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solid tumors
kidney cancer

Nephrectomy May Be Avoided in Some Patients With Advanced Renal Cell Carcinoma

In the modern era of targeted therapy, some patients with metastatic renal cell carcinoma may be able to forgo nephrectomy and be treated with sunitinib (Sutent) alone, according to results of the phase III CARMENA trial reported during the Plenary Session at the 2018 ASCO Annual Meeting.1 The...

solid tumors
skin cancer

The Raven

The call from the dermatologist came at noon on Good Friday, just after my wife left with our two young daughters for a week on her family’s tree farm in Northern Michigan. I was on call for the hospital inpatient leukemia service, so I could not join them. When the dermatologist solemnly began,...

hematologic malignancies
leukemia

Minimal Residual Disease Testing in AML: Still a Shifting Target

Testing for minimal residual disease (MRD) has become an established part of the management of acute lymphoblastic leukemia (ALL), but in acute myeloid leukemia (AML), the technology still warrants validation. To address issues and set new standards, the European LeukemiaNet Working Party recently ...

leukemia

EHA 2018: Single-Agent Quizartinib vs Chemotherapy in Relapsed or Refractory AML

Results from the phase III QuANTUM-R study of single-agent quizartinib in relapsed or refractory acute myeloid leukemia (AML) were presented by Cortes et al at the 23rd Annual Congress of the European Hematology Association (EHA) (Abstract LB2600). Study Findings QuANTUM-R study results showed...

leukemia

EHA 2018: Undetectable MRD Rates With Venetoclax Plus Rituximab in Relapsed or Refractory CLL

Investigational data from a new analysis of undetectable minimal residual disease (MRD) rates from the phase III MURANO trial of venetoclax (Venclexta, a first-in-class oral B-cell lymphoma 2 [BCL2] inhibitor) in combination with rituximab (Rituxan) in patients with relapsed or refractory chronic...

multiple myeloma

Once- vs Twice-Weekly Carfilzomib in Relapsed or Refractory Multiple Myeloma

An interim analysis of the phase III ARROW trial reported in The Lancet Oncology by Moreau et al indicated that a higher-dose once-weekly schedule of carfilzomib was associated with prolonged progression-free survival vs a twice-weekly schedule in patients with relapsed or refractory multiple...

Expert Point of View: Colin D. Weekes, MD, PhD and Andrew Epstein, MD

Colin D. Weekes, MD, PhD, of Massachusetts General Hospital and Harvard Medical School, called the results of the PRODIGE trial “practice-changing.” Dr. Weekes was the invited discussant of the study and was interviewed by The ASCO Post. “The magnitude of effect is beyond what we have ever seen in...

skin cancer
immunotherapy

Activity of the PD-1 Inhibitor Cemiplimab in Advanced Cutaneous Squamous Cell Carcinoma

As reported at the 2018 ASCO Annual Meeting (Abstract 9519) and in The New England Journal of Medicine by Migden et al, results of early-phase testing show activity of the programmed cell death protein 1 (PD-1) inhibitor cemiplimab in advanced cutaneous squamous cell carcinoma. Currently, no...

solid tumors
pancreatic cancer

Adjuvant Modified FOLFIRINOX Yields Unprecedented Survival in Pancreatic Cancer

Adjuvant treatment with modified FOLFIRINOX resulted in the longest overall survival yet reported for patients with resected pancreatic cancer, according to the results of the phase III Unicancer GI PRODIGE 24/CCTG PA.6 trial, presented at the 2018 ASCO Annual Meeting.1 With adjuvant modified...

lymphoma
immunotherapy

EHA 2018: Tisagenlecleucel Demonstrates More Than 1-Year Durability of Response in Adults With Relapsed or Refractory DLBCL

Fourteen-month results from the JULIET clinical trial showed ongoing durable responses are achievable with tisagenlecleucel (Kymriah) when administered to adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL). This updated analysis was presented by Borchmann et al at ...

multiple myeloma

EHA 2018: Elotuzumab Plus Pomalidomide and Low-Dose Dexamethasone vs Pomalidomide/Dexamethasone Alone in Relapsed or Refractory Multiple Myeloma

The ELOQUENT-3 trial, an international phase II study evaluating the addition of elotuzumab (Empliciti) to pomalidomide (Pomalyst) and low-dose dexamethasone in patients with relapsed/refractory multiple myeloma, achieved its primary endpoint, showing a statistically significant and clinically...

leukemia

EHA 2018: Alvocidib in Patients With Relapsed or Refractory MCL-1–Dependent AML

Preliminary data from Zella 201—an ongoing phase II study evaluating the efficacy and safety of alvocidib, a potent cyclin-dependent kinase 9 (CDK9) inhibitor, in combination with cytarabine and mitoxantrone in patients with relapsed or refractory MCL-1–dependent acute myeloid leukemia...

hepatobiliary cancer
immunotherapy

KEYNOTE-224: Pembrolizumab in Advanced Hepatocellular Carcinoma Pretreated With Sorafenib

As reported in The Lancet Oncology by Zhu et al, the phase II KEYNOTE-224 study has shown activity of pembrolizumab in advanced hepatocellular carcinoma (HCC) pretreated with sorafenib. Study Details In the study, 104 eligible patients who were intolerant of or progressed on sorafenib were...

lung cancer

Final Overall Survival Analysis of First-Line Crizotinib vs Chemotherapy in Advanced ALK-Positive NSCLC

As reported by Solomon and colleagues in the Journal of Clinical Oncology, the final overall survival results of the phase III PROFILE 1014 trial showed evidence of survival benefit of first-line crizotinib (Xalkori) vs chemotherapy in advanced ALK-positive non–small cell lung cancer (NSCLC). ...

issues in oncology

Informed Consent Issues for Patients With Advanced Cancer in Phase I Trials

As reported by Hlubocky et al in the Journal of Oncology Practice, oncologists may not provide patients with advanced cancer participating in phase I clinical trials with sufficient information about prognosis and purposes of phase I testing during enrollment discussions. Study Details The study...

lung cancer

Prophylactic Cranial Irradiation in Stage III NSCLC

In a Dutch phase III trial reported in the Journal of Clinical Oncology, De Ruysscher et al found that prophylactic cranial irradiation (PCI) prevented symptomatic brain metastases vs observation in patients with stage III non–small cell lung cancer (NSCLC) receiving treatment with curative...

breast cancer

FDA and EMA Accept Regulatory Submissions for Review of Talazoparib for Patients With Germline BRCA-Mutated Metastatic Breast Cancer

The U.S. Food and Drug Administration (FDA) recently accepted for filing and granted Priority Review designation a new drug application for talazoparib. The submission is based on results from the EMBRACA trial, which evaluated talazoparib vs chemotherapy in patients with germline BRCA-mutated,...

pancreatic cancer

Study Finds Recent-Onset Type 2 Diabetes May Be Early Manifestation of Pancreatic Cancer

According to the American Cancer Society, pancreatic cancer is one of the most deadly cancers, with an overall 5-year survival rate of just 8%, mainly because the vast majority of patients, about 80%, are diagnosed at a late stage of disease. Research has shown that identification of high-risk ...

breast cancer
lung cancer

Characteristics and Screening of Brain Metastases in Breast Cancer and NSCLC

In a research letter published in JAMA Oncology, Cagney et al found that brain metastases were more advanced and more likely to be symptomatic in patients with breast cancer compared to patients with non–small cell lung cancer (NSCLC). Current guidelines recommend magnetic resonance imaging...

lymphoma
immunotherapy

FDA Expands Approval of Pembrolizumab to Include New Lymphoma Indication

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for the treatment of adult and pediatric patients with refractory primary mediastinal large B-cell lymphoma or those who have relapsed after two or more prior lines of therapy. KEYNOTE-170...

gynecologic cancers
immunotherapy

FDA Approves Pembrolizumab for Previously Treated Recurrent or Metastatic PD-L1–Expressing Cervical Cancer

On June 12, the U.S. Food and Drug Administration (FDA) approved pembrolizumab (Keytruda) for the treatment of patients with recurrent or metastatic cervical cancer and disease progression on or after chemotherapy whose tumors express programmed cell death ligand 1 (PD-L1) [Combined Positive Score...

symptom management

Rivaroxaban vs Dalteparin in Patients With Venous Thromboembolism

In a UK pilot trial (SELECT-D) reported in the Journal of Clinical Oncology, Young et al found that the oral factor Xa inhibitor rivaroxaban was associated with a lower rate of recurrent venous thromboembolism (VTE) but a higher rate of clinically relevant nonmajor bleeding compared with the...

cns cancers

Risk-Adapted Treatment for Young Children With Medulloblastoma

In a phase II trial (SJYC07) reported in The Lancet Oncology, Robinson et al found that risk-adapted treatment did not improve event-free survival in young children with medulloblastoma. Analysis by methylation status showed superior outcome in the sonic hedgehog (SHH) subgroup. Study Details The ...

ASTRO Collaborates With ASCO and Conquer Cancer to Support Methods Workshop

For the third year, the American Society for Radiation Oncology (ASTRO) is supporting the ASCO/American Association for Cancer Research (AACR) Workshop on Methods in Clinical Cancer Research, to take place July 18–August 3, 2018, at Vail Mountain Marriott Resort in Vail, Colorado.  Celebrating its ...

lung cancer

Early Evidence of Neoadjuvant PD-1 Blockade in Non–Small Cell Lung Cancer

A NOVEL APPROACH using two doses of nivolumab (Opdivo) prior to surgery achieved major pathologic responses in 45% of patients with resectable stages I to IIIA non–small cell lung cancer (NSCLC), according to the results of a small Stand Up 2 Cancer–Cancer Research Institute Dream Team study...

gynecologic cancers
pain management

Study Evaluates Effect of Restrictive Opioid Protocol After Gynecologic Surgery

THE NUMBER of opioids prescribed after surgery for gynecologic cancer decreased significantly after implementation of an ultra-restrictive opioid prescription protocol, with no apparent negative effect on patient satisfaction or pain, according to research presented by Jaron Mark, MD, and...

gynecologic cancers

Poorer Outcomes Reported With Minimally Invasive Surgery Than Open Approach in Early Cervical Cancer

PATIENTS UNDERGOING minimally invasive radical hysterectomy for early cervical cancer had higher rates of disease recurrence and worse disease-free, progression-free, and overall survival than did women who had the open approach, according to results from the phase III LACC trial, presented by...

gynecologic cancers

Clinical Findings Predict Early Treatment Discontinuation in Patients Receiving Immunotherapy for Ovarian Cancer

PRETREATMENT CLINICAL findings may predict early treatment discontinuation in patients with ovarian cancer receiving checkpoint blockade immunotherapy agents. Data presented by MD candidate Julia L. Boland at the 2018 Society of Gynecologic Oncology Annual Meeting on Women’s Cancer revealed that...

lung cancer
symptom management
cns cancers

Quick Takes From Original Research Presented at the 2018 NCCN Annual Conference

THE QUANTITY of original research presented at the National Comprehensive Cancer Network® (NCCN®) Annual Conference has been growing, and at the 2018 meeting, 121 researchers presented their work. The ASCO Post captured some of the findings for this report.  Blood Markers Correlate With Anti–PD-1...

cns cancers

Durable Responses Observed With Novel Oncolytic Therapy in Recurrent Glioma

IN A PILOT study of recurrent glioma, 26% of patients treated with the optimal dose of vocimagene amiretroprepvec (aka Toca 511), a novel oncolytic virus therapy, achieved durable, long-term responses and remained alive 3 or more years later. This outcome far exceeded “historical benchmarks” for...

breast cancer
symptom management

Early Detection and Intervention Reduce Breast Cancer–Related Lymphedema

A NEW STUDY has found that early detection along with a simple intervention can be highly effective in preventing breast cancer–related lymphedema for at-risk women. According to data presented at the 2018 Annual Meeting of the American Society of Breast Surgeons,1 82% of women identified at an...

breast cancer

Recurrence Rates After Lumpectomy Significantly Improved in Patients Receiving ‘Modern-Era’ Therapy

A STUDY OF local recurrence rates following lumpectomy has shown significant improvement in patients receiving modern, multimodal therapies, suggesting breast-conserving surgery may be an option for more patients with breast cancer, according to data presented at the 2018 American Society of Breast ...

issues in oncology
geriatric oncology

Geriatric Assessment Improves Communication Between Oncologists and Older Patients

A FEDERALLY FUNDED randomized study demonstrated that use of geriatric assessment in the routine care of older adults with advanced cancer significantly improved doctor-patient communication about age-related concerns as well as patient satisfaction with the communication. The study was presented...

lung cancer
cost of care
genomics/genetics

Decision-Analytic Model Finds Upfront, Comprehensive Genetic Testing in Advanced Lung Cancer Is Cost-Efficient

AN ECONOMIC model comparing different types of genetic testing in metastatic non–small cell lung cancer (NSCLC) found using next-generation sequencing to test for all known lung cancer–related gene changes at the time of diagnosis was less costly and faster than sequentially testing one or a...

lung cancer

Immunotherapy Benefits Survival, Improves Safety, vs Platinum-Based Chemotherapy for PD-L1–Expressing NSCLC

IMMUNOTHERAPY WITH pembrolizumab (Keytruda) improved overall survival compared with investigator’s choice of platinum-based chemotherapy as first-line treatment for patients with advanced non–small cell lung cancer (NSCLC) in the KEYNOTE-042 trial. Median overall survival was improved by 4 to 8...

‘Pearls of Wisdom’ for Leadership and Success in Academic Medicine Gathered Over a 35-Year Career

Dr. Hayes, ASCO President 2016–2017, is Professor of Internal Medicine; Stuart B. Padnos Professor in Breast Cancer; and Clinical Director of the Breast Oncology Program at the University of Michigan Comprehensive Cancer Center, Ann Arbor. AS I COMPLETE my 3-year term as ASCO President, I am...

lymphoma
leukemia

Adherence to Oral Anticancer Treatment: Priorities in Lymphoma and CLL

ADVANCES IN cancer treatment have been nothing short of breathtaking in recent years. Among the most important has been the advent of effective oral therapies, marking a significant change in the way many patients receive treatment and in the oversight required by the cancer care team. As with...

breast cancer

TAILORx: Endocrine Therapy Alone Is Sufficient for Most Patients With ‘Intermediate-Risk’ Breast Cancer

THE HIGHLY ANTICIPATED results of the phase III TAILORx study are in—and they indicate that the vast majority of patients with “intermediate-risk” early-stage breast cancer can forgo chemotherapy.  “Our study shows that chemotherapy may be avoided in about 70% of women with hormone...

leukemia
lymphoma

FDA Approves Second-Line Venetoclax for CLL or SLL With or Without 17p Deletion

On June 8, the U.S. Food and Drug Administration (FDA) granted regular approval to venetoclax (Venclexta) for patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL), with or without 17p deletion, who have received at least one prior therapy. MURANO Approval was based ...

issues in oncology
supportive care

Hearing Loss

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

solid tumors
gynecologic cancers

Addition of Pazopanib to Paclitaxel in Persistent or Recurrent Ovarian Cancer

In a phase II trial reported in JAMA Oncology by Debra L. Richardson, MD, of Stephenson Cancer Center, Oklahoma University Health Science Center, and colleagues, the addition of pazopanib (Votrient) to paclitaxel did not improve progression-free survival among women with persistent or recurrent...

solid tumors
gynecologic cancers

HPV Vaccine Could Have Prevented My Cancer

In the fall of 2015, I was feeling great. At age 37, I had just completed running my fourth half-marathon and regularly hiked trails near my home in Arlington, Texas, to stay fit in-between races. The only symptom that foretold what was in my future was some light watery discharge I was...

solid tumors
colorectal cancer

Following Guidelines for Healthy Eating and Physical Activity May Improve Survival in Patients Treated for Colon Cancer

Following guidelines for proper nutrition, maintaining a healthy weight, and staying physically active may improve survival among patients treated for colon cancer, according to the results of a study with nearly 1,000 patients followed for a median of 7 years.1 “The study suggests that if...

solid tumors
breast cancer

The X-Ray Era: 1901–1915

The text and photographs on this page are excerpted from a four-volume series of books titled Oncology: Tumors & Treatment, A Photographic History, by Stanley B. Burns, MD, FACS, and Elizabeth A. Burns. The photos below are from the volume titled “The X-Ray Era: 1901–1915.” The photographs...

lymphoma
immunotherapy

2018 ASCO: Lenalidomide Plus Rituximab vs Rituximab Plus Chemotherapy in Previously Untreated Follicular Lymphoma

Results from RELEVANCE, a phase III, randomized, open-label, international clinical study conducted in partnership with the Lymphoma Academic Research Organisation (LYSARC), were presented by Fowler et al at the 2018 ASCO Annual Meeting (Abstract 7005). This study evaluated the investigational...

prostate cancer

2018 ASCO: Olaparib in Combination With Abiraterone in Metastatic Castration-Resistant Prostate Cancer

Data presented by Clarke et al at the 2018 ASCO Annual Meeting (Abstract 5003) showed clinical improvement in median radiologic progression-free survival with olaparib (Lynparza) in combination with abiraterone (Yonsa, Zytiga) compared to abiraterone monotherapy, a current standard of care, in...

lung cancer
immunotherapy

2018 ASCO: Pembrolizumab Plus Chemotherapy as First-Line Treatment of Metastatic Squamous NSCLC: KEYNOTE-407 Study

Results from KEYNOTE-407, a randomized, double-blind, placebo-controlled, phase III study evaluating pembrolizumab (Keytruda) in combination with carboplatin/paclitaxel or carboplatin/nab-paclitaxel (Abraxane) as first-line treatment for metastatic squamous non–small cell lung cancer...

solid tumors
issues in oncology
survivorship
breast cancer

Tai Chi for the Treatment of Insomnia in Breast Cancer Survivors

Underrecognized and inadequately managed, insomnia is a significant burden for many cancer survivors. Often persistent over several years following diagnosis and treatment, sleep problems negatively affect quality of life and elevate the risk of depression and anxiety. In this installment of The...

colorectal cancer

Young-Onset Colorectal Cancer Survivors, Patients, and Caregivers Asked to Participate in Third Annual Survey

The Colorectal Cancer Alliance has opened its third annual international survey of young-onset colorectal cancer patients, survivors, and caregivers, with the intent of learning about and tracking the medical and psychosocial experiences of this often overlooked group, which comprises 11% of...

solid tumors
skin cancer
head and neck cancer

Dabrafenib Plus Trametinib for Thyroid Cancer, Melanoma With BRAF Mutations

On May 4, 2018, dabrafenib (Tafinlar) and trametinib (Mekinist) in combination was granted approval for treatment of patients with locally advanced or metastatic anaplastic thyroid cancer with BRAF V600E mutation and no satisfactory locoregional treatment options.1-3 Dabrafenib is not indicated for ...

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