News

Michael R. Grunwald, MD,&nbsp;discusses new and emerging agents in AML and ALL, as well as sequencing and toxicity challenges with these treatments.<br /> &nbsp;

The biggest clinical unmet need in the treatment of patients with mantle cell lymphoma is overcoming resistance to BTK inhibitors, as patients who progress on treatment with ibrutinib&nbsp;(Imbruvica) and acalabrutinib (Calquence) are often incurable, according to Michael Wang, MD. Investigators are now challenged to find a new avenue of treatment.

An overall response rate of&nbsp;41.6% (95% CI, 32.9-50.8) was induced with the use of ivosidenib in patients with&nbsp;<em>IDH1</em>-positive relapsed/refractory acute myeloid leukemia, according to data presented at the 2018 ASCO Annual Meeting&nbsp;and published simultaneously online in the <em>New England Journal of Medicine</em>.

Yelena Y. Janjigian, MD, has been appointed chief of the Gastrointestinal Medical Oncology Service in the Division of Solid Tumor Oncology, Department of Medicine at Memorial Sloan Kettering Cancer Center in New York. She will succeed Leonard Saltz, MD, who had held this position for 5 years. Saltz will assume the position of executive director for clincal value and sustainability.

Pembrolizumab (Keytruda) has been granted&nbsp;an accelerated approval by the FDA&nbsp;for the treatment of adult and pediatric patients with refractory primary mediastinal large B-cell lymphoma (PMBCL), or those who have relapsed after 2 or more prior lines of therapy.&nbsp;The approval is based on results from 53 patients with relapsed/refractory PMBCL enrolled in the multicenter, open-label, single-arm KEYNOTE&#8209;170 trial.

The combination of the VEGFR/FGFR inhibitor lenvatinib and the PD-1 inhibitor pembrolizumab induced a confirmed overall response rate of 26.9% (95% CI, 11.6%-47.8%) in patients with unresectable hepatocellular carcinoma, according to results from a 2-part, phase Ib trial.

Based on results from the phase III GOG-0218 trial, bevacizumab (Avastin) has been approved by the FDA&nbsp;for use in combination with carboplatin and paclitaxel, followed by&nbsp;bevacizumab monotherapy, for the treatment of women with advanced ovarian cancer following initial surgical resection.

While 70.6% of oncologists do not feel sufficiently informed to make clinical recommendations regarding medical marijuana, most do conduct discussions in the clinic and close to half recommend it to their patients, according to findings from a national-level survey recently published in the <em>Journal of Clinical Oncology</em>.

The indication for the&nbsp;Orbis Paxman Hair Loss Cooling System has been expanded by the FDA to include the prevention of chemotherapy-related alopecia in patients with solid tumors, according to Paxman, the maker of the device. The system was previously approved&nbsp;to treat chemotherapy-related alopecia in patients with breast cancer.

Pembrolizumab (Keytruda) has been granted an&nbsp;accelerated approval by the FDA&nbsp;for the treatment of patients with advanced, PD-L1&ndash;positive cervical cancer with disease progression on or after chemotherapy.<br /> &nbsp;

A supplemental new drug application adding overall survival data from the phase III ASPIRE trial to the label&nbsp;for carfilzomib (Kyprolis) has been approved by the FDA, according to Amgen, the manufacturer of the proteasome inhibitor.&nbsp; Carfilzomib is approved&nbsp;for use in patients with relapsed or refractory multiple myeloma.

During a presentation at the 2018 Community Oncology Conference, hosted by the Community Oncology Alliance, Bob Twillman, PhD, emphasized a lack of understanding within the medical community on pain management. He referenced a survey conducted by the Association of American Medical Colleges, which found that a significantly small percentage of medical schools included a separate course in pain management in their curriculum.

Osimertinib (Tagrisso) has been approved by The European Commission as a frontline treatment for patients with&nbsp;<em>EGFR</em>-mutant locally-advanced or metastatic non&ndash;small cell lung cancer. The approval is based on data&nbsp;from the phase III FLAURA trial.

An important step for treatment of patients with ovarian cancer has been testing for genetic alterations. Mike Janicek, MD, says that the use of genetic testing must become more common in order to push the field of ovarian cancer forward.

Although patients who develop brain metastases from renal cell carcinoma typically have poor outcomes, investigators from Yale University have identified a subset of patients who demonstrated extended survival.¹Those patients with a single metastasis were less likely to develop central nervous system\ recurrence after local therapy. This is an encouraging development because these patients have historically been excluded from participating in clinical trials and receiving aggressive treatment regimens.

Based on data from the phase III MURANO trial, venetoclax has been granted a regular approval by the FDA&nbsp;for the treatment of patients with chronic lymphocytic leukemia or small lymphocytic lymphoma, with or without 17p deletion, who has received at least 1 prior therapy.

An objective response rate was achieved in 18 of 37 patients with&nbsp;relapsed/refractory non-Hodgkin lymphoma who received the combination of&nbsp;the BTK inhibitor ibrutinib with the PI3K inhibitor buparlisib, according to findings of a phase I/II trial&nbsp;reported at the 2018 ASCO Annual Meeting.

Rafael Fonseca, MD, recently shared the treatment considerations and decisions he makes when treating patients with multiple myeloma. Fonseca, professor of medicine, chair, Department of Internal Medicine, Mayo Clinic, explained how he would treat these patients based on case scenarios during a <em>Targeted Oncology </em>live case-based peer perspectives presentation.

Progression-free survival was found to be almost identical at 48 weeks with&nbsp;MYL-1401O in combination with a taxane as initial therapy followed by MYL-1401O monotherapy as maintenance versus trastuzumab in patients with HER2-positive metastatic breast cancer, according to phase III findings of the&nbsp;HERITAGE trial. Results of the trial were presented at the 2018 ASCO Annual Meeting.

According to Pfizer, the manufacturer of the PARP inhibitor talazoparib,&nbsp;a priority review was granted by the FDA to a new drug application for this PARP inhibitor for treatment of patients with germline <em>BRCA </em>mutation&ndash;positive, HER2-negative locally advanced or metastatic breast cancer.

The 2018 ASCO Annual Meeting was a great success, with over 40,000 people in attendance and over 5000 abstracts presented from June 1-5 in Chicago, Illinois. Data from several phase III trials in lung cancer were presented, with especially significant results in non&ndash;small cell lung cancer. Other big areas during this year&rsquo;s meeting included breast, gastrointestinal, genitourinary, and hematologic cancers.

In results from the phase III REACH-2 trial,&nbsp;ramucirumab reduced the risk of death by 29% versus placebo as a second-line treatment for&nbsp;patients with advanced hepatocellular carcinoma. Results from the study were presented during the&nbsp;2018 ASCO Annual Meeting.

The investigational second-generation tyrosine kinase inhibitor dacomitinib demonstrated an improved median overall survival of 34.1 months compared to 26.8 months with&nbsp;gefitinib as a first-line treatment for patients with advanced,&nbsp;<em>EGFR</em>-mutant non&ndash;small cell lung cancer, according to data from a open-label, phase III trial presented at the 2018 ASCO Annual Meeting.¹

Overall survival improved with the combination of atezolizumab, bevacizumab, carboplatin, and paclitaxel versus a treatment regimen of bevacizumab and chemotherapy alone in patients with advanced wild-type nonsquamous non&ndash;small cell lung cancer.

In patients with&nbsp;peritoneal carcinomatosis undergoing surgery, the addition of heated chemotherapy to the abdomen during surgery did not provide a survival benefit, data&nbsp;from a phase III study presented at the 2018 ASCO Annual Meeting, in Chicago, Illinois, showed.

According to findings of an early study presented at the 2018 ASCO Annual Meeting, the combination of pegilodecakin and a PD-1 inhibitor demonstrated an overall response rate of 41% in patients with advanced non&ndash;small cell lung cancer.&nbsp;

According to results presented at the 2018 ASCO Annual Meeting,&nbsp;moxetumomab pasudotox, a first-in-class recombinant immunotoxin targeting CD22, demonstrated deep and durable responses in a substantial proportion of pretreated patients with relapsed/refractory hairy cell leukemia.

Based on data reported at the 2018 ASCO Annual Meeting, the primary endpoint of the phase III RELEVANCE trial was not met with the combination of rituximab plus lenalidomide showing similar efficacy results compared with rituximab plus chemotherapy in treatment-naive patients with follicular lymphoma. The chemotherapy-free regimen, however, did show a more favorable toxicity profile.&nbsp;

According to initial results from a phase Ib/II study presented at the 2018 ASCO Annual Meeting, 50% of a small group of patients with relapsed or refractory non-Hodgkin lymphoma achieved responses from the combination of an anti-CD47 antibody plus rituximab.

Treatment-naive patients with chronic lymphocytic leukemia achieved high rates of&nbsp;minimal residual disease&ndash;negative status of 77% with peripheral blood testing after 6 cycles from treatment with ibrutinib (Imbruvica) and venetoclax (Venclexta). Additionally, patients in the CAPTIVATE trial, wihch was presented during the 2018 ASCO Annual Meeting, achieved an objective response rate of 100%.