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issues in oncology
cost of care
cardio-oncology

Financial Impact of Cardiovascular Disease and Cancer Care: Overlapping Toxicities

The leading causes of mortality in the United States are cardiovascular disease (23%) and cancer (21%), accounting for more than 40% of total deaths reported.1,2 The increasing rise in health-care expenditures over the past several decades has driven the need for metrics to further evaluate the...

issues in oncology
cost of care

Financial Toxicity Associated With Atherosclerotic Cardiovascular Disease, Cancer, and Both in U.S. Adult Patients

In a study of National Health Interview Survey (NHIS) data reported in JACC: CardioOncology, Javier Valero-Elizondo, MD, MPH, of Houston Methodist DeBakey Heart and Vascular Center, and colleagues, found that U.S. adult patients aged 18 to < 65 years with atherosclerotic cardiovascular disease...

Expert Point of View: Florian Lordick, MD, PhD

Florian Lordick, MD, PhD, Professor of Oncology and Director of the University Cancer Center Leipzig, Germany, applauded the positive finding for nivolumab plus chemotherapy in CheckMate 6491 and questioned why nivolumab plus ipilimumab did not meet its endpoint. “I’m calling this a big step...

solid tumors

CheckMate 649: Long-Term Data Support Nivolumab Plus Chemotherapy but Not Nivolumab Plus Ipilimumab in Gastric Cancer

Longer follow-up data from the phase III CheckMate 649 trial support the use of nivolumab plus chemotherapy as a new standard first-line regimen in patients with advanced gastric cancer, gastroesophageal junction cancer, and esophageal adenocarcinoma. The findings were reported by Yelena Janjigian, ...

hematologic malignancies
covid-19

Patients With Hematologic Malignancies: How Robust Is Their Immunity to SARS–CoV-2?

A large study from the United Kingdom has taken a deep dive into SARS–CoV-2 in the setting of cancer, yielding both concerning and encouraging findings about natural and vaccine-induced immunity. The study was presented at the Presidential Symposium during the European Society for Medical Oncology...

breast cancer

KEYNOTE-522: Neoadjuvant Pembrolizumab Improves Event-Free Survival in Triple-Negative Breast Cancer

The latest analysis of the phase III KEYNOTE-522 trial demonstrated significant improvements in clinical outcomes with pembrolizumab plus chemotherapy vs chemotherapy alone as a neoadjuvant/adjuvant treatment of triple-negative breast cancer.1 This is the first large, randomized, phase III trial to ...

breast cancer

Early Triple-Negative Breast Cancer: Are Checkpoint Inhibitors Ready for Neoadjuvant or Adjuvant Use?

Recent clinical trials have been encouraging for the neoadjuvant or adjuvant use of immune checkpoint inhibitors in triple-negative breast cancer, but is this approach ready for the clinic? This question was addressed at the 38th Miami Breast Cancer Conference, held virtually this year, by Adam M....

breast cancer

Margetuximab-cmkb Plus Chemotherapy Prolongs Progression-Free Survival in Heavily Pretreated HER2 Positive Breast Cancer

As reported in JAMA Oncology by Hope S. Rugo, MD, of the University of California San Francisco Helen Diller Family Comprehensive Cancer Center, and colleagues, the phase III SOPHIA trial has shown significantly prolonged progression-free survival with margetuximab-cmkb plus chemotherapy vs...

breast cancer

Reduction in Ipsilateral Recurrence Risk With Radiotherapy vs Observation After Lumpectomy for Good-Risk DCIS

In an analysis of long-term outcomes from the phase III NRG/RTOG 9804 trial reported in the Journal of Clinical Oncology, Beryl McCormick, MD, of Memorial Sloan Kettering Cancer Center, and colleagues found that whole-breast irradiation vs observation was associated with a reduced risk of all and...

thyroid cancer

Cabozantinib Prolongs Progression-Free Survival in Previously Treated Radioiodine-Refractory Differentiated Thyroid Cancer

As reported in The Lancet Oncology by Marcia S. Brose, MD, Abramson Cancer Center, University of Pennsylvania, and colleagues, the phase III COSMIC-311 trial has shown that cabozantinib produced a numerically higher objective response rate and significantly prolonged progression-free survival vs...

hematologic malignancies

Zanubrutinib for Waldenström’s Macroglobulinemia

On August 31, 2021, the Bruton’s tyrosine kinase inhibitor zanubrutinib was approved for treatment of adults with Waldenström’s macroglobulinemia.1 Supporting Efficacy Data Approval was based on findings in patients receiving zanubrutinib in the phase III open-label ASPEN trial (ClinicalTrials.gov...

hepatobiliary cancer

Addition of Ramucirumab or Merestinib to First-Line Chemotherapy in Advanced Biliary Tract Cancer

In a phase II trial reported in The Lancet Oncology, Juan W. Valle, MD, and colleagues found that no progression-free survival benefit was achieved with the addition of either the VEGFR2 inhibitor ramucirumab or the MEK inhibitor merestinib to first-line cisplatin/gemcitabine chemotherapy in...

hematologic malignancies
leukemia
immunotherapy
global cancer care

A Look at Tomorrow’s CAR T-Cell Therapy Today

Some of the most impressive data on chimeric antigen receptor (CAR) T-cell therapy have come from studies conducted in China. Attendees at the 2021 Pan Pacific Lymphoma Conference heard from one of the leading Chinese investigators, Peihua (Peggy) Lu, MD, of Lu Daopei Hospital, who described the...

lymphoma
immunotherapy

Axicabtagene Ciloleucel for Adult Patients With Primary Mediastinal B-Cell Lymphoma: Real-World Outcomes

In a retrospective cohort study reported in a research letter in Blood Advances, Jennifer L. Crombie, MD, and colleagues found that axicabtagene ciloleucel produced high overall and complete response rates in patients with primary mediastinal B-cell lymphoma. They also observed some evidence to...

prostate cancer

Characteristics of and Outcomes in Luminal and Basal Subtypes of Metastatic Castration-Resistant Prostate Cancer

In a retrospective cohort study reported in JAMA Oncology, Aggarwal et al found that metastatic castration-resistant prostate cancer could be categorized into luminal and basal subtypes, and that androgen-signaling inhibitor treatment was associated with better outcomes in patients diagnosed with...

prostate cancer

Ga-68 PSMA-11 PET for Detection of Pelvic Nodal Metastasis in Intermediate- to High-Risk Prostate Cancer

In a collaborative phase III trial reported in JAMA Oncology, Thomas A. Hope, MD, and colleagues found that gallium-68 prostate-specific membrane antigen–11 positron-emission tomography (Ga-68 PSMA-11 PET) had 40% sensitivity and 95% specificity in the detection of pelvic nodal metastases prior to...

lung cancer
genomics/genetics

Poziotinib, a Tyrosine Kinase Inhibitor, for HER2 Exon 20–Mutant NSCLC

In a single-center phase II trial reported in the Journal of Clinical Oncology, Elamin et al found that the tyrosine kinase inhibitor poziotinib showed activity in previously treated patients with HER2 exon 20–mutant advanced non–small cell lung cancer (NSCLC). As related by the investigators,...

multiple myeloma
immunotherapy

CASSIOPEIA Part 2: Maintenance Daratumumab After Initial Therapy for Newly Diagnosed Multiple Myeloma

As reported in The Lancet Oncology by Philippe Moreau, MD, and colleagues, an interim analysis of part 2 of the phase III CASSIOPEIA trial has shown significantly prolonged progression-free survival with maintenance daratumumab vs observation following induction and consolidation with or without...

skin cancer

Overall Survival With the Bispecific Fusion Protein Tebentafusp for Metastatic Uveal Melanoma

In an interim analysis of the phase III IMCgp100-202 trial reported in The New England Journal of Medicine, Nathan et al found that tebentafusp, a bispecific protein consisting of an affinity-enhanced T-cell receptor fused to an anti-CD3 effector, significantly improved overall survival vs...

hepatobiliary cancer

Ivosidenib for Previously Treated IDH1-Mutant Advanced or Metastatic Cholangiocarcinoma

On August 25, 2021, ivosidenib was approved for adults with previously treated, locally advanced or metastatic cholangiocarcinoma with an IDH1 mutation, as detected by a U.S. Food and Drug Administration (FDA)-approved test.1 The FDA simultaneously approved the Oncomine Dx Target Test as a...

breast cancer

New Evidence Drives Need for Revised Guideline on Hormone-Sensitive Advanced Breast Cancer

A recently updated ASCO guideline offers both new and revised guidance on the treatment of hormone receptor–positive, HER2-negative metastatic breast cancer.1 “ASCO regularly updates its guidelines to make sure everything is current and valuable for oncologists and patients. About a year ago,...

skin cancer

Adoptive Cell Therapy May Soon Be Available for Patients With Melanoma

Oncologists who treat patients with melanoma will need to become familiar with another immunotherapy approach. For refractory metastatic disease, adoptive cell therapy is on the horizon. “Adoptive cell therapy will offer additional hope for our patients with melanoma. We’ll likely be seeing this...

gastroesophageal cancer

Nivolumab Plus Chemotherapy Improves Survival in Advanced Gastric and Esophageal Adenocarcinomas: Now to Figure Out the Details in These Heterogeneous Diseases

There is no doubt that subsets of patients with esophageal and gastric cancers benefit from immune checkpoint inhibitor therapy. The complexity lies in identifying the appropriate histology, tumor location, expression of programmed cell death receptors and ligands, mechanism of checkpoint...

gastroesophageal cancer

Adding First-Line Nivolumab to Chemotherapy Improves Survival in Gastric, Gastroesophageal Junction, and Esophageal Adenocarcinomas

As reported in The Lancet by Yelena Y. Janjigian, MD, of the Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, and colleagues, the phase III CheckMate 649 trial has shown that the addition of first-line nivolumab to chemotherapy resulted in improved overall and...

solid tumors
hematologic malignancies

ASCO 2021: Roundup of Studies You May Have Missed

As ASCO Annual Meeting attendees know by now, clinicians don’t have to be at McCormick Place to hear practice-changing findings and forward-looking advances in the field of oncology. Interesting content was no exception at the 2021 conference, so in addition to covering the biggest news from the...

immunotherapy
lymphoma

Lymphoid Malignancies: What’s Next for Antibody-Drug Conjugates?

Antibody-drug conjugates are improving outcomes of patients with lymphoma, often those who have exhausted treatment options after chimeric antigen receptor (CAR) T-cell therapy. Four available antibody-drug conjugates are in the clinic, with brentuximab vedotin moving into the front-line...

leukemia

First-Line Acalabrutinib, Venetoclax, and Obinutuzumab for Chronic Lymphocytic Leukemia

In a phase II study reported in The Lancet Oncology, Matthew S. Davids, MD, and colleagues found that first-line triple combination therapy with acalabrutinib, venetoclax, and obinutuzumab produced measurable residual disease (MRD)-negative complete remission in a substantial proportion of patients ...

lymphoma
immunotherapy

Long-Term Outcomes in JULIET Trial of Tisagenlecleucel for Relapsed or Refractory Aggressive B-Cell Lymphomas

As reported by Stephen J. Schuster, MD, and colleagues in The Lancet Oncology, long-term outcomes of the pivotal phase II JULIET trial showed overall and complete response rates of 53% and 39% in adult patients with relapsed or refractory aggressive B-cell lymphomas treated with the T-cell...

Strict Adherence to Algorithm Required

According to the investigators, the SENTOR trial suggests that sentinel lymph node biopsy should be considered for the surgical staging of apparent clinical stage I endometrial cancer with no evidence of extrauterine disease on imaging or intraoperative survey.1 “If [sentinel lymph node biopsy] is...

gynecologic cancers

Study Shows Sentinel Lymph Node Biopsy to Be ‘Viable Option’ for Surgical Staging of Endometrial Cancer

Sentinel lymph node biopsy “had similar diagnostic accuracy and prognostic ability as lymphadenectomy in patients with high-grade endometrial cancer at greatest risk for nodal metastases,” according to the SENTOR trial, a prospective cohort study of 156 patients with clinical stage I disease. Using ...

gynecologic cancers
immunotherapy

Novel Treatments Show Activity in Advanced Cervical Cancer

The treatment of recurrent or metastatic cervical cancer has not changed much in recent years, but according to preliminary trials presented at the European Society for Medical Oncology (ESMO) Virtual Congress 2020, checkpoint inhibitors and antibody-drug conjugates may become new options. In the...

gynecologic cancers

With the Exception of Cervical Cancer, HPV-Associated Cancers Are on the Rise, Especially in Older Adults

Although the incidence of cervical cancer has decreased 1.03% a year over the past 17 years in the United States, likely due to screening or vaccination, other human papillomavirus (HPV)-associated cancers are increasing in both men and women, according to a study by Cheng-I Liao, MD, currently of...

gynecologic cancers

Niraparib Plus Bevacizumab Shows Clinical Benefit in Advanced Ovarian Cancer

The addition of niraparib maintenance to first-line platinum-based chemotherapy with bevacizumab demonstrated clinical benefit in patients with advanced ovarian cancer, according to data from the OVARIO study presented by Melissa M. Hardesty, MD, MPH, during the Society of Gynecologic Oncology...

gynecologic cancers

Fuzuloparib Maintenance Therapy Improves Progression-Free Survival in Patients With Recurrent Ovarian Cancer

A new poly (ADP-ribose) polymerase (PARP) inhibitor could soon be joining an already crowded treatment landscape in ovarian cancer, according to data presented at the Society of Gynecologic Oncology (SGO) 2021 Annual Meeting on Women’s Cancer, which was held virtually.1 Results of the phase III...

gynecologic cancers
immunotherapy

Immunotherapy With Cemiplimab-rwlc Yields Survival Benefit in Advanced Cervical Cancer

The PD-L1 inhibitor cemiplimab-rwlc has become the first immunotherapy to yield a statistically significant and clinically meaningful survival benefit in recurrent or metastatic cervical cancer progressing after first-line platinum-containing chemotherapy. Patients were enrolled irrespective of...

leukemia

Fixed-Dose, First-Line Ibrutinib/Venetoclax Combination Achieves Durable Remissions in CLL

The combination of fixed-duration, first-line treatment with ibrutinib plus venetoclax achieved complete responses in more than half of patients with chronic lymphocytic leukemia (CLL)/small lymphocytic leukemia (SLL), based on the primary analysis of the fixed-dose cohort of the phase II CAPTIVATE ...

multiple myeloma

Bispecific Antibodies Advance in Relapsed or Refractory Multiple Myeloma

For the challenging population of patients with multiple myeloma who have become refractory to essentially all current treatments, new approaches are much needed. Early clinical trials data suggest bispecific antibodies may help meet this need, as suggested by studies presented at the 2021 ASCO...

Expert Point of View: Jason J. Luke, MD

Invited discussant of of the C-144-01 study,1 Jason J. Luke, MD, Associate Professor of Medicine and Director of the Cancer Immunotherapeutics Center, University of Pittsburgh Hillman Cancer Center, Pittsburgh, noted that lifileucel is “clearly an active regimen in the post–PD-1/CTLA-4 setting and...

skin cancer

Lifileucel After Disease Progression in Metastatic Melanoma: Durable Responses Achieved in Phase II Trial

Despite the fact that we have made significant progress in metastatic melanoma with immune checkpoint inhibitors—now the standard of care—most patients experience disease progression and are left without approved treatments. There is a need for newer treatments with clinical benefit. Lifileucel, an ...

head and neck cancer

CheckMate 648: First-Line Nivolumab Regimens Improve Survival in Esophageal Squamous Cell Carcinoma

As first-line treatment of advanced esophageal squamous cell carcinoma, nivolumab-containing regimens improved overall survival over standard-of-care chemotherapy, according to the first results of the global phase III CheckMate 648 trial presented at the 2021 ASCO Annual Meeting by Ian Chau, MD,...

Expert Point of View: Nicolas Girard, MD, PhD

Invited discussant Nicolas Girard, MD, PhD, of the Curie Institute, Paris, said: “A major challenge in non–small cell lung cancer is what happens when osimertinib resistance develops.” “A key takeaway point from this study is that the efficacy is driven by resistance mechanism. The overall...

lung cancer
issues in oncology
genomics/genetics

Survey Examines Oncology Clinician Perceptions of Biomarker Testing for Underserved Patients With Lung Cancer

Less than half of community oncologists surveyed indicated that they use biomarker testing to guide patient discussions compared with 73% of academic clinicians, according to a report by Boehmer et al presented at the International Association for the Study of Lung Cancer (IASLC) 2021 World...

covid-19

Rates of Adverse Reactions to the Moderna mRNA-1273 COVID-19 Vaccine in Patients With Cancer and Recent Radiotherapy

In an Italian single-center study reported in a letter in The Lancet Oncology, Scoccianti et al found that patients who underwent radiotherapy for cancer within the 6 months prior to receipt of the Moderna mRNA-1273 COVID-19 vaccine did not experience a difference in adverse reactions to the...

multiple myeloma

Daratumumab and Hyaluronidase-fihj With Pomalidomide Plus Dexamethasone in Multiple Myeloma

On July 9, 2021, daratumumab and hyaluronidase-fihj was approved for use in combination with pomalidomide and dexamethasone (Pd) for treatment of adults with multiple myeloma who have received at least one prior line of therapy, including lenalidomide and a proteasome inhibitor.1 Supporting...

gastroesophageal cancer

Reduced-Intensity Chemotherapy for Older, Frail Patients With Advanced Gastroesophageal Cancer

Patients who had advanced gastroesophageal cancer but were considered unsuitable for full-dose chemotherapy because of their advanced age and/or frailty “had an improved patient experience with no significant detriment in cancer control” when treated with reduced-intensity chemotherapy in the phase ...

lung cancer

Amivantamab-vmjw for Previously Treated Advanced NSCLC With EGFR Mutation

On May 21, 2021, amivantamab-vmjw, a bispecific antibody directed against EGFR and MET receptors, was granted accelerated approval for treatment of adults with locally advanced or metastatic non–small cell lung cancer (NSCLC) with EGFR exon 20 insertion mutations, as detected by a U.S. Food and...

hematologic malignancies

Highlights From Transplantation and Cellular Therapy Meetings of ASTCT and CIBMTR

“Progress lies not in enhancing what is, but in advancing toward what will be.” —Khalil Gibran The Combined Annual Meetings of the American Society for Transplantation and Cellular Therapy (ASTCT) and the Center for International Blood & Marrow Transplant Research (CIBMTR) were held virtually...

breast cancer
immunotherapy

Pembrolizumab for High-Risk, Early-Stage Triple-Negative Breast Cancer

On July 26, 2021, pembrolizumab was approved for high-risk, early-stage, triple-negative breast cancer in combination with chemotherapy as neoadjuvant treatment and continued as adjuvant treatment.1 Pembrolizumab was also granted regular approval in combination with chemotherapy for locally...

lung cancer
covid-19

IASLC 2021: Enrollment in Clinical Trials for Lung Cancer Declined Significantly During the COVID-19 Pandemic

Enrollment in lung cancer clinical trials declined by 43% during the COVID-19 pandemic, according to research presented by Smeltzer et al at the International Association for the Study of Lung Cancer (IASLC) 2021 World Conference on Lung Cancer (Abstract PL02.09). IASLC Survey To assess the impact...

lymphoma
immunotherapy

Assumptions, Data … and More Questions!

I read with great interest the results from the phase II ZUMA-12 study of axicabtagene ciloleucel, presented during the 2020 American Society of Hematology (ASH) Annual Meeting & Exposition.1 But the results raised several questions for me. Axicabtagene ciloleucel, an autologous anti-CD19...

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