A Collection of Hematology & Oncology Articles
The practice of oncology and hematology is in constant evolution. These articles highlight some of the most notable advancements and discoveries in the modern medical world. We invite you to use this site frequently and collaborate with medical professionals across the globe.
Welcome
At Florida Cancer Specialists & Research Institute (FCS), our physicians and advanced practice providers are deeply vested in clinical research to provide the most cutting-edge treatment options available to our patients. In our own practices we are fortunate to offer over 300 clinical trials across 37 locations including 3 dedicated Phase 1 Drug Development Units. We value every opportunity to share best practices and the latest research both within and outside of our institution. We welcome you to use this collection as a resource to support your own research and understanding as we strive together to advance cancer care one step at a time.
Recent Articles
Plasma Proteome–Based Test for First-Line Treatment Selection in Metastatic Non–Small Cell Lung Cancer
FCS medical oncologist and hematologist Ernesto Bustinza-Linares, MD has co-authored an abstract published in the American Society of Clinical Oncology Journal, JCO Precision Oncology, that uncovers a new testing method to determine personalized care options for patients with metastatic non-small cell lung cancer (NSCLC). The abstract’s authors address the limitations of existing guidelines that recommend checkpoint immunotherapy, sometimes in combination with chemotherapy, for treating NSCLC, which often discounts patient variability and immune factors. The findings from the study show that by incorporating additional plasma proteome-based testing, combined with the standard protein inhibitor testing, clear differences in patient outcomes were observed after applying targeted treatments based on the testing results.
Randomized, Double-Blind Phase III Study of Pazopanib Versus Placebo in Patients With Metastatic Renal Cell Carcinoma Who Have No Evidence of Disease After Metastasectomy: ECOG-ACRIN E2810
Adjuvant therapy with pazopanib after metastesectomy for met-ccRCC did not show a meaningful benefit. It seems that the current standard is for adjuvant pembro after metastesectomy within a year of nephrectomy.
PACE: A Randomized Phase II Study of Fulvestrant, Palbociclib, and Avelumab After Progression on Cyclin-Dependent Kinase 4/6 Inhibitor and Aromatase Inhibitor for Hormone Receptor–Positive/Human Epidermal Growth Factor Receptor–Negative Metastatic Breast Cancer
Findings from the PACE study show that the addition of Palbociclib to Fulvestrant was not better than Fulvestrant alone, and the addition of Avelumab to Fulvestrant improved and nearly doubled the PFS. This is compelling and should be studied further for our patients with HR+ HER2- MBC.
Trastuzumab Plus Gemcitabine-Cisplatin for Treatment-Naïve Human Epidermal Growth Factor Receptor 2–Positive Biliary Tract Adenocarcinoma: A Multicenter, Open-Label, Phase II Study (TAB)
HER2 is a target we should be considering in BTC’s starting in the first line. The overall response rates were 80% with 55% having a CR/PR. Interestingly it seems HER2 is much more prevalent in GBC compared to cholangio’s, at least in this study.
Enfortumab Vedotin and Pembrolizumab in Untreated Advanced Urothelial Cancer
This antibody doublet is essentially the new SOC in met-urothelial cancer. The anti-PD1 and ADC combination is compelling in many ways and the survival outcomes compared to chemo were very significant. This combination is on NCCN, as well.
Hypoxia-Directed Treatment of Human Papillomavirus–Related Oropharyngeal Carcinoma
Interesting study where HPV+ head/neck cancer patients were assessed with a unique PET/CT with F-fluoromisonidazole, which assesses hypoxia in tissue. If, after two weeks of chemoradiation, the tumor became hypoxic, the patients were allowed to have chemotherapy alone while nonresponders went on to complete chemoradiation. At two years of follow-up, both arms were equivalent. There is more and more interest in how to safely de-escalate HPV+ head/neck cancer patients, but still, none have shown this can be done without compromising outcomes; this may be worth following to see if this works out.
Cemiplimab for Kidney Transplant Recipients With Advanced Cutaneous Squamous Cell Carcinoma
Granted, this is a small study of 12 patients, it is nice to see an official report indicating safety regarding the use of CPI in the setting of advanced cutaneous SCC’s secondary to chronic immunosuppressive therapy after renal transplant. Patients were treated with steroids and rapamycin before/after the cemiplimab infusions, and no patients had rejection events.
Oral Iptacopan Monotherapy in Paroxysmal Nocturnal Hemoglobinuria
Rare disease but nice to have an effective oral treatment option for PNH. Iptacopan, a first-in-class oral factor B inhibitor, has shown to improve Hb by >2g in the vast majority of patients in two studies discussed here.
FCS Physician Focus
Plasma Proteome–Based Test for First-Line Treatment Selection in Metastatic Non–Small Cell Lung Cancer
FCS medical oncologist and hematologist Ernesto Bustinza-Linares, MD has co-authored an abstract published in the American Society of Clinical Oncology Journal, JCO Precision Oncology, that uncovers a new testing method to determine personalized care options for patients with metastatic non-small cell lung cancer (NSCLC). The abstract’s authors address the limitations of existing guidelines that recommend checkpoint immunotherapy, sometimes in combination with chemotherapy, for treating NSCLC, which often discounts patient variability and immune factors. The findings from the study show that by incorporating additional plasma proteome-based testing, combined with the standard protein inhibitor testing, clear differences in patient outcomes were observed after applying targeted treatments based on the testing results.
Florida Cancer Specialists & Research Institute
