TOP - May 2019, Vol 12, No 2

Options for the treatment of patients with advanced hormone receptor (HR)-positive, HER2-­negative breast cancer are expanding. The updated National Comprehensive Cancer Network (NCCN) guideline (version 1.2019) for the management of invasive breast cancer is focused on HR-positive, HER2-­negative disease.
The addition of the PD-1 inhibitor durvalumab (Imfinzi) and the CTLA-4 inhibitor tremelimu­mab to best supportive care improved overall survival (OS) by >2 months compared with best supportive care alone in patients with advanced refractory colorectal cancer (CRC), according to results of the phase 2 Canadian Cancer Trials Group (CCTG) CO.26 clinical trial.
A novel tumor metabolism-altering oral regimen that combines a tyrosine derivative (D,L-­alpha-metyrosine) with 3 repurposed agents (sirolimus, phenytoin, and methoxsalen) has demonstrated promising activity in patients with previously treated metastatic pancreatic cancer.
Many patients with leukemia or lymphoma who receive treatment with anti-CD19 chimeric antigen receptor (CAR) T-cell therapy achieve minimum residual disease (MRD) negativity, and many are in complete remission well beyond 12 months. As such, CAR T-cell therapies are curing these patients.
Promising markers of response to immune checkpoint inhibition include tumor mutation burden (TMB) and genomic markers that reflect a disruption of the tumor immunity cycle, said Natalie Vokes, MD, MPhil, Medical Oncology Fellow, Dana-Farber Cancer Institute, Boston, at the 2019 ASCO-SITC Clinical Immuno-Oncology Symposium.
Chimeric antigen receptor (CAR) T-cell therapy is associated with unique adverse events that require vigilant monitoring, aggressive care, and specialized management. Marco L. Davila, MD, PhD, Medical Oncologist, Blood and Marrow Transplant and Cellular Immunotherapy Program, Moffitt Cancer Center, Tampa, FL, provided an overview of this topic at the 2019 ASCO-SITC Clinical Immuno-Oncology Symposium.
Moving PD-1 or PD-L1 inhibitors to an early line of therapy, immediately after chemoradiation, has improved survival for patients with unresectable, stage III non–small-cell lung cancer (NSCLC).
Tumor expression of PD-L1 has consistently predicted ­response and survival outcomes in non–small-cell lung cancer (NSCLC), whereas the role of PD-L1 in immune cells is unclear, said Edward B. Garon, MD, Director, Thoracic Oncology Program, David Geffen School of Medicine, University of California, Los Angeles, at the 2019 ASCO-SITC Clinical Immuno-Oncology Symposium.
First-line therapy with pembrolizumab (Keytruda) plus ­axitinib (Inlyta) significantly improved overall survival (OS), progression-free survival (PFS), and objective response rates compared with standard-of-care sunitinib (Sutent) in patients with clear-cell metastatic renal-cell carcinoma (RCC) in KEYNOTE-426.
Darolutamide, an investigational androgen receptor inhibitor, significantly improved metastasis-free survival in men with high-risk nonmetastatic castration-resistant prostate cancer (CRPC) compared with placebo in a large phase 3 clinical trial.
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