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Virostko J, Sorace AG, Slavkova KP, Kazerouni AS, Jarrett AM, DiCarlo JC, Woodard S, Avery S, Goodgame B, Patt D, Yankeelov TE. Quantitative multiparametric MRI predicts response to neoadjuvant therapy in the community setting. Breast Cancer Res 2021; 23:110. [PMID: 34838096 PMCID: PMC8627106 DOI: 10.1186/s13058-021-01489-6] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2021] [Accepted: 11/17/2021] [Indexed: 11/10/2022] Open
Abstract
BACKGROUND The purpose of this study was to determine whether advanced quantitative magnetic resonance imaging (MRI) can be deployed outside of large, research-oriented academic hospitals and into community care settings to predict eventual pathological complete response (pCR) to neoadjuvant therapy (NAT) in patients with locally advanced breast cancer. METHODS Patients with stage II/III breast cancer (N = 28) were enrolled in a multicenter study performed in community radiology settings. Dynamic contrast-enhanced (DCE) and diffusion-weighted (DW)-MRI data were acquired at four time points during the course of NAT. Estimates of the vascular perfusion and permeability, as assessed by the volume transfer rate (Ktrans) using the Patlak model, were generated from the DCE-MRI data while estimates of cell density, as assessed by the apparent diffusion coefficient (ADC), were calculated from DW-MRI data. Tumor volume was calculated using semi-automatic segmentation and combined with Ktrans and ADC to yield bulk tumor blood flow and cellularity, respectively. The percent change in quantitative parameters at each MRI scan was calculated and compared to pathological response at the time of surgery. The predictive accuracy of each MRI parameter at different time points was quantified using receiver operating characteristic curves. RESULTS Tumor size and quantitative MRI parameters were similar at baseline between groups that achieved pCR (n = 8) and those that did not (n = 20). Patients achieving a pCR had a larger decline in volume and cellularity than those who did not achieve pCR after one cycle of NAT (p < 0.05). At the third and fourth MRI, changes in tumor volume, Ktrans, ADC, cellularity, and bulk tumor flow from baseline (pre-treatment) were all significantly greater (p < 0.05) in the cohort who achieved pCR compared to those patients with non-pCR. CONCLUSIONS Quantitative analysis of DCE-MRI and DW-MRI can be implemented in the community care setting to accurately predict the response of breast cancer to NAT. Dissemination of quantitative MRI into the community setting allows for the incorporation of these parameters into the standard of care and increases the number of clinical community sites able to participate in novel drug trials that require quantitative MRI.
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Affiliation(s)
- John Virostko
- Department of Diagnostic Medicine, University of Texas at Austin, Austin, TX, 78712, USA
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, TX, USA
- Department of Oncology, University of Texas at Austin, Austin, TX, USA
- Oden Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX, USA
| | - Anna G Sorace
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
- Department of Biomedical Engineering, University of Alabama at Birmingham, Birmingham, AL, USA
- O'Neal Comprehensive Cancer Center, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Kalina P Slavkova
- Department of Physics, University of Texas at Austin, Austin, TX, USA
| | - Anum S Kazerouni
- Department of Radiology, University of Washington, Seattle, WA, USA
| | - Angela M Jarrett
- Oden Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX, USA
| | - Julie C DiCarlo
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, TX, USA
- Oden Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX, USA
| | - Stefanie Woodard
- Department of Radiology, University of Alabama at Birmingham, Birmingham, AL, USA
| | - Sarah Avery
- Austin Radiological Association, Austin, TX, USA
| | - Boone Goodgame
- Dell Seton Medical Center at the University of Texas, Austin, USA
| | | | - Thomas E Yankeelov
- Department of Diagnostic Medicine, University of Texas at Austin, Austin, TX, 78712, USA.
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, TX, USA.
- Department of Oncology, University of Texas at Austin, Austin, TX, USA.
- Oden Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, TX, USA.
- Department of Biomedical Engineering, University of Texas at Austin, Austin, TX, USA.
- Department of Imaging Physics, MD Anderson Cancer Center, Houston, TX, USA.
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Gunaratne MDSK, Sahakian AJ, Abeykoon JP, Ansell SM, Gertz MA, Kapoor P, Paulus A, Ailawadhi S, Reeder CB, Witzig TE, Habermann TM, Novak AJ, Lacy MQ, Kyle RA, Go RS, Paludo J. Treatment facility volume and patient outcomes in Waldenstrom macroglobulinemia. Leuk Lymphoma 2020; 62:308-315. [PMID: 33054437 DOI: 10.1080/10428194.2020.1832669] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
Waldenstrom macroglobulinemia (WM) has an annual incidence of 3-3.2 cases per million-person/year. National Cancer Data Base was used to identify newly diagnosed WM cases requiring initiation of therapy and their annual facility volume was used to divide the treatment facilities into four quartiles (Qs). Cox regression was used to analyze the association between facility volume and survival, adjusted by demographics, socioeconomic, geographic, comorbidity factors and year of diagnosis. A total of 3064 patients treated in 795 facilities were included. The unadjusted median overall survival (OS) by facility volume was: Q1:6.5 years (5-year OS 55%), Q2:7 years (5-year OS 60%), Q3:8 years (5-year OS 64%), and Q4: NR (5-year OS 71%), p < 0.0001. Our results demonstrated that a volume-outcome relationship exists in WM and is an independent predictor of overall survival in addition to the established risk factors as age and disease severity.
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Affiliation(s)
| | | | | | | | - Morie A Gertz
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | | | - Aneel Paulus
- Division of Hematology and Oncology, Mayo Clinic, Jacksonville, FL, USA
| | | | - Craig B Reeder
- Division of Hematology and Oncology, Mayo Clinic, Scottsdale, AZ, USA
| | | | | | - Anne J Novak
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Martha Q Lacy
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Robert A Kyle
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Ronald S Go
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
| | - Jonas Paludo
- Division of Hematology, Mayo Clinic, Rochester, MN, USA
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Chen YW, Ornstein MC, Wood LS, Allman KD, Martin A, Beach J, Gilligan T, Garcia JA, Rini BI. The association between facility case volume and overall survival in patients with metastatic renal cell carcinoma in the targeted therapy era. Urol Oncol 2018; 36:470.e19-470.e29. [DOI: 10.1016/j.urolonc.2018.06.013] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/24/2018] [Revised: 05/27/2018] [Accepted: 06/27/2018] [Indexed: 12/25/2022]
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Sorace AG, Wu C, Barnes SL, Jarrett AM, Avery S, Patt D, Goodgame B, Luci JJ, Kang H, Abramson RG, Yankeelov TE, Virostko J. Repeatability, reproducibility, and accuracy of quantitative mri of the breast in the community radiology setting. J Magn Reson Imaging 2018; 48:10.1002/jmri.26011. [PMID: 29570895 PMCID: PMC6151298 DOI: 10.1002/jmri.26011] [Citation(s) in RCA: 36] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2017] [Accepted: 03/02/2018] [Indexed: 02/05/2023] Open
Abstract
BACKGROUND Quantitative diffusion-weighted MRI (DW-MRI) and dynamic contrast-enhanced MRI (DCE-MRI) have the potential to impact patient care by providing noninvasive biological information in breast cancer. PURPOSE/HYPOTHESIS To quantify the repeatability, reproducibility, and accuracy of apparent diffusion coefficient (ADC) and T1 -mapping of the breast in community radiology practices. STUDY TYPE Prospective. SUBJECTS/PHANTOM Ice-water DW-MRI and T1 gel phantoms were used to assess accuracy. Normal subjects (n = 3) and phantoms across three sites (one academic, two community) were used to assess reproducibility. Test-retest analysis at one site in normal subjects (n = 12) was used to assess repeatability. FIELD STRENGTH/SEQUENCE 3T Siemens Skyra MRI quantitative DW-MRI and T1 -mapping. ASSESSMENT Quantitative DW-MRI and T1 -mapping parametric maps of phantoms and fibroglandular and adipose tissue of the breast. STATISTICAL TESTS Average values of breast tissue were quantified and Bland-Altman analysis was performed to assess the repeatability of the MRI techniques, while the Friedman test assessed reproducibility. RESULTS ADC measurements were reproducible across sites, with an average difference of 1.6% in an ice-water phantom and 7.0% in breast fibroglandular tissue. T1 measurements in gel phantoms had an average difference of 2.8% across three sites, whereas breast fibroglandular and adipose tissue had 8.4% and 7.5% average differences, respectively. In the repeatability study, we found no bias between first and second scanning sessions (P = 0.1). The difference between repeated measurements was independent of the mean for each MRI metric (P = 0.156, P = 0.862, P = 0.197 for ADC, T1 of fibroglandular tissue, and T1 of adipose tissue, respectively). DATA CONCLUSION Community radiology practices can perform repeatable, reproducible, and accurate quantitative T1 -mapping and DW-MRI. This has the potential to dramatically expand the number of sites that can participate in multisite clinical trials and increase clinical translation of quantitative MRI techniques for cancer response assessment. LEVEL OF EVIDENCE 1 Technical Efficacy: Stage 2 J. Magn. Reson. Imaging 2018.
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Affiliation(s)
- Anna G. Sorace
- Department of Diagnostic Medicine, University of Texas at Austin, Austin, Texas, USA
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, Texas, USA
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
| | - Chengyue Wu
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
| | - Stephanie L. Barnes
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
- Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Angela M. Jarrett
- Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, Texas, USA
| | - Sarah Avery
- Austin Radiological Association, Austin, Texas, USA
| | | | - Boone Goodgame
- Seton Hospital, Austin, Texas, USA
- Department of Internal Medicine, University of Texas at Austin, Austin, Texas, USA
| | - Jeffery J. Luci
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
- Department of Neuroscience, University of Texas at Austin, Austin, Texas, USA
| | - Hakmook Kang
- Department of Biostatistics, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Richard G. Abramson
- Department of Radiology and Radiological Sciences, Vanderbilt University Medical Center, Nashville, Tennessee, USA
| | - Thomas E. Yankeelov
- Department of Diagnostic Medicine, University of Texas at Austin, Austin, Texas, USA
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, Texas, USA
- Department of Biomedical Engineering, University of Texas at Austin, Austin, Texas, USA
- Institute for Computational Engineering and Sciences, University of Texas at Austin, Austin, Texas, USA
| | - John Virostko
- Department of Diagnostic Medicine, University of Texas at Austin, Austin, Texas, USA
- Livestrong Cancer Institutes, University of Texas at Austin, Austin, Texas, USA
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Abrams TA, Meyer G, Meyerhardt JA, Wolpin BM, Schrag D, Fuchs CS. Patterns of Chemotherapy Use in a U.S.-Based Cohort of Patients with Metastatic Pancreatic Cancer. Oncologist 2017; 22:925-933. [PMID: 28476943 DOI: 10.1634/theoncologist.2016-0447] [Citation(s) in RCA: 37] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2016] [Accepted: 02/09/2017] [Indexed: 02/06/2023] Open
Abstract
PURPOSE Few population studies have examined patterns of systemic therapy administration in metastatic pancreatic cancer (MPC) or the predictors associated with specific treatment choices. PATIENTS AND METHODS We assessed 4,011 consecutive MPC patients who received chemotherapy between January 2005 and December 2015 at academic, private, and community-based oncology practices subscribing to a U.S.-wide chemotherapy order entry system capturing disease, patient, provider, and treatment data. Multivariate analyses of these prospectively recorded characteristics identified significant predictors of specific therapeutic choices. RESULTS Overall, 100 different regimens were used in first-line treatment of MPC. First-line gemcitabine monotherapy usage fell steadily from 72% in 2006 to 16% in 2015. This steep decline mirrored increases in first-line usage of both 5 fluorouracil, leucovorin, irinotecan and oxaliplatin (FOLFIRINOX) and gemcitabine + nab-paclitaxel. Younger male patients were more likely to receive FOLFIRINOX as first-line treatment, whereas patients treated at community practices and by oncologists with lower MPC patient volume were more likely to receive gemcitabine plus nab-paclitaxel (all p ≤ .05). Among all patients receiving first-line chemotherapy for MPC, 49% went on to receive second-line therapy and 19% received third-line therapy; administration of second- and third-line therapies increased steadily over the time course of follow-up. Younger patients and those treated by oncologists with higher MPC patient volume were more likely to receive second- and third-line therapies. CONCLUSION This population-based study provides insight into treatment patterns of MPC in the U.S. Usage patterns varied greatly according to patient and provider characteristics. IMPLICATIONS FOR PRACTICE This study examined real world metastatic pancreatic cancer treatment patterns in the United States with the goals of understanding changes in chemotherapy treatment frequencies over time and determining the individual predictors that underlie the chemotherapy choices oncologists make for their patients. Our data set is unique in that it captured not only patient-level data, but also oncologist-level data. It also captured data from private and community practices as well as academic centers. To our knowledge, this is the only data set that can give this degree of insight into oncologist decision making practices.
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Affiliation(s)
| | - Gary Meyer
- IntrinsiQ Specialty Solutions, a part of AmerisouceBergen, Frisco, Texas, USA
| | | | - Brian M Wolpin
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
| | - Deborah Schrag
- Dana-Farber Cancer Institute, Boston, Massachusetts, USA
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Bach PB. Should the American Society of Clinical Oncology Ask for Peer Review Before Publishing Its Advocacy Research? J Clin Oncol 2016; 34:4447-4448. [PMID: 27998217 DOI: 10.1200/jco.2016.69.6369] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Peter B Bach
- Peter B. Bach, Memorial Sloan Kettering Cancer Center, New York, NY
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7
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Go RS, Bartley AC, Crowson CS, Shah ND, Habermann EB, Holton SJ, Holmes DR. Association Between Treatment Facility Volume and Mortality of Patients With Multiple Myeloma. J Clin Oncol 2016; 35:598-604. [PMID: 28199819 DOI: 10.1200/jco.2016.68.3805] [Citation(s) in RCA: 54] [Impact Index Per Article: 6.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Purpose To determine the association between the number of patients with multiple myeloma (MM) treated annually at a treatment facility (volume) and all-cause mortality (outcome). Methods Using the National Cancer Database, we identified patients diagnosed with MM between 2003 and 2011. We classified the facilities by quartiles (Q; mean patients with MM treated per year): Q1: < 3.6; Q2: 3.6 to 6.1, Q3: 6.1 to 10.3, and Q4: > 10.3. We used random intercepts to account for clustering of patients within facilities and Cox regression to determine the volume-outcome relationship, adjusting for demographic (sex, age, race, ethnicity), socioeconomic (income, education, insurance type), geographic (area of residence, treatment facility location, travel distance), and comorbid (Charlson-Deyo score) factors and year of diagnosis. Results There were 94,722 patients with MM treated at 1,333 facilities. The median age at diagnosis was 67 years, and 54.7% were men. The median annual facility volume was 6.1 patients per year (range, 0.2 to 109.9). The distribution of patients according to facility volume was: Q1: 5.2%, Q2: 12.6%, Q3: 21.9%, and Q4: 60.3%. The unadjusted median overall survival by facility volume was: Q1: 26.9 months, Q2: 29.1 months, Q3: 31.9 months, and Q4: 49.1 months ( P < .001). Multivariable analysis showed that facility volume was independently associated with all-cause mortality. Compared with patients treated at Q4 facilities, patients treated at lower-quartile facilities had a higher risk of death (Q3 hazard ratio [HR], 1.12 [95% CI, 1.08 to 1.16]; Q2 HR, 1.17 [95% CI, 1.12 to 1.21]; Q1 HR, 1.22 [95% CI, 1.17 to 1.28]). Conclusion Patients who were treated for MM at higher-volume facilities had a lower risk of mortality compared with those who were treated at lower-volume facilities.
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Abstract
Big data represents a new opportunity to increase our understanding of cancer care as it is practiced globally and to improve it through the refinement of clinic guidelines and the identification of knowledge gaps. Here we review the historical approach to evidence development (randomized clinical trials), some of their limitations, and the complementary role that big data analytics may play.
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Affiliation(s)
- Clifford A Hudis
- Memorial Sloan Kettering Cancer Center, United States; Weill Cornell Medical College, United States.
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9
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Ravindran A, Gonsalves WI, Hashmi SK, Kapoor P, Marshall AL, Siddiqui MA, Go RS. Estimating the annual volume of hematologic cancer cases per hematologist-oncologist in the United States: are we treating rare cancers too rarely? Leuk Lymphoma 2016; 58:251-252. [PMID: 27282880 DOI: 10.1080/10428194.2016.1193854] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/21/2022]
Affiliation(s)
| | | | | | - Prashant Kapoor
- a Division of Hematology , Mayo Clinic , Rochester , MN , USA
| | | | | | - Ronald S Go
- a Division of Hematology , Mayo Clinic , Rochester , MN , USA.,b Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery , Rochester , MN , USA
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Kosty MP, Pickard T, Viale P. Collaborative Practice in an Era of Multidisciplinary Care. Am Soc Clin Oncol Educ Book 2016; 35:3-8. [PMID: 27249679 DOI: 10.1200/edbk_100004] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022]
Affiliation(s)
- Michael P Kosty
- From the Scripps Green Cancer Center, Scripps Clinic, La Jolla, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA
| | - Todd Pickard
- From the Scripps Green Cancer Center, Scripps Clinic, La Jolla, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA
| | - Pamela Viale
- From the Scripps Green Cancer Center, Scripps Clinic, La Jolla, CA; The University of Texas MD Anderson Cancer Center, Houston, TX; Department of Physiological Nursing, University of California, San Francisco, San Francisco, CA
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Kosty MP, Acheson AK, Tetzlaff ED. Clinical oncology practice 2015: preparing for the future. Am Soc Clin Oncol Educ Book 2016:e622-7. [PMID: 25993232 DOI: 10.14694/edbook_am.2015.35.e622] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
The clinical practice of oncology has become increasingly complex. An explosion of medical knowledge, increased demands on provider time, and involved patients have changed the way many oncologists practice. What was an acceptable practice model in the past may now be relatively inefficient. This review covers three areas that address these changes. The American Society of Clinical Oncology (ASCO) National Oncology Census defines who the U.S. oncology community is, and their perceptions of how practice patterns may be changing. The National Cancer Institute (NCI)-ASCO Teams in Cancer Care Project explores how best to employ team science to improve the efficiency and quality of cancer care in the United States. Finally, how physician assistants (PAs) and nurse practitioners (NPs) might be best integrated into team-based care in oncology and the barriers to integration are reviewed.
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Affiliation(s)
- Michael P Kosty
- From the Division of Hematology/Oncology, Scripps Clinic, La Jolla, CA; Providence Oncology and Hematology Care, Providence Cancer Center, Portland, OR; Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | - Anupama Kurup Acheson
- From the Division of Hematology/Oncology, Scripps Clinic, La Jolla, CA; Providence Oncology and Hematology Care, Providence Cancer Center, Portland, OR; Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA
| | - Eric D Tetzlaff
- From the Division of Hematology/Oncology, Scripps Clinic, La Jolla, CA; Providence Oncology and Hematology Care, Providence Cancer Center, Portland, OR; Department of Hematology/Oncology, Fox Chase Cancer Center, Philadelphia, PA
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Go RS, Bottner WA, Gertz MA. Making the Case to Study the Volume-Outcome Relationship in Hematologic Cancers. Mayo Clin Proc 2015; 90:1393-9. [PMID: 26298310 DOI: 10.1016/j.mayocp.2015.07.003] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/04/2015] [Revised: 06/25/2015] [Accepted: 07/02/2015] [Indexed: 11/17/2022]
Abstract
The positive relationship between the volume of health services (hospital and physician) and health-related outcomes is established in the complex surgical treatment of cancers and certain nononcologic medical conditions. However, this topic has not been systematically explored in the medical management of cancers. We summarize the limited current state of knowledge about the volume-outcome relationship in the management of hematologic cancers and provide reasons why further research on this subject is necessary. We highlight the relatively low annual volume of hematologic cancers in the United States, the increasing complexity of making a diagnosis due to constant change in classification and prognostication, the rapid availability of novel agents with unique mechanisms of action and toxicities, and the proliferation of treatment guidelines distinct to each disease subtype. We also discuss the potential implications pertaining to medical practice and trainee education, including effects on quality of care, access and referral patterns, and subspecialty training.
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Affiliation(s)
- Ronald S Go
- Division of Hematology, Mayo Clinic, Rochester, MN; Mayo Clinic Robert D. and Patricia E. Kern Center for the Science of Health Care Delivery, Rochester, MN.
| | - Wayne A Bottner
- Section of Hematology, Gundersen Health System, La Crosse, WI
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Chung AE, Basch EM. Potential and challenges of patient-generated health data for high-quality cancer care. J Oncol Pract 2015; 11:195-7. [PMID: 25852139 DOI: 10.1200/jop.2015.003715] [Citation(s) in RCA: 30] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Electronic health records and information technology that allow for customizable alerts, intelligent filtering of data, and meaningful aggregation of multiple streams of patient-generated health data with clinical data will be integral to the successful integration of patient-generated health data into routine cancer care.
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Affiliation(s)
- Arlene E Chung
- Program for Clinical and Health Informatics, University of North Carolina School of Medicine; and Lineberger Comprehensive Cancer Center Cancer Outcomes Research Program, University of North Carolina, Chapel Hill, NC
| | - Ethan M Basch
- Program for Clinical and Health Informatics, University of North Carolina School of Medicine; and Lineberger Comprehensive Cancer Center Cancer Outcomes Research Program, University of North Carolina, Chapel Hill, NC
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Hiatt RA, Tai CG, Blayney DW, Deapen D, Hogarth M, Kizer KW, Lipscomb J, Malin J, Phillips SK, Santa J, Schrag D. Leveraging State Cancer Registries to Measure and Improve the Quality of Cancer Care: A Potential Strategy for California and Beyond. J Natl Cancer Inst 2015; 107:djv047. [DOI: 10.1093/jnci/djv047] [Citation(s) in RCA: 24] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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16
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Blayney DW, McNiff K, Eisenberg PD, Gilmore T, Jacobsen PB, Jacobson JO, Kadlubek PJ, Neuss MN, Simone J. Development and Future of the American Society of Clinical Oncology's Quality Oncology Practice Initiative. J Clin Oncol 2014; 32:3907-13. [DOI: 10.1200/jco.2014.56.8899] [Citation(s) in RCA: 22] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Affiliation(s)
- Douglas W. Blayney
- Stanford Cancer Institute, Stanford University School of Medicine, Stanford, CA
| | | | | | - Terry Gilmore
- American Society of Clinical Oncology, Alexandria, VA
| | | | | | | | - Michael N. Neuss
- Vanderbilt-Ingram Cancer Center, Vanderbilt University Medical Center, Nashville, TN
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17
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Goldberg P, Conti RM. Problems with public reporting of cancer quality outcomes data. J Oncol Pract 2014; 10:215-8. [PMID: 24839285 DOI: 10.1200/jop.2014.001405] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The authors say public reporting of even the most well-defined end points—survival after treatment—can be misleading when used to compare outcomes across providers, and these data can suffer from patient-selection and treatment-intensity biases.
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Affiliation(s)
- Paul Goldberg
- The Cancer Letter, Washington, DC; and University of Chicago, Chicago, IL
| | - Rena M Conti
- The Cancer Letter, Washington, DC; and University of Chicago, Chicago, IL
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Abrams TA, Meyer G, Schrag D, Meyerhardt JA, Moloney J, Fuchs CS. Chemotherapy usage patterns in a US-wide cohort of patients with metastatic colorectal cancer. J Natl Cancer Inst 2014; 106:djt371. [PMID: 24511107 DOI: 10.1093/jnci/djt371] [Citation(s) in RCA: 76] [Impact Index Per Article: 7.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Abstract
BACKGROUND Since the introduction of biologic therapies for the treatment of metastatic colorectal cancer (mCRC), few studies have examined patterns of care or predictors of specific treatment approaches. METHODS We assessed 4877 mCRC patients who received chemotherapy between January 2004 and March 2011 at academic, private, and community-based oncology practices subscribing to a US-wide chemotherapy order entry (system capturing disease, patient, provider, and treatment data. Multivariable analyses of these prospectively recorded characteristics were used to identify independent predictors of specific therapeutic choices. All statistical tests were two-sided. RESULTS Throughout the study period, fluoropyrimidine/oxaliplatin combination was the most commonly used first-line chemotherapy regimen, representing 71% of first-line therapy by 2007. First-line bevacizumab use averaged 51%, peaking at 55% in 2006. Of those who received first-line bevacizumab, 34% continued to receive bevacizumab in the second-line. Only 26% of patients in our cohort ever received an anti-EGFR monoclonal antibody (cetuximab = 22%; panitumumab = 6%) at some point in their treatment course. Patients treated at academic centers, with longer duration of first-line therapy, and at sites in the western United States were statistically more likely to receive an anti-EGFR antibody. Anti-EGFR antibody use fell by 18% after the US Food and Drug Administration limited its use to patients with KRAS wild-type tumors in June 2009. CONCLUSIONS Analysis of this US-wide mCRC cohort demonstrates that bevacizumab has been more consistently integrated into treatment regimens than anti-EGFR antibody therapies, particularly in first-line therapy. However, treatment choices vary substantially according to specific patient, practice, and provider characteristics.
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Affiliation(s)
- Thomas A Abrams
- Affiliations of authors: Department of Medical Oncology, Dana-Farber Cancer Institute, Boston, MA (TAA, DS, JAM, CSF); IntrinsiQ, LLC, an AmerisourceBergen Specialty Group Company, Burlington, MA (GM, JM)
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The State of Cancer Care in America, 2014: A Report by the American Society of Clinical Oncology. J Oncol Pract 2014; 10:119-42. [DOI: 10.1200/jop.2014.001386] [Citation(s) in RCA: 131] [Impact Index Per Article: 13.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This publication is ASCO's inaugural report on the state of cancer care in America. Going forward, these annual reports will track progress against cancer and examine the most important trends that affect the oncology community's ability to provide high-quality, high-value cancer care.
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Sledge GW, Hudis CA, Swain SM, Yu PM, Mann JT, Hauser RS, Lichter AS. ASCO's approach to a learning health care system in oncology. J Oncol Pract 2014; 9:145-8. [PMID: 23942494 DOI: 10.1200/jop.2013.000957] [Citation(s) in RCA: 43] [Impact Index Per Article: 4.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The promise of emerging science and the challenges confronting today's health care system can both be addressed by fully embracing the IoM's vision of a learning health care system. ASCO's initial foray into realizing this vision for oncology shows great promise.
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Barr TR, Towle EL. The Oncology Ecosystem: Oncology Practice Trends From the National Practice Benchmark. J Oncol Pract 2013; 9:39s-44s. [PMID: 29431043 DOI: 10.1200/jop.2013.001225] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Practices that participate in the National Practice Benchmark and are engaged in the management of their business in their local market will exhibit greater resilience, adaptability, and transformability than those who do not actively measure and manage.
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Affiliation(s)
- Thomas R Barr
- Oncology Metrics, a division of Altos Solutions, Los Altos, CA
| | - Elaine L Towle
- Oncology Metrics, a division of Altos Solutions, Los Altos, CA
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