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Hepatobiliary Cancer

Triplet Chemotherapy in Unresectable Locally Advanced or Metastatic Biliary Tract Cancers

In a phase II trial reported in JAMA Oncology, Rachna T. Shroff, MD, and colleagues found that the addition of nab-paclitaxel to standard gemcitabine and cisplatin resulted in promising outcomes in patients with unresectable locally advanced or metastatic biliary tract cancers. The study included...

Hepatobiliary Cancer

FDA Approves Ramucirumab for Hepatocellular Carcinoma

ON MAY 10, the U.S. Food and Drug Administration (FDA) approved ramucirumab (Cyramza) as a single agent for hepatocellular carcinoma in patients who have an alpha fetoprotein (AFP) level ≥ 400 ng/mL and have been previously treated with sorafenib. REACH-2 Trial APPROVAL WAS based on the REACH-2...

hepatobiliary cancer
immunotherapy

Early-Stage Study of Nivolumab Alone or in Combination With Cisplatin/Gemcitabine in Biliary Tract Cancer

In a Japanese phase I trial reported by Ueno et al in The Lancet Gastroenterology & Hepatology, researchers found nivolumab showed activity and had a manageable safety profile in patients with unresectable or recurrent biliary tract cancer. Methods The open-label phase I trial was conducted...

hepatobiliary cancer

Rate of 'Textbook Outcomes' in Curative-Intent Resection of Intrahepatic Cholangiocarcinoma

In a multi-institutional international analysis reported in JAMA Surgery, Merath et al found that a textbook outcome was achieved in a minority of patients undergoing curative-intent resection of intrahepatic cholangiocarcinoma. Study Details The study involved data on 687 patients from 15 major...

hepatobiliary cancer

ARRS 2019: Percutaneous Liver Ablation Intervention vs Surgery for Hepatocellular Carcinoma

Compared to surgery, percutaneous liver ablation interventions in patients with hepatocellular carcinoma were associated with lower in-hospital mortality, length of hospital stay, and hospitalization costs, according to a study presented by Sodagari et al at the American Roentgen Ray Society...

hepatobiliary cancer

ARRS 2019: Arterial-Phase Hyperenhancement for Hepatocellular Carcinoma Treated With SBRT

Although arterial-phase hyperenhancement is a key feature of untreated or recurrent hepatocellular carcinoma, standard response assessment such as modified Response Evaluation Criteria in Solid Tumors (mRECIST) should be used with caution, particularly in the early phases after stereotactic body...

hepatobiliary cancer

FDA Approves Ramucirumab for Hepatocellular Carcinoma

On May 10, the U.S. Food and Drug Administration (FDA) approved ramucirumab (Cyramza) as a single agent for hepatocellular carcinoma in patients who have an alpha-fetoprotein (AFP) level ≥ 400 ng/mL and have been previously treated with sorafenib. REACH-2 Trial Approval was based on the...

Solid Tumors
Hepatobiliary Cancer

Adjuvant Capecitabine After Resection for Biliary Tract Cancer

In the phase III BILCAP trial reported in The Lancet Oncology, John N. Primrose, FMedSci, and colleagues found evidence that adjuvant capecitabine may improve overall survival vs observation following surgery for patients with resected biliary tract cancer.  The open-label study included 447...

hepatobiliary cancer

Minimal Adjuvant Chemotherapy for Pediatric Hepatoblastoma Resected at Diagnosis

In an analysis from the Children’s Oncology Group phase III AHEP0731 trial reported in The Lancet Oncology, Katzenstein et al found that minimal adjuvant chemotherapy with two cycles of cisplatin, fluorouracil, and vincristine was associated with disease control in pediatric patients with...

hepatobiliary cancer

Addition of Nab-paclitaxel to Gemcitabine and Cisplatin in Advanced Biliary Tract Cancers

In a phase II trial reported in JAMA Oncology, Shroff and colleagues found that the addition of nab-paclitaxel to standard gemcitabine and cisplatin resulted in promising outcomes in patients with unresectable locally advanced or metastatic biliary tract cancers. The study included 60 patients...

Hepatobiliary Cancer

Ramucirumab After Sorafenib in Advanced Hepatocellular Carcinoma: An Efficacious Therapy With Applicability Challenges

In the 2 years since the U.S. Food and Drug Administration’s (FDA) approval of regorafenib in the treatment of patients with sorafenib-refractory advanced hepatocellular carcinoma, we oncologists have witnessed a veritable avalanche of newly approved medicines for the treatment of advanced...

Hepatobiliary Cancer

Ramucirumab in Sorafenib-Pretreated Patients With Advanced Hepatocellular Carcinoma

In the phase III REACH-2 trial reported in The Lancet Oncology, Andrew X. Zhu, MD, of Harvard Medical School and Massachusetts General Hospital, and colleagues found that ramucirumab improved overall and progression-free survival vs placebo in patients with advanced hepatocellular carcinoma and...

hepatobiliary cancer
issues in oncology

Trends in Liver Cancer Death Rates by Educational Attainment

A new study has found that rising rates of liver cancer deaths in the United States have largely been confined to individuals who have received less education—especially among men. Published by Ma et al in Cancer, the findings emphasize the need for enhanced efforts to address the growing...

hepatobiliary cancer

Capecitabine vs Observation Following Surgery for Resected Biliary Tract Cancer

Watch John Marshall, MD, and BILCAP first author John Neil Primrose, PhD, MBBS, discuss the trial at the 2017 ASCO Annual Meeting. In the phase III BILCAP trial reported in The Lancet Oncology, Primrose and colleagues found evidence that adjuvant capecitabine may improve overall...

Hepatobiliary Cancer

CELESTIAL Trial in Advanced Hepatocellular Carcinoma: Analysis on Quality-Adjusted Life-Years

ON JANUARY 14, 2019, the U.S. Food and Drug Administration (FDA) approved cabozantinib, an orally available receptor tyrosine kinase inhibitor, for patients with hepatocellular carcinoma who have been previously treated with sorafenib. The FDA’s approval was based on the results of the phase III...

Kidney Cancer
Bladder Cancer
Prostate Cancer
Hepatobiliary Cancer

Conference Highlights From the 2019 Gastrointestinal and Genitourinary Cancers Symposiums

THIS YEAR saw a huge turnout and a large number of scientific abstracts presented at both the 2019 Gastrointestinal (GI) Cancers Symposium, held on January 17–19, and the 2019 Genitourinary (GU) Cancers Symposium, held on February 14–16, both in San Francisco. The GU Cancers Symposium attracted...

Colorectal Cancer
Neuroendocrine Tumors
Gastrointestinal Cancer
Hepatobiliary Cancer

New Data in Colorectal, Neuroendocrine, Gastric, and Hepatocellular Cancers

THE ANNUAL GASTROINTESTINAL CANCERS SYMPOSIUM took place earlier this year in San Francisco. In addition to important studies captured in our past few issues, The ASCO Post here briefly summarizes additional interesting studies. Adjuvant Hyperthermic Intraperitoneal Chemotherapy in Colon Cancer...

hepatobiliary cancer

Demographic Factors Increasing Risk of Liver Cancer Development in Patients With Fatty Liver Disease

A new study published by Zarrinpar et al in Liver International has found that elderly, diabetic, and Hispanic patients with steatohepatitis—fatty liver disease—may have a higher risk of developing liver cancer. Ali Zarrinpar, MD, PhD, Associate Professor of Surgery at the...

Hepatobiliary Cancer

Cabozantinib for Hepatocellular Carcinoma Previously Treated With Sorafenib

In the Clinic provides overviews of novel oncology agents, addressing indications, mechanisms of action, administration recommendations, safety profiles, and other essential information needed for the appropriate clinical use of these drugs. On January 14, 2019, cabozantinib was approved for the...

Hepatobiliary Cancer

BRAF/MEK Targeting May Yield Benefit in Treating Biliary Tract Cancer

ROUTINE TESTING for BRAF V600E mutations in patients with biliary tract cancer may prove to be a good idea, based on the findings of a phase II study in which treatment with dabrafenib plus trametinib showed activity.1 The results suggest there may be a benefit to testing patients with biliary...

hepatobiliary cancer

Adjuvant Gemcitabine Plus Oxaliplatin vs Surveillance in Resected Biliary Tract Cancer

In a French phase III trial (PRODIGE 12-ACCORD 18-UNICANCER GI) reported in the Journal of Clinical Oncology, Edeline et al found that adjuvant gemcitabine plus oxaliplatin (GEMOX) did not significantly improve relapse-free survival vs surveillance following resection for localized biliary tract...

hepatobiliary cancer

Ramucirumab in Sorafenib-Pretreated Patients With Advanced HCC and Increased α-Fetoprotein

In the phase III REACH-2 trial reported in The Lancet Oncology, Zhu et al found that ramucirumab improved overall and progression-free survival vs placebo in patients with advanced hepatocellular carcinoma (HCC) and increased α-fetoprotein levels who had previously received sorafenib. Study...

hepatobiliary cancer

Andrew X. Zhu, MD, PhD, on Liver Cancer: Outcomes in the REFLECT Study on Lenvatinib

Andrew X. Zhu, MD, PhD, of the Massachusetts General Hospital Cancer Center, discusses an analysis of survival and objective response in patients with hepatocellular carcinoma who took part in a phase III study of lenvatinib (Abstract 186).

hepatobiliary cancer

Heinz-Josef Lenz, MD, on BRAF V600E–Mutated Biliary Tract Cancer: Results From the ROAR Basket Trial

Heinz-Josef Lenz, MD, of the University of Southern California Norris Comprehensive Cancer Center, discusses the efficacy and safety of dabrafenib and trametinib in patients with BRAF V600E–mutated biliary tract cancer (Abstract 187).

hepatobiliary cancer
immunotherapy

Ahmed Omar Kaseb, MD, on Liver Cancer: Results From an Immunotherapy Trial

Ahmed Omar Kaseb, MD, of The University of Texas MD Anderson Cancer Center, discusses phase II study findings on nivolumab alone vs nivolumab plus ipilimumab in patients with resectable hepatocellular carcinoma (Abstract 185).

Hepatobiliary Cancer

FDA Approves Cabozantinib in Previously Treated Hepatocellular Carcinoma

On January 14, the U.S. Food and Drug Administration (FDA) approved cabozantinib (Cabometyx) tablets for patients with hepatocellular carcinoma who have been previously treated with sorafenib. The FDA’s approval of this oral tyrosine kinase inhibitor was based on the results of the phase III...

hepatobiliary cancer
immunotherapy

2019 GI Cancers Symposium: Nivolumab vs Nivolumab Plus Ipilimumab in Resectable Hepatocellular Carcinoma

Anti–programmed cell death protein 1 and anti–cytotoxic T-lymphocyte–associated protein 4 antibodies have shown activity in hepatocellular carcinoma. Based on these earlier findings, researchers sought to examine the safety, efficacy, and tolerability of perioperative treatment...

hepatobiliary cancer

FDA Approves Cabozantinib for Previously Treated Hepatocellular Carcinoma

On January 14, the U.S. Food and Drug Administration (FDA) approved cabozantinib (Cabometyx) tablets for patients with hepatocellular carcinoma who have been previously treated with sorafenib. The FDA’s approval of cabozantinib was based on results from the phase III CELESTIAL trial....

hepatobiliary cancer
issues in oncology

Role of Donor Race in Liver Transplant Outcomes in African American Patients With Hepatocellular Carcinoma

Among African American adults undergoing liver transplant to treat hepatocellular carcinoma, patients whose organ donor was also African American lived significantly longer than those with a racially unmatched donor, report authors of a new study using national data. Their findings were published...

Hepatobiliary Cancer
Immunotherapy

Pembrolizumab in Sorafenib-Pretreated Hepatocellular Carcinoma

ON NOVEMBER 9, 2018, pembrolizumab (Keytruda) was granted accelerated approval for treatment of patients with hepatocellular carcinoma previously treated with sorafenib (Nexavar).1,2 Supporting Efficacy Data APPROVAL WAS BASED on durable responses in the phase II KEYNOTE-224 trial...

Global Cancer Care
Hepatobiliary Cancer

Controlling the Global Burden of Liver Cancer

The burden of mortality related to liver cancer is increasing worldwide. Prevention and control of viral hepatitis will be vital in combating this burden, but curbing the growing epidemic of obesity must also be seen as a key part of liver cancer prevention, according to Rosmawati Mohamed, MD, of...

Hepatobiliary Cancer

Lenvatinib in Unresectable Hepatocellular Carcinoma

On August 16, 2018, lenvatinib (Lenvima) was approved for the first-line treatment of patients with unresectable hepatocellular carcinoma.1,2 Supporting Efficacy Data Approval was based on the findings of a phase III open-label noninferiority trial (REFLECT), in which 954 patients with previously...

hepatobiliary cancer
gastrointestinal cancer

EORTC-NCI-AACR: Dabrafenib Plus Trametinib Active in Some BRAF V600E–Mutated Gastrointestinal Cancers

In a late-breaking presentation at the 30th EORTC-NCI-AACR Symposium on Molecular Targets and Cancer Therapeutics, Zev Wainberg, MD, reported on results from a phase II international clinical trial of dabrafenib (Tafinlar) plus trametinib (Mekinist), which showed some activity in 36 patients ...

Hepatobiliary Cancer

FDA Approves Pembrolizumab for Hepatocellular Carcinoma Previously Treated With a Kinase Inhibitor

ON NOVEMBER 9, 2018, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for patients with hepatocellular carcinoma who have been previously treated with the kinase inhibitor sorafenib (Nexavar). KEYNOTE-224 APPROVAL WAS based on KEYNOTE-224, a...

Solid Tumors
Hepatobiliary Cancer

Global Liver Institute Supports More Frequent Liver Cancer Screening

When detected early, liver cancer is highly treatable and, in many cases, curable, yet the number of new cases of liver cancer in the United States has increased by 43% in the past 16 years, whereas the incidence of other cancers is on the decline. This past October, during Liver Cancer Awareness...

hepatobiliary cancer

Risk Factors for Late Recurrence After Resection for Hepatocellular Carcinoma

In a Chinese retrospective study reported in JAMA Surgery, Xu et al found that risk of late recurrence (> 2 years) of hepatocellular carcinoma (HCC) after curative liver resection was associated with male sex, presence of cirrhosis, and aggressive characteristics of the initial HCC. The study...

hepatobiliary cancer

FDA Approves Pembrolizumab for Hepatocellular Carcinoma Previously Treated With a Kinase Inhibitor

On November 9, 2018, the U.S. Food and Drug Administration (FDA) granted accelerated approval to pembrolizumab (Keytruda) for patients with hepatocellular carcinoma who have been previously treated with the kinase inhibitor sorafenib. KEYNOTE-224 Approval was based on KEYNOTE-224, a single-arm,...

Solid Tumors
Hepatobiliary Cancer

Cabozantinib in Advanced Hepatocellular Cancer: Call for Revision of Practice Standards

As reported in The New England Journal of Medicine by Ghassan K. Abou-Alfa, MD, and colleagues, and reviewed in this issue of The ASCO Post, the phase III CELESTIAL trial has demonstrated that cabozantinib (Cabometyx) improved the median overall survival to 10.2 months in comparison to 8 months...

Hepatobiliary Cancer

Cabozantinib Improves Survival in Patients With Previously Treated Hepatocellular Carcinoma

As reported in The New England Journal of Medicine by Ghassan K. Abou‑Alfa, MD, of Memorial Sloan Kettering Cancer Center, and colleagues, the second interim analysis of the phase III CELESTIAL trial has shown a significant improvement in overall and progression-free survival with cabozantinib...

hepatobiliary cancer

Eileen M. O’Reilly, MD, on Hepatobiliary Cancer: Multimodality Approaches

Eileen M. O’Reilly, MD, of Memorial Sloan Kettering Cancer Center, discusses the latest information on locoregional and systemic treatments of hepatocellular carcinoma as well as targeted therapy for biliary cancer.

hepatobiliary cancer

Regular Aspirin Use and Reduction in Risk for Hepatocellular Carcinoma

A pooled analysis of two large U.S. prospective cohort studies reported in JAMA Oncology by Simon et al indicates that regular use of aspirin is associated with a significant reduction in risk for hepatocellular carcinoma (HCC), with an apparent dose- and duration-dependent effect. Study Details...

hepatobiliary cancer

Risk of Hepatocellular Carcinoma With Entecavir vs Tenofovir Treatment for Chronic Hepatitis B

In a Korean nationwide cohort study reported in JAMA Oncology, Choi et al found that hepatocellular carcinoma (HCC) appeared to be more common with first-line entecavir vs tenofovir treatment for chronic hepatitis B. The study involved data from the Korean National Health Insurance Service...

Solid Tumors
Hepatobiliary Cancer

Cabozantinib in Second-Line Treatment of Advanced Hepatocellular Carcinoma

Compared with placebo, cabozantinib (Cabometyx) significantly improved overall survival and progression-free survival in patients with advanced hepatocellular carcinoma who were previously treated with sorafenib (Nexavar), with no new safety signals, according to data from the phase III CELESTIAL ...

hepatobiliary cancer

First-Line Nab-Paclitaxel and Gemcitabine in Advanced Cholangiocarcinoma

In a phase II trial reported in JAMA Oncology, Sahai et al found that the first-line combination of nab-paclitaxel and gemcitabine—though it did not meet the progression-free survival primary endpoint—may constitute a treatment option in advanced cholangiocarcinoma. Study Details In...

Hepatobiliary Cancer
Lung Cancer
Bladder Cancer

Recent Drug Approvals and Revisions in Prescribing Information

THE U.S. FOOD AND DRUG ADMINISTRATION (FDA) issued the following approvals and prescribing information revisions in August 2018. Lenvatinib Approved for Unresectable Hepatocellular Carcinoma THE FDA approved lenvatinib (Lenvima) for the first-line treatment of patients with unresectable...

hepatobiliary cancer

Nonalcoholic Fatty Liver Disease May Be Risk Factor for Liver Cancer

Nonalcoholic fatty liver disease is a common disease, and with the incidence of liver cancer rising across the country, little has been understood about the link between it and hepatocellular carcinoma. To establish a better understanding of the link between hepatocellular carcinoma risk and...

hepatobiliary cancer

FDA Approves Lenvatinib for Unresectable Hepatocellular Carcinoma

Today, the U.S. Food and Drug Administration (FDA) approved lenvatinib capsules (Lenvima) for first-line treatment of patients with unresectable hepatocellular carcinoma (HCC). REFLECT Trial Approval was based on the international, multicenter, randomized, open-label, noninferiority REFLECT trial ...

hepatobiliary cancer
immunotherapy

FDA Grants Breakthrough Therapy Designation for Atezolizumab/Bevacizumab Combination as First-Line Treatment for Advanced or Metastatic HCC

The U.S. Food and Drug Administration (FDA) recently granted Breakthrough Therapy designation for atezolizumab (Tecentriq) in combination with bevacizumab (Avastin) as a first-line treatment for people with advanced or metastatic hepatocellular carcinoma (HCC), the most common form of liver...

colorectal cancer
kidney cancer
hepatobiliary cancer
lung cancer
pancreatic cancer
issues in oncology
bladder cancer

Large Disparities in Cancer Mortality Rates Found Among Different Racial/Ethnic Populations in New York State

According to the American Cancer Society, cancer is the leading cause of death for Hispanics and Asian/Pacific Islanders in the United States. However, their cancer burden is less than that of non-Hispanic whites and especially non-Hispanic blacks, who bear the most disproportionate share of the...

hepatobiliary cancer

Cabozantinib vs Placebo in Advanced Hepatocellular Carcinoma Previously Treated With Sorafenib

As reported in The New England Journal of Medicine by Abou-Alfa and colleagues, the second interim analysis of the phase III CELESTIAL trial has shown a significant improvement in overall and progression-free survival with cabozantinib (Cabometyx) vs placebo in patients with sorafenib...

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