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kidney cancer
prostate cancer
immunotherapy

Novel Treatments Under Study in Renal Cell Carcinoma and Prostate Cancer

There were numerous notable presentations at the 2019 Genitourinary Cancers Symposium, many of which were covered in The ASCO Post over the past few months. To add to our continued coverage of this meeting, here are some highlights from studies focusing on novel therapeutics in renal cell carcinoma ...

kidney cancer
prostate cancer
immunotherapy

Novel Treatments Under Study in Renal Cell Carcinoma and Prostate Cancer

There were numerous notable presentations at the 2019 Genitourinary Cancers Symposium, many of which were covered in The ASCO Post over the past few months. To add to our continued coverage of this meeting, here are some highlights from studies focusing on novel therapeutics in renal cell carcinoma ...

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...

prostate cancer

Study Highlights on Novel Agents and Supportive Care Strategies in Prostate Cancer

In addition to our regular coverage of major news stories from the 2019 ASCO Annual Meeting, here is an additional roundup of important studies related to prostate cancer. ARAMIS: Darolutamide and Quality of Life Darolutamide, a next-generation androgen receptor antagonist, significantly prolonged...

Expert Point of View: Andrea Necchi, MD

Formal discussant of the EV-201 trial, Andrea Necchi, MD, of the Fondazione IRCCS, Istituto Nazionale dei Tumori, Milan, Italy, found the data pending phase III studies promising: “This study explored enfortumab vedotin in a newly defined population who failed to respond to prior chemotherapy and...

bladder cancer
immunotherapy

Enfortumab Vedotin After Checkpoint Inhibition in Metastatic Urothelial Cancer

A phase II study found that treatment with the antibody-drug conjugate enfortumab vedotin achieved responses in 44% of patients with locally advanced or metastatic urothelial cancer previously treated with platinum chemotherapy and a checkpoint inhibitor. This is a noteworthy study because it...

Expert Point of View: Christine Lovly, MD, PhD

Formal discussant of the studies on TAK-788 and BLU-667, Christine Lovly, MD, PhD, of the Vanderbilt Ingram Cancer Center, in Nashville, called both studies “very exciting.” “In 2019, we have a plethora of information on genomic drivers in lung cancer. There are a lot of great initiatives to drive ...

lung cancer

Advances in Targeted Therapy for Non–Small Cell Lung Cancer

Targeted therapies for non–small cell lung cancer (NSCLC) are a hotbed of investigation. Two new targeted therapies are promising for patients with lung tumors that are either EGFR exon 20 insertions or RET-rearranged. At the 2019 ASCO Annual Meeting, attendees heard early data on therapies...

Expert Point of View: Maximilian Diehn, MD, PhD

Neoadjuvant immunotherapy is potentially attractive because it addresses micrometastases early in the course of treatment and may improve compliance with systemic therapy, said formal discussant Maximilian Diehn, MD, PhD, of Stanford Cancer Institute, Stanford University School of Medicine, Palo...

lung cancer
immunotherapy

Neoadjuvant Immunotherapy May Benefit Patients With Early-Stage NSCLC

Neoadjuvant immunotherapy had encouraging activity and demonstrated favorable safety in patients with resectable early-stage non–small cell lung cancer (NSCLC), according to two studies presented at the 2019 ASCO Annual Meeting.1,2 This approach has the potential to boost the survival rate in...

prostate cancer

Two Studies Question the Role of Continuous LHRH Antagonists in Metastatic Castration‑Resistant Prostate Cancer

In the field of prostate cancer, the use of androgen-deprivation therapy (ADT) in men with metastatic castration-resistant prostate cancer is received wisdom. When experts are asked why ADT is continued once the disease has figured out how to evade hormone suppression, the answer invariably is...

leukemia
immunotherapy

Fixed-Duration Venetoclax Plus Obinutuzumab as First-Line Treatment in Older Patients With CLL Who Have Comorbidities

A fixed-duration regimen of venetoclax plus obinutuzumab demonstrated superior progression-free survival, complete response rates, and minimal residual disease (MRD) negativity compared with chlorambucil plus obinutuzumab as first-line therapy for older patients with chronic lymphocytic leukemia...

Expert Point of View: Charles Drake, MD, PhD

IN A SEPARATE interview with The ASCO Post, Charles Drake, MD, PhD, commented on the clinical implications of the ENZAMET and TITAN trials, as well as studies of apalutamide, abiraterone acetate, and docetaxel used in metastatic hormone-sensitive prostate cancer. Dr. Drake is Director of...

prostate cancer

Apalutamide Improves Survival Outcomes in Castration-Sensitive Metastatic Prostate Cancer in TITAN Trial

Adding apalutamide to androgen-deprivation therapy (ADT) significantly improved survival in men with metastatic castration-sensitive (also termed hormone-sensitive) prostate cancer, according to the results of the phase III TITAN trial, which were presented at the 2019 ASCO Annual Meeting and...

prostate cancer

Chemotherapy and/or Hormonal Agents: Differing Perspectives

WHEN ASKED which treatment to start with—docetaxel or enzalutamide, Dr. Sweeney said, “Patients fit for chemotherapy with high-volume disease can receive chemotherapy [docetaxel] and come back to these newer hormonal treatments or start with anyone of the hormonal options. Choosing among the newer...

prostate cancer

ENZAMET Trial Shows Enzalutamide Improves Overall Survival in Hormone-Sensitive Metastatic Prostate Cancer

Agents that improve survival in metastatic castration-resistant prostate cancer when added to background androgen-deprivation therapy (ADT) are showing success in treating metastatic prostate cancer earlier while it is still hormone-sensitive. These agents include docetaxel (chemotherapy) and...

genomics/genetics

Two Pediatric Trials Find Targets for Treatment-Refractory Cancers

An interim analysis of the large Pediatric MATCH trial found that 24% of children and young adolescents with cancers refractory to current treatments had been assigned to treatment with investigational targeted study agents based on genetic alterations detected in their tumors,1 which is more than...

immunotherapy
lung cancer

KEYNOTE-001 Shows Long-Term Survival Benefit With Pembrolizumab in Advanced NSCLC

Before the introduction of immunotherapy with checkpoint inhibitors, the 5-year life expectancy for patients with advanced non–small cell lung cancer (NSCLC) was 5.5%. This dismal outlook has changed. Treatment with the immune checkpoint inhibitor pembrolizumab dramatically improved overall...

Expert Point of View: Yousuf Zafar, MD

At the Plenary Session, formal discussant of Dr. Davidoff’s study, Yousuf Zafar, MD, of Duke Cancer Institute, Durham, North Carolina, gave an impassioned talk about the need to address racial disparities in cancer care. “This is a nontraditional study to be selected for the ASCO Plenary Session....

issues in oncology
health-care policy

ACA Increases Access to Health Care, Early Diagnosis, and Timely Treatment for Patients With Cancer

  The evidence is in: the Affordable Care Act (ACA) has enabled improved access to earlier diagnosis, earlier care, and reduced racial disparities in access to care for patients with cancer, according to two studies presented at the 2019 ASCO Annual Meeting. In states that adopted Medicaid...

lung cancer
immunotherapy

Miriam Knoll, MD, and Richard J. White, DO, on Non–Small Cell Lung Cancer: Predicting Radiotherapy/Immunotherapy Treatment Outcomes

Miriam Knoll, MD, of Hackensack University Medical Center, and Richard J. White, DO, of Allegheny Health Network, discuss improved overall survival among younger female patients with non–small cell lung cancer who have a lower comorbidity score, lower grade, private insurance, and treatment with...

Expert Point of View: David Gandara, MD

“MYSTIC is the second phase III trial to compare a first-line immune checkpoint inhibitor with platinum that failed to meet the primary endpoint. However, both MYSTIC and CheckMate 026 identified patients who benefited from an immune checkpoint inhibitor based on tumor mutational burden,”...

lung cancer

Evidence Mounts for Tumor Mutational Burden as Biomarker of Immune Checkpoint Inhibitor Benefit in NSCLC

The search for biomarkers to identify patients who are likely to respond to immunotherapy continues. According to biomarker tissue and blood analysis of patients enrolled in the phase III MYSTIC trial, high tumor mutational burden in both tissue and blood identified patients with non–small cell...

Expert Point of View: Efrat Dotan, MD, and Colin D. Weekes, MD, PhD

Efrat Dotan, MD, Associate Professor, Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, commented on this study. “This abstract presents the interim analysis of a phase II study evaluating the use of maintenance therapy with the poly (ADP-ribose) polymerase PARP inhibitor...

pancreatic cancer

Study Shows Rucaparib Active as Maintenance Therapy in Pancreatic Cancer

The poly (ADP-ribose) polymerase (PARP) inhibitor rucaparib holds promise as maintenance therapy for advanced, platinum-sensitive, BRCA- or PALB2-mutated pancreatic cancer, according to an interim analysis of an ongoing phase II clinical trial presented at the 2019 Annual Meeting of the American...

immunotherapy
breast cancer
lung cancer
prostate cancer
kidney cancer
bladder cancer
colorectal cancer
pancreatic cancer
sarcoma
leukemia
skin cancer
head and neck cancer

NCCN Clinical Practice Guidelines in Oncology: 2019 Updates

In 1996, the National Comprehensive Cancer Network® (NCCN®) published its first set of Clinical Practice Guidelines in Oncology (NCCN Guidelines®), covering eight tumor types. NCCN Guidelines are now published for more than 70 tumor types and topics. Some of the key updates for 2019 were presented...

Expert Point of View: Armin Shahrokni, MD

“Older and frail adults with cancer are the types of patients we deal with every day,” said Armin Shahrokni, MD, a geriatric oncologist at Memorial Sloan Kettering Cancer Center in New York. “The GO2 study is important, and I suspect it will be practice-changing,” he predicted. Older and frail...

gastrointestinal cancer

Study Finds Less Chemotherapy Noninferior to More in Frail and Elderly Patients With Advanced Gastroesophageal Cancer

A large randomized trial has found that frail and elderly patients with advanced gastroesophageal cancer may be safely and successfully treated with dose-reduced chemotherapy. In the GO2 phase III trial, low doses of oxaliplatin/capecitabine performed similarly to intermediate and high doses of the ...

immunotherapy
lung cancer

Pembrolizumab as Third-Line Option for Extensive-Stage Small Cell Lung Cancer

USE OF the anti–programmed cell death protein 1 (anti–PD-1) checkpoint inhibitor pembrolizumab after two or more prior lines of therapy led to responses in patients with advanced small cell lung cancer (SCLC) in a pooled analysis of two clinical trials: phase Ib KEYNOTE-028 and phase II...

breast cancer
pancreatic cancer
sarcoma
immunotherapy
issues in oncology

AACR Study Presentations Include New Data in Breast and Prostate Cancers, Sarcoma, and High-Risk Individuals

THE 2019 American Association for Cancer Research (AACR) Annual Meeting was held March 29 to April 3 in Atlanta. In addition to our regular coverage of news stories from the meeting, here are some brief highlights of additional noteworthy studies. Stage IV HER2-Positive Breast Cancer: Surgery or No ...

lymphoma

Expert Point of View: Louis M. Weiner, MD, and Thomas Habermann, MD

“THIS REPRESENTS the fruits of years of research. Umbralisib is a more potent and selective PI3K inhibitor targeted to the delta isoform. This provides a more precise target for drugs that block that protein, and it more effectively disables signaling. The B cell is central to the survival of...

lymphoma

Umbralisib: Potential Option for Relapsed or Refractory Marginal Zone Lymphoma

UMBRALISIB—an investigational PI3K-delta inhibitor—produced impressive results as monotherapy in patients with relapsed or refractory marginal zone lymphoma, according to an interim analysis of the phase II UNITY-NHL trial presented at the 2019 American Association for Cancer Research (AACR) Annual ...

neuroendocrine tumors
immunotherapy

Expert Point of View: Namrata Vijayvergia, MD

NAMRATA VIJAYVERGIA, MD, of Fox Chase Cancer Center, Philadelphia, commented on this study. “This is an important study because it is done in a rare tumor type; not a lot of clinical trials are conducted in this disease. Recently, three other studies of single-agent therapy with checkpoint...

neuroendocrine tumors
immunotherapy

Dual-Immunotherapy Approach Shows Efficacy in High-Grade Neuroendocrine Tumors

COMBINING TWO established immunotherapy agents achieved tumor shrinkage in rare, aggressive, extrapancreatic high-grade neuroendocrine tumors, according to the results of SWOG S1609, a phase II clinical basket trial also known as DART (Dual Anti– CLTA-4 and Anti–PD-1 Blockade in Rare Tumors). The...

lung cancer

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

FORMAL STUDY discussant, Roy S. Herbst, MD, PhD, Chief of Medical Oncology at the Yale Cancer Center, New Haven, Connecticut, stated that the findings of the TATTON analyses are “compelling,” and the combination of osimertinib plus savolitinib can be considered a “win,” although randomized trials...

lung cancer

Osimertinib Plus Savolitinib in Advanced NSCLC Driven by MET Resistance

THE ADDITION of the MET inhibitor savolitinib to the EGFR inhibitor osimertinib led to activity in patients with MET-amplified, EGFR-mutated non–small lung cancer (NSCLC) with acquired resistance to previous therapies, according to interim results from two expansion cohorts of a phase Ib clinical...

solid tumors
immunotherapy

Preliminary Results Show Activity for Mesothelin‑Directed CAR T-Cell Therapy in Malignant Mesothelioma

A phase I clinical trial showed encouraging results with chimeric antigen receptor (CAR) T-cell therapy targeted to the mesothelin protein in patients with mesothelin-associated malignant pleural solid tumors—primarily, malignant mesothelioma—that had progressed following standard platinum-based...

Expert Point of View: Tapan Kadia, MD, and Louis Weiner, MD

Commenting on the ADMIRAL trial, Tapan Kadia, MD, Associate Professor at MD Anderson Cancer Center in Houston, reminded the audience that the most important discovery with genetic sequencing is that acute myeloid leukemia (AML) is a group of heterogeneous diseases. “The FLT3-ITD mutation is one...

hematologic malignancies
leukemia

Phase III Data Support Use of Gilteritinib in Relapsed or Refractory FLT3-Mutated AML

Treatment with gilteritinib, an oral type 1, FLT inhibitor, significantly improved overall survival compared with chemotherapy in patients with FLT3-positive relapsed or refractory acute myeloid leukemia (AML), according to the final results of the phase III ADMIRAL trial.1 The longest survival for ...

kidney cancer
immunotherapy

Expert Point of View: Tracy Rose, MD, MPH

THE FORMAL DISCUSSANT of the KEYNOTE-427 trial, Tracy Rose, MD, MPH, of the University of North Carolina, Chapel Hill, told listeners: “I think pembrolizumab should now be considered an option for non–clear cell kidney cancer. Response rates, however, remain inferior to those seen in clear cell...

kidney cancer
immunotherapy

Study Finds Pembrolizumab Active in Advanced Non–Clear Cell Kidney Cancer

IMMUNOTHERAPY WITH the checkpoint inhibitor pembrolizumab may prove to be an effective option for patients with advanced non–clear cell renal cell carcinoma, according to results in cohort B of the KEYNOTE-427 trial, presented at the 2019 Genitourinary Cancers Symposium.1 Response rates were...

Expert Point of View: William Kevin Kelly, DO

Formal discussant of the CheckMate 650 trial, William Kevin Kelly, DO, Professor of Medical Oncology at the Sidney Kimmel Cancer Center and Jefferson Health in Philadelphia, commented on the combination therapy’s toxicity. “The discontinuation of study drug was significant. An important issue is...

prostate cancer
immunotherapy

Nivolumab Combined With Ipilimumab Shows Activity in Prostate Cancer Subsets

In contrast with melanoma, lung cancer, and kidney cancer, immune checkpoint inhibitor therapy has been disappointing in prostate cancer thus far. Because of success in treating other tumor types, interest remains high in exploring the effect of immunotherapy with checkpoint inhibition in prostate...

Expert Point of View: Ian Davis, MBBS, PhD, FRACP, FAChPM, and Howard I. Scher, MD

Although ARCHES was a positive trial, the results may not signal a practice change at this time, according to formal discussant Ian Davis, MBBS, PhD, FRACP, FAChPM, of Monash University Eastern Health Clinical School, Melbourne. “We should probably not change practice yet on the basis of these...

prostate cancer

Enzalutamide Plus ADT Extends Progression-Free Survival in Metastatic Hormone-Sensitive Prostate Cancer

Adding enzalutamide to androgen-deprivation therapy (ADT) significantly prolonged radiographic progression-free survival in men with metastatic hormone-sensitive prostate cancer, reducing the risk of disease progression or death by 61% compared with ADT plus placebo, according to the results of the ...

breast cancer
immunotherapy

Expert Point of View: Matthew P. Goetz, MD

“WHAT’S IMPORTANT for clinicians to take away from this analysis is that there is clearly zero benefit of atezolizumab/nab-paclitaxel in patients with programmed cell death ligand 1 (PD-L1)-negative disease. In PD-L1–positive patients, the combination improves progression-free survival and overall ...

breast cancer
immunotherapy

IMpassion130 Substudy: Atezolizumab/Nab-Paclitaxel Survival Benefits Limited to PD-L1–Positive Triple-Negative Breast Cancer

THE PHASE III IMpassion130 trial, first reported at the European Society for Medical Oncology (ESMO) 2018 Congress1 and published in The New England Journal of Medicine,2 found that the combination of front-line atezolizumab plus nab-paclitaxel significantly improved disease-free and overall...

prostate cancer

Expert Point of View: Emmanuel S. Antonarakis, MD

EMMANUEL S. ANTONARAKIS, MD, Associate Professor of Oncology, Johns Hopkins University, Baltimore, commented on the state of current knowledge about poly (ADP-ribose) polymerase (PARP) inhibitors in prostate cancer. “PARP inhibitors are definitely making inroads in the management of patients with...

prostate cancer

PARP Inhibitors Moving Ahead in Prostate Cancer

MULTIPLE POLY (ADP-ribose) polymerase (PARP) inhibitors are under study in metastatic prostate cancer and no clear winner has emerged yet. Some studies suggest that the best use of PARP inhibitors may be in patients whose cancers harbor DNA-repair defects and BRCA1/2 mutations, but other data...

bladder cancer

Expert Point of View: Matthew I. Milowsky, MD

FORMAL STUDY discussant Matthew I. Milowsky, MD, of the University of North Carolina, Lineberger Comprehensive Cancer Center, Chapel Hill, said there had been few drug approvals in advanced bladder cancer until 5 new checkpoint inhibitors were approved over the past 2 years. “Although these agents...

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