Phoebe Starr


Authored Items

Healthcare Providers and Underserved Populations Need Information About Clinical Trials and Biobanking

June 2018, Vol 8, No 6 - Health Disparities

People from lower socioeconomic backgrounds, minority groups, and rural areas are not well-represented in clinical trials and biobanking, which hampers research on health disparities. Patients in these subgroups are willing to enroll in clinical trials, but they are often not asked to participate, and neither they nor their healthcare providers are well-informed about this important research. [ Read More ]

A Home Run for Pembrolizumab plus Chemotherapy Combination in Newly Diagnosed Metastatic Non–Small-Cell Lung Cancer

June 2018, Vol 8, No 6 - Lung Cancer

A burning question is whether immunotherapy combinations will further improve outcomes compared with checkpoint inhibitor therapy alone—and if so, which combinations will rise to the top. Combining pembrolizumab (Key­truda) with standard pemetrexed (Alimta) plus a platinum-based chemotherapy improved overall survival (OS) versus chemotherapy alone as first-line therapy for patients with metastatic nonsquamous non–small-cell lung cancer (NSCLC) in KEYNOTE-189, a phase 3 clinical trial. The survival benefit with pembroliz­umab plus chemotherapy was independent of PD-L1 expression. [ Read More ]

High Tumor Mutational Burden Predicts Response to Nivolumab plus Ipilimumab Combination in Lung Cancer

June 2018, Vol 8, No 6 - Lung Cancer

The combination of nivolumab (Opdivo) plus ipilimumab (Yervoy) extended progression-free survival (PFS) versus standard chemotherapy as first-line treatment for patients with advanced non–small-cell lung cancer (NSCLC) and a high tumor mutational burden (TMB). This finding was unrelated to levels of PD-L1 expression, said Matthew D. Hellmann, MD, Medical Oncologist, Memorial Sloan Kettering Cancer Center, New York City. [ Read More ]

Acquired HER2 Mutations in Metastatic Breast Cancer Confer Resistance to ER-Directed Therapy

June 2018, Vol 8, No 6 - Breast Cancer

Metastatic estrogen receptor (ER)-positive breast cancer responds well to anti-ER therapies, but eventually resistance occurs and the drugs fail to work. A new study presented at the 2018 AACR meeting suggests that HER2 mutations can be acquired during metastatic cancer and their development represents a previously unreported mechanism of resistance to treatment. This resistance can be overcome by the irreversible HER2 inhibitor neratinib (Nerlynx). [ Read More ]

Adjuvant Chemotherapy in Upper-Tract Urothelial Cancer Shows Impressive Gains in the POUT Trial

April 2018, Vol 8, No 4 - GU Cancers Symposium Highlights, Urothelial Cancer

Adjuvant chemotherapy had impressive gains in disease-free survival (DFS) and metastasis-free survival versus surveillance in upper-tract urothelial cancer (UTUC), according to the results of the phase 3 POUT clinical trial that were presented at the 2018 Genitourinary Cancers Symposium. There was a suggestion of a survival gain with chemotherapy, but longer follow-up is needed. [ Read More ]

Immune Checkpoint Inhibitor plus VEGFR Inhibitor Combo Outperforms Sunitinib in Renal-Cell Carcinoma

April 2018, Vol 8, No 4 - GU Cancers Symposium Highlights, Renal-Cell Carcinoma

Progression-free survival (PFS) was extended by 3.5 months with first-line atezolizumab (Tecentriq) plus bevacizumab (Avastin) in patients with metastatic renal-cell carcinoma (RCC) versus standard-of-care sunitinib (Sutent) in the phase 3 IMmotion151 clinical trial presented at the 2018 Genitourinary Cancers Symposium. The PFS benefit of the combination of an immune checkpoint inhibitor and a vascular endothelial growth factor receptor (VEGFR) inhibitor was longer in patients with PD-L1–positive tumors. In addition, atezolizumab plus bevacizumab had an improved side-effect profile versus sunitinib. [ Read More ]

Apalutamide and Enzalutamide Each Delays Prostate Cancer Metastasis by Approximately 2 Years

April 2018, Vol 8, No 4 - GU Cancers Symposium Highlights, Prostate Cancer

In 2 separate studies, apalutamide (Erleada) and enzalutamide (Xtandi) reduced the risk for metastasis and prolonged metastasis-­free survival in patients with nonmetastatic castrate-resistant prostate cancer (CRPC), according to the results of 2 clinical trials presented at the 2018 Genitourinary Cancers Symposium. [ Read More ]

A New Combination as First-Line Regimen in Advanced Hodgkin Lymphoma?

March 2018, Vol 8, No 3 - Hematologic Malignancies

Adding brentuximab vedotin (Adcetris) to doxorubicin, vinblastine, and dacarbazine (A+AVD) instead of the standard regimen with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) as frontline treatment for advanced Hodgkin lymphoma reduced the risk for disease progression, death, or the need for additional therapy by 23%, according to new data presented at ASH 2017. [ Read More ]

Venetoclax plus Rituximab New Chemotherapy-Free Option for Chronic Lymphocytic Leukemia

March 2018, Vol 8, No 3 - Hematologic Malignancies

Venetoclax (Venclexta) plus rituximab (Rituxan) achieved superior progression-free survival (PFS) and overall survival (OS) compared with standard-of-care bendamustine (Treanda/Bendeka) plus rituximab in patients with relapsed or refractory chronic lymphocytic leukemia (CLL). PFS improved by 81% and OS by 52% with venetoclax plus rituximab, and the depth of response was impressive—complete response and complete response with incomplete platelet recovery was 26.8%, and minimal residual disease negativity in peripheral blood was 83.5%. [ Read More ]

Direct Oral Anticoagulants: New Standard of Care for VTE in Patients with Cancer?

March 2018, Vol 8, No 3 - Side-Effects Management

Direct oral anticoagulants (DOACs) may soon replace low-molecular-weight heparin (LMWH) as the standard of care for the management of venous thromboembolism (VTE) in patients with cancer, judging by the results of 2 randomized trials presented at ASH 2017. The caveat is that DOACs are associated with more bleeding events, especially in patients with gastrointestinal (GI) cancer who should continue receiving LMWH. [ Read More ]

CAR T-Cell Therapy Makes Significant Inroads in Lymphoma: Kymriah and Yescarta Show Durable Remissions

February 2018, Vol 8, No 2 - ASH 2017 Highlights, Hematologic Malignancies, Lymphoma

The data for CD19-directed chimeric antigen receptor (CAR) T-cell therapy continue to show excellent and durable responses in patients with lymphoma who have no other treatment options. Two studies presented at ASH 2017 provide encouraging news for 2 new drugs, including long-term follow-up of the pivotal ZUMA-1 study of the CAR T-cell therapy axicabtagene ciloleucel (Yescarta), and primary results from the JULIET study of tisagenlecleucel (Kymriah). [ Read More ]

Psychological Distress in Patients with Cancer Warrants Attention

December 2017, Vol 7, No 12 - Supportive Care

San Diego, CA—The National Comprehensive Cancer Network (NCCN) estimates that at least 33% of patients with cancer have significant psychological distress, and many patients have some levels of distress. High levels of distress are associated with negative outcomes from cancer treatment. The psychological well-­being of patients with cancer has been less well-studied than the effects of treatments, but recently, more attention is focused on the “whole patient.” [ Read More ]

Ramucirumab plus Docetaxel Superior to Docetaxel Monotherapy in Platinum-Refractory Advanced Urothelial Cancer

December 2017, Vol 7, No 12 - ESMO Highlights, Urothelial Cancer

Ramucirumab (Cyramza), a vascular endothelial growth factor receptor 2 inhibitor, added to docetaxel improved progression-free survival (PFS) and nearly doubled the objective response rate (ORR) compared with docetaxel monotherapy in patients with advanced or metastatic urothelial cancer that progressed with platinum-based chemotherapy in the phase 3 RANGE clinical trial. This is the first phase 3 clinical trial to show a PFS advantage over chemotherapy alone in this setting. Lead investigator Daniel P. Petrylak, MD, Professor of Medicine and of Urol­ogy, Yale School of Medicine and Yale Cancer Center, New Haven, CT, presented the results at the 2017 European Society for Medical Oncology (ESMO) Congress. [ Read More ]

Taselisib, a PI3K Inhibitor, Shrinks Tumors in Early Breast Cancer, with Added Activity in Patients with PI3KCA Mutation

December 2017, Vol 7, No 12 - Breast Cancer, ESMO Highlights

For the first time, a randomized clinical trial has shown significant tumor shrinkage with a phosphoinositide-3-kinase (PI3K) inhibitor in patients with estrogen receptor (ER)-positive, HER2-negative early breast cancer. The phase 3 study LORELEI compared neoadjuvant therapy with letrozole plus placebo versus letrozole plus taselisib, a PI3K inhibitor, in this patient population. [ Read More ]

MONARCH 3: Adding Abemaciclib to an Aromatase Inhibitor Improves Outcomes in Metastatic Breast Cancer

December 2017, Vol 7, No 12 - Breast Cancer, ESMO Highlights

The addition of the cyclin-dependent kinase (CDK)4/CDK6 inhibitor abemaciclib (Verzenio) to an aromatase inhibitor improved progression-free survival (PFS) over aromatase inhibitor monotherapy in women with hormone receptor (HR)-positive, HER2-­negative advanced breast cancer, according to an interim analysis of the phase 3 MONARCH 3 clinical trial presented at the 2017 European Society for Medical Oncology (ESMO) Congress. The study was also re­cently published in the Journal of Clinical Oncology. [ Read More ]

Rucaparib Maintenance Extends Survival in Platinum-Sensitive Ovarian Cancer

November 2017, Vol 7, No 11 - ESMO Highlights, Ovarian Cancer

Madrid, Spain—Maintenance therapy with the poly ADP-ribose polymerase (PARP) inhibitor rucaparib (Rubraca) after response to platinum-containing therapy significantly improved progression-free survival (PFS) by 11.2 months in patients with recurrent ovarian cancer compared with placebo, according to overall results of the ARIEL3 trial. The study was presented at the 2017 European Society for Medical Oncology (ESMO) Congress. [ Read More ]

Practice-Changing: Nivolumab plus Ipilimumab Beat Sunitinib as First-Line Treatment for Metastatic RCC

November 2017, Vol 7, No 11 - ESMO Highlights, Renal-Cell Carcinoma

Madrid, Spain—The combination of nivolumab (Opdivo) plus ipilimu­mab (Yervoy) improved overall response rates (ORRs), progression-free survival (PFS), and overall survival (OS) in patients with intermediate- and poor-risk metastatic renal-cell carcinoma (RCC) compared with sunitinib in the CheckMate-214 study. These results were presented at the 2017 European Society for Medical Oncology Congress. [ Read More ]

Regular CT Scans for NSCLC Follow-Up May Not Be Necessary

November 2017, Vol 7, No 11 - ESMO Highlights, Lung Cancer

Madrid, Spain—Findings from a randomized clinical trial suggest that follow-up computed tomography (CT) scans in patients with fully resected non–small-cell lung cancer (NSCLC) may not be needed every 3 to 6 months in the first 2 years after surgery. Results of the IFCT-0302 study were presented at the 2017 European Society for Medical Oncology (ESMO) Congress, showing no significant difference in overall survival (OS) among patients who had CT scans as part of their follow-up versus those who did not. [ Read More ]

Potentially Practice-Changing Results: PD-L1 Inhibitor for Unresectable, Stage III Lung Cancer

October 2017, Vol 7, No 10 - Lung Cancer

Madrid, Spain—Durvalumab (Imfinzi), a PD-L1 inhibitor, improved progression-free survival (PFS) by 11.2 months compared with placebo in patients with locally advanced, unresectable stage III non–small-cell lung cancer (NSCLC) that did not progress after standard treatment with chemoradiotherapy. These results—presented at the 2017 European Society for Medical Oncology (ESMO) Congress—come from PACIFIC, the first phase 3 clinical trial of a PD-L1 inhibitor in patients with locally advanced NSCLC outside of the metastatic setting. [ Read More ]

Novel Drug “Home Run” for TRK Mutation–Positive Tumors

August 2017, Vol 7, No 8: Special Edition – Highlights from ASCO 2017 - Clinical Highlights

Chicago, IL—Larotrectinib (LOXO-101), an investigational agent that targets tropomyosin receptor kinase (TRK) fusions, has demonstrated excellent, consistent, and durable antitumor activity in a range of tumor types in adults and children, reported lead investigator David M. Hyman, MD, Chief, Early Drug Development Service, Memorial Sloan Kettering Cancer Center, New York City, at the 2017 ASCO annual meeting. Larotrectinib was called “the first oral tumor-agnostic therapy,” because of its unprecedented high response rates in 17 tumor types that express TRK. [ Read More ]

Rising Costs of Cancer Drugs Explored

August 2017, Vol 7, No 8 - Value-Based Care

San Antonio, TX—The cost of cancer drugs has increased exponentially over the past decade, straining the healthcare system and patients’ ability to pay for them. Cancer treatments that cost $150,000 or more are not unusual in the United States. Pharmaceutical manufacturers continue to increase drug prices through packaging maneuvers and the use of artificial expiration dates, and as a result, some old drugs “in new clothing” remain expensive. [ Read More ]

Novel Assay Provides 100 Times More Information than Current Liquid Biopsies for Early Cancer Detection

July 2017, Vol 7, No 7 - ASCO 2017 Highlights

Chicago, IL—A new high-intensity genomic sequencing strategy (developed by Grail Inc) detects circulating tumor DNA (ctDNA) at a high rate. The new approach is a major improvement on previous tests using ctDNA, which focus on a limited number of driver mutations to inform treatment strategies for metastatic disease or to monitor disease burden. The new test offers ultra-deep sequencing with a broad genomic coverage, but it is not ready for prime time to detect occult cancer. At present, the test is a research platform and is not commercially available. [ Read More ]

Adding Indoximod to Pembrolizumab Boosts Immune Response in Melanoma

June 2017, Vol 7, No 6 - Immunotherapy

Washington, DC—Adding the investigational drug indoximod, an indole­amine 2,3-dioxygenase (IDO) pathway inhibitor, to the checkpoint inhibitor pembrolizumab (Keytruda) led to higher response rates in patients with advanced melanoma than what is reported with pembrolizumab monotherapy, said lead investigator Yousef Zakharia, MD, Clinical Assistant Professor of Internal Medicine, Division of Hema­tology, Oncology and Blood and Marrow Transplantation, University of Iowa, Iowa City, at the 2017 American Association for Cancer Research meeting. [ Read More ]

Excellent Responses to Atezolizumab in Small Subset of Women with Triple-Negative Breast Cancer

May 2017, Vol 7, No 5 - AACR 2017 Highlights, Breast Cancer

Washington, DC—Preliminary data show excellent and durable responses to atezolizumab (Tecentriq) in 10% of women with triple-negative breast cancer, one of the most aggressive and difficult-to-treat cancers. Of the responders to atezolizumab, 100% were alive at 1 year compared with only 38% of nonresponders. The trick will be to identify which women will respond to immune checkpoint inhibitor therapy. Thus far, no biomarkers for response have been identified. [ Read More ]

Longest Follow-Up in Patients with NSCLC Who Responded to Immunotherapy with Nivolumab

May 2017, Vol 7, No 5 - AACR 2017 Highlights

Washington, DC—In the longest follow-up on single-agent nivolumab (Opdivo) to date, 5-year overall survival was 16% in patients with advanced non–small-cell lung cancer (NSCLC) in the updated results of a phase 1b dose-ranging study (CA209-003). This represents a quadrupling of 5-year overall survival with standard platinum doublets, which is approximately 4% for patients with metastatic NSCLC. [ Read More ]

Pacritinib Shows Good Efficacy in Myelofibrosis: Will the FDA Release Hold on the Drug?

March 2017, Vol 7, No 3 - Emerging Therapies

The investigational drug pacritinib, a JAK1/JAK2 inhibitor, achieved benefits in patients with myelofibrosis, including a significant reduction in the spleen volume compared with the best available therapy that included the JAK1/JAK2 inhibitor ruxolitinib (Jakafi), according to the phase 3 PERSIST-2 clinical trial. The results were presented by John O. Mascarenhas, MD, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, at the 2016 American Society of Hematology (ASH) meeting. [ Read More ]

Abemaciclib, a CDK4/CDK6 Inhibitor, Shows Promise in Early-Stage Breast Cancer

March 2017, Vol 7, No 3 - Breast Cancer

Neoadjuvant therapy with the investigational CDK4/CDK6 inhibitor, abemaciclib, alone or in combination with anastrozole (Arimidex) showed promising activity in postmenopausal hormone receptor (HR)-positive, HER2-negative breast cancer enrolled in the phase 2 NeoMONARCH study. Correlative tissue studies demonstrated that abemaciclib inhibited cell-cycle proliferation and activated the immune system, supporting its anticancer activity. [ Read More ]

Benefit of Extended Adjuvant Aromatase Inhibition in Breast Cancer Questionable

March 2017, Vol 7, No 3 - Breast Cancer

Extended adjuvant endocrine therapy beyond 5 years with an aromatase inhibitor (AI) failed to improve disease-free survival (DFS) in patients with hormone receptor (HR)-positive breast cancer who were enrolled in the 3 large National Surgical Adjuvant Breast and Bowel Project (NSABP) B-52, IDEAL, and DATA studies, which were presented at the 2016 San Antonio Breast Cancer Symposium. [ Read More ]

Obinutuzumab Prolongs Survival in Follicular Lymphoma

February 2017, Vol 7, No 2 - ASH 2016 Highlights

Obinutuzumab (Gazyva)-based induction and maintenance chemotherapy extended progression-free survival (PFS) compared with standard-of-care rituximab (Ritux­an)-based chemotherapy in patients with untreated follicular lymphoma, said Robert E. Marcus, MBBS, FRCP, FRCPath, King’s College Hospital, London, who presented the results from the phase 3 GALLIUM clinical trial at the 2016 American Society of Hematology meeting. [ Read More ]

CAR T-Cell Therapy Succeeds in Aggressive Lymphoma

February 2017, Vol 7, No 2 - ASH 2016 Highlights, Hematologic Malignancies, Lymphoma

The investigational chimeric antigen receptor (CAR) T-cell therapy KTE-C19 achieved complete responses that were durable for >1 year in more than 75% of patients with aggressive lymphomas who had no other effective treatment options, according to results from the phase 2 pivotal clinical trial ZUMA-1 that were presented by Sattva S. Neelapu, MD, Department of Lymphoma/Myeloma, M.D. Anderson Cancer Center, at the 2016 American Society of Hematology meeting. [ Read More ]

Strategies to Reduce the Use of Tyrosine Kinase Inhibitors in Chronic Myeloid Leukemia

February 2017, Vol 7, No 2 - ASH 2016 Highlights

Although tyrosine kinase inhibitors (TKIs), including imatinib (Gleevec), nilotinib (Tasigna), and dasatinib (Sprycel), have dramatically improved outcomes in patients with chronic myeloid leukemia (CML), the costs of these drugs have spiraled out of control, causing some patients to stop treatment or cut their dosage because of financial toxicity. Data presented at the 2016 American Society of Hematology meeting show that it is possible for some patients with CML to reduce their TKI dose by 50% and maintain remission, perhaps even stop treatment altogether once deep and durable remission has been achieved after approximately 5 years of treatment. [ Read More ]

R-CHOP Prevails Over Dose-Adjusted EPOCH-R as Standard of Care for Diffuse Large B-Cell Lymphoma

February 2017, Vol 7, No 2 - ASH 2016 Highlights

The CALGB/Alliance 50303 clinical trial failed to show that dose-adjusted treatment with the EPOCH-R (etoposide, phosphate, prednisone, vincristine sulfate, cyclophosphamide, doxorubicin hydrochloride, and rituximab) regimen was superior to standard therapy with R-CHOP (rituximab, cyclophosphamide, doxorubicin hydrochloride, vincristine sulfate, and prednisone) in patients with diffuse large B-cell lymphoma (DLBCL). Both treatment regimens were equally effective for event-free survival and overall survival (OS), but dose-adjusted [ Read More ]