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Independent News for the Oncologist and Hematologist/Oncologist CLINICALONCOLOGY.COM • August 2015 • Vol. 10, No. 8
HEMATOLOGIC DISEASE Report From ASCO Meeting: Carfilzomib Bests Bortezomib in ENDEAVOR Relapsed MM Trial ...................................... 6 RAPID Study Prompting Change in Approach to Early-Stage HL .......................
6
Srdan Verstovsek, MD: How I Manage Primary Myelofibrosis ...........................
7
SOLID TUMORS Massimo Cristofanilli, MD: How I Manage Luminal A and Luminal B Breast Cancers .................................. 10 Report From ASCO Meeting: Ablation of Unresectable CRC Liver Metastases Yields Big OS Benefit ........ 13
CURRENT PRACTICE Cytotoxic vs targeted therapy: looking for cancer cures ...........................
21
by the
numbers
Predicted 10-y Incidence of CRC on Follow-Up Colonoscopy Men
Women
791
378
a
per 100,000 person-years
Story on page 14
Report From ASCO Meeting
Should WBRT Be Added to SRS for Brain Metastases? N0574 results add no support, but update of previous Japanese trial showed increased OS Chicago—In cancer patients with one to three brain metastases, adding whole-brain radiation therapy (WBRT) to stereotactic radiosurgery (SRS) does not improve overall survival and has negative effects on cognitive function and quality of life (QoL) compared with SRS alone, according to results from the Phase III N0574 trial presented at the plenary session at the see BRAIN METASTASES, page 24
Micrograph of oral cancer, including cancer of the lips and tongue; elective neck dissection should be the standard of care for early-stage, clinically node-negative oral cancers. Story on page 18.
ASCO Roundup: Several Key MM Trials Offer Promise
Value in Cancer Care:
D
F
It’s Time for Change
espite advances in understanding disease biology, multiple myeloma (MM) largely remains an incurable yet controllable disease. Survival outcomes have improved since the integration of protea- Saad Usmani, MD some inhibitors and immunomodulatory drugs into MM therapy throughout the early to late 2000s, and now several new drug classes and immunotherapy approaches in various stages of clinical development are showing promise. Several key clinical trials in MM were presented at the 2015 annual meeting of the see MM TRIALS, page 5
or years, health care experts have been sounding the alarm that rising health care costs are unsustainable and more emphasis needs to be placed on value, particularly in cancer care. In late June, the American Society of Clinical Oncology (ASCO) released a conceptual framework for assessing the value of cancer treatment options. The document proposes a methodology to compare the relative clinical benefits, side effects and costs of treatment regimens that have been tested head-to-head in randomized clinical trials. “Our goal is to drive discussion and debate on this critical issue, and we are soliciting feedback from stakeholders. That feedback will inform the evolution of the framework, which I’m sure will change over time and, ultimately, [will result in] … a user-friendly tool for physicians and patients in the clinic,” said Julie Vose, MD, the ASCO president and the chief of oncology/hematology at University of Nebraska Medical Center, in Omaha.
Proposed Framework To Empower Patients The framework—developed by the 22-member ASCO Value in Cancer Care Task Force, in collaboration with patient advocates, physicians, payors and pharmaceutical manufacturers—was published in the Journal of Clinical Oncology (2015 Jun 22. [Epub ahead of
see VALUE, page 22
RE VIE WS & COMMENTAR IES
Expert Insights From NYP/Weill Cornell Medical Center Ibrutinib effective as rescue for Waldenstrom’s macroglobulinemia ....................................... 20
Irinotecan found equal to irinotecan + cisplatin in small gastric cancer study ............................. 19 Manish Shah, MD
Peter Martin, MD