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Expert Point of View: Hope S. Rugo, MD

The Formal discussant of this presentation, Hope S. Rugo, MD, of the University of California, San Francisco, said, “Tailoring treatment to biology results in incremental improvements in outcome.” She continued: “This analysis gives us excellent data on the natural history of mostly hormone...

solid tumors
breast cancer

About One in Four Women With Small Breast Tumors May Benefit From Chemotherapy

A large subset analysis of the MINDACT trial suggests that oncologists may be undertreating women with small (< 1 cm) node-negative breast tumors, which are clinically considered to be low risk but can be genomically high risk. About one in four women with small node-negative breast tumors <...

solid tumors
lung cancer

Unraveling PD-L1 Assays in NSCLC: Are They Interchangeable?

With the availability of at least five checkpoint inhibitors to treat non–small cell lung cancer (NSCLC) and other solid tumors, appropriate patient selection for these expensive treatments remains key. The hope is that testing the level of programmed cell death ligand 1 (PD-L1) expression in tumor ...

gynecologic cancers

EXPERT POINT OF VIEW: Geraldine M. Jacobson, MD, MPH, MBA

GERALDINE M. JACOBSON, MD, MPH, MBA, ASTRO Secretary/Treasurer, Professor and Chair of Radiation Oncology at the West Virginia University School of Medicine, Morgantown, went into more detail about the importance of this study. “The study directly compared brachytherapy/chemotherapy, which we use...

gynecologic cancers

Pelvic Radiation Therapy Preferred Over Brachytherapy Plus Chemotherapy in Treatment of High-Risk Endometrial Cancer

VAGINAL CUFF BRACHYTHERAPY plus chemotherapy failed to show superiority over pelvic radiation therapy for women with high-risk stage I–II endometrial cancer in a phase III trial.1 Furthermore, vaginal cuff brachytherapy plus chemotherapy led to more pelvic and para-aortic nodal recurrences and...

head and neck cancer

EXPERT POINT OF VIEW: Sandrine Faivre, MD, PhD

Commenting on these study results, formal discussant Sandrine Faivre, MD, PhD, of Bichat-Beaujon University Hospitals Paris Nord Val de Seine, Paris, France, said: “It is a challenge to identify patients who we should allow to remain on immune checkpoint inhibitor treatment. In KEYNOTE-040, the...

head and neck cancer

Pembrolizumab Benefits Patients With Recurrent Metastatic Head and Neck Cancer, Mainly High PD-L1–Expressing Tumors

Pembrolizumab (Keytruda) may be a better choice than standard of care for patients with recurrent or metastatic head and neck squamous cell carcinoma, especially those whose tumors express programmed cell death ligand 1 (PD-L1) in 50% or more of cells, suggest results of the phase III KEYNOTE-040...

breast cancer
gynecologic cancers

More Data From ESMO 2017

In GEICAM 2006-10, the addition of fulvestrant at 250 mg/d to anastrozole did not improve 5-year disease-free survival over anastrozole alone (91.0% vs 90.8%).  “Immune induction” with chemotherapy or radiotherapy appeared to enhance response to nivolumab in women with metastatic triple-negative...

breast cancer
gynecologic cancers

International Trials Reveal New Findings in the Management of Breast and Ovarian Cancers

The European Society for Medical Oncology (ESMO) 2017 Congress, held in Madrid, featured important news including at least seven practice-changing or potentially practice-changing trials, which are covered in recent issues of The ASCO Post. Here we present additional highlights of studies in breast ...

lung cancer

Expert Point of View: Luis Paz-Ares, MD

FORMAL DISCUSSANT of the ALEX and ALUR trials, Luis Paz-Ares, MD, Professor of Medicine at the Hospital Universitario 12 de Octubre, Madrid, said that the ALEX trial is “good news” for patients. “Importantly, 40% had baseline metastases. Disease progression was nicely controlled with alectinib...

lung cancer

Alectinib Yields Favorable Results in Phase&nbsp;III Trials of ALK-Positive NSCLC

RESULTS OF TWO separate phase III trials confirm the activity of alectinib (Alecensa) in the central nervous system (CNS) in patients with anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC). Results lend support for alectinib as the better first-line treatment option over...

prostate cancer

Expert Point of View: Stéphane Oudard, MD

DURING A DISCUSSION of Dr. Vale’s poster, Stéphane Oudard, MD, Professor of Oncology and Chief of the Oncology Clinical and Translational Research Unit at Georges Pompidou Hospital in Paris, France, said that although newer treatments have improved survival, there are still many challenges in...

prostate cancer

Expert Point of View: Cora Sternberg, MD

FORMAL DISCUSSANT of the STAMPEDE trial, Cora Sternberg, MD, Chief of the Department of Medical Oncology, San Camillo Forlanini Hospital, Rome, commended the study design. “This multiarm, multistage design is very innovative. The investigators plan up to 10 trials over 20 years. The first results...

prostate cancer

Abiraterone or Docetaxel: Which Is Optimal for Hormone-Sensitive High-Risk Prostate Cancer?

ABIRATERONE ACETATE (Zytiga) plus prednisone and docetaxel have moved up from the castrate-resistant metastatic setting to earlier in the course of disease as treatment of high-risk hormone-sensitive prostate cancer in men who are initiating androgen-deprivation therapy, based on level 1 evidence...

bladder cancer

Expert Point of View: Yohann Loriot, MD, PhD

FORMAL DISCUSSANT of the RANGE trial at the ESMO 2017 Congress, Yohann Loriot, MD, PhD, of the Institut Gustave Roussy and University of Paris-Saclay, Villejuif, Paris, said that although the study met its primary endpoint, he was not sure the absolute improvement in progression-free survival is...

bladder cancer

Positive Early Data on Second-Line Ramucirumab/Docetaxel in Platinum-Refractory Advanced Urothelial Cancer

RAMUCIRUMAB (CYRAMZA) added to docetaxel improved progression-free survival and almost doubled the overall response rate compared with docetaxel alone in patients with advanced or metastatic urothelial cancer that has progressed on platinum-based chemotherapy. These results of the phase III RANGE...

head and neck cancer

Expert Point of View: Paul Harari, MD

COMMENTING ON THIS STUDY, ASTRO President Paul Harari, MD, was enthusiastic about the results. Dr. Harari is the Jack Fowler Professor and Chairman of the Department of Human Oncology at the University of Wisconsin School of Medicine and Public Health and Associate Director of the University of...

head and neck cancer

Cutting Radiation Exposure by 50% Appears Safe and Effective in HPV-Positive Head and Neck Cancer

AGGRESSIVE REDUCTION in radiation therapy appears to be a potential win-win situation for patients with human papillomavirus (HPV)-associated oropharyngeal squamous cell carcinoma, according to the results of a phase II trial presented at the 2017 Annual Meeting of the American Society for...

solid tumors

Expert Point of View: Brian G. Czito, MD, and Phuoc T. Tran, MD, PhD

“THESE PRELIMINARY STUDY RESULTS suggest that combining these modalities [immunotherapy and radiation therapy] can halt tumor growth in 30% to 57% of patients, with the radiation-induced tumor response acting as a sort of vaccine in combination with immunotherapy. This cutting-edge strategy...

solid tumors

Immunotherapy Plus Radiation Appears Active in Patients With Solid Tumors and Lung or Liver Metastases

THE NOVEL COMBINATION of immunotherapy with ipilimumab (Yervoy) plus radiation achieved a clinical benefit in up to 57% of patients with solid tumors and metastases to the lungs or liver, according to evidence from a phase II trial presented at the 2017 Annual Meeting of the American Society for...

lung cancer

Expert Point of View: Brian G. Czito, MD, and Benjamin Movsas, MD

BRIAN G. CZITO, MD, a radiation oncologist at Duke Cancer Institute in Durham, North Carolina, commented on the study presented by Iyengar et al at the 2017 American Society for Radiation Oncology Annual Meeting.  “This study of focal high-dose radiation in stage IV patients with limited...

lung cancer

Consolidative Radiation Therapy: New Paradigm for Limited Metastatic NSCLC?

ADDING CONSOLIDATIVE RADIATION therapy to maintenance chemotherapy had a robust effect on preventing disease progression compared with maintenance chemotherapy alone in patients with limited metastatic non–small cell lung cancer (NSCLC), according to a late-breaking study presented at the 2017...

bladder cancer

Expert Point of View: Maria De Santis, MD

THE 2017 EUROPEAN SOCIETY for Medical Oncology (ESMO) Congress spokesperson Maria De Santis, MD, of the University of Warwick, Coventry, and Queen Elizabeth Hospital, Cancer Center, in Birmingham, UK, said the survival advantage in KEYNOTE-045 updated results was noteworthy.  “These results...

bladder cancer

Second-Line Pembrolizumab Extends Survival in Urothelial Cancer

PEMBROLIZUMAB (KEYTRUDA) extended survival by about 3 months in patients with advanced urothelial cancer whose disease progressed on platinum-based chemotherapy vs investigator’s choice of therapy, according to the mature results of the KEYNOTE-045 trial presented at the European Society for...

gynecologic cancers

Strong Showing for Rucaparib Maintenance Therapy for Platinum-Sensitive Ovarian Cancer

EVIDENCE CONTINUES to mount for the benefits of poly (ADP-ribose) polymerase (PARP) inhibition in ovarian cancer. Rucaparib (Rubraca) maintenance therapy after response to platinum-containing therapy significantly improved progression-free survival in patients with recurrent ovarian cancer compared ...

lung cancer

‘Clinically Meaningful’ Results With First-Line Osimertinib in EGFR–Positive NSCLC

OSIMERTINIB (TAGRISSO) showed encouraging results as first-line therapy for patients with epidermal growth factor receptor (EGFR)–mutated non–small-cell lung cancer (NSCLC) in the phase III FLAURA trial, according to results presented at the 2017 European Society for Medical Oncology (ESMO)...

lung cancer

Expert Point of View: Tony Mok, MD, FASCO

“IN 2008, I presented the IPASS results. FLAURA has beaten me to the ground. The results exceeded expectations, and FLAURA is undoubtedly a positive study,” stated formal discussant Professor Tony Mok, MD, FASCO, Chair of Department of Clinical Oncology, the Chinese University of Hong Kong. “It is ...

kidney cancer

Expert Point of View: Manuela Schmidinger, MD

FORMAL DISCUSSANT, Manuela Schmidinger, MD, of the Medical University of Austria, Vienna, commented on the CheckMate 214 findings. “We have just seen a change in the paradigm in the treatment of metastatic renal cell cancer.”  “More than a decade ago, VEGF [vascular endothelial growth factor]...

kidney cancer

Nivolumab Plus Ipilimumab vs Sunitinib Alone as First-Line Therapy for Metastatic Renal Cell Carcinoma

A CHANGE IN PARADIGM may be on the horizon for the treatment of metastatic renal cell carcinoma. According to the results of CheckMate 214, the combination of ipilimumab (Yervoy) plus nivolumab (Opdivo) outperformed the standard of care—sunitinib (Sutent)—for first-line treatment, with improved...

prostate cancer

Emotional and Psychological Distress Associated With Prostate Cancer

A cancer diagnosis presents emotional and psychological challenges for patients and caregivers, and prostate cancer has some unique challenges, in part because management is not writ in stone. At several points along the trajectory of illness, men with prostate cancer face decisions that can be...

lung cancer

Expert Point of View: Johan Vansteenkiste, MD, PhD

FORMAL DISCUSSANT of this trial, Johan Vansteenkiste, MD, PhD, Head of the Respiratory Oncology Unit at the University Hospital KU Leuven, Belgium, was enthusiastic about the PACIFIC trial results. “We had an earthquake of immunotherapy in lung cancer this past year at ESMO. After an earthquake,...

lung cancer

PD-L1 Inhibitor Consolidation Therapy for NSCLC: New Standard of Care?

THE PROGRAMMED CELL DEATH ligand 1 (PD-L1) inhibitor durvalumab (Imfinzi) improved progression-free survival by 11.2 months compared with placebo in patients with locally advanced, unresectable stage III non–small cell lung cancer (NSCLC) whose disease did not progress following standard treatment ...

prostate cancer

International Consensus (or Not) on Management of Advanced Prostate Cancer

ALTHOUGH THE National Comprehensive Cancer Network® (NCCN®) Clinical Practice Guidelines in Oncology (NCCN Guidelines®) strongly influence the management of advanced prostate cancer, they do not always reflect actual clinical practice. It turns out that in the real world, there are multiple areas ...

sarcoma
cns cancers
lymphoma
survivorship

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

MOST ONCOLOGISTS are familiar with the findings of the plenary sessions featured at the 2017 ASCO Annual Meeting, with topics ranging from the duration of adjuvant oxaliplatin-based therapy in stage III colon cancer to patient-reported outcomes for symptom monitoring during routine cancer...

solid tumors

Expert Point of View: Siwen Hu-Lieskovan, MD

“COMBINATION STRATEGIES are being developed, but the big question is what and how to combine,” said formal discussant Siwen Hu-Lieskovan, MD, of the University of California Los Angeles. “Anti–programmed cell death protein 1 (PD-1) therapy works at the last step of T-cell activation and relies on...

solid tumors

Combination Strategies for Jump-Starting the Immune Response

CHECKPOINT INHIBITORS have dramatically changed the landscape of the treatment of melanoma, lung, bladder, and other cancers. Researchers are focusing on exploring ways to extend the use of checkpoint inhibitors to other disease states and to combine them with novel agents and improve outcomes.  At ...

lung cancer

Retreatment With Checkpoint Inhibitors May Be Feasible for Some Patients With NSCLC

INCREASING NUMBERS of patients are being treated with checkpoint inhibitors, and about one-quarter to one-third will develop immune-related adverse events. One question on the minds of oncologists is can these patients be safely re-treated once their adverse events resolve?  One of the first...

lung cancer

Expert Point of View: John Heymach, MD

"TO PUT THESE RESULTS into context, currently we have three approved epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors for EGFR-positive non–small cell lung cancer (NSCLC): gefitinib (Iressa), erlotinib (Tarceva), and afatinib (Gilotrif). Not many studies have compared these drugs ...

lung cancer

Dacomitinib Outperforms Gefitinib in EGFR-Positive NSCLC

DACOMITINIB, a second-generation epidermal growth factor receptor (EGFR)-targeted tyrosine kinase inhibitor, outperformed gefitinib (Iressa) as first-line treatment for EGFR-positive advanced non–small cell lung cancer (NSCLC) in the phase III ARCHER 1050 study.1 Dacomitinib improved...

kidney cancer

Expert Point of View: Hans Hammers, MD, PhD

THE COMBINATION of checkpoint inhibitors and vascular endothelial growth factor (VEGF) inhibitors is attractive in renal cell carcinoma, said formal discussant of this trial, Hans Hammers, MD, PhD, of the University of Texas Southwestern Medical Center in Dallas.  “Twenty-one percent of patients...

kidney cancer

Atezolizumab/Bevacizumab Moves Forward in Metastatic Renal Cell Carcinoma

THE COMBINATION of atezolizumab (Tecentriq) plus bevacizumab (Avastin) showed promising results as first-line treatment of patients with metastatic renal cell carcinoma, according to a phase II trial called IMmotion 150. Based on these results, the phase III IMmotion 151 trial is comparing...

leukemia

Expert Point of View: Nitin Jain, MD, and Susan O'Brien, MD

Formal discussant of the GENUINE trial, Nitin Jain, MD, of The University of Texas MD Anderson Cancer Center, Houston, noted that the majority of responses to ibrutinib (Imbruvica) in high-risk patients are partial responses. “These patients [have disease progression] even in the context of...

leukemia

Ublituximab/Ibrutinib Beneficial in Patients With Chronic Lymphocytic Leukemia

The addition of ublituximab (a glycoengineered anti-CD20 antibody) to ibrutinib (Imbruvica) improved response rates, depth of response, and led to quicker resolution of ibrutinib-associated lymphocytosis in patients with high-risk chronic lymphocytic leukemia (CLL) in the phase III GENUINE trial,...

lung cancer

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

“This is a watershed moment in the treatment of anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC). Often studies show only incremental improvements with a new treatment. This is different. Alectinib [Alecensa] shows a dramatic increase in efficacy that is also accompanied ...

lung cancer

Alectinib vs Crizotinib in First-Line Treatment of ALK-Positive NSCLC

In 2011, crizotinib (Xalkori) became the first effective targeted therapy for anaplastic lymphoma kinase (ALK)-positive non–small cell lung cancer (NSCLC). Now data from a phase III trial show that alectinib (Alecensa), a second-generation ALK inhibitor, outperformed crizotinib, the current...

leukemia

Expert Point of View: Susan O'Brien, MD

Commenting on the studies of CAR T cells in chronic lymphocytic leukemia (CLL) thus far, Susan O’Brien, MD, of the University of California at Irvine, said: “Some people are disappointed in the results, but the problem is there was too much hype to begin with. The first article on CAR T published...

leukemia

Newer Approaches With CAR T Cells Explored in CLL

Chimeric antigen receptor (CAR) T-cell therapy is a hot area of research and development in hematologic malignancies and, more recently, some solid tumors. Results have been particularly good in acute lymphocytic leukemia, and one or more CAR T-cell products may be getting close to approval by the ...

breast cancer

Expert Point of View: Allison Kurian, MD, MSc

Formal discussant of this paper, Allison Kurian, MD, MSc, of Stanford University School of Medicine, said: “I think these results are practice-changing. Toxicity and quality of life were better with olaparib [Lynparza].” Dr. Kurian noted that the study did not report correlative biomarkers for...

breast cancer

Olaparib Improves Progression-Free Survival in BRCA-Associated Breast Cancer

The PARP INHIBITOR olaparib (Lynparza) improved progression-free survival in women with HER2-negative metastatic breast cancer that was either hormone receptor–positive or triple-negative in patients who had a germline BRCA mutation.1,2 These results of the international, randomized, open-label,...

prostate cancer

Expert Point of View: Sumanta Pal, MD

LATITUDE Trial ASCO expert Sumanta Pal, MD, of the City of Hope Comprehensive Cancer Center in Duarte, California, commented on the LATITUDE trial at a press conference. “In 2014, docetaxel added to hormonal therapy showed an improved survival benefit in two trials—CHAARTED and STAMPEDE. It was no ...

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