Cancer Fighters Thrive

SUMMER 2015

Cancer Fighters Thrive is a quarterly print and online magazine bringing readers practical, innovative and inspirational information about cancer treatment and survivorship.

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SUMMER 20 15 | C A NCER FIGH T ER S THRI V E 21 C A NCERFIGHTER S THRI V E .COM New Immunotherapy Drug Approved for Lung Cancer The U.S. Food and Drug Administration (FDA) has approved Opdivo ® , an immunotherapy drug, to treat patients with non–small cell lung cancer after they have received a platinum-based chemotherapy. Marketed by Bristol-Myers Squibb, Opdivo has been available to treat inoperable, advanced melanoma skin cancer that has not responded to other drugs. For lung cancer Opdivo blocks a protein called PD-1 on certain immune cells. This protein helps cancer cells avoid being found and destroyed by the body's immune system. Blocking the PD-1 protein can help the immune system recognize cancer cells and attack them. "This new type of treatment is signifcant news for lung cancer patients because it is different from any type of drug available at this time," says Daniel Nader, DO, Pulmonologist and National Clinical Director of Pulmonary/ Critical Care at Cancer Treatment Centers of America ® (CTCA) in Tulsa, Oklahoma. "The PD-1 drugs like Opdivo are going to be the next big tool in the toolbox to manage lung cancer," Dr. Nader adds. "Phase III trials are under way with FDA approval pending for other drugs in this class, which will allow a new class of agent that uses the immune system to stop cancer growth. So far there are studies that reveal it has improved survival over standard chemotherapy. Stay on the lookout when your medical oncologist makes a suggestion of use of one of these agents." Source FDA Approves Opdivo (Nivolumab) for Lung Cancer. American Cancer Society. Retrieved March 20, 2015, from http://www.cancer.org/cancer/news/news/fda- approves-opdivo-nivolumab-for-lung-cancer Shorter Course of Radiation Therapy for Early-Stage Breast Cancer as Efective, and Less Expensive Since 2011 guidelines have recommended that some patients diagnosed with early-stage breast cancer may undergo hypofractionated (short) whole- breast irradiation (WBI) after breast- conserving surgery, rather than the conventional (long) treatment. Hypofractionated radiation delivers higher doses of treatment over a shorter period. Whereas conventional WBI is delivered over fve to seven weeks, hypofractionated WBI is a two-and-a-half- to four-week schedule of treatment. A study published in the Journal of the American Medical Association in December 2014 aimed to evaluate whether patients were opting for this abbreviated course of treatment since these guidelines had been issued and if hypofractionated WBI resulted in cost savings for patients. Results of the study indicate that more women are choosing the shorter, more intense course of treatment (34.5 percent in 2013 versus 11 percent in 2008); and women who choose hypofractionated WBI do save money, spending about 10 percent less in the frst year after treatment. Pablo Lavagnini, MD, Director of Radiation Oncology at CTCA in Philadelphia, Pennsylvania, says that the study shows the benefts this abbreviated schedule offers patients: " Hypofractionated WBI is a much more convenient and economical schedule," he says. Dr. Lavagnini also notes that the guidelines and increase in patient uptake of this shorter schedule of radiation refect the positive results of this treatment model in Canada and Europe, where both hypofractionated WBI and intraoperative radiation therapy (IORT) were adopted by physicians ahead of widespread use in the United States. "At CTCA we have adopted the protocol pioneered by Umberto Veronesi, MD, Director of the European Institute of Oncology, which consists of one treatment of IORT during surgery followed by 13 radiation treatments over two and a half weeks," Dr. Lavagnini says. Ultimately, he says, patients should know that this abbreviated schedule offers an equivalent dose of radiation "delivered in a more effcient and convenient way." Source Bekelman, J. E., Sylwestrzak, G., Barron, J., et al. (2014). Uptake and costs of hypofractionated vs conventional whole breast irradiation after breast conserving surgery in the United States, 2008–2013. Journal of the American Medical Association, 312, 2542-2550. doi: 10.1001/jama.2014.16616 Research Today CANCER JOURNEY

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