Advanced Urothelial Carcinoma: Moving the Field ForwardMarch 16th 2013
Current efforts utilizing genomic strategies to unravel the biology of urothelial carcinoma will undoubtedly lead to rational targets, new therapies, and a renewed enthusiasm among researchers and clinicians working in this field-which ultimately will improve the lives of patients with this devastating disease.
"Missing the Target" in Urothelial CancerMarch 16th 2013
Advanced urothelial cancer remains, along with pancreatic cancer, one of the last solid tumors for which essentially no progress has been made for 25 years. It’s time to think out of the box, and to develop novel and creative ways of overcoming the real, but not insurmountable, logistical challenges to carrying out the needed clinical trials.
Genomic Subtypes in Choosing Adjuvant Therapy for Breast CancerMarch 15th 2013
Additional insight into the biology of ER-positive breast cancers, particularly the higher risk luminal B cancers, could aid in identifying potential targets and new, effective therapies. And though the majority of triple-negative breast cancers are the “basal-like” subtype, significant proportions are in other subtypes.
The Evolving Role of Multi-Gene Tests in Breast Cancer ManagementMarch 15th 2013
If MGTs could predict which patients were most prone to late recurrence and thus might benefit from extended adjuvant endocrine therapy, it would be a huge advancement in the care and survivorship of our patients. More studies of MGTs are required to clarify their role in evaluating prognosis and predicting response to therapy in breast cancer.
Omics as Useful Tools in Clinical Practice: Are We There Yet?March 15th 2013
Clinicians and bioinformatics experts must learn to speak the same language, starting with basic principles regarding analytical validity, clinical validity, and clinical utility. More than ever, a true partnership between clinical, laboratory, and bioinformatics scientists as part of a multidisciplinary team is needed to benefit our patients.
HER2-Directed Treatment of Metastatic Breast Cancer: Unanswered QuestionsMarch 15th 2013
As more drugs become available in the HER2 arena, clinicians will be faced with increasing challenges regarding which sequences and combinations of drugs will be the best for their patients. In the era in which we practice, a great deal of this is likely to be dictated by the payers.
Keys to Supportive Care in Pancreatic Cancer: Early Palliative Care, Improved CommunicationMarch 15th 2013
Optimal supportive care for patients with pancreatic cancer is essential. Putting these interventions into practice requires that oncologists and oncology teams incorporate innovations at both the individual and the system level.
The Challenge of Palliating Pancreatic CancerMarch 15th 2013
FDA approval of palliative chemotherapy is largely based on disease-free and overall survival, quality of life, and symptom reduction; the latter should be routinely measured by the treating oncologist. Physician assessments of symptoms underreport symptom severity compared to patient-reported symptom assessments.
How Can We Optimize Treatment of HER2-Positive Metastatic Breast Cancer?March 15th 2013
Third, how much do we really know about de novo and acquired resistance to trastuzumab and lapatinib? There are several possible clinical relevant mechanisms of trastuzumab resistance, including crosstalk with other receptors, amplification of the PI3K/AKT pathway, alteration of the trastuzumab binding domain, and loss of HER2 expression.
Fifteen Years of Anti-HER2 TherapyMarch 15th 2013
Last month brought the accelerated approval by the US Food and Drug Administration (FDA) of a fourth agent targeting the human epidermal growth factor receptor 2 (HER2) oncogene product: TDM-1 (Kadcyla), a conjugate of trastuzumab and a cytotoxic, emtansine.