Upcoming meeting: Tumor Models, London, January 2013

The path to successful clinical development of oncology drugs starts with using predictive tumor models. This is easier said than done. 

The organizers of the Tumor Models meeting in London (January 29-31, 2013) have assembled a roster of speakers from AstraZeneca, Eisai, Roche, MedImmune, Genentech, Sanofi and others to discuss tumor models used at these companies, optimization of traditional models, and explore alternative models and methods to better predict drug efficacy.

New Cancer Drugs Reach US Patients Earlier but at a Price

A report released by Tufts Center for the Study of Drug Development concludes that FDA approved more cancer drugs and faster than European regulators during 2000-2011.

Cost of Cancer Drug Development, 4 Billion. Cost to Patient, 0.1 Million. Benefit, Priceless! Business Model, Unsustainable

I recently rediscovered an article by Forbes's Mathew Herper, "The Truly Staggering Cost Of Inventing New Drugs." In this article, Mathew pegs the true cost of bringing drugs to market at 4 billion dollars.

Adolescent and Young Cancer Survivors Face Long-Term Health Problems

A recent study in the journal Cancer suggests that teenagers and young adults (15-29 years old at diagnosis) who survived cancer often have poor health compared to their peers later in life.  Long-term consequences of cancer, treatments and behavior (including approach to life) affect health of body and mind.


Researchers from the Center for Disease Control and Prevention, Atlanta, Georgia, led by Eric Tai, examined data from 4054 adolescent and young adult (AYA) cancer survivors in the registry called Behavioral Risk Factor Surveillance System (BRFSS).

What is Cancer

Sometimes the most obvious and commonplace things are paradoxically equally hard to describe because we often do not think how to define them unless somebody throws a curve ball and asks!  "What is cancer?" is one such apparently obvious thing.

Making Chemotherapy Toxicity Palatable by What You Put or Don’t on Dinner Plate

Watching what we eat and how much we eat may be an effective tool to manage the toxicity of chemotherapy drugs says this month's online article in the New England Journal of Medicine.

What are the Smart Apps in Oncologist's Phone

Last June, a Romanian start-up Cronian Labs released an iPhone app Skin Scan which claimed that it can help with early diagnosis (or warning signs) of melanoma.  The availability of Skin Scan at Apple iTunes Store was widely covered in the media (eg, read here and here).  And, it was also the first time I put medical apps on my radar screen.

There are now hundreds of medical apps, and it is not unsurprising to find oncologists and cancer researchers using a variety of these as reference tools, calculators and diagnostic aids.  Here is a short list:

Targeting Tumor Microenvironment, Boston: Pre-meeting notes 2

In the run up to the Targeting the Tumor Microenvironment meeting, taking place in Boston, this October, there are some great resources available to you to download free of charge from the website resources page.

Targeting Tumor Microenvironment, Boston: Pre-meeting notes 1

"Targeting the Tumor Microenvironment" meeting will take place in Boston in October and will be looking at how to achieve tumor delivery, tackle drug resistance and improve clinical efficacy.

Increasing Anti-Tumor Response by Localized High Dose Radiation

Sci Transl Med 6 June 2012: 

Vol. 4, Issue 137, p. 137ra74 
Sci. Transl. Med. DOI: 10.1126/scitranslmed.3003649

• RESEARCH ARTICLE

TUMOR RADIOTHERAPY

Phase 1 Study of Stereotactic Body Radiotherapy and Interleukin-2—Tumor and Immunological Responses

Health Costs of Smoking and Prop 29

Smoking causes 5-6 million avoidable deaths annually worldwide.  One in 5 men and 1 in 20 women who die after age 30 die of smoking-related causes.  

These distressing numbers should be enough to galvanize the California voters who will decide to accept or reject the California Cancer Research Act, commonly called Proposition 29 (or Prop 29).  If Prop 29 passes, the money raised through new taxes on cigarettes will support research into smoking-related diseases.

Spotting EMILIA at ASCO12 Chicago

EMILIA trial is the first study to evaluate the efficacy of an antibody drug conjugate T-DM1 in metastaic breast cancer (mBC) patients.  At ASCO 2012 meeting in Chicago, Dr. Kim Blackwell of Duke University presented the final analysis of the progression-free survival (PFS) results in mBC patients treated with T-DM1.  A few days back, this trial was featured in the NBC Nightly News (read here.)

Notes on Prostate Cancer From ASCO 2012

Phase 3 date on abiraterone trial in asymptomatic or mildly symptomatic patients with metastatic castration-resistant prostate cancer (mCRPC) was profiled in the ASCO daily news.  These results have the potential of changing the standard of care in mCRPC.

T-DM1 Shows a Way to Deliver Chemo Without Side Effects

Two months ago, Trastuzumab Emtansine (T-DM1) metastatic breast cancer trial (called EMILIA trial) reached a major milestone when patients treated with T-DM1 had longer cancer-free periods, also called progression-free survival or PFS, compared to those patients who were on a combination chemotherapy consisting of lapatinib (Tykerb) and capecitabine (Xeloda). (read here).  Today, NBC Nightly News gave a human face to this trial.

Choosing Cancer Charity: CureSearch for Children's Cancer

In a new series on this blog called "Choosing Cancer Charity," I have chosen to present CureSearch National Childhood Cancer Foundation, also called CureSearch for Children's Cancer to the readers this month.  There are several reasons that motivates me to pitch this charity for your dollars, and donations of time, expertise and support.

Oral Mucositis: an Underappreciated Problem in Cancer Care

How big is the problem?
25-30% of all cancer patients undergoing chemo suffer form oral mucositis, and almost all of the BMT patients.

Focus on Tumour immunology & immunotherapy from Nature Reviews Cancer and Nature Reviews Immunology

The tumour microenvironment is an important aspect of cancer biology that contributes to tumour initiation, tumour progression and responses to therapy. Cells and molecules of the immune system are a fundamental component of the tumour microenvironment. 

Breast Cancer Tweets From AACR 2012 Annual Meeting

AACR 2012 meeting summary - Breast cancer

Postcard From the AACR 2012 Annual Meeting - Part 4

AACR 2012 meeting summary - Part 4
The Grapevine, quotes, and interesting stuff

Postcard From the AACR 2012 Annual Meeting - Part 3

AACR 2012 meeting summary - Part 3.
Personalized medicine, diagnosis, whole genome sequencing, NGS, TCGA project, etc

Postcard From the AACR 2012 Annual Meeting - Part 2

AACR 2012 meeting summary - Part 2

Postcard From the AACR 2012 Annual Meeting - Part 1

Annual Meeting of the American Association for Cancer Research (AACR) is ongoing right now in the city of Al Capone.  And 17,000 cancer biologists, oncologists and just about anyone interested in the cancer research have taken over the Chicago downtown which means that there is a tsunami of oncology-related information and much to learn.  


Here is what has bubbled to the top and comes through the much-appreciated efforts of a handful of people who have shared this distilled knowledge via twitter.  These include Pieter Droppert @NT, Naoto T. Ueno @teamoncology, @JNCI_Now,  Scott Merville‏ @smerv ,  David Woessner‏ @pinfoto , Kenna Shaw‏ @wyattsgirl, and others.

EMILIA Study Results: Roche's Trastuzumab Emtansine (T-DM1) Delays Metastatic Breast Cancer Progression

Trastuzumab Emtansine (T-DM1) increases progression-free survival (PFS) in metastatic breast cancer patients compared to patients who received lapatinib (Tykerb; GlaxoSmithKline Plc) and  capecitabine (Xeloda; Roche) combination, Roche made the announcement today in a press release.  The overall surivival (OS) data is not mature yet.

The Link Between Diabetes and Breast Cancer

Both diabetes and cancer have long preoccupied public-health concerns, strained national budgets, and are associated with complications that may affect quality of life. They also share some of the same risk factors, such as age, smoking, weight gain, and a diet poor in fruits and vegetables. The earliest link between diabetes and cancer was alluded to in the 1930s,[1,2] however, convincing epidemiological evidence has emerged only recently proving an association between diabetes and cancer.[3]

Personalized Medicine: Moore's Law Brings $1000 Genomes Within Reach

The promise of personalized medicine has long hinged on faster, cheaper and ubiquitous availability of whole genome sequencing.  

In order to make effective health care decisions to manage or fight cancer using personalized medicine strategy, oncologists ought to be able to follow the chameleonistic genome of cancer cells, and stay one step ahead by targeting strategies cancer cells employ to develop drug resistance, escape and metastasize.

Friday Grand Rounds: Susan Desmond-Hellmann Outlines Her Vision for UCSF and Teaches Us a Thing or Two About Leadership and Goals

Today, we are going to listen to an interview with Susan Desmond-Hellmann.  She is a UCSF-trained oncologist who, after spending 14 years at the helm of Genentech, is now back at UCSF as its first woman chancellor.

Zytiga is the Darling of the Day. Really!

Zytiga was in news today, but more so were its competitors, Provenge and MDV3100. The big news was early unblinding of Zytiga trial in metastatic prostate cancer patients due to significant improvement seen in progression-free survival (PFS) and other endpoints.

Nipping the Cancer Drug Counterfeit Problem in the Bud

The problem faced by cancer patients in the western countries is that of shortages and not counterfeit.  However, there was a recent scare of counterfeit Avastin almost entering the supply chain through Canada.  

Yesterday's passing of a bill co-sponsored by Senators Michael Bennet (R-CO), Patrick Leahy (D-VT) and Chuck Grassley (R-IA) is designed to nip this problem by toughening up penalties.

Whacking the Hedgehogs in Basal Cell Carcinoma with Vismodegib

If the year 2011 was the year for the 5% of skin cancers, this is the year for the 95% majority.  Last year saw approvals of two new melanoma cancer drugs, vemurafenib and  ipilimumab.  But, this year may be dubbed as the year when the other skin cancer called basal cell carcinoma finally gets a new Erivedge loaded Webley.

Skin cancer is the most common type of cancer in the western world—40% of all cancers are skin cancers with 80% of skin cancers being nonmelanoma, and primarily basal cell carcinoma.

Vemurafenib Seeks Wider Audience

Vemurafenib (Zelboraf ^®; Genentech/Daiichi Sankyo) is a BRAF V600E kinase inhibitor approved for metastatic melanoma.  Since its approval last year, vemurafenib has become the drug of choice for these patients.  BRAF V600E mutant gene is also found in several other solid cancer, including colon, ovarian and thyroid, and certain leukemias.  Zelboraf is making inroads in these cancer types.

One-Two Punch: Curbing HER-2 Positive Breast Cancer with Herceptin-Tykerb Combo

Using Tykerb (lapatinib; GlaxoSmithKline, U.K.) and Herceptin (trastuzumab; Genentech, South San Francisco, Calif.) anti-HER-2 drugs together doubles the odds of recovery compared to either drug alone in HER-2 positive early breast cancer patients, reports NeoALTTO trial investigators in the January 17th online publication at Lancet Oncology journal homepage.  This study provides a proof-of-concept that dual HER-2 block is better than using a single agent HER-2 blocker.

Meeting Report: AACR-IASLC Joint Conference on Molecular Origins of Lung Cancer

Lung cancer is the most common cause of cancer-related death, accounting for one-third of all cancer deaths.  Lung cancer is also the second most common cancer in men (after prostate cancer) and women (after breast cancer).  Over 200,000 people are diagnosed with and about 150,000 people die from lung cancer every year in the United States [a, b].  While surgery, chemotherapy and radiotherapy are routine treatment choices, in the recent years, patients have benefited from the introduction of targeted therapies based on the discovery of mutations in the EGFR and KRAS genes, and EML/ALK translocations.   EGFR mutations are more commonly found in non-small cell lung cancer (NSCLC) tumors in Asian population (30-40%) than Caucasians (10-15%).   About 4% of the patients carry EML/ALK translocation.


The ongoing 2012 AACR-IASLC Joint Conference on Molecular Origins of Lung Cancer: Biology, Therapy and Personalized Medicine in San Diego highlights some of the recent advances in lung cancer biology, diagnosis and treatment (see below)

Most Common Somatic Mutations in Cancer

Here is a list of most common mutations in cancer genes.  This list is from a recent PLoS ONE article and it contains 60 most common mutations in 15 cancer genes.