Oncology Practice Management Issues


March 2017, Vol 7, No 3

How Washington Is Shaping a New Healthcare Reform

Gail Thompson

Cancer Center Business Summit

Former Senator Bill Frist, MD, opened the 2017 Cancer Center Business Summit in Las Vegas, NV, in early February, with a smile and a warning that we are in unfamiliar territory as the new Congress and the new administration move into 2017, territory that may occur only 2 or 3 times in a century. He said that, “For the first time since 1929, the GOP [the Republican Party] controls Congress, the White House, most governorships and state houses, as well as the Supreme Court.” [ Read More ]

Benefit of Extended Adjuvant Aromatase Inhibition in Breast Cancer Questionable

Phoebe Starr

Breast Cancer

Extended adjuvant endocrine therapy beyond 5 years with an aromatase inhibitor (AI) failed to improve disease-free survival (DFS) in patients with hormone receptor (HR)-positive breast cancer who were enrolled in the 3 large National Surgical Adjuvant Breast and Bowel Project (NSABP) B-52, IDEAL, and DATA studies, which were presented at the 2016 San Antonio Breast Cancer Symposium. [ Read More ]

Immunotherapy with Nivolumab plus Ipilimumab Improves Outcomes in Metastatic Urothelial Cancer

Walter Alexander

Immunotherapy

Results of a phase 1/2 study that investigated 2 dosing regi­-mens of 2 immunotherapies—the PD-1 inhibitor nivolumab (Opdivo) plus the CTLA-4 inhibitor ipilimumab (Yervoy)—in patients with previously treated metastatic urothelial carcinoma showed higher response rates and longer median overall survival with the regimen of nivolumab 1 mg/kg plus ipilimumab 3 mg/kg than with the dosing of nivolumab 3 mg/kg plus ipilimumab 1 mg/kg. [ Read More ]

New Research Explains Reasons for Latent Metastasis, Charting a Way for Novel Immunotherapies

Jessica Miller

Immunotherapy

Cancer often returns years after successful treatment, and it often metastasizes to new organs, which is known as latent metastasis. Certain cancer cells, recently labeled as latency competent cancer (LCC) cells, are capable of becoming dormant for extended periods of time, thereby evading the body’s immunity and leading to cancer recurrence in distant organs after the initial remission. [ Read More ]

Shifting Targets for Providers, Payers, and Patients with Cancer: Perspectives in Healthcare Reform

Gail Thompson

Cancer Center Business Summit

A panel discussion at the 2017 Cancer Center Business Summit revealed continuing gaps in the evolution of healthcare reform among providers, payers, and patients with cancer. Michael Kolodziej, MD, National Medical Director, Managed Care Strategy, Flatiron Health, New York, NY—an oncologist with experience on the provider and the payer sides—moderated the panel discussion, which offered perspectives from the trenches on healthcare reform. [ Read More ]

Tools to Improve Patient Engagement in Value-Based Care

Gail Thompson

Cancer Center Business Summit

With the advent of a shift to value-based care and increasing accountability for effective care, patient engagement is emerging as the primary mechanism to effect change. However, the sheer volume of patients means that physicians and nurses cannot hope to touch them every day in the meaningful ways needed to fully engage each patient. Technology solutions must rise to the occasion. [ Read More ]

Select Clinical Trials Currently Enrolling Patients with Multiple Myeloma

Clinical Trials Tracker

The following clinical trials represent a selection of key studies that are currently recruiting patients with multiple myeloma for inclusion in investigations of new therapies or new regimens of existing treatments for patients with multiple myeloma. Each description includes the NLM Identifier to be used as a reference with ClinicalTrials.gov. This information can help oncology practice managers and providers direct eligible patients to an appropriate clinical trial. [ Read More ]

Abemaciclib, a CDK4/CDK6 Inhibitor, Shows Promise in Early-Stage Breast Cancer

Phoebe Starr

Breast Cancer

Neoadjuvant therapy with the investigational CDK4/CDK6 inhibitor, abemaciclib, alone or in combination with anastrozole (Arimidex) showed promising activity in postmenopausal hormone receptor (HR)-positive, HER2-negative breast cancer enrolled in the phase 2 NeoMONARCH study. Correlative tissue studies demonstrated that abemaciclib inhibited cell-cycle proliferation and activated the immune system, supporting its anticancer activity. [ Read More ]

National Cancer Mortality Rates Decline, but Some Regions See an Increase

Laura Morgan

Cancer Trends

Cancer mortality rates have declined by more than 20% in the United States between 1980 and 2014, but substantial differences in trends and patterns exist among certain US regions, with some counties exhibiting especially high cancer mortality rates, according to a new analysis by Ali H. Mokdad, PhD, Institute for Health Metrics and Evaluation, University of Washington, Seattle, and colleagues. [ Read More ]

Cisplatin Added to Standard Regimen Leads to Unprecedented Response Rate in Patients with Stage IV Pancreatic Cancer

Wayne Kuznar

GI Cancers Symposium

The addition of cisplatin to standard therapy with gemci­tabine and nab-paclitaxel was associated with a median overall survival (OS) that “has not been seen in stage IV pancreatic cancer,” according to Gayle Jameson, MSN, ACNP-BC, Nurse Practitioner Investigator of Clinical Trials, HonorHealth Research Institute, Scottsdale, AZ, who reported the results from a phase 1b single-arm pilot study using the triplet at the 2017 Gastrointestinal Cancers Symposium. [ Read More ]

Nivolumab a New Treatment Option for Patients with Advanced Gastric Cancer

Wayne Kuznar

GI Cancers Symposium

Nivolumab (Opdivo) as salvage treatment significantly reduced the risk for death after second-line or later chemotherapy in patients with advanced gastric or gastroesophageal junction cancer. In a double-blind, randomized phase 3 trial, the median overall survival was improved by 37% in patients assigned to nivolumab versus placebo after previous treatment with at least 2 regimens, reported Yoon-Koo Kang, MD, PhD, Department of Oncology, Asan Medical Center, Seoul, South Korea, at the 2017 Gastrointestinal Cancers Symposium. [ Read More ]

Reduced-Dose Sorafenib with Uptitration in Hepatocellular Carcinoma Is Cost-Saving Without Compromising Outcome

Wayne Kuznar

GI Cancers Symposium

Starting at a low dose of sorafenib (Nexavar) and titrating up to the full dose of 800 mg, rather than starting the full dose, does not adversely affect outcomes, while improving tolerability and reducing costs in the treatment of patients with hepatocellular carcinoma (HCC). This was the conclusion from a review of 4900 veterans diagnosed with HCC who were prescribed sorafenib at Veterans Administration (VA) hospitals. [ Read More ]

CAR-Targeting CD22 an Effective Salvage Therapy in Relapsed Pediatric Acute Lymphoblastic Leukemia

Wayne Kuznar

Emerging Therapies

Chimeric antigen receptor (CAR)-targeting CD22 therapy induced clinical responses and a high rate of complete remission in children and young adults with relapsed or refractory acute lymphoblastic leukemia (ALL), including patients who had received anti-CD19 CAR T-cell therapy, said Terry J. Fry, MD, Hematologic Malignancies Section, Pediatric Oncology Branch, Center for Cancer Research, National Cancer Institute (NCI), at the 2016 American Society of Hematology meeting. These findings create the opportunity for bispecific or multispecific CAR T-cell targeting. [ Read More ]

Anti-CD19 CAR T-Cell Therapy After Stem-Cell Transplantation Effective in Advanced Multiple Myeloma

Wayne Kuznar

Emerging Therapies

Anti-CD19 chimeric antigen receptor (CAR) T-cell administration after autologous stem-cell transplantation (ASCT) showed clinical activity in patients with advanced multiple myeloma, according to results of a pilot study presented at the 2016 American Society of Hematology meeting. Substantially longer progression-free survival (PFS) was seen in 2 of 10 patients who received ASCT plus CTL019 than in patients who received first-line ASCT, said Alfred L. Garfall, MD, MS, Assistant Professor of Medicine, Abramson Cancer Center, University of Pennsylvania, Philadelphia. [ Read More ]

Pacritinib Shows Good Efficacy in Myelofibrosis: Will the FDA Release Hold on the Drug?

Phoebe Starr

Emerging Therapies

The investigational drug pacritinib, a JAK1/JAK2 inhibitor, achieved benefits in patients with myelofibrosis, including a significant reduction in the spleen volume compared with the best available therapy that included the JAK1/JAK2 inhibitor ruxolitinib (Jakafi), according to the phase 3 PERSIST-2 clinical trial. The results were presented by John O. Mascarenhas, MD, Tisch Cancer Institute, Icahn School of Medicine at Mount Sinai, New York City, at the 2016 American Society of Hematology (ASH) meeting. [ Read More ]