Latest Cancer News

Opdivo Precision Cancer Medicine Improves Outcomes in Advanced Liver Cancer

Results from the CheckMate 040 clinical trial have been recently reported and found that Opdivo (nivolumab), an immuno-oncology drug which acts by modulating the immune system, produces durable responses with long-term survival rates in patients with liver cancer, regardless of whether or not patients were infected with Hepatitis B or C.  These study results were presented at The International Liver Congress™ 2017 in Amsterdam, and showed that the overall response rate was 19.3% in patients previously treated with Nexaver (sorafenib), and responses were ongoing in 71% of patients.  Overall ~ 60% of these advanced patients were alive greater than one year from beginning Opdivo.

Liver cancer, or hepatocellular carcinoma (HCC), is the second most common cause of cancer-related deaths worldwide.1,2 The prognosis for patients with advanced liver cancer is poor,2 and the multikinase inhibitor, Nexaver, has been the only approved treatment, until the recent approval of Stirvaga.3,4

Opdivo is a programmed-death-1 (PD-1) immune checkpoint inhibitor that is designed to use the body’s own immune system to help restore the anti-cancer immune response.5 It restores T-cell-mediated anti-cancer activity so that the T cells recognize and attack cancer cells.5

Discuss this article with other patients and caregivers on CancerConnect.

The CheckMate 040 clinical trial was designed to evaluate Opdivo in patients with advanced liver cancer who were previously treated with Nexavar and were not suitable for surgery.6 All 145 patients were treated with intravenous Opdivo every 2 weeks until the cancer progressed or side effects became intolerable.  In addition to the overall response rate of 19%, average overall survival was 16.7 months. Responses to Opdivo occurred regardless of programmed death-1 (PD-1) ligand expression on cancer cells.

References

  1. 1 World Health Organization. Cancer. Available from: http://www.who.int/mediacentre/factsheets/fs297/en/. Last accessed: April 2017.
  2. 2 World Health Organization. GLOBOCAN 2012: Estimated cancer incidence, mortality and prevalence worldwide in 2012. Available from: http://globocan.iarc.fr/Pages/fact_sheets_cancer.aspx. Last accessed: April 2017.
  3. 3 EASL-EORTC Clinical Practice Guidelines: Management of hepatocellular carcinoma. J Hepatol. 2012;56:908-943.
  4. http://news.cancerconnect.com/first-new-drug-liver-cancer-decade-stivarga/
  5. 5 Melero I, et al. Nivolumab dose escalation and expansion in patients with advanced hepatocellular carcinoma (HCC): The CheckMate 040 study. J Clin Oncol. 2017;35 (suppl 4S: abstract 226.
  6. 6 ClinicalTrials.gov. NCT Identifier: NCT01658878. A study to evaluate the effectiveness, safety and tolerability of nivolumab and the combination nivolumab plus ipilimumab in patients with advanced liver cancer (CheckMate 040). Available from: https://clinicaltrials.gov/show/NCT01658878. Last accessed: April 2017.

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Skin Cancer Prevention Tips from the Skin Cancer Foundation

The development of skin cancer is certainly a risk for any individual, but particularly for those of us who spend time in the outdoors. As summer approaches it’s important to keep in mind that by taking certain steps to protect yourself from the sun, you can safely enjoy your time outside. The following recommendations from the Skin Cancer Foundation tell you how.

“The public needs to know that we are experiencing a skin cancer epidemic,” says Dr. Perry Robbins, founder and president of the Skin Cancer Foundation. “We encourage people to enjoy the outdoors, but we want them to do it safely. By following our basic sun protection tips, you can enjoy outdoor activities and keep your skin healthy at the same time.”

  • Seek the shade, especially between 10 a.m. and 4 p.m.
  • Do not allow your skin to burn.
  • Avoid tanning and UV tanning booths.
  • Use a sunscreen with an SPF of 15 or higher every day.
  • Apply 1 ounce (2 tablespoons) of sunscreen to all exposed areas 30 minutes before going outside. Reapply every two hours or immediately after swimming or excessive sweating.
  • Cover up with clothing, including a broad-brimmed hat and UV-blocking sunglasses.
  • Keep newborns out of the sun. Sunscreen should be used on babies over the age of six months.
  • Examine your skin from head to toe every month.
  • See your physician every year for a professional skin exam.

Learn more about skin cancer prevention here

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Half of Breast Cancer Patients Pursue Reconstructive Surgery Without Understanding of Risks

More than half of breast cancer patients (57 percent) undergoing mastectomy lack the necessary medical knowledge to make a high-quality decision about reconstructive surgery that aligns with their personal goals, suggesting a trend toward overtreatment, according to a new study conducted by researchers at The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).

“High-quality” decisions were defined as those that demonstrated adequate medical knowledge of treatment choices – including associated risks – and that also matched with the patient’s specific goals and preferences for choosing whether or not to pursue reconstructive surgery.  Researchers say shared decision-making tools are needed to help women make decisions based on a full understanding of treatment choices and associated risks alongside their personal goals for surgery.

Researchers report the findings online first in the medical journal JAMA Surgery May 3, 2017.

Discuss this article with other patients and caregivers on OSU CancerConnect.

Study Design and Methods
In this observational, single-institution study, researchers sought to evaluate the quality of 126 adult breast cancer patients’ decisions about breast reconstruction  after mastectomy. All patients had stage I-III invasive ductal/lobular breast cancer, ductal carcinoma in situ (DCIS) or were having preventive mastectomies. The majority of patients (73 percent) had early-stage disease.

Researchers measured study participants’ medical knowledge about mastectomy and mastectomy with reconstruction — for example, effects of surgery on appearance and associated risks. They also measured individual preferences of what mattered most to patients. Key preference factors included breast appearance/shape post treatment, length of recovery time and risk for complications.

“We found that less than half of the women had adequate medical knowledge about breast reconstruction and made a choice that aligned with their personal preferences. This is very concerning to us, because it means that some women did not get the treatment they truly preferred, and quite a few had more treatment than they preferred,” says Dr. Clara Lee, principal investigator of the study and a breast reconstructive surgeon at the OSUCCC – James. Lee holds a dual associate professor appointment in the colleges of medicine and public health at Ohio State.

“Many women were quite concerned about complication risks, but they didn’t actually know how high the risk was. This may explain some of the overtreatment that we saw,” she adds.

Researchers found that only 43 percent of the patients in the study demonstrated an understanding of at least half of the important facts about reconstruction and made a choice that was consistent with their preferences. Understanding of surgical complications was particularly low, with only 14 percent of patients demonstrating strong knowledge of associated risks.

“As physicians we need to talk about the pros and cons of surgery to help women make treatment choices.  Shared decision-making between the surgeon and patient would be particularly useful for this decision. We need to connect patients with decision aids to help them really think through what is most important to them,” Lee adds.

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Avelumab Immunotherapy Approved for Bladder Cancer

Bavencio (Avelumab), a programmed cell death ligand–1 (PD L1) inhibitor, has been approved for treatment of patients with locally advanced or metastatic urothelial carcinoma whose disease progressed during or following platinum-containing chemotherapy or within 12 months of neoadjuvant or adjuvant platinum-containing chemotherapy.

Discuss this article with other patients and caregivers- CancerConnect.

About Urothelial Cancer

Bladder cancer is the most common type of urothelial carcinoma, and up to half of all people with the advanced form of the disease are unable to receive cisplatin chemotherapy as an initial treatment and therefore have a high unmet medical need. Urothelial carcinoma also includes cancers of the urethra, ureters and renal pelvis.  According to the American Cancer Society (ACS), it is estimated that more than 79,000 Americans will be diagnosed in 2017 with bladder cancer, which is the most common type of urothelial cancer.

Discuss this article with other patients and caregivers facing a diagnosis of bladder cancer.

About Bavencio

Bavencio targets the programmed cell death-ligand PD-1/PD-L1 pathway with potential immune checkpoint inhibitory and anti-cancer activity.  When Bavencio binds to PD-L1 it blocks the interaction of PD-L1 with its receptor protein 1 (PD-1). This inhibits the activation of PD-1 and restores immune function through the activation of cytotoxic T lymphocytes targeted to PD-L1-overexpressing cancer cells.

Bavencio was granted an accelerated approval by the US Food and Drug Administration (FDA) on the basis of a single clinical trial that enrolled 242 patients. All patients in the clinical trial had locally advanced or metastatic urothelial carcinoma and had experienced disease progression while receiving or after having received platinum-based chemotherapy or within 12 months of receiving a platinum-containing neoadjuvant or adjuvant chemotherapy regimen.

Patients were treated with intravenous Bavencio every 2 weeks until cancer progression or unacceptable side effects. The results of the clinical trial confirmed an overall response rate of 13.3% to 16.6% although additional follow up is required.  Patients took on average 2.0 months (range, 1.3 – 11.0) to respond to treatment and the average duration of response had not been reached.

Bavencio joins three similar immunotherapies already approved for the treatment of bladder cancer, expanding patients options for treatment for the first time in many years.

Reference:  https://www.fda.gov/Drugs/InformationOnDrugs/ApprovedDrugs/ucm547965.htm

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FDA Approval Suggests Keytruda® Combined With Chemotherapy May Become New Standard Initial Treatment for Patients With Metastatic Non-Small Cell Lung Cancer

The U.S. Food and Drug Administration (FDA) has approved Keytruda® (pembrolizumab), an anti-PD-1 precision cancer medicine, in combination with Alimta®  (pemetrexed) and carboplatin chemotherapy as first-line treatment of metastatic non-small cell lung cancer (NSCLC), irrespective of PD-L1 expression.

Lung cancer remains the leading cause of cancer-related deaths worldwide. In the United States, NSCLC accounts for 75–80% of all lung cancers. Although progress has been made in recent years, the majority of patients with advanced stage lung cancer still die from their disease. New treatments are needed. Precision cancer medicines continues to impact the lives of lung cancer patients with research into genomics and genetics leading to unprecedented progress in improving outcomes. Tailored treatments have emerged to match a person’s genetic make­up or a tumor’s genetic profile. As a result, patients with lung cancer now typically re­ceive molecular testing that guides their physicians in determining which therapies are more likely to boost the chances of survival while limiting the potential for adverse effects. Results from studies evaluating immunomodulatory approaches using anti-PD-1 and anti-PD-L1 antibodies have demonstrated promising results and are advancing the standard of care for lung cancer.

No more searching – Advanced cancer treatments can be found in clinical trials. Cure Forward can make finding lung cancer clinical trials easier.

PD-1 is a protein that inhibits certain types of immune responses. Drugs that block PD-1, such as Keytruda may enhance the ability of the immune system to fight cancer. In earlier studies Keytruda has demonstrated anticancer activity in lung cancer and has been previously approved for the treatment of advanced melanoma.

About Keytruda®

Keytruda® is a monoclonal antibody that helps to restore the body’s immune system in fighting cancer. It creates its anti-cancer effects by blocking a specific protein used by cancer cells called PD-L1, to escape an attack by the immune system. Once PD-L1 is blocked, cells of the immune system are able to identify cancer cells as a threat, and initiate an attack to destroy the cancer. Keytruda is approved for the treatment of several types of cancer.

The approval was based on data from the Keynote-021 clinical trail evaluating 123 previously untreated patients with metastatic nonsquamous NSCLC with no EGFR or ALK genomic markers and irrespective of PD-L1 expression. In this trial, Keytruda + Alimta and carboplatin demonstrated an objective response rate of 55% which is nearly nearly double the 29% achieved with chemotherapy alone.  The Keytruda regimen also delayed the time to cancer progression from 8.9 months to 13 months extending the overall cancer free survival.

These data suggests that combination of precision cancer immunotherapy with chemotherapy may become the new standard initial treatment for individuals with advanced NSCLC.

Reference: http://www.mrknewsroom.com/news-release/prescription-medicine-news/fda-approves-mercks-keytruda-pembrolizumab-first-line-combin

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FDA Approves Imfinzi for Treatment of Urothelial Cancer

The US Food and Drug Administration (FDA) today granted accelerated approval to Imfinzi (durvalumab) for the treatment of patients with locally advanced or metastatic urothelial carcinoma who have disease progression during or following platinum-containing chemotherapy or who have disease progression within 12 months of treatment with that chemotherapy.

Bladder cancer is the most common type of urothelial carcinoma, and up to half of all people with the advanced form of the disease are unable to receive cisplatin chemotherapy as an initial treatment and therefore have a high unmet medical need. Urothelial carcinoma also includes cancers of the urethra, ureters and renal pelvis.  According to the American Cancer Society (ACS), it is estimated that more than 79,000 Americans will be diagnosed in 2017 with bladder cancer, which is the most common type of urothelial cancer.

Discuss this article with other patients and caregivers- CancerConnect.

About Imfinzi

Imfinzi is a precision cancer immunotherapy designed to bind with a protein called PD-L1, which is expressed on cancer cells and tumor-infiltrating immune cells, blocking its interaction with the PD-1 receptor. By inhibiting PD-L1, Imfinzi may enable the activation of T cells.

Approval was based on a trial evaluating 182 patients with locally advanced or metastatic urothelial carcinoma whose disease progressed after prior platinum-containing chemotherapy.

Overall the therapy was well tolerated and objective response rates of 17.0% were reported. The median response duration was not reached (range, 0.9+ to 19.9+ months). Response to treatment was also analyzed by PD-L1 expression status. Among the 182 patients, the confirmed ORR was 26.3% in 95 patients with a high PD-L1 score and 4.1% in 73 patients with a low or negative PD-L1 score.

Imfinzi joins Tecentriq, Opdivo, as recent precision immunotherapies approved for the treatment of bladder and other urothelial cancers.

Reference: https://www.fda.gov/drugs/informationondrugs/approveddrugs/ucm555930.htm

Discuss this article with other patients and caregivers – CancerConnect.

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First New Drug for Liver Cancer in a Decade: Stivarga

The US Food and Drug Administration (FDA) has expanded the indication for Stivarga (regorafenib) to now include treatment for patients with hepatocellular carcinoma (HCC) who have previously been treated with the drug Nexavar.

Expansion of Stivarga, ‘s indication marks the first FDA-approved treatment for a liver cancer in almost a decade.

Stivarga is an oral multikinase inhibitor that has shown antiangiogenic activity. It is already approved for the treatment of metastatic colorectal cancer and gastrointestinal stromal tumors that cannot be surgically removed.

Discuss this article with other patients and caregivers- CancerConnect.

The expanded approval for use in liver cancer was based on the results of a comparative clinical trial that included 573 patients with progressive HCC who had previously undergone treatment with Nexavar.

Median overall survival was 10.6 months in the Stivarga group compared with 7.8 months in those receiving placebo, representing a significant reduction in the risk for death. The median progression-free survival was also significantly longer in the Stivarga.

This application for expanded use in liver cancer was granted priority review designation. This indication also received orphan drug designation, which provides incentives to assist and encourage the development of drugs for rare diseases.

Reference: https://www.fda.gov/NewsEvents/Newsroom/PressAnnouncements/ucm555608.htm

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Kite Pharma Updates Results of CAR-T cell therapy in Aggressive Non-Hodgkin Lymphoma

Results from the ZUMA-1 trial of axicabtagene ciloleucel (KTE-C19) in patients with chemorefractory aggressive non-Hodgkin lymphoma (NHL) were updated recently at the American Society of Hematology Annual Meeting in San Diego, California.  Overall 76% of patients with Diffuse Large B-Cell Lymphoma (DLBCL) responded to treatment, 47% achieving a complete remissions (CR).

About axicabtagene ciloleucel

Axicabtagene ciloleucel, is an investigational therapy in which a patient’s T cells are engineered to express a chimeric antigen receptor (CAR) to target the antigen CD19, a protein expressed on the cell surface of B-cell lymphomas and leukemias, and redirect the T cells to kill cancer cells.

About CAR-T

CAR-T, or chimeric antigen receptor T-cells, is a new form of cancer immunotherapy in which a patient’s own T cells are removed and then engineered to identify and kill malignant blood cancer cells. The use of a patient’s own immune cells to fight cancer is proving to be a promising therapeutic approach in the treatment of some lymphomas.

One characteristic of a cancer cell is its ability to evade an attack by a person’s immune system. Immune cells are constantly surveying the body for potential threats, such as a bacteria or virus. Once the immune system detects such a threat, it initiates an attack against it.

Historically, researchers have remained perplexed as to how cancer cells remain undetected as a threat by the immune system. However, research has recently unraveled some of the mechanisms used by cancer cells to evade immune detection. Furthermore, researchers have also learned ways to stimulate the immune system to effectively recognize cancer cells.

One method of stimulating the immune system to detect cancer cells is referred to as chimeric antigen receptor T cell (CAR-T) therapy. Using this type of treatment, researchers take a sample of blood from the patient, and collect certain immune cells called T-cells.

Through laboratory processes, the collected T-cells are reprogrammed to recognize and attack the patient’s cancer cells. Once the T-cells multiply and reach a certain number in the laboratory (usually hundreds of millions to billions), they are re-infused into the patient. The infused T-cells then circulate throughout the body, attacking the patient’s cancer cells.

The ZUMA-1 clinical trial enrolled 111 patients with chemo-refractory diffuse large B-cell lymphoma, primary mediastinal B-cell lymphoma (PMBCL), or transformed follicular lymphoma. Chemo-refractory disease was defined as progressive or stable disease as best response to last line of therapy, or disease progression ≤12 months after autologous stem cell transplant.

Manufacturing was successful for 110 patients, and 101 patients were treated. Responses were observed across key subgroups, including 75 percent CR in patients who relapsed in ≤12 months after autologous stem cell transplant and 47 percent CR in patients refractory to second line or later chemotherapy.

The most common significant side effects included neutropenia (63%), anemia (42%), febrile neutropenia (29%), and thrombocytopenia (26%).  Three patients died while undergoing treatment.

Reference: Feuerstein, Adam. Kite Pharma Claims CAT-T Trial Victory, FDA Filing Next. The Street. Can be accessed at https://www.thestreet.com/story/13752310/1/kite-pharma-claims-car-t-trial-victory-fda-filing-next.html

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Endometriosis Patients are at Increased Risk for Ovarian Cancer, Study Confirms

A large study based on the Nurses’ Health confirms that endometriosis is associated with increased risk of ovarian cancer.  Moreover, it further clarifies that this condition is not linked to a greater risk for endometrial cancer.

Many women with endometriosis are asymptomatic and only in more severe cases are these patients subjected to minimally invasive surgery, or laparoscopic surgery, to confirm diagnosis. Because of this, many studies rely on self-reports of the condition and not on fully confirmed diagnoses, which may impact the results obtained.

To confirm previous reports of an association between endometriosis and ovarian cancer, the authors of the study compared self-reported vs. laparoscopically confirmed cases of endometriosis, to the incidence of this type of cancer.

The authors also evaluated the association between endometriosis and the risk of endometrial cancer, which remains unclear because it has been explored scarcely.

Based on the NHSII, one of the largest studies to address risk for major chronic diseases in women, the authors obtained lifestyle, health behaviors, and medical history-related information from 116,429 female registered nurses.

The authors reported that throughout 18 years of follow-up, 228 cases of ovarian cancer and 166 cases of endometrial cancer were documented, representing 0.22% and 0.17% of the eligible women, respectively.

They found that self-reported cases of endometriosis were associated with an 81% increased risk of ovarian cancer, compared to women with no history of this condition. This association was even stronger in women who had endometriosis confirmed via laparoscopic surgery, with 114% increased risk to develop ovarian cancer.

Evaluation of the endometrial cancer cases showed that endometriosis, either self-reported or surgically confirmed, was not associated with increased risk for this type of cancer.

Delays in diagnosis or post-endometriosis diagnosis factors, such as oral contraceptive use and parity, had little impact in the risk assessments.

“This study adds to the evidence that endometriosis is not strongly linked to endometrial cancer risk and that the association with ovarian cancer is robust to misclassification, diagnostic delay, and changes in exposures post-endometriosis diagnosis,” the authors wrote.

This study suggests that, although self-reports of endometriosis may be confounding and lead to misclassification, they still are reliable determinants for ovarian cancer risk associations. However, the authors stressed that these results should be replicated in future studies.

Reference: Endometriosis and risk of ovarian and endometrial cancers in a large prospective cohort of U.S. nurses

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Have a Question about Chronic Myeloid Leukemia? Join us on May 25th!

CancerConnect Presents: Ask the Expert with Dana-Farber Cancer Institute’s Dr. Luskin

CancerConnect announces the opportunity to engage with leukemia expert, Marlise Luskin, MD, MSCE. On May 25th, 2017, Dr. Luskin will answer your pre-submitted questions about chronic myeloid leukemia (CML) on CancerConnect. CancerConnect is an online support community for individuals affected by cancer.

Dr. Luskin is a physician in the Adult Leukemia Program at Dana-Farber Cancer Institute and an Instructor in Medicine at Harvard Medical School. Her areas of expertise are adult leukemias, myelodysplastic syndromes and myeloproliferative neoplasms. To learn more about Dr. Luskin, click here.

Join the Conversation and Get Your Questions about CML Answered!

We will be accepting questions for Dr. Luskin on CML until 8am EDT on Monday, May 22nd. To submit your question for Dr. Luskin:

  • Use this form or
  • Submit your question directly in the CancerConnect Community here, or
  • You can also submit a question on our facebook page or using twitter, just mention @Cancer_Connect.

Dr. Luskin’s Q&A session will be posted on CancerConnect on May 25th, and can be accessed here. Thank you for your participation.

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