October 2019, Vol 10, No 5

San Diego, CA—As the treatment landscape in oncology changes on a seemingly daily basis, providers face increasingly complex decisions, and it is not just the myriad of therapies available: oncologists must balance drug efficacy and toxicity, clinical outcomes, and patient quality of life, all while providing value-based care. Enter clinical pathways, a multidisciplinary management tool used to guide evidence-­based care for subgroups of patients with predictable clinical courses.

In today’s fast-paced healthcare environment, managing health benefits requires dexterity, foresight, and collaboration. At the inaugural multistakeholder Employer-Provider Interface Council (EPIC) of the Hospital Quality Foundation interactive Leadership Conference that took place on June 11, 2019, the relationships among employer plan sponsors, employee healthcare consumers, and healthcare providers were explored. To understand how health benefits are managed to deliver value to stakeholders, several speakers discussed the importance of how to define and derive value in the rapidly changing healthcare industry. Each presentation was followed by reactions from a stakeholders panel from various segments of the healthcare industry, including consumer advocacy, employer, payer, government, and provider.

Diagnosis of cholangiocarcinoma (CCA) is often identified at a late stage. Analyzing the tumor-specific mutation profile of a patient with CCA can improve the diagnosis and treatment for the individual patient. The molecular profile of CCA can be done through the use of circulating tumor (ct) DNA sequencing, which may help to target specific mutations and improve treatment selection for this rare type of cancer.

San Diego, CA—New research sponsored by the National Cancer Institute highlights the uphill battle faced by patients with limited financial resources even in clinical trials. According to data presented at the 2019 ASCO Quality Care Symposium, patients with Medicaid or with no insurance had significantly worse overall survival in positive clinical trials compared with privately insured patients.

Chicago, IL—Tumor-specific antigens provide personalized targets for immunotherapy. Neoantigen vaccines are a new type of immunotherapy that can elicit immune response and achieve remission. Evidence is compelling to support neoantigens as the target of effective immune responses against cancer and to support an association between neoantigen load with improved clinical outcome, said Patrick Alexander Ott, MD, PhD, Clinical Director, Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, MA, at ASCO 2019.

Chicago, IL—Treatment with the immune checkpoint inhibitor pembroliz­umab (Keytruda) dramatically improved 5-year survival for patients with advanced non–small-cell lung cancer (NSCLC) compared with expected survival in the preimmunotherapy era, according to the 5-year follow-up data from the phase 1b KEYNOTE-001 clinical trial. The study was presented at ASCO 2019 and was published simultaneously in the Journal of Clinical Oncology.

San Diego, CA—The economic burden faced by patients with cancer who have low income may be more pervasive than previously thought. According to data presented at the 2019 ASCO Quality Care Symposium, even patients enrolled in clinical trials are at high risk for financial toxicity.

In a new analysis, researchers examined the estimated cost of lost earnings that resulted from cancer-related deaths in the United States, nationally and by state (Islami F, et al. JAMA Oncol. 2019 Jul 3 [Epub ahead of print].).

Anaheim, CA—The speed at which the genetics revolution has propelled forward in oncology has created enormous ramifications and unanticipated challenges, according to Suzanne Mahon, RN, DNSc, AOCN, AGN-BC, CNS, Professor, Division of Hematology/Oncology, Department of Internal Medicine, Saint Louis University, MO.

San Diego, CA—Patient-centered clinical pathways may hold the promise of truly personalized medicine, improving value-based care and clinical outcomes. However, according to Cary P. Gross, MD, Director, Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale School of Medicine, New Haven, CT, substantial challenges still stand in the way of including the patient’s voice in these pathways.