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Independent News for the Oncologist and Hematologist/Oncologist CLINICALONCOLOGY.COM • July 2014 • Vol. 9, No. 7
INSIDE CURRENT PRACTICE ACCC presenters recommend aligning treatments with patient priorities ................... 6 Model puts price tag on Medicare lung cancer screening ................................. 9 HEMATOLOGIC DISEASE Sagar Lonial, MD: How I manage autologous transplantation in multiple myeloma .................................. 18
by the
numbers
How do the new melanoma therapies compare? Drug Regimen
Response Median Rate, % OS, mo
Ipilimumab 3 mg/kg q3wk × 4
10.1
10.9
Vemurafenib 48.4 960 mg bid
13.6
Dacarbazine 5.4 1,000 mg/m2
9.7
Dabrafenib 150 mg bid
NR
50
NEJM M 2011;364:2507-2516; NEJM M 2010;363: 711-723; Lancett 2012;380(9839):358-365
For full story, see
clinicaloncology.com
IMAGES in ONCOLOGY
Negative ALTTO Trial Shakes Up Breast Ca Research Chicago—Negative results from the Phase III ALTTO trial have put the kibosh on using dual anti-HER2 therapy with lapatinib (Tykerb, GlaxoSmithKline) and trastuzumab (Herceptin, Genentech) in the adjuvant breast cancer setting. The study results also have undermined the use of smaller neoadjuvant breast cancer trials to identify therapies that will work in the adjuvant setting. “This is a serious disappointment, not just for the investigators, but for the entire field [of breast cancer],” said George Sledge Jr., MD, a professor of medicine and the chief of the Division of Oncology at Stanford University School of Medicine, in California. He was not involved with ALTTO but served as the discussant for the study (abstract LBA4) when it was presented at the recent annual meeting of the American Society see SHAKE-UP, P page 8
Twitter Hits and Impressions Double At #ASCO14
For more information, see page 7.
Vogl, NY...
CHAARTED Trial Should Cause Sea Change in Rx! For every man with newly diagnosed metastatic prostate ca, ask: “should he get docetaxel now?”
Chicago—Last month, oncologists were a-twitter about the American Society of Clinical Oncology’s annual meeting—#ASCO14 for those conversant in Twitter parlance. According to numbers from Symplur, a U.S. firm specializing in health care social media analytics, tweets from the meeting hit 38,056 this year, greatly outstripping the 14,634 sent out see TWITTER HITS, S page 6
‘Untitled’; this Sezary Cell seems to be erupting in the blood smear.
A
major change has just taken place in the approach to metastatic prostate cancer. For the first time, aggressive, early intervention has had a major effect on both survival and time to disease progression. Based on the ECOG-ACRIG study presented at the 2014 annual meeting of the American Society of Clinical Oncology by Christopher Sweeney, docetaxel given concurrently with initiation of androgen-deprivation therapy (ADT) prolongs median survival by 14 months and increases Steven Vogl, MD 5-year survival by 22%, with the curves separating progressively with increasing follow-up.1 For high-volume disease (visceral metastases or at least four bone metastases, with at least one metastasis in appendicular skeleton), median overall survival increased by an even more impressive 17 months. Additionally, median time to symptoms or radiographic progression increased by 13 months for the entire population. see VOGL, NY Y page 8
RE VIE WS & COMMENTAR IES
Expert Insights From The Ohio State University—The James Inverse relationship between adenomas detected and later cancer ................ 13 Peter P. Stanich, MD
Survival benefit from panitumumab in wildtype KRAS S metastatic CRC ............................... 14 Richard Goldberg, MD