April 2016, Vol. 5, No. 3

Making Strides in Personalizing Medicine

Dear Colleague, This generation has witnessed amazing advances in the realm of precision medicine. It has learned that making personalized medicine a reality takes forward movement on many fronts—from basic research to novel drugs, from clinical trials to policy. Within our pages, we strive to present the full range of [ Read More ]

Al B. Benson III, MD, FACP, FASCO

Letter to Our Readers

NCI-MATCH: A Paradigm Shift in the Evolution of Personalized Medicine Trials

An Interview with Douglas R. Lowy, MD, of the National Cancer Institute

Precision medicine has become a high-profile term with equally as high expectations. With the president’s announcement last year of a Precision Medicine Initiative (PMI) and his more recent calling for a “moonshot” to cure cancer headed by Vice President Biden, the march toward personalizing care continues to gain momentum. In [ Read More ]

Interview with the Innovators

State of Personalized Medicine in Breast Cancer

It was estimated that 231,840 new breast cancers would be diagnosed in 2015, with 40,290 breast cancer–related deaths during the same period in the United States alone.1 With improvements in screening, diagnosis, staging, and surgical and radiation techniques we have been able to cure the majority of patients with early-stage [ Read More ]

Sarika Jain, Sachin G. Pai, Cesar A. Santa-Maria, William J. Gradishar

Breast Cancer

The Rebirth of Ex Vivo Cell Screening for Clinical Use

Interest in high-throughput (HT) ex vivo cell screening of an individual’s cells for personalized cancer treatment is on the upswing, largely due to improvements in technology and assay development. Attempts decades ago to implement the strategy, which assesses the sensitivity and resistance of tumor cells to a panel of drugs [ Read More ]

Joe Olechno, PhD

Ex Vivo Screening

Prolonged Survival of a Patient with Relapsed, Metastatic, SPARC-Overexpressed Lung Adenocarcinoma Treated with Low-Dose nab-Paclitaxel

Secreted protein acidic and rich in cysteine (SPARC), also known as osteonectin and BM-40, is a collagen-binding matricellular protein that is involved in the regulation of a number of biological functions, including assembly of the extracellular matrix and the activity of matrix metalloproteinases and growth factors.1,2 In cancer, increased levels [ Read More ]

W. Larry Gluck, MD

Lung Adenocarcinoma

Checkpoint Inhibition: A Promising Immunotherapeutic Approach for Colorectal Cancer

According to the American Cancer Society, colorectal cancer (CRC) is the third most common cancer in both men and women and the second leading cause of cancer death.1 An estimated 132,700 new cases of CRC and 49,700 deaths from CRC were expected to occur in 2015.1 The 5- and 10-year [ Read More ]

Checkpoint Inhibition

RECQL and Breast Cancer Risk

The number of genes associated with breast cancer risk continues to increase. Recently, through whole exome sequencing, 2 groups of researchers have demonstrated that mutations in RECQL increase the risk of breast cancer.1 The first paper, by Cybulski and colleagues, was published online in Nature Genetics in April 2015, and [ Read More ]

Cristi Radford, MS, CGC

Genetic Counseling

A Role for Intralesional Monotherapy in Melanoma: Debate

Rather than establishing a clear winner, a debate (“Intralesional Monotherapy: Is There a Role?”) at the HemOnc Today Melanoma and Cutaneous Malignancies conference confirmed the words of Sanjiv S. Agarwala, MD, the meeting’s chairman and moderator: “Intralesional therapy is here to stay.” Roles for intra­lesional therapy as either monotherapy or [ Read More ]

Melanoma

Combination Checkpoint Blockade—It Is the New Standard for All Patients

According to Steven O’Day, MD, Professor of Medical Oncology, The John Wayne Cancer Institute, Santa Monica, CA, the essential arguments supporting combinations of checkpoint blockade immunotherapy as the standard for treating metastatic melanoma arise out of their high disease control rates, rapid deep responses, improved response rates, longer progression-free survival, [ Read More ]

Steven O’Day, MD and Jeffrey Weber, MD, PhD

Melanoma

Data Drive Quality Improvement in an Oncology Patient-Centered Medical Home

Aggregated real-time data provide the tools to rapidly identify opportunities for improvement of delivered services and initiation of quality improvement projects. Enhanced IT capabilities like the iRiS software app are foundational for practice transformation to future value-based cancer care models, according to John Sprandio, MD, Medical Oncologist and Chief Physician [ Read More ]

2016 ASCO Quality Care Symposium

How Do We Measure Quality in the Age of Precision Medicine?

Assessing quality in the age of precision medicine can be challenging for stakeholders. In a session at the 2016 ASCO Quality Care Symposium, experts from an array of fields presented their perspectives on the unique opportunities and hurdles faced by different parties and their advice for assessing quality in this [ Read More ]

2016 ASCO Quality Care Symposium

Improving Value by Understanding Total Cost of Cancer Care

Aggressive cancer treatments, emergency department (ED) visits, and hospital admissions at the end of life are major cost drivers. The use of cost data to inform infrastructure investments can help cancer centers to move toward value-based payment models, improve end-of-life planning, and reduce futile care, according to Kerin Adelson, MD.The [ Read More ]

2016 ASCO Quality Care Symposium

Secondary Pathology Review Improves Clinical Outcomes

Secondary pathology review can significantly improve clinical outcomes through precise and accurate pathologic diagnoses, according to Lavinia P. Middleton, MD. “Accurate pathological diagnoses have become a high priority in cancer diagnosis,” said Middleton, Professor, Department of Pathology at The University of Texas MD Anderson Cancer Center in Houston. Increasing costs [ Read More ]

2016 ASCO Quality Care Symposium

Stem Cell Inhibitor Active in Pancreatic Cancer, CRC

A first-in-class cancer stem cell inhibitor demonstrated activity in advanced pancreatic cancer and colorectal cancer (CRC), according to 2 small studies reported at the Gastrointestinal Cancers Symposium in San Francisco. About half of 31 patients with heavily pretreated pancreatic cancer achieved disease control when treated with BBI608 plus paclitaxel. All [ Read More ]

Gastrointestinal Cancers Symposium

Biomarker for Uveal Melanoma Has Immediate Clinical Impact

A new biomarker can identify the subgroup of Class 1 uveal melanomas most likely to metastasize, according to a retrospective study published in Clinical Cancer Research, a journal of the American Association for Cancer Research (AACR). Among Class 1 uveal melanomas, those with high levels of PRAME mRNA were more [ Read More ]

American Association for Cancer Research

Personalized Medicine’s Skeptics

The premise of personalized medicine is actually rather simple. If the diagnosis is correct at the molecular level, the prescribed treatment has a greater potential to be more accurate, efficacious, and safe. And if treatments are more accurate, patients will benefit from improved outcomes, and the health system will expend [ Read More ]

Edward Abrahams, PhD

The Last Word