. Recent trials report comparable or improved efficacy of direct-acting oral coagulants (DOACs) over low–molecular-weight heparins (LMWH) in the treatment of cancer-related VTE (cVTE) at the expense of increased...

skin cancer
immunotherapy

Real-World Treatment Impact of Newer Agents on Survival of Patients With Metastatic Melanoma

The approval of several new agents for metastatic melanoma in the past several years has led to changes in how the disease is treated and managed. Treatments such as the programmed cell death protein 1 (PD-1) inhibitors pembrolizumab, ipilimumab, and nivolumab; BRAF inhibitors; and MEK inhibitors...

solid tumors

Impact of Stereotactic Ablative Radiotherapy on Survival for Patients With Advanced Cancers

The first report from a phase II, multicenter clinical trial has found that a newer, more aggressive form of radiation therapy—stereotactic ablative radiation—can extend long-term survival for some patients with stage IV cancers, while maintaining their quality of life. The study was...

gynecologic cancers
immunotherapy

Avelumab in Recurrent or Refractory Ovarian Cancer

In phase Ib results from the JAVELIN Solid Tumor Trial reported in JAMA Oncology, Disis et al found that avelumab produced durable responses in some patients with recurrent or refractory ovarian cancer. In the study, an expansion cohort of 125 women with advanced disease who had received...

lung cancer

Clonal MET Amplification and Tyrosine Kinase Inhibitor Treatment Outcome in EGFR-Mutant NSCLC

In a Singaporean study reported in the Journal of Clinical Oncology, Lai et al found that tyrosine kinase inhibitor treatment outcome did not differ according to mesenchymal epithelial transition factor (MET)-high vs MET-low status in treatment-naive, EGFR-mutant non–small cell lung cancer...

issues in oncology

New Standards for Safe Handling of Hazardous Drugs Focus on Developing Evidence-Based Measures

ASCO recently published standards on the safe handling of hazardous drugs in the Journal of Clinical Oncology.1 ASCO’s standards largely endorse best practices issued by other stakeholder groups for safely handling hazardous drugs but offer alternatives in several key areas where more research is...

issues in oncology

New JOP Article Highlights Challenges Oncologists Face Due to a Lack of Interoperability, and How CancerLinQ® Can Help

A new article in the Journal of Oncology Practice (JOP)1 looks at how ASCO’s commitment to CancerLinQ® can lead to improvements in the interoperability of electronic health records (EHRs). The article, by Wendy S. Rubinstein, MD, PhD, FACP, FACMG, Deputy Medical Director of CancerLinQ LLC,...

Expert Point of View: Steven Gore, MD, Eyten Stein, MD, and Elihu H. Estey, MD

In discussions after these presentations, several points were made by several experts. To begin, Steven Gore, MD, Director of Hematologic Malignancies at Yale Medical School, called the study of venetoclax plus 10-day decitabine “very important,” but he raised the issue of appropriate dosing. He...

leukemia

Data Mount for Venetoclax as Add-on Therapy in Acute Myeloid Leukemia

The benefit of adding venetoclax to a hypomethylating agent or low-dose cytarabine in the front-line treatment of acute myeloid leukemia (AML) was evident from a number of studies reported at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition (see Table 1). For elderly...

Expert Point of View: Ravi Vij, MD and Saad Usmani, MD

Ravi Vij, MD, Professor of Medicine at Washington University School of Medicine, St. Louis, and Saad Usmani, MD, Director of Plasma Cell Disorders at Levine Cancer Institute, Charlotte, North Carolina, spoke to The ASCO Post about the studies presented on chimeric antigen receptor (CAR) T-cell...

immunotherapy
multiple myeloma

Multiple Myeloma Pipeline Filled With CAR T-Cell Therapies

The burgeoning pipeline of chimeric antigen receptor (CAR) T-cell therapies targeting B-cell maturation antigen (BCMA) in multiple myeloma was on full display at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. A bispecific antibody also made its debut in this busy...

Expert Point of View: Mrinal S. 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,...

supportive care
hematologic malignancies

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, 37.9% remained transfusion-free ...

breast cancer

Small Differences Found in Breast Cancer Recurrence With Partial-Breast vs Whole-Breast Irradiation

Partial-breast irradiation delivered over 5 to 10 days did not meet noninferiority criteria compared with whole-breast irradiation given over 5 to 7 weeks, according to 10-year results of the large NRG (NSABP B-39/RTOG 0413) trial presented at the 2018 San Antonio Breast Cancer Symposium.1 However, ...

breast cancer

Selected Abstracts From the San Antonio Breast Cancer Symposium

Each year, The ASCO Post asks Jame Abraham, MD, FACP, Director of the Breast Oncology Program at Taussig Cancer Institute and Professor of Medicine at the Cleveland Clinic Lerner College of Medicine, to offer his picks for the most important research presented at the 2018 San Antonio Breast Cancer ...

hepatobiliary cancer

Ramucirumab in Sorafenib-Pretreated Patients With Advanced HCC and Increased α-Fetoprotein

In the phase III REACH-2 trial reported in The Lancet Oncology, Zhu et al found that ramucirumab improved overall and progression-free survival vs placebo in patients with advanced hepatocellular carcinoma (HCC) and increased α-fetoprotein levels who had previously received sorafenib. Study...

Expert Point of View: Harry H. Yoon, MD

Harry H. Yoon, MD, Associate Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, the invited discussant of the study presented by Janjigan et al, commented on the strong rationale for combining an anti-HER2 agent, anti–programmed cell death protein 1 (PD-1) agent, and chemotherapy....

immunotherapy
gastrointestinal cancer

First-Line Trastuzumab Plus Pembrolizumab Shows Efficacy in Patients With Metastatic Esophagogastric Cancer

When added to first-line chemotherapy in patients with untreated metastatic HER2-positive esophageal, gastroesophageal junction, and gastric adenocarcinoma, the combination of pembrolizumab and trastuzumab produced responses in 87% of patients, with 100% of patients experiencing disease control and ...

gastrointestinal cancer
head and neck cancer

Andecaliximab in Untreated Gastric or Gastroesophageal Junction Cancer

The large phase III GAMMA-1 trial failed to replicate the encouraging findings from a previous smaller study of andecaliximab plus chemotherapy in untreated HER2-negative gastric or gastroesophageal junction adenocarcinoma, according to Manish A. Shah, MD, of Weill Cornell Medicine/New York...

head and neck cancer

KEYNOTE-181: Pembrolizumab vs Chemotherapy in Second-Line Treatment of Advanced Esophageal Cancer

In the global phase III KEYNOTE-181 trial, pembrolizumab as second-line therapy for advanced esophageal cancer did not improve overall survival in the whole population, vs chemotherapy, but did improve survival for patients with strong expression of programmed cell death ligand 1 (PD-L1),...

skin cancer
immunotherapy

How Effective Is Talimogene Laherparepvec Injection in Metastatic Melanoma?

Injection of a genetically modified virus that induces the body’s own immune cells to attack metastatic melanoma effectively treated almost 40% of patients with tumors that could not be surgically removed, according to findings published by Louie et al in the Journal of the American...

multiple myeloma

Trial of Autologous Transplantation, Consolidation, and Maintenance Therapy in Multiple Myeloma

In a phase III trial reported in the Journal of Clinical Oncology, Stadtmauer and colleagues found that second autologous hematopoietic cell transplantation (AHCT) or RVD (lenalidomide, bortezomib, dexamethasone) consolidation as post-AHCT interventions did not improve outcomes vs single...

lung cancer
immunotherapy

Nivolumab or Nivolumab Plus Ipilimumab in Relapsed Malignant Pleural Mesothelioma

In a French phase II trial reported in The Lancet Oncology, Scherpereel et al found evidence of activity with nivolumab or the combination of nivolumab plus ipilimumab in patients with relapsed malignant pleural mesothelioma. Study Details In the open-label, noncomparative trial, 125 patients...

lung cancer
immunotherapy

Avelumab in Previously Treated Advanced Unresectable Mesothelioma

In a phase Ib trial reported in JAMA Oncology, Hassan et al found that the anti–programmed cell death ligand 1 antibody avelumab produced durable responses and a high rate of disease control in some patients with advanced unresectable mesothelioma progressing after platinum and pemetrexed...

lung cancer

FDA Expands Pemetrexed Label With Combination of Pembrolizumab and Platinum Chemotherapy for the First-Line Treatment of Metastatic Nonsquamous NSCLC

Today, the U.S. Food and Drug Administration (FDA) granted approval for a new indication for pemetrexed (Alimta) for injection in combination with pembrolizumab (Keytruda) and platinum chemotherapy for the first-line treatment of patients with metastatic nonsquamous non–small cell...

solid tumors
issues in oncology
legislation

ASCO Clinical Cancer Advances 2019 Names Advance of the Year: Progress in Treating Rare Cancers

Over the past year, major research advances provided new treatment options for patients with rare, difficult-to-treat cancers. In recognition of these achievements, ASCO named “Progress in Treating Rare Cancers” as the Advance of the Year. To continue the forward momentum, ASCO also...

lung cancer
lymphoma
skin cancer

FDA Pipeline: Updates on Treatments in NSCLC and Lymphomas, Plus New Dosimetry Software

The U.S. Food and Drug Administration (FDA) recently granted the following application, designations, and clearance: sBLA for Atezolizumab Plus Chemotherapy for First-Line Treatment of Metastatic, Nonsquamous NSCLC On January 17, the FDA accepted a supplemental biologics license application...

breast cancer
cost of care

Cost-Effectiveness Analysis of Gene-Expression Profiling Assay in Breast Cancer

A new report published by Wang et al in JNCCN—Journal of the National Comprehensive Cancer Network found that using Oncotype DX—the most commonly used test for predicting the benefit of adjuvant chemotherapy to reduce the risk of disease recurrence—is not...

skin cancer

Surgical Factors Contributing to Invasive Squamous Cell Carcinoma Recurrence

Invasive squamous cell carcinoma (SCC) is typically treated surgically, with guidelines in place recommending surgical margins for excision based on the SCC being classified as low or high risk. Researchers undertook a study to examine recurrence rates of SCC after surgical excision, taking into...

leukemia
myelodysplastic syndromes

Combination Azacitidine and Lenalidomide as Salvage Therapy for Relapsed AML After Allogeneic Stem Cell Transplantation

In a phase I trial reported in the Journal of Clinical Oncology, Craddock et al found evidence that the sequential combination of azacitidine and lenalidomide may be an effective salvage therapy in patients with acute myeloid leukemia (AML) relapsing after allogeneic stem cell transplantation...

breast cancer

Short-Term Safety Outcomes in Mastectomy and Immediate Implant-Based Breast Reconstruction

In a prospective cohort study reported in The Lancet Oncology, Potter et al found that complications following immediate implant-based breast reconstruction—with or without mesh—were higher than considered acceptable by UK national standards. As noted by the investigators, the study was ...

lymphoma

Hastening the Development of Novel Therapies for Peripheral T-Cell Lymphomas

Peripheral T-cell lymphomas (PTCLs) make up a small fraction of all non-Hodgkin lymphomas—just 15%—in the United States.1 Although rare in the United States, the incidence of PTCL is common across Asia, the Caribbean, and sub-Saharan Africa. Although the reason for such global variation in PTCL is...

breast cancer

Genomic Classifier for Luminal Androgen Receptor Triple-Negative Breast Cancer

TRIPLE-NEGATIVE breast cancer is a heterogeneous disease that comprises several subtypes, which may respond differently to therapy. Breast cancer researchers at the Mayo Clinic are developing a novel genomic signature that may improve the identification of the luminal androgen receptor vs basal...

breast cancer
immunotherapy

IMpassion130 Trial: Changing the Treatment Landscape in Metastatic Triple-Negative Breast Cancer

THE IMPASSION130 trial—reported in The New England Journal of Medicine by Schmid et al1 and reviewed in this issue of The ASCO Post—was an eagerly awaited study in newly diagnosed metastatic triple-negative breast cancer. To briefly review, 902 patients were randomly assigned in a 1:1 fashion to...

breast cancer
immunotherapy

Addition of Atezolizumab to Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer: IMpassion130 Trial

AS REPORTED in The New England Journal of Medicine by Peter Schmid, MD, PhD, of the Barts Cancer Institute, Queen Mary University of London, and colleagues, the phase III IMpassion130 trial has shown that the addition of atezolizumab to nanoparticle albumin-bound (nab)-paclitaxel significantly...

MMRF Launches First Platform Trial in Multiple Myeloma

THE MULTIPLE MYELOMA Research Foundation (MMRF) has announced the launch of MyDRUG, the first platform trial exclusively in multiple myeloma, which aims to investigate targeted treatments for patients with high-risk myeloma. MyDRUG represents the culmination of the MMRF’s Precision Medicine Model,...

Georgia Society of Clinical Oncology, Other Medical Associations Win Concessions in CVS/Aetna Merger

THE GEORGIA SOCIETY of Clinical Oncology (GASCO), in partnership with the Medical Association of Georgia, the Georgia Pharmacy Association, and Georgia Watch, worked with the Georgia Office of the Insurance Commissioner to secure what is described as “significant, one-of-a-kind concessions” from...

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