785 results match your criteria Am Soc Clin Oncol Educ Book[Journal]


Supporting Caregivers of Patients With Cancer: A Summary of Technology-Mediated Interventions and Future Directions.

Am Soc Clin Oncol Educ Book 2018 May;38:838-849

From the University of Michigan, Ann Arbor, MI; Texas Children's Hospital, Baylor College of Medicine, Houston, TX; Children's Hospital of Pittsburgh, Pittsburgh, PA.

This paper aims to review literature published on the support of cancer caregivers with health technology. Eighteen articles were reviewed to better understand cancer caregiving and categorized into four different themes: (1) design guidelines, (2) information facilitation, (3) social support, and (4) multicomponent interventions. Analysis of the current articles revealed that there are substantial gaps in knowledge regarding a range of health technologies that facilitate family caregiver support and its distribution to health institutions. Read More

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http://ascopubs.org/doi/10.1200/EDBK_201397
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http://dx.doi.org/10.1200/EDBK_201397DOI Listing
May 2018
6 Reads

Care After Chemotherapy: Peripheral Neuropathy, Cannabis for Symptom Control, and Mindfulness.

Am Soc Clin Oncol Educ Book 2018 May;38:469-479

From the Division of Gynecologic Oncology, University of Minnesota, Minneapolis, MN; Division of Palliative Medicine, Johns Hopkins University, Baltimore, MD; Division of Oncology, Johns Hopkins University, Baltimore, MD; Division of Gynecologic Oncology, Women's Cancer Center of Nevada, Las Vegas, NV; The Apothecary Shoppe, Las Vegas, NV.

As cancer therapies improve, patients are living longer. With these improvements in therapy comes a responsibility to optimize patients' quality of life during cancer therapy and beyond. This report reviews three timely and important topics. Read More

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http://dx.doi.org/10.1200/EDBK_209437DOI Listing
May 2018
2 Reads

Role of Germline Genetics in Identifying Survivors at Risk for Adverse Effects of Cancer Treatment.

Am Soc Clin Oncol Educ Book 2018 May;38:775-786

From the Radiation Epidemiology Branch, Division of Cancer Epidemiology and Genetics, National Cancer Institute at the National Institutes of Health, Bethesda, MD; Department of Radiation Oncology, University of Rochester Medical Center, Rochester, NY; Department of Medicine, University of Chicago, Chicago, IL.

The growing population of cancer survivors often faces adverse effects of treatment, which have a substantial impact on morbidity and mortality. Although certain adverse effects are thought to have a significant heritable component, much work remains to be done to understand the role of germline genetic factors in the development of treatment-related toxicities. In this article, we review current understanding of genetic susceptibility to a range of adverse outcomes among cancer survivors (e. Read More

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http://dx.doi.org/10.1200/EDBK_201391DOI Listing
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC6415750PMC
May 2018
19 Reads

Incorporating Biology Into Breast Cancer Staging: American Joint Committee on Cancer, Eighth Edition, Revisions and Beyond.

Am Soc Clin Oncol Educ Book 2018 May;38:38-46

From the Dana-Farber Cancer Institute and Brigham and Women's Cancer Center, Boston, MA; Ontario Institute for Cancer Research, Ontario, Canada; Cancer Prevention Institute of California, Fremont, CA; Memorial Sloan Kettering Cancer Center, New York, NY.

Higher-quality imaging, refined surgical procedures, enhanced pathologic evaluation, and improved understanding of the impact of tumor biology on treatment and prognosis have necessitated revisions of the AJCC breast cancer staging system. The eighth edition includes clinical and pathologic prognostic stages that incorporate biologic variables-grade, estrogen and progesterone receptor status, HER2 status, and multigene panels-with the anatomic extent of disease defined by tumor, node, and metastasis categories. The prognostic staging systems facilitate more refined stratification with respect to survival than anatomic stage alone. Read More

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http://dx.doi.org/10.1200/EDBK_200981DOI Listing
May 2018
5 Reads

What Makes a Pancreatic Cancer Resectable?

Authors:
Douglas B Evans

Am Soc Clin Oncol Educ Book 2018 May;38:300-305

From the Pancreatic Cancer Program and Department of Surgery, Medical College of Wisconsin, Milwaukee, WI.

The majority of patients with localized pancreatic cancer who undergo surgery with or without adjuvant therapy will develop metastatic disease, suggesting that surgery alone is not sufficient for cure and micrometastases are present at the time of diagnosis even when not clinically apparent. As such, the field is rapidly moving to consensus on treatment sequencing, which emphasizes the early delivery of systemic therapy and the application of surgery to the population of patients most likely to receive clinical benefit from such large operations-namely, those with stable or responding disease following systemic therapy and often chemoradiation. There remains incomplete consensus about the definition of what is operable (both tumor anatomy and patient age/comorbidities) and whether the operation should be performed in a high-volume center by more experienced surgeons. Read More

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http://dx.doi.org/10.1200/EDBK_200861DOI Listing

Cardiac Toxicities in the Era of Precision Medicine: Underlying Risk Factors, Targeted Therapies, and Cardiac Biomarkers.

Am Soc Clin Oncol Educ Book 2018 May;38:764-774

From the Division of Hematology/Oncology, University of Minnesota, Minneapolis, MN; Peter Munk Cardiac Center, Toronto General Hospital, University Health Network, Division of Cardiology, University of Toronto, Toronto, ON, Canada; Division of Cardiology, Vanderbilt University, Nashville, TN.

Cancer therapies can cause a variety of cardiac toxicities, including ischemia, cardiomyopathy, heart failure, myocarditis, arrhythmias, vascular disease, hypertension, and hyperlipidemia. Addressing cardiovascular risk at baseline, before initiating therapy, during cancer treatment, and in the survivorship period is imperative. It may be useful to risk stratify individuals with cardiovascular risk factors using biomarkers or imaging before they receive potentially cardiotoxic therapies. Read More

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http://ascopubs.org/doi/10.1200/EDBK_208509
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http://dx.doi.org/10.1200/EDBK_208509DOI Listing
May 2018
2 Reads

Global Health Perspective in Sarcomas and Other Rare Cancers.

Am Soc Clin Oncol Educ Book 2018 May;38:916-924

From the Sylvester Comprehensive Cancer Center at the University of Miami, Miami, FL; AC Camargo Cancer Center, Sao Paulo, Brazil; Tata Memorial Hospital, New Delhi, India.

Sarcomas, rare and heterogenous malignancies that comprise less than 1% of all cancers, have poor outcomes in the metastatic and refractory setting. Their management requires a multidisciplinary approach that consists of medical and surgical oncologists, radiation oncologists, and pathologists as well as ancillary support. In addition to systemic treatments, most patients will require surgical resection and radiation therapy, which mandates the use of the latest technologies and specialized expertise. Read More

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http://dx.doi.org/10.1200/EDBK_200589DOI Listing
May 2018
21 Reads

Value and Cost of Myeloma Therapy.

Am Soc Clin Oncol Educ Book 2018 May;38:662-666

From the Division of Hematology, Mayo Clinic, Rochester, MN.

Major advances have occurred in the treatment of multiple myeloma, including several new drugs that typically cost more than $100,000 per year. Although the gains in myeloma therapy improve overall survival considerably, they are available to only a fraction of the population of patients with myeloma in the world because of regulatory barriers and cost. Myeloma is an example of what is happening in cancer on a much larger scale. Read More

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http://dx.doi.org/10.1200/EDBK_200867DOI Listing

Breast Cancer in Latin America: A Map of the Disease in the Region.

Authors:
Eduardo Cazap

Am Soc Clin Oncol Educ Book 2018 May;38:451-456

From the Latin American and Caribbean Society of Medical Oncology, Buenos Aires, Argentina.

In the next few decades, breast cancer will become a leading global public health problem as it increases disproportionately in low- and middle-income countries. Disparities are clear when comparisons are made with rates in Europe and the United States, but they also exist between the countries of the region or even within the same country in Latin America. Large cities or urban areas have better access and resource availability than small towns or remote zones. Read More

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http://dx.doi.org/10.1200/EDBK_201315DOI Listing

Challenging Cases: Management of Immune-Related Toxicity.

Authors:
Jeffrey S Weber

Am Soc Clin Oncol Educ Book 2018 May;38:179-183

From the Laura and Isaac Perlmutter Cancer Center, New York, NY.

The approvals of six checkpoint inhibitory antibodies since 2011 have established immunotherapy for cancer as a fifth treatment modality after chemotherapy, surgery, radiation, and targeted therapy. Long-lasting responses have been observed in melanoma, non-small cell lung cancer, renal cell cancer, and head and neck cancer, to name a few, and more approvals for these drugs undoubtedly are coming in the near future. The application of checkpoint inhibitors has expanded well beyond melanoma, and, with wider use, the management of the immune-related adverse events (irAEs) that accompany these drugs has received increased attention. Read More

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http://dx.doi.org/10.1200/EDBK_209557DOI Listing
May 2018
6 Reads

No Decision Is Final: Career Planning and Career Transitions.

Am Soc Clin Oncol Educ Book 2018 May;38:881-886

From the Louisiana State University Health Sciences Center, New Orleans, LA; U.S. Food and Drug Administration, Silver Spring, MD, The Sidney Kimmel Cancer Center at Johns Hopkins, Baltimore, MD; Memorial Cancer Institute, Hollywood, FL; Merck & Co., Inc., Rahway, NJ.

Several factors play a role in job selection after completion of a hematology/oncology training program, such as a fellows' overall career goals, expected income potential, and limitations imposed by visa status, among many others. Training programs play an integral role in mentoring trainees in career selection. For many, the first job is often not career-long. Read More

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http://dx.doi.org/10.1200/EDBK_200983DOI Listing
May 2018
14 Reads

Gastrointestinal and Hepatic Toxicities of Checkpoint Inhibitors: Algorithms for Management.

Am Soc Clin Oncol Educ Book 2018 May;38:13-19

From the Harvard Medical School, Boston, MA; Brigham and Women's Hospital, Boston, MA; Dana-Farber Cancer Institute, Brookline, MA.

Gastrointestinal toxicities are among the leading causes of immune-related adverse effects of checkpoint blockade. These adverse events can be severe enough to require interruption or withdrawal of immune checkpoint blockade therapy. Patients with immune-related adverse effects require early recognition with an evaluation to rule out alternative etiologies and effective management to minimize complications. Read More

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http://dx.doi.org/10.1200/EDBK_100013DOI Listing
May 2018
1 Read

Major Changes in Head and Neck Staging for 2018.

Am Soc Clin Oncol Educ Book 2018 May;38:505-514

From the Department of Surgery, Nebraska Methodist Hospital, Creighton University, Omaha, NE; Department of Radiation Oncology, University of Toronto, Department of Otolaryngology/Head and Neck Surgery, University of Toronto, Toronto, ON, Canada; Head and Neck Service, Department of Surgery, Memorial Sloan Kettering Cancer Center, New York, NY.

Oncologists should be aware of three major modifications and additions to staging head and neck cancer that became effective in 2018. Oral cavity cancers have the addition of depth of invasion; oropharyngeal cancers (OPCs) are now distinguished by the immunohistochemical stain, p16, into those that are associated with high-risk human papillomavirus and those that are not; and all sites except nasopharyngeal carcinoma and high-risk human papillomavirus OPC will now include the important parameter of extranodal extension. The rationale and emerging data supporting these changes are discussed in this article and the accompanying oral presentation at the 2018 ASCO Annual Meeting. Read More

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http://dx.doi.org/10.1200/EDBK_199697DOI Listing
May 2018
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New and Important Changes in the TNM Staging System for Breast Cancer.

Am Soc Clin Oncol Educ Book 2018 May;38:457-467

From the Department of Breast Medical Oncology, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX; Departments of Surgical Oncology and Cancer Prevention and Control, Roswell Park Comprehensive Cancer Center, Buffalo, NY; Department of Surgery, Division of Surgical Oncology, John Wayne Cancer Institute, Santa Monica, CA.

Expanded understanding of biologic factors that modulate the clinical course of malignant disease have led to the gradual integration of biomarkers into staging classifications. The American Joint Committee on Cancer (AJCC) TNM staging system is universally used and has largely displaced other staging classifications for most, although not all, cancers. Many of the chapters of the eighth edition of the AJCC TNM staging system integrated biomarkers with anatomic definitions. Read More

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http://dx.doi.org/10.1200/EDBK_201313DOI Listing

What Will We Expect From Novel Therapies to Esophageal and Gastric Malignancies?

Am Soc Clin Oncol Educ Book 2018 May;38:249-261

From the Department of Biomedical Sciences and Medicine, Division of Oncology, University of Algarve, Faro, Portugal; Algarve Biomedical Center, Campus Gambelas, Faro, Portugal; Faculty of Medicine, University of Porto, Porto, Portugal; Research Centre, Division of Medical Oncology, Hospital São Mateus, NOHC Clinic, Fortaleza, CE, Brazil; Algarve Hospital and University Center, Department of Oncology, Faro, Portugal; Portuguese Public Health School, Nova University, Lisbon, Portugal; Centre for Biomedical Research, University of Algarve, Faro, Portugal; Department of Biomedicine, Faculty of Medicine, University of Porto, Porto, Portugal; Faculty of Nutrition and Food Sciences, University of Porto, Porto, Portugal; Academic Medical Center Amsterdam, Center for Experimental Molecular Medicine, Amsterdam, The Netherlands; and the Division of Medical Oncology, Sylvester Comprehensive Cancer Center, University of Miami, Miami, FL.

Esophageal cancer and gastric cancer are aggressive diseases for which treatment approaches are facing a new era. Some molecular pathways, such as VEGF, EGFR, fibroblast growth factor receptor, PIK3CA, and PARP-1, have been studied, and novel targeted drugs are presumed to be developed in the near future. From The Cancer Genome Atlas report, 80% of Epstein-Barr virus tumors and 42% of tumors with microsatellite instability have PIK3CA mutations, suggesting that this pathway could be reevaluated as a possible target for new systemic treatment of gastric cancer. Read More

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http://dx.doi.org/10.1200/EDBK_198805DOI Listing
May 2018
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Immunotherapy in Older Adults With Advanced Cancers: Implications for Clinical Decision-Making and Future Research.

Am Soc Clin Oncol Educ Book 2018 May;38:400-414

From the National Cancer Centre Singapore, Singapore; Hospital Universitario Fundacion Jimenez Diaz, Madrid, Spain; University of Rochester, Rochester, NY.

Immunotherapy has expanded the therapeutic landscape for advanced cancers, including solid tumors and lymphomas. For many patients with cancer, these agents have been shown to have substantial efficacy and favorable toxicity compared with cytotoxic agents, particularly in the second-line setting. With the advent of anti-PD-1 and anti-PD-L1 checkpoint inhibitors, combination immunotherapy- and chemoimmunotherapy-based strategies have emerged as promising novel regimens to improve cancer-related outcomes. Read More

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http://dx.doi.org/10.1200/EDBK_201435DOI Listing

Predicting and Preventing Anthracycline-Related Cardiotoxicity.

Am Soc Clin Oncol Educ Book 2018 May;38:3-12

From the City of Hope, Duarte, CA; University of Alabama at Birmingham, Birmingham, AL.

Anthracyclines (doxorubicin, daunorubicin, epirubicin, and idarubicin) are among the most potent chemotherapeutic agents and have truly revolutionized the management of childhood cancer. They form the backbone of chemotherapy regimens used to treat childhood acute lymphoblastic leukemia, acute myeloid leukemia, Hodgkin lymphoma, Ewing sarcoma, osteosarcoma, and neuroblastoma. More than 50% of children with cancer are treated with anthracyclines. Read More

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http://dx.doi.org/10.1200/EDBK_100015DOI Listing
May 2018
6 Reads

Evolution of Targeted Therapy in Breast Cancer: Where Precision Medicine Began.

Am Soc Clin Oncol Educ Book 2018 May;38:78-86

From the Winship Cancer Institute, Emory University School of Medicine, Atlanta, GA; University of Iowa, Iowa City, IA; Medical University of Vienna and Austrian Breast and Colorectal Cancer Study Group, Vienna, Austria; UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC.

As we consider best practices and approaches to targeted therapy in the clinic and in terms of trial design, breast cancer can serve as a useful model for other disease types, because estrogen receptor-positive and HER2-positive breast cancer have been known entities for several decades. In this review, we provide a history of the development of anti-estrogen therapy and anti-HER2-directed therapy and we discuss our growing understanding of resistance to targeted therapy as seen through this lens. We highlight some of the recent breakthroughs that have enhanced our understanding of resistance to endocrine and anti-HER2 therapy, and we discuss some of the ongoing research in the field. Read More

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http://dx.doi.org/10.1200/EDBK_201037DOI Listing

From Burnout to Resilience: An Update for Oncologists.

Am Soc Clin Oncol Educ Book 2018 May;38:862-872

From The Royal Marsden NHS Foundation Trust, London, United Kingdom; Memorial Sloan Kettering Cancer Center and Weill Cornell Medical College, New York, NY; College of Medicine, University of Florida, Gainesville, FL; Institute of Cancer Research, London, United Kingdom.

Physician burnout remains a highly complex and topical issue. The negative impact of burnout on physicians, patients, and institutions has become increasingly apparent. Globally, a multitude of professional bodies and organizational leaders are giving this important subject much-deserved attention. Read More

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http://dx.doi.org/10.1200/EDBK_201023DOI Listing

Approaches to Chronic Lymphocytic Leukemia Therapy in the Era of New Agents: The Conundrum of Many Options.

Am Soc Clin Oncol Educ Book 2018 May;38:580-591

From the Department of Leukemia, Division of Cancer Medicine, The University of Texas MD Anderson Cancer Center, Houston, TX; Cardinal Health Specialty Solutions, Chicago, IL; Chronic Lymphocytic Leukemia Program, Memorial Sloan Kettering Cancer Center, New York, NY; Chao Family Comprehensive Cancer Center, University of California Irvine, Orange, CA.

Three small molecule inhibitors have been approved for the treatment of chronic lymphocytic leukemia (CLL) in the last 4 years. Ibrutinib, idelalisib, and venetoclax are oral agents with excellent efficacy and different toxicity profiles. Issues discussed herein include the current role for chemoimmunotherapy in CLL, the use of oral inhibitors in older patients, and the sequencing of these molecules in daily practice. Read More

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http://dx.doi.org/10.1200/EDBK_200691DOI Listing

Cancer of Unknown Primary Site: New Treatment Paradigms in the Era of Precision Medicine.

Am Soc Clin Oncol Educ Book 2018 May;38:20-25

From the Sarah Cannon Research Institute and Tennessee Oncology, Nashville, TN.

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http://ascopubs.org/doi/10.1200/EDBK_100014
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http://dx.doi.org/10.1200/EDBK_100014DOI Listing
May 2018
2 Reads

Best Practices in Oncology Distress Management: Beyond the Screen.

Am Soc Clin Oncol Educ Book 2018 May;38:813-821

From the Duke University School of Nursing, Durham, NC; Sheri & Les Biller Patient and Family Resource Center, Department of Supportive Care Medicine, Department of Population Sciences, City of Hope, Duarte, CA; Supportive Care Oncology Program, Northeast Cancer Centre, Sudbury, ON, Canada; Departments of Psychiatry and Medicine, University of North Carolina at Chapel Hill, Chapel Hill, NC.

The field of psychosocial oncology is a young discipline with a rapidly expanding evidence base. Over the past few decades, several lines of research have established that psychosocial problems, such as anxiety, depression, post-traumatic stress, fatigue, sexual dysfunction, and cognitive complaints, are common and consequential in patients with cancer. The word "distress" was chosen deliberately to capture a broad concept; consequently, distress screening is meant to function as an initial step in the more targeted evaluation of the source(s) of the patient's distress. Read More

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http://ascopubs.org/doi/10.1200/EDBK_201307
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http://dx.doi.org/10.1200/EDBK_201307DOI Listing
May 2018
9 Reads

Recent Advances in Lynch Syndrome: Diagnosis, Treatment, and Cancer Prevention.

Am Soc Clin Oncol Educ Book 2018 May;38:101-109

From the Dana-Farber Cancer Institute, Brigham & Women's Hospital, and Harvard Medical School, Boston, MA; The Ohio State University Comprehensive Cancer Center, Columbus, OH.

Identification of individuals with inherited predispositions to cancer, including Lynch syndrome, can help prevent cancer and cancer-related death by allowing for the uptake of specific cancer prevention and screening as well as the use of therapies directed toward the underlying neoplastic process for individuals with advanced cancer. In the 25 years since the discovery of microsatellite instability (MSI) and the first recognition of germline mismatch repair (MMR) gene variants as the etiologic basis of Lynch syndrome, there has been tremendous progress in the understanding of the spectrum of cancer risk associated with Lynch syndrome as well as in cancer prevention and risk-reduction strategies. The past few years, in particular, have brought transformative changes in the treatment of Lynch syndrome-associated cancers with immune checkpoint inhibitors. Read More

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http://dx.doi.org/10.1200/EDBK_208341DOI Listing
May 2018
1 Read

Identification, Prioritization, and Treatment of Mutations Identified by Next-Generation Sequencing.

Am Soc Clin Oncol Educ Book 2018 May;38:873-880

From the Division of Medical Oncology, Mayo Clinic, Rochester, MN; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Division of Oncology, Aurora Health Care, Milwaukee, WI.

Many targeted therapies-and, more recently, immunotherapies-have been approved by the U.S. Food and Drug Administration (FDA) with companion diagnostic tests. Read More

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http://dx.doi.org/10.1200/EDBK_208339DOI Listing

Metastatic Castration-Sensitive Prostate Cancer: Optimizing Patient Selection and Treatment.

Am Soc Clin Oncol Educ Book 2018 May;38:363-371

From the Division of Oncology, University of Utah/Huntsman Cancer Institute, Salt Lake City, UT; Division of Oncology, University of Washington/Fred Hutchinson Cancer Research Center, Seattle, WA; Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA; Division of Hematology/Oncology, University of California-San Francisco, Helen Diller Comprehensive Cancer Center, San Francisco, CA.

The treatment landscape for metastatic castration-sensitive prostate cancer (mCSPC) has rapidly evolved over the past 5 years. Although androgen-deprivation therapy (ADT) is still the backbone of treatment, the addition of docetaxel or abiraterone acetate has improved outcomes for patients with mCSPC and become standard of care. With multiple treatment options available for patients with mCSPC, treatment selection to optimize patient outcomes has become increasingly difficult. Read More

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http://ascopubs.org/doi/10.1200/EDBK_200967
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http://dx.doi.org/10.1200/EDBK_200967DOI Listing
May 2018
5 Reads

Incorporating Genomics Into the Care of Patients With Advanced Breast Cancer.

Am Soc Clin Oncol Educ Book 2018 May;38:56-64

From the University of Wisconsin Carbone Cancer Center, Madison, WI; Department of Medicine, Division of Hematology/Oncology, University of Wisconsin, Madison, WI; Yale Cancer Center, New Haven, CT; Princess Margaret Hospital, Calgary, ON, Canada; Princess Margaret Cancer Center, Toronto, ON, Canada.

Metastatic breast cancer is a very heterogeneous disease. Recent advances in genomic sequencing have revealed genetic diversity between patients and across distinct subclonal cell populations within the same patient that may evolve across metastatic tumor sites and during treatment. With the increasing availability of commercial and laboratory-developed tests that can detect genomic alterations from patient tumor and blood samples, translating this knowledge into improved clinical care remains a challenge. Read More

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http://dx.doi.org/10.1200/EDBK_200731DOI Listing
May 2018
1 Read

Multidisciplinary Management of Oligometastatic Soft Tissue Sarcoma.

Am Soc Clin Oncol Educ Book 2018 May;38:939-948

From the Department of Medicine, Division of Hematology-Oncology, UNC Lineberger Cancer Center, The University of North Carolina, Chapel Hill, NC; Orthopaedic Oncology at Aurora Cancer Care, Orthopaedic Surgery, Aurora St. Luke's Medical Center, Milwaukee, WI; Department of Cardiothoracic Surgery, Aurora Healthcare, Milwaukee, WI; Department of Radiology, Duke University Medical Center, Durham, NC; Department of Radiation Oncology, Department of Pharmacology and Cancer Biology, Duke University Medical Center, Durham, NC.

Soft tissue sarcomas (STS) encompass a group of rare but heterogeneous diseases. Nevertheless, many patients, particularly those with oligometastatic disease can benefit from thoughtful multimodality evaluation and treatment regardless of the STS subtype. Here, we review surgical, interventional radiology, radiation, and chemotherapy approaches to maximize disease palliation and improve survival, including occasionally long-term disease-free survival. Read More

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http://dx.doi.org/10.1200/EDBK_200573DOI Listing
May 2018
1 Read

Bones in Multiple Myeloma: Imaging and Therapy.

Am Soc Clin Oncol Educ Book 2018 May;38:638-646

From the "Seràgnoli" Institute of Hematology, Bologna University School of Medicine, Bologna, Italy; Washington University School of Medicine, St. Louis, MO; Indiana University Simon Cancer Center, Indianapolis, IN.

Bone disease is the most frequent disease-defining clinical feature of multiple myeloma (MM), with 90% of patients developing bone lesions over the course of their disease. For this reason, imaging plays a major role in the management of disease in patients with MM. Although conventional radiography has traditionally been the standard of care, its low sensitivity in detecting osteolytic lesions has called for more advanced imaging modalities. Read More

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http://dx.doi.org/10.1200/EDBK_205583DOI Listing

"How Much Time Do I Have?": Communicating Prognosis in the Era of Exceptional Responders.

Am Soc Clin Oncol Educ Book 2018 May;38:787-794

From the Cancer Patient Experience Research Program, Duke Cancer Institute, Division of Hematologic Malignancies and Cellular Therapy, Duke University School of Medicine, Durham, NC; Massachusetts General Hospital, Boston, MA; Department of Medicine, Division of Hematology/Oncology, Indiana University Melvin and Bren Simon Cancer Center, Indiana University School of Medicine, Indianapolis, IN.

Prognostication is the science by which clinicians estimate a patient's expected outcome. A robust literature shows that many patients with advanced cancer have inaccurate perceptions of their prognosis, thus raising questions about whether patients are truly making informed decisions. Clinicians' ability to communicate prognostic information is further complicated today by the availability of novel, efficacious immunotherapies and genome-guided treatments. Read More

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http://dx.doi.org/10.1200/EDBK_201211DOI Listing

Neoadjuvant Chemotherapy, Concurrent Chemoradiation, and Adjuvant Chemotherapy for High-Risk Extremity Soft Tissue Sarcoma.

Am Soc Clin Oncol Educ Book 2018 May;38:910-915

From the Department of Radiation Oncology, Dana-Farber Cancer Institute and Brigham and Women's Hospital, Boston, MA; Department of Adult Medicine, Gustave Roussy, Villejuif, France; Division of Medical Oncology, Sarcoma Program, Sylvester Comprehensive Cancer Center, Miami, FL.

Standard treatment of large intermediate- and high-grade extremity soft tissue sarcoma (ESTS) typically includes wide excision and radiation therapy. Many patients do well with this approach, but for those with unfavorable features, risk for distant recurrence and, ultimately, mortality can exceed 50%. Unfortunately, universally accepted data elucidating effective treatments to prevent recurrences and improve survival for such high-risk patients are lacking. Read More

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http://dx.doi.org/10.1200/EDBK_201421DOI Listing
May 2018
1 Read

Sequencing Therapy for Genetically Defined Subgroups of Non-Small Cell Lung Cancer.

Am Soc Clin Oncol Educ Book 2018 May;38:726-739

From the Department of Medicine, Memorial Sloan Kettering Cancer Center, Weil Cornell Medical College, New York, NY; Department of Medical Oncology, Institut Gustave Roussy, Villejuif, France; Department of Medicine, Division of Hematology and Oncology, Vanderbilt University Medical Center, Vanderbilt Ingram Cancer Center, Nashville, TN.

The practice of precision medicine for patients with metastatic non-small cell lung cancer (NSCLC), particularly those patients with adenocarcinoma histology (the predominant subtype of NSCLC), has become the accepted standard of care worldwide. Implementation of prospective tumor molecular profiling and rational therapeutic decision-making based on the presence of recurrently detected oncogenic "driver" alterations in the tumor genome has revolutionized the way that lung cancer is diagnosed and treated in the clinic. Over the past two decades, there has been a deluge of therapeutically actionable driver alterations and accompanying small molecule inhibitors to target these drivers. Read More

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http://dx.doi.org/10.1200/EDBK_201331DOI Listing
May 2018
3 Reads

Implementation of Patient-Reported Outcomes in Routine Medical Care.

Am Soc Clin Oncol Educ Book 2018 May;38:122-134

From the UNC Lineberger Comprehensive Cancer Center, Chapel Hill, NC; Odette Cancer Centre, University of Toronto, Toronto, ON, Canada; Geisel School of Medicine, Dartmouth College, Hanover, NH; University of Leeds, Leeds, United Kingdom.

There is increasing interest to integrate collection of patient-reported outcomes (PROs) in routine practice to enhance clinical care. Multiple studies show that systematic monitoring of patients using PROs improves patient-clinician communication, clinician awareness of symptoms, symptom management, patient satisfaction, quality of life, and overall survival. The general approach includes a brief electronic survey, administered via the Web or an app or an automated telephone system, with alerts to clinicians for concerning or worsening issues. Read More

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http://dx.doi.org/10.1200/EDBK_200383DOI Listing

Patterns of Response and Progression to Immunotherapy.

Am Soc Clin Oncol Educ Book 2018 May;38:169-178

From the Department of Drug Development and Innovation, Institut Curie, Paris and Saint-Cloud, France; Montefiore Medical Center, Albert Einstein College of Medicine, Bronx, NY; Melanoma Institute Australia, North Sydney, NSW, Australia; INSERM U900 Research Unit, Saint-Cloud, France; Versailles Saint-Quentin-en-Yvelines University, Montigny-le-Bretonneux, France.

Patterns of response and progression to immunotherapy may differ from those observed with drugs such as chemotherapy and molecularly targeted agents. Specifically, some patients experience a response after progression that is retrospectively named pseudoprogression. This phenomenon of pseudoprogression, first reported in patients with melanoma who were treated with ipilimumab, has led to the development of immune-specific related response criteria, such as irRC (immune-related response criteria), irRECIST (immune-related RECIST), and iRECIST (immunotherapy RECIST) that allow continued treatment beyond progression. Read More

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http://dx.doi.org/10.1200/EDBK_200643DOI Listing

The Winds of Change: Emerging Therapeutics in Prostate Cancer.

Am Soc Clin Oncol Educ Book 2018 May;38:382-390

From the From Monash University, Melbourne, Australia; Genitourinary Malignancies Branch, National Cancer Institute, National Institutes of Health, Bethesda, MD.

The last decade has seen substantial advances in androgen receptor targeting in prostate cancer. In addition, advances have been made in immunotherapy and radiopharmaceutical-based therapy, although their optimal use in the clinic remains unclear. Recent understanding of the relevance and actionability of DNA damage repair mutations in a considerable minority of patients with prostate cancer is likely to open up a new frontier in prostate cancer therapeutics. Read More

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http://dx.doi.org/10.1200/EDBK_201295DOI Listing

Tumor Response Assessment for Precision Cancer Therapy: Response Evaluation Criteria in Solid Tumors and Beyond.

Authors:
Mizuki Nishino

Am Soc Clin Oncol Educ Book 2018 May;38:1019-1029

From the Department of Radiology, Brigham and Women's Hospital and Dana-Farber Cancer Institute, Boston, MA.

Objective assessment of tumor responses and treatment results has been the basis for the advancement of cancer therapies, and imaging plays a key role to provide a "common language" to describe the results of cancer treatment. Although Response Evaluation Criteria in Solid Tumors (RECIST) has been the most widely accepted method for assessing tumor response in the past decades, the limitations of RECIST have increasingly becoming recognized, especially with the recent advances of precision-medicine approaches to cancer. This article reviews the current concept of tumor response evaluations based on RECIST, describes the limitations of RECIST, and proposes strategies to overcome the limitations. Read More

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http://ascopubs.org/doi/10.1200/EDBK_201441
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http://dx.doi.org/10.1200/EDBK_201441DOI Listing
May 2018
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Communicating the Financial Burden of Treatment With Patients.

Am Soc Clin Oncol Educ Book 2018 May;38:524-531

From the Department of Medicine, Division of Hematology and Oncology, Massachusetts General Hospital Cancer Center and Harvard Medical School, Boston, MA; CancerCare, New York, NY; Divisions of Unintentional Injury Prevention and Cancer Prevention and Control, Centers for Disease Control and Prevention, Atlanta, GA.

In recent years, high health care costs and the financial burden of cancer care have received increased attention. In response to the financial burden of cancer care, patients may jeopardize their health outcomes by not properly adhering to prescribed therapies or even forgoing and delaying care in an effort to defray costs. In addition, the financial burden experienced by patients with cancer may negatively impact clinical outcomes, such as quality of life, physical and psychological symptoms, and potentially, even survival. Read More

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http://dx.doi.org/10.1200/EDBK_201051DOI Listing
May 2018
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Caring for Colleagues and Loved Ones With Cancer.

Am Soc Clin Oncol Educ Book 2018 May;38:903-908

From the Winship Cancer Institute of Emory University, Atlanta, GA; Harbin Clinic LLC, Rome, GA; Sarah Cannon Cancer Institutes HCA Midwest Health, Overland Park, KS; Emory University School of Medicine, Atlanta, GA; Monash Medical Centre, Glen Waverley, Australia; University of Florida College of Medicine, Gainesville, FL.

Throughout the arc of a career in medicine, physicians are universally faced with the difficult decision of when to provide care for a colleague and when to refer to another physician. Gauging the magnitude of your relationship, both professionally and personally, and then weighing how to add the roles of physician and patient to your preexisting relationship is complex. We review and discuss care of family and colleagues, address ethical boundaries both firm and flexible, and explore the emotional weight of those relationships. Read More

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http://dx.doi.org/10.1200/EDBK_201451DOI Listing
May 2018
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Personalized Management of Advanced Kidney Cancer.

Am Soc Clin Oncol Educ Book 2018 May;38:330-341

From the Tom Baker Cancer Centre, University of Calgary, Calgary, Alberta, Canada; Kidney Cancer Program, Simmons Comprehensive Cancer Center, University of Texas Southwestern Medical Center, Dallas, TX; Karmanos Cancer Institute, Wayne State University, Detroit, MI.

The treatment of renal cell carcinoma represents one of the great success stories in translational cancer research, with the development of novel therapies targeting key oncogenic pathways. These include drugs that target the VEGF and mTOR pathways, as well as novel immuno-oncology agents. Despite the therapeutic advancements, there is a paucity of well-validated prognostic and predictive biomarkers in advanced kidney cancer. Read More

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http://dx.doi.org/10.1200/EDBK_201215DOI Listing
May 2018
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Integrating Genomics Into Neuro-Oncology Clinical Trials and Practice.

Am Soc Clin Oncol Educ Book 2018 May;38:148-157

From the Division of Medical Oncology, Department of Oncology, Mayo Clinic, Rochester, MN; Division of Neurosurgery, Department of Surgery, University of Toronto, Toronto, ON, Canada; Department of Pathology, Brigham and Women's Hospital, Harvard Medical School, Boston, MA; MacFeeters Hamilton Centre for Neuro-Oncology Research, University of Toronto, Toronto, ON, Canada; Ludwig Center at Harvard, Department of Pathology, Boston Children's Hospital, and Department of Oncologic Pathology, Dana-Farber Cancer Institute, Harvard Medical School, Boston, MA.

Important advances in our understanding of the molecular biology of brain tumors have resulted in a rapid evolution in the taxonomy of central nervous system (CNS) tumors, which culminated in the revised 2016 World Health Organization classification of CNS tumors that incorporates an integrated molecular/histologic diagnostic approach. Our expanding understanding of brain tumor genomics and molecular evolution during the disease course has started to impact clinical management. Furthermore, incorporation of genomic information in ongoing and planned neuro-oncology clinical trials is expected to lead to improved outcomes and result in personalized treatment options for patients with CNS malignancies. Read More

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http://dx.doi.org/10.1200/EDBK_200989DOI Listing

CAR T Cells and Other Cellular Therapies for Multiple Myeloma: 2018 Update.

Authors:
Adam D Cohen

Am Soc Clin Oncol Educ Book 2018 May;38:e6-e15

From the Abramson Cancer Center, University of Pennsylvania, Philadelphia, PA.

Cellular therapies are a rapidly evolving approach to myeloma treatment, which bring a unique mechanism of action with the potential to overcome drug resistance and induce long-term remissions. Two primary approaches are being studied: non-gene-modified strategies, which rely on the endogenous anti-myeloma T-cell repertoire, and gene-modified strategies, which introduce a new T-cell receptor (TCR) or a chimeric antigen receptor (CAR) to confer novel antigen specificity. CAR T cells show the greatest activity to date. Read More

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http://dx.doi.org/10.1200/EDBK_200889DOI Listing

Cognitive Changes in Cancer Survivors.

Am Soc Clin Oncol Educ Book 2018 May;38:795-806

From the University of Rochester Medical Center, Rochester, NY; St. Jude Children's Research Hospital, Memphis, TN; The University of Texas MD Anderson Cancer Center, Houston, TX.

Advances in cancer treatments have led to substantially improved survival for patients with cancer. However, many patients experience changes in cognition as a side effect of both cancer and cancer treatment. This occurs with both central nervous system (CNS) tumors and non-CNS tumors and in both children and adults. Read More

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http://dx.doi.org/10.1200/EDBK_201179DOI Listing
May 2018
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Emerging Strategies in Systemic Therapy for the Treatment of Melanoma.

Am Soc Clin Oncol Educ Book 2018 May;38:751-758

From the Istituto Nazionale Tumori "Fondazione G. Pascale," Naples, Italy; Massachusetts General Hospital Cancer Center, Boston, MA; Center for Cancer Research, National Cancer Institute, Bethesda, MD.

Recent years have seen major improvements in survival of patients with advanced melanoma with the advent of various novel systemic immunotherapies and targeted therapies. As our understanding of these agents and their various mechanisms of action improves, even more impressive outcomes are being achieved through use of various combination strategies, including the combining of different immunotherapies with one another as well as with other modalities. However, despite the improved outcomes that have been achieved in advanced melanoma, responses to treatment are heterogeneous and may not always be durable. Read More

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http://dx.doi.org/10.1200/EDBK_199047DOI Listing
May 2018
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Practice-Changing Developments in Stage III Melanoma: Surgery, Adjuvant Targeted Therapy, and Immunotherapy.

Am Soc Clin Oncol Educ Book 2018 May;38:759-762

From the Department of Hematology/Oncology, Winship Cancer Institute, Emory University, Atlanta, GA; Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland; Department of Surgical Oncology, Netherlands Cancer Institute, Antoni van Leeuwenhoek Hospital, Amsterdam, Netherlands.

In this article, we will focus on the practice-changing developments for stage III melanoma, from the use of the sentinel node (SN) biopsy to complete lymph node dissection (CLND) and upcoming adjuvant therapies. MSLT-1 (Multicenter Selective Lymphadenectomy Trial-1) was the first and only prospective randomized controlled trial to examine whether the SN biopsy has any notable melanoma-specific survival benefit (primary endpoint). MSLT-1 randomly assigned 2,001 patients to undergo either wide local excision (WLE) and an SN biopsy or WLE and nodal observation. Read More

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http://dx.doi.org/10.1200/EDBK_200241DOI Listing

Art and Challenges of Precision Medicine: Interpreting and Integrating Genomic Data Into Clinical Practice.

Am Soc Clin Oncol Educ Book 2018 May;38:546-553

From the Innovation Center for Biomedical Informatics, Georgetown University, Washington, DC; Swedish Cancer Institute, Seattle, WA; The Ohio State University, Columbus, OH.

Precision medicine is at the forefront of innovation in cancer care. With the development of technologies to rapidly sequence DNA from tumors, cell-free DNA, proteins, and even metabolites coupled with the rapid decline in the cost of genomic sequencing, there has been an exponential increase in the amount of data generated for each patient diagnosed with cancer. The ability to harness this explosion of data will be critical to improving treatments for patients. Read More

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http://dx.doi.org/10.1200/EDBK_200759DOI Listing
May 2018
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Risk Stratification and Targets in Multiple Myeloma: From Genomics to the Bedside.

Am Soc Clin Oncol Educ Book 2018 May;38:675-680

From the Hematology Department, University Hospital, Nancy, France; Myeloma Genomics Laboratory, University Hospital, Toulouse, France; and Myeloma Genomics Laboratory, University Hospital, Toulouse, France.

In the past 15 years, significant improvements in overall survival have been observed in multiple myeloma (MM), mainly due to the availability of novel drugs with variable mechanisms of action. However, these improvements do not benefit all patients, and some of them, defined as high risk, still display short survival. The most important risk factors are the genetic abnormalities present in the malignant plasma cells. Read More

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http://dx.doi.org/10.1200/EDBK_200879DOI Listing
May 2018
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Immune Checkpoint Inhibitors in the Management of Lung Cancer.

Am Soc Clin Oncol Educ Book 2018 May;38:682-695

From the Department of Oncology, Lausanne University Hospital, Lausanne, Switzerland; Department of Hematology and Medical Oncology, Winship Cancer Institute of Emory University, Atlanta, GA; and the Department of Internal Medicine, Division of Hematology/Oncology, University of Michigan, Ann Arbor, MI.

Immune checkpoint inhibitors, specifically PD-1-directed agents, have changed the treatment paradigm of non-small cell lung cancer (NSCLC) and are being actively evaluated in patients with small cell lung cancer. After initial studies demonstrated survival advantage with these agents in patients with recurrent NSCLC, these agents now have demonstrated survival advantage in some patients with early-stage NSCLC. Further evaluation of these agents in combination with chemotherapy regimens and other checkpoint inhibitors is ongoing. Read More

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http://dx.doi.org/10.1200/EDBK_201319DOI Listing

Value and Cost of Myeloma Therapy-We Can Afford It.

Am Soc Clin Oncol Educ Book 2018 May;38:647-655

From the Mayo Clinic, Phoenix, AZ; McGiveny Global Advisors, Wayne, PA.

A national conversation regarding the price and affordability of drugs exists, where concern for value and benefits of medications is challenged by the increasing price of both injectable and oral medications, including the cost of care of myeloma. At the same time, we have seen unprecedented improvements in the overall survival of patients with myeloma, mostly because of the availability of these new drugs. Here, we present data to assert that these medications and associated expenses are of direct benefit to patients and society. Read More

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http://dx.doi.org/10.1200/EDBK_200869DOI Listing
May 2018
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National Cancer Institute Programmatic Collaboration for Investigational Radiopharmaceuticals.

Am Soc Clin Oncol Educ Book 2018 May;38:488-494

From the Cancer Therapy Evaluation Program, National Cancer Institute, National Institutes of Health, Bethesda, MD; Radiation Research Program, National Cancer Institute, National Institutes of Health, Bethesda, MD.

Radiopharmaceutical therapies have provided an attractive therapeutic approach since the introduction of I to treat thyroid cancer. New insights in cancer biology and radiochemistry have brought radiopharmaceuticals to the leading edge of oncology clinical research. National Cancer Institute (NCI) programs watch for new radiopharmaceutical breakthroughs that should be used to treat patients with unmet therapeutic needs. Read More

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http://dx.doi.org/10.1200/EDBK_200199DOI Listing
May 2018
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Cost, Value, and Financial Hardship in Cancer Care: Implications for Pediatric Oncology.

Am Soc Clin Oncol Educ Book 2018 May;38:850-860

From Tufts Medical Center, Boston, MA; Children's Hospital of Atlanta/Emory University, Atlanta, GA; American Cancer Society, Atlanta, GA.

Cancer care in the United States faces a perfect storm: an aging population and expected increased cancer incidence, growing numbers of cancer survivors with ongoing care needs, and continued scientific advancements, offering extraordinary promise at extraordinary cost. How, then, do we as pediatric oncologists engage in the dialogue about cancer cost considerations? The purpose of this article and its accompanying session presented at the 2018 ASCO Annual Meeting is to introduce concepts of cost, value, and financial hardship. In the first section, we will provide an overview of principles of health economics, including components of cost, time horizon consideration, discounting, and methods to calculate incremental cost-effectiveness among therapeutic approaches. Read More

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http://dx.doi.org/10.1200/EDBK_200359DOI Listing
May 2018
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Implementing Precision Medicine Programs and Clinical Trials in the Community-Based Oncology Practice: Barriers and Best Practices.

Am Soc Clin Oncol Educ Book 2018 May;38:188-196

From the Levine Cancer Institute, Atrium Health, Charlotte, NC; Sanford Research, Sioux Falls, SD; Aurora Health Care, Milwaukee, WI.

There has been a rapid uptick in the pace of oncology precision medicine advancements over the past several decades as a result of increasingly sophisticated technology and the ability to study more patients through innovative trial designs. As more precision oncology approaches are developed, the need for precision medicine trials is increasing in the community setting, where most patients with cancer are treated. However, community-based practices, as well as some academic centers, may face unique barriers to implementing precision medicine programs and trials within their communities. Read More

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http://dx.doi.org/10.1200/EDBK_200633DOI Listing
May 2018
2 Reads