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Showing 1 - 50Tools for High-Quality, Accessible Care
Tools that make it easier for patients to access care and for their physicians to monitor their health status have also emerged with the advent of digital resources. In the closing panel of the NCCN Policy Summit, participants described tools developed by their own organizations to improve quality...
The Promise and the Challenge: Experts and Innovators Explore the Impact of New Technologies in Cancer Care
Artificial intelligence, digital therapeutics, telehealth, biometric monitoring: the terms alone are enough to suggest that cancer care is entering a new age, one characterized by tools and practices based on technologic innovation. To explore the impact of these new tools, the National...
Understanding Patients’ Needs and Preferences: Cancer Care Stakeholders Explore Barriers and Best Practices
The keynote speaker did not mince words. “I tell everyone, do not use the term age-appropriate therapy,” said Jan White, a cancer survivor and patient advocate who described her own experience with stage IV non-Hodgkin lymphoma. “Patients with cancer,” she said, “are more than their age, gender,...
Panel With Diverse Perspectives Explores Strategies to Reduce Costs for Cancer Care
“Imagine that it’s 5 years from now, and we are in a situation where the cost of cancer care has flattened, and costs are even going down,” said Clifford Goodman, PhD, a Senior Vice President at the Lewin Group, turning to a panel of oncology and policy experts at his side. “What policies got us...
NCCN Member Institutions
Abramson Cancer Center at the University of Pennsylvania, Philadelphia, PA Fred & Pamela Buffett Cancer Center, Omaha, NE Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, OH City of Hope National Medical...
National Comprehensive Cancer Network Celebrates Its 25th Year
It was February 1996, and the first annual meeting of the National Comprehensive Cancer Network® (NCCN®) was drawing to a close, when Chief Executive Officer (CEO) Bruce R. Ross, MD, invited comments from the floor. An oncologist who had attended at the urging of a friend—somewhat reluctantly—stood ...
NCCN Working Group Policy Recommendations
As the 21st Century Cures Act approaches its 4th anniversary, the National Comprehensive Cancer Network® (NCCN®) convened a working group made up of multidisciplinary experts from across the country to analyze current issues related to the 21st Century Cures Act and to develop recommendations for ...
The 21st Century Cures Act: A Look Back, a Look Ahead
It was ambitious and it was controversial, but the bipartisan 21st Century Cures Act (Cures) made it through both houses of Congress and was signed into law in December 2016. Sponsored by Representatives Diana DeGette (D-CO) and Fred Upton (R-MI), the landmark legislation funded new medical...
FDA’s Pilot Project Patient Voice Website and Workshop With ASCO
Project Patient Voice (PPV) is a program that will gather and make available online, patient-reported outcomes from cancer clinical trials. Launched by the U.S. Food and Drug Administration (FDA)’s Oncology Center of Excellence (OCE), it is the first program of its kind to communicate...
Value-Based and Patient-Centered Cancer Care: Looking at Closing Gaps in Perspectives of Value
Value-based care in oncology—a concept that emphasizes quality over quantity—has evolved over the past 2 decades to become a guiding principle of both public and private payers. The concept was part of the Medicare Improvements for Patients and Providers Act (MIPPA) of 2008; informed elements of...
The Oncology Care Model and Quality of Care: Defining, Measuring, and Implementing New Approaches to Cancer Care
The Oncology Care Model was instituted in 2016 by the Center for Medicare & Medicaid Innovation as a move away from the fee-for-service payment model and toward value-based care. It has sparked discussion ever since. How should quality be defined? Whose and what values should it reflect? How...
Differences By Sex in Lung Cancer Incidence and Mortality: What Is Known, and What Does It Mean?
The finding that women have a higher incidence of lung cancer than men of the same age and with the same smoking history was unexpected when it first emerged from studies in the 1990s. Just as unexpected was a subsequent finding. Even with their higher risk, women have a lower mortality and higher...
Looking at the Impact of State Policies on Access to High-Quality Care
The state of Washington is adding a public option to its health insurance marketplace; Massachusetts, Connecticut, and others have passed laws requiring that payers cover fertility preservation procedures for patients with cancer. Many states are seeking to expand Medicaid eligibility, and some, in ...
NCCN Summit Tackles Inequities in Access to Care
WHEN BRANDON CANYON’S mother Leone was diagnosed with uterine cancer, he drove her to treatment sessions at the nearest cancer center—a 200-mile round trip on rough roads. Gas was a significant expense, but their only other option was to forgo treatment. The Canyons are members of the Navajo...
Prevent Cancer Foundation Award Goes to Big Tobacco Foe, Sharon Y. Eubanks, JD
One Friday afternoon in March 1999, Pat Glynn, an attorney and manager at the Department of Justice, called a colleague, Sharon Y. Eubanks, JD, to talk about a newly formed Tobacco Task Force. Full of enthusiasm, he described plans to bring a federal suit against the major tobacco companies on...
Low-Dose CT Lung Screening: New Developments Support Increased Quality, More Data, Deep Learning
Two years ago, Rick Avila, MS, Chief Executive Officer (CEO) of Accumetra, LLC, was using rolls of Scotch tape as a research tool. The Scotch tape was a phantom, or reference object, and his company was working with computed tomography (CT) lung screening sites around the world to determine the...
Health-Policy Forum Focuses on New Care-Delivery Paradigms
What was an MBA doing at the podium of a clinical oncology meeting? Ten years ago or so, that might have been surprising. But in an era of rapid change—in therapies, costs, payment models, and practice—it only makes sense. Amy Porter-Tacoronte, MBA, Health System Chief Administrative Officer at the ...
Navigating the ‘New Normal’: NCCN Summit Examines Access to High-Quality Cancer Care
It’s not just the leaps in development of precision medicines, the soaring costs, the new payment models, clinical trial designs, sources of data, and federal policies. It’s all of them plus the rapidity with which change is happening that makes this era of oncology exceptional. “I would say...
NCCN Summit Explores Survivorship Issues for Patients and Clinicians
When Yelak Biru was diagnosed with multiple myeloma in 1995, he and his physicians had one main posttreatment goal: to detect and treat any relapse early and to prolong survival as long as possible with the limited drugs available. Then, in the early 2000s, came newer treatments. Myeloma survival...
Broadening the Evidence Base for Older Patients: FDA-ASCO Workshop Explores Emerging Strategies
In the not-so-distant past, clinical trials were considered an option only for the young and fit. Enrolling older people “used to be thought unethical,” said Janet Woodcock, MD, Director of the U.S. Food and Drug Administration (FDA)’s Center for Drug Evaluation and Research (CDER), as she opened...
Launching Harmonized NCCN Guidelines for Sub-Saharan Africa
Cancer care in Sub-Saharan Africa, as in other low-resource settings, can be a challenge: The right medications and equipment may be in short supply, maintaining equipment can be a problem, basic chemotherapy drugs may be unaffordable, and patients may not see doctors until the cancer is advanced....
Managing Low-Dose CT Screening for Lung Cancer
As low-dose computed tomography (CT) screening for lung cancer has moved from clinical trials to clinical practice, management issues are growing more urgent for screening centers around the country: for instance, how to support referrals from and to other providers; how to ensure the quality of...
Financial Toxicity: Cancer Supportive Care Professionals Consider the Side Effects of Soaring Costs
IS IT POSSIBLE to identify patients with cancer who are at risk for financial stress and intervene to reduce that risk? And could reducing financial stress—or financial toxicity, as it is often called in the context of cancer care—improve both health-related quality of life and physical health?...
World Health Assembly’s New Cancer Resolution Reflects New Realities
The World Health Assembly (WHA)—the decision-making body of the World Health Organization (WHO)—adopted a long-expected cancer resolution at its 2017 meeting, the body’s first resolution on cancer in 12 years and the first to emphasize, among other issues, the accessibility and affordability of...
Value-Based Decision-Making Tools: The View Ahead
As new treatment decision-making tools make their way toward and into the clinic, oncologists are getting a sense of how they may affect clinical practice—and beginning to look farther down the road. “What do you see ahead for clinicians?” asked Christian Downs, JD, Executive Director of the...
Exploring the Opportunities and Challenges of Seamless Drug Development
The traditional three-phase clinical trial process for testing new drugs does not necessarily make sense when it comes to targeted therapies, according to many experts, including regulators, academic researchers, industry chief executive officers, and patient advocates alike. Instead of three...
Exploring the Opportunities and Challenges of Seamless Drug Development
The traditional three-phase clinical trial process for testing new drugs does not necessarily make sense when it comes to targeted therapies, according to many experts, including regulators, academic researchers, industry chief executive officers, and patient advocates alike. Instead of three...
NCCN Working Group on Value Tools Presents Preliminary Findings and Recommendations
Over the past several years, the introduction of decision-making tools for patients from major cancer organizations, including ASCO and the National Comprehensive Cancer Network® (NCCN®), has been news, applauded as a step toward more patient-centered care and featured at many meetings. Next steps, ...
Exploring Practical Strategies for Cancer Care in Low-Resource Settings
One of the featured “Big Debates” at the 2016 World Cancer Congress in Paris addressed this question: Are scarce resources best applied to prevention rather than treatment? Many experts do not see prevention vs treatment in such stark terms or even as a realistic scenario. It’s a false dichotomy,...
NCCN Launches Campaign to Eradicate Fatal Vincristine Errors
It is uniformly fatal and impossible to undo. When the chemotherapy drug vincristine is placed in a syringe and injected intrathecally—into the spinal fluid—the patient always dies. And despite safety guidelines and labels, deaths continue to occur. Now the National Comprehensive Cancer Network®...
As More Biosimilars Move Toward U.S. Market, Questions Remain About Cost Savings and Uptake by Physicians and Patients
The U.S. Food and Drug Administration (FDA) approved its first biosimilar drug, filgrastim-sndz (Zarxio), in 2015, allowing it to compete with the granulocyte colony-stimulating factor filgrastim (Neupogen) to treat neutropenia in chemotherapy patients. So far, filgrastim-sndz is the only...
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 ...
Late Effects of Blood and Marrow Transplantation: Consensus Conference Maps Research Directions
More than 60,000 blood and marrow transplants are performed each year worldwide, and the number of long-term survivors is increasing rapidly. But with success has come a host of new issues for patients, providers, and researchers. “Back when transplants were new, the 1-year mortality rate was high, ...
Photonics and the Cancer Moonshot Initiative: Partnership Highlights Role of Technology and IT Infrastructure in Reaching Goals
Photonics—the science of light—may not be associated with cancer in most people’s minds. But photonic technologies are: CT (computed tomography) scans and digital x-rays, for instance, are in everyday use, and next-generation oncology applications are in development. As the White House’s National...
As Low-Dose CT Screening Moves Into the Clinic, Implementation Issues Move Up on the Agenda
Low-dose computed tomography (CT) screening for lung cancer in high-risk groups is moving into the clinic in the wake of its approval by the U.S. Centers for Medicaid & Medicare Services. That does not mean, however, the discussion is over. As low-dose CT moves from research to everyday...
Comparing Treatments by Efficacy, Toxicity, and Cost
Last year, five organizations introduced new methods to compare cancer treatments. For more on ASCO’s Value Framework, see page 120. The NCCN Evidence Blocks™ use a simple graphic to show experts’ ratings of systemic therapies in five areas: efficacy, safety, quality and quantity of evidence,...
How Will Value Framework Tools Be Used in Everyday Practice?
Value framework tools made a splash in 2015, with five different groups unveiling methods to help physicians and patients compare therapies based on efficacy, toxicity, and/or cost. Now these potential users are beginning to examine and debate the tools, including how and whether they will work in...
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...
Evolving Tools for Clinical Decision-Making
Value in cancer care—and how to define it—is a hot topic. There is general agreement that it is some measure of benefit vs cost, but “should the focus be on providing value to patients at a population level or at an individual level?” asked Alan Balch, PhD, CEO of the Patient Advocate Foundation,...
Data on Watchful Waiting for Low-risk Prostate Cancer May Swing Focus to Higher-risk Tumors and Quality of Life
Surgery did not increase survival rates compared to watchful waiting in men with clinically localized prostate cancer. Results were particularly strong for men with prostate-specific antigen (PSA) levels of 10 ng/dL and under, and those who have low-risk disease, according to data from the Prostate ...
NIH Panel Endorses Active Surveillance in Low-risk Prostate Cancer
Active surveillance of localized prostate cancer is a viable management option that should be offered to low-risk patients in place of immediate treatment, said a panel of experts convened by the National Institutes of Health. A fairly new concept, active surveillance takes a more proactive...
Expert Point of View: Controlled Study Links ‘Chemobrain’ to Longitudinal Changes in Brain
Commenting on the study by Deprez et al, Patricia Ganz, MD, noted the importance of the finding for clinicians. “This study tells us that self-reported complaints mapped onto the neuropsychologic tasks; this has not been shown very often,” said Dr. Ganz, who is Director of the Division of Cancer...
Controlled Study Links ‘Chemobrain’ to Longitudinal Changes in Brain
The phenomenon called “chemobrain”—impaired cognitive functioning following chemotherapy—correlates with longitudinal changes in the brain’s white matter, according a recent study in the Journal of Clinical Oncology.1 Structural changes in the white matter, measured by magnetic resonance diffusion...
Expert Point of View: More New Data Support Use of Daily Aspirin to Prevent Cancers
Is it time to recommend aspirin for cancer prevention? “It’s the question we are asking,” said Andrew T. Chan, MD, Massachusetts General Hospital and Harvard Medical School, who wrote a commentary accompanying three new studies in The Lancet and Lancet Oncology. The studies, by Peter M. Rothwell,...
More New Data Support Use of Daily Aspirin to Prevent Cancers
Three new studies have added data to the growing evidence that low-dose, daily aspirin helps prevent colorectal cancer and other malignancies and may be useful in preventing metastases as well.1-3 Coming on the heels of other recent studies, the results appear to strengthen the case for using...
Symposium Focuses on Policy Issues in Personalized Cancer Care
“What is the biggest barrier to progress in personalized medicine?” asked moderator Anna Barker, PhD, leading a panel discussion at a recent meeting convened by the Washington-based advocacy group, the Personalized Medicine Coalition, with the American Association for Cancer Research and Feinstein...
SIDEBAR: Coalition Activities
The new Data Liquidity Coalition has identified five activity tracks. Marcia Kean, MBA, a leader of the coalition steering committee, described the tracks: 1. Intellectual Capital is a set of activities that would seek to identify and illuminate some of the key issues in the space, such as the...
Data Liquidity Coalition Takes Shape
A coalition to promote and implement data sharing in cancer by facilitating data ‘liquidity,’ first proposed in February at an Institute of Medicine (IOM) workshop, is taking shape with the formation of a steering committee and action plans that include a demonstration project. For several years,...
Finding Lynch Syndrome among Patients with Colorectal Cancer: Routine Tumor Testing Looks Best
Oncologists generally agree that screening patients with colorectal cancer for Lynch syndrome is a good thing. Patients who turn out to have the hereditary syndrome can inform their first-degree relatives, who in turn can undergo genetic testing. Those who have the characteristic mutations can take ...
Expert Point of View: Frederick R. Appelbaum, MD
Commenting on the trial of bone marrow vs peripheral blood stem cell transplants, Frederick R. Appelbaum, MD, at the Fred Hutchinson Cancer Research Center, wrote that the results should change practice. But he added in his editorial, “it will be interesting to see whether it really does.”1...
