Author: Editor

James Larkin, MD, PhD, of the Royal Marsden NHS Foundation Trust, London, UK, discusses aggressive melanoma, which he considers to be one of the key areas in the field. One of the problems that patients have come across with trials is that it usually takes 2-3 weeks to start the program since patients require up-to-date scans etc. However, Dr Larkin points out, such patients cannot wait this long to start treatments, but in order to collect sufficient data to advance the study, the reality is that it is unlikely for every patient to go onto a clinical trial. Recorded at…

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Sharon Liberali, BDS (Adel), DClinDent (FICD, FPFA, FRACDS) of Adelaide Dental Hospital, Adelaide, Australia, discusses the role of dentist in treatment stages leading up to allogeneic stem cell transplantation. Dentists focus on identifying the risks of odontogenic-related infections that may potentially cause a febrile illness during the course of the chemotherapy. In the longer term, post-transplant dentists can identify issues around risk for patients, including risks around graft-versus-host disease (GVHD), dental decay and risks around new malignancies in the soft tissues of the mouth and the lips. It is very important patients receive a comprehensive clinical and radiographic dental examination…

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Sharon Liberali, BDS (Adel), DClinDent (FICD, FPFA, FRACDS) of Adelaide Dental Hospital, Adelaide, Australia, emphasizes the importance of the treatment planning process for the dentist, in order for them to analyze and project which teeth are at risk of osteonecrosis of the jaw (ONJ). Bisphosphonates have a strong affinity for the bone, even if patients have stopped taking the medication for quite some time. The bone remembers these drugs in the system, therefore the risk of ONJ is almost lifelong for these patients. Dr. Liberali mentions that dentists have a clinical responsibility for a soft tissue examination, as well as…

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Gregory Crawford, MBBS, MPHC, MD, FRACGP, FAChPM of The University of Adelaide, Adelaide, Australia discusses a session organised by the Palliative Care Work Group, looking at end of life issues, e.g. what is a good death. A push for advanced care directives across the world helps people with end of life decisions. What doctors think their patients want can be quite different from what people themselves want. Being comfortable, having the right people around, and symptoms control are often mentioned by patients who are looking at the end of their life. Recorded at the Multinational Association of Supportive Care in…

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James Larkin, MD, PhD, of the Royal Marsden NHS Foundation Trust, London, UK, discusses the session Clinical problems in oncology that he was involved in at the 2016 Annual Meeting of the American Society of Oncology (ASCO), held in Chicago, IL. He believes that this session provided a good opportunity to discuss some of the problems faced in the day-to-day practice. Clinical trials have not been able to provide excessive insights into how to deal with such problems that may arise with patients, such as dealing with patients with brain metastases, who are often excluded from clinical trials. This is…

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Karen Mustian, PhD, MPH, ACSM of the University of Rochester Medical Center, Rochester, New York, NY gives a brief overview of cachexia, which is a condition where patients lose over 10% of their muscle mass and/or fat mass. It puts patients at high risk for treatment dose reductions and is associated with a poor prognosis and a functional decline. It is also very closely associated with severe fatigue. Dr. Mustian proceeds to describe that more recently, there have been studies suggesting the use of exercise to treat fatigue and cachexia. It is therefore essential for doctors to realize that it…

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James Larkin, MD, PhD, of the Royal Marsden NHS Foundation Trust, London, UK, explains the treatment options available for patients with stage III melanoma, which means that the disease has been cured with surgery but there is a risk of it coming back. According to Dr Larkin, treatment options are limited and usually participation in clinical trials is the recommended option for such patients. Last year, there was a trial comparing nivolumab and ipilimumab (IPI), and now there is a trial involving the use of pembrolizumab (PEMBRO) as a treatment option. For patients with stage III melanoma that cannot be…

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

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Martin Reck, MD, PhD of the LungenClinic Grosshansdorf, Grosshansdorf, Germany, highlights the importance of the randomized Phase III JAVELIN Lung 100 trial in non-small-cell lung cancer (NSCLC) (NCT02576574). This trial is investigating the new immune checkpoint inhibitor, the programmed death-1 receptor ligand (PD-L1), avelumab, compared to platinum-based chemotherapy in patients with metastatic or recurrent PD-L1-positive NSCLC who have never been treated before. This is an on-going trial and results are expected in early 2017. Finally, he mentions that the primary endpoint is progression-free survival (PFS) and further, they will look at overall survival (OS), tumor response and tolerability, which is…

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James Larkin, MD, PhD, of the Royal Marsden NHS Foundation Trust, London, UK, discusses the upcoming Melanoma Patient Conference in June 2016. He believes that it is a very positive event, and patients are already very involved in discussions about their own care, highlighting that he has noticed that within the last 5-10 years, patients have become increasingly aware of the clinical trials that are happening all around the UK and have even asked to be referred. He believes the enthusiasm and knowledge within the community exists even more now, and when it comes to discussing treatment options, it is…

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Eleni Efstathiou, MD, PhD of the University of Texas MD Anderson Cancer Center, Houston, Texas, TX, provides an overview of the Phase II trial of leuprolide acetate (LHRHa) and abiraterone acetate with or without ENZA (neoadjuvant enzalutamide) in high-risk prostate cancer (NCT01946165). Dr Efstathiou explains that the trial should not be considered as an independent trial, but as one in a series of companion trials. She explains that novel agents that are available from the more advanced disease settings, to explore what may be happening at a tumor micro-environment level, and treating patients and sampling their cancers. This was done…

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Anas Younes, MD of Memorial Sloan Kettering Cancer Center, New York, NY talks about how social media can give you an overview of the medical field as journals, doctors, nurses and researchers use it frequently. Prof. Younes goes into further detail and explains the benefits of participating in social media discussions. Recorded at the American Society of Clinical Oncology (ASCO) 2016 Annual Meeting, in Chicago, IL.

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Anas Younes, MD of Memorial Sloan Kettering Cancer Center, New York, NY talks about the iwNHL 2016 meeting that will occur between 2325 September in San Diego, CA. This invitation-only meeting will bring together the top thought leaders in the field of lymphoma. This year the meeting will focus on different types of lymphoma (large cell, mantle cell and T-cell lymphomas), but also areas such as immunotherapy and the updated Response Evaluation Criteria in Solid Tumours (RECIST), that will harmonize lymphoma response criteria using unidimensional measurements.

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Karen Mustian, PhD, MPH, ACSM of the University of Rochester Medical Center, Rochester, New York, NY, discusses various fatigue dimensions and treatments, highlighting the difference between treatment for mental and physical fatigue. For mental fatigue both aerobic and anaerobic activity could be prescribed for patients. It would be suggested to the patient to do 10 minutes a day, most days of the week (3-5 days a week) in order to see a change in the mental fatigue. However, Dr Mustian highlights that the prescription would be different for physical fatigue. The data and evidence suggest that patients need to do…

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Sharon Liberali, BDS (Adel), DClinDent (FICD, FPFA, FRACDS) of Adelaide Dental Hospital, Adelaide, Australia, emphasises the importance of dentists during multiple myeloma (MM) patients preparation for autologous stem cell transplantation. Dr. Liberali explains that patients treated with bisphosphonates are at significant risk of osteonecrosis of the jaw, (ONJ), with the risk increasing particularly around dental extractions. She mentions the importance of examining patients before they start bisphosphonate treatment, in order to provide any necessary dental extractions. Dr. Liberali also notes that in many cases, patients may not have visited the dentist for a very long time and may have several…

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Charles Loprinzi, MD from Mayo Clinic, Rochester, MN discusses neurotoxicities caused by a chemotherapy treatment. Numbness, tingling, shooting, and burning pain can come with the chemotherapy and last long after the treatment is completed. The exact cause is unknown, with chemotherapy drugs affecting the nerves in different ways, e.g. causing loss of nerves at the end of the fingertips and toes. The neurotoxicity is often reversible to some degree, with some patients experiencing debilitating problems for months, or years. The two most common drugs causing neurotoxicity are paclitaxel and oxaliplatin. The pain tends to get better after a paclitaxel therapy…

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Karen Mustian, PhD, MPH, ACSM of the University of Rochester Medical Center, Rochester, New York, NY, discusses advantages of using yoga as part of an exercise routine. Dr Mustians clinical trial showed yogas efficacy in improving sleep quality, insomnia, fatigue, and quality of life. In addition, Dr Mustians studies showed an improvement in regulation of patients circadian rhythm. Disruption in circardian rhythm is associated with disruptions in immune responses and inflammation, as well as sleep. Yoga helps to regulate the cancer survivors circadian rhythm, leading to improvements in sleep quality, insomnia, and fatigue. Recorded at the Multinational Association of Supportive…

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Karen Mustian, PhD, MPH, ACSM of the University of Rochester Medical Center, Rochester, New York, NY, discusses the importance of exercise in treating cancer-related fatigue. Dr Mustian presented a talk where she summarized the data from 113 randomized clinical trials that were conducted by investigators from around the world. Aerobic (i.e. walking, cycling and swimming) and anaerobic exercises (such as resistance bands and weight training), either on its own, or in combination, help with a patients fatigue. The data suggests that exercise interventions actually produce larger improvements in fatigue and a more significant improvement than what pharmaceuticals have to offer.…

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Mark Schubert, DDS, MSD of Seattle Care Alliance, Seattle, WA provides an overview of his journey through plasmacytoma treatment. With symptoms beginning in 2007, he mentions experiencing fatigue, peripheral neuropathies and weight loss, before officially being diagnosed with plasmacytoma in his left ilium. He then provides a brief overview of the various forms of treatment received: 5 courses of radiation, a treatment with lenalidomide and dexamethasone for a number of years, a switch to bortezomib and dexamethasone and then preceded to an autologous transplant in March 2014. Following that process, he was maintained with bortezomib and is now taking ixazomib.…

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Rachel Gibson, PhD of University of South Australia, Adelaide, Australia highlights the 25th anniversary of MASCC in Adelaide, Australia. MASCC organisation has dedicated 25 years working on many approaches to improve supportive care resulting in positive advances for cancer patients. Dr. Gibsons key message emphasizes supportive care as the absolute cornerstone of a patients journey. There is now a wealth of understanding behind the specific side effects of cancer treatment, therefore allowing supportive care to discover ways to support and treat patients experiencing treatment related side effects. Dr. Gibson highlights the importance of patients being aware that supportive care is…

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Mark Schubert, DDS, MSD of Seattle Care Alliance Seattle, WA discusses what he as a dental clinician has learnt through his own experience of cancer care treatment, with the aim to translate this knowledge to other patients and hopefully improve their patient care. Dr. Schubert mentions the noticeable change in patients reaction after discovering that he shares the same experience of cancer care as a patient, a closer relationship is built alongside reducing anxiety, as patients feel he can relate to them. Dr. Schubert mentions having the ability to provide his patients with information on a more personal level, for…

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Dr. Luke Peppone of University of Rochester Medical Center, Rochester, NY discusses results from a preliminary study measuring omega 3 versus omega 6 supplementation for fatigue among breast cancer survivors (NCT02352779). The study took patients with a fatigue level of 4 out of a 0-10 scale. Patients were randomized into one of three groups and were either given a high dose of omega 3 supplement (sourced from fish oil), a high dose of omega 6 supplement (sourced from soybean oil), or a combination of a low dose of both omega 3 and 6. Results show that those with a high…

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Rachel Gibson, PhD of University of South Australia, Adelaide, Australia explores the links between chemotherapy induced toxicities that would normally be treated in isolation. With chemotherapy induced diarrhea, many patients are experiencing significant pain. Dr. Gibson mentions studies which have explored this further in the brain, in the case of chemotherapy induced neuropathy. Results from studies show that pathogenic bacteria responsible for producing LPS are also found in the spinal cord. Therefore, there is hope to show that in the spinal cord there are two linked toxicities. This would be the first time showing clear mechanistic links between toxicities and…

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In this Ask the Expert segment, Dr. Gareth Morgan of UAMS Myeloma Institute answers a question from Patient Power viewer, Rick, about taking a break from treatment. Rick would like to temporarily stop treatment with Kyprolis (carfilzomib) and wants to know if this will reduce the effectiveness of the medication. Dr. Morgans response is directed toward patient quality of life. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on Twitter | http://www.twitter.com/patientpower Follow on Google+ | http://www.google.com/+patientpowerinfo

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Thomas Powles, MD, PhD from Barts Cancer Institute, London, UK discusses key points of a new Phase III clinical trial looking at moving immune single agent and immune combination therapy into the frontline setting in bladder cancer (NCT02516241). The trial has three arms: chemotherapy vs. single agent durvalumab vs. a combination of durvalumab and tremelimumab. The hope is that chemotherapy can be replaced. Recorded at the American Society of Oncology (ASCO) 2016 Annual Meeting held in Chicago, IL.

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Sumanta Pal, MD of City of Hope, Duarte, CA, discusses the introduction of new data of the new single-agent cabozantinib for advanced renal cell carcinoma. The agent is a dual MET and VEGFR2 inhibitor, and has been assessed in metastatic renal cell carcinoma and other diseases. Dr Pal highlights his involvement in the Phase I trials of cabozantinibs development in renal cell carcinoma, where impressive responses were observed. He proceeds to highlight that most recently, cabozantinib was used in a Phase III METEOR trial comparing it to the agent everolimus (NCT01865747). This study identified an improvement in response rate, overall…

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Paolo Ascierto, MD, of the National Tumor Institute Fondazione G. Pascale, Naples, Italy, discusses the safety of nivolumab for advanced melanoma in the context of the Phase II CheckMate 172 trial (NCT02156804). According to Prof. Ascierto, nivolumab has shown to be safe with few side effects. He further explains the impact of ipilimumab, the first checkpoint inhibitors and the toxicity associated with its use. However, he emphasizes that nivolumab is a more potent compound with less side effects with an incidence of immune-related grade 3/4 adverse events of around 5-6%. Recorded at the American Society of Oncology (ASCO) 2016 Annual…

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James Larkin, MD, PhD, of the Royal Marsden NHS Foundation Trust, London, UK, discusses the next steps for the treatment of advanced melanoma. Dr Larkin first discusses that it really comes back down to the patients who are not benefiting from the use of checkpoint inhibitors such as nivolumab and pembrolizumab. He highlights that a lot of the interest in this situation lies with figuring out what is inside of the tumor which stops the drug from carrying out its full effect. He believes that in cases of clinical trials, when the drug alone is not working, a biopsy should…

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Erika Hamilton of Sarah Cannon Research Institute, Nashville, TN talks about a Phase I trial of ONT-380 in combination with capecitabine and T-DM1 (trastuzumab emtansine), in patients with HER2+ metastatic breast cancer (NCT02025192). ONT-380 is a potent small molecule selective inhibitor of HER2. She explains that what is exciting about this compound is that it also crosses into the brain; as a result, what was unusual is that patients with both untreated and treated brain metastases were also allowed into the study, making the patients a very high risk population. The study showed that the response rate of ONT-380 in…

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David Ross Camidge, MD, PhD of the University of Colorado, Denver, CO, provides an insight into emibetuzumab, a monoclonal antibody directed towards the mesenchymal-to-epithelial transition (MET) factor. MET can be a primary driver of some subtypes of lung cancer, particularly the mutated MET Exon 14, and highly amplified versions of MET. He further explains that it is also a mechanism of acquired resistance in those who have an EG5 mutation, who were initially treated with an Eg5 kinesin inhibitor, but then develop acquired resistance. He explains that we already understand T790M mutation, which occurs in about 60% of cases. He…

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What is phlebotomy, and how will it help my polycythemia vera (PV)? Patient Power Founder and Host, Andrew Schorr,, discusses this cornerstone treatment with Dr. Mark Heaney of Columbia University Medical Center. Dr. Heaney explains phlebotomy, and the reason its the cornerstone of PV treatment. low-dose aspirin and cytoreductive therapies, hydroxyurea (Hydrea) and ruxolitinib (Jakafi), are also explained. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on Twitter | http://www.twitter.com/patientpower Follow on Google+ | http://www.google.com/+patientpowerinfo

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What is the role of transplant in treatment of multiple myeloma? From our town meeting in Little Rock, Arkansas, in partnership with UAMS Myeloma Institute, myeloma expert Dr. Gareth Morgan shares his perspective. Listen as Dr. Morgan discusses the vital and ongoing role of transplant as well as doublet, triplet and quadruplet combination therapies for myeloma. According to Dr. Morgan, the time has come to address a deeper understanding of cure and long-term control of this disease. 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+…

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What are the benefits to participating in multiple myeloma clinical trials? Dr. Faith Davies of UAMS Myeloma Institute responds to questions about accessing optimal care for individual myeloma patients. Dr. Davies discusses the ever increasing myeloma treatment arsenal that includes new medications and genetic testing. To get tomorrows medicine today, myeloma expert Dr. Davies recommends joining a clinical trial, involving your family and building a partnership between your local oncologist and myeloma specialist. Dont go on a journey without a good, detailed map! Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on…

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Will my essential thrombocythemia (ET) or polycythemia vera (PV) progress to myelofibrosis (MF)? Patient Power host and MF patient, Andrew Schorr, asks MPN expert Dr. Mark Heaney of Columbia University Medical Center questions regarding the connection between ET and PV and their potential progression to MF. Dr. Heaney explains why ongoing serial follow-ups remain important even though MPN progression does not always occur. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on Twitter | http://www.twitter.com/patientpower Follow on Google+ | http://www.google.com/+patientpowerinfo

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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

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Rafael Fonseca, MD from the Mayo Clinic, Scottsdale, AZ discusses the importance of monoclonal antibodies for multiple myeloma (MM). At the American Society of Oncology (ASCO) 2016 Annual Meeting held in Chicago, IL, Prof. Fonseca discussed a Phase Ib trial of isatuximab plus lenalidomide and dexamethasone in relapsed/refractory MM presented by Dr Ravi Vij. Prof. Fonseca highlights the attention monoclonal antibodies, particulary those that target CD38, receive and mentions daratumumab and isatuximab as examples. According to Prof. Fonseca, it is becoming apparent that monoclonal antibodies combine very well and can achieve deep levels of responses.

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Philippe Rousselot, MD, PhD from Versailles Hospital and University, Versailles, France discusses the concern of molecular relapse in chronic myeloid leukemia (CML) patients. If therapy is stopped for patients in deep molecular response, despite being treated for years, approximately half of them will experience molecular relapse. This has been exemplified by the EURO-SKI study (NCT01596114). Prof. Rousselots focusses on the location of the cells that are responsible for those molecular relapses, and if they can be targeted. He goes on to discuss some of his own work targeting the expression of STAT5 in those cells, and the ability to erode…

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Emili Montserrat, MD, PhD from the University of Barcelona, Barcelona, Spain discusses the goals and work of the European Research Initiative on CLL (ERIC). Some of the goals and work of ERIC include: enabiling the collaboration of researchers in the field of chronic lymphocytic leukemia (CLL), writing guidelines and diagostic criteria. Prof. Montserrat points out that a large majority of doctors use the techniques and guidelines of ERIC in regard to minimal residual disease (MRD). He further discusses the future initiatives of ERIC, which includes developing diagnostic criteria abd emphasizes the importance of international collaboration. Recorded at the European Hematology…

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Georg Lenz, MD, PhD, from the University of Münster, Münster, Germany discusses the clinical significance of diagnosing diffuse large B-cell lymphoma (DLBCL) on a molecular level at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. Prof. Lenz mentions how treatment can become specific by utilizing genetics and introducing novel inhibitors that target specific signaling pathways. He holds the optimism that this can improve survival for affected patients.

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Katja Weisel, MD from University Hospital Tuebingen, Tuebingen, Germany gives an overview of the current situation for multiple myeloma patients with more advanced disease, i.e. later relapse or exhausted treatment options. In these situations there is an unmet need for drugs which enable a sustained response. The standard treatment at the moment for this population of patients is pomalidomide plus low-dose dexamethasone. In the NIMBUS trial (NCT01311687), highly pre-treated patients with up to 17 prior treatment lines, have shown significant improvement in progression-free survival (PFS) and complete survival. Dr Weisel continues to discuss the recent developments in treatment for multiple…

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Philippe Rousselot, MD, PhD from Versailles Hospital and University, Versailles, France, discusses the use of blinatumomab in patients with acute lymphoblastic leukemia (ALL). blinatumomab is a class of bi-specific T-cell engagers (BiTEs) that works by targeting CD19 and CD3 antigens on B-cells. The drug works by bringing the T-cell to the blast and directly promoting lysis. Prof. Rousselot mentions that the toxicity profile is different to other drugs, for example there are no problems associated with the liver or the platelets. Toxicity for blinatumomab is more neurologically based, during the initial phases of the treatment and after the initial phases,…

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Stephan Grupp, MD, PhD from Children’s Hospital of Philadelphia, Philadelphia, PA discusses his research into pediatric acute lymphoid leukemia (ALL). In a relapsed or refractory setting 93% of the patients entered complete remission (CR) when treated with CTL019, a chimeric antigen receptor T-cell (CAR T-cell). Furthermore, many of these patients were able to stay in remission. Dr Grupp also discussed toxicity associated with these engineered T-cell, specifically cytokine release syndrome. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Michael Hallek, MD from the University of Cologne, Cologne, Germany discusses the potential benefits of biosimilars. Prof. Hallek suggests that they make the market more competitive, which in turn, might lower the price of drugs. He also talks about the difficulties associated with the production of biosimilars of proteins. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Philippe Rousselot, MD, PhD from Versailles Hospital and University, Versailles, France, discusses the role of inotuzumab ozogamicin, which is currently being used as a newer treatment for patients in the acute lymphoblastic leukemia (ALL) relapse/refractory setting. inotuzumab ozogamicin is an investigational antibody-drug immunoconjugate, with a CD22 affinity. inotuzumab ozogamicin works by targeting the CD22 antigen, once internalized into the malignant cell, it is combined with calicheamicin (a sort of chemotherapy) which is then released to destroy it. Prof. Rousselot mentions how inotuzumab can also have some toxicities, mainly of the platelets and the liver. He talks about a study (NCT01564784)…

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Emili Montserrat, MD, PhD from the University of Barcelona, Barcelona, Spain discusses the best treatment advice for patients with chronic lymphocytic leukemia (CLL). Prof. Montserrats overall message is that CLL patients have to be seen by CLL experts in specialized centers in order to receive a very specific kind of care. Patients with CLL should know that only one out of two will require therapy over time, which is very good news. Thinking in terms of goals of therapy, Prof. Montserrat believes that overall survival (OS) doesnt necessarily have to be fueled with complicated drugs and agents, it can also…

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Emili Montserrat, MD, PhD from the University of Barcelona, Barcelona, Spain discusses the issue of drug cost in chronic lymphocytic leukemia (CLL). Prof. Montserrat points out that not all patients suffering from CLL are treated with novel agents. They have an important role, but only for a specific group of patients. Prof. Montserrat, also discusses the importance of having support from pharmaceutical companies, in order to make the cost of this therapy affordable (joining two or three agents can cost up to 300,000 Euros per year). Nevertheless, he mentions how the industry have been very good in lowering the prices…

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Emili Montserrat, MD, PhD from the University of Barcelona, Barcelona, Spain discusses the influence of the European Research Initiative on chronic lymphocytic leukemia CLL (ERIC). Prof. Montserrat mentions that sometimes there is some confusion between the goals of therapy and endpoints in trials, and that it should be kept in mind that the goal of therapy is to prolong survival and to improve quality of life. He further discusses the joint projects in terms of promoting biological tests, investigating the utility of new agents in-vitro, which is a kind of accelerated Phase 0 study, in order to be more efficient…

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For decades, the hallmark of medical treatment for cancer and hematological malignancies has been intravenous cytotoxic chemotherapy. These drugs target rapidly dividing cells, including cancer cells and certain normal tissues. As a result, many patients experience the classic toxicities of alopecia, gastrointestinal symptoms, and myelosuppression. But how we treat these diseases has changed dramatically in the past decades. While traditional cytotoxic chemotherapy remains the treatment of choice, targeted therapies are now a major component in our arsenal in the war on cancer. These novel targeted anti-cancer drug therapies have been designed to block the growth and spread of certain cancers…

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Stephan Grupp, MD, PhD from Children’s Hospital of Philadelphia, Philadelphia, PA outlines his work at the University of Pennsylvania. Currently his team is investigating the characteristics of T-cells and how they work in treatment, with the hope of answering such questions: Can we predict patients who are going to do well? Can we understand what the requirements are for the collected T-cells? Can we extend this to areas outside of leukemia? Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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The National Cancer Act signed in 1971 officially started what is commonly referred to as the war against cancer. Since the signing of the bill, billions of dollars have been used towards a total national commitment towards the conquest of cancer with a stated goal of finding a cure. Government spending has been tremendously beneficial, providing funding for basic cancer research which is the foundation for new cancer treatments. As a result of ongoing research we now have a tremendous wealth of information, a better understanding of cancer biology and many novel treatments. But there is still a lot of…

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Peter Hillmen, MBChb, PhD, FRCP, FRCPath from St. James’ University Hospital, Leeds, UK discusses the use of the word ‘cure’ in chronic lymphocytic leukemia (CLL). According to Prof. Hillmen, the word ‘cure’ is not used frequently, instead physicians talks about ‘control’ and ‘treatment-free intervals’. The aim is to move towards a cure. With combinations of novel agents and chemotherapy, deep remissions are seen in patients, and this work may lead to a cure according to Prof. Hillmen. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Peter Hillmen, MBChb, PhD, FRCP, FRCPath from St. James’ University Hospital, Leeds, UK discusses allogeneic stem cell transplantation for chronic lymphocytic leukemia (CLL). According to Prof. Hillmen, allogeneic stem cell transplantation is the only therapy that can cure a minority of patients. However, there are side effects associated with a transplant, such as graft-versus-host disease (GvHD), and therefore it is not the treatment of choice. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Michele Baccarani, MD from University of Bologna, Bologna, Italy, discusses the symposium on Current and emerging treatment goals in chronic myeloid leukemia (CML) held at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. In particular, Prof. Baccarani discusses the new issue of treatment-free remission (TFR). Survival of patients with tyrosine kinase inhibitors (TKIs) is excellent, which makes it difficult to design studies to improve the outcome of treatment of CML according to Prof. Baccarani. Due to the success of the treatment, many patients die of other causes and therefore, the number of patients who stay alive without…

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Georg Lenz from the University of Münster, Münster, Germany discusses the current unmet need in diffuse large B-cell lymphoma (DLBCL), which he states to be patients who do not respond to the current standard treatment of rituximab plus CHOP chemotherapy. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Georg Lenz from the University of Münster, Münster, Germany discusses diffuse large B-cell lymphoma (DLBCL) at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. Researchers have found that there are many different DLBCL subtypes, for examples the ACB and the GCB subtype. Prof. Lenz stresses the importance of recognising these different subtypes in respect to diagnosis and treatment.

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Haifa Kathrin Al-Ali, MD from the University of Leipzig, Leipzig, Germany discusses what can be done for myelofibrosis patients who develop peripheral neuropathy while treated with momelotinib. Dr Al-Ali explains that not much can be done for those patients at the moment. If patients have diabetes, vitamin deficiencies, or other causes of peripheral neuropathy, these should be attended to. Dr Al-Ali mentions that there does not seem to be a correlation between a factor known to cause peripheral neuropathy and momelotinib. Therefore, this seems to be a drug dependent issue. Dr. Al-Ali concludes that further investigation needs to be done.…

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Karthik Ramasamy, MBBS, MRCP, FRCPath, PhD from Oxford University Hospitals NHS Foundation Trust, Oxford, UK discusses the next steps that need to be taken to assess treatment options for multiple myeloma (MM) patients. Dr Ramasamy speaks of the importance of understanding the genetics of myeloma and relapse. He mentions a talk by Prof. Keith Stewart from the Mayo Clinic given during a debate session on using doublets vs triplets combinations. The use of combinations, including triplets or even quadruplets, should be informed by genetics according to Dr Ramasamy. Recorded at the 2016 Annual Meeting of the British Society of Haematology…

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Gail Roboz, MD from Weill Medical College of Cornell University, New York, NY discusses the standardization of flow cytometry in acute myeloid leukemia (AML). Currently there is a lack of harmonization in ideas of pathologists working with AML. However, Dr Roboz outlines the European Leukemia Nets attempts to create a standardization of techniques to create a worldwide effort to understand what residual detectable populations mean and how much they need to be reduce in order to demonstrate a new therapys efficacy. Recorded at the 2016 Annual Meeting of the British Society of Haematology (BSH) and International Society of Hematology (ISH),…

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Giuseppe Saglio, MD of the University of Turin, Turin, Italy discusses the pros and cons of chronic myeloid leukemia (CML) first-line therapy, including imatinib, nilotinib and dasatinib. Prof Saglio mentions that trials indicate that higher doses of imatinib may be beneficial for patients. There are higher toxicity levels in 2nd generation tyrosine kinase inhibitors (TKI), such as nilotinib and dasatinib, which include an increased risk of cardiovascular events. However, a deeper molecular response is observed with these drugs. Prof Saglio further discusses the goals that need to be achieved for specific patients and that the more treatments are available, the…

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Mark Caulfield, MD from the Genomics England and Queen Mary University, London, UK discusses aspects on the UK hematology community. The UK hematology community with some international partners is shaping a hematology-oncology programs focusing on blood cancers which have unmet needs in regards to diagnostic and stratified healthcare. Programs are primarily built around clinical trials and aim to test the effectiveness of medication and how to select the correct medicine for patients. Recorded at the 2016 Annual Meeting of the British Society of Haematology (BSH) and International Society of Hematology (ISH) in Glasgow, Scotland.

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Finbarr Cotter, MD, PhD from British Society of Hematology (BSH) Conferences and Barts Health NHS Trust, UK discusses some of the issues that arise in hematology at an international level. An example of topics covered include hematology in countries with fewer resources, as well as looking at laboratory pathology and hemoglobinopathies. Prof Cotter also spoke of BSHs joint symposium with several American Society of Hematology (ASH) members where novel ways to treat sickle cell disease were discussed – specifically how to switch on hemoglobin F and to reduce the requirements for transfusions. Recorded at the 2016 Annual Meeting of the…

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Peter Hillmen, MBChb, PhD, FRCP, FRCPath from St. James’ University Hospital, Leeds, UK talks about current clinical trials in chronic lymphocytic leukemia (CLL) and how they might change the standard of care. Fludarabine, cyclophosphamide and rituximab (FCR) therapy is the standard of care for young, fit patients. Prof. Hillmen discusses upcoming trials, such as the FLAIR trial of rituximab and ibrutinib vs FCR (ISRCTN01844152). For elderly patients, obinutuzumab, chlorambucil, and bendamustine are starting to be used. Prof. Hillmen then discusses the use of ibrutinib, which is generally well-tolerated. Further, he discusses new agents such as acalabrutinib and the results with…

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Karthik Ramasamy, MBBS, MRCP, FRCPath, PhD from Oxford University Hospitals NHS Foundation Trust, Oxford, UK discusses the different forms of multiple myeloma (MM) and approaches to determine better treatments in the future. The new National Institute for Health and Care Excellence (NICE) myeloma guidelines, highlights that genetic tests need to be done in order to understand what is driving the disease in patients. Dr Ramasamy discusses how understanding the genetics of myeloma patients better would be advantageous in terms of understanding who the high risk patients are, who needs closer attention, who needs more continuous therapy, application of stem cell transplant…

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The BioZorb marker is valuable in oncoplastic breast reduction procedures during breast cancer surgery, according to MedStar Georgetown University Hospital breast surgeon Shawna Willey, MD, FACS. She notes the marker can also help replace some breast volume in lumpectomy cases that do not include a reduction.

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How can patients best manage side effects for better quality of life? Andrew Schorr, facilitates a dialogue between advanced prostate cancer experts, Dr. William Catalona, Dr. Russell Szmulewitz of University of Chicago Medical Center, and Judith Paice, PhD, RN. The panel discusses pain and fatigue, the balancing act of pain medications, and the positive influence of a support system. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on Twitter | http://www.twitter.com/patientpower Follow on Google+ | http://www.google.com/+patientpowerinfo

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AACR brought young investigators to Capitol Hill to explain the importance for continued momentum for ample funding for cancer support. To encourage investigators, Dr. Christine Lovly continues with passion towards a cure. The research requires the participation of patients in clinical trials. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on Twitter | http://www.twitter.com/patientpower Follow on Google+ | http://www.google.com/+patientpowerinfo

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Owen O’Connor, MD, PhD from Columbia University Medical Center, New York, NY discusses the positive trend in the research for treating T-cell lymphoma. The last 5 years have been extraordinary with the development of HDAC inhibitors, with three approved world wide – vorinostat and romidepsin in the US and chidamide in China. Dr OConnor mentions how he was sceptical about adding these new drugs to CHOP backbones. He also discusses the presentation at ASH which outlined studies investigating combinations of pralatrexate and romidepsin, and combinations of hypomethylating agents and HDAC inhibitors. Recorded at the European Hematology Association (EHA) 2016 Annual…

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Michael Hallek, MD from the University of Cologne, Cologne, Germany gives an overview of the German CLL Study Group (GCLLSG), which will hold its Xth International Workshop in Cologne from 16-18 September, 2016. According to Prof. Hallek, it is a small meeting and the aim is to have free discussions. The first day will cover the program of the German CLL Study Group trials. On the second day, key topics in CLL such as pathogenesis, prognostication, novel treatments and combination therapy will be discussed with international experts. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Michael Hallek, MD from the University of Cologne, Cologne, Germany talks about the issue of drug cost in oncology. According to Prof. Hallek, this is a political problem and an economic burden for society. He argues that politicans, companies, health insurers and patients need to work together proactively anf find a solution to make sure, that combination therapies are affordable everywhere in the world. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Davide Rossi, MD, PhD from University of Eastern Piedmont, Vercelli, Italy discusses the unmet needs of chronic lymphocytic leukemia (CLL) patients. There are issues related the treatment of elderly patients and ultra-high risk patients with mutations of the TP53 gene. Furthermore, the issue of affordability of these novel agents must be tackled. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Matthew Davids, MD from Dana-Farber Cancer Institute, Boston, MA outlines the differences in the treatment of older and younger patients. In older patients monotherapy with kinase inhibitors and venetoclax may be a suitable option. In younger patients doctors may have more ambitious goals, curing these patients or at least getting them into complete remission (CR). Multiple strategies could be explored either with combining novel agents with traditional chemoimmunotherapy, or using only a combination of novel agents. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Owen O’Connor, MD, PhD from Columbia University Medical Center, New York, NY discusses his colleague Dr George Tangs investigation into the PI3 kinases, with the aim of understanding why TGR-1202 is different from idelalisib and duvelisib. His work has reinforced the knowledge of TGR-1202s chemical structure and the effect it has on protein translation, specifically MIC protein. Dr OConnor also discusses the Phase II UNITY trial (NCT02793583) that aims to assess the efficacy and safety of Ublituximab + TGR-1202 and TGR-1202 monotherapy in patients previously treated for diffuse large B-cell lymphoma (DLBCL). Recorded at the European Hematology Association (EHA) 2016…

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Matthew Davids, MD from Dana-Farber Cancer Institute, Boston, MA outlines the poster demonstrating preliminary results from an investigator initiated study looking at the BTK inhibitor ibrutinib given in combination with FCR chemotherapy as a first line therapy in patients 65 years or younger. Results have shown very good tolerability and good levels of minimal residual disease (MRD) negativity. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Owen O’Connor, MD, PhD from Columbia University Medical Center, New York, NY outlines his presentation on the updates from the Phase I clinical trial examining ublituximab in combination with TGR-1202 for non-Hodgkin lymphoma (NCT02006485). Current results confirmed that the drug is well-tolerated and has a highly-favourable safety profile and a continued demonstration of good efficacy in patients with indolent lymphoma, as well as patients with diffuse large B-cell lymphoma (DLBCL). Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark

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Davide Rossi, MD, PhD from University of Eastern Piedmont, Vercelli, Italy outlines the novel treatment options for chronic lymphocytic leukemia (CLL) patients. Due to the vast number of these new treatments doctors need to have tools to help them tailor treatments to the patient. Consequently there is a growing need to develop prognostic and predictive factors that may help in the customization of treatment. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Matthew Davids, MD, from Dana-Farber Cancer Institute, Boston, MA outlines the importance of being aware of a patient’s tumor lysis risk status in chronic lymphocytic leukemia (CLL). This status can be determined by the the size of their lymph nodes and the height of their lymphocytosis. Dr Davids continues on to emphasize the importance starting venetoclax treatment at a low dose and ramping the dosage up week by week. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Matthew Davids, MD from Dana-Farber Cancer Institute, Boston, MA outlines the poster demonstrating the safety analysis of venetoclax, BCL-2 inhibitor, which has been approved for relapsed/refractory chronic lymphocytic leukemia (CLL) 17p patients. The analysis of 300 patients showed no new safety signals, only a small risk of laboratory tumor lysis syndrome, neutropenia and gastrointestinal toxicities. Dr Davids further discusses how patients on venetoclax show tolerance to the drug for long periods of time. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Anton Hagenbeek, MD, PhD from the University of Amsterdam, Amsterdam, Netherlands discusses how he hopes the treatment of cancer will progress in future. Prof. Hagenbeek hopes for intelligent combinations of targeted agents and a move towards personalized medicine. He further argues for conducting small Phase II trials in order to speed up the process of drug approval, meaning that drugs could become available at faster rates. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Anton Hagenbeek, MD, PhD from the University of Amsterdam, Amsterdam, Netherlands talks about the issue of drug costs in oncology. Drug combinations are effective but particulalry costly according to Prof. Hagenbeek. He argues that there is an urgent need to talk to the biotech companies producing the drugs and to agree on transparent pricing of these drugs and socially acceptable profit margins. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Anton Hagenbeek, MD, PhD from the University of Amsterdam, Amsterdam, Netherlands discusses how he hopes the treatment of cancer will progress in future. Prof. Hagenbeek hopes for intelligent combinations of targeted agents and a move towards personalized medicine. He further argues for conducting small Phase II trials in order to speed up the process of drug approval, meaning that drugs could become available at faster rates. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark

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Immunotherapy is a groundbreaking therapy for solid tumors. Where are we with using immunotherapy to treat multiple myeloma? Myeloma expert Dr. Jatin Shah of MD Anderson Cancer Center responds with cutting edge information about the current state of immunotherapy. Listen as Dr. Shah discusses exciting news on checkpoint inhibitors and CAR-T cell data for patients living with multiple myeloma. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on Twitter | http://www.twitter.com/patientpower Follow on Google+ | http://www.google.com/+patientpowerinfo

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Should patients consider participating in a clinical trial? Andrew Schorr, Patient Power founder and host, leads a discussion with advanced prostate experts, Dr. William Catalona and Dr. Russell Szmulewitz as they explore various approaches to deciding if a clinical trial is right for you. Drs. Catalona and Szmulewitz work to break down the barriers to understanding why and how clinical trials work. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on Twitter | http://www.twitter.com/patientpower Follow on Google+ | http://www.google.com/+patientpowerinfo

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Should patients consider participating in a clinical trial? Andrew Schorr, Patient Power founder and host, leads a discussion with advanced prostate experts, Dr. William Catalona and Dr. Russell Szmulewitz as they explore various approaches to deciding if a clinical trial is right for you. Drs. Catalona and Szmulewitz work to break down the barriers to understanding why and how clinical trials work. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on Twitter | http://www.twitter.com/patientpower Follow on Google+ | http://www.google.com/+patientpowerinfo

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Eduardo Rego, MD, PhD from University of São Paulo, Brazil discusses coagulopathy in acute myeloid leukemia (AML) at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. There are several new features that are now known, such as the presence of microparticles derived from self-fragments of leukemia cells as well as healthy cells. These microparticles have a very high expression of tissue factor (TF). TF plays an important role in coagulation. Experimental studies on annexin II which is a surface receptor that binds to plasminogen and TPA, have shown a subsequent increases in plasmin generation. This knowledge has…

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Eduardo Rego, MD, PhD from University of São Paulo, Brazil discusses the main challenges, primarily bleeding, practitioners face when treating acute promyelocytic leukemia (APL), a subtype of acute myeloid leukemia (AML). Most patients present severe bleeding, primarily intracranial bleeding. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Eduardo Rego, MD, PhD from University of São Paulo, Brazil outlines his presentation on his experience with networking as a way of improving the assistance and results of patients with acute leukemia in developing countries. With the support of the American Society of Hematology (ASH) the International Consortium on Acute Promyelocytic Leukemia (IC-APL) was established to reduce the gap between developed and developing countries.The structure is based on networking and includes providing medical education to the community, as well as providing fast and efficient methods of diagnostics. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Eduardo Rego, MD, PhD from University of São Paulo, Brazil outlines his presentation on his experience with networking as a way of improving the assistance and results of patients with acute leukemia in developing countries. With the support of the American Society of Hematology (ASH) the International Consortium on Acute Promyelocytic Leukemia (IC-APL) was established to reduce the gap between developed and developing countries. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Barbara Eichhorst, MD from University of Cologne, Cologne, Germany outlines the format of the annual workshop of the German CLL Study Group (GCLLSG) where physicians and researchers present the results of clinical trials and discuss problems. According to Dr Eichhorst there are open and closed sessions, where open sessions are free for the public to participate in while closed sessions are only for experts. In these closed sessions, ongoing and upcoming trials are discussed. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Jean-Jacques Kiladjian, MD, PhD from Saint-Louis Hospital & Paris Diderot University, Paris, France discusses the impact of patients registries on research and the patient community. Dr Kiladjian gives the example of Dr Martin Griesshammer, MD, PhD who presented data from a patient registry of pregnant women with polycythemia vera (PV), with the data consequently helping in the management of pregnancy in these patients. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Jean-Jacques Kiladjian, MD, PhD from Saint-Louis Hospital & Paris Diderot University, Paris, France discusses a selection of topics covered during the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. Dr Kiladjian outlines presentations on myeloproliferative neoplasms, specifically essential thrombocythemia (ET) and the PT-1 trial, and polycythemia vera (PV). In talks regarding treatment of PV it was discussed how ruxolitinib could lessen the JAK2 mutant allele burden.

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Significant advances have elevated breast cancer care to new levels of success and complexity. One such advance has been the availability of cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitors in women with estrogen receptor-positive (ER+) metastatic breast cancer (MBC). This webcast consists of the faculty presentations from a satellite symposium held June 4, 2016 at the annual oncology meeting that explored the current and expanding pool of information about these agents, as well as best practices for their current and potential use in MBC. In this presentation, Dr. Maura N. Dickler discusses the ongoing investigations and future applications of…

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Significant advances have elevated breast cancer care to new levels of success and complexity. One such advance has been the availability of cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitors in women with estrogen receptor-positive (ER+) metastatic breast cancer (MBC). This webcast consists of the faculty presentations from a satellite symposium held June 4, 2016 at the annual oncology meeting that explored the current and expanding pool of information about these agents, as well as best practices for their current and potential use in MBC. In this presentation, Dr. Nicholas C. Turner discusses the current clinical data for the use…

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Significant advances have elevated breast cancer care to new levels of success and complexity. One such advance has been the availability of cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitors in women with estrogen receptor-positive (ER+) metastatic breast cancer (MBC). This webcast consists of the faculty presentations from a satellite symposium held June 4, 2016 at the annual oncology meeting that explored the current and expanding pool of information about these agents, as well as best practices for their current and potential use in MBC. In this presentation, Dr. Harold J. Burstein discusses the mechanistic activity and development history of…

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Significant advances have elevated breast cancer care to new levels of success and complexity. One such advance has been the availability of cyclin-dependent kinase 4 and 6 (CDK 4/6) inhibitors in women with estrogen receptor-positive (ER+) metastatic breast cancer (MBC). Please join expert faculty discussing highlights of a satellite symposium held June 4, 2016 at the annual oncology meeting that explores the current and expanding pool of information about these agents, as well as best practices for their current and potential use in MBC.

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Andrew Zelenetz, MD, PhD, from Memorial Sloan-Kettering Cancer Center, New York, NY discusses the results of a Phase III trial of bendamustine and rituximab plus placebo vs bendamustine and rituximab plus idelalisib (NCT01569295). The primary endpoint was progression-free survival (PFS), which was favorable to adding idealisib. There was also an overall survival (OS) advantage to adding idealisib. Dr Zelenetz further discusses the side effects of this drug combination. Recorded at the 2016 Annual Meeting of the British Society of Haematology (BSH) and International Society of Hematology (ISH), held in Glasgow, Scotland.

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Irene Ghobrial, MD of the Dana-Farber Cancer Institute (DFCI), discusses progression of multiple myeloma (MM), which comes from conditions such as monoclonal gammopathy of undetermined significance (MGUS) and smoldering multiple myeloma. It is not know, however, which patients will progress. Improving our understanding of the development of the disease means that we could be treating patients earlier and avoiding the progression into advanced multiple myeloma and the associated complications, such as organ damage. Current biomarkers cannot be used to predict with accuracy the progression of the disease, so we need better tools, such as next-generation sequencing (NGS) and molecular biomarkers.…

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Howard Burris, MD from Sarah Cannon, Nashville, TN discusses the use and benefits of liquid biopsies, which include being less invasive, more timely and easier to obtain. Dr Burris further discusses whether liquid biospies will eliminate the need to do solid tumor biopsies and argues that both will have a place in clinical practice. Recorded at the American Society of Oncology (ASCO) 2016 Annual Meeting held in Chicago, IL.

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Howard Burris, MD from Sarah Cannon, Nashville, TN discusses TGR-1202 for chronic lymphocytic leukemia (CLL) and Non-Hodgkin lymphoma (NHL). TGR-1202 is a PI3K delta inhibitor and Dr Burris discusses how it may be the third compound in this area that will be used in the clinic next to idelalisib and IPI-145. TGR-1202 is well tolerated and is used as a single agent and in combination. Recorded at the American Society of Oncology (ASCO) 2016 Annual Meeting held in Chicago, IL.

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Andrew Zelenetz, MD, PhD, from Memorial Sloan-Kettering Cancer Center, New York, NY discusses the results of a Phase III trial of bendamustine and rituximab plus placebo vs bendamustine and rituximab plus idelalisib (NCT01569295). The primary endpoint was progression-free survival (PFS), which was favorable to adding idealisib. There was also an overall survival (OS) advantage to adding idealisib. Dr Zelenetz further discusses the side effects of this drug combination. Recorded at the 2016 Annual Meeting of the British Society of Haematology (BSH) and International Society of Hematology (ISH), held in Glasgow, Scotland.

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Charles Craddock, CBE, FRCP, FRCPath, DPhil, from Queen Elizabeth Hospital, Birmingham, UK explains how the definition of elderly is less dependent on chronological age but instead biological age in acute myeloid leukemia (AML). Consequently this implies that intense chemotherapy and transplants may be suitable in fit patients up to the age of 70, whereas in younger patients with co-morbidities treatment is associated with greater risks. However molecular complexities is significantly greater in old patients with AML thus there is a higher risk of relapse after intensive chemotherapy, therefore treatment strategies must be tailored. Prof Craddock also discusses the important role…

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Jae Park, MD from Memorial Sloan Kettering Cancer Center, New York, NY discusses current research in acute lymphoblastic leukemia (ALL). Dr Park first discusses a Phase III TOWER study which investigated blinatumomab vs standard of care (NCT02013167), with results showing blinatumomab performing better than conventional therapy. Then Dr Park continued to discuss a second trial on inotuzaumab, which also is compared to a standard of care arm. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Jacqueline Barrientos, MD from Northwell Health, New York, NY discusses drug treatment options for chronic lymphocytic leukemia (CLL), specifically ibrutinib, idelalisib and venetoclax. Current research on these drugs looks promising however side-effects that have not been seen before are arising. In studies with ibrutinib the data is showing higher incidence of minimal residual disease (MRD) negativity over time. Idelalisib research is demonstrating that frontline patients chance of developing an autoimmune complication or infection is very high. Consequently in Europe idelalisib is not recommended for frontline patients and clinical trials for frontline patients have been ceased. Finally venetoclax studies have stressed…

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Jacqueline Barrientos, MD from Northwell Health, New York, NY discuss a placebo-controlled study of idelalisib in combination with bendamustine plus rituximab, also known as BR (NCT01569295). The results after a longer follow-up showed a median progression free survival (PFS) of 23 months while patients with 17p deletions had a PFS of 16 months. Dr Barrientos continues to discuss why this difference in PFS may have arisen, either because of a higher rate of discontinuation of therapy in 17p del patients due to side effects or due to chromosome instability leading to resistance. Recorded at the European Hematology Association (EHA) 2016…

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Haifa Kathrin Al-Ali, MD from University of Leipzig, Leipzig, Germany discusses the unmet medical need of patients with polycythemia vera (PV) and essential thrombocythemia (ET), by outlining her arguments for new treatment options. Currently, all treatment guidelines are based on the risk of thrombosis. If the patient is low-risk based on age or history of thrombosis, they receive phlebotomy or low dose aspirin. If they are high risk they will receive high-dose aspirin and hydroxyurea, or a second line of treatment of interferon alpha. However even with these treatments thrombotic events still occur, highlighting how these drug are ineffective. Furthermore,…

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Haifa Kathrin Al-Ali, MD from University of Leipzig, Leipzig, Germany discusses Momelotinib at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. Momelotinib is a JAK 1 and JAK 2 inhibitor and even though only data from the Phase I and Phase II trial is available, there has been positive results similar to ruxolitinib. Momelotinib has shown to have an essentially positive impact with patients with anemia and transfusion dependency. This differing result to ruxolitinib is thought to be due to momelotinibs inhibition of the hepcidin production pathway in hepatocytes. However, momelotinib has a specific side-effect, peripheral neuropathy,…

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Bruno Paiva, PhD from the University of Navarra, Pamplona, Spain outlines his presentation on the role of minimal residual disease (MRD) in multiple myeloma, specifically its role as a prognostic factor and in the future as biomarker to aid in treatment decisions. Dr Paiva, outlines the importance of studying the biology of tumor resistant clones at the MRD level. The first reason discussed is to understand the mechanisms of ultra-chemoresistance in order to develop novel targets and therapy combinations. The second is to understand the biology and genetic features of the MRD cell. Recorded at the European Hematology Association (EHA)…

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Barbara Eichhorst, MD from University of Cologne, Cologne, Germany outlines tumor lysis syndrome as a side-effect of venetoclax in treatment of patients with chronic lymphocytic leukemia (CLL). Tumor lysis syndrome can be avoided if the initial dosage begins at 20mg and is doubled every week till a dosage of 400mg is reached. Certain patients have a particularly high risk of developing tumor lysis, especially those with a high lymphoma burden, high lymphocyte count or large lymph nodes (above 10cm). These patients may have to come more frequently or stay for extended periods of time in the clinic. Recorded at the…

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Barbara Eichhorst, MD from University of Cologne, Cologne, Germany outlines current clinical research in chronic lymphocytic leukemia (CLL). Dr Eichhorst discusses the recruitment of patients in the CLL14 trial which is testing efficacy and safety of obinutuzumab plus venetoclax versus obinutuzumab plus chlorambucil (NCT02242942). She then continues to discuss the upcoming results from the Phase II CLL2-GiVe trial which involved an induction treatment of bendamustine followed by maintenance treatment of ibrutinib or venetoclax in combination with obinutuzumab (NCT02758665). Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Barbara Eichhorst, MD from University of Cologne, Cologne, Germany discusses the economic burden of treating chronic lymphocytic leukemia (CLL). A solution Dr Eichhorst proposes is raising the price of treatment in the beginning, but ensuring that this treatment eradicates the disease. Consequently the patient does not have to pay for continuous treatment. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Barbara Eichhorst, MD from University of Cologne, Cologne, Germany discusses using venetoclax in the treatment of patients with chronic lymphocytic leukemia (CLL). Venetoclax will be approved for high risk CLL patients with 17p deletions, and has received good results in studies. Furthermore it has performed well in contrast with ibrutinib or idelalisib, as complete responses (CR) and minimal residual disease (MRD) negativity in relapsed/refractory CLL has been reported – even in monotherapy. Dr Eichhorst also discusses combinations with the CD20 antibody. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Barbara Eichhorst, MD from University of Cologne, Cologne, Germany discusses updates in current clinical trials being undertaken in the field of chronic lymphocytic leukemia (CLL). Treatment of patients with 17p deletions have shown very good response rates, with a median progression-free survival of 13 months. Dr Eichhorst also discusses the HELIOS Phase III study of ibrutinib in combination with bendamustine and rituximab in relapsed/refractory CLL (EudraCT No. 2012-000600-150). The bendamustine and rituximab plus ibrutinib arm of this study has shown continuous improvement in the response quality and minimal residual negativity (MRD). Recorded at the European Hematology Association (EHA) 2016 Annual…

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Barbara Eichhorst, MD from University of Cologne, Cologne, Germany discusses the treatment of elderly CLL patients. In the beginning of treatment a geriatric assessment should be undertaken as well as offering support to the patient in the form of psychologists, to help the patients through the treatment phase. Prof Eichhorst also discusses ibrutinib as a treatment option for those patients who cannot tolerate CD20 antibody or who cannot travel to a hematologist and consequently an oral drug would be beneficial. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Barbara Eichhorst, MD from University of Cologne, Cologne, Germany discussing treatment options for co-morbid chronic lymphocytic leukemia (CLL) patients. These individuals face frequent medical problems which have to be taken into consideration when choosing a treatment regimen. Dosage reduced treatment should be considered as an option, for example fludareabine plus cyclophosphamide plus rituximab. Another combination that has shown promising responses is bendamustine plus rituximab. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Are any immunotherapy approaches currently available to treat advanced prostate cancer patients? Andrew Schorr, Patient Power Founder and Host, leads a discussion with experts Dr. William Catalona and Dr. Russell Szmulewitz. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on Twitter | http://www.twitter.com/patientpower Follow on Google+ | http://www.google.com/+patientpowerinfo

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Haifa Kathrin Al-Ali, MD from University of Leipzig, Leipzig, Germany discusses momelotinib at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. Momelotinib is a JAK 1 and JAK 2 inhibitor and even though only data from the Phase I and Phase II trial is available, there has been positive results similar to ruxolitinib. Momelotinib has shown to have an essentially positive impact with patients with anemia and transfusion dependency. This differing result to ruxolitinib is thought to be due to momelotinibs inhibition of the hepcidin production pathway in hepatocytes. However, momelotinib has a specific side-effect, peripheral neuropathy,…

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Robin Foà, MD from the Sapienza University, Rome, Italy gives an overview of the session on ‘Biosimilars: shaping the future of Hematology’ held at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. Prof. Foà discusses how advancements in therapy are impacting on the prognosis of various cancers and, in this context, the problems associated with an aging society. He then talks about drug costs and the issue of access to novel drugs. According to Prof. Foà, biosimilars may help reduce costs and increase access to drugs.

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Klaus Okkenhaug, PhD from Babraham Institute, Cambridge, UK discusses alternative options for the treatment for chronic lymphocytic leukemia (CLL). Similar to idelalisib are the SYK inhibitors which are awaiting approval. There are also BTK inhibitors, such as ibrutinib.Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Mohamad Mohty, MD, PhD from Saint-Antoine Hospital, Paris, France discusses the current progress being made in multiple myeloma (MM) research. In frontline patients eligible for transplant, practitioners should aim to deepen the response rate and target minimal residual disease (MRD) before transplant. Prof Mohty suggests that second generation proteasome inhibitors are extremely potent in this setting and will be further strengthened by the addition of a monoclonal antibody, such as daratumumab, to achieve negative MRD status. In the transplant setting, current research is showing the importance of maintenance therapy. The meta analysis of three large randomised trials has shown an…

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Jae Park, MD from Memorial Sloan Kettering Cancer Center, New York, NY discusses the efficacy and safety of the CD19 targeted chimeric antigen receptor (CAR) T-cells in relapsed B-cell acute lymphoblastic leukemia (ALL) adult patients. CAR T-cells are the patient’s own T-cells which have been genetically engineered to express a chimeric antigen receptors that’s engineered to target a specific tumour antigens, in this case CD19. A phase I clinical trial has been conducted on 51 subjects, and has had positive results. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Mark Levis, MD, PhD from The Johns Hopkins University, Baltimore, MD discusses treatment of acute myeloid leukemia (AML) patients. Although there is still little understanding of the pathogenesis of AML, practitioners do know to target CD19 – a B-cell specific surface protein. Two targeted therapies are currently available in AML therapy, inotuzumab and blinatumomab. Inotuzumab is very indiscriminate while contrastingly blinatumomab, a bi-specific T-cell engager (BiTEs), is very specific. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Stephan Grupp, MD, PhD from Children’s Hospital of Philadelphia, Philadelphia, PA outlines his work at the University of Pennsylvania. Currently his team is investigating the characteristics of T-cells and how they work in treatment, with the hope of answering such questions: Can we predict patients who are going to do well? Can we understand what the requirements are for the collected T-cells? Can we extend this to areas outside of leukemia? Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Stephan Grupp, MD, PhD from Children’s Hospital of Philadelphia, Philadelphia, PA discusses his research into pediatric acute lymphoid leukemia (ALL). In a relapsed or refractory setting 93% of the patients entered complete remission (CR) when treated with CTL019, a chimeric antigen receptor T cell (CART). Furthermore, many of these patients were able to stay in remission. Dr Grupp also discussed toxicity associated with these engineered T-cell, specifically cytokine release syndrome. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Robin Foà, MD from the Sapienza University, Rome, Italy discusses the advances in the diagnostics and treatment of acute lymphocblastic leukemia (ALL) at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. Prof. Foà first talks about changes in diagnostics and how biological stratification is becoming more sophisticated. For example, patients should be tested for Philadelphia chromosome-positive (Ph+) ALL at presentation and if tested positive, should receive a different therapy with tyrosine kinase inhibitors targeting the specific abnormality. Further, the monitoring of minimal residual disease (MRD) is now guding treatment in clinical trials, which determines decisions such as…

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Mark Levis, MD, PhD from The Johns Hopkins University, Baltimore, MD discusses a common question that acute myeloid leukemia (AML) patients ask on their first visit, how did I get this?. Today there is a much better understanding of AML and often its cause cannot be pinpointed to a patients actions but rather is caused by the natural increase of mutations with age. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Robin Foà, MD from the Sapienza University, Rome, Italy discusses the question of how the trials on biosimilars should be run and what needs to be done for biosimilars to get approved. According to Prof. Foà, this is a difficult question and he points out that the European Medicines Agency (EMA) has stated that extrapolation is acceptable. He talks about the importance of demonstrating the safety and efficacy of biosimilars and discusses when extrapolation may be acceptable. Prof. Foà further argues that it is unrealistic to repeat all trials. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in…

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Klaus Okkenhaug, PhD from Babraham Institute, Cambridge, UK discusses the importance of PI3 kinase, specifically the delta isoform in chronic lymphocytic lymphoma (CLL) and indolent non hodgkin’s lymphoma (NHL). PI3 kinase delta is selectively expressed in immune cells and is particularly involved in the activation and differentiation of B-cells. It is a target for the drug idelalisib, and works by interfering in the B-cell receptor signalling pathway or signaling downstream of chemokine receptors. However, patients treated with idelalisib have shown adverse effects, commonly colitis. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Robin Foà, MD from the Sapienza University, Rome, Italy discusses whether biosimilars may help increase the access to novel drugs. Prof. Foà points out that the saving might be around 30% of the original drug cost, which means that biosimilars would not necessarily make novel drugs accessible everywhere. Biosimilars are a step forward but they will not solve the problem according to Prof. Foà. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Mark Levis, MD, PhD from The Johns Hopkins University, Baltimore, MD spoke on the lack of evolution in acute myeloid leukemia (AML) at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. Dr Levis noted that there has not been any major new advances in 40 years. However this may be changing as a Dr Levis then continued on to discuss the RATIFY Phase III trial which Daunorubicin, Cytarabine, and Midostaurin in treating AML patients (NCT006512610).

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Peter Hillmen, MD, PhD from St. James’ University Hospital, Leeds, UK discusses the debate ‘Can we cure CLL today?’ held at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. According to Prof Hillmen, the key question is how to define cure. He also discusses minimal residual disease (MRD) and the difference between measurable and unmeasurbale MRD. Prof Hillmen argues that it is unlikely that many or any patients are being cured at the moment even though some patients may never relapse.

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Andrew Davies, MRCP, PhD from University of Southampton, Southampton, UK describes the role and actions of the precision medicine for aggressive lymphoma (PMAL) consortium. Designed to be a collaboration between academia and industry, aims include optimising diagnostic and stratification of patients with diffuse large B-Cell lymphoma (DLBCL). PMAL includes a network of individuals looking at transcriptome technology for use in DLBCL, optimizing signatures, identifying endotypes and mutation screening, among many other areas. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Michael Hallek, MD from the University of Cologne, Cologne, Germany gives an overview of the International Workshop on Chronic Lymphocytic Leukemia (iwCLL) meeting, wich will be held in New York City on May 12-15, 2017. According to Prof. Hallek, combinations of new agents will be a hot topic and there will be a debate about prognostic factors in the era of novel agents. For example, the new prognostic score called CLL-IPI will be discussed in the context of novel drugs. Another topic will be the pathogenesis of CLL and how an understanding of the different pathways will provide novel targets.…

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Andrew Davies, MRCP, PhD from University of Southampton, Southampton, UK discusses diffuse large B-Cell lymphoma (DLBCL). A study conducted in Denmark looked at patients who had received complete remission (CR) or complete remission unconfirmed (CRU) compared with a matched population. It was shown that patients under 50 had the same overall survival (OS) as the normal population. In patients over 50 there is still gap between DLBCL patients and the normal populations OS. Dr Davies further discusses a randomized Phase III trial examining the effect of early intensification of rituximab (ISRCTN82286322). The results showed that increasing rituximab dose during the…

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Rafael Fonseca, MD from the Mayo Clinic, Scottsdale, AZ talks about why doctors should use social media channels such as Facebook and Twitter. According to Prof Fonesca, Twitter is a rich source of information and patients as well as many physicians use it. He also shares some tips such as remembering that Twitter is a public space.

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Andrew Davies, MRCP, PhD from University of Southampton, Southampton, UK discusses the pooled analysis of NCT01236391, NCT01599949 and NCT01646021 trials which all analysed at the outcome of mantle cell lymphoma (MCL) patients treated with ibrutinib. Overall, there were 370 patients with a complete remission (CR) of 20% and an overall response rate (ORR) of 66%. In patients who achieved CR over 90% were still alive after 2 years. Recorded at the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark.

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Andrew Davies, MRCP, PhD from University of Southampton, Southampton, UK gives an overview of the subjects discussed during the European Hematology Association (EHA) 2016 Annual Congress in Copenhagen, Denmark. Subjects include PI 3-Kinase and BTK inhibition, as well as looking into high risk features of chronic lymphocytic leukemia (CLL) and non-hodgkin lymphoma (NHL). Dr Davies also discusses how practitioners are moving away from clinical parameters such as the follicular lymphoma international prognostic index (FLIPI), and now identifying high-risk patients using a M7-FLIPI. This is a combination of FLIPI performance status and the mutation status of 7 genes, which is a…

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” Andrew Davies, MRCP, PhD from University of Southampton, Southampton, UK discusses his participation in the joint symposia regarding high risk chronic lymphocytic leukemia (CLL) and follicular lymphoma, and the use of idelalisib in treatment. Dr Davies outlines his participation in a phase II trial to assess the efficacy and safety of idelalisib in subjects with indolent B-Cell non-hodgkin lymphoma (NHL) refractory to alkylating agents and to rituximab (NCT01282424) Results showed an overall response rate of 56%, and a median progression free survival of over 11 months. According to Dr Davies idelalisib gives a clear option for patients whose disease…

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

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In this Ask the Expert segment, Terry is concerned about his mothers treatment and side effects. He wants to know if a reduction of the dose of Revlimid and dexamethasone will make the treatment less effective. MPN expert Dr. Jatin Shah, a myeloma expert from MD Anderson Cancer Center, responds with a discussion of the balance between managing side effects and dosage as well as various causes of GI upsets. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on Twitter | http://www.twitter.com/patientpower Follow on Google+ | http://www.google.com/+patientpowerinfo

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From our MPN Ask the Expert series, Patient Power viewer, Jane, asks a question about using iron supplements for MPN patients who are anemic due to iron deficiency. MPN expert Dr. John Mascarenhas of Mount Sinai School of Medicine responds with a two-part answer: one for polycythemia vera (PV) patients and another for myelofibrosis (MF) patients. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on Twitter | http://www.twitter.com/patientpower Follow on Google+ | http://www.google.com/+patientpowerinfo

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In this Ask the Expert segment, Terry is concerned about his mothers treatment and side effects. He wants to know if a reduction of the dose of Revlimid and dexamethasone will make the treatment less effective. MPN expert Dr. Jatin Shah, a myeloma expert from MD Anderson Cancer Center, responds with a discussion of the balance between managing side effects and dosage as well as various causes of GI upsets. Get email alerts | http://www.patientpower.info/alerts Subscribe on YouTube | http://www.youtube.com/patientpower Like on Facebook | http://www.fb.com/patientpower.info Follow on Twitter | http://www.twitter.com/patientpower Follow on Google+ | http://www.google.com/+patientpowerinfo

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