Oncology Times - Ot Broadcasts From The Ipad Archives

A mathematical study of real-world data from 27,855 women whose breast cancer was diagnosed between 2008 and 2020 has shown that a machine-learning artificial intelligence algorithm was able to predict mortality and could become a key weapon in the clinician’s armory when selecting therapies on the basis of predicted survival. Initial findings and conclusions from the study were reported at the European Society for Medical Oncology (ESMO) Breast Cancer Congress 2023. First author of the study, Laura Vuduc from the Department of Applied Mathematics at CentraleSupélec, Paris-Saclay University in Gif-sur-Yvette near Paris, France, talked about the importance of this new development with OncTimesTalk correspondent, Peter Goodwin.

Caution was expressed at the 2023 American Society of Clinical Oncology (ASCO) Annual Meeting about potential adverse effects from one form of breast cancer treatment de-escalation. A poster warns about risks from omitting axillary sentinel node surgery in older women.   In this edition of OncTimesTalk correspondent Peter Goodwin hears about axillary dissection in older women with clinically node-negative breast cancer from Mariam Rana, MD, FRCSC, Oncology Surgeon with the University of Saskatchewan in Canada College of Medicine, in discussion with Robert Hills, DPhil, Chair of Medical Statistics at Oxford University Nuffield Department of Population Health, who leads the secretariat for the Early Breast Cancer Trialists' Collaborative Group.   They discuss Rana’s ASCO poster that found the omission of axillary surgery to stage the axilla may be associated with a higher risk of overall mortality in older women with early-stage breast cancer, compared to those who have this surgery.

A real-world study reported at the ESMO Breast Cancer 2023 Annual Congress identified a risk for inappropriate therapeutic decision-making resulting from an alarmingly high rate of false-negative tests coming from biopsy specimens looking for biological parameters such as PR and HER2.  Study researchers at the University of Catania suggested tumor heterogeneity was a big reason why markers like PR and HER2 were being missed that subsequently turned up in surgical specimens. But biopsy technique was also an issue, they concluded. OncTimesTalk correspondent Peter Goodwin caught up with one of the study authors, Federica Martorana, Assistant Professor of Medical Oncology. Together with lead author Sabrina Nucera from the University of Messina, and their co-authors, she said they retrospectively analyzed data from samples—collected over a 10 year period—for which both biopsy and surgical specimens were available. They excluded patients receiving neoadjuvant therapy and looked for differences in t

Patients with breast cancer who complied fully with their adjuvant endocrine medication lived 15 percent longer than those who skipped doses, according to a huge real-world study coordinated from Tübingen University, in Baden-Württemberg, Germany, reported at the 2023 ASCO Annual Meeting. OncTimesTalk correspondent Peter Goodwin discusses the findings with senior author of the study, Dominik Dannehl, MD, a physician at the Department of Women's Health, Tübingen University Hospital, in Tübingen, Baden-Württemberg, Germany.

Being overweight or obese can reduce the benefit of extending adjuvant breast cancer hormone therapy in women younger than 60 years, according to research from the DATA trial discussed at the European Society for Medical Oncology (ESMO) Breast Cancer 2023 Congress. Senna W.M. Lammers, MD, from Maastricht University Medical Centre in The Netherlands, reported her findings from the DATA trial looking at the benefit of extending adjuvant hormonal therapy by treating women with hormone receptor-positive breast cancer who had already received tamoxifen with an additional course of anastrozole. The study confirmed an overall benefit in disease-free survival from extending the endocrine therapy, but also found this was impacted by body mass index: with overweight and obese patients benefiting less if they were under the age of 60.

Non-small cell lung cancer was one of the big topics at the 2023 ASCO Annual Meeting where Heather Wakelee, MD, FASCO, Professor of Medicine and Chief of the Division of Oncology at Stanford University in California, was overheard reminding a junior cancer doctor that the only adjuvant therapy for lung cancer had been chemotherapy just a couple of decades previously.  Now, a plethora of targeted therapies are available, and Wakelee reported a big improvement in outcome from one of them—pembrolizumab—used both before and after surgery in early Stage II and III disease (mostly Stage III). “These results indicate perioperative pembrolizumab given in combination with chemotherapy prior to surgery and for up to one year as a single agent after surgery led to significant improvement in event-free survival (defined by local progression precluding definitive surgery, recurrence, or death) with a strong trend towards improvement in overall survival. These results indicate peri-operative pembroli

End-of-life care for patients with cancer could be significantly improved while simultaneously reducing cost according to the findings of a study from the University of Pennsylvania. Ravi Parikh, MD, MPH, talks with OncTimesTalk correspondent Peter Goodwin about his findings on the value of harnessing AI to help doctors have serious illness conversations with patients during end-of-life care.

Roy Herbst, MD PhD, Deputy Director of the Yale Cancer Center at Yale School of Medicine, talks with OncTimesTalk correspondent Peter Goodwin about his group’s findings from the international Phase III ADAURA clinical trial looking at adjuvant therapy with the anti EGFR-mutant drug osimertinib in patients with completely resected stage one B to three A non-small cell lung cancer. In a late-breaking abstract reported at the 2023 American Society of Clinical Oncology Meeting Plenary Session, Herbst showed that osimertinib not only improved disease-free survival, but also brought a clear and big benefit in overall survival.

Roy Herbst, MD PhD, Deputy Director of the Yale Cancer Center at Yale School of Medicine, talks with OncTimesTalk correspondent Peter Goodwin about his group’s findings from the international Phase III ADAURA clinical trial looking at adjuvant therapy with the anti EGFR-mutant drug osimertinib in patients with completely resected stage one B to three A non-small cell lung cancer. In a late-breaking abstract reported at the 2023 American Society of Clinical Oncology Meeting Plenary Session, Herbst showed that osimertinib not only improved disease-free survival, but also brought a clear and big benefit in overall survival.

Progress in esophageal cancer is forging ahead at Columbia University in New York. Brian Henick, MD, is a medical oncologist specializing in the care of patients with malignancies of the aerodigestive tract. As Associate Director of Experimental Therapeutics and Director of Translational Research in Aerodigestive Cancers in Medical Oncology, Henick is involved in a wide range of studies at Columbia. Oncology Times correspondent Peter Goodwin recently had the opportunity to ask Henick about new therapy approaches for esophageal cancer, in particular molecular mechanisms and immunotherapies.

Today we are introducing the new Oncology Times Editorial Board Chair: Stephanie L. Graff, MD, FACP. In her new role, Graff will help Oncology Times continue to provide essential clinical news and analysis for the cancer care community. Graff is Director of Breast Oncology at Lifespan Cancer Institute and Assistant Professor of Medicine at Brown University. Oncology Times contributor Catlin Nalley sat down with Graff to discuss her career path and oncology care philosophy.

When cancer advances to an incurable stage, some patients may prioritize treatment that will extend their life as long as possible, and others may prefer a care plan that’s designed to minimize pain. Talking to patients about their prognosis and values can help clinicians develop care plans that are better aligned to each patient’s goals. However, it’s essential that the discussions happen before patients become too ill. The results of a long-term clinical trial showed electronic nudges delivered to health care clinicians based on a machine learning algorithm that predicts mortality risk quadrupled rates of conversations with patients about their end-of-life care preferences (JAMA Oncol 2023; doi:10.1001/jamaoncol.2022.6303). The study, published by Penn Medicine investigators, also found that the machine learning-triggered reminders significantly decreased use of aggressive chemotherapy and other systemic therapies at end of life. Oncology Times interviewed study author Ravi B. Parikh, MD, about the results

Despite increased screening and HPV vaccines, cervical cancer remains the fourth-leading cause of cancer death among women worldwide. Screening guidelines are constantly scrutinized and reassessed. The most current U.S. Preventative Services Task Force (USPSTF) guidelines recommend screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk HPV testing, or every 5 years with high-risk HPV testing with cytology. To get the full picture on how gynecologists and oncologists today are navigating screening guidelines and new treatment options with their patients, Oncology Times interviewed Deana Gerber, MD, an obstetrics and gynecology specialist at NYU Langone Health’s Perlmutter Cancer Center. Gerber treats women who have cancer of the reproductive tract and who have been diagnosed with a genetic mutation that increases their risk

This episode is Research Review, a quarterly review of the research you may have missed. Today, we are covering the American Society of Hematology Annual Meeting highlights. First Up, results from the ECOG-ACRIN E1910 Randomized Phase III clinical trial showed that blinatumomab improved overall survival in newly diagnosed adult patients with b-lineage acute lymphoblastic leukemia. First author of this new research, Mark Litzow, MD, from the Mayo Clinic in Rochester, MN, talked with journalist Peter Goodwin at the ASH Annual Meeting. They discussed the use of blinatumomab in patients whose initial therapy for acute lymphoblastic leukemia had achieved minimum residual disease—MRD (Abstract LBA-1). Next, researchers explored the potential of using genomic DNA and RNA profiles in a machine-learning algorithm to predict which patients with acute myeloid leukemia or advanced myelodysplastic syndrome will respond to venetoclax-based therapy (Abstract 2789). Maher Albitar, MD, discussed the findings. Moving on, the d

Sarcoma represents an incredibly rare group of cancers comprised of 50 histologic subtypes, with approximately 13,000 new diagnoses per year. Each histologic type exhibits a unique biologic behavior, and, as such, prognosis and optimal treatment strategies vary. Sarcoma can appear anywhere in the body, and local invasion of nearby organs may make surgical resection difficult or impossible. This makes sarcoma exceedingly complex to diagnose and treat. Today on OncTimes Talk, we interview Gary K. Schwartz, MD, and discuss treatment approaches for sarcoma, the fundamental needs of sarcoma patients, and how the oncology community at large can better understand this complex disease. Schwartz is Chief of the Division of Hematology and Oncology at NewYork-Presbyterian/Columbia University Irving Medical Center and Associate Director of the Herbert Irving Comprehensive Cancer Center. With a clinical focus in melanoma and sarcoma, Schwartz is a recognized leader in the field of translational research and his work foc

A study using chimeric antigen receptor (CAR)-T cells has proven to be safe for treating patients with relapsed or refractory acute myeloid leukemia (AML). The agent known as PRGN-3006 also brought remissions among patients who had chemotherapy for lymphodepletion prior to their CAR-T cell procedure (Abstract 4633). After the lead author of the new study, David Sallman, MD, from the Moffitt Cancer Center in Tampa, Florida, had reported the new findings at the 2022 Annual Meeting of the American Society of Hematology, OncTimes Talk correspondent Peter Goodwin interviewed him about the study and about the overall prospects of using CAR-T cells to treat AML. PRGN-3006 UltraCAR-T is a multigenic autologous chimeric antigen receptor (CAR)-T simultaneously expressing a CAR specifically targeting CD33; membrane bound IL-15 (mbIL15) for enhanced in vivo expansion and persistence; and a kill switch to conditionally eliminate CAR-T cells for an improved safety profile. CD33 is over-expressed on AML blasts with lesser

Colorectal cancer is the third most diagnosed cancer and the second leading cause of cancer deaths worldwide. The current gold standard for screening, the colonoscopy, reduces cancer deaths by 67 percent, according to a 2018 study from Kaiser Permanente. So, we know screening is effective. However, obstacles remain. Colonoscopies are invasive and costs can be prohibitive. An alarming trend has also emerged, with incidence of early-onset colorectal cancer increasing over the last few decades. Today on OncTimes Talk, we interview Anil K. Rustgi, MD, on the current state of colorectal cancer screening, advancements in non-invasive testing, and the mechanisms behind early-onset colorectal cancer. In addition to being a world-renowned leader in the field of gastrointestinal oncology, Rustgi is the Director of the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia University Irving Medical Center. His research focuses on tumor initiation, the tumor microenvironment, and tumor metastasis in

BARCELONA, Spain—Patients with solid tumors expressing mutated AKT oncogenes responded to therapy with a pan-AKT inhibitor—the investigational drug ipatasertib—in a Phase I study reported at the 2022 EORTC—NCI—AACR symposium on Molecular Targets and Cancer Therapeutics. Nearly a quarter of the patients treated with the AKT blocker had their tumors shrink. These included patients with breast, endometrial, and salivary gland cancers. Tumors remained stable in just over half of the remaining patients. The presenting author at the Barcelona symposium, Carolyn McCourt, MD, Associate Professor of Obstetrics and Gynecology at Washington University in St. Louis, talked with OncTimes Talk reporter Peter Goodwin.

BARCELONA, Spain—Liquid biopsies are increasingly used to identify cancer progression and could also provide molecular evidence of higher risk for hematologic malignancies and solid tumors, according to findings from a study of circulating tumor DNA reported at the European Organization for Research and Treatment of Cancer—National Cancer Institute—American Association for Cancer Research (EORTC-NCI-AACR) 2022 Symposium on Molecular Targets and Cancer Therapeutics. Marco Tagliamento, MD, medical oncologist and research fellow at the Gustave Roussy Institute, France, told the symposium about study findings from the large Gustave Roussy Molecular Tumor Board dataset able to identify genetic mutations involved in clonal hematopoiesis. Tagliamento told the conference 113 patients—8 percent of their total—were found to have had at least one clonal hematopoiesis mutation that could be considered to place them at higher risk of developing hematologic malignancies. “Out of these patients, 45 were referred to our hem

In oncology today, there is an urgent need to better understand the implications of racial bias and disparities on the health outcomes of patients. Although breast cancer mortality rates decreased by 43 percent from 1989 to 2020, Black women remain more likely to die from breast cancer compared with White women, according to the 2022 American Cancer Society’s update on breast cancer statistics in the United States. What is the underlying cause of disparities in breast cancer? It comes down to a variety of factors, from screening disparities and clinical trial participation to differences in genetics and biology. Today on OncTimes Talk, we sit down with Lisa A. Newman, MD, MPH, FACS, FASCO, to discuss each of these categories and explore how oncologists and the medical community at large can finally close the gap. Newman is a world-renowned surgical oncologist and was appointed Chief of the Section of Breast Surgery at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine. She also lea