April 2019, Vol 10, No 2

Orlando, FL—The discontinuation of a tyrosine kinase inhibitor (TKI) is considered safe and appropriate in consenting patients with chronic-phase chronic myeloid leukemia (CML) under specific circumstances and with careful molecular monitoring, according to the updated National Comprehensive Cancer Network (NCCN) management guideline for CML.

On March 11, 2019, the FDA approved trastuzumab-qyyp (Trazimera; Pfizer) as the fourth biosimilar to trastuzumab (Herceptin; Genentech) for the treatment of patients with HER2-positive breast cancer or HER2-positive metastatic gastric or gastroesophageal junction adenocarcinoma. This approval was based on several studies confirming that trastuzumab-qyyp is biosimilar to the originator drug, Herceptin.

It is no surprise that healthcare costs are at an all-time high and continue to take center stage in political, social, and economic debates. Employers, as health plan sponsors and as purchasers of care, are looking to take matters into their own hands and tackle the problem through innovative reimbursement strategies. Not all employers, however, are built the same. Experiences in controlling healthcare costs vary between small and large employers. The most affected employers are in the middle and are known as midsize employers.

San Francisco, CA—Increased understanding of tumor genetics and tumor metabolism has led to improved therapies for cancer. The impact of cancer metabolism on tumor pathways is particularly important in pancreatic cancer. A novel tumor metabolism–altering oral drug known as SM-88 combines the investigative tyrosine derivative (D,L-alpha-metyrosine) with 3 repurposed agents—an mTOR inhibitor (sirolimus), a CYP3A4 inducer (phenyt­oin), and an oxidative stress catalyst (methoxsalen).

San Francisco, CA—Updated results from the safety lead-in of the phase 3 BEACON CRC clinical trial show a mature median overall survival (OS) of 15.3 months with the triple-drug regimen of encorafenib (Braftovi), a BRAF inhibitor; binimetinib (Mektovi), a MEK inhibitor; and cetuximab (Erbitux), an EGFR inhibitor, for the treatment of patients with metastatic colorectal cancer (CRC) and BRAF V600E mutation.

San Francisco, CA—Pembrolizumab (Keytruda) as a second-line therapy improved overall survival (OS) in patients with advanced or metastatic esophageal cancer and high PD-L1 expression compared with chemotherapy, according to findings from the phase 3 KEYNOTE-­­­181 study presented at the 2019 Gastrointestinal Cancers Symposium.

San Francisco, CA—Adjuvant treatment with durvalumab (Imfinzi), a checkpoint inhibitor, in patients with residual disease after trimodal therapy for advanced esophageal or gastroesophageal junction (GEJ) adeno­carcinoma was associated with a 79% 1-year relapse-free survival rate in a phase 2 clinical trial. Historically, the 1-year relapse rate has been 50% in patients with GEJ carcinoma who do not achieve a pathologic complete response with trimodal therapy, even with additional chemotherapy, said Hirva Mamdani, MD, Thoracic Oncology, Karmanos Cancer Institute/Wayne State University, Detroit, MI, at the 2019 Gastrointestinal Cancers Symposium.

San Francisco, CA—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.

San Francisco, CA—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.

San Antonio, TX—Reaching pathologic complete response (pCR) after neo­adjuvant chemotherapy correlates with significantly improved event-free survival (EFS) and overall survival (OS) in patients with localized breast cancer, according to results of a large comprehensive meta-analysis presented at the 2018 San Antonio Breast Cancer Symposium.