John L. Marshall, MD


May 22, 2015

Editorial Collaboration

Medscape &

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John Marshall for Medscape, on my vacation right before ASCO. I don't know whose idea it was to have vacation right before ASCO, but here we are anyway. Hello, everybody. Hope you're getting ready for ASCO.

I have just a few comments to get everybody ready for what's coming up. The meeting is going to be about learning and refining what we know. We're going to learn more about molecular profiling, how to do it, what it means, and how to actually measure it, because I don't think we've really done a good job of understanding this "garbage in, garbage out" phenomenon around molecular profiling.

Of course, we're all going to be learning more about how to use our immune system to treat cancer. What an exciting time this is, and we're going to see more and more results as we learn about our immune system and how to control it in fighting cancer.

We're going to be refining our local therapies. We've learned about how to treat liver-directed therapy with radiofrequency ablation using intrahepatic radiation spheres.[1,2] That's exciting. We're refining our rectal cancer therapies. We're learning how to target old targets, such as HER2, in new diseases. Look out for a colon abstract that shows some benefit in that setting.[3]

The overriding theme of this meeting—I've got to give ASCO a shout-out—is value. How do we really understand what it is we're expending? What is the return on what we're spending? We're on the bubble and the bubble's about to pop. We're under the gun on this one, and we'd better do a good job or else our system may crumble a bit. So make sure you attend some of these sessions on value, because I think they will set the new theme and new tone for us going forward in cancer medicine today.

Back to my vacation. I've got to hit the beach. You might even hear it in the background.

John Marshall for Medscape.


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