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Optimizing the Duration of Trastuzumab: A Fresh PerspectiveABSTRACT Prior to the introduction of trastuzumab, the first targeted anti-HER2 agent, in 1998, patients diagnosed with HER2-positive breast cancer felt like they were being handed a death sentence. Despite treatment with aggressive chemotherapy, their tumors recurred faster, more often spread to brain and liver, and were associated with higher rates of death than HER2-negative tumors. However, in the 1980s, cancer researchers and oncologists recognized that HER2 could be targeted by a small molecule that binds to the receptor on the cell surface and blocks the signal telling the cell to divide. This small molecule was called trastuzumab, and it eventually completely changed how HER2-positive breast cancer was treated. The drug was first approved in the metastatic setting, and then the results of 2 pivotal randomized control trials demonstrated that the administration of trastuzumab in the adjuvant setting decreased the risk of breast cancer recurrence by 50%. These trials showed trastuzumab to be unequivocally effective in the adjuvant setting and the HERA trial results led to the adoption of 1 year of adjuvant trastuzumab as the standard of care. Since that time, the field of anti–HER2-targeted therapy has exploded, with the development of multiple targeted agents for use in the advanced and up-front settings. Although trastuzumab significantly improves outcomes for women diagnosed with HER2-positive breast cancer and has few adverse effects (AEs), the disadvantages are that it requires intravenous administration every 3 weeks and can be associated with cardiac AEs. It is also expensive. Given all of these factors, the question of whether a duration of trastuzumab that is shorter than 1 year may be acceptable for some patients with early-stage HER2-positive breast cancer is an important and very relevant one. Here, we will review the studies that have examined this question and evaluate their results.
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OncView™ Podcast: Advances in Systemic Therapy of Differentiated Thyroid CancerIn an OncView™ program, Lori Wirth, MD, shared her insights into the current treatment of patients with differentiated thyroid cancer.
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Future Directions in Graft vs Host Disease ManagementClosing out their panel on GVHD management, expert hematologist/oncologists share their hope for future evolution in the treatment landscape.
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Benjamin Cooper, MD, Remarks on Future Analyses of TAK-676 Plus Pembrolizumab in Solid Tumors Undergoing RadiationBenjamin Cooper, MD, discussed potential future studies exploring TAK-676 plus pembrolizumab after radiation for those with solid tumors.
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Considerations for the Management of Oncology Patients During the COVID-19 PandemicABSTRACT Worldwide incidence and mortality due to the coronavirus disease 2019 (COVID-19) pandemic is greatest in the United States, with the initial epicenter in New York. In Nassau County, New York, where we practice, our institution has had more than 2500 cases and has discharged from the hospital more than 1000 patients. As many academic and private institutions have swiftly shifted their clinical and research priorities to address the pandemic, data are emerging regarding both the impact of malignancy on COVID-19 outcomes as well as the challenges faced in assuring that cancer care remains unimpeded. Of concern, recent studies of cancer patients primarily in China and Italy have suggested that advanced malignancy is associated with increased susceptibility to severe COVID-19 infection. At present, more than 500 clinical trials are underway investigating the pathogenesis and treatment of COVID-19, including expanded use of oncology drugs, such as small molecular inhibitors of cytokine pathways. Here, we begin by reviewing the latest understanding of COVID-19 pathophysiology and then focus our attention on the impact of this virus on hematologic and oncologic practice. Finally, we highlight ongoing investigational treatment approaches that are so relevant to the care of oncology patients during this extraordinary pandemic.
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Circulating Tumor DNA as a Predictive Biomarker for Clinical Outcomes With Margetuximab and Pembrolizumab in Pretreated HER2-Positive Gastric/ Gastroesophageal AdenocarcinomaDaniel V. T. Catenacci, MD, and colleagues present findings from a study of circulating tumor DNA as a predictive biomarker for gastric and gastroesophageal cancer.
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HER2+ Breast Cancer Clinical PearlsAdvice for community physicians treating HER2+ breast cancer.
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SHP2/KRAS Inhibitor Combo Yields Activity in KRAS G12C+ Solid TumorsInvestigators of the phase 1b/2 KontRASt-01 trial will continue their evaluation of TNO155 plus JDQ433 in KRAS G12C-mutated solid tumors as part of an expansion portion of the trial.
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Erdheim-Chester Disease: A Case Report of BRAF V600E–Negative, MAP2K1-Positive ECD Diagnosed by Blood Next-Generation Sequencing Assay and a Brief Literature ReviewInvestigators report a case of a man, aged 55 years, with an extensive and prolonged course of an unexplained multi-systemic disease, and also review common clinical manifestations, mutations, diagnoses, and targeted therapies for Erdheim-Chester disease.
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Multidisciplinary Efforts are 'Essential' to Manage Gynecologic Cancer SymptomsA recovery tracker and other digital tools may be useful in helping to manage patient symptoms following debulking surgery for gynecologic cancer, according to an expert from Memorial Sloan Kettering Cancer Center.
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Treatment of Multiple Myeloma: Q&A Session With Yale Cancer Center and SatellitesA Q&A session with the expert panel.
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Decisional Capacity Determination in Patients With CancerExperts discuss the process of assessing decision-making capacity in patients with cancer.
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Decisional Capacity Determination in Patients With CancerExperts discuss the process of assessing decision-making capacity in patients with cancer.
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Key Takeaways: Optimal Use of JAK Inhibitors in MF and Future Directions in CarePanelists share key takeaways on management strategies in myelofibrosis and hope for future evolutions in the treatment paradigm.
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Optimization of Genetic Testing for mCRPCJason M. Hafron, MD, CMO, and Oliver Sartor, MD, share their approach for the optimal management of mCRPC through genetic testing.
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Oncology Peer Review On-The-Go: Characterization of Blood-Based Molecular Profiling in Pancreatic AdenocarcinomaChristine Chung, DO, spoke with CancerNetwork® about the latest research from the journal ONCOLOGY® about implications of blood-based molecular markers in pancreatic adenocarcinoma.
Latest:
Circulating Tumor DNA as a Predictive Biomarker for Clinical Outcomes With Margetuximab and Pembrolizumab in Pretreated HER2-Positive Gastric/ Gastroesophageal AdenocarcinomaDaniel V. T. Catenacci, MD, and colleagues present findings from a study of circulating tumor DNA as a predictive biomarker for gastric and gastroesophageal cancer.
