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lymphoma
immunotherapy

Role of Radiotherapy for Patients With Refractory Lymphoma Receiving CAR T-Cell Therapy

Although the role of radiotherapy in chimeric antigen receptor (CAR) T-cell therapy for lymphoma is still evolving, radiotherapy “would be an ideal bridging therapy” for patients with chemorefractory diffuse large B-cell lymphoma, stated George Mikhaeel, MD, Professor of Radiation Oncology and...

gynecologic cancers

Three Phase III Trials Suggest Paradigm Shift With PARP Inhibitors in Ovarian Cancer

Ovarian cancer is typically a second-tier newsmaker at the world’s premier oncology conferences, but at the European Society for Medical Oncology (ESMO) Congress 2019, this tumor type generated universal buzz. Impressive findings were presented for three PARP inhibitors in front-line maintenance...

Expert Point of View: Sherene Loi, MD, PhD

Formal discussant Sherene Loi, MD, PhD, Professor of Cancer Therapeutics at the Peter MacCallum Cancer Centre, Melbourne, Australia, characterized the results of KEYNOTE-522 as “exciting.” “This is the first phase III neoadjuvant study in triple-negative breast cancer. Despite breast cancer not...

breast cancer
immunotherapy

Phase III Evidence Supports Neoadjuvant Immunotherapy Plus Chemotherapy for Early Triple-Negative Breast Cancer

Immunotherapy has changed the treatment paradigms for melanoma, lung cancer, bladder cancer, and renal cancer. Now, checkpoint inhibitor therapy is making inroads in triple-negative breast cancer—one of the most difficult-to-treat aggressive types of breast cancer. The addition of the checkpoint...

Expert Point of View: Kelvin Kar-Wing Chan, MD, PhD

Kelvin Kar-Wing Chan, MD, PhD, a medical oncologist and Associate Scientist at Odette Sunnybrook Health Sciences Centre, Toronto, commented that from the patient’s perspective, rising cancer costs can lead to financial hardship, whether material (ie, medical debts and bankruptcy) or psychological...

lung cancer

Out-of-Pocket Costs for Oral Tyrosine Kinase Inhibitors and Survival in Advanced Lung Cancer

Tyrosine kinase inhibitors have changed the paradigm of care for advanced EGFR- and ALK-positive non–small cell lung cancer (NSCLC), but not all patients taking these drugs may receive the same benefit. The results of a recent retrospective analysis suggest that higher out-of-pocket costs for...

Selected Breast Cancer Abstracts From ESMO 2019

This week, we’ll be discussing selected breast cancer abstracts presented at the ESMO Congress 2019, including the MONALEESA-3 and MONARCH-2 studies of CDK4/6 inhibitors for advanced breast cancer; the BROCADE 3 trial of veliparib plus carboplatin and paclitaxel in some advanced BRCA-mutated breast ...

issues in oncology

Virtual Molecular Tumor Boards May Help to Efficiently Deliver Precision Medicine to Patients

Using virtual, cloud-based, interconnected computing techniques applied to 51,000 variables, researchers reduced the time needed to assess a patient’s tumor profile and suitability for clinical trials from 14 to 4 days. This method also increased the number of cases that could be assessed compared...

lung cancer

IASLC North America: Lung Cancer Screening Among First Responders

National lung cancer screening guidelines are inadequate to diagnose patients who contract lung cancer from occupational exposure, including first responders, according to a study reported by Vershalee Shukla, MD, at the International Association for the Study of Lung Cancer’s (IASLC) North America ...

symptom management

Romiplostim for Patients With Chemotherapy-Induced Thrombocytopenia

In a single-center phase II study reported in the Journal of Clinical Oncology, Soff et al found that treatment with romiplostim was effective in rapidly correcting chemotherapy-induced thrombocytopenia, with maintenance treatment being effective in reducing risk of recurrent chemotherapy-induced...

lung cancer

RELAY Trial: Addition of Ramucirumab to Erlotinib in Previously Untreated, EGFR-Mutated Advanced NSCLC

As reported in The Lancet Oncology by Nakagawa et al, the phase III RELAY trial has shown that the addition of the VEGFR2 inhibitor ramucirumab to the EGFR inhibitor erlotinib improved progression-free survival in treatment-naive, advanced EGFR-mutated non–small cell lung cancer (NSCLC). Study...

BRAF and MEK Inhibition in Advanced Melanoma With Rare BRAF Mutations

In a study reported in the Journal of Clinical Oncology, Menzer et al found that combined BRAF/MEK inhibitor therapy appeared to be more active than single-inhibitor therapy in advanced melanoma with rare BRAF mutations. Study Details The study involved data from 103 patients with advanced melanoma ...

Expert Point of View: Pilar Garrido, MD, PhD

At a press conference at the European Society for Medical Oncology (ESMO) Congress 2019, Pilar Garrido, MD, PhD, of Ramon y Cajal University Hospital, Madrid, commented on the FLAURA trial: “These results are good news for patients with lung cancer, which is the most common cause of cancer deaths. ...

lung cancer

FLAURA Trial: First-Line Osimertinib Improves Overall Survival in EGFR-Mutated Advanced Lung Cancer

First-line treatment with osimertinib extended overall survival compared with the older tyrosine kinase inhibitors gefitinib and erlotinib in patients with EGFR-mutated advanced non–small cell lung cancer (NSCLC), according to late-breaking final overall survival results of the phase III FLAURA...

Expert Point of View: Lizza E. Hendriks, MD, PhD

Formal discussant of the ASCEND-7 trial, Lizza E. Hendriks, MD, PhD, of the Maastricht University Medical Center, The Netherlands, said that up to 50% of patients with non–small cell lung cancer (NSCLC) will develop central nervous system (CNS) metastases, and these patients can have poor quality...

lung cancer

Ceritinib Active in Treating Brain Metastases in Non–Small Cell Lung Cancer

The ALK inhibitor ceritinib demonstrated efficacy in patients with ALK-positive non–small cell lung cancer (NSCLC) and active brain metastases, according to the results of the ASCEND-7 trial reported at the European Society for Medical Oncology (ESMO) Congress 2019.1 Substantial intracranial...

solid tumors

Anti-GD2 Monoclonal Antibody Plus Induction Chemotherapy in High-Risk Neuroblastoma

A phase II study evaluating whether combining an investigational anti-GD2 monoclonal antibody with induction chemotherapy improved outcomes in children with newly diagnosed high-risk neuroblastoma found that the therapy significantly improved 2-year event-free survival. Furman et al published the...

breast cancer
cost of care

Deviation From NCCN Guidelines May Result in Greater Costs for Patients With Metastatic Breast Cancer

A study published by Williams et al in JNCCN—Journal of the National Comprehensive Cancer Network found that direct costs for patients with metastatic breast cancer increased when their treatment differed from recommendations found in the NCCN Clinical Practice Guidelines in Oncology® (NCCN...

gastroesophageal cancer
immunotherapy

Nivolumab vs Chemotherapy in Previously Treated Advanced Esophageal Squamous Cell Carcinoma

As reported in The Lancet Oncology by Kato and colleagues, the phase III ATTRACTION-3 trial conducted in predominantly Asian patients has shown a survival benefit with nivolumab vs paclitaxel or docetaxel in patients with advanced esophageal squamous cell carcinoma who were refractory to or...

hematologic malignancies
issues in oncology

High Blood Pressure and Cardiac Adverse Events in Patients Treated With Ibrutinib

Over half of patients treated with the Bruton’s tyrosine kinase inhibitor ibrutinib developed new or worsened high blood pressure within 6 months of starting the medication, according to a study published by Dickerson et al in Blood. The analysis is also the first to tie ibrutinib-related...

issues in oncology
lymphoma

Effect of Race and Ethnicity on Survival in Pediatric and Adolescent Hodgkin Lymphoma

In a Children’s Oncology Group (COG) study reported in the Journal of Clinical Oncology, Kahn et al found that event-free survival in pediatric and adolescent patients with Hodgkin lymphoma was similar by race and ethnicity in COG trials, but that adjusted overall survival was better in white...

colorectal cancer

Colorectal Cancer Screening With Fecal Immunochemical Testing, Sigmoidoscopy, or Colonoscopy for Patients Aged 50 to 79 Years Old

As reported in The British Medical Journal (BMJ) by Helsingen et al, a clinical practice guideline on colorectal cancer screening published as a BMJ Rapid Recommendations guideline indicates that previously unscreened individuals aged 50 to 79 years old with 15-year colorectal cancer risk of ≥ 3%...

sarcoma

Maintenance Chemotherapy Improves Survival in High-Risk Rhabdomyosarcoma

In the phase III RMS 2005 trial reported by Gianni Bisogno, MD, and colleagues in The Lancet Oncology, maintenance vinorelbine and low-dose continuous cyclophosphamide was associated with nonsignificant improvement in disease-free survival and significantly improved overall survival vs no further...

prostate cancer

Expert Point of View: Gert de Meerleer, MD

Commenting on both RADICALS-RT and the meta-analysis, formal discussant Gert de Meerleer, MD, of the University Hospital, Leuven, Belgium, stated: “A big applause for these trials. I agree with both conclusions and congratulate both groups of authors for finding noncommercial funding.” Dr. de...

prostate cancer

Studies Suggest Early Salvage Radiotherapy May Be Preferable to Adjuvant Radiotherapy After Prostatectomy

Early salvage radiotherapy appears to be a better choice after radical prostatectomy for men with prostate cancer than adjuvant radiotherapy, according to late-breaking results from the ­RADICALS-RT trial and the ARTISTIC meta-analysis of three trials that included RADICALS-RT. Observation after...

palliative care

Expert Point of View: Paul B. Jacobsen, PhD, FASCO

Paul B. Jacobsen, PhD, FASCO, Associate Director of the National Cancer Institute’s Division of Cancer Control and Population Science’s Healthcare Delivery Research Program, said that this study exemplifies the type of work that is needed to more broadly and rapidly translate promising research...

palliative care

Community Health Workers May Improve Value of End-of-Life Cancer Care

The results of simple interventions involving community health workers suggest that improvements in value-based cancer care need not come from health-care professionals. According to data presented at the 2019 ASCO Quality Care Symposium,1 reliance upon community health workers trained to assess...

breast cancer
genomics/genetics

ASCO Breakthrough: Breast Cancer Gene Expression Signature May Help Predict Recurrence Postradiotherapy

Researchers have identified a gene pattern that may help predict which patients with breast cancer will have early or late disease recurrence following radiation therapy. The ability to predict the timing of recurrence could change—and improve—treatment strategies and determine the length of...

genomics/genetics

ASCO Breakthrough: Effect of ATM Mutations on Response to Radiotherapy

Somatic mutations of DNA damage repair genes like ATM and BRCA1 or BRCA2 may result in poor disease prognosis and chemotherapy resistance. However, a study by Lee et al presented at ASCO Breakthrough: A Global Summit for Oncology Innovators (Abstract 130) investigated the possibility that these...

lung cancer

ASCO Breakthrough: Computer-Aided Diagnosis System for Detecting Lung Nodule Locations and Characteristics

A computer-aided diagnosis system using deep-learning analysis to detect lung lesion locations and quantitatively characterize the lesions on computed tomography (CT) images offered a fast and convenient approach for assisting radiologists in the diagnosis of lung nodule pathologies. These findings ...

solid tumors

Plasma miR371 Expression as a Biomarker for Active Germ Cell Malignancy

In a study reported in the Journal of Clinical Oncology, Nappi et al showed that plasma microRNA miR371 expression was associated with high specificity and positive predictive values in predicting active germ cell malignancy. Study Details The study included 111 patients with a history of or newly ...

prostate cancer

Acute Toxicity With Intensity-Modulated Fractionated Radiotherapy vs Stereotactic Body Radiotherapy for Prostate Cancer

In an analysis from the phase III PACE-B trial reported in The Lancet Oncology, Brand et al found that shortened treatment courses with stereotactic body radiotherapy did not increase gastrointestinal or genitourinary acute toxicity vs intensity-modulated fractionated radiotherapy in low-risk to...

integrative oncology

Addressing the Gap in Integrative Oncology Education

In 2018, the University of Michigan Medical School in Ann Arbor launched the Integrative Oncology Scholars Program, with the goal of teaching oncology health-care providers how to evaluate the scientific evidence on the efficacy and safety of complementary therapies for patients with cancer. The...

prostate cancer
integrative oncology

Mindfulness Training for Men Diagnosed With Prostate Cancer Who Are on Active Surveillance

GUEST EDITOR Integrative Oncology is guest edited by Jun J. Mao, MD, MSCE, Laurance S. Rockefeller Chair in Integrative Medicine and Chief of Integrative Medicine Service at Memorial Sloan Kettering Cancer Center, New York. The ASCO Post’s Integrative Oncology series is intended to facilitate the...

colorectal cancer

Parenchymal-Sparing Hepatectomy for Colorectal Cancer Liver Metastases

In a meta-analysis published by Deng et al in Cancer Medicine, researchers found parenchymal-sparing hepatectomy was associated with better perioperative outcomes vs extended hepatectomy for the treatment of colorectal cancer liver metastases, without compromising long-term oncologic outcomes. The...

colorectal cancer

Effect of Tumor Sidedness and Molecular Alterations on Outcomes in Patients With RAS/BRAF Wild-Type Metastatic Colorectal Cancer

In a study reported in the Journal of Clinical Oncology, Morano et al assessed prognostic/predictive role of tumor sidedness and presence of uncommon molecular alterations in anti-EGFR treatment primary resistance in patients with RAS/BRAF wild-type metastatic colorectal cancer. Study Details The...

solid tumors

ASCO Breakthrough: Targeted Methylation Sequencing Assay May Provide New Tool for Cancer Detection Across Stages and Tissues of Origin

A study by Oxnard et al using bisulfite sequencing of plasma cell-free DNA to identify methylomic signatures for multicancer detection and tissue of origin found the assay achieved accurate detection of multiple cancers across stages and tissue of origin localization. The targeted methylation assay ...

gynecologic cancers

Care of Malignant Bowel Obstruction in Patients With Advanced Gynecologic Cancer

In a single-center retrospective study reported in the Journal of Oncology Practice, Lee et al found that implementation of an interprofessional malignant bowel obstruction program changed care patterns and improved outcomes for women with advanced gynecologic cancers and malignant bowel...

solid tumors

ASCO Breakthrough: Blood-Based Screening Assay With a Novel Multivariate Cancer Risk Score Model

A novel multivariate cancer risk score model demonstrated 60% sensitivity at 98.5% specificity. These findings demonstrate that a blood-based cancer screening assay with a novel risk score model may be a viable method for detecting cancer in asymptomatic individuals, especially in populations at...

lung cancer

Andrew C. von Eschenbach, MD, Honored for Leadership in National Lung Screening Trial

The Prevent Cancer Foundation recently honored Andrew C. von Eschenbach, MD, with the James L. Mulshine, MD, Leadership Award for his work leading the National Lung Screening Trial (NLST), the first large-scale clinical trial for low-dose computed tomography (CT) lung cancer screening. The award...

Lung Cancer Research Highlights From ESMO 2019

This week, we’ll be discussing research highlights in lung cancer presented at the ESMO Congress 2019, including the FLAURA trial of osimertinib in EGFR-mutated non–small cell lung cancer; the CheckMate 227 of nivolumab plus ipilimumab vs chemotherapy in non–small cell lung cancer with a PD-L1...

Ariel Hollinshead Hyun, PhD, a Pioneer in Cancer Vaccines, Dies at Age 90

Inspiration comes in many forms. For cancer researcher Ariel Hollinshead Hyun, PhD, known professionally as Dr. Hollinshead, it came at the age of 15, when she was captivated by Paul de Kruif’s book Microbe Hunters. She was fascinated by the lives of early bacteriologists detailed in the book and...

Susan G. Komen Unveils $26 Million Investment in Research and Treatments in Metastatic Breast Cancer

SUSAN G. KOMEN recently announced $26 million in funding for new research projects that focus on metastatic breast cancer, new treatments, and disparities in breast cancer outcomes. This year’s grant slate focuses on key areas that will help the organization achieve its bold goal to reduce the...

lupron

Cancer Taught Me What It Means to Be a Man

Let’s face it, men don’t go to the doctor as often as we should. At least that has been my experience. I felt compelled to finally make an appointment with my primary care physician after I began working as a research assistant at the Smidt Heart Institute at Cedars-Sinai in 2014, as it felt...

issues in oncology

Being an Expert Witness in a Legal Proceeding: A Learning Experience

I read with great interest and appreciation the Law and Ethics in Oncology column, “Should You Become an Expert Witness in a Legal Proceeding? Here Are the Pros and Cons,” by Thaddeus Pope, JD, PhD (August 25, 2019, issue of The ASCO Post). I am an oncologist and have been an expert witness in a...

issues in oncology

Survey Identifies Gap in Culturally Competent Cancer Care for LGBTQI+ Latinx Population

Most Latinx people who are LGBTQI+ (lesbian, gay, bisexual, transgender, queer, and intersex) reported being reluctant to share their gender identity and/or sexual orientation with a health-care provider, and a majority have never received cancer information tailored for their community, according...

A Tale of Two Eugenes

The ASCO Post is pleased to reproduce installments of the Art of Oncology as published previously in the Journal of Clinical Oncology. These articles focus on the experience of suffering from cancer or of caring for people diagnosed with cancer, and they include narratives, topical essays,...

Vassiliki Papadimitrakopoulou, MD, Appointed Clinical Development Leader of Pfizer Oncology

Vassiliki Papadimitrakopoulou, MD, has been appointed Clinical Development Leader of Pfizer Oncology. Dr. Papadimitrakopoulou will be based in New York City. Recognized around the world for her expertise in personalized genomics-driven cancer therapies, immunotherapies, translational research, and ...

tecentriq
abraxane

Atezolizumab for PD-L1–Positive Locally Advanced or Metastatic Triple-Negative Breast Cancer

EARLIER THIS YEAR, atezolizumab was granted accelerated approval in combination with nab-paclitaxel in the treatment of patients with unresectable locally advanced or metastatic triple-negative breast cancer whose tumors express programmed cell death ligand 1 (PD-L1–stained tumor-infiltrating...

head and neck cancer
issues in oncology

Researchers Examine the Rise in HPV-Related Oropharyngeal Cancers

Human papillomavirus (HPV) causes nearly all cervical cancers and is attributed to some cancers of the vagina, vulva, penis, anus, and oropharynx. Although most HPV infections are asymptomatic and usually resolve within 1 to 2 years, persistent infections can lead to precancer and cancer. According ...

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