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In my practice, I am constantly being asked how to properly treat scalp involvement in relation to these skin toxicities.

I currently have a 77-year-old non-Hodgkin lymphoma patient that recently started bendamustine/rituximab combination therapy. After increasing the intravenous rituximab rate per protocol, she developed chills.

I currently have a 68-year-old patient with EGFR-mutated adenocarcinoma of the lung, who presented with metastatic disease to the brain, liver, and bone in late 2014.

If you’ve been in oncology long enough, you’ve likely seen the patient who presents with metastatic disease, gets first-line therapy, progresses, switches to second-line therapy, progresses again, and so on, with their cancer becoming increasingly more resistant to therapy.

In 1992, I moved to the Washington DC area and attended a conference on new and projected trends in cancer care at the National Institutes of Health.

Sarcomas are a heterogeneous and motley collection of cancers, which struggle with an identity crisis on many levels. The trials often lump vastly different subgroups, and are often unable to collect sufficient numbers of any one disease subtype to complete a unique cohort.

Not surprisingly, this was a very popular topic. I’m not sure why the ASCO planners didn’t anticipate this, because I had to wait a few minutes outside the door to even get in. At one point, it was standing room only!


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