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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...

Expect Questions About Minimally Invasive Surgery for Early-Stage Cervical Cancer

A recent systematic review and meta-analysis found that women with early-stage cervical cancer treated with minimally invasive radical hysterectomy had a 71% increased risk of disease recurrence and a 56% increased risk of death compared with those treated with open radical hysterectomy.1 “These...

gynecologic cancers

Higher Risk of Disease Recurrence and Death With Minimally Invasive vs Open Surgery for Early-Stage Cervical Cancer

Women with early-stage cervical cancer treated with minimally invasive radical hysterectomy had a 71% increased risk of recurrence and a 56% increased risk of death compared with those treated with open radical hysterectomy, according to a systematic review and meta-analysis of 15 studies involving ...

lung cancer

Do Not Rush to High-Dose Twice-Daily Radiation for Limited Small Cell Lung Cancer

Bjørn Henning Gronberg, MD, PhD, presented a paper at the ASCO20 Virtual Scientific Program reporting astounding positive results favoring higher-dose, twice-daily radiation therapy in limited-stage small cell lung cancer.1 This was a phase II study (large for phase II but small for phase III)...

integrative oncology

Elderberry

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, Yen Nien Hou, PharmD, DiplOM, LAc, and Jyothirmai Gubili, MS, focus on...

hepatobiliary cancer
immunotherapy

Atezolizumab Plus Bevacizumab for Unresectable or Metastatic Hepatocellular Carcinoma

On May 29, 2020, atezolizumab in combination with bevacizumab was approved for treatment of patients with unresectable or metastatic hepatocellular carcinoma who have not received prior systemic therapy.1-3 Supporting Efficacy Data Approval was based on findings in the international, open-label,...

hepatobiliary cancer
immunotherapy

IMbrave150: A New Standard of Care to Treat Hepatocellular Cancers?

In 2007, sorafenib became the first approved systemic therapy for hepatocellular cancers and the first agent to improve overall survival in these patients.1 In a similar multikinase inhibitor strategy, lenvatinib was found to be noninferior to sorafenib in overall survival in the same patient...

multiple myeloma
immunotherapy

Expert Point of View: Suzanne Lentzsch, MD, PhD, and Joshua Richter, MD

Two myeloma specialists weighed in on the disappointing findings of SWOG S1211: Suzanne Lentzsch, MD, PhD, Professor of Medicine at Columbia University and Director of the Multiple Myeloma and Amyloidosis Service, and Joshua Richter, MD, Assistant Professor of Medicine, Icahn School of Medicine at...

hepatobiliary cancer
immunotherapy

IMbrave150 Trial: Atezolizumab Plus Bevacizumab Improves Survival in Unresectable Hepatocellular Carcinoma

As reported in The New England Journal of Medicine by Richard S. Finn, MD, of Jonsson Comprehensive Cancer Center, Geffen School of Medicine at the University of California, Los Angeles, and colleagues, the phase III IMbrave150 trial has shown that anti–programmed cell death ligand 1 (PD-L1) plus...

lung cancer

Nivolumab Plus Ipilimumab in Two New Lung Cancer Indications

The combination of nivolumab and ipilimumab was recently approved by the U.S. Food and Drug Administration (FDA) for the treatment of patients with non–small cell lung cancer (NSCLC) in two different regimens: On May 15, 2020, the two-drug combination was approved for first-line treatment in...

pain management

Understanding the Underlying Mechanisms of Pain in Patients With Cancer

Pain is among the most difficult medical issues for oncologists to confront, said Tony L. Yaksh, PhD, Professor of Anesthesiology and Pharmacology at the University of California, San Diego, during his keynote address at the 2019 Supportive Care in Oncology Symposium. Failure to adequately manage...

health-care policy

Addressing Discrimination and Bias in Medical Education

“As a medical student, I often felt marginalized from my medical community. I have been told that my name is ‘not American,’ fallen prey to being confused for support staff such as a janitor (even while wearing my white coat), and been asked questions like, ‘Where are you really from?’ or ‘How old...

gynecologic cancers

Two Studies Report Secondary Surgery Extends Survival in Recurrent Ovarian Cancer

Two phase III trials provide 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...

skin cancer
immunotherapy

Longer-Term Results of Pivotal Study in Advanced Cutaneous Squamous Cell Carcinoma

New, longer-term data from a pivotal phase II trial in advanced cutaneous squamous cell carcinoma (CSCC), were presented during the ASCO20 Virtual Scientific Program and discussed during a poster discussion.1 Danny Rischin, MD, of the Peter MacCallum Cancer Centre, Victoria, Australia, presented...

prostate cancer

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

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...

lung cancer
immunotherapy

First-Line Nivolumab Plus Ipilimumab Shows Activity in NSCLC, With or Without Chemotherapy

Advanced non–small cell lung cancer (NSCLC) in patients whose tumors have no EGFR or ALK alterations poses a particular challenge in terms of first-line therapy. The use of nivolumab plus ipilimumab as well as nivolumab/ipilimumab plus two cycles of chemotherapy, respectively, as first-line therapy ...

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 at the ASCO20 Virtual Scientific Program by Elizabeth R. Plimack,...

Expert Point of View: David Wise, MD and Celestia S. “Tia” Higano, MD, FACP

“GnRH antagonists have several advantages over GnRH agonists,” explained David Wise, MD, of Perlmutter Cancer Center at NYU Langone Health in New York. “There is no testosterone flare on initiation [as there is with leuprolide], no increase in cardiac toxicity, and faster onset of action. Currently ...

prostate cancer

Novel Androgen-Deprivation Therapy With Relugolix Causes Fewer Cardiac Events Than Leuprolide in Advanced Prostate Cancer

Men with prostate cancer on androgen-deprivation therapy are usually treated with leuprolide, a long-acting injectable luteinizing hormone-releasing hormone (LHRH) agonist requiring an every-3-month injection, but it may be possible for ADT to be delivered by a daily oral treatment, pending...

integrative oncology

Integrating Physical Activity Into Cancer Care

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. Accumulating evidence suggests the benefits of physical activity through the cancer continuum....

covid-19

COVID-19 and Patients With Cancer: A Call to Action for Trainees

As oncology trainees, we develop skills to synthesize complex data and communicate this information with empathy as we accompany our patients through the trenches of a cancer diagnosis. With the current COVID-19 pandemic, an unprecedented layer of challenges has surfaced, as our patients who are...

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