June 15, 2014
Today marks a major step forward in cancer clinical trials and drug development with the launch of the Lung-MAP protocol to evaluate new treatments for squamous cell lung cancer, a common cancer which has proven resistant to the standard drugs currently available. In response to this genuine unmet need, Lung-MAP has been designed to move new therapies more quickly from the laboratory to the bedside of patients afflicted with this serious disease and few options available.
Many--including present company--have written about the need to improve this process. We are in a new era of cancer drug development, spearheaded by our ever increasing knowledge of cancer genes and the targets within those genes that can be used to disrupt the cancer cell on its inexorable road to proliferation and destruction. Getting those drugs speedily through development and clinical testing has been a real challenge. And, going forward, finding the patients with the "right" genomic signature who are candidates to receive these therapies is going to be difficult. In simple terms, we need to find the patients where they live and match them to these new drugs as quickly as possible. And that hopefully will translate into more and better treatments for patients, and save lives. More...
June 04, 2014
As in years past, the trip home from the Annual Meeting of the American Society of Clinical Oncology in Chicago gives me a moment to reflect on what I have heard and hopefully learned over the past five days.
This meeting is a whirlwind of activity and information, far too much for any one person to absorb and process. You can be focused on one topic, you can be general, and you can hear new cutting edge research or be educated on topics of general interest in cancer. You can go to the exhibit hall and be overwhelmed by the booths and displays (I tend not to go there, but obviously many others do). I suspect you get the idea.
Ultimately for me it is the take away messages about trends in cancer research and cancer care that matter the most personally. And this year the trends appear to be somewhat similar to past years, with perhaps some new wrinkles. What is undeniable is that if immunotherapy is the queen at the ball, then "panomics" (I really like that word) holds the keys to the kingdom. More...
June 04, 2014
It was the picture (see below) that, to me, said it all: a 96 year old woman -- one of the first patients in the world to receive a brand new cancer drug--, and a large tumor on her neck had melted completely away. But it was the smile on her lips that you couldn't avoid noticing. More...
June 02, 2014
The brave new world of melanoma treatment continues at the Annual Meeting of the American Society of Clinical Oncology in Chicago. And notwithstanding the excitement, there are some other pieces of information around the edges that remind us once again that a breakthrough today may not be quite as promising when viewed a couple of years from now. More...
May 31, 2014
At the annual meeting of the American Society of Clinical Oncology (ASCO) here in Chicago, something vitally important is happening: there is an increasing recognition of something no one really wanted to talk about in polite company until now. It is the fact that the costs of many of the new treatments being developed are extraordinary.
The headlines about cost and value of cancer care greeted me when I walked into the McCormick Center in Chicago for the opening sessions of the meeting. This is the leading cancer meeting in the world, and what happens here makes news worldwide, significantly impacting the lives of patients with cancer wherever they may be.
Now there is an increasing recognition of the elephant in the room: the costs of these new treatments are extraordinary. No matter how one chooses to slice and dice the arguments, these drugs are expensive with costs per month of $8000 and upwards getting a lot of attention and increasing concerns, especially at this meeting. More...
May 16, 2014
This was the dream: we would use technology to create a seamless healthcare system, one where people, computers and machines would work together to improve patient care in many different ways. Health care would be more efficient, it would be safer, it would be less expensive, we would be able to transfer health-related information quickly and accurately.
After spending three days at a meeting this past week with some of the top experts in the field, I am not so certain that the dream is going to come true anytime soon. Perhaps more concerning, the problems--including patient safety issues--that are cropping up in so many areas are very troubling. More...
May 11, 2014
My wife and I did something special this past Friday evening. We attended a Relay for Life in our hometown of Thomasville GA. And the memories of the event will not be soon forgotten, for so many reasons. More...
March 27, 2014
I had the opportunity earlier this week to participate in a Twitter chat on the topic of colorectal cancer awareness. The chat was intended to bring attention to a nationwide campaign called "80 by 2018" designed to increase colorectal cancer screening rates to 80% of the population over the next 4 years. If it is successful, we should see a decline in both incidence and deaths from this disease.
But I am haunted by two of the comments I tweeted during the session chat that won't leave my conscience:
"As a doc, you don't forget the patients you couldn't help. And you celebrate those you did. #CRCawareness is key #80by2018"
"Let's remember that screening doesn't help everyone, so don't forget the need for more research in understanding #CRC #80by2018"
While we celebrate the opportunity to save more lives with screening, we cannot ignore or forget those for whom screening for colorectal cancer (or other cancers, for that matter) couldn't or didn't make a difference. More...
March 19, 2014
An article published this week in the American Cancer Society journal CA: A Journal for Clinicians received a lot of media attention. The report showed dramatic declines in the rate of people being diagnosed with colorectal cancer, as well as decreases in the rates of colorectal cancer deaths over the past number of years.
But the press didn't say much about the fact that not everyone has benefitted from the progress we have made in the prevention, early detection, and improved treatment for colorectal cancer. It is a sad but very real commentary on how we approach health care in this country that African Americans have not benefitted equally from this progress in treating a cancer that for many people can be prevented or effectively treated when found before it spreads to other parts of the body.
As a nation, I believe it is incumbent that we address this glaring health disparity. To do less is unacceptable. More...
October 18, 2013
I attended a meeting in Washington this past Wednesday that got me to thinking about the fact that as we revolutionize cancer research and treatment, we are also going to have to revolutionize cancer care. And that
may prove to be an even more daunting task than finding new treatments for the disease itself.
The meeting was sponsored by a collaboration called "Turning The Tide Against Cancer". The organizers brought together experts from a variety of disciplines ranging from insurance companies and economists to advocacy groups and highly regarded cancer specialists to discuss policy solutions to support innovation in cancer research and care. Walking in, I anticipated this was going to be another one of those sessions where we talked about funding for research, bringing research into clinical trials, and having patients get access to new drugs. But I was wrong. The discussions quickly steered into a different direction: what do we need to do to make the cancer care system work for patients?
Of course there were the continuing themes of "big data" and the impact of genomics on drug development and patient care, but a surprising amount of the discussion centered around new payment models, quality of care, and fundamental redesign of medical care to become more patient centric. And although we talked a lot about data gathering and analysis, what stuck with me was the redesign piece. I thought the discussion around redesign would focus on personalized medicine, but we spent a lot of time on changing the fundamental structure of cancer care and payment.
How are those two linked? Did we miss our focus?
The answer? If we don't change the way the system is working, we won't realize the promise of personalized medicine. Seems pretty simple and straight forward until you start thinking about the implications. More...