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issues in oncology

Balancing Harms and Benefits of Cancer Screening: The Debate Continues

Over the past several decades, widespread cancer screening has saved lives from various cancer types. However, despite advances in early-detection technologies, many cancers still remain undetected until they become symptomatic, conferring poor prognoses and outcomes. Moreover, some methods of...

leukemia

Inotuzumab Ozogamicin for Relapsed/Refractory B-Cell Precursor ALL

On August 17, 2017, inotuzumab ozogamicin (Besponsa) was approved for the treatment of adults with relapsed or refractory B-cell precursor acute lymphoblastic leukemia (ALL).1,2  Supporting Efficacy Data  APPROVAL WAS BASED on complete remission rates in the open-label phase III INO-VATE ALL...

issues in oncology

Duration Studies in Oncology Have Often Been Poorly Designed and Analyzed

The ASCO Post is pleased to introduce “At Microphone 1,” an occasional column written by Steven E. Vogl, MD, of Bronx, New York. When he’s not in his clinic, Dr. Vogl can generally be found at major oncology meetings, and often at the microphone where he stands ready with important questions for...

skin cancer

No Improvement in Melanoma-Specific Survival With Completion Dissection vs Observation for Sentinel-Node Metastasis

THE PHASE III MSLT- II TRIAL showed that completion dissection was not associated with improved melanoma-specific overall survival vs observation in patients with sentinel-node metastasis, although a benefit was observed in regional disease control. The findings were reported in The New England...

thyroid cancer
prostate cancer
lung cancer
survivorship
palliative care

News From JCO and JOP

STAYING UP-TO-DATE in the fast-paced world of oncology literature is a daunting task at best. To assist with that task, The ASCO Post has assembled an assortment of studies recently published in the Journal of Clinical Oncology (JCO) and the Journal of Oncology Practice (JOP). Future installments...

sarcoma

Sarcoma Management Is Slowly Evolving

THE BACKBONE treatment for soft-tissue sarcomas has long been anthracycline-based, but new approaches are coming. These novel strategies were discussed at the 2017 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia, by Melinda L. Yushak, MD, MPH, Assistant Professor ...

gastrointestinal cancer

Regorafenib in Hepatocellular Carcinoma Previously Treated With Sorafenib

On April 27, 2017, the indications for regorafenib (Stivarga) were expanded to include treatment of patients with hepatocellular carcinoma who have been previously treated with sorafenib (Nexavar).1,2 Supporting Efficacy Data The new approval was based on the finding of improved overall survival...

cns cancers

Small Steps Forward in Brain Tumor Therapy

SOME RECENT ADVANCES in the treatment of brain tumors are promising, but others are less so, according to Jeffrey J. Olson, MD, Professor of Neurosurgery at Emory University, Atlanta. At the 2017 Debates and Didactics in Hematology and Oncology Conference, held in Sea Island, Georgia, and...

skin cancer

Is Complete Lymphadenectomy Still Standard of Care in Melanoma?

DOES COMPLETE lymph node dissection for sentinel node–positive melanoma still have a role in the management of this disease? That’s debatable. Although it does not improve overall survival over observation alone, complete lymphadenectomy may have other benefits, according to a dialogue at the...

gynecologic cancers

Update on Nonimmunotherapy Advances in Endometrial, Cervical, and Ovarian Cancers

AT THE 12TH ANNUAL New Orleans Summer Cancer Meeting, Thomas Herzog, MD, Deputy Director of the University of Cincinnati Cancer Institute and Professor of the Division of Gynecologic Oncology at the University of Cincinnati College of Medicine, delivered an update on nonimmunotherapy advances in...

lung cancer

Expert Point of View: Johan Vansteenkiste, MD, PhD

FORMAL DISCUSSANT of this trial, Johan Vansteenkiste, MD, PhD, Head of the Respiratory Oncology Unit at the University Hospital KU Leuven, Belgium, was enthusiastic about the PACIFIC trial results. “We had an earthquake of immunotherapy in lung cancer this past year at ESMO. After an earthquake,...

lung cancer

PD-L1 Inhibitor Consolidation Therapy for NSCLC: New Standard of Care?

THE PROGRAMMED CELL DEATH ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) improved progression-free survival by 11.2 months compared with placebo in patients with locally advanced, unresectable stage III non–small cell lung cancer (NSCLC) whose disease did not progress following standard treatment ...

hematologic malignancies
lymphoma

New Response Evaluation Criteria for Lymphoma Clinical Trials: RECIL 2017

New criteria for evaluating response in lymphoma clinical trials—RECIL 2017—have been developed by an International Working Group with the aim of harmonizing criteria with the RECIST criteria used for solid tumors.1 The new criteria were reported by Anas Younes, MD, of Memorial Sloan Kettering...

hepatobiliary cancer

Hepatocellular Carcinoma: Current Thoughts on Liver Transplantation

LIVER TRANSPLANT offers the highest rates of long-term survival for patients with hepatocellular carcinoma, according to Maria Russell, MD, Assistant Professor of Surgery at Emory University, Atlanta. At the 2017 Debates and Didactics in Hematology and Oncology Conference at Sea Island, Georgia,...

breast cancer

Religiously Tailored Educational Intervention to Encourage Mammography in American Muslim Women

Despite the U.S. Preventive Services Task Force recommendation that women between the ages of 50 and 74 undergo mammography every 2 years, only about 50% of American Muslim women do so, compared with 67% of all American women. A study by Padela et al investigating the mammography-related barrier...

skin cancer

Significant Improvement in Outcomes Reported With Adjuvant Therapy for Melanoma

FOR PATIENTS with malignant melanoma, the significant improvement in outcomes with targeted agents and antibodies against the programmed cell death protein 1 (PD-1) has now been observed in the adjuvant setting. Two landmark studies presented at the European Society for Medical Oncology (ESMO) 2017 ...

issues in oncology

Adoptive Cell Therapy—Act 1: The Beginning

ON AUGUST 30, 2017, the first genetically engineered T-cell therapy (tisagenlecleucel [Kymriah]) was approved by the U.S. Food and Drug Administration (FDA) for the treatment of patients up to 25 years of age with B-cell precursor acute lymphoblastic leukemia that is refractory or in second or...

supportive care
symptom management

Tibetan Yoga Practice May Improve Sleep Quality for Patients With Breast Cancer Undergoing Chemotherapy

Participating in twice-weekly practice of Tibetan yoga may reduce sleep disturbances and improve sleep quality in breast cancer patients receiving chemotherapy, according to a study published by Chaoul et al in Cancer. The study, led by researchers from The University of Texas MD Anderson Cancer...

breast cancer

Surgeon-Initiated Gene-Expression Profile Testing in Early-Stage Breast Cancer and Time to Start of Chemotherapy

In a single-center study reported in the Journal of Oncology Practice, Losk et al found that an intervention including surgeon initiation of gene-expression profile testing with Oncotype DX significantly reduced the time to testing, receipt of testing results, and initiation of chemotherapy in...

skin cancer

Overall Survival With Nivolumab/Ipilimumab, or Nivolumab Alone, vs Ipilimumab in Advanced Melanoma

Overall survival outcomes in the phase III CheckMate 067 trial indicate improved survival with nivolumab (Opdivo)/ipilimumab (Yervoy) vs ipilimumab and with nivolumab vs ipilimumab in patients with previously untreated advanced melanoma. These findings were reported in The New England Journal of...

gynecologic cancers

Final Efficacy Analysis of 9-Valent Human Papillomavirus Vaccine Trial

The final efficacy analysis of a trial of 9-valent human papillomavirus (HPV) vaccine has shown a high preventive effect against disease due to the additional HPV pathogenic strains covered compared with the quadrivalent vaccine at up to 6 years. These findings were reported by Huh et al in The...

leukemia

Combination of Inotuzumab Ozogamicin and Low-Intensity Chemotherapy in Relapsed or Refractory Ph-Negative ALL

In a single-center phase II trial reported in JAMA Oncology, Jabbour et al found that the combination of inotuzumab ozogamicin (Besponsa) and low-intensity chemotherapy produced promising results in patients with relapsed or refractory Philadelphia chromosome (Ph)-negative acute lymphoblastic...

issues in oncology
symptom management

Assessing and Managing CAR T-Cell Treatment Toxicities

Immune-cell based therapies opening a new frontier for cancer treatment carry unique, potentially lethal side effects that provide a new challenge for oncologists—one addressed by a team led by clinicians at The University of Texas MD Anderson Cancer Center with proposed guidelines for...

lymphoma

Addition of Bortezomib to R-CHOP in Non–Germinal Center B-Cell–Like Lymphoma

A phase II trial reported in the Journal of Clinical Oncology by Leonard et al showed no significant progression-free survival benefit of adding bortezomib (Velcade) to R-CHOP (rituximab [Rituxan], cyclophosphamide, doxorubicin, vincristine, and prednisone) in previously untreated patients with...

sarcoma

First-Line Gemcitabine/Docetaxel vs Doxorubicin in Advanced Soft-Tissue Sarcoma

In the UK-Swiss phase III GeDDiS trial, the combination of gemcitabine and docetaxel did not significantly improve progression-free survival vs doxorubicin in first-line treatment of locally advanced or metastatic soft-tissue sarcoma. Findings were reported in The Lancet Oncology by Seddon et al....

bladder cancer

ESMO 2017: KEYNOTE-045: Updated Results Support Pembrolizumab as Second-Line Treatment in Advanced Urothelial Cancer

Mature results from the KEYNOTE-045 trial presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract LBA37_PR) confirmed significantly longer survival in patients with advanced urothelial cancer who received the checkpoint inhibitor pembrolizumab after initial...

issues in oncology

ESMO 2017: Patients Struggle With Key Aspects of Clinical Trial Methodology

Clinical trials are fundamental to the development of new treatments for cancer, yet the annual accrual to cancer clinical trials worldwide is low, estimated at 3%–5%. A nationwide study in Ireland, the preliminary results of which were presented at the European Society for Medical Oncology...

breast cancer

ESMO 2017: MONARCH 3: Abemaciclib as Initial Therapy Improves Outcome in Endocrine-Sensitive Advanced Breast Cancer

The results of the MONARCH 3 trial, presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract 236O_PR), showed that adding the cyclin-dependent kinase (CDK) 4/6 inhibitor abemaciclib to endocrine therapy improved progression-free survival compared to endocrine...

bladder cancer

Recombinant Adenovirus Interferon-α With Syn3 in BCG-Refractory or Relapsed Non–Muscle Invasive Bladder Cancer

A phase II study has shown activity of recombinant adenovirus interferon-α with Syn3 (rAd-IFNα/Syn3), a replication-deficient recombinant adenovirus gene transfer vector, in patients with high-grade bacillus Calmette-Guerin (BCG)-refractory or -relapsed non–muscle invasive bladder ...

lung cancer

Osimertinib in First-Line Treatment of EGFR Mutation–Positive Advanced NSCLC

Osimertinib (Tagrisso) has shown high activity in the phase I expansion component of the AURA trial in previously untreated patients with EGFR mutation–positive advanced non–small cell lung cancer (NSCLC). These findings were reported by Ramalingam et al in the Journal of Clinical...

lung cancer

ESMO 2017: PACIFIC Trial: Durvalumab Improves Progression-Free Survival in Stage III Lung Cancer

Durvalumab improves progression-free survival in patients with locally advanced, unresectable stage III lung cancer, according to late-breaking results from the phase III PACIFIC trial presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract LBA1_PR) and...

gastrointestinal cancer

ESMO 2017: Pembrolizumab Shows Promising Response Rate in Pretreated Metastatic Gastric Cancer

Pembrolizumab (Keytruda) has shown a promising response rate in patients with pretreated metastatic gastric cancer, according to late-breaking results from the KEYNOTE-059 trial presented at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid (Abstract LBA28_PR). The expected...

sarcoma

Eribulin vs Dacarbazine in Advanced Liposarcoma Subgroup

The subgroup analysis of outcomes among patients with advanced liposarcoma from a pivotal phase III trial comparing eribulin (Halaven) vs dacarbazine in previously treated liposarcoma or leiomyosarcoma was reported in the Journal of Clinical Oncology by Demetri et al. Overall, the phase III trial...

head and neck cancer

Pembrolizumab in PD-L1–Positive Nasopharyngeal Carcinoma

As reported by Hsu et al in the Journal of Clinical Oncology, pembrolizumab (Keytruda) has shown activity in programmed cell death ligand 1 (PD-L1)–positive recurrent or metastatic nasopharyngeal carcinoma, in a cohort of the phase Ib KEYNOTE-028 trial. Study Details In the study, 27...

breast cancer

First-in-Human Study of Tamoxifen Metabolite Z-Endoxifen in Endocrine-Refractory Metastatic Breast Cancer

A first-in-human phase I study of the oral tamoxifen metabolite Z-endoxifen showed high drug exposure, acceptable toxicity, and antitumor activity in endocrine-refractory estrogen receptor–positive metastatic breast cancer. The findings were reported in the Journal of Clinical Oncology by...

breast cancer

ESMO 2017: Adding Taselisib to Neoadjuvant Letrozole Improves Outcomes in Early Breast Cancer

Adding taselisib to letrozole before surgery significantly improved outcomes for patients with early breast cancer that was both estrogen receptor–positive and HER2-negative, according to results of the LORELEI trial, presented at the European Society for Medical Oncology (ESMO) 2017 Congress ...

prostate cancer

ESMO 2017: Patients With High-Risk Prostate Cancer May Benefit From Addition of Docetaxel or Abiraterone/Prednisolone to Long-Term Hormone Therapy

Patients with high-risk prostate cancer starting long-term hormone therapy may benefit from two new treatments, according to late-breaking results from the STAMPEDE trial presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (LBA31_PR). Long-term hormone therapy...

skin cancer

ESMO 2017: Combination Targeted Adjuvant Therapy Doubles Relapse-Free Survival in Stage III Melanoma

Combination targeted adjuvant therapy with dabrafenib (Tafinlar) and trametinib (Mekinist) doubles relapse-free survival in patients with stage III BRAF-mutant melanoma, according to late-breaking results from the COMBI-AD trial presented on September 11 at the European Society for Medical Oncology ...

skin cancer

ESMO 2017: Adjuvant Nivolumab Superior to Ipilimumab in Surgically Resected Stage III/IV Melanoma

Adjuvant nivolumab (Opdivo) is superior to standard-of-care ipilimumab (Yervoy) in patients with surgically resected stage III/IV melanoma who are at high risk of relapse, according to late-breaking results from the CheckMate 238 trial presented on September 11 at the European Society for Medical...

colorectal cancer

Remnant Liver Ischemia and Cancer-Specific Survival After Resection of Colorectal Liver Metastases

In a single-center experience reported by Yamashita et al in JAMA Surgery, postoperative remnant liver ischemia of grade ≥ 2 was associated with worse cancer-specific survival after resection of colorectal liver metastases. Study Details The retrospective analysis included 202 patients who...

lung cancer

Adding First-Line Ipilimumab to Paclitaxel/Carboplatin in Advanced Squamous NSCLC

In a phase III trial reported by Govindan et al in the Journal of Clinical Oncology, the addition of first-line ipilimumab (Yervoy) to paclitaxel/carboplatin did not improve overall survival in patients with advanced squamous non–small cell lung cancer (NSCLC). Study Details In the...

gynecologic cancers

ESMO 2017: Rucaparib Boosts Progression-Free Survival in BRCA-Mutant Recurrent Ovarian Cancer

Rucaparib (Rubraca) maintenance therapy increases progression-free survival in BRCA-mutant recurrent ovarian cancer by 77%, according to late-breaking results from the ARIEL3 trial reported at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract LBA40_PR). Most...

gastroesophageal cancer

ESMO 2017: MIRO Trial: 3-Year Outcomes Favor Laparoscopic Surgery for Esophageal Cancer

Patients requiring surgery for esophageal cancer fare better after undergoing a hybrid minimally invasive esophagostomy compared to an open esophagostomy, according to long-term results of the MIRO trial presented at the European Society for Medical Oncology (ESMO) 2017 Congress in Madrid (Abstract ...

gynecologic cancers

ESMO 2017: ICON8 Trial Reaffirms Standard Chemotherapy Dosing in Ovarian Cancer

Caucasian women with ovarian cancer can safely stick to the standard every-3-week dosing schedule for paclitaxel rather than boosting up to a weekly dose-dense regimen, according to results of the phase III ICON8 trial presented at the European Society for Medical Oncology (ESMO) 2017 Congress in...

head and neck cancer

Cabozantinib Salvage Therapy in Tyrosine Kinase Inhibitor–Refractory Differentiated Thyroid Cancer

A phase II study has shown that cabozantinib (Cometriq) produces responses in patients with tyrosine kinase inhibitor–refractory differentiated thyroid cancer. The findings were reported by Cabanillas et al in the Journal of Clinical Oncology. MET plays a role in vascular endothelial growth...

lung cancer

ESMO 2017: Phase III IFCT-0302 Trial Assesses Minimal vs CT Scan–Based Follow-up for Completely Resected NSCLC

The optimal follow-up protocol for patients with completely resected non–small cell lung cancer (NSCLC) remains elusive after results of the IFCT-0302 trial, presented at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid, did not show a difference in overall survival...

breast cancer

ESMO 2017: MINDACT Study in Early-Stage Breast Cancer Shows Even Small Tumors Can Be Aggressive

Even small tumors in the breast can be aggressive, according to a study in patients with early-stage breast cancer presented at the 2017 European Society for Medical Oncology (ESMO) Congress in Madrid (Abstract 150O_PR). Researchers found that 24% of small tumors were aggressive, and patients...

leukemia

Guadecitabine in Treatment-Naive Older Patients With Acute Myeloid Leukemia

The results of a phase II trial have shown high activity of guadecitabine, a next-generation hypomethylating drug, in treatment-naive older patients with acute myeloid leukemia. The findings were reported in The Lancet Oncology by Kantarjian et al. Guadecitabine has a longer half-life and exposure...

global cancer care

Conquer Cancer Foundation and ASCO International Development and Education Award

Applications Being Accepted Through October 31, 2017  THE INTERNATIONAL DEVELOPMENT AND EDUCATION AWARD (IDEA) provides support for early-career oncologists in low-and middle-income countries and facilitates the sharing of knowledge between these oncologists and ASCO members. The program pairs IDEA ...

cns cancers

Dinutuximab vs Temsirolimus in Combination Therapy for Children With Resistant Neuroblastoma

A randomized phase II trial (Children’s Oncology Group [COG] ANBL1221) has resulted in the selection of dinutuximab (Unituxin) plus irinotecan/temozolomide as a regimen to be further evaluated in the treatment of pediatric patients with refractory or relapsed neuroblastoma. Study results were...

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