November 2019, Vol 9, No 11

As the treatment landscape in oncology changes on a seemingly daily basis, providers face increasingly complex decisions, and it is not just the myriad of therapies available: oncologists must balance drug efficacy and toxicity, clinical outcomes, and patient quality of life, all while providing value-based care. Enter clinical pathways, a multidisciplinary management tool used to guide evidence-­based care for subgroups of patients with predictable clinical courses. Read Article ›

Patient-centered clinical pathways may hold the promise of truly personalized medicine, improving value-based care and clinical outcomes. However, according to Cary P. Gross, MD, Director, Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale School of Medicine, New Haven, CT, substantial challenges still stand in the way of including the patient’s voice in these pathways. Read Article ›

Great progress has been made in the fight against cancer, but not all patients have benefited equally. Disparities exist among specific populations in terms of survival and cancer-related mortality, incidence and prevalence, as well as adverse health conditions, according to Karen M. Winkfield, MD, PhD, Director, Office of Cancer Health Equity, Wake Forest Baptist Medical Center Comprehensive Cancer Center, Winston-Salem, NC. Dr Winkfield discussed the topic at the 2019 ASCO Quality Care Symposium. Read Article ›

The economic burden faced by patients with cancer who have low income may be more pervasive than previously thought. According to data presented at the 2019 ASCO Quality Care Symposium, even patients enrolled in clinical trials are at high risk for financial toxicity. Read Article ›

Diagnosis of cholangiocarcinoma (CCA) is often identified at a late stage. Analyzing the tumor-specific mutation profile of a patient with CCA can improve the diagnosis and treatment for the individual patient. The molecular profile of CCA can be done through the use of circulating tumor (ct) DNA sequencing, which may help to target specific mutations and improve treatment selection for this rare type of cancer. Read Article ›

New research sponsored by the National Cancer Institute highlights the uphill battle faced by patients with limited financial resources even in clinical trials. According to data presented at the 2019 ASCO Quality Care Symposium, patients with Medicaid or with no insurance had significantly worse overall survival in positive clinical trials compared with privately insured patients. Read Article ›

Late-breaking data from 2 clinical trials presented at ESMO 2019 will likely change the treatment paradigm for pre- or postmenopausal women with hormone receptor (HR)-­positive, HER2-negative breast cancer, regardless of menopausal status. The MONALEESA-3 study and the MONARCH-2 study showed an improved overall survival (OS) with the addition of the CDK4/6 inhibitor ribociclib (Kisqali) or abemaciclib (Verzenio) to endocrine therapy as first- or second-line therapy. The results were presented at the Presidential Session of the meeting. Read Article ›

With the goal of treating as many patients as possible with the highest level of care and respect, infusion centers often mistakenly operate under the logic that appointments must be scheduled well before they occur—that by booking early and locking things down, schedules will run smoothly and accommodate more patients. In reality, scheduling appointments with significant lead times, often weeks or months before the actual appointment, may actually cause more problems and serve fewer patients. Therefore, it is worth reconsidering how infusion centers schedule appointments. Read Article ›

On September 17, 2019, the FDA approved a new indication for apalutamide (Erleada; Janssen Biotech) for the treatment of patients with metastatic castration-sensitive prostate cancer (CSPC). Apalutamide was initially approved in 2018 for the treatment of nonmetastatic castration-resistant prostate cancer. The FDA granted apalutamide priority review for the new indication. Read Article ›

On September 17, 2019, the FDA accelerated the approval of a new combination of pembrolizumab (Keytruda; Merck) plus lenvatinib (Lenvima; Eisai) for patients with advanced endometrial carcinoma that is not associated with microsatellite instability high (MSI-H) or mismatch repair–deficient (dMMR) tumors in patients whose disease progressed after systemic therapy and who are candidates for curative surgery or radiation. The FDA granted this application priority review and a breakthrough therapy designation. Read Article ›

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