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What are the benefits to participating in multiple myeloma clinical trials? Dr. Faith Davies of UAMS Myeloma Institute responds to questions about accessing optimal care for individual myeloma patients. Dr. Davies discusses the ever increasing myeloma treatment arsenal that includes new medications and genetic testing. To get tomorrows medicine today, myeloma expert Dr. Davies recommends joining a clinical trial, involving your family and building a partnership between your local oncologist and myeloma specialist. Dont go on a journey without a good, detailed map! 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…

Will my essential thrombocythemia (ET) or polycythemia vera (PV) progress to myelofibrosis (MF)? Patient Power host and MF patient, Andrew Schorr, asks MPN expert Dr. Mark Heaney of Columbia University Medical Center questions regarding the connection between ET and PV and their potential progression to MF. Dr. Heaney explains why ongoing serial follow-ups remain important even though MPN progression does not always occur. 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

Toni Choueiri, MD of the Dana-Farber Cancer Center, Boston, MA discusses the Phase III METEOR randomized clinical trial of cabozantinib vs everolimus in advanced clear cell renal cell carcinoma (ccRCC) (NCT01865747). This trial randomized patients to everolimus on a standard dose of 10 mg/day or cabozantinib, which was administered at a dose of 60 mg/day. Cabozantinib is a multi-tyrosine kinase inhibitor that offers inhibition of the vascular endothelial growth factor (VEGF) receptor. There was a 1:1 randomization between cabozantinib and everolimus. The primary endpoint of the study of progression-free survival (PFS) was met, and he mentions that the results were…

Neal Shore, MD of the Carolina Urologic Research Center, Myrtle Beach, SC, discusses the advances in the development of treatments and therapies for patients with advanced prostate cancer. Dr Shore highlights that patients who initially failed localized treatments and progressed to a requirement for androgen suppressive immunotherapy, will invariably convert from an androgen sensitive state to a castration-resistant state. Since 2010, five new therapeutics have been approved worldwide. However, there are still challenges surrounding accessibility and cost. According to Dr Shore, there is a paucity in terms of sequencing data and combination data that are done in a large, prospective…

Paolo Ascierto, MD, of the National Tumor Institute Fondazione G. Pascale, Naples, Italy, discusses the Phase II safety study CheckMate 172 of nivolumab for treating advanced melanoma patients (NCT02156804). He mentions that patients of the study were pre-treated with ipilimumab, and in case of BRAF mutation, were also treated with a BRAF inhibitor. Over 1000 patients were enrolled in the study, and results will be shown regarding the first 300 patients, who have a minimum follow-up of six months. He further highlights that the results that were to be presented are very preliminary results but are interesting as they confirm…

Jonathan Ledermann, MD, FRCP from University College London, London, UK discusses his presentation on the update on the results of the Study 19 trial (NCT00753545). Study 19 was a randomized maintenance trial using olaparib in patients with recurrent high grade serous ovarian cancer, who had previously responded to platinum-based chemotherapy. Patients were randomized to olaparib or a placebo. Prof. Ledermann talks about the 3 year follow-up on overall surviva (OS) and how there was meaningful improvement in patients taking olaparib. These findings, however, were not statistically significant. Prof. Ledermann further discusses how the trial looked into several supplementary exploratory endpoints…

Hendrik-Tobias Arkenau, MD, PhD from the Sarah Cannon Research Institute, London, UK discusses his highlights from the American Society of Oncology (ASCO) 2016 Annual Meeting held in Chicago, IL. Dr Arkenau points out that immunotherapy used to treat various cancers such as melanoma, renal cell, and lung cancer, is a key topic. Dr Arkenau discusses the use of a PD-L1 inhibitor called avelumab in patients with gastric cancers. Furthermore, Dr Arkenau talks about advancements in patients with mismatch repair gene defects, which, for example, occur in around 5% of colon cancer patients.

David Ross Camidge, MD, PhD of the University of Colorado, Denver, CO, provides an insight into the study (NCT01631552) of a new antibody-drug conjugate (ADC) sacituzumab govitecan (IMMU-132). IMMU-132 targets Trop-2, a very commonly expressed epithelial marker in different cancers, such as in 70-80% of lung cancers. The ADC uses the antibody as a delivery system, where the conjugate is the toxin. In this case, the old-fashioned but effective toxin used is SM38, an active ingredient of irinotecan. Prof. Camidge explains that researchers have previously looked at irinotecan in lung cancer, highlighting its 4% response rate. He further explains that…

James Larkin, MD, PhD, of the Royal Marsden NHS Foundation Trust, London, UK discusses the use of the new immunotherapy checkpoint inhibitors, and the influence they have had on melanoma. He proceeds to state that even in the best case scenario, response rate to treatment with both ipilimumab and nivolumab (IPI+NIVO) is around 50-60%, and with NIVO or pembrolizumab (PEMBRO), the response rate is around 30-40%. Given these figures, it is clear that there are a substantial number of patients who are not responding to treatment. The immune system is complicated and understanding who will respond to treatment and why…

Sumanta Pal, MD of City of Hope, Duarte, CA, discusses the BGJ398 clinical trial in patients with previously treated advanced/metastatic urothelial carcinoma (NCT01004224). He explains that for the past three decades, all that has been available for patients is cisplatin based chemotherapy, and most recently the PD-L1 antibody atezolizumab. However, the main concern surrounds the fact that there are still going to be patients who will not respond to immunotherapy, and since patients progress beyond chemotherapy, more options are now needed. BGJ398 is a targeted drug that antagonizes FGFR3, which is a compound or a mutation that arises within 20%…

Erika Hamilton of Sarah Cannon Research Institute, Nashville, TN talks about the Phase I trial of AZD2014 for the treatment of patients with with estrogen receptor (ER+) metastatic breast cancer (BC) (NCT01597388). AZD2014 is a dual mammalian target of rapamycin (mTORC1/2) inhibitor that works in contrast with everolimus, which is the approved agent that acts to only inhibit mTORC1. Since signaling through mTORC2 is a resistance mechanism for everolimus, they are particularly excited to see this activity in combination with fulvestrant for a dual mTOR inhibit, i.e. blocking mTOR complex 1 and 2. She highlights that the study allowed patients…

Bristol-Myers Squibb Company announced that CheckMate 026, a trial investigating the use of Opdivo or nivolumab as monotherapy, did not meet its primary endpoint of progression-free survival in patients with previously untreated advanced non-small cell lung cancer whose tumors expressed PD-L1 at equal to or less than 5%. Giovanni Caforio, M.D., chief executive officer, Bristol-Myers Squibb, commented quote Opdivo has become a foundational treatment that is transforming cancer care across multiple tumor types. While we are disappointed CheckMate 026 did not meet its primary endpoint in this broad patient population, we remain committed to improving patient outcomes through our comprehensive…

Jalid Sehouli, MD, PhD from Charité Comprehensive Cancer Center, Berlin, Germany discusses the Phase II TRIAS 2009 trial of sorafenib with topotecan in patients with platinum-resistant recurrent ovarian cancer (NCT01047891). According to Prof. Sehouli, this combination can increase progression-free survival (PFS) and shows an overall survival (OS) benefit compared to the standard treatment. Recorded at the 2016 Annual Meeting of the American Society of Clinical Oncology (ASCO), held in Chicago, IL.

Grant McArthur, MBBS, BMedSci, PhD, FRACP from the Peter MacCallum Cancer Centre, Melbourne, Australia gives an overview of mutations in melanoma and developments in therapies to combat such mutations. 70-80% of melanoma cases have activating mutations in BRAF MEK/ERK pathway. 40-50% have mutations in BRAF and 15-20% have mutations in NRAS. Prof. Grant McArthur explains the first positive Phase III trial called NEMO of binimetinib targeting the RAS oncogene in patients with NRAS-mutated melanoma (NCT01763164). Meaningful improvements in progression-free survival (PFS) have been seen and Prof. McArthur finds this promising for the future. Recorded at the American Society of Oncology…

Grant McArthur, MBBS, BMedSci, PhD, FRACP from the Peter MacCallum Cancer Centre, Melbourne, Australia discusses the results of the Phase III coBRIM trial (NCT01689519), which focuses on therapies for BRAF-mutated melanoma (MM). The clinical trial aimed to test the hypothesis that combination of vemurafenib (V) and cobimetinib (C) was superior to monotherapy with vemurafenib plus placebo. Findings showed median overall survival (OS) was 22 months in the group with combination therapy and 17 months in the group treated with monotherapy. According to Prof. McArthur, subsets are of particular interest. For example, BRAF-mutated melanoma is considered to be in different prognostic…

Gary K. Schwartz, MD of the Columbia University Medical Center, New York, NY discusses the success and potential of immunology as a treatment for sarcomas. Dr Schwartz explains that sarcoma is a complex cancer, representing 60 different cancers; he continues, highlighting that it now poses as a challenge when doctors are trying to develop new therapies directed at the vast scope of tumor subtypes that need to be considered. He then discusses studies on immunotherapy presented at the 2016 Annual Meeting of the American Society of Clinical Oncology (ASCO), held in Chicago, IL. The first Phase II trial he discusses…

Manmeet Ahluwalia, MD of the Cleveland Clinic Cancer Center discusses how ANG1005 shows promise for patients with leptomenigeal disease

Manmeet Ahluwalia, MD from Cleveland Clinic Cancer Center and the Predictive and Prognostic biomarkers for Brain Metastasis

Manmeet Ahluwalia, MD of Cleveland Clinic Cancer Center discusses the side effect profile of ANG1005 from ASCO 2016

Manmeet Ahluwalia, MD of Cleveland Clinic Cancer Center outlines how ANG1005 shows promise in Brain Cancer at ASCO 2016

Manmeet Ahluwalia, MD of Cleveland Clinic Cancer Center discusses Blood Brain Barrier and TKI in Brain Cancer treatment at ASCO 2016

Manmeet Ahluwalia, MD of Cleveland Clinic Cancer Center discusses Treating Brain Metastasis is being redefined due to genomic profiling from ASCO 2016

Jame Abraham, MD discusses PD-L1 in Triple Negative Breast Cancer from ASCO 2016

Jame Abraham, MD @CleClinicMD Cleveland Clinic Cancer Center highlights the Current and future Immunotherapy outlook in breast cancer from ASCO 2016

Dr. Jame Abraham, MD of the Cleveland Clinic Cancer Center @CleClinicMD discusses the PALOMA trials summary and Palbociclib in ER-positive breast cancer

In this presentation from the ESMO 18th World Congress on Gastrointestinal Cancer, Dr. George Hanna discusses which esophageal cancer patients should not be operated upon.

In this presentation from the ESMO 18th World Congress on Gastrointestinal Cancer, Dr. David Cunningham discusses which esophageal cancer patients should be operated upon.

In this presentation from the ESMO 18th World Congress on Gastrointestinal Cancer, Dr. Margaret A. Tempero discusses new agents and strategies on the horizon in pancreatic cancer.

In this presentation from the ESMO 18th World Congress on Gastrointestinal Cancer, Dr. Massimo Falconi examines whether or not we are making progress in surgery of the pancreas.

In this presentation from the ESMO 18th World Congress on Gastrointestinal Cancer, Dr. Thomas Seufferlein argues that it is not justified to move from adjuvant to neo-adjuvant treatment in the treatment of pancreatic cancer.

In this presentation from the ESMO 18th World Congress on Gastrointestinal Cancer, Dr. Jordan D. Berlin argues that it is justified to move from adjuvant to neo-adjuvant treatment in the treatment of pancreatic cancer.

In this presentation from the ESMO 18th World Congress on Gastrointestinal Cancer, Dr. Pascal Hammel discusses screening in familial pancreatic cancer.

In this presentation from the ESMO 18th World Congress on Gastrointestinal Cancer, Dr. Dileep Lobo examines whether peri-operative nutritional support can improve the outcome of gastrointestinal cancer patients.

In this presentation from the ESMO 18th World Congress on Gastrointestinal Cancer, Dr. Florian Strasser discusses cachexia and sarcopenia in gastrointestinal cancer, with a focus on the mechanisms and how to interfere with them.

In this presentation from the ESMO 18th World Congress on Gastrointestinal Cancer, Dr. Jens Ricke discusses the pitfalls in imaging for liver tumors.

Giuseppe Saglio, MD of the University of Turin, Turin, Italy discusses the back and forth between basic research and clinical research in relation to the treatment of patients with chronic myeloid leukemia (CML). Recorded at the 2016 Annual Meeting of the British Society of Haematology (BSH) and International Society of Hematology (ISH), held in Glasgow, Scotland.

Giuseppe Saglio, MD of the University of Turin, Turin, Italy provides an overview of the results of the Phase III trial of DASISION in patients with chronic myeloid leukemia (CML) and the future of CML treatment (NCT00481247). In the DASISION trial, patients were randomized to receive either dasatinib or imatinib therapy. The findings were in favor of dasatinib therapy, which resulted in deeper and faster achievement of molecular response and further, it was well tolerated. There was a problem with the occurrence in some cases of pleural effusions. When this occurred the treatment was restarted or dosage was reduced. Prof…

Gail Roboz, MD from Weill Medical College of Cornell University, New York, NY discusses new treatments for elderly acute myeloid leukemia (AML) patients outside of clinical trials. Although azacitidine and decitabine are not novel agents their application is new, and has somewhat replaced low-dose ara-C. However, azacitidine and decitabine produce low remission rates. According to Dr Roboz there is an increased interest in adding partners to the hypermethylating agent backbone to boast rates of complete remission. Furthermore, an increased number of transplants are being undertaken in elderly patients and if the efficacy of azacitidine and decitabine can be augmented, and…

Nearly 12% of men with advanced prostate cancer have inherited mutations in genes that play a role in repairing damaged DNA, according to a new study. Inherited mutations in DNA-repair genesincluding BRCA2, ATM, and CHEK2are associated with an increased risk of several other cancers, including breast, ovarian, and pancreatic cancer. This finding offers a new window into understanding how metastatic prostate cancers develop, said Peter Nelson, M.D., of the Fred Hutchinson Cancer Research Center, who co-led the study. Reporting their results in the New England Journal of Medicine on July 6, the researchers noted that, in the future, men who…

Thomas Powles, MD, PhD from Barts Cancer Institute, London, UK discusses the BISCAY clinical trial in bladder cancer (NCT02546661). The trial looks at a group of patients with bladder cancer and next-generation sequencing (NGS) was performed on their tumor samples looking for specific mutations. The treatment will then be based on the patients’ mutations; for example if patient have an FGFR3 mutations, they will receive an FGFR3 inhibitior plus immunotherapy (durvalumab). Prof. Powles anticipates that high response rates will be seen in patients with specific mutations, who are receiving targeted therapy. Recorded at the American Society of Oncology (ASCO) 2016…

Philippe Rousselot, MD, PhD from Versailles Hospital and University, Versailles, France discusses the current medical need of Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) patients. After five years of follow up, most studies have shown a relapse rate of around 60%, despite the combination of tyrosine kinase inhibitors (TKIs, mainly imatinib and chemotherapy), with various dosage levels, as well as the aim of allogeneic bone marrow transplantation. Prof. Rousselot, goes on to discuss a trial (NCT00391989) testing dasatinib as first-line treatment in elderly ALL patients. Very few of the participants had been allografted and of those that relapsed, analysis showed…

Thomas Powles, MD, PhD from Barts Cancer Institute, London, UK discusses a talk on immune checkpoint inhibitors in bladder cancer given at the American Society of Oncology (ASCO) 2016 Annual Meeting held in Chicago, IL. Topics discussed included immune checkpoint inhibitors and biomarkers. Prof. Powles discusses how atezolizumab, traditionally used in second line settings is now being used in the frontline setting for patients who are not eligible for cisplatin-based chemotherapy (NCT02108652); the survival of these patients increased from 8-9 months to 15 months. The study was small with around 120 patients, but according to Prof. Powles the results are…

Joseph Mikhael, MD from the Mayo Clinic, Scottsdale, AZ discusses his highlights for multiple myeloma (MM) from the American Society of Oncology (ASCO) 2016 Annual Meeting held in Chicago, IL. First, Prof. Mikhael discusses monoclonal antibodies and the CASTOR trial of daratumumab, bortezomib and dexamethasone vs bortezomib and dexamethasone prestented by Dr Antonio Palumbo at ASCO (NCT02136134). At the moment, daratumumab is approved for monotherapy and later in the disease course. This study confirms the use of monoclonal antibodies earlier in the course of the disease and in combination according to Prof. Mikhael. He then discusses the POLLUX trial of…

Anton Hagenbeek, MD, PhD from University of Amsterdam, Netherlands provides a summary of the press briefings held at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. First, Prof. Hagenbeek discusses a follow-up trial on immune checkpoint inhibitor nivolumab in Hodgkin lymphoma called Checkmate 205 (NCT02181738) presented by Prof. Anas Younes. Nivolumab works by reactivating T-cells in the lymph nodes, attacking the malignant cells and kills them through giving an antibody that prevents contact between the Reed-Sternberg cells and the lymphocyte which paralyzes the lymphocyte. Releasing the break would then allow for the T-cell to kill the Hodgkin…

John Pagel, MD, PhD of the Swedish Cancer Institute, Seattle, WA discusses highlights for chronic lymphocytic leukemia (CLL) from the American Society of Oncology (ASCO) 2016 Annual Meeting held in Chicago, IL. Dr Pagel talks about data on from the HELIOS trial of ibrutinib in combination with bendamustine and rituximab (EudraCT No. 2012-000600-15). Further, data around CAR T-cell therapy, which is promising, will be discussed at the meeting. Dr Pagel also mentions acalabrutinib, a second generation BTK inhibitor. Finally, he discusses the prognostication of patients and the CLL-IPI score, which will help predicte how patients will do over time and…

John Pagel, MD, PhD of the Swedish Cancer Institute, Seattle, WA provides an overview of an educational session on the current issues in therapeutic endeavours for chronic lymphocytic leukemia (CLL) at the American Society of Oncology (ASCO) 2016 Annual Meeting held in Chicago, IL. The current status of CLL therapy was discussed with a focus on using different agents for different patients. For example, chemoimmunotherapy may not be appropriate for elderly or unfit patients but provides a major benefit for younger, fit patients in terms of long-term survival without additional therapy. For patients who cannot receive immunotherapy, the option of…

Finbarr Cotter, MD, PhD from British Society of Hematology (BSH) Conferences and Barts Health NHS Trust, UK discussing the 2016 Annual Meeting of the BSH and International Society of Hematology (ISH) held in Glasgow, Scotland. ISH is one of the oldest hematology organisation while BSH has been having an annual meeting since 1960. During these conferences which colleagues can get together to present and discuss research.

Andrew Zelenetz, MD, PhD, from Memorial Sloan-Kettering Cancer Center, New York, NY discusses the mechanism of action of ibrutinib and idelalisib and further drug combinations under investigation in CLL. Both drugs impact the growth and survival of CLL cells but in a parallel way according to Dr Zelenetz. He further discusses various studies looking at combinations, such as idelalisib with BTK inhibitor ONO-4059, and PI3K delta inhibitor ME-401 with a novel BTK inhibitor. Recorded at the 2016 Annual Meeting of the British Society of Haematology (BSH) and International Society of Hematology (ISH), held in Glasgow, Scotland.

Susan O’Brien, MD from the University of California, Irvine, CA discusses Philadelphia chromosome-positive (Ph+) acute lymphoblastic leukemia (ALL) and the question of stem cell transplantation at the American Society of Oncology (ASCO) 2016 Annual Meeting held in Chicago, IL. Historically, Ph+ ALL was considered one of the most high-risk ALLs as the disease always recurred. Allogeneic stem cell transplant was seen as the only possible cure, however, this was limited by factors such as age. Dr O’Brien explains how the outcome for Ph+ ALL and chronic myeloid leukemia (CML) patients was changed with the use of tyrosine kinase inhibitors (TKI)…