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health-care policy

Providing Perspective on Pressing Economic Issues Facing Cancer Care—Now and in the Future

CANCERSCAPE, the 2016 Annual Meeting of the Association of Community Cancer Centers (ACCC), provided a forum for about 300 attendees to gain insight into the complexities of oncology treatment, where “clinical advances, policy mandates, and value-based payment reform intersect.” Of particular...

ASCO Pledges to Advance Interoperability Among Health Information Systems

ASCO has joined members of the health-care community in pledging to the U.S. Department of Health and Human Services (HHS) to commit to principles that will advance interoperability among health information systems. A formal announcement of the initiative was delivered by HHS Secretary Sylvia M....

Understanding and Preparing for MACRA

The Medicare Access and CHIP Reauthorization Act of 2015 (MACRA) was passed in April 2015, introducing comprehensive changes to how Medicare pays physicians for services. As the policies passed in MACRA are rolled out over the coming years, they will profoundly impact reimbursement and care...

Donate Now to Access the Conquer Cancer Foundation Donor Lounge at ASCO Annual Meeting

The Foundation’s Donor Lounge is the perfect space to recharge or meet with friends and colleagues during ASCO’s Annual Meeting. It’s where industry leaders network and enjoy access to complimentary light refreshments and where busy attendees escape for a quiet place to relax. Make accessing this...

Diversity Training Key to Increasing Cultural Competence Among Oncology Surgeons

A study in the Journal of Oncology Practice (JOP)1 measured the level of cultural competence among surgeons from six hospitals in the Puget Sound region of Washington State, home to a large population of American Indians and Alaskan Natives. According to the study, “Assessing Cultural Competence...

lymphoma

MicroRNA miR-181a Reduces NFκB Signaling in Diffuse Large B-Cell Lymphomas

A recent study by researchers at Sylvester Comprehensive Cancer Center at the University of Miami Miller School of Medicine showed that a microRNA called miR-181a dampens signals from the cancer-driving NFκB protein pathway in diffuse large B-cell lymphoma (DLBCL). By reducing NFκB...

health-care policy

NCI Announces Blue Ribbon Panel to Help Guide Vice President Biden’s National Cancer Moonshot Initiative

On April 4, 2016, The National Cancer Institute (NCI), part of the National Institutes of Health (NIH), announced a Blue Ribbon Panel of scientific experts, cancer leaders, and patient advocates that will inform the scientific direction and goals at NCI of Vice President Joe Biden’s National...

skin cancer

Vitamin D Level Associated With Melanoma Outcome Independent of C-Reactive Protein Level

In a study reported in the Journal of Clinical Oncology, Fang et al found that lower vitamin D levels were associated with poorer outcome in patients with melanoma independent of C-reactive protein (CRP) levels. Study Details The study involved data from 1,042 prospectively observed patients with ...

breast cancer

Pathologic Complete Response to Neoadjuvant Therapy Associated With Improved Outcomes in HER2-Positive Breast Cancer

Pathologic complete response to neoadjuvant therapy in HER2-positive breast cancer was associated with a significantly better outcome vs non–pathologic complete response, in a patient-level meta-analysis reported by Broglio et al in JAMA Oncology. Response vs No Response The study included...

gynecologic cancers

Study Reports No Overall Benefit of Adding Farletuzumab to Chemotherapy in Relapsed Ovarian Cancer, but Potential Subgroup Benefit Identified

Addition of the antifolate receptor-α antibody farletuzumab to carboplatin/taxane did not improve progression-free survival in patients with ovarian cancer in first platinum-sensitive relapse, reported Vergote et al in the Journal of Clinical Oncology. However, benefit was observed in...

issues in oncology

New Commission on Cancer Standards Clarifies and Emphasizes Process, Quality, Data Reporting, and More

The 2016 edition of the Commission on Cancer’s accreditation standards manual clarifies and provides additional information in many areas and raises the bar for compliance in some, including psychosocial distress screening, survivorship care, data reporting, and activities in prevention and...

issues in oncology

Outcome Measures in Quality and Identifying High-Quality Practice

At this year’s ASCO Quality Care Symposium, Craig Earle, MD, MSc, of the Ontario Institute for Cancer Research, used Donabedian’s Triad—structure, process, and outcome—to set the stage for his presentation on the science of quality. “The theory behind Donabedian’s Triad is that structure...

issues in oncology
cost of care

Experts Consider What It Means to Improve Quality of Care in an Era of Increasing Reliance on Targeted Therapies

Precision medicine is judged according to different values across the multiple stakeholders involved in cancer care. At this year’s Quality Care Symposium, presenters from different sectors of oncology addressed a central question: How do we assess quality in the age of precision medicine?1,2 Right ...

breast cancer

A Business Professor and Husband Turns Breast Cancer Researcher

In more than 25 years of viewing posters at oncology meetings, I’ve met researchers from virtually all professional walks of life, but it was not until the 2016 Miami Breast Cancer Conference, that the author’s affiliation turned my head: It was a business school. “Utilizing Metastatic Tumor...

breast cancer

Metastatic Breast Cancer With Discordant Tumors: Small Study Reports Treatment by Primary Status May Improve Survival

In a small retrospective series, patients with metastatic breast cancer treated according to the receptor status of the primary tumor, not the metastatic one, had significantly longer median overall survival. The study was reported at the 2016 Miami Breast Cancer Conference by T. Allen Pannell, Jr, ...

Jeffrey Fowler, MD, Begins Presidency of Society of Gynecologic Oncology

Jeffrey Fowler, MD, John G. Boutselis Chair in Gynecologic Oncology and Professor and Vice-Chair of Obstetrics and Gynecology at The Ohio State University Wexner Medical Center, started his 1-year term as the 48th President of the Society of Gynecologic Oncology (SGO) at the conclusion of the...

breast cancer

Breast Cancer Vaccines Moving Forward at a Fast Clip

Vaccines for both secondary and primary prevention of breast cancer are showing potential in clinical trials, according to Elizabeth A. Mittendorf, MD, PhD, who is leading much of the vaccine research at the University of Texas MD Anderson Cancer Center, Houston. Vaccine platforms being explored...

gynecologic cancers

Trabectedin Improves Progression-Free Survival in Uterine Leiomyosarcoma

In women with uterine leiomyosarcoma, trabectedin (Yondelis), a novel cytotoxic agent, significantly improved progression-free survival, compared with dacarbazine (4.2 vs 1.5 months, hazard ratio [HR] = 0.55, P < .001). According to the study’s authors, a lack of cumulative toxicity allows...

issues in oncology

Computer-Assisted Decision Support in Medical Oncology: We Need It Now

Today’s medical oncologist is increasingly challenged to stay current with the latest developments in cancer treatment. I have been fortunate to speak with many oncologists over the past quarter-century on how professional life has evolved since the 1990s. These conversations have left me with a...

prostate cancer

Throwing Out the Baby With the Bathwater: A Critical Appraisal of the USPSTF Recommendation Against Screening for Prostate Cancer

In 2012, the U.S. Preventive Services Task Force (USPSTF) issued a recommendation against routine screening for prostate cancer.1,2 The grade D recommendation was considered controversial at the time, and remains so now, because many stakeholders have weighed the same body of evidence and come to...

lung cancer

The POPLAR Trial: PD-L1 Blockade With Atezolizumab in Second- or Third-Line Non–Small Cell Lung Cancer

The randomized phase II ­POPLAR trial—reported by Fehrenbacher and colleagues and reviewed in this issue of The ASCO Post—is another key piece of information for the medical community regarding the value of immune checkpoint blockers in second/third-line treatment of patients with non–small cell...

cns cancers

Glioblastoma Multiforme With Mismatch Repair Deficiency May Be Target for Immune Checkpoint Inhibition

Glioblastoma multiforme resulting from germline biallelic mismatch repair deficiency was characterized by hypermutation and elevated neoantigen load—characteristics associated with response to immune checkpoint inhibitors in other settings—according to a study reported in the Journal of ...

breast cancer

Ultrasound Screening for Breast Cancer May Be Linked to Increased Detection of Invasive Tumors but More False-Positive Results

As reported in the Journal of the National Cancer Institute by Berg et al, an analysis from the American College of Radiology Imaging Network (ACRIN) 6666 study indicates that use of ultrasound in primary screening for breast cancer resulted in increased detection of invasive cancers but more...

survivorship

ENDO 2016: Engineered Ovary Implant Restores Fertility in Mice

Northwestern University scientists used a three-dimensional (3D) printer to create a prosthetic ovary—an implant that allowed mice that had their ovaries surgically removed to bear live young. The results were presented by Laronda et al on Saturday, April 2, at the Endocrine Society's Annual...

breast cancer

ENDO 2016: BPA Changes Fetal Development of the Mammary Gland, Can Raise Breast Cancer Risk

A new culture system that tests the role of chemical exposure on the developing mammary gland has found that bisphenol A (BPA) directly affects the mammary gland of mouse embryos. The study results, presented by Speroni et al Friday, April 1, at the Endocrine Society's Annual Meeting in Boston...

health-care policy
palliative care

Joseph Simone, MD: Highlights of the 21st Annual NCCN Conference

Joseph V. Simone, MD, of the Simone Consulting Company, gives his expert perspective on the important messages of this year’s meeting.

gynecologic cancers

Wui-Jin Koh, MD, on Vulvar Cancer: Guidelines Update

Wui-Jin Koh, MD, of the Fred Hutchinson Cancer Research Center, discusses the multiple services required to best treat this rare cancer.

breast cancer

Good Outcome Reported With Endocrine Therapy and Omission of Chemotherapy Based on 21-Gene Recurrence Score in Breast Cancer

Treatment with adjuvant endocrine therapy and omission of chemotherapy on the basis of a 21-gene recurrence score ≤ 11 was associated with a high 3-year disease-free survival rate in women with hormone receptor–positive, HER2-negative breast cancer, according to a trial reported in...

issues in oncology

TP53 Gene Variant S47 May Contribute to Increased Cancer Risk in People of African Descent

For years, clinical data have shown that African Americans have a higher death rate and shorter period of survival among patients with commonly diagnosed cancers. While studies have focused on whether socioeconomic factors contribute to these statistics, researchers have been diligently trying to...

prostate cancer

Widely Cited Prostate-Specific Antigen Screening Publications Influence Biopsy Rates and Associated Complications

While absolute rates of biopsy and postbiopsy complications have decreased following several benchmark prostate-specific antigen (PSA) screening publications, the relative risk for each patient continues to increase, according to a new study by Mayo Clinic researchers. The study is the largest to...

breast cancer

ASCO Endorses Cancer Care Ontario Recommendations on Decision-Making in Adjuvant Systemic Therapy for Early-Stage, Operable Breast Cancer

As reported in the Journal of Clinical Oncology by N. Lynn Henry, MD, PhD, of the University of Michigan Comprehensive Cancer Center, and colleagues, ASCO has endorsed Cancer Care Ontario (CCO) guideline recommendations on the role of patient and disease factors in decisions on adjuvant systemic...

prostate cancer

Lower Vitamin D Levels Associated With Adverse Pathology at Prostatectomy in Men With Localized Prostate Cancer

In a study reported in the Journal of Clinical Oncology, Nyame et al found that lower serum 25-hydroxyvitamin D (25-OH D) levels were associated with an increased likelihood of adverse pathology at radical prostatectomy in men with localized prostate cancer. Study Details The cross-sectional...

bladder cancer

Study Finds Adaptive Image-Guided Radiation Therapy for Bladder Preservation Clinically Feasible in Urinary Bladder Cancer

A prospective study examining a trimodality treatment approach in localized bladder cancer cases using adaptive image-guided, intensity-modulated radiation therapy found that the bladder preservation rate at 3 years was 83%. These findings were published by Murthy et al in the International Journal ...

colorectal cancer

Endoscopic Mucosal Resection Is an Alternative to Surgery in Most Patients With Complex Colon Polyps

Using the latest advances in endoscopic resection techniques, more than 75% of patients with complex colon polyps could avoid surgery for their polyp removal, according to new research from The University of Texas MD Anderson Cancer Center. The findings, published by Raju et al in Gastrointestinal ...

symptom management

FDA Approves Defibrotide Sodium for the Treatment of Hepatic Veno-Occlusive Disease Following Hematopoietic Stem Cell Transplantation

On March 30, 2016, the U.S. Food and Drug Administration (FDA) approved defibrotide sodium (Defitelio) for the treatment of adult and pediatric patients with hepatic veno-occlusive disease, also known as sinusoidal obstructive syndrome, with renal or pulmonary dysfunction following hematopoietic...

breast cancer

Danish Study Shows Increased Risk for Cancers in Addition to Breast Cancer in CHEK2 Mutation Heterozygotes

In a study reported in the Journal of Clinical Oncology, Näslund-Koch et al found an increased risk for cancers in addition to breast cancer in individuals heterozygous for the CHEK2*1100delC germline mutation associated with an increased breast cancer risk. CHEK2 is a cell-cycle checkpoint...

breast cancer
supportive care

Epoetin Alfa vs Best Standard of Care in Treatment of Anemia in Patients With Metastatic Breast Cancer Receiving Chemotherapy

Use of epoetin alfa (Epogen, Procrit) vs best standard of care to treat anemia did not achieve noninferiority for investigator-assessed progression-free survival in patients receiving chemotherapy for metastatic breast cancer, reported Leyland-Jones et al in the Journal of Clinical Oncology....

issues in oncology

PET Probe [18F]CFA Detects Deoxycytidine Kinase Activity, May Lead to New Ways to Improve Response to Treatment

A promising new discovery by University of California, Los Angeles (UCLA) scientists could lead to a new method of identifying cancer patients whose disease expresses high levels of an enzyme and who are more likely to respond to particular treatments. Their findings were published by Kim et al in...

breast cancer

Therapeutic Combinations May Prevent Resistance to CDK4/6 Inhibition in Estrogen Receptor–Positive Breast Cancer

In preclinical studies, breast cancer cells became resistant to therapeutics targeting CDK4/6, such as palbociclib (Ibrance), in multiple ways. According to the research published by Herrera-Abreu et al in Cancer Research, different combinations of therapeutics might prevent and overcome the...

breast cancer
symptom management

DigniCap Scalp Cooling System Now Available for Women With Breast Cancer at 10 U.S. Cancer Treatment Centers

Dignitana Inc. announced today that the DigniCap scalp cooling system, which was cleared by the U.S. Food and Drug Administration (FDA) in December 2015 to effectively reduce the likelihood of chemotherapy-induced hair loss in women with breast cancer, is now available at 10 cancer treatment...

pancreatic cancer

Meta-analysis of Gene-Expression Datasets Identifies Novel Five-Gene Pancreatic Cancer Classifier

Pancreatic cancer is often diagnosed at a late stage, when curative treatment is no longer possible. A team led by investigators at Beth Israel Deaconess Medical Center (BIDMC) identified and validated an accurate five-gene classifier for discriminating early pancreatic cancer from nonmalignant...

lung cancer

No Treatment Failure or Survival Benefit but Less Toxicity With Comprehensive Geriatric Assessment in Elderly Patients With Advanced NSCLC

Use of comprehensive geriatric assessment to guide therapy in elderly patients with stage IV non–small cell lung cancer (NSCLC) did not improve treatment failure–free or overall survival but was associated with slightly reduced toxicity, based on the results of the phase III...

breast cancer

Digital Breast Tomosynthesis Shows Sustained Effectiveness in Breast Cancer Screening

In a single-center retrospective study reported in JAMA Oncology, McDonald et al found that adding digital breast tomosynthesis to digital mammography reduced recall rates, increased cancer detection, and was associated with a numeric reduction in interval cancers. Study Details The analysis...

lung cancer
gastroesophageal cancer

Possible Overuse of PET to Detect Recurrence of Lung and Esophageal Cancers

Healy et al found that greater use of positron-emission tomography (PET) for detection of recurrence of lung and esophageal cancers was not associated with improved survival, suggesting potential overuse of the modality in this setting. They reported their results in the Journal of the National...

bladder cancer

MRI-Guided Adaptive Reoptimization in Radiotherapy Shows Promise in Urinary Bladder Cancer Treatment

A new radiotherapy technique could help doctors to focus treatment more precisely on tumors in the bladder and reduce damage to surrounding healthy tissue. Researchers showed that pretreatment imaging using magnetic resonance imaging (MRI) was effective at guiding radiotherapy toward tumors in the...

skin cancer

Microneedle Patch Delivers Localized Anti–PD-1 Antibody Immunotherapy to Melanoma in Preclinical Models

Biomedical engineering researchers at North Carolina State University (NC State) and the University of North Carolina at Chapel Hill (UNC Chapel Hill) have developed a technique that uses a patch embedded with microneedles to deliver cancer immunotherapy treatment directly to the site of melanoma....

leukemia

Minimal Residual Disease in AML: Worth Looking?

As summarized in this issue of The ASCO Post, Ivey and colleagues demonstrated that assessing for NPM1-mutated gene transcripts by reverse-transcriptase quantitative polymerase chain reaction assay is a feasible approach for measuring minimal residual disease after acute myeloid leukemia (AML)...

issues in oncology

Quality Improvement Projects Aim at Reducing Errors in Prescribing IV and Oral Chemotherapy

Two quality improvement projects described in the Journal of Oncology Practice resulted in reduced errors in prescribing intravenous (IV) and oral chemotherapy. A project at the University of Texas Medical Branch in Galveston outpatient infusion centers first identified 15 different types of...

colorectal cancer

Patients Diagnosed With Stage I to III Rectal Cancer at Younger Age Have Increased Risk for Positive Lymph Nodes

Patients diagnosed with stage I to III rectal cancer at a younger age are at increased risk of having positive lymph nodes, according to an analysis of data published in the Journal of the National Cancer Institute. “This finding merits further investigation and may ultimately impact treatment...

solid tumors

High Rate of Overuse of Serum Tumor Marker Testing

A retrospective review to evaluate the frequency of serum tumor marker testing “found a high rate of serum tumor marker testing overuse and extreme overuse in patients with advanced solid tumors,” Melissa K. Accordino, MD, of Columbia University College of Physicians and Surgeons, New York,...

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