GYNECOLOGIC CANCERS

The American Cancer Society has estimated that in 2019 in the United States, approximately 13,240 new patients will receive a diagnosis of cervical cancer and 4170 individuals will die from the disease. However, because of effective screening programs using cytology and/or high-risk human papillomavirus DNA testing in industrialized nations, incidence and mortality rates have declined.

A number of promising biologic therapies are beginning to transform the treatment of adult patients with acute lymphoblastic leukemia, with the greatest potential seen with blinatumomab and inotuzumab ozogamicin in combination with chemotherapy, according to a presentation by Hagop M. Kantarjian, MD, at the 37th Annual CFS.<br /> &nbsp;

Although a vaccine for the human papillomavirus (HPV) is widely available, an average of 34,800 HPV-associated cancers attributable to the virus, including cervical, vaginal, vulva, penile, anal, and oropharynx were reported in the United States from 2012 through 2016, according to data published in Morbidity and Mortality Weekly Report.

Daniel Catenacci, MD, discusses how he makes decisions with immunotherapeutic agents for the treatment of patients with gastroesophageal junction cancer. He says he bases his sequencing decisions on a number of factors.

In October 2019, the FDA approved a new treatment option for patients with advanced ovarian, fallopian tube, or primary peritoneal cancer, as well as a new dosing regimen for patients receiving moderately emetogenic chemotherapy. Additionally, the FDA granted breakthrough therapy designations to 2 therapies, as well as an orphan drug designation, a priority review, and 2 fast track designations.

The FDA has approved niraparib for the treatment of patients with advanced ovarian, fallopian tube, or primary peritoneal cancer treated with &ge;3 prior chemotherapy regimens and whose cancer is associated with homologous recombination deficiency positivity.

The FDA has approved a supplemental New Drug Application for a single dose of aprepitant injectable emulsion for intravenous use in patients receiving moderately emetogenic chemotherapy. The approval expands the dose for aprepitant to include a 130 mg single-dose regimen for the prevention of acute and delayed chemotherapy-induced nausea and vomiting.<br /> &nbsp;

Pamela L. Kunz, MD, discusses the most recent FDA approval of Lutathera (lutetium [Lu 177] dotatate) for the treatment of patients with gastroenteropancreatic NETs (GEP-NETs), including foregut, midgut, and hindgut tumors.

The advent of an era of targeted immunotherapy and CAR T-cell therapies for the treatment of adult patients with acute lymphoblastic leukemia may reduce the need for hematopoietic stem cell transplant in certain cases.<br /> &nbsp;

The case for the combination of olaparib and durvalumab in patients with metastatic breast cancer and relapsed ovarian cancer with germline&nbsp;BRCA&nbsp;mutations was strengthened based on the updated results from the phase I/II MEDIOLA, which was covered in 2 separate presentations at the 2019 ESMO Congress.

Robert L. Coleman, MD, professor of medicine, The University of Texas MD Anderson Cancer Center, explains the rationale for the VELIA trial of veliparib with frontline chemotherapy and maintenance in patients with high-grade ovarian cancer.

Following the 2019 ESMO Congress, experts across various fields highlighted some next steps and how these treatment options will improve the treatment landscape for patients with ovarian, lung, breast, GI, or GU cancers. Overall, the abstracts presented at this year&rsquo;s meeting will change the treatment paradigm in a number of patient populations.

The FDA has granted a fast track designation to navicixizumab for the treatment of patients with high-grade ovarian, primary peritoneal, or fallopian tube cancer who have received &ge;3 prior therapies and/or prior bevacizumab.

Marcelo C. Pasquini, MD, discusses the rationale for analyzing real-world data for the use of tisagenlecleucel, a chimeric antigen receptor T-cell therapy, as a treatment for patients with acute lymphoblastic leukemia and diffuse large B-cell lymphoma. This CD19 CAR T cell was approved 2 years ago for use in both ALL and DLBCL.

In a randomized trial, treatment with MEK inhibitor trametinib showed significant improvement in progression-free survival and overall survival in patients with recurrent, low-grade serous ovarian cancer.<br /> &nbsp;

The addition of direct oral oral anticoagulants for the management of venous thromboembolism in patients with cancer is the latest change to previous guidelines issued by the American Society of Clinical Oncology.

Patients with high-grade serous ovarian cancer experienced a 32% reduction in the risk of progression or death with frontline combination veliparib plus carboplatin and paclitaxel followed by veliparib maintenance, according to the data from the phase III VELIA trial presented at the 2019 ESMO Congress, and simultaneously published in the&nbsp;New England Journal of Medicine.

Using a measure known as the growth modulation index, patients with TRK fusion&ndash;positive cancers who were treated with larotrectinib had a clinically meaningful improvement in progression-free survival compared with the time to progression on their prior treatment, an analysis of patients enrolled in 1 of 3 clinical trials has found.

Due to treatment benefit observed in pediatric patients with acute lymphoblastic leukemia,&nbsp;2 clinical trials investigating blinatumomab (Blincyto) versus chemotherapy were stopped early, according to the drug developer Amgen.

In the CheckMate-358 study, the combination of nivolumab and ipilimumab showed durable clinical activity in patients with recurrent or metastatic cervical cancer, regardless of tumor PD-L1 expression.

The risk of progression or death was reduced by 63% with&nbsp;ivosidenib as treatment of pretreated patients with IDH1-mutant advanced cholangiocarcinoma&nbsp;compared with placebo, according to data from the phase III&nbsp;ClarIDHy study that was presented at the 2019 ESMO Congress.

Three clinical trials presented at the 2019 ESMO Congress show that the tropomyosin receptor kinase&nbsp;inhibitor larotrectinib continues to show anti-tumor activity, including long-lasting objective responses and low toxicity, according to results from an integrated analysis.

Robert L. Coleman, MD, FACOG, FACS, discusses&nbsp;the results of the phase III VELIA trial in patients with advanced ovarian cancer.&nbsp;

The combination of olaparib and bevacizumab as frontline maintenance improved the median progression-free survival by 5.5 months over bevacizumab and placebo in patients with&nbsp;newly diagnosed, advanced ovarian cancer following prior treatment with a platinum-based chemotherapy plus bevacizumab, according to the phase III PAOLA-1 findings presented at the 2019 ESMO Congress.

Median progression-free survival was improved by 5.6 months with PARP inhibitor niraparib as first-line treatment for patients with newly diagnosed, advanced ovarian cancer who responded to platinum-based chemotherapy&nbsp;compared with placebo, according to data from the phase III PRIMA study presented at the ESMO Congress 2019 and simultaneously published in the <em>New England Journal of Medicine</em>.

Cediranib in combination with olaparib demonstrated an improvement in&nbsp;progression-free survival when used as treatment for patients with platinum-resistant ovarian cancer (PROC). However, the difference in PFS compared with chemotherapy did not achieve statistical significance, according to a randomized trial presented at the 2019 ESMO Congress.

An objective response rate of 35.5% was seen with&nbsp;treatment with pemigatinib, a selective oral inhibitor of&nbsp;FGFR1, 2, and 3, in patients with&nbsp;previously treated, locally advanced or metastatic cholangiocarcinoma with an&nbsp;<em>FGFR2&nbsp;</em>rearrangement or fusion,&nbsp;according to findings from the phase II FIGHT-202 clinical trial presented at ESMO 2019.

Gulam A. Manji, MD, PhD, discusses the need to identify mutations that may be actionable in patients with colorectal cancer. The identification of such mutations can further impact patient survival and improve efficacy, says Manji, in both CRC and other gastrointestinal cancers.

In an interview with&nbsp;<em>Targeted Oncology</em>, Marcelo C. Pasquini, MD, discussed the importance of obtaining real-world data and establishing registries for collecting patient outcomes, and how real-world data compare with data from pivotal trials. He also explained the challenges with accessibility to CAR T-cell therapies.

Amol K. Narang, MD, discusses the unanswered questions that still need to be addressed to further expand the role of stereotactic body radiation therapy in gastrointestinal cancers.