Personalized Medicine

The first randomized trial to compare robotic-assisted prostatectomy with conventional open radical prostatectomy found no meaningful differences between these techniques in urinary and sexual function or in the rate of positive surgical margins in men with localized prostate cancer in the first 12 weeks after surgery (Yaxley JW, et al. Lancet. 2016 Jul 26. Epub ahead of print).

Interim results from a phase 1b study indicate that the investigational monoclonal antibody isatuximab, in combination with lenalidomide and dexamethasone, achieves responses in >50% of patients with relapsed or refractory multiple myeloma, including those with disease refractory to immunomodulatory drugs (IMiDs).

Adding the recently approved daratumumab (Darzalex), a human, CD38-directed monoclonal antibody, to a standard regimen of bortezomib (Velcade) and dexamethasone improved progression-free survival (PFS) by >60% compared with the standard regimen in patients with relapsed or refractory multiple myeloma, according to Antonio Palumbo, MD, Chief of the Multiple Myeloma Unit, University of Torino, Italy.

A gene-expression signature assay called ColDx (Almac Diagnostics) successfully identified high-risk patients with stage II colon cancer who would benefit from chemotherapy, according to results of a new, prospective analysis of the previously published phase 3 Alliance C9581 clinical trial.

Ongoing clinical 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 cancer site.

Oral and poster presentations of several promising agents in early- and late-phase clinical trials dotted the program at ASCO 2016. The presentations included studies with positive findings associated with many investigational therapies, including first-in-class therapies such as chimeric antigen receptor (CAR) T-cells for the treatment of patients with B-cell malignancies or acute myeloid leukemia (AML); a vaccine (galinpepimut-S) for the treatment of patients with AML; and a chimeric monoclonal antibody against claudin 18.2 for the treatment of patients with advanced gastric cancers.

The first-in-class antibody-drug conjugate rovalpituzumab tesirine (Rova-T) may be a new treatment option for patients with small-cell lung cancer (SCLC), which has a very poor prognosis and few treatment options. Rova-T is particularly promising in SCLC tumors that overexpress the delta-like (DLL) 3 protein, according to first-in-human study results presented at ASCO 2016.

Holding what was essentially a one-person debate, Michael B. Atkins, MD, Deputy Director of the Georgetown-Lombardi Comprehensive Cancer Center, Washington, DC, described strong cases for immunotherapy or molecularly targeted therapy as initial treatment for patients with advanced BRAF mutation–positive melanoma.

When combined with other clinically relevant parameters, a novel protein biomarker called IsoPSA can improve selection of patients with prostate cancer for biopsy. IsoPSA holds promise for improved diagnostic accuracy, said Eric A. Klein, MD, Chairman, Glickman Urological and Kidney Institute, Cleveland Clinic, OH, at the 2016 American Urological Association annual meeting.

Early intervention utilizing a team approach is important to successful palliative care, agreed a multidisciplinary panel convened at the 2016 National Comprehensive Cancer Network (NCCN) annual conference.