Author: Editor

Is interferon or hydroxyurea (Hydrea) more effective as a treatment for polycythemia vera (PV)? MPN expert and researcher, Dr. Heinz Gisslinger, discusses the results from PROUD-PV Phase III study. He details the pros and cons of interferon versus hydroxyurea and how these findings will affect patients. 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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Can CML patients responding positively to therapy have their medications safely reduced? CML expert Dr. Mhairi Copland of the University of Glasgow reports the findings from a clinical trial studying the safety of reducing tyrosine kinase inhibitor (TKI) therapy in patients with CML. Tune in to learn when dosage reduction may be appropriate. 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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Jasmine Micklem, PhD, of the South Australian Health and Medical Research Institute, Adelaide, Australia, and Roslyn Weetra, an Aboriginal Elder and cancer survivor, discuss the improvements required in supportive care services for indigenous communities. Ms. Weetra mentions an ongoing, strong government commitment about helping aboriginal people going through cancer treatment and providing aboriginal cancer coordinators, and a transitional program from hospital to home, allowing the patient to access sufficient information and the full range of services, with an equal pathway to a fair treatment plan. Dr. Micklem continues by highlighting the issue of higher mortalities due to people not entering…

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Bernardo Rapoport, MD of The Medical Oncology Centre of Rosebank, Johannesburg, South Africa discusses side effects associated with different types of checkpoint inhibitors. Colitis is more common with anti-CTLA-4 treatment and pneumonitis is associated with anti-PD-1 therapy. As a general rule, anti-CTLA-4 agents like ipilimumab have more immune-related adverse events. Doctors have to weigh benefits and risks of each treatment. Dr Rapoport says that a price of a combined treatment needs to be reduced if this type of therapy is to be used outside of clinical trials. Recorded at the Multinational Association of Supportive Care in Cancer (MASCC) and International…

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Charles Kamen, PhD of University of Rochester Medical Center, Rochester, NY discusses the impact of dyadic exercises on cancer patients. Many people, including patients, do not enjoy exercising. This could be addressed by dyadic exercises, where patients and caregivers train together. A study performed by Dr Kamen measured cancer-related fatigue, psychological distress, physical function, and inflammation. The two part exercise intervention included walking and resistance training. The cancer-related fatigue and depression decreased over the course of the intervention in both study arms, however, there was a steeper decrease in psychological distress in the dyadic exercise group, compared to patients training…

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Peter Hillmen from St. James University Hospital, Leeds, UK introduces the 17th International Workshop on chronic lymphocytic leukemia (iwCLL), which will be held in New York between 12 and 15 May, 2017. Themes covered will span early CLL through to relapsed/refractory disease new treatments, guidelines and major clinical trials. Smaller, more intimate meetings like this one give us the chance to spend a lot of time talking about CLL compared with larger meetings that focus on a wide range of haematological malignancies. Early registration closes 16 December and abstracts will be available early in the new year. A young investigator…

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Stephen Sonis, DMD, DMSc of Brigham and Women’s Hospital, Boston, MA discusses costs of cancer care. The cost of new cancer drugs has gone up dramatically and that trend is likely to continue. The opportunity for supportive care is to find an effective way to deal with the incremental costs of toxicities. Prof Sonis mentions the cost-benefit accountability, which is going to be incumbent for third party payers and patients. Recorded at the Multinational Association of Supportive Care in Cancer (MASCC) and International Society of Ocular Oncology (ISOO) 2016 Annual Meeting on Supportive Care in Cancer held in Adelaide, Australia.

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Michael Brown, MBBS, FRACP, FRCPA of Royal Adelaide Hospital, Adelaide, Australia discusses global immune checkpoint inhibitor studies. Prof Brown mentions that it has been known for decades that patients with tumors which have infiltrating lymphocytes have a better prognosis. The reason for this could be a low level control, which may mean that checkpoint inhibitors uncap a process which is already under way, a reinvigoration of the immune response. The most striking data is in melanoma with 20% of survivors after 10 years for anti-CTLA-4 therapy with ipilimumab, and 34% survivors after 5 years for anti-PD-1 therapy with nivolumab. Recorded…

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Jervoise Andreyev, MA, PhD, FRCP of The Royal Marsden NHS Foundation Trust, London, United Kingdom talks about MASCC discussions focused on gastrointestinal (GI) side effects. Approximately 1-5% of patients die as a result of chemotherapy-induced diarrhea, which requires research to address this complication. Dr Andreyev highlights the importance of MASCC in raising awareness of GI side effects. Drugs affect the GI physiology and that causes symptoms. By treating the physiology it is then possible to improve the symptoms. This is an important conceptual advance in management of GI side effects. Recorded at the Multinational Association of Supportive Care in Cancer…

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Jasmine Micklem, PhD, of the South Australian Health and Medical Research Institute, Adelaide, Australia, discusses disparities in the incidence of cancer in aboriginal communities. Roslyn Weetra, an Aboriginal Elder and cancer survivor, mentions not being able to relate to the staff and that often there has been a cultural barrier. She believes supportive care workers could have incorporated more of the aboriginal culture, to help patients navigate through all the possibilities of cancer treatment. Dr. Micklem discusses a partnership project funded by the council, to allow for some changes to occur in the cancer care services to include aboriginal communities.…

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Bernardo Rapoport, MD and Ronwyn Van Eeden MBChB, FCP(SA) of The Medical Oncology Centre of Rosebank, Johannesburg, South Africa talk about the future direction for cancer immunotherapy. Creating awareness about different pathophysiology of drugs and their immune-related adverse event profiles is one of the key messages from MASCC 2016. Dr Rapoport believes that in the next 10 years we will see a shift from chemotherapy to immunotherapy as a key cancer treatment option. At the moment, studies with checkpoint inhibitors show ongoing responses in some patients after the treatment is completed. Recorded at the Multinational Association of Supportive Care in…

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Meera Agar, MBBS, MPC, FRACP, PhD of University of Technology Sydney, Sydney, Australia discusses delirium treatment options. The guidelines internationally recommend that delirium symptoms are treated in a targeted way, but there has never been a clinical trial to establish the best approach. Prof Agar in collaboration with the Palliative Care Clinical Studies Collaborative (PaCCSC) undertook a clinical trial to explore the use of antipsychotic drugs: risperidone and haloperidol. The goal of the study was to improve targeted delirium symptoms in palliative care patients. There were three study arms: risperidone, haloperidol, and a placebo solution. Delirium symptoms improved better in…

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Matthew Ciorba, MD of Washington University School of Medicine in St. Louis, St. Louis, MO discusses how to use probiotics in cancer medical practice. More studies are needed to prove efficacy of probiotic products in cancer patient populations. Based on Dr Ciorbas research, probiotics should be used as prophylaxis rather than therapy and should be started before the radiation treatment begins. Lactobacillus bacterial strain appears to have higher efficacy than Bifidobacteria species. In addition, appropriate dosing needs to be considered. Doctors should monitor patients closely and try to get involved in clinical trials. In the future, Dr Ciorba expects that…

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Jean Klastersky, MD, PhD of Institut Jules Bordet, Brussels, Belgium summarises key messages from the MASCC 2016 session focused on immune checkpoint inhibitors. Patients predispositions to severe reactions have to be considered. Prof Klastersky mentions that patients should be stratified, so that clinicians can pay more attention to some of them and make decisions based on their clinical experience. Many of the side effects, including pulmonary and GI, can be mimicked by other causes, so a differential diagnosis is required. The take home message is that adverse effects of immune checkpoint inhibitors are quite common, often mild, but occasionally life…

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