McMahon Publishing
Advances in Cancer Care clinicaloncology.com • JANUARY/FEBRUARY 2009 • Vol. 4, No. 1
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F DA approves oral fludarabine, Gleevec for GIST, and degarelix for prostate cancer. Mozobil helps SCT. SOLID TUMORS
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E ndoTAG-1 shows promise for pancreatic cancer.
C h17 polysomy predicts response to anthracyclines.
A Is trump tamoxifen for preventing breast cancer recurrence.
HematOlogic DISEASE
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R ichard Stone, MD, and Jennifer Brown, MD, PhD, highlight ASH meeting news.
New Standard for Previously Untreated Advanced CLL
Large Study Confirms Risk for Death From ESA Use
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meta-analysis of cancer patients in randomized controlled trials adds to the growing evidence that erythropoiesis-stimulating agents (ESAs) can harm patients. The study revealed that the use of ESAs was associated with a relative increase in on-study mortality of 17% and a relative decrease in overall survival of 6%. “What are the implications for clinical practice? The increased risk of death must be balanced against the benefits of ESAs, taking into account each patient’s clinical circumstances and preferences,” said Julia Bohlius, MD, MScPH, from the University of Bern, in Switzerland. She presented the study (LBA6) at the annual meeting of the American Society of Hematology (ASH). Previous studies have shown that see ESAs, page 34
CLINICAL TRIALS
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A list of Phase II and III trials initiated within the past 30 days.
EDUCATIONAL REVIEWS
E arly Stage Breast Disease: Endocrine Therapy and Biphosphonates After page 6.
Myelodysplasia: Recent Advances After page 14. CONTINUING MEDICAL EDUCATION
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I ndividualizing Cancer Care in the Era of Evidence-based Treatment Part 4: Breast Cancer
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Pharmacist’s Touch Helps Private Onc Offices Thrive
POLICY & MANAGEMENT
Louisville, Ky.—By adding just one clinical pharmacist to its staff, a medium-sized private oncology practice was able to secure millions of dollars in research grants and use the funds to help patients gain access to potentially lifesaving investigational drug therapies. The grants and related cost-saving measures more than paid for the pharmacist’s salary, according to Siu-Fun Wong, PharmD, associate professor of pharmacy practice and administration, Western University of Health Sciences, Pomona, Calif. But more importantly, the staffing strategy enabled see TOUCH, page 27
San Francisco—Clinicians have a new first-line treatment for physically fit patients with advanced chronic lymphocytic leukemia (CLL), according to a multinational Phase III trial presented at the annual meeting of the American Society of Hematology (abstract 325). The addition of rituximab (Rituxan, Genentech/Idec) to the previous standard of fludarabine and cyclophosphamide (FC) nearly doubled complete response Rituximab is an immunotherapy. rates and lengthened progression-free survival by 10 months. The proportion of patients who achieve a comstudy was characterized as the largest plete response and for the median length ever conducted in the CLL subgroup. of the progression-free survival,” said “The trial demonstrates that the addi- Michael Hallek, MD, University of Cologne tion of rituximab is superior for the see NEW STANDARD, page 15
Billing/Payment Changes, Audits Will Impact Oncology Practices
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everal changes to Medicare regulations will affect the day-to-day activity of oncology practices in 2009. In addition, the Office of Inspector General’s work plan includes measures that could increase scrutiny of your practice. Are you ready?
Physician Fee Schedule The CMS-1403-FC 2009 Final Rule includes changes to Medicare’s payment policies under the Physician Fee Schedule and other revisions to Part B for CY 2009. The rule also includes information on the e-prescribing exemption for
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PRSRT STD U.S. POSTAGE
PAID EASTON, PA PERMIT #117
Abeloff’s Clinical Oncology: Expert Consult: Online and Print Martin D. Abeloff, James O. Armitage, John E. Niederhuber, Michael B. Kastan, W. Gillies McKenna See page 35.
computer-generated facsimile transmissions and payment for certain durable medical equipment, prosthetics, orthotics and supplies. The following list describes significant changes found in the final rule that will impact physicians. • Includes a 1.1% increase in total Medicare reimbursement, but not across the board. The process used is complicated with increases of 12% in many relative value units and a reduction of the conversion factor, from $38.09 to $36.07, by approximately 6%. Centers for Medicare see PRITCHARD GROUP/REGULATORY, page 32
NEW INDICATION Gleevec gets indication for GIST. See page 15.
Courtesy of Roche/Genentech
FDA NEWS