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Niraparib and Pembrolizumab for Breast Cancer
Poly(adenosine diphosphate-ribose) polymerase inhibitor and anti–programmed death receptor 1 therapy have limited clinical activity for advanced triple-negative breast cancer (TNBC). Vinayak et al conducted a phase 2 study of niraparib plus pembrolizumab to assess its clinical activity and safety in patients with advanced or metastatic TNBC. Results showed more responses in patients with BRCA mutations than in those with wild-type tumors. Odunsi and Pejovic provide an Editorial.
Editorial and Related Article
Birth Defects and Cancer Risk in Children
Some birth defects are strongly associated with childhood cancer, but comprehensive evaluation of childhood cancer risk has been limited. Lupo et al performed a multistate, population-based, registry linkage study to identify birth defect–childhood cancer associations. Results showed that the number of birth defects diagnosed was directly associated with cancer risk in children with nonchromosomal birth defects. These findings may guide cancer screening in children with birth defects. Spector and Olshan provide an Editorial.
Afatinib vs Placebo After CRT in HNSCC
Locoregionally advanced head and neck squamous cell cancer (HNSCC) is treated curatively; however, risk of recurrence remains high among some patients. Burtness et al performed a phase 3, double-blind clinical trial to assess whether afatinib administered after chemoradiotherapy (CRT) would improve disease-free survival (DFS) in patients with HNSCC. Results showed that afatinib after CRT did not improve DFS and was associated with more adverse events than placebo.
Lapatinib for Gastroesophageal Cancer
The use of anti–human epidermal growth factor receptor 2 (HER2) therapy as an adjuvant regimen in patients with curable HER2-positive advanced gastroesophageal cancer has not yet been examined. Smyth et al conducted a phase 2, open-label trial to assess the safety of adding lapatinib to epirubicin, cisplatin, and capecitabine chemotherapy. Results showed that lapatinib administration was feasible and did not compromise operative management; however, the toxic effects exceeded predefined acceptable parameters.
Predicting Response to Checkpoint Blockade
Biomarker assays have been used to predict response to programmed cell death 1 (PD-1)/programmed cell death ligand 1 (PD-L1) checkpoint blockade, but relative diagnostic performance of the assays has not been established. Lu et al conducted a meta-analysis to study the diagnostic accuracy of 4 biomarker assays in predicting clinical response to anti–PD 1/PD-L1 therapies. Results showed that all assays had comparable negative predictive values, but multiplex immunohistochemistry/immunofluorescence had a higher positive predictive value than the other assays.
Continuing Medical Education
Highlights. JAMA Oncol. 2019;5(8):1081. doi:10.1001/jamaoncol.2018.4773
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