Author: Editor

Alok Khorana, MD of Cleveland Clinic discusses a cohort study that focused on bleeding predictors in hospitalized cancer patients at the 58th ASH Annual Meeting in San Diego, CA.

Sudipto Mukherjee, MD, MPH of Cleveland Clinic discusses several and recent developments in AML treatment at the 58th ASH Annual Meeting in San Diego, CA.

Sudipto Mukherjee, MD, MPH of Cleveland Clinic discusses how the new drug, eltrombopag, works safely and more effectively for patients with AML at the 58th ASH Annual Meeting in San Diego, CA.

Sudipto Mukherjee, MD, MPH of Cleveland Clinic gives an overview of his abstract: A Single Arm, Phase II Study of Eltrombopag to Enhance Platelet Count Recovery in Older Patients with Acute Myeloid Leukemia Undergoing Remission Induction Therapy, which was presented at the 58th ASH Annual Meeting in San Diego, CA.

Yogenthiran Saunthararajah, MD of Cleveland Clinic discusses potential and non-toxic treatments for Sickle Cell Disease at the 58th ASH Annual Meeting in San Diego, CA.

Yogenthiran Saunthararajah, MD of Cleveland Clinic, discusses the current updates and trends surrounding treatment in Sickle Cell Disease at the 58th ASH Annual Meeting in San Diego, CA.

Yogenthiran Saunthararajah, MD of Cleveland Clinic gives an overview of his abstract, Phase 1 Evaluation of Oral Tetrahydrouridine-Decitabine As Non-Cytotoxic Epigenetic Disease Modification for Sickle Cell Disease, that was presented at the 58th ASH Annual Meeting in San Diego, CA.

Brian Hill, MD, PhD of Cleveland Clinic discusses the possibility of a combination between checkpoint inhibitors and CAR T-Cell therapy for CLL treatment at the 58th ASH Annual Meeting in San Diego, CA.

Brian Hill, MD, PhD of Cleveland Clinic discusses the important role of checkpoint inhibitors in Richter’s Transformation treatment at the 58th ASH Annual Meeting in San Diego, CA.

Brian Hill, MD, PhD of Cleveland Clinic, gives an overview of the updates surrounding CLL treatments, specifically how CAR T-Cell therapy will be the best line of therapy for patients who fail novel agents at the 58th ASH Annual Meeting in San Diego, CA.

Brian Hill, MD, PhD, of Cleveland Clinic discusses how Venetoclax may be the best novel agent for patients who are intolerant to Ibrutinib at the 58th ASH Annual Meeting in San Diego, CA.

Brian Hill, MD, PhD, of Cleveland Clinic discusses updates surrounding CLL, specifically responses to Ibrutinib and Venetoclax as the optimal choice of therapy at the 58th ASH Annual Meeting in San Diego, CA.

Navneet Majhail, MD of Cleveland Clinic, discusses how TP53 mutations lead to poor overall survival in patients with MDS at the 58th ASH Annual Meeting in San Diego, CA.

Navneet Majhail, MD, of Cleveland Clinic, discusses the importance of genetic alterations and mutation profiles of patients that are undergoing transplantation at the 58th ASH Annual Meeting in San Diego, CA.

Navneet Majhail, MD of Cleveland Clinic, gives an overview of Abstract 69: Genetic Alterations Predict Outcomes in Patients with Myelodysplastic Syndrome Receiving Allogeneic Hematopoietic Stem Cell Transplantation, which was presented at the 58th ASH Annual Meeting in San Diego, CA.

Jasmine Micklem, PhD, of the South Australian Health and Medical Research Institute, Adelaide, Australia, and Roslyn Weetra, an Aboriginal Elder and cancer survivor, discuss the improvements required in supportive care services for indigenous communities. Ms. Weetra mentions an ongoing, strong government commitment about helping aboriginal people going through cancer treatment and providing aboriginal cancer coordinators, and a transitional program from hospital to home, allowing the patient to access sufficient information and the full range of services, with an equal pathway to a fair treatment plan. Dr. Micklem continues by highlighting the issue of higher mortalities due to people not entering…

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

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

Jennifer Brown, MD of Dana Farber, discusses a current and promising trial that combines ibrutinib with a standard chemo-immunotherapy combination: fludarabine, cyclophosphamide, rituximab (FCR), at the 58th ASH Annual Meeting in San Diego, CA.

Jennifer Brown, MD of Dana Farber, discusses a promising study that combines Ibrutinib with TGR-1202 and its results at the 58th ASH Annual Meeting in San Diego, CA.

Jennifer Brown, MD of Dana Farber, discusses the update of the 5 year data from the Ibrutinib study at the 58th ASH Annual Meeting in San Diego, CA.

Jennifer Brown, MD of Dana Farber, gives an overview of the latest treatment trends for CLL for the upcoming year at the 58th ASH Annual Meeting in San Diego, CA.

Jennifer Brown, MD of Dana Farber discusses the updates of CAR T-Cell Therapy in CLL from the 58th ASH Annual Meeting in San Diego, CA.

Steven T. Rosen, MD of City of Hope, discusses the use of novel strategies for stem cell efficacy versus its toxicity at the 58th ASH Annual Meeting in San Diego, CA.

Steven T. Rosen, MD of City of Hope, discusses the potential of leflunomide for multiple myeloma at the 58th ASH Annual Meeting in San Diego, CA.

Steven T. Rosen, MD of City of Hope, gives an overview of the current trials on stem cell research for acute leukemia at the 58th ASH Annual Meeting in San Diego, CA.

Susan M. O’Brien, MD of University of California Irvine, discusses the future of clinical trials for ibrutinib that may result in higher complete remission at the 58th ASH Annual Meeting in San Diego, CA.

Susan M. O’Brien, MD of University of California Irvine, discusses possible drug holidays and combination therapy for CLL at the 58th ASH Annual Meeting in San Diego, CA.

Susan M. O’Brien, MD of University of California Irvine gives an overview of the updates in combination therapy for CLL at the 58th ASH Annual Meeting in San Diego, CA.

Joshua Brody, MD, PhD, of Mount Sinai Hospital, gives a shoutout to his grandma and grandpa at the 58th ASH Annual Meeting in San Diego, CA.

Joshua Brody, MD, PhD of Mount Sinai Hospital, discusses how to rationally combine immunotherapies for patients with lymphoma by increasing the specificity of the anti-tumor immune response at the 58th ASH Annual Meeting in San Diego, CA.

Joshua Brody, MD, PhD of Mount Sinai Hospital, discusses the GALLIUM Trial and advances in immunotherapy for lymphoma at the 58th ASH Annual Meeting in San Diego, CA.

Joshua Brody, MD, PhD, of Mount Sinai Hospital, gives an update on CAR T-Cell Lymphoma data from the 58th ASH Annual Meeting in San Diego, CA.

Joshua Brody, MD, PhD, of Mount Sinai Hospital, discusses how animal studies closely resemble clinical trial results in combining in situ vaccination with immune checkpoint in patients with Lymphoma at the 58th ASH Annual Meeting in San Diego, CA.

Joshua Brody, MD, PhD, of Mount Sinai Hospital, discusses his abstract on Combining In Situ Vaccination with Immune Checkpoint Blockade Induces Long-Term Regression of Lymphoma Tumors at the 58th ASH Annual Meeting in San Diego, CA.

Joshua Brody, MD, PhD, of Mount Sinai Hospital, gives an overview of a clinical trial by Dana Farber that shows patients with primary central nervous system lymphoma has a 100% response rate with anti-PD1 therapy at the 58th ASH Annual Meeting in San Diego, CA.

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

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

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

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

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

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

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

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

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

Bernardo Rapoport, MD and Ronwyn Van Eeden MBChB, FCP(SA) of The Medical Oncology Centre of Rosebank, Johannesburg, South Africa discuss a side effect profile associated with checkpoint inhibitors. Doctors need to be aware of immune-related side effects, which are different than chemotherapy side effects like chemotherapy-induced nausea and vomiting (CINV). Sometimes symptoms can be vague, like fatigue or lethargy, but they may have a severe impact on patients. Recorded at the Multinational Association of Supportive Care in Cancer (MASCC) and International Society of Ocular Oncology (ISOO) 2016 Annual Meeting on Supportive Care in Cancer held in Adelaide, Australia.

Roslyn Weetra, an Aboriginal Elder and cancer survivor, discusses her experience with cancer being a member of the Australian aboriginal community. She was diagnosed with non-Hodgkins lymphoma and required hospital treatment. At the beginning of her treatment she mentions not understanding what some of the medical jargon meant, as well as difficulty in understanding how the cancer was going to impact her. Referring to her aboriginal culture, cancer treatment, including chemicals and non-traditional healing remedies, was an uncomfortable scenario for her. Ms. Weetra also mentions there being a lack of information that she could access at mainstream hospitals. Jasmine Micklem,…

Bernardo Rapoport, MD and Ronwyn Van Eeden MBChB, FCP(SA) of The Medical Oncology Centre of Rosebank, Johannesburg, South Africa give a summary of immunotherapy messages from MASCC 2016. Dr Rapoport points out that immunotherapy is here to stay, however, even though it looks like it is less toxic than chemotherapy, if side effects are not managed correctly it could be fatal. Dr Van Eeden mentions that clinicians need to be aware of immune-related adverse events and should know how to manage them when treating patients with immunotherapy. Recorded at the Multinational Association of Supportive Care in Cancer (MASCC) and International…

Gordon Howarth, PhD of The University of Adelaide, Adelaide, Australia discusses mucositis with a focus on probiotics screening system. Mucositis is caused by chemotherapy or radiotherapy, as the same mechanism targets tumor and the lining of the mouth and the intestine. Mucositis is generally temporary, but the nerve damage can be permanent. Dr Howarth mentions that many of the plant extracts have got agents in them which can counteract the inflammation of the intestine. Some probiotic bacteria secret factors which inhibit mucositis development. A screening system is required to find the correct probiotics for this condition, followed by clinical trials…

Bernardo Rapoport, MD and Ronwyn Van Eeden MBChB, FCP(SA) of The Medical Oncology Centre of Rosebank, Johannesburg, South Africa talk about a correlation between a side effect occurrence and patient outcomes. One of the examples mentioned is vitiligo, as patients who develop this condition seem to respond better to the checkpoint inhibitor treatment. Dr Rapoport mentions that patients with colitis are among the long-term survivors, which Dr Rapoport compares to a therapeutic index, where certain level of toxicity is expected in order to have activity of a drug. Dr Van Ronwyn points out that toxicities need to be graded accordingly,…

Susan M. O’Brien, MD of University of California Irvine, gives an overview of Abstract 233: Five-Year Experience with Single-Agent Ibrutinib in Patients with Previously Untreated and Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Leukemia at the 58th Annual ASH Meeting in San Diego, CA.

Susan M. O’Brien, MD of University of California Irvine, gives an overview of Five-Year Experience with Single-Agent Ibrutinib in Patients with Previously Untreated and Relapsed/Refractory Chronic Lymphocytic Leukemia/Small Lymphocytic Leukemia at the 58th ASH Annual Meeting in San Diego, CA.

As part of our 2016 American Society of Hematology (ASH) annual meeting coverage, MPN experts Dr. Catriona Jamieson, Dr. John Mascarenhas, Dr. Stephen Oh and our own Andrew Schorr, gathered to discuss the latest updates on treatment and research for myeloproliferative neoplasms (MPNs). In this fruitful discussion, the experts shared their perspectives and optimism for the future, reviewed treatments in development and results from recent trials, the role of genetic testing, and advice for patients related to seeking the best care and therapy. 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…

Doctors and Healthcare Professionals answer questions at the Press Briefing Q&A: Improved Outcomes in Leukemia, Trauma Settings with Personalized Medicine Approaches at the 58th ASH Annual Meeting in San Diego, CA.

Francois-Xavier Mahon, MD, PhD of University of Bordeaux, presents a press briefing on Cessation of Tyrosine Kinase Inhibitors Treatment in Chronic Myeloid Leukemia Patients with Deep Molecular Response: Results of the Euro-Ski Trial at the 58th ASH Annual Meeting in San Diego, CA.

Evi X. Stavrou, MD of Case Western Reserve University, presents a press briefing on Miniaturized Microfluidic Dielectric Sensor for Point-of-Care Assessment of Blood Coagulation at the 58th ASH Annual Meeting in San Diego, CA.

Mhairi Copland, BSc (Hons) MB ChB PhD FRCP FRCPath of the University of Glasgow, presents a press briefing of Chronic Myeloid Leukaemia Patients with Stable Molecular Responses (at least MR3) May Safely Decrease the Dose of Their Tyrosine Kinase Inhibitor: Data from the British Destiny Study at the 58th ASH Annual Meeting in San Diego, CA.

Harry P. Erba, MD, PhD of the University of Alabama at Birmingham School of Medicine, presents a press brief on A Phase 1b Study of Vadastuximab Talirine in Combination with 7+3 Induction Therapy for Patients with Newly Diagnosed Acute Myeloid Leukemia (AML) at the 58th ASH Annual Meeting in San Diego, CA.

Julie Jaffray, MD of Children’s Hospital Los Angeles, presents a press brief on Determining the Incidence and Risk Factors for Central Venous Catheter Related Thrombosis in Children at the 58th ASH Annual Meeting in San Diego, CA.

Mikkael Sekeres, MD, MS of Cleveland Clinic, introduces the press briefing to Improved Outcomes in Leukemia, Trauma Settings with Personalized Medicine Approaches at the 58th ASH Annual Meeting in San Diego, CA. This press briefing features studies showing new means of treating hematologic illnesses by tailoring medicines to patients specific disease characteristics.

Doctors and Healthcare Professionals answer questions at the Press Briefing Q&A: Developing Novel Therapies and Unique Delivery Methods to Improve Treatment for Bleeding Crises at the 58th ASH Annual Meeting in San Diego, CA.

Terry J. Fry, MD of National Cancer Institute, presents a press brief on Minimal Residual Disease Negative Complete Remissions Following Anti-CD22 Chimeric Antigen Receptor (CAR) in Children and Young Adults with Relapsed/Refractory Acute Lymphoblastic Leukemia (ALL) at the 58th ASH Annual Meeting in San Diego, CA.

Katherine A. High, MD of Spark Therapeutics, presents a press briefing on Spk-9001: Adeno-Associated Virus Mediated Gene Transfer for Hemophilia B Achieves Sustained Mean Factor IX Activity Levels of >30% without Immunosuppression at the 58th ASH Annual Meeting in San Diego, CA.

Allan Doctor, MD of Washington University School of Medicine in St. Louis, presents Erythromer (EM), a Nanoscale Bio-Synthetic Artificial Red Cell: Proof of Concept and In Vivo Efficacy Results at the 58th ASH Annual Meeting in San Diego, CA.

Caroline E. Hansen, BS of Georgia Institute of Technology presents Leveraging the Contractile Force of Platelets for Targeted Factor VIII Delivery in Hemophilia with Inhibitors at the 58th ASH Annual Meeting in San Diego, CA.

Jeffrey E. Lancet, MD of Moffitt Cancer Center presents Survival Following Allogeneic Hematopoietic Cell Transplantation in Older High-Risk Acute Myeloid Leukemia Patients Initially Treated with CPX-351 Liposome Injection Versus Standard Cytarabine and Daunorubicin: Subgroup Analysis of a Large Phase III Trial at the 58th ASH Annual Meeting in San Diego, CA.

Dr. Armand Keating, MD, FRCP(C), Director, Cell Therapy Program and Philip S. Orsino Facility for Cell Therapy, Princess Margaret Hospital/Ontario Cancer Institute, introduces the 58th ASH Annual Meeting Press Briefing in San Diego, CA. Research to be presented introduces new therapies and methods, concluding that gene therapy and emerging drug delivery methods hold promise for patients with various forms of blood diseases.

Stephen Sonis, DMD, DMSc of Brigham and Women’s Hospital, Boston, MA discusses cancer supportive care and its importance for cancer prognosis in the future. Incidence of cancer is going to increase significantly in the next 25 years, but prof Sonis points out that survivability is going to increase too, although that depends largely on patients location. In developed countries the gap between survivability and mortality is getting better, which means that supportive care deals not only with acute toxicities, but also with toxicities which continue through survivorship. Recorded at the Multinational Association of Supportive Care in Cancer (MASCC) and International…

Phyllis Butow, BA (Hons), Dip Ed, MClinPsych, MPH, PhD of The University of Sydney, Sydney, Australia talks about a family involvement in patient-doctor communication. Family members are very important parts of consultations. However, family members bring their own agendas and issues. Some may have conflicting views leading to challenges for doctors in terms of managing a large family group and reaching a mutual agreement on a way forward. E-communications can be helpful in terms of training the doctors to deliver that sort of care effectively. Modelling is used frequently to demonstrate difficult situations and some different ways of approaching a…

Michael Brown, MBBS, FRACP, FRCPA of Royal Adelaide Hospital, Adelaide, Australia discusses side effects associated with immune checkpoint inhibitors. For anti-CLTA-4 therapies the side effects are more severe and include colitis, which can be resolved with immunosuppression. The anti-PD-1 antibodies are milder in their toxicity range, but serious side effects can occur, including pneumonitis. A combination of checkpoint inhibitors may have greater efficacy, but this comes at a price of a higher toxicity. Prof Brown points out that there is no data indicating that management of side effects with immunosuppression impairs treatment efficacy. Supportive care plays an important role in…

Mette Marcussen, DDS, PhD of Aalborg University Hospital, Aalborg, Denmark discusses studies focused on identification of mucositis biomarkers. Biopsies from patients treated with melphalan, one of the most toxic chemotherapy drugs, were analyzed at three different time points: before, after, and during melphalan treatment. A gene expression analysis confirmed results from the animal studies, highlighting the role of immunoregulatory and DNA damage genes. Only two genes were differently expressed in patients with mild and severe mucositis. Interestingly, two variants of a gene expressed on the surface of dendritic cells in the mucosa showed different expression patterns, which could be a…

Matthew Ciorba, MD of Washington University School of Medicine in St. Louis, St. Louis, MO discusses mucositis prevention using probiotics. A phase 1 clinical trial focused on safety of probiotics in cancer patients uses Lactobacillus bacterial strain, which was shown to be effective in mucositis prevention in animal models. Dr Ciorba describes freeze-dried pills containing bacteria, which is a preferred option of probiotic delivery to the gut, as the purity and potency is more certain compared to a yogurt based product. Recorded at the Multinational Association of Supportive Care in Cancer (MASCC) and International Society of Ocular Oncology (ISOO) 2016…

Jean Klastersky, MD, PhD of Institut Jules Bordet, Brussels, Belgium talks about the severity of side effects associated with immune checkpoint inhibitors. The side effects are relatively common, but they are rarely severe. However, Prof Klastersky points out that in some cases they may be life threatening, which requires fast detection and treatment. This is a difficult task for clinicians, as there are no biomarkers, which can predict the severity of complications. Corticosteroids are used to counteract the side effects, followed by more potent immunosuppressants. Depending on the situation the checkpoint inhibitor treatment may be discontinued. Combining two different classes…

Ian Hewson, BDSc, FICD, FADI, FPFA of Alfred Hospital, Melbourne, Australia talks about his treatment journey after being diagnosed with low grade follicular lymphoma (FL). Side effects from 6 cycles of CHOP treatment included peripheral neuropathy and overall feeling of being unwell. Dr Hewson mentions that sometimes it is better not to treat until disease progression, as treatments are associated with side effects like losing hair. A discussion with a clinician about wait and watch is recommended to address any doubts. Recorded at the Multinational Association of Supportive Care in Cancer (MASCC) and International Society of Ocular Oncology (ISOO) 2016…

Gordon Howarth, PhD of The University of Adelaide, Adelaide, Australia talks about probiotics and the way they are perceived. Unlike antibiotics which are widely used and recognised by the medical community, probiotics do not have the same recognition. Generally probiotics are harmless, with their mechanism of action changing from organism to organism. Dr Howarth highlights Streptococcus thermophilus TH-4, which secrets folic acid and could be used to ameliorate damage done by methotrexate, a chemotherapy drug. Recorded at the Multinational Association of Supportive Care in Cancer (MASCC) and International Society of Ocular Oncology (ISOO) 2016 Annual Meeting on Supportive Care in…

David Currow, BMed, PhD, MPH, FRACP, FAChPM, FAHMS, GAICD of Flinders University, Adelaide, Australia, discusses delirium in cancer patients. Patients, who are acutely unwell are at a much higher risk of being acutely confused. This is observed more frequently late in life, however, all patients being treated for cancer or living with the disease are at a greater risk than the population at large. A high index of suspicion is needed when peoples cognition changes. The majority of patients experience a hyperactive delirium, but hypoactive delirium can also occur. Vivid recollections of delirium, including hallucinations are common. Dr Currow highlights…

Bernardo Rapoport, MD and Ronwyn Van Eeden MBChB, FCP(SA) of The Medical Oncology Centre of Rosebank, Johannesburg, South Africa discuss how to manage immune-related toxicities associated with checkpoint inhibitors. Skin toxicity is a common side effect, which can be quite debilitating and affecting patients quality of life. Colitis symptoms can be very severe and should be treated promptly with corticosteroids or infliximab to avoid morbidity and mortality. Recorded at the Multinational Association of Supportive Care in Cancer (MASCC) and International Society of Ocular Oncology (ISOO) 2016 Annual Meeting on Supportive Care in Cancer held in Adelaide, Australia.

Rachel Gibson, PhD of University of South Australia, Adelaide, Australia, discusses the role of gut microbiome in causing diarrhea in chemotherapy-treated patients. Dr. Gibson mentions recruiting a number of patients who had been hospitalized due to their chemotherapy-induced diarrhea, taking a stool sample for the investigation. Analyzing these results, Dr. Gibson mentions that results showed a clear differentiation between the commensal and pathogenic bacteria, as patients displayed huge numbers of pathogenic bacteria. This suggests chemotherapy was altering the gut microbiome. She then highlights how this will allow for targeting of specific treatments and investigations to look into the gut microbiome.…

Phyllis Butow, BA (Hons), Dip Ed, MClinPsych, MPH, PhD of The University of Sydney, Sydney, Australia discusses teaching communication skills online. She mentions one of the issues being how communication skills is taught, this is because the best way of teaching communication skills is face-to-face, getting feedback in a safe environment where different strategies can be attempted. However, this is not very cost effective and it is difficult to get people together. Dr. Butow mentions the need to replicate online what can be done in person. Strategies that have already been applied include: showing people videos of communication and getting…

Matthew Ciorba, MD of Washington University School of Medicine in St. Louis, St. Louis, MO discusses how microbes can modify response to cancer therapy. Many patients receive both radiation and chemotherapy, or at radiosensitizing chemotherapy in case of gastrointestinal cancer. Mucositis is one of the significant side effects which can result in symptoms like diarrhea, nausea, vomiting, and anemia. New therapies are needed to help prevent mucositis. Historical data suggest that the intestinal microbiome can modify the guts response to radiation injury. Dr Ciorba mentions studies focused on the use of probiotics and points out that not all probiotics are…

Jean Klastersky, MD, PhD of Institut Jules Bordet, Brussels, Belgium gives an overview of a session focused on geriatric assessment. Supportive care or palliative care consultation is focused primarily on symptom management and coping strategies. Geriatric assessment has a broader spectrum, looking at the cancer within other health problems, nutritional and functional needs. Sometimes cancer is not the main problem for the patient and the symptoms experienced may be due to another condition. Doctors should look beyond cancer and do a correct geriatric screening in order to individualise the plan of care. Recorded at the Multinational Association of Supportive Care…

Jean Klastersky, MD, PhD of Institut Jules Bordet, Brussels, Belgium discusses adverse effects associated with immune checkpoint inhibitors. Prof Klastersky points out that adverse effects in this field are different than the adverse effects observed in classical chemotherapy, which means new challenges for cancer supportive care. Fatigue and nausea are the most common adverse effects observed. In addition, there are other complications, like colitis, pneumonitis, eye and dermatological conditions. No link between likelihood of response and the appearance of side effects has to be established so far. Recorded at the Multinational Association of Supportive Care in Cancer (MASCC) and International…

Ian Hewson, BDSc, FICD, FADI, FPFA of Alfred Hospital, Melbourne, Australia discusses his experiences after being diagnosed with low grade follicular lymphoma (FL). FL can be controlled by chemotherapy, but it is probably not curable at this stage. One of the treatments is to not treat and dr Hewson and his doctor decided to wait and watch. The FL started progressing after 3 years. Having knowledge of the disease progression was useful to help manage expectations. Dr Hewson assessed his working commitments and retired from one of the hospitals, which made his working life more manageable. Recorded at the Multinational…

Gordon Howarth, PhD of The University of Adelaide, Adelaide, Australia discusses complementary therapies for patients with mucositis. The role of researchers is to move towards a more robust characterisation of complementary medicines. A whole range of plant extracts, animal extracts, and Chinese traditional medicines have been tried clinically. A starting material and results of these studies have been variable, so another approach is required. Dr Howarth suggests looking at clinical efficacy in animal models and in vitro systems first, followed by human studies for selected medicines, which meet rigorous criteria. Recorded at the Multinational Association of Supportive Care in Cancer…

Giovanni Rosti, MD of Ospedale Generale, Treviso, Italy highlights key discussion points from MASCC 2016. New drugs help to reduce vomiting, but patients still experience nausea. Two things are needed to address this problem. First, a way to measure nausea in a dynamic way. Second, new drugs to treat nausea. Dr Rosti mentions that medical oncologists should have a broader view and aim to help patients experiencing side effects like pain. There is a need to abolish the barriers, e.g. a lack of opioid treatment in some countries, and increase the understanding of supportive care treatments, which to patients are…

David Currow, BMed, PhD, MPH, FRACP, FAChPM, FAHMS, GAICD of Flinders University, Adelaide, Australia, discusses chronic breathlessness in cancer patients. Breathlessness is a major problem for people affected by cancer, which can be a result of the disease, comorbidities, or getting weak from cachexia. Dr Currow mentions the importance of stepwise progression: treating the treatable, then moving to the non-pharmacological support and finally to low-dose regular extended-release morphine. Breathlessness is incredibly debilitating and leads to further deconditioning. Dr Currow highlights the symposium data showing the importance of reversing the reversible causes. Recorded at the Multinational Association of Supportive Care in…

Bernardo Rapoport, MD and Ronwyn Van Eeden MBChB, FCP(SA) of The Medical Oncology Centre of Rosebank, Johannesburg, South Africa discuss immune-related side effects associated with checkpoint inhibitors. Dr Rapoport says that checkpoint inhibitors have been a major breakthrough in the management of malignant melanoma and non-small cell lung cancer. New checkpoint inhibitors are used to treat triple-negative breast cancer, blood cancer, ovarian and gastric cancer. Dr Van Eededn mentions that it is a new therapy with a different mechanism of action and side effect profile than chemotherapy or targeted therapies. Dr Rapoport and dr Van Eeden talk about anti-CLTA-4 and…

Alex Molassiotis, RN, MSc, PhD of The Hong Kong Polytechnic University, Hong Kong, discusses personalized treatments for nausea and vomiting. Nausea and vomiting is a multifactorial problem and it is not always clear which factors are involved, therefore patients need to be evaluated in order to identify the risk. A following prescription of antiemetics based on that risk is then required, beyond just the antiemetics that are directly linked to managing chemotherapy related problems. Dr. Molassiotis provides a hypothetical example of a personalized treatment for nausea. He mentions that if the patient is young, very anxious and with a past…

Patient Power Founder Andrew Schorr and MPN world expert Dr. Srdan Verstovsek of the University of Texas MD Anderson Cancer Center discuss team efforts between specialists and community doctors around the world. Dr. Verstovsek explains the important role that community doctors play in cancer care and how he works with patients and their local doctors to provide guidance, help with management, and keep them informed. 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

In this Ask the Expert segment, Dr. Ruben Mesa from Mayo Clinic responds to a Patient Power community member’s question about the connection between hypertension and essential thrombocythemia (ET). Dr. Mesa provides advice on how closely blood pressure should be monitored for someone with ET. 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

Afaf Girgis, PhD, of the University of New South Wales, Sydney, Australia, discusses the importance of psycho-oncology at the 2016 National Cancer Research Institute (NCRI) Conference in Liverpool, UK. Prof. Girgis explains that psycho-oncology is such a growing field at the moment and it is now well accepted that the psycho-social impact of cancer is just as important to assess as the physical impact of cancer. She goes on to say that if we are able to assess and understand that and actually address it, patients can be helped to complete their cancer treatment and cope with their cancer journey…

Robert Coleman, MBBS, MD, FRCP, FRCPE of Sheffield Cancer Research, University of Sheffield, UK gives an overview of a debate discussing new drug development vs repurposing existing drugs. Dr Coleman points out that the drug development process is no longer fit for purpose, with new drugs being too expensive to afford. The way to proceed could be to repurpose existing drugs, based on the available evidence and new clinical trials. The opposite view focuses on progress, innovation, and optimism, as without drug discovery there would be no drugs to repurpose. Dr Coleman finishes by saying that a mixture of both…

Lieping Chen, MD, PhD of Yale School of Medicine, New Haven, CT discusses two approaches to cancer immunotherapy. Immune system activation approach aims to push the immune system to the limit, but this may result in toxicities before treatment efficacy is reached. The alternative approach, as shown in the PD-1/PD-L1 study, is to regulate the immune system response to the normal level, which offers lower toxicity levels compared to other treatments like chemotherapy. 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 key messages from the small-cell lung cancer (SCLC) session. Experts, who participated in the session talked about a lack of progress with systemic therapy, targeted agents, and chemotherapy. However, as Dr Faivre-Finn points out, a lot of progress has been made in SCLC with radiotherapy treatments due to better integration of radiotherapy and systemic therapy. Results of the CONVERT trial show better survival and less toxicity. Moreover, there is evidence that prophylactic cranial irradiation improves survival, with recent data from a European trial…

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…

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.

Clemens Wendtner, MD of Klinikum Schwabing, Munich, Germany, highlights key advances in the field of chronic lymphocytic leukemia (CLL) discussed at the German CLL Study Group (GCLLSG) 2016 meeting. Dr Wendtner mentions the importance of subclones in CLL, new kinase inhibitor combinations, and immunotherapy. Using checkpoint inhibitors combined with immunostimulatory drugs may be a new avenue in CLL research. Recorded at the 2016 International Workshop of the German CLL Study Group (GCLLSG) in Cologne, Germany.

Barbara Eichhorst, MD of the University of Cologne, Cologne, Germany, how to take care of the mental well-being of chronic lymphocytic leukemia (CLL) patients. For patients in the wach-and-wait period, particularly in the first year, it helps if they are seen on a regular basis; it is important for them to build and maintain self-confidence. It is important to make sure they get their vaccinations and that after the first 1-2 years, if they have s a slowly progressing CLL, that they are mentally stable. For those patients who receive a long, continuous therapy, it is essential to monitor them…

World-renowned MPN expert Dr. Ruben Mesa of Mayo Clinic discusses the recently updated NCCN guidelines that help advise doctors around the world on how to treat MPNs. Watch to hear Dr. Mesas explanation of how these are used in practice and how the guidelines have evolved over time. 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

In this video, Drs. Morton Coleman and John P. Leonard summarize the key take-home points presented on lymphoma during Lymphoma & Myeloma 2016: An International Congress on Hematologic Malignancies, and examine their clinical implications. Earn CME credit for this activity at the following location: http://elc.imedex.com/ELC/Specialty-Search.aspx?search=7227 © 2016 Imedex, LLC.

In this video, Drs. Morton Coleman and Richard R. Furman summarize the key take-home points presented on CLL during Lymphoma & Myeloma 2016: An International Congress on Hematologic Malignancies, and examine their clinical implications. Earn CME credit for this activity at the following location: http://elc.imedex.com/ELC/Specialty-Search.aspx?search=7226 © 2016 Imedex, LLC.

In this video Drs. Morton Coleman and Ruben Niesvizky summarize the key take-home points presented on multiple myeloma during Lymphoma & Myeloma 2016: An International Congress on Hematologic Malignancies, and examine their clinical implications. Earn CME credit for this activity at the following location: http://elc.imedex.com/ELC/Specialty-Search.aspx?search=7225 © 2016 Imedex, LLC.

Raquibul Hannan, MD Radiation Oncologist, University of Texas Southwestern discusses SABR and immunotherapy.

Raquibul Hannan, MD Radiation Oncologist, University of Texas Southwestern discusses Utilizing SABR in the oligo-metastatic disease.

Raquibul Hannan, MD Radiation Oncologist, University of Texas Southwestern discusses SABR in locally advanced RCC and oligo-metastatic disease.

Raquibul Hannan, MD Radiation Oncologist, University of Texas Southwestern discusses What is the role of SABR in CNS mets in RCC.

Eric Jonasch, MD of MD Anderson gives an overview of several presentations covering the Understanding Molecular Subtypes of Non-Clear Cell RCC.

Chung-Han Lee, MD, PhD, Medical Oncologist, Memorial Sloan Kettering interview on Medullary Renal Cell Carcinoma (RCC): Genomics and Treatment Outcomes.

Ithaar H. Derweesh, M.D., University of California, San Diego discusses neoadjuvant therapy for patients with metastatic disease and extra renal burden.

Ithaar H. Derweesh, M.D., University of California, San Diego discusses the historical data for neoadjuvant therapy in RCC.

Guru Sonpavde, MD, Associate Professor of Medicine Director, Urologic Oncology, UAB Comprehensive Cancer Center notes that More Single Agent Therapy needed in Kidney Cancer.

Guru Sonpavde, MD, Associate Professor of Medicine Director, Urologic Oncology, UAB Comprehensive Cancer Center discusses VEGF followed by PD-1 inhibition or PD-1 inhibition followed by VEGF.

Guru Sonpavde, MD, Associate Professor of Medicine Director, Urologic Oncology, UAB Comprehensive Cancer Center answers the question Why would sequencing VEGF and PD-1 inhibition be a better option than combination therapy in Kidney Cancer.

David McDermott, MD of Dana Farber discusses toxicity concerns with the combination VEGF PD-1.

David McDermott, MD of Dana Farber answers the question Why VEGF + PD-1 are logical choices for combination therapy in mRCC?

Naomi B. Haas, MD, Director, Prostate and Kidney Cancer Program, Associate Professor of Medicine at the Hospital of the University of Pennsylvania discusses the Current State of Adjuvant Therapy in Kidney Cancer.

Are memory issues typical for patients with myelofibrosis? Is aspirin the answer? In this Ask the Expert segment, Dr. Prithviraj Bose from The University of Texas MD Anderson Cancer Center, responds to a viewer question related to trouble concentrating and memory lapses associated with myeloproliferative neoplasms (MPNs). 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

Dr. Sima Porten, MD MPH, Assistant Professor, Department of Urology UCSF answers the question What are some of the limitations of partial nephrectomies?

Dr. Sima Porten, MD MPH, Assistant Professor, Department of Urology UCSF answers the question What patients should be selected for partial nephrectomy?

Kamran Ahrar, MD, MBA, Professor, Interventional Radiology answers the question Why is renal tumor ablation underutilized?

Kamran Ahrar, MD, MBA, Professor, Interventional Radiology answers the question what is the current role of renal tumor ablation?

hillip M. Pierorazio, MD, Assistant Professor of Urology and Oncology, Brady Urological Institute, Sidney Kimmel Cancer Center, Johns Hopkins Hospital recaps the active surveillance study primary results.

Phillip Pierorazio, MD, Assistant Professor of Urology and Oncology, Brady Urological Institute, Sidney Kimmel Cancer Center, Johns Hopkins Hospital outlines the John Hopkins active surveillance study for renal masses.

Dr. Daniel Heng MD @DrDanielHeng University of Calgary discusses genomic investigation in the ASSURE and S-TRAC adjuvant trials.

Daniel Heng, MD University of Calgary @DrDanielHeng describes what is the role of genomic investigation in predicting recurrence of local RCC.

Alexander Kutikov, MD, FACS, Associate Professor of Urologic Oncology Fox Chase Cancer Center answers the question of what is the algorithmfor for proceeding with renal mass biopsy.

Alexander Kutikov, MD, FACS explains the current standards of care for renal mass biopsies at the 2016 annual International Kidney Cancer Symposium.

Aly-Khan A. Lalani, MD of the University of Alberta gives a quick overview of the latest in Proton Pump Inhibitors in mRCC.

Paula Ragan, CEO of X4 Pharmaceuticals gives a quick overview of her presentation at the 2016 annual International Kidney Cancer Symposium.

Professor Thomas Powles MBBS, MRCP, MD, Barts Cancer Institute presents Clinical outcomes based on MET expression level in METEOR, a randomized phase 3 trial of cabozantinib versus everolimus in advanced renal cell carcinoma (RCC) at the 2016 annual International Kidney Cancer Symposium.

Toni K. Choueiri, MD, Director and Disease Center Leader, The Lank Center for Genitourinary Oncology, President of Medical Staff, Dana-Farber Cancer Institute accepts the Schonfeld award at the 2016 annual International Kidney Cancer Symposium.

Brian I. Rini, M.D., Department of Solid Tumor Oncology, Cleveland Clinic Taussig Cancer Center presents Axitinib is an Ideal Choice in Refractory Renal Cell Carcinoma.

Thomas E Hutson, DO, PharmD FACP Director, GU Oncology Program, Co-Director, Urologic Cancer Research and Treatment Center, Texas Oncology/ Baylor Sammons Cancer Center, Professor of Medicine, Texas AM College of Medicine presents LENVATINIB + EVEROLIMUS A powerful treatment for refractory RCC at the 2016 annual International Kidney Cancer Symposium.

Nizar M. Tannir, MD, FACP, Professor and Deputy Chair, GU Medical Oncology, MD Anderson presents Cabozantinib is the best salvage therapy for RCC at the 2016 annual International Kidney Cancer Symposium.

Saby George, MD, FACP, Associate Professor of Medicine and Oncology, Genitourinary Oncology Program , Roswell Park Cancer Institute presents Nivolumab as a second-line therapy for metastatic RCC at the 2016 annual International Kidney Cancer Symposium.

HIF-2 Inhibitor discussion at the 2016 annual International Kidney Cancer Symposium.

…77 year WF presents with back painHistory of renal cell carcinoma, s/p right radical nephrectomy in 2000T1bN0M0 Clear cell renal cell carcinomaStopped surveillance after 5 yearsPMH: HyperlipidemiaPSH: nephrectomy, hysterectomyCT chest: NegativeLabs: eGFR 56, otherwise WNL 80 year old WM presents with chronic constipation and abdominal painPMH: DM II, HtnPSH: Left ankleLabs: Hb 10.6, Glucose 246, Cr 1.13Presents to our EC with worsening bilateral LE edema 79 year old WM presents with gross hematuriaPMH: HypertensionPSH: hernia repair and varicocele repairLabs: Hb 12.6, ESR 78, LDH 429Was enrolled in the randomized phase II presurgical immune checkpoint blockade trial (2013-0715).Randomized to nivolumab plus…

Bernard Escudier, Institut Gustave Roussy presents Developing the next generation of studies in RCC at the 2016 annual International Kidney Cancer Symposium.

James Brugarolas, M.D., Ph.D., Kidney Cancer Program Leader, Virginia Murchison Linthicum Endowed Scholar, Associate Professor of Internal Medicine University of Texas Southwestern Medical Center at the 2016 annual International Kidney Cancer Symposium.

Axel Bex, MD, PhD, The Netherlands Cancer Institute presents Durable Responses: How Do We Get There? The role of metastasectomy at the 2016 annual International Kidney Cancer Symposium.

Dylan Martini, MD, Dana-Farber Cancer Institute presents Outcomes in PD-1/PD-L1 inh. responders who discontinued therapy for immune-related adverse events: Analysis of nine patients with metastatic renal cell carcinoma at the 2016 annual International Kidney Cancer Symposium.

James J. Hsieh, MD, PhD, Memorial Sloan Kettering Cancer Center presents Differential Overall Survival Results in RECORD-3 Study Based on Three Distinct Clear Cell Metastatic Renal Cell Carcinoma Molecular Subgroups Classified by BAP1 and/or PBRM1 Mutations at the 2016 annual International Kidney Cancer Symposium.

Lana Hamieh, MD, Research Fellow in Medicine (EXT) presents Characterization of Patients with Poor-Risk Metastatic Renal Cell Carcinoma at the 2016 annual International Kidney Cancer Symposium.

Jun Gong, Fellow, City of Hope presents Latency of potential treatment-related adverse events among patients treated with TKI/VEGF-directed therapy for metastatic renal cell carcinoma (mRCC) at the 2016 annual International Kidney Cancer Symposium.

Jill Rachel Mains, MD, Dept. of Radiology and Oncology, Aarhus University Hospital presents Baseline Low B-value Diffusion-weighted Magnetic Resonance Imaging is Prognostic in Metastatic Renal Cell Carcinoma and Correlates with Dynamic Contrast-enhanced Ultrasound and Dynamic Contrast-enhanced Computed Tomography: Results from the DARENCA-1 Study at the 2016 annual International Kidney Cancer Symposium.

Rana McKay, MD, Dana-Farber, presents Impact of Aspirin and Non-Aspirin NSAIDs on Outcomes in Metastatic RCC at the 2016 annual International Kidney Cancer Symposium.

Aly-Khan A. Lalani, Department of Medical Oncology, Cross Cancer Institute, University of Alberta presents Proton Pump Inhibitors and Survival Outcomes in Patients with Metastatic Renal Cell Carcinoma (mRCC) at the 2016 annual International Kidney Cancer Symposium.

Chung-Han Lee, MD, PhD, Medical Oncologist, Memorial Sloan Kettering presents Medullary Renal Cell Carcinoma (RCC): Genomics and Treatment Outcomes at the 2016 annual International Kidney Cancer Symposium.

Maria Becerra, Research Fellow at Memorial Sloan Kettering Cancer Center presents Characterization of genomic alterations associated with metastatic tropism in a cohort of patients with renal cell carcinoma at the 2016 annual International Kidney Cancer Symposium.

Thomas Hutson, Memorial Sloan Kettering Cancer Center, New York, NY presents A randomized phase 2 trial of CRLX101 in combination with bevacizumab in patients with metastatic renal cell carcinoma (mRCC) vs standard of care at the 2016 annual International Kidney Cancer Symposium.

Rana McKay, MD, Assistant Professor of Medicine, HMS/DFCI/BWH presents PD-1/PD-L1 Blockage in Non-Clear Cell RCC at the 2016 annual International Kidney Cancer Symposium.

Toni K. Choueiri Lank Center for Genitourinary Oncology, Dana-Farber Cancer Institute presents Savolitinib (volitinib, AZD6094, HMPL-504): Future Directions at the 2016 annual International Kidney Cancer Symposium.

Primo N. Lara, Jr., MD, Professor of Medicine, University of California Davis School of Medicine, Acting Director, UC Davis Comprehensive Cancer Center presents PAPMET trial (SWOG 1500) in Papillary Renal Cell Cancer: Rationale and Current Status at the 2016 annual International Kidney Cancer Symposium.

Laurence Albiges, MD, Gustave Roussy presents Crizotinib In Papillary RCC at the 2016 annual International Kidney Cancer Symposium.

Brian Shuch, MD, Assistant Professor of Urology/Radiology, Yale School of Medicine presents Developments in Biology of Non-Clear Cell RCC at the 2016 annual International Kidney Cancer Symposium.

Debate: Kidney Cancer: Should we explore drug combination strategies in an adjuvant setting?

Priti S. Hegde, PhD, Director, CI Franchise Lead, Biomarkers Genentech Roche presents Blocking VEGF in addition to checkpoint inhibition in RCC at the 2016 annual International Kidney Cancer Symposium.

Paula Ragan, CEO, X4 Pharmaceuticals presents Addressing Unmet Need in ccRCC Through Targeted CXCR4 Blockade at the 2016 annual International Kidney Cancer Symposium.

Christopher Turner, MD, Vice President, Clinical Science presents Novel RCC Targets from Immuno-Oncology and Antibody-Drug Conjugates at the 2016 annual International Kidney Cancer Symposium.

Ian M. Waxman, MD, Bristol-Myers Squibb presents New opportunities for immuno-oncology in renal cell carcinoma at the 2016 annual International Kidney Cancer Symposium.

Moderator Michael B. Atkins , Georgetown-Lombardi Comprehensive Cancer Center participates in a debate: In 2020 Which Approach do you predict will lead to Optimal Outcomes and Why in Kidney Cancer?

Neeraj Agarwal, MD, Associate Professor of Medicine Director, GU Medical Oncology, Huntsman Cancer Institute presents Toxicities with PD-1 Inhibitors: The Price of the Cure at the 2016 annual International Kidney Cancer Symposium.

Tian Zhang, MD, Duke Cancer Institute, Duke University Medical Center presents “Vaccines in Renal Cell Carcinoma: A Lost Cause or the Way Forward?” at the 2016 annual International Kidney Cancer Symposium.

Guru Sonpavde, MD, Associate Professor of Medicine Director, Urologic Oncology, UAB Comprehensive Cancer Center presents Sequencing VEGF and PD-1 Inhibition for RCC at the 2016 annual International Kidney Cancer Symposium.

Hans Hammers MD, PhD, Kidney Cancer Program, UT Southwestern presents PD1 and CTLA4 Inhibition in RCC at the 2016 annual International Kidney Cancer Symposium.

David McDermott, MD, Leader, Kidney Cancer Program Dana-Farber/Harvard Cancer Center presents To Combine: VEGF + PD-1 at the 2016 annual International Kidney Cancer Symposium.

Charles G. Drake MD / PhD, Director GU Medical Oncology, Co-Director Immunotherapy Program, Associate Director for Clinical Research, Herbert Irving Cancer Center at Columbia University presents To Combine or Sequence: Biological Rationale at the 2016 annual International Kidney Cancer Symposium.

Robert G. Uzzo, M.D.Willing G. Pepper Chairman of Surgery Fox Chase Cancer Center, Temple University School of Medicine Chair, Department of Urology, Urological Institute at Einstein Healthcare Network presents Atezolizumab Adjuvant RCC Trial: A Surgical Perspective at the 2016 annual International Kidney Cancer Symposium.

Mohamad E. Allaf, MD, Associate Professor of Urology, Oncology, & BME MEA Endowed Director, Minimally Invasive Surgery Johns Hopkins Medicine presents Phase 3 Perioperative Nivolumab in M0 RCC (PROSPER RCC, ECOG ACRIN 8143) A UROLOGISTS PERSPECTIVE at the 2016 annual International Kidney Cancer Symposium.

Sumanta K. Pal, MD, City of Hope Comprehensive Cancer Center presents Atezolizumab Adjuvant Study: Medical Oncologist Perspective at the 2016 annual International Kidney Cancer Symposium.

Lauren C. Harshman MD, Assistant Professor of Medicine, Harvard Medical School, Dana-Farber, presents a strong case for a neoadjuvant/adjvuant approach to priming the immune system before surgery at the 2016 annual International Kidney Cancer Symposium.

Naomi B. Haas, MD, Director, Prostate and Kidney Cancer Program, Associate Professor of Medicine at the Hospital of the University of Pennsylvania presents “Have we learned any lessons from adjuvant VEGF-directed therapy?” at the 2016 annual International Kidney Cancer Symposium.

Bradley C. Leibovich, MD, FACS, Chair, Department of Urology, David C. Utz Professor of Urology, Mayo Clinic, Rochester, MN presents Preoperative 3-D Modeling & Intraoperative Imaging for Renal Surgery at the 2016 annual International Kidney Cancer Symposium.

Jose A. Karam, MD, FACS, Assistant Professor, Department of Urology, MD Anderson asks “Cytoreductive Nephrectomy: Yes, No, Clinical Trial?” at the 2016 annual International Kidney Cancer Symposium.

R. Houston Thompson, MD, Professor of Urology, Mayo Clinic presents Cytoreductive Nephrectomy: Optimizing Surgical Outcomes and Minimizing Complications at the 2016 annual International Kidney Cancer Symposium.

E. Jason Abel, MD, FACS, Associate Professor, Department of Urology, University of Wisconsin presents Cytoreductive nephrectomy in locally advanced renal tumors at the 2016 annual International Kidney Cancer Symposium.

Viraj Master MD PhD FACS, Professor Associate Chair for Clinical Affairs and Quality, Director of Clinical Research Unit Department of Urology, Emory University asks the question “Lymphadenectomy in RCC: Yes, No, Clinical Trial?” at the 2016 annual International Kidney Cancer Symposium.

Ithaar H. Derweesh, M.D., University of California, San Diego asks the question “Neoadjuvant Therapy: Where are we in 2016?” at the 2016 annual International Kidney Cancer Symposium.

Kamran Ahrar, MD, MBA, Professor, Interventional Radiology presents Renal Tumor Ablation: Current Technologies and Outcomes at the 2016 annual International Kidney Cancer Symposium.

Phillip M. Pierorazio, MD, Assistant Professor of Urology and Oncology, Brady Urological Institute, Sidney Kimmel Cancer Center, Johns Hopkins Hospital, Baltimore, Maryland asks the question Active Surveillance For Renal Masses: Where Are We In 2016? at the 2016 annual International Kidney Cancer Symposium.

Alexander Kutikov, MD, FACS, Associate Professor of Urologic Oncology Fox Chase Cancer Center, Philadelphia, PA presents “Renal Biopsy: Always, Sometimes or Never?” at the 2016 annual International Kidney Cancer Symposium.

Brandon Manley presents Characterizing Recurrent And Lethal Small Renal Masses In Clear Cell Renal Cell Carcinoma Using Recurrent Somatic Mutations at the 2016 annual International Kidney Cancer Symposium.

Dr. Nicholas G. Cost, M.D. Assistant Professor, Department of Surgery, Division of Urology University of Colorado Cancer Center presents RCC in Adolescents and Young Adults (AYAs): Diagnosis and Management at the 2016 annual International Kidney Cancer Symposium.

Dr. Karim Touijer, MD, MPH. Memorial Sloan-Kettering Cancer Center presents Surgery for cT1b RCC: Partial Nephrectomy, Radical nephrectomy, Clinical Trial? at the 2016 annual International Kidney Cancer Symposium.

Dr. Daniel Heng MD MPH FRCPC of Tom Baker Cancer Center, University of Calgary @DrDanielHeng presents Renal cell carcinoma prognostication in 2016 at the 2016 annual International Kidney Cancer Symposium.

Dr. Sima Porten, MD MPH, Assistant Professor, Department of Urology UCSF presents Partial Nephrectomy 2016, Techniques, Outcomes, and Selection at the 2016 annual International Kidney Cancer Symposium

Dr. Jamil Syed BS Research Fellow of Yale Department of Urology presents The Incidence and Predictive Factors of Metachronous Bilateral Renal Cell Carcinoma: A SEER Analysis at the2016 annual Kidney Cancer Association meeting

Is stem cell transplant (SCT) a viable option for MPN patients? Noted MPN specialist and researcher, Dr. David Snyder from City of Hope, discusses new refinements to SCT, including the matching process as well as protocols for preparing for transplant. Dr. Snyder stresses that the conversation about SCT should happen early in treatment and should be an ongoing dialogue between patient and specialist. 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

Stephan Stilgenbauer, MD, PhD of Ulm University, Ulm, Germany, talks about individualized treatment and delivering the right treatment for the right patient in chronic lymphocytic leukemia (CLL). Prof. Stilgenbauer explains that we are now on the road towards individualized treatment. There is data available from genome wide sequencing (GWS) studies that really help identify the landscape of CLL cancer driver mutations. Prof. Stilgenbauer mentions bringing this into clinical trials in the light of the novel agents, to identify the particular subgroups that benefit best from a particular given treatment. Prof. Stilgenbauer is optimistic that the coming months will bring new,…

Barbara Eichhorst, MD of the University of Cologne, Cologne, Germany, discusses how sharing data between groups on cancer can help a progression in the treatment of chronic lymphocytic leukemia (CLL). Dr Eichhorst mentions focusing on the molecular basis of cancer and treating it more according to genetic lesions. There are many things that can be learnt from other diseases, for example, with checkpoint inhibitors in solid tumors. Further, we can learn from chronic myeloid leukemia (CML) where kinase inhibitors have been available for nearly 20 years now; experts have learnt that it is important to get fast and deep remissions.…

Arnon Kater, MD, PhD of the Academic Medical Center, Amsterdam, Netherlands talks about how to overcome mental health issues that may be seen within chronic lymphocytic leukemia (CLL) patients at the 2016 International Workshop of the German CLL Study Group (GCLLSG) in Cologne, Germany. Prof. Kater explains that when you deal with CLL, who you are never going to cure, considering their quality of life becomes very important. Although it is very challenging, clinicians must help patients understand that they shouldnt be the disease but instead have the disease. In this way it is easier for the patient to live…

Jennifer Woyach, MD of The Ohio State University Comprehensive Cancer Center, Columbus, OH talks developments in chronic lymphocytic leukaemia (CLL) at the 2016 International Workshop of the German CLL Study Group (GCLLSG) in Cologne, Germany. Dr Woyach explains that this an exciting time for CLL as we are moving away from chemotherapy towards targeted therapies alone or in combination with expectation of good efficacy, good tolerability and hopefully long durations of remission.

Jasmin Bahlo, PhD of University of Cologne, Cologne, Germany talks about the analysis of the projects that are underway at the German CLL Study Group (GCLLSG) at the 2016 International Workshop of the GCLLSG in Cologne, Germany. Dr Bahlo explains that there is a lot of analysis to do; for example there are Phase III trials that are being analysed, there is the data for the CLLM1 trial (NCT01556776), which is being prepared for publication and further, they have a publication on minimal residual disease (MRD) in combination with response to treatment.

Barbara Eichhorst, MD of the University of Cologne, Cologne, Germany, discusses how best to deal with Richters transformation. Dr Eichhorst begins by stating that the best treatment for Richters transformation is to control the chronic lymphocytic leukemia (CLL), so that the transformation will not have a chance to develop. Dr. Eichhorst mentions a presentation given at this years GCLLSG congress, showing the different mutations observed in Richters transformation in comparison to de novo diffuse large B-cell lymphoma (DLBCL). It is already established that Richters is a completely different disease to DLBCL and CLL. As there are so many genetic aberrations…

Federico Caligris-Cappio, MD of Università Vita-Salute San Raffaele, Milan, Italy, talks about new treatment and traditional treatment options for chronic lymphocytic leukemia (CLL) at the 2016 International Workshop of the German CLL Study Group (GCLLSG) in Cologne, Germany. Prof. Caligris-Cappio explains that whenever there are new drugs, there is a huge temptation to jump to these drugs and forget about the rest. He believes that doctors must think about the particular patient in these situations. All the aspects of the patient, their fears and expectations, must be taken into consideration and weighed up to decide which treatment is best for…

Arnon Kater, MD, PhD of the Academic Medical Center, Amsterdam, Netherlands talks about how he thinks clinicians should talk to chronic lymphocytic leukemia (CLL) patients about their hopes and expectations at the 2016 International Workshop of the German CLL Study Group (GCLLSG) in Cologne, Germany. He explains that clinicians should not talk about cures to patients. Furthermore, patients should know that CLL is becoming more and more a chronic disease. Further, it is extremely important for quality of life assessments to be done for all the new clinical studies; even though the side effects are often small, having these side…

Barbara Eichhorst, MD of the University of Cologne, Cologne, Germany, discusses potential concerns with venetoclax. The advantage of venetoclax is that the drug is administered for a certain time period (up to 12 months). What is seen so far in frontline therapy, is that all patients respond to this therapy. There is concern, however, regarding the incidence rate of Richters transformation, as it still holds a very poor prognosis. Furthermore, with late toxicities, more Richters transformation could occur. However, these observations are based heavily on pre-treated patients with 17p deletion where it is known that they have a significant risk…

Carsten Niemann, MD, PhD of Rigshospitalet, Copenhagen, Denmark, provides brief guidance on preventing infections in chronic lymphocytic leukemia (CLL) patients. During neutropenia due to treatment, patients can suffer from infections from their own microbiome; when patients are not neutropenic, most infections come through the hands. Therefore good hand hygiene and continuous use of disinfectants is important. Dr Niemanns second piece of advice is to have the flu shot, as those with CLL will have a greater risk of developing a bacterial infection as a superinfection on top of having the flu. He notes the pneumococcal vaccine used against common pneumonia…

Jennifer Woyach, MD of The Ohio State University Comprehensive Cancer Center, Columbus, OH talks about selinexor for chronic lymphocytic leukaemia (CLL) at the 2016 International Workshop of the German CLL Study Group (GCLLSG) in Cologne, Germany. Selinexor is an inhibitor of XPO1, which has been shown to be overactive in a number of cancers, including CLL. Dr Woyach explains that an inhibitor for XPO1 appears to reduce BTK protein expression and downstream B-cell receptor (BCR) signalling. They are interested in combining it with ibrutinib or other BTK inhibitors; there is a trial assessing this combination (NCT02303392).

Nicholas Chiorazzi, MD from The Feinstein Institute for Medical Research, Manhasset, NY discusses how cell surface markers change over time and how they can be utilized to understand more about the tissue. Researchers cannot very often get samples from solid they can get bone marrow samples on occasion and rarely, lymph node samples. Therefore, it is required to figure out markers on the surface of cells in the blood that represent cells that have recently left the solid tissue, for instance the bone marrow, lymph node, or the spleen. Dr Chiorazzi mentions how experts have been able to define several…

Stephan Stilgenbauer, MD, PhD of Ulm University, Ulm, Germany, discusses the cost of treatment and collaborations in chronic lymphocytic leukemia (CLL). Novel drugs are of great benefit but they come at a price. There are several developments, trying to combine these agents into regimens that then have to be given only for a finite treatment duration, which is beneficial for the patient. There is also competition now as there are other agents, for example BTK inhibitors, challenging the paradigm of the lead compound. Prof. Stilgenbauer believes this is very good competition as groups combine their forces and companies support the…