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Expert Point of View: Harry H. Yoon, MD

Harry H. Yoon, MD, Associate Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, the invited discussant of the study presented by Janjigan et al, commented on the strong rationale for combining an anti-HER2 agent, anti–programmed cell death protein 1 (PD-1) agent, and chemotherapy....

Expert Point of View: Martine Extermann, MD, PhD

As invited discussant of the GAMMA-1 trial, Martine Extermann, MD, PhD, of Moffitt Cancer Center and Research Institute, Tampa, Florida, first commented on the “teaser” in the findings—the potential for benefit of andecaliximab in older patients. “The drug works better in older patients. As a...

gastrointestinal cancer
head and neck cancer

Andecaliximab in Untreated Gastric or Gastroesophageal Junction Cancer

The large phase III GAMMA-1 trial failed to replicate the encouraging findings from a previous smaller study of andecaliximab plus chemotherapy in untreated HER2-negative gastric or gastroesophageal junction adenocarcinoma, according to Manish A. Shah, MD, of Weill Cornell Medicine/New York...

issues in oncology

Essential Elements of an Effective Clinical Trials System: Business and Mission

Clinical trials aimed to improve health and quality of life are the cornerstone of progress in medicine. Support comes from academic medical centers, philanthropy, the National Institutes of Health (NIH), industry, or combinations thereof. Clinical trials need to be hypothesis-driven and address...

Expert Point of View: Harry H. Yoon, MD

KEYNOTE-181’s invited discussant, Harry H. Yoon, MD, Associate Professor of Oncology at the Mayo Clinic, Rochester, Minnesota, said the findings have a “potentially immediate clinical impact” for second-line treatment of esophageal cancer, including esophageal squamous cell carcinoma and Siewert...

skin cancer
immunotherapy

How Effective Is Talimogene Laherparepvec Injection in Metastatic Melanoma?

Injection of a genetically modified virus that induces the body’s own immune cells to attack metastatic melanoma effectively treated almost 40% of patients with tumors that could not be surgically removed, according to findings published by Louie et al in the Journal of the American...

lung cancer
lymphoma
skin cancer

FDA Pipeline: Updates on Treatments in NSCLC and Lymphomas, Plus New Dosimetry Software

The U.S. Food and Drug Administration (FDA) recently granted the following application, designations, and clearance: sBLA for Atezolizumab Plus Chemotherapy for First-Line Treatment of Metastatic, Nonsquamous NSCLC On January 17, the FDA accepted a supplemental biologics license application...

gastroesophageal cancer

Effectiveness of EsophaCap Tool in the Diagnosis of Barrett’s Esophagus

Barrett’s esophagus is the only known precursor of esophageal adenocarcinoma. Although endoscopy and biopsy are standard methods for diagnosing Barrett’s esophagus, their high cost and risk limit their use as a screening modality. Researchers sought to develop a screening method based...

issues in oncology

Prevalence of Infection With HBV, HBC, and HIV in Patients With Newly Diagnosed Cancer

In a prospective cohort study reported in JAMA Oncology, Ramsey et al identified the prevalence of hepatitis B virus (HBV), hepatitis C virus (HCV), and human immunodeficiency virus (HIV) infection in patients with newly diagnosed cancer and found that a substantial proportion were unaware of...

solid tumors
hematologic malignancies

Standard Site-Specific Therapy Based on Gene-Expression Profiling vs Empirical Chemotherapy for Cancer of Unknown Primary

In a Japanese phase II trial reported in the Journal of Clinical Oncology, Hayashi et al found that standard site-specific treatment based on gene-expression profiling was not associated with better outcomes vs empirical paclitaxel and carboplatin in patients with cancer of unknown primary site....

breast cancer
cost of care

Cost-Effectiveness Analysis of Gene-Expression Profiling Assay in Breast Cancer

A new report published by Wang et al in JNCCN—Journal of the National Comprehensive Cancer Network found that using Oncotype DX—the most commonly used test for predicting the benefit of adjuvant chemotherapy to reduce the risk of disease recurrence—is not...

issues in oncology
survivorship
cost of care

Cancer Survivors and Medical Financial Hardship

New research indicates that cancer survivors carry greater financial burdens related to medical debt payments and bills compared with individuals without a cancer history, with the greatest hardships in younger survivors. Published by Zheng et al in Cancer, the study also found that among...

prostate cancer

Long-Term Effects of Finasteride vs Placebo on Prostate Cancer Mortality

In a letter to the editor of The New England Journal of Medicine, Goodman et al reported a long-term follow-up of the Prostate Cancer Prevention Trial indicating that finasteride treatment was not associated with an increased risk of death from prostate cancer. Study Details As previously...

lymphoma
skin cancer

2018 Update of WHO-EORTC Classification of Primary Cutaneous Lymphomas

As reported by Willemze and colleagues in Blood, the World Health Organization (WHO) and the European Organisation for Research and Treatment of Cancer (EORTC) have released a 2018 update of their classification of primary cutaneous lymphomas. As noted by the authors, “Primary cutaneous...

sarcoma
immunotherapy

Results Reported From the Phase III ANNOUNCE Trial of Olaratumab in Soft-Tissue Sarcoma

The recently reported results of ANNOUNCE, the phase III study of olaratumab in combination with doxorubicin in patients with advanced or metastatic soft-tissue sarcoma, did not confirm the clinical benefit of olaratumab in combination with doxorubicin as compared to doxorubicin, a...

leukemia
myelodysplastic syndromes

Combination Azacitidine and Lenalidomide as Salvage Therapy for Relapsed AML After Allogeneic Stem Cell Transplantation

In a phase I trial reported in the Journal of Clinical Oncology, Craddock et al found evidence that the sequential combination of azacitidine and lenalidomide may be an effective salvage therapy in patients with acute myeloid leukemia (AML) relapsing after allogeneic stem cell transplantation...

lymphoma

Hastening the Development of Novel Therapies for Peripheral T-Cell Lymphomas

Peripheral T-cell lymphomas (PTCLs) make up a small fraction of all non-Hodgkin lymphomas—just 15%—in the United States.1 Although rare in the United States, the incidence of PTCL is common across Asia, the Caribbean, and sub-Saharan Africa. Although the reason for such global variation in PTCL is...

Community Oncology Alliance Elects New Officers and Board Members

THE COMMUNITY Oncology Alliance (COA) recently announced that Michael Diaz, MD, a practicing medical oncologist at Florida Cancer Specialists & Research Institute, has been elected President of COA. His 1-year term began on January 1, 2019. In addition, Kashyap Patel, MD, a practicing...

breast cancer

Genomic Classifier for Luminal Androgen Receptor Triple-Negative Breast Cancer

TRIPLE-NEGATIVE breast cancer is a heterogeneous disease that comprises several subtypes, which may respond differently to therapy. Breast cancer researchers at the Mayo Clinic are developing a novel genomic signature that may improve the identification of the luminal androgen receptor vs basal...

breast cancer
immunotherapy

IMpassion130 Trial: Changing the Treatment Landscape in Metastatic Triple-Negative Breast Cancer

THE IMPASSION130 trial—reported in The New England Journal of Medicine by Schmid et al1 and reviewed in this issue of The ASCO Post—was an eagerly awaited study in newly diagnosed metastatic triple-negative breast cancer. To briefly review, 902 patients were randomly assigned in a 1:1 fashion to...

breast cancer
immunotherapy

Addition of Atezolizumab to Nab-Paclitaxel in Advanced Triple-Negative Breast Cancer: IMpassion130 Trial

AS REPORTED in The New England Journal of Medicine by Peter Schmid, MD, PhD, of the Barts Cancer Institute, Queen Mary University of London, and colleagues, the phase III IMpassion130 trial has shown that the addition of atezolizumab to nanoparticle albumin-bound (nab)-paclitaxel significantly...

geriatric oncology

Changing Perceptions on Surgical Intervention for Geriatric Patients With Cancer: Role of the SIOG Surgical Task Force

Surgery is an integral part of treatment of elderly patients with solid malignancies. The times we are living in will be remembered by health-care providers for the significant “contradictions” in the medical and surgical care of elderly patients with cancer. On the one hand, it has been...

breast cancer
immunotherapy

Challenge Moving Forward in Breast Cancer Treatment: To Show That New Approaches Change Outcomes

ADVANCES IN treating breast cancer over the past 20 years have brought us to the point where treatment can be confidently de-escalated for some patients, and immunotherapy and precision decision-making may change the way breast cancer is treated for others, William Gradishar MD, FASCO, told the...

breast cancer

Preventing Locoregional Recurrence of Breast Cancer Should Not Deter Efforts to Decelerate Therapy

“SURGEONS AND radiation oncologists are obsessed with locoregional recurrence of breast cancer,” Monica Morrow, MD, FASCO, remarked at the 2018 Lynn Sage Breast Cancer Symposium, Chicago. Working to prevent locoregional recurrence, “even if it may not be the major threat to mortality, is...

breast cancer

Risk of Local Recurrence in Breast Cancer: Impact of Molecular Subtype and Surgical Approach

THE RISK of local recurrence in breast cancer “does not differ substantially based on the operation we perform, but it does differ substantially by subtype,” Tari A. King MD, FACS, stated at the 2018 Lynn Sage Breast Cancer Symposium in Chicago.1 At 10-year follow-up, Dr. King reported, local...

leukemia

Expert Point of View: Elihu H. Estey, MD; Steven Gore, MD; and Mark J. Levis, MD, PhD

ELIHU H. ESTEY, MD, Professor of Medicine at the University of Washington and Director of Acute Myeloid Leukemia (AML) Clinical Research at the Fred Hutchinson Cancer Research Center, Seattle, added that with these “robust” outcomes, future trial patients may “not be eager to wind up in the...

leukemia

BEAT AML Umbrella Trial: Bringing Personalized Medicine to Acute Myeloid Leukemia

THE MULTIARM, multicollaborative BEAT AML umbrella trial demonstrated the feasibility of using next-generation sequencing to assign treatment tailored to individual genomics of elderly patients with acute myeloid leukemia (AML) within 7 days. This may prove to be a major advance, since typically...

breast cancer
symptom management

Oxybutynin: A Novel Option for Managing Hot Flashes?

OXYBUTYNIN, AN ANTICHOLINERGIC drug approved for the treatment of overactive bladder, reduced the frequency and intensity of hot flashes in women who were suffering frequent hot flashes, including breast cancer survivors who were receiving tamoxifen or aromatase inhibitors. These results of the...

lymphoma

PET-Adapted Treatment in Newly Diagnosed Advanced Hodgkin Lymphoma

In the phase III AHL2011 trial reported in The Lancet Oncology, Casasnovas et al found that positron-emission tomography (PET)-guided treatment produced good outcomes in newly diagnosed advanced Hodgkin lymphoma, allowing de-escalation of induction to ABVD (doxorubicin, bleomycin, vinblastine, and...

immunotherapy
lung cancer

PACIFIC Trial of Durvalumab Sets Standard in Stage III Unresectable NSCLC

IMMUNOTHERAPY HAS revolutionized the treatment of lung cancer over the past several years. Although lung cancer is associated with immunosuppression at baseline for most patients, the addition of immune checkpoint inhibitors can overcome that suppression and lead to antitumor immune responses....

issues in oncology
cost of care

How to Save Billions on Cancer Care Costs: The Potential of Value-Based Prescribing in Oncology

IT IS TIME for value-based prescribing—the reduction of prescribing costs using basic pharmacologic principles—to be tested and deployed in oncology. The savings are real and there for the taking. If you are concerned about the high costs in cancer care, here is a chance to get maximum value for...

health-care policy
lung cancer

Shared Decision-Making and Use of Low-Dose CT Screening for Lung Cancer

In a study reported in a research letter in JAMA Internal Medicine, Goodwin et al found that only a small proportion of Medicare enrollees undergoing low-dose computed tomography (CT) screening for lung cancer had a prescreening shared decision-making session, which is mandated by the Centers for...

colorectal cancer

23andMe Receives FDA Clearance for Direct-to-Consumer Genetic Test on a Hereditary Colorectal Cancer Syndrome

On January 22, 23andMe received U.S. Food and Drug Administration (FDA) clearance for a genetic health risk report on MUTYH-associated polyposis, a hereditary colorectal cancer syndrome. The clearance follows the FDA’s authorization for 23andMe’s BRCA1/BRCA2 (Selected Variants)...

kidney cancer

Personalized Treatment May Extend Life Expectancy for Patients With Chronic Kidney Disease and Small Renal Tumors

Personalized treatment plans may extend life expectancy for patients with early-stage kidney cancer who also have risk factors for worsening kidney disease, according to a new study published by Kang et al in Radiology. Kidney tumors are often discovered at an early stage and are frequently...

leukemia

Newly Defined Subtypes of B-Cell Acute Lymphoblastic Leukemia

Investigators have identified multiple new subtypes of the most common childhood cancer, B-cell acute lymphoblastic leukemia (ALL)—research that has the potential to improve the diagnosis and treatment of high-risk patients. Researchers used integrated genomic analysis, including...

colorectal cancer

2019 GI Cancers Symposium: Is Adjuvant HIPEC Effective in Reducing the Risk of Peritoneal Metastases in Patients With Colon Cancer?

Patients with advanced or perforated colon cancer may be at elevated risk of peritoneal metastases. Since many patients with peritoneal metastases are diagnosed at a late stage, researchers sought to study the effectiveness of hyperthermic intraperitoneal chemotherapy (HIPEC) in the adjuvant...

lymphoma

Outcomes With AHCT Consolidation in Younger Patients With Mantle Cell Lymphoma in the Rituximab Era

In a retrospective study reported in the Journal of Clinical Oncology, Gerson et al found evidence that autologous hematopoietic cell transplantation (AHCT) consolidation after induction chemotherapy was associated with a progression-free survival benefit in patients with mantle cell lymphoma aged...

hematologic malignancies
leukemia

Remnants of Cancer Remain, but Demons Are Now Gone

In the summer of 2002, I was a physically active 17-year-old boy on the cusp of adulthood. I was about to enter my senior year in high school, and like other teens my age, I was excited about college and the promise of the undreamed-of opportunities that lay ahead. At first, the lethargy I was...

issues in oncology

Established, Modifiable Cancer Risk Factors

According to a new American Cancer Society report published by Susan M. Gapstur, PhD, MPH, American Cancer Society Senior Vice President of Behavioral and Epidemiology Research, and colleages in CA: A Cancer Journal for Clinicians, the highest priority in a national cancer control plan is the...

immunotherapy
symptom management

Adoptive T-Cell Therapy for Progressive Multifocal Leukoencephalopathy

An emerging treatment known as adoptive T-cell therapy has proven effective in a phase II clinical trial for treating progressive multifocal leukoencephalopathy (PML), a rare and often fatal brain infection sometimes observed in patients with cancer and other diseases in which the immune system is...

supportive care
integrative oncology

Use of Valerian to Relieve Anxiety in Patients With Cancer

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. Eugenie Spiguel, MSN, ANP-BC, and Jyothirmai Gubili, MS, explore the use of valerian for...

hematologic malignancies
multiple myeloma
immunotherapy

Novel Therapeutics for Relapsed or Refractory Multiple Myeloma, Part 2

Here is an update on several different studies focusing on novel treatments for patients with relapsed or refractory multiple myeloma presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. The featured therapeutics include the oral agent selinexor in...

issues in oncology
supportive care

Findings From ASCO’s Second National Cancer Opinion Survey

Despite a recent study showing that patients with cancer who chose alternative therapies over conventional cancer treatment have a higher risk of death, nearly 4 in 10 Americans believe cancer can be cured by alternative remedies alone, according to the results of ASCO’s 2018 National Cancer...

hepatobiliary cancer
immunotherapy

2019 GI Cancers Symposium: Nivolumab vs Nivolumab Plus Ipilimumab in Resectable Hepatocellular Carcinoma

Anti–programmed cell death protein 1 and anti–cytotoxic T-lymphocyte–associated protein 4 antibodies have shown activity in hepatocellular carcinoma. Based on these earlier findings, researchers sought to examine the safety, efficacy, and tolerability of perioperative treatment...

hematologic malignancies
multiple myeloma

Novel Treatments in Newly Diagnosed Multiple Myeloma, Part 1

Here is an update on several different studies focusing on novel treatments for patients with newly diagnosed multiple myeloma presented at the 2018 American Society of Hematology (ASH) Annual Meeting & Exposition. Featured therapeutics include daratumumab plus lenalidomide and dexamethasone, ...

issues in oncology
legislation
health-care policy

New Regulations Require Better Communication With Patients Who Have Disabilities and Limited English Proficiency

Ever since President Barack Obama signed the Patient Protection and Affordable Care Act (ACA) into law on March 23, 2010, the nondiscrimination provision of the law, Section 1557, which prohibits discrimination on the basis of race, color, national origin, sex, age, or disability in certain health ...

ASCO and ESMO Publish Joint Assessment of Value Frameworks

ASCO and the European Society for Medical Oncology (ESMO) published a joint analysis comparing the results of both organizations’ value frameworks in ASCO’s Journal of Clinical Oncology.1 The analysis found that the frameworks produce comparable measures of the clinical benefits of new therapies in ...

breast cancer

Breast Cancer Surveillance Consortium Analysis of Trends in Breast Density Assessment

In a study reported in the Journal of the National Cancer Institute, Sprague et al found that only small changes in the proportions of women found to have dense breasts on digital mammography have occurred with revisions in Breast Imaging Reporting and Data System (BI-RADS) density classification...

gastroesophageal cancer
gastrointestinal cancer

2019 GI Cancers Symposium: Addition of Andecaliximab to mFOLFOX6 in Treatment-Naive Advanced Gastric or GEJ Adenocarcinoma

A phase I/Ib study found that the addition of andecaliximab, a monoclonal antibody that inhibits matrix metalloproteinase 9, to modified fluorouracil (5-FU), leucovorin, and oxaliplatin (mFOLFOX6) showed activity in gastric and or gastroesophageal junction (GEJ) carcinoma. Based on these...

head and neck cancer

Study Finds World Trade Center Responders May Be at Increased Risk for Head and Neck Cancers

A study by Graber et al in the International Journal of Cancer has found a significant increase in head and neck cancers among workers and volunteers who responded to the September 11 terrorist attacks on the World Trade Center (WTC), pointing to newly emerging risks that require ongoing monitoring ...

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