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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...

colorectal cancer
immunotherapy

Encorafenib Combined With Cetuximab in Previously Treated BRAF V600E–Mutant Metastatic Colorectal Cancer

On April 8, 2020, encorafenib was approved for use in combination with cetuximab for the treatment of previously treated adult patients with metastatic colorectal cancer with a BRAF V600E mutation detected by a U.S. Food and Drug Administration (FDA)-approved test.1,2 Encorafenib is not indicated...

issues in oncology

Understanding Patient-Reported Outcomes in Cancer Trials: A Beginner’s Guide

Patient-reported outcomes are measures used in clinical trials to capture aspects of a patient’s health condition, reported directly by the patient, without introduction of bias from third parties. They are distinct from the physical toxicities reported by clinicians1 and are collected using a...

breast cancer
immunotherapy

KEYNOTE-522: A Biomarker Resource for PD-1 Inhibition in Early Triple-Negative Breast Cancer

In the phase III KEYNOTE-522 trial reported in The New England Journal of Medicine and reviewed in this issue of The ASCO Post, Schmid et al1 found that the addition of pembrolizumab to neoadjuvant chemotherapy in stage II or III triple-negative breast cancer significantly improved the pathologic...

breast cancer
immunotherapy

Neoadjuvant and Adjuvant Pembrolizumab Improves Outcomes in Early Triple-Negative Breast Cancer

As reported in The New England Journal of Medicine by Peter Schmid, MD, PhD, of Barts Cancer Institute, Queen Mary University of London, and colleagues, analyses in the phase III KEYNOTE-522 trial have shown that the addition of pembrolizumab to neoadjuvant chemotherapy and the use of adjuvant...

gynecologic cancers

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

As reported in The New England Journal of Medicine by Isabelle Ray‑Coquard, MD, PhD, of the Centre Leon 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...

sarcoma
skin cancer
cns cancers

Early Signs of Activity With Immunotherapies in Low-Incidence Cancers

Immunotherapy is showing promise for patients with rare cancers, offering new treatment opportunities and clinical trials to those with previously limited options. At the 2020 ASCO-SITC Clinical Immuno-Oncology Symposium, presenters discussed the use of immunotherapy in three low-incidence cancers: ...

gynecologic cancers

PARP Inhibitors in Maintenance Treatment for Advanced Ovarian Cancer

Based on multiple phase III prospective trials, there is evidence that both 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 218, ICON7, SOLO-1, PRIMA,...

gynecologic cancers

Advanced Ovarian Cancer: Use of Neoadjuvant Chemotherapy Increasing Along With Survival

The use of neoadjuvant chemotherapy for advanced ovarian cancer may not have the negative impact on survival feared by many gynecologic oncologists. In fact, according to a pair of studies that were to have been presented at the Society of Gynecologic Oncology (SGO) 2020 Annual Meeting on Women’s...

colorectal cancer
covid-19

Treating Colorectal Cancer in the Time of COVID-19

The treatment of colorectal cancer has always been something of an art—but never more so than during the COVID-19 pandemic. The ASCO Post asked three experts in this malignancy to share their concerns and their approaches to achieving good patient outcomes while minimizing the risk of COVID-19...

covid-19

Hypercoagulability in Critically Ill Patients With COVID-19: Where Do We Stand?

“Life is short, art long, opportunity fleeting, experience treacherous, judgment difficult.” ―Hippocrates 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 and Connors...

Adapting Adjuvant Endocrine Therapy by Patient Age and Risk

The individualization and optimization of adjuvant endocrine therapy for breast cancer are important and not always simple. Guidance on this issue was offered at the 2020 Miami Breast Cancer Conference by Joyce O’Shaughnessy, MD, the Celebrating Woman Chair in Breast Cancer Research at Baylor...

immunotherapy
solid tumors

PD-1 Inhibition in Mismatch Repair–Deficient/Microsatellite Instability–High Cancers Other Than Colorectal Cancer

Mismatch repair (MMR)-deficiency and consequently high DNA microsatellite instability (MSI-H) are associated with high tumor mutational burden. A high mutational load increases the potential number of neoantigens that can be presented by the tumor cell and recognized by host lymphocytes. Detection...

hematologic malignancies

Gut Bacterial Diversity: A Marker or Driver of Outcomes After Hematopoietic Cell Transplantation?

Previous single-center studies have linked the gut microbiota (via stool sample analysis) to outcomes after hematopoietic cell transplantation (HCT), such as overall mortality, transplant-related mortality, graft-vs-host disease, and graft-vs-host–related mortality.1-4 Although intriguing, these...

genomics/genetics

How CRISPR-Cas9 Gene Editing May Improve the Effectiveness of Cellular Therapeutics in Patients With Cancer

The results from the first in-human phase I clinical trial in the United States evaluating CRISPR-Cas9–edited T cells in patients with advanced cancer has shown that the therapy is both feasible and safe, representing a big step forward in the potential of using gene editing to boost the natural...

breast cancer

Beyond CDK4/6 Inhibitors: What Subsequent Treatment Is Best?

Inhibitors of cyclin-dependent kinases 4 and 6 (CDK4/6) have changed the natural history of hormone receptor–positive metastatic breast cancer. While median progression-free survival on these drugs is approximately 27 months, the disease eventually progresses and clinicians must choose a subsequent ...

breast cancer

More Antibody-Drug Conjugates on the Horizon for Breast Cancer

Novel antibody-drug conjugates that target actionable cell-surface markers in metastatic breast cancer will soon expand the utility of the class that already includes ado-trastuzumab emtansine (T-DM1), according to two speakers at the 2020 Miami Breast Cancer Conference. These new agents were...

immunotherapy
breast cancer
skin cancer
lung cancer

What’s the Current Status of Neoadjuvant Immunotherapy?

For several tumor types, can the successes achieved with immunotherapy in the metastatic and adjuvant settings be replicated in the neoadjuvant setting? An explosion in clinical trials—with more than 300 listed on ClinicalTrials.gov—point to “yes.” “The neoadjuvant use of immunotherapy is of great ...

prostate cancer

Upfront Apalutamide Delays Time to Second Progression in Metastatic Castration-Sensitive Prostate Cancer

The addition of apalutamide to androgen-deprivation therapy (ADT) reduced the risk of second disease progression or death (PFS2) by 34% vs ADT alone in patients with metastatic castration-sensitive prostate cancer, in a post hoc analysis of the phase III TITAN trial presented at the 2020...

Merry-Jennifer Markham, MD, FACP, FASCO, Rose From Humble Beginnings to a Leadership Role in Oncology

Merry-Jennifer Markham, MD, FACP, FASCO, grew up in Fort White, Florida, a rural speck on the map in the northern part of the state. Fort White is home to the Ichetucknee River and Springs, a crystal-clear natural wonder known only to the locals until 1972, when it was declared a National Natural...

hematologic malignancies

Intestinal Microbiota and Mortality in Recipients of Allogeneic Hematopoietic Cell Transplantation

In a study reported in The New England Journal of Medicine, Jonathan U. Peled, MD, PhD, of the Adult Bone Marrow Transplantation Service, Memorial Sloan Kettering Cancer Center (MSK), New York, and colleagues found that intestinal microbiota from patients undergoing allogeneic hematopoietic cell...

EXPECT INTEREST AND QUESTIONS ABOUT STATINS AND METFORMIN

A study showing that statins used alone or in combination with metformin was associated with reduced prostate cancer mortality and all-cause mortality among men with high-risk prostate cancer may raise more questions about these already commonly used drugs.1 “Metformin is the first-line therapy for ...

prostate cancer

Statins With or Without Metformin Are Associated With Increased Survival in Patients With High‑Risk Prostate Cancer

A population-based retrospective cohort study involving 12,700 patients found that men with high-risk prostate cancer who took a statin alone or in combination with metformin had reduced all-cause and prostate cancer–specific mortality. The associations between the medications and reduced...

lymphoma

Vitamin D and Lymphoma: An Apparent Benefit, but Further Study Required

Vitamin D is a steroid-like hormone involved primarily in human calcium homeostasis. Obtained through sun exposure as well as food and dietary supplements,1 vitamin D in humans is metabolized in the liver and kidneys to its active form, 1,25-dihydroxyvitamin D (1,25[OH]2D).2 Other cell types,...

integrative oncology
covid-19

Mind-Body Therapies for Relieving Anxiety and Stress in Patients With Cancer During COVID-19 Pandemic

The rapid spread of the novel coronavirus disease (COVID-19) has dramatically disrupted societal life within a very short time. Patients with cancer in particular can be affected by delays in routine medical care in addition to experiencing heightened anxiety and stress associated with the threat...

integrative oncology
covid-19

Online Mind-Body Resources for Oncologists and Health-Care Workers During the COVID-19 Pandemic

The spread of COVID-19 continues to have a dramatic impact around the world, disrupting social lives and the delivery of oncologic treatments to patients with cancer. Even under “normal” circumstances, health-care professionals, including those in oncology, are prone to occupational stress....

breast cancer
immunotherapy

Updates From Selected Clinical Trials in Breast Cancer

Each year, The ASCO Post asks Jame Abraham, MD, FACP, Chairman of the Department of Hematology and Medical Oncology at Taussig Cancer Institute and Professor of Medicine at the Cleveland Clinic Lerner College of Medicine, to offer his picks for the most important research presented at 2019 San...

breast cancer
immunotherapy

Immunotherapy ‘Comes of Age’ in Breast Cancer

Immunotherapeutics in breast cancer will likely not be limited to late-stage triple-negative breast cancer. Earlier lines, combination regimens, and expansion into different disease subtypes should become part of this emerging landscape, according to Hope S. Rugo, MD, FASCO, Professor of Medicine...

hematologic malignancies
immunotherapy

Bispecific Antibodies: Successes and Challenges

Bispecific T-cell engager (BiTE) antibodies, such blinatumomab, may be the most appealing type of bispecific antibodies, a class of manufactured constructs that is expected to expand into the solid tumor space, according to Hermann Einsele, MD, Professor of Medicine at the University of Würzburg,...

covid-19

The Blind Leading the Blind: COVID-19, Cancer, and the Need for More Data

In the novel Blindness, Portuguese author José Saramago describes an epidemic that quickly and inexorably causes nearly all inhabitants of an unnamed city to lose their sight. The Nobel Laureate writes in long uninterrupted sentences, making the reader experience the fears and anxieties of the...

leukemia
lymphoma

Selected ASH Abstracts on Chronic Lymphocytic Leukemia and Small Lymphocytic Lymphoma

ABSTRACT 355: MURANO study: Four-year analysis confirms sustained benefit (compared to bendamustine and rituximab; n = 195) of time-limited venetoclax/rituximab (n = 194) in relapsed or refractory chronic lymphocytic leukemia/small lymphocytic lymphoma (CLL/SLL; ClinicalTrials.gov NCT02005471)1...

issues in oncology

Cancer During Pregnancy: Whose Moral Compass to Follow?

As has often been written, “Cancer is the greatest equalizer.” It tends to strike its victims regardless of their financial status. In low- and middle-income countries, however, the impact of poverty on the treatment of cancer is strikingly conspicuous. It is the major catalyst for delay in seeking ...

issues in oncology
survivorship

How Exercise Oncology Can Improve Cancer Outcome and Survivorship

Researchers from the American College of Sports Medicine (ACSM) recently reviewed hundreds of epidemiologic studies on the link between physical activity and both cancer risk and cancer mortality. A subsequent analysis of the findings by a panel of experts representing 17 partner organizations,...

pancreatic cancer

Cisplatin/Gemcitabine Alone and With Veliparib in BRCA-Mutated Advanced Pancreatic Cancer

In patients with pancreatic ductal adenocarcinoma and a germline BRCA/PALB2 mutation, first-line therapy with cisplatin plus gemcitabine yielded high response rates and encouraging survival, according to Eileen M. O’Reilly, MD, of Memorial Sloan Kettering Cancer Center, who presented the findings...

pancreatic cancer

Maintenance Olaparib in BRCA1/2-Positive Pancreatic Cancer Yields Improved Progression-Free Survival, Preserves Quality of Life

Health-related quality of life was preserved during maintenance olaparib in patients with BRCA 1/2-positive pancreatic cancer, as evidenced by a low symptom burden over time.1 POLO investigators reported their findings in posters presented at the 2020 Gastrointestinal Cancers Symposium. Other...

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