Oncology

On day 1 of the Association of Community Cancer Centers (ACCC)'s 45th Annual Meeting & Cancer Center Business Summit, we spoke with Tom Gallo, the outgoing president of ACCC and Nicole Braccio, PharmD, director of policy at the National Patient Advocate Foundation.

While the high price of drugs is an issue, what is really important is the actual cost patients are faced with at the pharmacy counter, said Ted Okon, executive director of the Community Oncology Alliance, and Daniel Klein, president and executive director of the Patient Access Network Foundation, at the University of Michigan Center for Value-Based Insurance Design (V-BID), V-BID Summit.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

This week, the top managed care news included the 2020 budget plan proposing a mix of healthcare spending cuts and increases; the FDA approving the first immunotherapy regimen for breast cancer; and researchers uncovering how sodium glucose co-transporter-2 inhibitors work.

Care coordinators are a support system for the clinical and the clerical teams to make sure that nothing falls through the cracks, explained Jessa Dunivan, patient services manager, Northwest Medical Specialties.

There are similarities between the challenges of accessing good cancer care in rural areas of the United States and Rwanda, such as poverty, transportation, and lack of routine care, said Lawrence N. Shulman, MD, director of the Center for Global Cancer Medicine at the Abramson Cancer Center, and professor of Medicine at the Hospital of the University of Pennsylvania.

In an effort to increase patient accrual, broaden patients’ access to cancer clinical trials, and lead to trial results that better represent treatment effects in the real world, the FDA published 4 draft guidances and 1 final guidance to promote the inclusion of pediatric patients and patients with comorbidities that can occur alongside cancer.

Sometimes, patients may misunderstand the role of the social worker as part of the care team, but ultimately, they end up really being appreciative of the services, said Abra Kelson, MSW, LSWA-IC, medical social work supervisor, Northwest Medical Specialties.

The approval is based off of progression-free survival data from the IMpassion130 study and represents the first approved immunotherapy regimen for breast cancer.

I think we’re in a bit of a lull for exciting new therapy developments, likely because the development of the checkpoint inhibitors has just been so extraordinary revolutionary, explained Janice Mehnert, MD, Head of the Phase I Developmental Therapeutics Program at Rutgers Cancer Institute of New Jersey, and the Head of the Melanoma Research Team.

While use of palliative care at the end of life has increased, disparities remain, and not all patients who are terminally ill with blood cancers are having discussions about their goals of care at the end of life.

Administration of immuno-oncology therapy for cancer diagnoses in the community clinic setting is associated with lower costs compared with administration in a hospital-based clinic setting.

Two abstracts presented at the Transplantation and Cellular Therapy Meetings analyzed the detection of minimal residual disease during and after hematopoietic stem cell transplantation.

Since carfilzomib was approved at a 27 mg/m2 twice-weekly dose, it has since been optimized at 56 mg/m2 twice-weekly and a recent study found benefits of a 70 mg/m2 once-weekly dose. However, most patients are still treated with the original approval dosage, suggesting they might be undertreated.

Scientists at the National Institutes of Health have recently found that biologic age, or a DNA-based estimate of a person’s age, is associated with future development of breast cancer.

How to improve patient-reported measurement in oncology valued-based care is the focus of a new report from The National Pharmaceutical Council and Discern Health.

Researchers have confirmed that there is no link between flu shots and miscarriages; a liquid biopsy is as effective as tissue-based testing for identifying treatment for lung cancer; and physicians generate an average of $2 million a year for hospitals.

Bruce Feinberg, DO, vice president and chief medical officer for Cardinal Health Specialty Solutions, recently chaired a discussion centered on the flurry of megamergers in healthcare: Walmart and Humana, Aetna and CVS, Cigna and Express Scripts, and Amazon and PillPack.

On March 7, The American Journal of Managed Care® will host its latest Institute for Value-Based Medicine in Dallas, Texas, with the Advancing Quality Oncology Care in the Evolving Value-Based Care Landscape meeting.

A high proportion of patients with acute myeloid leukemia (AML) who achieve a negative minimal residual disease (MRD) status still relapse, indicating a more sensitive method of detecting MRD is needed.

Therapeutic updates from Patient-Centered Oncology Care® 2018.

Updates on reporting otucomes and pathway design from Patient-Centered Oncology Care®.

Various stakeholders discuss the future of oncology care at the Patient-Centered Oncology Care® meeting. Editor’s Note: After this issue went to press, Wes Hall passed away February 20, 2019, after living more than 5 years with stage IV stomach cancer. He was active in the Community Oncology Alliance Patient Advocacy Network and supported participation in clinical trials.

The major alternative payment model put forth by Medicare, the Oncology Care Model, doesn’t tell practices how they are doing until after the fact. This puts practices at risk for things beyond their control, said Barbara McAneny, MD, a New Mexico oncologist/hematologist who is the current president of the American Medical Association (AMA).

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.

Researchers have used positron emission tomography scans to identify which patients with a type of human epidermal growth factor receptor 2–positive breast cancer might benefit most from targeted agents alone and can be spared chemotherapy.

The majority of countries could see an end to cervical cancer as a public health problem by 2060, according to a new study in The Lancet Oncology.

The update follows a study published in November that found almost no difference in the frequency of mutations between patients with breast cancer who met National Comprehensive Cancer Network guidelines and those who didn't.

Worldwide, more than half a million new cases of hepatocellular carcinoma (HCC) are diagnosed annually. The incidence of HCC in the United States is rising with an estimated 31,000 new cases in 2018. Disease prognosis remains poor, with a 5-year survival rate across all disease stages estimated between 10%-20%, and 3% for those diagnosed with distant disease. Although morbidity is significant, especially among patients with advanced-stage disease, limited information exists on the humanistic and economic burden of HCC.

Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.