Personalized Medicine

Living Life to the Fullest, with Cancer

September 2012, Vol 3, No 6 - Palliative Care

Amy J. Berman, BS, RN, was diagnosed with incurable stage IV breast cancer almost 2 years ago. In the following interview, she discusses with Value-Based Cancer Care (VBCC) her recent experience, and why she chose to focus on quality of life rather than on the length of her life.

VBCC: Can you share with us your professional background, and how this relates to your cancer diagnosis and treatment decisions, and how this may also relate to other patients with cancer?

[ Read More ]

eviti: Decision Support at the Point of Care for Oncologists

Arlene A. Forastiere, MD

May 2012, Vol 3, No 3 - Oncology

An independent health information technology company, eviti, Inc, provides a suite of web-based decision-support services that connects and delivers value to all parties in the care process—patients receive quality care, physicians are assured payment, insurers pay for quality care only, and pharmacy benefit managers (PBMs) or specialty pharmacy improve adherence. This decision support platform is a transformative solution that reduces variability in care, improves quality, and enables realignment of provider incentives.

[ Read More ]

Vismodegib: A New Treatment Option for Basal-Cell Carcinoma

Rhonda Williams

March 2012, Vol 3, No 2 - Cancer Drugs

Basal-cell carcinoma (BCC) and squamous-cell carcinoma (SCC), commonly referred to as non-melanoma skin cancers (NMSCs), are the most common types of cancers in the United States. These 2 cancers account for approximately 2 million cases of skin cancer annually.1 BCC is approximately 4 to 5 times more common than SCC.2 Although rarely metastatic, BCC and SCC can cause substantial local destruction involving extensive areas of soft tissue, cartilage, and bone, as well as disfigurement. [ Read More ]

Chemotherapy Administration Sequencing Chart

March 2012, Vol 3, No 2 - Chemotherapy

Oncology pharmacists receive numerous questions regarding the sequence of chemotherapy administration. Several chemotherapy agents (eg, doxorubicin, docetaxel, paclitaxel) are extensively metabolized through the cytochrome P450 pathway, and many chemotherapy agents (eg, taxanes, platinum agents) have high degrees of protein binding. In addition, many chemotherapy agents have cell cycle–specific mechanisms of action that may increase the cytotoxicity or antagonize the mechanism of the second agent. [ Read More ]

Dose-Dense Chemotherapy plus Growth Factors in Elderly ER-Positive Patients Unnecessary, Costly

Caroline Helwick

March 2012, Vol 3, No 2 - Breast Cancer

San Antonio, TX—Women with estrogen receptor (ER)-positive breast cancer are unlikely to benefit from dosedense chemotherapy, but many are receiving this type of treatment, which involves the use of colonystimulating factors (CSFs), that is, growth factors. Limit ing the use of these therapies in a population that is unlikely to benefit from it, would save nearly $40 million annually, suggests a study presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium. Dawn L. [ Read More ]

New Data Suggest Oncotype DX Unnecessary in Some Cases of Low-Grade Cancer

Rosemary Frei, MSc

March 2012, Vol 3, No 2 - Breast Cancer

Grapevine, TX—A New Jersey research team is making the case for relying less on the Oncotype DX test for breast-cancer prognosis and instead focusing on conventional pathological analyses. Pathologists at Saint Barnabas Medical Center, Livingston, NJ, and Monmouth Medical Center, Long Branch, NJ, found that in a retrospective review of 90 cases, 88% of those who had the following 3 characteristics were in the Oncotype DX low-risk category:

[ Read More ]

Oncotype DX Assay Cost- Effective for Patients with ER-Positive Breast Cancer

March 2012, Vol 3, No 2 - Breast Cancer

San Antonio, TX—Assessing all eligible patients with breast cancer for recurrence risk with the 21-gene Oncotype DX assay at diagnosis could save $330.8 million annually by avoiding ineffective chemotherapy, according to data presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium. This analysis involved nearly 200,000 estrogen receptor (ER)-positive tumor samples. The Oncotype DX assay, which is approved in this subgroup of patients with breast cancer, yields a risk score for disease recurrence. [ Read More ]

For Metastatic Breast Cancer, Nab-Paclitaxel Requires Less Growth Factor Support

Caroline Helwick

March 2012, Vol 3, No 2 - Breast Cancer

San Antonio, TX—In a retrospective utilization and cost analysis, nab-paclitaxel (Abraxane) therapy was associated with substantially lower total use of prophylactic colony-stimulating factor (CSF) than docetaxel (Taxotere) and paclitaxel (Taxol) in the treatment of breast cancer. The study was reported at the 2011 San Antonio Breast Cancer Sympo sium by Rex W. Force, PharmD, Professor and Director of Research, Family Medicine and Pharmacy Practice, Idaho State University, and Partner, ImproveRX, LLC, and colleagues. [ Read More ]

Which Patients with Prostate Cancer Should Receive Hormone Therapy in Addition to Radiation?

Phoebe Starr

February 2012, Vol 3, No 1 - Prostate Cancer

Miami, FL—Although several studies have shown that the addition of androgen-deprivation therapy (ADT) to radiation improves disease-free survival (DFS) in men with intermediate-risk prostate cancer, this is a heterogeneous group of patients, and it is not clear whether they should all receive ADT plus radiation, or whether the benefit is confined to a specific subset of patients.

[ Read More ]

Physician-Led Approach Can Cut Unnecessary Testing in Prostate Cancer

Caroline Helwick

February 2012, Vol 3, No 1 - Prostate Cancer

Feedback from their peers helped physicians refrain from ordering unnecessary tests for patients with newly diagnosed cancer, according to a recent study (Miller DC, et al. J Urol. 2011;186:844-849. Epub 2011 Jul 23).

Physicians ordered fewer tests after becoming more aware of practice guidelines and being presented with comparative data on tests they and their colleagues ordered. The program also improved the quality of care by reducing variations in practice patterns.

[ Read More ]