Fourteen years ago, I was recruited to the University of Miami to develop a program in cancer disparities.
Ibrutinib is a selective and irreversible inhibitor of Bruton's tyrosine kinase (BTK) that entered phase 1 clinical trials in 2009 based on preclinical efficacy in models of B-cell malignancy and autoimmune disease.[1, 2] The initial phase 1 trial showed clear efficacy in a number of lymphoid malignancies at doses as low as 1.25 mg/kg/d. Furthermore, full receptor occupancy was demonstrated at 2.5 mg/kg/d. Despite these pharmacological and early clinical findings, development of ibrutinib continued at doses of 420 mg qd and 560 mg qd, levels 3-4 fold higher than suggested by the pharmacological data. In addition, the absorption of ibrutinib is enhanced by administration of food, which may explain why even the lowest dose showed efficacy in some patients.
Despite much progress in lung cancer over the last decade, lung cancer is the most frequent cause of cancer death.
Cancer immunotherapy, and in particular immune checkpoint blockade, has transformed oncology with the potential for durable responses even in patients with metastatic disease. To date, regulatory approvals and clinical trials have focused on the study of these agents in relatively more common tumor types, such as melanoma, non-small cell lung cancer, bladder cancer, and kidney cancer, amongst others.
FDA has approved a supplemental Biologics License Application updating the Opdivo (nivolumab) dosing schedule to include 480 mg infused every four weeks for a majority of approved indications.
Could diet and exercise really cure breast cancer?
Diversity is to be celebrated in our society as enriching our experiences, our cultures and the richness of our lives. Diversity within the context of cancer care and research has appropriately grown to include considerations of diversity of race, ethnic heritage, age, gender, and experiences.
Imagine a hospital ward 100 years from now. Will multi-drug resistant infections be as prominent as they are today? I suspect so, because as antibiotics evolve, so will the infectious diseases they target. It's an arms race in which both sides have a capacity to learn and adapt. Not so cancer. Cancers can't learn from each other. But cancer patients can. This profound imbalance in the capacity for learning is an advantage that all cancer patients share. It is our super power. And we barely use it.
Despite the many advances in oncology, important problems continue to beset the field, including rapidly rising costs, uneven patterns of care, and poor access to (and participation in) cancer trials. A model that has been recently developed and tested to address these issues is the so-called academic hybrid community cancer center.
