When cancer advances to an incurable stage, some patients may prioritize treatment that will extend their life as long as possible, and others may prefer a care plan that’s designed to minimize pain. Talking to patients about their prognosis and values can help clinicians develop care plans that are better aligned to each patient’s goals. However, it’s essential that the discussions happen before patients become too ill.

The results of a long-term clinical trial showed electronic nudges delivered to health care clinicians based on a machine learning algorithm that predicts mortality risk quadrupled rates of conversations with patients about their end-of-life care preferences (JAMA Oncol 2023; doi:10.1001/jamaoncol.2022.6303). The study, published by Penn Medicine investigators, also found that the machine learning-triggered reminders significantly decreased use of aggressive chemotherapy and other systemic therapies at end of life.

Oncology Times interviewed study author Ravi B. Parikh, MD, about the results. Parikh is an oncologist and Assistant Professor of Medical Ethics and Health Policy and Medicine in the Perelman School of Medicine at the University of Pennsylvania and Associate Director of the Penn Center for Cancer Care Innovation at Abramson Cancer Center.

Despite increased screening and HPV vaccines, cervical cancer remains the fourth-leading cause of cancer death among women worldwide. Screening guidelines are constantly scrutinized and reassessed. The most current U.S. Preventative Services Task Force (USPSTF) guidelines recommend screening for cervical cancer every 3 years with cervical cytology alone in women aged 21 to 29 years. For women aged 30 to 65 years, the USPSTF recommends screening every 3 years with cervical cytology alone, every 5 years with high-risk HPV testing, or every 5 years with high-risk HPV testing with cytology.

To get the full picture on how gynecologists and oncologists today are navigating screening guidelines and new treatment options with their patients, Oncology Times interviewed Deanna Gerber, MD, an obstetrics and gynecology specialist at NYU Langone Health’s Perlmutter Cancer Center. Gerber treats women who have cancer of the reproductive tract and who have been diagnosed with a genetic mutation that increases their risk of gynecologic cancer. She offers preventive treatments and risk-reducing surgery as a routine part of her care approach. She discussed how oncologists can approach conversations around screening and address the issue of screening overuse and underuse.

This episode is Research Review, a quarterly review of the research you may have missed. Today, we are covering the American Society of Hematology Annual Meeting highlights. First Up, results from the ECOG-ACRIN E1910 Randomized Phase III clinical trial showed that blinatumomab improved overall survival in newly diagnosed adult patients with b-lineage acute lymphoblastic leukemia.

First author of this new research, Mark Litzow, MD, from the Mayo Clinic in Rochester, MN, talked with journalist Peter Goodwin at the ASH Annual Meeting. They discussed the use of blinatumomab in patients whose initial therapy for acute lymphoblastic leukemia had achieved minimum residual disease—MRD (Abstract LBA-1).

Next, researchers explored the potential of using genomic DNA and RNA profiles in a machine-learning algorithm to predict which patients with acute myeloid leukemia or advanced myelodysplastic syndrome will respond to venetoclax-based therapy (Abstract 2789). Maher Albitar, MD, discussed the findings.

Moving on, the downside of curative therapy for Hodgkin's lymphoma was under discussion at ASH. The conference heard about “epigenetic age” and neurocognitive function in young adults previously treated for Hodgkin's disease. OncTimes Talk correspondent Peter Goodwin asked first author of a report on this, Annalynn M. Williams, PhD, from the University of Rochester, in New York, about the impact of standard treatments on the subsequent lives of children (Abstract 902).

Finally, we interviewed James McCloskey, MD, from the John Theurer Cancer Center at Hackensack University Medical Center, about the results of the V-Mast study showing the value of combining CPX-351 with midostaurin for high-risk acute myeloid leukemia. In this Phase III study in older adults with newly diagnosed, high-risk/secondary AML, CPX-351 significantly improved overall survival and remission rates versus conventional 7+3 chemotherapy, with a comparable safety profile (Abstract 1436).

A study using chimeric antigen receptor (CAR)-T cells has proven to be safe for treating patients with relapsed or refractory acute myeloid leukemia (AML). The agent known as PRGN-3006 also brought remissions among patients who had chemotherapy for lymphodepletion prior to their CAR-T cell procedure (Abstract 4633). After the lead author of the new study, David Sallman, MD, from the Moffitt Cancer Center in Tampa, Florida, had reported the new findings at the 2022 Annual Meeting of the American Society of Hematology, OncTimes Talk correspondent Peter Goodwin interviewed him about the study and about the overall prospects of using CAR-T cells to treat AML.

PRGN-3006 UltraCAR-T is a multigenic autologous chimeric antigen receptor (CAR)-T simultaneously expressing a CAR specifically targeting CD33; membrane bound IL-15 (mbIL15) for enhanced in vivo expansion and persistence; and a kill switch to conditionally eliminate CAR-T cells for an improved safety profile. CD33 is over-expressed on AML blasts with lesser expression on normal hematopoietic stem cells. PRGN-3006 UltraCAR-T drug product is manufactured via an overnight process at medical centers using the Company's proprietary non-viral and UltraPorator systems and released for infusion in patients the next day. The decentralized, overnight UltraCAR-T manufacturing process, which does not use viral vectors or ex vivo activation and expansion of T cells, has the potential to address major limitations of current T cell therapies. PRGN-3006 UltraCAR-T has been granted Orphan Drug Designation and Fast Track Designation in patients with AML by the FDA.

The Phase I/Ib clinical study is designed to enroll in two phases, an initial dose escalation phase followed by a dose expansion phase, to evaluate safety and determine the recommended Phase II dose of PRGN-3006 delivered via intravenous (IV) infusion without lymphodepletion (Cohort 1) or with lymphodepletion (Cohort 2). The study is also evaluating in vivo persistence and anti-tumor activity of PRGN-3006.

Colorectal cancer is the third most diagnosed cancer and the second leading cause of cancer deaths worldwide. The current gold standard for screening, the colonoscopy, reduces cancer deaths by 67 percent, according to a 2018 study from Kaiser Permanente. So, we know screening is effective. However, obstacles remain. Colonoscopies are invasive and costs can be prohibitive. An alarming trend has also emerged, with incidence of early-onset colorectal cancer increasing over the last few decades.

Today on OncTimes Talk, we interview Anil K. Rustgi, MD, on the current state of colorectal cancer screening, advancements in non-invasive testing, and the mechanisms behind early-onset colorectal cancer.

In addition to being a world-renowned leader in the field of gastrointestinal oncology, Rustgi is the Director of the Herbert Irving Comprehensive Cancer Center at NewYork-Presbyterian/Columbia University Irving Medical Center. His research focuses on tumor initiation, the tumor microenvironment, and tumor metastasis in gastrointestinal cancers.

BARCELONA, Spain—Patients with solid tumors expressing mutated AKT oncogenes responded to therapy with a pan-AKT inhibitor—the investigational drug ipatasertib—in a Phase I study reported at the 2022 EORTC—NCI—AACR symposium on Molecular Targets and Cancer Therapeutics.

Nearly a quarter of the patients treated with the AKT blocker had their tumors shrink. These included patients with breast, endometrial, and salivary gland cancers. Tumors remained stable in just over half of the remaining patients. The presenting author at the Barcelona symposium, Carolyn McCourt, MD, Associate Professor of Obstetrics and Gynecology at Washington University in St. Louis, talked with OncTimes Talk reporter Peter Goodwin.

BARCELONA, Spain—Liquid biopsies are increasingly used to identify cancer progression and could also provide molecular evidence of higher risk for hematologic malignancies and solid tumors, according to findings from a study of circulating tumor DNA reported at the European Organization for Research and Treatment of Cancer—National Cancer Institute—American Association for Cancer Research (EORTC-NCI-AACR) 2022 Symposium on Molecular Targets and Cancer Therapeutics.

Marco Tagliamento, PhD student, medical oncologist, and research fellow at the Gustave Roussy Institute, France, told the symposium about study findings from the large Gustave Roussy Molecular Tumor Board dataset able to identify genetic mutations involved in clonal hematopoiesis. Tagliamento told the conference 113 patients—8 percent of their total—were found to have had at least one clonal hematopoiesis mutation that could be considered to place them at higher risk of developing hematologic malignancies.

“Out of these patients, 45 were referred to our hematology unit by their oncologist and five were subsequently diagnosed with blood cancer: one with myelomonocytic leukemia, two with myelodysplastic syndrome and two with essential thrombocythemia,” Tagliamento told the symposium.

Journalist Peter Goodwin briefly interviewed Tagliamento on his findings at EORTC-NCI-AACR.

In oncology today, there is an urgent need to better understand the implications of racial bias and disparities on the health outcomes of patients. Although breast cancer mortality rates decreased by 43 percent from 1989 to 2020, Black women remain more likely to die from breast cancer compared with White women, according to the 2022 American Cancer Society’s update on breast cancer statistics in the United States.

What is the underlying cause of disparities in breast cancer? It comes down to a variety of factors, from screening disparities and clinical trial participation to differences in genetics and biology. Today on OncTimes Talk, we sit down with Lisa A. Newman, MD, MPH, FACS, FASCO, to discuss each of these categories and explore how oncologists and the medical community at large can finally close the gap.

Newman is a world-renowned surgical oncologist and was appointed Chief of the Section of Breast Surgery at NewYork-Presbyterian/Weill Cornell Medical Center and Weill Cornell Medicine. She also leads the multidisciplinary breast oncology programs at the NewYork-Presbyterian David H. Koch Center, providing compassionate care to breast cancer patients. Newman’s primary research has focused on ethnicity-related variation in breast cancer risk and management of high-risk patients.

At the ASCO 2022 Annual Meeting, Oncology Times reporter Peter Goodwin caught up with Julia C. Tchou, MD, PhD, FACS, from the University of Pennsylvania Health System, during her poster session. Her research examined the feasibility and acceptability of a weight loss group program via telehealth for breast cancer survivors.

Colleague Conversations offers insights into hematology/oncology from two different perspectives: a seasoned hematologist/oncologist and a clinician earlier in their career. Oncology Times reporter Catlin Nalley sat down with Lucy A. Godley, MD, PhD, and Gina Keiffer, MD, to discuss germline predisposition to hematologic malignancies. They delve into our growing understanding of this area, including current and future research endeavors, and examine how germline predisposition intersects with disparities in cancer care. Godley is the Hospira Foundation Professor of Medicine and Human Genetics at The University of Chicago Medicine, and Keiffer is board certified in Internal Medicine, Hematology, and Oncology at Jefferson Health in New Jersey.

As Russian forces continue to bombard Ukraine, concerns are mounting about the most vulnerable citizens there, including the ill and those with cancer. Today on OncTimes Talk, we review the war in Ukraine and discuss how the war is impacting cancer patients and health systems in neighboring countries. Trying to process the refugee flow is very daunting because “the numbers are absolutely staggering,” according to Richard Sullivan, MD, PhD, a member of the World Health Organization Emergency Committee, as well as Director of the Institute of Cancer Policy at King’s College, London. Sullivan gave a briefing on the developing situation in Ukraine during an ASCO/ECO webinar titled “Cancer Care During the War in Ukraine,” on March 18.

Later in the episode, we interview Deborah Mukherji, MD, MBBS, FRCP, at the American University of Beirut to discuss the experiences of refuges in Syria and Lebanon and how humanitarian and health agencies around the world can better serve displaced people.

A bilateral prophylactic mastectomy for women at high risk of developing breast cancer can reduce their risk of developing the disease by up to 90 percent, according to the National Cancer Institute. An increasing number of women, including young women, are taking up this option. And while the data shows mastectomy is an effective method of reducing breast cancer risk, doctors still have to consider patients' choices which often involve other factors. For the individual patient, choosing a mastectomy is a complex non-linear process that is affected by personal knowledge, past experiences, and emotions surrounding identity and societal expectation.

To understand these factors more, Oncology Times interviewed Clara N. Lee, MD, Associate Professor of plastic and reconstructive surgery at The Ohio State University College of Medicine. Lee’s clinical practice focuses on breast reconstruction and microvascular surgery and her research focuses on understanding and improving how people with cancer make decisions about surgery. She recently authored a paper titled “The Role of Emotion in Cancer Surgery Decisions: Applying Concepts From Decision Psychology” published in the Annals of Surgery (2021; doi: 10.1097/SLA.0000000000004574). She has expertise in patient-reported outcomes for breast reconstruction and patient decision-making about breast cancer treatments. We discussed a bit of her research into the emotional journeys of patients who are deciding whether to proceed with contralateral prophylactic mastectomy

While the threat of climate change may conjure images of sea level rise, extreme weather patterns, and drought, the full picture of how climate change will impact oncology practice and care is still emerging. We do know that climate change will impact cancer risk, increase exposure to carcinogens, impede access to care, and ultimately effect survival.

To discuss some of these impending changes and what oncologists and patients can do to prepare, Oncology Times interviewed Robert A. Hiatt, MD, PhD, Professor in the Department of Epidemiology and Biostatistics, and Associate Director of Population Sciences at the UCSF Helen Diller Family Comprehensive Cancer Center.

In early February, President Joe Biden announced that he is supercharging the Cancer Moonshot program to accelerate progress against cancer and save lives. The ambitious, jumpstarted Cancer Moonshot aims to reduce the U.S. death rate due to cancer by at least 50 percent over the next 25 years, and to improve the lives of all Americans living with and surviving cancer.

The recharged Cancer Moonshot calls for a bipartisan across-the-board, all-hands-on-deck U.S. effort, which includes establishing a “Cancer Cabinet” consisting of the heads of major government agencies. Biden is asking Congress to approve $6 billion net new money to advance promising new treatments.

In a press briefing in early February, Candace Johnson, PhD, the President and CEO of Roswell Park Comprehensive Cancer Center discussed the reinvigorated Moonshots program with Congressman Brian Higgins (D-NY 26th District). Roswell Park Comprehensive Cancer Center will benefit from the newly announced federal Cancer Moonshot Initiative and Representative Brian Higgins said the center was selected because of its extraordinary background in cancer research and treatment.

Today we revisit three studies presented at the ASH 2021 Annual Meeting.

Primary Analysis of ZUMA-7
The 2021 American Society of Hematology Plenary Sessions in Atlanta, Georgia, heard data from a new study of CAR-T cell therapy in patients with diffuse large B-cell lymphoma: the Phase III randomized ZUMA-7 trial. This compared Axicabtagene Ciloleucel (Axi-Cell) with the current standard-of-care in patients whose disease had relapsed or was refractory after first-line therapy.

After the talk, Oncology Times reporter Peter Goodwin caught up with the lead investigator Frederick Locke, MD, Co-Leader of the Immuno-Oncology Program, and Vice Chair of the Department of Blood and Marrow Transplant and Cellular Immunotherapy at the Moffitt Cancer Center in Tampa, FL.

How Patients with AML & MDS Respond to COVID Vaccines
ASH 2021 held a cluster of sessions devoted to coronavirus infection in patients with hematologic malignancies.

Since cancer patients in general are at higher risk from COVID-19 than the general population, it has become vitally important to know whether vaccines can protect them.

Vaccine responses in patients with myelodysplastic syndrome and acute myeloid leukemia have been investigated by a team led by Jeffrey Lancet, MD, Chair of Malignant Hematology at the Moffit Cancer Center in Tampa, Florida.

Oncology Times reporter Peter Goodwin asked him about his findings.

Antibody Response to Vaccination

Whether or not to vaccinate your patient for COVID-19 may not be obvious in some clinical situations, and in hematologic malignancy this cannot be assumed.

At ASH, German investigator Susanne Saussele, MD, reported her group’s findings about vaccination responses in patients with a range of myeloid and lymphoid malignancies. She is Head of the CML Excellence Center III. Medizinische Klinik, Hematology and Oncology at the University of Mannheim in Mannheim, Germany.

Today we are bringing you a round up of three stories from around the world. We will start at the 2021 World Cancer Leader’s Summit, then move onto a story on how radiotherapy can cut late gastrointestinal toxicity for cervical cancer patients, and finish with lessons on what COVID has taught us about cancer care. All interviews are brought to you by journalist Peter Goodwin.

First up, we hear from radiation oncologist Stephen Hahn, MD, who was the U.S. Food and Drug Administration's Commissioner from 2019 to 2021—where he oversaw all manner of regulations concerning COVID-19 vaccines and therapeutics. In his 2021 address at the World Cancer Leaders' Summit, Hahn discussed "What can we learn from the development of COVID-19 vaccines." During the summit, leading cancer decision-makers from about a hundred countries met online to assess whether innovations generated during the pandemic of COVID-19 could be harnessed to improve cancer treatment and prevention. Journalist Peter Goodwin was curious to know about decision-making at the FDA during this crucial period of American history.

Next, from Mumbai, India—there's news that the new adjuvant radiotherapy standard of care for cervical cancer—image-guided intensity-modulated radiotherapy (IG-IMRT)—should cut late gastrointestinal (GI) toxicity rates by 50 percent. This according to mature results from the Phase III, randomized Postoperative Adjuvant Radiation in Cervical Cancer (PARCER) study.

Although IG-IMRT is a newer—more costly—form of radiotherapy that has already been shown to reduce early toxicity rates to some extent when compared with conventional three-dimensional conformal radiation therapy (3D-CRT), up until now it had not been shown to outperform the older technique either in terms of medium-term toxicity or anti-cancer activity.

The PARCER findings, however, demonstrate clear superiority for long term GI toxicity. They confirm equivalent anti-neoplastic efficacy.

Peter Goodwin interviewed first author Supriya Chopra MD, DNB, from the Tata Memorial Centre’s Homi Bhabha National Institute in Kharghar near Mumbai, India. She discusses the strong mandate that the study has brought for choosing IG-IMRT adjuvant radiotherapy for patients with early cervical cancer in whom surgery is needed.

Lastly, The COVID-19 pandemic has taught us a lot about cancer care—according to one of India's most prominent oncologists, C.S. Pramesh, MS FRCS, Director of the Tata Memorial Centre in Mumbai, India. He also spoke at the 2021 World Cancer Leaders’ Summit, organized by the Union for International Cancer Control, and hosted virtually by the American Society for Clinical Pathology. After the meeting OncTimes Talk reporter Peter Goodwin caught up with him to ask for his take on the impact the pandemic has had on cancer medicine, and about his views on how to improve medical practice and cope better with future crises.

At the 2021 Annual Meeting of the American Society of Hematology, researchers presented more data on additional risks faced by patients who have acute leukemia or myelodysplastic syndrome and have become infected with COVID-19. In a key study presented at ASH, Dr. Pinkal Desai from New York’s Weill Cornell Medical College has identified clinical predictors of outcome among these patients. Oncology Times reporter Peter Goodwin talked with Dr. Desai about her findings and clinical recommendations.

A new study provides support for high effectiveness of the Pfizer COVID vaccine against hospital admissions up until around 6 months after being fully vaccinated. The real-world, retrospective cohort study included data from 3.4 million Californian residents and was recently published in The Lancet. 

The importance of this Californian study is that up until now we've mainly relied on phase three study results to assess vaccine efficacy. This study (and another, even bigger one in Chile—with the CoronaVac) brings much greater statistical significance to the outcome findings and makes it possible to look at subgroups.

In this episode, Lead author Dr. Sara Y Tartof, a Research Scientist Epidemiologist with Kaiser Permanente Department of Research & Evaluation in Southern California discusses the implications for vaccination programs with Oncology Times reporter Peter Goodwin.

What’s in the OncTimesTalk, May 2021 Edition?

New clinical findings on:
Nivolumab in gastro-esophageal cancer, CDK4/6 inhibition for breast cancer, COVID-19 vaccination limitations, sitagliptin/graft-versus-host disease, breast cancer individualization, neo-adjuvant chemotherapy for rectal cancer.
Featuring:
Ronan Kelly (Austin TX), Erica Mayer (Boston MA), Sibylle Loibl (Frankfurt, Germany), Shabir Madhi (Johannesburg South Africa) and Thierry Conroy (Nancy, France).

Interviews in this edition:

Ronan J Kelly MD MBA, Baylor University Medical Center, Dallas
Adjuvant Nivolumab “Practice Changing” in Resected Gastroesophageal Cancer
Ronan Kelly tells OncTimesTalk about a big reduction in the risk of death, and doubling of median disease-free survival, from using nivolumab as adjuvant therapy for patients with esophageal, and gastro-esophageal junction, cancers after
chemoradiotherapy plus surgery in the placebo-controlled phase-three CheckMate 577 study.
https://www.nejm.org/doi/full/10.1056/NEJMoa2032125

Erica L. Mayer MD, Dana-Farber Cancer Institute, Boston, MA
Palbociclib Added No Benefit to Breast Cancer Adjuvant Endocrine Therapy
Erica Mayer discusses the PALLAS study findings with OncTimesTalk that adding the CDK 4/6 inhibitor palbociclib to endocrine therapy failed to improve invasive disease-free survival among patients with early breast cancer despite its proven efficacy in metastatic disease.
https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(20)30642-2/fulltext

Breast Cancer: A Guide to Therapy Individualization 
Sibylle Loibl, Professor of Obstretrics and Gynaecology, University of Frankfurt, CEO and Chair, German Breast Group.
Sibylle Loibl discusses her expert panel’s findings with OncTimesTalk about optimizing the many powerful methods for managing breast cancer to individualize treatment. “Future research in breast cancer will focus not only on new drugs, but even more on the individualization of therapy for every single tumor in every single patient,” she wrote in “The Lancet”.
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32381-3/fulltext

Sherif S. Farag MD PHD, Director of the Stem Cell Transplant and Cellular Therapy, Melvin and Bren Simon Comprehensive Cancer Center, Indiana University School of Medicine, in Indianapolis
Sitagliptin Reduced Graft Versus Host Disease in Stem Cell Transplantation
A non-randomized 36-patient phase-two clinical study found a big reduction in acute graft-versus-host disease after adding the dipeptidyl peptidase-4 (DPP-4) inhibitor sitagliptin (a long established antiglycemic agent) to immunosuppression for allogeneic stem-cell transplantation.  Sherif Farag discusses the study findings with OncTimesTalk.
http://www.nejm.org/doi/full/10.1056/NEJMoa2027372

Shabir A. Madhi PhD, Professor of Vaccinology and Director of the Vaccines & Infectious Diseases Analytics Research Unit at the University of Witwatersrand in Johannesburg, Co-Director of African Leadership in Vaccinology Expertise.
SARS-CoV-2 Vaccine Was Ineffective Against B.1.351 (“South African”) Variant
A “first-generation” vaccine for COVID-19 failed to prevent mild or moderate disease caused by the B.1.351 coronavirus variant in South Africa in a randomized, double-blind, controlled trial of the ChAdOx1 nCoV-19 vaccine among relatively young adults. Shabir Madhi tells OncTimesTalk, however, that vaccination with such first-generation vaccines should still protect against severe disease and death from the new variant because T-cell responses had been preserved in the South African variant.
https://www.nejm.org/doi/full/10.1056/NEJMoa2102214

Thierry Conroy MD, Professor, Department of Medical Oncology, Institut de Cancérologie de Lorraine, 54519 Vandoeuvre-lès-Nancy, France
Neoadjuvant Chemotherapy Before Preoperative Chemoradiotherapy in Locally Advanced Rectal Cancer
A multi-center, randomized, open-label, phase-three trial has shown that outcomes for patients with rectal cancer can be improved still further by using neoadjuvant chemotherapy before the current standard of care (chemo-radiotherapy and surgery).  Professor Thierry Conroy, from the Cancer Institute in Nancy, gives OncTimesTalk the details on why they decided to try an additional treatment and the benefit it brought.
https://www.thelancet.com/journals/lanonc/article/PIIS1470-2045(21)00079-6/fulltext

Andrew Zelenetz, MD, PhD, Chief of the Lymphoma Service and Vice Chair of Medical Informatics at Memorial Sloan Kettering Cancer Center, tells OT how oncologists there are training a computer to understand and compare big data sets…

Here’s why he says that work will help cancer patients at MSKCC and beyond.

David E. Weissman, MD, founded the Palliative Care Center at the Medical College of Wisconsin, serves as Director of the Medical School Palliative Care Education Project, and is also Co-Director of the Center to Advance Palliative Care’s initiative to help oncs meet revised standards of care (Improving Palliative Care—Outpatients [OPAL-OP]).

Listen to what he told OT are the trends in palliative care he sees in practice.

Alen Voskanian, MD—Innovation Advisor to the Centers for Medicare and Medicaid Services—describes the CMS project to test new payment and service delivery models.

He shared with OT the key clinical implications for oncologists and the whole cancer care team.

Steven Schroeder, MD, Chairman of the newly formed National Commission on Physician Payment Reform, discusses the commission’s upcoming report on how physicians are paid and what pay incentives mean to patient care—and how oncologists can contribute their thoughts.

Hear his chat with OT Contributing Writer and “Practice Matters” blogger Lola Butcher.

Evangelos Terpos, speaking at the European Hematology Association 2010 Congress in Barcelona, discusses his group's encouraging findings based on 10 years of experience with thalidomide, lenalidomide, and bortezomib.

Speaking at the meeting in Barcelona, Gilles Salles of the University of Lyon discusses the results showing that patients who had achieved remissions after immunochemotherapy had only half the risk of recurrence if they also received rituximab maintenance therapy for two years compared with patients who did not.

Dr. Sekeres, Director of the Leukemia Program at the Cleveland Clinic Taussig Cancer Institute and Chair of the Hematology/Oncology Pharmacy & Therapeutics Committee, discusses his particular research interests of myelodysplastic syndromes and acute myelogenous leukemia, including the overlaps between the two in older adults, new opportunities to better define MDS epidemiologically in the US, and new treatment approaches.

Dr. Govindan, Professor of Medicine and Director of the Thoracic Medical Oncology Program at Washington University Alvin J. Siteman Cancer Center, elaborates on his article in the April 10 issue about the promise and excitement of the new advances in technology that are now making possible a “panoramic view of the rugged genomic landscape of the cancer cell,” transforming cancer research and treatment.

Lori Pierce on breast-conserving therapy + adjuvant chemotherapy for BRCA 1 & 2 carriers; Annette Heemskerk-Gerritsen on the relationship between contralateral mastectomy & survival; and a recommendation by Ajay Sahu for a "cooling off" period for low-risk patients thinking of having prophylactic contralateral mastectomy.

Prof Giuseppe Saglio of the University of Turin and San Luigi Gonzaga Hospital in Italy on nilotinib as a new standard of care for chronic myeloid leukaemia. ASH President Nancy Berliner of Brigham & Women's Hospital adds her thoughts.

Jorge Cortes of M. D. Anderson Cancer Center on three different ASH papers by his group looking at alternatives to standard imatinib in CML. Jane Apperley of Hammersmith Hospital and Imperial College London, reflects on these, and discusses strategies for dealing with imatinib resistance.

OT Broadcast News Scientific Editor George Canellos of Dana-Farber Cancer Institute on what some were jokingly calling a re-run of World War II that took place in the Non-Hodgkin’s Lymphoma session: R-CHOP 14 vs R-CHOP 21 in elderly patients with diffuse large B-cell lymphoma.

Andrzej Jakubowiak of the University of Michigan discusses a 4-drug regimen to treat newly diagnosed multiple myeloma....Ruben Niesvizky of Weill Cornell Medical College in New York City on the novel proteasome inhibitor carfilzomib, used in combination with lenalidomide and dexamethasone to treat relapsed or refractory multiple myeloma. OT interviewers: Peter Goodwin and Sarah Maxwell.

George Canellos on aggressive chemotherapy's failure to benefit patients with high-risk B-cell lymphoma.

Massimo Martelli of University of Perugia on infused donor T-regulatory cells to prevent graft-vs-host-disease in patients with leukemia & lymphoma; comments from Armand Keating of the University of Toronto.

Mathias Rummel of University Hospital in Germany on using bendamustine rather than CHOP combined with rituximab for treating indolent lymphomas—front-line. Commenting: Dr. Canellos and Richard Van Etten of Tufts University.

Eduardo Rego of the University of Sao Paolo on his networking between North and South America to improve treatment of APL in developing countries. Adding their thoughts: Dr. Canellos and Richard Larson of the University of Chicago. OT Interviewers: Peter Goodwin and Sarah Maxwell.

George Canellos: Raising the curtain on ASH 2009. Jorge Cortes, M. D. Anderson Cancer Center, on omacetaxine for CML patients with resistance to imatinib caused by the T 315I mutation; Commentary from Jane Apperley of Imperial College and Dr. Canellos.

Srdan Verstovsek, also of M. D. Anderson, on JAK signaling inhibition as a treatment for myelofibrosis; Commentary from Richard Larson of University of Chicago and Dr. Canellos.

George Canellos, What’s hot from the ASH Plenary Session.

Maria-Victoria Mateos of Salamanca University in Spain on melphalan as the better partner drug for bortezomib in multiple myeloma; Commentary Dr. Canellos and Jesus San-Miguel, also of Salamanca, and Richard Van Etten of Tufts University.

Steven Devine of Ohio State University on T-cell depletion to avoid GVHD in AML; commentary from Dr. Canellos and Armand Keating of the University of Toronto.

Cornelis van de Velde at ECCO15-ESMO34 on the largest comparison of an aromatase inhibitor with tamoxifen as initial adjuvant therapy for patients with hormone receptor-positive breast cancer--analysis of results from the TEAM (Tamoxifen Exemestane Adjuvant Multinational) study reported at ECCO15-ESMO34.

John Burn talking at ECCO15-ESMO34 in Berlin about his international study showing that aspirin prevented the development of Hereditary Non-Polyposis Colon Cancer in people genetically at risk for the disease.

Mieke Van Hemelrijck at ECCO15-ESMO34 on findings that cardiovascular mortality from heart failure and arrhythmia in addition to ischemic heart disease and myocardial infarction increased among patients treated with endocrine therapy—of whatever type—for their prostate cancer.

Norman Wolmark on the study's frustrating but unequivocal results showing that bevacizumab did not extend disease-free survival in adjuvant therapy for early colon cancer at 3 years, even though there had been a benefit at 1 year. Also weighing in: Nicholas Petrelli

Richard Sullivan at ECCO15-ESMO34 on the need for research that is more “trans-national” and funded globally to shift priorities to prevention, surgical innovation and technological development, and creative, “outward branching” thinking. The need, he says, is not just for more investment but for a radical change in thinking and culture.

Éveline Boucher of Centre Eugene Marquis in France on the encouraging preliminary results of her Phase II open-label study of 101 patients reported at the ESMO World Congress on Gastrointestinal Cancer

Michel Ducreux, Head of the GI Service at Institut Gustave Roussy, talks about the new evidence and its clinical implications, as reported in his Phase II study at the ESMO World Congress on Gastrointestinal Cancer.

Eric Raymond of Beaujon University Hospital in France discusses his study reported at the ESMO World Congress on Gastrointestinal Cancer

New research for advanced NSCLC showing that combining monoclonal antibodies and chemotherapy can extend life: OTBN Editor Peter Goodwin and Producer Sarah Maxwell talk to Robert Pirker, Christian Manegold, Giorgio Scagliotti, Nick Thatcher, and Howard Sandler, MD. PLUS: Michel Coleman on the latest findings from the CONCORD study of international differences in survival rates for breast, prostate, and colorectal cancers.

Peter Goodwin talks to key investigators Francesco Zaja (on rituximab for ITP); Hannes Wandt (on how platelet transfusions may be able to be withheld in certain patients receiving stem cell transplants for hematologic cancers); and Michael Hallek and Tadeusz Robak (on improved benefits for CLL patients with rituximab added to standard chemotherapy). Offering perspective are Kenneth Kaushansky, Linda Burns, and George Canellos.

• Greater Role for Umbilical Cord Blood in Adult Transplants (Mary Eapen, commentary from Armand Keating).
• Ex Vivo Expansion of Cord Blood Derived Progenitor Cells: Patient Transplant Data (Colleen Delaney, commentary from Armand Keating).
• Erythropoiesis-Stimulating Agents in Cancer Patients: Meta-Analysis Mortality Findings (Julia Bohlius, commentary from Linda Burns and George Canellos).
• Imatinib: Durable Responses and Survival in CML: 7-Year IRIS Results; Can Imatinib Be Stopped? (Stephen O'Brien).

Silvia Novello and Giorgio Scagliotti on harnessing insulin-like growth factor receptor inhibition in a Phase II study that showed clinical activity of figitumumab to be at least as good as that of inhibitors of other growth factors already being used in cancer.

Todd Tuttle from University of Minnesota & Abram Recht from Beth Israel Deaconess Medical Center on the surprisingly big recent increase in the use of prophylactic bilateral mastectomy for DCIS.

Paddy Stone of St. George's Hospital, University of London, & David Cella from Northwestern University Feinberg School of Medicine about the effective use of questionnaires for assessing, screening, and perhaps diagnosing cancer-related fatigue syndrome.

Stanley H. Winokur, MD, on his clever, fun, and ever-evolving one-minute daily Internet quiz that lets oncologists test their knowledge & compete against others.
TheSmartestOncologist.com

Also from the Palm Beach Cancer Symposium, Kathy Albain, MD, talks about the St. Gallen consensus meeting’s updated recommendations about adjuvant therapy for breast cancer—i.e., endorsing the 21-gene recurrence score and 70-gene profiling assay as key tools in decision-making for chemotherapy for ER-positive disease.

Marshall Posner, MD, talking from Palm Beach Cancer Symposium: Increased prevalence of HPV-related oropharyngeal cancers, more responsive to treatment with induction docetaxel, cisplatin, & 5-FU prior to standard chemoradiotherapy.

Also: (1) Feasibility of patients becoming pregnant while having TKI treatment after having stable disease for at least two years; and (2) Decreased need for allogeneic transplant.

Interviewed at the Palm Beach Cancer Symposium, John Macdonald, Chief Medical Officer of Aptium Oncology in Los Angeles, talks about his latest data on the relevance of KRAS tumor status—i.e., whether the gene is wild-type or mutant determines the sensitivity of the tumor to anti-EGF or anti-VEGF receptor therapy. He also discusses the disappointing finding that blocking both of these proliferation pathways does not lead to improved efficacy when two targeted drugs are used in combination.