CANCER BUZZ

Anemia presents a significant challenge in the management of patients with low-risk myelodysplastic syndromes (MDS). As clinicians focus on maintaining quality of life, it is necessary to understand the care sequencing of anemia treatment in patients with low-risk MDS. In this episode, CANCER BUZZ speaks with Steven Gilmore, PharmD, BCOP, Senior Manager of Clinical Content in Pharmacy and Clinical Programs with McKesson Specialty Health, and Christopher Benton, MD, hematologist and medical oncologist at Rocky Mountain Cancer Centers, to review key considerations and emerging trends for the treatment of anemia in the low-risk MDS population.

"Social determinants [are] an important element in terms of patient compliance...MDS is a disease that primarily affects older individuals. And sometimes this can be hard [for them], to make it into the clinic on a weekly or biweekly basis in order to get an injection of the ESA."—Christopher Benton, MD

"Everyone on the health care team can contribute [to] the management of MDS—hematologist-oncologists…clinical pharmacists and APPs [advanced practice providers]…hematopathologists…dietitians and social workers—all of the expertise from these professionals leads to a holistic approach that addresses medical, psychosocial, and supportive care needs of the patient."—Steven Gilmore, PharmD, BCOP

Christopher Benton, MD

Hematologist and Medical Oncologist

Rocky Mountain Cancer Centers

Denver, CO

Steven Gilmore, PharmD, BCOP

Senior Manager, Clinical Content, Pharmacy & Clinical Programs

McKesson Specialty Health

Baltimore, MD

This episode was developed in connection with the ACCC education initiative Anemia Mitigation & Optimal Care for MDS Patients and is supported by Bristol Myers Squibb.

Resources:

ACCC Myelodysplastic Syndromes

ASH 2020 Treatment Algorithm Lower-Risk MDS

This AI-driven incidental findings program identifies and then monitors pancreatic abnormalities to improve the quality of care to patients who are at increased risk for developing pancreatic cancer. To do so, the patient management software integrates with the electronic health record and facilitates patient identification, risk assessment, care plan tracking, patient and provider communication, outcomes recording, and registry functionality. In the 2 years following program implementation, 82 pancreatic cancers were detected from incidental findings with 65% of patients being diagnosed in earlier stages (stages I, II, and II), as well as instances of ampullary cancer, gallbladder cancer, and gastric cancer.

Guest:

Russell Langan, MD, FACS, FSSO

Associate Chief Surgical Officer, System Integration and Quality & Director of Surgical Oncology

RWJBarnabas Health, Rutgers Cancer Institute of New Jersey, Cooperman Barnabas Medical Center

Livingston, New Jersey

"There remains a knowledge gap with respect to the risk associated with pancreatic cysts. Many patients are identified to have a pancreatic cyst on an incidental scan and then told [by providers] that there's no risk. [Some] patients will then return years later with pancreatic cancer. And it's very unfortunate because we know that risk could have been addressed when it was in its precancerous state." —Russell Langan, MD, FACS, FSSO

Hear more about this innovation at the ACCC 41st National Oncology Conference, October 9-11, 2024, in Minneapolis, Minnesota. Register today.

Additional Resources:

Reimagining Healthcare for Incidental Lung Nodules

Oncology Capture of ED Patients with Incidental Radiologic Findings

Pancreatic Cancer and Community Engagement: A Scoping Review of the Literature

Let's Win Pancreatic Cancer: A Partner for Patients and Care Teams

This machine learning algorithm runs nightly and is linked to a smart texting application that goes out to patients every morning for 7 days following chemotherapy, asking about symptoms like diarrhea, fever, nausea, vomiting, and pain. Patients reporting severe or worsening symptoms have the smart text escalated to the oncology clinic where they received chemotherapy. Initial analysis broken down by responders (those that opted in and answered the daily text messages) and non-responders (opted out or opted in but did not answer the texts) found that ED visits were 5.7% for responders compared to 6.7% for non-responders. Across the health system, about 30 responders are added daily to the program.

Guest:

Michelle Eichelmann

Executive Director, Oncology Services and Precision Medicine

Mercy, Mercy Oncology Services

Saint Louis, Missouri

"It's one thing to mine data out of our EMR, but to actually use it in a proactive approach to patients I think is very unique. That's the key behind this...not just data, but what do we do with the data?" —Michelle Eichelmann

Hear more about this innovation at the ACCC 41st National Oncology Conference, October 9-11, 2024, in Minneapolis, Minnesota.

Additional Resources:

Smart-Texting High-Risk Patients After Chemotherapy Reduces ED Visits – ACCCBUZZ Blog

Reducing ED Visits and Hospital Admissions after Chemotherapy with Predictive Modeling of Risk Factors

Utilizing Technology to Identify Patient Co-Morbidities and Reduce Hospital and ED Admissions

ACCC 41st National Oncology Conference Registration

While molecularly targeted therapies based on actionable biomarkers are improving outcomes for patients with lung cancer, access to biomarker testing continues to hinder equitable and comprehensive care for underserved patients. In this episode, CANCER BUZZ TV speaks with Tom Lycan, DO, MHS, assistant professor of Hematology & Oncology at the Wake Forest School of Medicine, about a practical tool that can provide a care plan roadmap for providers and patients to mitigate precision medicine disparities.

"[The 4R Care Sequences pathway] gives an overarching view of what they [patients] are looking for in the immediate future and also down the road, and it can be a very helpful thing for patients and navigators, and honestly for clinicians...when I'm meeting with patients in-clinic, it helps me to just point to this and go through and review their pathway with the patient, so that I also can reframe everything in how we're coming up with a [treatment] plan together."—Tom Lycan, DO, MHS

Tom Lycan, DO, MHS

Assistant Professor, Hematology & Oncology,

Department of Internal Medicine

Wake Forest School of Medicine

Winston-Salem, NC

This episode was developed in connection with the ACCC education program Eliminating Precision Medicine Disparities, in partnership with the LUNGevity Foundation, and is supported by Janssen Oncology and Pfizer.

Resources:

Eliminating Precision Medicine Disparities - ACCC

LUNGevity Patient Resources

Care Action Plans for People with Cancer - ACCC

Fostering a High-Functioning Team in Cancer Care Using the 4R Oncology Model: Assessment in a Large Health System and a Blueprint for Other Institutions

Development of this comprehensive bispecific antibody program included policy development; toxicity management; creation of patient and staff education documents; creation of clinician tools like a toxicity scoring and charting tool and an electronic order set that segregates treatment options; and a monitoring system to safely transition patients from inpatient to outpatient care.

Guest:

Courtney VanHouzen, PharmD

PGY-2 Oncology Resident

Munson Healthcare, Cowell Family Cancer Center

Traverse City, Michigan

"While this [implementation of bispecific T-cell engager therapy] is not an easy thing to make happen, it's possible for it to be done safely and effectively. That's what we're trying to show community cancer centers across the country—that they're able to offer this therapy to their patients."

Hear more about this innovation at the ACCC 41st National Oncology Conference, October 9-11, 2024, in Minneapolis, Minnesota.

Resources:

Expanding Access to Cellular and Bispecific Therapies – Considerations and Recommendations by ACCC and SITC

Sharing Operational Insights for the Delivery of Bispecific Antibodies in Solid Tumors

Best Practices in Expanding Access to Bispecific Antibodies and Adverse Event Management

This rule-based informatics solution pulls from the electronic health record to automate the election of an appropriate biosimilar therapy based on the patient's insurance and hospital formulary preferences, streamlining prior authorization and approval processes. This e-tool decreased administrative burden to providers, pharmacists, and prior authorization specialists and increased biosimilar utilization by 21.9%.

Guest:

Sarah Hudson-DiSalle, PharmD, RPh, FACCC

Assistant Director of Reimbursement Services

The Ohio State University Comprehensive Cancer Center – Arthur G. James Cancer Hospital and Richard J. Solove Research Institute

"Using an EHR auto-selection tool that takes into consideration insurance preferences and contractual relationships to provide a proactive solution has helped our providers, our pharmacists, and our prior authorization specialists."

Hear more about this innovation at the ACCC 41st National Oncology Conference, October 9-11, 2024, in Minneapolis, Minnesota.

Resources:

Biosimilars Implementation Roadmap

[MINI PODCAST] Ep 103: Precision Medicine: Robots, Biologics, and Advocates: Lessons from the Pharmacy

Improve Oral Oncolytic Workflow and Reduce Treatment Delays with a Pharmacist Collaborative Practice Agreement

Shifting Chemo Administration from Inpatient to Outpatient Setting Improves Care and Reduces Costs

Reducing Revenue Loss and Patient Financial Toxicity with Pharmacy Pre-Certification and Denials Management

[PODCAST] Ep 39: Biosimilars—What Patients Need to Know

As the use of chimeric antigen receptor (CAR) T-cell therapy continues to expand as an effective treatment for hematologic malignancies, understanding how to identify eligible patients early and implementation of an effective framework for identification can improve care coordination and better prepare community cancer programs for widespread use of CAR T-cell therapy. In this episode, CANCER BUZZ speaks with David L. Porter, MD, director of Cell Therapy and Transplant at Penn Medicine, about the challenges community oncologists face and the key role they can play in identifying and recommending eligible patients for CAR T-cell therapy.

"The single most important thing for a patient out in the community at a place that doesn't have familiarity or immediate access to CAR T-cells is to refer them somewhere that does and refer them soon and timely." – David L. Porter, MD

Guest:

David L. Porter, MD

Director, Cell Therapy and Transplant

Jodi Fisher Horowitz Professor in Leukemia Care Excellence

Penn Medicine- University of Pennsylvania Health System (UPHS)

Philadelphia, PA

This episode has been developed in connection with the ACCC education program Tips for Early Patient Identification for CAR T-Cell Therapy and Creating "Stickiness" with Community Providers for Optimal Care Coordination. This episode was made possible with support by Kite Pharma.

Additional Reading/Sources

If They RECUR, You Should Refer: A Community Oncologist Patient ID Roundtable Summary

Essentials for Identifying Patients – Bringing CAR T-cell Therapy to Community Oncology

Optimizing Care Coordination – Bringing CAR T-cell Therapy to Community Oncology

Social determinants of health have been proven to impact access to care, but further delineation is necessary to describe their effect on treatment selection itself. To mitigate this knowledge gap, the Association of Cancer Care Centers (ACCC) sought to identify the impact that social determinants of health may have on guideline-concordant treatment selection in hormone receptor positive, HER2 negative, metastatic breast cancer and early breast cancer. In this episode, CANCER BUZZ speaks with Niharika Dixit, MD, medical oncologist at Zuckerberg San Francisco General Hospital and professor of medicine at UCSF Helen Diller Family Comprehensive Cancer Center. Dr. Dixit sheds light on inadequate insurance coverage and the challenges faced by health systems during comprehensive treatment planning. She considers the impact of social determinants of health on screening, timely diagnosis, treatment tolerability, and adherence.

"Many of the patients who have barriers related to social determinants of health would not be included in the clinical trials that determine the guidelines for treating breast cancer. I cannot overstate the importance of that—addressing social determinants of health brings more patients who are from racial and ethnic minoritized groups, who would make our clinical trials richer and our evidence-based guidelines more generalizable."—Niharika Dixit, MD

Niharika Dixit, MD Medical Oncologist Zuckerberg San Francisco General Hospital San Francisco, CA

Professor of Medicine UCSF Helen Diller Family Comprehensive Cancer Center San Francisco, CA

This podcast was developed in connection with the ACCC educational initiative Social Drivers of Health in Metastatic Breast Cancer and made possible with support by Pfizer.

Resources:

ACCC Social Drivers of Health in Metastatic Breast Cancer

Social Determinants of Health and Health Equity

Immunotherapy is redefining survivorship to include an increasing population of patients who live with cancer and navigate toxicities that differ from those that accompany traditional treatments. In this episode, CANCER BUZZ speaks with Brittney Baer, BSN, RN, patient care coordinator for the Immune Effector Cell program at Vanderbilt University Medical Center's Vanderbilt-Ingram Cancer Center, about key strategies and solutions to prioritize patient quality of life by addressing barriers to holistic survivorship care.

"I think simply talking to your patients and seeing what they would like to see [in terms of survivorship care] out of your cancer center—you don't have to start a huge holistic program right away...whether it be a nutritional program, a one-day-a-week meditation class, or a yoga class...start small and then start growing from there."—Brittney Baer, BSN, RN

Brittney Baer, BSN, RN

Patient Care Coordinator, Immune Effector Cell Program

Vanderbilt University Medical Center - Vanderbilt-Ingram Cancer Center

Nashville, TN

This episode was made possible by support from Bristol Myers Squibb and developed in connection with ACCC's Immuno-Oncology Institute, which is made possible by support from Bristol Myers Squibb, Merck & Co., and AstraZeneca.

Resources:

About the Institute - ACCC

IO Institute Survivorship Resources

State of Survivorship Survey - NCCS

Germline and somatic testing for in prostate cancer can improve outcomes and promote early detection and prevention, yet many patients are not aware of testing and the impact it can have on treatment options. In this episode, CANCER BUZZ speaks with David Gill, MD, medical oncologist at Intermountain Healthcare's Intermountain Cancer Center and Lindsey Byrne, MS, LCGC, licensed certified genetic counselor at The Ohio State University Comprehensive Cancer Center, who discuss how genetic counselors and increased patient education can help cancer programs close the practice gap and promote guideline-concordant testing among patients diagnosed with prostate cancer.

"I'd really advocate—even in your patients with a negative NGS panel—please still consider getting germline testing in those patients." –David Gill, MD

"We know that individuals, yes, they're dealing with a diagnosis of cancer, but the first thing people say to me when I sit down with them is, 'All right, I have this figured out, but what does this mean for my family?' They're really worried about their family, and that's where our focus is, to help take care of that."—Lindsey Byrne, MS, LCGC

David Gill, MD

Medical Oncologist

Intermountain Healthcare - Intermountain Cancer Center

Salt Lake City, Utah

Lindsey Byrne, MS, LCGC

Licensed Certified Genetic Counselor

The Ohio State University Comprehensive Cancer Center – The James

Columbus, Ohio

This episode was developed in connection with the ACCC education program Germline and Somatic Testing for Mutations to Optimize Outcomes in Metastatic Prostate Cancer and is supported by AstraZeneca, Johnson & Johnson, and Pfizer.

Resources:

Germline and Somatic Testing for Mutations to Optimize Outcomes in Metastatic Prostate Cancer - ACCC

Abstract: Homologous recombination repair gene mutation (HRRm) testing patterns and treatment selection from a real-world cohort of patients with metastatic castration-resistant prostate cancer (mCRPC)

Abstract: Utilization of genetic counseling and testing for patients with prostate cancer following integration of a genetic counselor into a genitourinary cancer clinic