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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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.

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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…

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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…

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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…

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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.

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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…

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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…

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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.

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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…

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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…

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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…

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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…

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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…

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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…

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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…

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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…

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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.

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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…

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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…

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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…

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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…

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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…

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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…

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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…

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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.

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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…

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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…

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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.

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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…

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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…

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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…

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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…

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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…

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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…

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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.

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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…

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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…

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David Currow, PhD, MPH, FRACP, FAChPM, FAHMS, GAICD of Flinders University, Adelaide, Australia talks about his poster at the 2016 World Conference of Lung Cancer (WCLC) summarizing two Phase III studies: ROMANA-1 and ROMANA-2 looking at efficacy and safety of anamorelin in cachexia for patients with non-small cell lung cancer (NSCLC) (NCT01387269, NCT01387282). These studies had identical eligibility criteria, primary outcomes and analysis. The results showed a sustained increase in lean body mass, an improvement in patient reported appetite, an improvement in fat mass across the 12 weeks of treatment in both studies as well as total mass. The studies…

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Charlotta Pisinger, PhD, MD, MPH of the Rigshospitalet, Copenhagen, Denmark discusses e-cigarettes and their impact on health. She talks about her recently updated systematic review with the WHO, which shows a growing body of evidence that e-cigarettes are harmful. Increasing numbers of different brands and flavors mean research cant keep up with their differing risk profiles. Some have a very high level of carcinogenic substances, some have none. She discusses animal studies of vapor exposure that show that animals develop asthma and chronic obstructive pulmonary disease (COPD), as well as having an increased risk of infections and higher mortality. Human…

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Charles Rudin MD, PhD of the Memorial Sloan Kettering Cancer Center, New York, NY discusses targeted therapies, immunotherapy and their combination in non-small cell lung cancer (NSCLC) therapy. Targeted therapy and immunotherapy are complimentary strategies. Targeted inhibitors are associated with very high response rate in tumors with specific mutations which are targeted by these drugs. However, almost all patients treated with targeted inhibitors will relapse. Immunotherapy is different in that are a smaller fraction of patients will respond, but response is potentially more durable. The goal of this trial was to try and get the benefits of each type of…

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Beth Eaby-Sandy MSN, CRNP, OCN, of the Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA explains the different toxicities seen with immunotherapy compared to chemotherapy. Toxicities associated with immunotherapy are generally uncommon, but can be life threatening if they progress. It important for nurses to understand why these patients are having these toxicities, and how they differ from chemotherapy. Nurses must tell patients when to get in contact. Three of the most common severe immune-mediated toxicities from immunotherapies used in lung cancer are: pneumonitis, colitis, and rash/dermatitis. Pneumonitis and colitis are the two that can be life-threatening. Patients with pneumonitis…

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Barbara Melosky, MD, FRCPC, of the University of British Columbia, Vancouver, BC discusses how the world of epidermal growth factor receptor (EGFR) mutating lung cancers has changed in terms of management, understanding, and the choices which are available. Research is investigating which patients might benefit from certain medications, as choice is expanding with each generation of drugs. There are first-generation EGFR tyrosine kinase inhibitors (TKIs); gefitinib, and erlotinib, second generation EGFR TKIs; afatinib, dacomitinib, and third generation; osimertinib. Dr Melosky is most excited about AURA3 data for osimertinib (NCT02151981). The choices today in the first-line setting for patients depend on…

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Ales Ryska, MD, PhD, of the Charles University, Medical Faculty Hospital, Prague, Czech Republic gives an overview of a session he chaired, which focused on a multidisciplinary approach for the diagnosis of lung cancer. He explains how all specialties are required for correct diagnosis today, including endoscopists, pulmonologists, surgeons, pathologists, and molecular biologists. The first presentation was about the main challenges in the testing of lung cancer, covering what is currently available, and what prospects there are for the near future. His second presentation was about what is new with bronchoscopic techniques. Specifically, how endoscopy can get more material for…

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At ASH 2016, MPN experts from across the nation share their perspective on what the future holds for MPNs, in both the short term and long term. Dr. John Mascarenhas from Mount Sinai School of Medicine in New York City, Dr. Catriona Jamieson of UC San Diego Health Moores Cancer Center, and Dr. Stephen T. Oh of Washington University School of Medicine provide an optimistic outlook on MPN research and treatment. 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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It is an honor and a privilege to be selected to present at the American Society of Hematology Conference. Dr. Jonathan Gerber is among the select few chosen due to the importance of his work over the past several years. In this video clip, Dr. Jonathan Gerber talks about the significance of research collaboration from industry leaders across the country.

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At ASH 2016, experts from across the nation discuss how genetic testing is affecting the evolution of treatment for MPNs. Dr. Stephen Oh of Washington University School of Medicine explains exactly what genetic testing could mean for patients. Dr. Catriona Jamieson of UC San Diego Health Moores Cancer Center follows by helping viewers to understand what the ongoing learnings reveal and the effect of looking at things at a “nano” level. 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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We continue to provide informational videos for our Spanish speaking community and welcome Dr. Luis Raez, MD FACP FCCP, Chief of Hematology/Oncology and Medical Director at Memorial Cancer Institute, and Clinical Associate Professor of Medicine at Florida International University. Dr. Raez joined GRACE to discuss the basics of lung cancer. In this 27th video for the Spanish lung cancer video library, Dr. Raez discusses potential side effects of immune checkpoint inhibitors and basic management approaches.

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In this presentation from Lymphoma & Myeloma 2016, Dr. Kenneth C. Anderson discusses new paradigms and therapies in the treatment of relapsed/refractory myeloma, with an emphasis on small molecules and monoclonal antibodies. Earn CME credit for a related activity at the following location: http://elc.imedex.com/ELC/Specialty-Search.aspx?search=7225 © 2016 Imedex, LLC.

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In this Key Insights activity, Drs. Corey J. Langer, MD and Joshua Bauml discuss the key take-home points from the 21st Annual Perspectives in Thoracic Oncology meeting held November 18-19, 2016 in New York. Earn CME credit for this activity at the following location: http://elc.imedex.com/ELC/Specialty-Search.aspx?search=7228 © 2016 Imedex, LLC.

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At ASH 2016, MPN experts from around the nation came together to review current and developing therapies for MPNs. Dr. John Mascarenhas of Mount Sinai School of Medicine in New York City discussed the use of agents that are currently approved for other conditions as well as JAK inhibitors in development. Dr. Catriona Jamieson from UC San Diegos Moores Cancer Center explains the possibility of therapy tailored to each patient, while Dr. Stephen Oh from Washington University School of Medicine expands on telomerase inhibitors and anti-fibrotic medicines. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook…

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As part of our ASH 2016 coverage, Dr. John Mascarenhas, from Mount Sinai School of Medicine, joined Patient Power to discuss the research taking place with interferon as a treatment for myeloproliferative neoplasms (MPNs). While interferon has been around for some time, theres a recent re-emergence of research in the field. Dr. Mascarenhas addresses the interim results of current studies and the new clinical trials set to begin in 2017. Learn more about interferon and why this may be a viable option for some patients with MPNs. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook…

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In this Best of the Day discussion from the annual hematology meeting held in San Diego, Drs. Joseph R. Mikhael and Sonali M. Smith analyze and discuss pertinent clinical studies and late breaking updates pertaining the care of patients with lymphoma. This engaging conversation provides updates in a comprehensive and accessible format that facilitates the incorporation of the latest treatment advances into clinical practice. Earn CME credit for this activity at the following location: https://elc.imedex.com/ELC/Activity-Overview.aspx?activityid=7243&specialty=Hematology

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In this Best of the Day discussion from the annual hematology meeting held in San Diego, Drs. Joseph R. Mikhael and David P. Steensma analyze and discuss pertinent clinical studies and late breaking updates pertaining the care of patients with acute myeloid leukemia (AML) and myelodysplastic syndromes (MDS). This engaging conversation provides updates in a comprehensive and accessible format that facilitates the incorporation of the latest treatment advances into clinical practice. Earn CME credit for this activity at the following location: https://elc.imedex.com/ELC/Activity-Overview.aspx?activityid=7242&specialty=Hematology

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In this Best of the Day discussion from the annual hematology meeting held in San Diego, Drs. Joseph R. Mikhael and Saad V. Usmani analyze and discuss pertinent clinical studies and late breaking updates pertaining the care of patients with multiple myeloma. This engaging conversation provides updates in a comprehensive and accessible format that facilitates the incorporation of the latest treatment advances into clinical practice. Earn CME credit for this activity at the following location: https://elc.imedex.com/ELC/Activity-Overview.aspx?activityid=7241&specialty=Hematology

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In this Best of the Day discussion from the annual hematology meeting held in San Diego, Drs. Joseph R. Mikhael and Neil E. Kay analyze and discuss pertinent clinical studies and late breaking updates pertaining the care of patients with chronic lymphocytic leukemia (CLL). This engaging conversation provides updates in a comprehensive and accessible format that facilitates the incorporation of the latest treatment advances into clinical practice. Earn CME credit for this activity at the following location: https://elc.imedex.com/ELC/Activity-Overview.aspx?activityid=7240&specialty=Hematology

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In this Best of the Day discussion from the annual hematology meeting held in San Diego, Drs. Joseph R. Mikhael and Ruben A. Mesa analyze and discuss pertinent clinical studies and late breaking updates pertaining the care of patients with chronic myelogenous leukemia (CML) and myeloproliferative neoplasms (MPN). This engaging conversation provides updates in a comprehensive and accessible format that facilitates the incorporation of the latest treatment advances into clinical practice. Earn CME credit for this activity here: https://elc.imedex.com/ELC/Activity-Overview.aspx?activityid=7239&specialty=Hematology

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David Ilson, MD of Memoral Sloan Kettering Cancer Center discusses data released at ASCO GI 2017. A total of 198 patients who completed chemoradiation were analyzed for the primary endpoint of pCR. Among the entire group, the pCR rate was 22.7%. The highest pCR rate of 37.5% occurred in PET responders who received both induction and concurrent FOLFOX, whereas the lowest rate of 12.5% occurred in PET responders who received both induction and concurrent carboplatin/paclitaxel. Notably, the pCR rate for PET nonresponders who switched from FOLFOX to carboplatin/paclitaxel was 19.0% and for those who switched from carboplatin/paclitaxel to FOLFOX was…

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David Ilson, MD of Memorial Sloan Kettering gives an overview of the CALGB 80803 PET Assessment to Optimize Neoadjuvant Chemotherapy in Esophageal Cancer. Background: To determine whether changing chemotherapy (CT) during pre-op chemoradiation (CRT) based on response to induction CT by 18F-fluoro-deoxyglucose PET imaging can lead to improved pathologic complete response (pCR) in patients (pts) with resectable esophageal and gastroesophageal junction (GEJ) adenocarcinomas. Methods: 257 eligible pts were enrolled, underwent baseline PET scan, and were randomized to one of 2 induction CT arms: Modified FOLFOX-6 (oxaliplatin, leucovorin, 5-FU), days 1, 15, 29 or Carboplatin/Paclitaxel (CP), days 1, 8, 22, 29.…

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Jonathan R. Strosberg, MD of the H. Lee Moffitt Cancer Center discusses the Phase III trial results of NETTER-1 as reported by the New England Journal of Medicine http://www.nejm.org/doi/full/10.1056/NEJMoa1607427CONCLUSIONS: Treatment with 177Lu-Dotatate resulted in markedly longer progression-free survival and a significantly higher response rate than high-dose octreotide LAR among patients with advanced midgut neuroendocrine tumors. Preliminary evidence of an overall survival benefit was seen in an interim analysis; confirmation will be required in the planned final analysis. Clinically significant myelosuppression occurred in less than 10% of patients in the 177Lu-Dotatate group.

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Bertram Wiedenmann, MD, PhD of Charité Universitätsmedizin Berlin? discusses the NETTER-1 results for patients with neuroendocrine tumors received an 18% response rate. Here is more details about the trial background: Patients with advanced midgut neuroendocrine tumors who have had disease progression during first-line somatostatin analogue therapy have limited therapeutic options. This randomized, controlled trial evaluated the efficacy and safety of lutetium-177 (177Lu)Dotatate in patients with advanced, progressive, somatostatin-receptorpositive midgut neuroendocrine tumors.

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Dr. Dale Shepard, MD of Cleveland Clinic gives an update on the The International Watch & Wait database (IWWD) for rectal cancer. Here is the Background: In 2014 the IWWD was established by EURECCA and the Champalimaud Foundation. The main goal of this database is to collect all available data to expand knowledge on the benefits, risks and oncological safety of organ preserving strategies in rectal cancer. In April 2015 the database was opened for data registration. Methods: An international multicentre observational study. Data was collected by participating centres and stored in a highly secured NEN7510 certified and encrypted research…

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GRACE is pleased to present a series of webcasts with faculty member John Pagel, MD, PhD, DSc, from Swedish Cancer Institute. Dr. Pagel was one of many to attend the American Society of Hematologys Annual Meeting (ASH) in early December 2016 and graciously sat down with GRACE to recap highlights from the meeting. Our fifth video in this series provides an update on CAR-T cell therapy in lymphoma.

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GRACE is pleased to present a series of webcasts with faculty member John Pagel, MD, PhD, DSc, from Swedish Cancer Institute. Dr. Pagel was one of many to attend the American Society of Hematologys Annual Meeting (ASH) in early December 2016 and graciously sat down with GRACE to recap highlights from the meeting. Our fourth video in this series updates us on antibody therapies in indolent non-hodgkins lymphoma.

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Daratumumab (DARA), a human CD38 IgG1? monoclonal antibody, has demonstrated single agent efficacy while being highly tolerable as a monotherapy, and significant efficacy in combination with standard-of-care regimens in pts with multiple myeloma (MM) who have received ?1 prior lines of therapy (Lokhorst HM. NEJM 2015, 373(13):1207-19; Lonial S. Lancet 2016, 387:1551-60; Palumbo A. NEJM 2016, in press; Dimopoulos MA. NEJM 2016, in press). DARA is currently administered as an intravenous (IV) infusion. Subcutaneous (SC) delivery of DARA is being tested in combination with the recombinant human hyaluronidase enzyme (rHuPH20) to facilitate systemic absorption of DARA after SC infusion into…

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