August 2014, Vol 3, No 5

PMO: Advancing the Practitioner’s Ability to Provide Customized Care to Patients

Dear Colleague, Until recently, cancer treatment relied solely on histological diagnosis for determining systemic therapy. Aside from considerations related to a patient’s underlying comorbidities and performance status, there was minimal deviation from an organ-of-origin–based treatment strategy. This relatively primitive understanding of malignancy failed to exploit biological and molecular differences within [ Read More ]

Al B. Benson III, MD, FACP, FASCO

Letter to Our Readers

Personalized Medicine and Value:

An Interview with Faculty at the Fourth Annual Conference of the Association for Value-Based Cancer Care

C. Daniel Mullins, PhD, is a professor and former department chair of the Pharmaceutical Health Services Research Department at the University of Maryland School of Pharmacy. Linda Bosserman, MD, is a community medical oncologist at Wilshire Oncology. Andrew Stainthorpe, PhD, is associate director of the National Institute of Health and [ Read More ]

C. Daniel Mullins, PhD

Interview with the Innovators

RAS and Colon Cancer: What You’re Missing

Dr Ali received her medical degree from St. George’s University, St. George’s, Grenada, and is currently practicing as a first-year fellow in the Division of Hematology/Oncology at Scripps Clinic. Dr Sigal received his medical degree from the University of California, Los Angeles, and is currently practicing in the Division of [ Read More ]

Sonia L. Ali, MD

THE BIOMARKER

Blocking Immune Checkpoints in Metastatic Melanoma

Dr Puzanov is currently an associate professor of medicine at Vanderbilt University School of Medicine and the director of melanoma clinical research at Vanderbilt-Ingram Cancer Center in Nashville, TN. He received his MD from Charles University in Prague, Czech Republic. His major interests are phase 1 drug development with emphasis [ Read More ]

Igor Puzanov, MD, MSCI, FACP

Immunotherapy

Improved Survival With Antiandrogen After ADT in Metastatic CRPC

Treatment with enzalutamide after progression with androgen deprivation therapy (ADT) led to a significant improvement in survival for men with metastatic castration-resistant prostate cancer (mCRPC). Patients randomized to placebo had a median radiographic progression-free survival (rPFS; primary end point) of 3.9 months, whereas the median had not been reached in [ Read More ]

2014 AUA Annual Meeting

PSA Trend Analysis May Help Avoid Unnecessary Biopsies

Delaying a prostate-specific antigen (PSA)-triggered prostate biopsy to allow for additional PSA assessments might have avoided more than 70% of subsequent biopsies, according to a study of negative biopsies for 28,000 men. An analysis based on deceleration of PSA growth rate suggested that 80% of negative biopsies might have been [ Read More ]

Federal Spending on Cancer Research and Access to Care Called Woefully Inadequate by ASCO President

Sequester Threatens Progress Made in Cancer The impact of federal budget cuts on cancer research is threatening progress against cancer and access to increasing demand for cancer services, said ASCO President Clifford Hudis, MD, in his presidential address. He called for achievement of “social justice in cancer care” by loosening [ Read More ]

ASCO 2014 HIghlights

Less May Be More With Zoledronic Acid

In breast cancer patients with bone metastasis, less frequent infusion of zoledronic acid was as effective as the standard monthly dose, the randomized OPTIMIZE-2 study showed. “We found that less frequent treatment may reduce the risk of serious side effects, with the additional benefits of reduced inconvenience to the patient [ Read More ]

ASCO 2014 HIghlights

Oncologists Want to Discuss Cost of Treatments With Patients but Believe They Are Not Well Equipped to Do So

Oncologists responding to a national electronic survey overwhelmingly believe that discussing out-of-pocket costs of therapy with patients is important, and that both out-of-pocket costs as well as societal cost of therapy will play a larger role in cancer treatment decisions over the next 5 years. Results of the survey were [ Read More ]

ASCO 2014 HIghlights

Ibrutinib Tops Ofatumumab as Second-Line Therapy for CLL

For the second-line treatment of chronic lymphocytic leukemia (CLL), ibrutinib improved not only progression-free survival (PFS) but also overall survival (OS), the phase 3 RESONATE study showed. In conjunction with the ASCO presentation, the study was published online in the New England Journal of Medicine. “Ibrutinib beat a standard comparator [ Read More ]

ASCO 2014 HIghlights

Anti–PD-1 Antibodies in NSCLC and Renal Cell Carcinoma

Attendees at ASCO got a look at maturing data for the anti–PD-1 monoclonal antibody nivolumab in non–small cell lung cancer (NSCLC) and at early results for this drug in other tumor types. They also heard early results for pembrolizumab. In phase 1 and 2 trials, these immunotherapies made a strong [ Read More ]

ASCO 2014 HIghlights

Bevacizumab Not Cost-Effective in Metastatic Colorectal Cancer

The addition of bevacizumab to chemotherapy for metastatic colorectal cancer is not cost-effective,” according to Daniel A. Goldstein, MD, of Emory University, Atlanta, GA, who led a cost-effectiveness analysis that earned an ASCO Merit Award at the annual meeting. The lack of cost-effectiveness was demonstrated at a willingness-to-pay threshold of [ Read More ]

ASCO 2014 HIghlights

Enthusiasm High for Anti­–PD-1 Agents

Judging by the high attendance at sessions where data on the anti–PD-1 antibodies were presented, oncologists can hardly wait to have these immunotherapies in the clinic. The key ASCO data in stage III/IV melanoma are presented here. Data on Nivolumab Maturing The long-term follow-up of the pivotal phase 1 trial [ Read More ]

ASCO 2014 HIghlights

Value-Based Insurance – Not Such an Easy Sell

The need to design insurance coverage that promotes value in cancer care is no longer a matter of debate, but how to accomplish it remains a huge challenge, according to Lee Newcomer, MD, senior vice president, oncology, genetics, and women’s health, UnitedHealthcare, who discussed value in cancer care from the [ Read More ]

Value-Based Cancer Care

The Case for Personalized Medicine: Defining the Field and Envisioning the Future of Healthcare

“In a time of unprecedented scientific breakthroughs and technological advancements, personalized health care has the capacity to detect the onset of disease at its earliest stages, pre-empt the progression of disease, and, at the same time, increase the efficiency of the health care system by improving quality, accessibility, and affordability.” [ Read More ]

Edward Abrahams, PhD

The Last Word