Author: Editor

Susan OBrien, M.D., UC Irvine Health outlines how small molecule combinations may some day supplant chemotherapy in CLL at MOASC Spotlight on ASH 2017.

Susan OBrien, M.D., UC Irvine Health gives an Update on Resonate 2 Trial and presents new Venetoclax data at MOASC Spotlight on ASH 2017.

Susan OBrien, M.D., UC Irvine Health discusses how new Ibrutinib data may change current practices in CLL from MOASC Spotlight on ASH 2017

Minh-Ha Tran, DO, Associate Medical Director, Transfusion Medicine, Pathology School of Medicine presents an updates in transfusion medicine at the MOASC Spotlight on ASH

Lauren C. Pinter-Brown MD, FACP, Health Sciences Professor of Medicine and Dermatology, Chao Family Comprehensive Cancer Center, UC-Irvine discusses new research and updates to lymphoma during MOASC Spotlight on ASH

Susan OBrien, M.D., UC Irvine Health gives a comprehensive overview and update on CLL for 2017 at MOASC Spotlight on ASH

Gordon D. McLaren, M.D., University of California, Irvine, Irvine, CA, VA Long Beach Healthcare System, Long Beach, CA discusses Hereditary Hemochromatosis: Not Just HFE Anymore at MOASC Spotlight on ASH program.

Deepa Jeyakumar, MD, Assistant Clinical Professor, Division of Hematology/Oncology, UC Irvine Health gives an overview of new data and research from ASH on AML

Jana Pelouchova from the European Cancer Patient Coalition, Brussels, Belgium discusses the challenges faced by caregivers, which she presented at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. She emphasizes that caregivers often receive information second-hand, particularly if they are unable to attend meetings with healthcare practitioners. She describes how this can be frustrating for caregivers, who are already under substantial stress, and encourages a discussion on how the provision of information and support to caregivers can be improved.

Gabe Sonke, MD, PhD, from the Netherlands Cancer Institute, Amsterdam, Netherlands, discusses results from the Phase III MONALEESA-2 trial on the safety and efficacy of the selective CDK4/6 inhibitor ridociclib combined with letrozole in advanced breast cancer in postmenopausal women (NCT01958021), which he presented at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. He describes how treatment of metastatic, hormone receptor-positive (HR+) HER2- breast cancer, where endocrine resistance is common, with a combination of ridociclib and letrozole prolonged progression-free survival (PFS) compared to letrozole with placebo in this randomized, double-blind, placebo controlled Phase III…

Dirk Schadendorf, MD, PhD, from the University Hospital Essen, Essen, Germany, discusses developments in melanoma treatment at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. He describes how epidemiological data suggest that while the incidence of melanoma is increasing by 5% each year, a 25% decrease in melanoma-related mortality is expected by 2050. Prof. Schadendorf suggests factors which will be important in achieving this, particularly prevention and early detection, which is linked to access to the healthcare system including dermatologists to allow early diagnosis. Currently, interferon alpha is used as adjuvant therapy, however, several…

Angela Fleischman MD PhD, UC Irvine Health gives an update on the New Developments in MPN from MOASC Spotlight on ASH 2017.

Martine Piccart, MD, PhD, from the Free University of Brussels, Brussels, Belgium, describes the AURORA program (NCT02102165), which seeks to understand the evolution of metastasis in breast cancer, at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. The prospective program led by the Breast International Group (BIG) will use next-generation sequencing (NGS) and tumor DNA analysis in plasma to determine changes in tumor DNA between the primary tumor and developing metastasis in breast cancer patients. Prof. Piccart explains how data will be integrated on a central IT platform to allow different cases to be…

Werner Lichtenegger, MD, PhD from Charité University Hospital, Berlin, Germany, highlights innovations in gynecological cancer treatment at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. He discusses new PARP inhibitors olaparib and niraparib and their respective benefits. Treatment with both olaparib and niraparib improves progression-free survival (PFS), and particularly in ovarian cancer patients with BRCA mutations and HR-deficiency induces selective cell death of cancer cells. Prof. Lichtenegger points out that interestingly niraparib is also effective in patients without BRCA mutations.

Rodabe N. Amaria, MD from the University of Texas MD Anderson Cancer Center, Houston, TX summarizes results on a recent randomized Phase II clinical trial of neoadjuvant treatment with BRAF and MEK inhibitors for melanoma (NCT02231775) she presented at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. Results from this trial on patients with clinical Stage III and oligometastatic Stage IV melanoma with the BRAF mutation indicate that neoadjuvant treatment with dabrafenib and trametinib resulted in a significant improvement in relapse-free survival (RFS) compared to standard of care treatment consisting of initial surgery followed…

Aditi Choudhry, MD Hematology Oncology Fellow UC Irvine presents the Five-Year Experience With Single-Agent Ibrutinib in Patients With Previously Untreated and Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Leukemia at the MOASC Spotlight on ASH 2017.

Martine Piccart, MD, PhD, from the Free University of Brussels, Brussels, Belgium, describes the MINDACT trial in patients with early breast cancer (NCT00433589), which she presented at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. This trial determined whether having results from the MammaPrint test, which determines the genomic signature of each patient, alters the way in which women with early breast cancer are treated. Prof. Piccart discusses the results of the study, indicating that patients with high clinical risk but a low risk MammaPrint signature who did not receive adjuvant therapy, had excellent…

Yasir Khan, MD and Yu Cheng, MD of the University of California, Irvine, Hematology/Oncology Fellowship present Common Consults with regards to Thrombosis in Cancer Patients at MOASC ASH Spotlight 2017

Jana Pelouchova from the European Cancer Patient Coalition, Brussels, Belgium discusses a panel debate on informed patients at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. She talks about the role of video vignettes and explains how information is distributed to patients, and asks how the selection and reliability of the resources that patients access can be improved. In addition, she encourages a discussion on what can be done to improve communication with patients, for example if they are interested in alternative therapies or in joining a clinical trial.

Helena Ullgren, RN at the Karolinska University Hospital, Stockholm, Sweden, discusses her talk on the gold standard for effective care transitions from curative to early palliative care at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. She describes her experience of how patients often assume that oncological and palliative care teams are in contact to coordinate the transition from curative to palliative care, however this is not always the case, with responsibility for communication between the teams often resting on the patient. Helena Ullgren concludes that early palliative care may not be beneficial if…

Gabe Sonke, MD, PhD, from the Netherlands Cancer Institute, Amsterdam, Netherlands, discusses his research on the late side effects of breast cancer treatment presented at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. By combining information from different patient databases, as well as information from the patients healthcare practitioners, Dr Sonke explains how his research has shown that radiotherapy for breast cancer also affects the heart and increases the risk of myocardial infarction later in life. He points out that this needs to be considered when discussing risks with patients, and should also be…

Dirk Schadendorf, MD, PhD, from the University Hospital Essen, Essen, Germany, discusses the risks and benefits of adjuvant ipilimumab treatment after complete resection of Stage III melanoma based on the results of a recent Phase III trial (EORTC 18071, NCT00636168) at the European Cancer Congress of the European Cancer Organisation (ECCO) 2017 in Amsterdam, Netherlands. Prof. Schadendorf describes that patients receiving adjuvant ipilimumab treatment following surgical resection of Stage III melanoma, who are at risk of relapse, have an 11% increase in overall survival (OS) after 5 years. However, 50% of Stage III melanoma patients are surviving to 5 years…

Elizabeth Brém, MD, HS Clinical Assistant Professor, Chao Comprehensive Cancer Center presents Updates and Ongoing Controversies in Hodgkin Lymphoma at the Medical Oncology Association Southern California Spotlight on ASH 2017.

Dr. Shirish Gadgeel of the Karmanos Cancer Institute at Wayne State University in Detroit, presented new analysis results in specific subgroups of patients enrolled in the OAK trial. OAK was the first randomized Phase III study evaluating an anti-PDL1 antibody (atezolizumab) in the management of advanced non-small cell lung cancer (NSCLC). The subgroup analysis presented by Dr Gadgeel evaluated the efficacy of atezolizumab compared to docetaxel in a variety of clinically-relevant subgroups of NSCLC based on PDL-1 gene expression, central nervous system (CNS) metastasis, history of smoking, and patient age. The results presented by Dr Gadgeel showed that atezolizumab improves…

Gerhad Mostbeck, MD of the Otto Wagner Hospital, Vienna, Austria talks about how the aims of radiology in patients with lung cancer have completely changed over the last 20 years. This change is the result of new therapeutic options and a need for accurate radiologic staging as well as the use of multimodality imaging, especially FDG-PET, which gives not only morphologic but also functional information. However, the remaining constant is the question of how to diagnose tissue, but not only for cytological diagnosis but also biomarker diagnosis which requires more information from histologic material and from a relatively large amount…

Shirish Gadgeel, MD, from Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI, provides us with updated information on a North American study (NP28761) evaluating alectinib in patients with ALKpositive NonSmallCell Lung Cancer (NSCLC) who are resistant to crizotinib, the first line ALK inhibitor. Based on results from several studies, alectinib has been approved in the US and Japan for the treatment of patients who have progressed on or are intolerant to crizotinib. Shirish Gadgeel gives us an overview of the results from the updated study that had a longer 17-month follow-up than the primary analysis. The study showed…

Frank Griesinger, MD, PhD from the Pius-Hospital Oldenburg, Oldenburg, Germany discusses the question of central nervous system (CNS) metastasis in patients with ALK positive tumors. CNS metastasis is a big issue in when treating ALK-positive tumors. Approximately 30% of patients show CNS metastasis even before they are treated with an ALK inhibitors, but after first treatment with an ALK inhibitor, 60-70% show CNS metastasis. Dr Griesinger explains that having targeted drugs that effectively target the CNS metastases would allow to delay whole-brain irradiation, thus delaying the associated cognitive impairment experienced by patients. Recorded at the 2016 World Congress of Lung…

Shirish Gadgeel, MD of Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI discusses driver genetic alterations, which can be targeted for therapeutic benefit in non-small cell lung cancer (NSCLC). Fibroblast growth factor receptor (FGFR) amplifications and translocations are a common target in several malignancies. Dr Gadgeel discusses a retrospective analysis of patients with FGFR translocations. The data suggests that appropriately targeting and treating FGFR mutations can provide clinical benefit, however, dr Gadgeel points out that FGFR translocations are not common, occurring in 0.4% of patients. Recorded at the 2016 World Congress of Lung Cancer (WCLC) of the International…

Alex Spira, MD, PhD, FACP of Virginia Cancer Specialists, Fairfax, VA discusses side effects of immunotherapy in lung cancer. Dr Spira explains that side effects from immunotherapy are less severe than from chemotherapy and traditional drugs. However, side effects are real and can make patients very ill. Therefore, it is important to educate healthcare professionals about the side effects so that they can identify them early. Recorded at the 2016 World Conference of Lung Cancer (WCLC) of the International Association for the Study of Lung Cancer (IASLC) in Vienna, Austria.

Shirish Gadgeel, MD of Barbara Ann Karmanos Cancer Institute, Wayne State University, Detroit, MI gives an overview of his presentation focused on the use of rociletinib and osimertinib in EGFR-mutated non-small cell lung cancer (NSCLC). T790M is the most common mutation in patients with EGFR-positive NSCLC treated with front-line EGFR TKIs. Rociletinib and osimertinib both target the T790M mutation and both showed evidence of clinical evidence in clinical trials. Osimertinib was approved by the FDA in October 2015. Rocilietinib did not receive the FDA approval and the development of the drug has been discontinued. Dr Gadgeels presentation at WCLC focuses…

Stefania Vallone, Lung Cancer Europe (LuCe) talks about the challenges facing lung cancer patients. LuCE conducted a survey asking lung cancer patients and patient advocates about unmet needs and challenges in their countries, and what measures they think need to be in place to address these issues. The results of the survey were presented at an interactive session at the WCLC conference and identified the lack of research funding, detection at a late stage and stigma as the three main issues in Europe. However, these results did not mirror the answers provided by the audience attending the interactive session, indicating…

Robert Pirker, MD at the Medical University of Vienna, Austria and President of the World Conference on Lung Cancer (WCLC16) outlines the key highlights of the WCLC16 congress. Key advances discussed during the conference include the use of immune checkpoint inhibitors in the treatment of lung cancer, as well as advances in targeted therapies and emerging combinations of various therapies. Dr Pirker also highlighted that, in order to provide the right treatment, it is necessary to accurately understand tumor characteristics through TNM staging and molecular analysis. Updated guidelines for TNM staging were presented at the conference and will be implemented…

Nicolas Girard, MD, PhD, of Hospital Louis Pradel, Claude Bernard University, Lyon, France, discusses how to maximize clinical benefits for patients with ALK-positive non-small cell lung cancer (NSCLC), which is a rare subset of NSCLC. ALK arrangements predict the efficacy of treatment with certain tyrosine kinase inhibitors (TKI). There are several TKIs available for patients, including crizotinib, alectinib and ceritinib as well as additional third generation ALK tyrosine kinase inhibitors. Crizotinib is the current standard of care for first-line treatment both in the ESMO and NCCN guidelines. Data comparing crizotinib and chemotherapy in the first-line setting show clear benefits in…

Gerhad Mostbeck, MD of the Otto Wagner Hospital, Vienna, Austria talks about the challenges associated with biopsies for the diagnosis of lung cancer. The decision to go forward with a biopsy procedure is taken within an interdisciplinary team of doctors and takes into consideration the invasiveness of the procedure and associated risks as well as the accuracy of the methods used and importantly, patients consent. Another challenge is that lung cancer changes throughout the course of the disease; it changes with treatment and with metastasis. This means that medical teams have to conduct more biopsies than they were used to…

Frank Griesinger, MD, PhD from the Pius-Hospital Oldenburg, Oldenburg, Germany discusses progress in the development of a German clinical research platform. The platform started a year ago and aims to prospectively capture in-depth data including clinical characteristics, health insurance, socio-economic factors, patient outcomes and quality of life. Around 10,000 patients were recruited into this registry which also include data from a bio bank and a tissue repository with clinically annotated material. According to Dr. Griesinger, this is a very important study that will allow to analyse how patients are treated in Germany, and to identify correlations between molecular, clinical and…

Anne Ireland, MSN,RN, AOCN, CENP of the City of Hope National Medical Centre, Duarte, CA is interested in the adoption and implementation of electronic health records as well as the use of technology innovations to improve healthcare. She believes that technologies such as wearables and social applications can help healthcare practitioners better connect with patients and enhance health promotion, disease prevention and healthcare services. For example, digital patient portals can enable patients to report their symptoms from home and receive timely responses from medical staff. These portals could potentially also be used to request appointments and renew prescriptions, making access…

Alex Spira, MD, PhD, FACP of Virginia Cancer Specialists, Fairfax, VA talks about immunotherapies and the new challenges they present for clinicians. Immunotherapy drugs lead to side effects and toxicities that are different from the typical oncology side effects that clinicians are used to dealing with. Alex explains how these challenges should be tackled and predicts that immunotherapy will be increasingly used as frontline therapy and also in combination with other agents. Recorded at the 2016 World Conference of Lung Cancer (WCLC) of the International Association for the Study of Lung Cancer (IASLC) in Vienna, Austria.

Sergei Grando, MD, PhD of University of California, Irvine School of Medicine, Irvine, CA talks about the popularity of e-cigarettes and the carcinogenic properties of nicotine. Recorded at the 2016 World Conference of Lung Cancer (WCLC) of the International Association for the Study of Lung Cancer (IASLC) in Vienna, Austria.

Maurice Pe?rol, MD, Léon-Bérard Cancer Centre, Lyon, France talks about angiogenesis inhibition in lung cancer across treatment lines. VEGF pathway activation in tumors leads to new vessel development in tumors, or angiogenesis. Several inhibitors of this pathway are used in the treatment of non-small cell lung cancer (NSCLC). In first line, bevacizumab is the only approved drug for NSCLC and consistently improves the response rate and the progression-free survival (PFS) for patients treated with platinum-based chemotherapy, albeit with a smaller effect on overall survival (OS). In second line, two angiogenesis inhibitors have recently been developed; ramucirumab and nintedanib. Ramucirumab, a…

Martina Pötschke-Langer, MD, from the German Cancer Research Center, Heidelberg, Germany, discusses strategies to improve tobacco control in central European countries. The role of the doctors, especially of oncologists, is crucial as their voice will be heard. When doctors are intervening in tobacco prevention and control programmes of their governments, politicians are more likely to get involved and act. However, this is sometimes difficult if doctors are not so used to the right argument, especially on the level of tobacco control measures, for example, legislations and so on. Regardless, the overall goal is very clear, to reduce the smoking rate…

Yu Shyr, PhD of Vanderbilt University School of Medicine, Nashville, TN discusses drug development in lung cancer and a need for a broader approach, using genomics, proteomics, and lipidomics to create a signature or network in personalized precision medicine. Currently, most drug development focuses on targeted therapy for single gene mutations with low prevalence rates. There is an obvious lack of focus on those patients without these mutations. Recorded at the 2016 World Conference of Lung Cancer (WCLC) of the International Association for the Study of Lung Cancer (IASLC) in Vienna, Austria.

Sergei Grando, MD, PhD of University of California, Irvine School of Medicine, Irvine, CA discusses the role of nicotine in lung cancer and its effect on therapy in lung cancer. Nicotine can damage the DNA of cells and can cause mutations. It also can promote tumor growth and facilitate survival of cancer cells. Therefore, it both increases likelihood of developing cancer, and is counterproductive to chemotherapy and radiotherapy by reducing their efficacy. Dr Grando talks about his research into how the signaling pathways activated by nicotine could potentially be blocked as a novel approach. This could be applicable for many…

Sanjay Agrawal, MBBS of University Hospitals of Leicester NHS Trust, UK discusses e-cigarettes compared to smoking. 85% of lung cancer patients are smokers. Crucially, a third of patients in clinic are still smokers. Referral to stop smoking services, the use of tablets, patches, or behavioral support often fail with these patients. However, many do vaping and e-cigarettes as a way to stop smoking instead. In England, the rate of smoking has reduced in recent years and the use of e-cigarettes has increased. E-cigarettes are not entirely harmless but much safer than smoking tobacco. Cochrane analysis looking at e-cigarettes found the…

Rosalyn Juergens, MD, PhD of McMaster University, Juravinski Cancer Centre, Canada gives an overview of her presentation of the data from the Canadian Clinical Trials Group Investigational New Drug Committee (IND), trial IND.226 (NCT02537418). This looked at quadruple therapy in lung cancer, which was chemotherapy plus two different forms of immunotherapy, CTLA-4 inhibitor (tremelimumab) and PD-L1 inhibitor (durvalumab). This was a Phase I, dose escalation study looking at safety and tolerability. Combinations of immuno-oncology drugs have been a challenge in the past, so seeing whether patients can sustain the treatment before moving onto quadruple therapy was important. It was found…

Matthias Guckenberger, MD of University Hospital Zurich, Switzerland discusses his talk on Stereotactic Body Radiotherapy (SBRT) at the 2016 World Conference of Lung Cancer (WCLC) of the International Association for the Study of Lung Cancer (IASLC) in Vienna, Austria. He talks about its use for early stage non-small cell lung cancers (NSCLC) as a curative approach, and its use for more advanced stage disease (oligometastatic disease) and its use for patients with brain metastases. SBRT has become the guideline recommended treatment for inoperable patients with early stage NSCLC. Investigations in the last few years have looked at expanding the indications…

Mary Duffy, RSCN, RGN, RSM of the Peter MacCallum Cancer Centre, Victoria, Australia talks about the International Thoracic Oncology Nursing Forum (ITONF) nurses workshop at the 2016 World Conference of Lung Cancer (WCLC) of the International Association for the Study of Lung Cancer (IASLC) in Vienna, Austria. She discusses the importance of clinical trials for lung cancer patients, lung cancers nurses attitudes to patients, and how we think of clinical trials. Also discussed was the importance of clinical trials for the thoracic surgical group. The prevention of smoking cessation was brought up, particularly, the key function of lung cancer nurses…

Johan Vansteenkiste, MD, PhD of University Hospitals Leuven, Belgium talks about how patients with squamous cell carcinoma of the lung do worse than those with adenocarcinoma of the lung. Squamous cell carcinoma patients have smoking-induced cancers, meaning they have comorbidities including lung disease, heart disease, renal disease, diabetes, in addition to being older. This creates a different patient with limitations for surgery, limitations for systemic treatments such as chemotherapy, and further, no targeted agents are available. Recently some developments have been seen for these patients with epidermal growth factor receptor (EGFR) antibodies and immunotherapy. Recorded at the 2016 World Conference…

Lung Cancer Patient/Activist Janet Freeman-Daily talks about the successes of targeted therapies and immunotherapies in lung cancer. From a personal standpoint, her treatment with crizotinib has allowed her to survive with no evidence of cancer for four years. Her talk at the 2016 World Conference of Lung Cancer (WCLC) of the International Association for the Study of Lung Cancer (IASLC) in Vienna, Austria discusses patient access to molecular testing and novel therapies, and how this can be solved.

Hossein Borghaei, DO, MS of Fox Chase Cancer Center, Philadelphia, PA gives an outline of his talk on the different anti-PD-L1 and PD-1 antibodies in the market for non-small cell lung cancer (NSCLC) held at the 2016 World Conference of Lung Cancer (WCLC) of the International Association for the Study of Lung Cancer (IASLC) in Vienna, Austria. . The PD-L1 inhibitor, avelumab, has an additional property called antibody dependent cellular cytotoxicity (ADCC). Strategies to augment the ADCC component of avelumab may allow for treatment of patients who do not have robust responses to single agent anti-PD-L1s. The use of genetic…

Frank Griesinger, MD, PhD from the Pius-Hospital Oldenburg, Oldenburg, Germany discusses the role of p53 mutation in EGFR mutation positive (M+) non-small cell lung cancer (NSCLC). Prof. Griesinger explains that they looked EGFR-mutated patients to see if an additional genetic alteration, i.e. a p53 mutation, has an impact of survival; it does seem to have an impact on progression-free survival (PFS) and overall survival (OS), which are inferior in patients with p53 mutation. Further, there are pathogenic and non-pathogenic p53 mutations and this also has an impact on survival. He explains that patients should be tested for the mutation and…