Interviews

Eytan Stein, MD, discusses the benefits of being able to identify drivers in acute myeloid leukemia and having drugs coming into the clinics to target those biological mutations.

Thomas Stinchcombe, MD, discusses the complicated nature of squamous cell lung cancer. Stinchcombe says that there has been a recent boom in targeted therapies for non-squamous cell lung cancer, though not as much research in squamous cell lung cancer due to its multitude of mutations.

John Leonard, MD, discusses the inefficacy of early treatment and treatment options for patients with follicular lymphoma. Leonard says the relapse rate for patients with follicular lymphoma is around 80%.

Christina Baik, MD, MPH, assistant professor, Seattle Cancer Care Alliance, Thoracic/Head and Neck, Department of Medicine, Division of Medical Oncology, University of Washington, discusses the efficacy of alectinib after first-line crizotinib in patients with ALK-positive lung cancer. Baik says alectinib generally works for about 8 months and is easy to take for patients.

Sagar Lonial, MD, professor, School of Medicine, executive vice chair, Department of Hematology & Medical Oncology, chief medical officer, Winship Cancer Institute, Emory University, discusses whether or not to treat patients with smoldering multiple myeloma (SMM), or asymptomatic myeloma.

Sunil Verma, MD, Medical Director, Tom Baker Cancer Centre, Professor and Department Head, Oncology, Cumming School of Medicine, University of Calgary, discusses the future of immunotherapies and anti-HER2 drugs in the treatment paradigm for HER2-positive breast cancer.

Elizabeth Mittendorf, MD, PhD, associate professor, Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, discusses discovering a predictive biomarker response in vaccine therapy for patients with breast cancer.

Edward Kim, MD, chair of the department of Solid Tumor Oncology, Levine Cancer Institute, discusses the further work that needs to be done when indicating patient populations with certain biomarkers in non-small cell lung cancer (NSCLC).

Sarah Goldberg, MD, MPH, assistant professor of Medicine and Medical Oncology, Yale Cancer Center, discusses coming trials looking at immunotherapy beyond the second-line setting in non-small cell lung cancer (NSCLC).

Julia White, MD, professor of Radiation Oncology, Ohio State University, discusses the pros and cons of multi-gene assays when trying to determine the risk of local recurrence in patients with breast cancer.

Verma says one of the major new understandings of the disease is that the HER2 receptor needs to be suppressed at all times within the treatment paradigm of the malignancy.

Ursula Matulonis, MD, medical director of Gynecologic Oncology at Dana-Farber Cancer Institute, discusses two upcoming trials for both platinum-resistant and platinum-sensitive recurrent ovarian cancer.

​Elizabeth Mittendorf, MD, PhD, associate professor, Department of Surgical Oncology, University of Texas MD Anderson Cancer Center, discusses an upcoming peptide vaccine to prevent recurrence in patients with breast cancer.

Hays says current genetic testing gives oncologists a wide variety of information that may make choosing the correct treatment "a little more difficult." Hays adds that within the current treatment paradigm of gynecologic cancer, oncologists are mainly focusing on BRCA mutations.

Partridge says that the current school of thought is younger women should be treated the same as older women with breast cancer, though younger women tend to develop more aggressive breast cancer with more nodal involvement.

Perou says this research also found three expression subtypes within lobular breast cancer, one of which showed a proliferative phenotype and portended a slightly worse prognosis.

Cooperberg says a growing body of evidence dictates that surgery in prostate cancer may be a more effective local therapy than radiation alone.

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.

Postow says there have been algorithms developed over recently years to determine patient's toxicities and prescribe certain immunosupressive treatments to help abate the symptoms.

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.