Communication Challenges Loom as Germline Versus Somatic Cancer Data Evolve
July 8th 2014Essentially all members of the medical community, including the most "generalist" family practice physicians, are being required to understand and incorporate into their daily practice an ever-increasing quantity of information related to the broad realm of molecular medicine
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Discovery Dilemma: Narrow "Superiority" Standard Is an Inferior Way to Evaluate Novel Therapies
February 27th 2014The lack of documented superiority in a given randomized oncology trial may not indicate the absence of clinical utility but rather the presence of equivalent favorable activity for each of the two agents.
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Pancreatic Cancer Starkly Illustrates Challenges of Developing Targeted Therapies
February 4th 2014A recent study determined that it would take 6.7 years on average to enroll enough patients with pancreatic cancer for the trials that opened in 2011-a tall order considering that the 5-year relative survival rate for those diagnosed with pancreatic ductal adenocarcinoma is only 6%.
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"N of 1" Research: Molecular Findings Create Urgency for New Drug Discovery Paradigm
January 13th 2014There has been considerable discussion within the oncology literature during the past several years regarding the level of evidence required to consider a new antineoplastic agent an acceptable "standard-of-care" in routine disease management.
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Reality Check Needed: Comorbidities Loom in Practice, But Not in Clinical Trials
January 2nd 2014How should the dose and schedule of antineoplastic therapies be modified in patients with known chronic liver, cardiac, or pulmonary disease when these conditions were excluded from the trials that permitted their routine clinical use? How should treatment be changed in the presence of significant obesity?
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Beyond Tissue Biopsies: Blood Assays May Provide "Liquid" Molecular Analyses for "Solid" Tumors
November 27th 2013While a number of biological and clinical factors differentiate so-called "solid" from "liquid" cancers, there is perhaps no single difference that is more relevant than the ability in liquid cancers to easily obtain malignant cells from the blood for subsequent analysis in the laboratory.
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A recognized recurring theme in many population-based cancer genetic studies is the highly provocative presence of a quite small percentage of tumors that possess specific molecular abnormalities unequivocally demonstrated to be "actionable," at least in one clinical setting.
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Dr. Markman on Gynecologic Cancer Molecular Testing
November 4th 2013Maurie Markman, MD, senior vice president for Clinical Affairs and National Director for Medical Oncology, Cancer Treatment Centers of America, Eastern Regional Medical Center, discusses the role of molecular testing in gynecologic cancers.
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Evidence-Based Medicine: Examining the Gap Between Rhetoric and Reality
October 17th 2013In many circumstances, the absence of so-called definitive evidence does not equate with the absence of evidence, just the level required by some to declare an approach to be an acceptable standard-of-care option.
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Dr. Markman on Targets for the Treatment of Ovarian Cancer
September 30th 2013Maurie Markman, MD, from the Cancer Treatment Centers of America, discusses the discovery of mutations and targets in ovarian cancer and the current progress being made in the development of a "breakthrough" agent for ovarian cancer.
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A Failure to Communicate: Patients Misunderstand Cancer Genetic Testing
July 30th 2013Patients diagnosed with cancer today are considered to be genuine partners in all major treatment decisions. Yet, how well do they understand the nature and goals of genetic testing that might be recommended as part of the management of their disease?
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Clinical Trial Biopsies: Ethical Concerns Raised About Disclosure, Follow-Up
April 22nd 2013Two recent reports have challenged certain assumptions in the drug development process that raise ethical concerns, individually and collectively, which the clinical cancer research community must address.
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Rethinking Overall Survival: Still an Acceptable Sole Primary Endpoint in Cancer Clinical Trials?
March 29th 2013A clinical commentary by Maurie Markman, MD, addressing whether overall survival can still be considered the sole acceptable primary endpoint in studies of novel anticancer therapeutic strategies.
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EGFR's Evolution: New Insights Refine Role of Mutation in NSCLC
March 1st 2013Despite all we have learned about the importance of sensitizing EGFR mutations in defining the management of advanced NSCLC, our education regarding the relevance of this molecular target in optimizing clinical outcomes continues.
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A Nobel Prize in Waiting: Understanding Unexpected and Prolonged Remissions
December 19th 2012Ipilimumab provides a striking example of the way in which some patients derive long-term benefits from therapy while others do not. The reasons for such differences should be a priority for translational research.
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Evolution of Targeted Therapy: GIST Experience Points the Way to Defining Third-Line Treatment
November 19th 2012Targeted antineoplastic therapy based on the presence of a well-defined molecular target should be recognized as a standard-of-care approach in an increasing number of clinical settings.
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When Toxicity Counts: It's Time to Reappraise Non-Severe but Clinically Relevant Side Effects
November 2nd 2012As an increasing number of cancers are considered chronic diseases treatable with continuous drug delivery, it is essential that our vocabulary describing the side effects experienced by our patients more appropriately reflects this new paradigm.
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Redefining Standard-of-Care: In Rare Cancers, the Experiences of Two Patients May Be Enough
October 24th 2012As more individual cancers undergo molecular profiling, we can anticipate that the scenario in which a targeted drug demonstrates rather remarkable clinical activity against a rare tumor type will become increasingly common.
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