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solid tumors

Anti–PD-L1 Antibody in Advanced Urothelial Carcinoma After Platinum Failure

As reported in The Lancet Oncology by Patel et al, the anti–programmed cell death ligand 1 (PD-L1) antibody avelumab (Bavencio) produced durable responses in patients with locally advanced or metastatic urothelial carcinoma after failure of platinum-based therapy in two expansion cohorts of...

hematologic malignancies
symptom management

ASH 2017: Abatacept Nearly Eliminates Severe Acute GVHD After Hematopoietic Stem Cell Transplant

Results from a phase II clinical trial presented by Kean et al at the 59th American Society of Hematology (ASH) Annual Meeting (Abstract 212) show that the drug abatacept (Orencia) nearly eliminated life-threatening severe acute graft-versus-host disease (GVHD) in patients receiving hematopoietic...

prostate cancer

Novel Clinical-Genomic Risk Group Classification for Localized Prostate Cancer

As reported in the Journal of Clinical Oncology, Spratt et al have developed an integrated clinical-genomic risk classifier for predicting distant metastasis in patients with localized prostate cancer. The classifier uses National Comprehensive Cancer Network® (NCCN) risk categories and risk...

breast cancer

BELLE-3 Trial: Combination Therapy in Resistant Advanced Breast Cancer

The phase III BELLE-3 trial has shown prolonged progression-free survival but a worse safety profile with the addition of the pan-phosphoinositide 3-kinase inhibitor buparlisib to fulvestrant (Faslodex) in postmenopausal women with hormone receptor–positive, HER2-negative advanced breast...

lymphoma

ASH 2017: JULIET Trial: 6-Month Analysis of Tisagenlecleucel in Relapsed/Refractory DLBCL Shows Sustained Responses

Six months after receiving a single dose of tisagenlecleucel, a chimeric antigen receptor (CAR) T-cell therapy that targets CD-19, high response rates persist among adult patients with relapsed or refractory diffuse large B-cell lymphoma (DLBCL), according to findings reported by Schuster et al at...

lymphoma

ASH 2017: Sustained Benefit With Ibrutinib in Relapsed or Refractory Mantle Cell Lymphoma

The results of a pooled analysis of patients with relapsed or refractory mantle cell lymphoma (MCL) treated with ibrutinib (Imbruvica) were presented at the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition (Abstract 151). The extended follow-up data demonstrated that...

leukemia

ASH 2017: RESONATE-2 Trial: Patient-Reported Outcomes on Ibrutinib Treatment in Patients With CLL

At the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition, the 3-year follow-up data from the RESONATE-2 study (PCYC-1115/1116) were presented. The investigators found that patients with previously untreated chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL)...

breast cancer

SABCS 2017: Postmenopausal Women Who Lose Weight May Have Reduced Breast Cancer Risk

Postmenopausal women who lose weight may have a significantly reduced chance of developing breast cancer, according to data presented by Chlebowski et al at the 2017 San Antonio Breast Cancer Symposium (Abstract GS5-07). “Breast cancer is among the leading types of cancer and...

breast cancer

SABCS 2017: Phase III EMBRACA Trial Meets Primary Endpoint

Patients with advanced HER2-negative breast cancer with germline BRCA mutations had significantly prolonged progression-free survival when treated with the poly(ADP-ribose) polymerase (PARP) inhibitor talazoparib, compared with those who received chemotherapy of physician’s choice, according...

solid tumors
breast cancer

AKT Inhibitor Ipatasertib in Metastatic Triple-Negative Breast Cancer

The randomized phase II LOTUS trial has shown improved progression-free survival with the addition of the AKT inhibitor ipatasertib to paclitaxel in the first-line treatment of metastatic triple-negative breast cancer. These results were reported by Sung-Bae Kim, MD, of the University of Ulsan...

solid tumors
breast cancer

Partial-Breast and Reduced-Dose Radiotherapy After Breast-Conserving Surgery

The UK IMPORT LOW phase III trial has shown noninferiority in local relapse for partial-breast and reduced-dose vs standard whole-breast radiotherapy after breast-conserving surgery in early breast cancer. These study results were reported by Charlotte E. Coles, PhD, of the University of...

solid tumors
pancreatic cancer

Achieving One’s Childhood Dreams While Facing Pancreatic Cancer

BOOMARK Title: The Last LectureAuthor: Randy Pausch with Jeffrey ZaslowPublisher: HyperionDate: April 2008Price: $21.95, hardcover; 206 pages Faced with imminent death, how does one chose to live out the remainder of one’s life? Such is the question at the heart of The Last Lecture, a memoir...

Love Triumphs Amid a Battle With Cancer

BOOKMARK Title: The Red Devil: To Hell With Cancer—and BackAuthor: Katherine Russell RichPublisher: CrownDate Published: October 1999Price: $23.95, hardcover, 256 pages Over the past year or so, there have been several best-selling memoirs of people fighting and ultimately losing their battle with ...

hematologic malignancies
leukemia

Clinical Trials Actively Recruiting Patients With Pediatric Leukemia

The information contained in this Clinical Trials Resource Guide includes actively recruiting clinical studies focused on pediatric leukemia. These studies highlight quality-of-life reporting; neutropenia management; combination chemotherapy; chimeric antigen receptor (CAR) T-cell therapy and some...

Gratitude

The following essay by Stan Winokur, MD, is adapted from The Big Casino: America’s Best Cancer Doctors Share Their Most Powerful Stories, which was coedited by Dr. Winokur and -Vincent Coppola and published in May 2014. The book is available on Amazon.com and thebigcasino.org. I looked into her...

hematologic malignancies

Liposome-Encapsulated Daunorubicin and Cytarabine for AML Subtypes

On August 3, 2017, a liposome-encapsulated combination of daunorubicin and cytarabine (Vyxeos) was approved for treatment of adults with newly diagnosed therapy-related acute myeloid leukemia (AML) or AML with myelodysplasia-related changes.1,2 This is the first U.S. Food and Drug...

hematologic malignancies

Ibrutinib in Chronic Graft-vs-Host Disease

On August 2, 2017, ibrutinib (Imbruvica) was approved for treatment of adult patients with chronic graft-vs-host disease after failure of one or more lines of systemic therapy.1,2 This is the first U.S. Food and Drug Administration (FDA)-approved therapy for treatment of chronic graft-vs-host...

hematologic malignancies
lymphoma

Acalabrutinib in Previously Treated Mantle Cell Lymphoma

On October 31, 2017, the Bruton’s tyrosine kinase (BTK) inhibitor acalabrutinib (Calquence) was granted accelerated approval for treatment of adult patients with mantle cell lymphoma who have received at least one prior therapy.1,2 Supporting Efficacy Data Approval was based on objective response...

Barbara Savoldo, MD, PhD, Awarded Grant for Immunotherapy Research

University of North Carolina Lineberger Comprehensive Cancer Center researcher Barbara Savoldo, MD, PhD, has been awarded a $600,000, 3-year grant from to support research of an immunotherapy being developed. The grant will help fund clinical research into an investigational chimeric antigen...

solid tumors

Future Directions for CAR T-Cell Therapy

Chimeric antigen receptor (CAR) T-cell therapy burst upon the scene as an innovative approach to the treatment of hematologic malignancies, mainly for patients who have exhausted all other treatment options. Recently two CAR T-cell products were approved by the U.S. Food and Drug Administration...

solid tumors
gynecologic cancers

Olaparib Tablets for Maintenance Treatment in Ovarian Cancer

On August 17, 2017, olaparib -(Lynparza) in tablet form was granted regular approval for maintenance treatment of adult patients with recurrent epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to platinum-based chemotherapy.1,2 Olaparib...

breast cancer

SABCS 2017: 2 Years of Extended Anastrozole Therapy Proved as Effective as 5 Years in Hormone Receptor–Positive Breast Cancer

Postmenopausal women with hormone receptor–positive breast cancer who took the aromatase inhibitor anastrozole for 2 years after an initial 5 years of adjuvant endocrine therapy received an equal benefit to those who took the drug for 5 additional years. The trial results suggest that a...

breast cancer

SABCS 2017: SOLD Trial Data Support Current Standard 12-Month Adjuvant Trastuzumab for HER2-Positive Breast Cancer

Disease-free survival after 9 weeks of adjuvant trastuzumab (Herceptin) and standard chemotherapy was not comparable to disease-free survival after 12 months of adjuvant trastuzumab and standard chemotherapy for women with early-stage HER2-positive breast cancer, supporting the current...

solid tumors

Immunotherapy Has Indelibly Changed the Treatment Paradigm in Urothelial Carcinoma

Cisplatin-based combination chemotherapy is the preferred first-line therapy for metastatic urothelial cancer and the only treatment shown to improve survival in patients with previously untreated disease for many years. This chemotherapy also has proven to be beneficial in the neoadjuvant and...

solid tumors

First-Line Pembrolizumab in Cisplatin-Ineligible Advanced Urothelial Cancer

As reported in The Lancet Oncology by Arjun V. Balar, MD, of Perlmutter Cancer Center of New York York Langone Medical Center, and colleagues, first-line pembrolizumab (Keytruda) produced durable responses in cisplatin-ineligible patients with locally advanced and unresectable or metastatic...

solid tumors
lung cancer

Immunotherapy Plus Chemotherapy in Non–Small Cell Lung Cancer: Despite the Failure of Ipilimumab, Guarded Optimism Persists

Ipilimumab (Yervoy) is a fully human monoclonal antibody that inhibits cytotoxic T-lymphocyte–associated protein 4 (CTLA-4) and was the first checkpoint inhibitor approved after showing survival benefit in metastatic melanoma.1 Indeed, in the first-line setting for metastatic melanoma, ipilimumab ...

supportive care

Intravenous Rolapitant for Chemotherapy-Induced Delayed Nausea and Vomiting

On October 25, 2017, intravenous (IV) rolapitant (Varubi) was approved for use in combination with other antiemetic agents in adults for the prevention of delayed nausea and vomiting associated with initial and repeat courses of emetogenic cancer chemotherapy, including but not limited to highly...

hematologic malignancies
leukemia

Dasatinib in Pediatric Patients With Chronic Myeloid Leukemia

On November 9, 2017, dasatinib (Sprycel) was granted regular approval for treatment of pediatric patients with Philadelphia chromosome–positive chronic myeloid leukemia (CML) in chronic phase.1,2 Supporting Efficacy Data Approval was based on findings among 97 pediatric patients with chronic-phase...

hematologic malignancies

Answers to Hematology Expert Review Questions

Question 1  Which statement about epidemiology and clinical features of atypical CML is correct? Correct answer: C. Symptoms of atypical CML may be related to anemia and thrombocytopenia. Expert PerspectiveThe exact incidence of atypical CML is unknown, but the median patient age at diagnosis is in ...

hematologic malignancies

New WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that quizzes readers on issues in hematology. In this installment, Drs. Abutalib and Medeiros explore the recently updated World Health Organization (WHO) classification of hematopoietic and lymphoid tissue...

hematologic malignancies

Recent Study Findings in CAR T-Cell Therapy for Neoplastic Malignancies

Here is an update on two recent clinical trials focusing on chimeric antigen receptor (CAR) T-cell therapy for neoplastic malignancies. Highlighted are the findings from an early-phase study in refractory aggressive lymphoma and a study in chronic lymphocytic leukemia after failure of ibrutinib...

hematologic malignancies
lymphoma

Follicular Lymphoma: Is the Road to Cure Paved With Gallium?

The roadside along the path to curing follicular lymphoma is riddled with the debris of failed cytotoxic regimens. For decades, clinical trials unsuccessfully pitted various chemotherapy combinations against each other. It took but a single, noncytotoxic molecule, rituximab (Rituxan), to forever...

hematologic malignancies
lymphoma

Obinutuzumab-Based First-Line Treatment Improves Progression-Free Survival vs Rituximab-Based Treatment in Follicular Lymphoma

In the phase III GALLIUM trial reported in The New England Journal of Medicine by Robert Marcus, MBBS, of University College London, and colleagues, obinutuzumab (Gazyva)-based therapy significantly prolonged progression-free survival vs rituximab (Rituxan)-based therapy in patients with previously ...

hematologic malignancies

Vemurafenib in Erdheim-Chester Disease

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On November 6, 2017, vemurafenib (Zelboraf) was granted...

Mount Sinai Institutes Join $215 Million Partnership to Increase Patients’ Immunotherapy Success

The Tisch Cancer Institute and the Precision Immunology Institute at Mount Sinai Health System are part of a $215 million public-private Cancer Moonshot research collaboration launched by the National Institutes of Health and 11 leading pharmaceutical companies. The 5-year initiative, called...

issues in oncology

Cancer and Obesity: Not Such a Linear Relationship

Obesity has been established as a strong risk factor for the development of cancer. African Americans and Hispanics are particularly at risk, and their access to health care is often poor. How do racial and ethnic disparities in the development of obesity as well as access to care intersect to...

supportive care
palliative care

Caring for the Frail, Older Patient With Cancer: Four Practical Approaches

Cancer may be a disease of aging, but data suggest that older patients with cancer are undertreated, especially with respect to chemotherapy. One analysis showed that approximately 40% of patients in their 70s—and 60% of patients in their 80s—do not receive adjuvant therapy after surgery for colon...

supportive care
palliative care

‘Triple Threat’ Conditions May Predict Mortality in Patients With Cancer Presenting to Emergency Departments

Dyspnea, delirium, and poor performance—so-called “triple threat” conditions—are known to predict short survival in palliative care. According to data presented at the 2017 Palliative and Supportive Care in Oncology Symposium,1 however, the presence of at least two of these symptoms in patients...

supportive care
palliative care

Concurrent Palliative Care: Recommendations From the ASCO Clinical Practice Guideline

Updated in 2016, the ASCO clinical practice guideline on the integration of palliative care into standard oncology care provides evidence-based recommendations to oncology clinicians, patients, family and friend caregivers, and palliative care specialists about providing high-quality care for...

solid tumors
breast cancer

Preparing for Steep Increase in Breast Cancer Among the Elderly

“We are in the midst of a steep increase” in the incidence of breast cancer among women aged 65 years and older, Arti Hurria, MD, reported at the 19th Annual Lynn Sage Breast Cancer Symposium, Chicago.1 “Are we prepared as a health-care system and as providers to address this burgeoning need?” she...

solid tumors
breast cancer

Combined Therapies Increase Adverse Events in Patients With Hormone Receptor–Positive Metastatic Breast Cancer

In patients with hormone receptor–positive metastatic breast cancer, the combination of targeted agents and hormone therapy is associated with a significantly increased risk of severe adverse events, according to research presented by Matteo Lambertini, MD, European Society for Medical Oncology...

solid tumors
breast cancer

Managing Neurotoxicity in Advanced Breast Cancer

Neurotoxicity in advanced breast cancer is not limited to chemotherapy-induced peripheral neuropathy, according to Matti Aapro, MD, of IMO Clinique de Genolier, Switzerland. Surgery, radiation therapy, and medical therapy can all have detrimental effects on either the central or peripheral nervous ...

solid tumors
lung cancer

Durvalumab Therapy Improves Outcomes in Patients With Unresectable Stage III NSCLC

The PACIFIC study showed that the addition of the programmed cell death ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) following chemoradiotherapy for patients with unresectable stage III non–small cell lung cancer (NSCLC) dramatically improved progression-free survival compared with placebo....

hematologic malignancies
lymphoma
multiple myeloma

CAR T-Cell Therapy Makes Further Inroads in Lymphoma and Myeloma

With the recent U.S. Food and Drug Administration (FDA) approvals of two chimeric antigen receptor (CAR) T-cell products, this novel approach seems to be moving into the mainstream. The approvals were tisagenlecleucel (also known as CTL019; Kymriah) for the treatment of pediatric B-cell acute...

hematologic malignancies
multiple myeloma

Evidence-Based Support for Triplet Therapies in Multiple Myeloma

Over the past 15 years, multiple myeloma has garnered among the highest number of regulatory approvals by the U.S. Food and Drug Administration (FDA) for the management of all phases of the disease. This fast-expanding repertoire of treatment options has pushed the median survival of multiple...

breast cancer

SABCS 2017: MONALEESA-7: Ribociclib Improved Progression-Free Survival for Pre- and Perimenopausal Women With HR-Positive Advanced Breast Cancer

Adding the cyclin-dependent kinase (CDK) 4/6 inhibitor ribociclib (Kisqali) to standard endocrine therapy with temporary ovarian suppression significantly improved progression-free survival for pre- and perimenopausal women with advanced hormone receptor–positive (HR-positive), HER2-negative...

breast cancer

SABCS 2017: Combination of Pembrolizumab and Trastuzumab Shows Early Promise for Patients With Trastuzumab-Resistant Breast Cancer

A combination of pembrolizumab (Keytruda) and trastuzumab (Herceptin) tested in patients with trastuzumab-resistant advanced HER2-positive breast cancer was well tolerated and had clinical benefit in patients whose tumors were positive for a biomarker for pembrolizumab, according to data presented...

hematologic malignancies

Targeted Therapies Highlighted at This Year’s ASH Annual Meeting

In a webcast press briefing prior to the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition, journalists got a peek at some of the most anticipated abstracts. ASH President Kenneth C. Anderson, MD, Director of the Lebow Institute for Myeloma Therapeutics and Jerome Lipper...

hematologic malignancies

ASCO Clinical Practice Guideline Update: Platelet Transfusion for Patients With Cancer

As reported in the Journal of Clinical Oncology by Charles A. Schiffer, MD, of Karmanos Cancer Institute, Wayne State University School of Medicine, and colleagues, ASCO has issued a clinical practice guideline update on platelet transfusions in patients with cancer. The updated guideline replaces ...

breast cancer

SABCS 2017: Increasing the Dose Intensity of Chemotherapy May Lower the Risk of Breast Cancer Recurrence and Death

Increasing the dose intensity of chemotherapy—by either shortening the intervals between the cycles or by sequential administration instead of concurrent administration of the drugs—reduced the risk of early-stage breast cancer recurrence and death compared with standard chemotherapy...

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