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lung cancer

What Is the Best Palliation for End-Stage Lung Cancer?

Patients with advanced lung cancer can experience burdensome symptoms at the end of life. Pulmonologists can alleviate some of this suffering, but it’s a balancing act between doing too much and not enough, according to specialists who spoke at CHEST 2019, the annual meeting of the American College ...

Expert Point of View: Alfredo Falcone, MD

The invited discussant of BEACON CRC, Alfredo Falcone, MD, of the Department of Oncology and Translational Medicine at the University of Pisa, Italy, commented: “The ‘story’ of BEACON represents a good example of the European Society for Medical Oncology Congress theme: Translating Science Into...

colorectal cancer

Targeted Triplet Therapy Improved Overall Survival in BRAF-Mutated Colorectal Cancer

For patients with metastatic colorectal cancer harboring BRAF V600E mutations, three drugs seem to be better than two, the most recent analysis of the phase III BEACON CRC study has shown.1 The results, presented at the 2019 European Society for Medical Oncology (ESMO) Congress, were concurrently...

gastrointestinal cancer

Maximizing Benefit in the Treatment of Immune-Mediated Colitis

Immune-related colitis is the second most common toxicity associated with checkpoint inhibitors, affecting up to 40% of patients. The ASCO Post interviewed Yinghong Wang, MD, PhD, Director of Medication-Induced Colitis and Enteritis, Director of Fecal Microbiota Transplantation, and Associate...

immunotherapy
gynecologic cancers

Expert Point of View: Nicoletta Colombo, MD

The invited discussant of the two trials in cervical and endometrial cancers presented at the ESMO Congress 2019 was Nicoletta Colombo, MD, of the University of Milan-Bicocca in Italy, who commented on what she called “exciting results in cancers with unmet needs.” Dr. Colombo noted: “The studies...

immunotherapy
gynecologic cancers

Immunotherapy Shows Strong Benefit in Two Gynecologic Cancers

In studies reported at the ESMO Congress 2019, immunotherapy yielded encouraging outcomes in two gynecologic cancer populations in need of new treatments, including patients with advanced cervical cancer that is microsatellite-stable and patients previously treated for advanced endometrial cancer.  ...

gynecologic cancers

Expert Point of View: Ana Oaknin, MD, PhD

Ana Oaknin, MD, PhD, Head of the Gynecologic Cancer Program at Vall d’Hebron Institute of Oncology, Barcelona, discussed the PRIMA/ENGOT-OV26/GOG-3012 trial along with the results of the phase III PAOLA-1/ENGOT-ov25 trial of olaparib plus bevacizumab maintenance. According to Dr. Oaknin, the...

gynecologic cancers

PRIMA Trial Reports Benefit With Niraparib Across Ovarian Cancer Subsets

In women with advanced ovarian cancer responding to first-line chemotherapy, maintenance therapy with the PARP inhibitor niraparib significantly reduced the risk of disease progression by 38% overall and by 60% in women with BRCA mutations. Even patients without a homologous recombination...

gynecologic cancers

Expert Point of View: Mansoor R. Mirza, MD

The time has come to offer all patients a PARP [poly (ADP-ribose) polymerase] inhibitor,” said Mansoor R. Mirza, MD, Chief Oncologist at Copenhagen University Hospital and the invited discussant of the VELIA trial at the ESMO Presidential Symposium. He noted, however, that he wasn’t sure veliparib...

gynecologic cancers

Veliparib Plus Chemotherapy Meets Primary Endpoint in Advanced Ovarian Cancer

As first-line treatment for women with advanced ovarian cancer, the addition of veliparib during induction followed by veliparib maintenance therapy significantly reduced the risk of disease progression or death in the phase III VELIA/GOG-3005 trial reported at the European Society for Medical...

breast cancer

Expert Point of View: Mafalda ­Oliveira, MD, PhD

Formal discussant Mafalda ­Oliveira, MD, PhD, of Vall d’Hebron Institute of Oncology in Barcelona, commented that monarcHER was a “well-designed, hypothesis-generating trial that addresses clinically relevant questions,” including whether cyclin-dependent kinase 4 and 6 inhibition now has broader...

breast cancer

Abemaciclib Benefits Patients With HER2-Positive Breast Cancer in monarcHER Trial

Inhibitors of cyclin-dependent kinases 4 and 6 (CDK4/6) are associated with a robust benefit in patients with hormone receptor–positive, HER2-negative breast cancer, but now the monarcHER trial has confirmed their benefit in the HER2-positive population. The new findings were reported at the...

Expert Point of View: Ana Oaknin, MD, PhD

“The main goal in ovarian cancer is to avoid relapse after first-line therapy because otherwise, the probability of cure is quite low,” said European Society for Medical Oncology (ESMO) discussant of the PAOLA-1 trial, Ana Oaknin, MD, PhD, of the Vall d’Hebron Institute of Oncology, Barcelona....

gynecologic cancers

PAOLA-1 Trial: Front-Line Olaparib/Bevacizumab Maintenance Benefits Women With Advanced Ovarian Cancer

In women with newly diagnosed ovarian cancer, front-line maintenance therapy with olaparib plus bevacizumab reduced the risk of disease progression by 41% overall and by 69% in the subset of patients with BRCA-mutated disease, vs bevacizumab and placebo, in the phase III PAOLA-1/ENGOT-ov25 trial...

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

Chair of the German Breast Group, Sibylle Loibl, MD, of the University of Frankfurt, commented as a formal discussant of MONALEESA-3 and MONARCH 2. “It’s great to see overall survival in the first- and second-line metastatic breast cancer settings. We haven’t seen that in many years,” she said....

breast cancer

Landmark Studies Show Clear Overall Survival Benefit for CDK4/6 Inhibitors in Advanced Breast Cancer

CDK4/6 inhibitors clearly improve overall survival in advanced breast cancer, as this prized endpoint was robustly demonstrated in two landmark phase III trials reported at the European Society for Medical Oncology (ESMO) Congress 2019. Dennis J. Slamon, MD, PhD, of the University of California,...

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...

cns cancers

Early Research on Novel Interleukin-12 Gene Therapy in Glioblastoma

Recurrent high-grade glioblastoma has a poor prognosis, with a median overall survival of 6 to 9 months. Treatment is limited, partly because immunotherapy has not yet been shown to be effective in the immunosuppressive microenvironment of this tumor. A novel treatment approach involving...

libtayo
decadron
opdivo
temodar

Early Research on Novel Interleukin-12 ‘Gene Therapy’ in Glioblastoma

Recurrent high-grade glioblastoma has a poor prognosis, with a median overall survival of 6 to 9 months. Treatment is limited, partly because immunotherapy has not yet been shown to be effective in the immunosuppressive microenvironment of this tumor. A novel treatment approach involving...

prostate cancer

Ronald de Wit, MD, PhD, on Prostate Cancer: Results of the CARD Trial on Cabazitaxel, Abiraterone, and Enzalutamide

Ronald de Wit, MD, PhD, of the University Medical Center Rotterdam, discusses study findings which showed that cabazitaxel improved radiographic progression-free survival as well as overall survival in patients with metastatic castration-resistant prostate cancer (Abstract LBA13).

glucophage

Diabetes and Cancer: Researchers Link Hyperglycemia to DNA Damage

Hyperglycemia may induce DNA damage and inhibit DNA repair, which may explain why individuals with diabetes may have an increased risk for developing cancer, according to a researcher from City of Hope, Duarte, California, who presented these findings at the American Chemical Society (ACS) Fall...

issues in oncology
solid tumors

Daniel M. Trifiletti, MD, on Optimizing Whole-Brain Radiotherapy Dose and Fractionation for Patients With Brain Metastases

Daniel M. Trifiletti, MD, of the Mayo Clinic, discusses study findings showing that, between two different radiation doses (30 Gy/10 fractions vs 37.5 Gy/15 fractions), there was no difference in the time to cognitive failure, tumor control, or overall survival for patients with brain metastases...

velcade
darzalex
revlimid
xifaxan

Tailoring Upfront Daratumumab Treatment for Some Patients With Multiple Myeloma

The monoclonal antibody daratumumab has been widely embraced for the treatment of multiple myeloma, but for newly diagnosed patients, its benefit has been proved only in some patients, according to Craig Hofmeister, MD, MPH, Associate Professor of Medicine at the Winship Cancer Institute of Emory...

blenoxane
lipodox
etopophos
revlimid
rituxan
marqibo

Current Controversies in Lymphoma: From the Role of Liquid Biopsy to Ways to Improve Upon Standard Chemotherapy

Two topics that hematologists are currently grappling with were addressed at the 2019 Debates and Didactics Conference in Sea Island, Georgia, sponsored by Emory University Winship Cancer Institute, by Editor-in-Chief of The ASCO Post, James O. Armitage, MD, FASCO.1 They focus on the emerging role ...

velcade
fragmin
lipodox
savaysa
lixiana
etopophos
xarelto
nolvadex
soltamox
venclexta
velban

Conundrums in Managing Cancer-Associated Thrombosis

Although there may be a clear role for prophylactic anticoagulation in hospitalized patients and those undergoing surgery, indication for prophylactic anticoagulation for patients with cancer seen in the ambulatory setting has yet to emerge. Until clinical trial data on prophylactic...

symptom management

Angela M. Stover, PhD, on Patient-Reported Outcome Performance Measures for Oncology Practice

Angela M. Stover, PhD, of the University of North Carolina at Chapel Hill, discusses ASCO’s initiative to develop patient-based performance measures for assessing and managing symptoms. The measures have made substantial differences in reducing nausea, constipation, and insomnia (Abstract 173).

cns cancers
lymphoma

Primary Central Nervous System Lymphoma: Striving for a Curative Therapy

Primary central nervous system (CNS) lymphoma is a rare type of non-Hodgkin lymphoma in which standards of care have not been well established. In light of recent insights into its pathophysiology and the emergence of novel approaches, The ASCO Post asked Tracy T. Batchelor, MD, a specialist in...

skin cancer

Stage IV Melanoma: What Current Role Should Surgery Play?

Advanced melanoma has become a different entity in the era of immunotherapy and targeted agents. Considering the potential for good outcomes from systemic therapy in advanced disease, has the role of surgery changed? Should it be offered up front or limited to patients with oligometastatic ...

multiple myeloma

Is It Time to Intervene in Smoldering Myeloma?

Early intervention in smoldering multiple myeloma prevents progression to symptomatic disease and should be strongly considered for patients meeting new criteria for high risk, according to Sagar Lonial, MD, Professor and Chair of Hematology and Medical Oncology and the Anne and Bernard Gray...

breast cancer

Expert Point of View: Carla S. Fisher, MD

CARLA S. FISHER, MD, Medical Director of Breast Surgical Oncology and Associate Professor of Surgery at Indiana University School of Medicine, Indianapolis, commented on the study that sought to identify HER2- positive patients who do, and do not, need surgery after neoadjuvant chemotherapy. “As...

breast cancer

Can Some Women With HER2-Positive Breast Cancer Forgo Surgery?

Breast cancer researchers at The University of Texas MD Anderson Cancer Center, Houston, are beginning to select patients with HER2-positive breast cancer who might forgo surgery after neoadjuvant chemotherapy. While this fine-tuning is currently intended to inform clinical trials—in particular, to ...

lung cancer
immunotherapy

Optimal First-Line Therapy for Stage IV Non–Small Cell Lung Cancer: Immunotherapy Alone or With Chemotherapy?

Recent studies in non–small cell lung cancer (NSCLC) have shown benefit for combining checkpoint inhibitors with chemotherapy. Should combinations, therefore, be the first choice for treating patients with newly diagnosed stage IV disease? Two lung cancer experts debated this point at the 2019...

solid tumors

Expert Point of View: Thomas Paul Slavin, Jr, MD

Thomas Paul Slavin, Jr, MD, of City of Hope National Medical Center, where he is Assistant Clinical Professor in the Department of Medical Oncology, Division of Clinical Cancer Genomics, and a Program Member of Cancer Control and Population Sciences, commented on these substudy findings. The...

solid tumors

Exploratory Analysis Shows DNA Methylation Assay Highly Specific for Cancer Detection

A cell-free DNA test based on the presence of DNA methylation has proven highly specific as a multicancer detection test and appears especially good at detecting high-risk malignancies. In most cases, it can also accurately pinpoint the tumor’s tissue of origin, researchers reported at the 2019...

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...

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