Pembrolizumab Shows Activity in Brain Metastases from NSCLC, Melanoma


“Pembrolizumab demonstrated therapeutic activity in brain metastases of patients with non–small cell lung cancer or melanoma, according to early results of an ongoing randomized phase 2 trial.

“ ‘In the United States, about 50,000 patients with metastatic melanoma or non–small cell lung cancer develop brain metastases every year. … At diagnosis, 10% of patients with metastatic NSCLC have brain metastases and another 30% develop brain involvement,’ Sarah B. Goldberg, MD, MPH, assistant professor in the department of medical oncology in the Smilow Cancer Hospital at Yale School of Medicine, and colleagues wrote. ‘Many effective drugs in development have not been well studied for central nervous system penetrations, and patients with untreated brain metastases are excluded from most clinical trials.’ ”

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UCSF Center Adds to Revolution of Care for BRCA Carriers


“A new center at University of California, San Francisco, is designed to provide comprehensive and integrated care for patients with cancer who carry BRCA and other mutations.

“The Center for BRCA Research at UCSF Helen Diller Family Comprehensive Cancer Center joins Basser Center for BRCA in Philadelphia as the only facilities solely devoted to BRCA–related cancers.

“HemOnc Today spoke with Pamela N. Munster, MD, leader of the developmental therapeutics program and co-director of the Center for BRCA Research, about how the center came about, how she became involved, and what she hopes the center will do for BRCA mutation carriers and their families.”

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Increasing Trend of NSCLC Among Never-Smokers Prompts New Research Efforts

“Twenty percent of lung cancer cases in the United States are diagnosed in people who never smoked.

“This translates to between16,000 and 24,000 Americans annually, according to the American Cancer Society.  The majority of these cases are non–small cell lung cancer.

“Although the exact cause for increased proportion of lung cancer cases among never-smokers has not been established, researchers suggest environmental factors may to be blame.

“However, they emphasize more data are needed to identify the factors that are driving the increase ― and determine the most appropriate treatment options for never-smokers ― before changing practice.”

Enzalutamide Superior to Bicalutamide for Castration-Resistant Prostate Cancer

“The oral androgen receptor inhibitor enzalutamide significantly reduced the risk for prostate cancer progression or death compared with bicalutamide in patients with castration-resistant prostate cancer, according to findings from the STRIVE trial.

“Enzalutamide (Xtandi, Astellas) has been found to improve survival in men with castration-resistant prostate cancer prior to and following chemotherapy. It binds the androgen receptor in the same way as bicalutamide does, but with greater affinity, according to researchers.

“Since bicalutamide is the standard treatment for this population of patients, researchers conducted this phase 2 trial to compare the two treatments.”

Greater MET/CEP7 Expression May Predict Therapy Response in NSCLC

“Patients with non–small cell lung cancer who had higher MET positivity appeared less likely to harbor other cancer drivers, according to study results.

“Thus, a greater MET/CEP7 ratio — or a comparison of the MET copy number to the number of chromosome 7 centromeres — may predict benefit from treatment with crizotinib (Xalkori, Pfizer) in patients with NSCLC.

“ ‘Generally, there are two ways that the number of copies of the MET gene can be increased: the tumor can make multiple copies of the entire chromosome on which it sits — chromosome 7 — or it can amplify just the MET region,’ Sinead A. Noonan, MD, senior thoracic oncology fellow at University of Colorado School of Medicine, said in a press release. ‘In the first case, MET is unlikely to be the specific driver of the cancer’s biology. But if the MET region is amplified separate from the rest of the chromosome, this should suggest that the MET gene is indeed the area of specific importance to the cancer.’ “

Shorter-Course Radiation Non-Inferior to Conventional Therapy for Low-Risk Prostate Cancer

“Hypofractionated radiation therapy yielded a similar rate of DFS and toxicity profile as conventional radiotherapy among men with low-risk prostate cancer, according to results of a randomized phase 3 non-inferiority study presented at the ASTRO Annual Meeting.

“Given in larger doses over a shorter period, hypofractionated radiation therapy is being studied as a possible improved treatment option for some patients.

“Howard Sandler, MD, MS, FASTRO, professor and chair of the department of radiation oncology at Cedars Sinai Medical Center in New York, and colleagues sought to evaluate whether the hypofractionated therapy schedule — or 70 Gy in 28 fractions over 5.6 weeks — resulted in a 5-year DFS that was not lower than that of the conventional schedule, or 73.8 Gy in 41 fractions over 8.2 weeks, by more than 7%.”

Men's Health Supplements Fail to Improve Prostate Cancer Outcomes

“Using men’s health supplements did not help prevent distant metastases, cancer-related death or adverse events among men undergoing definitive radiation therapy for localized prostate cancer, according to the results of a retrospective study presented at the ASTRO Annual Meeting.

“ ‘Around 50% of the patients we see are on any kind of supplement,’ Nicholas G. Zaorsky, MD, resident physician in radiation oncology at Fox Chase Cancer Center, told HemOnc Today. ‘At least 10% are on men’s health supplements. We wanted to understand whether these supplements actually made a difference in terms of outcomes or side effects.’

“The researchers defined men’s health supplements as supplements specifically labeled and marketed with the terms ‘men’s health’ or ‘prostate health.’ These supplements are frequently labeled as having potential anticancer benefits, although no associations have been proven, according to the researchers.”

Urine Biomarkers May Reduce Repeat Biopsies for Prostate Cancer

“Incorporating scores from two urine-based biomarker assays may reduce the number of biopsies men with clinically localized prostate cancer need to undergo without greatly affecting 10-year survival rates, according to the results of a decision analysis.

“ ‘Results from recent studies have demonstrated the potential clinical utility of the urine-based PROGENSA prostate cancer antigen 3 (PCA3) assay (Gen-Probe, Inc.) to predict repeat biopsy outcomes in men with elevated serum PSA levels and previous negative biopsy findings,’ Brian T. Denton, PhD, associate professor of industrial and operations engineering at University of Michigan, and colleagues wrote. ‘A recent literature review reported current evidence suggesting that the PCA3 test is clinically useful for selecting which patients should undergo repeat biopsy. Several studies have determined that urine assessment of [T2:ERG] is also associated with biopsy outcome and may be better at discriminating between low-grade and high-grade cancers.‘ “

“Denton and colleagues performed a decision analysis using a decision tree to evaluate the clinical value of using PCA3 and T2:ERG scores to determine the need for repeat biopsy in men with clinically localized prostate cancer who had at least one prior negative biopsy. Researchers estimated the probability for cancer by using the Prostate Cancer Prevention Trial Risk Calculator.”

FDA Grants Priority Review to Rociletinib for Advanced NSCLC

“The FDA granted priority review to a new drug application for rociletinib.

“Rociletinib (Clovis Oncology) — a novel, oral, targeted covalent mutant-selective epidermal growth factor receptor inhibitor — is intended for patients with advanced EGFR-mutant, T790M-positive non–small cell lung cancer who already received EGFR-targeted therapy.

“The FDA is expected to make a decision about the agent’s status by March 30, 2016.”