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Colorectal Cancer
Genomics/Genetics

Alkylating Signature in Colorectal Cancer May Be Linked to High Red Meat Intake

The association between the consumption of red and processed meats and the development of colorectal cancer, as well as pancreatic and prostate cancers, has been known since 2015, when the International Agency for Research on Cancer (IARC) classified the consumption of red meat as probably...

Leukemia
Genomics/Genetics

Addition of Gemtuzumab Ozogamicin to Conventional Background Chemotherapy in Pediatric Patients With KMT2A-Rearranged AML

As reported in the Journal of Clinical Oncology by Pollard et al, a subgroup of pediatric patients with KMT2A-rearranged acute myeloid leukemia (AML) in the phase III Children’s Oncology Group AAML0531 trial had improved outcomes with the addition of the CD33-targeting agent gemtuzumab ozogamicin...

Breast Cancer
Genomics/Genetics

ASCO Releases Rapid Guideline Recommendation Update for Patients With High-Risk, HER2-Negative, Germline BRCA–Mutated Breast Cancer

A new ASCO guideline update recommends offering 1 year of adjuvant olaparib to patients with high-risk, early-stage, HER2-negative breast cancer and germline BRCA mutations after completion of (neo)adjuvant chemotherapy and local treatment, including radiation. The recommendations update the 2020...

Lung Cancer
Genomics/Genetics

Pralsetinib in Advanced RET Fusion–Positive NSCLC: ARROW Trial

As reported in The Lancet Oncology by Justin F. Gainor, MD, and colleagues, an interim analysis of the phase I/II ARROW trial has shown that the oral RET inhibitor pralsetinib produced high response rates in previously treated and treatment-naive patients with advanced RET fusion–positive non–small ...

Breast Cancer
Lung Cancer
Skin Cancer
Genomics/Genetics

Real-World Survival Outcomes With Targeted Therapy for Intracranial Metastatic Disease

In a retrospective cohort study reported in JAMA Oncology, Erickson et al found that real-world use of targeted therapy after diagnosis of intracranial metastatic disease was associated with improved overall survival vs no use of targeted therapy in patients with HER2-positive breast cancer,...

Lung Cancer
Genomics/Genetics

Global Registry Analysis of NRG1 Fusion–Positive Lung Cancer

In an analysis from the global eNRGy1 registry for NRG1 fusion–positive lung cancers reported in the Journal of Clinical Oncology, Alexander Drilon, MD, and colleagues found greater than expected heterogeneity in characteristics of disease. Additionally, patients had poor responses to cytotoxic,...

colorectal cancer
immunotherapy
genomics/genetics

Cathy Eng, MD, on Colorectal Cancer: FOLFOXIRI, Cetuximab, and Bevacizumab as First-Line Treatment

Cathy Eng, MD, of Vanderbilt-Ingram Cancer Center, discusses two abstracts from a session she co-chaired: the phase II DEEPER trial, which explored the use of FOLFOXIRI plus cetuximab vs FOLFOXIRI plus bevacizumab as first-line treatment in metastatic colorectal cancer with RAS wild-type tumors; and the phase II FIRE-4.5 study, which investigated FOLFOXIRI plus either bevacizumab or cetuximab as first-line treatment of BRAF V600E–mutant advanced disease (Abstracts 3501 and 3502).

Lung Cancer
Genomics/Genetics
Issues in Oncology

Expert Point of View: Christine Lovly, MD, PhD

Invited discussant Christine Lovly, MD, PhD, Associate Professor of Medicine, Ingram Associate Professor of Cancer Research, Vanderbilt University Ingram Cancer Center, Nashville, discussed progress in targeted therapies for NSCLC. “We have a tremendous amount of knowledge about driver mutations in ...

Lung Cancer
Genomics/Genetics
Issues in Oncology

More Widespread Biomarker Testing for NSCLC in Oncology Practices and More Testing in Black Patients: An Urgent Priority

Even though next-generation sequencing is recommended by the National Comprehensive Cancer Network (NCCN) for biomarker testing for patients with non–small cell lung cancer (NSCLC), the uptake among community oncology practices is suboptimal, and the uptake is even lower among Black patients with...

Lung Cancer
Genomics/Genetics

Sotorasib for KRAS G12C–Mutated NSCLC: Overall Survival and Exploratory Subgroup Analyses

Results from the phase II cohort of the CodeBreaK 100 study showed that treatment with the KRAS G12C inhibitor sotorasib achieved a 37.1% objective response rate and a median overall survival of 12.5 months in previously treated patients with KRAS G12C–mutated non–small cell lung cancer (NSCLC)....

lung cancer
genomics/genetics
immunotherapy

Pasi A. Janne, MD, PhD, on NSCLC: Patritumab Deruxtecan to Target HER3

Pasi A. Janne, MD, PhD, of Dana-Farber Cancer Institute, discusses study findings that show patritumab deruxtecan is effective in patients with EGFR-mutated and inhibitor-resistant non–small cell lung cancer. Dr. Janne also explains why targeting HER3, a mutation expressed in most EGFR-altered cancers, is a beneficial treatment approach (Abstract 9007).

breast cancer
genomics/genetics

Andrew Tutt, PhD, MBChB, on Breast Cancer: Olaparib After Chemotherapy in Germline BRCA1/2–Mutated Tumors

Andrew Tutt, PhD, MBChB, of the Institute of Cancer Research, London, discusses findings from the phase III OlympiA trial, which showed that adjuvant olaparib, a PARP inhibitor, following adjuvant or neoadjuvant chemotherapy, may improve invasive disease–free survival in patients with germline BRCA-mutated and high-risk HER2-negative early breast cancer, which might lead to a new indication in this setting (Abstract LBA1).

Breast Cancer
Genomics/Genetics

OlympiA: Adjuvant Olaparib Extends Disease-Free Survival in BRCA-Mutated Early-Stage HER2-Negative Breast Cancer

One year of adjuvant therapy with the PARP inhibitor olaparib extended disease-free survival in patients with high-risk, early-stage, HER2-negative breast cancer with BRCA1/2 germline mutations, according to a prespecified interim analysis of the phase III OlympiA trial presented by Andrew Tutt, MB ...

Solid Tumors
Genomics/Genetics
Immunotherapy

Pertuzumab/Trastuzumab Demonstrates Activity in Tissue-Agnostic Trial for Patients With HER2-Positive Tumors

Results from the phase II MyPathway basket trial found that the HER2-targeted therapies pertuzumab and trastuzumab demonstrated durable activity in patients with a wide variety of tumors marked by HER2 amplification or overexpression, although responses were limited in those with KRAS mutations....

Breast Cancer
Genomics/Genetics

Are There Differences in the Prevalence of Germline Pathogenic Variants in Susceptibility Genes in Black vs White Women With Breast Cancer?

In a population-based study reported in JAMA Oncology, Susan M. Domchek, MD, and colleagues found “no clinically meaningful differences” in the prevalence of germline pathogenic variants in 12 established breast cancer susceptibility genes between Black and non-Hispanic White women with breast...

Hepatobiliary Cancer
Genomics/Genetics

FDA Grants Accelerated Approval to Infigratinib for Metastatic Cholangiocarcinoma With an FGFR2 Fusion or Rearrangement

On May 28, 2021, the U.S. Food and Drug Administration (FDA) granted accelerated approval to the kinase inhibitor infigratinib (Truseltiq) for adults with previously treated, unresectable, locally advanced or metastatic cholangiocarcinoma with a fibroblast growth factor receptor 2 (FGFR2) fusion or ...

Lung Cancer
Genomics/Genetics

FDA Approves Sotorasib for KRAS G12C–Mutated NSCLC

On May 28, the U.S. Food and Drug Administration (FDA) approved sotorasib (Lumakras) as the first treatment for adult patients with non–small cell lung cancer (NSCLC) whose tumors have a KRAS G12C genetic mutation and who have received at least one prior systemic therapy. This is the first approved ...

Hepatobiliary Cancer
Genomics/Genetics

Actionable Mutations Identified in Majority of Genome-Sequenced Resected Cholangiocarcinomas

Tumor genomic profiling of resected cholangiocarcinomas may reveal mutations targetable with agents currently being used for other cancers, according to the results of a study presented at the Society of Surgical Oncology (SSO) 2021 International Conference on Surgical Cancer Care.1 Among patients...

Lung Cancer
Genomics/Genetics

FDA Grants Accelerated Approval to Amivantamab-vmjw for Metastatic EGFR Exon 20 Insertion–Mutated NSCLC

On May 21, the U.S. Food and Drug Administration (FDA) granted accelerated approval to amivantamab-vmjw (Rybrevant), a bispecific antibody directed against epidermal growth factor and MET receptors, for adult patients with locally advanced or metastatic non–small cell lung cancer (NSCLC) and...

Gastrointestinal Cancer
Genomics/Genetics

Avapritinib vs Other Tyrosine Kinase Inhibitors for PDGFRA D842V–Mutated Gastrointestinal Stromal Tumors

Data from a study published by Margaret von Mehren, MD, and colleagues in BMC Cancer showed that avapritinib, a platelet-derived growth factor receptor A (PDGFRA) inhibitor, has a “clinically meaningful benefit” for the treatment of gastrointestinal stromal tumors (GIST) with PDGFRA D842V...

Colorectal Cancer
Genomics/Genetics

Standard Multigene Testing Could Detect More Hereditary Cancer Syndromes in Patients With Colorectal Cancer

Up to 38.6% of people with colon cancer who have a hereditary cancer syndrome—including 6.3% of those with Lynch syndrome—could have their conditions remain undetected with current universal tumor-screening methods, and at least 7.1% of people with colorectal cancer have an identifiable inherited...

CNS Cancers
Genomics/Genetics

Dual BRAF/MEK Inhibition Under Study in BRAF V600E–Mutant Gliomas

The combination of dabrafenib plus trametinib led to encouraging and durable responses in patients with low- and high-grade gliomas harboring BRAF V600E mutations, according to the results of the phase II basket study known as ROAR. Results were presented during the virtual edition of the American...

Skin Cancer
Genomics/Genetics

Mutational Profile of Acral Nevi May Differ From Acral Melanoma

Melanocytic nevi are nonmalignant growths that arise from pigment-producing cells of the skin. They are mostly found in sun-exposed areas; however, they also can be found in sun-protected areas, such as the palms, soles of the feet, and nail beds, where they are known as acral nevi. While the...

Breast Cancer
Gynecologic Cancers
Pancreatic Cancer
Genomics/Genetics

ACMG Clinical Practice Resource Provides New Guidance for Management of Individuals With PALB2 Gene Variants

The American College of Medical Genetics and Genomics (ACMG) has released a clinical practice resource from a global team of specialists in cancer genetics that will help inform the clinical management of patients who harbor a PALB2 variant and may be at increased risk of developing breast,...

Pancreatic Cancer
Genomics/Genetics

Maintenance Rucaparib in Patients With Platinum-Sensitive Pancreatic Cancer and Germline or Somatic BRCA1, BRCA2, or PALB2 Variants

In a single-institution phase II study reported in the Journal of Clinical Oncology, Kim A. Reiss, MD, and colleagues found that maintenance treatment with the poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib produced responses and was associated with good progression-free survival in...

Genomics/Genetics
Solid Tumors
Hematologic Malignancies

Surveillance Protocol and Early Cancer Detection in Patients With Constitutional Mismatch Repair Deficiency Syndrome

As reported in the Journal of Clinical Oncology by Durno et al in the International Replication Repair Deficiency Consortium (IRRDC), use of an IRRDC surveillance protocol was associated with improved overall survival among patients with constitutional mismatch repair deficiency syndrome (CMMRD)....

Lung Cancer
Genomics/Genetics

ASCO and Ontario Health Publish Joint Update on Guideline for Targeted Therapy in NSCLC With Driver Alterations

ASCO and Ontario Health (Cancer Care Ontario) have jointly published an update1 to the 2017 ASCO guideline2 regarding systemic therapy recommendations for stage IV non–small cell lung cancer (NSCLC) with driver alterations. Guideline Co-Chair Nasser H. Hanna, MD, of the Indiana University Simon...

Gynecologic Cancers
Genomics/Genetics

Expert Point of View: Ursula Matulonis, MD, and Konstantin Zakashansky, MD

Perspectives on ARIEL4 were provided for The ASCO Post by the invited discussant Ursula Matulonis, MD, Professor of Medicine, Harvard Medical School, and Chief of Gynecologic Oncology and the Brock Wilson Family Chair at ­Dana-Farber Cancer Institute, Boston, and by Konstantin Zakashansky, MD,...

Gynecologic Cancers
Genomics/Genetics

Phase III ARIEL4 Confirms Rucaparib’s Benefit in BRCA-Mutated Relapsed Ovarian Cancer

In patients with BRCA-mutated, advanced, relapsed ovarian cancer, treatment with the PARP (poly [ADP-ribose] polymerase) inhibitor rucaparib led to a significant improvement in progression-free survival compared with standard-of-care chemotherapy, according to results of the international phase III ...

Genomics/Genetics
Issues in Oncology
Breast Cancer

Relationship Between Germline BRCA Pathogenic Variants and Diminished Ovarian Reserve

In a study reported in the Journal of Clinical Oncology, Turan et al found the presence of germline BRCA pathogenic variants was associated with diminished ovarian reserve in young women, particularly in those diagnosed with breast cancer and those with BRCA1 variants. Study Details The individual...

Issues in Oncology
Genomics/Genetics

Expanding Role of Liquid Biopsies in Cancer Detection and Therapeutics: Now and in the Near Future

“It is possible that within the next several years, perhaps 75% of cancers can be detected by screening,” Bert ­Vogelstein, MD, PhD, projected at the Society of Surgical Oncology (SSO) 2021 International Conference on Surgical Cancer Care.1 “I anticipate that perhaps 50% of cancers can be detected...

Solid Tumors
Genomics/Genetics

Expert Point of View: Antoni Ribas, MD, PhD

“This study is important because of the large numbers of genetic samples and the significance of the results,” stated Antoni Ribas, MD, PhD, President of the American Association for Cancer Research and Director of Tumor Immunology at UCLA’s Jonsson Comprehensive Cancer Center. “The study included...

Genomics/Genetics
Solid Tumors

Heritability Genes Identified in Childhood Neuroblastoma

Researchers have made progress in unravelling the genetic underpinnings of pediatric neuroblastoma. Two main inherited pathogenic genetic variants have been identified and appear to be associated with worse outcomes: the ALK gene and loss of function in PHOX2B. The research, conducted with the...

Immunotherapy
Lung Cancer
Genomics/Genetics

First-Line Immune Checkpoint Inhibitor Monotherapy vs Chemoimmunotherapy in Advanced NSCLC According to KRAS Variant Status

In a study reported in a research letter in JAMA Oncology, Sun et al found that first-line immune checkpoint inhibitor monotherapy was associated with better overall survival among patients with advanced non–small cell lung cancer (NSCLC) with PD-L1 expression ≥ 50% and KRAS variant vs KRAS...

Colorectal Cancer
Genomics/Genetics

Study Explores Rates of Germline Mutations in Patients With Colorectal Cancer

In a recent study published by Uson Junior et al in Clinical Gastroenterology and Hepatology, researchers found one in six patients with colorectal cancer had an inherited cancer-related genetic mutation, which may be linked to a predisposition to the disease. In addition, the researchers...

Prostate Cancer
Genomics/Genetics

Effect of Genomic Prostate Score Testing on Choice of Active Surveillance in a Predominantly Black Patient Population

In the ENACT study, reported in the Journal of Clinical Oncology, Murphy et al found that use of the 12-gene Genomic Prostate Score (GPS) in a predominantly Black patient population with relatively low-risk prostate cancer tended to be associated with reduced selection of active...

Genomics/Genetics
Lung Cancer

Patient Knowledge and Expectations Regarding Genomic Testing Results

As reported in JCO Oncology Practice by Roth et al, many participants in a biomarker-driven master protocol trial (Lung Cancer Master Protocol [Lung-MAP]; SWOG S1400GEN) did not display correct knowledge or expectations about using the results of genomic testing. Study Details Lung-MAP is a...

Leukemia
Genomics/Genetics

Certain Genetic Mutations May Increase Risk of Death From Infection in Patients With CLL

Death from infection—the leading cause of death for patients with chronic lymphocytic leukemia (CLL)—may be linked to specific gene mutations, according to results from a study published by Else et al in the journal Leukemia. Testing for these mutations could be used to identify patients at a...

Gynecologic Cancers
Genomics/Genetics

Genome-Wide Association Study of Variants Linked to Cervical Preinvasive and Invasive Disease

In a genome-wide association study reported in The Lancet Oncology, Bowden et al identified six independent variants among the PAX8, CLPTM1L, and HLA genes that were associated with risk for invasive cervical cancer or cervical intraepithelial neoplasia grade 3 (CIN3). As stated by the...

Colorectal Cancer
Genomics/Genetics

Patients of Different Races With Early-Onset Colorectal Cancer Exhibit Distinct Genetic Features

Racial differences in genetic mutations were observed among patients with early-onset colorectal cancer, according to data presented by Andreana N. Holowatyj, PhD, MS, during the virtual American Association for Cancer Research (AACR) Annual Meeting 2021 (Abstract 101). The incidence of early-onset ...

solid tumors
gastrointestinal cancer
genomics/genetics

Vivek Subbiah, MD, on RET Fusion–Positive Cancers: Efficacy of Selpercatinib

Vivek Subbiah, MD, of The University of Texas MD Anderson Cancer Center, discusses data on selpercatinib that showed promising activity across a variety of RET fusion–positive cancers, including treatment-refractory gastrointestinal malignancies. This analysis highlights the need for genomic profiling to identify actionable oncogenic drivers.

Lung Cancer
Genomics/Genetics

Expert Point of View: Gillianne G.Y. Lai, MBBS

Gillianne G.Y. Lai, MBBS, of the National Cancer Centre, Singapore, discussed the presentations on novel agents for exon 20 insertion mutations in non–small cell lung cancer (NSCLC), which account for about one-third of tyrosine kinase resistance mutations. Although tyrosine kinase mutations are...

Lung Cancer
Genomics/Genetics

Lung Cancers With Rare EGFR Mutations Being Tackled by Novel Agents

Next-generation inhibitors of epidermal growth factor receptor (EGFR) exon 20 insertion mutations showed promise in patients with advanced non–small cell lung cancer (NSCLC) in early-phase trials presented during the International Association Society for Lung Cancer 2020 World Conference on Lung...

Genomics/Genetics
Issues in Oncology

How Exceptional Responders Are Providing Clues to Personalizing Cancer Treatment

The findings from a recent study of patients with cancer who had an exceptional response to chemotherapy are yielding new clues on the molecular changes in patients’ tumors. These findings may explain the genetic alterations contributing to these patients’ dramatic and long-lasting responses to...

colorectal cancer
genomics/genetics

Heinz-Josef Lenz, MD, and Axel Grothey, MD, on Colorectal Cancer: Molecular Testing and Interpreting an NGS Report

Immunotherapy
Genomics/Genetics
Solid Tumors

Is Tumor Mutational Burden Alone Sufficient to Predict Response to Immunotherapy?

In a letter to the editor published in The New England Journal of Medicine, Benoit Rousseau, MD, and colleagues presented evidence that high tumor mutational burden (TMB) alone is not sufficient to predict improved outcomes with immune checkpoint inhibitor therapy in patients with solid tumors. As...

Gastroesophageal Cancer
Genomics/Genetics

Gene Sequencing, Esophageal Brushings May Identify Patients With Barrett’s Esophagus at Risk for Cancer Progression

A combination of esophageal brushing and extensive genetic sequencing of the sample collected may detect chromosome alterations in people with Barrett’s esophagus, identifying patients at risk for progressing to esophageal cancer. These findings were published by Douville et al in ...

Breast Cancer
Genomics/Genetics

Germline BRCA1/2 and Other Predisposition Genes in Patients With Metastatic Breast Cancer: Prevalence and Association With Prognosis

In a German prospective registry study reported in the Journal of Clinical Oncology, Peter A. Fasching, MD, and colleagues identified the prevalence of germline mutations in BRCA1/2 and other breast cancer risk genes in patients with metastatic disease and found similar prognosis with presence vs...

Lung Cancer
Genomics/Genetics

Patients With NSCLC and Driver Mutations May Be More Likely to Present With Brain Metastasis at Diagnosis

The incidence of brain metastasis at diagnosis in patients with non–small cell lung cancer (NSCLC) harboring driver mutations was high, according to findings presented by Rashkit et al at the European Lung Cancer Virtual Congress 2021 (Abstract 38P). However, these patients achieved treatment...

Head and Neck Cancer
Genomics/Genetics

Tipifarnib for Patients With Advanced HRAS-Mutant Head and Neck Cancer and High Variant Allele Frequency

In a phase II trial reported in the Journal of Clinical Oncology, Ho et al found that tipifarnib produced a high response rate among patients with recurrent or metastatic head and neck squamous cell carcinoma with HRAS mutations and high variant allele frequency. As stated by the investigators,...

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