Oncology

Precision Promise, the Pancreatic Cancer Action Network (PanCAN)'s precision medicine trial, seeks to transform outcomes for pancreatic cancer patients with the goal set to double survival by 2020.

Perennial favorite, Aimee Tharaldson, PharmD, senior clinical consultant of emerging therapeutics at Express Scripts, opened the Academy of Managed Care Pharmacy 2016 Nexus, October 3, 2016, in National Harbor, Maryland, with a discussion of specialty pharmaceutical drugs in the pipeline.

The funds that the Patient Access Network (PAN) Foundation provides to patients are often used to help with the cost of medications, and there has been a large increase in the number of patients looking for assistance for the cost of cancer treatments, explained Daniel J. Klein, president and CEO of the PAN Foundation.

A study suggests that regions of England where patients show less awareness of cancer symptoms tend to have lower cancer survival rates, particularly in lower-income areas. The research, published in the British Journal of Cancer also examined whether barriers to care can affect the likelihood of surviving different cancers.

The cancer community has seen tremendous progress in the field of immunotherapy. However, educating patients and care providers across healthcare on this new tool remains a significant challenge.

This week, the top stories in managed care included 2 reports on the fight against addiction, researchers have learned more about the effects of healthy living on avoiding cancers, and a study finds fitness trackers do not help people lose more weight.

Timothy M. Johnson, MD, spoke enthusiastically about the possibilities of sentinel lymph node biopsy in his lecture at the 25th European Academy of Dermatology and Venereology Congress in Vienna, Austria. His presentation, called “Melanoma Sentinel Node Biopsy: Past, Present and Future in the New Era of Systemic Therapies,” covered guidelines for the procedure as well as new possibilities for melanoma patients.

Based on ICER’s evaluation, a significant reduction in the wholesale acquisition cost (WAC) of approved checkpoint inhibitors would be necessary to achieve a pre-determined value-based price benchmark.

While there have been large increases in the cost of new cancer treatments for patients with metastatic breast, lung, or kidney cancer, or chronic myeloid leukemia, researchers found that there were also large gains in life expectancy.

Patients with melanoma have more promising options than ever with the advent of targeted therapies and immunotherapies, said Mario Lacouture, MD, director of the Oncodermatology Program at Memorial Sloan Kettering Cancer Center. His research aims to provide patients the best possible quality of life while taking these treatments, which can often have adverse effects.

Researchers at the Mayo Clinic are recommending that premenopausal women with a low risk of ovarian cancer should be spared unnecessary comorbidities associated with bilateral oophorectomy.

A new study has found that after adjusting for changes in screening, there was a decrease in incidence of all grades of cervical intraepithelial neoplasia (CIN) for women 15- to 19-years old, and CIN grade 2 in women 20- to 24-years old.

A study published in the journal Cancer has discovered that a 2012 recommendation for prostate cancer screening did not change physician behavior.

Mohs surgery is generally the gold standard for rare and more aggressive tumors because the surgeon can ensure the roots of the tumor are gone, but the technique keeps the hole small, said Ally-Khan B. Somani, MD, PhD, at the 25th European Academy of Dermatology and Venereology Congress.

Reimbursement issues surrounding Mohs surgery are getting worse, which provides a challenge for surgeons who would perform the procedure, explained Aleksandar L. Krunic, MD, PhD, during the 25th European Academy of Dermatology and Venereology Congress.

A new study presented at the annual meeting of the American Society for Radiation Oncology has found a significant survival advantage of combining chemotherapy and radiotherapy following surgery in patients with medulloblastoma.

Use of stereotactic body radiation therapy improved survival in elderly patients diagnosed with early-stage non-small cell lung cancer by about 20% over a decade.

Advancement in basic science and medical technology has made cancer a curable disease for many patients. Approximately 40% of Americans will be diagnosed with cancer in their lifetime, but as of 2014, 1 in 22 Americans is a cancer survivor, which equals 14.5 million cancer survivors in the US, explained Joseph C. Alvarnas, MD, director of value-based analytics for the City of Hope.

Jack Whelan, an e-patient advocate and patient with a rare blood disease, spoke at The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Care Meeting. In his presentation, Whelan explained that patient centricity and education is important for all parties in the healthcare industry to better take hold of.

In the United States healthcare system, discussions of value are almost always associated with the equation of quality over cost. However, patients don’t necessarily think that way, explained Yousuf Zafar, MD, MHS, associate professor of medicine and public policy at the Duke Cancer Institute.

While President Barack Obama outlined a series of budget plans for oncology care in the fall of 2015, which was designed to allocate an estimated $130 million to sequence 1 million volunteers, $70 million to identify “genome drivers” and $10 million to the FDA to build databases, Michael A. Kolodziej, MD, FACP, national medical director of Oncology Solutions at Aetna, believes there to be different areas of oncology care that need more attention and resources. Kolodziej presented at The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Meeting.

There are a number of issues concerning big data in the oncology world, the most prominent of which concerns the number of patients participating in clinical trials, Robert J. Green, MD, MSCE, vice president of clinical strategy at Flatiron Health, explained during his presentation at The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Meeting. He added that only 4% of adult cancer patients participate in a clinical trial.

Family history is at the core of precision medicine, Joy Larsen Haidle, MS, CGC, 2015 president of the National Society of Genetic Counselors, said during her presentation at The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Care Meeting. During her presentation, Haidle explained that while hereditary cancer was traditionally viewed as occurring between 5% and 10% of the cancer population, recent data suggest that number may be a lot closer to 25% today.

Scott Gottlieb, MD, resident fellow at the American Enterprise Institute; Michael A. Kolodziej, MD, national medical director of oncology strategy at Aetna; Bruce Quinn, MD, PhD, MBA, senior director at FaegreBD Consulting; and Joy Larsen Haidle, MS, CGC, 2015 president of the National Society of Genetic Counselors, discussed the impacts of FDA regulation on diagnostics in oncology during The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Care Meeting. The panel discussion was moderated by Dennis P. Scanlon, professor of health policy and administrator and director of the Center for Health Care and Policy Research at The Pennsylvania State University.

Competition as a means of tackling the escalating issue of drug prices is not working, said Peter B. Bach, MD, MAPP, physician at Memorial Sloan Kettering Cancer Center, in a panel discussion at The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Care Meeting. He explained that implementing a system in which the attributes of the drug determine its price is a more reasonable, value-based approach.

One of the reasons Julie M. Vose, MD, MBA, FASCO, 2015-2016 president of the American Society of Clinical Oncology, became involved with medicine in the first place was the ability to help patients. However, she said that the administrative burden physicians take on in today’s health system can often take away from that experience.

Population health is a method that looks at the total costs of care, focuses on the prevalent chronic diseases, and, additionally, examines the various social determinants of health of an entire community. However, Burton F. VanderLaan, MD, FACP, medical director of Priority Health, explained that precision medicine, specifically in precision oncology, seeks to do just the opposite by employing variation and individualizing treatment rather than standardizing it.

Stacey W. McCullough, DO, senior vice president of Pharmacy at Tennessee Oncology, PLLC; Bruce W. Sherman, MD, FCCP, FACOEM, medical director for Population Health Management for the RightOpt private exchange offering for Buck Consultants, A Xerox Company; and Glen D. Stettin, MD, senior vice president of clinical research and new solutions at Express Scripts, came together to discuss the role of pharmacy benefit managers (PBMs) as a means of helping to manage high-cost treatment options. The discussion, moderated by Bruce A. Feinberg, DO, vice president and chief medical officer of Cardinal Health Specialty Solutions, was held during The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Care Meeting.

Julian Malinak, MPH, finance lead for the pioneer accountable care organization (ACO) and next generation ACO models and technical advisor for financial policy at CMS Innovation Center, explained that CMS, as well as other organizations, are pushing away from the traditional fee-for-service methods by creating delivery models like ACOs and employing various tools and services, such as bundled payments, and are beginning to examine these methods in the oncology setting.

In the past 5 years, the FDA has approved 52 new agents for oncology use, and 24 of those agents have novel mechanisms, explained Stacey W. McCullough, PharmD, senior vice president of Pharmacy at Tennessee Oncology, PLLC, during her presentation at The American Journal of Managed Care’s 4th Annual Patient-Centered Oncology Care Meeting. With these emerging options in oncology care, there are 3 things to consider when choosing the appropriate option for the patient, she said.