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issues in oncology
cost of care

Financial Toxicity Experienced by Adults With Cancer

In a study reported in the Journal of Oncology Practice, Knight et al found that 26% of patients with cancer acknowledged ‘financial toxicity’—treatment-related financial harm—with respect to cancer care, and that this toxicity was associated with consequences such as...

palliative care
issues in oncology
symptom management

2018 Palliative Care: Can an AI-Based App Help Manage Cancer-Related Pain?

A study of 112 patients with metastatic solid tumors found that the use of an artificial intelligence (AI)-based smartphone app reduced both the severity of patients’ reported pain and hospital admissions. After an 8-week period, patients who used the AI-powered app to monitor and address...

issues in oncology
symptom management

2018 Palliative Care: Immunotherapy-Related Adverse Events May Be More Common Than Initially Reported

An analysis of nearly 2,800 patients with non­–small cell lung cancer (NSCLC) who received the immune checkpoint inhibitors nivolumab (Opdivo), pembrolizumab (Keytruda), or atezolizumab (Tecentriq) found that adverse events may be more common than reported in the initial trials that led...

leukemia
issues in oncology
symptom management

Effect of Early Cardiotoxicity on Outcomes in Pediatric AML

In an analysis from the Children’s Oncology Group AAML0531 trial reported in the Journal of Clinical Oncology, Getz et al found that early treatment-related cardiotoxicity may be associated with poorer event-free and overall survival in pediatric acute myeloid leukemia (AML). Study Details...

issues in oncology
cost of care

Findings From the National Cancer Opinion Survey: Alternative Therapies, Cost of Care, and More

Nearly 4 in 10 Americans believe cancer can be cured solely through alternative therapies, according to ASCO's second annual National Cancer Opinion Survey. This is despite research showing that patients who use alternative therapies instead of standard cancer treatments have much higher...

breast cancer
issues in oncology

Prognostic Risk Model for African American Women With Breast Cancer

A prognostic model developed using a machine learning approach may be able to identify African American patients with breast cancer who have an increased risk of death, according to results of a study presented by Bhattarai et al at the 11th AACR Conference on The Science of Cancer Health...

solid tumors
issues in oncology

2018 ASTRO: Phase I Trial of SBRT for Oligometastatic Disease With Multiple Metastases

The phase I NRG Oncology clinical trial BR001 tested the hypothesis that stereotactic body radiotherapy (SBRT) could be used safely in patients with oligometastatic disease characterized by multiple metastases. Results from the trial indicate that using SBRT is safe as treatment for patients with 2 ...

solid tumors
issues in oncology

Fluoropyrimidine DPYD Genotype–Guided Dosing in Patients With Cancer

In a Dutch study reported in The Lancet Oncology, Henricks et al found that DPYD genotype–guided dosing reduced the frequency of severe fluoropyrimidine toxicity in patients with cancer. Increased fluoropyrimidine toxicity is associated with reduced activity of the metabolic...

issues in oncology

Michael Soike, MD, on Brain Metastases: Radiosurgery vs Radiotherapy

Michael Soike, MD, of Wake Forest University Medical Center, discusses results from a large multicenter study that suggests salvage stereotactic radiosurgery leads to improved overall survival compared with whole-brain radiotherapy for patients with progressive brain metastases (Presentation 296 in Scientific Symposium 40).

issues in oncology

Vinai Gondi, MD, on Treating Brain Metastases, Preserving Cognitive Function

Vinai Gondi, MD, of Northwestern Medicine, discusses the early results of a phase III NRG Oncology trial that suggests a practice change in treating brain metastases: avoiding the hippocampus when delivering whole-brain radiotherapy (Abstract LBA9).

prostate cancer
issues in oncology

2018 ASTRO: Radiation Therapy Outcomes in African American Patients With Prostate Cancer

A new analysis of genetic data from a large prospective registry and clinical data from several randomized trials indicates that African American patients may have comparatively higher cure rates when treated with radiation therapy than Caucasian patients. The study, which is the first report...

issues in oncology
immunotherapy
symptom management

Caroline Robert, MD, PhD, on Immunotherapy Toxicities: Expert Perspective

Caroline Robert, MD, PhD, of Gustave Roussy Cancer Centre, discusses managing toxicities of immunotherapy, including neurotoxicity, and treating beyond acute adverse events.

issues in oncology

Matti S. Aapro, MD, on Advanced Disease: Reducing Use of Futile Treatments

Matti S. Aapro, MD, of the Genolier Cancer Centre, discusses the challenges of avoiding futile treatments and the need to work with patients, integrate palliative care, and monitor toxicities.

issues in oncology
cost of care

ESMO 2018: Variations Between European Countries in Time to Reimbursement Decisions for New Cancer Treatments Approved by the EMA

Some European countries take more than twice as long as others to reach health technology assessment (HTA) decisions to reimburse new cancer treatments following their approval by the European Medicines Agency (EMA). The average decision time is longer than 1 year in some countries, according to a...

issues in oncology
gastroesophageal cancer
symptom management

ESMO 2018: Pooled Analysis of Influence of Sex on Chemotherapy Efficacy and Toxicity in Esophagogastric Cancer

In an analysis presented by Davidson et al at the European Society for Medical Oncology (ESMO) 2018 Congress (Abstract 619PD_PR), data were pooled from four UK randomized controlled clinical trials of first-line chemotherapy in esophagogastric cancer, finding significant differences in a...

palliative care
lung cancer
issues in oncology
cost of care

ICU Admissions During Terminal Hospitalizations in Patients With Stage IV Lung Cancer

In a study reported in the Journal of Oncology Practice, Mrad et al found an increase in the proportion of patients with stage IV lung cancer admitted to the intensive care unit (ICU) during terminal hospitalization between 1998 and 2014. A large increase in palliative care contacts also occurred,...

lung cancer
issues in oncology
pain management

Opioid Use Following Video-Assisted Thoracoscopic Surgery or Open Resection in Early-Stage Lung Cancer

In a study reported in a research letter in JAMA Oncology, Tuminello et al found that video-assisted thorascopic surgery (VATS) was less likely than open resection to be associated with long-term opioid use in patients undergoing surgery for early-stage lung cancer. Study Details The study...

breast cancer
issues in oncology

Adherence to Endocrine Therapy for Breast Cancer in Black Women and White Women

In a study reported in the Journal of the National Cancer Institute, Wheeler et al found that black women reported nonadherence to endocrine therapy for breast cancer more often than white women, although no significant difference in discontinuation of treatment was observed. The study...

breast cancer
issues in oncology

Report Examines Shortages of Oncologists, Variation in Cancer Rates

Doximity has released a new study detailing a concerning trend that could potentially impact cancer care in the United States. Doximity researchers examined retirement trends, percentage of state-trained specialists, and prevalence of breast cancer on a city-by-city basis. The report is the...

breast cancer
issues in oncology
survivorship

Cognitive Outcomes Among Older Survivors of Breast Cancer

In a study (Thinking and Living with Cancer) reported in the Journal of Clinical Oncology, Mandelblatt et al found that poorer cognitive function in older survivors of breast cancer was associated with chemotherapy, hormone therapy, and ApoE genotype. The ApoE ε4 allele has been associated...

breast cancer
issues in oncology

Cognitive Impairment in Patients With Breast Cancer Treated With Chemotherapy

In a study reported in the Journal of Clinical Oncology, Janelsins et al found cognitive impairment in women receiving chemotherapy for breast cancer that persisted for at least 6 months after treatment. Study Details The study, conducted within the National Cancer Institute Community Clinical...

prostate cancer
issues in oncology

PCF Releases First National Report on Public Perception of Prostate Cancer in the United States

The Prostate Cancer Foundation (PCF) recently released the results of its first national public awareness report about risks, actions, and attitudes toward prostate cancer in the PCF 3P Report 2018: Public Perception of Prostate Cancer. Each year, even though more than three million men in...

issues in oncology
symptom management

Small Study Shows Fecal Microbiota Transplantation May Help Restore Beneficial Bacteria in Patients With Cancer

Researchers have shown that autologous fecal microbiota transplantation may be a safe and effective way to help replenish beneficial gut bacteria in patients with cancer who require intense antibiotics during allogeneic hematopoietic stem cell transplantation. Their findings were published by Taur...

issues in oncology
cost of care

U.S. Spending on Antineoplastic Agents

In a study reported in the Journal of Oncology Practice, Hong et al found that the U.S. health-care system increased spending on antineoplastic agents from $26.8 billion in 2011 to $42.1 billion in 2016. The study was a retrospective, cross-sectional analysis of IQVIA (formerly QuintilesIMS)...

leukemia
issues in oncology

Lack of Clinical Trial Participation and Shorter Duration of Therapy Linked to Disease Relapse in AYAs With Leukemia

Despite survival gains for children diagnosed with acute lymphoblastic leukemia (ALL), adolescents and young adults (AYAs)—those between the ages of 15 and 39—diagnosed with the disease have seen only modest improvements in survival. A study by Wolfson et al in Cancer Epidemiology,...

colorectal cancer
issues in oncology

Sex-Linked Differences in Cancer May Identify Specific Genetic Drivers, Predict Responses to Treatment

Analysis of male- and female-derived tumor samples revealed differences in prognostic biomarkers, genes that drive cancer, and in regulation of key pathways that may predict responses to treatment, according to results published in two studies in Cancer Research, one by Li et al and the other...

issues in oncology
survivorship

Risk of Late Venous Thromboembolism in Survivors of Childhood Cancer

In a report from the Childhood Cancer Survivor Study published in the Journal of Clinical Oncology, Madenci et al found that survivors of childhood cancer are at increased risk of late venous thromboembolism, with several factors increasing such risk. The study involved data from a...

lymphoma
issues in oncology

Ovarian Function After Response-Adapted Treatment in Younger Women With Advanced Hodgkin Lymphoma

In a secondary analysis of the UK phase III RATHL trial reported in The Lancet Oncology, Anderson et al found that ovarian function recovery was affected by age and type of response-adapted therapy in women receiving treatment for advanced Hodgkin lymphoma. The analysis included 67 eligible...

issues in oncology

Monika K. Krzyzanowska, MD, MPH, on Quality Improvement: Avoiding the Pitfalls

Monika K. Krzyzanowska, MD, MPH, of Princess Margaret Cancer Centre, summarized the Keynote Lecture, including the points that clinicians should carefully plan their quality improvement projects, understand the barriers to quality, and ensure their efforts are sustainable.

issues in oncology
solid tumors

Lalan S. Wilfong, MD, on Metastatic Solid Tumors: Limiting Low-Value Care

Lalan S. Wilfong, MD, of Texas Oncology, discusses reducing the use of a white blood cell growth factor treatment in advanced and incurable solid tumors for patients treated at a community oncology practice.

issues in oncology
symptom management
pain management

Angela M. Stover, PhD, on Patient-Reported Symptoms: Results From the STAR and PRO-TECT Trials

Angela M. Stover, PhD, of the University of North Carolina at Chapel Hill, discusses study findings on ways to alert clinicians when patients signal symptoms such as pain or diarrhea that may be cause for concern (Abstract 158).

issues in oncology

Simron Singh, MD, MPH, on Patient-Centered Care: Measuring Experience

Simron Singh, MD, MPH, of Sunnybrook Health Sciences Centre, discusses initial results of his data on a new patient experience measurement strategy used at Cancer Care Ontario.

issues in oncology
pain management

Jay B. Shah, MD, on Reducing Opioid Use After Urologic Oncology Surgery

Jay B. Shah, MD, of Stanford University, discusses the role that surgeons can play as gatekeepers to the opioid epidemic, including the view that complex cancer operations can be performed with little to no opioid use (Abstract 269).

issues in oncology
cost of care

Aaron Lyss, MBA, on Getting the Highest-Value Quality Intervention

Aaron Lyss, MBA, of Tennessee Oncology, discusses ways that clinicians and patients can employ the most cost- and treatment-effective measures, clinical trials, and incident learning systems.

issues in oncology
pain management
legislation

Fumiko Ladd Chino, MD, on Opioid-Associated Deaths in Patients With Cancer

Fumiko Ladd Chino, MD, of Duke University, discusses results from a population study she conducted of the opioid epidemic over the past 10 years and why these medications for cancer pain should continue to be excluded from restrictive-prescribing laws (Abstract 230).

issues in oncology
cost of care

Douglas W. Blayney, MD, on Quality Care: Better, Safer, Cheaper

Douglas W. Blayney, MD, of Stanford University, and winner of the Joseph V. Simone Award for Excellence, summarizes his talk on the expense of cancer care and how we can reduce costs while maintaining safety and high value for people with cancer.

issues in oncology

Neeraj K. Arora, PhD, on Patient-Centered Care in Clinical Practice

Neeraj K. Arora, PhD, of the Patient Centered Outcomes Research Institute (PCORI), discusses his work at PCORI and the central role that patients play in improving care and outcomes. To learn more, visit https://www.pcori.org/.

leukemia
issues in oncology
cost of care

Cost-Effectiveness Models for Tisagenlecleucel in Relapsed or Refractory Pediatric B-Cell ALL

As reported by Lin et al in the Journal of Clinical Oncology, cost-effectiveness modeling of treatment with the anti-CD19 chimeric antigen receptor T-cell therapy tisagenlecleucel (Kymriah) in relapsed or refractory pediatric B-cell acute lymphoblastic leukemia (ALL) showed that price reduction...

lung cancer
issues in oncology

Health Resource Utilization and CNS Metastases in EGFR-Mutant Advanced NSCLC

In a single-center study reported in the Journal of Oncology Practice, Chooback et al found that central nervous system (CNS)  metastases are frequent in patients with EGFR-mutant advanced non­–small cell lung cancer (NSCLC) and are associated with increased health resource...

issues in oncology
pain management

2018 Quality Care: New Approach Successfully Reduces Opioid Use After Urologic Oncology Surgery

In a study conducted by Stanford Health Care, researchers achieved a 46% reduction in opioid use among 443 patients with cancer who underwent a range of urologic surgeries without increasing their pain or anxiety. They achieved this reduction through a two-pillared approach: (1) maximizing the use...

breast cancer
issues in oncology
cost of care

2018 Quality Care: Nationwide Survey Reveals Patients With Metastatic Breast Cancer Face Major Financial Stress Due to Treatment Costs

A new nationwide analysis of more than 1,000 people living with metastatic breast cancer from 41 states reveals significant cancer-related financial burden known as financial toxicity, particularly for uninsured patients. The study will be presented by Wheeler et al at the upcoming 2018 ASCO...

issues in oncology
pain management

2018 Quality Care: Opioid Deaths Are 10 Times Less Likely to Occur in Patients With Cancer Compared to the General Population

According to the U.S. Department of Health and Human Services, in 2016, over 42,000 Americans died from opioid overdose, making the epidemic a top public health concern. Although opioids are commonly used for cancer-associated pain, the risks for overdose in patients with cancer were unknown. A...

issues in oncology
cost of care

2018 Quality Care: Older Patients With Advanced Cancer Experiencing Financial Difficulties Have Worse Quality of Life and Mental Health

Older patients with advanced cancer experiencing financial toxicity due to the cost of their treatment have higher rates of severe anxiety and depression and poorer quality of life than patients who do not experience financial hardship. In addition, for those patients having financial difficulty,...

prostate cancer
issues in oncology
cost of care

Estimated Medicare Cost for Prostate Cancer Care in Older Men

Although national guidelines recommend against prostate cancer screening in men age 70 and older, researchers from the University of North Carolina (UNC) Lineberger Comprehensive Cancer Center estimate that screening for and treating prostate cancer in men in this age group costs Medicare more than ...

prostate cancer
issues in oncology

Researchers Identify Pitfall in PSMA PET Imaging Method

Prostate-specific membrane antigen (PSMA) positron-emission tomography (PET) imaging has become a popular method for determining the stage of a patient’s prostate cancer. However, researchers have identified a pitfall in this imaging technique and are cautioning medical professionals to be...

issues in oncology
immunotherapy

Uncommon Lethal Complications of Immune Checkpoint Inhibitors

In a systematic review and meta-analysis reported in JAMA Oncology, Wang et al identified frequency and types of fatal toxic effects in patients receiving immune checkpoint inhibitor therapy. Study Details The study involved analysis of fatal immune checkpoint inhibitor–associated toxic...

lung cancer
issues in oncology

Survey Shows Increased Public Awareness of Lung Cancer Over Past Decade

Survey results released by the Lung Cancer Alliance (LCA) show that general awareness about lung cancer has improved significantly over the past decade, with 94% of the public reporting familiarity with lung cancer. Despite this change in overall perspective, findings also indicate that lung cancer ...

health-care policy
issues in oncology

AACR Releases Annual Cancer Progress Report

The American Association for Cancer Research (AACR) has released its annual Cancer Progress Report highlighting how federally funded research discoveries are fueling the development of new and even more effective ways to prevent, detect, diagnose, and treat cancer. Key advances outlined...

lung cancer
issues in oncology
survivorship

Small Study Shows Chemotherapy May Lead to Early Menopause in Young Women With Lung Cancer

A new study suggests chemotherapy may cause acute amenorrhea, leading to early menopause in women with lung cancer. The study is the first to comment on amenorrhea rates in women younger than 50, concluding that women with lung cancer who desire future fertility should be educated about risks and...

cns cancers
issues in oncology

Factors in Endocrine Deficiency in Pediatric and Young Adult Patients Receiving Radiotherapy for Brain Tumors

In a study reported in the Journal of Clinical Oncology, Vatner et al identified factors associated with an increased risk of endocrine deficiency in pediatric and young adult patients receiving radiation therapy for brain tumors, including hypothalamus and pituitary radiation dose. Study Details ...

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