April 2013, Vol 2, No 2
Information Overload – the Search for Clinical Relevance in the Oncology LiteratureUncategorized
The field of oncology is changing at an unprecedented rate. Not that long ago, a few dozen chemotherapeutic agents were used to treat a wide variety of tumor types – and most of them were used empirically. It used to be relatively easy to keep current on advances as only a handful of randomized trials were published or presented each year for the most common disease sites. Now, there are well over 100 commercially available anticancer agents, many of which have targeted applications, and it seems that new FDA-approved indications are being announced on a weekly basis. Every day, oncologists are inundated with information touting the results of the latest randomized trials for both common and uncommon malignancies. Even for an academic oncologist, it is challenging to keep current on the constant flow of new data.
It can be even more challenging to determine which results actually represent clinically meaningful advances. Many of the recent advances in oncology are truly remarkable scientific achievements, and we remain hopeful that they will translate into greater clinical gains. However, trials with statistically significant results that are of marginal clinical benefit do not justify the empiric use of expensive, state-of-the-art treatments in all patients with an advanced, incurable disease. This approach is neither scientifically rational nor economically sustainable. What such studies tell us is that some patients do benefit from newer targeted therapies. It is now incumbent upon us to take these findings a step further by defining the predictive factors that will prospectively identify those patients who will benefit so we can begin to direct our treatments in a more rational, effective, and fiscally sound manner.
That is why Personalized Medicine in Oncology exists. We offer articles, interviews, and news exploring the best ways to effectively personalize oncology treatments. And now, we want your feedback. Please visit and bookmark us at www.personalizedmedonc.com to weigh in on the topics presented in our pages and on our Web site. We are looking forward to hearing from you and maintaining a meaningful dialogue.
Al B. Benson III, MD
PMO Editor in Chief
Physician-Reported Clinical Utility of the 92-Gene Molecular Classifier in Tumors With Uncertain Diagnosis Following Standard Clinicopathologic Evaluation
Advances in understanding the genetic basis of many cancers and the development of molecularly targeted therapies are increasing the need for diagnostic resolution. Patient outcomes have improved with the use of predictive biomarker testing, targeted therapies, and site-specific chemotherapy regimens.1,2 However, tumor classification remains unknown or uncertain in a quarter [ Read More ]
About 3% to 5% of the general population is believed to have a mutation in the gene that encodes a major 5-fluorouracil (5-FU) metabolizing enzyme. This mutation can extend the half-life of 5-FU, leading to increased plasma concentrations and potential toxicities, said Colleen Rock, PharmD, PhD, at the Hematology/Oncology Pharmacy [ Read More ]