ASCO: American Society of Clinical Oncology

A number of abstracts at the 2019 American Society of Clinical Oncology Annual Meeting, held May 31 to June 4, 2019, in Chicago, Illinois, featured studies that focused on using real-world data to advance research and cancer care in non–small cell lung cancer (NSCLC).

During the American Society of Clinical Oncology’s Annual Meeting which took place May 31-June 4, 2019 in Chicago, Illinois, oncologists and representatives from UnitedHealthcare and the Center for Medicare and Medicaid Innovation (CMMI) took the stage to discuss oncology reimbursement reform and whether there are changes on the horizon for the promotion of higher value care.

The follow-up to the landmark TAILORx trial shows that adding a clinical risk evaluation of the breast cancer tumor may have prognostic value; the authors' recommendations are drawn from other studies.

Parth Shah, PharmD, PhD, of the Fred Hutchinson Cancer Research Center, led a discussion on the uptake challenges of the human papilloma virus (HPV) vaccine at the American Society of Clinical Oncology’s Annual Meeting by first explaining the known percentages of attributable cancers to the virus in the United States: cervical cancer 91%, vagina cancer 75%, and vulva cancer 69%, among others. Although multiple cancers are attributable to the virus, explained Shah, of the population ages 13-17 in the United States that should be vaccinated, both boys and girls, only 49% actually receive the vaccine.

Oncologists, patient advocates, patients, and other stakeholders from around the world gathered to hear different perspectives regarding the use of cannabis in symptom management for patients with cancer. Panelist after panelist went up to present available data, and each reiterated the same point: We need more research.

Patients with advanced pancreatic cancer linked to germline genetic mutations did not see their disease worsen for an additional 3.6 months when treated with olaparib, but an early interim analysis did not show a statistically significant difference in overall survival (OS), according to study results presented Sunday at the American Society of Clinical Oncology Annual Meeting 2019.

Drug pricing seemed like an appropriate topic for ASCO's town hall as the Trump administration has made lowering the cost of medications a major objective. By doing so, the administration has put out a series of proposals looking to address the cost of drugs, such as the International Pricing Index (IPI), and the recently finalized rule around direct-to-consumer advertising for pharmaceutical companies.

“How do you currently collaborate with your primary care colleagues in caring for patients with cancer?” This was how Larissa Nekhlyudov, MD, MPH, opened a session titled “Bringing the Primary Care Physician Back Into Cancer Care,” during the American Society of Clinical Oncology’s Annual Meeting, held in Chicago, Illinois from May 31-June 4, 2019.

Sara M. Tolaney, MD, MPH, instructor of medicine, Harvard Medical School, attending physician of medical oncology, Dana-Farber Cancer Institute, discusses challenges with managing patients with HER2-positive breast cancer and how clinical trials provide another treatment approach for these patients.

Organizations are trying to think about how they can involve team-based care by incorporating individuals who have a certain skill set that can relieve the practicing clinician, physician, nurse practitioner, or physician assistant from some of the burden, explained Dennis P. Scanlon, PhD, professor, Health Policy and Administration, and director, Center for Health Care and Policy Research, Pennsylvania State University.

Individuals, families, and local, state, and federal government all have incurred costs as a result of the opioid epidemic, explained Dennis P. Scanlon, PhD, professor, Health Policy and Administration, and director, Center for Health Care and Policy Research, Pennsylvania State University.

We know that there are a lot of problems with precision medicine and lots of areas that we need to define better, but that shouldn’t stop us from moving forward and trying to optimize the care for our patients, said Michael Thompson, MD, PhD, FASCO, Aurora Advanced Healthcare.

Sara M. Tolaney, MD, MPH, instructor of medicine, Harvard Medical School, attending physician of medical oncology, Dana-Farber Cancer Institute, outlines the role of adjuvant therapy in treating patients with HER2-positive breast cancer, as well as the absence of biomarkers in this patient population.

We need to bring together our real-world data and our reimbursement systems to recognize the fact that a lot of what could be gained by precision medicine is going to be based on a lot of research, explained Peter Paul Yu, MD, FASCO, FACP, physician-in-chief, Hartford HealthCare Cancer Center.

There are small subgroups within each tumor type and within each molecular type, and someday, we might be able to actually pair the 2 to give patients a little bit more personalization and precision to their treatments, said Victoria Villaflor, MD, associate professor of Medicine, hematology and oncology.

Peter Paul Yu, MD, FASCO, FACP, physician-in-chief, Hartford HealthCare Cancer Center, discusses the shift toward interoperability among electronic health record systems and efforts needed to accelerate this shift.

Michael Thompson, MD, PhD, FASCO, Aurora Advanced Healthcare, discusses challenges associated with conducting precision medicine trials in the community setting.

It’s been years since a large portion of colon cancer patients have seen any innovations in treatment. However, there are dietary and physical behavioral changes individuals can make that positively impact colon cancer survival said Leonard Saltz, MD, executive director of Clinical Value and Sustainability, head of Colorectal Oncology Section, Memorial Sloan Kettering Cancer Center.

There are a lot of new and exciting agents that are being explored for metastatic HER2-positive disease, explained Sara M. Tolaney, MD, MPH, instructor of medicine, Harvard Medical School, attending physician of medical oncology, Dana-Farber Cancer Institute.

Immune therapies, or check point inhibitors, have been very successful in a subset of patient with multiple different types of malignancies and has changed their trajectory tremendously, explained Victoria Villaflor, MD, associate professor of Medicine, hematology and oncology, Northwestern University.

Next-generation sequencings tests are just starting to change the landscape for cancer patients, explained Peter Paul Yu, MD, FASCO, FACP, physician-in-chief, Hartford HealthCare Cancer Center.

What has really changed in the shift to precision medicine is that it adds a layer of data to each step we go through with the patient, explained James Lin Chen, MD, Ohio State University, and chair of ASCO CancerLinQ Oncology Informatics Task Force.

Cancer patients are agreeing to treatment plans lacking a fundamental understanding of the impacts on their finances, explained Ellen Miller Sonet, MBA, JD, chief strategy and policy officer, CancerCare.

Michael Thompson, MD, PhD, FASCO, Aurora Advanced Healthcare, outlines novel therapies being used in the treatment of hematologic malignancies and identified biomarkers for deciding on a treatment approach.

Leonard Saltz, MD, executive director of Clinical Value and Sustainability, head of Colorectal Oncology Section, Memorial Sloan Kettering Cancer Center, discusses the role next-generation sequencing currently plays in advancing precision medicine.

At the 2018 American Society of Clinical Oncology Annual Meeting, a study conducted in France revealed the impact of electronic patient-reported outcomes (PROs) on survival among patients being treated for lung cancer. The study was presented by Fabrice Denis, MD, PhD, radiation oncologist at Institut Inter-regional de Cancérologie Jean Bernard, Le Mans, France.

During a session at the 2018 American Society of Clinical Oncology Annual Meeting, June 1-5, in Chicago, Illinois, panelists discussed the financial burdens of cancer diagnosis and treatment, the barriers facing clinicians and patients in discussing these financial burdens, and solutions that can be implemented to alleviate the burden.

As the opioid epidemic persists in the United States, there are growing questions and concerns over how to manage cancer-related pain and aberrant opioid use. During a session at the 2018 American Society of Clinical Oncology Annual Meeting, Egidio Del Fabbro, MD, Virginia Commonwealth University Massey Cancer Center, discussed several management strategies that can be used to address these concerns.

Researchers are examining combination therapies with immunotherapy, with and without chemotherapy.

FDA has fast-tracked the Biologics License Application for cemiplimab, with a decision expected October 28, 2018.