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Oncology Updates

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https://www.readbyqxmd.com/read/28535106/value-tools-in-managed-care-decision-making-current-hurdles-and-future-opportunities
#1
Jeremy Schafer, Dominic Galante, Jason Shafrin
BACKGROUND: Organizations such as the National Comprehensive Cancer Network, American Society of Clinical Oncology, Institute for Clinical and Economic Review, and Memorial Sloan Kettering have created distinct tools to help different stakeholders assess the value of oncology treatments. However, the oncology value tools were not necessarily created for payers, and it is unclear whether payers are using these tools as part of their drug management process. OBJECTIVE: To understand what value tools payers are using in oncology management and what benefits and shortcomings the tools may have from the payer perspective...
June 2017: Journal of Managed Care & Specialty Pharmacy
https://www.readbyqxmd.com/read/28528679/evidence-based-peer-review-for-radiation-therapy-updated-review-of-the-literature-with-a-focus-on-tumour-subsite-and-treatment-modality
#2
M Huo, P Gorayski, M Poulsen, K Thompson, M B Pinkham
Technological advances in radiation therapy permit steep dose gradients from the target to spare normal tissue, but increase the risk of geographic miss. Suboptimal target delineation adversely affects clinical outcomes. Prospective peer review is a method for quality assurance of oncologists' radiotherapy plans. Published surveys suggest it is widely implemented. However, it may not be feasible to review every case before commencement of radiation therapy in all departments. The rate of plan changes following peer review of cases without a specific subsite or modality is typically around 10%...
May 18, 2017: Clinical Oncology: a Journal of the Royal College of Radiologists
https://www.readbyqxmd.com/read/28527613/no-344-opportunistic-salpingectomy-and-other-methods-of-risk-reduction-for-ovarian-fallopian-tube-peritoneal-cancer-in-the-general-population
#3
Shannon Salvador, Stephanie Scott, Julie Ann Francis, Anita Agrawal, Christopher Giede
OBJECTIVE: This guideline reviews the potential benefits of opportunistic salpingectomy to prevent the development of high grade serous cancers (HGSC) of the ovary/fallopian tube/peritoneum based on current evidence supporting the fallopian tube origin of disease. INTENDED USERS: Gynaecologists, obstetricians, family doctors, registered nurses, nurse practitioners, residents, and health care providers. TARGET POPULATION: Adult women (18 and older): OPTIONS: Women considering hysterectomy who wish to retain their ovaries in situ have traditionally also retained their fallopian tubes...
June 2017: Journal of Obstetrics and Gynaecology Canada: JOGC, Journal D'obstétrique et Gynécologie du Canada: JOGC
https://www.readbyqxmd.com/read/28516376/an-update-on-the-approach-to-the-imaging-of-brain-tumors
#4
REVIEW
Katherine M Mullen, Raymond Y Huang
PURPOSE OF REVIEW: Neuroimaging plays a critical role in diagnosis of brain tumors and in assessment of response to therapy. However, challenges remain, including accurately and reproducibly assessing response to therapy, defining endpoints for neuro-oncology trials, providing prognostic information, and differentiating progressive disease from post-therapeutic changes particularly in the setting of antiangiogenic and other novel therapies. RECENT FINDINGS: Recent advances in the imaging of brain tumors include application of advanced MRI imaging techniques to assess tumor response to therapy and analysis of imaging features correlating to molecular markers, grade, and prognosis...
July 2017: Current Neurology and Neuroscience Reports
https://www.readbyqxmd.com/read/28515258/evolving-treatment-of-soft-tissue-sarcoma
#5
Suzanne George
Soft tissue sarcomas comprise multiple histologic subtypes, occur at a number of anatomic sites, and require individualized treatment. Over the past 5 years, 4 new drugs were approved for sarcoma, most of which are driven by histology or the anticipated response to treatment. Surgical resection remains the primary treatment for resectable tumors. For unresectable or metastatic disease, doxorubicin remains the backbone of chemotherapy, but other agents have improved on its single-agent efficacy. Chief among them is olaratumab, which, in combination with doxorubicin, is preferred over doxorubicin alone in the updated NCCN Clinical Practice Guidelines in Oncology for Soft Tissue Sarcoma...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515248/systemic-management-of-colorectal-cancer
#6
Wells A Messersmith
Advances have been made in the systemic treatment of colorectal cancer, with approximately 12 chemotherapy or biologic agents approved for use as a single agent or in a combination. However, numerous gaps in our understanding of the disease remain, such as the lack of benefit with biologics in the adjuvant setting, the absence of biomarkers for most systemic therapies, and the reason why left-sided and right-sided tumors behave differently. At the 22nd NCCN Annual Conference, Dr. Wells A. Messersmith presented several impactful updates to the 2017 NCCN Clinical Practice Guidelines in Oncology for Colon Cancer and reviewed the outcomes with a host of therapies used for both early-stage and metastatic disease...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28515243/nccn-guidelines-update-evolving-radiation-therapy-recommendations-for-breast-cancer
#7
Kilian E Salerno
In the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Breast Cancer, among adjuvant radiotherapy options for whole-breast irradiation after breast-conserving surgery, hypofractionation is preferred. For the use of accelerated partial-breast irradiation, the NCCN Guidelines have adopted the updated definition of "suitability" used by the American Society for Radiation Oncology. Regional nodal irradiation is indicated-either in the setting of breast-conserving surgery or after mastectomy-for women with ≥4 positive nodes and should be strongly considered for 1 to 3 positive lymph nodes and select patients with node-negative disease deemed at high risk for recurrence...
May 2017: Journal of the National Comprehensive Cancer Network: JNCCN
https://www.readbyqxmd.com/read/28508348/cost-analysis-of-minimally-invasive-radical-hysterectomy-for-cervical-cancer-performed-by-a-single-surgeon-in-an-italian-center-an-update-in-gynecologic-oncological-field
#8
Antonio Pellegrino, Gianluca Raffaello Damiani, Giorgio Fachechi, Cecilia Pirovano, Maria Gaetani, Aly Youssef
The objective of this study is to perform an economic analysis and examine the influence of procedural volume of our hospital, evaluating the accounting systems of Robotic radical hysterectomy (RRH) vs Laparoscopic radical hysterectomy (TLRH) in patients with cervical carcinoma, due to the costs widely variable and lack in literature. Costs were collected prospectively, from March 2010 to March 2016. Direct costs were determined by examining the overall medical pathway for each type of intervention. 52 patients with cervical carcinoma, which were matched by age, body mass index, tumor size, International Federation of Gynecology and Obstetrics (FIGO) stage, comorbidity, previous neoadjuvant chemotherapy, histology type, and tumor grade to obtain homogeneous samples...
May 15, 2017: Updates in Surgery
https://www.readbyqxmd.com/read/28504497/liver-disease-and-dyslipidemia-as-a-manifestation-of-lysosomal-acid-lipase-deficiency-lal-d-clinical-and-diagnostic-aspects-and-a-new-treatment-an-update
#9
Luisa Bay, Cristina Canero Velasco, Mirta Ciocca, Andrea Cotti, Miriam Cuarterolo, Alejandro Fainboim, Eduardo Fassio, Marcela Galoppo, Federico Pinero, Paula Rozenfeld
Lysosomal acid lipase deficiency (LAL-D) is still a little recognized genetic disease with significant morbidity and mortality in children and adults. This document provides guidance on when to suspect LAL-D and how to diagnose it. It is recommended to add lysosomal acid lipase deficiency to the List of differential diagnoses of sepsis, oncological diseases, storage diseases, persistent diarrhea, chronic malnutrition, and hemophagocytic lymphohistiocytosis. It should also be considered in young patients with dyslipidemia and atherosclerosis as well as diseases associated with fatty liver and/or hepatomegaly...
June 1, 2017: Archivos Argentinos de Pediatría
https://www.readbyqxmd.com/read/28501093/future-directions-in-improving-outcomes-for-patients-with-gastric-and-esophageal-cancer
#10
REVIEW
Manish A Shah
"This issue of Hematology/Oncology Clinics of North America provides an update to the current understanding of the physiology of gastric and esophageal cancers and the state-of-the-art management of disease. Over the past 10 years, we have witnessed dramatic changes in both our understanding of the disease and its management. We have 2 new biological agents approved to treat advanced disease, with several more prospects under development. In this article, the author looks to the future, attempting to answer the question of which advancements will play the biggest role in improving patient outcomes in this still-devastating disease...
June 2017: Hematology/oncology Clinics of North America
https://www.readbyqxmd.com/read/28498097/the-asplenic-patient-post-insult-immunocompetence-infection-and-vaccination
#11
Brandon Dionne, Walter Dehority, Meghan Brett, Thomas R Howdieshell
BACKGROUND: Splenic injury can occur through multiple mechanisms and may result in various degrees of residual immunocompetence. Functionally or anatomically asplenic patients are at higher risk for infection, particularly with encapsulated bacteria. Vaccination is recommended to prevent infection with these organisms; however, the recommendations are routinely updated, and vaccine selection and timing are complex. METHODS: Review of the pertinent English-language literature, including the recommendations of the U...
May 12, 2017: Surgical Infections
https://www.readbyqxmd.com/read/28490926/challenges-and-insights-in-implementing-coordinated-care-between-oncology-and-primary-care-providers-a-canadian-perspective
#12
J R Tomasone, M Vukmirovic, M C Brouwers, E Grunfeld, R Urquhart, M A O'Brien, M Walker, F Webster, M Fitch
We report here on the current state of cancer care coordination in Canada and discuss challenges and insights with respect to the implementation of collaborative models of care. We also make recommendations for future research. This work is based on the findings of the Canadian Team to Improve Community-Based Cancer Care Along the Continuum (canimpact) casebook project. The casebook project identified models of collaborative cancer care by systematically documenting and analyzing Canadian initiatives that aim to improve or enhance care coordination between primary care providers and oncology specialists...
April 2017: Current Oncology
https://www.readbyqxmd.com/read/28479239/renal-mass-and-localized-renal-cancer-aua-guideline
#13
Steven Campbell, Robert G Uzzo, Mohamad E Allaf, Eric B Bass, Jeffrey A Cadeddu, Anthony Chang, Peter E Clark, Brian J Davis, Ithaar H Derweesh, Leo Giambarresi, Debra A Gervais, Susie L Hu, Brian R Lane, Bradley C Leibovich, Philip M Pierorazio
PURPOSE: This AUA Guideline focuses on evaluation/counseling and management of adult patients with clinically-localized renal masses suspicious for cancer, including solid-enhancing tumors and Bosniak 3/4 complex-cystic lesions. MATERIALS/METHODS: Systematic review utilized research from the Agency for Healthcare Research and Quality (AHRQ) and additional supplementation by the authors and consultant methodologists. Evidence-based statements were based on body of evidence strength Grade A/B/C (Strong/Moderate/Conditional Recommendations, respectively) with additional statements presented as Clinical Principles or Expert Opinions...
May 4, 2017: Journal of Urology
https://www.readbyqxmd.com/read/28472313/implementing-evidence-based-palliative-care-programs-and-policy-for-cancer-patients-epidemiologic-and-policy-implications-of-the-2016-american-society-of-clinical-oncology-clinical-practice-guideline-update
#14
Sarina R Isenberg, Rebecca A Aslakson, Thomas J Smith
The American Society of Clinical Oncology (ASCO) recently convened an Ad Hoc Palliative Care Expert Panel to update a 2012 provisional clinical opinion by conducting a systematic review of clinical trials in palliative care in oncology. The key takeaways from the updated ASCO clinical practice guidelines (CPGs) are that more people should be referred to interdisciplinary palliative care teams and that more palliative care specialists and palliative care-trained oncologists are needed to meet this demand. The following summary statement is based on multiple randomized clinical trials: "Inpatients and outpatients with advanced cancer should receive dedicated palliative care services, early in the disease course, concurrent with active treatment...
January 1, 2017: Epidemiologic Reviews
https://www.readbyqxmd.com/read/28469492/diagnostic-strategies-for-early-recognition-of-cancer-therapeutics-related-cardiac-dysfunction
#15
REVIEW
Carlos R Manrique, Michael Park, Nidhish Tiwari, Juan Carlos Plana, Mario J Garcia
Cardiovascular toxicity in the form of cardiac dysfunction continues to be an obstacle for patients with cancer. Survival and quality of life of cancer survivors are frequently affected by increased incidence of cardiovascular disease. The involvement of the cardiovascular system by primary or secondary malignancies, as well as its dysfunction secondary to the administration of antineoplastics, has led to the development of a new discipline called Cardio-Oncology, an exciting cardiology subspecialty with more questions than answers and as a result an enormous opportunity for research in the field...
2017: Clinical Medicine Insights. Cardiology
https://www.readbyqxmd.com/read/28463149/duration-of-androgen-deprivation-in-locally-advanced-prostate-cancer-long-term-update-of-nrg-oncology-rtog-9202
#16
Colleen A F Lawton, Xiaolei Lin, Gerald E Hanks, Herbert Lepor, David J Grignon, Harmar D Brereton, Meena Bedi, Seth A Rosenthal, Kenneth L Zeitzer, Varagur M Venkatesan, Eric M Horwitz, Thomas M Pisansky, Harold Kim, Matthew B Parliament, Rachel Rabinovitch, Mack Roach, Young Kwok, James J Dignam, Howard M Sandler
PURPOSE: Trial RTOG 9202 was a phase 3 randomized trial designed to determine the optimal duration of androgen deprivation therapy (ADT) when combined with definitive radiation therapy (RT) in the treatment of locally advanced nonmetastatic adenocarcinoma of the prostate. Long-term follow-up results of this study now available are relevant to the management of this disease. METHODS AND MATERIALS: Men (N=1554) with adenocarcinoma of the prostate (cT2c-T4, N0-Nx) with a prostate-specific antigen (PSA) <150 ng/mL and no evidence of distant metastasis were randomized (June 1992 to April 1995) to short-term ADT (STAD: 4 months of flutamide 250 mg 3 times per day and goserelin 3...
June 1, 2017: International Journal of Radiation Oncology, Biology, Physics
https://www.readbyqxmd.com/read/28462518/alvimopan-for-recovery-of-bowel-function-after-radical-cystectomy
#17
REVIEW
Shahnaz Sultan, Bernadette Coles, Philipp Dahm
BACKGROUND: Alvimopan is used in abdominal surgery to reduce postoperative ileus in patients undergoing small bowel resections with primary anastomosis. The role and efficacy of alvimopan in patients undergoing radical cystectomy with urinary diversion is not well understood. OBJECTIVES: To assess the effects of alvimopan in the context of enhanced recovery pathways compared to enhanced recovery pathways alone for perioperative bowel dysfunction in patients undergoing radical cystectomy...
May 2, 2017: Cochrane Database of Systematic Reviews
https://www.readbyqxmd.com/read/28459614/guideline-for-the-management-of-fever-and-neutropenia-in-children-with-cancer-and-hematopoietic-stem-cell-transplantation-recipients-2017-update
#18
Thomas Lehrnbecher, Paula Robinson, Brian Fisher, Sarah Alexander, Roland A Ammann, Melissa Beauchemin, Fabianne Carlesse, Andreas H Groll, Gabrielle M Haeusler, Maria Santolaya, William J Steinbach, Elio Castagnola, Bonnie L Davis, L Lee Dupuis, Aditya H Gaur, Wim J E Tissing, Theo Zaoutis, Robert Phillips, Lillian Sung
Purpose To update a clinical practice guideline (CPG) for the empirical management of fever and neutropenia (FN) in children with cancer and hematopoietic stem-cell transplantation recipients. Methods The International Pediatric Fever and Neutropenia Guideline Panel is a multidisciplinary and multinational group of experts in pediatric oncology and infectious diseases that includes a patient advocate. For questions of risk stratification and evaluation, we updated systematic reviews of observational studies...
May 1, 2017: Journal of Clinical Oncology: Official Journal of the American Society of Clinical Oncology
https://www.readbyqxmd.com/read/28453694/clinical-benefit-price-and-approval-characteristics-of-fda-approved-new-drugs-for-treating-advanced-solid-cancer-2000-2015
#19
A Vivot, J Jacot, J-D Zeitoun, P Ravaud, P Crequit, R Porcher
Background: Prices of anti-cancer drugs are skyrocking. We aimed to assess the clinical benefit of new drugs for treating advanced solid tumors at the time of their approval by the US Food and Drug Administration (FDA) and to search for a relation between price and clinical benefit of drugs. Materials and methods: We included all new molecular entities and new biologics for treating advanced solid cancer that were approved by the FDA between 2000 and 2015. The clinical benefit of drugs was graded based on FDA medical review of pivotal clinical trials using the 2016-updated of the American Society of Clinical Oncology Value Framework (ASCO-VF) and the European Society for Medical Oncology Magnitude of Clinical Benefit Scale (ESMO-MCBS)...
May 1, 2017: Annals of Oncology: Official Journal of the European Society for Medical Oncology
https://www.readbyqxmd.com/read/28447341/chemotherapy-alone-versus-chemotherapy-plus-radiotherapy-for-adults-with-early-stage-hodgkin-lymphoma
#20
REVIEW
Oliver Blank, Bastian von Tresckow, Ina Monsef, Lena Specht, Andreas Engert, Nicole Skoetz
BACKGROUND: Combined modality treatment consisting of chemotherapy followed by localised radiotherapy is the standard treatment for patients with early stage Hodgkin lymphoma (HL). However, due to long- term adverse effects such as secondary malignancies the role of radiotherapy has been questioned recently and some clinical study groups advocate chemotherapy only for this indication. OBJECTIVES: To assess the effects of chemotherapy alone compared to chemotherapy plus radiotherapy in adults with early stage HL ...
April 27, 2017: Cochrane Database of Systematic Reviews
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