Karen Mustian, PhD, MPH, ACSM of the University of Rochester Medical Center, Rochester, New York, NY highlights the importance of exercise in cancer care. Dr Mustian believes that as an oncologist, it is especially important to discuss exercise with cancer patients, ensuring that they are aware of what their toxicities and side effects are, and what exercise might help with. Since their clinics may be really busy, and treatment of the disease is the prime focus, oncologists should be aware of the exercise professionals around the community, and make a referral as they would for any other specialty medical need…
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Alex Molassiotis, RN, MSc, PhD of The Hong Kong Polytechnic University, Hong Kong, discusses nausea and vomiting risk factors. Clinicians need to start thinking beyond chemotherapy, as nausea is a more multifactorial side effect. Risk factors play a big role as they make a difference for each individual patient, even if they receive the same diagnosis and chemotherapy treatment. Risk factors include: being female, a younger patient, having anxiety about treatment and having the expectation of vomiting. Recent updates on MASCC guidelines have been published including the recommendation of certain new drugs to be added to the older combinations as…
David Currow, BMed, PhD, MPH, FRACP, FAChPM, FAHMS, GAICD of Flinders University, Adelaide, Australia, discusses challenges in cancer supportive care. Cultural challenges around the acceptability of treatments in some places around the world, or limited access to inexpensive drugs like opioids needs to be addressed. Dr Currow mentions that its important that cancer supportive care services are actively developed at the same time as cancer treatments, without waiting for a perfect cancer service. World Health Organization (WHO) essential medications need to be available throughout the world, as patients with poorly controlled symptoms are less likely to finish the treatment. In…
Paolo Bossi, MD of Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy summaries the important messages to take away from the various workshops and a presentation regarding mucositis treatment. Physicians should try to listen to their patients and learn about the patients reported outcomes as this is really important in order to identify the real impact of mucositis. Try to prevent is another key message, with a multidisciplinary group to enable a better level of patient satisfaction. Phototherapy is mentioned as a promising, cheaper and simple method, and should be standardized in the future. However, this method is quite time…
Douglas Peterson, DMD, PhD, FDS RCSEd of UConn Health, Farmington, CT discusses management techniques allied to help treat symptom clusters. If a patient has one or more complications, the team will address those using current guidelines based on high quality evidence. Research regarding symptom clusters continues to drive towards a better understanding of the causes of these complications, trying to predict which patients would develop certain types of complications, in order to try and prevent them. Dr. Peterson mentions how his work focuses on the range of complications of the head and neck, including: oral mucositis, pain, taste changes and…
David Hui, MD, MSc of MD Anderson Cancer Center, Houston, TX discusses end-of-life decisions faced by a clinical team. Understanding patients disease stage compared with their prognosis has a major impact on the decision making process. Doctors should personalize goals of care and discuss guidelines with their patients, which may answer some of the common misconceptions like thinking that more nutrition means better patient outcomes. Defining comfortable death is a challenging issue. Dr Hui mentions that with the use of technology it is possible to ensure optimal symptom control, however, patients experience different symptoms. Some of these symptoms can be…
Winston Tan, MD of Mayo Clinic, Jacksonville, FL discusses a treatment of bone metastases in prostate cancer. Dr Tan mentions that addition of bisphosphonates does not increase the overall survival of patients suffering from various cancer types, including breast cancer, prostate cancer, and renal cancer. Cabozantinib, approved for metastatic renal cancer makes the bone metastases disappear, however, it has not been shown to increase survival in patients with a metastatic prostate cancer in a phase III randomised clinical trial. A combination of two or three drugs may be required to achieve better results in patients. The next step would be…
Paolo Bossi, MD of Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy discusses the role of probiotics in gut mucositis, as a new field of research investigating the role of microbiota in mucositis emerges. The goal of the research is to understand whether change in patients microbiome can result in mucositis reduction. Dr Bossi mentions that for gut mucositis it is important to give patients probiotics, in particular during radiation. He finishes off with the mention that there needs to be an improvement of knowledge for dysbiosis in gut mucositis, however, the field is not well researched at present. Recorded…
Irma Verdonck-de Leeuw, PhD of VU University Medical Center, Amsterdam, The Netherlands discusses online intervention approaches to treat insomniac cancer patients. It is already established that cognitive behavioral therapy (CBT) works for sleeping problems in general, however many cancer patients are fed up with a history of frequent hospital visits and are no longer interested in seeing further care professionals. This paved the way for online intervention to treat insomnia. Online interventions are found to be very effective in the general population for people who suffer with sleep disturbances, this has led to the testing of its effectiveness in cancer…
Douglas Peterson, DMD, PhD, FDS RCSEd of UConn Health, Farmington, CT discusses working towards a better understanding as to why patients develop a constellation of toxicities, referred to as a symptom cluster. Certain cancer treatments such as head and neck radiation, can cause a wide range of clusters of toxicities. With head and neck radiation, patients can develop oral mucositis and for some, it can disrupt their cancer therapy due to pain. They may even need to be hospitalized due to the severity of their pain. A patient may also develop fatigue, or taste changes. They may be unable to…
David Currow, BMed, PhD, MPH, FRACP, FAChPM, FAHMS, GAICD of Flinders University, Adelaide, Australia, discusses anamorelin in ROMANA 1 and ROMANA 2 studies. Anamorelin acts as a selective ghrelin receptor agonist and has a potential to increase lean body mass, appetite, and fat mass in people with cancer cachexia. Dr Currow highlights the 24-week follow-up data from ROMANA studies showing increase in lean body mass and fat mass, and decrease in anorexia, which was maintained in the anamorelin-treated study arm. Cachexia is one of the prognostic factors in cancer and Dr Currow sees this as a tremendous opportunity to open…
Alex Molassiotis, RN, MSc, PhD of The Hong Kong Polytechnic University, Hong Kong discusses focus on nausea and vomiting together, making new developments, drugs and risk models. There is a recent realization that although vomiting can be managed quite well, nausea is becoming a bigger problem. There is now a refocus on efforts to better understand nausea. Despite very little known about nausea due to its connection with vomiting, it has been realized that the pathophysiology behind nausea differs. The reasons patients develop nausea may also be different and beyond just the chemotherapy or treatment they receive. Dr. Molassiotis mentions…
Afaf Girgis, PhD, of the University of New South Wales, Sydney, Australia talks about ways to make unmet needs easier to identify by healthcare professionals at the 2016 National Cancer Research Institute (NCRI) Conference in Liverpool, UK. She starts by explaining that If we go through assessing unmet needs in a clinical situation, for example through a recently developed e-health program where a link to a survey is sent to patients which they complete before coming to the clinic. This survey identifies issues such as distress, symptoms and unmet needs. This means that when the patients come to the healthcare…
Lieping Chen, MD, PhD of Yale School of Medicine, New Haven, CT discusses future directions in cancer treatment. Thanks to scientific discoveries like PD-1/PD-L1 researchers know what to look for, which is a significant shift in approach, from looking at a whole body to focus on tumor microenvironment. Prof. Chen expects exciting discoveries in the next 5 years, but points out that science requires a lot of work and takes time, and many molecular pathways are still to be discovered. Recorded at the 2016 National Cancer Research Institute (NCRI) Conference in Liverpool, UK.
Alex Mitchell, MBBS, BMedSci, MSc, MD, MCPsyc, of the University of Leicester, UK, discusses the next steps for screening programs for the detection of distress of cancer patients at the 2016 National Cancer Research Institute (NCRI) Conference in Liverpool, UK. Prof. Mitchell says that the bottom line is that centers around the world should be screening for distress more but the barriers for implementation must be addressed. A barrier that is often not addressed is the acceptability of what follows screening. The screening test itself only really helps with identifying if the patient is suffering. However, what comes next is…
Lieping Chen, MD, PhD of Yale School of Medicine, New Haven, CT discusses the PD-1/PD-L1 molecular pathway. The two molecules regulate immune response and control inflammation, acting similarly to a brake in a car. Cancer cells use this mechanism and amplify it to escape the immune system response and continue growing. Anti-PD-1 and anti-PD-L1 drugs developed to counteract this action are effective in 30% of solid tumors. Prof. Chen points out that further work is required to discover new treatments. Recorded at the 2016 National Cancer Research Institute (NCRI) Conference in Liverpool, UK.
Corinne Faivre-Finn, FRCR, MD, PhD of University of Manchester and the Christie NHS Foundation Trust, UK discusses next steps for the CONVERT trial in limited-stage small-cell lung cancer (LS-SCLC). Biomarker data collected as part of the clinical trial need to be analyzed to further understand their role as prognostic markers in LS-SCLC. Dr Faivre-Finn highlights that data on the role of circulating tumor cells are going to be reported at the World Conference on Lung Cancer in Vienna in December 2016. Recorded at the 2016 National Cancer Research Institute (NCRI) Conference in Liverpool, UK.
Afaf Girgis, PhD, of the University of New South Wales, Sydney, Australia, discusses unmet needs for cancer patients and care givers at the 2016 National Cancer Research Institute (NCRI) Conference in Liverpool, UK. Prof. Girgis explains that research tells us that patients have a lot of psychological unmet needs and unmet needs for information. One of the biggest unmet need is dealing with the issue of cancer recurrence. Whether a patient is recently diagnosed or a long-term survivor, the issue of cancer recurrence comes up very strongly for people. There is a lot of developing research now to try and…
Lieping Chen, MD, PhD of Yale School of Medicine, New Haven, CT gives an overview of his talk on PD-1/PD-L1 molecular pathway research. For almost 20 years, Prof. Chen and his team have studied the PD-1/PD-L1 pathway, from cloning the molecules, identifying their function and role in the cancer setting, all leading to a development of anti-PD-1 and anti-PD-L1 therapies. Prof. Chen mentions that these therapies are used in patients when other conventional therapies failed, but he expects this cancer immunotherapy to have a broader application in the future, including early stage diseases. Recorded at the 2016 National Cancer Research…
Corinne Faivre-Finn, FRCR, MD, PhD of University of Manchester and the Christie NHS Foundation Trust, UK, gives an overview of the CONVERT trial (ISRCTN91927162), which is an international, randomized control study in patients, who have limited-stage small-cell lung cancer (LS-SCLC). The study compared two schedules of radiotherapy, which was delivered either twice a day or as a higher dose once a day, concurrently with chemotherapy. There was no difference in survival between the two groups, however, with lower toxicity levels and longer survival compared to previous clinical trials. CONVERT was not an equivalence trial, but Dr Faivre-Finn points out that…
Alex Mitchell, MBBS, BMedSci, MSc, MD, MCPsyc, of the University of Leicester, UK, gives an overview of his talk on screening cancer patients for distress at the 2016 National Cancer Research Institute (NCRI) Conference in Liverpool, UK. Prof. Mitchell starts by explaining that many centers have now introduced screening although the different measures that are used are quite unwieldy. Increasingly we are moving to user-friendly tools, which are simple and easy to interpret for patients. However, even with those tools, the question is how accurate they are and if they are being implemented around the world. Prof. Mitchell explains that…
Afaf Girgis, PhD, of the University of New South Wales, Sydney, Australia, gives an overview of her talk on unmet needs at the 2016 National Cancer Research Institute (NCRI) Conference in Liverpool, UK. Prof. Girgis begins by explaining that the main purpose of assessing unmet needs is to better understand the specific issues that patients have, which they are not currently getting supported for. Unmet needs are different to satisfaction surveys where we can understand how satisfied patients are with services but which do not tell us if people still have unmet needs in particular areas. It is also different…
Giovanni Rosti, MD of Ospedale Generale, Treviso, Italy discusses a study focused on ex-patients after the standard 5-year follow-up period is finished. Dr Rosti creates an ambulatory, a place where people who had cancer can visit, get a medical check-up and lifestyle instructions. This initiative leads to identification of unmet needs, as patients find it difficult to cope with social and sexual issues. First step for clinicians to understand patients issues is to collect the information. Then the information can be shared with specialists in a given category, e.g. psychology or gynaecology. Dr Rosti mentions that supportive care is not…
Gregory Crawford, MBBS, MPHC, MD, FRACGP, FAChPM of The University of Adelaide, Adelaide, Australia discusses how to handle end of life discussions as a doctor. In case of uncertainty it is important to ask patients how much information they want, as some patients would like to know details, while others prefer to talk in general terms. Dr Crawford mentions that it is useful to plan for the worst and hope for the best. Hope is important to patients, but it changes over time. Systems are required to provide support for pain control and physical care, not only in hospitals, but…
Irma Verdonck-de Leeuw, PhD of VU University Medical Center, Amsterdam, The Netherlands discusses sleep disturbances and supportive care approaches. There are many cancer patients who have a clinical level of sleep problems, namely insomnia and it is quite important that they receive treatment for this, as some patients can also experience fatigue or may have depressive mood disturbances alongside their insomnia, resulting in a whole cluster of symptoms that they suffer from. Dr. Leeuw highlights that there are several causes that interact with each other, for instance depression adding to sleep deprivation as the patient is ruminating all kinds of…
Jeeve Kanagalingam, MD of Mount Elizabeth Novena Hospital, Singapore, discusses oral mucositis investigations. Looking at patient and physician perspectives of oral mucositis, survey done in six countries in Asia, interviewed patients who suffered from oral mucositis as well as their physicians. The study shows that there is a very poor prevention of oral mucositis. Secondly, study results show very poor early detection, and thirdly there is huge misalignment between what patients think is important and what physicians think is important. The general perception amongst physicians is that there is a lack of effective remedies for this condition. Dr Kanagalingam mentions…
Paolo Bossi, MD of Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy discusses a MASCC 2016 workshop focused on mucositis management. The pre-clinical part of the workshop was focused on animal models of mucositis developed by Prof Stephen Sonis and the role of a photobiomodulation. Dr Bossi highlights the importance of basic oral care, as prevention is the first opportunity to give patients mucositis management when symptoms occur. Treating the painful impact of mucositis is also significant and medication should be tailored according to the patient. Recorded at the Multinational Association of Supportive Care in Cancer (MASCC) and International Society…
Winston Tan, MD of Mayo Clinic, Jacksonville, FL discusses the impact of cancer on the bone micro-environment. Bone metastasis is debilitating to patients, for example prostate cancer patients becoming bedridden due to bone pains. He emphasizes the importance of understanding what other factors can be targeted in the treatment of prostate cancer. Part of the micro-environment includes the macrophages, the immune factors that feed the system, the factors that affect osteoblast function and the vascular-endothelial factors. Dr. Tan briefly describes the bone microenvironment as anything else outside the cancer that enhances its growth and maintenance, thereby causing debilitation. The bone…
Antonio Llombart, MD, PhD, of the University Hospital Arnau de Vilanova, Valencia, Spain, discusses physical exercise to help lower the risk of relapse in breast cancer patients at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. As well as specific treatments such as endocrine therapy, targeted agent therapy and chemotherapy, for patients who are suffering from breast cancer, there are other aspects which are almost as important to maintain quality of life but also have impact on the tumor. One of the facts that has been observed in retrospective and prospective studies is that physical…
Antonio Llombart, MD, PhD, of the University Hospital Arnau de Vilanova, Valencia, Spain, discusses extended endocrine therapy for the prevention of relapse of breast cancer at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. He explains that an important debate amongst doctors has concerned the extended endocrine treatment for more than 5 years. The standard treatment of endocrine therapy was 5 years. However, new trials have shown that expanding treatment for more than 5 years could increase or could prevent late relapses. The debate is about which patients are good candidates for this treatment and…
Julia Camps Herrero, MD of the Hospital de la Ribera, Alzira, Spain, discusses the use of various methods for the detection of breast cancer at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa), in Barcelona, Spain. She starts by explaining that mammography is not perfect. Up to 40% of cancers can be missed in very dense breasts. Other methods that are better than mammography have therefore been looked into. These are methods that do not need radiation, methods that do not need contrast, and methods that can look into breast density more effectively. One improved method is tomosynthesis;…
Katy Hogben, MBBS, FRCS, PhD, talks about when and in what cases radiotherapy is used for the treatment of breast cancer at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. She explains that in the UK, all women who have high risk or high grade DCIS and have a wide local excision will be offered radiotherapy as an adjunctive treatment. Women with a low risk or low grade DCIS wont be offered radiotherapy. Furthermore, for the group of women with intermediate risk DCIS, radiotherapy will be discussed based on individual factors. These factors will include…
Antonio Llombart, MD, PhD, of the University Hospital Arnau de Vilanova, Valencia, Spain, discusses two trials, the SOFT and TEXT trials, investigating combination treatments for patients with breast cancer (NCT00066690 and NCT00066703) at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. We have known for a while that endocrine treatment is the base for endocrine sensitive tumors. In fact, the first active treatment that we knew for breast cancer was ovarian suppression. Right now the question is, if the suppression of ovarian function is effective when we have other treatments and whether or not adding…
Mafalda Oliveira, MD of the Vall d’Hebron University Hospital, Barcelona, Spain discusses her talk on the results of the Phase Ib trial of ribociclib (LEE011) with everolimus and exemestane in the treatment of hormone receptor-positive HER2 negative advanced breast cancer (NCT01857193) at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. She explains that this trial was aimed to test whether the addition of the new drug ribociclib to exemestane and everolimus is tolerable and feasible and whether the outcomes of these patients can be improved. During her talk she gives a general overview of the…
Wolfgang Janni, MD, PhD, of the University of Ulm, Ulm, Germany, talks about his side of the debate of whether denosumab or bisphosphonate are more effective drugs for the treatment of breast cancer at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. He explains that his role in the debate is to argue in favor of using denosumab instead of bisphosphonate. He believes that there is very convincing data comparing bisphosphonates and denosumab. Furthermore, the efficacy of denosumab in terms of preventing skeletal-related events, such as pain and also costs associated with with skeletal-related events…
Peter Schmid, FRCP, MD, PhD of the Barts Cancer Institute, London, UK, talks about recent studies where platinum compounds are added to chemotherapy to improve long-term outcome at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. Prof Schmid explains that there has been good evidence from studies that show that the addition of platinum compounds to standard chemotherapy can significantly, in a meaningful way increase the rate of pathological complete response (CR). We also know from large studies from meta-analyses that an increased rate in pathologic complete response (pathCR) translates to long-term outcome. He therefore…
Pierfranco Conte, MD of the University of Padova, Padova, Italy talks about his side of the debate on whether or not there are any correct rules for the sequence treatment of chemotherapy at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. Prof. Conte explains that he believes there are no right rules for the sequence of treatment for chemotherapy for advanced breast cancer. There are however some general and generally accepted rules. One of these is that in case of hormone receptor-positive disease you should prefer an endocrine therapy in front-line and only switch to…
Laura Esserman, MD, MBA, of the UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA talks about neoadjuvant therapy at at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. She explains that neoadjuvant therapy is the idea that if someone is at risk of having their cancer come back in the rest of their body (known as systemic recurrence), instead of giving the chemotherapy or the hormone therapy after the surgery, they would benefit from being given the therapy before surgery. The basis of that is that if someone is going to get systemic…
Katy Hogben, MBBS, FRCS, PhD, of Imperial College Healthcare, London, UK discusses the importance of MRI at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. She explains that MRI is a very important tool and we are very lucky to have it in the Western world where it is used extensively. She believes that it is, however, not for every patient. MRI is discussed for every patient in multidisciplinary team meetings as an adjunct to diagnosis in early breast cancer patients.
Julia Camps Herrero , MD of the Hospital de la Ribera, Alzira, Spain, discusses the use of MRI for the diagnosis of breast cancer at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa), in Barcelona, Spain. She believes that MRI is an essential tool because it is the best diagnostic technique available nowadays for breast cancer. The problem with MRI, however, is that it has to meet minimum requirements in order to be good for the patient – it has to be technically good, and it has to be interpreted by a breast radiologist so that he can…
Bruce Mann, MBBS, PhD, FRACS, of the Peter MacCallum Cancer Centre, Victoria, Australia, talks about the World Congress on Controversies in Breast Cancer (CoBrCa) 2016 meeting. He starts by explaining that CoBrCa 2016 is the second conference on breast cancer with the first in 2015 being highly successful. He explains that the concept of CoBrCa is to cover clinical controversies and issues that doctors looking after patients with breast cancer come across each week in their clinical practice where the answers are not clear cut and where there are differences of opinion amongst doctors. CoBrCa aims to solve these conflicting…
Antonio Llombart, MD, PhD, of the University Hospital Arnau de Vilanova, Valencia, Spain, discusses new combination treatments for patients with breast cancer at the 2016 World Congress on Controversies in Breast Cancer (CoBrCa) in Barcelona, Spain. He explains that it has been known for almost 40 years that endocrine therapy is the most important treatment for patients with endocrine dependent estrogen receptor-positive early breast cancer. We have been treating these patients with anti-endocrine therapies such as ovarian suppression for more than one century. At some point in the past, the value of ovarian suppression was questioned because it was replaced…
Is it recommended that all MPN patients be on a cholesterol-lowering medication? Dr. Olatoyosi Odenike from the University of Chicago Medical Center responds in this Ask the Expert segment. Dr. Odenike explains how these two medical issues are separate but have overlapping concerns. 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
Whats the best way to access genetic testing? Is it necessary? Is it expensive? Does insurance cover the costs? Experts from the UAMS Myeloma Institute share their advice and combined knowledge. Listen as myeloma expert Drs. Gareth Morgan, Frits van Rhee, and Faith Davies discuss gene expression profiling including when and where to get it done. They also review whats covered by insurance as well as liquid genetic profiling. 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
What is the expected life span and quality of life for a patient diagnosed with essential thrombocythemia (ET)? In this Ask the Expert segment, Dr. Prithviraj Bose from The University of Texas MD Anderson Cancer Center discusses reviews the typical monitoring and risks of ET and refers to the diagnosis as the most favorable prognosis among the classic MPN diagnoses. 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
Do the new PV (polycythemia vera) medications such as JAK2 inhibitors benefit patients that do not have a spleen? Dr. Prithviraj Bose of MD Anderson Cancer Center discusses both splenomegaly and splenectomy in PV patients. Listen for his explanation on JAK2 based on the RESPONSE II clinical trial data. 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
Barbara Eichhorst, MD of the University of Cologne, Cologne, Germany, discusses the treatments of elderly chronic lymphocytic leukemia (CLL) patients and the use of novel therapies. There are novel therapies that are significantly better tolerated by the elderly. However, if combination therapies are used in the future, this could be difficult for this population, particularly from a mental point of view. Dr Eichhorst mentions how available combination treatments, which are better tolerated in the general sense, may not be applicable to the elderly patient population. For example with venetoclax, there is a ramp-up period and therefore it may not suitable…
Stephan Stilgenbauer, MD, PhD of Ulm University, Ulm, Germany, discusses the development of drugs for treatment in chronic lymphocytic leukemia (CLL). He starts by mentioning that clinicians shouldnt forget about chemotherapy or chemoimmunotherapy, which for particular patient sub-groups such as the ones with low risk genetics or mutated IGHV genes, result in very long remission after a relatively short period of treatment. Prof. Stilgenbauer mentions ibrutinib and venetoclax and furthermore, that there are second and even third generation compounds in that direction coming down the road. He also talks about PI3K inhibitors and how after some difficulty with idelalisib, they…
Anna Schuh, MD, PhD, MRCP, FRCPath of University of Oxford, Oxford, UK, discusses new developments in the field of precision medicine for chronic lymphocytic leukemia (CLL). There are many treatment options available to patients, combined with a range of diagnostic tools to identify biological differences seen in CLL. Dr Schuh mentions that precision medicine means giving the right treatment to the right patient, at the right time. New sequencing technologies face challenges, like getting samples quickly to laboratories and testing standardization. Dr Schuh highlights the advances in TP53 mutation detection and whole genome sequencing (WGS), which gives an unbiased view…
Julia von Tresckow, MD of University of Cologne, Cologne, Germany, discusses the CLL2-BIG trial, which is one of four trials with the triple-T concept of a tailored and targeted treatment aimed at total eradication of minimal residue disease (MRD). The CLL2-BIG trial is an exploratory phase II trial designed to show that a combination regimen of ibrutinib and obinutuzumab is safe and efficacious in an all-comer population. Recorded at the 2016 International Workshop of the German CLL Study Group (GCLLSG) in Cologne, Germany.