Oncology

Dramatic progress has been made in reducing colon cancer incidence and death rates in the U.S., but concerns remain about striking racial and socio-economic disparities, according to new national statistics on colorectal cancer.

U.S. patients not only are spending too much on medical treatments, there are still too many ways dollar-driven health care causes harm, according to a top official with the American Cancer Society.

A more individualized view of what drives the onset of non-small cell lung cancer is raising treatment hopes as new therapies emerge and are under development, said Leora Horn, MD, MSc, of the Vanderbilt-Ingram Cancer Center, who presented an overview Friday at the National Comprehensive Cancer Network's 19th Annual Conference: Advancing the Standard of Cancer Care, held in Hollywood, Florida.

The title of the talk by Celestia S. Higano, MD, New Developments in the Treatment of Hormone Refractory Prostate Cancer, was notable in the use of a term that has been replaced over the past decade with castration resistant. It was a change that Dr Higano, of the Fred Hutchison Cancer Research Center in Seattle, Washington, admits she did not support at the time.

Advances in treating multiple myeloma have transformed the field over the past decade, giving clinicians more effective therapy options for newly diagnosed patients who are candidates for stem cell transplant and those who are not.

Friday's session of the National Comprehensive Cancer Network's 19th Annual Conference: Advancing the Standard of Cancer Care, featured a well-attended roundtable, The Affordable Care Act: Where Are We Now? Moderated by Clifford Goodman, PhD, of The Lewin Group, the wide-ranging discussion featured panelists Christian G. Downs, JD, MHA, Association of Community Cancer Centers; Liz Fowler, PhD, JD, Johnson & Johnson; Michael Kolodziej, MD, Aetna; Lee H. Newcomer, MD, MHA, UnitedHealthcare; Mohammed S. Ogaily, MD, Henry Ford Health System; W. Thomas Purcell, MD, MBA, University of Colorado Cancer Center; and John C. Winkelmann, MD, Councillor, American Society of Hematology, Oncology Hematology Care, Inc.

Fox Chase Cancer Center's Crystal Denlinger, MD, presented Optimal Post-Treatment Surveillance: Is More Really Better?, addressing a topic that challenges not only patients and their physicians, but also payers as the nation moves toward a healthcare system defined by the maxim "better quality at a lower cost."

In his talk, Melanoma Guideline Update: New Agents and Opportunities for Treatment, John A. Thompson, MD, of the Fred Hutchinson Cancer Research Center in Seattle, Washington, first showed the preferred list of treatments for advanced or metastatic melanoma: ipilimumab, vemurafenib, dabrafenib, dabrafenib plus trametinib, high-dose interleukin-2, and the drugs-to-come in the category: clinical trials.

Who should receive genetic counseling and screening for colorectal cancer (CRC)? And how early should annual colonoscopies happen once those at risk are identified? These are important questions with equally important and complex answers.

Life-saving therapies that halt cancer can take a toll on the skeletal system, leaving survivors with bone loss or more serious injuries such as broken wrists, ribs, or hips. Watchful attention, screening, and therapy are needed to prevent these outcomes.

The National Comprehensive Cancer Network (NCCN) has revised its medical guidelines to expand Lynch syndrome screening. Lynch syndrome is the most common cause of hereditary colon cancer in adults.

Genetic counseling-including testing and risk assessment-is one of the most rapidly growing areas of oncology and has become the standard of care for patients with a personal and family history of breast, ovary, or colon cancer.

Ed Pezalla, MD, MPH, national medical director for pharmacy policy and strategy, office of the CMO, Aetna, says payers and health plans are preparing for patient-centered care by utilizing digital tools. Everything from virtual people to cost search tools are used to assist employed and general patient populations. Dr Pezalla says many of these tools will also be used in the public and private health insurance exchanges to help people make decisions as they purchase health plans.

Dennis Falci, MBA, director, US managed markets training, sales training and leadership development, Sanofi-Aventis SA, says it's no secret-Health Insurance Exchanges are a hot topic in health news.

A 4-year study assessing the impact of early outpatient palliative care versus standard oncology care in a variety of advanced cancers found promising results. The researchers observed that when palliative care teams collaborated earlier in the course of illness, it improved patients' quality of life and satisfaction.

Belgian cancer testing group MDxHealth recently announced an agreement with US health organization Prime Health Services to extend access to its prostate cancer test to 144 million insured people. MDxHealth suggests that collaboration will permit faster reimbursement for cancer testing.

How Can Molecular Diagnostic Companies Show Value if Insurers Won't Pay?

Researchers from the Johns Hopkins Sidney Kimmel Comprehensive Cancer Center in Baltimore suggest that controlling the costs to treat cancer without increasing risk to patients requires a collaborative approach.

The malady of rising medical costs is acute, especially in the field of oncology. As populations age, new cancer cases are expected to reach 21.4 million in 2030, while treatment costs are projected to increase 40 percent by 2020.

Oncology clinical pathways have helped health plans deliver quality care while keeping an eye on costs. The lack of standardization in pathways can be cumbersome on a busy oncology practice. If Medicare adopts a pathways model, it could offer a framework for broader use.

The US Food and Drug Administration (FDA) on Wednesday granted accelerated approval for the expanded use of ibrutinib, marketed as Imbruvica, for chronic lymphocytic leukemia (CLL) patients who have previously received at least one therapy. The therapy is notable for its relative lack of toxic effects.

The value of the mammogram is being questioned after 1 study found that the mortality rates resulting from breast cancer were the same in women who got screened and those who did not.

Testing the entire genetic makeup -- or all the DNA -- of tumor cells from women with advanced breast cancer may help identify patients who could be helped by specific treatments, according to new research.

Drugstore giant CVS Caremark's decision to stop selling tobacco products at its stores is being hailed as a victory among public health advocates, a move they predict will force CVS competitors to follow suit as they look to play a growing part in the delivery of the country's healthcare.

Pat Gleason, PharmD, FCCP, BCPS, director of health outcomes, Prime Therapeutics, and Shelley Sanchez, senior director of specialty product development, Prime Therapeutics, presented on 1 approach to managing the specialty drug benefit, which includes optimizing the use of PhARMA manufacturer coupons and patient assistance programs (PAPs).

Presenters in this talk focused on how the creation of health insurance exchanges (HIEs) and other federal and state regulations will impact the provision and administration of pharmacy benefits.

According to Howard K. Crowley, head of pharmacy strategic initiatives, Aetna Pharmacy Management, a Towers Watson/ National Business Group on Health survey found that 29% of employers rank the rising costs of specialty drugs as a top challenge to keeping health benefit coverage affordable.

This week AJMC is covering session highlights from the PBMI Annual Drug Benefit conference.

Chris Belmont, vice president and chief information officer, MD Anderson Cancer Center, says the right timing and the right context are essential to effective health data management.