August 2016, Vol. 5, No. 6

Presenting Emerging Data and Calling for Molecular Tumor Board Case Studies

Dear Colleague, On behalf of all of us at Personalized Medicine in Oncology (PMO), I hope you are enjoying the summer and finding time for the recreation necessary to return to the care of your patients with a renewed spirit. After the busy ASCO season, we have taken advantage of [ Read More ]


Letter to Our Readers

“Check”-ing the Data: A Review of Immune Checkpoint Inhibitor Biomarkers

David Hermel, MD
Resident Physician, Internal Medicine
University of Southern California, Los Angeles, CA

Darren Sigal, MD
Attending Physician, Division of Hematology/Oncology
Scripps Clinic Medical Group, San Diego, CA

William Coley’s late 19th-century observation of “spontaneous tumor regression” following injection of streptococcal organisms into the bloodstream of his patients set the stage for more than a century of public debate over the relationship between cancer and the immune system.1 Only recently, with the success of immune checkpoint inhibitors in [ Read More ]


Increased Risk for Serous/Serous-like Endometrial Cancer Found in BRCA1 Carriers

Both BRCA1 and BRCA2 mutations have been shown to confer an increased risk for ovarian, fallopian tube, and primary perineal cancer. As a result, guidelines recommend bilateral salpingo-oophorectomy (BSO) upon completion of child bearing and preferably between ages 35 and 40 years as a risk-reducing option.1 However, what has been [ Read More ]

Cristi Radford, MS, CGC

Genetic Counseling

RAF Family Inhibitor Has Preliminary Activity in Multiple Types of Tumors

A multitargeted RAF inhibitor demonstrated activity in several types of advanced solid tumors associated with different mutations in the RAF family of genes, results of a preliminary clinical trial showed. Of 29 evaluable patients, 3 had confirmed partial responses to treatment with BGB-283, 1 had an unconfirmed response, and 14 [ Read More ]


Liquid Biopsies Have High Correlation with Tissue Biopsy for Genetic Mutations

Somatic alterations in circulating tumor (ct) DNA, ie, a liquid biopsy, are consistent with alterations found in tissue biopsy, with the exception of resistance mutations, in patients with advanced solid tumors, said Philip Mack, PhD. The finding, which comes from a genomic analysis of blood samples from more than 15,000 [ Read More ]


Targeting CD38 Leads to Responses in Relapsed/Refractory MM

Interim results from a phase 1b study indicate that the monoclonal antibody isatuximab in combination with lenalidomide and dexamethasone results in responses in more than 50% of patients with relapsed/refractory multiple myeloma (MM), including those refractory to immunomodulatory therapy. Based on the positive findings from this trial, a global phase [ Read More ]


AML Vaccine Induces Immunologic Responses in Phase 2 Study

Serial vaccination with galinpepimut-S (GPS) induces immunologic responses in patients with acute myeloid leukemia (AML) who are in remission. Both disease-free survival (DFS) and overall survival (OS) appear to be improved in AML patients with an immune response to GPS, according to data from a phase 2 trial of GPS. [ Read More ]


“Smart Bomb” Drug: Rova-T Promising in SCLC

The antibody-drug conjugate rovalpituzumab tesirine (Rova-T) may be a new option for treatment of small cell lung cancer (SCLC), a disease with a very poor prognosis and few treatment options. Rova-T looked particularly promising in SCLC tumors that overexpress delta-like protein 3 (DLL3), according to a first-in-human trial presented at [ Read More ]


Refining Use of CAR-T in ALL

Chimeric antigen receptor T-cells (CAR-T) have saved lives in some patients with acute lymphoblastic leukemia (ALL) who had run out of other treatment options. This type of immunotherapy is making inroads in other hematologic malignancies as well, but it is still being studied in very sick patients.The downside of CAR-T [ Read More ]


New Paradigm: Matching Therapy to Molecular Alterations

Ongoing trials at academic centers around the country are testing a new strategy of matching available targeted therapies to molecular abnormalities in tumors instead of treating the site of cancer.MyPathway is one such effort that appears to be paying off, according to preliminary results presented at the 2016 ASCO Annual [ Read More ]


Out-of-Pocket Costs Linked to Compliance with Oral Oncologics

Access and adherence to long-term cancer therapies are emerging as major public health issues around the world, as high out-of-pocket costs for oral anticancer agents are linked with noncompliance that can directly affect outcomes.“Solutions should involve increasing access and reducing cost – especially out-of-pocket costs,” said Dawn L. Hershman, MD, [ Read More ]


Opportunities for Shared Decision-Making in Clinical Practice

Although the Institute of Medicine recommends taking a shared decision-making approach to discussions about medical treatments, an overview of evidence at the 2016 ASCO Annual Meeting suggests that clinicians are not very effective in actually following this recommendation. According to Terrance Lynn Albrecht, PhD, this approach requires equal investment by [ Read More ]


CAR T-Cell Therapy Produces High Response Rates in Refractory B-Cell Malignancies

A durable complete response (CR) was achieved in a high proportion of adult patients with refractory B-cell malignancies who were treated with CD19+ chimeric antigen receptor (CAR) T cells made up of a defined 1:1 ratio of CD8+ and CD4+ cells. The data were presented by Cameron John Turtle, MBBS, [ Read More ]


Atezolizumab Could Be Start of “Seismic Shift” in Treatment of Metastatic Urothelial Cancer

Atezolizumab has clinically meaningful activity as primary therapy in patients with cisplatin-ineligible locally advanced/metastatic urothelial cancer, according to data from the IMvigor 210 study. Preliminary results also showed encouraging overall survival (OS) data, said Arjun V. Balar, MD, Codirector of the Genitourinary Cancers Program, New York University Langone Medical Center, [ Read More ]


Addition of Bcl-2 Inhibitor to MM Regimen Produces Promising Responses in Relapsed/Refractory MM

Venetoclax, an investigational oral selective small molecule Bcl-2 inhibitor, added to bortezomib and dexamethasone resulted in impressive response rates in a phase 1b trial of patients with heavily pretreated relapsed/refractory (RR) multiple myeloma (MM). In the trial, the objective response rate (ORR) was higher among patients whose myeloma cells produced [ Read More ]


Alectinib May Constitute New Frontline Treatment for ALK-Positive NSCLC

Alectinib, an oral ALK inhibitor recently approved for the treatment of advanced ALK-positive non–small cell lung cancer (NSCLC) after crizotinib failure, significantly improved progression-free survival (PFS) compared with crizotinib in the frontline setting, according to data from a head-to-head open-label phase 3 Japanese study. In December 2015, the FDA granted [ Read More ]


Combination Immunotherapy Makes Progress in Advanced Melanoma

Evidence is mounting that 2 immunotherapies are better than 1 as first-line treatment of advanced melanoma. A phase 3 study showed that nivolumab plus ipilimumab was superior to either agent alone, and a phase 1 study suggests that pembrolizumab can be safely and effectively combined as first-line treatment in this [ Read More ]


Phase 3 Evidence for New Standard in Elderly Glioblastoma Patients

Short-course (hypofractionated) radiotherapy (RT) and temozolomide (TMZ) followed by TMZ significantly prolonged survival versus short-course RT alone in newly diagnosed elderly patients with glioblastoma. These results of a global cooperative group phase 3 trial were 1 of 4 talks selected for the plenary session at the 2016 ASCO Annual Meeting. [ Read More ]


The President and Personalized Medicine

“As science and technology have advanced,” President Obama wrote in an op-ed he titled ‘Medicine’s Next Step’ in the Boston Globe for July 7, “it’s become possible to make it personalized as well, giving us the tools to better understand, prevent, and treat everyone’s individual health needs.”No one has laid [ Read More ]

Edward Abrahams, PhD

The Last Word