Fight Colorectal Cancer’s Medical Advisory Board Member, Axel Grothey, MD, focused this webinar to stage III colon cancer patients. Dr. Grothey, medical oncologist at Mayo Clinic, will spend the hour discussing current treatment options and exciting new research that pertains to stage III colon cancer patients.
The Changing Role of PARP Inhibitors in the Treatment of Ovarian Cancerbkling
In recent years, researchers have been looking into using a class of drugs called PARP inhibitors to prevent the progression and recurrence of ovarian cancer. Dr. Kathleen Moore of Stephenson Cancer Center, Principal Investigator of the SOLO-1 trial, explains how the results of this trial may affect ovarian cancer patients and where research on ovarian cancer treatment is headed next.
advancements in the diagnostics help detect states like oligometastasis ,which can lead to selection of patients for local and MDT and prolong the time to adjuvant therapy, at present There is no consensus on the treatment of oligometastatic cancer and clinical trials can help in evidence formation.
The Changing Role of PARP Inhibitors in the Treatment of Ovarian Cancerbkling
In recent years, researchers have been looking into using a class of drugs called PARP inhibitors to prevent the progression and recurrence of ovarian cancer. Dr. Kathleen Moore of Stephenson Cancer Center, Principal Investigator of the SOLO-1 trial, explains how the results of this trial may affect ovarian cancer patients and where research on ovarian cancer treatment is headed next.
advancements in the diagnostics help detect states like oligometastasis ,which can lead to selection of patients for local and MDT and prolong the time to adjuvant therapy, at present There is no consensus on the treatment of oligometastatic cancer and clinical trials can help in evidence formation.
Tried to summarise all landmark trials in carcinoma breast in radiation oncology,medical oncology as well in surgical oncology.
References taken from Devita Book,Breast Disease book from Springer,journals like NEJM,JAMA,LANCET,ANNL ONCOLOGY etc,internet,Perez book,Practical Clinical Oncology by Hanna etc textbooks.
Thanks.
To share the knowledge from 2015 GI ASCO, Dr. Al Benson, one of FightCRC Medical Advisory Board members, and Andi Dwyer discuss key highlights as they pertain to colorectal cancer from the symposium and what they mean for patients.
Dr. Dustin Deming led us through a discussion on the latest research and treatments for colorectal cancer patients presented at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.
A few of the topics covered include research on immunotherapy and trials studying:
– MSI-H (review of the Anti-PD-1 trial)
– HER2 amplification
– BRAF mutations
For more updates on colorectal cancer research, visit our blog: http://fightcolorectalcancer.org/category/research-treatment/
Tried to summarise all landmark trials in carcinoma breast in radiation oncology,medical oncology as well in surgical oncology.
References taken from Devita Book,Breast Disease book from Springer,journals like NEJM,JAMA,LANCET,ANNL ONCOLOGY etc,internet,Perez book,Practical Clinical Oncology by Hanna etc textbooks.
Thanks.
To share the knowledge from 2015 GI ASCO, Dr. Al Benson, one of FightCRC Medical Advisory Board members, and Andi Dwyer discuss key highlights as they pertain to colorectal cancer from the symposium and what they mean for patients.
Dr. Dustin Deming led us through a discussion on the latest research and treatments for colorectal cancer patients presented at the American Society of Clinical Oncology (ASCO) Annual Meeting in Chicago.
A few of the topics covered include research on immunotherapy and trials studying:
– MSI-H (review of the Anti-PD-1 trial)
– HER2 amplification
– BRAF mutations
For more updates on colorectal cancer research, visit our blog: http://fightcolorectalcancer.org/category/research-treatment/
RESEARCH & TREATMENT NEWS: Highlights from the 2014 GI Cancer SymposiumFight Colorectal Cancer
Each January, the brightest minds in colorectal cancer research meet at the Gastrointestinal Cancer Symposium.
Fight Colorectal Cancer and The Colon Cancer Alliance are partnering to bring you the big news in colorectal cancer from the symposium. Dr. Allyson Ocean will be presenting.
Get insights about new types of treatments on the horizon, diagnostic tests available, research for upcoming drugs/biomarkers and the way colorectal cancer is treated. We’ll take a look back and a look forward. You’re not going to want to miss it.
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.
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.
How to have quality of life in Advanced ovarian malignancyRajesh Gajbhiye
Presentation given by Dr Rakhi Gajbhiye, Mauli Hospital Nagpur at MGIMS sewagram for an International conference on Womens Health Fatal Disorders Survival with Quality in collaboration with FOGSI.
This was the function to commemorate 100 th birth centenary of Dr Sushila
2017 ASCO RECAP: The Latest in Colorectal Cancer Research #CRCWebinarFight Colorectal Cancer
Don’t miss our recap webinar from the American Society of Clinical Oncology Annual Conference (ASCO) where we discuss the latest research and treatments for colorectal cancer patients presented during the conference.
Dr. Dustin Deming, a medical oncologist and Fight CRC Medical Advisory Board Member will guide us through his findings. Dr. Deming brings a unique perspective as a researcher, oncologist and colorectal cancer survivor. In this webinar we will dive into the research and explain what it means for those living with colorectal cancer.
Chair and Presenter, Marianne Davies, DNP, ACNP, AOCNP, FAAN, Matthew A. Gubens, MD, MS, and Elizabeth S. Waxman, BSN, MSN, APN-BC, prepared useful Practice Aids pertaining to NSCLC for this CME/NCPD/ILNA/IPCE activity titled “Nurses at the Forefront of the Continuing Success Story of Immunotherapy in NSCLC: Best Practices for Guiding and Supporting Patients Through Treatment and Survivorship.” For the full presentation, downloadable Practice Aids, and complete CME/NCPD/ILNA/IPCE information, and to apply for credit, please visit us at https://bit.ly/3FvAeOR. CME/NCPD/ILNA/IPCE credit will be available until May 27, 2024.
Dr. Jennifer Wargo presents the latest on research biopsies and translational research in melanoma at the MRF's Patient Symposium at MD Anderson Cancer Center on January 31, 2015.
Understand the concept of Colorectal Cancer clinical trials and the differences across the phases. Presented by Dr. Sam J. Lubner MD, FACP University of Wisconsin Carbone Cancer Center
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.
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 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.
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.
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.
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?
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.
Pulmonary Thromboembolism - etilogy, types, medical- Surgical and nursing man...VarunMahajani
Disruption of blood supply to lung alveoli due to blockage of one or more pulmonary blood vessels is called as Pulmonary thromboembolism. In this presentation we will discuss its causes, types and its management in depth.
Ethanol (CH3CH2OH), or beverage alcohol, is a two-carbon alcohol
that is rapidly distributed in the body and brain. Ethanol alters many
neurochemical systems and has rewarding and addictive properties. It
is the oldest recreational drug and likely contributes to more morbidity,
mortality, and public health costs than all illicit drugs combined. The
5th edition of the Diagnostic and Statistical Manual of Mental Disorders
(DSM-5) integrates alcohol abuse and alcohol dependence into a single
disorder called alcohol use disorder (AUD), with mild, moderate,
and severe subclassifications (American Psychiatric Association, 2013).
In the DSM-5, all types of substance abuse and dependence have been
combined into a single substance use disorder (SUD) on a continuum
from mild to severe. A diagnosis of AUD requires that at least two of
the 11 DSM-5 behaviors be present within a 12-month period (mild
AUD: 2–3 criteria; moderate AUD: 4–5 criteria; severe AUD: 6–11 criteria).
The four main behavioral effects of AUD are impaired control over
drinking, negative social consequences, risky use, and altered physiological
effects (tolerance, withdrawal). This chapter presents an overview
of the prevalence and harmful consequences of AUD in the U.S.,
the systemic nature of the disease, neurocircuitry and stages of AUD,
comorbidities, fetal alcohol spectrum disorders, genetic risk factors, and
pharmacotherapies for AUD.
These lecture slides, by Dr Sidra Arshad, offer a quick overview of physiological basis of a normal electrocardiogram.
Learning objectives:
1. Define an electrocardiogram (ECG) and electrocardiography
2. Describe how dipoles generated by the heart produce the waveforms of the ECG
3. Describe the components of a normal electrocardiogram of a typical bipolar leads (limb II)
4. Differentiate between intervals and segments
5. Enlist some common indications for obtaining an ECG
Study Resources:
1. Chapter 11, Guyton and Hall Textbook of Medical Physiology, 14th edition
2. Chapter 9, Human Physiology - From Cells to Systems, Lauralee Sherwood, 9th edition
3. Chapter 29, Ganong’s Review of Medical Physiology, 26th edition
4. Electrocardiogram, StatPearls - https://www.ncbi.nlm.nih.gov/books/NBK549803/
5. ECG in Medical Practice by ABM Abdullah, 4th edition
6. ECG Basics, http://www.nataliescasebook.com/tag/e-c-g-basics
Report Back from SGO 2024: What’s the Latest in Cervical Cancer?bkling
Are you curious about what’s new in cervical cancer research or unsure what the findings mean? Join Dr. Emily Ko, a gynecologic oncologist at Penn Medicine, to learn about the latest updates from the Society of Gynecologic Oncology (SGO) 2024 Annual Meeting on Women’s Cancer. Dr. Ko will discuss what the research presented at the conference means for you and answer your questions about the new developments.
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.
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.
Ozempic: Preoperative Management of Patients on GLP-1 Receptor Agonists Saeid Safari
Preoperative Management of Patients on GLP-1 Receptor Agonists like Ozempic and Semiglutide
ASA GUIDELINE
NYSORA Guideline
2 Case Reports of Gastric Ultrasound
Explore natural remedies for syphilis treatment in Singapore. Discover alternative therapies, herbal remedies, and lifestyle changes that may complement conventional treatments. Learn about holistic approaches to managing syphilis symptoms and supporting overall health.
Lung Cancer: Artificial Intelligence, Synergetics, Complex System Analysis, S...Oleg Kshivets
RESULTS: Overall life span (LS) was 2252.1±1742.5 days and cumulative 5-year survival (5YS) reached 73.2%, 10 years – 64.8%, 20 years – 42.5%. 513 LCP lived more than 5 years (LS=3124.6±1525.6 days), 148 LCP – more than 10 years (LS=5054.4±1504.1 days).199 LCP died because of LC (LS=562.7±374.5 days). 5YS of LCP after bi/lobectomies was significantly superior in comparison with LCP after pneumonectomies (78.1% vs.63.7%, P=0.00001 by log-rank test). AT significantly improved 5YS (66.3% vs. 34.8%) (P=0.00000 by log-rank test) only for LCP with N1-2. Cox modeling displayed that 5YS of LCP significantly depended on: phase transition (PT) early-invasive LC in terms of synergetics, PT N0—N12, cell ratio factors (ratio between cancer cells- CC and blood cells subpopulations), G1-3, histology, glucose, AT, blood cell circuit, prothrombin index, heparin tolerance, recalcification time (P=0.000-0.038). Neural networks, genetic algorithm selection and bootstrap simulation revealed relationships between 5YS and PT early-invasive LC (rank=1), PT N0—N12 (rank=2), thrombocytes/CC (3), erythrocytes/CC (4), eosinophils/CC (5), healthy cells/CC (6), lymphocytes/CC (7), segmented neutrophils/CC (8), stick neutrophils/CC (9), monocytes/CC (10); leucocytes/CC (11). Correct prediction of 5YS was 100% by neural networks computing (area under ROC curve=1.0; error=0.0).
CONCLUSIONS: 5YS of LCP after radical procedures significantly depended on: 1) PT early-invasive cancer; 2) PT N0--N12; 3) cell ratio factors; 4) blood cell circuit; 5) biochemical factors; 6) hemostasis system; 7) AT; 8) LC characteristics; 9) LC cell dynamics; 10) surgery type: lobectomy/pneumonectomy; 11) anthropometric data. Optimal diagnosis and treatment strategies for LC are: 1) screening and early detection of LC; 2) availability of experienced thoracic surgeons because of complexity of radical procedures; 3) aggressive en block surgery and adequate lymph node dissection for completeness; 4) precise prediction; 5) adjuvant chemoimmunoradiotherapy for LCP with unfavorable prognosis.
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
Title: Sense of Smell
Presenter: Dr. Faiza, Assistant Professor of Physiology
Qualifications:
MBBS (Best Graduate, AIMC Lahore)
FCPS Physiology
ICMT, CHPE, DHPE (STMU)
MPH (GC University, Faisalabad)
MBA (Virtual University of Pakistan)
Learning Objectives:
Describe the primary categories of smells and the concept of odor blindness.
Explain the structure and location of the olfactory membrane and mucosa, including the types and roles of cells involved in olfaction.
Describe the pathway and mechanisms of olfactory signal transmission from the olfactory receptors to the brain.
Illustrate the biochemical cascade triggered by odorant binding to olfactory receptors, including the role of G-proteins and second messengers in generating an action potential.
Identify different types of olfactory disorders such as anosmia, hyposmia, hyperosmia, and dysosmia, including their potential causes.
Key Topics:
Olfactory Genes:
3% of the human genome accounts for olfactory genes.
400 genes for odorant receptors.
Olfactory Membrane:
Located in the superior part of the nasal cavity.
Medially: Folds downward along the superior septum.
Laterally: Folds over the superior turbinate and upper surface of the middle turbinate.
Total surface area: 5-10 square centimeters.
Olfactory Mucosa:
Olfactory Cells: Bipolar nerve cells derived from the CNS (100 million), with 4-25 olfactory cilia per cell.
Sustentacular Cells: Produce mucus and maintain ionic and molecular environment.
Basal Cells: Replace worn-out olfactory cells with an average lifespan of 1-2 months.
Bowman’s Gland: Secretes mucus.
Stimulation of Olfactory Cells:
Odorant dissolves in mucus and attaches to receptors on olfactory cilia.
Involves a cascade effect through G-proteins and second messengers, leading to depolarization and action potential generation in the olfactory nerve.
Quality of a Good Odorant:
Small (3-20 Carbon atoms), volatile, water-soluble, and lipid-soluble.
Facilitated by odorant-binding proteins in mucus.
Membrane Potential and Action Potential:
Resting membrane potential: -55mV.
Action potential frequency in the olfactory nerve increases with odorant strength.
Adaptation Towards the Sense of Smell:
Rapid adaptation within the first second, with further slow adaptation.
Psychological adaptation greater than receptor adaptation, involving feedback inhibition from the central nervous system.
Primary Sensations of Smell:
Camphoraceous, Musky, Floral, Pepperminty, Ethereal, Pungent, Putrid.
Odor Detection Threshold:
Examples: Hydrogen sulfide (0.0005 ppm), Methyl-mercaptan (0.002 ppm).
Some toxic substances are odorless at lethal concentrations.
Characteristics of Smell:
Odor blindness for single substances due to lack of appropriate receptor protein.
Behavioral and emotional influences of smell.
Transmission of Olfactory Signals:
From olfactory cells to glomeruli in the olfactory bulb, involving lateral inhibition.
Primitive, less old, and new olfactory systems with different path
Pharynx and Clinical Correlations BY Dr.Rabia Inam Gandapore.pptx
Treatment Options Stage III Colon Cancer - CRCWebinar June 21 2017
1. Treatment Options for Stage III
Colon Cancer
Our webinar will begin shortly.
WELCOME!
2. • Speaker: Axel Grothey, MD
• Archived Webinars: FightCRC.org/webinars
• AFTER THE WEBINAR: Expect an email with links to the
material & a survey. If you fill it out, we’ll send you an “I
booty” bracelet
• Ask a question in the panel on the RIGHT SIDE of your screen
• Follow along via Twitter – use the hashtag #CRCWebinar
Today’s Webinar:
4. Disclaimer
:
The information and services provided by
Fight Colorectal Cancer are for general
informational purposes only. The information
and services are not intended to be
substitutes for professional medical advice,
diagnoses or treatment.
If you are ill, or suspect that you are ill, see a
doctor immediately. In an emergency, call
911 or go to the nearest emergency room.
Fight Colorectal Cancer never recommends
or endorses any specific physicians,
5. Speaker:
Axel Grothey, MD, is a consultant in the Division of Medical Oncology,
Department of Oncology, at Mayo Clinic. He holds the academic rank of
professor of oncology in Clinical and Translational Science at Mayo Graduate
School. He is a member of Mayo Clinic’s Cancer Center.
Dr. Grothey’s clinical interests focus on gastrointestinal cancers, in particular,
colorectal cancer, anti-angiogenesis, signal transduction inhibitors, and clinical
trial design and statistics. As a consultant and investigator, his research has been
funded by the National Cancer Institute (NCI)and the National Institutes of
Health, among other organizations. Dr. Grothey serves in journal review and
editorial activities for numerous medical journals and is editor for Clinical
Colorectal Cancer, Emerging Cancer Therapeutics, Practice Update Oncology,
and Therapeutic Advances in Medical Oncology. In educational activities, he
has served as a teacher, and he is a five-time recipient of Teacher of the Year
recognition at Mayo Clinic. Dr. Grothey has given numerous international,
national and regional presentations, as well as invited and visiting professor
presentations. He has co-authored more than 500 articles, books, book chapters,
editorials, abstracts, and letters.
6. Prospective Pooled Analysis of Six Phase III
Trials Investigating Duration of Adjuvant
Oxaliplatin-based therapy (3 vs 6 months) for
Patients with Stage III Colon Cancer:
The IDEA (International Duration Evaluation of
Adjuvant Chemotherapy) Collaboration
Qian Shi, Alberto F. Sobrero, Anthony F. Shields, Takayuki Yoshino, James Paul, Julien Taieb,
Ioannis Souglakos, Rachel Kerr, Roberto Labianca, Jeffrey A. Meyerhardt, Franck Bonnetain,
Toshiaki Watanabe, Ioannis Boukovinas, Lindsay A. Renfro, Axel Grothey, Donna Niedzwiecki,
Valter Torri, Thierry Andre, Daniel J. Sargent, Timothy Iveson
7. Background and Rationale
• Current standard of care for stage III colon cancer patients:
6 months of oxaliplatin-based adjuvant therapy with FOLFOX or CAPOX
(XELOX)
• Oxaliplatin is associated with cumulative dose-dependent neurotoxicity
• Debilitating for many patients, both short- and long-term
– Nerve damage (e.g. numbness, tingling, pain) can persist long after
discontinuation of therapy, sometimes permanently
• Dose reductions and early discontinuation of therapy are common
• Shorter duration treatment without loss of efficacy would be of benefit to
patients and health care resources
Presented by: Qian Shi, PhD on behalf of IDEA collaborators
8. International Duration Evaluation of Adjuvant
Chemotherapy (IDEA) Collaboration
Presented by: Qian Shi, PhD on behalf of IDEA collaborators
• Academic collaboration of clinicians and statisticians from six
randomized phase III trials (12 countries)
– SCOT (UK, Denmark, Spain, Australia, Sweden, New Zealand),
TOSCA (Italy), Alliance/SWOG 80702 (US, Canada), IDEA France,
ACHIEVE (Japan), HORG (Greece)
• Total of 12,834 patients with stage III disease included in analysis
– High number of patients needed to make sure with high confidence
that we are not sacrificing efficacy of therapy for decreased toxicity
11. Stage III Colon Cancer
Presented by: Jeffrey Meyerhardt, MD, MPH
12. Stage III Colon Cancer
Cured with Surgery Alone
Didn’t need chemo
Presented by: Jeffrey Meyerhardt, MD, MPH
13. Stage III Colon Cancer
Recur despite surgery
and chemo
Chemo didn’t help
(at least enough)
Presented by: Jeffrey Meyerhardt, MD, MPH
14. Stage III Colon Cancer
Cured because they got adjuvant
therapy after surgery
Only ones that benefit from
chemo (as measured by cure)
Fluoropyrimidine
FOLFOX/CAPOX
Presented by: Jeffrey Meyerhardt, MD, MPH
15. Stage III Colon Cancer
These people all get side
effects from chemotherapy
The 3 trials today and IDEA
collaboration goal is to reduce
side effects, burdens of
therapy, and costs for all
these patients
Presented by: Jeffrey Meyerhardt, MD, MPH
16. Study Overview
• Objective:
Reduce side-effects of therapy
without giving up (too much) anti-
cancer efficacy of therapy
• Non-inferiority design:
As agreed upon by patient advocates and
oncologists, shorter duration of therapy
should not sacrifice more than 12% of
benefit of adjuvant therapy
In statistical terms: upper 95% confidence
interval of Hazard Ratio (HR) of disease free
survival (DFS) should not exceed 1.12
Presented by: Qian Shi, PhD on behalf of IDEA collaborators
Stage III
Colon
Cancer
Patients
R
3 months
6 months
FOLFOX*
or CAPOX*
*Investigator’s choice, no
randomization
12,834 patients
20. Subgroup Analyses
Subgroup
3 year DFS rate (%)
Interpretation
3 months arm 6 months arm
Risk of recurrence
Low-risk ~60%
(T1-3N1)
83.1 83.3
3 months duration
appropriate for low-
risk groupHigh-risk ~40%
(T4 or N2)
62.7 64.4
Regimen
FOLFOX ~60% 73.6 76.0
If CAPOX preferred,
3 months duration
appropriate
independent of stageCAPOX ~40% 75.9 74.8
∆ -0.2
∆ -1.7
∆ -2.4
∆ +1.1
Presented by: Qian Shi, PhD on behalf of IDEA collaborators
21. IDEA Consensus: Risk-based approach to
adjuvant chemotherapy in stage III colon cancer
Presented by: Qian Shi, PhD on behalf of IDEA collaborators
Risk group Recommended duration of adjuvant therapy
T1-3 N1
T4 and/or N2
3 months
Duration of therapy determined by
- tolerability of therapy
- patient preference
- assessment of risk of recurrence
- Regimen (CAPOX vs FOLFOX)
6 months
(~60% of stage III)
(Or other high-risk factors)
22. Conclusions
• IDEA data provide a framework for discussions on risks and benefits of
individualized adjuvant therapy approaches
• Shorter duration of therapy associated with remarkable reduction in
(neuro)toxicity
• For low-risk cancers (~60% of stage III) 3 months duration of
oxaliplatin-based therapy is adequate
– Applies to about 20,000 patients per year in the US
• Yet unexplained finding that shorter duration of CAPOX is adequate,
whereas for FOLFOX a longer duration might be required, in particular,
in high-risk cancers
– No direct comparison between FOLFOX and CAPOX possible!
23. Notable Facts
• IDEA represents an international academic
collaboration conducted over more than a decade
• By far largest prospective study conducted in the
history of colorectal cancer research
• No commercial funding to support these practice-
changing efforts, individual studies were supported
by public funds and philanthropy
24. Question & Answer:
SNAP A
#STRONGARMSELFIE
Bayer HealthCare will donate $1 for every
photo posted (up to $25,000).
Flex a “strong arm” & post it to Twitter or
Instagram! (Use the hashtag!)