ASCO 2015 Highlights

The incidence of metastatic prostate cancer increased by >70% from 2004 to 2013, including >90% in the age-group most likely to benefit from definitive treatment, according to a new analysis of a national database (Weiner AB, et al. Prostate Cancer Prostatic Dis. 2016 Jul 19. Epub ahead of print).

It does not take a crystal ball, or even an economist, to foretell that disaster is imminent in the healthcare system if premiums and out-of-pocket costs continue to rise, along with the cost of cancer drugs. Although the government attempts to rectify the situation with Medicare payment reform, new payment and care delivery models, such as the Oncology Care Model (OCM) pilot, and laws, such as the 2015 Medicare Access and CHIP Reauthorization Act (MACRA), present financial challenges for oncologists.

In today’s changing oncology landscape, the quality and value of cancer care have become increasingly integrated. With the rising costs of cancer treatment, payers and policymakers aim to better define value, as well as to educate patients about their therapeutic options. Insurers and payers have implemented a variety of strategies to control costs at the behest of employer plan sponsors, including utilizing oncology clinical pathways.

A new study of the geographic distribution of cancer surgeries in the Medicare population has shown that performing radical prostatectomies in high-volume centers leads to improved outcomes and reduced costs of care. Referring patients to a high-volume provider within 100 miles could save >$20 million annually, according to data presented at the 2016 American Society of Clinical Oncology annual meeting and published just before the meeting.

Although immune checkpoint inhibitors can significantly extend survival of patients with metastatic disease, more than 50% of the patients who use them have serious, grade 3 to grade 5 adverse events. These toxicities comprise a considerable proportion of the total number of immune checkpoint inhibitors, especially those that target PD-1, said Neil T. Mason, MBA, Personalized Medicine Strategist, Moffitt Cancer Center, Tampa, FL, who presented his study results at a poster session at the 2016 American Society of Clinical Oncology annual meeting.

The first study to assess the addition of temozolomide (Temodar) chemotherapy during short-course radiation therapy, followed by monthly maintenance of temozolomide in elderly patients with glioblastoma showed a significantly reduced risk for death, said the study co-author James R. Perry, MD, FRCPC, The Crolla Family Endowed Chair in Brain Tumour Research, Odette Cancer and Sunnybrook Health Sciences Centres, Toronto, Canada, in a plenary session at the 2016 American Society of Clinical Oncology annual meeting.

The national Cancer Moonshot initiative, led by Vice President Joe Biden, was established to accelerate the progress in cancer outcomes, including prevention, diagnosis, and treatment. First introduced in January 2016, the initiative is focused on moving cancer research forward in a meaningful way by encouraging greater cooperation between cancer research institutions and increasing data-sharing for that purpose, said Douglas R. Lowy, MD, Acting Director, National Cancer Institute (NCI), at the 2016 American Association of Physicists in Medicine annual meeting in Washington, DC.

Every patient with cancer and cancer survivors should undergo screening for pain at each follow-up visit, and clinicians should individualize the recommendations for intervention as indicated by each patient’s self-reported pain, according to the first-ever clinical guidelines for managing pain in cancer survivors recently published by a panel of experts convened by the American Society of Clinical Oncology (ASCO).