Interviews

Boughey says an ongoing national clinical trial is looking at patients with ER+ breast cancer and treating them with neoadjuvant endocrine therapy.

Partridge says there continues to be a growing epidemic of women getting a bilateral mastectomy for unilateral breast cancer. These surgeries include women who are not at high-risk.

Postow cites the combination of vemurafenib and ipilimumab as one that produced a high rate of liver inflammation and skin rash in patients, which was then deemed not to be given to patients outside of clinical trials.

Atkins says because treatments currently used in patients with visible metastatic melanoma are normally efficacious between 50% and 60% of the time, then the expectation for these treatments in the adjuvant setting could be effective around 80% of the time.

Gangadhar says this preference toward single-agent immunotherapy is due to a lack of evidence supporting the use of a combination immunotherapy approach. The other reason a dual approach is less utilized in melanoma patients is due to the significant increase in toxicities.

Instead of adjuvant treatment, Andtbacka suggests treating patients with melanoma in the neoadjuvant setting. The benefit of neoadjuvant treatment versus adjuvant treatment is that oncologists can see the effect on the tumor, as well as perform biopsies and be able to determine changes in the tumor to develop certain biomarkers.

Weber says these treatments, such as ipilimumab plus nivolumab, or dabrafenib and trametinib, have seen marked improvements since 2009, and continue to become more important in the treatment paradigm of melanoma.

Fischkoff says the goal of Lion Biotechnologies is to utilize a central manufacturing facility where medical professionals can submit tumor samples of their patients, and received the proper TIL-based treatment back from the manufacturing facility.

Hamid says the future will hold adding more tolerable regimens in to the treatment paradigm of melanoma, based on the past success of the treatments already utilized and approved.

Carnaby says prophylactic gastrostomy tube placement may not be as supportive as previously thought in the health of the muscles in these patients.

Bible says most oncologists would consider lenvatinib as a first-line therapy for patients who require systemic therapy where there are not suitable, focal palliative options.

Cohen says while the data from the study looking at nivolumab has not been released yet, the halting of the trial due it having met its primary OS endpoint likely means good news.

Cabanillas says her and her team set a goal of reducing the time between when they are contacted about a patient with anaplastic thyroid cancer, and when the patient is given an appointment time, to fewer than 5 business days.

Zevallos says that while HPV-positive oropharyngeal SCC has a positive outcome for patients, smoking status should be taken into account for these patients when making a decision to deintensify therapy.

Melotek says the trial's primary endpoint was comparison of efficacy when cetuximab is added to both therapies with historical control, with a secondary endpoint being further investigation of the usefulness of both chemotherapy platforms.

Hoffman-Censits says atezolizumab has recently undergone a phase II clinical trial for patients with bladder cancer who failed platinum-based chemotherapy.

Seiwert says in general, immunotherapies produce a response rate of between 20- to 25%, 1 in 4 patients respond, and the treatment type is equally effective in both HPV-positive and HPV-negative disease.

Zevallos says the study consisted of 66 patients and found that there were distinct genomic differences between HPV-positive smokers and non-smokers.

The two platforms involved in the study were the FHX regimen and a cisplatin radiation approach with accelerated radiation. Siltuximab was also used in the study as induction chemotherapy alongside carboplatin and paclitaxel.

Whitworth says that while it is generally perceived that the ER-positive/HER2-negative breast cancer patient population is the luminal subtype, 1 of every 5 of those patients would actually considered basal subtype.

Bear discusses studies adding treatments to chemotherapy in order to increase the pathological complete response (pCR) rate and the difficulties of translating those benefits into better overall survival (OS) rates for patients with breast cancer.

Winer says patients who do well on carboplatin and show both a good pathologic complete response and good disease free survival may be patients who have refractory disease and are responding well to the treatment, while others may be patients who were bound to do well regardless.

Seidman says currently there is not a HER2 histochemical test for gene amplification or signatures to best select patients for either CDK46 or MTOR inhibitor, as well for PI3 kinase inhibition.

Sharpe, whose lab aided in the discover of the pathway, says blocking the pathway in order to treat cancers is important because it allows T cells to work better.

Yardena Samuels, PhD, on the ineffectiveness of targeting a single gene of proteins in patients with melanoma. Samuels says this strategy may work for the short term for treatment, but patients would tend to develop a resistance much quicker to treatment strategies using this method.

Holmen says that utilizing targeted therapies could potentially be the answer, though clinically-tested combinations have historically not done as well as clinicians had hoped.

Randolph says pre-operative loss of voice tracks "robustly" with invasive thyroid cancer, and being aware of this issue before surgery helps surgeons better treat their patients.

Churilla said the majority of patients on a national level had insurance, with only 15% of patients utilizing medicaid and 5% of patients being uninsured.