Solove Research Institute

Columbus, OH, United States

Solove Research Institute

Columbus, OH, United States
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News Article | May 22, 2017
Site: www.eurekalert.org

A new study shows that so-called "light" cigarettes have no health benefits to smokers and have likely contributed to the rise of a certain form of lung cancer that occurs deep in the lungs. For this new study, researchers at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James) and five other universities/cancer centers examined why the most common type of lung cancer, called adenocarcinoma, has increased over the last 50 years, rather than decreasing as smokers have been able to quit. Other types of lung cancer have been decreasing in relationship to fewer people smoking, but not lung adenocarcinoma. Because of this, lung adenocarcinoma is now the most common type of lung cancer. Results confirm what tobacco-control researchers have suspected for years: There is no health benefit to high-ventilation (light) cigarettes - long marketed by the tobacco industry as a "healthier" option - and these cigarettes have actually have caused more harm. Holes in cigarette filters were introduced 50 years ago and were critical to claims for low-tar cigarettes "This was done to fool smokers and the public health community into thinking that they actually were safer," says Peter Shields, MD, deputy director of the OSUCCC - James and a lung medical oncologist. "Our data suggests a clear relationship between the addition of ventilation holes to cigarettes and increasing rates of lung adenocarcinoma seen over the past 20 years. What is especially concerning is that these holes are still added to virtually all cigarettes that are smoked today." The U.S. Food and Drug Administration (FDA) was given the authority to regulate the manufacture, distribution and marketing of tobacco products through the Family Smoking Prevention and Tobacco Control Act in 2009. Current regulations ban tobacco companies from labeling and marketing cigarettes as "low tar" or "light." Study authors, however, say that given this new data, the FDA should take immediate action to regulate the use of the ventilation holes, up to and including a complete ban of the holes. "The FDA has a public health obligation to take immediate regulatory action to eliminate the use of ventilation holes on cigarettes," adds Shields. "It is a somewhat complicated process to enact such regulations, but there is more than enough data to start the process. We believe that such an action would drive down the use and toxicity of conventional cigarettes, and drive smokers to either quit or use less harmful products. There are some open questions about unintended consequences for enacting a ban, which provides for an important research agenda." A team made up of lung oncology, public health and tobacco regulation researchers conducted a comprehensive, multi-faceted analysis of existing literature that included chemistry and toxicology studies, human clinical trials and epidemiological studies of both smoking behavior and cancer risk. They studied scientific publications in the peer-reviewed literature and internal tobacco company documents. Researchers hypothesized that the higher incidence rates of lung adenocarcinoma were attributable to the filter ventilation holes, which allow smokers to inhale more smoke that also has higher levels of carcinogens, mutagens and other toxins. "The filter ventilation holes change how the tobacco is burned, producing more carcinogens, which then also allows the smoke to reach the deeper parts of the lung where adenocarcinomas more frequently occur," explains Shields. To date, all the scientific evidence involves the adverse impact of adding ventilation, but not removing it. Additional research is needed to confirm that the addictiveness of the cigarette or toxic exposures from cigarettes would not increase with elimination of the ventilation holes. The OSUCCC - James and researchers at the University of Minnesota, Roswell Park Cancer Institute, Virginia Tech, Harvard University and Medical University of South Carolina are conducting additional research to reconcile human biomarkers studies and smoke distribution/exposure in the lung. Funding for this research comes from the National Cancer Institute and Food and Drug Administration Center for Tobacco Products. Coauthors include OSUCCC - James researchers Min-Ae Song, PhD, Micah Berman, JD, Theodore Brasky, PhD, and Casper Woroszylo, PhD; Neal Benowitz, MD, University of California-San Francisco; Michael Cummings, PhD, Medical University of South Carolina; Dorothy Hatsukami, PhD, University of Minnesota; Vaughan Rees, PhD, Harvard University; Richard O'Connor, PhD, Roswell Park Cancer Institute; and Catalin Marian, PhD, of Victor Babes University of Medicine and Pharmacy (Romania).


News Article | May 22, 2017
Site: www.eurekalert.org

COLUMBUS, Ohio -- A new study shows that so-called "light" cigarettes have no health benefits to smokers and have likely contributed to the rise of a certain form of lung cancer that occurs deep in the lungs. For this new study, researchers at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James) and five other universities/cancer centers examined why the most common type of lung cancer, called adenocarcinoma, has increased over the last 50 years, rather than decreasing as smokers have been able to quit. Other types of lung cancer have been decreasing in relationship to fewer people smoking, but not lung adenocarcinoma. Because of this, lung adenocarcinoma is now the most common type of lung cancer. Results confirm what tobacco-control researchers have suspected for years: There is no health benefit to high-ventilation (light) cigarettes - long marketed by the tobacco industry as a "healthier" option - and these cigarettes have actually have caused more harm. Holes in cigarette filters were introduced 50 years ago and were critical to claims for low-tar cigarettes "This was done to fool smokers and the public health community into thinking that they actually were safer," says Peter Shields, MD, deputy director of the OSUCCC - James and a lung medical oncologist. "Our data suggests a clear relationship between the addition of ventilation holes to cigarettes and increasing rates of lung adenocarcinoma seen over the past 20 years. What is especially concerning is that these holes are still added to virtually all cigarettes that are smoked today." The U.S. Food and Drug Administration (FDA) was given the authority to regulate the manufacture, distribution and marketing of tobacco products through the Family Smoking Prevention and Tobacco Control Act in 2009. Current regulations ban tobacco companies from labeling and marketing cigarettes as "low tar" or "light." Study authors, however, say that given this new data, the FDA should take immediate action to regulate the use of the ventilation holes, up to and including a complete ban of the holes. "The FDA has a public health obligation to take immediate regulatory action to eliminate the use of ventilation holes on cigarettes," adds Shields. "It is a somewhat complicated process to enact such regulations, but there is more than enough data to start the process. We believe that such an action would drive down the use and toxicity of conventional cigarettes, and drive smokers to either quit or use less harmful products. There are some open questions about unintended consequences for enacting a ban, which provides for an important research agenda." A team made up of lung oncology, public health and tobacco regulation researchers conducted a comprehensive, multi-faceted analysis of existing literature that included chemistry and toxicology studies, human clinical trials and epidemiological studies of both smoking behavior and cancer risk. They studied scientific publications in the peer-reviewed literature and internal tobacco company documents. Researchers hypothesized that the higher incidence rates of lung adenocarcinoma were attributable to the filter ventilation holes, which allow smokers to inhale more smoke that also has higher levels of carcinogens, mutagens and other toxins. "The filter ventilation holes change how the tobacco is burned, producing more carcinogens, which then also allows the smoke to reach the deeper parts of the lung where adenocarcinomas more frequently occur," explains Shields. To date, all the scientific evidence involves the adverse impact of adding ventilation, but not removing it. Additional research is needed to confirm that the addictiveness of the cigarette or toxic exposures from cigarettes would not increase with elimination of the ventilation holes. The OSUCCC - James and researchers at the University of Minnesota, Roswell Park Cancer Institute, Virginia Tech, Harvard University and Medical University of South Carolina are conducting additional research to reconcile human biomarkers studies and smoke distribution/exposure in the lung. Funding for this research comes from the National Cancer Institute and Food and Drug Administration Center for Tobacco Products. Coauthors include OSUCCC - James researchers Min-Ae Song, PhD, Micah Berman, JD, Theodore Brasky, PhD, and Casper Woroszylo, PhD; Neal Benowitz, MD, University of California-San Francisco; Michael Cummings, PhD, Medical University of South Carolina; Dorothy Hatsukami, PhD, University of Minnesota; Vaughan Rees, PhD, Harvard University; Richard O'Connor, PhD, Roswell Park Cancer Institute; and Catalin Marian, PhD, of Victor Babes University of Medicine and Pharmacy (Romania). The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute strives to create a cancer-free world by integrating scientific research with excellence in education and patient-centered care, a strategy that leads to better methods of prevention, detection and treatment. Ohio State is one of only 47 National Cancer Institute (NCI)-designated Comprehensive Cancer Centers and one of only a few centers funded by the NCI to conduct both phase I and phase II clinical trials on novel anticancer drugs sponsored by the NCI. As the cancer program's 308-bed adult patient-care component, The James is one of the top cancer hospitals in the nation as ranked by U.S. News & World Report and has achieved Magnet designation, the highest honor an organization can receive for quality patient care and professional nursing practice. At 21 floors and with more than 1.1 million square feet, The James is a transformational facility that fosters collaboration and integration of cancer research and clinical cancer care. Learn more at cancer.osu.edu.


News Article | May 3, 2017
Site: www.eurekalert.org

COLUMBUS, Ohio - More than half of breast cancer patients (57 percent) undergoing mastectomy lack the necessary medical knowledge to make a high-quality decision about reconstructive surgery that aligns with their personal goals, suggesting a trend toward overtreatment, according to a new study conducted by researchers at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James). "High-quality" decisions were defined as those that demonstrated adequate medical knowledge of treatment choices - including associated risks - and that also matched with the patient's specific goals and preferences for choosing whether or not to pursue reconstructive surgery. Researchers say shared decision-making tools are needed to help women make decisions based on a full understanding of treatment choices and associated risks alongside their personal goals for surgery. Researchers report the findings online first in the medical journal JAMA Surgery May 3, 2017. In this observational, single-institution study, researchers sought to evaluate the quality of 126 adult breast cancer patients' decisions about breast reconstruction after mastectomy. All patients had stage I-III invasive ductal/lobular breast cancer, ductal carcinoma in situ (DCIS) or were having preventive mastectomies. The majority of patients (73 percent) had early-stage disease. Researchers measured study participants' medical knowledge about mastectomy and mastectomy with reconstruction -- for example, effects of surgery on appearance and associated risks. They also measured individual preferences of what mattered most to patients. Key preference factors included breast appearance/shape post treatment, length of recovery time and risk for complications. "We found that less than half of the women had adequate medical knowledge about breast reconstruction and made a choice that aligned with their personal preferences. This is very concerning to us, because it means that some women did not get the treatment they truly preferred, and quite a few had more treatment than they preferred," says Clara Lee, MD, principal investigator of the study and a breast reconstructive surgeon at The OSUCCC - James. Lee holds a dual associate professor appointment in the colleges of medicine and public health at Ohio State. "Many women were quite concerned about complication risks, but they didn't actually know how high the risk was. This may explain some of the overtreatment that we saw," she adds. Researchers found that only 43 percent of the patients in the study demonstrated an understanding of at least half of the important facts about reconstruction and made a choice that was consistent with their preferences. Understanding of surgical complications was particularly low, with only 14 percent of patients demonstrating strong knowledge of associated risks. "As breast cancer providers, we need to talk about the pros and cons of surgery to help women make treatment choices. Shared decision-making between the surgeon and patient would be particularly useful for this decision. We need to connect patients with decision aids to help them really think through what is most important to them," Lee adds. Collaborators in this National Cancer Institute-funded study include Allison Deal, MD, and Ruth Huh, BA, of Lineberger Comprehensive Cancer Center at University of North Carolina Chapel Hill; Michael Pignone, MD, MPH, of University of Texas at Austin; and Peter Ubel, MD, of Duke University. "The interesting thing is that these findings are not unique to breast reconstruction," adds Pignone, study coauthor and chair of the Department of Internal Medicine at the Dell Medical School at The University of Texas at Austin. "In other places where we've looked at decision quality, we see gaps in patients' understanding of key information and poor alignment between the things they care most about and the treatments that they choose. It means that we need to do a much better job of providing decision support to patients, so that the care they get is, ultimately, the care they want." Lee and colleagues in Ohio State's colleges of engineering, communication and public health are working on a study to evaluate treatment decisions in early-stage breast cancer patients to assess how communication with their providers affects their decision-making. This ongoing study examines patients' knowledge, preferences, and expectations about future well-being. Information from this study is expected to help clinicians develop tools to aid patients in making an informed decision about their care. The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute strives to create a cancer-free world by integrating scientific research with excellence in education and patient-centered care, a strategy that leads to better methods of prevention, detection and treatment. Ohio State is one of only 47 National Cancer Institute (NCI)-designated Comprehensive Cancer Centers and one of only a few centers funded by the NCI to conduct both phase I and phase II clinical trials on novel anticancer drugs sponsored by the NCI. As the cancer program's 308-bed adult patient-care component, The James is one of the top cancer hospitals in the nation as ranked by U.S. News & World Report and has achieved Magnet designation, the highest honor an organization can receive for quality patient care and professional nursing practice. At 21 floors and with more than 1.1 million square feet, The James is a transformational facility that fosters collaboration and integration of cancer research and clinical cancer care. Learn more at cancer.osu.edu.


News Article | May 3, 2017
Site: www.eurekalert.org

More than half of breast cancer patients (57 percent) undergoing mastectomy lack the necessary medical knowledge to make a high-quality decision about reconstructive surgery that aligns with their personal goals, suggesting a trend toward overtreatment, according to a new study conducted at The Ohio State University Comprehensive Cancer Center -- Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James). "High-quality" decisions were defined as those that demonstrated adequate medical knowledge of treatment choices -- including associated risks -- and that also matched with the patient's specific goals and preferences for choosing whether or not to pursue reconstructive surgery. Researchers say shared decision-making tools are needed to help women make decisions based on a full understanding of treatment choices and associated risks alongside their personal goals for surgery. Researchers report the findings online first in the medical journal JAMA Surgery May 3, 2017. In this observational, single-institution study, researchers sought to evaluate the quality of 126 adult breast cancer patients' decisions about breast reconstruction after mastectomy. All patients had stage I-III invasive ductal/lobular breast cancer, ductal carcinoma in situ (DCIS) or were having preventive mastectomies, and the majority (73 percent) had early-stage disease. Researchers measured study participants' medical knowledge about mastectomy and mastectomy with reconstruction -- for example, effects of surgery on appearance and associated risks. They also measured individual preferences of what mattered most to patients. Key preference factors included breast appearance/shape post treatment, length of recovery time and risk for complications. "We found that less than half of the women had adequate medical knowledge about breast reconstruction and made a choice that aligned with their personal preferences. This is very concerning to us, because it means that some women did not get the treatment they truly preferred, and quite a few had more treatment than they preferred," says Clara Lee, MD, principal investigator of the study and a breast reconstructive surgeon at The OSUCCC - James. Lee holds a dual associate professor appointment in the colleges of medicine and public health at Ohio State. "Many women were quite concerned about complication risks, but they didn't actually know how high the risk was. This may explain some of the overtreatment that we saw," she adds. Researchers found that only 43 percent of the patients in the study demonstrated an understanding of at least half of the important facts about reconstruction and made a choice that was consistent with their preferences. Understanding of surgical complications was particularly low, with only 14 percent of patients demonstrating strong knowledge of associated risks. "As breast cancer providers, we need to talk about the pros and cons of surgery to help women make treatment choices. Shared decision-making between the surgeon and patient would be particularly useful for this decision. We need to connect patients with decision aids to help them really think through what is most important to them," Lee adds. Collaborators in this National Cancer Institute-funded study include Allison Deal, MD, and Ruth Huh, BA, of Lineberger Comprehensive Cancer Center at University of North Carolina Chapel Hill; Michael Pignone, MD, MPH, of University of Texas at Austin; and Peter Ubel, MD, of Duke University. Lee and colleagues in Ohio State's colleges of engineering, communication and public health are working on a study to evaluate treatment decisions in early-stage breast cancer patients to assess how communication with their providers affects their decision-making. This ongoing study examines patients' knowledge, preferences, and expectations about future well-being. Information from this study is expected to help clinicians develop tools to aid patients in making an informed decision about their care. The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute strives to create a cancer-free world by integrating scientific research with excellence in education and patient-centered care, a strategy that leads to better methods of prevention, detection and treatment. Ohio State is one of only 47 National Cancer Institute (NCI)-designated Comprehensive Cancer Centers and one of only a few centers funded by the NCI to conduct both phase I and phase II clinical trials on novel anticancer drugs sponsored by the NCI. As the cancer program's 308-bed adult patient-care component, The James is one of the top cancer hospitals in the nation as ranked by U.S. News & World Report and has achieved Magnet designation, the highest honor an organization can receive for quality patient care and professional nursing practice. At 21 floors and with more than 1.1 million square feet, The James is a transformational facility that fosters collaboration and integration of cancer research and clinical cancer care. Learn more at cancer.osu.edu.


With this collaboration, CancerLinQ subscribers will now have access to a link that will bring them directly to the NCCN Compendium®, where they can subscribe, for a fee. NCCN is able to make available its resources to the growing CancerLinQ network, which includes thousands of oncologists treating millions of patients from a variety of practice types and institutions across the United States. This collaboration represents one of the ways in which NCCN is empowering physicians to access NCCN resources through everyday health information technology (HIT) workflow. "CancerLinQ exists in service to our members to improve quality," said Kevin Fitzpatrick, Chief Executive Officer, CancerLinQ LLC. "As we continue to convene collaborators across the oncology community, we encourage efforts that enable resources to be more easily accessible for providers to make informed and timely decisions in the delivery of care to their patients. This collaboration is just one more positive step in that direction." The NCCN Compendium contains recommendations for the appropriate use of drugs and biologics to support decision-making for patients with cancer. The recommendations are derived directly from relevant NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), along with their clinical context, route of administration, recommended use, and NCCN category of evidence. In addition to NCCN Guidelines-specific indication and use, NCCN adds relevant information, such as pharmacologic class, relevant classification codes, and U.S. Food and Drug Administration (FDA) indication, to the searchable database. All information is reviewed by members of the relevant NCCN Guidelines® panel before publication. The CancerLinQ platform is a big data initiative focused on cancer patient medical information, aimed at improving the quality of patient care and outcomes. It is the only major cancer data initiative being developed and led by physicians. When complete, CancerLinQ will unlock real-world patient care data from millions of electronic health records and securely process and analyze the data to provide immediate quality feedback and clinical decision support to providers. Doctors will receive personalized insights on a scope that was previously unattainable, and patients will benefit by having access to high quality care based on up-to-date insights and findings. The NCCN Guidelines are the recognized standard for clinical policy in cancer care and are the most thorough and most frequently updated clinical practice guidelines available in any area of medicine. For more information, visit NCCN.org. About the National Comprehensive Cancer Network The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 27 leading cancer centers devoted to patient care, research, and education, is dedicated to improving the quality, effectiveness, and efficiency of cancer care so that patients can live better lives. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The NCCN Member Institutions are: Fred & Pamela Buffett Cancer Center, Omaha, NE; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center, Boston, MA; Duke Cancer Institute, Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Mayo Clinic Cancer Center, Phoenix/Scottsdale, AZ, Jacksonville, FL, and Rochester, MN; Memorial Sloan Kettering Cancer Center, New York, NY; Moffitt Cancer Center, Tampa, FL; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute, Columbus, OH; Roswell Park Cancer Institute, Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center, Memphis, TN; Stanford Cancer Institute, Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; UC San Diego Moores Cancer Center, La Jolla, CA; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; University of Colorado Cancer Center, Aurora, CO; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; The University of Texas MD Anderson Cancer Center, Houston, TX; University of Wisconsin Carbone Cancer Center, Madison, WI; Vanderbilt-Ingram Cancer Center, Nashville, TN; and Yale Cancer Center/Smilow Cancer Hospital, New Haven, CT. About ASCO Founded in 1964, the American Society of Clinical Oncology, Inc. (ASCO®) is committed to making a world of difference in cancer care. As the world's leading organization of its kind, ASCO represents more than 40,000 oncology professionals who care for people living with cancer. Through research, education, and promotion of the highest-quality patient care, ASCO works to conquer cancer and create a world where cancer is prevented or cured, and every survivor is healthy. ASCO is supported by its affiliate organization, the Conquer Cancer Foundation. Learn more at www.ASCO.org, explore patient education resources at www.Cancer.Net, and follow us on Facebook, Twitter, LinkedIn, and YouTube. About CancerLinQ LLC CancerLinQ LLC is a subsidiary of American Society of Clinical Oncology, Inc. established for the development and operation of the CancerLinQ® initiative. CancerLinQ is a health information technology platform aimed at enhancing and improving the understanding and treatment of cancer. To learn more, visit www.cancerlinq.org. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/nccn-and-cancerlinq-collaborating-to-provide-evidence-based-decision-making-resources-to-physicians-300466207.html


"Addressing safety issues throughout the cancer care continuum must be met with an increased focus on guidelines, awareness, resources, and training," said F. Marc Stewart, MD, Oncologist and Medical Director, Seattle Cancer Care Alliance, and Co-Chair of the NCCN Best Practices Committee. "Understanding patient safety issues from patient, provider, and cancer center perspectives and recognizing the innovative approaches to address these gaps are integral components of high-quality cancer care." Clifford Goodman, PhD, of The Lewin Group will moderate the summit, which will consist of short presentations followed by roundtable discussions with lively discourse and ample time for audience questions. An abbreviated agenda is below. As developers of the widely used NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) that set the standard of cancer care in the United States, NCCN is invested in provision of high-quality, safe, value-based cancer care. Moreover, the library of NCCN Chemotherapy Order Templates (NCCN Templates®) include chemotherapy, immunotherapy, supportive care agents, monitoring parameters, and safety instructions based directly on recommendations within the NCCN Guidelines®. The NCCN Templates® were initially published as a result of the first NCCN patient safety policy summit held in 2006, and today NCCN has published more than 1,100 chemotherapy order templates, which have been integrated into various electronic health record (EHR) platforms for use at point of care. Panel Discussion: Safety and Accountability in Cancer Care; Past, Present, and Future Moderated by Clifford Goodman, PhD, The Lewin Group Panelists: Amy P. Abernethy, MD, PhD, Flatiron Jonathan S. Deutsch, MD, Bristol-Myers Squibb Terry Langbaum, MHS, The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins Steven R. Peskin, MD, MBA, FACP, Horizon Blue Cross Blue Shield of New Jersey F. Marc Stewart, MD, Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance Patient Access to Safe, High-Quality Cancer Care under a New Administration Clifford A. Hudis, MD, FACP, FASCO, American Society of Clinical Oncology (ASCO) Panel Discussion: Barriers and Opportunities in Ensuring Access to Safe, High-Quality Cancer Care Moderated by Clifford Goodman, PhD, The Lewin Group Panelists: Eliot Fishman, PhD, Families USA Bruce Gould, MD, Northwest Georgia Oncology Centers Clifford A. Hudis, MD, FACP, FASCO, ASCO Lee Newcomer, MD, MHA, UnitedHealthcare  Caroline Pearson, Avalere Rodney L. Whitlock, PhD, ML Strategies *Subject to change. For more information about the NCCN Oncology Policy Program and to register for the event, visit NCCN.org/policy. About the National Comprehensive Cancer Network The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 27 leading cancer centers devoted to patient care, research, and education, is dedicated to improving the quality, effectiveness, and efficiency of cancer care so that patients can live better lives. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The NCCN Member Institutions are: Fred & Pamela Buffett Cancer Center, Omaha, NE; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center, Boston, MA; Duke Cancer Institute, Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Mayo Clinic Cancer Center, Phoenix/Scottsdale, AZ, Jacksonville, FL, and Rochester, MN; Memorial Sloan Kettering Cancer Center, New York, NY; Moffitt Cancer Center, Tampa, FL; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute, Columbus, OH; Roswell Park Cancer Institute, Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center, Memphis, TN; Stanford Cancer Institute, Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; UC San Diego Moores Cancer Center, La Jolla, CA; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; University of Colorado Cancer Center, Aurora, CO; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; The University of Texas MD Anderson Cancer Center, Houston, TX; University of Wisconsin Carbone Cancer Center, Madison, WI; Vanderbilt-Ingram Cancer Center, Nashville, TN; and Yale Cancer Center/Smilow Cancer Hospital, New Haven, CT. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/whats-next-nccn-gathers-health-care-policy-experts-to-deliberate-challenges-to-patient-safety-and-access-to-cancer-care-under-the-new-administration-300467297.html


News Article | June 8, 2017
Site: www.eurekalert.org

COLUMBUS - A single chemotherapy treatment can result in a significant negative impact on walking gait and balance, putting patients at an increasing risk for falls, according to a new study involving breast cancer patients conducted by researchers at The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute (OSUCCC - James). Up to 60 percent of patients experience chemotherapy-induced peripheral neuropathy (CIPN), nerve damage that impacts feeling in the hands or feet; however, when and to what extent this damage impacts functional abilities has been largely unknown. This new study is the first to objectively measure the functional abilities of cancer patients during and after taxane-based chemotherapy. Researchers followed 33 patients with stage I-III breast cancer, assessing functional performance (standing balance and gait) and patient-reported outcomes at five timepoints spanning before treatment began up to three months post-treatment completion. Researchers observed a 28 percent increase in side-to-side sway (medial-lateral) after just one chemotherapy treatment. That increased to 48 percent with cumulative chemotherapy exposure. Patients also demonstrated a 5 percent reduction in walking speed after three cycles of chemotherapy. "This is not simply a quality of life concern -- CIPN can impact a patient's ability to receive treatment at all, limiting the potential for a cure. For patients who have great difficulty with neuropathy, we often have to modify their treatment regimen to make it tolerable -- sometimes the therapy has to be ceased entirely," says Maryam Lustberg, MD, MPH, senior author of the study and director of breast cancer survivorship services at the OSUCCC - James. "We need to make these treatments more tolerable to patients so they can get the full benefit of the treatments." Lustberg and her colleagues report that taxane exposure is also associated with worsened sensory symptoms and poorer postural control. There was also an association between patients' balance and self-reported sensory symptoms. The study was published online ahead of print in the medical journal Breast Cancer Research and Treatment April 3, 2017. CIPN leads to pain, falls and difficulty walking as well as performing activities of daily living. Although symptoms can improve with time, up to 30 percent of patients have persistent symptoms that last at least six months. Researchers say the study provides initial support for the feasibility and potential utility of implementing objective measures of physical function into the oncology clinic. "Cancer survivors are at a significant increased risk for falls, and the incidence rate of falling after chemotherapy is a serious concern for survivors' long-term quality of life," adds Lustberg. "Our study provides new insights on how taxane-based chemotherapy can impact fundamental aspects of patient function. These new insights can help us develop better strategies to help patients combat these challenges and, in some cases, choose a different therapy to treat the disease but with reduced side effects." The OSUCCC - James is expanding this research to assess CIPN in colorectal cancer patients receiving taxane-based chemotherapy. Study co-author Ajit Chaudhari, PhD, associate professor of physical therapy, orthopedics, mechanical engineering and biomedical engineering at The Ohio State University Wexner Medical Center says the study was an important first step in achieving better long-term outcomes after cancer and provides a new tool for integrating gait and balance screening into clinical care. "We have created an easy-to-use clinical tool that has strong potential to quickly help clinicians identify patients -- very early on -- who are developing a chemotherapy reaction that impacts gait and balance," says Chaudhari. "It's no longer good enough for someone to just 'survive' cancer because many patients have decades of life ahead of them. It is critical to do everything we can to make the rest of their lives as productive and enjoyable as they want it to be." This research was funded by grants from the National Cancer Institute and National Science Foundation Graduate Research Fellowship Program. Collaborators in the study include Ohio State researchers Scott Monfort, Xueliang Pan, PhD, Robyn Patrick, Bhuvaneswari Ramaswamy, MD, Robert Wesolowski, MD, Michelle Naughton, PhD, MPH; and Charles Loprinzi, MD, of Mayo Clinic. The Ohio State University Comprehensive Cancer Center - Arthur G. James Cancer Hospital and Richard J. Solove Research Institute strives to create a cancer-free world by integrating scientific research with excellence in education and patient-centered care, a strategy that leads to better methods of prevention, detection and treatment. Ohio State is one of 47 National Cancer Institute-designated Comprehensive Cancer Centers and one of only a few centers funded by the NCI to conduct both phase I and phase II clinical trials on novel anticancer drugs. As the cancer program's 308-bed adult patient-care component, The James is one of the top cancer hospitals in the nation as ranked by U.S. News & World Report and has achieved Magnet designation, the highest honor an organization can receive for quality patient care and professional nursing practice. With 21 floors and more than 1.1 million square feet, The James is a transformational facility that fosters collaboration and integration of cancer research and clinical cancer care. For more information, visit cancer.osu.edu.


A recent study conducted by researchers at Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, led by Barbara Dull, MD, further confirmed the recommendations of the NCCN Guidelines panel. The study, "Overuse of Chest CT in Patients with Stage I and II Breast Cancer: An Opportunity to Increase Guidelines Compliance at an NCCN Member Institution," is published in the June issue of JNCCN – Journal of the National Comprehensive Cancer Network. Using data from a prospective database, Dr. Dull and colleagues studied records of more than 3,300 patients diagnosed with early-stage breast cancer between 1998 and 2012 and found that 11% of patients with stage I and more than 36% of patients with stage II breast cancer underwent chest CT within six months of diagnosis, despite NCCN Guidelines recommendations. Of these 683 patients, only nine were diagnosed with pulmonary metastases. However, benign pulmonary nodules were discovered in 175 patients. "The overwhelming majority of nodules found in this study's patient population classified as false positive results," said Dr. Dull. "Not only do the costs of the chest CT and subsequent imaging and work-up put a cost constraint on the already burdened health care system, but the psychological impact of such results on a patient and their family is enormous." "I hope patients and their physicians are reassured by findings like these," added Amy Cyr, MD, corresponding author of the study. "Chest CT and other staging studies are of extremely low yield for identifying metastases in patients with early-stage breast cancer, and even for the 1.3% of patients in our cohort ultimately diagnosed with pulmonary disease, many were not diagnosed because of that original CT scan, but were instead diagnosed on scans as long as two years after diagnosis, suggesting even lower utility. Unfortunately, for the 26.9% of patients with positive CT scans (the vast majority of which were false positives), the subsequent evaluation needed not only raises health care costs and anxiety, but also has the potential to delay oncologic treatment." The NCCN Guidelines recommendations for patients with early-stage breast cancer are reinforced by other leading organizations in oncology, including the American Society of Clinical Oncology (ASCO), European Society for Medical Oncology (ESMO), and Britain's National Institute for Health and Clinical Excellence (NICE). According to the study, patients who underwent staging chest CT were generally younger and more likely to have unfavorable tumor markers. However, there were no statistical differences between patients diagnosed with metastases and those with false positive results. "Even with numerous guidelines and recommendations, staging studies are routinely performed in patients with stage I and II breast cancer. Despite NCCN recommendations, many patients with asymptomatic early-stage breast cancer continue to undergo chest CT as part of their initial evaluation. Adherence to the NCCN Guidelines and other evidence-based recommendations will spare patients unnecessary testing and, in an era of increasing health care costs, also curb excessive spending," said Dr. Dull. The NCCN Guidelines are the recognized standard for clinical policy in cancer care and are often the most thorough and most frequently updated clinical practice guidelines available in any area of medicine. "Notwithstanding the publicized potential risks of radiation exposure and the disputable value of chest CT in early-stage breast cancer, referring clinicians still order it, not infrequently, based on anecdotal cases, concerns regarding legal ramifications, or to satisfy insistent patients. At all stages of cancer care, including at presentation, during neoadjuvant or adjuvant therapy, and with advanced disease, evidence-based guidelines are needed to help direct treating physicians and their patients in selecting appropriate and indicated imaging studies," said Pamela J. DiPiro, MD, Dana-Farber/Brigham and Women's Cancer Center, in a June JNCCN commentary titled, "Evidence-Based Guidelines: Optimizing Imaging in Cancer Care." The study, "Overuse of Chest CT in Patients with Stage I and II Breast Cancer: An Opportunity to Increase Guidelines Compliance at an NCCN Member Institution," is available free of charge until September 30, 2017 at JNCCN.org. About JNCCN – Journal of the National Comprehensive Cancer Network More than 24,000 oncologists and other cancer care professionals across the United States read JNCCN–Journal of the National Comprehensive Cancer Network. This peer-reviewed, indexed medical journal provides the latest information about best clinical practices, health services research, and translational medicine. JNCCN features updates on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), review articles elaborating on guidelines recommendations, health services research, and case reports highlighting molecular insights in patient care. JNCCN is published by Harborside Press. Visit JNCCN.org. To inquire if you are eligible for a FREE subscription to JNCCN, visit http://www.nccn.org/jnccn/subscribe.asp JNCCN 360 is a new online resource for oncology professionals featuring up-to-date news, literature, trials, clinical perspectives on current therapies, and much more. Visit JNCCN360.org About the National Comprehensive Cancer Network The National Comprehensive Cancer Network® (NCCN®), a not-for-profit alliance of 27 leading cancer centers devoted to patient care, research, and education, is dedicated to improving the quality, effectiveness, and efficiency of cancer care so that patients can live better lives. Through the leadership and expertise of clinical professionals at NCCN Member Institutions, NCCN develops resources that present valuable information to the numerous stakeholders in the health care delivery system. As the arbiter of high-quality cancer care, NCCN promotes the importance of continuous quality improvement and recognizes the significance of creating clinical practice guidelines appropriate for use by patients, clinicians, and other health care decision-makers. The NCCN Member Institutions are: Fred & Pamela Buffett Cancer Center, Omaha, NE; Case Comprehensive Cancer Center/University Hospitals Seidman Cancer Center and Cleveland Clinic Taussig Cancer Institute, Cleveland, OH; City of Hope Comprehensive Cancer Center, Los Angeles, CA; Dana-Farber/Brigham and Women's Cancer Center | Massachusetts General Hospital Cancer Center, Boston, MA; Duke Cancer Institute, Durham, NC; Fox Chase Cancer Center, Philadelphia, PA; Huntsman Cancer Institute at the University of Utah, Salt Lake City, UT; Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, Seattle, WA; The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins, Baltimore, MD; Robert H. Lurie Comprehensive Cancer Center of Northwestern University, Chicago, IL; Mayo Clinic Cancer Center, Phoenix/Scottsdale, AZ, Jacksonville, FL, and Rochester, MN; Memorial Sloan Kettering Cancer Center, New York, NY; Moffitt Cancer Center, Tampa, FL; The Ohio State University Comprehensive Cancer Center - James Cancer Hospital and Solove Research Institute, Columbus, OH; Roswell Park Cancer Institute, Buffalo, NY; Siteman Cancer Center at Barnes-Jewish Hospital and Washington University School of Medicine, St. Louis, MO; St. Jude Children's Research Hospital/The University of Tennessee Health Science Center, Memphis, TN; Stanford Cancer Institute, Stanford, CA; University of Alabama at Birmingham Comprehensive Cancer Center, Birmingham, AL; UC San Diego Moores Cancer Center, La Jolla, CA; UCSF Helen Diller Family Comprehensive Cancer Center, San Francisco, CA; University of Colorado Cancer Center, Aurora, CO; University of Michigan Comprehensive Cancer Center, Ann Arbor, MI; The University of Texas MD Anderson Cancer Center, Houston, TX; University of Wisconsin Carbone Cancer Center, Madison, WI; Vanderbilt-Ingram Cancer Center, Nashville, TN; and Yale Cancer Center/Smilow Cancer Hospital, New Haven, CT. To view the original version on PR Newswire, visit:http://www.prnewswire.com/news-releases/nccn-guidelines-compliance-for-chest-ct-reduces-false-positives-and-decreases-health-care-spending-in-breast-cancer-study-finds-300475325.html

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