NEWS & VIEWS APRIL 20, 2019

2019 GU Cancers Symposium: First-Line Effect of PET/CT on Surgical Planning for Head and Plus Axitinib Versus Sunitinib in Advanced Renal Neck Cancer Cell Carcinoma In a study reported in Journal of Clinical Oncology, Lowe et al8 found that As reported at the 2019 Genitourinary Cancers Symposium and in The 18F-fluorodeoxyglucose positron-emission tomography/computed New England Journal of Medicine, Rini et al1 found significant benefits in tomography (PET/CT) had a high negative predictive value in the overall and progression-free survival with the combination of clinically N0 neck in patients with newly diagnosed head and neck pembrolizumab plus axitinib versus sunitinib in the first-line treatment of squamous cell carcinoma, with results frequently altering surgical plans. advanced renal cell carcinoma. Biologic Age and Elevated Breast Cancer Risk FDA Approves Trifluridine/Tipiracil for Recurrent, Metastatic Biologic age—a DNA-based estimate of a person’s age—may be Gastric, and GEJ Adenocarcinoma associated with development of breast cancer, according a report 9 On February 22, the US Food and Drug Administration2 approved published by Kresovich et al in Journal of the National Cancer Institute. trifluridine/tipiracil tablets (Lonsurf)—a fixed combination of trifluridine, First-Line Treatment of Indolent Non-Hodgkin Lymphoma or a nucleoside metabolic inhibitor, and tipiracil, a thymidine Mantle Cell Lymphoma With Bendamustine/ vs — phosphorylase inhibitor for adult patients with metastatic gastric or R-CHOP or R-CVP gastroesophageal junction (GEJ) adenocarcinoma previously treated As reported in Journal of Clinical Oncology by Flinn et al,10 5-year follow- with at least two prior lines of chemotherapy that included up of the phase III BRIGHT trial has shown improved outcomes with first- a fluoropyrimidine, a platinum, either a taxane or , and if line bendamustine/rituximab vs R-CHOP (rituximab plus appropriate, HER2-targeted therapy. cyclophosphamide, doxorubicin, vincristine, and prednisone) or R-CVP Decline in Rates for HPV16/18-Positive Cervical Precancers (rituximab plus cyclophosphamide, vincristine, and prednisone) in Since Introduction of the HPV Vaccine patients with indolent non-Hodgkin lymphoma or mantle cell lymphoma. A study analyzing data on the prevalence of cervical precancers positive Addition of Lomustine to Temozolomide and Radiotherapy in for two strains of human papillomavirus (HPV) since the HPV vaccine was Newly Diagnosed Glioblastoma With Methylated introduced has found that among vaccinated women aged 18 to 39 with MGMT cervical intraepithelial neoplasia grades 2 to 3 or adenocarcinoma in situ, Promoter 11 the proportion caused by HPV16/18 decreased by 22% between 2008 In a phase III trial reported in The Lancet, Herrlinger et al found that the and 2014. These findings were published by McClung et al3 in Cancer addition of adjuvant lomustine to temozolomide and radiotherapy Epidemiology, Biomarkers and Prevention. improved overall survival in newly diagnosed glioblastoma with methylated MGMT promoter. The researchers noted that the findings Medical Expenses in Patients With Coronary Artery Disease should be viewed with caution given the relatively small number of and Cancer patients in the trial. New research published by Chopra et al4 in JNCCN–Journal of the National Comprehensive Cancer Network has found that coronary artery REFERENCES disease–related medical expenses were considerably higher for patients 1. Rini BI, Plimack ER, Stus V, et al: Pembrolizumab plus axitinib versus sunitinib for ad- vanced renal-cell carcinoma. N Engl J Med DOI: 10.1056/NEJMoa1816714 with this chronic condition who were also diagnosed with 2. US Food and Drug Administration: Home page. http://www.fda.gov cancer—particularly colorectal cancer. 3. World Health Organization: Human papillomavirus (HPV) and cervical cancer. https:// www.who.int/news-room/fact-sheets/detail/human-papillomavirus-(hpv)-and-cervical- Neoplasm and Malignancy Risk in Nonproband Carriers of cancer Pathogenic Germline Variants in DICER1 4. Chopra I, Mattes MD, Findley P, et al: Impact of incident cancer on short-term coronary – fi In a study reported in Journal of Clinical Oncology, Stewart et al5 artery disease related healthcare expenditures among Medicare bene ciaries. J Natl Compr Cancer Netw https://doi.org/10.6004/jnccn.2018.7078 fi identi ed the risk of neoplasms and malignancies among nonproband 5. Stewart DR, Best AF, Williams GM, et al: Neoplasm risk among individuals with a patho- carriers of pathogenic germline variants in DICER1. genic germline variant in DICER1. J Clin Oncol 37:668-676, 2019 6. Bardia A, Mayer IA, Vahdat LT, et al: Sacituzumab govitecan-hziy in refractory metastatic Sacituzumab Govitecan-hziy in Heavily Pretreated, triple-negative breast cancer. N Engl J Med 380:741-751, 2019 Metastatic Triple-Negative Breast Cancer 7. Biccler JL, Glimelius I, Eloranta S, et al: Relapse risk and loss of lifetime after modern combined modality treatment of young patients with Hodgkin lymphoma: A Nordic In a phase I/II trial reported in The New England Journal of Medicine, Lymphoma Epidemiology Group study. J Clin Oncol 37:703-713, 2019 6 Bardia et al found durable responses with the antibody-drug conjugate 8. Lowe VJ, Duan F, Subramaniam RM, et al: Multicenter trial of [18F]fluorodeoxyglucose sacituzumab govitecan-hziy in patients with heavily pretreated, positron emission tomography/computed tomography staging of head and neck cancer and negative predictive value and surgical impact in the N0 neck: Results from ACRIN 6685. J metastatic triple-negative breast cancer. Clin Oncol DOI: 10.1200/JCO.18.01182 9. Kresovich JK, Xu Z, O’Brien KM, et al: Methylation-based biological age and breast cancer Relapse Risk and Survival With Contemporary Therapy in risk. J Natl Cancer Inst https://doi.org/10.1093/jnci/djz020 Young Patients With Hodgkin Lymphoma 10. Flinn IW, van der Jagt R, Kahl B, et al: First-line treatment of patients with indolent non- In a study reported in Journal of Clinical Oncology, Biccler et al7 found Hodgkin lymphoma or mantle-cell lymphoma with bendamustine plus rituximab versus R- CHOP or R-CVP: Results of the BRIGHT 5-year follow-up study. J Clin Oncol DOI: 10.1200/ that relapse risk and loss in expectation of lifetime were low in young JCO.18.00605 patients receiving contemporary therapy for classical Hodgkin 11. Herrlinger U, Tzaridis T, Mack F, et al: Lomustine-temozolomide combination therapy lymphoma. Outcomes were particularly good among patients achieving versus standard temozolomide therapy in patients with newly diagnosed gliblastoma with methylated MGMT promoter (CeTeG/NOA-09): A randomised, open-label, phase 3 trial. event-free survival for 24 months. Lancet https://doi.org/10.1016/S0140-6736(18)31791-4