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leukemia

ADMIRAL Trial: More Than Standard Chemotherapy Needed for FLT3-Mutant Advanced AML

The important ADMIRAL trial, reported by Perl et al in The New England Journal of Medicine1 and reviewed in this issue of The ASCO Post, shows the efficacy of a specific FLT3 inhibitor in patients with advanced acute myeloid leukemia (AML) and enhances the era of personalized medicine in leukemia. ...

issues in oncology

Practicing Wellness to Reduce Burnout

Numerous wellness strategies are accessible to busy physicians and oncologists, which can be incorporated into their daily routine. Here we discuss such aspects as stress reduction, mindfulness, eating well, sleeping well, and spirituality for the wellness of oncologists. Those who regularly adhere ...

A Deeper Understanding of the Miracle of the Human Body

Despite millennia of anatomic and biomedical search and discovery, there are parts and functions of the human body that remain a mystery. For years, medical students were taught that there are 78 organs in the human body. In February 2017, that number was revised, with the announcement of a new...

skin cancer
immunotherapy

Immune-Related Adverse Events and Recurrence-Free Survival With Adjuvant Immunotherapy vs Placebo in Stage III Melanoma

In an analysis of the EORTC 1325/KEYNOTE-054 trial of adjuvant pembrolizumab vs placebo in stage III melanoma reported in JAMA Oncology, Alexander M.M. Eggermont, MD, PhD, and colleagues found that patients treated with pembrolizumab who experienced immune-related adverse events had improved...

bladder cancer
immunotherapy

FDA Approves PD-1 Inhibitor for BCG-Unresponsive, High-Risk Non–Muscle Invasive Bladder Cancer

Today, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) for the 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...

breast cancer

Recurrence Risk With Accelerated Partial- vs Whole-Breast Irradiation After Breast-Conserving Surgery for Early Breast Cancer: Long-Term Follow-up

As reported in The Lancet by Frank A. Vicini, MD, and colleagues, 10-year follow-up in the phase III NSABP B-39/RTOG 0413 equivalence trial has shown that accelerated partial-breast irradiation did not achieve equivalence to whole-breast irradiation in preventing local recurrence in women receiving ...

breast cancer

Long-Term Results of IBIS-II: Anastrozole for Breast Cancer Prevention

As reported by Jack Cuzick, PhD, and colleagues in The Lancet, blinded follow-up of the IBIS-II trial has shown the continued benefit of anastrozole vs placebo in preventing breast cancer in high-risk postmenopausal women during the 5-year posttreatment period. For the international double-blind...

leukemia

Asciminib for Patients With CML After Failure of ABL Kinase Inhibitor Treatment

In a phase I trial reported in The New England Journal of Medicine, Hughes et al found that asciminib, an oral BCR-ABL1 inhibitor with a mechanism of action different from available ABL1 tyrosine kinase inhibitors, was active in patients with chronic myeloid leukemia (CML) after failure of ABL...

multiple myeloma

Taking a Reasonable Approach to Treating Newly Diagnosed Multiple Myeloma

Multiple myeloma is a malignancy characterized by clonal proliferation of terminally differentiated plasma cells within the bone marrow. Although it leads to a host of different issues within the body, overall survival has steadily improved in recent years. “This is largely because of better...

lymphoma
immunotherapy

KEYNOTE-013 and KEYNOTE-170: Improving the Precision of Checkpoint Blockade in Patients With Diffuse Large B-Cell Lymphoma

Primary mediastinal B-cell lymphoma is an uncommon but distinct clinicopathologic variant of diffuse large B-cell lymphoma (DLBCL) that typically presents with an aggressive mediastinal mass and invasion of local structures. Most patients are young, typically in their 20s and 30s, and there is a...

lymphoma
immunotherapy

Pembrolizumab in Relapsed or Refractory Primary Mediastinal Large B-Cell Lymphoma: KEYNOTE-013 and KEYNOTE-170

Findings in the phase Ib KEYNOTE-013 and phase II KEYNOTE-170 trials, reported in the Journal of Clinical Oncology by Philippe Armand, MD, PhD, of Dana­Farber Cancer Institute, and colleagues, indicate that pembrolizumab is active in relapsed or refractory primary mediastinal large B-cell...

head and neck cancer
immunotherapy

Pembrolizumab vs Cetuximab Plus Chemotherapy in Recurrent or Metastatic Head/Neck Squamous Cell Cancer

As reported in The Lancet by Barbara Burtness, MD, of the Department of Medicine, Yale University School of Medicine, and colleagues, the phase III KEYNOTE-048 trial has shown improved overall survival with first-line pembrolizumab plus chemotherapy vs cetuximab plus chemotherapy among patients...

lung cancer
bladder cancer
colorectal cancer
hematologic malignancies
myelodysplastic syndromes
breast cancer
head and neck cancer
immunotherapy

FDA Pipeline: Priority Reviews in SCLC, Bladder Cancer, Colorectal Cancer

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Reviews for treatments in extensive-stage small cell lung cancer (SCLC), non–muscle invasive bladder cancer, and BRAF V600E–mutant colorectal cancer. The Agency also recently issued multiple Breakthrough Therapy designations and ...

skin cancer

Pembrolizumab in Adjuvant Treatment of Melanoma With Involvement of Lymph Nodes After Complete Resection

In early 2019, pembrolizumab was approved for the adjuvant treatment of patients with melanoma with involvement of lymph node(s) following complete resection.1,2 Supporting Efficacy Data Approval was based on findings in the double-blind EORTC 1325/KEYNOTE-054 trial (ClinicalTrials.gov identifier...

hepatobiliary cancer
immunotherapy

Does Second-Line Pembrolizumab in Patients With Advanced Hepatocellular Carcinoma Previously Treated With Sorafenib Confer a Survival Benefit?

As reported in the Journal of Clinical Oncology by Richard S. Finn, MD, and colleagues, the phase III KEYNOTE-240 trial has shown no statistically significant progression-free or overall survival benefit with pembrolizumab vs placebo in patients with advanced hepatocellular carcinoma who were...

prostate cancer
immunotherapy

Pembrolizumab in Refractory Metastatic Castration-Resistant Prostate Cancer

In the phase II KEYNOTE-199 study, reported in the Journal of Clinical Oncology by Antonarakis et al, pembrolizumab showed activity and had an acceptable safety profile in patients with treatment-refractory metastatic castration-resistant prostate cancer. Study Details The trial was conducted at 85 ...

head and neck cancer
immunotherapy

Immunotherapy for Head/Neck Squamous Cell Carcinoma: Questions Raised by KEYNOTE-048

There is a new first-line treatment option for patients with newly diagnosed, recurrent, or metastatic head and neck squamous cell carcinoma. As reported by Burtness et al in The Lancet, pembrolizumab improved overall survival vs the standard-of-care regimen of cetuximab and platinum-based...

gynecologic cancers
immunotherapy

ESMO Immuno-Oncology 2019: Sitravatinib/Tislelizumab Shows Antitumor Activity in Ovarian Cancer

Results from a phase Ib study reported at the European Society for Medical Oncology (ESMO) Immuno-Oncology Congress 2019 showed manageable safety and encouraging antitumor activity in patients with advanced ovarian cancer treated with the novel combination of sitravatinib and tislelizumab. These...

gynecologic cancers

Thermal Ablation vs Cryotherapy or Loop Excision in Zambian Women Positive for Cervical Precancer

In the pilot phase of an ongoing randomized trial reported in The Lancet Oncology, Partha Basu, MD, and colleagues found that thermal ablation and cryotherapy produced similar treatment success rates in Zambian women positive for cervical precancer on visual inspection with acetic acid. The...

kidney cancer

First-Line Pembrolizumab Plus Axitinib for Advanced Renal Cell Carcinoma

On April 19, 2019, pembrolizumab was approved for use in combination with the small-molecule tyrosine kinase inhibitor axitinib for the first-line treatment of patients with advanced renal cell carcinoma.1,2 Supporting Efficacy Data Approval was based on findings in the open-label phase III...

gynecologic cancers

Niraparib for Homologous Recombination Deficiency–Positive Advanced Ovarian Cancer

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 October 23, 2019, the poly (ADP-ribose) polymerase...

multiple myeloma
geriatric oncology

ASH 2019: Is Autologous Hematopoietic Stem Cell Transplant Safe and Effective for Patients Aged 70 or Older With Multiple Myeloma?

Even though autologous hematopoietic stem cell transplantation (AHCT) is an effective treatment for multiple myeloma, only 4 out of 10 patients receive this therapy. A new study presented by Munshi et al at the 2019 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 782) ...

hematologic malignancies
immunotherapy

ASH 2019: CAR-NK Therapy for B-Cell Malignancies Shows Activity in Preclinical Studies

Preclinical studies have provided the first evidence that cellular immunotherapy for B-cell cancers could ultimately become an off-the-shelf product, capable of being uniformly manufactured in large quantities. The product—FT596—is among the first cellular immunotherapies to be based on...

prostate cancer

Is Nonmetastatic Castration-Resistant Prostate Cancer a Valid Disease Category?

Does nonmetastatic castration-resistant prostate cancer really exist? Although it is considered a disease category, it turns out that the definition depends on the type of imaging used. Many patients with castration-resistant prostate cancer who were categorized as “nonmetastatic” on conventional...

lung cancer
immunotherapy

Does Adding Pembrolizumab or Placebo to Chemotherapy for Patients With Metastatic Squamous NSCLC Improve Quality of Life?

In a health-related quality of life analysis from the phase III KEYNOTE-407 trial reported in the Journal of Clinical Oncology, Mazières et al found that the patients with metastatic squamous non–small cell lung cancer (NSCLC) who received pembrolizumab in addition to chemotherapy had better...

supportive care

Checkpoint Inhibitor Pneumonitis: A Pulmonologist’s Perspective

Oncologists have become accustomed to seeing pneumonitis associated with immune checkpoint inhibitor treatment in non–small cell lung cancer (NSCLC), requiring intervention by pulmonologists in the management of severe cases. At CHEST 2019, the annual meeting of the American College of Chest...

breast cancer

Emerging Alternatives in the Third-Line Setting for Metastatic HER2-Positive Breast Cancer

In the post-trastuzumab era, a number of U.S. Food and Drug Administration (FDA)-approved targeted agents for metastatic HER2-positive breast cancer are available, but there is no preferred option for third-line treatment and beyond. At the 2019 Chemotherapy Foundation Symposium, Shanu Modi, MD,...

colorectal cancer
immunotherapy

Pembrolizumab in Previously Treated Metastatic MSI-H/dMMR Colorectal Cancer

As reported in the Journal of Clinical Oncology by Dung T. Le, MD, and colleagues, the phase II KEYNOTE-164 trial demonstrated activity of pembrolizumab in previously treated metastatic microsatellite instability–high (MSI-H)/mismatch repair–deficient (dMMR) colorectal cancer. Findings from the...

supportive care
pain management

Assessing Cancer Pain Management in the Era of the Opioid Epidemic

A vast majority of patients with cancer receiving opioids for the management of pain will adhere to the opioids as prescribed and will have no major difficulties with dose reduction and even treatment discontinuation if the pain syndrome resolves. However, about 20% of patients with cancer are at...

gynecologic cancers
global cancer care

Thermal Ablation vs Cryotherapy or Loop Excision in Zambian Women Positive for Cervical Precancer

In the pilot phase of an ongoing randomized trial reported in The Lancet Oncology, Pinder et al found that thermal ablation and cryotherapy produced similar treatment success rates in Zambian women positive for cervical precancer on visual inspection with acetic acid. The investigators noted that...

multiple myeloma

A Diagnosis of Multiple Myeloma Taught Me to Live in the Moment

I was just 39 in 2015 when I was diagnosed with multiple myeloma. I have a wife and three young children whom I love, a challenging and fulfilling career, and I wasn’t ready to die. When I was first diagnosed, I met with a medical oncologist who had little experience treating this type of cancer....

lung cancer

Despite Challenges, Pioneer in CT Screening for Early Lung Cancer Works to Move the Field Forward

In 1999, a team of researchers from Weill Cornell Medical College advocated the use of a then-novel practice: low-dose radiation CT screening for lung cancer. It captures a full thoracic image in a single breath hold, and can recognize a tumor in its earliest stages when the chance for cure is...

Clinical Happenings and Highlights at the 2019 ASH Annual Meeting

The 61st American Society of Hematology (ASH) Annual Meeting & Exposition is being held December 7–10, 2019, at the Orange County Convention Center in Orlando. Be sure to visit The ASCO Post in the exhibit hall (booth 2429, Harborside) and watch interviews with experts being filmed there live....

gastrointestinal cancer

Circulating Tumor DNA: A Prognostic Marker in Stage III Colon Cancer?

Circulating tumor DNA in the blood could serve as a marker of prognosis in patients with colon cancer receiving adjuvant oxaliplatin, according to a subanalysis of the IDEA trial, presented at the European Society for Medical Oncology (ESMO) Congress 2019.1 After 2 years of adjuvant...

hematologic malignancies
immunotherapy

Answers to Hematology Expert Review Questions

Question 1 Which of the following statements about cytokine-release syndrome and neurotoxicity after tisagenlecleucel infusion is correct? Correct answer: B. The median time to onset of cytokine-release syndrome is 3 days. Expert Perspective Following tisagenlecleucel infusion, cytokine-release...

head and neck cancer
immunotherapy

Pembrolizumab With or Without Chemotherapy vs Cetuximab Plus Chemotherapy in Recurrent or Metastatic HNSCC

As reported in The Lancet by Barbara Burtness, MD, and colleagues, the phase III KEYNOTE-048 trial has shown improved overall survival with first-line pembrolizumab plus chemotherapy vs cetuximab plus chemotherapy among patients with recurrent or metastatic squamous cell carcinoma of the head and...

integrative oncology

Boswellia

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. In this installment, Gary Deng, MD, PhD, and Jyothirmai Gubili, MS, focus on the herbal extract...

solid tumors
immunotherapy

Pembrolizumab in Noncolorectal MSI-H/dMMR Solid Tumors

As reported in the Journal of Clinical Oncology by Marabelle et al, the phase II KEYNOTE-158 trial has shown robust activity of pembrolizumab in patients with noncolorectal microsatellite instability­–high (MSI-H)/mismatch repair–deficient (dMMR) solid tumors. Findings in the study supported the...

prostate cancer
breast cancer
bladder cancer
pancreatic cancer
kidney cancer
thyroid cancer
gynecologic cancers
immunotherapy

ESMO Congress 2019: Quick Takes From Key Clinical Trials

The ESMO Congress continues to grow as a pivotal platform for research in clinical oncology. At the ESMO Congress 2019, important findings were showcased in more than 2,200 studies, including 93 late-breaking abstracts. The ASCO Post summarized much of that news in separate articles over several...

gynecologic cancers

PRIMA Trial Reports Benefit With Niraparib Across Ovarian Cancer Subsets

In women with advanced ovarian cancer responding to first-line chemotherapy, maintenance therapy with the PARP inhibitor niraparib significantly reduced the risk of disease progression by 38% overall and by 60% in women with BRCA mutations. Even patients without a homologous recombination...

leukemia
lymphoma

Venetoclax for Chronic Lymphocytic Leukemia or Small Lymphocytic Lymphoma

On May 15, 2019, venetoclax was approved for the treatment of adult patients with previously untreated chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).1,2 Supporting Efficacy Data Approval was based on findings from the open-label phase III CLL14 trial (ClinicalTrials.gov...

gynecologic cancers

Veliparib Plus Chemotherapy Meets Primary Endpoint in Advanced Ovarian Cancer

As first-line treatment for women with advanced ovarian cancer, the addition of veliparib during induction followed by veliparib maintenance therapy significantly reduced the risk of disease progression or death in the phase III VELIA/GOG-3005 trial reported at the European Society for Medical...

prostate cancer

DNA Vaccine for Patients With Progressive, Nonmetastatic, Castration-Sensitive Prostate Cancer

In a phase II study reported in the Journal of Clinical Oncology, McNeel et al found that a DNA vaccine (pTVG-HP) encoding prostatic acid phosphatase did not improve 2-year metastasis-free survival vs control treatment in patients with progressive, nonmetastatic, castration-sensitive prostate...

immunotherapy
solid tumors

Pembrolizumab for Patients With Advanced Adrenocortical Carcinoma

In a single-center phase II study reported in the Journal of Clinical Oncology, Raj et al found that pembrolizumab showed activity in advanced adrenocortical carcinoma. Study Details Thirty-nine patients with advanced adrenocortical carcinoma were enrolled in the study between February 2016 and...

hematologic malignancies

Fedratinib for Myelofibrosis

On August 16, 2019, fedratinib was approved for the treatment of adults with intermediate-2 or high-risk primary or secondary (post-polycythemia vera or post-essential thrombocythemia) myelofibrosis.1,2 Supporting Efficacy Data The approval was based on findings from the phase III double-blind...

gynecologic cancers
immunotherapy

Pembrolizumab/Lenvatinib in Advanced Endometrial Carcinoma Without Microsatellite Instability–High or Mismatch Repair–Deficient Disease

On September 17, 2019, the combination of pembrolizumab plus lenvatinib was granted accelerated approval for the treatment of patients with advanced endometrial carcinoma that is not microsatellite instability–high (MSI-H) or mismatch repair–deficient (dMMR) and who have disease progression...

immunotherapy
lymphoma

Immunotherapy in Relapsed or Refractory Primary Mediastinal Large B-Cell Lymphoma

Findings from the phase Ib KEYNOTE-013 and phase II KEYNOTE-170 trials reported in the Journal of Clinical Oncology by Armand et al indicated that pembrolizumab is highly active in relapsed or refractory primary mediastinal large B-cell lymphoma (PMBCL). The KEYNOTE-170 trial supported the 2018...

avastin

Addition of Bevacizumab to Chemotherapy in Recurrent or Metastatic Head and Neck Cancer

As reported in the Journal of Clinical Oncology by Argiris et al, the Eastern Cooperative Oncology Group (ECOG)-American College of Radiology Imaging Network Cancer Research Group–coordinated phase III E1305 trial has shown no overall survival benefit with the addition of bevacizumab to...

solid tumors
immunotherapy

Pegilodecakin Plus Pembrolizumab or Nivolumab in Advanced Solid Tumors

In a phase Ib trial reported in The Lancet Oncology, Naing et al found that the combination of pegilodecakin (pegylated interleukin [IL]-10) with the programmed cell death protein 1 (PD-1) inhibitor pembrolizumab or nivolumab was active in previously treated advanced solid tumors.  In the study,...

issues in oncology

Virtual Molecular Tumor Boards May Help to Efficiently Deliver Precision Medicine to Patients

Using virtual, cloud-based, interconnected computing techniques applied to 51,000 variables, researchers reduced the time needed to assess a patient’s tumor profile and suitability for clinical trials from 14 to 4 days. This method also increased the number of cases that could be assessed compared...

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