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OSMO Fall 2018 Oncology Conference

921 SW Sixth Avenue
Portland, OR 97204 United States

Hilton Portland Downtown

Saturday, November 3, 2018 (8:00 AM - 2:00 PM) (PDT)
Event Details

All Practicing Physicans/NPs/PAs and their supporting staff are welcome to attend at no cost.

*****If you are Industry employed please contact Liz Cleland osmoLIZ@Comcast.net as attendance invitations are given based on corporate membership levels please do not register on this site


Friday, November 2, 2018

6:00pm-7:30pm
Evening Networking Reception on the Top Floor of the Hilton with 360 degree views of Portland!

7:30pm-9:00pm
OSMO Practice Member Dinner-same location


Saturday, November 3, 2018

Delivering on the Promise of Personalized Medicine
Gordon Mills, MD, PhD
OHSU Knight Cancer Institute  
                    

One of the key lessons of the last century of cancer therapy is that combination therapy is, in most cases, necessary, particularly in advanced disease and complex epithelial tumors, to obtain tumor control. However, as we have matured in the era of precision oncology which includes small molecule targeted therapeutics and immuno-oncology agents, while response to targeted therapies are relatively frequent, durable responses are rare and in contrast response to immuno-oncology agents are less frequent but are commonly durable and can approximate cures.  It is thus clear that rational combination therapy approaches not only within a single modality but across different therapy approaches such as targeted and immunotherapy will be necessary to fulfill the promise of precision medicine. The short term of response to therapy for most patients is due to a major degree to the almost inevitable emergence of resistance. We have used PARP inhibitors as an effective emerging therapy to explore genomic and adaptive mechanisms of resistance. Importantly, the tumor as well as the tumor ecosystem adapts to the stress induced by targeted or immunotherapy agents. These adaptive responses, which can be observed in tissue culture, animal models, and patient samples, offer therapeutic opportunities which can be targeted to increase the fraction of patients who will benefit as well as the depth and duration of responses. Based on this paradigm, we have identified a series of unexpected mechanisms of resistance to PARP inhibitors and have developed rational combination therapies to interdict emerging resistance. Based on these preclinical studies, we have promoted a number of therapies to clinical trials and have demonstrated exciting preliminary responses

 

The Future of Cancer Care through Biologic Profiling and Big Data
Thomas Brown, MD, MBA
Executive Director of the Swedish Cancer Institute (SCI)

 In 2014, the Swedish Cancer Institute (SCI) embarked on an integrated program of Personalized Medicine, with the double meaning of the unique biologic characteristics of a patient’s tumor on the one hand, and on the other, the unique psycho-social and economic characteristics of the patient, their family, and their community.  Five components of this program were launched over an 18 month period:  1- an in-house highly actionable 68 item gene alteration panel performed with targeted sequencing using formalin fixed, paraffin embedded tissue ; 2- an IRB approved registry trial to document how this genomic information is used in the management of patients, now having accrued over 1,000 patients; 3- early adoption of a cloud-based IT platform to collect, organize and analyze the genomic information in the context of the clinical information within the electronic medical record, to include a clinical trials matching algorithm; 4- launching of a prospective molecular tumor board, now functioning for over two years, and serving as an important educational platform for providers; and 5- a state-of-the-art Innovative Therapeutics Unit (ITU) for conduct of early phase clinical trials of targeted therapies informed by genomic and broader biological profiling.  The resultant emerging data set is used for three primary purposes:  1-Prioritization of on and off-label therapies; 2-Prioritization of clinical trial options; and 3-Data mining research.  In addition, this integrated program can contribute to sharing de-identified data across health system boundaries, as exemplified by SCI’s participation in AACR Project GENIE.  At the SCI, the intention is to apply biologic profiling, (genomic sequencing; transcriptomics; proteomics; micro-biomics; and immune profiling) to assist in the management of patients across the cancer care continuum, to include: risk assessment; prevention; early detection; screening; treatment; and survivorship.  This approach underscores the shift of defining illness in a new manner, focused on risk of illness on an individual or population basis.  The challenges to this approach include: rapidly evolving technologies and rapidly evolving evidence-based applications of such; patient, provider and payer expectations with the need for associated education; cost of laboratory studies, as well as cost of associated therapeutic options; and ultimately, the value of precision or personalized medicine in the context of modern oncologic care.  

 

Gray Market Pricing of Chemotherapy Agents: Issues and Implications  
Naveen Gudigantala, Ph.D.
University of Portland

Despite many years of efforts, we are continuing to face drug shortages for many types of drugs, including chemotherapy agents. These drug shortages have created “gray markets”, where in the drugs in short supply are hoarded, bought and sold repeatedly in the industry supply chains, and eventually sold at exorbitant prices. A 2012 congressional report details an incident involving the shipment of 25 vials of fluorouracil, which was initially sold by a primary distributor to a pharmacy in Maryland for $7, which then was traded multiple times in the secondary market, and finally sold to an end customer, a hospital in CA for $600, representing an increase of 8,471% in price. Also, the gray marketers may not keep the drugs in safe condition affecting the “authenticity” of drugs sold. This talk covers why gray markets for cancer drugs emerge, persist, the current situation involving measures to control them, and how various stakeholders can work together to address this issue.

 

American Board of Medical Specialties Reform Efforts for Maintenance
of Certification and How to Make Voices of Community Physician Heard
John Moorhead, MD

Practicing clinicians value board certification and have agitated for a more relevant, less burdensome process for continuing board certification. The ABMS has responded with more flexibility in Standards and member boards have responded with an ongoing process which focuses on ‘assessment FOR learning’ programs. ABMS has instituted a new governance structure which encourages ongoing input from practicing clinicians to the evolution of board certification programs and policy. Dr. Moorhead will the review current status of these activities.


Persistent Pain and Opioids:  How a Modern Understanding of Pain Can Help Solve the Opioid Epidemic                                              
Ruben Halperin, MD, MPH
Providence Portland, OR

 “The United States is in the midst of two intersecting crises in health care:  the opioid and the persistent pain crises. Roughly ⅓ of all Americans live with persistent pain and 10 million are on chronic opioid therapy (COT).  Over the last 20 years, prescribing of opioids for chronic pain has increased 4-fold.  Sadly, increased use of opioids has neither improved lives or reduced pain for many patients but has led to an epidemic of opioid use disorder and opioid overdose deaths.

Last year the CDC published guidelines to improve the care of pain patients and the safety of opioid prescribing.   The report challenged the medical community to do a better job.   Oregon has been on the cutting edge of modern pain care for the last few years and is one of the few states where opioid abuse and opioid overdose deaths have decreased in the last 3 years.”


  • 8:00-8:30am  Registration and Breakfast with Exhibitors
  • 8:30-8:45am  Welcome & Introductions
    Kevin H Yee, MD, Treasurer, OSMO
  • 8:45-9:30am  Delivering on the Promise of Personalized Medicine
    Gordon Mills, MD, PhD, OHSU Knight Cancer Institute
  • 9:30-10:15amThe Future of Cancer Care through Biologic Profiling and Big Data
    Thomas Brown, MD, MBA
    Executive Director, Swedish Cancer Institute
    C0-Chair PSJH Personalized Medicine Program
    Co-Chair PSJH Cancer Leadership Council
  • 10:15-10:30am Panel Q&A
    Gordon Mills, MD, PhD and Thomas Brown, MD, MBA
  • 10:30-11:00 am Break in Exhibitor Hall
  • 11:00-11:30am Gray Market Pricing of Chemotherapy Agents: Issues and Implications
    Naveen Gudigantala, Ph.D., University of Portland
  • 11:30-12:00pm American Board of Medical Specialties Reform Efforts for Maintenance
    of Certification and How to Make Voices of Community Physician Heard

    John Moorhead, MD
  • 12:00-12:30 pm Persistent Pain and Opioids: How a modern understanding of pain can help solve the opioid epidemic
    Ruben Halperin, MD, MPH, Providence Portland, OR
  • 12:30-1:15 pm Lunch with Exhibitors – Meeting Adjourned


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Additional Information
Event Contact:
Liz Cleland
Contact Organization:
Oregon Society of Medical Oncology | OSMO
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