CANCER BUZZ

Anemia can negatively affect quality of life and treatment outcomes for patients with high-risk myelodysplastic syndrome (MDS) and acute myeloid leukemia. In this episode, CANCER BUZZ speaks with Amy DeZern, MD, MHS, director, Bone Marrow Failure and MDS Program, Johns Hopkins University School of Medicine in Baltimore, Maryland, Donald Moore, PharmD, BCPS, BCOP, DPLA, FCCP, clinical oncology pharmacy manager, Atrium Health Levine Cancer in Charlotte, North Carolina, and David Sallman, MD, assistant member, Department of Malignant Hematology, Moffitt Cancer Center in Tampa, Florida. Their discussion elucidates an array of patient-centered approaches, touches on social determinants of health, and highlights collaborative measures to support care coordination in the management of anemia in patients with high-risk myelodysplastic syndrome and acute myeloid leukemia.

"It really does take a village to manage the anemia of high-risk MDS…We as providers need to think through transfusion mitigation strategies but also keep our patients safe." –Amy DeZern, MD, MHS

"Health disparities can play a really important role in affecting outcomes. And a lot of that is multifactorial—it may be due to patients without insurance having a higher tendency to delay seeking care due to the associated cost of seeking medical attention, and therefore they may present sicker."—Donald Moore, PharmD, BCPS, BCOP, DPLA, FCCP

"There's no question, especially as therapies are getting more complex, and the side effects as far as the severity of cytopenias are increasing, this collaboration between blood bank centers and community oncologists is going to be increasingly important."—David Sallman, MD

Amy DeZern, MD, MHS

Director, Bone Marrow Failure and MDS Program

Professor of Oncology and Medicine

Johns Hopkins University School of Medicine

Baltimore, MD

Donald Moore, PharmD, BCPS, BCOP, DPLA, FCCP

Clinical Oncology Pharmacy Manager

Atrium Health Levine Cancer

Charlotte, NC

David Sallman, MD

Assistant Member, Department of Malignant Hematology

Moffitt Cancer Center

Tampa, Florida

This episode was developed in connection with an initiative of the ACCC education program Myelodyplastic Syndromes, Optimal Management of Anemia in Adults with High-Risk MDS, which is supported by Gilead.

Resources:

Myelodysplastic Syndromes - ACCC

Achieving & Maintaining Better Outcomes for Patients with Acute Myeloid Leukemia Project - ACCC

Disparities in Acute Myeloid Leukemia - ACCC

Prior to 2020, patients newly diagnosed with breast cancer at Atrium Health Wake Forest Baptist's Comprehensive Cancer Center experienced high variability in the number of days it took to see a breast cancer provider. Scheduling was decentralized across the departments and rarely could multiple visits be coordinated to occur on the same day, within the same location. Addressing this issue required a coordinated, multidisciplinary approach that involved engaging the cancer center leadership across 3 treatment departments—medical, radiation, and surgical oncology—administration, physicians, advanced practice providers (APPs), patient navigation, genetic counseling, scheduling, imaging, lab, and pathology. The primary goals of the initiative were to transform patient experience and improve timeliness to care for every newly diagnosed patient.

Guest:

Hunter Hayes, MBA

Associate Principal

The Chartis Group

"Being able to get patients seen quickly; being able to retain patients for their full cancer treatment is incredibly important…competition is growing and being able to keep those patients and keep their experience positive is critical."

Read more in "Improving the Care of Patients Newly Diagnosed With Breast Cancer" coming in your Volume 38, Number 2, Oncology Issues.

Resources:

Improving Cancer Care Teamwork: Five Patient-Centered Strategies to Strengthen Care Coordination

Machine Learning and Predictive Analytics Solution Transforms Infusion Center Operations

Location Technology Improves Efficiency, Safety & the Patient Experience

Breast Care ACCESS Project

Improving timely identification and referral of patients who may be eligible for chimeric antigen receptor (CAR) T-cell therapy is critical for improving outcomes for patients with hematologic malignancies. On February 7, 2024, ACCC hosted a virtual Working Summit: Advancing CAR T-Cell Therapy Care Continuity and Collaborative Patient Education to explore topics including patient and caregiver needs as well as care coordination between referring providers and certified CAR T-cell therapy centers.

In this episode, CANCER BUZZ speaks with Amy D. Smith, FNP-BC, director of the Meredith and Jeannie Ray Cancer Center at Ivinson Memorial Hospital and co-chair of the Summit about the event's key findings, which can guide cancer programs in building a framework for optimized CAR T-cell therapy care coordination.

"The goal really was how do we get those patients [receiving CAR T-cell therapy] back here and get them back into some kind of normalcy in their life sooner? A lot of that is building relationships and having trust with those providers in the academic centers that are performing the CAR T, so that they know that we can provide safe care at home." –Amy D. Smith, FNP-BC

"Keeping care close to home is near to my heart, living in a rural area. That was one takeaway... how do we collaborate better to make this happen for our patients and care teams? –Amy D. Smith, FNP-BC

Amy D. Smith, FNP-BC

Director, Meredith and Jeannie Ray Cancer Center

Ivinson Memorial Hospital

Laramie, WY

This episode was developed in connection with the ACCC education program Tips for Early Patient Identification for CAR T-Cell Therapy and Care Continuity with Community Providers and made possible with support by Kite Pharma, Johnson & Johnson, and Legend Biotech, and through partnerships with Cancer Support Community, the Association of American Cancer Institutes, and the Advanced Practitioner Society for Hematology and Oncology.

Resources:

• ACCC CAR T-Cell Therapy Focus Group Highlights
• Tips for Early Patient Identification for CAR T-Cell Therapy and Care Continuity with Community Providers
• Community CAR T-Cell Patient Identification Framework – CANCER BUZZ [Mini Podcast] Ep 138
• If They Recur, You Should Refer—A Community Oncologist Patient ID Roundtable Summary – from Oncology Issues Vol. 38, No. 6

The 4R Oncology® Model facilitates enhanced patient engagement and timely care provision by streamlining delivery of complex interdependent care. Implementation of the 4R Oncology® model in breast and lung cancer clinics has improved patients' involvement in organizing their care, enabled the development of high-functioning multidisciplinary care teams, and helped to optimize the timing and coordination of sequence of care. In this episode, CANCER BUZZ speaks with Raymond Liu, MD, director of research of Hematology-Oncology in Kaiser Permanente Northern California, director of cancer survivorship in Kaiser Permanente San Francisco, and assistant clinical professor at UCSF, who shares how successful implementation of the 4R Oncology® model empowers patients and clinicians and coheres care teams.

"When people could see that plan, and they could bring that home with them, and they saw that it was all guideline-based and mapped through in a very, very detailed way, they were empowered to answer their questions, especially for their loved ones, and to really reflect on what was said [in the doctor-patient consultation] at home." –Raymond Liu, MD

"Care is so complex now; our innovations are really, really going fast but we have not been able to deliver the care in a way that's understandable sometimes, and so by putting it in a single care plan, the patients really engage with it, and we found that the call volumes came down." –Raymond Liu, MD

Raymond Liu, MD

Director of Research of Hematology-Oncology

Kaiser Permanente Northern California

Oakland, CA

Director of Cancer Survivorship

Kaiser Permanente San Franciso

San Francisco, CA

Assistant Clinical Professor

University of California San Francisco

San Francisco, CA

This episode was developed in connection with the ACCC program Care Action Plans for People with Cancer. ACCC, in partnership with the Center for Business Models in Healthcare, is making 4R Care Sequences® available at no cost to ACCC members. 4R Oncology® is the intellectual property of CBM-HC (Executive Frameworks, Ltd.), but is not a commercial product or service. 4R Care Sequence® templates were developed based on studies sponsored by Genentech, Inc.

Resources:

4R Oncology®

JCO Article Fostering High-Functioning Team

JCO Impact of 4R Oncology® Model

While advancements in oral medicine are improving the treatment landscape for head and neck cancer, routine dental care and preventative oral cancer screenings can help identify head and neck cancers early. In this episode, Alessandro Villa, DDS, PhD, MPH, chief of Oral Medicine, Oral Oncology, and Dentistry at Baptist Health South Florida's Miami Cancer Institute, emphasizes the proactive role dentists can play in early identification of cancer—as well as the need for equitable access to dental care—and explores how a cross-disciplinary cancer care team and patient education work in tandem to better manage complications from head and neck treatment.

"It is widely known that any patient with a diagnosis of head and neck cancer who is scheduled to receive treatment with chemo and radiation therapy should see a dentist prior to starting cancer therapy. We should make sure that access is available for this patient." —Alessandro Villa, DDS, PhD, MPH

Alessandro Villa, DDS, PhD, MPH

Chief of Oral Medicine, Oral Oncology, and Dentistry

Miami Cancer Institute, Baptist Health South Florida

Miami, FL

This episode was made in connection with the ACCC education program Multidisciplinary Approaches to Head & Neck Cancer Care in partnership with Head and Neck Cancer Alliance and the American Society of Radiation Oncology (ASTRO) and with support provided by EMD Serono.

Resources:

Multidisciplinary Approaches to Head & Neck Cancer Care

Head and Neck Patient and Caregiver Resources

Making the Case for Head & Neck Cancer Patient Care Navigators

Advancements in clinical data and research have shown the immunotherapeutic potential of bispecific antibodies as treatment for hematologic cancers and solid tumors. In this episode, CANCER BUZZ speaks with Aaron Cumpston, PharmD, pharmacy clinical specialist for bone marrow transplant and Christine Barrett, PharmD, BCOP, medical oncology clinical pharmacy specialist who discuss the challenges of care coordination and therapy and share operational best practices for the delivery of bispecific antibodies in the community setting.

"I think we're finding these drugs to be highly effective and having high response rates and also very durable response rates in very refractory patients."—Aaron Cumpston, PharmD, BCOP

"I know that in community practice it can be really difficult, but there is a network of institutions out there that have taken on administering these BiTE therapies and have a lot of experience that can be very helpful for those in community practice." —Christine Barrett, PharmD, BCOP

Aaron Cumpston, PharmD, BCOP

Pharmacy Clinical Specialist – Hematologic Malignancy, Transplant, and Cellular Therapy

WVU Medicine

WVU Cancer Institute - Mary Babb Randolph Cancer Center

Morgantown, WV

Christine Barrett, PharmD, BCOP

Medical Oncology Clinical Pharmacy Specialist

WVU Medicine

WVU Cancer Institute - Mary Babb Randolph Cancer Center

Morgantown, WV

This episode was developed in connection with the ACCC education program Sharing Operational Insights for the Delivery of Bispecific Antibodies in Solid Tumor and is supported by Amgen.

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 Tumor

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

As the need for access to guideline-concordant biomarker testing for underserved populations continues to grow, hear what care teams need to know about coverage for Medicaid beneficiaries and the legislative outlook for 2024. In this episode, CANCER BUZZ speaks with Hilary Gee Goeckner, MSW, director of State and Local Campaigns for the American Cancer Society Cancer Action Network (ASC CAN), who shares policy perspectives and the latest on state legislation to expand coverage for biomarker testing for Medicaid beneficiaries.

"There are a lot of challenges around implementation—getting the legislation passed is just the first step…It is also important for providers to be aware of the new rules that affect many plans and their states so they are able to order testing that may not have been covered or rejected previously." –Hilary Gee Goeckner, MSW

Hilary Gee Goeckner, MSW

Director, State and Local Campaigns, Access to Care

American Cancer Society Cancer Action Network

Washington, D.C.

This episode was developed in connection with the ACCC education program Improving Access to Biomarker Testing in Medicaid Populations and is made possible with support by Foundation Medicine and Exact Sciences.

Resources:

The Cost of Biomarker Testing: Moving from Support-Based to Sustainable Solutions

Comprehensive Cancer Care: The Role of Biomarker Testing

Biomarker Testing for Medicaid Beneficiaries (Podcast)

Access to Biomarker Testing - American Cancer Society Cancer Action Network

The Road to Comprehensive Biomarker Testing for All – ACCC Buzz Blog

Improving Access to Biomarker Testing in Medicaid Populations

Precision Medicine in Rural and Underserved Areas – ACCC Buzz Blog

Patient Perceptions of Biomarker Testing – Oncology Issues

Cancer Diagnostics - Biomarkers

Eliminating Precision Medicine Disparities

The ACCC Oncology Reimbursement Meetings (ORMs) help all members of the multidisciplinary cancer care team navigate the annual changes in oncology reimbursement and regulations— while improving their knowledge on effective strategies for success in an everchanging oncology landscape. In this episode, CANCER BUZZ speaks with Jordan Karwedsky, financial counselor, Green Bay Oncology, about her session at the ORMs last fall, where she discussed best practices cancer care teams can adopt as they prepare for the open enrollment season.

"If you have a patient who is uninsured or underinsured, make a note that is a reminder for you so come November when open enrollment begins, you can reach out to them and help them optimize their insurance. In the meantime, if they need treatment, then work with the drug companies to save them as much money on their treatment."

"Highlights from recent ORMs include how to work with your legislature, either at the state or federal level, to advocate for laws that will help patients."

Jordan Karwedsky

Financial Counselor

Green Bay Oncology

In one of the upcoming ORMs this spring, Karwedsky will share strategies for patient navigation in the digital age. For more information, please visit the ACCC website.

Resources:

· Preparing for Open Enrollment

· ACCC Financial Advocacy Network

· ACCC Financial Advocacy Boot Camp

· ACCC Patient Assistance & Reimbursement Guide

· Patient Navigation: Taking Stock of the Past and Looking to the Future

While social determinants of health can impact access to care and treatment options for many patients with cancer, when combined with the complexities of acute myeloid leukemia, these factors become critical to treatment outcomes and quality of life for patients. In this episode, CANCER BUZZ speaks with Linda Hayward, patient financial advocate at the University of Maryland, Kaufman Cancer Center at Upper Chesapeake Health, about the challenges of treatment and strategies to address disparities in access and care for patients with acute myeloid leukemia.

"When patients are financially underserved [this] plays a major factor in a patient getting treatment…if we [financial advocates] were not here to help our patients, many would forgo treatments." –Linda Hayward, Patient Financial Advocate

"Patient financial advocates can help patients navigate different resources……if we [financial advocates] were not here to help our patients, many would forgo treatments." –Linda Hayward, Patient Financial Advocate

Guest:

Linda Hayward

Patient Financial Advocate

University of Maryland, Kaufman Cancer Center at Upper Chesapeake Health

Bel Air, Maryland

This episode was developed as a part of the ACCC education program Addressing Disparities in Access to Care for Acute Myeloid Leukemia, designed to explores the current challenges in care coordination and therapy options for patients with acute myeloid leukemia and highlights strategies and best practices to improve outcomes for these patients. This episode was made possible with support by AbbVie.

Additional Reading/Sources

· Strategies to Addressing Disparities in Patients with AML [Video Podcast]

· Improving Care Delivery for Transplant-Ineligible Patients with AML

· ACCC Financial Advocacy Service Guidelines

· AML Care Coordination in the Community Setting [Video Podcast]

· Critical Conversation Strategies for Patients with AML [Video Podcast]

· Shared Decision-making in Acute Myeloid Leukemia

· Achieving and Maintaining Better Outcomes for Patients with AML

· Talking about Acute Myeloid Leukemia (Cancer Support Community)

· Shared Decision-making: Practical Implementation for the Oncology Team (ACCC)

Maintenance therapy for patients with acute myeloid leukemia, particularly those who are ineligible for transplant, can be critical to treatment outcomes and quality of life for patients. In this episode, CANCER BUZZ speaks with Thomas LeBlanc, MD, hematologic oncologist, associate professor of Medicine, and associate professor in Population Health Sciences at Duke Cancer Institute, about the importance of keeping patients with acute myeloid leukemia in first remission as long as possible through maintenance therapy.

"You have to be aware of the benefits of maintenance therapy…and for patients who are being considered for transplant but who do not end up getting a transplant, it should really be the default option that those patients receive a maintenance therapy." –Thomas W. LeBlanc, MD

Guest:

Thomas W. LeBlanc, MD

Hematologic Oncologist,

Associate Professor of Medicine,

Associate Professor in Population Health Sciences

Duke Cancer Network, Duke Cancer Institute

Durham, North Carolina

This is the fourth and final episode of a four-part series developed in connection with the ACCC education program Achieving and Maintaining Better Outcomes for Patients with Acute Myeloid Leukemia. This episode was made possible with support by Bristol Myers-Squibb.

Additional Reading/Sources

Improving Care Delivery for Transplant-Ineligible Patients with AML

AML Care Coordination in the Community Setting [Video Podcast]

Critical Conversation Strategies for Patients with AML [Video Podcast]

Strategies to Addressing Disparities in Patients with AML [Video Podcast]

Shared Decision-making in Acute Myeloid Leukemia

Achieving and Maintaining Better Outcomes for Patients with AML

Talking about Acute Myeloid Leukemia (Cancer Support Community)

Shared Decision-making: Practical Implementation for the Oncology Team (ACCC)