OBR Daily Commentary

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Axitinib Active in Treatment-naive Metastatic Renal Cell Carcinoma

(Healio) Nov 18, 2013 - First-line therapy with axitinib demonstrated clinical activity in metastatic renal cell carcinoma, and dose titration with axitinib is associated with a higher rate of objective response than placebo titration, according to results of a randomized phase 2 study.

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Robert A. Figlin, MD., FACP (Posted: November 18, 2013)

quotesEfforts to improve outcomes with tyrosine kinase inhibitors in renal cell carcinoma is suggested by Rini et all in their dose escalation efforts with axitinib in the treatment naive renal cancer patient. Despite the improvements in objective response rates between those that could undergo dose titration compared to a placebo control group, the results cannot as yet be offered to patients receiving therapy. Axitinib is approved in the United States in the second-line setting following prior TKI therapy, and the use of objective response rates to demonstrate benefit belies the fact that progression free survival and overall survival are more important and appropriate endpoints. What this study does help us understand is that we are still learning how best to offer patients the optimal outcome with a TKI balanced by the toxicity and the appropriate outcomes for a noncurative approach to treatment of this disease.quotes

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Report Finds Crisis in Cancer Care from Aging Boomers, Complexity of Therapies, Rising Costs

(Washington Post/Associated Press) Sep 10, 2013 - The U.S. is facing a crisis in how to deliver cancer care, as the baby boomers reach their tumor-prone years and doctors have a hard time keeping up with complex new treatments, government advisers reported Tuesday.

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Robert A. Figlin, MD., FACP (Posted: September 11, 2013)

quotesThe Institute of Medicine report highlights the challenges that cancer doctors will face as the population ages, more survivors than ever benefit from our current treatments, and the complexity of treatment algorithms continue. Build upon that the growing use of genetic testing to identify signatures in an individual cancer that we hope will lead to more personalized treatment plans only complicates the issues. While this is taking place, major changes are occurring in graduate medical education that may limit the numbers of clinicians with developed expertise to address these challenges. What are some solutions? More cancer experts? Better and more integrated palliative care services? Improved comparative effectiveness research? Better use of mid-level providers (nurse practitioners, physician assistants)? Better understanding of the effects of treatments on populations that receive the therapy - clinical trials whose population mirror the disease, especially in an aging population? The IOM report highlights that the answers must come through an approach that has all constituencies at the table, and that balances the proposed solutions with the increasing challenges.quotes

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Pazopanib Shows Better Quality-of-life in Advanced Kidney Cancer

(Dana-Farber) Aug 21, 2013 - Two oral targeted drugs approved for metastatic kidney cancer worked equally well, but one proved superior in tolerability, according to results of a large international clinical trial led by researchers at Dana-Farber Cancer Institute.

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Robert A. Figlin, MD., FACP (Posted: August 22, 2013)

quotesComparative effectiveness research will become increasingly important in cancer care. This is especially true in diseases where there is high levels of evidence for drugs targeting similar pathways. Kidney cancer is one of those diseases where several treatment options are available to patients and doctors with similar efficacy but having never been compared head-to-head. The trial reported in the NEJM is one such example. The authors compared sunitinib to pazopanib therapy in metastatic renal cancer patients previously untreated. They demonstrated through a non-inferiority design similar efficacy. Secondary endpoints demonstrated a difference in the toxicity profile allowing physicians to better tailor treatment options for patients with consideration of individual patient co-morbidities. quotes

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Meet the Editorial Board

Prostate Cancer
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Tomasz M. Beer, MD, FACP

Professor of Medicine, Division of Hematology/Medical O...

Community Oncology
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Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
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Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
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H. Jack West, MD

Associate Clinical Professor, Medical Oncology Executi...

Gastrointestinal Cancers
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Howard S. Hochster, MD

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
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Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics Professo...

Editor-In-Chief
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Robert A. Figlin, MD., FACP

Steven Spielberg Family Chair in Hematology Oncology P...

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Stephen M. Schleicher, M.D., MBA

Community Oncology, Medical Oncologist, OneOncology...

Health Policy
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Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
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Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Health Policy
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William McGivney, PhD

National Health Policy Expert...