Medications

We Are Beginning To Realize The Promise Of Cell Free DNA In Cancer Care

Right now, when we want to know everything we can about a tumor, we do surgery: a biopsy to take a sample of it and look at it under a microscope and determine as best we can how to treat it. But what if instead you could get a blood test, and learn even more. That’s the promise of the relatively new science of what is called cell free DNA (cfDNA). It holds the hope of helping us better understand cancer, its behavior in our bodies over time, and even offering clues on how to better treat cancer in ways we would never have imagined even a few short years ago.

It was an important area of discussion at the American Society of Clinical Oncology meeting this week. It’s a meeting where, every year, we get a sense of the future of cancer treatment before it becomes a reality. From genomics, to immunotherapy, to targeted therapies–you name it—promising areas appear on the scene, then either become part of our reality or lose luster as the process unfolds over the course of several ASCO annual meetings. This year, several studies presented on the topic of the so-called “liquid biopsy” illustrate how … Continue reading →

Precision/Personalized Medicine: Can We Afford Our Success?

Here at the at annual meeting of the American Society of Clinical Oncology in Chicago, we are beginning to see the future of cancer therapy—and it raises a provocative question: will precision medicine become so precise, we risk turning off the much-needed investment of human, intellectual and financial capital that keeps progress flowing?

The sheer number of new drugs and new combinations of drugs being reported here at the world’s biggest, and most relevant cancer conference is staggering. Not all of them are ready for prime time, and some may never be successful in the clinic for large numbers of patients, but it is clear the era of old fashioned chemotherapy is diminishing and newer forms of therapies (targeted and immunotherapies among others) are on the rapid ascent.

But with progress, it’s becoming clear that a changing paradigm in cancer care that was predicted a number of years ago is now coming to life.… Continue reading →

Keeping A Cool Head On Cold Cap news

The Food and Drug Administration this week approved a device to reduce hair loss in women receiving chemotherapy for the treatment of breast cancer. The media attention has been extensive and highly favorable. But taking a closer look at this, there are a couple things, as yet unreported, that have me more than a little concerned.

The machine is a form of a cold cap, and is designed to reduce the blood circulation to the scalp while a woman receives treatment to either reduce the risk of breast cancer returning, or to treat recurrent disease. The theory—which has been around for decades—is that if one reduces the circulation of blood to the scalp you also reduce the circulation of the drugs that can cause hair loss to the hair follicles. The result is that the hair doesn’t fall out, a common and very sad side effect of some chemotherapy drugs.

It is that same phenomenon, reducing chemo’s attack on the hair follicles that has always been the concern, as well: by preventing the chemotherapy from reaching the scalp, are we creating a “safe haven” for tumor cells that may cause a problem years or even decades later?

But that’s only … Continue reading →

10 Years And Half A Million Words…

I just noticed this blog celebrated its 10th anniversary this September. So I hope you won’t mind me taking this opportunity to share some observations and reminiscences of what it’s been like to document by blog a decade of the changing landscape of cancer.

The first blog was published on September 9, 2005 when I introduced the blog and my vision for what i hoped it would represent.

The blog originated with a concept developed by our media relations team. Social media was just coming into prominence, and the Society was looking at ways to get into this space. Bob Lutz, a senior executive at General Motors at the time, was the model: he wrote a regular blog himself, and was pretty open in sharing his thoughts. It was clearly not one of those ghost written, pre-packaged types of things. How he found the time to do a blog was an interesting question, but the concept was intriguing: if we could have one of our senior folks write something similar, perhaps it would get some recognition in this rapidly expanding means of communicating.

So we ventured into the space and I started writing “Dr. Len’s Blog”. One of … Continue reading →

Some Of The Answers To Cancer Care May Be Found With Our Companion Dogs Walking Right Beside Us

Fate can work in mysterious ways.

A couple of months ago I was invited to participate in a symposium conducted by the National Cancer Policy Board at the Institute of Medicine in Washington DC. The topic was cancer in dogs, and how we might find ways to benefit dogs, their owners and science to better inform the treatment of cancer in humans through what is called “comparative oncology”.  It was an unusual topic in my experience and that of my colleagues, so I eagerly anticipated learning about something I hadn’t given much consideration to in the past.

Little did I know at the time how personal this journey was going to be for me and my family.

Shortly after I accepted the invitation, we received sad news: our Golden Retriever Lily-who has been a member of our family for 11 years-developed swelling in her face. Our vet saw her the next day and told us she had lymphoma. The outlook without treatment wasn’t good, and with treatment wasn’t much better.  

Tears flowed in our home that evening.

A week later we found a mass on Lily’s back leg. Another trip to the vet, another needle biopsy, and another … Continue reading →

The Survivors And Advocates Highlight That Personalized Medicine Is About All Of Us

When it comes to personalized/precision medicine we should never forget it’s all about the people, particularly the cancer survivors whose very lives depend on us getting it done quickly and getting it right.

That was the message from a discussion I had the privilege to moderate  on Monday evening with cancer survivors and representatives of advocacy organizations, professional associations, government agencies, and industry at a session held in conjunction with the annual meeting of the American Society of Clinical Oncology (ASCO),  now wrapping up in Chicago.

There has been an incredible amount of big science presented at this meeting that relates very directly to the care we provide cancer patients. Some of that science has immediate application to cancer care. On several occasions, acknowledged experts opined in front of thousands of physicians, other scientists, and health professionals that new treatments-particularly immunotherapy-were new standards of care in the management of patients with certain cancers.

Running in parallel to the development of new approaches to the treatment of cancer is the science that is helping to define and personalize which patients would benefit most from which treatments. As an example, for the new immunotherapy drugs there are biomarkers that may eventually … Continue reading →

Advancing The Tenet That In Cancer Care We Need To Embrace Curing When We Can And Comforting Always

It was the title of an article in JAMA Oncology that captured my attention this past week: “Advancing a Quality-of-Life Agenda in Cancer Advocacy: Beyond the War Metaphor.” That and, the fact that two of the authors (Rebecca Kirch and Otis Brawley) are my colleagues from the American Cancer Society.

As the American Society of Clinical Oncology (ASCO) convenes its annual scientific meeting in Chicago–where thousands of participants from around the world gather to learn about the latest advances in cancer research and treatment–we should not lose sight of the fact that the quality of life for patients during cancer treatment and survival is a critical part of what we must address as part of a holistic approach to the cancer care paradigm.

For decades cancer prevention and treatment has focused on the war metaphor: fight cancer, beat cancer, fight hard, whatever. The reality is that not infrequently people do everything right and they still die from this dread disease. Does that mean they didn’t fight hard enough? I don’t think so, and I suspect many of you agree.

But there is a yawning gap, and that is that we don’t pay as much attention to the … Continue reading →

Is It Time For Precision/Personalized Medicine?

This blog was originally published on the Medpage Today website on January 22, 2015. It is reposted here with permission.

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Are we prepared for the genomics revolution?

The President’s proposed Precision Medicine Initiative as mentioned in his recent State of the Union address suggests it’s probably time to get ready for some changes in our daily routines as health professionals.

I’m not talking about the incredible information that has already been produced by researchers examining the human genome. Nor am I referring to the work that is going on in major cancer centers and elsewhere exploring how to better match patients with genomic analyses of their cancers, for example.

And I am not talking about the advances in targeted therapies associated with diagnostic tests that can help guide the treatment of patients with a variety of cancers including but not limited to lung and breast cancers as examples.

No, I am asking whether we are prepared to usher in the new era of medical practice where genomic analyses in one form or another will be a part of our everyday medical practice. It’s not just about cancer, my friends. It will be coming to a primary care practice near … Continue reading →

CanceRX 2014: We Need Innovative Approaches To Support Cancer Drug Development

What if you were sitting in the room with some of the best financial and scientific minds in the country and someone asked how many of you would be willing to contribute a modest sum of money to create a company with the potential of speeding up the evaluation of drugs that could revolutionize cancer treatment?

That was the opening question of a fascinating meeting I attended recently at the Massachusetts Institute of Technology, one where I didn’t want to leave my seat for a moment for fear I would miss another thought-provoking comment or idea.

The meeting was called CanceRX 2014, and for two solid days about 300 participants listened, debated, and engaged in discussion on how to make that scenario happen. No small task, to be certain. But in this era of ever increasing research discoveries of new treatment targets, it is clear that we need some innovative thinking to take what we learn in the laboratory to the bedsides of the patients we care for. And to make that happen we need as much “out of the box” thinking as we can muster. [more]

Let’s assume that we can  continue to accomplish the grand goals … Continue reading →