William King

During the 2023 American Society of Clinical Oncology (ASCO) Genitourinary Cancers Symposium, a panel of experts identified some of the key challenges to achieving health equity in bladder cancer care and discussed what can be done to improve access to clinical trials, mitigate financial toxicity, and promote value-based care.

In a session during the 2023 NCCN Annual Conference, Deborah M. Stephens, DO, provided important updates to treatment recommendations for patients with chronic lymphocytic leukemia (CLL)/small lymphocytic lymphoma (SLL), and identified key factors for selecting frontline and subsequent therapies, including immunoglobulin heavy chain variable (IGHV) gene status, 17p deletion (del17p)/TP53 mutation status, age, patient comorbidities, and resistance mutations.

Surgery is typically the gold standard for patients with biopsy-proven, clear cell, renal cell carcinoma (RCC) with no evidence of metastatic disease, said Eric Jonasch, MD, in a session during the NCCN Annual Conference. In this setting, there is probably not a role for systemic neoadjuvant treatment, as response rates of 15% to 45% have been recorded with axitinib (Inlyta), sunitinib (Sutent), and other tyrosine kinase inhibitors (TKIs).

Molecular/genetic characterization has taken on greater importance in the classification of adult gliomas and in diagnostic and treatment decision-making. “These tumors are now grouped and predicated more on molecular features rather than histopathologic criteria,” said L. Burt Nabors, MD, in a presentation during the 2023 NCCN Annual Conference.

An analysis from the ARASENS trial showed that the addition of darolutamide to androgen-deprivation therapy and docetaxel significantly improved overall survival in subgroups of patients with metastatic hormone-sensitive prostate cancer with high-volume and high-risk disease, contributing to the evidence that this combination should be considered the new standard of care for this patient population.

The decision to use adjuvant therapies in patients with renal-cell carcinoma (RCC) should be based on risk, patient goals, and shared decision-making. This topic was explored in a presentation by Matthew Zibelman, MD, Associate Professor, Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA, at the 2023 American Society of Clinical Oncology Genitourinary Cancers Symposium.

Patients with hormone receptor (HR)-positive, HER2-negative advanced breast cancer, including those with visceral crises, treated with the CDK4/6 inhibitor ribociclib (Kisqali) plus endocrine therapy had a significantly longer progression-free survival (PFS) and fewer adverse events (AEs) compared with those treated with combination chemotherapy, according to results from the phase 2 RIGHT Choice trial.

Using circulating tumor cell (CTC) count to guide the choice of first-line treatment—chemotherapy or endocrine therapy—improved overall survival (OS) compared with investigator’s choice of treatment for patients with metastatic, estrogen receptor (ER)-positive, HER2-negative breast cancer, according to results from the STIC CTC trial, which were discussed at the 2022 San Antonio Breast Cancer Symposium (SABCS) by François-Clément Bidard, MD, PhD, Co-Coordinator, Breast Cancer Research, Institut Curie, Paris, France, and Professor, Medicine, Department of Medical Oncology, Institut Curie and Université de Versailles Saint-Quentin-en-Yvelines, France.

In patients with hormone receptor (HR)-positive, HER2-low or -negative, locally advanced or metastatic breast cancer resistant to aromatase inhibitors, the addition of the investigational first-in-class AKT inhibitor capivasertib (AZD5363) to fulvestrant (Faslodex) led to a statistically significant and clinically meaningful improvement in progression-free survival (PFS) compared with placebo plus fulvestrant. The PFS benefit observed with capivasertib was even greater in a subset of patients with an AKT pathway alteration.

Minimizing some of the most distressing symptoms of cancer and its treatment requires systematic screening and risk assessment, as well as a focus on the underlying cause of these symptoms, according to experts at the European Society for Medical Oncology (ESMO) Congress 2022.

More than 50% of adults with refractory or relapsed large B-cell lymphoma (LBCL) who were not deemed candidates for high-dose chemotherapy and hematopoietic stem-cell transplantation (HSCT) had complete responses (CRs) following treatment with the chimeric antigen receptor (CAR) T-cell therapy lisocabtagene maraleucel (Breyanzi).

During a special symposium at the European Society for Medical Oncology Congress 2022, a panel of experts identified some of the key challenges facing young oncology nurses and discussed strategies to better support and empower these professionals academically, clinically, and professionally.

Several baseline factors were associated with an increased risk for early treatment discontinuation in the phase 3 monarchE clinical trial, which assessed adjuvant abemaciclib (Verzenio) in patients with hormone receptor–positive, HER2-negative early breast cancer, according to findings from a multivariate analysis presented during the 2022 American Society of Clinical Oncology Annual Meeting.

The addition of pembrolizumab (Keytruda) to chemotherapy with or without bevacizumab (Avastin) resulted in significantly and clinically meaningful improvements in overall survival (OS) and progression-free survival (PFS) in women with cervical cancer.

The theme for the 2022 American Society of Clinical Oncology (ASCO) Annual Meeting selected by 2021-2022 ASCO President Everett E. Vokes, MD, John E. Ultmann Professor of Medicine, and Chair, Department of Medicine, University of Chicago Duchossois Center for Advanced Medicine, Hyde Park, was advancing equitable cancer care through innovation.

Targeting HER2 with the antibody–drug conjugate fam-trastuzumab deruxtecan-nxki (Enhertu; T-DXd) provided clinically meaningful benefits for patients with HER2-low metastatic breast cancer, according to findings presented at the 2022 American Society of Clinical Oncology Annual Meeting.

Telehealth is playing a larger role in the delivery of cancer care, but there is more work that needs to be done to permanently increase access, according to a panel of experts during a plenary session at the National Comprehensive Cancer Network (NCCN) 2022 Annual Conference.

Updates to the screening guidelines for colorectal cancer (CRC) from the National Comprehensive Cancer Network (NCCN) include lowering the initial screening age for average-risk individuals and second- and third-degree family members with CRC, as well as an extension in the interval for surveillance colonoscopy for low-risk individuals.

Treatment with nivolumab (Opdivo) plus ipilimumab (Yervoy) in the neoadjuvant setting plus adjuvant nivolumab resulted in a high rate of pathologic complete response (pCR) in patients with resectable microsatellite instable (MSI)/mismatch repair deficient (dMMR) oeso-gastric junction (OGJ) adenocarcinoma, according to findings from the GERCOR NEONIPIGA clinical trial, which were presented by Thierry André, MD, Professor, Medical Oncology, Sorbonne Université, Hôpital Saint Antoine, Paris, France, at the 2022 ASCO Gastrointestinal Cancers Symposium.

Pembrolizumab (Keytruda) added to best supportive care (BSC) improved outcomes including overall survival (OS) versus BSC alone in Asian patients with advanced hepatocellular carcinoma (HCC) previously treated with sorafenib (Nexavar), according to final results from the KEYNOTE-394 trial.

Treatment with the androgen receptor inhibitor darolutamide (Nubeqa), in combination with androgen-deprivation therapy (ADT) and docetaxel, significantly improved overall survival (OS) compared with ADT and docetaxel alone in patients with metastatic hormone-sensitive prostate cancer (mHSPC), according to recent results from the phase 3 ARASENS clinical trial, which were simultaneously published in the New England Journal of Medicine.

The addition of isatuximab (Sarclisa) to the triplet of lenalidomide (Revlimid), bortezomib (Velcade), and dexamethasone (RVd) achieved superior minimal residual disease (MRD) negativity rates versus standard therapy with RVd alone as induction treatment in transplant-eligible patients with newly diagnosed multiple myeloma, according to results of the phase 3 GMMG-HD7 clinical trial presented at the 2021 ASH Annual Meeting and Exposition.

Trastuzumab deruxtecan (Enhertu; T-DXd) continues to show superior antitumor activity and improved survival compared with standard chemotherapy in patients with advanced HER2-expressing gastric or gastroesophageal junction (GEJ) cancer, according to updated results from the phase 2 DESTINY-Gastric01 trial.

Interim results from a phase 2 clinical trial showed that a novel combination of aldoxorubicin, N-803 (an IL-15 superagonist), and PD-L1 natural killer cell therapy (Nant Cancer Vaccine) plus low-dose chemotherapy doubled overall survival (OS) compared with historical controls in patients with locally advanced or metastatic pancreatic cancer.

Continuous enzalutamide (Xtandi) treatment in combination with docetaxel significantly improved progression-free survival (PFS) compared with placebo plus docetaxel in men with metastatic castration-resistant prostate cancer who had disease progression on enzalutamide alone, according to results from the phase 3b PRESIDE clinical trial.

Neoadjuvant enfortumab vedotin (Padcev) showed promising antitumor activity in patients with muscle-invasive bladder cancer (MIBC) who were ineligible for cisplatin therapy, according to preliminary findings from cohort H of the phase 1b/2 EV-103 clinical trial.

The neoadjuvant combination of avelumab (Bavencio) and axitinib (Inlyta) resulted in a partial response (PR) rate of 30% in patients with localized renal-cell carcinoma (RCC) at high risk for relapse after nephrectomy, according to results from the phase 2 NeoAvAx clinical trial.

Community-based providers remain at the core of the oncology care delivery system. A panel moderated by Barbara McAneny, MD, Chief Executive Officer, New Mexico Oncology Hematology Consultants, Albuquerque, at the 11th Annual Summit of the Association for Value-Based Cancer Care in 2021 explored the road ahead for community practices in terms of balancing value and delivering optimal access to care for patients.

With better insights into the biology of cancer and other diseases, genetic medicine is entering “a whole new ballgame,” said Scott Gottlieb, MD, Former FDA Commissioner, during the keynote session at the 11th Annual Summit of the Association for Value-Based Cancer Care in 2021.

A single dose of ciltacabtagene autoleucel (cilta-cel), an investigational B-cell maturation antigen–directed CAR T-cell therapy, resulted in early, deep, and durable responses in heavily pretreated patients with relapsed or refractory multiple myeloma, according to updated results from the phase 1b/2 CARTITUDE-1 clinical trial.

Early results from the CheckMate-648 clinical trial, which evaluated the efficacy and safety of Opdivo (nivolumab), a PD-1 inhibitor, plus Yervoy (ipilimumab), a CTLA-4 inhibitor, or nivolumab plus chemotherapy, suggest a potential new standard of care for the first-line treatment of patients with advanced esophageal squamous-cell carcinoma (ESCC).

The use of the PARP inhibitor olaparib (Lynparza) for 1 year after receiving standard chemotherapy in the neoadjuvant or the adjuvant setting significantly improved invasive disease-free survival in patients with high-risk, early-stage, HER2-negative breast cancer and BRCA1 or BRCA2 mutations, according to results presented at the American Society of Clinical Oncology 2021 virtual annual meeting.

According to results from a recent study, balstilimab, an investigational PD-1 inhibitor, demonstrated meaningful and durable clinical activity in patients with recurrent or metastatic cervical cancer. These findings were presented by Cailin E. Joyce, MD, Director, Applied Technology, Agenus, Boston, MA, during the American Society of Clinical Oncology 2021 virtual annual meeting.

The addition of the lymphocyte activation gene-3 (LAG-3)-blocking antibody relatlimab to nivolumab (Opdivo) led to significantly longer progression-free survival (PFS) compared with nivolumab alone in previously untreated patients with advanced melanoma, according to results of the phase 3 RELATIVITY-047 clinical trial presented at the American Society of Clinical Oncology 2021 virtual annual meeting.

Despite improvements in the treatment of advanced ovarian cancer, less than half of newly diagnosed patients survive longer than 5 years, and relapse rates remain high. At the Society of Gynecologic Oncology (SGO) 2021 Virtual Annual Meeting on Women’s Cancer, experts presented updated results from 2 phase 3 clinical trials showing the benefit of the poly (ADP-ribose) polymerase (PARP) inhibitors olaparib (Lynparza) and niraparib (Zejula) as maintenance therapy in women with advanced or recurrent disease.

A small-molecule CD73 inhibitor (AB680) induced a 41% overall response rate (ORR) when combined with chemotherapy (with nab-paclitaxel and gemcitabine), plus the novel PD-1 inhibitor zimberelimab, as a first-line treatment for patients with metastatic pancreatic cancer according to results of the dose-escalation portion of the phase 1/1b ARC-8 study.

The combination of the investigational drug pevonedistat in combination with azacitidine injection (Vidaza) leads to longer event-free survival (EFS) and a higher complete response rate than azacitidine alone in patients with high-risk myelodysplastic syndromes (MDS), according to results from a phase 2, open-label, international clinical trial.

A post-hoc analysis of a pivotal clinical trial showed that belantamab mafodotin-blmf (Blenrep), a first-in-class antibody–drug conjugate targeting B-cell maturation antigen, induced deep and durable responses in heavily pretreated patients with relapsed or refractory multiple myeloma.

Cancer health disparities remain a challenge in the United States, despite some strides being made to reduce these disparities, according to a new report from the American Association for Cancer Research (AACR) that was released in a virtual presentation on September 16, 2020.

The small molecule inhibitor of tyrosine kinase WEE1 adavosertib demonstrated promising clinical activity in a single-arm, phase 2 study of patients with unselected uterine serous cancer (USC), with an objective response rate of 29.4%, said Joyce F. Liu, MD, MPH, Director of Clinical Research, Division of Gynecologic Oncology, Dana-Farber Cancer Institute, Boston, MA, at the ASCO 2020 virtual annual meeting. The responses were durable, with a median duration of response of 9.03 months.

Capmatinib (Tabrecta), an oral kinase inhibitor, has shown clinical activity in patients with high-level MET-amplified advanced non–small-cell lung cancer (NSCLC), according to new data presented at the ASCO 2020 virtual annual meeting.

A total of 80% of patients with relapsed or refractory indolent non-Hodgkin lymphoma (NHL) achieved a complete response (CR) to axicabtagene ciloleucel (Yescarta), and those responses have proved durable, according to the interim results of the phase 2 ZUMA-5 study, said Caron A. Jacobson, MD, Medical Director, Immune Effector Cell Therapy Program, Dana-Farber Cancer Institute, Boston, MA, at the ASCO 2020 virtual annual meeting.

There has been increased focus on the study of tumor alterations that may predict treatment benefit or serve as possible actionable targets for new therapeutic approaches in cancer.

Circulating tumor DNA (ctDNA) analysis is a useful sequencing platform in metastatic castration-resistant prostate cancer (CRPC), and ctDNA alterations are detected in most patients with this type of prostate cancer, according to Justin Shaya, MD, Hematology/Oncology Fellow, UC San Diego Moores Cancer Center, CA.

Preliminary results from a single-arm study demonstrated promising progression-free survival (PFS) and a clinically meaningful objective response rate (ORR) with the combination of pembrolizumab (Keytruda) and nab-paclitaxel (Abraxane) as second- or third-line therapy in patients with advanced urothelial carcinoma.

Treatment with a combination of pembrolizumab (Keytruda) and enzalutamide (Xtandi) continues to show substantial activity in patients with metastatic castration-resistant prostate cancer (CRPC) who have already been treated with abiraterone (Zytiga), according to results of a recent clinical trial, which were presented during the virtual 2020 American Urological Association Annual Meeting.