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cost of care

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?...

global cancer care
health-care policy

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...

issues in oncology
cost of care

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...

issues in oncology

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...

issues in oncology

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, ...

global cancer care
issues in oncology

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®...

cost of care
issues in oncology

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 ...

hematologic malignancies

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, ...

health-care policy

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...

issues in oncology

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,...

issues in oncology

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...

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...

health-care policy
issues in oncology

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,...

prostate cancer

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 ...

prostate cancer

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...

survivorship

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,...

colorectal cancer

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...

issues in oncology

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...

issues in oncology

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,...

solid tumors
colorectal cancer

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 ...

hematologic malignancies

Bone Marrow Transplants Reduce Risk of Graft-vs-Host Disease Compared to Peripheral Blood

Patients who receive bone marrow transplants are significantly less likely to develop chronic graft-vs-host disease than those who receive peripheral blood stem cell transplants, according to a new, large randomized trial, the first of its kind with unrelated donors. Published recently in The New...

breast cancer

Does All DCIS Need Treatment? Debaters Take Sides at Surgical Oncology Meeting 

There are a few things about ductal carcinoma in situ (DCIS) on which everyone agrees: Incidence increased dramatically with the advent of mammography screening, not all cases detected will go on to cause symptoms in the patient’s lifetime, and there’s no proven way to tell which cases will...

health-care policy

Rally for Medical Research Draws Thousands in Person and on Social Media 

In estimated 10,000 demonstrators filled the streets in front of Washington, DC’s historic Carnegie Library on April 8 to protest budget cuts at the National Institutes of Health. The Rally for Medical Research was held to “emphasize to our policymakers that medical research must become a national...

skin cancer

Sentinel Node Biopsy in Melanoma: Essential or Optional? 

Is sentinel node biopsy in melanoma an essential component of care? Despite a large multinational trial and recently published or updated guidelines, the question is still a thorny one according to experts who debated the issue at the recent meeting of the Society of Surgical Oncology in...

issues in oncology

CancerLinQ Prototype Demonstrates Use of Big Data in Clinical Care 

ASCO has unveiled the prototype of a computer system that will allow oncologists, from their desks, to leverage “big data” to measure the quality of care that their practices provide. The prototype is a major step in the development of CancerLinQ, a system that will eventually allow millions of...

skin cancer

Does Every Melanoma Patient with a Positive Sentinel Node Need More Lymph Nodes Removed? 

When sentinel node biopsy was shown to predict whether early melanoma had spread to regional lymph nodes, it revolutionized care. Before that, dissection of all regional lymph nodes was the norm for most patients. After that, the standard of care became a sentinel node biopsy and then—only if the...

survivorship

Fertility Rates in Childhood Cancer Survivors Suggest Strategies for Follow-up Care 

Childhood cancer survivors with clinical infertility have a good chance of achieving pregnancy, according to new findings from the Childhood Cancer Survivor Study (CCSS). Study Background As a group, women who survive childhood cancer are known to have lower fertility rates. This study, however,...

issues in oncology

FDA Hears Proposals on Codevelopment of Companion Diagnostics for Breakthrough Therapies

A companion diagnostic developed for use with a drug that has received Breakthrough Therapy designation from the U.S. Food and Drug Administration (FDA) should automatically be eligible for priority review, according to an expert panel that presented this proposal and four others to the FDA in...

breast cancer

Breast Cancer Vaccines for Primary Prevention Move Toward Clinical Use

The first candidate vaccine to prevent recurrence of breast cancer entered clinical trials about 8 years ago, and since then, the idea of a vaccine for secondary prevention has gained traction; more such vaccines are now in development. But this fall, it was vaccines for primary prevention that had ...

breast cancer

Risk-Based Breast Cancer Screening: Studies Suggest Alternatives to Age-Based Guidelines

Measuring certain hormone levels could help determine a woman’s risk for breast cancer and add a key factor to current risk-prediction models, according to investigators from Harvard Medical School. Their new study results were presented at the American Association for Cancer Research (AACR) Annual ...

health-care policy

Major Cancer Advances in 2013 Highlight Importance of Federal Funding

About one-third of the most important clinical advances in cancer last year were made possible at least in part through federal funding, according to ASCO’s annual report on progress in cancer, published in the Journal of Clinical Oncology.1 Significant Declines in Funding The report, “Clinical...

lung cancer
lymphoma

Belinostat Moves Forward in Trials for Two Aggressive Cancers

In February, the U.S. Food and Drug Administration (FDA) granted belinostat (Beleodaq), a targeted histone deacetylase (HDAC) inhibitor, priority review status based on a pivotal phase II trial in peripheral T-cell lymphoma. Just 1 month later, researchers at the National Cancer Institute (NCI) in...

survivorship

Promoting Health Behaviors Among Cancer Survivors

Promoting healthy behaviors among cancer survivors is associated with improved quality of life according to many studies. But how to translate that evidence into community practice remains a huge question, and the need for answers is growing.  It’s not only the lack of consensus on how to help...

issues in oncology

Oncology Advanced Practitioners in the Midst of Growth, Change

The number of nurse practitioners (NPs) and physician assistants (PAs) in community cancer practices is growing, according to ASCO’s annual census of oncology practice, published in March 2014.1 As though to illustrate that finding, a new professional society—the Advanced Practitioner Society for...

issues in oncology

Navigating Cancer in the Era of Personalized Medicine: Rev 2014 Explores Emerging Issues, Ideas for Action

Diagnosed with stage IV non–small cell lung cancer in 2011, Stephen Wright turned to patient support groups where he learned about the anaplastic lymphoma kinase (ALK) mutation and a new drug that targeted it, crizotinib (Xalkori). He asked—then insisted—that he be tested for the mutation. He found ...

issues in oncology

Oncology Practice: What Are the Factors Driving Change?

Clinical practice changes in response to new medical evidence, but not always immediately or all at once. So what else determines whether and how quickly practice changes in response to evidence, for instance, that a widely used drug is effective only in patients with a certain biomarker? In a new ...

lung cancer

Lung Cancer Webinar Highlights Brain Metastases and Thoracic Radiotherapy

Postoperative radiation therapy, given after adjuvant chemotherapy, significantly increased overall survival in non–small cell lung cancer (NSCLC) compared to chemotherapy alone, according to a study reported at ASCO’s 2014 Annual Meeting.1 That study, an analysis of records in the National Cancer...

lung cancer

Optimal Chemoradiotherapy Dosing and Recurrence After Stereotactic Body Radiotherapy Explored in Lung Cancer Webinar

Cetuximab (Erbitux) added no survival benefit to chemoradiation in stage III non–small cell lung cancer (NSCLC), according to results reported in a Plenary Session of the 2013 World Conference on Lung Cancer in Sydney, Australia.1 It was the second surprise result from the Radiation Therapy...

issues in oncology
cost of care

Expert Panel Explores Cost, Value, and Patient-Centered Care in Cancer Treatment

In assessing a cancer treatment, cost and value are two key factors. So how, the moderator asked, do they enter into your everyday decisions? Tanisha Carino, PhD, Executive Vice President of Avalere Health, was speaking to a clinical oncologist, a patient advocate, a pharma executive, and a health ...

issues in oncology

Young Adults With Cancer: Unique Issues Highlight Importance of Patient-Centered Care

Suleika Jaouad, a journalist, was 22 and had just gotten her first chance to cover a major news story—the revolution underway in Tunisia—when she was diagnosed with myelodysplastic syndrome that had evolved into acute myeloid leukemia (AML). Months into her treatment, she began to write again, but ...

issues in oncology

Focused Ultrasound, a Young Technology, Begins to Grow

In the United States, it’s been a good 2 years for focused ultrasound. The technology, which uses multiple, intersecting ultrasound beams to treat cancer and other diseases, completed its first successful U.S. phase III oncology trial—to alleviate the pain of bone metastases—and received approval...

health-care policy

Molecular Pathologists vs the FDA: Proposed Regulation of Laboratory-Developed Tests Sparks Debate

The packed ballroom looked like a plenary session at any big medical research meeting. But on the dais were representatives of the Food and Drug Administration (FDA), the subject was the Agency’s proposed regulation of laboratory-developed tests, and the attendees who lined up to ask questions for...

breast cancer

First National Data on Breast Cancer Subtypes Mark New Era in Biomarker Epidemiology

This year’s Report to the Nation on the Status of Cancer contains the first national combined data set on the incidence of four major breast cancer subtypes by race/ethnicity, poverty level, geography, and other factors. The findings show that “there are unique racial/ethnic-specific incidence...

hematologic malignancies
leukemia
issues in oncology

Acute Myeloid Leukemia in the Elderly: Trial Data Stir Hope for the Transplant Option

Older patients with acute myeloid leukemia (AML) have high relapse rates after induction chemotherapy, low survival rates, and fewer treatment options compared with younger patients. One of the options for both younger and older patients is hematopoietic cell transplantation, but relatively few...

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