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GUEST EDITOR Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief of Integrative Medicine Service at Memorial Sloan Kettering Cancer Center, New York. The ASCO Post’s Integrative Oncology series is intended to...
The Future of Immunotherapy: Building on Checkpoint Blockade
THE EMERGENCE of anticancer agents that block immune checkpoints has transformed the field of oncology, leading to durable responses and improvements in overall survival in melanoma, renal cell carcinoma, head/neck squamous cell carcinoma, urothelial bladder cancer, and non–small cell lung cancer....
Anti–TIM-3 Antibody Well Tolerated as Monotherapy and in Combination With Anti–PD-L1 Antibody
INITIAL DATA from the ongoing, multicenter, first-in-human, phase Ia/Ib dose-escalation and -expansion study suggest that an anti–T-cell immunoglobulin domain and mucin domain–containing molecule 3 (anti–TIM-3) antibody alone or in combination with immune checkpoint blockade could counter intrinsic ...
Lenvatinib Plus Pembrolizumab Shows Activity in Advanced Urothelial Cancer
THE COMBINATION of lenvatinib plus pembrolizumab has demonstrated antitumor activity in patients with advanced urothelial cancer, including patients receiving later-line treatment. Results of a phase Ib/II trial showed an objective response rate of 25% and a median progression-free survival of 5.4...
Advanced HER2-Positive Breast Cancer: All Eyes on These Novel Agents
NEW AGENTS for the treatment of advanced HER2-positive breast cancer should be coming soon to your clinic, according to Sara A. Hurvitz, MD, Director of the Breast Cancer Clinical Research Program and Associate Professor of Medicine at the David Geffen School of Medicine at the University of...
Full Disclosure: What Oncologists Must Tell Patients About Their Experience and Training
Informed consent is an important part of delivering quality cancer care. Traditional ethical and legal rules require clinicians to disclose three types of information: (1) the patient’s diagnosis; (2) the nature of the proposed intervention and its intended benefits, risks, and adverse effects;...
Allogeneic Hematopoietic Cell Transplantation and Cell Therapy
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 several studies of allogeneic hematopoietic cell transplantation (allo-HCT) and cellular therapy, as used in myelodysplastic syndromes (MDS), acute...
FDA Approves Atezolizumab for Extensive-Stage Small Cell Lung Cancer
On March 18, 2019, the U.S. Food and Drug Administration (FDA) approved atezolizumab (Tecentriq) in combination with carboplatin and etoposide for the first-line treatment of adult patients with extensive-stage small cell lung cancer. Approval was based on the IMpower133 study (ClinicalTrials.gov...
Study Finds Shorter Treatment Course for Rectal Cancer May Actually Improve Outcomes
In patients with locally advanced rectal cancer, the delivery of all radiotherapy and chemotherapy neoadjuvantly—with a shorter course of radiation—may improve the chance of complete response and downstaging over conventional treatment, according to investigators from Washington University, St....
Study Finds Pembrolizumab Active in Advanced Non–Clear Cell Kidney Cancer
IMMUNOTHERAPY WITH the checkpoint inhibitor pembrolizumab may prove to be an effective option for patients with advanced non–clear cell renal cell carcinoma, according to results in cohort B of the KEYNOTE-427 trial, presented at the 2019 Genitourinary Cancers Symposium.1 Response rates were...
Nivolumab Combined With Ipilimumab Shows Activity in Prostate Cancer Subsets
In contrast with melanoma, lung cancer, and kidney cancer, immune checkpoint inhibitor therapy has been disappointing in prostate cancer thus far. Because of success in treating other tumor types, interest remains high in exploring the effect of immunotherapy with checkpoint inhibition in prostate...
Enzalutamide Plus ADT Extends Progression-Free Survival in Metastatic Hormone-Sensitive Prostate Cancer
Adding enzalutamide to androgen-deprivation therapy (ADT) significantly prolonged radiographic progression-free survival in men with metastatic hormone-sensitive prostate cancer, reducing the risk of disease progression or death by 61% compared with ADT plus placebo, according to the results of the ...
Skin Cancer 2019: Small Study of Electrochemotherapy for Basal Cell Carcinomas in the Head and Neck Region
Increasing evidence is emerging about the effectiveness of electrochemotherapy in the treatment of basal cell carcinomas in the head and neck region. A study presented by Kis et al at the World Congress on Advanced Treatments and Technologies in Skin Cancer (Skin Cancer 2019) (Poster Board 6) aimed ...
Capecitabine vs Observation Following Surgery for Resected Biliary Tract Cancer
Watch John Marshall, MD, and BILCAP first author John Neil Primrose, PhD, MBBS, discuss the trial at the 2017 ASCO Annual Meeting. In the phase III BILCAP trial reported in The Lancet Oncology, Primrose and colleagues found evidence that adjuvant capecitabine may improve overall...
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),...
Trends in Neoadjuvant Therapy for Resectable Pancreatic Cancer
SEVERAL STUDIES 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...
Antibody-Drug Conjugate Shows Activity in Heavily Pretreated Bladder Cancer
PRELIMINARY EVIDENCE suggests that the antibody-drug conjugate sacituzumab govitecan is active in patients previously treated with chemotherapy or checkpoint inhibitor therapy for metastatic urothelial cancer. These results from a phase I/II basket study of this agent were presented at the 2019...
CheckMate 650: Nivolumab and Ipilimumab in Metastatic, Castration-Resistant Prostate Cancer
SOME PATIENTS with metastatic prostate cancer may respond to a combination of immune checkpoint inhibitors after treatment with hormonal therapy and chemotherapy is not successful, according to early results from the phase II CheckMate 650 trial. Principal Investigator Padmanee Sharma, MD, PhD,...
SBRT vs Conventionally Fractionated, or Moderately Hypofractionated External-Beam Radiotherapy, for Localized Prostate Cancer
TREATMENT WITH stereotactic body radiation therapy (SBRT) results in a similar safety profile to conventionally fractionated, or moderately hypofractionated external-beam radiotherapy, in men with low- or intermediate- risk prostate cancer, according to preliminary results of the Prostate Advances ...
Interim Analysis of the ARCHES Trial: Enzalutamide Plus Androgen-Deprivation Therapy for Metastatic Hormone-Sensitive Prostate Cancer
ADDING ENZALUTAMIDE to androgen-deprivation therapy (ADT) significantly prolonged radiographic progression-free survival in men with metastatic hormone-sensitive prostate cancer, reducing the risk of progression or death by 61% compared with ADT plus placebo, according to results of the phase III...
CALYPSO: Savolitinib Plus Durvalumab in Metastatic Papillary Renal Cell Carcinoma
THE COMBINATION of savolitinib and durvalumab achieved durable responses in approximately one-fourth of patients with metastatic papillary renal cell carcinoma in the phase II CALYPSO study.1 Treatment options are limited for papillary renal cell carcinoma. Clinical guidelines recommend enrollment...
Pembrolizumab/Cabozantinib Shows Activity in Previously Treated Renal Cell Carcinoma
THE COMBINATION of pembrolizumab and cabozantinib demonstrated antitumor activity in patients with previously treated metastatic renal cell carcinoma and both drugs were tolerable at their approved doses, according to data from a dose-escalation cohort of a phase I study.1 Among eight patients with ...
JAVELIN Renal 101: Avelumab Plus Axitinib vs Sunitinib in the First-Line Treatment of Advanced Kidney Cancer
THE PROGRAMMED cell death-ligand 1 (PD-L1) inhibitor, avelumab, was combined with the multitargeted vascular growth endothelial factor (VEGF) agent, axitinib, and compared to monotherapy with sunitinib in the first-line treatment of patients with metastatic renal cell carcinoma. Toni K. Choueiri,...
Expert Point of View: Lori Wood, MD
LORI WOOD, MD, of Dalhousie University in Halifax, Nova Scotia, Canada was the formal discussant for the KEYNOTE 426 study presented at the 2019 Genitourinary Cancers Symposium.1,2 Dr. Wood called the KEYNOTE 426 phase III trial “practice-changing,” and added, “The majority of patients with...
KEYNOTE 426: Pembrolizumab Plus Axitinib vs Sunitinib in First-Line Therapy for Advanced Renal Cell Carcinoma
AS REPORTED at the 2019 Genitourinary Cancers Symposium by Thomas Powles, MD, and as published in The New England Journal of Medicine by Brian Rini, MD, and colleagues, significant benefits in overall and progression-free survival were achieved with the combination of pembrolizumab plus axitinib...
Conference Highlights From the 2019 Gastrointestinal and Genitourinary Cancers Symposiums
THIS YEAR saw a huge turnout and a large number of scientific abstracts presented at both the 2019 Gastrointestinal (GI) Cancers Symposium, held on January 17–19, and the 2019 Genitourinary (GU) Cancers Symposium, held on February 14–16, both in San Francisco. The GU Cancers Symposium attracted...
FDA Pipeline: Designations in Glioblastoma, Neurofibromatosis, Multiple Myeloma, and AML
This week, the U.S. Food and Drug Administration (FDA) granted designations for treatments for recurrent glioblastoma, neurofibromatosis type 1 and plexiform neurofibromas, multiple myeloma, and relapsed or refractory FLT3-ITD acute myeloid leukemia (AML). Fast Track Designation for Ad-RTS-hIL-12...
Patient-Reported Outcomes in the COMBI-AD Trial
In a study focused on the phase III COMBI-AD trial reported in The Lancet Oncology, Schadendorf et al found no difference in patient-reported outcomes with adjuvant dabrafenib plus trametinib vs placebo in patients with resected BRAF V600E– or BRAF V600K–mutant stage III melanoma. The...
Final Overall Survival Results With Fulvestrant Plus Anastrozole in Metastatic Breast Cancer
As reported in The New England Journal of Medicine by Mehta et al, the final overall survival results of the phase III SWOG S0226 trial show that the addition of first-line fulvestrant to anastrozole was associated with improved overall survival in postmenopausal women with hormone...
FDA Expands Palbociclib Indication in HR-Positive, HER2-Negative Breast Cancer to Include Male Patients
Today, the U.S. Food and Drug Administration (FDA) extended the indication of palbociclib (Ibrance) capsules in combination with specific endocrine therapies for hormone receptor (HR)–positive, HER2-negative advanced or metastatic breast cancer to include male patients. “Today, we are...
AACR 2019: Phase I Trial Evaluates LOXO-195 in Patients With NTRK-Positive Solid Tumors
The investigational anticancer therapeutic LOXO-195, which targets a family of proteins called tropomyosin receptor kinases (TRKs), was safe, tolerable, and showed signs of clinical activity in patients who had solid tumors that harbored NTRK gene fusions and had become resistant to other...
Lenvatinib Plus Pembrolizumab in Advanced Endometrial Cancer
In an interim analysis of a phase II study reported in The Lancet Oncology, Makker et al found that lenvatinib plus pembrolizumab was active in advanced endometrial cancer. Study Details In the study, 54 patients from 11 sites with metastatic endometrial cancer unselected for microsatellite...
AUGMENT: Addition of Lenalidomide to Rituximab in Relapsed or Refractory Indolent Lymphoma
In the phase III AUGMENT trial reported in the Journal of Clinical Oncology, Leonard et al found that the addition of lenalidomide to rituximab significantly prolonged progression-free survival in patients with relapsed or refractory indolent lymphoma. Study Details The double-blind trial...
AACR 2019: Effect of Timing of Radiotherapy on Mucositis in Patients With Head and Neck Cancer
New research presented by Gu et al at the American Association for Cancer Research (AACR) Annual Meeting 2019 found that administering radiation treatments in the morning as opposed to later in the day may significantly reduce the severity of mucositis and its related impacts (Abstract 4860). ...
Geriatric Assessment, Hospitalization, and Long-Term Care Use in Older Cancer Survivors
In a study reported in the Journal of Oncology Practice, Williams et al found that items in geriatric assessment were significantly predictive of hospitalization frequency and long-term care use among older cancer survivors. Study Details The study included 125 patients aged ≥ 65 years from...
BEACON Colorectal Cancer Trial: Safety Lead-in With Triplet Therapy for BRAF V600E–Mutant Metastatic Disease
As reported in the Journal of Clinical Oncology by Van Cutsem et al, treatment with encorafenib, binimetinib, and cetuximab for BRAF V600E–mutant metastatic colorectal cancer was associated with a manageable safety profile and evidence of activity in the safety lead-in to the phase III BEACON ...
AACR 2019: Entinostat Plus Pembrolizumab in Patients With Melanoma Previously Treated With Anti–PD-1 Therapy
A combination of the experimental histone deacetylase (HDAC) inhibitor entinostat with the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab showed clinical responses in patients with melanoma that had progressed on prior anti–PD-1 treatment, according to results from the phase...
AACR 2019: CD40 Antibody Combined With Chemotherapy in Advanced Pancreatic Cancer
An interim analysis of a small phase Ib study by O’Hara et al evaluating the CD40 agonistic monoclonal antibody APX005M in combination with gemcitabine and nab-paclitaxel with or without the programmed cell death protein 1 (PD-1) inhibitor nivolumab in untreated patients with metastatic...
AACR 2019: Data Analysis Shows Activity of Pembrolizumab in Pretreated Patients With Advanced Small Cell Lung Cancer
The results of an analysis of pooled data from the phase Ib KEYNOTE-028 trial and the phase II KEYNOTE-158 study of the anti–programmed cell death protein 1 monoclonal antibody pembrolizumab in the treatment of advanced small cell lung cancer has found that the therapy provided antitumor...
AACR 2019: HER2-Targeted CAR T-Cell Therapy Plus Chemotherapy in Advanced Sarcoma
A small phase I study by Navai et al investigated a combination of lymphodepletion chemotherapy and HER2-specific chimeric antigen receptor (CAR) T-cell therapy for pediatric and adult patients with advanced HER2-positive sarcoma. The combination showed promising antitumor activity and was found to ...
FDA Oncology Center of Excellence Issues Annual Report
The U.S. Food and Drug Administration (FDA) Oncology Center of Excellence (OCE) has issued its 2018 Annual Report, including updates on regulatory reviews and initiatives, OCE programs, guidances, and more. Regulatory Reviews The OCE is tasked with clinical medical oncology reviews, irrespective...
Venetoclax Plus Low-Dose Cytarabine in Older Patients With Previously Untreated AML Ineligible for Intensive Chemotherapy
In a phase Ib/II trial reported in the Journal of Clinical Oncology, Wei et al found that the combination of venetoclax and low-dose cytarabine produced a high response rate in previously untreated older patients with acute myeloid leukemia (AML) who were ineligible for intensive chemotherapy. In...
Conquer Cancer Honors Researchers With Merit Awards
ASCO’S CONQUER CANCER FOUNDATION is pleased to announce the recipients of the Gastrointestinal Cancers, Genitourinary Cancers, and Clinical Immuno-Oncology Symposium Merit Awards. Conquer Cancer Merit Awards recognize oncology fellows’ and trainees’ high-quality research submitted in abstracts to...
New ASCO Guideline Makes Safe Handling of Hazardous Drugs a Priority
ASCO HAS PUBLISHED a new guideline, “Safe Handling of Hazardous Drugs: ASCO Standards,” to promote the safety of pharmacists, nurses, and all staff who handle potentially dangerous medicines, such as chemotherapy compounds.1 Safety is pivotal in the entire drug workflow, including drug mixing and...
ASCO Endorses Active Surveillance Guideline for Low-Risk Prostate Cancer
ASCO ENDORSES and reinforces the evidence-based American Urological Association (AUA), American Society for Radiation Oncology (ASTRO), and the Society of Urologic Oncology (SUO) Guideline published in 2018 in the Journal of Urology. ASCO’s endorsement of a guideline on clinically localized...
Prostatectomy vs Watchful Waiting: Clinical Dilemma Centers on Aggressive vs Indolent Disease
THE MANAGEMENT of localized prostate cancer remains controversial. Although the widespread use of prostate-specific antigen (PSA) testing has resulted in a dramatic increase in the diagnosis and treatment of prostate cancer, many men do not benefit from intervention because the disease is either...
Radical Prostatectomy or Watchful Waiting: 29-Year Follow-up of Scandinavian Trial
AS REPORTED in The New England Journal of Medicine by Anna Bill-Axelson, MD, PhD, Lars Holmberg, MD, PhD, both of Uppsala University Hospital, and and colleagues, the 29-year follow-up of the Scandinavian Prostate Cancer Group Study Number 4 (SPCG-4) trial has shown that radical prostatectomy is...
Maintenance Ixazomib Delays Disease Progression in Newly Diagnosed Myeloma
IN PATIENTS with newly diagnosed multiple myeloma who responded well to induction therapy and underwent transplant, 2 years of maintenance therapy with ixazomib led to a 38% improvement in progression-free survival compared with placebo, according to the results of the phase III TOURMALINE-MM3...
Expert Point of View: Ajay K. Nooka, MD, MPH
THE ASCO POST asked Ajay K. Nooka, MD, MPH, Associate Professor, Division of Bone Marrow Transplant at Winship Cancer Institute, Emory University, to comment on studies involving daratumumab. “After the phase III SWOG S0777 trial demonstrated a survival benefit with a 3-drug induction regimen...
ASH Reports Show Benefit of Adding Daratumumab to Initial Therapy in Multiple Myeloma
DARATUMUMAB APPEARS to be the “gift that keeps on giving” to the myeloma community. “It seems we can add daratumumab to almost anything and make the regimen better. It’s got good activity and a good safety profile,” said Kenneth Shain, MD, PhD, Director of the Myeloma Working Group at Moffitt...
