Chicago, IL—Canadian researchers reported a finding at the 2012 American Society of Clinical Oncol ogy meeting that runs contrary to what other researchers have ob served in the majority of studies. In this study, as oral drug costs increased, so did the likelihood of patients adhering to a prescribed regimen.[ Read More ]
July 2012, Vol 3, No 5
New Androgen Receptor–Signaling Inhibitor Extends Survival, Improves QOL in Advanced Prostate Cancer
Chicago, IL—The novel androgen receptor–signaling inhibitor enzalutamide, also known as MDV3100, significantly prolonged overall survival (OS), slowed disease progression, and improved quality-of-life (QOL) measures in men with castration-resistant prostate cancer after docetaxel failure, according to results from a large phase 3 clinical trial.[ Read More ]
Houston, TX—Patient navigation assures timely access to care for many patients, especially the medically underserved population, and it will soon become mandated for institutions accredited by the Commission on Cancer, reported Mandi Pratt-Chapman, MA, Associate Director of the Community Programs, Codirector of the Center for the Advancement of Cancer Survivorship, Navigation and Policy, George Washington Cancer Institute, Washington, DC, at the Second Annual Conference of the Association for Value-Based Cancer Care.[ Read More ]
Over the past 2 years, we have written about the impact of accountable care organizations, value-based purchasing, health insurance exchanges, and other programs relevant to the oncology community. These initiatives were all born out of the Affordable Care Act (ACA), which, on June 28, 2012, had its major day of reckoning. In a 5 to 4 decision authored by Chief Justice John Roberts, the US Supreme Court upheld the ACA’s individual mandate—the requirement that most Americans obtain health insurance that meets the definition of minimum essential coverage.[ Read More ]
Despite significant improvements in the treatment of patients with advanced-stage, newly diagnosed Hodgkin lymphoma (HL) with combined chemotherapy and radiotherapy that have led to durable remission rates of approximately 60% to 80%, a large proportion of patients are not cured and new therapies are needed. Patients with relapsed and/or refractory HL have poor prognosis. [ Read More ]
The treatment of metastatic gastrointestinal stromal tumor (GIST) was revolutionized with the introduction of imatinib as first-line therapy, with 60% control rates and median progression-free survival (PFS) of 27 weeks with sunitinib in the second-line setting. Neverthe less, resistance to tyrosine kinase inhibitor therapy eventually develops in the majority of patients with advanced GIST; no third-line therapy is yet approved. New data suggest that regorafenib, a unique inhibitor of several kinase-associated cancers, has a wide-range activity in this patient population (George S, et al. [ Read More ]
The programmed death 1 (PD-1) receptor is expressed by activated T cells and mediates immunosuppression involved in tumor growth. Results from two phase 1 clinical trials—one evaluating an anti–PD-1 antibody (Topalian SL, et al. N Engl J Med. 2012; 366:2443-2454) and the second evaluating an anti–PD-1 ligand (PD-L1) antibody (Brahmer JR, et al. N Engl J Med. [ Read More ]
According to Genome Health Solutions cofounder Mark S. Boguski, MD, PhD, FCAP, Harvard Medical School’s Center for Biomedical Informatics and Beth Israel Deaconess Medical Center, at this point in time, the promise of genomics lies “not so much in therapeutics or disease prevention, but in precision diagnostics that will really enable personalized medicine.”[ Read More ]
A team of researchers from the University of Colorado led by Tyler Robin, PhD, Department of OB/GYN, Denver Anschutz Medical Campus, has discovered a new biomarker in Ewing’s sarcoma that explains the lack of disease response to current chemotherapy in some patients with this cancer, who until now have had a very poor prognosis. The identification of EYA3 protein as a novel biomarker—a mediator of chemoresistance—in Ewing’s sarcoma explains the mechanism of EYA3 overexpression as the culprit in the resistance to chemotherapy in this disease. [ Read More ]
Texas Children’s Cancer Center has opened the first center dedicated entirely to the research, care, and treatment of children with lymphoma. The Fayez Sarofim Lymphoma Center at Texas Children’s Cancer Center was made possible by a gift of $10 million to Texas Children’s Hospital.[ Read More ]
Greenville Hospital System (GHS) has launched the Center for Integrative Oncology and Survivorship, which offers emotional services for cancer survivors developed by Cancer Support Community (CSC), an international provider of cancer-related social and emotional services. “Research shows that social and emotional support is as important as medical care in the fact of a cancer diagnosis,” said Larry Gluck, MD, Medical Director, GHS Cancer Center, SC. [ Read More ]
Several researchers at the University of Rochester Medical Center have been studying the effects of exercise on patients with cancer for some time now.
“In 15 years, we have gone from being afraid to recommend exercise to people with cancer to having enough data that show, by and large, that it is safe and effective, particularly for relief of treatment side effects,” suggests Karen Mustian, PhD, MPH, Assistant Professor of Radiation Oncology, University of Rochester Medical Center, NY.[ Read More ]
The US Food and Drug Administration (FDA) has approved the Access Hybritech p2PSA (Beckman Coulter) test, which measures a form of prostate-specific antigen (PSA) called [-2]proPSA in the blood and can help men whose PSA test scores are elevated decide whether they should have a biopsy to rule out prostate cancer.[ Read More ]
The FDA’s Oncologic Drugs Advisory Committee (ODAC) recommended in an 11 to 0 vote (and 1 absentee) to approve carfilzomib (Kyprolis; Onyx), a new-generation proteasome inhibitor, for the treatment of patients with refractory and relapsed multiple myeloma who have failed at least 2 other myeloma therapies—the proteasome inhibitor bortezomib (Velcade) and the immunomodulatory drug lenalidomide (Revlimid).[ Read More ]
Approximately 1 in 5 patients with cancer who are undergoing radiotherapy as part of their treatment can count on unexpected hospital stays—adding an economic and clinical burden on the patient and on the healthcare system, according to an analysis by Nabeel H. Arastu, BS, and colleagues at the Brody School of Medicine at East Carolina University, Greenville, NC, which was presented at the 2012 ASCO meeting.[ Read More ]
Chicago, IL—Older patients with cancer and Medicare coverage often incur greater out-of-pocket (OOP) expenses compared with their counterparts without cancer. Factors contributing to the greater expenses for those patients include comorbidities and lack of supplemental insurance. As a result, older patients often hesitate to seek treatment for cancer because of financial concerns, according to a study presented by Amy J. [ Read More ]
Chicago, IL—In a cohort of patients at risk for colorectal cancer (CRC), the majority were willing to pay some out-of-pocket (OOP) expenses for genetic testing, Fox Chase Cancer Center researchers reported in a poster that was presented at the 2012 American Society of Clinical Oncology (ASCO) meeting and earned an ASCO Merit Award.
“These participants are fearful of a positive result and anticipate benefits afforded by genetic testing in controlling cancer risk,” said Jennifer M. Matro, MD, a medical oncology fellow at Fox Chase in Philadelphia.[ Read More ]
Chicago, IL—Improved cancer screening can save lives, and despite the high cost of implementing such a measure, it was found cost-effective and therefore valuable in a recent analysis using quality-adjusted life-years (QALYs), said Michael S. Broder, MD, President of Partnership for Health Analytic Research, LLC (PHAR), CA, and colleagues, at the 2012 American Society of Clinical Oncology meeting.[ Read More ]
Chicago, IL—Researchers from the University of North Carolina in Chapel Hill reported at the 2012 American Society of Clinical Oncology meeting that endocrine therapy is substantially underutilized among the low-income breast cancer population.
For women with estrogen receptor (ER)-positive or progesterone receptor (PR)-positive disease, endocrine therapy reduces the 5-year recurrence risk by as much as 40%, but this study showed that low income may be an obstacle to receiving this guideline-recommended treatment.[ Read More ]
Tivozanib, a potent investigational tyrosine kinase inhibitor with a long half-life, demonstrated significant improvement in progression-free survival (PFS) as first-line targeted therapy for metastatic renal-cell carcinoma (RCC), according to results from a phase 3 randomized, open-label trial.
The results suggest that “tivozanib should be considered a first-line treatment option for metastatic RCC,” said Robert Motzer, MD, an oncologist at Memorial Sloan-Kettering Cancer Center, New York, and the trial’s lead investigator.[ Read More ]
Chicago, IL—Adverse events (AEs) related to chemotherapy for metastatic breast cancer create a substantial economic burden that is primarily explained by increased inpatient, outpatient, and pharmacy costs, said lead investigator Sara A. Hurvitz, MD, Director of the Oncology Breast Can cer Program at University of California, Los Angeles (UCLA) Jonsson Comprehensive Cancer Center and Assistant Clinical Professor at UCLA School of Medicine, who presented an economic analysis at the 2012 Ameri can Society of Clinical Oncology meeting.[ Read More ]
Houston, TX—There is no question that evidence-based guidelines and pathways are critical to the success of value-based oncology, but not all stakeholders have an equal voice, said Craig Deligdish, MD, Chief Medical Officer at Oncology Resource Networks of America at the Second Annual Meeting of the Association for Value-Based Cancer Care. The goals inherent in value-based oncology benefit programs include:[ Read More ]
Houston, TX—“Collaboration, coordination, data, and innovation are key to achieving value-based cancer care,” said Loreen M. Brown, MSW, Vice President of Reimbursement and Access Consulting, Xcenda, AmerisourceBergen Consulting Services.
Speaking at the Second Annual Conference of the Association for Value-Based Cancer Care, Ms Brown made the following points about the “evolving market” of oncology:[ Read More ]
Houston, TX—Payer-sponsored programs that promote appropriate endof- life care are beneficial to all stakeholders, according to Ira M. Klein, MD, MBA, Chief of Staff to the Chief Medical Officer, Aetna Oncology Strategy.
At the Second Annual Conference of the Association for Value-Based Cancer Care, Dr Klein discussed advancedcare directives and emphasized that the patient and family “should be at the center of what you do.”[ Read More ]
Houston, TX—Hard times are getting even tougher for small oncology practices, said Leonard Natelson, Chief Executive Officer, Hematology/Oncology Associates, Rockland, NY, at the Second Annual Conference of the Association for Value-Based Cancer Care.
Hematology/Oncology Associates is an independent practice of 5 physicians, which in the Northeast region is considered “large,” Mr Natelson said. He cited 5 main challenges facing community oncologists today:[ Read More ]
Houston, TX—“The key question on everyone’s mind is, how do we monetize the value of pathways?” said Peter G. Ellis, MD, Deputy Director of Clinical Services and Associate Chief Medical Officer, University of Pittsburgh Cancer Centers, PA, at the Second Annual Conference of the Association for Value-Based Cancer Care. Clearly, Dr Ellis said, the use of pathways has internal practice value.
Pathways:[ Read More ]
San Francisco, CA—Knowledge of pharmacogenomics—the genomic factors contributing to individual variability in response to drug therapy (or personalized medicine)—enhances the ability to diagnose, prevent, and treat disease, especially a variety of cancers. The correct application of pharmacogenomics to patient management is essential for providing cost-effective care, but many providers, includ - ing physicians and pharmacists, are lacking appropriate knowledge of the science. [ Read More ]
San Francisco, CA—Although the upfront cost of vemurafenib is high, its use to treat patients with metastatic melanoma actually results in a costsavings per health plan member per month (PMPM), according to an analysis presented at the 2012 Academy of Managed Care Pharmacy annual meeting.
In a hypothetical health plan of 500,000 enrollees, the use of vemurafenib for the treatment of patients with BRAF V600E mutation is costsaving by $0.04 PMPM, reported William B. Wong, MS, PharmD, of the University of Washington, Seattle.[ Read More ]
San Francisco, CA—In its national coverage decision (NCD) for sipuleucel-T in the treatment of advanced prostate cancer, the Centers for Medicare & Medicaid Services (CMS) left the coverage decision for any off-label use of medications to the discretion of the local Medicare contractors, citing an absence of data on which to make a coverage decision.[ Read More ]
Cervical cancer remains an important public health issue. The US Preventive Services Task Force (USPSTF) has issued an update to its 2003 cervical cancer screening recommendations based on current evidence (Moyer VA, on behalf of the USPSTF. Ann Intern Med. 2012;156:880-891). The key updated points in the new guidelines include:[ Read More ]
In childhood cancer survivors, subsequent malignant neoplasms are a leading cause of premature death, second only to recurrence of the primary cancer. The Childhood Cancer Survivor Study included a cohort of 14,337 childhood cancer survivors (which is believed to be the largest cohort of this type) and assessed the risk for gastrointestinal (GI) malignant neoplasms in this population (Henderson TO, et al. Ann Intern Med. 2012;156:757-766).[ Read More ]
Diagnostic surgery is often used to evaluate the 15% to 30% of thyroid nodules that cannot be judged benign or malignant by the use of fine-needle aspiration (FNA). However, such surgery is associated with a 2% to 10% risk of serious complications. A new geneexpression test may soon be used for the diagnosis of such nodules, which could reduce the use of diagnostic surgery in this population (Alexander EK, et al. N Engl J Med. Epub 2012 Jun 25).[ Read More ]
San Francisco, CA—The vast majority of published evidence indicates that the relative treatment effect of chemotherapy for stage III colon cancer is as good for elderly patients as it is for younger ones, according to a systematic literature review by Anna Hung, a student in the program, and C. Daniel Mullins, PhD, Professor, Pharmacoeconomics, Pharmaceutical Health Services Research Department, Associate Director, Center on Drugs and Public Policy. The study was presented at the 2012 Academy of Managed Care Pharmacy annual meeting.[ Read More ]
San Francisco, CA—In what appears to be the first study to use real-world, non–clinical trial data to evaluate the cost-effectiveness of pemetrexed/platinum (Pem/P) therapy used first line in patients with advanced non–smallcell lung cancer (NSCLC), this combination trended toward being more effective and less costly than carboplatin/ paclitaxel plus bevacizumab (C/Pa+B), reported Manan Shah, PharmD, PhD, with Xcenda, Palm Harbor, FL, and colleagues at the 2012 Academy of Managed Care Pharmacy annual meeting.[ Read More ]
Chicago, IL—The surprising results of a randomized trial on patient preference for one cancer therapy over another show that patient-reported quality-of-life (QOL) differences influence treatment preference far more than physicians had imagined, suggested researchers at the 2012 American Society of Clinical Oncology meeting.[ Read More ]