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Chemotherapy for Acute Myeloid Leukemia: Where Should It Be Given?

USING THE National Cancer Database, Bhatt et al1 recently reported that of the 61,775 adults with acute myeloid leukemia (AML), those who received chemotherapy from 2003 to 2011 lived longer than those who, in those same years, did not; the study is reviewed in this issue of The ASCO Post....

skin cancer

No Improvement in Survival Reported With Epacadostat Plus Pembrolizumab in Advanced Melanoma

IN PATIENTS with unresectable or metastatic melanoma, adding epacadostat to pembrolizumab (Keytruda) did not result in greater clinical benefit over pembrolizumab alone, according to data from the phase III ECHO-301/KEYNOTE-252 study. These results were originally presented at the 2018 ASCO Annual...

hepatobiliary cancer
lung cancer
bladder cancer

Recent Drug Approvals and Revisions in Prescribing Information

THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) issued the following approvals and prescribing information revisions in August 2018. Lenvatinib Approved for Unresectable Hepatocellular Carcinoma THE FDA approved lenvatinib (Lenvima) for the first-line treatment of patients with unresectable...

head and neck cancer

Adding Nimotuzumab to Chemoradiation Improved Survival in Locally Advanced Head and Neck Cancer

IN PATIENTS with locally advanced squamous cell carcinoma of the head and neck, nimotuzumab—a humanized monoclonal antibody against the epidermal growth factor receptor—in combination with cisplatin and radiotherapy was superior to cisplatin and radiotherapy alone in improving progression-free...

lymphoma

Clarifying the Complexity of Genomic Testing in Non-Hodgkin Lymphoma

AS MORE is learned about the genomic landscape in non-Hodgkin lymphoma, clinicians are grappling with how to apply this information in the clinic. At the 2018 Pan Pacific Lymphoma Conference, Andrew D. Zelenetz, MD, PhD, helped them understand this emerging area.1 Dr. Zelenetz is Professor of...

lymphoma

Relapsed or Refractory Hodgkin Lymphoma: Optimizing Salvage Therapy

As novel therapies come on board for treating relapsed or refractory Hodgkin lymphoma, the field is advancing toward more personalized therapy. The goal, even in the advanced-disease setting, is to increase the chances of complete response and negative positron-emission tomography (PET), while...

breast cancer

Proteomics May Be Used to Predict Treatment Outcomes in Triple-Negative Breast Cancer

In triple-negative breast cancer, researchers have so far been unable to identify markers that can classify patients by prognosis or probability of responding to different treatments. In a study published by Zagorac et al in Nature Communications, researchers from the Spanish National Cancer...

solid tumors
lung cancer

FDA Grants Breakthrough Therapy Designation to LOXO-292 for Treatment of Lung and Thyroid Cancers

The U.S. Food and Drug Administration (FDA) recently granted Breakthrough Therapy designation to LOXO-292, a selective RET inhibitor, for: the treatment of patients with metastatic RET fusion–positive non–small cell lung cancer (NSCLC) who require systemic therapy and have had...

cns cancers
issues in oncology

Factors in Endocrine Deficiency in Pediatric and Young Adult Patients Receiving Radiotherapy for Brain Tumors

In a study reported in the Journal of Clinical Oncology, Vatner et al identified factors associated with an increased risk of endocrine deficiency in pediatric and young adult patients receiving radiation therapy for brain tumors, including hypothalamus and pituitary radiation dose. Study Details ...

sarcoma
immunotherapy

Immune Checkpoint Inhibitors in Patients With HIV-Associated Kaposi Sarcoma

Widespread use of antiretroviral therapy in the treatment of patients infected with human immunodeficiency virus (HIV) has led to a decline in the incidence of HIV-related Kaposi sarcoma, an incurable malignancy associated with HIV. Nevertheless, about 15% of these patients will go on to...

solid tumors
head and neck cancer

Every Day Is a Bonus

I have always been plagued with nagging headaches, so when they intensified in late 2010, I wasn’t too concerned. But when my eyes began involuntarily moving rapidly back and forth as I was writing Christmas cards, I knew the symptoms were a sign of something serious. A magnetic resonance imaging...

hematologic malignancies
leukemia

Outcomes After Discontinuation of Tyrosine Kinase Inhibitor Therapy in Chronic Myeloid Leukemia

In an interim analysis of a European trial reported in The Lancet Oncology, Francois-Xavier Mahon, MD, of Institut Bergonié, Bordeaux, and colleagues found that discontinuation of tyrosine kinase inhibitor therapy in patients with chronic myeloid leukemia (CML) with deep molecular response was...

solid tumors

PDL1 Amplification in Solid Tumors

In a study reported in JAMA Oncology, Aaron M. Goodman, MD, of the University of California, San Diego Moores Center for Personalized Cancer Therapy, and colleagues found amplification of PDL1 genes in 0.7% of solid tumors, including more than 100 tumor types. Response to checkpoint inhibition was ...

prostate cancer

Treating Nonmetastatic Castration-Resistant Prostate Cancer: Implications of the PROSPER Trial

A MAN in his early 70s sits in our office. His general health is good, and he is feeling well. Yet he is deeply worried. Four years ago, when his prostate-specific antigen (PSA) level rapidly increased after radical prostatectomy and subsequent radiation therapy, he was started on...

skin cancer

Overall Survival Improved With Encorafenib/Binimetinib Combination in BRAF-Mutant Melanoma

IN PATIENTS with advanced BRAF V600–mutant melanoma, combining the BRAF inhibitor encorafenib (Braftovi) with the MEK inhibitor binimetinib (Mektovi) improved overall survival compared to vemurafenib (Zelboraf) or encorafenib as monotherapy, with a favorable toxicity profile, according to updated...

issues in oncology

If It Isn’t Documented, Does It Count?

“The quality of mercy is not strained. It droppeth as the gentle rain from heaven Upon the place beneath.” —William Shakespeare THESE LINES from The Merchant of Venice suggest that mercy should be freely given. However, the metrics of quality is strained, pouring like a thunderous storm obscuring...

solid tumors

Trametinib Treatment for Histiocytic Sarcoma With Activating MAP2K1 Mutation

In a letter to the editor in The New England Journal of Medicine, Mrinal M. Gounder, MD, of Memorial Sloan Kettering Cancer Center, New York, and colleagues described the successful treatment of a patient with histiocytic sarcoma and an activating MAP2K1 (MEK1) mutation with the MAPK kinase 1 and...

head and neck cancer

Prediction of Survival and Disease Control in HPV-Negative Head and Neck Cancer Using Molecular Markers

A new method may predict the course of human papillomavirus (HPV)-negative head and neck cancer after radiochemotherapy. According to findings published by Hess et al in Clinical Cancer Research, five microRNAs (miRNAs) may be able to provide the decisive data. Squamous cell carcinomas of the head ...

hematologic malignancies
lymphoma

A Story of a Mother and Daughter and Cancer

BOOKMARK Title: The Cookie Cure: A Mother-Daughter Memoir of Cookies and CancerAuthors: Susan Stachler With Laura StachlerPublisher: SourcebooksPublication date: February 2018Price: $19.95, paperback, 320 pages Cancer memoirs vary in their voice and message. Some are slapstick humorous attempts to ...

colorectal cancer

Genetic Forecasting May Predict Response to Cetuximab in Colorectal Cancer

Blood tests could predict how long it takes until colorectal cancer becomes resistant to treatment based on the same principle used in forecasting the weather, a new study by Khan et al in Cancer Discovery has found. The liquid biopsies could also predict patients that are unlikely to initially...

leukemia

Comparison of Methotrexate Intensification Regimens in Children and Young Adults With T-Cell ALL

As reported by Winter et al in the Journal of Clinical Oncology, findings in the Children’s Oncology Group (COG) AALL0434 trial indicate improved outcomes with a COG methotrexate intensification regimen vs a high-dose methotrexate intensification regimen in children and young adults with...

breast cancer

Rates of Inherited Breast Cancer in Nigerian Women

In a study reported in the Journal of Clinical Oncology, Zheng et al found a high frequency of inherited breast cancer among Nigerian women, with presence of deleterious mutations posing very high risk of disease. As noted by the investigators, “…Among Nigerian women, breast cancer is ...

breast cancer

Ribociclib in Hormone Receptor–Positive, HER2-Negative Advanced Breast Cancer

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On July 18, 2018, the indication for ribociclib (Kisqali) ...

Love in the Time of Cancer

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

Improving the Lives of Patients With Cancer Is Richard L. Schilsky’s Lifelong Mission

In 2009, as Richard L. Schilsky, MD, FACP, FSCT, FASCO, was preparing his Presidential Address for that year’s ASCO Annual Meeting, he came across his 6th grade essay titled “My Ambition,” which foretold with eerie specificity the career path he would follow over the next 6 decades. In the paper,...

solid tumors
lung cancer

Active Surveillance of Lung Subsolid Nodules May Reduce Unnecessary Surgery and Overtreatment

Subsolid nodules can be considered a biomarker of lung cancer risk and should be managed with long-term active surveillance. Conservative management of subsolid nodules may reduce unnecessary surgery and overtreatment in patients with multiple comorbidities and aggressive lung cancer arising from...

cost of care

Patient-Reported Financial Sacrifice and Cancer Care

In a study reported in the Journal of Oncology Practice, Chino et al found that high proportions of insured patients with cancer—most with stage IV disease—reported being willing to make considerable personal and financial sacrifices to receive cancer care. The study included a...

lymphoma

Brentuximab Vedotin Plus Gemcitabine in Pediatric and Young Adult Patients With Relapsed/Refractory Hodgkin Lymphoma

In a Children’s Oncology Group phase I/II trial reported in The Lancet Oncology, Cole et al found that the combination of brentuximab vedotin (Adcetris) and gemcitabine was active in pediatric and young adult patients with relapsed or refractory Hodgkin lymphoma. As noted by the...

issues in oncology

Sex-Based Approaches to Oncology in the Era of Precision Oncology: Upcoming ESMO Workshop

Sex-based approaches to studying and treating disease have remained largely unexplored in medical oncology, despite the field’s growing interest in precision medicine and accumulating evidence that sex is a major factor in disease risk and response to treatment. At an upcoming European...

immunotherapy

Radiomic Signature for CD8 Cell Tumor Infiltration and Response to Treatment

In a study reported in The Lancet Oncology, Sun et al developed a radiomic signature of infiltrating CD8 cells that could identify tumor immune phenotype and help predict outcome of programmed cell death protein 1 (PD-1)/programmed cell death ligand 1 (PD-L1) inhibitor treatment. Study Details...

issues in oncology

Cancer May Be Linked to Poor Prognosis in Patients With Broken Heart Syndrome

Cancer may be linked to an increased risk of death and prehospitalization in patients with broken heart syndrome, according to research presented by Santoro et al at the 2018 European Society of Cardiology Congress. Study author Francesco Santoro, MD, of the University of Foggia, Italy, said, ...

hepatobiliary cancer

Nonalcoholic Fatty Liver Disease May Be Risk Factor for Liver Cancer

Nonalcoholic fatty liver disease is a common disease, and with the incidence of liver cancer rising across the country, little has been understood about the link between it and hepatocellular carcinoma. To establish a better understanding of the link between hepatocellular carcinoma risk and...

cns cancers
skin cancer
immunotherapy

Immunotherapy Combination in Melanoma Brain Metastases

In the phase II CheckMate 204 study reported in The New England Journal of Medicine, Tawbi et al found that combined nivolumab (Opdivo) and ipilimumab (Yervoy) produced a high rate of intracranial clinical benefit in patients with melanoma brain metastases. Study Details The study included 94...

prostate cancer

Hypofractionated Dose-Escalated IMRT vs Conventionally Fractionated IMRT in Localized Prostate Cancer

In a long-term follow-up of a phase III trial reported in the Journal of Clinical Oncology, Hoffman et al found that dose-escalated moderately hypofractionated intensity-modulated radiation therapy (HIMRT) improved disease control and reduced treatment duration vs conventionally fractionated IMRT...

gastroesophageal cancer
immunotherapy

Immunotherapy in Advanced Esophagogastric Cancer

As reported in the Journal of Clinical Oncology by Janjigian et al, the phase I/II CheckMate-032 study has shown activity of nivolumab (Opdivo) and nivolumab plus ipilimumab (Yervoy) in advanced esophagogastric cancer. In the esophagogastric cohort of the multicohort study, 160 patients (who...

gynecologic cancers

U.S. Preventive Services Task Force Recommendation Statement on Screening for Cervical Cancer

As reported in JAMA, the U.S. Preventive Services Task Force (USPSTF) has updated its 2012 recommendations on screening for cervical cancer. Key Recommendations The key USPSTF recommendations on screening are as follows: The USPSTF recommends screening for cervical cancer every 3 years with...

multiple myeloma
immunotherapy

FDA Accepts sBLA for Elotuzumab Plus Pomalidomide and Low-Dose Dexamethasone in Patients With Relapsed or Refractory Multiple Myeloma

The U.S. Food and Drug Administration (FDA) recently accepted a supplemental biologics license application (sBLA) for elotuzumab (Empliciti) in combination with pomalidomide (Pomalyst) and low-dose dexamethasone for the treatment of patients with relapsed or refractory multiple myeloma who...

lymphoma

ctDNA and Treatment Outcome in Diffuse Large B-Cell Lymphoma

In a study reported in the Journal of Clinical Oncology, Kurtz et al found that baseline circulating tumor DNA (ctDNA) and molecular response to treatment were independent predictors of treatment outcome in diffuse large B-cell lymphoma. Study Details The association of ctDNA with treatment...

leukemia
lymphoma
immunotherapy

CAR T-Cell Therapy in Europe: Differing Decisions on Approval of Two Agents

The European Commission (EC) recently approved the chimeric antigen receptor (CAR) T-cell therapy tisagenlecleucel (Kymriah) in the European Union (EU) for the treatment of pediatric and young adult patients up to 25 years of age with B-cell acute lymphoblastic leukemia (ALL) that is...

pancreatic cancer

Association of Immunologic Markers With Survival in Upfront Resectable Pancreatic Cancer

In a research letter published in JAMA Surgery, Tang et al found that higher levels of intratumoral CD3-positive T cells and postoperative circulating monocyte counts were associated with improved survival in patients with upfront resectable pancreatic ductal adenocarcinoma. The prospective cohort ...

breast cancer

EMBRACA Trial Compares Talazoparib vs Standard Therapy in Advanced Breast Cancer With a Germline BRCA Mutation

As reported in The New England Journal of Medicine by Litton et al, the phase III EMBRACA trial has shown significantly improved progression-free survival with the poly (ADP-ribose) polymerase inhibitor talazoparib vs physician choice of standard single-agent therapy in patients with advanced...

issues in oncology

New Software Aims to Predict Patients’ Resistance to Cancer Treatment

New computer software may be used to predict how cancers may respond to a new drug—before it has ever been given to patients. Researchers hope that this new tool could transform the discovery of cancer drugs by predicting how tumors become resistant to treatment before it first becomes...

prostate cancer

Early-Life Alcohol Intake May Increase the Odds of High-Grade Prostate Cancer Later in Life

Compared with nondrinkers, men who consumed at least 7 drinks per week during adolescence (ages 15–19) had 3 times the odds of being diagnosed with clinically significant prostate cancer, according to results published by Michael et al in Cancer Prevention Research. “The prostate...

cns cancers
issues in oncology

Memory Issues in Children With Medulloblastoma Undergoing Radiation Therapy

Children with certain types of brain tumors who undergo radiation treatment are less likely to recall the specifics of events they experienced after radiation than to remember pretreatment happenings, according to a Baylor University study comparing them to children with healthy brains. These...

lymphoma
skin cancer

Mogamulizumab vs Vorinostat in Previously Treated Cutaneous T-Cell Lymphoma

As reported by Kim and colleagues in The Lancet Oncology, the phase III MAVORIC trial showed that the anti-C-C chemokine receptor 4 (CCR4) monoclonal antibody mogamulizumab (Poteligeo) significantly improved progression-free survival vs vorinostat (Zolinza) among patients with previously treated...

issues in oncology

Most Oncologists Have Discussed Medical Marijuana With Patients, Survey Finds

DATA FROM a new survey show that as many as 80% of oncologists have discussed medical marijuana use with their patients. According to the authors, this is the first nationally representative survey to examine oncologists’ practices and beliefs on the subject since the implementation of state...

skin cancer

Activity of T Cells in Metastatic Melanoma Resistant to Immune Checkpoint Inhibitor Treatment

In a study reported in the Annals of Oncology, Andersen et al found that tumor-infiltrating lymphocytes isolated from metastatic melanoma lesions in patients with disease progression after checkpoint inhibitor therapy remain functional. Moreover, they concluded these tumor-infiltrating lymphocytes...

On Not Being Ready

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

breast cancer

I Am Too Young for Breast Cancer

Two years ago, when I began having pain and bloody discharge in my left breast, I thought it was the return of a solitary intraductal papilloma I had had in that breast when I was a college student 6 years earlier, so the symptoms didn’t initially alarm me. It wasn’t until I noticed that the mass...

issues in oncology
cns cancers

A Firsthand Account of Cancer and Mental Illness

Brain tumors are among the most challenging clinical scenarios faced by the oncology community. Along with devastating physiologic damage, brain tumors often have a dramatic effect on the patient’s cognitive, neurologic, and psychological functions. However, the body of literature focusing on...

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