Independent News for the Oncologist and Hematologist/Oncologist clinicaloncology.com • April 2011 • Vol. 6, No. 4
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I n this month’s column, Maurie Markman, MD, asks who gets to define ‘clinical benefit’?
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Bevacizumab fails to show benefit in adjuvant treatment of colon cancer in AVANT study.
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W atchful waiting before surgery presented as new strategy for rectal cancer.
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C hanges in hormone and HER2 status underscore need for multiple biopsies in breast cancer patients.
Continuous Sunitinib Dosing Regimen Is Not Recommended in RCC Orlando, Fla.—In patients with renal cancer, continuous dosing with 37.5 mg of sunitinib (Sutent, Pfizer) per day is not superior to the standard regimen of 50 mg per day for four weeks with two weeks off (4/2). This news comes from a Phase II trial presented at the Genitourinary Cancers Symposium (abstract LBA308). The results should put an end to the use of an initial 37.5 mg per day continuous dosing schedule for sunitinib in kidney cancer, said lead author Robert Motzer, MD, attending physician at Memorial Sloan-Kettering Cancer Center in New York City, who presented the findings. “The trial was a Phase II and not a Phase III, so it did have some limitations, but see DOSING, page 25
HematOlogic DISEASE
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PET-CT imaging highly prognostic in PRIMA study subanalysis.
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I nvestigational JAK1/JAK2 inhibitor shows promise in Phase II trial of myelo- proliferative neoplasms. CLINICAL TRIALS
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Recently launched Phase II and Phase III clinical trials.
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Palliative Chemo: When Is Enough Too Much?
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etween 15% and 20% of people with cancer receive chemotherapy within 14 days of their death—at a point when the treatment has virtually no chance of extending survival or the quality of their life. It’s referred to as “palliative” chemotherapy, but it frequently “palliates” very little—indeed, it often causes more discomfort and additional burden to the patient and family. True palliative chemotherapy does have a purpose, and not all chemotherapy near the end of life is futile, said Thomas J. Smith, MD, FACP, co-founder of the palliative care program at the Massey Cancer Center at Virginia Commonwealth University, Richmond. see PALLIATIVE, page 18
In Prostate Cancer Patients With Biochemical Relapse ...
Study Supports Intermittent Adjuvant Hormone Therapy Orlando, Fla.—When levels of prostatespecific antigen (PSA) begin to rise after definitive radiation therapy, most men with prostate cancer do just as well whether they receive intermittent or continuous administration of hormone therapy, according to a large multicenter trial reported at the Genitourinary Cancers Symposium (abstract 3). “Intermittent androgen suppression should be the standard of care for most patients with PSA recurrence after initial treatment with radiation Prostate cancer cells. therapy or radical prostatectomy and subsequent radiation,” said Oliver Sartor, MD, professor of medicine Laurence Klotz, MD, chief of urology at and urology at Tulane University School Sunnybrook Health Sciences Center in of Medicine in New Orleans, who was not see HORMONE, page 8 Toronto, who presented the study.
POLICY & MANAGEMENT
Oncology Medical Home Model Could Increase Reimbursement Found Money: Part 2 of a Four-Part Series
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or oncology practices, the discouraging reimbursement landscape may at last have some hopeful glimmers. One bright spot is the emergence of integrated care delivery models such as accountable care organizations (ACOs) and patient-centered medical homes (PCMHs). Both models may be on the verge of reaping financial incentives from Medicare and Medicaid, as well as private insurers, in return for producing measurable quality outcomes and cost
savings. Physician practices and hospitals have been scrambling to align themselves into networks that fit one or another of the new models, particularly ACOs. Prompting the new interest in alternative care models is the 2010 Affordable Care Act (ACA) and its offspring, the Center for Medicare and Medicaid Innovation, which has been charged with “spreading new ways of delivering care and new ways of paying for care.” Commercial health see FOUND MONEY, page 22
McMahonMedicalBooks.com Hematology: Clinical Principles and Applications: Fourth Edition Bernadette F. Rodak
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