Brentuximab Vedotin in Hodgkin Lymphoma 3, 5 | Triple-Negative Breast Cancer
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| Nivolumab in Melanoma
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VOLUME 6, ISSUE 1
JANUARY 25, 2015
Editor-in-Chief, James O. Armitage, MD | ASCOPost.com
ASH Annual Meeting
Carfilzomib-Based Triplet Yields ‘Unprecedented’ Duration of Remission in Relapsed Myeloma By Caroline Helwick
By Chandrakanth Are, MBBS, MBA, FRCS, FACS
T
he phase III global ASPIRE trial documented an “unprecedented” duration of remission in relapsed multiple myeloma patients receiving carfilzomib (Kyprolis) plus a standard-of-care doublet, according to Keith Stewart, MB, ChB, Professor of Medicine at the Mayo Clinic in Scottsdale, Arizona, who presented the findings at the 56th American Society of Hematology (ASH) Annual Meeting and Exposition in San Francisco.1 ASPIRE enrolled 792 relapsed or refractory patients from 20 countries. Patients had received one to three prior regimens (on average, two).
Key Findings Patients who received carfilzomib plus lenalidomide (Revlimid) and low-dose dexamethasone (KRd) achieved a median progression-free survival of 26.3 months, whereas patients in the control arm, who received lenalidomide/dexamethasone alone (Rd), had a
median progression-free survival of only 17.6 months—a 31% reduction in risk (P < .0001), Dr. Stewart reported. Furthermore, no significant increase was observed in cardiac, renal, or pulmonary toxicity, providing evidence from a large clinical Keith Stewart, MB, ChB trial that the drug can be safely administered, Dr. Stewart said. “By adding carfilzomib to the gold standard in multiple myeloma therapy, we are observing an unprecedented duration of remission, without additional toxicity, in relapsed and heavily pretreated patients,” he said. “The best result ever reported in this population,” he told journalists at a press briefing, was a median progression-free survival of just 19 months, which was continued on page 12
San Antonio Breast Cancer Symposium
Ovarian Suppression Plus Hormonal Therapy May Be Practice-Changing in Premenopausal Hormone Receptor–Positive Early-Stage Breast Cancer By Alice Goodman
R
What Is a Physician? Call a Spade a Spade
esults of the large International Breast Cancer Study Group (IBCSG)-coordinated SOFT trial present a convincing argument for the addition of ovarian function suppression to adjuvant hormonal therapy to reduce the risk of tumor recurrence in younger women with hormone receptor–positive early-stage breast cancer at high enough risk to be treated with chemotherapy and who remain premenopausal. Compared with tamoxifen alone,
ovarian function suppression plus exemestane achieved a greater reduction in the risk of tumor recurrence than ovarian function suppression plus tamoxifen. In the cohort of premenopausal women younger than age 35, substantial benefits were seen with ovarian suppression. In the cohort of women who had not received chemotherapy, tamoxifen alone was just as effective as tamoxifen plus ovarian function suppression. Thus, tamoxifen appears to be sufficient therapy to reduce the risk of tumor I believe this trial is practicerecurrence for premenopausal women with low-risk changing. If I see a woman under age cancers not requiring che35 with hormone receptor–positive motherapy. This group of premenopausal women was breast cancer, I will know how to older with predominantly advise her. small node-negative tumors —Prudence Francis, MD of low to intermediate grade.
A
nyone who has awoken from a decadeslong amnestic spell can be forgiven for thinking that physicians cannot do anything right nowadays. Compared with decades ago, when physicians did mostly right, we now seem to be nowhere close to correctness. Nearly every malady that befalls the health-care environment is blamed on physicians. We are a befuddled bunch who collectively amount to nothing good, as evident from what is portrayed in the media and literature. continued on page 185
Dr. Are is Associate Professor of Surgical Oncology, Vice Chair of Education, and Program Director of the General Surgery Residency Program at University of Nebraska Medical Center, Omaha. Disclaimer: This commentary represents the views of the author and may not necessarily reflect the views of ASCO. Some details have been changed to protect patient privacy.
MORE IN THIS ISSUE Oncology Meetings Coverage ASH Annual Meeting ������������ 1, 3–5, 11–13, 116–118 SABCS ���� 1, 14, 19–22, 28–30, 78–92 American College of Sugeons �������������������35 Symposium in Thoracic Oncology ���� 37, 41, 44, 46–47 Molecular Pathology ������������������������� 47, 50 FDA Updates ���������� 23–27, 61, 101, 114 John Marshall, MD, on Colorectal Cancer ���������������������������������� 51 Direct From ASCO ��������������������������� 71–74 Jacek Jassem, MD, PhD, and Rafat Dziadziuszko, MD, PhD, on Crizotinib in NSCLC ������������������������������ 100 Daniel F. Hayes, MD, FASCO, Elected 2016–2017 ASCO President �������������������� 101
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