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M. Rajer



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    P3.03 - Poster Session with Presenters Present (ID 473)

    • Event: WCLC 2016
    • Type: Poster Presenters Present
    • Track: Mesothelioma/Thymic Malignancies/Esophageal Cancer/Other Thoracic Malignancies
    • Presentations: 1
    • Now Available
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      P3.03-030 - Cisplatin with Pemetrexed or Gemcitabine in Prolonged Infusion for Inoperable Mesothelioma: A Phase II Randomized Trial (Now Available) (ID 5853)

      M. Rajer

      • Abstract
      • Slides

      Background:
      In a single-arm Phase II trial on 78 patients with advanced mesothelioma, promising objective response rate (ORR, 50%) and overall survival (OS, median: 17.0 months) after treatment with cisplatin and low-dose gemcitabine in long infusion (C-GILI) were reported (Kovac et al, Anticancer Drugs 23:230-38, 2012). Here we present a randomized Phase II clinical trial, comparing cisplatin/pemetrexed (CP) and C-GILI.

      Methods:
      Eligible patients had histologically confirmed malignant mesothelioma, were chemonaive, had performance status (PS) 0-2, adequate organ function to receive cisplatin-based chemotherapy and signed informed consent. Patients were randomized between group A (pemetrexed 500 mg/m2 and cisplatin 75 mg/m2, both on day 1 every 3 weeks) and group B (gemcitabine 250 mg/m2 in 6-hours infusion, d1 and d 8, and cisplatin 75 mg/m2 on d 2, every 3 weeks). The primary endpoint was progression-free survival (PFS); secondary endpoints were ORR, toxicity, quality of life and OS. After progression, cross-over to the alternative regimen was recommended.

      Results:
      Ninety-six patients entered the trial. Median age was 63 years, 75% were male and 68% had documented exposure to asbestos. Patients were randomized between Group A (CP, 51 pts) and Group B (C-GILI, 45 pts). With ORR over 45%, both regimens were effective. The main Grade 3-4 toxicity was neutropenia: 13.7% for arm A and 33.3% for arm B. Details on demographics, histologic features and effects of treatment are presented in the Table. Median PFS and OS for all patients are 9.4 and 18.6 months, respectively.

      Conclusion:
      Both arms of primary treatment were effective and well tolerated. Overall survival is among the longest reported so far. This trial confirms the value of C-GILI for treatment of mesothelioma. This treatment may find its indication as second-line treatment, as well as in the first line for deprivileged patients for whom the costs of pemetrexed may be prohibitive.

      Group A CP, 51 pts Group B C-GILI, 45 pts
      DEMOGRAPHICS Male/Female 35/16 37/8
      Median age 63 64
      PS 0-1/PS 2 40/11 36/9
      epitheliod/biphasic/ sarcomatoid/unspec 42/2/4/3 32/8/4/2
      PRIMARY TREATMENT ORR, % 48.9 50.0
      PFS (months, median) 10.6 8.6
      % of pts with any grade ≥ 3 toxicity 51.1 55.6
      SECOND-LINE TREATMENT AND SURVIVAL % of pts crossing-over to alternative combination 77.8 61.1
      OS (months, median) 20.6 18.6


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    YI01b - Scientific Mentoring (ID 415)

    • Event: WCLC 2016
    • Type: Young Investigator Session
    • Track:
    • Presentations: 1
    • Now Available
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      YI01b.03 - Scientitific Mentoring: The Reality (Now Available) (ID 6741)

      M. Rajer

      • Abstract
      • Presentation
      • Slides

      Abstract:
      All oncologists are part of the mentor-mentee relationship at some point of their career. Mentoring can be considered one of the critical factors in achieving a successful career. The importance of a good mentor is best described by the sentence of Robert S.Kerbel: “I have been extremely fortunate if not blessed, with having series of outstanding mentors [1].” In spite of the importance of mentoring, what makes good mentors and mentoring is often not well defined [2]. According to Nature’s guide for mentors, one of the most important characteristics of a good mentor is his/her orientation towards mentee’s long-term career development as a main focus of mentoring. In this way, the mentor becomes a “mentor for life” and not only temporary supervisor [2]. According to mentees, a good mentor has some distinct personal characteristics like enthusiasm, passion, positivity, compassion and understanding. Beside these, some others like appreciating individual differences, being respectful and unselfish are also very important. To properly advise and guide mentees in their work, mentors should be able to see their individual characteristics and support their personal strengths. Showing respect means that the protégée is not only seen as an workforce, but also as a genuine collaborator. Regarding unselfishness: letting the mentee be the first author of a common article, even if the mentor provided the initial idea is a good example [2]. Personal characteristics aside, abilities to become a good mentor can be gained by following some useful rules. Mentors should be generally available and have an “open door” policy instead of restricted and limited dedicated time. Availability should also be shown by quickly answering e-mails and phones calls. They should be inspirational and show optimism on every-day issues but – even more importantly - when facing failure. Mentors should find a balance between doing and letting do, should support mentees in analytical thinking and adapt to their needs according to the progress of the protégée (e.g. different mentoring at the beginning and the end of the PhD course). They should celebrate successes with the mentee [2, 3]. Scientific mentors have the obligation to teach, encourage and support students in some specific activities in which skills are essential in the world of science. Examples are writing and oral presentations. Supporting writing with fast and accurate reviews, while resisting the temptation of rewriting instead of the student is one of the main goals. Extensive mentoring regarding oral presentations is also needed due to the fact, that not many students have a natural gift for presenting. Mentors should also try to provide as many opportunities for oral presentations as possible. Involving students in mentors’ networking should also be a continuous process [2]. How to choose a good mentor is a question that should be carefully addressed. In selecting mentors, trainees should follow some recommendations. They should look for possible mentors online, see which mentors possibly have the same interests, e-mail previous mentees inquiring about their experience with the mentor and afterwards meet the potential mentor in person at work. Trainees should carefully look for signs of poor mentorship, like no available time for one-to-one conversation, repressed and stressed co-workers that show no respect for their head, the potential mentor [2, 4]. Even if some trials report objective data, evaluating mentorships can be challenging since it is a complex interpersonal interaction. In a trial reported by Badawi the majority (74%) of mentors and mentees report the experience as rewarding, worth their time and effort, many (58%) achieve their goals in a timely manner and plan to continue (89%) their collaboration after the mentorship period is finished [5]. High satisfaction with the mentorship experience is commonly reported in other surveys. DeCastro conducted a trial on 1708 clinicians-researchers and only 10% of them were not satisfied with the experience, without differences between male and female mentees [6]. Some surveys, like the one reported by Dhami, show the importance of formal mentorship. Satisfaction with the mentorship experience was greater in mentees included in formal mentorship compared to those who had an informal one (72% vs. 36%, p<0.01) [7]. Formal mentoring influences also on research productivity. In the survey of Riechelman, responders with mentors were more involved (more available time dedicated) in academic research compared to those without mentors [8]. A model mentor is involved in the fruitful career development of the mentee and broadly shares the knowledge, skills and expertise that the mentee needs. As the mentee advances and gains independence, a good mentor is able to guide him/her toward new opportunities and facilitates the mentee’s growth [9]. 1. Kerbel, R.S., Some guidelines for building a successful career in cancer research. Cancer Biol Ther, 2003. 2(1): p. 111-4. 2. Lee, A., C. Dennis, and P. Campbell, Nature's guide for mentors. Nature, 2007. 447(7146): p. 791-7. 3. Powers, P.J., Engaged mentors offer inspiration and open doors. Am J Med, 2006. 119(1): p. 3. 4. Purcell, E.P., et al., Research to reality (R2R) mentorship program: building partnership, capacity, and evidence. Health Promot Pract, 2013. 14(3): p. 321-7. 5. Badawy, S.M., et al., Early career mentoring through the American Society of Pediatric Hematology/Oncology: Lessons learned from a pilot program. Pediatr Blood Cancer, 2016. 6. DeCastro, R., et al., Mentoring and the career satisfaction of male and female academic medical faculty. Acad Med, 2014. 89(2): p. 301-11. 7. Dhami, G., et al., Mentorship Programs in Radiation Oncology Residency Training Programs: A Critical Unmet Need. Int J Radiat Oncol Biol Phys, 2016. 94(1): p. 27-30. 8. Riechelmann, R.P., et al., The influence of mentorship on research productivity in oncology. Am J Clin Oncol, 2007. 30(5): p. 549-55. 9. Gitlin, S.D. and M.L. Lypson, For Residents and Fellows: What to Look for in a Laboratory Research Mentor. J Cancer Educ, 2015.

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