Medicare Cracks Down on Opioid Prescriptions, Abuse; Health Care Tops Poll of American Worries; Leading Chemotherapy Researcher, Physician Dies at 92
An estimated 14.4 million Medicare recipients were prescribed some form of opioid treatment in 2016, paid for by their Medicare benefits. In an attempt to help curb the national opioid epidemic, officials from the Center for Medicare and Medicaid Services (CMS) announced that Medicare would no longer pay for long-term, high-dose prescription pain medication. Unsurprisingly, the plan received flak from patient and provider advocacy groups alike. Opponents to the CMS announcement decried the efforts, citing barriers to crucial medications needed for patients in chronic or severe pain—including those with cancer.
Key Funding Increases for Cancer Research, Nursing, Public Health; Patients, Providers, or Politicians: Whose Choices Matter Most?; FDA Targets Flavored Tobacco Products
Racing against the clock to ensure the government stayed funded through September 2018, President Trump signed the Consolidation Appropriations Act, a $1.3 trillion spending bill that includes funding for a number of key nursing and public health initiatives. The bill, which had made its way through the House of Representatives and the Senate last week, also contains new clarifying language for the Dickey Amendment, ending a 22-year ban on government-funded gun violence research. ONS joined the Nursing Community Coalition—led in part by the efforts of the American Nurses Association—to support evidence-based inquiry into gun violence and its potential impacts on public health.
FDA Approves Brentuximab Vedotin for Previously Untreated Stage III, IV Classical Hodgkin Lymphoma
On March 20, 2018, the U.S. Food and Drug Administration (FDA) approved brentuximab vedotin to treat adult patients with previously untreated stage III or IV classical Hodgkin lymphoma in combination with chemotherapy.
President’s Budget Proposal Recommends Severe Cuts to HHS
Putting together the federal budget is an arduous task. Department by department, suggestions for program funding increases and decreases are reviewed, discussed, analyzed, and submitted. Budget officials are trying to match the administration’s priorities and review the fiscal environment, not to mention craft spending items to gain support from congress, who ultimately votes on the budget.
NIH: A Look Back at 2017 in Research
To plan for a strong future, one must understand the past. Reviewing the previous year’s accomplishments is always a good policy for reflection and improvement. It can help remind us of the accomplishments achieved in 12 short months. Such was the case at the National Institutes of Health (NIH), as director Francis Collins addressed the research achievements for 2017 in his opening blog.
FDA Approves Lutetium Lu 177 Dotatate for Treatment of GEP-NETS
On January 26, 2018, the U.S. Food and Drug Administration (FDA) approved lutetium Lu 177 dotatate a radiolabeled somatostatin analog, for the treatment of somatostatin receptor-positive gastroenteropancreatic neuroendocrine tumors (GEP-NETs), including foregut, midgut, and hindgut neuroendocrine tumors in adults.
Understanding Medicinal Cannabis in Cancer Care
Medicinal cannabis, a topic that remains largely unstudied in human trials in the United States, is slowly becoming introduced in areas of health care and oncology in states that have legalized it for medical and adult recreational use.
Multiple Myeloma Survivors Still Experience Symptoms and Psychological Concerns
Survival from multiple myeloma (MM) has improved, and more attention is required for symptom burden and psychological impact in the long-term management of this disease. Researchers assessed the incidence of self-reported pain, depression, financial and family burden, and impairment of performance status, as well as determined the correlation of total distress with survival. Joshua R. Richter, MD, at the John Theurer Cancer Center in Hackensack, NJ, discussed the findings at the ASH Annual Meeting.
Physical Activity Level Before and After Cancer Diagnosis Impacts Survival for Lymphoma
Researchers assessed the impact of physical activity levels before and after cancer diagnosis on overall survival (OS) and lymphoma-specific survival (LSS) outcomes in patients with lymphoma. They found that higher levels of physical activity during adult life and within three years of diagnosis improve survival. Priyanka Pophali, MD, at the Mayo Clinic in Rochester, MN, discussed the findings at the ASH Annual Meeting.
Better Symptom Management Is Needed for Patients With CML
Patients with chronic myeloid leukemia (CML) often experience symptoms and treatment-related adverse events (AEs) that are chronic and may require care from an interdisciplinary team. A study sought to assess symptom burden, palliative care needs, and experiences with healthcare team communication in this patient population. Alexandra K. Zaleta, PhD, at the Research and Training Institute, Cancer Support Community in Philadelphia, PA, discussed the findings at the ASH Annual Meeting.
Sexual Function Varies by Some Treatments in Breast Cancer Survivors
Surgical modality and receipt of chemotherapy or radiotherapy are not associated with sexual function, as measured by the Female Sexual Function Index (FSFI). Patients receiving endocrine therapy with an aromatase inhibitor had significantly lower sexual function scores than those who received no endocrine therapy or those on tamoxifen, said a group of U.S. researchers who presented their findings during a poster session on Saturday, December 10, at the San Antonio Breast Cancer Symposium.
Latinas With BRCA1 or 2 Mutations Are More Likely to Choose Surgery
The uptake of prophylactic surgeries among Latinas with germline BRCA mutations may be slightly lower than what has been reported in non-Hispanic whites but higher than in African Americans, a group of U.S. researchers said. They presented their findings on Saturday, December 10, during a poster session at the San Antonio Breast Cancer Symposium.
Real-World Findings for Ibrutinib in Patients With CLL: Toxicities, Discontinuations, and More
Ibrutinib is approved by the U.S. Food and Drug Administration (FDA) for the treatment of chronic lymphocytic leukemia (CLL). Researchers sought to study real-world outcomes related to adverse events (AEs), treatment discontinuation, outcomes, and subsequent therapies in those treated with frontline ibrutinib. Anthony R. Mato, MD, at the University of Pennsylvania Abramson Cancer Center in Philadelphia, PA, discussed the findings at the ASH Annual Meeting.
Do Survivorship Care Plans Decrease Cancer Treatment Distress?
Researchers conducted a randomized study to assess the impact of survivorship care plans (SCPs) on cancer survivors who underwent hematopoietic cell transplantation (HCT). They assessed confidence in survivorship information (primary analysis), as well as cancer treatment distress, knowledge of transplant exposures, health behaviors, healthcare use, and health general self-efficacy. Navneet S. Majhail, MD, MS, at the Taussig Cancer Institute at the Cleveland Clinic in Ohio, discussed the findings at the ASH Annual Meeting.
Factors Predict 30-Day Hospital Readmissions for Patients With Hematologic Malignancies
Data are limited on repeated unplanned hospital readmissions among patients with hematologic malignancies, so researchers analyzed baseline characteristics of patients with one or more 30-day unplanned readmissions, as well as factors related to these readmissions. Girish Kunapareddy, MD, at the Taussig Cancer Institute at the Cleveland Clinic in Ohio, discussed the findings at the ASH Annual Meeting.
Individualized Care Plans Decrease Emergency Department Use
Unplanned hospitalizations and emergency department (ED) visits are an ongoing problem for patients with cancer. At the Taussig Cancer Institute, just 6% of all discharged patients accounted for more than 40% of unplanned readmissions (defined as a hospitalization occurring within 30 days of discharge). Those patients are also at high risk for future admissions, intensive care unit (ICU) stay, ED visits, overuse of chemotherapy, and underuse of hospice resources. Researchers developed an individualized care plan (ICP) for patients with the highest preventable use to see if this would impact hospital use and readmissions. Girish Kunapareddy, MD, at the Taussig Cancer Institute at the Cleveland Clinic in Ohio, discussed the findings at the ASH Annual Meeting.
Supervised Exercise Reduces Fatigue in Patients With Breast Cancer
Exercise—preferably supervised—represents a viable intervention for prevention and treatment of fatigue among patients with breast cancer, a group of Australian, European, and U.S. researchers said. They presented their findings during a poster session on Saturday, December 9, during the San Antonio Breast Cancer Symposium.
Type 2 Diabetes May Increase Breast Cancer Mortality in Hispanic Women
The presence of type 2 diabetes mellitus at the time of breast cancer diagnosis has been suggested to adversely affect survival—independent of breast cancer stage, grade, and tumor phenotype—but few of those studies included people of Hispanic descent. Researchers from Johns Hopkins Bloomberg School of Public Health in Baltimore and the University of Louisville in Kentucky examined the association between self-reported diabetes history, breast cancer-specific and all-cause mortality among Hispanic and non-Hispanic white women diagnosed with breast cancer. They presented their results on Saturday, December 9, during a poster session at the San Antonio Breast Cancer Symposium.
Statins Enhance Venetoclax Response in CLL and MM
Venetoclax—an oral, small-molecule BCL-2 inhibitor—is approved by the U.S. Food and Drug Administration for the treatment of relapsed or refractory chronic lymphocytic leukemia (CLL) in those with del(17p) mutation. Statins, which are used to lower cholesterol, have shown a potential to induce apoptosis in various cancer cell lines, and evidence suggests a synergism when combined with BCL-2 inhibition. Based on this, researchers conducted a post-hoc analysis to see whether statins enhance the activity of venetoclax in patients with CLL or multiple myeloma (MM). Andrew W. Roberts, MS, at AbbVie Inc., in North Chicago, IL, discussed the findings at the ASH Annual Meeting.
Diet Choices and Supplement Use May Affect MPN Symptom Burden
Patients with myeloproliferative neoplasms (MPN) have increased inflammatory cytokines that contribute to symptom burden and nutritional deficiencies. Some studies have indicated that diets and supplements have demonstrated antioxidant and anti-inflammatory pharmacologic properties, such as decreased inflammatory markers and reactive oxygen species. Researchers conducted a study to examine nutritional and supplemental needs in this patient population. Robyn M. Scherber, MD, at Oregon Health and Science University in Portland, discussed the findings at the ASH Annual Meeting.
Patients With CLL Report Worse QoL and Other Factors
Researchers assessed how patients with chronic lymphocytic leukemia (CLL) describe quality of life (QoL) compared to other U.S. populations, as well as the effects on daily living, finances, and professional and family relationships. Joanne S. Buzaglo, PhD, at the Research and Training Institute, Cancer Support Community in Philadelphia, PA, discussed the findings at the ASH Annual Meeting.
Activity Tracker Data Correlates With Patient-Reported Outcomes
Patient-reported outcomes (PROs) are an important part of patient management but may be burdensome for patients to track. Wearable activity monitors provide objective, continuous activity data that may correlate with PROs, and researchers assessed the use of this technology in a study. Carrie A. Thompson, MD, at the Mayo Clinic in Rochester, MN, discussed the findings at the ASH Annual Meeting.
Factors Related to Palliative Care Use in Patients With Hematologic Malignancies
No data exist on current trends and practice patterns for palliative care use among patients with cancer, particularly those with hematologic malignancies. Sikander Ailawadhi, MD, at the Mayo Clinic in Jacksonville, FL, discussed their findings on these trends at the ASH Annual Meeting.
Disease Factors Influence Treatment Decisions More Than Comorbidities in Patients With Follicular Lymphoma
Data from U.S. Lymphocare suggest that older patients with follicular lymphoma (FL) are more commonly treated with watchful waiting or single-agent rituximab and found no difference in outcomes by treatment groups, but comorbidity was not studied. Researchers aimed to describe patient features, comorbidity use of positron-emission tomography (PET) staging, management choices, and the impact of polypharmacy on outcomes of patients with FL aged 70 years or older. Prathima Reddy, MD, at CHI Franciscan Hospital in Federal Way, WA, discussed the findings at the ASH Annual Meeting.
Study Assesses Ibrutinib’s Impact on Major Hemorrhage in Patients With B-Cell Malignancies
Ibrutinib is a first-in-class, once-daily inhibitor of Bruton tyrosine kinase that is approved for various B-cell malignancies. However, the drug is associated with increased rates of low-grade hemorrhage and sometimes serious hemorrhage, which is listed as a warning in the prescribing information. Patients with chronic lymphocytic leukemia (CLL), small lymphocytic lymphoma (SLL), and mantle cell lymphoma (MCL) are at an increased risk for major hemorrhage (MH) compared to the general population.
Autoimmune and Infectious Diseases Are Increased in DLBCL Survivors Compared to Other Cancer Survivors
Many lymphoma treatments are known to affect the immune system, so researchers assessed whether survivors of diffuse large B-cell lymphoma (DLBCL) have an altered risk of developing autoimmune and infectious diseases compared to other cancer survivors. Tanaya Shree, MD, PhD, at Stanford University Medical Center in California, discussed the findings at the ASH Annual Meeting.
Study Compares Adverse Event Profile for CPX-351 and Conventional 7+3 for AML
CPX-351 is a dual-drug liposomal encapsulation of cytarabine and daunorubicin that delivers a synergistic drug ratio. In a randomized, phase III study, researchers evaluated induction therapy with CPX-351 versus conventional cytarabine/daunorubicin (referred to as 7+3 regimen) in adults aged 60–75 years with newly diagnosed, treatment-related acute myeloid leukemia (AML) or AML with myelodysplasia-related changes. Bruno C Medeiros, MD, at Stanford University School of Medicine in California, discussed the findings at the ASH Annual Meeting.
Community Breast Physicians Network Study Supports Broader Testing
Ongoing and increasing evidence suggest that an equivalent rate of mutations may be found regardless of whether patients meet current testing criteria, according to a large group of community breast physicians. They presented their findings on Friday, December 8, during a poster session at the San Antonio Breast Cancer Symposium.
Exercise Is Beneficial in Metabolic Syndrome
Metabolic syndrome is associated with increased risk of cardiovascular disease, type 2 diabetes, and possibly cancer recurrence, and its occurrence is higher in breast cancer survivors than age-matched postmenopausal women. Now, a study on exercise has found that aerobic and resistance exercise intervention reduced metabolic syndrome in sedentary, overweight, and obese Hispanic breast cancer survivors. U.S. researchers presented their findings during a poster session on Friday, December 8, at the San Antonio Breast Cancer Symposium.
Disparities Remain in Breast Cancer Mortality Based on Health Insurance Status
Significantly higher rates of death are found in Medicaid and uninsured hospital admissions when compared to Medicare-enrolled admissions with breast cancer, suggesting that insurance status “appears to play a crucial role in patient outcomes.” Researchers with Drexel University in Philadelphia presented their findings on Friday, December 8, during a poster session at the San Antonio Breast Cancer Symposium.
Younger Age Equates to Unfavorable Subtypes, Higher Stage, and Worse Survival in BC
Patients with breast cancer who are younger than 40 years are likely to have unfavorable subtypes, higher stage, and lower overall survival and disease-free survival (DFS) as compared to their older counterparts, according to researchers at the Roswell Park Cancer Institute in Buffalo, NY. They presented their findings on Friday, December 8, during the San Antonio Breast Cancer Symposium.
Serum Vitamin D Linked to Inability to Achieve Pathologic Complete Response
Vitamin D deficiency is associated with the inability to reach pathologic complete response (pCR) in patients with breast cancer undergoing neoadjuvant systemic chemotherapy (NAC), and a trend for worse survival was seen in patients with triple negative tumors. Results from an analysis were presented on Thursday, December 7, during a poster session at the San Antonio Breast Cancer Symposium (SABCS).
Factors Increase Risk for Fibrosis After Whole Breast Radiation Therapy in Lateral Position
Whole breast radiation therapy in isocentric lateral decubitus position is well tolerated with good cosmesis and low rates of fibrosis, said a group that had previously confirmed the efficacy and safety of the technique. Researchers from the Institut Curie in Paris presented their results during a poster session on Thursday, December 7, at the San Antonio Breast Cancer Symposium.
Enrichment of Mucin Gene Family Shown in Breast Cancer Diagnosed During Pregnancy
The first study on the mutational landscape of breast cancer diagnosed during pregnancy (BCP) using whole-genome sequencing found that BCP is associated with a higher number of putative driver mutations, including mutations in mucin genes. Researchers presented their findings on Thursday, December 7, during a poster session at the San Antonio Breast Cancer Symposium.
Combination Checkpoint Inhibition/Epigenetic Modulation Improves Survival in HER2-Positive Breast Cancer Models
Researchers from Johns Hopkins University in Baltimore have found that adding the histone deacetylase inhibitor entinostat (ENT) to checkpoint inhibition decreases tumor burden and improves survival in human epidermal growth factor receptor 2 (HER2)-positive breast cancer models. The findings were reported during the San Antonio Breast Cancer Symposium on Wednesday, December 6.
Blocking ER-Coregulator Signaling Enhances Palbociclib Therapy in ER-Positive Breast Cancer
The novel combination of estrogen receptor (ER) coregulator binding modulator (ERX-11) and palbociclib may delay, or even overcome, endocrine therapy resistance in women with ER-positive advanced breast cancer, according to a group of researchers from the University of Texas (UT) Healthcare System. They reported their findings during the San Antonio Breast Cancer Symposium on Wednesday, December 6.
Extended Adjuvant Bisphosphonate Treatment Does Not Improve DFS, OS in Early-Stage Breast Cancer
Women with high-risk, early-stage breast cancer see no improvement in disease-free survival (DFS) or overall survival (OS) after five years of adjuvant bisphosphonate treatment compared with just two years of treatment, according to SUCCESS A, a phase III study. European researchers presented these findings during the San Antonio Breast Cancer Symposium on Wednesday, December 6.
Blood Test May Detect Tumor-Derived DNA in Early-Stage Cancers
Researchers have developed a test that detects tiny amounts of cancer-specific DNA in the blood and used it to accurately identify more than half of 138 people with early-stage colorectal, breast, lung, or ovarian cancers. The findings were published in Science Translational Medicine.
Aggressive Treatment Needed for Locoregional Recurrence in Patients With Breast Cancer
Researchers from Memorial Sloan Kettering Cancer Center in New York, NY, suggested that for women with locoregional recurrence (LRR) of breast cancer, contralateral axillary metastases should be treated aggressively for cure after excluding distant metastases. Challenges of and best practices for managing LRR was discussed at an education session during the San Antonio Breast Cancer Symposium on Tuesday, December 5.
Patients’ Out-of-Pocket Cancer Costs Are Higher Than Expected
Despite having healthcare coverage, a third of patients with cancer end up paying more out of pocket than they expected for their cancer treatments, a new study found. The results were published in JAMA Oncology.
FDA Approves Vemurafenib for Erdheim-Chester Disease
On November 6, 2017, the U.S. Food and Drug Administration granted regular approval to vemurafenib (Zelboraf®) for the treatment of patients with Erdheim-Chester Disease with BRAF V600 mutation.
What the Next Phase of the National Cancer Moonshot Initiative Means for Oncology Nurses
In one bold declaration during his final State of the Union Address in 2016, President Barack Obama raised our hopes to a singular goal—ending cancer as we know it—as he announced the National Cancer Moonshot Initiative, now called the Biden Cancer Initiative. Grounded in real research with tangible results, the intent was not even that daring: it was more realistic. Eradicating cancer, now understood to be many different aspects of the same disease, in five years was unlikely, but rather the goal was to achieve in five years what previously would take a decade.
Researchers Map More Than 760 Cancer-Dependent Genes
In an effort to build a comprehensive catalog of genetic causes of cancer, researchers from Harvard and Massachusetts Institute of Technology’s Broad Institute as well as Dana-Farber Cancer Institute have identified more than 760 genes that cells from multiple types of cancer depend on for growth and survival. The findings were published in Cell.
Protein May Explain Chemo Resistance in Patients With BRCA2 Mutations
Researchers have discovered a protein that may lead to a new way to prevent resistance and improve outcomes for patients whose cancers have a BRCA2 mutation. The findings were reported in Molecular Cell.
FDA Grants Accelerated Approval to Copanlisib for Relapsed Follicular Lymphoma
On September 14, 2017, the U.S. Food and Drug Administration (FDA) granted accelerated approval to copanlisib for the treatment of adult patients with relapsed follicular lymphoma who have received at least two prior systemic therapies.
Exercise's Role in Cancer Care
Until the 1980s, the value of exercise was unrecognized in the oncology setting. It was widely believed that patients with cancer undergoing cytotoxic treatments needed to rest and avoid exercise. But a 1989 study conducted by Winningham and Mac Vicar, both oncology nurses at the Ohio State University, dispelled this notion. The trial involved 45 women receiving adjuvant chemotherapy for operable breast cancer and showed that a 10-week interval-based, aerobic exercise was not only safe but also significantly improved body composition, aerobic capacity, and patient-reported nausea.
Governors Push Senators for 2018 ACA Funding; NCI Requests Input on Bioethics in Cancer Research; Congress Braces for Full September Agenda
Summer 2017 saw several attempts to repeal and replace the Affordable Care Act (ACA), none of which were successful. Now that the dust has started to settle—and Congress is slowly moving on to other issues—many are still dealing with the uncertainty left in the wake of the nation’s healthcare debate. This includes many concerned governors who are lobbying for funds to address their states’ current needs.