Oncology Practice Management Issues


March 2018, Vol 8, No 3

Begin End-of-Life Conversations When Diagnosing Metastatic Disease

Meg Barbor, MPH

Palliative Care

Discussions about prognosis, transitions to palliative care, and the end of life are—to say the least—challenging for patients and providers. But effective, honest, and supportive communications are keys to good clinical care and informed decision-­making, according to Dame Lesley Fallowfield, FMedSci, DPhil, Professor of Psycho Oncology, Sussex Health Outcomes Research & Education in Cancer, University of Sussex, Brighton, England. [ Read More ]

Utilization of Palliative Care “Dismal” for Patients with Hematologic Malignancies

Chase Doyle

Palliative Care

The largest-ever study of palliative care trends has shown the use of palliative care services to be “sporadic at best” for patients with hematologic malignancies. According to the review of nearly 300,000 patients, there was also significant heterogeneity in practice patterns, including National Cancer Institute (NCI)-designated practices, across all characteristics studied. [ Read More ]

Using Goals-of-Care Videos Can Revolutionize End-of-Life Decisions

Chase Doyle

Palliative Care

A recent survey by Consumer Reports shows that nearly 90% of Americans prefer to die at home, focused on comfort, and yet 66% of Americans aged >65 years die in a healthcare setting, intubated and in considerable pain. According to Angelo E. Volandes, MD, MPH, Internal Medicine Physician, Massachusetts General Hospital, Boston, this misalignment between the medical care people want and the care they ultimately receive is the most urgent problem in American healthcare today. [ Read More ]

Direct Oral Anticoagulants: New Standard of Care for VTE in Patients with Cancer?

Phoebe Starr

Side-Effects Management

Direct oral anticoagulants (DOACs) may soon replace low-molecular-weight heparin (LMWH) as the standard of care for the management of venous thromboembolism (VTE) in patients with cancer, judging by the results of 2 randomized trials presented at ASH 2017. The caveat is that DOACs are associated with more bleeding events, especially in patients with gastrointestinal (GI) cancer who should continue receiving LMWH. [ Read More ]

Gilotrif Receives New Indication as First-Line Treatment for Metastatic NSCLC with Nonresistant EGFR Mutations

FDA Approvals, News & Updates

On January 12, 2018, afatinib (Gilotrif; Boehringer Ingelheim) received FDA approval as first-line treatment for patients with metastatic non–small-cell lung cancer (NSCLC) associated with nonresistant EGFR mutations as identified via an FDA-approved test. Afatinib received orphan drug status for this indication, and was approved under the FDA priority review process. [ Read More ]

Lutathera First Radioactive Drug Approved for Adults with Gastroentero­pancreatic Neuroendocrine Tumors

FDA Approvals, News & Updates

On January 26, 2018, the FDA approved lutetium Lu 177 dotatate (Lutathera; Advanced Accelerator Applications), a radioactive drug, for the treatment of adults with somato­statin receptor–positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs). Lutetium Lu 177 dotatate was approved under the FDA’s priority review process, and was designated as an orphan drug. [ Read More ]

Erleada First Therapy Approved for Patients with Nonmetastatic Castration-Resistant Prostate Cancer

FDA Approvals, News & Updates

On February 14, 2018, apalu­tamide (Erleada; Janssen Pharmaceuticals), an androgen receptor inhibitor, received accelerated approval by the FDA for the treatment of patients with nonmetastatic, cas­tration-resistant prostate cancer (CRPC). Apalutamide is the first treatment approved by the FDA for patients with nonmetastatic CRPC, and was approved under the FDA priority review process. [ Read More ]

Imfinzi First Treatment Approved to Reduce Disease Progression in Unresectable Stage III NSCLC After Chemoradiation

FDA Approvals, News & Updates

On February 16, 2018, the FDA approved an expanded indication for durvalumab (Imfinzi; AstraZeneca), a PD-L1 inhibitor, for the treatment of patients with unresectable stage III non–small-cell lung cancer (NSCLC) that did not progress after chemoradiation. Durvalumab received accelerated approval in 2017 for the treatment of certain patients with metastatic or locally advanced bladder cancer. [ Read More ]

Survey Highlights Need for Improved Patient–Provider Communication and Symptom Management

Chase Doyle

Provider–Patient Communication

Patients with chronic myeloid leukemia (CML) may be living longer thanks to improved therapies, but the results of a new study suggest that they are burdened by ongoing symptoms and treatment side effects. According to data presented at ASH 2017, fatigue, muscle aches, sleep disturbance, and memory loss were reported by 70%, 57%, 46%, and 42% of patients, respectively. [ Read More ]

Venetoclax plus Rituximab New Chemotherapy-Free Option for Chronic Lymphocytic Leukemia

Phoebe Starr

Hematologic Malignancies

Venetoclax (Venclexta) plus rituximab (Rituxan) achieved superior progression-free survival (PFS) and overall survival (OS) compared with standard-of-care bendamustine (Treanda/Bendeka) plus rituximab in patients with relapsed or refractory chronic lymphocytic leukemia (CLL). PFS improved by 81% and OS by 52% with venetoclax plus rituximab, and the depth of response was impressive—complete response and complete response with incomplete platelet recovery was 26.8%, and minimal residual disease negativity in peripheral blood was 83.5%. [ Read More ]

Recent FDA Approvals for Acute Lymphoblastic Leukemia a “Watershed” Moment

Chase Doyle

Hematologic Malignancies

The past few years have witnessed significant progress in the treatment of several hematologic malignancies, and truly paradigm-changing therapies have recently emerged in acute lymphoblastic leukemia (ALL). At ASH 2017, Crystal L. Mackall, MD, Co-Director, Immunology & Immunotherapy of Cancer Program, Stanford University, CA, discussed the FDA approvals of 2 important treatments for patients with B-cell precursor ALL. [ Read More ]

A New Combination as First-Line Regimen in Advanced Hodgkin Lymphoma?

Phoebe Starr

Hematologic Malignancies

Adding brentuximab vedotin (Adcetris) to doxorubicin, vinblastine, and dacarbazine (A+AVD) instead of the standard regimen with doxorubicin, bleomycin, vinblastine, and dacarbazine (ABVD) as frontline treatment for advanced Hodgkin lymphoma reduced the risk for disease progression, death, or the need for additional therapy by 23%, according to new data presented at ASH 2017. [ Read More ]

Treatment Considerations for Relapsed or Refractory Multiple Myeloma

Corbin Davis

Hematologic Malignancies

Despite major advances in treatment interventions, multiple myeloma remains incurable in the majority of patients, and relapse is an expected part of the disease course. At the 2017 NCCN Hematologic Malignancies Congress, Natalie S. Callander, MD, a hematologist at the University of Wisconsin Carbone Cancer Center, Madison, outlined issues in the management of relapsed or refractory multiple myeloma. [ Read More ]

Select Clinical Trials Currently Enrolling Patients with Lymphoma

Clinical Trials Tracker

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