Oncology Practice Management Issues

May 2018, Vol 8, No 5

Managing Immune Checkpoint Inhibitor Side Effects: Key Recommendations

Clark Westfield

Side-Effects Management

Immunotherapies have transformed the treatment of cancer, but patients who receive immune checkpoint inhibitors may experience a range of side effects, which are only recently becoming familiar to oncologists and patients. The novelty of immune checkpoint inhibitors has led the American Society of Clinical Oncology (ASCO), in collaboration with the National Comprehensive Cancer Network (NCCN) to jointly develop a new guideline to help clinicians recognize and manage these side effects. [ Read More ]

Nivolumab Shows Durable Activity in Subgroups of Patients with Metastatic CRC

Charles Bankhead


Almost 66% of patients who had previously received treatment for metastatic co­lorectal cancer (mCRC) and DNA mismatch repair deficiency (dMMR) derived clinical benefit from monotherapy with nivolumab (Opdivo), long-term follow-up from a prospective clinical trial showed. After a median follow-up of almost 2 years, 34% of 74 evaluable patients had objective responses, including 7 complete responses. [ Read More ]

Adcetris Approved as Initial Treatment for Stage III or IV Classical Hodgkin Lymphoma

FDA Approvals, News & Updates

On March 20, 2018, the FDA approved a new indication for brentuximab vedotin (Adcetris; Seattle Genetics) as a first-line treatment, in combination with chemotherapy, for adults with untreated stage III or stage IV classical Hodgkin lymphoma. The FDA approved this indication using its priority review process and designated brentuximab vedotin as a breakthrough therapy. [ Read More ]

Tagrisso Now Approved as First-Line Therapy for Patients with Metastatic NSCLC and EGFR Mutations

FDA Approvals, News & Updates

On April 18, 2018, the FDA approved osimertinib (Tagrisso; AstraZeneca Pharmaceuticals) as first-line treatment for patients with metastatic non–small-cell lung cancer (NSCLC) and EGFR exon 19 deletions or exon 21 L858R mutations, as detected by an FDA-approved test. The FDA used its priority review process, and designated osimertinib as a breakthrough therapy for this indication. [ Read More ]

Survivorship Guidelines Present Challenges in Primary Care

Meg Barbor, MPH


In an ideal world, standardized survivorship guidelines would facilitate coordinated care between oncology and primary care, but in the real world, gaps exist and current guidelines clash, according to Linda Overholser, MD, MPH, Associate Professor, Division of General Internal Medicine, University of Colorado Denver School of Medicine. She discussed her experience using guidelines related to cancer follow-­up care at the 2018 Cancer Survivorship Symposium. [ Read More ]

Cabozantinib Active as First-Line Treatment of Differentiated Thyroid Cancer

Corbin Davis

2018 Head and Neck Cancers Symposium

Results from a phase 2 clinical trial have shown that cabozantinib (Cometriq) is active in radioiodine-refractory differentiated thyroid carcinoma in the first-line setting, according to data presented at the 2018 Multidisciplinary Head and Neck Cancers Symposium. Cabozantinib induction therapy resulted in a 54% response rate and an 80% clinical benefit, meeting the study primary end point. The treatment was also well-tolerated, with mostly grade 1 and 2 adverse events. [ Read More ]

Low Survival in Patients with Head and Neck Cancers Linked to Delays in Radiation Therapy After Surgery

Corbin Davis

2018 Head and Neck Cancers Symposium

A shorter interval from surgery to the start of radiation therapy has been linked to improved survival in patients with head and neck cancers, according to data presented at the 2018 Multidisciplinary Head and Neck Cancers Symposium. Results of a retrospective analysis showed that patients who received radiation within 42 days of surgery had a median overall survival (OS) of 10.5 years versus 8.2 years for those who received radiation 43 to 49 days after surgery. Moreover, when radiation was delayed by ≥50 days postsurgery, the median OS dropped to 6.5 years. The data also demonstrated improved OS for patients who received accelerated versus standard fractionated therapy, the investigators noted. [ Read More ]

NCCN Issues First Guideline for Immunotherapy-Related Adverse Events

Wayne Kuznar

NCCN Guideline Updates

The National Comprehensive Cancer Network (NCCN)’s first guideline (version 1.2018) for the management of side effects from immunotherapy recognizes “a new spectrum of adverse events” in patients who are receiving immune checkpoint inhibitor therapy, said John A. Thompson, MD, Director, Phase I Clinical Trials Program, Fred Hutchinson Cancer Research Center, Seattle, WA, at the 2018 NCCN annual conference. Dr Thompson is also chair of the NCCN panel on the management of immunotherapy-related toxicity. [ Read More ]

Using Cancer Drugs Wisely to Control Costs: Targeted Therapies May Hold the Key

Gail Thompson

2018 Cancer Center Business Summit Highlights

How we use, label, study, and think about cancer drugs could make seismic changes in the pricing and access of cancer treatments for patients, but we need to rethink what we are doing first. Thought leaders from the provider, distribution, payer, and pharmaceutical arenas addressed these challenges at the 2018 combined meeting of the Association of Community Cancer Centers and the Cancer Center Business Summit. The meeting included a panel discussion about the costs of drugs, and the significant rise in the costs of cancer drugs after the US Food and Drug Administration (FDA) approval. [ Read More ]