Oh, No Methotrexate!
Methotrexate has been used in cancer wards for over 50 years. And like other beyond-patent meds, it’s become less profitable to manufacture MTX compared to much costlier new agents.
Study Finds Wide Variation in Reoperation Rates after Lumpectomy for Breast Cancer
All of this meshes with my experience – knowing women who’ve had breast-conserving surgery and then got mixed information about the results and what to do next. You’d think lumpectomy would be a standard procedure by now, and that decisions about what to do after the procedure, surgically speaking (let alone decisions about chemo, hormonal treatments and radiation) would be straightforward in most cases.
What is the Disease Control Rate in Oncology?
Last week I came upon a new term in the cancer literature: the Disease Control Rate. The DCR refers to the total proportion of patients who demonstrate a response to treatment. In oncology terms: The DCR is the sum of complete responses (CR) + partial responses (PR) + stable disease (SD). Another way of explaining […]
Regorafenib, an Experimental Pill Tested in Colon and Rectal Cancer Patients, on Conference Agenda
Tomorrow the American Society of Clinical Oncology* will host its 9th annual GI Cancers Symposium. Bloomberg and the LA Times have already reported findings of a paper, still in abstract form, to be presented on Saturday. The drug of interest is regorafenib, a pill that loosely inhibits quite a few kinases – enzymes critical in […]
Learning From the San Antonio Breast Cancer Symposium, At a Distance
There’s a ton of BC and women’s health news this week. But yours truly is, among other things, not in San Antonio where is the 34th annual San Antonio Breast Cancer Symposium. NTW, quite a few major news outlets are covering this business closely and carefully, as are some bloggers I know. Upon reading the […]
Final Word on Avastin, and Why We Need Better Physicians
Today’s breaking breast cancer news is on Avastin. The FDA has just announced, formally, that it will rescind approval for the drug’s use in people with metastatic breast cancer. Commissioner Dr. Margaret Hamburg writes this her statement: I know I speak on behalf of the many physicians that have been involved with this issue here […]
Visiting the Scar Project Exhibit
On Friday I visited the Scar Project exhibit at Openhouse, on Mulberry Street just south of Spring. Photographer David Jay offers penetrating, large, wall-mounted images of young people with breast cancer. The photos reveal women who’ve have had surgery, radiation, reconstruction or partial reconstruction of the breasts. Some are strikingly beautiful. Some appear confused, others […]
Two Faces of Pancreatic Cancer
Early this week I was saddened to hear of a former colleague’s death from pancreatic cancer. Dr. Ralph Steinman, a physician-researcher at the Rockefeller University, received a Nobel Prize for his work on the innate immune system. For many, news of Ralph’s death at 68 years arrived synchronously with word of his award. Yesterday we […]
Reducing Cancer Care Costs by Comparative and Cost-Effectiveness Research (CER)
Well, it’s the day after Labor Day, time to resume our discussion of Bending the Cost Curve in Cancer Care. We’ve reached the end of the list, on ideas to reduce oncology costs put forth by Drs. Smith and Hillner in the May 25 issue of the NEJM. Really this 10th and final point intended for […]
FDA Approves Adcetris for Refractory Hodgkin’s Disease and a Rare T-Cell Lymphoma
Late Friday afternoon, the FDA announced its approval, upon accelerated review, of a new drug, Adcetris (brentuximab) for patients with Hodgkin’s lymphoma that has relapsed after bone marrow transplant and for some patients with T-cell anaplastic large cell lymphoma (ALCL). This interests me for a lot of reasons, among them that I used to work in the field of lymphoma immunology […]
Reducing Costs by Better Integration of Palliative Care in Cancer Treatment
We’re up to point 9 on the list – and nearing the end – on Bending the Cost Curve in Cancer Care from the May 26 NEJM. The suggestion from Drs. Smith and Hillner is that doctors better integrate palliative care into usual oncology care. The authors start this important section well: We can reduce […]
Big Melanoma News: FDA approves Vemurafenib (Zelboraf)
This morning the FDA announced approval of Zelboraf (vemurafenib) for treatment of some patients advanced melanoma. This is the second drug the agency has approved for this disease in recent months, after nearly two decades of a lack of new or effective therapies for melanoma. Zelboraf is a pill. This small-molecule drug is thought to […]
News on an Unusual Cancer Treatment by Heat in Surgery (Hipec)
There’s so much weird and exciting cancer news this week, it’s hard to keep up! Double-kudos to Andrew Pollack on his front-page and careful coverage in the New York Times of the hyperthermic intraperitoneal chemotherapy (Hipec) technique that’s being used at some name-brand health care facilities to treat colon cancer. First, he spares no detail […]
Reducing Cancer Care Costs: The Value of Physicians’ Cognitive Work
We’ve reached what may be my favorite of the proposed ways to reduce cancer care costs, published in the NEJM by Drs. Smith and Hillner. Idea Number 8 is to realign compensation to value cognitive services, rather than chemotherapy, more highly. What the authors are saying is that we’d save money if oncologists were paid more for […]
Breast Cancer Avastin Update
This afternoon Ed Silverman of Pharmalot reports that Roche has proposed a compromise to the FDA over Avastin’s use in women with metastatic breast cancer. The drug would be approved for use only in combination with paclitaxel (Taxol), for which the data are strongest, and with special warnings. He writes: The deal includes revised labeling […]
Implications of the Oncology Drug Shortage
Today’s New York Times features an op-ed by Dr. Ezekiel Emanuel, on the oncology drug shortage. It’s a serious problem that’s had too-little attention in the press: Of the 34 generic cancer drugs on the market, as of this month, 14 were in short supply. They include drugs that are the mainstay of treatment regimens […]
On Reducing Cancer Care Costs by Resetting Expectations, and Hope
Today we should move forward on the list published in the NEJM on Bending the Cost Curve in Cancer Care. We’re up to point 7 in our discussion, what’s 2nd in the authors’ proposed changes in attitudes and practice: “Both doctors and patients need to have more realistic expectations.” This point follows closely from the […]
Reducing Cancer Care Costs: Oncologists Need to Get a Grip on Reality, and Talk about Dying
We’ve reached the second half of our discussion on Bending the Cost Curve in Cancer Care. The authors of the NEJM paper, Drs. T. Smith and B. Hillner, go on to consider how doctors’ behavior influences costs in Changing Attitudes and Practice. Today’s point on the list: “Oncologists need to recognize that the costs of care are […]
Lowering Cancer Care Costs by Limiting Chemotherapy in Patients Who Aren’t Responding
This is the sixth post on Bending the Cost Curve in Cancer Care, based on the 10 suggestions put forth by Drs. Smith and Hillner in the May 26 NEJM. We’re up to number 5 on the list for changing oncologists’ behavior: by limiting further chemotherapy to clinical trial drugs in patients who are not […]
The Big C: Cathy Goes For Treatment
In this week’s episode, Boo!, Cathy wakes up in the morning eager and ready to start treatment on a clinical trial. The day doesn’t go well – the local treatment center doesn’t have needed information about her insurance, which can’t be tracked down on time, her 15 year old son gets in trouble at school, […]