The issue of value in cancer care was a prominent theme at the 2014 ASCO Annual Meeting. A question that inevitably arises in any discussion of value is what the professional and ethical obligations of practicing oncologists are in the current climate of escalating healthcare costs.
The David A. Karnofsky Memorial Award, ASCO’s highest scientific honor, went this year to Dr. Martine J. Piccart, who is internationally recognized for her unflagging dedication and innovative approaches to the development of drugs and regimens that will truly make a difference in the lives of patients with breast cancer.
Building on the landmark studies of the immunotherapeutic agent ipilimumab just a few years back, ASCO 2013 saw the presentation of truly impressive data on two PD1 blockers, as well as noteworthy studies of other immunotherapeutic approaches to advanced melanoma.
At the ASCO annual meeting, researchers presented persuasive evidence that a new class of targeted agents-MEK inhibitors-may warrant inclusion in the growing armamentarium for patients with advanced BRAF-mutated melanoma.
The new therapies that became available for advanced melanoma over the past year-the anti-CTLA4 antibody ipilimumab (Yervoy) and the selective BRAF inhibitor vemurafenib (Zelboraf)-represent promising new options for these patients, whose prognosis was heretofore almost universally dismal. However, the advent of new treatment strategies has made treatment decisions more complex.
In his plenary address as outgoing president of ASCO, Dr. George Sledge proposed that we are on the brink of a new era in cancer therapy – an era of genome-based treatment. He stressed that this new “genomic era” holds great promise for patients, citing as evidence a recent paper in JAMA that described a case in which the results of deep sequencing of a patient’s leukemic cells led to successful individualized therapy.
As early as 1932, physicians noticed an apparent association between type 2 diabetes and increased cancer risk. In recent years, the epidemiological evidence of such an association has mounted steadily-especially with the emergence of large databases, which have allowed us to document the link.