Author: Editor

Ian Tannock, MD, PhD, DSc, from the University of Toronto, Toronto, Canada, discusses the problems limiting the use of personalized medicine at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. Personalized medicine is currently typically defined as genetic analysis of a patients tumor, in order to match treatments to the mutations found. Prof. Tannock points out that for some mutations, such as HER2 in breast cancer, matching of treatments to mutations is very successful. However, for many mutations, no effective targeted agents are available. Furthermore, the targeted agents that can be used show similar…

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Paolo Ascierto, MD, of the National Tumor Institute Fondazione G. Pascale, Naples, Italy, introduces the SECOMBIT Phase II trial (NCT02631447) in metastatic melanoma with BRAF mutations at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. This trial with around 300 patients will address the important question of which sequence of immunotherapy and targeted therapy is most effective. Prof. Ascierto describes the three-armed SECOMBIT trial, which will compare overall survival (OS) in patients receiving immunotherapy (ipilimumab with nivolumab) followed by targeted therapy (encorafenib with binimetinib), targeted therapy followed by immunotherapy, or the sandwich approach where…

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Matti Aapro, MD, from the Clinique de Genolier, Genolier, Switzerland, discusses initiatives such as All.Can, which aim to improve the efficiency of cancer care at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. He describes how cancer care can become more sustainable by stopping duplication and follow-ups, which are not clinically useful. Dr Aapro praises the initiatives for considering the views of patients, doctors and nurses, and presenting these to politicians, who can then make well-informed policy decisions.

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Markus Hartmann, PhD, from European Consulting & Contracting in Oncology, Trier, Germany, discusses reasons for divergent outcomes of health technology assessment (HTA) and drug pricing across Europe, which he presented at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. His study found that while around 80% of European Medicines Agency (EMA) approved medicines were approved by national appraisal bodies in Germany and France, this was only 66% in England (National Institute for Health and Care Excellence, NICE) and 54% in Scotland (Scottish Medicines Consortium, SMC). Dr Hartmann explains the lower approval rates in the…

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Laurence Albiges, MD, PhD, from the Gustave Roussy Institute, Villejuif, France discusses the safety of cabozantinib treatment in metastatic renal cell carcinoma at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. Cabozantinib is a potent VEGFR tyrosine kinase inhibitor (TKI), and is used for second-line or later treatment in patients in whom prior VEGFR inhibitor treatment failed. Dr Albiges describes common side effects of cabozantinib treatment, which can include hypertension, hand-foot syndrome (acral erythema), diarrhea, and fatigue. Management of these will often require a dose reduction, with 2 out of 3 patients in the…

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Ian Tannock, MD, PhD, DSc, from the University of Toronto, Toronto, Canada, gives advice on presenting research at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. He points out that poor presentations are often characterized by a lack of planning and no logical sequence, as well as having too many slides or too much information per slide. He suggests a maximum of 10 15 slides for a 10 minute presentation, and highlights that both slides and posters should be easily readable from a distance. Finally, he says that it is also useful to develop…

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Francesco Florindi from the European Cancer Patient Coalition introduces new recommendations on fostering collaboration between cancer patient organizations and hospitals, which he presented at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. He discusses the new guideline document, Solving issues, building relationships, published jointly by the European Cancer Patient Coalition (ECPC), which represents 10 million individuals from over 400 member organizations, and the Organisation of European Cancer Institutes (OECI). Based on frameworks already in place, this document puts together the best practices into a method which member organizations and hospitals can implement to improve…

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Paolo Ascierto, MD, of the National Tumor Institute Fondazione G. Pascale, Naples, Italy, gives an overview of the use of biomarkers to select patients for checkpoint inhibitor therapy in melanoma at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. He says that there are currently no biomarkers in use to select patients who will benefit from checkpoint inhibitor treatment in melanoma, apart from tumor PD-L1 expression level, which is still controversial in melanoma. However, this is established in other types of cancer, such as the improved response to first-line treatment of metastatic non-small cell…

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Matti Aapro, MD, from the Clinique de Genolier, Genolier, Switzerland discusses research on the benefits of pegfilgrastim over filgrastim in managing chemotherapy-induced febrile neutropenia (FN), which he presented at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. He describes current guidelines stating that there is no difference between the clinical action of the granulocyte colony-stimulating factors (G-CSF) filgrastim and the long-acting pegfilgrastim if given as per label. However, he points out that in practice most health care practitioners prescribe filgrastim by the box, and therefore patients are treated for 5 days instead of the…

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Markus Hartmann, PhD, from European Consulting & Contracting in Oncology, Trier, Germany, discusses his talk on divergent outcomes of health technology assessment (HTA) across Europe, which he presented at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. He explains that while the approval of new drugs is centralized within the European Union at the European Medicines Agency (EMA), the subsequent HTA appraisal process is carried out nationally, with different procedures and different outcomes in various EU member states. The EMA assesses quality, safety and clinical efficacy of the drug, while HTA determines the cost…

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Laurence Albiges, MD, PhD, from the Gustave Roussy Institute, Villejuif, France discusses data on the efficacy of targeted therapies after PD-1/PD-L1 blockade in metastatic renal cell carcinoma, which she presented at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. She describes that currently, patients typically receive first-line treatment with sunitinib or pazopanib, followed by second-line treatment with nivolumab or the VEGFR inhibitor cabozantinib. However, little is known about the efficacy of cabozantinib and other VEGFR tyrosine kinase inhibitors (TKI) after nivolumab treatment. Dr Albiges speaks about two retrospective data sets, which indicate that VEGFR…

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Georgina Long, MD, PhD, from the University of Sydney, Sydney, Australia, gives an overview of her talk on neoadjuvant therapy in bulky Stage III melanoma at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. She discusses a trial (NCT01972347) using drugs effective in advanced melanoma at an earlier stage, whose results show that 50% of patients with bulky Stage III melanoma who received neoadjuvant treatment with dabrafenib and trametinib showed a complete pathologic response (cPR) following tumor resection, with the effect of this on long-term outcome still being assessed. Prof. Long highlights the importance…

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Martin Gore, PhD, FRCP, CBE from the Royal Marsden NHS Foundation, London, UK discusses why inefficiency in cancer care should be addressed at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. Prof. Gore highlights that inefficient cancer care, such as long waiting times and repeated tests, not only lead to financial losses, but also negatively impacts the patient experience by taking up large amounts of patient time, and not just that of health care professionals. He argues that this can best be addressed by taking action guided by patient surveys, rather than just being…

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Rodabe N. Amaria, MD from the University of Texas MD Anderson Cancer Center, Houston, TX gives an overview on the benefits of combined treatment with BRAF and MEK inhibitors for metastatic melanoma at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. She discusses the benefits of targeted therapy for melanoma with BRAF mutations using a combination of BRAF and MEK inhibitors, which are FDA-approved for Stage IV metastatic melanoma. Treatment with a single agent has a limited efficacy of 6-7 months before disease recurrence, as well as being less well tolerated. However, Dr Amaria…

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