H. Ali

Molecular Characterization of Head and Neck Cancer

Molecular targeted therapy in head and neck squamous cell carcinoma (HNSCC) continues to make strides, and holds much promise. Cetuximab remains the sole US FDA-approved molecular targeted therapy available for HNSCC, though several new biologic agents targeting the epidermal growth factor receptor (EGFR) and other pathways are currently in the regulatory approval pipeline. While targeted therapies have the potential to be personalized, their current use in HNSCC is not personalized. This is illustrated for EGFR-targeted drugs, where EGFR as a molecular target has yet to be individualized for HNSCC. Future research needs to identify factors that correlate with response (or lack of one) and the underlying genotype-phenotype relationship that dictates this response. Comprehensive exploration of genetic and epigenetic landscapes in HNSCC is opening new frontiers to further enlighten and mechanistically inform newer as well as existing molecular targets, and to set a course for eventually translating these discoveries into therapies for patients. This opinion offers a snapshot of the evolution of molecular subtyping in HNSCC and its current clinical applicability, as well as new emergent paradigms with implications for controlling this disease in the future.

Molecular characterization of head and neck cancer: How close to personalized targeted therapy?

Molecular targeted therapy in head and neck squamous cell carcinoma (HNSCC) continues to make strides, and holds much promise. Cetuximab remains the sole US FDA-approved molecular targeted therapy available for HNSCC, though several new biologic agents targeting the epidermal growth factor receptor (EGFR) and other pathways are currently in the regulatory approval pipeline. While targeted therapies have the potential to be personalized, their current use in HNSCC is not personalized. This is illustrated for EGFR-targeted drugs, where EGFR as a molecular target has yet to be individualized for HNSCC. Future research needs to identify factors that correlate with response (or lack of one) and the underlying genotype-phenotype relationship that dictates this response. Comprehensive exploration of genetic and epigenetic landscapes in HNSCC is opening new frontiers to further enlighten and mechanistically inform newer as well as existing molecular targets, and to set a course for eventually translating these discoveries into therapies for patients. This opinion offers a snapshot of the evolution of molecular subtyping in HNSCC and its current clinical applicability, as well as new emergent paradigms with implications for controlling this disease in the future.

nab-Paclitaxel–Based Therapy in Underserved Patient Populations: The ABOUND.PS2 Study in Patients With NSCLC and a Performance Status of 2

Introduction The phase II ABOUND.PS2 study (NCT02289456) assessed safety/tolerability of a first-line modified nab-paclitaxel/carboplatin regimen for patients with advanced non-small cell lung cancer (NSCLC) and Eastern Cooperative Oncology Group (ECOG) performance status (PS) 2. Methods Chemotherapy-naive patients with stage IIIB/IV NSCLC and ECOG PS 2 received four cycles of nab-paclitaxel 100 mg/m2 days 1 and 8 plus carboplatin area under the curve 5 day 1 q3w (induction). Patients without progression received nab-paclitaxel monotherapy (100 mg/m2 days 1 and 8 q3w) until progression/unacceptable toxicity. Primary endpoint: percentage of patients discontinuing induction due to treatment-emergent adverse events (TEAEs). Results 11/40 treated patients (27.5%; 95% CI, 14.60–43.89) discontinued chemotherapy induction due to TEAEs; 16/40 (40.0%) continued nab-paclitaxel monotherapy. Median progression-free and overall survival were 4.4 (95% CI, 2.99–7.00) and 7.7 (95% CI, 4.93–13.17) months. Grade 3/4 TEAEs during induction included neutropenia (22.5%), anemia (17.5%), thrombocytopenia (5.0%), and peripheral neuropathy (2.5%). Conclusion This nab-paclitaxel–based regimen was tolerable in patients with advanced NSCLC and ECOG PS 2, with efficacy comparable to historical chemotherapy data.

PS01.08: ABOUND.PS2 Interim Safety Results: nab-Paclitaxel/Carboplatin Followed by nab-Paclitaxel in NSCLC Patients with ECOG PS of 2: Topic: Medical Oncology

Asia (3.1 per 100,000), Northern Africa (2.8 per 100,000), and sub-Saharan Africa (2.2 per 100,000). The lowest estimated mortality rates were for Middle Africa (0.7 per 100,000). Conclusion: With current smoking patterns lung cancer will remain a major cause of death worldwide for several decades. Effective tobacco control policies must be implemented or enforced in order to further reduce smoking prevalence. Lung cancer mortality is likely to greatly increase in sub-Saharan Africa if appropriate tobacco control programs are not implemented. Although smoking is a highly preventable risk factor for lung cancer, exposure to other risk factors.

Poster SessionsPS01.08: ABOUND.PS2 Interim Safety Results: nab-Paclitaxel/Carboplatin Followed by nab-Paclitaxel in NSCLC Patients with ECOG PS of 2: Topic: Medical Oncology

Asia (3.1 per 100,000), Northern Africa (2.8 per 100,000), and sub-Saharan Africa (2.2 per 100,000). The lowest estimated mortality rates were for Middle Africa (0.7 per 100,000). Conclusion: With current smoking patterns lung cancer will remain a major cause of death worldwide for several decades. Effective tobacco control policies must be implemented or enforced in order to further reduce smoking prevalence. Lung cancer mortality is likely to greatly increase in sub-Saharan Africa if appropriate tobacco control programs are not implemented. Although smoking is a highly preventable risk factor for lung cancer, exposure to other risk factors.

PS01.08: ABOUND.PS2 Interim Safety Results: nab -Paclitaxel/Carboplatin Followed by nab -Paclitaxel in NSCLC Patients with ECOG PS of 2

Asia (3.1 per 100,000), Northern Africa (2.8 per 100,000), and sub-Saharan Africa (2.2 per 100,000). The lowest estimated mortality rates were for Middle Africa (0.7 per 100,000). Conclusion: With current smoking patterns lung cancer will remain a major cause of death worldwide for several decades. Effective tobacco control policies must be implemented or enforced in order to further reduce smoking prevalence. Lung cancer mortality is likely to greatly increase in sub-Saharan Africa if appropriate tobacco control programs are not implemented. Although smoking is a highly preventable risk factor for lung cancer, exposure to other risk factors.

A Pain in the Neck

A 68-YEAR-OLD FEMALE SMOKER RECENTLY DIAGNOSED WITH SMALL CELL LUNG cancer presents with a bulging area on her neck, behind her right ear (FIGURE 1). The patient denies headache or vomiting. Physical examination is remarkable for ataxia with chorea, particularly of her right upper extremity, which has remained relatively unchanged for the last few years. The patient has a history of hemangioblastoma resected 12 years earlier, which recurred after 3 years, at which time she had a second resection and radiation therapy, with poor follow-up since then. What Would You Do Next?

Sister Mary Joseph's nodule

A 44-year-old female presented with 1-year history of progressive abdominal distension (figure 1A) which she thought might be related to pregnancy and a tumour protruding through her umbilical area that was oozing serosanguinous fluid. The patient did not seek medical attention initially due to …