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prostate cancer

Abiraterone or Enzalutamide for Newly Diagnosed Metastatic Castrate-Resistant Prostate Cancer?

WHAT IS THE best choice of treatment for a man with newly diagnosed metastatic castration-resistant prostate cancer after treatment with androgen-deprivation therapy—abiraterone acetate (Zytiga) plus prednisone, or enzalutamide (Xtandi)? Both drugs achieve similar cancer control in this setting,...

issues in oncology

In Case You Missed It: Short Takes on Current Cancer Research

It would be impossible to cover all of the important presentations from the 5,000-plus abstracts accepted for the 2018 ASCO Annual Meeting. In addition to our regular meeting coverage of the top news stories, the following highlights focus on novel investigational approaches to therapy for various...

Expert Point of View: David Graham, MD, FASCO and Richard Schilsky, MD, FACP, FASCO, FSCT

ASCO expert David Graham, MD, FASCO, of the Levine Cancer Institute in Charlotte, North Carolina, was encouraged by the IMpower131 findings. “This is one more example of how immunotherapy is making steady gains against a number of cancers. Immunotherapy has been shown to be effective in other...

lung cancer
immunotherapy

Atezolizumab Plus Chemotherapy Extends Survival in Squamous NSCLC Regardless of PD-L1 Level

Patients with advanced squamous non–small cell lung cancer (NSCLC) had a greater benefit from first-line treatment with the combination of atezolizumab (Tecentriq) plus chemotherapy vs chemotherapy alone in the randomized, phase III, IMpower131 clinical trial.1 At the landmark of 12-month...

lung cancer

Expert Point of View: David Rimm, MD, PhD

“TUMOR MUTATIONAL burden is an emerging biomarker independent of programmed cell death ligand 1 (PD-L1) level. There are a few reasons for enthusiasm. Tumor mutational burden is a compelling biomarker for response and progression-free survival. Six-month progression-free survival is 50% with a...

lung cancer

Evidence Builds for Tumor Mutational Burden as Biomarker in Lung Cancer

TUMOR MUTATIONAL burden is emerging as a predictive biomarker for the combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) in non–small cell lung cancer (NSCLC), as well as other tumor types. However, experts say tumor mutational burden has hurdles to overcome. At the 2018 Annual Meeting of...

skin cancer

Expert Point of View: Jedd Wolchok, MD, PhD

“THIS IS a wonderful presentation and a very exciting trial,” said formal discussant Jedd Wolchok, MD, PhD, of Memorial Sloan Kettering Cancer Center, New York. Despite the remarkable advances achieved with anti–programmed cell death protein 1 and ligand 1 (anti–PD-1/anti–PD-L1) treatment, “there...

skin cancer
immunotherapy

Early Data Suggest TLR9 Agonist May Combat PD-1 Resistance in Advanced Melanoma

COMBINING CMP-001, a Toll-like receptor 9 (TLR9) agonist, plus pembrolizumab (Keytruda) appears to overcome resistance to anti–programmed cell death protein 1 (anti–PD-1) therapy, according to a preliminary phase Ib study.1 Adding CMP-001 to pembrolizumab was well tolerated, with antitumor efficacy ...

lung cancer

Expert Point of View: David Graham, MD, FASCO

ASCO EXPERT David Graham, MD, FASCO, Medical Director at the Levine Cancer Institute in Charlotte, North Carolina, was enthusiastic about this new technology. “This is an important first step showing there is an easier way to detect lung cancer at earlier stages. If the promise of this report...

lung cancer

Genome Sequencing of Blood Samples May Lead to Detection of Early- Stage Lung Cancer

IF THE INITIAL promise of research presented at the 2018 ASCO Annual Meeting bears fruit, we may one day have a simple blood test to screen for early-stage lung cancer and possibly other cancers. Although it is still very early days for this test, an initial report from the ongoing Circulating...

lung cancer

Expert Point of View: Marina Chiara Garassino, MD, and Justin Gainor, MD

“TODAY WE HAVE good news, because IMpower 150 is another clear positive trial on the combination of chemotherapy with immunotherapy. This is true in terms of progression-free and overall survival, which are both statistically significant [for atezolizumab (Tecentriq) plus bevacizumab (Avastin)...

lung cancer
immunotherapy

More Evidence of Benefit With Immunotherapy and Chemotherapy in Nonsquamous Non–Small Cell Lung Cancer

ATEZOLIZUMAB (TECENTRIQ) plus bevacizumab (Avastin) plus a platinum doublet (ABCP) improved overall survival by 22% compared with bevacizumab plus a platinum doublet (BCP) in patients with advanced wild-type (without an identified mutation) nonsquamous non–small cell lung cancer (NSCLC), according...

lung cancer

Expert Point of View: Charles Drake, MD, PhD

“THIS TRIAL is a clear winner for the treatment of squamous non–small cell lung cancer [NSCLC],” stated formal discussant Charles Drake, MD, PhD, of Herbert Irving Comprehensive Cancer Center, Columbia University Medical Center, New York.  “The concept underlying the combination of checkpoint...

lung cancer
immunotherapy

KEYNOTE-407: Pembrolizumab Plus Chemotherapy Benefits Response, Survival in Squamous NSCLC

THE COMBINATION of pembrolizumab (Keytruda) plus platinum-based chemotherapy improved overall survival, response rates, and duration of response in patients with advanced squamous cell non–small cell lung cancer (NSCLC) compared with chemotherapy alone irrespective of programmed cell death ligand 1 ...

Expert Point of View: Naiyer Rizvi, MD

“In CheckMate 227, the benefit of nivolumab [Opdivo] plus ipilimumab [Yervoy] was the same in tumor mutational burden–high patients whether or not they were programmed cell death ligand 1 (PD-L1)–high or –low,” said formal discussant of this paper, Naiyer Rizvi, MD, Director of Thoracic Oncology...

solid tumors
lung cancer

Nivolumab Plus Ipilimumab Improves Progression-Free Survival in NSCLC With High Tumor Mutational Burden

The combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) improved progression-free survival compared with chemotherapy as first-line treatment for patients with advanced non–small cell lung cancer (NSCLC) and a high tumor mutational burden irrespective of programmed cell death ligand 1...

Expert Point of View: Amir Fathi, MD, and Eunice S. Wang, MD

Commenting on this study, Amir Fathi, MD, a hematologist/oncologist at Massachusetts General Hospital and a co-investigator on the study, expressed hope about this new targeted approach. “Ivosidenib is an oral targeted inhibitor of the altered isocitrate dehydrogenase-1 (IDH1) protein. This...

hematologic malignancies
leukemia

Phase I Study Shows Safety, Efficacy of Ivosidenib in Acute Myeloid Leukemia

Ivosidenib, an isocitrate dehydrogenase-1 (IDH1) inhibitor, yielded durable and molecular remissions in some patients with IDH1-mutated advanced relapsed or refractory acute myeloid leukemia (AML). At a dose of 500 mg/d, ivosidenib was associated with a low frequency of grade 3 or higher...

Expert Point of View: Richard L. Schilsky, MD

“This study shows us that it is possible to get equally good outcomes with lower costs. In the United States, we have no real way to constrain the costs of health care, including the cost of drugs. The U.S. Food and Drug Administration does not consider drug price in deliberations about bringing...

solid tumors
gastrointestinal cancer
colorectal cancer

Care for Colorectal Cancer Costs Twice as Much in Western Washington vs British Columbia, With Similar Survival

It is widely acknowledged that the costs of cancer care are much higher in the United States than in Canada, with outcomes that are thought to be similar. A new study presented at the 2018 ASCO Annual Meeting supports that view, by documenting and quantifying the differences in health-care costs...

Expert Point of View: Andrew Epstein, MD

“This is a very important study,” said ASCO expert Andrew Epstein, MD, of Memorial Sloan Kettering Cancer Center (MSK), New York. “Hyperthermic intraperitoneal chemotherapy is used in the United States and elsewhere, even though the benefits are unknown. This study shows there are no benefits, and ...

solid tumors
gastrointestinal cancer
colorectal cancer

Less Is More: No Benefit Reported for Hyperthermic Intraperitoneal Chemotherapy in Colorectal Cancer

With a growing emphasis on value in cancer care, some types of resource-intensive therapies may need to be reconsidered. One such treatment may be hyperthermic intraperitoneal chemotherapy, which showed no benefit during surgery for colorectal cancer confined to the peritoneum in the PRODIGE 7...

Expert Point of View: Charles G. Drake, MD, PhD and Hatem H. Soliman, MD

Formal discussant of the GeparNuevo presentation, Charles G. Drake, MD, PhD, of the Herbert Irving Comprehensive Cancer Center at Columbia University Medical Center, New York, said, “It is important that neoadjuvant immunotherapy combinations are being studied. There is a lot of enthusiasm for...

breast cancer
immunotherapy

Priming the Immune System: Neoadjuvant Durvalumab Plus Chemotherapy May Be Beneficial in Triple-Negative Breast Cancer

The addition of durvalumab -(Imfinzi) to anthracycline/taxane-based chemotherapy had encouraging results as neoadjuvant therapy for early triple-negative breast cancer in the randomized phase II GeparNuevo study presented at the 2018 ASCO Annual Meeting.1 The results were positive in a subgroup of...

Expert Point of View: Daniel George, MD, Robert J. Motzer, MD, and Paul Russo, MD

Formal discussant of the CARMENA trial, Daniel George, MD, of Duke University Medical Center, Durham, North Carolina, had reservations about the broad application of these results. “CARMENA was designed to reassess the value and role of nephrectomy in patients who present with metastatic renal...

solid tumors
kidney cancer

Nephrectomy May Be Avoided in Some Patients With Advanced Renal Cell Carcinoma

In the modern era of targeted therapy, some patients with metastatic renal cell carcinoma may be able to forgo nephrectomy and be treated with sunitinib (Sutent) alone, according to results of the phase III CARMENA trial reported during the Plenary Session at the 2018 ASCO Annual Meeting.1 The...

lung cancer

Expert Point of View: John V. Heymach, MD, PhD

FORMAL DISCUSSANT of this trial, John V. Heymach, MD, PhD, of The University of Texas MD Anderson Cancer Center, Houston, also was optimistic about these early findings. “This is a proof-of-concept study showing this approach is safe. Only modest activity was observed with standard [Response...

lung cancer

Early Evidence of Neoadjuvant PD-1 Blockade in Non–Small Cell Lung Cancer

A NOVEL APPROACH using two doses of nivolumab (Opdivo) prior to surgery achieved major pathologic responses in 45% of patients with resectable stages I to IIIA non–small cell lung cancer (NSCLC), according to the results of a small Stand Up 2 Cancer–Cancer Research Institute Dream Team study...

lung cancer

Expert Point of View: John Heymach, MD, PhD, and Leena Gandhi, MD

“THIS STUDY represents a true milestone in the field of lung cancer. For the first time, the vast majority of patients with non–small cell lung cancer (NSCLC) can receive immunotherapy with pembrolizumab (Keytruda),” said ASCO expert John Heymach, MD, PhD, of MD Anderson Cancer Center, Houston,...

lung cancer

Immunotherapy Benefits Survival, Improves Safety, vs Platinum-Based Chemotherapy for PD-L1–Expressing NSCLC

IMMUNOTHERAPY WITH pembrolizumab (Keytruda) improved overall survival compared with investigator’s choice of platinum-based chemotherapy as first-line treatment for patients with advanced non–small cell lung cancer (NSCLC) in the KEYNOTE-042 trial. Median overall survival was improved by 4 to 8...

solid tumors
immunotherapy

New Data on ALK Inhibitors and CAR T-Cell Therapies

The 2018 American Association for Cancer Research (AACR) Annual Meeting was abuzz with more than 22,000 attendees from around the world who came to Chicago to hear the latest in basic science and clinical trial results. Here we present summaries of a few of the highlights from the AACR meeting...

Expert Point of View: Alexander Drilon, MD

Formal discussant of the study on BLU-667, Alexander Drilon, MD, Clinical Director, Early Drug Development Service at Memorial Sloan Kettering Cancer Center, New York, was enthusiastic about these early results. “We’ve known about RET for more than 30 years. To date, no targeted therapy has been...

solid tumors

First Selective RET Inhibitor Shows Efficacy in Multiple Cancers

A first-in-human study provides proof of concept that a novel oral agent targeted to RET genetic alterations is safe and active in RET-driven cancers. The agent, called BLU-667, achieved durable disease control in patients with lung and thyroid cancers harboring the RET oncogene, according to the...

colorectal cancer
breast cancer
hepatobiliary cancer
lung cancer
kidney cancer
prostate cancer
cns cancers
leukemia

NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®): 2018 Guidelines Updates

In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®) covering 8 tumor types. Guidelines are now published for more than 60 tumor types and topics. Some of the key updates were presented at NCCN’s 23rd...

Expert Point of View: Howard Weinstein, MD

“These are excellent results, both overall and for patients randomly assigned to nelarabine with either high-dose methotrexate or escalated-dose methotrexate,” said Howard Weinstein, MD, Chief of Pediatric Hematology/Oncology at Massachusetts General Hospital, Boston, who was not involved in this...

hematologic malignancies

Upfront Use of Nelarabine Plus Chemotherapy Improves Disease-Free Survival in T-Cell Malignancies

Upfront use of nelarabine plus standard Children’s Oncology Group–augmented Berlin-Frankfurt-Münster (aBFM) chemotherapy boosted survival rates in children and young adults with newly diagnosed T-cell acute lymphoblastic leukemia (T-ALL) and T-cell lymphoblastic leukemia (T-LL), according to the...

solid tumors
issues in oncology
symptom management

NCCN Debuts Three New Sets of Guidelines

THE NATIONAL Comprehensive Cancer Network® (NCCN®) debuted three sets of completely new guidelines for treating patients with uveal melanoma, for treating patients who have cancer and the human immunodeficiency virus (HIV), and for managing immune-related toxicities.  Cancer in People Living With...

skin cancer

Expert Point of View: Antoni Ribas, MD

FOUR RANDOMIZED trials have shown improvements in recurrence-free survival in patients with high-risk melanoma with the administration of adjuvant therapy over the past 3 years, noted formal discussant of the EORTC 1325/KEYNOTE-054 trial, Antoni Ribas, MD, Director of the Tumor Immunology Program...

skin cancer
immunotherapy

Adjuvant Pembrolizumab Improves Relapse-Free Survival in High-Risk Stage III Melanoma

ADJUVANT THERAPY with pembrolizumab (Keytruda) significantly prolonged recurrence-free survival compared with placebo for patients with resected high-risk stage III melanoma, according to the results of the EORTC 1325/KEYNOTE-054 trial.1 Patients who received pembrolizumab had a 43% reduction in...

lung cancer

Expert Point of View: Roy S. Herbst, MD, PhD

FORMAL DISCUSSANT of the KEYNOTE-189 trial, Roy S. Herbst, MD, PhD, Chief of Medical Oncology at Smilow Cancer Hospital, Yale Cancer Center, New Haven, heartily endorsed the new triplet combination of pembrolizumab, pemetrexed, and a platinum in advanced nonsquamous non– small cell lung cancer...

lung cancer
immunotherapy

Pembrolizumab Plus Standard Chemotherapy Improves Survival in Newly Diagnosed Metastatic Non–Small Cell Lung Cancer

ADDING THE IMMUNE checkpoint inhibitor pembrolizumab (Keytruda) to standard chemotherapy with pemetrexed (Alimta) and a platinum as first-line therapy was superior to chemotherapy alone in the KEYNOTE-189 trial.1 Induction and maintenance therapies with the new triplet therapy improved overall...

hematologic malignancies
leukemia
immunotherapy

Fine-Tuning Treatment in Myeloma and Leukemia

It is a difficult task to include every notable presentation from the 2017 American Society of Hematology (ASH) Annual Meeting & Exposition. In addition to our more comprehensive coverage of the news from that meeting over the past several issues, below are summaries of additional key...

Expert Point of View: Marisa Weiss, MD

At a press conference where the findings by Chlebowski et al were presented, Marisa Weiss, MD, Founder and Chief Medical Officer of Breastcancer.org and Director of Radiation Oncology at Lankenau Medical Center in Philadelphia, commended this study. “We could set a goal of losing 5 pounds for our...

breast cancer

Modest Weight Loss Reduces Breast Cancer Risk

Evidence of the numerous health benefits of weight loss continues to mount, and the hope is that doctors and patients are listening. A large observational study presented at the 2017 San Antonio Breast Cancer Symposium showed that weight loss of more than 5% is associated with a significantly lower ...

solid tumors

Expert Point of View: Aaron Richard Hansen, BSc, MBBS (Hon), FRACP

“FOR THIS RARE tumor with a paucity of data, all we have are phase II trials to make treatment selection,” said invited discussant Aaron Richard Hansen, BSc, MBBS (Hon), FRACP, of the Princess Margaret Hospital, Toronto. “For patients with de novo metastatic disease or relapse after definitive...

solid tumors

Vinflunine May Benefit Selected Patients With Penile Cancer

PENILE CANCER is rare, outcomes remain poor, and there are few data from randomized trials to guide treatment decisions. However, in the small phase II VinCaP study, presented at the 2018 Genitourinary Cancers Symposium, 45.5% of patients with advanced or metastatic penile cancer had a clinical...

bladder cancer
kidney cancer
prostate cancer

GU Symposium Focuses on Prognostic Model in Urothelial Cancer, Novel Therapies for Prostate and Kidney Cancers

THE 2018 GENITOURINARY Cancers Symposium hosted an international audience of oncologists and other stakeholders to hear about the latest advances in the field. We have included coverage of many of the top news stories from the meeting in previous issues of The ASCO Post. Here are summaries of a few ...

Expert Point of View: Kathryn Ruddy, MD

  “This is a very exciting study. Acupuncture is another tool to address arthralgias associated with aromatase inhibitor therapy,” said Kathryn Ruddy, MD, of the Mayo Clinic, Rochester, Minnesota. “I don’t think every patient with joint pain will opt for this for a variety of reasons, including...

symptom management
supportive care
solid tumors
breast cancer

Acupuncture for Joint Pain Associated With Aromatase Inhibition

Although aromatase inhibitors are highly effective as adjuvant therapy in metastatic breast cancer and for prevention of breast cancer, the side effects can be difficult to tolerate and often lead to discontinuation of therapy. A phase III randomized trial has found that acupuncture may relieve...

multiple myeloma

EXPERT POINT OF VIEW: Kenneth C. Anderson, MD, and S. Vincent Rajkumar, MD

AT A PREMEETING webinar, American Society of Hematology then President Kenneth C. Anderson, MD, Director of the Lebow Institute for Myeloma Therapeutics and Jerome Lipper Myeloma Center at Dana-Farber Cancer Institute, Boston, commented: “This study demonstrates this new treatment has good...

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