Journal of Oncology Practice最新文献

{"title":"Changing Paradigms in the Treatment of Brain Metastases.","authors":"R. Stupp","doi":"10.1200/JOP.19.00602","DOIUrl":"https://doi.org/10.1200/JOP.19.00602","url":null,"abstract":"","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"15 11 1","pages":"573-574"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00602","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42410554","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Integration of a Mandatory Palliative Care Education Into Hematology-Oncology Fellowship Training in a Comprehensive Cancer Center: A Survey of Hematology Oncology Fellows.","authors":"Suresh K Reddy,&nbsp;Kimberson Tanco,&nbsp;Sriram Yennu,&nbsp;Diane D Liu,&nbsp;Janet L Williams,&nbsp;Robert Wolff,&nbsp;Eduardo Bruera","doi":"10.1200/JOP.19.00056","DOIUrl":"https://doi.org/10.1200/JOP.19.00056","url":null,"abstract":"<p><strong>Purpose: </strong>The primary aim of this study was to determine the attitudes and beliefs of hematology and medical oncology (HMO) fellows regarding palliative care (PC) after they completed a 4-week mandatory PC rotation.</p><p><strong>Methods: </strong>The PC rotation included a 4-week standardized curriculum covering all PC domains. HMO fellows were provided educational materials and attended all didactic sessions. All had clinical rotation in an acute PC unit and an outpatient clinic. All HMO fellows from 2004 to 2017 were asked to complete a 32-item survey on oncology trainee perception of PC.</p><p><strong>Results: </strong>Of 105 HMO fellows, 77 (73%) completed the survey. HMO fellows reported that PC rotation improved assessment and management of symptoms (98%); opioid prescription (89%), opioid rotation (78%), and identification of opioid adverse effects (87%); communication with patients and families (91%), including advance care planning discussion (88%) and do-not-resuscitate discussion (88%); and they reported comfort with discussing ethical issues (74%). Participants reported improvement in knowledge of symptom assessment and management (n = 76; 98%) as compared with efficacy in ethics (n = 57 [74%]; <i>P</i> = .0001) and for coping with stress of terminal illness (n = 45 [58%]; <i>P</i> = .0001). The PC rotation educational experience was considered either far better or better (53%) or the same (45%) as other oncology rotations. Most respondents (98%) would recommend PC rotations to other HMO fellows, and 95% felt rotation should be mandatory.</p><p><strong>Conclusion: </strong>HMO fellows reported PC rotation improved their attitudes and knowledge in all PC domains. PC rotation was considered better than other oncology rotations and should be mandatory.</p>","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"15 11","pages":"e934-e941"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00056","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37390333","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Incidence and Management of Olaratumab Infusion-Related Reactions.","authors":"Brian A Van Tine,&nbsp;Rangaswamy Govindarajan,&nbsp;Steven Attia,&nbsp;Neeta Somaiah,&nbsp;Scott S Barker,&nbsp;Ashwin Shahir,&nbsp;Emily Barrett,&nbsp;Pablo Lee,&nbsp;Volker Wacheck,&nbsp;Samuel C Ramage,&nbsp;William D Tap","doi":"10.1200/JOP.18.00761","DOIUrl":"https://doi.org/10.1200/JOP.18.00761","url":null,"abstract":"<p><strong>Purpose: </strong>Olaratumab is a human monoclonal immunoglobulin G1 antibody against platelet-derived growth factor receptor-α. We report the nature and frequency of infusion-related reactions (IRRs) with olaratumab in clinical trials and postmarketing reports.</p><p><strong>Methods: </strong>Data from patients exposed to olaratumab across nine clinical trials were reviewed for IRRs. Blood samples were also analyzed for pre-existing immunoglobulin E anti-galactose-α-1,3-galactose (anti-α-Gal) antibodies.</p><p><strong>Results: </strong>In the clinical trials, IRRs were identified in 70 of 485 patients (14.4%). The most frequent symptoms included flushing, fever or chills, and dyspnea. For 68 of 70 patients (97.1%), the first IRR occurred during the first two cycles of treatment. Grade 3 or worse IRRs were reported in 11 patients (2.3%), all during the first infusion and usually within 15 minutes of the start of the infusion. One IRR-related fatality (0.2%) occurred in a nonpremedicated patient with grade 3 or worse cardiac comorbidities. There was an association between grade 3 or worse IRRs and pre-existing anti-α-Gal antibodies, with a trend toward higher IRR rates in US geographies known to have a higher prevalence of anti-α-Gal antibodies. IRRs in postmarketing reports were consistent in nature and severity with those in the clinical trials.</p><p><strong>Conclusion: </strong>Premedication with corticosteroids and antihistamines should occur in all patients before olaratumab infusion, as indicated in labels in the United States and the European Union. Patients receiving olaratumab should be monitored for IRRs in a setting where resuscitation equipment is available for the treatment of IRRs.</p>","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"15 11","pages":"e925-e933"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.18.00761","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37394303","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Has the Quality of Patient-Provider Communication About Survivorship Care Improved?","authors":"Ashish Rai, Neetu Chawla, Xuesong Han, Sun Hee Rim, Tenbroeck Smith, Janet de Moor, Karen R Yabroff","doi":"10.1200/JOP.19.00157","DOIUrl":"10.1200/JOP.19.00157","url":null,"abstract":"<p><strong>Purpose: </strong>The aim of the current study was to assess whether the quality of patient-provider communication on key elements of cancer survivorship care changed between 2011 and 2016.</p><p><strong>Methods: </strong>Participating survivors completed the 2011 or 2016 Medical Expenditure Panel Survey Experiences with Cancer Surveys (N = 2,266). Participants reported whether any clinician ever discussed different aspects of survivorship care. Responses ranged from \"Did not discuss at all\" to \"Discussed it with me in detail\". Distributions of responses were compared among all respondents and only among those who had received cancer-directed treatment within 3 years of the survey.</p><p><strong>Results: </strong>In 2011, the percentage of survivors who did not receive detailed instructions on follow-up care, late or long-term adverse effects, lifestyle recommendations, and emotional or social needs were 35.1% (95% CI, 31.9% to 38.4%), 54.2% (95% CI, 50.7% to 57.6%), 58.9% (95% CI, 55.3% to 62.5%), and 69.2% (95% CI, 65.9% to 72.3%), respectively, and the corresponding proportions for 2016 were 35.4% (95% CI, 31.9% to 37.8%), 55.5% (95% CI, 51.7% to 59.3%), 57.8% (95% CI, 54.2% to 61.2%), and 68.2% (95% CI, 64.3% to 71.8%), respectively. Findings were similar among recently treated respondents. Only 24% in 2011 and 22% in 2016 reported having detailed discussions about all four topics. In 2016, 47.6% of patients (95% CI, 43.8% to 51.4%) reported not having detailed discussions with their providers about a summary of their cancer treatments.</p><p><strong>Conclusion: </strong>Clear gaps in the quality of communication between survivors of cancer and providers persist. Our results highlight the need for continued efforts to improve communication between survivors of cancer and providers, including targeted interventions in key survivorship care areas.</p>","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"15 11","pages":"e916-e924"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6851794/pdf/JOP.19.00157.pdf","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37383005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Patient Navigation in Cancer: The Business Case to Support Clinical Needs.","authors":"Ronald M Kline, Gabrielle B Rocque, Elizabeth A Rohan, Kris A Blackley, Cynthia A Cantril, Mandi L Pratt-Chapman, Howard A Burris, Lawrence N Shulman","doi":"10.1200/JOP.19.00230","DOIUrl":"10.1200/JOP.19.00230","url":null,"abstract":"<p><strong>Purpose: </strong>Patient navigation (PN) is an increasingly recognized element of high-quality, patient-centered cancer care, yet PN in many cancer programs is absent or limited, often because of concerns of extra cost without tangible financial benefits.</p><p><strong>Methods: </strong>Five real-world examples of PN programs are used to demonstrate that in the pure fee-for-service and the alternative payment model worlds of reimbursement, strong cases can be made to support the benefits of PN.</p><p><strong>Results: </strong>In three large programs, PN resulted in increased patient retention and increased physician loyalty within the cancer programs, leading to increased revenue. In addition, in two programs, PN was associated with a reduction in unnecessary resource utilization, such as emergency department visits and hospitalizations. PN also reduces burdens on oncology providers, potentially reducing burnout, errors, and costly staff turnover.</p><p><strong>Conclusion: </strong>PN has resulted in improved patient outcomes and patient satisfaction and has important financial benefits for cancer programs in the fee-for-service and the alternative payment model worlds, lending support for more robust staffing of PN programs.</p>","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"585-590"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8790714/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"44910134","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Improving the Management of Brain Metastases in Oncogene-Addicted Non-Small-Cell Lung Cancer.","authors":"A. Fung, N. Leighl","doi":"10.1200/JOP.19.00575","DOIUrl":"https://doi.org/10.1200/JOP.19.00575","url":null,"abstract":"","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"15 11 1","pages":"571-572"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00575","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"43713918","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Standardizing Opioid Prescribing Practices for Cancer-Related Pain Via a Novel Interactive Documentation Template at a Public Hospital.","authors":"Maliha Nusrat,&nbsp;Amanda Parkes,&nbsp;Ryan Kieser,&nbsp;Bei Hu,&nbsp;Dalia Farhat,&nbsp;Alyssa Rieber,&nbsp;Hilary Ma","doi":"10.1200/JOP.18.00789","DOIUrl":"https://doi.org/10.1200/JOP.18.00789","url":null,"abstract":"<p><strong>Purpose: </strong>Opioid misuse during cancer pain management places patients at risk for harm and physicians for legal liability. Identifying and monitoring patients who are at risk is challenging given the lack of validated clinical tools and evidence-based guidelines. In the current study, we aimed to standardize opioid prescribing practices at a community oncology clinic to help ensure patient safety and physician compliance with Texas state regulations.</p><p><strong>Methods: </strong>We used the Plan-Do-Study-Act methodology. In the planning phase, current practices of assessing opioid efficacy, toxicity, and misuse were determined by surveying clinic physicians and reviewing patients' charts. We developed a new standardized process that incorporated published literature, the Texas Administrative Code, and expert opinion. Two interactive documentation templates (SmartPhrases) were designed to implement the standardized process. The intervention was studied using repeat physician surveys and chart reviews, which prompted action for refinement and sustainability.</p><p><strong>Results: </strong>At baseline, 9% of providers followed a systematic approach to prescribing opioids and 86% expressed an interest in process standardization. We noted high interprovider variability in the opioid risk stratification and refill process. At 2 months and 6 months postimplementation, provider satisfaction with the intervention was 83% and 75%, whereas compliance with SmartPhrase use was 70% and 54%, respectively. The frequency of state database check improved from 36% to 94% at 6 months. Improvement was also noted in assessment and documentation of baseline risk, chemical coping, and toxicity.</p><p><strong>Conclusion: </strong>We implemented a systematic approach for assessing opioid misuse, toxicity, and efficacy during cancer pain management at a community oncology clinic. The approach resulted in notable improvement in provider practices and documentation compliance.</p>","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"15 11","pages":"e989-e996"},"PeriodicalIF":0.0,"publicationDate":"2019-11-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.18.00789","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"37077113","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Assessing an ASCO Decision Aid for Improving the Accuracy and Attribution of Serious Adverse Event Reporting From Investigators to Sponsors.","authors":"K. Mileham, Caroline Schenkel, M. Chuk, A. Buchmeier, R. P. Perez, P. Hurley, Laura A. Levit, E. Garrett-Mayer, C. Davis, S. Bruinooge, J. Vose","doi":"10.1200/JOP.19.00366","DOIUrl":"https://doi.org/10.1200/JOP.19.00366","url":null,"abstract":"PURPOSE\u0000Investigators often send reports to sponsors that incorrectly categorize adverse event (AE)s as serious or attribute AEs to investigational drugs. Such errors can contribute to high volumes of uninformative investigational new drug safety reports that sponsors submit to the US Food and Drug Administration and participating investigators, which strain resources and impede the detection of valid safety signals. To improve the quality of serious AE (SAE) reporting by physician-investigators and research staff, ASCO developed and tested a Decision Aid.\u0000\u0000\u0000METHODS\u0000A preliminary study with crossover design was conducted in a convenience sample. Physician-investigators and research staff were randomly assigned to receive case studies. Case studies were assessed for seriousness and attribution, first unassisted and then with the Decision Aid. Participants completed a feedback survey about the Decision Aid. Effectiveness of reporting and attribution are reported as odds ratios (ORs) with 95% CI. Power to detect associations was limited because of a small sample size.\u0000\u0000\u0000RESULTS\u0000The Decision Aid did not significantly affect accuracy of determining seriousness (OR, 0.87; 95% CI, 0.31 to 2.46), but it did significantly increase accuracy of attributing an SAE to a drug (OR, 3.60; 95% CI, 1.15 to 11.4). Most of the 29 participants reported that the Decision Aid was helpful (93%) and improved decision-making time (69%) and confidence in reporting (83%), and that they would use the Decision Aid in practice (83%).\u0000\u0000\u0000CONCLUSION\u0000The Decision Aid shows promise as a method to improve the quality of SAE attribution, which may improve the detection of valid safety signals and reduce the administrative burden of uninformative investigational new drug safety reports. Study of the Decision Aid in a larger sample with analysis stratified by participant role and SAE reporting experience would further assess the tool's impact.","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900366"},"PeriodicalIF":0.0,"publicationDate":"2019-10-24","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/JOP.19.00366","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42479882","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Rare Case of Thoracic Desmoplastic Small Round Cell Tumor in a Three-Year-Old Boy.","authors":"Sunaina Suhag, R. Byrd, Kamna Jaiswal","doi":"10.1200/jop.19.00358","DOIUrl":"https://doi.org/10.1200/jop.19.00358","url":null,"abstract":"","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900358"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/jop.19.00358","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"42136179","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"SOS! Immunotherapy-Associated Sinusoidal Obstructive Syndrome.","authors":"T. P. Ho, S. Venkatesh, H. Alkhatib, Yiyi Yan","doi":"10.1200/jop.19.00276","DOIUrl":"https://doi.org/10.1200/jop.19.00276","url":null,"abstract":"","PeriodicalId":54273,"journal":{"name":"Journal of Oncology Practice","volume":"1 1","pages":"JOP1900276"},"PeriodicalIF":0.0,"publicationDate":"2019-10-16","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://sci-hub-pdf.com/10.1200/jop.19.00276","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"48317064","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":0,"RegionCategory":"","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}