Key Studies in Ulcerative Colitis From ACG 2020 Virtual Conference

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Miguel Regueiro, MD, an expert in gastroenterology at the Cleveland Clinic, reflects on the most important and clinically relevant studies on ulcerative colitis presented at the American College of Gastroenterology 2020 virtual annual scientific meeting. He starts with four studies from the OCTAVE clinical trials program. These studies examined the efficacy and safety of tofacitinib after treatment interruption and in pregnant women, presenting almost 7 years of follow-up. Long-term follow-up remains the theme as he turns to the VISIBLE open-label extension of treatment with vedolizumab SC, where the long-term safety of the drug was confirmed and clinical remission rates were maintained out to 2 years. He reports that a post-hoc analysis of the VARSITY trial appeared to show that vedolizumab achieves greater early control vs adalimumab. Dr Regueiro next discusses the late-breaking, phase 3 True North study of ozanimod for moderate to severe ulcerative colitis before finishing up with an analysis of the long-term trends for colectomy since the turn of the century.

 

Miguel D. Regueiro, MD, Chairman, Professor, Department of Gastroenterology, Hepatology, and Nutrition; Vice-Chair, Digestive Disease Institute, Cleveland Clinic, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.

Miguel D. Regueiro, MD, has disclosed the following relevant financial relationships: Serve(d) as an advisor and/or consultant for: AbbVie; Janssen; UCB; Takeda; Pfizer; Miraca Labs; Amgen; Celgene; Seres; Allergan; Genentech; Gilead; Salix; Prometheus. Received unrestricted educational grants from: AbbVie; Janssen; UCB; Pfizer; Takeda; Salix; Shire. Received research support from AbbVie; Janssen; Takeda; Pfizer.

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Miguel Regueiro, MD, an expert in gastroenterology at the Cleveland Clinic, reflects on the most important and clinically relevant studies on ulcerative colitis presented at the American College of Gastroenterology 2020 virtual annual scientific meeting. He starts with four studies from the OCTAVE clinical trials program. These studies examined the efficacy and safety of tofacitinib after treatment interruption and in pregnant women, presenting almost 7 years of follow-up. Long-term follow-up remains the theme as he turns to the VISIBLE open-label extension of treatment with vedolizumab SC, where the long-term safety of the drug was confirmed and clinical remission rates were maintained out to 2 years. He reports that a post-hoc analysis of the VARSITY trial appeared to show that vedolizumab achieves greater early control vs adalimumab. Dr Regueiro next discusses the late-breaking, phase 3 True North study of ozanimod for moderate to severe ulcerative colitis before finishing up with an analysis of the long-term trends for colectomy since the turn of the century.

 

Miguel D. Regueiro, MD, Chairman, Professor, Department of Gastroenterology, Hepatology, and Nutrition; Vice-Chair, Digestive Disease Institute, Cleveland Clinic, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.

Miguel D. Regueiro, MD, has disclosed the following relevant financial relationships: Serve(d) as an advisor and/or consultant for: AbbVie; Janssen; UCB; Takeda; Pfizer; Miraca Labs; Amgen; Celgene; Seres; Allergan; Genentech; Gilead; Salix; Prometheus. Received unrestricted educational grants from: AbbVie; Janssen; UCB; Pfizer; Takeda; Salix; Shire. Received research support from AbbVie; Janssen; Takeda; Pfizer.

Miguel Regueiro, MD, an expert in gastroenterology at the Cleveland Clinic, reflects on the most important and clinically relevant studies on ulcerative colitis presented at the American College of Gastroenterology 2020 virtual annual scientific meeting. He starts with four studies from the OCTAVE clinical trials program. These studies examined the efficacy and safety of tofacitinib after treatment interruption and in pregnant women, presenting almost 7 years of follow-up. Long-term follow-up remains the theme as he turns to the VISIBLE open-label extension of treatment with vedolizumab SC, where the long-term safety of the drug was confirmed and clinical remission rates were maintained out to 2 years. He reports that a post-hoc analysis of the VARSITY trial appeared to show that vedolizumab achieves greater early control vs adalimumab. Dr Regueiro next discusses the late-breaking, phase 3 True North study of ozanimod for moderate to severe ulcerative colitis before finishing up with an analysis of the long-term trends for colectomy since the turn of the century.

 

Miguel D. Regueiro, MD, Chairman, Professor, Department of Gastroenterology, Hepatology, and Nutrition; Vice-Chair, Digestive Disease Institute, Cleveland Clinic, Cleveland Clinic Lerner College of Medicine, Cleveland, Ohio.

Miguel D. Regueiro, MD, has disclosed the following relevant financial relationships: Serve(d) as an advisor and/or consultant for: AbbVie; Janssen; UCB; Takeda; Pfizer; Miraca Labs; Amgen; Celgene; Seres; Allergan; Genentech; Gilead; Salix; Prometheus. Received unrestricted educational grants from: AbbVie; Janssen; UCB; Pfizer; Takeda; Salix; Shire. Received research support from AbbVie; Janssen; Takeda; Pfizer.

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ECTRIMS 2020 Highlights: Managing RRMS, Symptoms in the Time of COVID-19

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ECTRIMS 2020 Highlights: Managing RRMS, Symptoms in the Time of COVID-19

A shift in managing symptoms for patients with relapsing-remitting multiple sclerosis (RRMS) may be in order as new research questions the efficacy of three commonly used drugs for MS-related fatigue. Results of a study from Johns Hopkins University show that amantadine, modafinil, and methylphenidate were not superior to placebo. As Dr Mark Freedman reports in this ReCAP, the study suggests that clinicians consider focusing more on patient sleep quality rather than tiredness in their evaluation of fatigue.

This study was presented during the 8th Joint Meeting of ACTRIMS-ECTRIMS, this year branded MSVirtual2020. Dr Freedman, a recognized neurologist from the University of Ottawa, shares key highlights from the online conference.

He explains the significance of new evidence that points to the potential for a selective retinoid X receptor agonist to promote remyelination in relapsing disease. He also discusses a study by researchers at the University of Melbourne that looked at data from the largest cohort of MS patients with COVID-19 and drew troubling conclusions.

Professor, Department of Neurology, University of Ottawa and The Ottawa Hospital Research Institute; Director, Multiple Sclerosis Research Unit, The Ottawa Hospital – General Campus, Ottawa, Ontario, Canada.

Mark S. Freedman, MSc, MD, has disclosed the following relevant financial relationships: Serve(d) on the advisory board, board of directors, or other similar groups for: Actelion (Janssen/Johnson & Johnson); Alexion; Atara Biotherapeutics; BayerHealthcare; BiogenIdec; Celgene; Clene Nanomedicine; GRI Bio; Hoffman La-Roche; Magenta Therapeutics; Merck Serono; MedDay; Novartis; Sanofi-Genzyme; Teva Canada Innovation. Serve(d) as a member of a speakers bureau for: Sanofi-Genzyme; EMD Serono. Received honoraria or consultation fees for: Actelion (Janssen/Johnson & Johnson); Alexion; BiogenIdec; Celgene (BMS); EMD Inc; Sanofi-Genzyme; Hoffman La-Roche; Merck Serono; Novartis; Teva Canada Innovation­. Received research or educational grants from: Sanofi-Genzyme Canada; Hoffman-La Roche; EMD Inc.

 

 
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A shift in managing symptoms for patients with relapsing-remitting multiple sclerosis (RRMS) may be in order as new research questions the efficacy of three commonly used drugs for MS-related fatigue. Results of a study from Johns Hopkins University show that amantadine, modafinil, and methylphenidate were not superior to placebo. As Dr Mark Freedman reports in this ReCAP, the study suggests that clinicians consider focusing more on patient sleep quality rather than tiredness in their evaluation of fatigue.

This study was presented during the 8th Joint Meeting of ACTRIMS-ECTRIMS, this year branded MSVirtual2020. Dr Freedman, a recognized neurologist from the University of Ottawa, shares key highlights from the online conference.

He explains the significance of new evidence that points to the potential for a selective retinoid X receptor agonist to promote remyelination in relapsing disease. He also discusses a study by researchers at the University of Melbourne that looked at data from the largest cohort of MS patients with COVID-19 and drew troubling conclusions.

Professor, Department of Neurology, University of Ottawa and The Ottawa Hospital Research Institute; Director, Multiple Sclerosis Research Unit, The Ottawa Hospital – General Campus, Ottawa, Ontario, Canada.

Mark S. Freedman, MSc, MD, has disclosed the following relevant financial relationships: Serve(d) on the advisory board, board of directors, or other similar groups for: Actelion (Janssen/Johnson & Johnson); Alexion; Atara Biotherapeutics; BayerHealthcare; BiogenIdec; Celgene; Clene Nanomedicine; GRI Bio; Hoffman La-Roche; Magenta Therapeutics; Merck Serono; MedDay; Novartis; Sanofi-Genzyme; Teva Canada Innovation. Serve(d) as a member of a speakers bureau for: Sanofi-Genzyme; EMD Serono. Received honoraria or consultation fees for: Actelion (Janssen/Johnson & Johnson); Alexion; BiogenIdec; Celgene (BMS); EMD Inc; Sanofi-Genzyme; Hoffman La-Roche; Merck Serono; Novartis; Teva Canada Innovation­. Received research or educational grants from: Sanofi-Genzyme Canada; Hoffman-La Roche; EMD Inc.

 

 

A shift in managing symptoms for patients with relapsing-remitting multiple sclerosis (RRMS) may be in order as new research questions the efficacy of three commonly used drugs for MS-related fatigue. Results of a study from Johns Hopkins University show that amantadine, modafinil, and methylphenidate were not superior to placebo. As Dr Mark Freedman reports in this ReCAP, the study suggests that clinicians consider focusing more on patient sleep quality rather than tiredness in their evaluation of fatigue.

This study was presented during the 8th Joint Meeting of ACTRIMS-ECTRIMS, this year branded MSVirtual2020. Dr Freedman, a recognized neurologist from the University of Ottawa, shares key highlights from the online conference.

He explains the significance of new evidence that points to the potential for a selective retinoid X receptor agonist to promote remyelination in relapsing disease. He also discusses a study by researchers at the University of Melbourne that looked at data from the largest cohort of MS patients with COVID-19 and drew troubling conclusions.

Professor, Department of Neurology, University of Ottawa and The Ottawa Hospital Research Institute; Director, Multiple Sclerosis Research Unit, The Ottawa Hospital – General Campus, Ottawa, Ontario, Canada.

Mark S. Freedman, MSc, MD, has disclosed the following relevant financial relationships: Serve(d) on the advisory board, board of directors, or other similar groups for: Actelion (Janssen/Johnson & Johnson); Alexion; Atara Biotherapeutics; BayerHealthcare; BiogenIdec; Celgene; Clene Nanomedicine; GRI Bio; Hoffman La-Roche; Magenta Therapeutics; Merck Serono; MedDay; Novartis; Sanofi-Genzyme; Teva Canada Innovation. Serve(d) as a member of a speakers bureau for: Sanofi-Genzyme; EMD Serono. Received honoraria or consultation fees for: Actelion (Janssen/Johnson & Johnson); Alexion; BiogenIdec; Celgene (BMS); EMD Inc; Sanofi-Genzyme; Hoffman La-Roche; Merck Serono; Novartis; Teva Canada Innovation­. Received research or educational grants from: Sanofi-Genzyme Canada; Hoffman-La Roche; EMD Inc.

 

 
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Biomarkers for Disease Activity in RRMS Reported at ACTRIMS/ECTRIMS 2020

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In relapsing-remitting multiple sclerosis (RRMS), MRI has provided a key indication of disease presence and activity. With the availability of serum neurofilament (sNfL) assays, disease activity can be correlated with sNfL levels.

Dr Tobias Derfuss, from University Hospital Basel in Basel, Switzerland, discusses emerging research reported at the ACTRIMS/ECTRIMS 2020 Virtual Meeting, focusing on the use of sNfL as a biomarker for monitoring treatment response and disease activity in RRMS.

Dr Derfuss highlights one study in which longitudinal observations showed that high levels of sNfL at baseline are associated with a high risk for gadolinium-enhancing lesions; the study authors suggest that quarterly monitoring may be adequate for surveillance of subclinical disease.

In another study, higher sNfL levels at baseline were linked to a higher risk for T2 lesions and a more pronounced brain atrophy rate, but disability progression was not correlated to baseline sNfL levels.

Finally, Dr Derfuss reports on a real-world, large cohort study supporting the value of sNfL to capture and predict disability progression independent of relapses.

Tobias J. Derfuss, MD, Professor, Head of Outpatient Clinic, Department of Neurology, University Hospital Board, Basel, Switzerland

Tobias J. Derfuss, MD, has disclosed the following relevant financial relationships:­ Received financial compensation for his activities in advisory boards, steering committees, data safety monitoring boards, and consultation for: Novartis; Merck; Biogen; Celgene; Actelion; Mitsubishi Pharma; MedDay; Roche; Sanofi Genzyme. Received research grant from: Novartis; Biogen; Roche; Swiss National Science Foundation; European Union; Swiss MS Society. Spouse is an employee of and holds stock options in: Novartis

 

 

 

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In relapsing-remitting multiple sclerosis (RRMS), MRI has provided a key indication of disease presence and activity. With the availability of serum neurofilament (sNfL) assays, disease activity can be correlated with sNfL levels.

Dr Tobias Derfuss, from University Hospital Basel in Basel, Switzerland, discusses emerging research reported at the ACTRIMS/ECTRIMS 2020 Virtual Meeting, focusing on the use of sNfL as a biomarker for monitoring treatment response and disease activity in RRMS.

Dr Derfuss highlights one study in which longitudinal observations showed that high levels of sNfL at baseline are associated with a high risk for gadolinium-enhancing lesions; the study authors suggest that quarterly monitoring may be adequate for surveillance of subclinical disease.

In another study, higher sNfL levels at baseline were linked to a higher risk for T2 lesions and a more pronounced brain atrophy rate, but disability progression was not correlated to baseline sNfL levels.

Finally, Dr Derfuss reports on a real-world, large cohort study supporting the value of sNfL to capture and predict disability progression independent of relapses.

Tobias J. Derfuss, MD, Professor, Head of Outpatient Clinic, Department of Neurology, University Hospital Board, Basel, Switzerland

Tobias J. Derfuss, MD, has disclosed the following relevant financial relationships:­ Received financial compensation for his activities in advisory boards, steering committees, data safety monitoring boards, and consultation for: Novartis; Merck; Biogen; Celgene; Actelion; Mitsubishi Pharma; MedDay; Roche; Sanofi Genzyme. Received research grant from: Novartis; Biogen; Roche; Swiss National Science Foundation; European Union; Swiss MS Society. Spouse is an employee of and holds stock options in: Novartis

 

 

 

In relapsing-remitting multiple sclerosis (RRMS), MRI has provided a key indication of disease presence and activity. With the availability of serum neurofilament (sNfL) assays, disease activity can be correlated with sNfL levels.

Dr Tobias Derfuss, from University Hospital Basel in Basel, Switzerland, discusses emerging research reported at the ACTRIMS/ECTRIMS 2020 Virtual Meeting, focusing on the use of sNfL as a biomarker for monitoring treatment response and disease activity in RRMS.

Dr Derfuss highlights one study in which longitudinal observations showed that high levels of sNfL at baseline are associated with a high risk for gadolinium-enhancing lesions; the study authors suggest that quarterly monitoring may be adequate for surveillance of subclinical disease.

In another study, higher sNfL levels at baseline were linked to a higher risk for T2 lesions and a more pronounced brain atrophy rate, but disability progression was not correlated to baseline sNfL levels.

Finally, Dr Derfuss reports on a real-world, large cohort study supporting the value of sNfL to capture and predict disability progression independent of relapses.

Tobias J. Derfuss, MD, Professor, Head of Outpatient Clinic, Department of Neurology, University Hospital Board, Basel, Switzerland

Tobias J. Derfuss, MD, has disclosed the following relevant financial relationships:­ Received financial compensation for his activities in advisory boards, steering committees, data safety monitoring boards, and consultation for: Novartis; Merck; Biogen; Celgene; Actelion; Mitsubishi Pharma; MedDay; Roche; Sanofi Genzyme. Received research grant from: Novartis; Biogen; Roche; Swiss National Science Foundation; European Union; Swiss MS Society. Spouse is an employee of and holds stock options in: Novartis

 

 

 

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Highlights in Disease-Modifying Therapies From ECTRIMS2020

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Highlights in Disease-Modifying Therapies From ECTRIMS2020

Dr Patricia Coyle from Stony Brook University Medical Center in New York highlights new data on disease-modifying therapies (DMTs) from the 8th Joint ACTRIMS-ECTRIMS Meeting, MSVirtual2020.

Focusing on relapsing-remitting multiple sclerosis (RRMS), Dr Coyle discusses new research that further explores the efficacy and rebound effects of DMTs, 24 of which are approved in the United States for this patient population.

She reports on results from a database study comparing DMTs vs moderate-efficacy drugs and escalating treatment in the first-line setting, a cohort of pediatric patients receiving adult-approved teriflunomide, and an exploration of fingolimod rebound syndrome.

Patricia K. Coyle, MD, Professor, Interim Chair, Director, Multiple Sclerosis Comprehensive Care Center, Department of Neurology, Stony Brook University Medical Center, Stony Brook, New York

 

 
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Dr Patricia Coyle from Stony Brook University Medical Center in New York highlights new data on disease-modifying therapies (DMTs) from the 8th Joint ACTRIMS-ECTRIMS Meeting, MSVirtual2020.

Focusing on relapsing-remitting multiple sclerosis (RRMS), Dr Coyle discusses new research that further explores the efficacy and rebound effects of DMTs, 24 of which are approved in the United States for this patient population.

She reports on results from a database study comparing DMTs vs moderate-efficacy drugs and escalating treatment in the first-line setting, a cohort of pediatric patients receiving adult-approved teriflunomide, and an exploration of fingolimod rebound syndrome.

Patricia K. Coyle, MD, Professor, Interim Chair, Director, Multiple Sclerosis Comprehensive Care Center, Department of Neurology, Stony Brook University Medical Center, Stony Brook, New York

 

 

Dr Patricia Coyle from Stony Brook University Medical Center in New York highlights new data on disease-modifying therapies (DMTs) from the 8th Joint ACTRIMS-ECTRIMS Meeting, MSVirtual2020.

Focusing on relapsing-remitting multiple sclerosis (RRMS), Dr Coyle discusses new research that further explores the efficacy and rebound effects of DMTs, 24 of which are approved in the United States for this patient population.

She reports on results from a database study comparing DMTs vs moderate-efficacy drugs and escalating treatment in the first-line setting, a cohort of pediatric patients receiving adult-approved teriflunomide, and an exploration of fingolimod rebound syndrome.

Patricia K. Coyle, MD, Professor, Interim Chair, Director, Multiple Sclerosis Comprehensive Care Center, Department of Neurology, Stony Brook University Medical Center, Stony Brook, New York

 

 
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Diagnosis and Monitoring Highlights From ECTRIMS 2020

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Promising imaging developments may soon improve clinicians' ability to diagnose and monitor the progression of multiple sclerosis (MS). Dr Patricia Coyle, director of the Multiple Sclerosis Comprehensive Care Center at Stony Brook University Medical Center, reports on findings presented at the 8th Joint ACTRIMS-ECTRIMS Conference, this year known as MSVirtual 2020.


Dr Coyle emphasizes the importance of appropriate diagnosis as well as the need to improve the misdiagnosis rate. Advanced monitoring techniques that can detect MS with more accuracy are key. 


She highlights exciting research in novel MRI markers, including central vein sign and paramagnetic rim sign (PRS). One study shows reliable methods for quantification of PRS, which is especially critical if this prognostic marker is to be adopted for clinical practice. 


Dr Coyle highlights other studies focused on techniques that help monitor the damage from progressing MS, including further analysis of optical coherence tomography. 
 

Patricia K. Coyle, MD, Professor, Interim Chair, Director, Multiple Sclerosis Comprehensive Care Center, Department of Neurology, Stony Brook University Medical Center, Stony Brook, New York

 

 
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Promising imaging developments may soon improve clinicians' ability to diagnose and monitor the progression of multiple sclerosis (MS). Dr Patricia Coyle, director of the Multiple Sclerosis Comprehensive Care Center at Stony Brook University Medical Center, reports on findings presented at the 8th Joint ACTRIMS-ECTRIMS Conference, this year known as MSVirtual 2020.


Dr Coyle emphasizes the importance of appropriate diagnosis as well as the need to improve the misdiagnosis rate. Advanced monitoring techniques that can detect MS with more accuracy are key. 


She highlights exciting research in novel MRI markers, including central vein sign and paramagnetic rim sign (PRS). One study shows reliable methods for quantification of PRS, which is especially critical if this prognostic marker is to be adopted for clinical practice. 


Dr Coyle highlights other studies focused on techniques that help monitor the damage from progressing MS, including further analysis of optical coherence tomography. 
 

Patricia K. Coyle, MD, Professor, Interim Chair, Director, Multiple Sclerosis Comprehensive Care Center, Department of Neurology, Stony Brook University Medical Center, Stony Brook, New York

 

 

Promising imaging developments may soon improve clinicians' ability to diagnose and monitor the progression of multiple sclerosis (MS). Dr Patricia Coyle, director of the Multiple Sclerosis Comprehensive Care Center at Stony Brook University Medical Center, reports on findings presented at the 8th Joint ACTRIMS-ECTRIMS Conference, this year known as MSVirtual 2020.


Dr Coyle emphasizes the importance of appropriate diagnosis as well as the need to improve the misdiagnosis rate. Advanced monitoring techniques that can detect MS with more accuracy are key. 


She highlights exciting research in novel MRI markers, including central vein sign and paramagnetic rim sign (PRS). One study shows reliable methods for quantification of PRS, which is especially critical if this prognostic marker is to be adopted for clinical practice. 


Dr Coyle highlights other studies focused on techniques that help monitor the damage from progressing MS, including further analysis of optical coherence tomography. 
 

Patricia K. Coyle, MD, Professor, Interim Chair, Director, Multiple Sclerosis Comprehensive Care Center, Department of Neurology, Stony Brook University Medical Center, Stony Brook, New York

 

 
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Breakthroughs in HCC and Liver Cancer From ASCO 2020

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Breakthroughs in HCC and Liver Cancer From ASCO 2020

Dr Andrew X. Zhu, liver cancer expert at Massachusetts General Hospital Cancer Center and Jiahui International Cancer Center, Shanghai, discusses the latest innovations and potentially practice-changing data in the management of hepatocellular carcinoma (HCC) and liver cancer from the ASCO 2020 virtual annual meeting.

 

Highlights include two trials looking at first- and second-line options in Chinese patients with advanced HCC, who account for more than 50% of cases worldwide. Donafenib significantly improved overall survival versus sorafenib in the first-line setting. Donafenib was well tolerated and showed a favorable safety profile. Apatinib achieved similarly impressive outcomes in the second-line setting and showed a manageable safety profile.

 

Next, Dr Zhu discusses the novel combination of tremelimumab and durvalumab in advanced HCC. One dosing regimen in particular more than doubled overall survival and responses rates.

 

He then reviews one of his own studies, a phase 1b trial of the multikinase inhibitor lenvatinib plus pembrolizumab in unresectable HCC, which achieved promising results.

 

Finally, transarterial chemoembolization (TACE) with epirubicin-loaded drug-eluting beads goes head-to-head with conventional epirubicin-lipiodol TACE to determine which has greater efficacy.

 
Andrew X. Zhu, MD, PhD

Director Emeritus, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Director, Jiahui International Cancer Center, Jiahui International Hospital, Shanghai, China. Andrew X. Zhu, MD, PhD, has disclosed the following relevant financial relationships: Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Bayer; Merck; Eisai; Roche; Eli Lilly and Company; Sanofi; Exelixis
 

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Dr Andrew X. Zhu, liver cancer expert at Massachusetts General Hospital Cancer Center and Jiahui International Cancer Center, Shanghai, discusses the latest innovations and potentially practice-changing data in the management of hepatocellular carcinoma (HCC) and liver cancer from the ASCO 2020 virtual annual meeting.

 

Highlights include two trials looking at first- and second-line options in Chinese patients with advanced HCC, who account for more than 50% of cases worldwide. Donafenib significantly improved overall survival versus sorafenib in the first-line setting. Donafenib was well tolerated and showed a favorable safety profile. Apatinib achieved similarly impressive outcomes in the second-line setting and showed a manageable safety profile.

 

Next, Dr Zhu discusses the novel combination of tremelimumab and durvalumab in advanced HCC. One dosing regimen in particular more than doubled overall survival and responses rates.

 

He then reviews one of his own studies, a phase 1b trial of the multikinase inhibitor lenvatinib plus pembrolizumab in unresectable HCC, which achieved promising results.

 

Finally, transarterial chemoembolization (TACE) with epirubicin-loaded drug-eluting beads goes head-to-head with conventional epirubicin-lipiodol TACE to determine which has greater efficacy.

 
Andrew X. Zhu, MD, PhD

Director Emeritus, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Director, Jiahui International Cancer Center, Jiahui International Hospital, Shanghai, China. Andrew X. Zhu, MD, PhD, has disclosed the following relevant financial relationships: Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Bayer; Merck; Eisai; Roche; Eli Lilly and Company; Sanofi; Exelixis
 

Dr Andrew X. Zhu, liver cancer expert at Massachusetts General Hospital Cancer Center and Jiahui International Cancer Center, Shanghai, discusses the latest innovations and potentially practice-changing data in the management of hepatocellular carcinoma (HCC) and liver cancer from the ASCO 2020 virtual annual meeting.

 

Highlights include two trials looking at first- and second-line options in Chinese patients with advanced HCC, who account for more than 50% of cases worldwide. Donafenib significantly improved overall survival versus sorafenib in the first-line setting. Donafenib was well tolerated and showed a favorable safety profile. Apatinib achieved similarly impressive outcomes in the second-line setting and showed a manageable safety profile.

 

Next, Dr Zhu discusses the novel combination of tremelimumab and durvalumab in advanced HCC. One dosing regimen in particular more than doubled overall survival and responses rates.

 

He then reviews one of his own studies, a phase 1b trial of the multikinase inhibitor lenvatinib plus pembrolizumab in unresectable HCC, which achieved promising results.

 

Finally, transarterial chemoembolization (TACE) with epirubicin-loaded drug-eluting beads goes head-to-head with conventional epirubicin-lipiodol TACE to determine which has greater efficacy.

 
Andrew X. Zhu, MD, PhD

Director Emeritus, Massachusetts General Hospital Cancer Center, Boston, Massachusetts; Director, Jiahui International Cancer Center, Jiahui International Hospital, Shanghai, China. Andrew X. Zhu, MD, PhD, has disclosed the following relevant financial relationships: Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Bayer; Merck; Eisai; Roche; Eli Lilly and Company; Sanofi; Exelixis
 

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Highlights in Ovarian Cancer From ASCO 2020

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The DESKTOP III trial, whose results were eagerly awaited, compared surgery followed by chemotherapy versus chemotherapy only in recurrent platinum-sensitive ovarian cancer. Dr. Maurie Markman, from Cancer Treatment Centers of America in Philadelphia, reports that the DESKTOP results, initially announced in 2017, continue to show an improvement in progression-free survival in favor of surgery plus chemotherapy. 
 
Dr. Markman next comments on the SOLO-2 study assessing maintenance olaparib in patients with platinum-sensitive relapsed ovarian cancer and a BRCA mutation, which showed significantly improved overall survival for patients receiving olaparib.
 
Among other olaparib trials, the phase 3 PAOLA-1 study looked at olaparib plus bevacizumab in platinum-sensitive recurrent ovarian cancer. The study explored the efficacy of this combination in treating tumors with BRCA1/BRCA2 mutations and found that all patients benefited.
 
Finally, Dr. Markman reports on noteworthy abstracts, including studies examining the adequacy of genetic testing and real-world data in management of patients with ovarian cancer.

 

 
Maurie Markman, MD

Maurie Markman, MD, Clinical Professor of Medicine, Drexel University College of Medicine; President, Medicine & Science, Cancer Treatment Centers of America, Philadelphia, Pennsylvania. Maurie Markman, MD, has disclosed the following relevant financial relationships: Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Merck, Inc. Serve(d) as a speaker or a member of a speakers bureau for: Genentech, Inc; Clovis; Tesaro; AstraZeneca Pharmaceuticals, LP

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The DESKTOP III trial, whose results were eagerly awaited, compared surgery followed by chemotherapy versus chemotherapy only in recurrent platinum-sensitive ovarian cancer. Dr. Maurie Markman, from Cancer Treatment Centers of America in Philadelphia, reports that the DESKTOP results, initially announced in 2017, continue to show an improvement in progression-free survival in favor of surgery plus chemotherapy. 
 
Dr. Markman next comments on the SOLO-2 study assessing maintenance olaparib in patients with platinum-sensitive relapsed ovarian cancer and a BRCA mutation, which showed significantly improved overall survival for patients receiving olaparib.
 
Among other olaparib trials, the phase 3 PAOLA-1 study looked at olaparib plus bevacizumab in platinum-sensitive recurrent ovarian cancer. The study explored the efficacy of this combination in treating tumors with BRCA1/BRCA2 mutations and found that all patients benefited.
 
Finally, Dr. Markman reports on noteworthy abstracts, including studies examining the adequacy of genetic testing and real-world data in management of patients with ovarian cancer.

 

 
Maurie Markman, MD

Maurie Markman, MD, Clinical Professor of Medicine, Drexel University College of Medicine; President, Medicine & Science, Cancer Treatment Centers of America, Philadelphia, Pennsylvania. Maurie Markman, MD, has disclosed the following relevant financial relationships: Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Merck, Inc. Serve(d) as a speaker or a member of a speakers bureau for: Genentech, Inc; Clovis; Tesaro; AstraZeneca Pharmaceuticals, LP

The DESKTOP III trial, whose results were eagerly awaited, compared surgery followed by chemotherapy versus chemotherapy only in recurrent platinum-sensitive ovarian cancer. Dr. Maurie Markman, from Cancer Treatment Centers of America in Philadelphia, reports that the DESKTOP results, initially announced in 2017, continue to show an improvement in progression-free survival in favor of surgery plus chemotherapy. 
 
Dr. Markman next comments on the SOLO-2 study assessing maintenance olaparib in patients with platinum-sensitive relapsed ovarian cancer and a BRCA mutation, which showed significantly improved overall survival for patients receiving olaparib.
 
Among other olaparib trials, the phase 3 PAOLA-1 study looked at olaparib plus bevacizumab in platinum-sensitive recurrent ovarian cancer. The study explored the efficacy of this combination in treating tumors with BRCA1/BRCA2 mutations and found that all patients benefited.
 
Finally, Dr. Markman reports on noteworthy abstracts, including studies examining the adequacy of genetic testing and real-world data in management of patients with ovarian cancer.

 

 
Maurie Markman, MD

Maurie Markman, MD, Clinical Professor of Medicine, Drexel University College of Medicine; President, Medicine & Science, Cancer Treatment Centers of America, Philadelphia, Pennsylvania. Maurie Markman, MD, has disclosed the following relevant financial relationships: Serve(d) as a director, officer, partner, employee, advisor, consultant, or trustee for: Merck, Inc. Serve(d) as a speaker or a member of a speakers bureau for: Genentech, Inc; Clovis; Tesaro; AstraZeneca Pharmaceuticals, LP

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Highlights in Non–Small Cell Lung Cancer From ASCO 2020

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Presented during the ASCO 2020 plenary session, the results of the phase 3 ADAURA trial will prove practice-changing, according to Dr. Mark Kris of Memorial Sloan Kettering Cancer Center. Over 600 patients whose resected tumors were found to have EGFR mutations were treated with osimertinib. The results more than doubled disease-free survival rates, from 44% to 90% at 2 years.

 

Among other adjuvant trials, the phase 2 VISION study looked at tepotinib, a once-daily, highly selective oral MET inhibitor. The study showed durable responses coupled with acceptable side effects. The drug has been given fast-track status by the US Food and Drug Administration.

 

Dr. Kris notes that the DESTINY study introduces trastuzumab deruxtecan, an antibody-drug conjugate, as a promising new class of drugs for lung cancer patients. Interim results presented at ASCO further support the HER2 mutation as another potential target for patients with lung cancer.

Finally, the phase 2 CITYSCAPE study provides preliminary evidence for a new checkpoint inhibitor. The monoclonal antibody tiragolumab was developed to block TIGIT. The study showed that the combination of tiragolumab and atezolizumab can improve both rates of response and time to disease recurrence — results Dr. Kris considers encouraging for patients with advanced lung cancer.

 
Mark G. Kris, MD

Mark G. Kris, MD, Professor, Department of Medicine, Weill Cornell Medical College; Attending Physician, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.

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Presented during the ASCO 2020 plenary session, the results of the phase 3 ADAURA trial will prove practice-changing, according to Dr. Mark Kris of Memorial Sloan Kettering Cancer Center. Over 600 patients whose resected tumors were found to have EGFR mutations were treated with osimertinib. The results more than doubled disease-free survival rates, from 44% to 90% at 2 years.

 

Among other adjuvant trials, the phase 2 VISION study looked at tepotinib, a once-daily, highly selective oral MET inhibitor. The study showed durable responses coupled with acceptable side effects. The drug has been given fast-track status by the US Food and Drug Administration.

 

Dr. Kris notes that the DESTINY study introduces trastuzumab deruxtecan, an antibody-drug conjugate, as a promising new class of drugs for lung cancer patients. Interim results presented at ASCO further support the HER2 mutation as another potential target for patients with lung cancer.

Finally, the phase 2 CITYSCAPE study provides preliminary evidence for a new checkpoint inhibitor. The monoclonal antibody tiragolumab was developed to block TIGIT. The study showed that the combination of tiragolumab and atezolizumab can improve both rates of response and time to disease recurrence — results Dr. Kris considers encouraging for patients with advanced lung cancer.

 
Mark G. Kris, MD

Mark G. Kris, MD, Professor, Department of Medicine, Weill Cornell Medical College; Attending Physician, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.

Presented during the ASCO 2020 plenary session, the results of the phase 3 ADAURA trial will prove practice-changing, according to Dr. Mark Kris of Memorial Sloan Kettering Cancer Center. Over 600 patients whose resected tumors were found to have EGFR mutations were treated with osimertinib. The results more than doubled disease-free survival rates, from 44% to 90% at 2 years.

 

Among other adjuvant trials, the phase 2 VISION study looked at tepotinib, a once-daily, highly selective oral MET inhibitor. The study showed durable responses coupled with acceptable side effects. The drug has been given fast-track status by the US Food and Drug Administration.

 

Dr. Kris notes that the DESTINY study introduces trastuzumab deruxtecan, an antibody-drug conjugate, as a promising new class of drugs for lung cancer patients. Interim results presented at ASCO further support the HER2 mutation as another potential target for patients with lung cancer.

Finally, the phase 2 CITYSCAPE study provides preliminary evidence for a new checkpoint inhibitor. The monoclonal antibody tiragolumab was developed to block TIGIT. The study showed that the combination of tiragolumab and atezolizumab can improve both rates of response and time to disease recurrence — results Dr. Kris considers encouraging for patients with advanced lung cancer.

 
Mark G. Kris, MD

Mark G. Kris, MD, Professor, Department of Medicine, Weill Cornell Medical College; Attending Physician, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, NY.

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Key Studies in Metastatic Breast Cancer From ASCO 2020

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Key findings in metastatic breast cancer, presented at the ASCO 2020 Virtual Annual Meeting, ranged across all tumor subtypes.

Arguably, the top news in breast cancer was a plenary presentation addressing the role of locoregional therapy in advanced disease. Dr. Harold Burstein, of Dana-Farber Cancer Institute, comments that this study indicates systemic therapy as the mainstay treatment for woman with newly diagnosed advanced disease and a tumor in the breast.

In triple-negative breast cancer, Dr. Burstein highlights two studies. The KEYNOTE-355 study validates the addition of a checkpoint inhibitor in first-line therapy in women whose tumors are PD-L1 positive. The intriguing results of the SWOG S1416 trial, Dr. Burstein comments, suggest the use of PARP inhibition may extend beyond BRCA1 and BRCA2 breast cancers.

In HER2-positive breast cancer, an update of the HER2CLIMB study indicates that the combination of tucatinib, trastuzumab, and capecitabine continues to benefit women with HER2-positive disease. Dr. Burstein expects this combination will be a new standard of care, particularly in women with brain metastases.

As for ER-positive breast cancer, Dr. Burstein reviews the BYLieve trial. Results of this study suggest alpelisib has activity in women with a PIK3CA mutation who have already received a CDK4/6 inhibitor.


Harold J. Burstein, Md, PhD

Professor, Department of Medicine, Harvard Medical School; Institute Physician, Dana-Farber Cancer Institute, Boston, Massachusetts. Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships.

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Key findings in metastatic breast cancer, presented at the ASCO 2020 Virtual Annual Meeting, ranged across all tumor subtypes.

Arguably, the top news in breast cancer was a plenary presentation addressing the role of locoregional therapy in advanced disease. Dr. Harold Burstein, of Dana-Farber Cancer Institute, comments that this study indicates systemic therapy as the mainstay treatment for woman with newly diagnosed advanced disease and a tumor in the breast.

In triple-negative breast cancer, Dr. Burstein highlights two studies. The KEYNOTE-355 study validates the addition of a checkpoint inhibitor in first-line therapy in women whose tumors are PD-L1 positive. The intriguing results of the SWOG S1416 trial, Dr. Burstein comments, suggest the use of PARP inhibition may extend beyond BRCA1 and BRCA2 breast cancers.

In HER2-positive breast cancer, an update of the HER2CLIMB study indicates that the combination of tucatinib, trastuzumab, and capecitabine continues to benefit women with HER2-positive disease. Dr. Burstein expects this combination will be a new standard of care, particularly in women with brain metastases.

As for ER-positive breast cancer, Dr. Burstein reviews the BYLieve trial. Results of this study suggest alpelisib has activity in women with a PIK3CA mutation who have already received a CDK4/6 inhibitor.


Harold J. Burstein, Md, PhD

Professor, Department of Medicine, Harvard Medical School; Institute Physician, Dana-Farber Cancer Institute, Boston, Massachusetts. Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships.

Key findings in metastatic breast cancer, presented at the ASCO 2020 Virtual Annual Meeting, ranged across all tumor subtypes.

Arguably, the top news in breast cancer was a plenary presentation addressing the role of locoregional therapy in advanced disease. Dr. Harold Burstein, of Dana-Farber Cancer Institute, comments that this study indicates systemic therapy as the mainstay treatment for woman with newly diagnosed advanced disease and a tumor in the breast.

In triple-negative breast cancer, Dr. Burstein highlights two studies. The KEYNOTE-355 study validates the addition of a checkpoint inhibitor in first-line therapy in women whose tumors are PD-L1 positive. The intriguing results of the SWOG S1416 trial, Dr. Burstein comments, suggest the use of PARP inhibition may extend beyond BRCA1 and BRCA2 breast cancers.

In HER2-positive breast cancer, an update of the HER2CLIMB study indicates that the combination of tucatinib, trastuzumab, and capecitabine continues to benefit women with HER2-positive disease. Dr. Burstein expects this combination will be a new standard of care, particularly in women with brain metastases.

As for ER-positive breast cancer, Dr. Burstein reviews the BYLieve trial. Results of this study suggest alpelisib has activity in women with a PIK3CA mutation who have already received a CDK4/6 inhibitor.


Harold J. Burstein, Md, PhD

Professor, Department of Medicine, Harvard Medical School; Institute Physician, Dana-Farber Cancer Institute, Boston, Massachusetts. Harold J. Burstein, MD, PhD, has disclosed no relevant financial relationships.

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