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Skin Cancer
Genomics/Genetics
Immunotherapy

SECOMBIT Trial Evaluates Optimal Treatment Sequencing in BRAF-Mutated Melanoma

Patients with untreated, metastatic BRAF-mutated melanoma may benefit from receiving immunotherapy first, moving to targeted therapy in the second line, data from the updated overall survival analysis of the randomized, phase II SECOMBIT trial suggest.1 The study aimed to define the optimal...

Gynecologic Cancers
Genomics/Genetics

Relationship Between Preexisting TP53 CHIP Variants and Risk of Secondary Myeloid Neoplasms in High-Grade Ovarian Cancer

In a study reported in JAMA Oncology, Kwan et al found that preexisting TP53 clonal hematopoiesis of indeterminate potential (CHIP) variants were associated with increased risk of secondary myeloid neoplasms in patients receiving poly (ADP-ribose) polymerase (PARP) inhibitor therapy with rucaparib...

Lung Cancer
Genomics/Genetics

Mobocertinib for Platinum-Pretreated Patients With EGFR Exon 20 Insertion–Positive Metastatic NSCLC

In a phase I/II trial reported in JAMA Oncology, Caicun Zhou, PhD, MD, and colleagues found that mobocertinib, a first-in-class oral kinase inhibitor, produced durable responses in platinum-pretreated patients with EGFR exon 20 insertion–positive metastatic non–small cell lung cancer (NSCLC).  The...

Lung Cancer
Genomics/Genetics

Second-Line Sotorasib Plus Afatinib for KRAS-Mutant NSCLC

The combination of the KRAS inhibitor sotorasib with afatinib, a pan-ErbB tyrosine kinase inhibitor, was feasible in treating patients with non–small cell lung cancer (NSCLC) and mutated KRAS whose disease had progressed on prior therapies, including KRAS inhibitors alone, according to interim...

Lung Cancer
Genomics/Genetics

Genomic Profiling of Lung Adenocarcinoma in Never-Smokers vs Smokers

In a study reported in the Journal of Clinical Oncology, Devarakonda et al found that never-smokers with lung adenocarcinoma had a high frequency of RTK/RAS/RAF pathway driver alterations—similar to smokers with lung adenocarcinoma—but also harbored a significantly higher total frequency of...

Genomics/Genetics

Characteristics of Genomically Targeted Single-Patient Use Requests for Pediatric Cancers

In a study reported in the Journal of Clinical Oncology, Sabnis et al analyzed characteristics of genomically targeted single-patient use requests for investigational agents for the treatment of pediatric cancers. These requests were made from pediatric cancer programs over a 5-year period. As...

bladder cancer
genomics/genetics

Thomas Powles, MD, PhD, on Urothelial Carcinoma: Erdafitinib, Cetrelimab, and FGFR Alterations

Thomas Powles, MD, PhD, of Queen Mary University of London, discusses phase II results from the NORSE study, which showed that the kinase inhibitor erdafitinib plus the monoclonal antibody cetrelimab produced meaningful responses in cisplatin-ineligible patients with first-line metastatic or locally advanced urothelial carcinoma and fibroblast growth factor receptor (FGFR) alterations (Abstract LBA27).

Breast Cancer
Genomics/Genetics

OlympiA Trial: Adjuvant Olaparib Extends Disease-Free Survival in BRCA-Mutated Early Breast Cancer

Adjuvant therapy with the PARP inhibitor olaparib for 1 year extended disease-free survival in patients with high-risk early-stage HER2-negative breast cancer with BRCA1/2 germline (inherited) mutations, according to a prespecified interim analysis of the phase III OlympiA trial presented at the...

Genomics/Genetics

Enhanced Surveillance and Risk-Reducing Intervention Options for Individuals With PALB2 Variants

PALB2 germline pathogenic variants are associated with a substantially increased risk for breast cancer and a smaller increased risk for pancreatic and ovarian cancers, warranting enhanced surveillance and the option of risk-reducing interventions, according to a global team of cancer genetic...

Genomics/Genetics

FDA Recognizes Memorial Sloan Kettering Database of Molecular Tumor Marker Information

On October 7, the U.S. Food and Drug Administration (FDA) granted recognition to a partial listing of the Memorial Sloan Kettering Cancer Center Oncology Knowledge Base (OncoKB) as the first tumor mutation database to be included in the Public Human Genetic Variant Databases.  The FDA recognized a...

colorectal cancer
genomics/genetics

Jenny F. Seligmann, MBChB, PhD, on Colorectal Cancer: Adavosertib Compared With Active Monitoring

Jenny F. Seligmann, MBChB, PhD, of the University of Leeds, discusses phase II findings that suggest adavosertib improved progression-free survival, compared with active monitoring, by inhibiting the WEE1 kinase in patients with RAS- and TP53-mutant metastatic colorectal cancer. In the trial, adavosertib’s activity tended to be even greater in left-sided tumors (Abstract 382O).

Hepatobiliary Cancer
Genomics/Genetics

Ivosidenib vs Placebo for Previously Treated Advanced IDH1-Mutated Cholangiocarcinoma: Final Overall Survival Analysis of the ClarIDHy Trial

As reported in JAMA Oncology by Andrew X. Zhu, MD, PhD, and colleagues, the final overall survival analysis of the pivotal phase III ClarIDHy trial showed prolonged overall survival with ivosidenib vs placebo in previously treated patients with unresectable or metastatic cholangiocarcinoma and an...

Colorectal Cancer
Genomics/Genetics

Addition of Panitumumab to Fluorouracil/Leucovorin as Maintenance Therapy for RAS Wild-Type Metastatic Colorectal Cancer

In the German phase II PANAMA trial reported in the Journal of Clinical Oncology, Modest et al found that the addition of the monoclonal antibody panitumumab to fluorouracil (5-FU)/leucovorin maintenance therapy improved progression-free survival in patients with RAS wild-type metastatic colorectal ...

Colorectal Cancer
Genomics/Genetics

Adavosertib for Patients With TP53- and RAS-Mutant Metastatic Colorectal Cancer

As reported in the Journal of Clinical Oncology by Seligmann et al, the phase II FOCUS4-C trial has shown activity of the WEE1 kinase inhibitor adavosertib in patients with TP53- and RAS-mutant metastatic colorectal cancer with disease control after first-line chemotherapy. As state by the...

Colorectal Cancer
Genomics/Genetics

FDA Expands Cetuximab Label With Combination of Encorafenib for Pretreated BRAF V600E Mutation–Positive Metastatic Colorectal Cancer

The U.S. Food and Drug Administration (FDA) has granted approval of a new indication for cetuximab (Erbitux) in combination with encorafenib (Braftovi) for the treatment of adult patients with metastatic colorectal cancer and a BRAF V600E mutation, as detected by an FDA-approved test, after prior...

Lung Cancer
Genomics/Genetics

Poziotinib, a Tyrosine Kinase Inhibitor, for HER2 Exon 20–Mutant NSCLC

In a single-center phase II trial reported in the Journal of Clinical Oncology, Elamin et al found that the tyrosine kinase inhibitor poziotinib showed activity in previously treated patients with HER2 exon 20–mutant advanced non–small cell lung cancer (NSCLC). As related by the investigators,...

Pancreatic Cancer
Genomics/Genetics

Risk of Pancreatic Cancer Associated With Germline ATM Pathogenic Variants

In a multicenter cohort study reported in JAMA Oncology, Hsu et al found that among pancreatic cancer kindreds, individuals with germline ATM pathogenic variants had a sixfold increased risk of developing pancreatic cancer vs noncarriers of pathogenic variants. Study Details The study involved data ...

lung cancer
genomics/genetics

Robin Cornelissen, MD, PhD, on HER2 Exon 20–Mutated NSCLC: Poziotinib in Treatment-Naive Disease

Robin Cornelissen, MD, PhD, of Erasmus University in Rotterdam, discusses phase II findings from the ZENITH20-4 study, which explored the question of whether poziotinib could benefit patients whose newly diagnosed non–small cell lung cancer harbors EGFR and HER2 exon 20 mutations. Potentially, this novel tyrosine kinase inhibitor may fill an unmet medical need (Abstract LBA46).

Solid Tumors
Genomics/Genetics

ATR Inhibitor Ceralasertib in ARID1A-Deficient and ARID1A-Intact Solid Tumors

In an ongoing phase II study, Aggarwal et al evaluated the efficacy of the ATR inhibitor ceralasertib alone and in combination with olaparib in patients with ARID1A-deficient and ARID1A-intact solid tumors. They observed antitumor activity with ceralasertib monotherapy in ARID1A-deficient solid...

Breast Cancer
Genomics/Genetics

Expert Point of View: Nadine M. Tung, MD

Formal discussant of the OlympiA trial, Nadine M. Tung, MD, Director of Breast Medical Oncology and the Cancer Genetics and Prevention Program at Beth Israel Deaconess Medical Center and Harvard Medical School, was enthusiastic about the ability of olaparib to improve invasive disease–free survival ...

Breast Cancer
Genomics/Genetics

OlympiA Trial: Adjuvant Olaparib Extends Disease-Free Survival in BRCA-Mutated Early Breast Cancer

Adjuvant therapy with the PARP inhibitor olaparib for 1 year extended disease-free survival in patients with high-risk early-stage HER2-negative breast cancer with BRCA1/2 germline (inherited) mutations, according to a prespecified interim analysis of the phase III OlympiA trial presented at the...

Lung Cancer
Issues in Oncology
Genomics/Genetics

Survey Examines Oncology Clinician Perceptions of Biomarker Testing for Underserved Patients With Lung Cancer

Less than half of community oncologists surveyed indicated that they use biomarker testing to guide patient discussions compared with 73% of academic clinicians, according to a report by Boehmer et al presented at the International Association for the Study of Lung Cancer (IASLC) 2021 World...

Gynecologic Cancers
Genomics/Genetics

Prevalence of Germline BRCA Mutations in Indian Women With Ovarian Cancer

Ovarian cancer is one of the most common gynecologic cancers, with 313,959 new cases and 207,252 deaths reported worldwide in 2020.1 Since there is no effective screening method, ovarian cancer in general is diagnosed in its late stage. The 5-year survival rate in women with ovarian cancer is less...

Gynecologic Cancers
Genomics/Genetics

High Prevalence of Germline BRCA Mutations in Indian Women With Ovarian Cancer

In a prospective cross-sectional study reported in JCO Global Oncology, Sudeep Gupta, MBBS, MD, DM, of Tata Memorial Centre, and colleagues found that Indian women with ovarian cancer not selected for study based on clinical factors had a high prevalence of germline pathogenic or likely pathogenic...

Genomics/Genetics

A Scientific Detective Tale With Consequences for the Future of Our Species

With completion of the Human Genome Project, medicine hit a turning point that enabled scientists to approach genetic diseases like cancer with new tools such as disruptive technologies like CRISPR (clustered regularly interspaced short palindromic repeats) gene editing. Progress in this novel...

Lung Cancer
Genomics/Genetics

Genomic Analysis of Lung Cancer in Never-Smokers

A genomic analysis of lung cancer in people with no history of smoking has found that a majority of these tumors arise from the accumulation of mutations caused by natural processes in the body. This study was conducted by an international team led by researchers at the National Cancer Institute...

Solid Tumors
Genomics/Genetics

Cell-Free DNA Analysis to Distinguish Development of Malignant Peripheral Nerve Sheath Tumors From Plexiform Neurofibromas

The inherited condition neurofibromatosis type 1, or NF1, is responsible for the development of benign tumors that grow along the nerves; in some individuals, however, these benign tumors transform into aggressive and malignant peripheral nerve sheath tumors. Determining whether this transformation ...

Leukemia
Genomics/Genetics

Effect of Concurrent Focal 22q11.22 Deletions and IKZF1 Alterations on Outcomes in Pediatric Patients With B-Cell ALL

In a study reported in JAMA Oncology, Mangum et al found that focal deletions in chromosome 22q11.22 were associated with poor outcomes in pediatric patients with B-cell acute lymphoblastic leukemia (ALL) with IKZF1 alterations. As stated by the investigators, “Alterations in the IKZF1 gene drive...

CNS Cancers
Genomics/Genetics

ALK Fusion–Positive High-Grade Glioma: Response to Lorlatinib in a Single Pediatric Case

In a letter to the editor published in The New England Journal of Medicine, Bagchi et al describe the course of treatment in a 3-year-old child with an intracranial tumor and his response to therapy with the kinase inhibitor lorlatinib. Key Points Magnetic resonance imaging (MRI) of the head in a...

Colorectal Cancer
Genomics/Genetics

Liquid Biopsy Is Changing Colon Cancer Management

The measurement of circulating tumor DNA (ctDNA) is changing the way gastrointestinal cancers are managed, according to Bassel F. El-Rayes, MD, Professor and Vice Chair for Clinical Research in the Department of Hematology and Oncology, Emory University, and Associate Cancer Center Director,...

Genomics/Genetics

Cancer Predisposition Screening Tool for Predicting Subsequent Malignancies in Childhood Cancer Survivors

In a Canadian study reported in the Journal of Clinical Oncology, Cullinan et al found that the McGill Interactive Pediatric OncoGenetic Guidelines (MIPOGG) tool provided predictive value for risk of subsequent malignant neoplasms in childhood cancer survivors beyond risk associated with treatment...

lung cancer
genomics/genetics

ALK-Positive Non–Small Cell Lung Cancer

In this video, Drs. Justin F. Gainor, Ibiayi Dagogo-Jack, and Jyoti D. Patel discuss current treatment options for ALK fusion–positive non–small cell lung cancer (NSCLC). Dr. Gainor presents the case of a 31-year-old patient with minimal tobacco exposure who was diagnosed with metastatic NSCLC. PD-L1 immunohistochemistry revealed a tumor proportion score of 90%, and an EML4-ALK fusion was found on targeted next-generation sequencing. The faculty discuss the importance of testing for oncogenic drivers even in the presence of high PD-L1 expression and review the different generations of ALK inhibitors and their distinguishing features. Finally, they discuss their decision-making processes as it relates to first-line therapy, emphasizing the importance of patient communication, understanding toxicity profiles and resistance, and long-term follow-up.

lung cancer
genomics/genetics

NTRK Fusion–Positive Non–Small Cell Lung Cancer

In this video, Drs. Justin F. Gainor, Ibiayi Dagogo-Jack, and Jyoti D. Patel discuss the management of NTRK fusion–positive non–small cell lung cancer (NSCLC). Dr. Gainor presents the case of a 44-year-old man with a 5 pack-year history of tobacco exposure who was diagnosed with metastatic NSCLC; molecular testing was initially negative, but subsequent targeted next-generation sequencing revealed an NTRK1 fusion, a key oncogenic driver. The faculty discuss when and where to order additional molecular testing or next-generation sequencing in patients such as this. They review recent clinical data surrounding two agents approved by the FDA for NTRK fusion–driven lung cancer, larotrectinib and entrectinib.

lung cancer
genomics/genetics

RET Fusion–Positive Non–Small Cell Lung Cancer

In this video, Drs. Justin F. Gainor, Ibiayi Dagogo-Jack, and Jyoti D. Patel discuss the management of RET fusion–positive non–small cell lung cancer (NSCLC). The case presented is a 65-year-old never-smoker patient with metastatic NSCLC who was found to have an EGFR A118V mutation and a KIF5B-RET fusion. The faculty provide background on RET fusions in lung cancer and discuss the different testing modalities used to identify RET alterations. In addition, they discuss how the treatment landscape for these patients has changed in recent years, reviewing data from the recent ARROW and LIBRETTO-001 trials.

Leukemia
Genomics/Genetics

Study Identifies Possible New Genetic Biomarkers of Pediatric Leukemia

In a study published by Magnum et al in JAMA Oncology, researchers reported on how two separate DNA changes appear to predict aggressive childhood leukemias when they occur in combination. The team evaluated tumor characteristics of more than 1,300 pediatric patients with B-cell acute lymphoblastic ...

Colorectal Cancer
Genomics/Genetics
Immunotherapy

Cetuximab Plus Avelumab as Rechallenge Therapy for RAS Wild-Type Metastatic Colorectal Cancer

In an Italian phase II trial reported in JAMA Oncology, Martinelli et al found that cetuximab rechallenge plus avelumab showed activity and was well tolerated in patients with RAS wild-type metastatic colorectal cancer who had responded to first-line chemotherapy plus an anti-EGFR agent and then...

Prostate Cancer
Genomics/Genetics

Talazoparib in Patients With Metastatic Castration-Resistant Prostate Cancer and DNA Repair Gene Alterations

In the phase II TALAPRO-1 trial reported in The Lancet Oncology, Johann S. de Bono, PhD, and colleagues found that monotherapy with the poly (ADP-ribose) polymerase (PARP) inhibitor talazoparib produced durable responses in patients with metastatic castration-resistant prostate cancer and DNA...

Breast Cancer
Genomics/Genetics

Simulation Model–Based Clinical Decision Tool for Predicting Benefit of Adjuvant Chemoendocrine vs Endocrine Therapy in HR-Positive, HER2-Negative Breast Cancer

As reported in the Journal of Clinical Oncology, Jayasekera et al have developed a clinical decision tool called BTxChoice that can be used with or without the 21-gene recurrence score to estimate the potential benefit of adjuvant chemoendocrine vs endocrine therapy in women with node-negative,...

Genomics/Genetics
Solid Tumors

Genomic-Adjusted Radiation Dose Model to Predict Radiotherapy Benefit Across Cancer Types

In a study reported in The Lancet Oncology, Scott et al found that application of the genomic-adjusted radiation dose (GARD) model to cohorts of patients with different types of cancer showed a significant association of GARD with benefit of radiotherapy. As stated by the investigators, “We...

Lung Cancer
Genomics/Genetics

Amivantamab for Patients With EGFR Exon 20 Insertion–Mutated NSCLC After Disease Progression on Platinum Therapy

As reported in the Journal of Clinical Oncology by Keunchil Park, MD, PhD, and colleagues, amivantamab-vmjw given at the selected phase II dose in a phase I trial (CHRYSALIS) produced durable responses in patients with EGFR exon 20 insertion–mutated non–small cell lung cancer (NSCLC) whose disease...

Breast Cancer
Genomics/Genetics

Outcomes and Behaviors Among Women Receiving or Declining Their Breast Cancer Polygenic Risk Score

A recent study examined patient-reported outcomes and risk-management behaviors of women choosing to receive or decline their breast cancer polygenic risk scores (PRS). The findings were published by Tatiane Yanes, PhD, and colleagues in Genetics in Medicine. The research aimed to look at how the...

Breast Cancer
Geriatric Oncology
Genomics/Genetics

Risk of Breast Cancer in Women Older Than Age 65 With Germline Pathogenic Variants in Predisposition Genes

In a study reported in the Journal of Clinical Oncology, Boddicker et al found that women older than age 65 in the general population who carry germline pathogenic variants in established high-risk breast cancer predisposition genes remain at significant risk of late-onset breast cancer and should...

Leukemia
Genomics/Genetics

Can Treatment With Thiopurines Induce Mutations That May Lead to Pediatric Leukemia Relapse?

Chemotherapy has helped make acute lymphoblastic leukemia (ALL) one of the most survivable childhood cancers. Now, a research team has shown how thiopurines may lead to mutations that set patients up for disease relapse. These findings were published by Yang et al in Nature Cancer. The research...

Lung Cancer
Genomics/Genetics

Study Identifies MET Amplification as a Driver for Some Non–Small Cell Lung Cancers

A study published by D. Ross Camidge, MD, PhD, and colleagues in the Journal of Thoracic Oncology has helped to define MET amplification as a rare but potentially actionable driver for non–small cell lung cancer (NSCLC). Dr. Camidge said many of the major developments in the treatment of NSCLC have ...

prostate cancer
genomics/genetics

Metastatic Castration-Resistant Prostate Cancer and DNA Repair Gene Alterations

In this video, Drs. Matthew R. Smith, Xin Gao, and Alicia K. Morgans discuss the role of PARP inhibitors in the treatment of metastatic castration-resistant prostate cancer and homologous recombination repair deficiency, focusing on data from the PROfound trial. Dr. Smith presents a case of a 67-year-old man with metastatic castration-resistant prostate cancer who experienced disease progression despite treatment with enzalutamide, and the faculty discuss the use of docetaxel vs olaparib when tumor genomic testing reports pathogenic mutations in BRCA2 or ATM.

Lung Cancer
Genomics/Genetics

Consensus Statement From IASLC on Liquid Biopsy for Advanced NSCLC

As reported in the Journal of Thoracic Oncology by Christian Rolfo, MD, PhD, and colleagues, the International Association for the Study of Lung Cancer (IASLC) has issued a consensus statement on the use of liquid biopsy in advanced non–small cell lung cancer (NSCLC). Select recommendations are...

Pancreatic Cancer
Genomics/Genetics

Prevalence of Homologous Recombination Deficiency in Patients With Pancreatic Cancer

In a systematic review and meta-analysis reported in the Journal of Clinical Oncology, Casolino et al identified the prevalence of homologous recombination deficiency (HRD) genes in patients with pancreatic ductal adenocarcinoma and found that the reported prevalence of HRD was higher with...

Solid Tumors
Genomics/Genetics

Genomic Characteristics of Pediatric Rhabdomyosarcoma Tumors

In an analysis from an international consortium reported in the Journal of Clinical Oncology, Shern et al identified genomic characteristics and associated outcomes in pediatric rhabdomyosarcoma. Among the findings were that MYOD1 and TP53 mutations were associated with poorer outcomes. As stated...

Lung Cancer
Genomics/Genetics
Immunotherapy

Expert Point of View: Edward B. Garon, MD, MS

Invited discussant of the BOOSTER trial,1 Edward B. Garon, MD, MS, Professor of Medicine and Director of the Thoracic Oncology Program, David Geffen School of Medicine at the University of California Los Angeles, said the study’s research question is appropriate, since osimertinib was established...

Lung Cancer
Genomics/Genetics
Immunotherapy

Study Finds Bevacizumab Offers No Boost to Second-Line Osimertinib in EGFR T790M–Mutated Lung Cancer

For the second-line treatment of advanced EGFR T790M–mutated non–small cell lung cancer (NSCLC), the performance of osimertinib alone was not found to be different from that of osimertinib plus bevacizumab in the phase II ETOP 10-16 ­BOOSTER trial, reported at a European Society for Medical...

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