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Pancreatic Metastases From Renal Cell Carcinoma Treated With Stereotactic Body Radiation TherapyIn this edition of our ongoing series, the authors present two cases involving renal cell carcinoma patients treated with SBRT for pancreatic metastases.
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Chemotherapy for Non–Small-Cell Lung Cancer, Part INon–small-cell lung cancer (NSCLC) accounts for approximately80% of all lung tumors. Patients diagnosed with early-stage diseasegenerally undergo surgery, but up to 50% develop local or distantrecurrences. The benefit of chemotherapy in this disease is modest, butnew drugs and combined strategies offer hope of improved survivalrates. Because the disease recurs outside the chest in 70% of cases, oneof the foremost goals of therapy is to prevent distant dissemination. Tothis end, chemotherapy may be administered preoperatively or afterresection of the tumor. The first part of this article, which concludesnext month, will address adjuvant and neoadjuvant chemotherapy inearly-stage non–small-cell lung cancer.
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Risk Models for Neutropenia in Patients With Breast CancerBreast cancer is the most common noncutaneous malignancy inwomen in industrialized countries. Chemotherapy prolongs survival inpatients with early-stage breast cancer, and maintaining the chemotherapydose intensity is crucial for increasing overall survival. Manypatients are, however, treated with less than the standard dose intensitybecause of neutropenia and its complications. Prophylactic colonystimulatingfactor (CSF) reduces the incidence and duration of neutropenia,facilitating the delivery of the planned chemotherapy doses.Targeting CSF to only at-risk patients is cost-effective, and predictivemodels are being investigated and developed to make it possible forclinicians to identify patients who are at highest risk for neutropeniccomplications. Both conditional risk factors (eg, the depth of the firstcycleabsolute neutrophil count nadir) and unconditional risk factors(eg, patient age, treatment regimen, and pretreatment blood cell counts)are predictors of neutropenic complications in early-stage breast cancer.Colony-stimulating factor targeted toward high-risk patients startingin the first cycle of chemotherapy may make it possible for fulldoses of chemotherapy to be administered, thereby maximizing patientbenefit. Recent studies of dose-dense chemotherapy regimens with CSFsupport in early-stage breast cancer have shown improvements in disease-free and overall survival, with less hematologic toxicity than withconventional therapy. These findings could lead to changes in how earlystagebreast cancer is managed.
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Risk Models for Neutropenia in Patients With Breast CancerBreast cancer is the most common noncutaneous malignancy inwomen in industrialized countries. Chemotherapy prolongs survival inpatients with early-stage breast cancer, and maintaining the chemotherapydose intensity is crucial for increasing overall survival. Manypatients are, however, treated with less than the standard dose intensitybecause of neutropenia and its complications. Prophylactic colonystimulatingfactor (CSF) reduces the incidence and duration of neutropenia,facilitating the delivery of the planned chemotherapy doses.Targeting CSF to only at-risk patients is cost-effective, and predictivemodels are being investigated and developed to make it possible forclinicians to identify patients who are at highest risk for neutropeniccomplications. Both conditional risk factors (eg, the depth of the firstcycleabsolute neutrophil count nadir) and unconditional risk factors(eg, patient age, treatment regimen, and pretreatment blood cell counts)are predictors of neutropenic complications in early-stage breast cancer.Colony-stimulating factor targeted toward high-risk patients startingin the first cycle of chemotherapy may make it possible for fulldoses of chemotherapy to be administered, thereby maximizing patientbenefit. Recent studies of dose-dense chemotherapy regimens with CSFsupport in early-stage breast cancer have shown improvements in disease-free and overall survival, with less hematologic toxicity than withconventional therapy. These findings could lead to changes in how earlystagebreast cancer is managed.
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Targeted Therapy for Mutation-Driven Metastatic Non–Small-Cell Lung Cancer: Considerations for ALK-Rearranged TumorsIn this article, important concepts in the molecular testing of non–small-cell lung cancer are highlighted.
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Extending Survival in Extensive-Stage Small-Cell Lung CancerIn this phase III trial, investigators assessed the clinical efficacy and safety of durvalumab with or without tremelimumab with etoposide and carboplatin or cisplatin chemotherapy followed by durvalumab with or without tremelimumab maintenance therapy compared with EP alone as first-line treatment in extensive-stage small-cell lung cancer.
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Dr. Lin on CAR T-Cell Therapy–Related Toxicities in Multiple MyelomaYi Lin, MD, PhD, discusses CAR T-cell therapy–related toxicities in multiple myeloma.
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Gary Owens, MS, on the Potential of ARCUS–Mediated Gene Editing in Duchenne Muscular DystrophyThe associate director for gene therapy discovery at Precision Biosciences discussed preclinical research he presented at ASGCT’s 2023 conference.
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Shalini Shenoy, MD, MBBS, on Comparing Treatment Options for Sickle Cell DiseaseThe director of the Stem Cell Transplant & Cellular Therapy Program at St. Louis Children’s Hospital discussed when the choice should be made to transition from symptom management to curative therapies.
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Jennifer Morganroth, MD, MBA, on the Importance of Preparing Clinical Resources for Genetic MedicinesThe neurology resident at Penn Medicine spoke about the preparations taken in the lead up to tofersen’s PDUFA date, which is set for April 25, 2023.
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Amar Kelkar, MD, on Assessing Price and Value for Cell and Gene TherapiesThe stem cell transplantation physician at the Dana-Farber Cancer Institute discussed how to look at the value therapies provide and how to improve the cost-effectiveness of their use.
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The Need for New Therapies in DLBC Lymphoma: Gilles Salles, MDThe lymphoma service chief at Memorial Sloan Kettering Cancer Center discussed the need for new therapies to treat diffuse large B-cell lymphoma.
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Improving Patient Access to Cell Therapy Through Decentralized ManufacturingDecentralized manufacturing could transform cell therapy delivery by reducing delays, costs, and logistical hurdles to improve patient outcomes.
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Gene Therapy Will Be a Major Area of Interest for Attendees at MDA’s 2025 ConferencePaul Melmeyer, MPP, the executive vice president of public policy & advocacy at MDA, discussed the growing interest in gene therapy for the annual meeting.
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Magdalena Cichewicz, PhD, on Improving AAV Gene Therapy With Synthetic PromotersThe scientist II at Senti Biosciences discussed the potential of synthetic promoters to improve target specificity in AAV vector-based gene therapies in retinal diseases and beyond.
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Clive Svendsen, PhD, on Unlocking the Potential of Astrocyte Cell TherapyThe director of the Regenerative Medicine Institute at Cedars Sinai discussed research being conducted with CNS10-NPC-GDNF in multiple indications.
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Emilie Aschenbrenner, PharmD, BCOP, on CAR-T Versus Bispecific Antibodies for the Treatment of LBCLThe hematology coordinator for pharmacy at Froedtert and the Medical College of Wisconsin discussed the advantages of each of the 2 modalities in the third and second line settings.
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Delivering Ultracompact CRISPR Systems With AAVLucas Harrington, PhD, the cofounder and chief scientific officer of Mammoth Biosciences, discussed the company’s mouse model research on treating hypertriglyceridemia.
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David Weinstein, MD, on Delivering Gene Therapy Directly to the BrainThe senior vice president of clinical development at Passage Bio discussed intracisternal magna administration of PBGM01.
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Frank Borriello, MD, PhD, on Next Steps for SUPLEXA-101 for Solid TumorsThe scientific cofounder and chief executive officer of Alloplex Biotherapeutics discussed progress of the phase 1 trial and possible future evaluations of the therapy.
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Marty Giedlin, PhD, on Advantages of Allogeneic NK Cell Therapy ApproachesThe senior vice president of Technical Operations at Senti Biosciences discussed the company’s NK cell logic-gating platform and allogeneic approach.
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Noninflammatory Neurotoxicity Events in Patients Receiving CAR-TCaroline Diorio, MD, FRCPC, FAAP, an attending physician at the Cancer Center at Children's Hospital of Philadelphia, discussed a study she coauthored that was recently published in Blood.
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Unraveling the Genetics of GlaucomaDetails enhance knowledge of biological pathways that contribute to disease pathogenesis.
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Unraveling the Genetics of GlaucomaDetails enhance knowledge of biological pathways that contribute to disease pathogenesis.
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Dr. Hwu on the Uptake of Cellular Therapy in OncologyPatrick Hwu, MD, discusses the uptake of cellular therapy in the treatment of patients with cancer.
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Binod Dhakal, MD, on Benefit of Cilta-Cel in Earlier Lines of Multiple Myeloma TreatmentThe associate professor at Medical College of Wisconsin discussed current studies evaluating cilta-cel and ongoing research.
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Stem Cell Therapy for TBI: Masahito Kawabori, MD, PhDThe associate professor at Hokkaido University and investigator of STEMTRA also discussed other efforts in stroke, Alzheimer disease, and Parkinson disease.
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Gene Transfer Therapy Requires Further Investigation Despite Potential Approval, Review SaysAfter a more than 35-year pursuit, the licensing of a gene therapy product for treating hemophilia may be available within 2 years.
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Dr. Hutson on Challenges With Targeted Therapy in Non-Clear Cell RCCThomas Hutson, DO, PharmD, discusses challenges with targeted therapy in non-clear cell renal cell carcinoma.
