ACCC Survey Recognizes Major Challenges Cancer Centers Experience

While an increasing number of immunotherapies are reaching market and becoming available, cancer centers feel unprepared to prescribe these treatments and handle adverse events and side effects, according to findings from a new survey from the Association of Community Cancer Centers (ACCC).

More than 200 cancer centers in the United States were included in the survey, and many found that new technology and cancer programs was difficult to integrate into effective patient care. The ACCC has recognized the need to educate, support, and provide resources regarding new immuno-oncology (I-O) treatments to cancer centers and published a report, Immuno-Oncology: Transforming the Delivery of Cancer Care in the Community, that offers insights, resources, education, and solutions to real-world challenges.

"As the I-O clinical landscape and volume of information evolves, establishing effective education and strong lines of communication become even more important—for every member of the care delivery team," Advisory Committee Chair Lee S. Schwartzberg, MD, FACP, chief of the Division of Hematology Oncology and professor of medicine at the University of Tennessee and executive director of The West Cancer Center, said in a press release.

While 96% of cancer centers reported prescribing immunotherapeutic agents, 32% reported being “very uncomfortable” in managing immune-related adverse events and side effects. Regarding molecular testing, only 27% of survey respondents reported that their oncologists participated in a molecular tumor board. 82% said that the biggest barrier to molecular testing was insurance coverage.

Electronic health records (EHRs) were found to be the biggest information technology challenge for cancer programs, with 31% saying that their EHR program does not have interoperability capabilities to transfer patient information to other systems. In addition, 80% of survey participants reported that their EHR systems have increased the workload of their physicians and staff.

The top threats to future cancer program growth included cost of drugs and/or new treatment modalities (68%), physician alignment around services and program goals (47%), and changes in healthcare coverage (46%).

The summary of the survey also included effective approaches for cancer programs and providers in managing immune-related adverse events, patient education, and coordination of care with specialists that may treat adverse events in cancer patients.

The ACCC listed top priorities for 2018 in the report that include:

• addressing the role of biomarkers to address cost mitigation
• understanding the variation in coverage for immunotherapy under different health plans
• identifying meaningful quality measures in value-based programs
• developing strategies to ensure practice sustainability in risk-sharing payment models

"ACCC meets these critical needs with peer-driven, need-to-know resources that share effective practices and create opportunities for real-time, clinician-to-clinician conversations about care delivery for patients on immunotherapy for cancer," concluded Schwartzberg.