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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...

lung cancer

Brigatinib for ALK-Positive Metastatic Non–Small Cell Lung Cancer

On May 22, 2020, brigatinib was approved for the treatment of adult patients with ALK-positive, metastatic non–small cell lung cancer (NSCLC), as detected by a U.S. Food and Drug Administration (FDA)-approved test.1,2 The FDA also approved the Vysis ALK Break Apart FISH Probe Kit as a companion...

hematologic malignancies
symptom management

Ruxolitinib Improves Response Rates in Glucocorticoid-Refractory Acute Graft-vs-Host Disease After Allogeneic SCT

In the phase III REACH2 trial reported in TheNew England Journal of Medicine, Robert Zeiser, MD, of the Department of Hematology, Oncology, and Stem Cell Transplantation, University Medical Center Freiburg, Germany, and colleagues found that the JAK1/2 inhibitor ruxolitinib improved response rate...

breast cancer

Improving Care for Women With Late-Stage Breast Cancer

The global toll of breast cancer on women is staggering. In 2018, nearly two million new breast cancer cases were diagnosed, an increase of more than 20% since 2008,1 and mortality rates have increased by 14%, bringing the annual number of deaths worldwide from the cancer to more than 611,625.2...

prostate cancer

Olaparib for Homologous Recombination Repair Gene-Mutated Metastatic Castration-Resistant Prostate Cancer

On May 19, 2020, olaparib was approved for the treatment of adult patients with deleterious or suspected deleterious germline or somatic homologous recombination repair (HRR) gene-mutated metastatic castration-resistant prostate cancer who experienced disease progression after treatment with...

breast cancer

Newer Late-Line Treatments May Change Front-Line Standard of Care in HER2-Positive Metastatic Breast Cancer

First- and second-line treatments of HER2-positive metastatic breast cancer have become the standard of care based on solid gains in overall survival, but the prevalence of resistance to these agents is increasing; up to 55% of patients will ultimately develop brain metastases. According to a pair...

colorectal cancer
immunotherapy

Trastuzumab Deruxtecan Shows Benefit in Refractory Colorectal Cancer

Having recently gained approval in metastatic breast cancer, fam-trastuzumab deruxtecan-nxki (T-DXd) is now proving its worth in metastatic colorectal cancer, according to results of the phase II DESTINY-CRC01 study in patients with HER2-positive disease.1 T-DXd is an antibody-drug conjugate...

lung cancer

Positive Findings in NSCLC for First-Line Nivolumab Plus Ipilimumab With or Without Chemotherapy

It is becoming more challenging to select first-line therapy for advanced non–small cell lung cancer (NSCLC) for patients whose tumors have no EGFR or ALK alterations. The results of two different studies presented at the ASCO20 Virtual Scientific Program—CheckMate 227 and CheckMate 9LA—support the ...

gynecologic cancers

Breastfeeding: A Public Health Strategy for Reducing Risk of Ovarian Cancer

Although early-stage disease is highly curable, most ovarian cancers are diagnosed at later stages due to a lack of effective screening. As a result, less than 50% of women survive beyond 5 years. Improving prevention by identifying modifiable risk factors could dramatically change the outcome of...

gynecologic cancers

Veliparib Plus Chemotherapy Shows Antitumor Activity in Front-Line Treatment of 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

Niraparib for First-Line Maintenance Treatment of Advanced Ovarian Cancer

On April 29, 2020, niraparib was approved for maintenance treatment of adult patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to first-line platinum-based chemotherapy.1,2 Supporting Efficacy Data Approval was based on...

gynecologic cancers

Expert Point of View: Thomas J. Herzog, MD, and Kathleen N. Moore, MD

Thomas J. Herzog, MD, Deputy Director, University of Cincinnati Cancer Center, who presented a distillation of the PAOLA-1 trial findings along with updated results of the PRIMA trial, called the difference in progression-free survival with the addition of olaparib to bevacizumab “remarkable” after ...

breast cancer

Talazoparib Yields No Overall Survival Benefit in EMBRACA Trial Update

The poly (ADP-ribose) polymerase inhibitor talazoparib did not improve overall survival in women with metastatic HER2-negative breast cancer and mutations in the BRCA1 and BRCA2 genes, according to new results from the phase III EMBRACA trial presented at the 2020 American Association for Cancer...

Staying Alert to Lingering Cognitive Impairment With Adjuvant Therapy for Early Breast Cancer

Long-term cancer-related cognitive impairment reported among women with early breast cancer receiving adjuvant endocrine therapy with or without chemotherapy “should alert clinicians to the importance of ongoing symptom monitoring among this large population of cancer survivors who receive at least ...

breast cancer

Cognitive Impairment in Women Treated for Early Breast Cancer: Chemoendocrine Adjuvant Therapy vs Endocrine Therapy Alone

Women with early-stage breast cancer who received adjuvant chemoendocrine therapy reported greater cognitive impairment at 3 and 6 months than women receiving adjuvant endocrine therapy alone, according to the results from a subgroup of women participating in the TAILORx trial.1 By 12 months, the...

leukemia

Ibrutinib in Combination With Rituximab in Chronic Lymphocytic Leukemia

On April 21, 2020, ibrutinib was granted an expanded indication for use in combination with rituximab for the initial treatment of adult patients with chronic lymphocytic leukemia (CLL) or small lymphocytic lymphoma (SLL).1,2 The recommended dosage of ibrutinib in CLL/SLL is 420 mg, once daily,...

hematologic malignancies
covid-19

Cancer and COVID-19: Considerations About Neutropenia, Anemia, and Thrombocytopenia

GUEST EDITORS Dr. Abutalib is Associate Director of the Hematology and Cellular Therapy Program and Director of the Clinical Apheresis Program at Cancer Treatment Centers of America, Zion, Illinois; Associate Professor at the Roseland Franklin University of Medicine and Science; and Founder and...

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...

gynecologic cancers

Olaparib Plus Bevacizumab in Maintenance Treatment for Ovarian, Fallopian Tube, or Primary Peritoneal Cancers

On May 8, 2020, olaparib was granted an expanded indication to include use in combination with bevacizumab for first-line maintenance treatment of adult patients with advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer who are in complete or partial response to first-line...

breast cancer

Sacituzumab Govitecan-hziy for Previously Treated Metastatic Triple-Negative Breast Cancer

On April 22, 2020, the antibody-drug conjugate sacituzumab govitecan-hziy was granted accelerated approval for treatment of adult patients with metastatic triple-negative breast cancer who have received at least two prior therapies for metastatic disease.1,2 Supporting Efficacy Data Approval was...

prostate cancer

PSA Level Prior to Salvage Radiotherapy: Tailoring Delivery of ADT to Men With Prostate Cancer Most Likely to Benefit

In a recent article in JAMA Oncology, reviewed in this issue of The ASCO Post, Dess et al present an important analysis to help guide decision-making in the setting of salvage radiotherapy in prostate cancer.1 This secondary analysis assessed the association of prostate-specific antigen (PSA)...

multiple myeloma

Addition of CD38-Directed Antibody Isatuximab to Multiple Myeloma Armamentarium

The treatment approaches to multiple myeloma have significantly changed over the past decade with the introduction of many new active agents. Among them, the monoclonal antibodies have been one of the most exciting advances in myeloma, complementing their success in other hematologic cancers. In...

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 show 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...

lymphoma

Lymphoma: Many Questions, Too Few Answers

The successful treatment of malignant lymphoma has been one of the great achievements in medical oncology, but certainly more work is needed to define key biologic targets as well as molecular markers for a more accurate definition of prognosis following therapy. In day-to-day practice, unanswered...

integrative oncology

Sleeping Well After Cancer: Patient-Centered Research for Treatment of Insomnia

Insomnia is a persistent sleep disorder that affects nearly 60% of people with cancer, diminishing their quality of life.1,2 Chronic insomnia disorder is defined by trouble falling asleep, staying asleep, or waking too early three times per week for 3 months or more.3 Standard care comprises...

covid-19

Is Estrogen Protective Against COVID-19?

Reports suggest that the severity of coronavirus infection may be significantly more pronounced in men than in women.1 Studies have demonstrated that estrogen reduces both influenza virus replication in human female nasal epithelial cells2 and moderates the cytokine storm in murine models of this...

cns cancers

Despites Advances, Treatment-Related Sequelae Remain Problematic in Pediatric Neuro-oncology

The management of pediatric brain and spinal cord tumors is extremely complex, as are the survivorship issues in this highly vulnerable patient population. To shed light on the current clinical reality in this setting, The ASCO Post recently spoke with Katherine E. Warren, MD, an internationally...

breast cancer

Tucatinib in Previously Treated HER2-Positive Metastatic Breast Cancer

On April 17, 2020, tucatinib was approved for use in combination with trastuzumab and capecitabine for treatment of adult patients with advanced unresectable or metastatic HER2-positive breast cancer. These patients included those with brain metastases and those who have received one or more prior...

myelodysplastic syndromes

Luspatercept-aamt for Anemia in Adults With Myelodysplastic Syndromes

On April 3, 2020, luspatercept-aamt was approved in the treatment of anemia failing to respond to an erythropoiesis-stimulating agent and requiring 2 or more red blood cell (RBC) units over 8 weeks.1,2 The treatment is geared toward adult patients with very low– to intermediate-risk myelodysplastic ...

solid tumors

Selumetinib for Pediatric Neurofibromatosis Type 1 With Symptomatic, Inoperable Plexiform Neurofibromas

On April 10, 2020, the oral MEK inhibitor selumetinib was approved for the treatment of patients 2 years of age and older with neurofibromatosis type 1 (NF1) who have symptomatic, inoperable plexiform neurofibromas.1,2 Selumetinib is the first therapy approved for children who have this disease....

integrative oncology

Yoga for Pediatric and Adolescent 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. Despite significant improvements reported in survival rates, symptom management in pediatric...

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