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breast cancer
kidney cancer
sarcoma
lymphoma
multiple myeloma

Notable Presentations at ASCO 2019 Included Studies in Sarcoma, Lymphoma, Myeloma, and Breast and Kidney Cancers

The 2019 ASCO Annual Meeting featured a wealth of presentations on important topics. In addition to our regular news coverage of the meeting, we present below some highlights of other studies that add to our knowledge base for treatment of various cancers. Olaratumab in Soft-Tissue Sarcoma...

lung cancer

Expert Point of View: Sarina Anne Piha-Paul, MD, and Benjamin Besse, MD, PhD

THE INVITED discussants of the presentations on repotrectinib and AMG 510 were enthusiastic about these agents. Sarina Anne Piha-Paul, MD, of The University of Texas MD Anderson Cancer Center, discussed AMG 510, and Benjamin Besse, MD, PhD, Head of the Cancer Medicine Department at the Institut...

gastrointestinal cancer
immunotherapy

Brief Update on Clinical Trials of New Treatments in Gastrointestinal Cancers

The 2019 ASCO Annual Meeting provided attendees with an abundance of clinically relevant abstracts in gastrointestinal cancers. Briefly featured here are clinical trial updates on pembrolizumab in the second-line treatment of hepatocellular carcinoma (KEYNOTE-240 trial), laparoscopic vs open...

lung cancer

Two Investigational Agents Demonstrate Safety, Efficacy in Lung Cancer

A handful of investigational drugs in early-phase trials always create a buzz at ASCO Annual Meetings. Two that garnered attention this year, and could eventually change outcomes in the clinic, are the first-in-class KRAS inhibitor AMG 510 and the ROS1 inhibitor repotrectinib. Should late-phase...

breast cancer

Expert Point of View: Mark Pegram, MD, and Sandra Swain, MD, FASCO

Mark Pegram, MD, the Susy Yuan-Huey Hung Professor of Medical Oncology and Director of the Stanford Breast Oncology Program, said the Dana-Farber study “independently confirms that HER2 heterogeneity is a distinct clinical entity with lower levels of HER2 expression and pathologic complete...

breast cancer

Is Heterogeneity Within HER2-Positive Tumors Clinically Relevant?

Breast cancers that display heterogeneity of HER2 expression may represent a distinct subset of HER2-positive breast cancer that is associated with lower rates of pathologic complete response, according to a phase II study from Dana-Farber Cancer Institute. This trial evaluated HER2 heterogeneity...

breast cancer
immunotherapy

Two Pivotal Studies in Breast Cancer Report Further Analyses

At the 2019 ASCO Annual Meeting, two pivotal breast cancer trials reported final or additional analyses: one confirmed the negative results seen in earlier reports,1 and the other supported a new survival benchmark.2 KRISTINE: Neoadjuvant T-DM1/Pertuzumab Sara A. Hurvitz, MD, of the David Geffen...

immunotherapy
skin cancer

Expert Point of View: Vernon K. Sondak, MD

Commenting for The ASCO Post, ­melanoma expert Vernon K. Sondak, MD, Chair of the Department of Cutaneous Oncology at Moffitt Cancer Center, Tampa, maintained that the association between immuno­therapy-related toxicity and better outcomes is not yet clear. He first noted the impact of novel...

immunotherapy
skin cancer

Study Finds Immune-Related Adverse Events Herald Benefit With Adjuvant Pembrolizumab in Melanoma

In the EORTC 1325/KEYNOTE-054 trial of adjuvant pembrolizumab in patients with stage III melanoma, recurrences were reduced by 44% in the immunotherapy arm, vs placebo, but this benefit increased to a 63% reduction in risk among patients developing an immune-related adverse event on treatment.1...

Expert Point of View: Jiping Wang, MD, PhD

“The jury is still out,” said APACT’s invited discussant, Jiping Wang, MD, PhD, a biostatistician and hepatobiliary pancreas surgical oncologist at Dana-Farber Cancer Institute and Brigham and Women’s Hospital, Boston. “The final overall survival analysis is needed to know the real benefit from...

pancreatic cancer

APACT Trial: Nab-paclitaxel/Gemcitabine vs Gemcitabine Alone in Adjuvant Treatment of Pancreatic Cancer

The largest adjuvant trial in pancreatic adenocarcinoma, the global phase III APACT trial, evaluated the combination of adjuvant nab-paclitaxel/gemcitabine vs gemcitabine monotherapy in patients with resected pancreatic cancer. Results of the study were reported by Margaret A. Tempero, MD, of the...

Expert Point of View: Carlos H. Barrios, MD

“Margetuximab pLUS capecitabine may represent a new alternative combination for third-line treatment of HER2-positive metastatic breast cancer,” said -SOPHIA’s invited discussant Carlos H. Barrios, MD, of the Centro de Pesquisa em Oncologia and Latin American Cooperative Oncology Group in Porto...

breast cancer
immunotherapy

SOPHIA Trial Tests Margetuximab in Heavily Pretreated Patients With HER2-Positive Metastatic Breast Cancer

In the phase III SOPHIA trial of 536 heavily pretreated patients with HER2-positive metastatic breast cancer, the novel anti-HER2 antibody margetuximab plus chemotherapy led to significant improvements in progression-free survival, response, and clinical benefit compared with...

Expert Point of View: William P. Harris, MD

The efficacy results of Alliance A021202 suggest that pazopanib is another promising systemic option for carcinoid tumors, according to William P. Harris, MD, Associate Professor of Medicine at the University of Washington and Fred Hutchinson Cancer Research Center, Seattle. “Progression-free...

gastrointestinal cancer

Study Shows Benefit With Pazopanib in Treatment of Carcinoid Tumors

Pazopanib significantly improved progression-free survival by 47% in patients with progressive carcinoid tumors, in a prospective randomized phase II trial presented at the 2019 ASCO Annual Meeting.1 “With these results, Alliance A021202 becomes the first randomized study to show that the vascular...

Expert Point of View: Jordan Berlin, MD

Jordan Berlin, MD, the Ingram Professor of Cancer Research and Professor of Medicine at Vanderbilt University Medical Center, Nashville, discussed the FOxTROT study at the oral session. “FOxTROT did reach its targeted hazard ratio, but the bottom line is the P value did not quite make it to where...

gastrointestinal cancer

Study Supports Neoadjuvant Chemotherapy in Operable Colon Cancer

For patients with operable colon cancer, neoadjuvant chemotherapy resulted in numerous benefits in the FOxTROT trial but did not reach target significance for the primary endpoint. The study was presented at the 2019 ASCO Annual Meeting by Matthew T. Seymour, MD, of the University of Leeds School...

Expert Point of View: Hanna K. Sanoff, MD, MPH

Study discussant Hanna K. Sanoff, MD, MPH, of the University of North Carolina Lineberger Comprehensive Center, summarized the key results of VISNU-1: first, survival is shorter for patients with high circulating tumor cell (CTC) count; second, the incremental benefit from FOLFOXIRI (fluorouracil...

colorectal cancer
immunotherapy

Targeting FOLFOXIRI Plus Bevacizumab to a Metastatic Colorectal Cancer Subset

In a population of patients with metastatic colorectal cancer deemed to be at high risk by the presence of circulating tumor cells (CTCs), first-line treatment with FOLFOXIRI plus bevacizumab improved progression-free survival by about 3 months, compared with modified FOLFOX plus bevacizumab,...

Expert Point of View: David P. Ryan, MD

The primary analysis of the IDEA trial demonstrated that low-risk stage III colorectal cancer could be acceptably treated with 3 months of capecitabine plus oxaliplatin (CAPOX), invited discussant David P. Ryan, MD, Chief of Hematology/Oncology at Massachusetts General Hospital Cancer Center,...

colorectal cancer

IDEA Collaboration Turns to Duration of Adjuvant Treatment in Stage II Colon Cancer

The findings of the landmark IDEA trial in stage III colorectal cancer, presented at the 2017 ASCO Annual Meeting and subsequently published in The New England Journal of Medicine,1 were upheld by a subsequent analysis by the same group, the International Duration Evaluation of Adjuvant...

Expert Point of View: Carlos H. Barrios, MD, and Jame Abraham, MD

Invited discussant of the NALA trial, Carlos H. Barrios, MD, of the Centro de Pesquisa em Oncologia and Latin American Cooperative Oncology Group in Porto Alegre, Brazil, said the results suggest that neratinib plus capecitabine “may represent an alternative for third-line treatment of...

breast cancer

NALA Trial: Neratinib Plus Capecitabine Shows Benefit in Metastatic Breast Cancer

In the global phase III NALA trial, treatment of metastatic HER2-positive breast cancer with neratinib plus capecitabine significantly improved progression-free survival, delayed the time to intervention for central nervous system disease, and showed a trend toward improved overall survival vs...

Expert Point of View: Eric P. Winer, MD, FASCO, and Sandra M. Swain, MD, FACP, FASCO

Eric P. Winer, MD, FASCO, Thompson Chair in Breast Cancer Research and Professor of Medicine, Harvard Medical School, and Director of the Breast Cancer Program at Dana-Farber Cancer Institute, Boston, commented on Dr. Sparano’s presentation for The ASCO Post. “We already use information in...

breast cancer

Clinical Risk Enhances Utility of TAILORx Findings in Young Women With Breast Cancer

Clinical risk factors add prognostic information that complements the 21-gene recurrence score, according to a new analysis from the landmark TAILORx trial.1,2 The integration of clinical risk with the recurrence score provides greater precision in determining recurrence risk and guiding the use of ...

issues in oncology

Project Facilitate: FDA’s Plan to Ease Expanded Access to Novel Therapies

The U.S. Food and Drug Administration (FDA) plans to provide oncologists with greater help in acquiring expanded access to investigational therapies. Deemed Project Facilitate, the pilot program was announced at a press briefing during the 2019 ASCO Annual Meeting. Project Facilitate is essentially ...

Expert Point of View: John T. Cole, MD, and Carlos H. Barrios, MD

“The end-of-study analysis of the CLEOPATRA trial demonstrates and confirms the long-term benefit of combined HER2-antibody therapy, with a significant number of ongoing responders,” said John T. Cole, MD, breast cancer specialist and Director of Clinical Cancer Research at Ochsner Health System...

breast cancer

CLEOPATRA End-of-Study Analysis in Metastatic Breast Cancer: 37% Alive at 8 Years

The end-of-study analysis of the landmark CLEOPATRA trial shows that 37% of patients with HER2-positive metastatic breast cancer are still alive at 8 years, according to principal investigator Sandra M. Swain, MD, FACP, FASCO, Associate Dean for Research Development at Georgetown University Medical ...

cns cancers
immunotherapy

Update on Early-Stage Studies of Novel Treatments in Glioblastoma

Outcomes are typically grim for patients with recurrent glioblastoma multiforme. At the 2019 Annual Scientific Meeting of the American Association of Neurological Surgeons (AANS), three early-stage studies hinted at ways that standard treatments might be made more effective. Metronomic Dosing of...

head and neck cancer
immunotherapy

Expert Point of View: Vanita Noronha, MD

The KEYNOTE-048 trial is practice-changing, according to its invited discussant, Vanita Noronha, MD, Professor of Oncology at Tata Memorial Centre in Mumbai, India. Although a number of questions remain to be answered, she said the take-home message is that the study “met most of its primary...

head and neck cancer

Improved Survival Shown With First-Line Pembrolizumab in Advanced Head and Neck Cancer

In the final analysis of KEYNOTE-048, first-line pembrolizumab monotherapy led to a significant improvement in overall survival, vs standard chemotherapy with targeted therapy (EXTREME regimen), in patients with recurrent or metastatic head and neck squamous cell carcinoma expressing programmed...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

Expert Point of View: Ian Chau, MD

IAN CHAU, MD, a consultant medical oncologist at the Gastrointestinal and Lymphoma Units of The Royal Marsden NHS Foundation Trust in London and Surrey, United Kingdom, was the invited discussant of KEYNOTE-062. In an interview with The ASCO Post, he first commented that although single-agent...

gastroesophageal cancer
gastrointestinal cancer
immunotherapy

KEYNOTE-062: Pembrolizumab Is a New First-Line Option in Gastric/Gastroesophageal Junction Cancer

KEYNOTE-062, a study of first-line treatment in patients with advanced gastric or gastroesophageal junction adenocarcinoma, found pembrolizumab to be noninferior to chemotherapy and perhaps better than chemotherapy in a subgroup of patients. The results were reported at the 2019 ASCO Annual Meeting ...

pancreatic cancer

Expert Point of View: Wells Messersmith, MD, and Allyson Ocean, MD

“THE RATIONALE for the POLO study is sound,” said invited study discussant Wells Messersmith, MD. “There’s clearly an unmet need in pancreatic cancer, and there are promising data for poly (ADP-ribose) polymerase (PARP) inhibitors in other BRCA-mutated tumors.” Dr. Messersmith is Professor and Head ...

pancreatic cancer

POLO Trial Shows Maintenance Olaparib Improves Progression-Free Survival in Metastatic Pancreatic Cancer

In patients with metastatic pancreatic cancer and germline mutations in BRCA1 or BRCA2, maintenance therapy with olaparib doubled the time to disease progression and the proportion of patients who were progression-free at 2 years, in the phase III POLO trial.1 “Maintenance olaparib provided a...

Expert Point of View: Jeffrey S. Falk, MD

Jeffrey S. Falk, MD, a surgical oncologist at the Ascension Saint John Hospital in Grosse Pointe Woods, Michigan, commented on these studies of same-day mastectomy and home recovery programs: “The impetus behind these two significant quality-improvement studies was to allow patients to recover...

breast cancer

Studies Report Early Success With Same-Day Mastectomy and Home Recovery Programs

Patients can safely recover from mastectomy at home, according to two studies reported at the 2019 American Society of Breast Surgeons Annual Meeting.1,2 The studies examined outcomes after implementation of comprehensive postmastectomy surgical home recovery programs, showing that they...

Expert Point of View: Sarah Blair, MD

“The investigators at Mayo Clinic achieved excellent results in improving 30-day and 1-year reconstruction rates in patients undergoing nipple-sparing mastectomy,” commented Sarah Blair, MD, a surgical oncologist at the University of California San Diego. “They clearly demonstrated that careful...

breast cancer

Nipple-Sparing Mastectomy May Be Suitable for Growing Number of Well-Selected Patients

As nipple-sparing mastectomy gains favor, it is being performed on a broader spectrum of patients once considered off limits by surgeons. A Mayo Clinic study in a contemporary cohort found no increase in complication rates or decrease in reconstruction success with this surgical approach.1 “We...

Expert Point of View: Julie A. Margenthaler, MD

“Lymphedema represents a significant morbidity for patients who experience it,” commented Julie A. Margenthaler, MD, of Washington University School of Medicine, St. Louis. “This study [PREVENT] demonstrates that bioimpedance spectroscopy can identify early signs of lymphedema, so interventions...

breast cancer
supportive care

Using Bioimpedance Spectroscopy to Prevent Progression of Lymphedema

Surveillance of women at risk for breast cancer–related lymphedema using bioimpedance spectroscopy was more effective in preventing lymphedema progression than traditional measurement of arm circumference, when each is combined with immediate compression therapy. These findings came from the...

Expert Point of View: Harold Burstein, MD, PhD, FASCO, and Jame Abraham, MD, FACP

Harold Burstein, MD, PhD, FASCO, Associate Professor of Medicine at Dana-Farber Cancer Institute, Boston, and Jame Abraham, MD, FACP, Director of the Breast Oncology Program at Taussig Cancer Institute and Co-Director of the Cleveland Clinic Comprehensive Breast Cancer Program, commented on what...

breast cancer

MONALEESA-7 Shows Overall Survival Benefit for Ribociclib/Endocrine Therapy

The first statistically significant overall survival benefit has been shown for a cyclin-dependent kinase (CDK) 4/6 inhibitor plus endocrine therapy as first-line treatment of advanced breast cancer. The results are from the phase III MONALEESA-7 trial, which evaluated ribociclib plus endocrine...

leukemia

Kerry A. Rogers, MD, on Chronic Lymphocytic Leukemia: Acalabrutinib With Obinutuzumab in Treatment-Naive and Relapsed or Refractory Disease

Kerry A. Rogers, MD, of The Ohio State University, discusses a 3-year follow-up of phase Ib safety and efficacy findings with the selective BTK inhibitor acalabrutinib and the anti-CD20 monoclonal antibody obinutuzumab in patients with CLL (Abstract 7500).  

leukemia
lymphoma
immunotherapy

William G. Wierda, MD, PhD, on Immunotherapy for Relapsed/Refractory CLL/SLL: Results From TRANSCEND CLL 004

William G. Wierda, MD, PhD, of The University of Texas MD Anderson Cancer Center, discusses the TRANSCEND CLL 004 trial, which studied the use of an experimental CD19-directed CAR T-cell product in heavily pretreated patients with chronic lymphocytic leukemia or small lymphocytic lymphoma (Abstract ...

issues in oncology
immunotherapy

NCCN Roundtable Tackles Issues With Innovative Immunotherapies

Immunotherapies are radically changing outcomes, but while helping patients, they are creating complexities surrounding their cost. At the 2019 Annual Conference of the National Comprehensive Cancer Network® (NCCN®), a roundtable of experts, including clinicians and payers, discussed how chimeric...

issues in oncology

2019 NCCN Posters Explore Next-Generation Sequencing, Cancer Burden vs Funding, Cardiac Monitoring, and Scalp Cooling

Posters presented at the National Comprehensive Cancer Network® (NCCN®) Annual Conference continue to grow in number and in quality. The ASCO Post presents a few that we found interesting at the recent 2019 meeting. Next-Generation Sequencing Not Always Helpful in Practice The value of...

cns cancers

Targeted Brachytherapy May Improve Outcomes in Recurrent Brain Tumors

For recurrent, previously irradiated brain tumors, innovative treatment with surgically targeted brachytherapy yielded good local control and overall survival, as compared to historic controls, neurosurgeons reported at the 2019 Annual Scientific Meeting of the American Association of Neurological...

Expert Point of View: Marcie L. Riches, MD, MS

Marcie L. Riches, MD, MS, Director of Clinical Research and Data Quality and Bone Marrow Transplant Clinic Medical Director, and Clinical Associate Chief of Hematology/Oncology at the University of North Carolina at Chapel Hill, commented on the study of tabelecleucel for The ASCO Post. At the...

hematologic malignancies

T-Cell Therapy for EBV-Associated Posttransplant Lymphoproliferative Disorder With CNS Involvement

An “off-the-shelf” allogeneic T-cell product, tabelecleucel, may effectively treat patients who develop Epstein-Barr virus (EBV)-associated posttransplant lymphoproliferative disorder with central nervous system (CNS) involvement, researchers from Memorial Sloan Kettering Cancer Center reported at...

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