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cost of care
issues in oncology
health-care policy

Affordable Care Act Increased Access to Cancer Care and Clinical Trial Participation Among Hispanics in California

Implementation of the Affordable Care Act may have led to a significant increase in the number of Hispanic breast cancer patients treated in California at a National Cancer Institute (NCI)-designated cancer center. Further, there was also an increase reported in the number of Hispanic women who...

Lombardi’s Ruesch Center Policy Briefing Features Strategies to Reduce Costs

Two major developments in oncology—the dramatic success of some immunotherapies and targeted drugs and an equally dramatic rise in the cost of care—have created policy issues, more serious than ever, regarding access to care. It is a time “of extraordinary opportunities combined with inequities in ...

The Medicinal Power of Minerals

In September, the National Institutes of Health (NIH), in partnership with the Smithsonian Institution National Museum of Natural History, opened the Minerals in Medicine exhibition at the NIH Clinical Center in Bethesda, Maryland. The exhibition, which includes more than 40 minerals and metals...

palliative care

Quality Improvement Project Results in Timelier Hospice Referrals

A quality improvement project conducted within the OhioHealth system showed that oncologists can change their behavior and refer patients earlier to hospice care. After a relatively minor intervention, 18 medical oncologists in private practice doubled the mean length of stay in hospice care for...

palliative care

Food as Medicine: Study Sets Out to Prove Its Effectiveness

Could the quality of life of patients with advanced-stage cancer be improved by personal delivery of nutritious, medically tailored meals? Researchers at the New York University School of Medicine Perlmutter Cancer Center think so, and they have set out to prove it in a randomized clinical trial....

hematologic malignancies
palliative care

Palliative Care Still in Its Infancy in Hematologic Malignancies

Palliative care is slowly but surely being integrated into the treatment of patients with solid tumors, but its role in the hematopoietic stem cell transplant setting is still lagging, speakers said at the 2016 Palliative Care in Oncology Symposium. “There is a huge symptom burden among patients...

leukemia

Donor Selection for HLA-Matched Hematopoietic Cell Transplantation

Question 1: Which statement about donor selection for allogeneic hematopoietic cell transplant is correct? Correct Answer: C. If a donor is available, the genotypic identity between the patient and his brother should be established by typing the patient’s parents; if this is not possible, the...

integrative oncology

Bromelain

Scientific Names: Sulfydryl proteolytic enzyme, cysteine proteinase Common Names: Ananase, Dayto Anase, Traumanase Overview Derived from the fruits and stems of pineapples, bromelain is a proteolytic enzyme that is used to treat burns and skin conditions, and as an anti-inflammatory agent....

genomics/genetics

Using Pharmacogenetics to Predict Cancer Prognosis, Response to Treatment, and Toxicity

Although clinical trials are helpful in determining the effectiveness of a specific drug across a patient population, they are not as reliable at pinpointing how well a particular patient will respond to the drug or dosing regimen or how the drug may impact the patient’s quality of life from...

colorectal cancer

ESMO 2016: Longer Interval Between Preoperative Chemoradiotherapy and Surgery Urged in Locally Advanced Rectal Cancer

A longer waiting interval from the end of preoperative chemoradiotherapy to surgery increases the rate of pathologic complete response and yields a higher proportion of patients achieving tumor downstaging in patients with locally advanced rectal cancer, according to new findings from a...

head and neck cancer

Rise in Oropharyngeal Cancer Incidence in the UK Not Solely Driven by HPV

The rise in the incidence of oropharyngeal squamous cell carcinoma in the United Kingdom from 2002 to 2011 was not solely attributable to a rise in the incidence of human papillomavirus (HPV)-positive disease, according to a study published in Cancer Research,1 which reported that the proportion of ...

colorectal cancer

ESMO 2016: Dabrafenib/Trametinib/Panitumumab Improves Efficacy in BRAF Mutation–Positive Metastatic Colorectal Cancer

Patients with metastatic colorectal cancer and tumors harboring the BRAF V600E mutation who received triple therapy with dabrafenib (Tafinlar), trametinib (Mekinist), and panitumumab (Vectibix) showed an improved best overall response and prolonged progression-free survival compared to...

Expert Point of View: Elizabeth Jaffee, MD

Elizabeth Jaffee, MD, Deputy Director of the Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins University, Baltimore, commented on the promise of neoantigens during a press briefing at the 2nd International Cancer Immunotherapy Conference. “In addition to the development of new drugs...

skin cancer

Personalized Vaccines May Protect Patients With High-Risk Melanoma

The field of cancer vaccines may be reinvigorated by a new understanding, and the therapeutic leveraging, of neoantigens. Researchers from Dana-Farber Cancer Institute in Boston are exploring this novel approach as a means of protecting patients with high-risk melanoma from recurrence. Early...

When Breath Becomes Air: Dr. Lucy Kalanithi Reflects on Dr. Paul Kalanithi’s Life and Writing

Perhaps more than any other book in recent memory, When Breath Becomes Air has struck a chord among readers, both inside the medical community and among the public, desiring an honest and philosophical consideration of death. The autobiographical account of Paul Kalanithi, MD, a physician diagnosed ...

skin cancer

Association of PD-L1 Expression and Response to Pembrolizumab in Advanced Melanoma

In an analysis from the phase IB KEYNOTE-001 trial, Daud et al found that the level of programmed cell death ligand 1 (PD-L1) expression was associated with outcomes of pembrolizumab (Keytruda) treatment in patients with advanced melanoma. These findings were reported in the Journal of Clinical...

Free PQRS Reporting Now Available Through QOPI®; No Additional Reporting Required

ASCO is pleased to announce that oncology practices can now complete all of their Physician Quality Reporting System (PQRS)1 requirements through the Quality Oncology Practice Initiative (QOPI®) platform. All users will be able to use the QOPI system to fulfill the Oncology Measures Group set of 7...

pancreatic cancer

Precision Promise Clinical Trial Focuses on Precision Medicine, Collaboration, and Data-Sharing in Pancreatic Cancer

The Pancreatic Cancer Action Network recently announced Precision Promise, the first large-scale precision medicine trial designed to transform outcomes for patients with pancreatic cancer. The organization also announced the 12 initial Precision Promise Clinical Trial Consortium sites selected to...

gynecologic cancers

What We Know and What We Need to Know About Neoadjuvant Chemotherapy in Advanced Ovarian Cancer

Ever since the landmark studies of Griffiths and colleagues in the 1970s,1 primary cytoreductive surgery followed by chemotherapy with the objective of achieving minimal residual disease has been the standard approach for women with advanced-stage epithelial ovarian cancer. However, what is...

gynecologic cancers

SGO and ASCO Clinical Practice Guideline on Neoadjuvant Chemotherapy for Newly Diagnosed Advanced Ovarian Cancer

As reported by Alexi A. Wright, MD, MPH, of Dana-Farber Cancer Institute, and colleagues in the Journal of Clinical Oncology, ASCO and the Society of Gynecologic Oncology (SGO) have released a clinical practice guideline on neoadjuvant therapy for patients with newly diagnosed stage IIIC or IV...

Expert Point of View: Olivier Michielin, MS, MD, PhD

The paper’s invited discussant was Olivier Michielin, MS, MD, PhD, Head of Personalized Analytical Oncology and the Melanoma Clinic at Lausanne University Hospital in Switzerland. He called the findings of the European Organisation for Research and Treatment (EORTC) 18071 trial a “new landmark in...

skin cancer

Adjuvant Ipilimumab Improves Survival in High-Risk Melanoma

Patients with stage III melanoma who were considered to be at high risk for recurrence derived an overall survival benefit from adjuvant treatment with ipilimumab (Yervoy), although it came at the price of considerable toxicity, according to updated survival results from the phase III European...

head and neck cancer

With Changing Strategies for Laryngeal Cancer, Multidisciplinary Team Approach Is Key

The treatment of cancer of the larynx has changed dramatically in recent years. With organ preservation now possible in many cases, it is more important than ever for patients to receive guidance from every corner of the field. In a recent article in the Journal of Oncology Practice (JOP),1 a...

health-care policy

NIH Expands National Precision Medicine Initiative Cohort Program

The National Institutes of Health (NIH) has announced awards to add four regional medical center groups to the national network of health-care provider organizations that will implement the Precision Medicine Initiative Cohort Program. Combined, the new health-care provider organizations will...

breast cancer

Mammography-Detected Small Breast Cancers May Represent Overdiagnosis, With Survival Gains Reflecting Improved Systemic Therapy

In a study using SEER (Surveillance, Epidemiology, and End Results) data reported in The New England Journal of Medicine, Welch et al found that screening mammography has resulted in a substantial increase in detection of small breast tumors, many of which represent overdiagnosis, accompanied by...

sarcoma

FDA Grants Accelerated Approval to Olaratumab for Treatment of Advanced Soft-Tissue Sarcoma

Today, the U.S. Food and Drug Administration (FDA) granted accelerated approval to olaratumab (Lartruvo) in combination with doxorubicin to treat adults with certain types of soft-tissue sarcoma. Olaratumab is approved for use with the FDA-approved chemotherapy drug doxorubicin for the treatment of ...

Expert Point of View: Colleen A. Lawton, MD

“This is very exciting work and is exactly what we need in prostate cancer,” said Colleen A. Lawton, MD, Vice-Chair of the Medical College of Wisconsin, Milwaukee, and moderator of a press conference where the study by Spratt et al was discussed. “The prognostic measures we use are rough and...

prostate cancer

Prognostic and Predictive Molecular Subtypes of Prostate Cancer Identified

Members of the oncology community have long complained that prostate cancer lags behind breast cancer regarding biomarkers for prognosis and treatment, but the good news is that this gap is narrowing. In the largest study of its kind to date, presented at the 58th Annual Meeting of the American...

cns cancers

Stereotactic Radiosurgery Achieves Better Quality of Life and Improved Cognition Than Whole-Brain Radiotherapy

Two separate randomized trials presented at the 58th Annual Meeting of the American Society of Radiation Oncology (ASTRO) affirmed the value of stereotactic radiosurgery as an option for postoperative treatment of the surgical cavity of resected brain metastases, potentially avoiding the cognitive...

issues in oncology
cost of care

COA Releases 2016 Community Oncology Practice Impact Report

On October 4, the Community Oncology Alliance (COA) released the 2016 Community Oncology Practice Impact Report, which tracks the changing landscape of cancer care in the United States. It documents a 121% increase in community cancer clinic closings and a 172% increase in consolidation into...

prostate cancer

Safety of Extreme Hypofractionation Reassuring in Intermediate-Risk Prostate Cancer

Giving patients larger fractions of radiation over shorter periods (ie, hypofractionation) is gaining ground in several types of cancers. This approach is attractive for patients’ convenience, shortening treatment and travel times, and also for resource utilization. Several studies have shown that ...

skin cancer

Investigational Immunotherapy Appears Safe and Somewhat Active in Advanced Melanoma

The investigational immunotherapeutic IMC-20D7S was found to be well tolerated and somewhat active in patients with advanced melanoma, including one complete response, according to the results of a phase I/Ib trial reported by Khalil et al in Clinical Cancer Research.  IMD-20D7S is a...

issues in oncology

‘Dear Presidential Candidates’: A Letter From an Oncologist

Dear Presidential Candidates: Wouldn’t it be great if history’s Alexander the Great was actually Dr. Alexander Fleming, the doctor-scientist who saved millions of lives by discovering penicillin, rather than the other Alexander, who conquered and killed thousands of innocent people? Wouldn’t it be...

breast cancer

Study Shows Strong Evidence Supporting Radiation Boost to Tumor Bed in Ductal Carcinoma in Situ

A radiation boost to the local tumor bed following treatment with breast-conserving therapy (ie, local excision followed by whole-breast radiation therapy) improves local control for patients with ductal carcinoma in situ, according to a study of pooled data from 10 academic centers,1 presented at...

Expert Point of View: Stephen R.D. Johnston, MD

“These results apply to about two-thirds of women with advanced breast cancer, ie, those with hormone receptor–positive metastatic breast cancer,” noted the formal discussant of this paper, Stephen R.D. Johnston, MD, of the Royal Marsden Hospital, London. “At present with first-line endocrine...

breast cancer

Combination of Ribociclib and Letrozole Improved Progression-Free Survival in Hormone Receptor–Positive Advanced Breast Cancer

The combination of the selective CDK4/6 inhibitor ribociclib plus letrozole significantly improved progression-free survival in hormone receptor–positive advanced breast cancer. When ribociclib was added to letrozole, progression-free survival improved by 44% compared with letrozole alone,...

lung cancer

ESMO 2016: First-Line Pembrolizumab Plus Chemotherapy Significantly Improves Outcomes in Advanced NSCLC

The addition of the programmed cell death protein 1 (PD-1) antibody pembrolizumab (Keytruda) to standard first-line chemotherapy for treatment-naive advanced non–small cell lung cancer significantly improves response rates and progression-free survival, Langer et al reported at the 2016...

lung cancer

First-Line Pembrolizumab Improves Survival vs Platinum-Based Chemotherapy in Advanced PD-L1–Positive NSCLC

Pembrolizumab (Keytruda) significantly improved progression-free and overall survival vs platinum-based chemotherapy in patients with previously untreated advanced non–small cell lung cancer (NSCLC) with ≥ 50% PD-L1 (programmed cell death ligand 1) expression and no sensitizing EGFR...

breast cancer

ESMO 2016: Antitumor Activity Demonstrated With Lurbinectedin in Patients With Metastatic Breast Cancer and BRCA Mutations

Lurbinectedin showed promising clinical benefit in pretreated patients with metastatic breast cancer and BRCA1 or BRCA2 mutations, including patients previously treated with platinum, according to phase II trial results presented by Balmaña et al at the 2016 European Society for Medical...

colorectal cancer

Massachusetts Health Insurance Expansion Associated With Increased Resection and Reduced Emergent Resection for Colorectal Cancer

In a study reported in the Journal of Clinical Oncology, Loehrer et al found that the 2006 Massachusetts health-care reform has resulted in increased rates of resection and reduced emergent resection for colorectal cancer. The study used the Hospital Cost and Utilization Project State Inpatient...

colorectal cancer

ESMO 2016: Nintedanib Improves Progression-Free Survival but Not Overall Survival in Metastatic Colorectal Cancer

Nintedanib (Ofev) improves progression-free survival but not overall survival in patients with metastatic colorectal cancer who are not responding to standard therapies, according to the results of the phase III LUME-colon 1 trial presented by Van Cutsem et al at the 2016 European Society of...

leukemia

Delayed Initiation of Tyrosine Kinase Inhibitors Reported in Medicare Patients With Chronic Myeloid Leukemia

In a study using Surveillance, Epidemiology, and End Results (SEER)-Medicaid data reported in the Journal of Clinical Oncology, Winn et al found that 68% of Medicare patients with chronic myeloid leukemia (CML) initiated tyrosine kinase inhibitor treatment within 180 days after diagnosis. Factors...

breast cancer

Lack of Androgen Receptor Protein May Contribute to Racial Disparities in Triple-Negative Breast Cancer Outcomes

Triple-negative breast cancer in African American women is much more likely to lack the androgen receptor protein compared with triple-negative breast cancer in European American women, and this may contribute to the racial disparity in survival outcomes among these two populations, according to a...

survivorship
cost of care

African American Cancer Survivors More Likely to Experience Lasting Debt Related to Cancer and Its Treatment

African American cancer survivors are more likely than whites to experience lasting debt or forgo necessary medical care as they struggle with the financial burden of cancer, while whites are somewhat more likely to use existing assets to pay for their cancer care, according to a study (C13)...

breast cancer
issues in oncology

Affordable Care Act Increased Access to Cancer Care and Clinical Trial Participation Among Hispanics

Implementation of the Affordable Care Act (ACA) in California may have led to a significant increase in the number of Hispanic breast cancer patients at a National Cancer Institute (NCI)-designated cancer center and an increase in the number of Hispanic women who consented to participate in a...

solid tumors

Modified Staging System for Pancreatic Neuroendocrine Tumors

As reported in the Journal of Clinical Oncology, Luo et al found that a modified staging classification based on the European Neuroendocrine Tumor Society (ENETS) and the American Joint Committee on Cancer (AJCC) staging classifications may improve distinction among risk groups in pancreatic...

kidney cancer

Extended Active Surveillance Prior to Systemic Therapy May Be Safe in Some Patients With Metastatic Renal Cell Carcinoma

In a phase II trial reported in The Lancet Oncology, Brian I. Rini, MD, of the Cleveland Clinic Taussig Cancer Institute, and colleagues found that some patients with metastatic renal cell carcinoma can safely undergo active surveillance for an extended duration prior to initiation of systemic...

breast cancer

Tailoring Breast Cancer Screening for Older Women by Breast Density and Risk

A collaborative modeling study evaluating outcomes for various screening intervals for women over the age of 50 based on breast density and risk for breast cancer has found that average-risk women with low breast density undergoing triennial screening and higher-risk women with high breast density...

HHS Takes Steps to Provide More Information on Clinical Trials to the Public

To make information about clinical trials widely available to the public, the U.S. Department of Health and Human Services (HHS) issued a final rule on September 19 that specifies requirements for registering certain clinical trials and submitting summary results information to ClinicalTrials.gov....

gynecologic cancers

Expect Questions About the FDA Discouraging Use of Ovarian Cancer Screening Tests

The release of a U.S. Food and Drug Administration (FDA) Safety Communication “alerting women about the risks associated with the use of tests being marketed as ovarian cancer screening tests”1 and recommending against using these tests comes not as a result of startling new studies, but from an...

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