CANCER BUZZ

As myeloproliferative neoplasms carry a significant symptom burden and oftentimes can require lifelong care coordination and close monitoring, hear how a strong multidisciplinary approach can impact shared decision-making and patient engagement. In this episode, CANCER BUZZ speaks with speaks with Andrew Kuykendall, MD, assistant member of the Department of Malignant Hematology at Moffitt Cancer Center in Tampa, Fla. and Katherine Mast, BSN, RN at Moffit Cancer Center about the impact of multidisciplinary coordination on patient care and outcomes for patients with myeloproliferative neoplasms.

"When we talk about shared-decision making, I think we can talk about it in the sense of sharing that decision-making with the patient, and also sharing it with the entire [multidisciplinary] team. We like to create that engagement where we [the multidisciplinary team] are all there together—to recount what is going on, refocus what our goals of therapy are, discuss what the different options are, and then put it in the patient's hands to say 'of these options, what do you think makes the most sense for what your goals are?'" – Andrew Kuykendall, MD

"Where we can make some of the biggest impact is having people on our team who really understand what it's like to have an MPN because we see this group of patients constantly. Having one person that they can come to is wonderful, but having multiple people that are on their team that they know are there to help and answer questions can be really profoundly impactful, especially if they have a rare disease and their local hematologist/oncologist may not know as much about it." – Katherine Mast, BSN, RN

This is the third video podcast in a four-episode series on myeloproliferative neoplasms in connection with the education program "Advancing Care for Patients with Myeloproliferative Neoplasms (MPNs)." This episode is supported by Incyte.

Guests:

Andrew Kuykendall, MD,

Assistant Member, Department of Malignant Hematology

Moffitt Cancer Center

Tampa, FL

Katherine Mast, BSN, RN

Registered Nurse

Moffitt Cancer Center

Tampa, FL

Resources:

Myeloproliferative Neoplasms (cancersupportcommunity.org)

National Comprehensive Cancer Network (NCCN) Guidelines: Myeloproliferative Neoplasms

Multiple myeloma refers to blood cancer found within the plasma cells of bone marrow. It is a rare cancer, affecting less than one percent of the U.S. population. Currently, there is no cure for multiple myeloma, but there are treatment options that can help people live longer, healthier lives. Stem cell transplant is a standard of care for eligible patients. However, over half of patients newly diagnosed with multiple myeloma are not eligible for transplant due to age or other major health problems, such as heart, lung, liver, or kidney disease. And studies have shown people who are ineligible for transplant have a lower survival rate.

Listen as Dr. Yee provides treatment planning options available to patients who are ineligible for transplant.

"Overtime these patients can experience significant improvements in quality of life…they can go back to their normal routine."

"Ultimately, there needs to be a shared decision between the patient and the care team in terms of what their goals and priorities are."

– Andrew Yee, MD

Andrew Yee, MD

Clinical Director

Center for Multiple Myeloma at Massachusetts General Hospital

Assistant Professor of Medicine

Harvard Medical School, Boston, MA

This podcast was generously supported by Janssen Oncology. This podcast was developed through a collaboration between The Association of Community Cancer Centers and The Leukemia & Lymphoma Society.

Resources:

ACCC's Multiple Myeloma Web Page

HealthTree Foundation

Leukemia & Lymphoma Society

National Cancer Institute

Patients with Chronic Lymphocytic Leukemia (CLL) are considered highly susceptible to bacteria and viruses due to immunocompromisation. Now, in the post-COVID era, we are facing multiple viruses at the same time (i.e., Influenza, RSV, and COVID). It is as important as ever for patients with CLL to continue receiving vaccinations, as well as following safety and preventive measures such as wearing masks and social distancing. CANCER BUZZ spoke to Brian Koffman, MDCM, DCFP, FCFP, DABFP, MSEd, Co-Founder, Executive Vice President, and Chief Medical Officer at the CLL Society in Chula Vista, CA. Hear the most up-to-date best practices, including shared decision-making, regarding treating patients with CLL in this post-COVID era.

"The pandemic forced into the spotlight the reality that all CLL patients, regardless of their treatment status, even those who have not been treated, are immunocompromised. Patients had to make shifts in their lifestyle."

"I think it is important that CLL patients realize that the pandemic is not over for the immunocompromised. And the virus that causes Covid infections, is not going away."

– Brian Koffman, MDCM, DCFP, FCFP, DABFP, MSEd

Brian Koffman, MDCM, DCFP, FCFP, DABFP, MSEd

Co-Founder, Executive Vice President, and Chief Medical Officer

CLL Society

Chula Vista, CA

Resources:

Patients with CLL have a lower risk of death from COVID-19 in the Omicron era (nih.gov)

CLL Society

Cancer Support Community

ClinicalTrials.gov

As community care teams work to provide equitable care for patients with chronic lymphocytic leukemia (CLL), understanding disparities as well as state and region-specific barriers that impact care is critical. CANCER BUZZ speaks with Adam Kittai, MD, hematologist, and assistant professor at The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute about ongoing research efforts to examine these disparities and ensuring equitable access to care for patients with CLL.

"In order to make a dent in cancer health equity, you need to have multi-level approach, including assessing what the problem is, implementing research that is small but additive, and focusing on the areas of the most unmet need. If we start to focus on the barriers that our patients experience, one patient at a time, we should be able to make a difference–if you focus on each patient in front of you and work on solving those barriers and [determining] reasons why they may not be getting equitable care as opposed to their cohorts." – Adam Kittai, MD, hematologist, and assistant professor at The Ohio State University Comprehensive Cancer Center- The James

This podcast was created in connection with the education program A Regional Approach to Advancing Care for Chronic Lymphocytic Leukemia Patients. This episode is supported by AstraZeneca, Janssen Oncology, and Pharmacyclics.

Guest:

Adam Kittai, MD

Hematologist and Assistant Professor, Division of Hematology

The Ohio State University Comprehensive Cancer Center- The James

Resources:

Multidisciplinary Chronic Lymphocytic Leukemia Care (accc-cancer.org)

Quality Improvement Case Studies

CLL: Models of Effective Care Delivery

Podcast EP 57: COVID-19 Challenges: Managing Patients with CLL

Chronic Lymphocytic Leukemia (CLL) (cancer.org)

Addressing Racial Disparities in CLL Care - Patient Empowerment Network (powerfulpatients.org)

CLL Resources - CLL Society

Andre Harvin teases his keynote at the ACCC 49th Annual Meeting and Cancer Center Business Summit, where he will talk about innovative solutions to streamline pharmacy operations that have saved his healthcare system millions of dollars. One of those innovative solutions—robotic pharmacists.

Guest:

Andre Harvin, PharmD, MS, MBA, Executive Director of Pharmacy, Oncology Services, Cone Health Cancer Center

"We know that there are a lot of frustrations with biosimilars…depending on the payer, it may limit which biosimilar you can actually utilize with the patient…which one you'll get the best reimbursement for, how much it will cost…There's so much that you have to take into account, and we want to show people how you can do that more seamlessly by leveraging technology."

Hear Andre speak live at the ACCC 49th Annual Meeting and Cancer Center Business Summit.

Resources:

Leveraging Pharmacy Informatics to Standardize Pharmacists Review of Oral Oncolytics for Hospitalized Patients

Transitioning Select Chemotherapeutics to the Outpatient Setting Improves Care and Reduces Costs

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

Biosimilars Implementation Roadmap

The Oncology Pharmacy Navigator: A New Best Practice Model for Managing Medications

Implementation of Drug Vial Optimization to Reduce Drug Waste

Kevin Davies, author of Editing Humanity: The CRISPR Revolution and the New Era of Genome Editing, teases his keynote at the ACCC 49th Annual Meeting and Cancer Center Business Summit, where he will talk about the history of genome technology and its potential to change precision medicine. The first FDA approval for a CRISPR therapy is imminent. But can this game-changing technology deliver safe and affordable precision medicine for patients?

Guest:

Kevin Davies, PhD, Executive Editor of The CRISPR Journal and GEN Biotechnology and author of Editing Humanity: The CRISPR Revolution and the New Era of Genome Editing, Breakthrough: The Race for the Breast Cancer Gene, and Cracking the Genome; co-author of DNA: The Story of the Genetic Revolution.

"Rather than just adding a healthy gene to a bunch of cells in a patient and hoping that the gene can correct the disease in question, we now have tools, including CRISPR, to go in and actually surgically fix or repair the broken sequence in the DNA we have inherited…we are literally performing precision chemistry on the double helix."

Hear Kevin speak live at the ACCC 49th Annual Meeting and Cancer Center Business Summit.

Resources:

• CRISPR-Directed Gene Editing in a Community Cancer Center
• AI's Role in Advancing Cancer Prevention Detection Diagnosis Treatment and Precision Medicine
• Precision Medicine Stewards: A Case Study from Sanford Health
• Manipulating Data to Make Precision Medicine Magic
• Eliminating Precision Medicine Disparities
• Development of a Model Precision Cancer Therapies Program in a Community Setting
• ACCESS: The First Step Toward Analyzing Precision Medicine Data

As myeloproliferative neoplasms are a group of progressive blood cancers that can develop quickly into more serious hematological diseases, hear what community practices need to know about treating these patients quickly and the impact that timeliness of care can have on patient outcomes. In this episode, CANCERBUZZ speaks with Srdan Verstovsek, MD, PhD, United Energy Resources Inc. professor of Medicine and hematologist oncologist at MD Anderson Cancer Center, University of Texas, about when to begin therapeutic care for MPNs and the urgency of treatment.

"We learned from experience over the last ten to twenty years that early intervention—when things are not too bad—will actually help us achieve the goals of therapy. We will have a chance to significantly decrease the size of the spleen or improve the quality of life if we do not wait for patient to be terribly sick. So, early intervention in terms of identifying the problem, objectivizing it, [and recognizing] that the symptoms are there, [indicate that we] should start the therapy now—why wait?"–Srdan Verstovsek, MD, PhD

This is the second video podcast in a four-episode series on myeloproliferative neoplasms in connection with the education program "Advancing Care for Patients with Myeloproliferative Neoplasms (MPNs)." This episode is supported by Incyte.

Srdan Verstovsek, MD, PhD

Professor of Medicine, Department of Leukemia, Division of Cancer Medicine

Hematologist Oncologist

MD Anderson Cancer Center, University of Texas

Houston, TX

Resources:

• Myeloproliferative Neoplasms (cancersupportcommunity.org)
• MPN10: Track the Severity of your MF- or ET-related symptoms
• Myeloproliferative Neoplasms (MPNs): 7 questions, answered (MD Anderson Cancer Center)

The patient navigation world has a new kid on the block. Just when we thought we knew everything there was to know about navigators, the role has been reinvented by a concept so intuitive, it is difficult to believe that these navigators are not standard practice in oncology. Meet population health navigators—individuals dedicated to supporting a specific underserved population, including rural, Black, and Latinx populations, through culturally and linguistically competent navigation services for patients with cancer, their families, and their caregivers. These navigators share a cultural connection and language with their patients and are non-clinical professionals—legal specialists, social workers, advocacy experts—who bring valuable, real-world skills and experiences to patients' cancer journey and help break down barriers more effectively by understanding the nuances of a patient's culture, language, and identity.

Guest:

Emily CopusManager, Navigation Program

Atrium Health Wake Forest Baptist

"It's so important to have somebody who looks like you when you walk into a room, especially when you are talking about something so vulnerable as a cancer diagnosis and all the challenges that come along with it. It just allows you to connect with someone on a different level."

Read more in "Population Health Navigators: An Innovative Approach for Supporting Underserved Patients" in Volume 38, Number One, Oncology Issues.

Resources:

• The Community Health Worker: A Cancer Program's Role in Population Health Efforts
• A Digital Population Tracking System Helps Improve Colorectal Cancer Survivorship Services
• Implementation of a Health Disparities & Equity Program at the Duke Cancer Institute
• Genetic Cancer Screening and Testing in a Medically Underserved Community
• Bridging the Gap: Early Detection of Cancer for the Medically Underserved

Because most cases of SCLC are diagnosed at advanced stages, it is rarely curable by the time of diagnosis. However, for some patients, treatment can improve quality of life. Multidisciplinary care coordination is especially important with aggressive cases of SCLC, as there may be several unique challenges to be addressed. CANCER BUZZ spoke to Ahmed Al-Hazzouri, MD, Medical Oncologist, Ryan Schroeder, MD, Pulmonologist, and Justin Wu, MD, Radiation Oncologist, from AdventHealth's Cancer Institute Waterman, Tavares, FL. Hear what impact a multidisciplinary team approach can have on patient experience and health outcomes.

"The Lung Nodule Clinic is a way for us to also promote community outreach to say, not only should you get screened, and educate the public about being screened, but can help you if there is an applicable finding."

– J. Ryan Schroeder, MD

Ahmed Al-Hazzouri, MD

Medical Oncologist

AdventHealth's Cancer Institute Waterman

Tavares, FL

Ryan Schroeder, MD

Pulmonologist

AdventHealth's Cancer Institute Waterman

Tavares, FL

Justin Wu, MD

Radiation Oncologist

AdventHealth's Cancer Institute Waterman

Tavares, FL

Resources:

Cancer Support Community

ClinicalTrials.gov

Go2 for Lung Cancer

LUNGEVITY

Lung Cancer Research Foundation

Treatment for patients with CLL has undergone a dramatic transformation with the approval of oral oncolytics. Oral oncolytic treatment for CLL offers many benefits such as convenience and effectiveness. However, with the introduction of oral oncolytic treatments, cancer care teams face new challenges (e.g., medication adherence, prescription interactions, toxicity management, financial burdens, among others). CANCER BUZZ spoke to Amy Goodrich, CRNP, Nurse Practitioner at John Hopkins Kimmel Cancer Center in Baltimore, MD. Hear about a nurse's role in care planning, engaging patients in education, and shared decision making for treatment goals and planning.

"We've been short oncologists for a long time, nurse practitioners and other advanced practitioners fill that gap… But our oncology nurses are such an important part of the care of these patients with just being the day-to-day touchpoints for these folks and really knowing how to engage with patients and really flesh out what is going on with them..." – Amy Goodrich, CRNP

Amy Goodrich, CRNP

Nurse Practitioner

Johns Hopkins Kimmel Cancer Center

Baltimore, MD

Resources:

Blog: Integrating Oral Oncolytics into Chronic Lymphocytic Leukemia Practice

Integrating Oral Oncolytics into Chronic Lymphocytic Leukemia (CLL) Practice

Successful Integration of Oral Oncolytics-Podcast EP 96

The Role of Pharmacy to Help Manage Patients with Cancer on Oral Oncolytics