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gynecologic cancers

SGO 2020: Updated Analysis of VELIA Trial Shows Antitumor Activity in Ovarian Cancer, but Is It Enough?

An updated analysis of the phase III VELIA/GOG-3005 trial, presented during the 2020 Society of Gynecologic Oncology (SGO) Annual Meeting on Women’s Cancer Webinar Series,1 suggested synergy between the poly (ADP-ribose) polymerase (PARP) inhibitor veliparib and platinum chemotherapy in the...

gynecologic cancers

ASCO20: Secondary Surgery May Extend Survival in Recurrent Ovarian Cancer

Two phase III trials provided support for secondary cytoreductive surgery in women with recurrent ovarian cancer, with the caveats that patient selection is key and the surgery should be performed at sites of excellence. The results of the DESKTOP III and SOC1 trials, both presented during the...

gynecologic cancers

ESMO 2019: Veliparib Plus First-Line Chemotherapy and as Maintenance Therapy in High-Grade Ovarian Cancer

In the phase III VELIA/GOG-3005 trial—reported at the European Society for Medical Oncology (ESMO) Congress 20191 and simultaneously published in The New England Journal of Medicine2—Robert L. Coleman, MD, of The University of Texas MD Anderson Cancer Center, Houston, and colleagues found that the ...

gynecologic cancers

ESMO 2019: PRIMA Trial Reports Benefit With Niraparib Across Ovarian Cancer Subsets

In women with advanced ovarian cancer responding to first-line chemotherapy, maintenance therapy with the poly (ADP-ribose) polymerase (PARP) inhibitor niraparib significantly reduced the risk of disease progression by 38% overall and by 60% in women with BRCA mutations. Even patients without a...

gynecologic cancers

Clinical Perspective on PAOLA-1: Maintenance Therapy for Advanced Ovarian Cancer

Based on multiple phase III prospective trials, there is evidence that both poly (ADP-ribose) polymerase (PARP) inhibitors and antiangiogenic therapies such as bevacizumab provide benefit when utilized in a maintenance strategy in the first-line treatment of advanced epithelial ovarian cancer (GOG...

gynecologic cancers

Addition of Olaparib to Bevacizumab Maintenance in Advanced Ovarian Cancer: PAOLA-1 Trial

As reported inThe New England Journal of Medicine by Isabelle Ray-Coquard, MD, PhD, of the Céntre Léon Berard, University Claude Bernard Lyon 1 and Groupe d’Investigateurs Nationaux pour l’Etude des Cancers Ovariens (GINECO), Paris, and colleagues, the phase III PAOLA-1 trial has shown a...

gynecologic cancers

Gynecologic Oncology Highlights 2019–2020 Almanac

Ovarian cancer is associated with the highest risk of mortality among the five most common gynecologic cancers (cervical, ovarian, uterine [endometrial], vaginal, and vulvar) in the United States; in 2020 in the United States, ovarian cancer will be diagnosed in an estimated 21,750 women, and...

lung cancer
immunotherapy

Is It Time to Add Checkpoint Inhibitors to the Treatment of Locally Advanced Lung Cancer?

After more than 20 years of failed strategies to improve survival rates for locally advanced lung cancers, checkpoint inhibitors have revolutionized therapy, but prognoses still lag behind other tumor types. During the ASCO20 Virtual Education Program, Mark G. Kris, MD, FASCO, a thoracic medical...

prostate cancer
cardio-oncology

Metastatic Prostate Cancer: Sorting Through the Treatment Maze

The message still needs to get out that metastatic castration-sensitive prostate cancer should be treated with both androgen-deprivation therapy (ADT) and either docetaxel or an androgen receptor pathway inhibitor. In spite of “overwhelming” support for ADT plus abiraterone/prednisone,...

integrative oncology

Acupuncture vs Sham Procedure and Usual Care for Chemotherapy-Induced Peripheral Neuropathy

Chemotherapy-induced peripheral neuropathy is a debilitating and enduring adverse effect of many antineoplastic agents, which negatively impacts the quality of life of patients with cancer and survivors. Current pharmacotherapy has limited efficacy and causes undesirable effects. In this...

breast cancer
survivorship

Breast Cancer Survival Is Significantly Decreased Among Premenopausal Women Previously Treated With Radiation for Childhood or AYA Cancer

Although radiotherapy is integral to the multidisciplinary therapy used in the treatment of common childhood and adolescent and young adult (AYA) cancers, including Hodgkin lymphomas, sarcomas, and breast cancer, the treatment is a strong risk factor for a secondary breast malignancy, especially...

issues in oncology

Developing Policies to Address Patient Racial Bias and Race-Based Provider Requests

Public momentum for efforts to address structural and systemic racism has led many health-care institutions to consider how they can work to bring about positive change. In this column, drawing on important recent work by Kimani Paul-Emile, JD, PhD, Professor of Law at Fordham University School of ...

integrative oncology

Ashwagandha

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. In this installment, Gary Deng, MD, PhD, and Jyothirmai Gubili, MS, present updated information on ...

covid-19

Managing Cancer in Older Adults During the COVID-19 Pandemic

The COVID-19 pandemic is an additional competing risk to factor in when making decisions about anticancer treatment for older adults. It poses a potential barrier to equal and evidence-based management of cancer in this group of patients. Implementing geriatric assessments in routine clinical...

skin cancer

Adding Immunotherapy to BRAF/MEK Inhibition in BRAF V600–Mutant Melanoma: First Step on the Journey

As investigators, we were always determined to find the drug to work with BRAF/MEK inhibitor combination therapy. It had come on like a storm and showed us that we could help even those with the most advanced metastatic melanoma, as long as it harbored the magical BRAF V600E mutation.1...

hematologic malignancies

The WHO Classification of Tumors of Hematopoietic and Lymphoid Tissues

The ASCO Post is pleased to present Hematology Expert Review, an ongoing feature that occasionally quizzes readers on issues in hematology. In this installment, Drs. Abutalib, Pemmaraju, and Medeiros highlight the clinically aggressive blastic plasmacytoid dendritic cell neoplasm. For each quiz...

gastrointestinal cancer

Switch Control Inhibitor for GISTs Harboring Drug-Resistance Mutations: The INVICTUS Trial

In May 2020, the U.S. Food and Drug Administration (FDA) approved ripretinib for patients who have received prior treatment with three or more kinase inhibitors, including imatinib, for advanced gastrointestinal stromal tumors (GIST). The approval was largely based on the findings of the...

covid-19

Reevaluating the Delivery of Palliative Care in the Era of COVID-19

Palliative care services are so crucial to the well-being of patients with cancer that, in 2017, ASCO updated its clinical practice guideline on the integration of palliative care into standard oncology care.1 The updated guideline recommends that all patients with advanced cancer receive dedicated ...

lymphoma

Chemotherapy-Free Approaches in Follicular and Mantle Cell Lymphomas

As chemotherapy and chemoimmunotherapy regimens reach their maximal impact in follicular lymphoma and mantle cell lymphoma, clinicians are turning to chemotherapy-free approaches to achieve better control, less toxicity, and (hopefully) a cure. During the ASCO20 Virtual Education Program, Sonali M. ...

pancreatic cancer

ASCO Updates Metastatic Pancreatic Cancer Guideline

ASCO has released an update to its Metastatic Pancreatic Cancer Guideline that includes recommendations for second-line treatment, including early biomarker testing for actionable genomic alterations.1 Last updated in 2018, this new version was triggered by novel evidence related to targeted...

colorectal cancer
genomics/genetics

Molecular Testing in Metastatic Colorectal Cancer: Understanding How, When, and What to Profile

“In line with the emergence of targeted therapies, molecular biomarker testing in metastatic colorectal cancer has evolved over the past decade,” noted Jeanne Tie, MD, MBChB, FRACP, who acknowledged there is confusion about the best ways to use molecular testing in the clinic. Dr. Tie, who is...

breast cancer
immunotherapy

Balancing Efficacy and Safety of Targeted Therapy in Breast Cancer Care

Novel targeted therapies have increased the likelihood of cure and prolonged survival in many patients with advanced breast cancer (Table 1), but these new agents also carry toxicity profiles that vary greatly from those of traditional chemotherapy. During the ASCO20 Virtual Education Program,...

Expert Point of View: Amit Mahipal, MBBS, MPH

Amit Mahipal, MBBS, MPH, Consultant, Associate Professor of Oncology, Mayo College of Medicine, Rochester, put the findings for tremelimumab/durvalumab into context regarding other studies evaluating checkpoint inhibitors in advanced hepatocellular carcinoma. In the current study by Kelly et al, he ...

prostate cancer

TITAN Trial: Apalutamide Adds to Options for Men With Metastatic Hormone-Sensitive Prostate Cancer

Androgen-deprivation therapy has been, and remains, the standard of care for patients with metastatic prostate cancer. Patients are often surprised to learn that was all we would do to control their disease and sometimes asked why they would not receive chemotherapy, as for other cancers. I would...

kidney cancer

Study Supports Pembrolizumab Plus Axitinib in Previously Untreated Advanced Renal Cell Carcinoma

Extended analysis of the phase III KEYNOTE-426 study upholds pembrolizumab plus axitinib as a preferred front-line regimen over sunitinib in patients with advanced sporadic renal cell carcinoma.1 These updated results were presented during the ASCO20 Virtual Scientific Program by Elizabeth R....

bladder cancer

Erdafitinib in FGFR-Altered Advanced Urothelial Carcinoma

As reported in The New England Journal of Medicine by Loriot et al, the fibroblast growth factor receptor 1-4 tyrosine kinase inhibitor erdafitinib showed activity in FGFR-altered advanced urothelial carcinoma.1 The study enrolled patients from sites in 14 countries between May 2015 and March 2018. ...

prostate cancer

Many Choices Now for Men With Metastatic Hormone-Sensitive Prostate Cancer: How to Decide?

Based on the recently published ENZAMET, ARCHES, and TITAN trials,1-3 we now have several choices of systemic combination therapies for men with metastatic hormone-sensitive prostate cancer. Today, men are faced with decisions of androgen-deprivation therapy alone or combinations with abiraterone,...

kidney cancer
immunotherapy

First-Line Combination Treatments Improve Outcomes vs Sunitinib in Advanced Renal Cell Carcinoma

Two recently reported phase III trials have shown the benefits of combination therapy vs sunitinib in the first-line treatment of advanced renal cell carcinoma. As reported in The New England Journal of Medicine by Brian I. Rini, MD, of Cleveland Clinic Taussig Cancer Institute, and colleagues, the ...

prostate cancer

Enzalutamide Improves Survival vs Standard First-LineTreatment in Hormone-Sensitive Metastatic Prostate Cancer

As reported inThe New England Journal of Medicine by Ian D. Davis, MBBS, PhD, FRACP, FAChPM, of Monash University and Eastern Health in Melbourne, and colleagues, the phase III ENZAMET trial has shown that the androgen receptor inhibitor enzalutamide improved progression-free and overall survival...

kidney cancer
immunotherapy

Novel Indications and New Drugs for the Treament of Patients With Renal Cell Carcinoma

Pembrolizumab Plus Axitinib: On April 19, 2019, pembrolizumab (Keytruda) was approved for use in combination with the small-molecule tyrosine kinase inhibitor axitinib (Inlyta) for the first-line treatment of patients with advanced renal cell carcinoma. Approval was based on findings in the phase...

prostate cancer

Addition of Apalutamide to Androgen-Deprivation Therapy in Metastatic Castration-Sensitive Prostate Cancer

As reported in The New England Journal of Medicine by Kim N. Chi, MD, of BC Cancer and Vancouver Prostate Centre, and colleagues, the first analysis of the phase III TITAN trial has shown that the addition of apalutamide to androgen-deprivation therapy improved radiographic progression-free and...

prostate cancer

Nonmetastatic Castration-Resistant Prostate Cancer

Nonmetastatic 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 androgen-deprivation...

prostate cancer

Phase III Study of AR Antagonist in Nonmetastatic Castration-Resistant Prostate Cancer

In the phase III ARAMIS trial reported in The New England Journal of Medicine,1 Karim Fizazi, MD, PhD, of the Institut Gustave Roussy, Universite Paris-Sud, Villejuif, France, and colleagues found that the androgen-receptor (AR) antagonist darolutamide significantly prolonged metastasis-free...

prostate cancer

Novel Indications and New Drugs for Castration-Resistant or Castrate-Sensitive Prostate Cancer

The past year has witnessed the U.S. Food and Drug Administration (FDA) approval of a number of drugs for treatment of patients with metastatic castrate-resistant prostate cancer or castrate-sensitive prostate cancer. Castrate-Resistant Prostate Cancer Olaparib: On May 19, 2020, olaparib...

prostate cancer

Final Analysis of the ARAMIS Trial in Men With Nonmetastatic Castration-Resistant Prostate Cancer

A year ago, initial results from the double-blind, multicenter, randomized phase III ARAMIS clinical trial evaluating the efficacy and safety of darolutamide, a structurally unique androgen-receptor antagonist, in men with nonmetastatic castration-resistant prostate cancer, were published in The...

prostate cancer

Final Overall Survival Analysis of the PROSPER Trial in Nonmetastatic Castration-Resistant Prostate Cancer

In the final overall survival analysis of the phase III PROSPER trial reported at the ASCO20 Virtual Scientific Program1 and published in The New England Journal of Medicine,2 Cora N. Sternberg, MD, and colleagues found that enzalutamide plus androgen-deprivation therapy (ADT) significantly...

prostate cancer

Androgen Deprivation With Oral Relugolix vs Leuprolide in Advanced Prostate Cancer: HERO Trial

As reported at the ASCO20 Virtual Scientific Program1 and in The New England Journal of Medicine2 by Neal D. Shore, MD, FACS, of Carolina Urologic Research Center, Myrtle Beach, South Carolina, and colleagues, the phase III HERO trial showed sustained castrate testosterone levels and lower risk of...

prostate cancer

In Biochemically Recurrent Prostate Cancer, PSMA-Targeted PET/CT Imaging May Be Useful

Positron-emission tomography/computed tomography (PET/CT) imaging with the prostate-specific membrane antigen (PSMA)-targeted radiotracer fluorine F-18 DCFPyL (PyL) successfully identified areas of occult metastasis in men with biochemically recurrent metastatic castration-resistant prostate...

prostate cancer

Lutetium-177–Labeled PSMA-617 Improves PSA Response in First Analysis From TheraP Trial in Metastatic Prostate Cancer

Initial results of the randomized phase II TheraP trial showed that therapy directed to prostate-specific membrane antigen (PSMA) with lutetium-177–labeled PSMA-617 (LuPSMA) significantly improved prostate-specific antigen (PSA) response compared with cabazitaxel in men with metastatic...

prostate cancer
kidney cancer
bladder cancer
immunotherapy

Genitourinary Oncology Highlights 2019–2020 Almanac

Over the past year, we have seen significant advances in the treatment of prostate, kidney, and urothelial cancers that will benefit patients now and in the future. We have learned about the final results of important clinical trials across multiple genitourinary cancers disease states leading to...

issues in oncology

Physicians, New Drugs, and Pharma

The U.S. Food and Drug Administration (FDA) and European Medicines Agency (EMA) have approved record numbers of new cancer drugs recently. This is extraordinarily good news for physicians, patients, and drug companies, but it raises important questions as to how effective these drugs are, whether...

Expert Point of View: David Sallman, MD

David Sallman, MD, an assistant member of the Malignant Hematology Department of Moffitt Cancer Center and Research Institute, Tampa, Florida, commented on the IMerge and QUAZAR studies for The ASCO Post. As background, he noted the “predominant struggle” of patients with lower-risk myelodysplastic ...

lung cancer
immunotherapy

Incorporating Immunotherapy Into Treatment of Early-Stage NSCLC

There is a strong rationale for incorporating immunotherapy into the treatment of early-stage non–small cell lung cancer (NSCLC), given the breakthrough results with PD-1 checkpoint inhibitors as monotherapy, combined with immunotherapy, or combined with chemotherapy in advanced-stage NSCLC. As...

integrative oncology

A Brief Primer on Managing Anxiety in Older Adults With Cancer

Cancer-related anxiety has negative impacts on emotional, physical, and social well-being, with data indicating older patients are likely to remain undiagnosed, leading to poor outcomes. In this installment of The ASCO Post’s Integrative Oncology series, Drs. Trevino, Saracino, and Roth highlight...

lymphoma
immunotherapy

Role of Rituximab in the Treatment of Children and Adolescents With Mature B-Cell Non-Hodgkin Lymphoma

Minard-Colin et al recently reported for the European Intergroup for Childhood Non-Hodgkin Lymphoma/Children’s Oncology Group (EICNHL/COG) a significant improvement in event-free survival among children and adolescents (aged 6 months to 18 years) with high-risk mature B-cell non-Hodgkin lymphoma...

lymphoma
immunotherapy

Addition of Rituximab to Standard Chemotherapy Improves Event-Free and Overall Survival in Children With High-Risk, Mature B-Cell Non-Hodgkin Lymphoma

In a European Intergroup for Childhood Non-Hodgkin Lymphoma/Children’s Oncology Group phase III trial reported in The New England Journal of Medicine, Véronique Minard‑Colin, MD, PhD, of Gustave Roussy, Université Paris-Saclay, Villejuif, France, and colleagues found that the addition of rituximab...

Expert Point of View: Komal Jhaveri, MD

“Surprisingly, the phase II PARSIFAL trial did not show a statistical superiority in progression-free survival for fulvestrant plus palbociclib over letrozole plus palbociclib in the first-line treatment of patients with endocrine-sensitive, metastatic breast cancer. The noninferiority hypothesis...

lymphoma

Monumental Progress in the Treatment of Diffuse Large B-Cell Lymphoma

Some monuments are difficult to topple. At least that was the case dating back to 1976, when investigators from the Southwest Oncology Group demonstrated the importance of doxorubicin in the treatment of patients with a group of lymphoid malignancies then referred to as diffuse aggressive...

covid-19

In Keynote Lecture, Anthony Fauci, MD, Explores What We Know About COVID-19 and What’s Being Done to Combat It

Kicking off the American Association for Cancer Research (AACR) Virtual Meeting: COVID-19 and Cancer earlier this week, Anthony Fauci, MD, gave the keynote lecture, “Coronavirus Infections: More Than Just the Common Cold.” As Dr. Fauci told listeners, “[COVID-19]—and other infectious...

geriatric oncology

The Importance of Measuring Health-Related Quality of Life in Older Adults

Compared with younger patients, older patients with cancer face unique challenges because many of them have age-related decreases in health-related quality of life. This can be a result of many factors, such as comorbidities, mental health, physical impairment, and financial stressors. A diagnosis...

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