Four Interesting Reviews You May Have Missed

  • Checkpoint Blockade for Breast Cancer. In recent years immunotherapy with immune checkpoint inhibitors has become standard of care for several hard-to-treat cancers. Breast cancer was initially considered a nonimmunogenic tumor, but recent evidence of the prognostic/predictive role of the immune system has led to the investigation of immunotherapeutic strategies. In this interesting article, the authors review data from early-phase clinical trials investigating immune checkpoint blockade as a treatment for breast cancer, noting that this approach is particularly effective in triple-negative breast cancer. The authors highlight the most recent results for both monotherapy and combination approaches and discuss potential future developments, including promising combinations and the need to identify reliable biomarkers for patient selection. ESMO Open. 2017;2(5):e000255.
  • Management of Gastric Neuroendocrine Tumors. The management of gastric neuroendocrine tumors (NETs) has changed significantly in recent years with the emergence of novel targeted therapies and new World Health Organization (WHO) classification. In this review, the authors review recent developments and highlight best practices for diagnosis, classification, and multidisciplinary treatment of types I, II, and III gastric NETs. Gastrointestinal Cancer Targ Ther. 2017;7:31-37.
  • New Guideline on Stereotactic Body Radiotherapy for Early-Stage NSCLC. The American Society for Clinical Oncology (ASCO) has endorsed the new guidelines for stereotactic body radiotherapy (SBRT) for early-stage non-small cell lung cancer (NSCLC) issued by the American Society for Radiation Oncology (ASTRO) with some minor modifications to better clarify certain recommendations for a broader audience. The guidelines discuss when to consider SBRT for operable and inoperable patients and how can SBRT techniques be individually tailored in high risk-clinical scenarios, such as patients with centrally located tumors, tumors >5 cm, synchronous multiple primary tumors, tumors abutting the chest wall, and those involved with mediastinal structures. The role of SBRT as salvage therapy for recurrent lung cancer is also discussed. In addition, the importance of shared decision making between multidisciplinary team physicians, patients, and families is emphasized. J Clin Oncol. 2017 Nov 6 [Epub ahead of print].
  • Advances in the Management of Relapsed/Refractory Multiple Myeloma. Recent years have witnessed a rapid evolution in the management of relapsed/refractory multiple myeloma, and novel agents continue to emerge at a staggering pace. In addition to second-generation and third-generation immunomodulatory agents (lenalidomide, pomalidomide) and next generation proteasome inhibitors (carfilzomib and ixazomib), pan-histone deacetylase inhibitors (panobinostat), monoclonal antibodies (elotuzumab and daratumumab), new targeted therapies (venetoclax, selinexor), and novel immunotherapies (immune checkpoint inhibitors, chimeric antigen receptor modified T [CAR-T] cells) have emerged for relapsed myeloma treatment. While these treatments continue to improve outcomes in the salvage setting, identifying best treatment combinations and sequences is becoming increasingly challenging. In this important article, the authors review the current state of the art of relapsed/refractory myeloma treatment, cautiously interpret data of recent randomized trials, and evaluate how novel treatments can be best incorporated into the current treatment paradigm. Finally, authors also discuss the role of salvage autologous stem cell transplantation as a consolidation to prolong progression-free survival and overall survival. Leukemia. 2017 Nov 16 [Epub ahead of print].


Clinical Opinion Poll

How would you treat 52 y/o fit woman with HER2+/HR- breast cancer with progression in lung and CNS (multiple mets) 1 yr after adjuvant pertuzumab/trastuzumab/chemo?