Boston, MA—In September 2014, the Institute of Medicine (IOM) released a report entitled, “Dying in America: Improving Quality and Honoring Individual Preferences Near the End of Life.” A key recommendation in the report is that clinicians need to initiate conversations about dying.
With the advent of gene expression profiling, we have gained the ability to objectively advise patients with breast cancer, among other cancers, on their risk of recurrence and potential benefit of therapies through the administration of assays designed to provide predictive and prognostic data. This is welcome news for a patient who has successfully endured treatment for cancer and remains fearful of the risk of relapse.
San Francisco, CA—Two programmed cell death receptor-1 (PD-1) inhibitors—the investigational drug nivo­lumab and the recently approved pem­bro­lizumab (Keytruda)—produced dramatic responses in patients with Hodg­kin lymphoma in phase 1 clinical trials. Complete or partial responses were reported by up to 87% of patients who had exhausted other treatment options, providing solid evidence that targeting the immune system can be effective in hematologic malignancies, similar to solid tumors. The data were presented at the 2014 American Society of Hematology meeting.
San Francisco, CA—The results of a phase 1b study of the combination of venetoclax plus rituximab (Rituxan) showed encouraging safety and excellent activity in patients with chronic lymphocytic leukemia (CLL). Venetoclax will move on to a phase 3 trial comparing venetoclax plus ri­tuximab versus bendamustine (Treanda) plus rituximab in patients with previously treated CLL. The drug is also being studied in acute myeloid leukemia (AML).
Pain is often thought of as the fifth vital sign; namely, pain is such a prevalent problem in patients with cancer, that we should strive to measure it at every visit and minimize it as part of patient-centered care. The job of the oncologist is to cure (when possible), prolong survival while maintaining quality of life (when possible), and to minimize pain and suffering, particularly for our patients who are not going to be cured of their malignancy.
Zurich, Switzerland—In previously treated patients with advanced melanoma, single-agent nivolumab dem­onstrated long-term survival that compares favorably with current standard-of-care agents, according to F. Stephen Hodi, Jr, MD, Director, Melanoma Center, Dana-Farber/Brigham and Women’s Cancer Center, Boston. The CA209-003 phase 1 clinical trial also showed that responses occurring early were durable even after the discontinuation of therapy, said Dr Hodi at the 2014 Society for Melanoma Research International Congress.
Zurich, Switzerland—For regimens joining BRAF and MEK inhibition in BRAF-mutated melanoma, recent clinical trial data showing unequivocal overall survival (OS) improvements effectively “close the book” on defining clinical benefit, according to Keith T. Flaherty, MD, Director of Developmental Therapeutics, Massachusetts General Hospital Cancer Center, Boston. Increases in complete response (CR) rates, added Dr Flaherty at the 2014 Society for Melanoma Research International Congress, suggest that with longer-term follow-up, increases in durable responses will also be demonstrated.
New York, NY—Poly (ADP-ribose) polymerase (PARP) inhibitors are an intense area of interest in gynecologic cancers. At least 8 PARP inhibitors are currently in various stages of development, with olaparib (Lynparza) and the investigational drug veliparib the most studied, but to date none has been approved by the FDA for gynecologic cancers.
Los Angeles, CA—Major coding changes in cancer tests are ahead, including the elimination of stacked coding and the creation of new codes by the Centers for Medicare & Medicaid Services (CMS), which should improve the clinical application of cancer test choices. Speaking at the Fourth Annual Conference of the Association for Value-Based Cancer Care, Marc Samuels, JD, MPH, President and CEO at ADVI, a healthcare consulting company, Washington, DC, said that value-based testing is important for healthcare cost containment.
Los Angeles, CA—A new patient incentive program aligns patient behaviors and choices with financial incentives in an effort to reduce the financial burden of cancer care for patients. The program was introduced to attendees at the Fourth Annual Conference of the Association for Value-­Based Cancer Care by Gordon Kuntz, Senior Director of Payer Solutions at ION Solutions.
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