Groups Endorse Shorter RT for Prostate Cancer

Excerpt:

“Hypofractionated external beam radiation therapy (EBRT) for early prostate cancer represents a reasonable alternative to standard treatment protocols involving lower doses of radiation administered over a longer period of time, according to a new clinical guideline.

” ‘Moderately hypofractionated’ EBRT regimens result in similar disease control and side effects as compared with conventional protocols, although the shortened regimens confer a small risk of more short-term gastrointestinal toxicity. Additionally, physicians should counsel patients about the limited data on oncologic outcomes beyond 5 years of follow-up, according to a panel representing the American Society for Radiation Oncology, American Society of Clinical Oncology, and American Urological Association.”

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Immunotherapy Effective Against Hereditary Melanoma

Excerpt:

Individuals with an inherited form of skin cancer often have a poor prognosis. The type of immunotherapy that was awarded this year’s Nobel Prize in Physiology or Medicine is, however, particularly effective in this patient group, research from Karolinska Institutet in Sweden shows. The study is published in the Journal of Medical Genetics.

“Congenital mutations of the CDKN2A gene are the strongest known risk factors for inherited . Individuals with  who carry mutations in this gene also have , according to previous research.”

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Dual Neoadjuvant Checkpoint Blockade Feasible in Melanoma

Excerpt:

“Combination neoadjuvant immune checkpoint blockade therapy yielded promising outcomes in high-risk resectable melanoma, although toxicity was an issue, according to a phase II trial.

“The combination of ipilimumab (Yervoy) and nivolumab (Opdivo) led to improved progression-free survival (PFS), distant metastasis-free survival (DMFS), and overall survival (OS) versus neoadjuvant nivolumab monotherapy in 23 patients with high-risk resectable melanoma, reported Jennifer A. Wargo, MD, of MD Anderson Cancer Center in Houston, and colleagues in Nature Medicine.”

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Biomarker Selects TNBC Patients for Targeted Therapy

Excerpt:

“A tumor necrosis-based gene expression signature (GS) successfully identified patients with triple-negative breast cancer (TNBC) responsive to neoadjuvant therapy with the novel targeted agent LCL161, according to researchers.

“The international, randomized phase II trial of 207 patients with localized TNBC showed that of the 30.1% with GS-positive disease, a significantly higher pathologic complete response (pCR) was seen in those treated with paclitaxel plus the inhibitor of apoptosis antagonist LCL161 compared with those treated with paclitaxel alone (38.2% versus 17.2%).”

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FDA Approves Vizimpro for EGFR-Mutated Non-Small Cell Lung Cancer

Excerpt:

“The FDA approved dacomitinib for the first-line treatment of patients with metastatic non-small cell lung cancer whose tumors have EGFR exon 19 deletion or exon 21 L858R substitution mutations.

“Dacomitinib (Vizimpro, Pfizer) is a once-daily oral pan-human EGFR tyrosine kinase inhibitor.”

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Pembrolizumab Plus Chemotherapy Prolongs OS, PFS for Metastatic Lung Cancer

Excerpt:

“The addition of pembrolizumab to chemotherapy extended OS and PFS compared with chemotherapy alone among patients with metastatic, squamous, non-small-cell lung cancer, according to results of the randomized phase 3 KEYNOTE-407 trial presented at International Association for the Study of Lung Cancer’s World Conference on Lung Cancer.

“The double-blind study included 559 treatment-naive patients with metastatic, squamous NSCLC. Patients who had symptomatic central nervous system metastases, a history of noninfectious pneumonitis that required the use of glucocorticoids, active autoimmune disease or who were receiving systemic immunosuppressive treatment were excluded.”

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Can Trastuzumab Duration Be Shortened in HER2-Positive Breast Cancer?

Excerpt:

“Adding to a growing list of similar results, the Short-HER study was unable to show noninferiority of 9 weeks of trastuzumab compared with the standard 1 year when given along with chemotherapy in women with HER2-positive breast cancer. Shorter administration does, however, reduce the risk of cardiotoxicity.

” ‘Adjuvant pivotal trials with 1-year trastuzumab have significantly improved the prognosis of HER2-positive early breast cancer,’ wrote study authors led by Pierfranco Conte, MD, of the Istituto Oncologico Veneto in Italy. Several studies have attempted to reduce the duration of trastuzumab, though most have failed to show noninferiority.”

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BRAF-MEK Inhibitor Combo Extends Survival n BRAF-Mutant Melanoma

Excerpt:

“The combination of encorafenib and binimetinib resulted in longer overall survival (OS) compared with vemurafenib in patients with BRAF V600–mutant melanoma, according to results of the COLUMBUS trial. Combined with an earlier report showing improved progression-free survival (PFS), this suggests the regimen should become an important option in this setting.

“Small-molecule BRAF inhibitors, originally introduced as monotherapy, offered improvements in outcomes for these melanoma patients. ‘However, response durations were short and BRAF inhibitor treatment was associated with the development of squamous cell skin cancer and other skin toxicities related to paradoxical MAPK pathway activation,’ wrote study authors led by Reinhard Dummer, MD, of University Hospital Zurich in Switzerland. Combinations of BRAF and MEK inhibition have improved the situation further, but better treatment options are still needed.”

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What to Expect When Active Surveillance Leads to Prostatectomy

Excerpt:

“A high proportion of men who entered active surveillance for early prostate cancer had one or more high-risk disease characteristics when they subsequently had radical prostatectomy, a Swedish study showed.

“Medical records showed that 52 of 132 men had at least one adverse pathology feature at radical prostatectomy. All the men initially opted for active surveillance, and the median time from enrollment to surgery was 1.9 years.”

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