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Expert Point of View: Charles Drake, MD, PhD

IN A SEPARATE interview with The ASCO Post, Charles Drake, MD, PhD, commented on the clinical implications of the ENZAMET and TITAN trials, as well as studies of apalutamide, abiraterone acetate, and docetaxel used in metastatic hormone-sensitive prostate cancer. Dr. Drake is Director of...

prostate cancer

Apalutamide Improves Survival Outcomes in Castration-Sensitive Metastatic Prostate Cancer in TITAN Trial

Adding apalutamide to androgen-deprivation therapy (ADT) significantly improved survival in men with metastatic castration-sensitive (also termed hormone-sensitive) prostate cancer, according to the results of the phase III TITAN trial, which were presented at the 2019 ASCO Annual Meeting and...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Expert Point of View: Ian Chau, MD

IAN CHAU, MD, a consultant medical oncologist at the Gastrointestinal and Lymphoma Units of The Royal Marsden NHS Foundation Trust in London and Surrey, United Kingdom, was the invited discussant of KEYNOTE-062. In an interview with The ASCO Post, he first commented that although single-agent...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

KEYNOTE-062: Pembrolizumab Is a New First-Line Option in Gastric/Gastroesophageal Junction Cancer

KEYNOTE-062, a study of first-line treatment in patients with advanced gastric or gastroesophageal junction adenocarcinoma, found pembrolizumab to be noninferior to chemotherapy and perhaps better than chemotherapy in a subgroup of patients. The results were reported at the 2019 ASCO Annual Meeting ...

pancreatic cancer

POLO Trial Shows Maintenance Olaparib Improves Progression-Free Survival in Metastatic Pancreatic Cancer

In patients with metastatic pancreatic cancer and germline mutations in BRCA1 or BRCA2, maintenance therapy with olaparib doubled the time to disease progression and the proportion of patients who were progression-free at 2 years, in the phase III POLO trial.1 “Maintenance olaparib provided a...

issues in oncology
colorectal cancer

Solving the Mystery of Why Colorectal Cancer Is on the Rise in Young Adults

Excluding skin cancer, colorectal cancer is the third most prevalent and lethal cancer among both men and women in the United States.1 Although the risk of developing colorectal cancer increases with age—more than 90% of cases occur in people aged 50 or older2—recent research shows that the...

issues in oncology

An ASCO Survey, Hope, and Conventional Therapies

HOW DO YOU respond when patients with a good prognosis want to delay chemotherapy to try an anticancer diet for a few months or visit an unregulated clinic for unproven therapies? I’m asking because of an alarming finding of ASCO’s 2018 National Cancer Opinion Survey: “Nearly 4 in 10 Americans...

head and neck cancer

Oral HPV DNA Persistence and Disease Progression in Oral Cavity and Oropharyngeal Squamous Cell Carcinoma

In a two-institution study reported in JAMA Oncology, Carole Fakhry, MD, and colleagues found that persistent detection of tumor-type human papillomavirus (HPV) DNA after primary treatment for oral and oropharyngeal squamous cell carcinomas was associated with poorer outcomes. Study Details The...

breast cancer

Evidence Lacking That Denosumab Alters the Course of Breast Cancer

I am writing to provide personal context to my column on adjuvant denosumab or bisphosphonates for resected breast cancer, which appears on page 52 in this issue of The ASCO Post. I have been upset since 2013 that adjuvant zoledronate has been recommended for women with breast cancer onset after...

hematologic malignancies
lymphoma

Transitioning From Healthy Physician to Patient With Cancer

As you probably already know, physicians do not make the best patients. When I began experiencing the early signs of Hodgkin lymphoma, in 2007, including a persistent cough, unusual fatigue, and pruritus, I self-diagnosed allergic rhinitis and began treatment with intranasal corticosteroids....

Ask Your Patients About Complementary and Alternative Therapies

The most common reason that patients with cancer do not tell their physicians about using complementary and alternative medicines is that their physicians do not ask, according to a nationwide survey.1 Among 3,118 survey participants who reported a history of cancer, 1,023 (33.3%) had used a...

supportive care

Are Your Patients Using Complementary and Alternative Therapies? You Might Not Know If You Don’t Ask

Nearly one-third of patients with cancer who reported that they used complementary and alternative therapies in a nationwide survey did not tell their physicians about the use of those therapies, and the most frequently cited reason for not telling their physicians was that their physicians did...

breast cancer

Denosumab Prevents Neither Breast Cancer Relapse Nor Death

The recently published report of Austrian Breast and Colorectal Cancer Study Group’s Study 18 (ABCSG-18)1 for the secondary endpoint of disease-free survival suggests that denosumab given in a low dose of 60 mg subcutaneously every 6 months during aromatase inhibitor adjuvant therapy is...

NYU Langone’s Perlmutter Cancer Center Expands Care With New Outpatient Facility

NYU Langone Health has opened the doors to a new multispecialty outpatient facility in Sunset Park, Brooklyn. This new location features the capabilities of the Perlmutter Cancer Center. Previously, patients received radiation treatment at NYU Langone Hospital–Brooklyn and chemotherapy and other...

issues in oncology
legislation

Curbside Consults: New Liability Risks to Avoid When You Are Not a Patient’s Physician

Like most clinicians, oncologists often informally consult their colleagues, both asking questions and seeking suggestions on how best to care for their patients.1,2 These informal or “curbside” consults (sometimes called “sidewalk,” “elevator,” or “hallway” consults) are valuable, because the...

prostate cancer

Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer: Delaying Overt Metastatic Disease Is a Major Advance

Nonmetastatic (M0) castration-resistant prostate cancer arises in the subset of men with biochemically recurrent disease (ie, rising prostate-specific antigen [PSA] level after definitive therapy in the absence of metastases) who develop PSA progression after chronic exposure to...

prostate cancer

ARAMIS Trial: Darolutamide in Nonmetastatic Castration-Resistant Prostate Cancer

In a phase III ARAMIS trial reported in The New England Journal of Medicine, Karim Fizazi, MD, of the Institut Gustave Roussy, Universite Paris-Sud, Villejuif, France, and colleagues found that the androgen-receptor antagonist darolutamide significantly prolonged metastasis-free survival vs placebo ...

prostate cancer
issues in oncology

Exposure to Specific Carcinogens and Prostate Cancer Risk Among World Trade Center First Responders

Since the attacks on the World Trade Center on September 11, 2001, studies have shown an increased risk of several cancers—including multiple myeloma and prostate, head and neck, and thyroid cancers—among first responders to the scene. The results from a new study by Gong et al...

Access Program to Be Established for Patients After Olaratumab Is Withdrawn From the Global Market

ELI LILLY AND COMPANY recently announced that it has been working to facilitate the withdrawal of olaratumab from the market for the treatment of advanced soft-tissue sarcoma. Lilly’s actions to withdraw olaratumab from the market follow completion of the international phase III ANNOUNCE clinical...

head and neck cancer

Immune Response to HPV16-Driven Tumorigenesis May Be Detectable Before Clinical Diagnosis of Oropharyngeal Squamous Cell Carcinoma

An international group of researchers has found that antibodies to the human papillomavirus type 16 (HPV16) may develop in the body between 6 to 40 years prior to a clinical diagnosis of oropharyngeal squamous cell carcinoma, and their presence indicates a strong increased risk of the disease....

issues in oncology
survivorship

Study Finds Primary Care Providers Are Engaged in Cancer Survivorship Care but Report Barriers to Optimal Care Delivery

A new study published by McDonough et al in the Journal of Oncology Practice found that while primary care physicians are often involved in cancer survivorship care, many do not feel adequately prepared for key components of it. The study shared the results of a survey of 117...

hepatobiliary cancer

Link Between Poor Oral Health and Increased Liver Cancer Risk

Poor oral health is associated with an increased risk of hepatocellular carcinoma, according to new research published by Jordão et al in the United European Gastroenterology Journal. Methods “Poor oral health has been associated with the risk of several chronic diseases, such as...

issues in oncology

AACR Environmental Carcinogenesis: Silicone-Based Wristbands for Detection of Occupational Environmental Exposures for Firefighters

First responders such as paramedics and firefighters may be exposed to hazardous occupational environmental exposures, but linking these exposures to conditions such as cancers is difficult due to the latency period of disease, magnitude of potential exposure, and potential interactions of...

colorectal cancer
issues in oncology

AACR Environmental Carcinogenesis: Lowering Exposure to Nitrates in Drinking Water May Reduce U.S. Cancer Cases

Nitrate levels in water resources have increased in many areas of the world, largely due to the use of inorganic fertilizer and animal manure in agricultural areas. Research has shown that the risk of specific cancers and birth defects may be increased when nitrate is ingested under conditions that ...

prostate cancer

Body Fat Distribution and Risk of Aggressive Prostate Cancer

In a prospective study of directly measured body fat distribution and prostate cancer risk, investigators found that higher levels of abdominal and thigh fat are associated with an increased risk of aggressive prostate cancer. The findings—published by Dickerman et al in Cancer—may lead ...

hematologic malignancies

Gait Speed Identifies Frailty, Could Help Predict Outcomes in Older Patients With Hematologic Cancers

The speed at which older individuals with blood cancers are able to walk 4 meters (about 13 feet) holds information about their overall health and may help to predict survival and unplanned hospital visits, according to study published by Liu et al in Blood. The association was...

breast cancer

Personalized Assay May Aid in Determining Risk of Recurrence of Triple-Negative Breast Cancer

Sixty percent of patients with triple-negative breast cancer will survive more than 5 years without disease after standard treatment, but 4 out of 10 women will have a rapid recurrence of the disease. There are currently no clinical tests to assess an individual patient’s prognosis, so all...

multiple myeloma

EHA 2019: BELLINI Trial Evaluates Addition of Venetoclax to Bortezomib/Dexamethasone in Relapsed or Refractory Multiple Myeloma

The phase III BELLINI trial—reported by Kumar et al at the 24th Annual Congress of the European Hematology Association (EHA; Abstract LB2601) investigated the efficacy and safety of venetoclax/bortezomib/dexamethasone vs bortezomib/dexamethasone in patients with relapsed or refractory...

lung cancer

FDA Expands Indications for Pembrolizumab to Include Metastatic SCLC With Disease Progression on or After Other Therapies

On June 17, the U.S. Food and Drug Administration (FDA) granted accelerated approval to the anti–programmed cell death protein 1 (PD-1) therapy pembrolizumab (Keytruda) as monotherapy for the treatment of patients with metastatic small cell lung cancer (SCLC) with disease...

lung cancer
issues in oncology

Radiotherapy Increases Adverse Cardiovascular Event Risk for Patients With Lung Cancer

A new retrospective study led by investigators from Brigham and Women’s Hospital and Dana-Farber Cancer Institute examined outcomes for patients after receiving treatment for locally advanced non–small cell lung cancer (NSCLC), finding that the average radiation dose delivered to the...

cns cancers
lymphoma

Cytoreductive Surgery for Primary Central Nervous System Lymphoma

Through a systematic review of published studies, researchers report they have identified a distinct subtype of primary central nervous system (PCNS) lymphoma that should be considered for surgical removal, suggesting a major shift in how this type of tumor is evaluated and managed. These findings...

leukemia

QuANTUM-R: Quizartinib vs Salvage Chemotherapy in Relapsed or Refractory FLT3-ITD–Positive AML

In the phase III QuANTUM-R trial reported in The Lancet Oncology, Cortes et al found that the FLT3 inhibitor quizartinib produced a modest but significant improvement in overall survival vs salvage chemotherapy in relapsed or refractory FLT3 internal tandem duplication (FLT3-ITD)-positive acute...

breast cancer
immunotherapy

TONIC: PD-1 Blockade in Metastatic Triple-Negative Breast Cancer

Clinical and translational data from the TONIC trial, published in a research letter by Voorwerk et al in Nature Medicine, indicated that short-term doxorubicin and cisplatin may induce a more favorable tumor microenvironment and increase the likelihood of response to programmed cell death protein...

issues in oncology
supportive care

Patient Perceptions of Management of Cancer-Related Pain, Fatigue, and Emotional Distress in Community Oncology Centers

In a study reported in the Journal of Clinical Oncology, Smith et al found that a high proportion of patients in community cancer centers did not report discussing, getting advice, or receiving desired help for cancer-related pain, fatigue, or emotional distress. The study involved surveys of...

gynecologic cancers

2019 ASCO: Paclitaxel/Carboplatin vs Paclitaxel/Ifosfamide in Carcinosarcoma of the Uterus or Ovary

Results from the phase III NRG Oncology clinical trial GOG 0261 comparing paclitaxel plus carboplatin to paclitaxel plus ifosfamide in women with stage I–IV recurrent carcinosarcoma of the uterus or ovary found that treatment with paclitaxel/carboplatin was not inferior to...

breast cancer

2019 ASCO: New TAILORx Data Provide Treatment Guidance for Women Under 50 With Early Breast Cancer

New information about adjuvant therapy to prevent recurrence of breast cancer in women 50 years of age or younger has emerged from the Trial Assigning Individualized Options for Treatment (Rx), or TAILORx. An analysis of a prespecified secondary endpoint in this trial found that an assessment of a ...

kidney cancer

2019 ASCO: No Benefit From Pazopanib in Advanced Renal Cell Carcinoma After Metastasectomy

The E2810 trial was conducted to determine whether treatment with the oral drug pazopanib following surgery to remove further metastases in patients with advanced renal cell carcinoma would improve their disease-free survival. Results from the study—which showed that primary endpoint of...

breast cancer

Joseph A. Sparano, MD, on Early Breast Cancer: Predicting Prognosis and Treatment Benefit in TAILORx

Joseph A. Sparano, MD, of the Montefiore Medical Center and Albert Einstein Cancer Center, discusses how clinical risk stratification provides additional prognostic information to the 21-gene recurrence score and may be used to identify premenopausal women for more effective antiestrogen therapy...

prostate cancer

2019 ASCO: TOPARP-B Finds Olaparib Shows Efficacy in Men With BRCA-Mutant Prostate Cancer

The poly (ADP-ribose) polymerase (PARP) inhibitor olaparib may benefit some men with prostate cancer, according to findings from the phase II TOPARP-B trial presented by Mateo et al at the 2019 ASCO Annual Meeting (Abstract 5005).   Olaparib previously showed activity against metastatic...

breast cancer
colorectal cancer
health-care policy
issues in oncology

Medicaid Expansion and Colorectal Cancer Screening

A new study examining Medicaid expansion and cancer screening found that the five states and District of Columbia that first adopted Medicaid expansion saw larger increases in colorectal cancer screening than states that did not expand Medicaid. The study—published by Fedewa et al in...

cns cancers

2019 ASCO: Subgroups of Patients With Low-Grade Glioma May Benefit From PCV Chemotherapy Plus Radiotherapy

A recent, updated predictive analysis of the three World Health Organization (WHO)-defined molecular subgroups based on IDH mutation status and 1p/19q codeletion status represented in the high-risk treatment arms of a phase III trial found that both IDH-mutant subgroups may derive benefit ...

issues in oncology

2019 ASCO: Discrimination, Gender Bias in Oncology Training and Professional Meetings

Two studies that explored types of discrimination and gender bias in health-care organizations were presented at the 2019 ASCO Annual Meeting. Discrimination Experienced by Fellows An abstract that reviewed discrimination and inclusion among hematology and oncology trainees was presented by...

lymphoma
immunotherapy

FDA Approves Polatuzumab Vedotin-piiq in Combination With Bendamustine and a Rituximab Product for DLBCL

On June 10, the U.S. Food and Drug Administration (FDA) granted accelerated approval to polatuzumab vedotin-piiq (Polivy), a CD79b-directed antibody-drug conjugate, in combination with bendamustine and a rituximab product for adult patients with relapsed or refractory diffuse large B-cell lymphoma...

issues in oncology

NCI Annual Report to the Nation on the Status of Cancer

The latest Annual Report to the Nation on the Status of Cancer finds that, for all cancer sites combined, cancer death rates continued to decline in men, women, and children in the United States from 1999 to 2016. Overall cancer incidence rates, or rates of new cancers, decreased in men from 2008...

sarcoma

Addition of a Tyrosine Kinase Inhibitor to Immunotherapy in Advanced Sarcomas

In a phase II trial reported in The Lancet Oncology, Breelyn Wilky, MD, and colleagues found evidence of activity of axitinib plus pembrolizumab in advanced sarcomas, including alveolar soft-part sarcoma. Study Details The study involved 33 patients with advanced or metastatic sarcomas, including...

issues in oncology
health-care policy

Major Settlement Raises Questions About Evidence-Based Value in Cancer Care

An Oklahoma jury recently awarded $25.5 million to the widower of a 53-year-old woman diagnosed with stage IV nasopharyngeal cancer who was denied coverage for proton therapy by her health insurer, Aetna. The patient’s family subsequently raised $92,000 to cover her proton therapy at The University ...

multiple myeloma

Cytogenetic Prognostic Index for Survival in Multiple Myeloma

In a study reported in the Journal of Clinical Oncology, Perrot et al identified a cytogenetic prognostic index predictive of survival in patients with newly diagnosed multiple myeloma. Study Details The study involved data from 1,635 patients in four trials conducted by the Intergroupe...

hematologic malignancies

Dana-Farber Opens Center for the Prevention of Progression for Precursor Hematologic Conditions

Against the backdrop of the online crowd-sourcing initiative PCROWD and other research by faculty investigators on precursor conditions that may develop into leukemia, myelodysplastic syndromes (MDS), or multiple myeloma, Dana-Farber Cancer Institute has opened the Center for the Prevention of...

hematologic malignancies

Selected Abstracts From the 2019 ASCO Annual Meeting

To complement The ASCO Post’s comprehensive coverage of the 2019 ASCO Annual Meeting, here are several abstracts selected from the meeting proceedings focusing on novel therapeutic regimens for plasma cell dyscrasias, particularly multiple myeloma. For full details of these study abstracts, visit ...

lymphoma
multiple myeloma
prostate cancer
immunotherapy

FDA Pipeline: Reviews and Designations in Multiple Myeloma, Lymphoma, Prostate Cancer

Recently, the U.S. Food and Drug Administration (FDA) granted Priority Review for daratumumab in combination with a triplet therapy in multiple myeloma, Breakthrough Therapy designation to copanlisib for marginal zone lymphoma, and Fast Track designation for ARV-110 in metastatic...

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