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Expert Point of View: Eric Van Cutsem, MD, PhD

Invited discussant Eric Van Cutsem, MD, PhD, of the University Hospitals Leuven in Belgium, put the JACOB trial findings in context of what is known for HER2-positive metastatic gastric/gastroesophageal junction cancer, where two targeted agents are approved: trastuzumab (Herceptin) in the first...

solid tumors
gastrointestinal cancer
gastroesophageal cancer

Metastatic Gastric Cancer: Dual HER2-Targeting Study Does Not Meet Primary Endpoint in Metastatic Gastric Cancer

Dual HER2 targeting in metastatic gastric and gastroesophageal junction cancers did not significantly improve outcomes over trastuzumab (Herceptin) alone—both in combination with chemotherapy—according to the results of the phase III JACOB study reported at the 2017 European Society for Medical...

IDEA Trial: ‘Going Beyond Statistics’ in Stage III Colon Cancer

According to Alberto Sobrero, MD, Head of Medical Oncology at Ospedale San Martino in Genova, Italy, the results of the pivotal IDEA trial, which evaluated the optimal duration of adjuvant chemotherapy for stage III colon cancer, were not clear to clinicians.1 The combined analysis of six...

skin cancer

Melanoma Mutations: What You Need to Know

CLINICIANS ARE now well acquainted with BRAF mutations in advanced melanoma, but there is more to genomics in this disease than identifying BRAF and prescribing a BRAF inhibitor.  At the 2017 Debates and Didactics Conference, held at Sea Island, Georgia, Melinda L. Yushak, MD, MPH, of Emory...

Expert Point of View: Nadia Harbeck, MD, PhD

Invited discussant Nadia Harbeck, MD, PhD, Head of the Breast Center of the University of Munich (LMU), Germany, said the UNICANCER-NeoPAL trial points toward the future of endocrine therapy in early breast cancer—using cyclin-dependent kinase 4/6 (CDK4/6) inhibitors as a means of “enhancing” this ...

solid tumors
breast cancer

Pathologic Complete Response Rates Not Improved With Neoadjuvant Letrozole/Palbociclib

As neoadjuvant treatment of women with high-risk luminal breast cancer, the combination of letrozole and palbociclib (Ibrance) did not reduce the residual cancer burden or improve the rates of breast-conserving surgery, in the phase II UNICANCER- NeoPAL study presented at the 2017 European Society ...

pancreatic cancer

Resectable Pancreatic Cancer: Neoadjuvant or Adjuvant Therapy?

For potentially curable treatment of resectable pancreatic cancer, adjuvant therapy remains the standard “for now,” but evidence is growing that neoadjuvant therapy may be more beneficial, at least in certain patient subsets, according to Thomas Seufferlein, MD, PhD, Professor of Medicine at the...

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 ...

gastrointestinal cancer

Quick Takes on Studies in Noncolorectal Gastrointestinal Cancers

In this roundup, The ASCO Post offers a glance at key findings from studies in noncolorectal gastrointestinal malignancies presented at the European Society for Medical Oncology (ESMO) 2017 Congress from investigators around the world. Docetaxel-Based Triplet in Gastric Cancer The superiority of...

gastrointestinal cancer

EXPERT POINT OF VIEW: Eric Van Cutsem, MD, PhD

Invited discussant Eric Van Cutsem, MD, PhD, of University Hospitals Leuven, Belgium, commented that both ATTRACTION-02 and KEYNOTE-059 suggest that anti-PD [programmed cell death protein] antibodies have activity in advanced gastric cancer, but their findings differed with regard to the impact of ...

gastrointestinal cancer

Anti–PD-1 Agents Gaining Momentum in Gastric Cancer

In updates of two important studies in metastatic gastric cancer reported at the European Society for Medical Oncology (ESMO) 2017 Congress, nivolumab -(Opdivo) and pembrolizumab (Keytruda) demonstrated activity—but to varying degrees and with some nuances. “Anti-PD [programmed cell death protein]...

lung cancer

In Patients With Non–Small Cell Lung Cancer, Tumor Mutation Load Emerging as Biomarker for Immunotherapy

Tumor mutation burden is emerging as a biomarker for selecting non–small cell lung cancer (NSCLC) patients for immunotherapy, according to Naiyer Rizvi, MD, the Price Family Chair of Clinical Translational Medicine, Professor of Medicine, and Director of Thoracic Oncology at Columbia University,...

lung cancer

EXPERT POINT OF VIEW: Balazs Halmos, MD

The study’s invited discussant, Balazs Halmos, MD, Director of Thoracic Oncology and Clinical Cancer Genomics at Montefiore Medical Center and Albert Einstein College of Medicine, New York, called tumor mutation burden a “highly promising” biomarker of response to immune checkpoint inhibitors....

lung cancer

Tumor Mutation Burden Shows Promise as a Response Biomarker in Small Cell Lung Cancer

Patients with small cell lung cancer (SCLC) and a high tumor mutation burden had a near doubling in response rate and 1-year overall survival when ipilimumab (Yervoy) was combined with nivolumab (Opdivo), vs nivolumab alone, new findings from CheckMate 032 have shown. Regardless of the treatment...

lung cancer

No Additional Benefit Found for Routine, Early Palliative Care in Mesothelioma

Early routine specialist palliative care for patients recently diagnosed with malignant pleural mesothelioma did not impact quality of life, an international multicenter study has found.1 “Regular early specialist palliative care for patients was not associated with improved quality of life, as...

lung cancer

EXPERT POINT OF VIEW: Kemp Kernstine, MD, PhD

The study’s invited discussant Kemp Kernstine, MD, PhD, the Robert Tucker Hayes Foundation Distinguished Chair in Cardiothoracic Surgery at The University of Texas Southwestern Medical Center, Dallas, welcomed the findings, but expressed some concerns about the study. To begin, of a database of...

lung cancer

Residual Tumor ‘Uncertain’ Classification Validated in Non–Small Cell Lung Cancer

After surgical resection of non–small cell lung cancer (NSCLC), investigators from the International Association for the Study of Lung Cancer (IASLC) have validated outcomes for tumors deemed to be of “uncertain” residual tumor status (ie, R[un]). “The residual tumor (R) classification reflects the ...

lung cancer

EXPERT POINT OF VIEW: Joan H. Schiller, MD

JOAN H. SCHILLER, MD, Deputy Director of Inova Schar Cancer Institute in Fairfax, Virginia, pointed out that no one particular chemotherapy regimen has been shown to improve overall survival vs other standard regimens. “So if we can’t identify one best chemotherapy, what else can we do to make...

lung cancer

Treatment Based on BRCA1 Expression Did Not Improve Survival in NSCLC

IN PATIENTS with early-stage non–small cell lung cancer (NSCLC), the use of expression of BRCA1 failed as an approach to customize chemotherapy, investigators from the Spanish Lung Cancer Cooperative Group reported at the 2017 International Association for the Study of Lung Cancer (IASLC) World...

gynecologic cancers

Expert Point of View: Markus Joerger, MD, PhD, and Domenica Lorusso, MD, PhD

PRESS CONFERENCE MODERATOR Markus Joerger, MD, PhD, of St. Gallen Cancer Center, Switzerland, indicated that prior to the current study, it was unclear whether chemotherapy followed by surgery would be superior to chemoradiotherapy. “I think we all agree that it has been confirmed as the standard...

gynecologic cancers

Standard of Care Upheld for Locally Advanced Cervical Cancer

THE FIRST FORMAL comparison of two acceptable approaches to locally advanced cervical cancer has concluded that standard chemoradiotherapy is preferable to neoadjuvant chemotherapy plus surgery. The findings confirm what most specialists have believed to be the optimal treatment.  The results came ...

skin cancer

Expert Point of View: Alexander Eggermont, MD, PhD

BASED ON THE RESULTS of COMBI-AD1 and CheckMate 238,2 invited discussant Alexander Eggermont, MD, PhD, Professor of Oncology at Gustave Roussy in Paris, commented: “It’s a good day for melanoma!”  In COMBI-AD, treatment with the combination of dabrafenib (Tafinlar) and trametinib (Mekinist)...

skin cancer

CheckMate 238: Nivolumab Shows Benefit as Adjuvant Melanoma Treatment

IN THE TREATMENT of malignant melanoma, immune checkpoint inhibitors are no longer just for metastatic disease, and the best type may be agents targeting the programmed cell death protein 1 (PD-1), according to results of CheckMate 238, presented at the European Society for Medical Oncology (ESMO)...

skin cancer

Adjuvant BRAF/MEK Inhibition Improves Survival in Resectable Melanoma

FOR PATIENTS with locally advanced, resectable melanoma harboring BRAF mutations, adjuvant treatment with BRAF/ MEK inhibition significantly improves overall survival, results of the COMBI-AD trial have shown. The study was presented at the European Society for Medical Oncology (ESMO) 2017...

skin cancer

Blood-Based Biomarker: Predicting Efficacy of Immunotherapy in Patients With Melanoma

IN WHAT APPEARS TO BE the largest blood-based biomarker study of a checkpoint inhibitor, an RNA transcript–based gene classifier was able to predict for melanoma patients’ response to tremelimumab. The study was recently published in the Journal for ImmunoTherapy of Cancer.1  “Our study, in many...

breast cancer

Expert Point of View: Nadia Harbeck, MD, PhD, and Sibylle Loibl, MD

NADIA HARBECK, MD, PhD, of the Breast Center at the University of Munich, Germany, said the findings of LORELEI are among a growing list of indications that “the future is bright for endocrine-based therapy.”  Although the results were hypothesis-generating and not yet practice-changing, she...

breast cancer

Selective PI3K Inhibitor Boosts Effect of Letrozole in Neoadjuvant Setting

FOR THE first time, an inhibitor of the phosphoinositide 3-kinase (PI3K) pathway (taselisib) used in combination with endocrine therapy in the neoadjuvant setting improved response rates over endocrine therapy alone—with good tolerability—in women with early breast cancer, according to the phase...

lung cancer

Expert Point of View: Paul Baas, MD, PhD

INVITED DISCUSSANT Paul Baas, MD, PhD, of The Netherlands Cancer Institute, called the MAPS2 trial an “excellent example of how studies in mesothelioma should be run.”  As Dr. Baas pointed out, both arms performed well as second- and third-line treatment, with median progression-free survival with ...

lung cancer

Relapsed Mesothelioma Controlled by Checkpoint Inhibition

IN PATIENTS with malignant pleural mesothelioma, combination immunotherapy with two checkpoint inhibitors in the second or third line of treatment extended survival to at least 15 months in the MAPS2 trial,1 sponsored by the Intergroupe Francophone de Cancérologie Thoracique (IFCT) and reported at ...

breast cancer

Expert Point of View: Nicholas Turner, MD

NICHOLAS TURNER, MD, of The Royal Marsden and the Institute of Cancer Research in the UK, called the findings of MONARCH 3 “practice-changing.” The cyclin-dependent kinase 4/6 (CDK4/6) inhibitors have answered the need for agents that target the biology of estrogen receptor–positive breast cancer, ...

breast cancer

Abemaciclib Plus Endocrine Therapy Extends Progression-Free Survival in First-Line Therapy for Advanced Breast Cancer

THE VALUE OF cyclin-dependent kinase 4/6 (CDK4/6) inhibitors in advanced breast cancer became ever more certain with the announcement of interim data from MONARCH 3, which evaluated abemaciclib in combination with endocrine therapy as first-line therapy for hormone receptor–positive/HER2-negative...

sarcoma

Sarcoma Management Is Slowly Evolving

THE BACKBONE treatment for soft-tissue sarcomas has long been anthracycline-based, but new approaches are coming. These novel strategies were discussed at the 2017 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia, by Melinda L. Yushak, MD, MPH, Assistant Professor ...

cns cancers

Small Steps Forward in Brain Tumor Therapy

SOME RECENT ADVANCES in the treatment of brain tumors are promising, but others are less so, according to Jeffrey J. Olson, MD, Professor of Neurosurgery at Emory University, Atlanta. At the 2017 Debates and Didactics in Hematology and Oncology Conference, held in Sea Island, Georgia, and...

skin cancer

Is Complete Lymphadenectomy Still Standard of Care in Melanoma?

DOES COMPLETE lymph node dissection for sentinel node–positive melanoma still have a role in the management of this disease? That’s debatable. Although it does not improve overall survival over observation alone, complete lymphadenectomy may have other benefits, according to a dialogue at the...

hematologic malignancies

Amyloidosis: Pearls for Simplifying the Diagnosis

AMYLOIDOSIS REMAINS a challenging and nuanced diagnosis. At the 2017 Debates and Didactics in Hematology and Oncology Conference, held in Sea Island, Georgia, Jonathan L. Kaufman, MD, discussed his approach to diagnosing amyloid light-chain amyloidosis. Dr. Kaufman is Associate Professor of...

hepatobiliary cancer

Hepatocellular Carcinoma: Current Thoughts on Liver Transplantation

LIVER TRANSPLANT offers the highest rates of long-term survival for patients with hepatocellular carcinoma, according to Maria Russell, MD, Assistant Professor of Surgery at Emory University, Atlanta. At the 2017 Debates and Didactics in Hematology and Oncology Conference at Sea Island, Georgia,...

skin cancer

Expert Point of View: Reinhard Dummer, MD, and Jeffrey Weber, MD, PhD

ASSUMING THE regimens evaluated in COMBI-AD and CheckMate 238 are both approved by the U.S. Food and Drug Administration for the treatment of high-risk resected melanoma, clinicians may be faced with a tough choice. ESMO experts and the study’s investigators weighed in on this issue in a lively...

skin cancer

Significant Improvement in Outcomes Reported With Adjuvant Therapy for Melanoma

FOR PATIENTS with malignant melanoma, the significant improvement in outcomes with targeted agents and antibodies against the programmed cell death protein 1 (PD-1) has now been observed in the adjuvant setting. Two landmark studies presented at the European Society for Medical Oncology (ESMO) 2017 ...

gastrointestinal cancer

Positioning 177-Lu-Dotatate Therapy and 68-Ga-Dotatate Scans in Management of Neuroendocrine Tumors

The results of the phase III NETTER-1 trial, recently published in The New England Journal of Medicine,1 have been met with great interest by clinicians who treat neuroendocrine tumors. In patients with advanced midgut lesions, treatment with the radiopharmaceutical lutetium-177-Dotatate...

lung cancer

Non–Small Cell Lung Cancer: Emerging Concepts for Checkpoint Inhibitors

With checkpoint inhibitors vitally important in the treatment of advanced non–small cell lung cancer (NSCLC), clinicians must become familiar with the nuances of their use. At the 2017 Debates and Didactics in Hematology and Oncology Conference in Sea Island, Georgia, Suresh S. Ramalingam, MD,...

gastrointestinal cancer

‘Sidedness’ in Colon Cancer: Using the Data in the Clinic

The evidence from clinical trials has established that “side matters” when it comes to colorectal cancer outcomes. How do clinicians use this information in their practices? Christina Wu, MD, of Emory University, shared her thoughts with attendees at the 2017 Debates and Didactics in Hematology and ...

hematologic malignancies
multiple myeloma

Multiple Myeloma: Researchers Are Digging Deeper Than Ever

Researchers are tackling multiple myeloma from many angles, and the result could be a flood of novel approaches soon within the oncologist’s reach, according to Kenneth C. Anderson, MD. At the 2017 Debates and Didactics in Hematology and Oncology Conference at Sea Island, Georgia, Dr. Anderson...

breast cancer

Triple-Negative Breast Cancer: Practical Approach, Promising Research

Triple-negative breast cancer has a reputation for being a particularly challenging malignancy, but breast cancer specialist Nancy Davidson, MD, Senior Vice President of the Clinical Research Division at the Fred Hutchinson Cancer Research Center, Seattle, put this in perspective in a recent...

colorectal cancer

New Data Reported on Vemurafenib, Vitamin D, Selective Internal Radiotherapy, and Circulating Tumor DNA in Colorectal Cancer

RESULTS OF the IDEA trial, which showed that some patients with stage III low-risk colon cancer may require less oxaliplatin therapy (see the June 25 issue of The ASCO Post), were among the findings highlighted at the 2017 ASCO Annual Meeting Plenary Session. Other studies of interest in colorectal ...

colorectal cancer

Expert Point of View: Frank Sinicrope, MD

FRANK SINICROPE, MD, Professor of Oncology and Co-Leader of the GI Cancer Program at the Mayo Clinic, Rochester, said CHARTA addressed whether patient outcomes can be improved with a triplet regimen plus bevacizumab (Avastin) vs a standard doublet plus bevacizumab. This was based upon the finding...

colorectal cancer

More Support for FOLFOXIRI/Bevacizumab in Advanced Colorectal Cancer

A RANDOMIZED head-to-head comparison in patients with advanced colorectal cancer found that a regimen of FOLFOXIRI (fluorouracil/leucovorin, oxaliplatin, irinotecan) plus bevacizumab (Avastin) was more effective than a regimen of FOLFOX (fluorouracil/leucovorin, oxaliplatin) plus bevacizumab as...

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...

hematologic malignancies
symptom management
supportive care
head and neck cancer
pancreatic cancer
solid tumors

NCCN Panelists Relay ‘What’s Hot’ in Their Fields

AT THE NATIONAL Comprehensive Cancer Network® (NCCN®) 22nd Annual Conference, experts from several fields met with journalists to highlight “what’s hot” in their specialties. The ASCO Post captured that conversation.  Myeloproliferative Neoplasms Guidelines  NCCN HAS LAUNCHED new NCCN Clinical...

breast cancer

Digital Tomosynthesis vs Mammography in Unmasking Breast Cancer

DIGITAL TOMOSYNTHESIS is rapidly replacing full-field digital mammography, because “it allows a more efficient diagnostic workflow and leads to a more confident interpretation,” according to Elizabeth A. Morris, MD, FACR, Chief of the Breast Imaging Service, Memorial Sloan Kettering Cancer Center, ...

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