Personalized Medicine

Los Angeles, CA—Although targeted drug development and testing are clearly transforming medicine, resistance to greater uptake of personalized medicine includes a shift in the evidence threshold in personalized testing and drawbacks to the delivery system, including the cost of molecular tests, said Peter B. Bach, MD, Director, Center for Health Policy and Outcomes, Memorial Sloan Kettering Cancer Center, New York, at the Fourth Annual Conference of the Association for Value-Based Cancer Care.

Orlando, FL—Treatment with enzalutamide (Xtandi) after progression with androgen-deprivation therapy (ADT) led to a significant improvement in survival for men with metastatic castration-resistant prostate cancer (mCRPC), according to a new randomized trial reported at the 2014 American Urological Association annual meeting.

Hollywood, FL—Driver mutations, most frequently KRAS and EGFR, account for approximately 50% of non–small-cell lung cancer (NSCLC), and this recognition is shifting the NSCLC treatment paradigm toward targeted therapy when possible, said Leora Horn, MD, MSc, Assistant Professor of Medicine, Division of Hematology/ Oncology, Vanderbilt University, Nashville, TN, at the 2014 National Comprehensive Cancer Network Conference.

Stockholm, Sweden—An inexpensive, noninvasive imaging modality is proving successful for verifying the presence of prostate cancer.

Hollywood, FL—The treatment options for patients with castration-resistant prostate cancer (CRPC) have increased over the past few years. Understanding the clinical disease states is essential when choosing therapy for this patient population, according to Celestia S. Higano, MD, Professor of Medicine and Urology, University of Washington, Seattle, who described the recent additions to the therapeutic armamentarium at the 2014 National Comprehensive Cancer Network Conference.

According to a new systematic review of the risks and benefits of breast cancer screening, regular mammography is associated with a 19% reduction in breast cancer mortality, but it is also associated with a 61% cumulative risk of a false-positive result, and approximately 19% of the cases are, in fact, considered overdiagnoses (Pace LE, Keating NL. JAMA. 2014;311:1327-1335).

The American Society of Clinical Oncology (ASCO) has issued new guidelines for the use of sentinel node biopsy (SNB) in patients with early-stage breast cancer (Lyman GH, et al. J Clin Oncol. 2014;32:1365-1383. The newer version expands the use of SNB to a larger group of patients, based on evidence from 9 randomized trials and 13 cohort studies conducted since 2005, when the first SNB guidelines were published.

Las Vegas, NV—Researchers are making a compelling case for screening women at high risk for breast cancer for more than BRCA mutations. In fact, 4 genetic mutations are well recognized in genetic-based breast cancer, including CDH1, PTEN, STK11, and TP53.

San Diego, CA—A preliminary study from a highly respected group of researchers suggests that a simple blood test for the androgen receptor splice variant-7 (AR-V7) in the AR gene can identify men with castrate-resistant prostate cancer (CRPC) who will not respond to enzalutamide (Xtandi).

San Diego, CA—Two studies, one in melanoma and one in non–small-cell lung cancer (NSCLC), presented at the 2014 American Association for Can­-cer Research meeting attempted to correlate response to the anti–programmed cell death (PD)-1 inhibitor MK-3475 with the biomarker PD-L1. The hope is that the level of PD-L1 expression will be a biomarker for the selection of patients for treatment with this new agent.