Two new drugs for colorectal cancer may offer new hope for late stage patients, and they might hit the market in 2013.
Dr. Rich Goldberg, physician-in-chief of the Ohio State University Medical Center and a leader in colorectal cancer research is going to give you the straight facts about these drugs:
* What hope might they offer?
* What side effects do they cause?
* Will either be the right drug for you?
About Dr. Goldberg:
Dr. Richard Goldberg is an internationally renowned gastrointestinal oncologist and the physician-in-chief at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Institute (OSUCCC-James). He is a member and former chair of the National Cancer Institute Colorectal Task Force and an international leader in evaluating new agents for the treatment of colorectal cancer and researching inherited colorectal cancer syndromes
Pathways and targets how might these affect my treatment decisions gail eckh...Fight Colorectal Cancer
Dr. Gail Eckhardt
Professor and Head of the Division of Medical Oncology at the University of Colorado Denver and Health Sciences Center.
Join us for an exciting webinar about pathways and targets. Dr. Eckhardt will discuss the basic of pathways within a cancer cell, and how (and why) they can affect treatment options for patients. She'll explain how we learn about how new pathways are discovered, and how this information tell us what drugs may work in certain patients and why some drugs don’t.
Dr. Eckhardt will discuss the idea of targeted therapies, and the difference between them and regular chemotherapy. She'll talk about the relationship between pathways and targeted drugs, and how this may impact drug development in the future.
Pathways and targets how might these affect my treatment decisions gail eckh...Fight Colorectal Cancer
Dr. Gail Eckhardt
Professor and Head of the Division of Medical Oncology at the University of Colorado Denver and Health Sciences Center.
Join us for an exciting webinar about pathways and targets. Dr. Eckhardt will discuss the basic of pathways within a cancer cell, and how (and why) they can affect treatment options for patients. She'll explain how we learn about how new pathways are discovered, and how this information tell us what drugs may work in certain patients and why some drugs don’t.
Dr. Eckhardt will discuss the idea of targeted therapies, and the difference between them and regular chemotherapy. She'll talk about the relationship between pathways and targeted drugs, and how this may impact drug development in the future.
David R. Jones, MD, and Roy S. Herbst, MD, PhD, prepared useful practice aids pertaining to lung cancer for this CME activity titled "Turning Tides in Targeted Therapy for Early-Stage EGFR-Mutated NSCLC: Latest Data and Practical Guidance for Thoracic Surgeons and the Multidisciplinary Team on the Emerging Role of EGFR-Targeted Therapy in Resectable Lung Cancer." For the full presentation, complete CME information, and to apply for credit, please visit us at https://bit.ly/2PSVELG. CME credit will be available until November 9, 2021.
Suresh S. Ramalingam, MD, FACP, FASCO, Alexander Drilon, MD, and John Heymach, MD, PhD, prepared useful Practice Aids pertaining to lung cancer for this CME/MOC activity titled "Everything You Need to Know About Molecular Testing and Targeted Therapies in NSCLC: Essential Guidance for Modern Patient-Centered Precision Lung Cancer Care." For the full presentation, complete CME/MOC information, and to apply for credit, please visit us at https://bit.ly/2IIiRzP. CME/MOC credit will be available until November 29, 2021.
Co-Chairs Roy S. Herbst, MD, PhD, and Lecia V. Sequist, MD, MPH, prepared useful Practice Aids pertaining to EGFR-mutated lung cancer for this CME activity titled “New Milestones and Changing Standards of Care in EGFR-Mutated NSCLC: Expanding the Benefits of Genomic Testing and EGFR-Targeted Therapy to Early-Stage Lung Cancer.” For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at http://bit.ly/36aVo39. CME credit will be available until March 8, 2022.
Maria Arcila, MD, Zofia Piotrowska, MD, and Joshua Bauml, MD, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC/CC activity titled “New Horizons in EGFR-Mutated NSCLC: Broadening the Impact of Precision Testing in the Context of an Expanding Treatment Landscape.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/CC information, and to apply for credit, please visit us at https://bit.ly/3kH1ygr. CME/MOC/CC credit will be available until January 25, 2022.
Join Dr. Emily Chan presentation on the latest research and treatments for colorectal cancer patients presented at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.
Cancer is a leading cause of death in developed countries. In this webcast Dr. Andreas Scherer will explain how personalized medicine can transform our approach to fighting this disease. He will also discuss current roadblocks and diagnostic challenges, and the pivotal role of Next Gen Sequencing to overcome these challenges.
The webcast will inform about best practices to design and implement a cancer testing pipeline: from sample preparation, to sequencing, to secondary and tertiary analysis of sequencing data. The goal is to rapidly identify clinically actionable data that allows an oncologist to quickly determine the best available treatment options.
The webcast will include demonstrations of the Golden Helix VarSeq software in the context of analyzing cancer gene panels and somatic mutations.
Presentation by Dr. Alain Beck, Senior Director, Antibody Physico-Chemistry, Centre d'Immunologie Pierre Fabre (CIPF), St Julien-en-Genevois, France. Talk given at Waters Antibody Drug Conjugates (ADC) 2014 Meeting, Nov. 20-21, Wilmslow UK.
Adjuvant Systemic Therapy | Lunch and Learn - Dec 2014 | Dr. Caroline LohrischCBCFBCYukon
Dr. Lohrisch's research presentation is about a multi-disciplinary approach to treatment therapies that will assist oncologists in choosing the right treatment, for the right woman, for the right disease.
Learn more about her research http://ow.ly/Fzfdt
David R. Jones, MD, and Roy S. Herbst, MD, PhD, prepared useful practice aids pertaining to lung cancer for this CME activity titled "Turning Tides in Targeted Therapy for Early-Stage EGFR-Mutated NSCLC: Latest Data and Practical Guidance for Thoracic Surgeons and the Multidisciplinary Team on the Emerging Role of EGFR-Targeted Therapy in Resectable Lung Cancer." For the full presentation, complete CME information, and to apply for credit, please visit us at https://bit.ly/2PSVELG. CME credit will be available until November 9, 2021.
Suresh S. Ramalingam, MD, FACP, FASCO, Alexander Drilon, MD, and John Heymach, MD, PhD, prepared useful Practice Aids pertaining to lung cancer for this CME/MOC activity titled "Everything You Need to Know About Molecular Testing and Targeted Therapies in NSCLC: Essential Guidance for Modern Patient-Centered Precision Lung Cancer Care." For the full presentation, complete CME/MOC information, and to apply for credit, please visit us at https://bit.ly/2IIiRzP. CME/MOC credit will be available until November 29, 2021.
Co-Chairs Roy S. Herbst, MD, PhD, and Lecia V. Sequist, MD, MPH, prepared useful Practice Aids pertaining to EGFR-mutated lung cancer for this CME activity titled “New Milestones and Changing Standards of Care in EGFR-Mutated NSCLC: Expanding the Benefits of Genomic Testing and EGFR-Targeted Therapy to Early-Stage Lung Cancer.” For the full presentation, downloadable Practice Aids, and complete CME information, and to apply for credit, please visit us at http://bit.ly/36aVo39. CME credit will be available until March 8, 2022.
Maria Arcila, MD, Zofia Piotrowska, MD, and Joshua Bauml, MD, prepared useful Practice Aids pertaining to NSCLC for this CME/MOC/CC activity titled “New Horizons in EGFR-Mutated NSCLC: Broadening the Impact of Precision Testing in the Context of an Expanding Treatment Landscape.” For the full presentation, downloadable Practice Aids, and complete CME/MOC/CC information, and to apply for credit, please visit us at https://bit.ly/3kH1ygr. CME/MOC/CC credit will be available until January 25, 2022.
Join Dr. Emily Chan presentation on the latest research and treatments for colorectal cancer patients presented at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.
Cancer is a leading cause of death in developed countries. In this webcast Dr. Andreas Scherer will explain how personalized medicine can transform our approach to fighting this disease. He will also discuss current roadblocks and diagnostic challenges, and the pivotal role of Next Gen Sequencing to overcome these challenges.
The webcast will inform about best practices to design and implement a cancer testing pipeline: from sample preparation, to sequencing, to secondary and tertiary analysis of sequencing data. The goal is to rapidly identify clinically actionable data that allows an oncologist to quickly determine the best available treatment options.
The webcast will include demonstrations of the Golden Helix VarSeq software in the context of analyzing cancer gene panels and somatic mutations.
Presentation by Dr. Alain Beck, Senior Director, Antibody Physico-Chemistry, Centre d'Immunologie Pierre Fabre (CIPF), St Julien-en-Genevois, France. Talk given at Waters Antibody Drug Conjugates (ADC) 2014 Meeting, Nov. 20-21, Wilmslow UK.
Adjuvant Systemic Therapy | Lunch and Learn - Dec 2014 | Dr. Caroline LohrischCBCFBCYukon
Dr. Lohrisch's research presentation is about a multi-disciplinary approach to treatment therapies that will assist oncologists in choosing the right treatment, for the right woman, for the right disease.
Learn more about her research http://ow.ly/Fzfdt
Molecular testing and tumor testing. Have you ever been asked about it? Have you wondered the importance of it, as it relates to your particular cancer? Have you ever wondered if you should or shouldn't have your tumor tested, and what that involves? Dr. Bekaii-Saab, MD will discuss the importance of testing the molecular biology of an individual patients tumor. How they do that and why it may or may not be important to have done. He will talk about how this is playing an even bigger role in choice of treatment options for patients now more than ever. And about the way physicians are making treatment choices based on each individuals molecular biology of their tumor.
Dr. Bekaii-Saab is the Section Chief, Gastrointestinal Oncology, James Cancer Hospital and Solove Research Institute. Dr. Bekaii-Saab is one of America’s Best Doctors. Additionally, he has been listed in U.S. News and World Report’s Top Doctors for multiple consecutive years. His research interests include experimental therapeutics/translational research focused on molecularly-targeted and immune-mediated therapies in gastrointestinal (GI) cancers. He is the principal investigator on numerous clinical trials, including studies supported through research grants from the National Cancer Institute (NCI) and the National Comprehensive Cancer Network (NCCN). Dr. Bekaii-Saab is the recipient of the prestigious NCI clinical investigator team leadership award and the ASCO leadership program development award.
21st Century Pharmacare to Optimize Access to 21st Century Therapies
Panel B: Not-so-Rare Therapies (Yesterday, Today, Tomorrow)
Moderator: Durhane Wong-Rieger, CORD
Panelists: Lisa Machado, Canadian CML Network; Jim Whitlock, The Hospital for Sick Children; John Kuruvilla, Princess Margaret Hospital; Aleksandar Ivovic, Diabetes Patient Advocate; Joanne Lewis, Diabetes Canada; Louise Binder, HIV Patient Advocate; Nancy Durand, Sunnybrook Health Sciences Centre
Join Fight CRC in a webinar about biomarkers. In this session, Dr. Chris Lieu will focus the discussion on the NTRK biomarker, in addition to ctDNA, and Next-Generation Sequencing.
This presentation (in English) made at ONCOTRANS in Besançon on Friday 3rd 2017 reviews the potential for TGF-beta inhibition in hepatocellular carcinoma based on preclinical and clinical data.
2014 11-27 ODDP 2014 course, Amsterdam, Alain van GoolAlain van Gool
Presentation as part of a comprehensive oncology drug development course, to discuss a pharmaceutical approach to identify, validate and develop biomarkers for personalized medicine for melanoma.
2016 11-17 Oncology by design 2016 course, Amsterdam, Alain van GoolAlain van Gool
Lecture on the the role of biomarkers in oncology drug development, given to a group of pharmaceutical industry specialists, in tandem with a lecture on oncology companion diagnostics given by Martina Kaufmann.
GPCR ligand screening assay
Monitors the very early activation stage of Frizzled-Receptors of the GPCR group
Our assay can be implemented in a cell-free chemical compound high-throughput target screening. GPCR is the largest known category of molecular targets with verified therapeutic value. Up to 40% of approved drugs are targeted to GPCRs. 25% of the top 200 best-selling drug targets are GPCRs.
Each January, the best and brightest minds in colorectal cancer research meet at the Gastrointestinal Cancers Symposium. Fight Colorectal Cancer and the Colon Cancer Alliance are partnering to bring you the big news in colorectal cancer from the 2013 symposium.
Join us to learn more about these topics:
- Can aspirin and other nonsteroidal anti-inflammatory drugs (NSAIDs) keep cancer from returning?
- The relationship of body mass index (BMI) and exercise in colorectal cancer
- What scientists are learning about how your immune system can fight cancer
- The latest on what biomarkers can tell us about your cancer
- Rectal cancer treatment that is based on your biological make-up
The webinar will be led by Dr. Richard Goldberg, an internationally renowned gastrointestinal oncologist who specializes in colorectal cancer. He is a tenured professor in the Department of Internal Medicine at The Ohio State University and serves as physician-in-chief at Ohio State’s Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC – James).
Biomarkers and biomarker testing are changing the way some colorectal cancer is treated and knowing your biomarkers can help your doctors identify your best treatment options and help you in making well informed decisions about how your cancer will be treated allowing you to be your own best advocate.
Join in on this informative webinar with guest Dr. Christopher Lieu from the University of Colorado Cancer Center, as he discusses everything you need to know about biomarkers.
Dr. Murphy presents slides discussing general screening trends in the US, including how the US compares to other countries, different screening modalities, and differences in screening by:
-Age
-Gender
-Geography
-Race/Ethnicity
Looking to kick start your physical activity? Hoping to learn about how body movement can be a huge benefit for CRC patients and survivors? Curious about Climb for a Cure? Join this interactive webinar featuring Karia Coleman, MSK, personal trainer and athletic strength coach, and Fight CRC advocates as they discuss the importance, challenges, and joys of physical activity.
From bowel frequency, pain, and more, many colorectal cancer treatments lead to digestive side effects. Join this webinar with Dr. Cathy Eng to learn all about the digestive system, the side effects that are common due to CRC treatment, and how to manage those side effects.
Maine recently passed major colorectal cancer (CRC) policy at the state level. Join us to listen to their story and learn what worked well for CRC state advocacy!
Indiana just passed major colorectal cancer (CRC) policy this year. Join us to listen to their story and learn what worked well for CRC advocacy in Indiana!
Kentucky was one of the first states in the US to pass major colorectal cancer (CRC) policy. Join us to listen to their story and learn what worked well for CRC state advocacy!
Join us as Eden Stotsky-Himelfarb, BSN, RN from Johns Hopkins Medicine discusses how to manage after a colorectal cancer diagnosis. In this session, she will cover understanding diagnoses, shared decision making, managing mental health, talking to family and colleagues, and more.
Some colorectal cancer treatments lead to side effects of the skin. In this webinar, Dr. Nicole LeBoeuf will discuss these specific side effects. She will talk about why they occur, how to prepare for them, and how to manage them.
Hear about the latest breaking colorectal cancer research! Fight CRC will be joined by Dr. Axel Grothey who will spend the hour detailing the research presented at the 2020 Gastrointestinal (GI) Cancers Symposium hosted by the American Society of Clinical Oncology.
Anticipating the end of life and making decisions about medical care at this time can be difficult and distressing for people with cancer and their loved ones. However, it is incredibly important to plan for the transition to end-of-life care.
In this webinar, we will discuss questions to ask when considering an end to curative treatment, what to expect with hospice and end-of-life care, a new medical care team, advance directives and healthcare proxies, options for pain, the role of caregivers and loved ones, and more.
In this webinar, Dr. Angela Nicholas, Dr. Chris Heery, and Wenora Johnson discuss all things clinical trials. Dr. Nicholas, a family practitioner and caregiver to her late husband, John MacCleod will dive into her experience searching for clinical trials along with advice to those currently searching, or planning on searching in the future. Dr. Heery, Chief Medical Officer for Precision Biosciences will spend time dispelling myths around clinical trials and challenges to enrollment, and Wenora Johnson, a stage III colon cancer survivor will describe the process and her point of view curating trials in the Fight CRC trial finder.
In this webinar, Dr. Popp will discuss everything you need to know about palliative care! This is an important webinar for colorectal cancer patients and their loved ones.
eeling worn out and exhausted all the time? You may be experiencing cancer-related fatigue. Tune in to this webinar to learn what cancer-related fatigue is, how to spot it, and how to manage it.
In this webinar, Dr. Azad discusses colorectal cancer recurrence. She addresses things to do to help reduce the risk of recurrence, in addition to what steps should be taken if colon or rectal cancer returns.
Join Fight CRC and Dr. Scott Kopetz to learn about the latest breaking colorectal cancer research from the American Society of Clinical Oncology 2019 Annual Conference.
May 2019 – What You Need to Know About Chemotherapy Induced Neuropathy WebinarFight Colorectal Cancer
Neuropathy is a common side effect for colorectal cancer patients. It is a side effect that can be incredibly challenging to manage, and can affect daily living. Join this informative webinar to learn all about neuropathy—why it happens, how to prepare for it, and methods to try and reduce its effects. This is an important webinar for all survivors and patients! Dana will speak from both the medical professional and patient angle, as she is a colon cancer survivor herself!
A cancer diagnosis and cancer treatment can be traumatic. An experience with cancer can lead to serious psychological distress that should be addressed. In this webinar, Schuyler Cunningham, Clinical Social Worker, talks about what trauma is, how to identify it, and what steps to take next.
There are countless questions when it comes to medical cannabis and colorectal cancer: How can it help? How do you get it? Are there drug interactions with chemo? What are the side effects? Is it legal where I live?
- Video recording of this lecture in English language: https://youtu.be/lK81BzxMqdo
- Video recording of this lecture in Arabic language: https://youtu.be/Ve4P0COk9OI
- Link to download the book free: https://nephrotube.blogspot.com/p/nephrotube-nephrology-books.html
- Link to NephroTube website: www.NephroTube.com
- Link to NephroTube social media accounts: https://nephrotube.blogspot.com/p/join-nephrotube-on-social-media.html
Knee anatomy and clinical tests 2024.pdfvimalpl1234
This includes all relevant anatomy and clinical tests compiled from standard textbooks, Campbell,netter etc..It is comprehensive and best suited for orthopaedicians and orthopaedic residents.
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Flu Vaccine Alert in Bangalore Karnatakaaddon Scans
As flu season approaches, health officials in Bangalore, Karnataka, are urging residents to get their flu vaccinations. The seasonal flu, while common, can lead to severe health complications, particularly for vulnerable populations such as young children, the elderly, and those with underlying health conditions.
Dr. Vidisha Kumari, a leading epidemiologist in Bangalore, emphasizes the importance of getting vaccinated. "The flu vaccine is our best defense against the influenza virus. It not only protects individuals but also helps prevent the spread of the virus in our communities," he says.
This year, the flu season is expected to coincide with a potential increase in other respiratory illnesses. The Karnataka Health Department has launched an awareness campaign highlighting the significance of flu vaccinations. They have set up multiple vaccination centers across Bangalore, making it convenient for residents to receive their shots.
To encourage widespread vaccination, the government is also collaborating with local schools, workplaces, and community centers to facilitate vaccination drives. Special attention is being given to ensuring that the vaccine is accessible to all, including marginalized communities who may have limited access to healthcare.
Residents are reminded that the flu vaccine is safe and effective. Common side effects are mild and may include soreness at the injection site, mild fever, or muscle aches. These side effects are generally short-lived and far less severe than the flu itself.
Healthcare providers are also stressing the importance of continuing COVID-19 precautions. Wearing masks, practicing good hand hygiene, and maintaining social distancing are still crucial, especially in crowded places.
Protect yourself and your loved ones by getting vaccinated. Together, we can help keep Bangalore healthy and safe this flu season. For more information on vaccination centers and schedules, residents can visit the Karnataka Health Department’s official website or follow their social media pages.
Stay informed, stay safe, and get your flu shot today!
New Directions in Targeted Therapeutic Approaches for Older Adults With Mantl...i3 Health
i3 Health is pleased to make the speaker slides from this activity available for use as a non-accredited self-study or teaching resource.
This slide deck presented by Dr. Kami Maddocks, Professor-Clinical in the Division of Hematology and
Associate Division Director for Ambulatory Operations
The Ohio State University Comprehensive Cancer Center, will provide insight into new directions in targeted therapeutic approaches for older adults with mantle cell lymphoma.
STATEMENT OF NEED
Mantle cell lymphoma (MCL) is a rare, aggressive B-cell non-Hodgkin lymphoma (NHL) accounting for 5% to 7% of all lymphomas. Its prognosis ranges from indolent disease that does not require treatment for years to very aggressive disease, which is associated with poor survival (Silkenstedt et al, 2021). Typically, MCL is diagnosed at advanced stage and in older patients who cannot tolerate intensive therapy (NCCN, 2022). Although recent advances have slightly increased remission rates, recurrence and relapse remain very common, leading to a median overall survival between 3 and 6 years (LLS, 2021). Though there are several effective options, progress is still needed towards establishing an accepted frontline approach for MCL (Castellino et al, 2022). Treatment selection and management of MCL are complicated by the heterogeneity of prognosis, advanced age and comorbidities of patients, and lack of an established standard approach for treatment, making it vital that clinicians be familiar with the latest research and advances in this area. In this activity chaired by Michael Wang, MD, Professor in the Department of Lymphoma & Myeloma at MD Anderson Cancer Center, expert faculty will discuss prognostic factors informing treatment, the promising results of recent trials in new therapeutic approaches, and the implications of treatment resistance in therapeutic selection for MCL.
Target Audience
Hematology/oncology fellows, attending faculty, and other health care professionals involved in the treatment of patients with mantle cell lymphoma (MCL).
Learning Objectives
1.) Identify clinical and biological prognostic factors that can guide treatment decision making for older adults with MCL
2.) Evaluate emerging data on targeted therapeutic approaches for treatment-naive and relapsed/refractory MCL and their applicability to older adults
3.) Assess mechanisms of resistance to targeted therapies for MCL and their implications for treatment selection
ARTIFICIAL INTELLIGENCE IN HEALTHCARE.pdfAnujkumaranit
Artificial intelligence (AI) refers to the simulation of human intelligence processes by machines, especially computer systems. It encompasses tasks such as learning, reasoning, problem-solving, perception, and language understanding. AI technologies are revolutionizing various fields, from healthcare to finance, by enabling machines to perform tasks that typically require human intelligence.
The prostate is an exocrine gland of the male mammalian reproductive system
It is a walnut-sized gland that forms part of the male reproductive system and is located in front of the rectum and just below the urinary bladder
Function is to store and secrete a clear, slightly alkaline fluid that constitutes 10-30% of the volume of the seminal fluid that along with the spermatozoa, constitutes semen
A healthy human prostate measures (4cm-vertical, by 3cm-horizontal, 2cm ant-post ).
It surrounds the urethra just below the urinary bladder. It has anterior, median, posterior and two lateral lobes
It’s work is regulated by androgens which are responsible for male sex characteristics
Generalised disease of the prostate due to hormonal derangement which leads to non malignant enlargement of the gland (increase in the number of epithelial cells and stromal tissue)to cause compression of the urethra leading to symptoms (LUTS
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TEST BANK for Operations Management, 14th Edition by William J. Stevenson, Verified Chapters 1 - 19, Complete Newest Version.pdf
These simplified slides by Dr. Sidra Arshad present an overview of the non-respiratory functions of the respiratory tract.
Learning objectives:
1. Enlist the non-respiratory functions of the respiratory tract
2. Briefly explain how these functions are carried out
3. Discuss the significance of dead space
4. Differentiate between minute ventilation and alveolar ventilation
5. Describe the cough and sneeze reflexes
Study Resources:
1. Chapter 39, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 34, Ganong’s Review of Medical Physiology, 26th edition
3. Chapter 17, Human Physiology by Lauralee Sherwood, 9th edition
4. Non-respiratory functions of the lungs https://academic.oup.com/bjaed/article/13/3/98/278874
NVBDCP.pptx Nation vector borne disease control programSapna Thakur
NVBDCP was launched in 2003-2004 . Vector-Borne Disease: Disease that results from an infection transmitted to humans and other animals by blood-feeding arthropods, such as mosquitoes, ticks, and fleas. Examples of vector-borne diseases include Dengue fever, West Nile Virus, Lyme disease, and malaria.
micro teaching on communication m.sc nursing.pdfAnurag Sharma
Microteaching is a unique model of practice teaching. It is a viable instrument for the. desired change in the teaching behavior or the behavior potential which, in specified types of real. classroom situations, tends to facilitate the achievement of specified types of objectives.
1. Welcome!
What New Drugs Are On the Way for
Colorectal Cancer?
Part of Fight Colorectal Cancer’s Monthly
Patient Webinar Series
Our webinar will begin shortly
www.FightColorectalCancer.org
877-427-2111
2. 1. Tonight’s speaker: Dr. Richard Goldberg
2. Archived webinars: Link.FightCRC.org/Webinars
3. Follow up survey to come via email. Get a free Blue
Star of Hope pin when you tell us how we did tonight
4. Ask a question in the panel on the right side of your
screen
5. Or call the Fight Colorectal Cancer Answer Line at
877-427-2111
3. Dr. Richard Goldberg
Physician-in-chief at The Ohio State University
Comprehensive Cancer Center
A member and former chair of the National Cancer
Institute Colorectal Task Force
An international leader in evaluating new agents for
the treatment of colorectal cancer and researching
inherited colorectal cancer syndromes
4. New Agents in
Colorectal Cancer
Management
Richard Goldberg
Wexner Medical Center at
The Ohio State University
5. Heterogeneity:
Incidence of Selected Mutations in
Advanced Colorectal Cancers
Study N KRAS NRAS BRAF PI3K Overlapping
Mutation Mutation Mutation Mutation Mutations
Rate Rate Rate Rate
De 747 40% 2.6% 4.7% 14.5% 20% of MT-KRAS
Roock had MT-PI3K
CAIRO 2 559 39.4% N/A 8.7% 9.9% 51% MT-KRAS
had MT-PI3K
COIN 1316 43% 4% 8% N/A 2% MT-KRAS
had MT-NRAS
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
6. In MCRC: Cytotoxics Remain the Nucleus
First Line:
5-FU/capecitabine +/- bevacizumab
FOLFOX +/- bevacizumab
FOLFIRI +/- bevacizumab
FOLFIRINOX +/- bevacizumab
? Role for EGFR targeted therapy in first line: 80405
Second Line
Reciprocal of first line +/- bevacizumab or an EGFR
monoclonal AB
Third Line:
KRAS wt: EGFR monoclonal +/- irinotecan
KRAS mt: no standard therapy
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
7. Drug Development:
The Spotlight is on Biologics
Repackaging cytotoxics
Liposome encapsulation: irinotecan or SN-38
Platinum analogues: pico- or satroplatin
Exploiting biologics
Pinpoint a single driving mutation (imatinib & c-kit)
Drug multiple targets
Discover a “dirty drug”: exs: regorafinib, BIBF1120
Combine biologics: ex. Bond 2
Combine biologics and cytotoxics: ex. Bond 2
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
8. Expression
Center – S. Siena, et al, JNCI, 2009
The Ohio State University Comprehensive Cancer
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
9. Expression
Center – S. Siena, et al, JNCI, 2009
The Ohio State University Comprehensive Cancer
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
10. Expression
Brivinib
Ramucirumab
BIBF 1120
Regorafinib
Perifosine
Center – S. Siena, et al, JNCI, 2009
The Ohio State University Comprehensive Cancer
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
11. Expression
Brivinib
Ramucirumab
BIBF 1120
Regorafinib
Perifosine
Center – S. Siena, et al, JNCI, 2009
The Ohio State University Comprehensive Cancer
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
12. Expression
Brivinib
Ramucirumab
BIBF 1120
Regorafinib
Perifosine
Center – S. Siena, et al, JNCI, 2009
The Ohio State University Comprehensive Cancer
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
13. Targeted Agents
On the formulary Target
Bevacizumab VEGF
Cetuximab EGFR receptor
Panitumumab EGFR receptor
On the way to ODAC?
Regorafenib VEGF, RAF, RET, KIT, PDGFR
Aflibercept (VEGF trap) VEGF
Perifosine Akt, JNK, MAPK
On the radar screen
Brivinib FGF & VEGF
Pertuzumab HER-2
Rilotumumab c-Met (hepatocyte GF)
Ramucirumab VEGF-2
BIBF1120 VEGF1-3, PDGF, FGFR
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
14. A drug that works
at the cell surface
AFLIBERCEPT
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
15. Large molecule VEGF inhibitors
PlGF VEGF-A VEGF-C,
VEGF-B VEGF-D
Bevacizumab
Ramucirumab
Aflibercept
(VEGF Trap)
Functions
VEGF-R1 VEGF-R2 VEGF-R3
(Flt-1) (KDR/Flk-1) (Flt-4)
Migration Proliferation Lymphangiogenesis
Invasion, Survival Survival, Permeability
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
16. Aflibercept
• Soluble fusion protein
Aflibercept
• Consists of portion of extracellular
VEGFR-1
domains of human VEGF receptors 1
and 2 fused to human IgG1 Fc portion
• Binds all VEGF-A isoforms, VEGF-B
and PlGF
• High affinity: binds VEGF-A and PlGF
IgG more tightly than native receptors
VEGFR-2 Fc • Half-life in humans ~17 days
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
17. 17
VELOUR
Phase III Trial 2nd Line
VEGF1 &2 and PDGF Decoy
30% of patients had prior BEV
Aflibercept
600 pts
4 mg/kg IV
+ FOLFIRI
mCRC after
failure of an
oxaliplatin R
based regimen
Placebo + FOLFIRI
Stratification factors: 600 pts
Prior bevacizumab (Y/N)
ECOG PS (0 vs 1 vs 2)
PI: Allegra
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
18. Overall Survival - ITT Population
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Cut-off date = February 7, 2011; Median follow-up = 22.28 months
Research Institute
19. Progression Free Survival
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Cut-off date = May 6, 2011 Research Institute
20. Response Rate
Placebo Aflibercept
Evaluable population*, % N = 530 N = 531
Best Overall Response
Complete response 0.4 0
Partial response 10.8 19.8
Stable disease 64.9 65.9
Progressive disease 21.5 10.4
Not evaluable 2.5 4.0
Overall Response Rate
(CR or PR) 11.1 19.8
95% CI 8.5 to 13.8 16.4 to 23.2
p= 0.0001**
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
21. Safety – Most frequent Adverse Events
Safety Population, % of patients Placebo, N = 605 Aflibercept N = 611
All All
Grade 3-4 Grade 3-4
Grades Grades
Diarrhea 56.5 7.8 69.2 19.3
Neutropenia** 56.3 29.5 67.8 36.7
Complicated neutropenia 2.8 5.7
Asthenic conditions (HLT) 50.2 10.6 60.4 16.9
Stomatitis & ulceration (HLT) 34.9 5.0 54.8 13.7
Thrombocytopenia** 33.8 1.7 47.4 3.3
Infections (SOC) 32.7 6.9 46.2 12.3
Decrease appetite 23.8 1.8 31.9 3.4
Weight decreased 14.4 0.8 31.9 2.6
Palmar plantar
4.3 0.5 11.0 2.8
erythrodysaesthesia
Skin hyperpigmentation 2.8 0 8.2 0
Dehydration 3.0 1.3 9.0 4.3
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
** From lab Research Institute
22. Safety – Anti-VEGF Associated Events
Safety population, % of Placebo N = 605 Aflibercept N = 611
patients
Grouped Term, PT All Grade Grade 3/4 All Grade Grade 3/4
Proteinuria* 40.7 1.2 62.2 7.9
Hypertension 10.7 1.5 41.4 19.3
Haemorrhage 19.0 1.7 37.8 2.9
Epistaxis 7.4 0 27.7 0.2
GI origin 5.1 1.0 10.0 2.0
Dysphonia (PT) 3.3 0 25.4 0.5
Headache (PT) 8.8 0.3 22.3 1.6
Venous thromboembolic event 7.3 6.3 9.3 7.9
Pulmonary embolism 3.5 3.5 4.7 4.7
Arterial thromboembolic event 1.5 0.5 2.6 1.8
Fistula (GI origin) 0.3 0.2 1.1 0.3
Wound healing 0.8 0 0.5 0.3
GI perforation 0.5 0.3 0.5 0.5
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
23. Deaths During Study Treatment
Placebo Aflibercept
% – Safety Population
N = 605 N = 611
Number of deaths within 30d from last dose 3.1 4.9
Disease progression 2.1 2.3
Adverse events: 1.0 2.6
Infections (sepsis and neutropenic sepsis) 0.5 0.7
Death/sudden death 0.3 0.3
Pulmonary embolism 0 0.2
GI hemorrhage (duodenal ulcer) 0 0.2
GI disorders (inflammation/obstruction) 0 0.3
Respiratory disorders 0.2 0.3
Other** 0 0.7
**Other: dehydration (2pts), metabolic encephalopathy (1pt), hypovolemic shock (1pt)
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
24. Discontinuation of Study Treatment
ITT Population Placebo Aflibercept
% N = 614 N = 612
Discontinued study treatment 97.4 96.9
Disease progression 71.2 49.8
Adverse event 12.1 26.6
Patient request 7.0 12.6
Investigator decision 3.4 3.3
Metastatic surgery 1.6 2.0
Other causes* 2.1 2.6
Study treatment ongoing 1.8 2.3
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
25. A drug that hits
A cell surface receptor
RAMUCIRUMAB
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
26. 26
Phase III Trial 2nd Line
Targets VEGFR-2
Projected completion date 8/2014
Primary EP: OS
525 pts Ramucirumab IV
+ FOLFIRI q 2 weeks
mCRC after
failure
FP/oxaliplatin R
+ BEV regimen
525 pts Placebo + FOLFIRI
q 2 weeks
PIs: Tabernero, Grothey
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
27. A drug being compared
To bevacizumab with
chemotherapy
BIBF 1120
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
28. 28
Phase II Trial First Line
Targets , VEGF, PDGF, FDGF
Presented at ESMO 9/11
Primary EP: OS
63 pts BIBF1120
+ mFOLFOX6
mCRC R
Bevacizumab
63 pts + mFOLFOX6
Van Cutsem
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
29. Efficacy/Toxicity
FOLFOX + FOLFOX +
Bevacizumab BIBF1120
No. of patients 63 63
ORR 53.7% 61.2%
PFS at 9 mos 69% 63%
Median OS N.A. N.A
GI toxicity, G>3 29.3 % 11.8%
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
30. A drug that hits
multiple internal targets
REGORAFINIB
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
31. Mode of action of regorafenib
Regorafenib inhibits
multiple cell-signaling
kinases:
Angiogenic
VEGFR1–3, TIE2
Stromal
PDGFR-β, FGFR
Oncogenic
KIT, PDGFR, RET
The Ohio State University Comprehensive Cancer
Center – Wilhelm SM et al. Int J Cancer 2011
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
32. 32
CORRECT Trial
Targets VEGF, TIE2, RAF, Ret, c-Kit
Primary EP: OS
505 pts Regorafinib po
+ BSC
mCRC after
failure of all R
standard Rx
Placebo
255 pts
+ BSC
PI: Grothey
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
33. Overall survival (primary endpoint)
Primary endpoint met prespecified stopping criteria at interim analysis
(1-sided p<0.009279 at approximately 74% of events required for final analysis)
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
34. Progression-free survival
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
35. Overall response and disease control rates
Regorafenib Placebo
Best response, %
N=505 N=255
Complete response 0 0
Partial response 1.0 0.4
Stable disease 43.8 14.9
Progressive disease 49.5 80.0
Disease control rate, %* 44.8 15.3
*DCR = PR + SD; p<0.000001
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
36. Drug-related, treatment-emergent adverse events
occurring in ≥10% of patients at any grade
Regorafenib Placebo
Adverse event, %
N=500 N=253
All Grade Grade Grade All Grade Grade Grade
grades 3 4 5 grades 3 4 5
Hand–foot skin reaction 46.6 16.6 0 0 7.5 0.4 0 0
Fatigue 47.4 9.2 0.4 0 28.1 4.7 0.4 0
Hypertension 27.8 7.2 0 0 5.9 0.8 0 0
Diarrhea 33.8 7.0 0.2 0 8.3 0.8 0 0
Rash/desquamation 26.0 5.8 0 0 4.0 0 0 0
Anorexia 30.4 3.2 0 0 15.4 2.8 0 0
Mucositis, oral 27.2 3.0 0 0 3.6 0 0 0
Thrombocytopenia 12.6 2.6 0.2 0 2.0 0.4 0 0
Fever 10.4 0.8 0 0 2.8 0 0 0
Nausea 14.4 0.4 0 0 11.1 0 0 0
Bleeding 11.4 0.4 0 0.4 2.8 0 0 0
Voice changes 29.4 0.2 0 0 5.5 0 0 0
Weight loss 13.8 0 0 0 2.4 0 0 0
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
37. Summary of CORRECT
Overall survival:
6.4 vs 5.0 months, HR=0.77, p=0.0052
Progression-free survival:
1.9 vs 1.7 months, HR=0.49, p<0.000001
Disease control rate (PR + SD):
44.8% vs 15.3%, p<0.000001
Main treatment-related adverse events:
fatigue, hand–foot skin reaction, diarrhea, poor
appetite, voice changes, hypertension, oral mucositis,
and rash/peeling skin
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
38. A drug that apparently
didn’t make it
PERIFOSINE
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
39. Perifosine
Oral alkylphospholipid
Inhibition of multiple signal transduction
pathways
AKT inhibition
NF- B inhibition
Activation of apoptotic pathway via JNK
Selective tumor cell accumulation and potential
disruption of membrane asymmetry
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
40. Perifosine: Mechanism of Action
Selective tumor cell accumulation and
potential disruption of membrane
asymmetry
Activates Prevents
apoptotic JNK AKT recruitment
pathway of AKT to the
Apoptosis Cell growth cell
and Survival membrane
Inhibition of Modulates the
NF- CDK 2
chemoresistance cell cycle via
Cellular Stress Cell Cyclep21
and Survival
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
41. 41
Perifosine
Targets PI3K & akt Pathway and NF-kB
Primary EP: OS
20 pts Perifosine po
+ capecitabine
after
failure of all R
standard Rx
18 pts Capecitabine
Bendell, J Clin Oncol, 33:3394-4400, 2011
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
42. Results: Response
35 / 38 Patients evaluable for efficacy
3 placebo patients not evaluable: 2 off for toxicity at d 14, 46; 1 off at d 4 for other disease
All Evaluable: n = 35
CR PR Duration of Response SD > 12 Weeks SD or >*
Group n
N (%) N (%) (months) N (%) N (%)
CR: 34
P-CAP 20 1 (5%) 3 (15%) 11 (55%) 15 (75%)
PR: 21, 19, 11
CAP 15 0 1 (7%) PR: 7 5 (33%) 6 (40%)
*p = 0.036
5-FU Refractory: n = 25
PR Duration of Response SD > 12 Weeks SD or >*
Group n
N (%) (months) N (%) N (%)
P-CAP 14 1 (7%) 19 months 8 (57%) 9 (64%)
CAP 11 0 - 3 (27%) 3 (27%)
*p = 0.066
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
45. Efficacy
perifosine+
Capecitabine capecitabine P-value
No. of patients 18 20
ORR (%) 7% 20% n.s.
TTP (wks) 10.1 27.5 p< 0.001
Median OS (mo) 6.5 15.1 p< 0.006
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
46. 46
X-Pect Phase III Study:
Completed Enrollment 7/11
Primary EP: OS
215 pts Perifosine po
+ capecitabine
mCRC after
failure of all R
standard Rx
215 pts Capecitabine
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
47. Press release 4/12:
Did not meet survival endpoint
Details pending
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
48. Conclusions
Patients with resectable disease at presentation are
potentially curable
Some with unresectable disease are too
Combination chemotherapy +/- biologics are
standard in fit patients
We are still learning how to best exploit out tools
We have a number of new drugs coming
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
49. Another drug that apparently
didn’t make it
BRIVINIB
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
50. PHASE III RANDOMIZED TRIAL OF CETUXIMAB +
EITHER BRIVANIB OR PLACEBO IN PATIENTS
WITH METASTATIC, CHEMOTHERAPY
REFRACTORY, K-RAS WILD-TYPE COLORECTAL
CARCINOMA:
THE NCIC CLINICAL TRIALS GROUP AND AGITG
CO.20 TRIAL
LL Siu, JD Shapiro, DJ Jonker, CS Karapetis, JR Zalcberg, J Simes,
F Couture, MJ Moore, TJ Price, J Siddiqui, LM Nott, D Charpentier, W
Liauw, M Sawyer, M Jefford, NM Magoski, A Haydon, I Walters, D Tu, CJ
O’Callaghan
GI ASCO 2012, Abstract 386
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
51. Schema
Targets VEGF and FGF
Brivanib
R +
1° endpoint:
A Cetuximab Overall Survival
N
n = 376
D
Last pt randomized:
O February 10, 2011
M Placebo
I Median follow-up:
Z + 19 months
E Cetuximab
n = 374
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
52. Combining targeted agents
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
53. A RANDOMIZED, PHASE IB/II TRIAL OF
RILOTUMUMAB
OR GANITUMAB
WITH PANITUMUMAB
VS PMAB ALONE
IN PATIENTS WITH WILD-TYPE KRAS
METASTATIC COLORECTAL CANCER
C Eng, E Van Cutsem, E Nowara, A Świeboda-Sadlej, NC. Tebbutt,
Mitchell, I Davidenko, KS Oliner, L Chen, J Huang, I McCaffery,
E Loh, D Smethurst, J Tabernero
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
54. Primary Endpoint:
Objective Response Rate
Panitumumab Panitumumab
Panitumumab
+ Rilotumumab + Ganitumab
+ Placebo
(AMG 102) (AMG 479)
(n = 48)
(n = 48) (n = 46)
Objective Response - n (%) 10 (21) 15 (31) 10 (22)
Complete Response (CR) 0 (0) 0 (0) 0 (0)
Partial Response (PR) 10 (21) 15 (31) 10 (22)
Stable Disease (SD) 17 (35) 19 (40) 18 (39)
Progressive Disease (PD) 16 (33) 11 (23) 15 (33)
Unevaluable/Not done 5 (10) 3 (6) 3 (6)
Disease control rate - % (95% CI) 56 (41-71) 71 (56-83) 61 (45-75)
Duration of response - median months 3.7 (3.6-NE) 5.1 (3.7-5.6) 3.7 (3.6-5.8)
(95% CI)
Posterior probability of Odds Ratio > 1 0.93 0.63
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
55. Progression-Free Survival
Panitumumab ± Rilotumumab (AMG 102)
(AMG 102)
Panitumumab ± Ganitumab (AMG 479)
(AMG 479)
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
56. Adverse Events
(Any Grade in 20% or Grade 3/4 in 2 Patients)
Panitumumab Panitumumab
Panitumumab
+ Rilotumumab + Ganitumab
+ Placebo
(AMG 102) (AMG 479)
(n = 48)
(n = 48) (n = 46)
AE (Preferred term) - % Any Grade Grade 3/4 Any Grade Grade 3/4 Any Grade Grade 3/4
Any AE 94 52 98 71 100 63
Rash 52 8 58 29 48 13
Acneiform dermatitis 33 10 35 15 26 11
Pruritus 25 0 21 0 28 2
Skin fissures 17 0 15 2 26 0
Paronychia 15 2 31 4 20 2
Dry skin 15 0 23 2 22 0
Acne 0 0 8 4 11 0
Skin toxicity 0 0 2 2 4 4
Constipation 25 6 10 0 13 0
Decreased appetite 17 2 21 2 20 2
Abdominal pain 15 6 10 4 9 7
Diarrhea 10 0 15 4 26 2
Hypomagnesemia 21 2 29 4 41 15
Fatigue 21 2 10 4 17 2
Anemia 17 8 4 0 2 0
Asthenia 15 0 8 0 13 4
AE, adverse event
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
57. Combinations Also on the Radar Screen
Agent(s) Target(s)
Bortezomib + cetuximab NFk-B, EGFR
Pertuzumab + cetuximab closed, toxicity
Rilotumumab + panitumumab HGF, EGFR
Ganitumab + panitumumab IGFR, EGFR
IMC-A12 + cetuximab IGFR, EGFR
Sorafenib + bevacizumab raf, VEGF
Erlotinib + panitumumab EGFR
Everolimus + cetuximab mTOR + EGFR
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
58. Cominations Also on the Radar Screen
Agent(s) Target(s)
AZD6244 + cetuxumab MEK, EGFR
BEZ235 + MEK 162 PI3-k, MEK
BKM120 + MEK162 PI3-k, MEK
Decitabine + panitumumab DNA methyltransferase
Simvistatin + panitumumab Turpenes + EGFR
Imprime PGG + cetuximab Immunity + EGFR
EMD 525797 + cetuximab Integrin + EGFR
Dasatinib + cetuximab BCR/ABL + EGFR
Lenalidomide + cetuximab Apoptotic + EGFR
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
59. Modulating BRAF
Downstream of RAS
A potential target for patients with k-RAS mt tumors
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
60. The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
61. BRAF Inhibitors: In early testing
Vemurafenib (PLX-4032)
Dabrafenib (GSK2118436)
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
62. Conclusions
Multiple targeted agents are in development
It is likely that combinations will be more effective
than single agents
Agents may work in specific subsets of CRC patients
who can be identified by genetic profiling
It appears the lean years in CRC drug development
may be over
The Ohio State University Comprehensive Cancer
Center –
Arthur G. James Cancer Hospital and Richard J. Solove
Research Institute
64. UPCOMING WEBINARS
MANAGING YOUR SYMPTOMS AND TREATMENT SIDE
EFFECTS
MAY 16, 2012
8-9:30 PM EASTERN TIME
WHAT'S NEW IN COLORECTAL CANCER RESEARCH?
JUNE 20, 2012
8 - 9:30 PM EASTERN TIME
WHEN YOU'RE OUT OF OPTIONS
JULY 18, 2012
8 - 9:30 PM EASTERN TIME