Conference Correspondent

The need to optimize the treatment of patients with cancer while using healthcare resources wisely—in other words, providing “value-based cancer care”—is not a topic of debate, but how to achieve this pressing goal is far from clear. In a panel discussion during the Association for Value-Based Cancer Care’s Second Annual Conference, held in Houston, Texas, strategists from the payer side of the issue discussed the current trends and the challenges they are facing.

At the Association for Value-Based Cancer Care (AVBCC) second annual meeting, Winston Wong, PharmD, expressed concerns that the site of delivery of cancer care affects efforts to rein in costs and provide value in cancer care. Wong expanded on this issue in the following interview.

Why do you believe that the site of delivery of cancer care can impact the attempt to rein in costs of cancer care and provide value?

The Oncotype DX breast cancer assay for ductal carcinoma in situ (DCIS) is a strong and significant predictor of 10-year risk of recurrence in women with DCIS, according to a study presented at the CTRC-AACR San Antonio Breast Cancer Symposium (SABCS) held in December 2011. It is the first clinically validated genomic assay to predict risk of local recurrence for women with DCIS, and it is now available from Genomic Health.

BRCA mutation carriers who have had breast cancer are at increased risk of developing contralateral breast cancer, according to a study presented at the 2011 CTRC-AACR San Antonio Breast Cancer Symposium. In fact, women with a BRCA1 or BRCA2 mutation had a greater than 10% risk of developing contralateral breast cancer, and the risk was strongly associated with younger age at diagnosis and a diagnosis of triple-negative (estrogen receptor–negative, progesterone receptor–negative, and HER2-negative) breast cancer.

Although management of lymphoma during pregnancy is not well studied, a retrospective review at 10 academic centers in the United States suggests that in selected cases, lymphoma can be treated with minimal maternal and fetal complications, and that treatment can be deferred until after giving birth in patients with low-risk lymphomas. The study was presented at the 53rd Annual Meeting of the American Society of Hematology held December 2011 in San Diego, California.

Administering gemtuzumab ozogamicin (GO) on a new schedule achieved impressive progression-free survival (PFS) and overall survival (OS) compared with standard chemotherapy in older patients with acute myeloid leukemia (AML) with favorable cytogenetics, according to a phase 3 study presented at the Plenary Session of the 53rd Annual Meeting of the American Society of Hematology (ASH). GO was taken off the market in 2010 due to toxicity concerns and is no longer available in the US.

A higher dose of radiation (74 Gy) does not improve overall survival for non–small cell lung cancer (NSCLC) that has spread to the lymph nodes compared with the standard radiation dose (60 Gy), according to a new study presented at the 53rd Annual Meeting of the American Society for Radiation Oncology.

WASHINGTON, DC—Psychosocial stress may play a role in the etiology of breast cancer aggressiveness, particularly among minority populations, according to study results. In a cross-sectional study, greater levels of fear, anxiety, or isolation were found to be associated with more aggressive breast cancer; however, no clear driver for the association is yet identified.

WASHINGTON, DC—Genetic differences among African-American and white men seem to be root causes of the prostate cancer disparities between the 2 groups, according to new data. Prostate cancer is the second most common cancer among men in the United States, with occurrences and mortality rates higher in African- American men compared with white men. Studies show that prostate cancer is a disease conferred by multiple gene mutations, numerous alterations in gene expression, and changes in genome composition.

WASHINGTON, DC—The overall incidence of breast cancer is generally higher among white women than black women. The incidence of a second breast cancer in the opposite breast, however, is higher among black women, according to new data.
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