Author: Editor

Julie Brahmer, MD of Johns Hopkins Kimmel Comprehensive Cancer Center gives an overview of some of the presentations that were discussed at AACR 2017. She states that these presentations range from Merkel Cell Carcinoma to Immunotherapy for Breast Cancer and Melanoma. This was recorded at the American Association for Cancer Research (AACR) 2017 Annual Meeting in Washington, DC.

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Peter Albers, MD, from the Heinrich-Heine-University Düsseldorf, Germany, explains that there is a big debate on whether robots should be used for surgical procedures at the European Association of Urology (EAU) conference 2017 in London, UK. Prof. Albers highlights that the complications which are seen are different compared to open surgery, however there are great visibility advantages of robot-assisted surgery. Prof. Albers points out that there is a lack of data comparing in detail robotic and open surgery. Aspects which need to be considered when comparing robotic and open surgery include familiar parameters, such as rate of positive margins, time…

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Thomas Powles, MBBS, MRCP, MD, from the Barts Cancer Institute, London, UK, discusses how checkpoint inhibitors can be used earlier in bladder cancer at the European Association of Urology (EAU) conference 2017 in London, UK. He explains that the current focus of immune checkpoint inhibitors in bladder cancer is in the advanced or metastatic stage. However, according to Prof. Powles, the bigger picture involves bringing these drugs into earlier disease stages. He speaks about checkpoint inhibitors which are being trialed in an adjuvant setting (CheckMate 274, NCT02632409; IMvigor010, NCT02450331) and neoadjuvant setting (NCT02451423). Prof. Powles concludes that the story of…

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Thomas Powles, MBBS, MRCP, MD, from the Barts Cancer Institute, London, UK, gives an overview of the use of checkpoint inhibitors in metastatic urothelial bladder cancer at the European Association of Urology (EAU) conference 2017 in London, UK. He explains that the differences seen clinically with immune checkpoint inhibitor treatment, and speaks about recent clinical trial results. According to Prof. Powles, one of the next key questions which needs to be addressed is whether frontline randomized Phase III studies show improved outcomes with immunotherapy compared to chemotherapy in bladder cancer. Whether biomarkers will be important for this also needs to…

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Susanne Osanto, MD, PhD, from the Leiden University Medical Center, Leiden, Netherlands, discusses the current landscape and future direction of systemic therapy for renal cell carcinoma (RCC) at the European Association of Urology (EAU) conference 2017 in London, UK. She highlights that impressive developments have been seen in metastatic kidney cancer. She describes results from a randomized Phase II study using a combination of lenvatinib and everolimus (NCT01136733), as well as the CheckMate 025 Phase III randomized trial (NCT01668784) and Phase III METEOR trial (NCT01865747) comparing everolimus with cabozantini. According to Prof. Osanto, recent trials have revolutionized the treatment of…

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Susanne Osanto, MD, PhD, from the Leiden University Medical Center, Leiden, Netherlands, discusses the clinical implications of circulating tumor cell (CTC) analysis in prostate cancer at the European Association of Urology (EAU) conference 2017 in London, UK. She argues that for patients with localized prostate cancer, there is currently no evidence that circulating tumor cells can be used in a clinical setting to monitor disease or treatment outcomes. In contrast, in patients with a higher tumor load, such as those with castration-resistant prostate cancer (CRPC) who need to undergo system treatment or in whom we know that treatment resistance has…

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Susanne Osanto, MD, PhD, from the Leiden University Medical Center, Leiden, Netherlands, discusses the clinical utility of circulating tumor cells (CTCs) at the European Association of Urology (EAU) conference 2017 in London, UK. She argues that this is a very powerful approach, which allows patients with metastatic disease to be tested for disease presence and the number of circulating cells, as well as the characteristics of the tumor cells. Prof. Osanto explains how circulating tumor cells can be molecularly profiled at a single-cell level.

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Rong Na, MD, from the Huashan Hospital, Fudan University, Shanghai, China discusses germline mutations in prostate cancer at the European Association of Urology (EAU) conference 2017 in London, UK. He introduces a study whose aim was to evaluate the association between germline mutations in DNA repair genes and the risk of prostate cancer, which evaluated the rate of carriers in lethal and indolent prostate cancer patients, as well as survival time. Dr Rong Na also discusses the next steps in this study.

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Peter Albers, MD, from the Heinrich-Heine-University Düsseldorf, Germany, discusses which factors are important to consider in surgical robots at the European Association of Urology (EAU) conference 2017 in London, UK. He highlights the advantages presented by robot-assisted surgery and points out new imaging technologies which are only possible in laparoscopic or robot-assisted surgery. Prof. Albers argues that the future of surgery will be in a minimally invasive approach and that technical improvements are necessary to maximize the advantages of robotic surgery.

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Jame Abraham, MD of Cleveland Clinic discusses his hopes for NSABP-FB10 becoming a Phase II and Phase III trial for patients with breast cancer. He also discusses how to manage the diarrhea and nausea in patients who underwent this study. This was recorded at the American Association for Cancer Research (AACR) 2017 Annual Meeting in Washington, DC.

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Mohamed Abazeed, MD, PhD of Cleveland Clinic explains the need for a genomic encyclopedia for radiation oncology. He argues that a genomic encyclopedia could help when deciding treatment if they already know which patients respond to certain therapies. This was recorded at the American Association for Cancer Research (AACR) 2017 Annual Meeting in Washington, DC.

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In this roundtable discussion, Drs. Gerald Prager, Tanios Bekaii-Saab, and Eric Van Cutsem examine the safety and efficacy profiles of the available agents for patients who have failed first- and second-line therapy, provide insight into how to manage adverse effects, and elucidate how best to incorporate said agents in the appropriate sequence, either in combination or alone, when they are available. Earn CME Credit for this activity: http://bit.ly/2lzM53l

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In this Key Insights activity, Dr. Scott Kopetz and conference chair David H. Ilson discuss the key non-colorectal cancer-related take-home messages from the 2017 Great Debates and Updates in Gastrointestinal Malignancies conference held March 24-25, 2017 in New York. Earn CME Credit for this activity: http://bit.ly/2oeonuL

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In this Key Insights activity, Dr. Scott Kopetz and conference chair Axel Grothey discuss the key colorectal cancer-related take-home messages from the 2017 Great Debates and Updates in Gastrointestinal Malignancies conference held March 24-25, 2017 in New York. Earn CME Credit for this activity: http://bit.ly/2oeokiz

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Mark Emberton, MD, FRCS Urol, from University College London Hospitals NHS Foundation Trust, London, UK discusses the value of MRI in prostate cancer at the European Association of Urology (EAU) conference 2017 in London, UK. Prof. Emberton explains that MRI allows the cancer to be identified, described, characterized and biopsied better, and will hopefully in future allow it to be treated better. He describes the PROMIS study (NCT01292291), and highlights that at EAU 2017, the ramifications of these data are just being explored. He concludes that MRI in prostate cancer offers more opportunity, fewer and better biopsies, better risk stratification,…

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Jochen Walz, MD, from the Paoli-Calmettes Institute, Marseille, France, discusses the limitations of magnetic resonance imaging (MRI) in prostate cancer diagnosis at the European Association of Urology (EAU) conference 2017 in London, UK. He explains that MRI can be used as a triage test in patients with suspicion of prostate cancer who have not yet had a diagnostic workup for prostate cancer. Some studies have described that if an MRI is negative in this case, there is no need to worry about the presence of significant cancer, while others have observed that significant cancer can be missed when using this…

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Joaquim Bellmunt, MD, PhD, from the Dana-Farber Cancer Institute, Boston, MA, discusses the implications of earlier immune-oncology treatments for multidisciplinary teams at the European Association of Urology (EAU) conference 2017 in London, UK. Dr Bellmunt highlights the new results on immune-oncological agents presented at this conference, and that the treatment of urological cancers requires a multidisciplinary team approach.He says it is crucial that the community treating genitourinary patients is aware of the treatment advances, and how to manage these in the setting of earlier treatments.

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Christian Stief, MD, from Ludwig-Maximilians-University, Munich, Germany discusses results from the ProtecT trial in prostate cancer at the European Association of Urology (EAU) conference 2017 in London, UK. This Phase III prospective randomized clinical trial evaluated the efficacy of different treatment modalities in low and intermediate risk prostate cancer. He outlines the data presented at EAU 2017, which focused on histological features of tissue from patients in the ProtecT trial. Discriminating between patients that progressed and those that did not, pathophysiology was retrospectively assessed in biopsy tissue, as well as the entire prostate if surgery was carried out. He explains…

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Axel Merseburger, from the Schleswig-Holstein University Hospital, Lübeck, Germany, speaks about highlights from the session on advanced prostate cancer at the European Association of Urology (EAU) conference 2017 in London, UK. He says that there was a lot of discussion about advanced prostate cancer, such as what to do with lymph node recurrence after prostatectomy if cancer is found in a small number of lymph nodes in the pelvis after a period of remission. A subsequent presentation covered the complications of this procedure. The session also covered systemic therapy in metastatic castration-resistant prostate cancer, and Prof. Merseburger highlights a study…

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Maurizio Brausi, MD, from the AUSL Modena, B. Ramazzini Hospital, Modena, Italy, discusses clinical trials of robotic surgery in radical cystectomy at the European Association of Urology (EAU) conference 2017 in London, UK. According to Prof. Brausi, the most important randomized trial in robotic surgery for radical cystectomy is a Phase III study carried out at the Memorial Sloan Kettering Cancer Center in New York, NY (NCT01076387). Prof. Brausi summarizes the results of the trial, and concludes that robotic surgery for muscle invasive bladder cancer shows promise but is not yet the standard.

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Jochen Walz, MD, from the Paoli-Calmettes Institute, Marseille, France, discusses the advantages of using imaging information for prostate cancer diagnosis and management at the European Association of Urology (EAU) conference 2017 in London, UK. Dr Walz explains that prostate cancer, according to EAU guidelines, is currently diagnosed by randomized biopsy without using imaging information to target the tumor. Several technologies are available to promote the use of imaging information in prostate cancer diagnosis. Reliable imaging will allow decisions to be made on whether a cancer needs to be treated or followed by active surveillance. He concludes that the use of…

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Joaquim Bellmunt, MD, PhD, from the Dana-Farber Cancer Institute, Boston, MA, gives an overview of checkpoint inhibitors for urothelial carcinoma treatment at the European Association of Urology conference 2017 in London, UK. Immunotherapy has been developed in patients with advanced disease failing first- or second-line treatment. Dr Bellmunt explains that based on the results seen, immunotherapy is now being moved to earlier phases of the disease and as a first-line treatment in patients with metastatic disease, patients ineligible for chemotherapy, or in an adjuvant or neoadjucant setting. Looking forward, Dr Bellmunt explains that biomarkers are being identified which will allow…

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Christian Stief, MD, from Ludwig-Maximilians-University, Munich, Germany discusses developments in prostate cancer presented at a video session at the European Association of Urology (EAU) conference 2017 in London, UK. He explains that prostate fusion biopsy, which combines MRI and ultrasound imaging, is becoming more readily available, and comparable to biopsy carried out in the MRI apparatus. Prof. Stief points out that fusion biopsy is cost effective and much easier for patients to endure, while also giving precise information on the tumor itself and the extent of the tumor. He also speaks about cryotherapy, where a specific spot undergoes cryotherapy right…

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Axel Merseburger, from the Schleswig-Holstein University Hospital, Lübeck, Germany, discusses the use of social media in uro-oncology at the European Association of Urology (EAU) conference 2017 in London, UK. He explains that using Twitter for just 15 minutes a week allows him to keep up to date with the latest news from conferences. Prof. Merseburger believes that Twitter is a good resource; it does not replace face to face meetings or conferences, but if someone is not able to go to a conference, Twitter allows them to get fast and immediate information on what is happening in their peer group.

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From our MPN Ask the Expert series, Patient Power viewer, Maryse, asks a question about the MPL mutation and if there are targeted treatments being developed for this mutation. Dr. Prithviraj Bose from The University of Texas MD Anderson Cancer Center responds by explaining the MPL mutations as it relates to others like JAK2 and CALR and goes on to discuss treatments that are meant to target the JAK-STAT pathway. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on Twitter | http://www.twitter.com/patientpower Follow on Google+ | http://www.google.com/+patientpowerinfo

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Joaquim Bellmunt, MD, PhD, from the Dana-Farber Cancer Institute, Boston, MA, summarizes the aims and results of the KEYNOTE-045 (NCT02256436) trial of pembrolizumab as a second-line agent in the treatment of urothelial carcinoma at the European Association of Urology conference 2017 in London, UK. He explains that this Phase III randomized trial was carried out in patients failing first-line platinum-base chemotherapy, or second- or third-line chemotherapy in some cases. Patients received pembrolizumab every three weeks, or standard of care chemotherapy (paclitaxel, docetaxel, or vinflunine). Dr Bellmunt highlights that this is the first trial showing an advantage of immunotherapy over chemotherapy…

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