Novel HER2 Inhibitor Offers Manageable Toxicity, Anti-Tumor Activity in Metastatic Breast Cancer

Excerpt:

“A phase I trial found that the HER2 inhibitor ONT-380 had a lower incidence of certain adverse events associated with this class of agent and notable anti-tumor activity in heavily pretreated patients with HER2-positive metastatic breast cancer (MBC).

” ‘Though existing targeted therapies are improving outcomes in patients with HER2-positive MBC, disease resistance does eventually develop in most patients,’ wrote study authors led by Stacy Moulder, MD, of the MD Anderson Cancer Center in Houston. Also, some agents preclude combination with other regimens due to off-target effects such as skin rash and diarrhea.”

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Half of Women with Early-Stage Breast Cancer Experience Severe Treatment-Associated Toxicity

Excerpt:

“Nearly half of women with early-stage invasive breast cancer reported at least one clinically burdensome toxicity during treatment, according to results from the iCanCare study.

“These burdens were also associated with poorer physical health and an increase in health care service use.

” ‘Clinicians constantly weigh the anticipated benefits of anticancer treatments against the risks for treatment-associated toxicities,’ Christopher R. Friese, PhD, RN, professor in the department of systems, populations and leadership at University of Michigan School of Nursing, and colleagues wrote.”

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Melanoma Therapy Tied to Cutaneous Adverse Events

“Anti-programmed cell death (PD)-1 therapy for metastatic melanoma is associated with the development of immune-related cutaneous events, according to research published in the March issue of the Journal of the American Academy of Dermatology.

“Shelley Ji Eun Hwang, M.B.B.S., from the University of Sydney, and colleagues reviewed the clinical and histologic information of 82 patients treated with single-agent anti-PD-1 therapy for  at one institution from May 2012 to February 2015.”


Long-term Toxicity Surprise With ADT for Prostate Cancer

“In a surprising study result, the use of intermittent androgen-deprivation therapy (ADT) for prostate cancer is not associated with fewer long-term adverse events than continuous ADT.

“The outcome was unexpected because it was hypothesized that the intermittent schedule, which gives patients a break from the treatment, would be less harmful.

“ADT is a cornerstone of locally advanced and metastatic prostate cancer treatment, but is associated with an array of adverse events, including sexual dysfunction, bone demineralization, cardiovascular disease, metabolic complications, cognitive changes, and diminished quality of life.”


Low-Dose Ipilimumab/Pembrolizumab Reduces Toxicity in Advanced Melanoma

“A combination of pembrolizumab and low-dose ipilimumab appears to be active and to have a better safety profile than a combination of nivolumab and full-dose ipilimumab in advanced melanoma patients, according to a new study presented at the Society for Melanoma Research 2015 International Congress, held November 18–21 in San Francisco.

“Pembrolizumab is a potent, highly selective, humanized monoclonal antibody against programmed death-1 (PD-1) that has shown robust antitumor activity against several advanced malignancies. In phase I testing, combination therapy with the anti–PD-1 antibody nivolumab and full doses (3 mg/kg) of the anti–CTLA-4 therapy ipilimumab was seemingly associated with improved response rates, but also led to increased toxicities, said Georgina Long, BSc, PhD, MBBS, of the Melanoma Institute Australia in Sydney, Australia.”


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%.”


Postprostatectomy Radiation Therapy Yields Low Toxicity and Favorable Patient-Reported Quality of Life

“A prospective study of guideline-based, postoperative, image-guided intensity-modulated radiation therapy in patients with prostate cancer found low toxicity profiles and favorable patient-reported quality of life following treatment, with researchers concluding that toxicity and health-related quality of life should not impact the recommendation of radiation therapy following prostatectomy. The research was published by Berlin et al in Practical Radiation Oncology.

“Postprostatectomy radiation therapy has been reported as underutilized, with randomized trials showing the benefit of adjuvant radiation therapy, but only about 10% of patients receiving the treatment. One potential reason for underutilization could be concern over side effects or a negative impact on health-related quality of life.”


Hormonal Drugs for Prostate Cancer Increase Risk, Incidence of Cardiovascular Events

“Patients who received hormonal regimens for the treatment of castration-resistant prostate cancer experienced a significant increase in incidence of and relative risk for cardiovascular toxicity, according to results of a meta-analysis.

“Roberto Iacovelli, MD, medical oncologist in the division of urogenital and head and neck tumors at European Institute of Oncology in Milan, and colleagues sought to define the incidence and RR of cardiovascular events in a population of patients treated with new hormonal therapies for metastatic castration-resistant prostate cancer.

“Incidence of all-grade toxicities (grades 1-4) and high-grade toxicities (grade 3-4) served as the primary outcome of the study.

“Iacovelli and colleagues identified six prospective phase 2 or phase 3 studies that included a total of 7,830 patients. Within each study, researchers considered treatment with a novel hormonal agent plus prednisone in the experimental arm (n = 4,520) and placebo plus prednisone (n = 3,310) as the control.”


Hypofractionation of Breast Radiotherapy Associated With Reduced Acute Toxicity

“In an analysis reported in JAMA Oncology, Jagsi et al found that hypofractionation of whole-breast radiotherapy was associated with reduced acute toxicity compared with conventional fractionation.

“The study involved data on physician-assessed toxic effects and patient-reported outcomes in 2,309 patients who received adjuvant whole-breast radiotherapy after lumpectomy for unilateral breast cancer at Michigan Radiation Oncology Quality Consortium sites from October 2011 through June 2014. Patients had to have a comprehensive physician toxicity evaluation within 1 week of completing radiotherapy and at least 1 weekly evaluation during treatment.”