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gastrointestinal cancer

New NCCN Guidelines®: First to Address Small Intestine Cancers

THE NATIONAL COMPREHENSIVE Cancer Network® (NCCN®) recently announced the publication of a new set of recommendations focused on cancers in the small intestine. The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) for Small Bowel Adenocarcinoma are the first treatment guidelines in...

prostate cancer

Darolutamide for Nonmetastatic Castration-Resistant Prostate Cancer

On July 30, 2019, darolutamide was approved for the treatment of patients with nonmetastatic castration-resistant prostate cancer.1,2 Approval was based on findings in the double-blind phase III ARAMIS trial (ClinicalTrials.gov identifier NCT02200614), in which 1,509 patients were randomly assigned ...

breast cancer

Tumor Size and Grade Matter, and Ovarian Ablation by Chemotherapy May Explain Subgroup Anomaly in TAILORx

At the 2019 ASCO Annual Meeting, and simultaneously in The New England Journal of Medicine, we heard the third paper reporting results from TAILORx.1,2 The first, in 2015,3 indicated that women with node-negative breast cancers with Oncotype DX recurrence scores less than 11 did extremely well...

Pelotonia Institute for Immuno-Oncology Launched at The Ohio State University Cancer Center

THE OHIO STATE UNIVERSITY Comprehensive Cancer Center–Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC– James) announced the formation of the Pelotonia Institute for Immuno-Oncology (PIIO), a comprehensive bench-to-bedside research initiative focused on harnessing...

kidney cancer
prostate cancer
immunotherapy

Novel Treatments Under Study in Renal Cell Carcinoma and Prostate Cancer

There were numerous notable presentations at the 2019 Genitourinary Cancers Symposium, many of which were covered in The ASCO Post over the past few months. To add to our continued coverage of this meeting, here are some highlights from studies focusing on novel therapeutics in renal cell carcinoma ...

issues in oncology
geriatric oncology

Polypharmacy Associated With Functional Decline in Older Patients With Advanced Cancer

Polypharmacy (ie, the concurrent use of eight or more medications) and potentially inappropriate medications may be associated with functional impairment in older adults with advanced cancer, according to research presented by ­Mostafa Mohamed, MBBCh, at the Multinational Association of Supportive...

prostate cancer

FDA Approves Darolutamide for Nonmetastatic Castration-Resistant Prostate Cancer

ON JULY 30, the U.S. Food and Drug Administration (FDA) approved darolutamide (Nubeqa) for the treatment of nonmetastatic castration-resistant prostate cancer. Approval was based on the ARAMIS study, a multicenter, double-blind, placebo-controlled clinical trial of 1,509 patients with nonmetastatic ...

issues in oncology
pain management

Opioids for Cancer Pain: A Review of the Evidence and Current Challenges

In the wake of the opioid crisis in the United States, patients with cancer pain are often undeservedly confronted with rigid barriers to receiving the opioids they need. To compound this problem, the research around opioids in cancer pain has been limited—placebo-controlled trials are lacking,...

health-care policy
immunotherapy

CMS Finalizes Decision to Cover CAR T-Cell Therapy for Medicare Beneficiaries

ON AUGUST 7, the Centers for Medicare & Medicaid Services (CMS) finalized the decision to cover U.S. Food and Drug Administration (FDA)-approved chimeric antigen receptor (CAR) T-cell therapy among recipients of Medicare benefits. FDA-approved CAR T-cell therapies are approved to treat patients ...

lung cancer
immunotherapy

Optimal First-Line Therapy for Stage IV Non–Small Cell Lung Cancer: Immunotherapy Alone or With Chemotherapy?

Recent studies in non–small cell lung cancer (NSCLC) have shown benefit for combining checkpoint inhibitors with chemotherapy. Should combinations, therefore, be the first choice for treating patients with newly diagnosed stage IV disease? Two lung cancer experts debated this point at the 2019...

issues in oncology
geriatric oncology

All Oncologists Are Geriatric Oncologists...They Just Don’t Know It Yet

You don’t have to be a geriatrician to properly evaluate and manage older patients with cancer. The wave of older patients with cancer predicted over 30 years ago is now fully upon us. The oncology community finds itself ill-prepared to manage the increased number of older patients. It is not just...

solid tumors

Expert Point of View: Thomas Paul Slavin, Jr, MD

Thomas Paul Slavin, Jr, MD, of City of Hope National Medical Center, where he is Assistant Clinical Professor in the Department of Medical Oncology, Division of Clinical Cancer Genomics, and a Program Member of Cancer Control and Population Sciences, commented on these substudy findings. The...

solid tumors

Exploratory Analysis Shows DNA Methylation Assay Highly Specific for Cancer Detection

A cell-free DNA test based on the presence of DNA methylation has proven highly specific as a multicancer detection test and appears especially good at detecting high-risk malignancies. In most cases, it can also accurately pinpoint the tumor’s tissue of origin, researchers reported at the 2019...

head and neck cancer

Swallowing-Related Quality of Life After Radiotherapy vs Surgery for Oropharyngeal Squamous Cell Carcinoma

In the phase II ORATOR trial reported in The Lancet Oncology, Nichols et al found a statistical but not clinically meaningful improvement in swallowing-related quality of life outcomes 1 year after treatment with radiotherapy vs transoral robotic surgery and neck dissection in patients with...

pancreatic cancer

USPSTF Recommendation on Screening for Pancreatic Cancer in Asymptomatic Adults

As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF), in a reaffirmation of its 2004 recommendation, has recommended against screening for pancreatic cancer in asymptomatic adults (a grade D recommendation).1 In developing the current recommendation, the USPSTF reviewed evidence on ...

immunotherapy
skin cancer
kidney cancer
lung cancer

Long-Term Follow-up of Patients With Melanoma, Kidney Cancer, and Lung Cancer Receiving Nivolumab

As reported by Suzanne L. Topalian, MD, and colleagues in JAMA Oncology, long-term follow up of patients from a phase I expansion cohort study indicated 5-year overall survival rates of 34.2%, 27.7%, and 15.6% among patients who received nivolumab monotherapy for advanced melanoma, renal cell...

Cancer Research Institute Names New ‘STARs’ of Cancer Immunotherapy Research

The Cancer Research Institute (CRI), a nonprofit organization dedicated to the discovery and development of immunotherapies for all types of cancer, recently unveiled the inaugural cohort of scientists chosen for the CRI Lloyd J. Old STAR Program (Scientists Taking Risks). Each “STAR” will receive...

breast cancer

Almost 20 Years Later, Breast Fitness Is More Relevant Than Ever

BOOKMARK Title: Breast Fitness: An Optimal Exercise and Health Plan for Reducing Your Risk of Breast CancerAuthors: Anne McTiernan, MD, PhD; Julie Gralow, MD; and Lisa TalbottPublisher: St. Martin’s PressPublication Date: October 2000 (first edition)Price: $48.75, hardcover, 352 pages   The...

George J. Bosl, MD, FASCO, MACP, Named Memorial Sloan Kettering’s First Ombudsperson

In July, George J. Bosl, MD, FASCO, MACP, became Memorial Sloan Kettering’s (MSK) first ombudsperson, working closely with staff to provide confidential, independent guidance on complex and evolving issues, particularly related to conflicts of interest. The role of ombudsperson is a result of the...

V. Craig Jordan, CMG, OBE, PhD, DSc, Honored for Accomplishments in Women’s Health

The Companion of the Most Distinguished order of St. Michael and St. George (CMG) is generally reserved for ambassadors and leaders of the United Kingdom’s defense and security services. Only 1, 750 appointees are permitted. This year, the Head of M16, the Secret Intelligence Service, was in the...

head and neck cancer

FDA Approves Pembrolizumab for Some Patients With PD-L1–Positive Esophageal Cancer

On July 30, the U.S. Food and Drug Administration (FDA) approved the programmed cell death protein 1 inhibitor pembrolizumab (Keytruda) as monotherapy for the treatment of patients with recurrent locally advanced or metastatic esophageal cancer whose tumors express programmed cell death ligand 1...

head and neck cancer

Deintensified Chemoradiotherapy for HPV-Associated Oropharyngeal Squamous Cell Carcinoma

In a phase II trial reported in the Journal of Clinical Oncology, Chera et al found that deintensified chemoradiotherapy produced favorable outcomes in human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma. Study Details In the multicenter trial, 114 patients were recruited...

An Early Decision to Become an Oncologist

GUEST EDITOR Dr. Abraham is the Director of the Breast Oncology Program at Taussig Cancer Institute, and Professor of Medicine, Lerner College of Medicine, Cleveland Clinic.   For this installment of the Living a Full Life series, Guest Editor Jame Abraham, MD, FACP, spoke with Gilberto de Lima...

lung cancer

Atezolizumab Plus Chemotherapy and Bevacizumab in First-Line Treatment of Metastatic Lung Cancer

In late 2018, atezolizumab was approved for use in combination with bevacizumab, paclitaxel, and carboplatin for the first-line treatment of patients with metastatic nonsquamous non–small cell lung cancer (NSCLC) with no EGFR or ALK genomic tumor aberration.1,2 Supporting Efficacy Data Approval was ...

issues in oncology
legislation

Should You Become an Expert Witness in a Legal Proceeding? Here Are the Pros and Cons

Hundreds of oncologists are working “side gigs” as expert witnesses in a wide range of medicolegal settings. With increasing conflict related to liability and insurance coverage, the demand continues to grow for objective physicians who are not involved in a specific case, have no personal...

issues in oncology

Racial Reporting and Representation in Oncology Trials

New research published by Loree et al in JAMA Oncology found that race and race subgroup analysis reporting does not occur frequently and that black and Hispanic populations are underrepresented in oncology trials that have led to U.S. Food and Drug Administration (FDA) approvals. The study raises...

pancreatic cancer

Adavosertib Plus Gemcitabine and Radiotherapy in Locally Advanced Pancreatic Cancer

In a phase I dose-escalation trial reported in the Journal of Clinical Oncology, Cuneo et al established the phase II dose of the Wee1 kinase inhibitor adavosertib in combination with gemcitabine and radiotherapy in locally advanced pancreatic cancer. Wee1 inhibition impedes DNA damage response and ...

skin cancer
symptom management

Risk of Cardiovascular Adverse Events in Patients With Melanoma Treated With Combined BRAF and MEK Inhibition vs BRAF Inhibition Alone

In a meta-analysis reported in JAMA Network Open, Mincu et al found that the risk of some types of cardiovascular adverse events was higher with combined BRAF and MEK inhibitor treatment vs BRAF inhibitor monotherapy in patients with melanoma. The meta-analysis included 2,317 patients in five...

issues in oncology

Obesity-Associated Cancers and Age Demographics

A study published by Koroukian et al in JAMA Network Open found that from 2000 to 2016, incident obesity-associated cancers were increasingly found in younger age groups. The authors suggest that interventions are needed to reduce obesity and to implement individualized screening programs. The...

solid tumors
immunotherapy

T-Cell Receptor Gene Therapy in HPV-Associated Epithelial Cancers

In a first-in-human phase I/II study reported in the Journal of Clinical Oncology, Doran et al found that autologous genetically engineered T cells expressing a T-cell receptor directed against the human papillomavirus (HPV)16 E6 oncoprotein were capable of inducing tumor regression in metastatic,...

breast cancer

Neoadjuvant Letrozole Plus Taselisib or Placebo in Postmenopausal Women With ER-Positive, HER2-Negative Early Breast Cancer

In the phase II LORELEI trial reported in The Lancet Oncology, Saura et al found that the addition of the phosphatidylinositol-3 kinase (PI3K) inhibitor taselisib to neoadjuvant letrozole improved objective response rates but not pathologic complete response rates in women with estrogen receptor...

issues in oncology

Relationship Between Sleep Apnea and Cancer Risk in Women

Women with severe sleep apnea appear to also have an elevated risk of developing cancer, according to findings from a study by Pataka et al in the European Respiratory Journal. No causal relationship was demonstrated, but a link between nocturnal hypoxia in women and higher cancer risk was...

NCORP Expands to More Sites

The National Cancer Institute (NCI) has awarded 53 grants to researchers in the NCI Community Oncology Research Program (NCORP) to conduct multisite cancer clinical trials and cancer care delivery studies in their communities. In addition to seven research hubs, these NCI grants went to 32...

lung cancer
immunotherapy

Pooled Analysis of 4-Year Survival With Nivolumab Therapy in Patients With Previously Treated Advanced NSCLC

In an analysis reported in The Lancet Oncology, Antonia et al identified long-term survival rates with nivolumab therapy in patients with previously treated advanced non–small cell lung cancer (NSCLC). The pooled analysis included data from the CheckMate 017, 057, 063, and 003 trials, each...

FDA OCE and Syapse Announce Research Collaboration Focused on Regulatory Use of Real-World Evidence

Syapse and the U.S. Food and Drug Administration (FDA) Oncology Center of Excellence (OCE) have signed a multiyear research collaboration agreement focused on the use of real-world evidence to support regulatory decision-making. Syapse and the OCE will work with stakeholders across the FDA to...

leukemia
prostate cancer
gastrointestinal cancer

FDA Pipeline: Designation in CLL, New Drug Application in GIST, New Prostate Ablation System Receives 510(k) Clearance

Recently, the U.S. Food and Drug Administration granted Breakthrough Therapy designation to acalabrutinib in chronic lymphocytic leukemia (CLL), accepted a new drug application for avapritinib in some types of gastrointestinal stromal tumors (GIST), and granted 501(k) clearance to market the...

hematologic malignancies

FDA Approves Fedratinib for Myelofibrosis

Today, the U.S. Food and Drug Administration (FDA) approved fedratinib (Inrebic) for adults with intermediate-2 or high-risk primary or secondary (postpolycythemia vera or postessential thrombocythemia) myelofibrosis. “Prior to today, there was one FDA-approved drug to treat patients with...

breast cancer

Circulating Tumor DNA and Relapse in Early-Stage Breast Cancer

In a study reported in JAMA Oncology, Garcia-Murillas et al found that detection of circulating tumor DNA (ctDNA) during follow-up after initial treatment for early breast cancer was associated with a high risk of relapse. Detection at diagnosis was also associated with poorer relapse-free...

issues in oncology

Single-Institution Study of Next-Generation Sequencing Outcomes in Patients With Cancer

In a single-institution retrospective study reported in the Journal of Oncology Practice, Davis and colleagues found that next-generation sequencing (NGS) tests resulted in changes in management in a small proportion of patients with cancer. Study Details The study involved retrospective review...

breast cancer
survivorship

Adiposity Distribution and Risk for Cardiovascular Disease Among Breast Cancer Survivors

In a study reported in the Journal of Clinical Oncology, Cespedes Feliciano et al found that increased visceral and intramuscular adiposity were associated with increased risk of cardiovascular disease among breast cancer survivors, independent of baseline risk factors and cancer treatment. Study...

lung cancer

Olaparib/Temozolomide Shows Activity in Patients With Relapsed Small Cell Lung Cancer

Small cell lung cancer accounts for approximately 15% of all lung cancers and has high metastatic potential and poor clinical outcomes. While untreated small cell lung cancers are usually highly sensitive to cytotoxic chemotherapy—with response rates of between 50% and 70%—patients...

issues in oncology

Age Disparities Among Patients in Cancer Clinical Trials and Patients With Cancer in the General Population

In a study reported in JAMA Oncology, Ludmir et al found that the median age of patients with common cancers enrolled in clinical trials was substantially lower than the median age of patients with the same cancers in the general population. Age disparity was greater in industry-funded trials....

prostate cancer

Are MRI-Assisted Biopsies More Effective Than Standard Ultrasound-Guided Biopsies Alone in the Detection of Prostate Cancer?

Using magnetic resonance imaging (MRI) to target biopsies is more effective at detecting prostate cancers that are likely to need treatment than standard ultrasound-guided biopsies alone, according to research published by Elwenspoek et al in JAMA Network Open. Prostate biopsies can cause side...

immunotherapy

Immune-Related Adverse Events Requiring Hospitalization in Patients Receiving Immune Checkpoint Inhibitors

In a single-center analysis reported in the Journal of Oncology Practice, Balaji et al found that immune-related adverse events associated with immune checkpoint inhibitor treatment often require hospitalization and multidisciplinary management. The study involved data from patients who had...

solid tumors

Pazopanib or Methotrexate/Vinblastine in Progressive Desmoid Tumors

In the French Sarcoma Group noncomparative phase II DESMOPAZ trial reported in The Lancet Oncology, Toulmonde et al found that the oral vascular endothelial growth factor (VEGF) receptor inhibitor pazopanib was active in adult patients with progressive desmoid tumors. As noted by the investigators, ...

pancreatic cancer

USPSTF Recommendation on Screening for Pancreatic Cancer in Asymptomatic Adults

As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF), in a reaffirmation of its 2004 recommendation, has recommended against screening for pancreatic cancer in asymptomatic adults (a grade D recommendation). In developing the current recommendation, the USPSTF reviewed...

WHO Releases Report on the Global Tobacco Epidemic

On July 26, 2019, the World Health Organization (WHO) issued a new report, “Global Tobacco Epidemic 2019,” to discuss national efforts being made to implement effective strategies from the WHO Framework Convention on Tobacco Control that have been proven to reduce the demand for tobacco....

lymphoma

Early Trial of IPH4102 in Cutaneous T-Cell Lymphoma

In a phase I trial reported in The Lancet Oncology, Martine Bagot, MD, and colleagues found that IPH4102—a first-in-class monoclonal antibody targeting KIR3DL2—was safe and showed activity in patients with relapsed or refractory cutaneous T-cell lymphoma, particularly those with Sézary syndrome....

Joseph A. Sparano, MD, to Receive William L. McGuire Memorial Lecture Award

Joseph A. Sparano, MD, will receive the William L. McGuire Memorial Lecture Award at the 2019 San Antonio Breast Cancer Symposium (SABCS), to be held December 10–14. The McGuire Award was established in 1992 to honor William L. McGuire, MD, who, along with Charles A. Coltman, MD, founded the SABCS...

immunotherapy
skin cancer

Pembrolizumab for Advanced Merkel Cell Carcinoma

Late in 2018, pembrolizumab was granted accelerated approval in the treatment of adult and pediatric patients with recurrent locally advanced or metastatic Merkel cell carcinoma.1,2 Supporting Efficacy Data Approval was based on Cancer Immunotherapy Trials Network protocol 9 (CITN-09), also known...

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