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Research and Reviews for the Practicing Oncologist
Encouraging data at ASCO 2014 for survival and fertility in some cancers
The American Society of Clinical Oncology marked its 50th anniversary at this year’s annual conference in Chicago, where it showcased the latest scientific advances in oncology and explored the translation of research findings into practice under its umbrella theme, Science and Society.
Drug combo extends survival by more than 1 year in metastatic prostate cancer patients
Key clinical finding Adding docetaxel to hormonal therapy at the time of diagnosis of metastatic prostate cancer extends survival. Major finding Patients receiving docetaxel and androgen deprivation therapy at the time of diagnoses had median overall survival that was 13.6 months longer than men who received androgen deprivation therapy alone. Data source Randomized trial in 790 men with newly diagnosed metastatic hormone-sensitive prostate cancer...
Click on the PDF icon at the top of this introduction to read the full article.
The American Society of Clinical Oncology marked its 50th anniversary at this year’s annual conference in Chicago, where it showcased the latest scientific advances in oncology and explored the translation of research findings into practice under its umbrella theme, Science and Society.
Drug combo extends survival by more than 1 year in metastatic prostate cancer patients
Key clinical finding Adding docetaxel to hormonal therapy at the time of diagnosis of metastatic prostate cancer extends survival. Major finding Patients receiving docetaxel and androgen deprivation therapy at the time of diagnoses had median overall survival that was 13.6 months longer than men who received androgen deprivation therapy alone. Data source Randomized trial in 790 men with newly diagnosed metastatic hormone-sensitive prostate cancer...
Click on the PDF icon at the top of this introduction to read the full article.
The American Society of Clinical Oncology marked its 50th anniversary at this year’s annual conference in Chicago, where it showcased the latest scientific advances in oncology and explored the translation of research findings into practice under its umbrella theme, Science and Society.
Drug combo extends survival by more than 1 year in metastatic prostate cancer patients
Key clinical finding Adding docetaxel to hormonal therapy at the time of diagnosis of metastatic prostate cancer extends survival. Major finding Patients receiving docetaxel and androgen deprivation therapy at the time of diagnoses had median overall survival that was 13.6 months longer than men who received androgen deprivation therapy alone. Data source Randomized trial in 790 men with newly diagnosed metastatic hormone-sensitive prostate cancer...
Click on the PDF icon at the top of this introduction to read the full article.
Palonosetron versus older 5-HT3 receptor antagonists for nausea prevention in patients receiving chemotherapy: a multistudy analysis
Background No clinical standard currently exists for the optimal management of nausea induced by emetogenic chemotherapy, particularly delayed nausea.
Objective To compare the efficacy and safety of palonosetron with older 5-HT3 receptor antagonists (RAs) in preventing chemotherapy-induced nausea.
Methods Data were pooled from 4 similarly designed multicenter, randomized, double-blind, clinical trials that compared single intravenous doses of palonosetron 0.25 mg or 0.75 mg with ondansetron 32 mg, dolasetron 100 mg, or granisetron 40 μg/kg, administered 30 minutes before moderately emetogenic chemotherapy (MEC ) or highly emetogenic chemotherapy (HEC). Pooled data within each chemotherapy category (MEC: n = 1,132; HEC: n = 1,781) were analyzed by a logistic regression model. Nausea endpoints were complete control rates (ie, no more than mild nausea, no vomiting, and no rescue medication), nausea-free rates, nausea severity, and requirement for rescue antiemetic/antinausea medication over 5 days following chemotherapy. Pooled safety data were summarized descriptively.
Results Numerically more palonosetron-treated patients were nausea-free on each day, and fewer had moderate-severe nausea. Similarly, usage of rescue medication was less frequent among palonosetron-treated patients. Complete control rates for palonosetron and older 5-HT3 RAs in the acute phase were 66% vs 63%, 52% vs 42% in the delayed phase (24-120 hours), and 46% vs 37% in the overall phase. The incidence of adverse events was similar for palonosetron and older 5-HT3 RAs.
Limitations This post hoc analysis summarized data for palonosetron and several other 5-HT3 RAs but was not powered for statistical comparisons between individual agents. Because nausea is inherently subjective, the reliability of assessments of some aspects (eg, severity) may be influenced by interindividual variability.
Conclusion Palonosetron may be more effective than older 5-HT3 RAs in preventing nausea, with comparable tolerability.
Disclosures and funding Dr Schwartzberg is a consultant to and Dr Cox an employee at Esai. Mr Ballinari is a member of staff at and Dr Thorn consults for Helsinn Healthcare SA. Funding to support this study and the preparation of this manuscript was provided by Eisai Inc.
Click on the PDF icon at the top of this introduction to read the full article.
Background No clinical standard currently exists for the optimal management of nausea induced by emetogenic chemotherapy, particularly delayed nausea.
Objective To compare the efficacy and safety of palonosetron with older 5-HT3 receptor antagonists (RAs) in preventing chemotherapy-induced nausea.
Methods Data were pooled from 4 similarly designed multicenter, randomized, double-blind, clinical trials that compared single intravenous doses of palonosetron 0.25 mg or 0.75 mg with ondansetron 32 mg, dolasetron 100 mg, or granisetron 40 μg/kg, administered 30 minutes before moderately emetogenic chemotherapy (MEC ) or highly emetogenic chemotherapy (HEC). Pooled data within each chemotherapy category (MEC: n = 1,132; HEC: n = 1,781) were analyzed by a logistic regression model. Nausea endpoints were complete control rates (ie, no more than mild nausea, no vomiting, and no rescue medication), nausea-free rates, nausea severity, and requirement for rescue antiemetic/antinausea medication over 5 days following chemotherapy. Pooled safety data were summarized descriptively.
Results Numerically more palonosetron-treated patients were nausea-free on each day, and fewer had moderate-severe nausea. Similarly, usage of rescue medication was less frequent among palonosetron-treated patients. Complete control rates for palonosetron and older 5-HT3 RAs in the acute phase were 66% vs 63%, 52% vs 42% in the delayed phase (24-120 hours), and 46% vs 37% in the overall phase. The incidence of adverse events was similar for palonosetron and older 5-HT3 RAs.
Limitations This post hoc analysis summarized data for palonosetron and several other 5-HT3 RAs but was not powered for statistical comparisons between individual agents. Because nausea is inherently subjective, the reliability of assessments of some aspects (eg, severity) may be influenced by interindividual variability.
Conclusion Palonosetron may be more effective than older 5-HT3 RAs in preventing nausea, with comparable tolerability.
Disclosures and funding Dr Schwartzberg is a consultant to and Dr Cox an employee at Esai. Mr Ballinari is a member of staff at and Dr Thorn consults for Helsinn Healthcare SA. Funding to support this study and the preparation of this manuscript was provided by Eisai Inc.
Click on the PDF icon at the top of this introduction to read the full article.
Background No clinical standard currently exists for the optimal management of nausea induced by emetogenic chemotherapy, particularly delayed nausea.
Objective To compare the efficacy and safety of palonosetron with older 5-HT3 receptor antagonists (RAs) in preventing chemotherapy-induced nausea.
Methods Data were pooled from 4 similarly designed multicenter, randomized, double-blind, clinical trials that compared single intravenous doses of palonosetron 0.25 mg or 0.75 mg with ondansetron 32 mg, dolasetron 100 mg, or granisetron 40 μg/kg, administered 30 minutes before moderately emetogenic chemotherapy (MEC ) or highly emetogenic chemotherapy (HEC). Pooled data within each chemotherapy category (MEC: n = 1,132; HEC: n = 1,781) were analyzed by a logistic regression model. Nausea endpoints were complete control rates (ie, no more than mild nausea, no vomiting, and no rescue medication), nausea-free rates, nausea severity, and requirement for rescue antiemetic/antinausea medication over 5 days following chemotherapy. Pooled safety data were summarized descriptively.
Results Numerically more palonosetron-treated patients were nausea-free on each day, and fewer had moderate-severe nausea. Similarly, usage of rescue medication was less frequent among palonosetron-treated patients. Complete control rates for palonosetron and older 5-HT3 RAs in the acute phase were 66% vs 63%, 52% vs 42% in the delayed phase (24-120 hours), and 46% vs 37% in the overall phase. The incidence of adverse events was similar for palonosetron and older 5-HT3 RAs.
Limitations This post hoc analysis summarized data for palonosetron and several other 5-HT3 RAs but was not powered for statistical comparisons between individual agents. Because nausea is inherently subjective, the reliability of assessments of some aspects (eg, severity) may be influenced by interindividual variability.
Conclusion Palonosetron may be more effective than older 5-HT3 RAs in preventing nausea, with comparable tolerability.
Disclosures and funding Dr Schwartzberg is a consultant to and Dr Cox an employee at Esai. Mr Ballinari is a member of staff at and Dr Thorn consults for Helsinn Healthcare SA. Funding to support this study and the preparation of this manuscript was provided by Eisai Inc.
Click on the PDF icon at the top of this introduction to read the full article.
Current and novel therapeutic approaches in myelodysplastic syndromes
Myelodysplastic syndromes (MDS) are a heterogeneous group of hematologic neoplasms with an annual incidence of 4.1 cases per 100,000 Americans. Patients with MDS suffer from chronic cytopenias that may lead to recurrent transfusions, infections, and increased risk for bleeding. They are also at risk for progression to acute myeloid leukemia. Allogeneic hematopoietic cell transplantation is the only potentially curative treatment for MDS, although 3 drugs have been approved by the US Food and Drug Administration for its treatment: lenalidomide, 5-azacitidine, and decitabine.
Click on the PDF icon at the top of this introduction to read the full article.
Myelodysplastic syndromes (MDS) are a heterogeneous group of hematologic neoplasms with an annual incidence of 4.1 cases per 100,000 Americans. Patients with MDS suffer from chronic cytopenias that may lead to recurrent transfusions, infections, and increased risk for bleeding. They are also at risk for progression to acute myeloid leukemia. Allogeneic hematopoietic cell transplantation is the only potentially curative treatment for MDS, although 3 drugs have been approved by the US Food and Drug Administration for its treatment: lenalidomide, 5-azacitidine, and decitabine.
Click on the PDF icon at the top of this introduction to read the full article.
Myelodysplastic syndromes (MDS) are a heterogeneous group of hematologic neoplasms with an annual incidence of 4.1 cases per 100,000 Americans. Patients with MDS suffer from chronic cytopenias that may lead to recurrent transfusions, infections, and increased risk for bleeding. They are also at risk for progression to acute myeloid leukemia. Allogeneic hematopoietic cell transplantation is the only potentially curative treatment for MDS, although 3 drugs have been approved by the US Food and Drug Administration for its treatment: lenalidomide, 5-azacitidine, and decitabine.
Click on the PDF icon at the top of this introduction to read the full article.
Trametinib plus dabrafenib for unresectable or metastatic melanoma with BRAF V600E or V600K mutations
On January 9, 2014, the combination of trametinib and dabrafenib was granted accelerated approval by the US Food and Drug Administration for the treatment of patients with unresectable or metastatic melanoma with BRAF V600E or V600K mutations as detected by an FDA-approved test.1,2 Approval of the combination is based on durable response rate observed in an open-label study.2,3 Improvements in disease-related symptoms and overall survival have not yet been demonstrated for the combination. Both drugs were approved for use as single agents in this setting in May 2013.
Click on the PDF icon at the top of this introduction to read the full article.
On January 9, 2014, the combination of trametinib and dabrafenib was granted accelerated approval by the US Food and Drug Administration for the treatment of patients with unresectable or metastatic melanoma with BRAF V600E or V600K mutations as detected by an FDA-approved test.1,2 Approval of the combination is based on durable response rate observed in an open-label study.2,3 Improvements in disease-related symptoms and overall survival have not yet been demonstrated for the combination. Both drugs were approved for use as single agents in this setting in May 2013.
Click on the PDF icon at the top of this introduction to read the full article.
On January 9, 2014, the combination of trametinib and dabrafenib was granted accelerated approval by the US Food and Drug Administration for the treatment of patients with unresectable or metastatic melanoma with BRAF V600E or V600K mutations as detected by an FDA-approved test.1,2 Approval of the combination is based on durable response rate observed in an open-label study.2,3 Improvements in disease-related symptoms and overall survival have not yet been demonstrated for the combination. Both drugs were approved for use as single agents in this setting in May 2013.
Click on the PDF icon at the top of this introduction to read the full article.
On being up to date and linked in
We are mindful of our role in providing our readers with quality research- and literature-based articles about emerging therapies and diagnostic and palliative approaches that will have a positive impact on how they practice. So far this year, we have brought you articles on current therapies for metastatic melanoma and hairy cell leukemia as well as updates on managing chronic myelogenous leukemia, the late effects of cancer therapies, and most recently, small renal tumors...
We are mindful of our role in providing our readers with quality research- and literature-based articles about emerging therapies and diagnostic and palliative approaches that will have a positive impact on how they practice. So far this year, we have brought you articles on current therapies for metastatic melanoma and hairy cell leukemia as well as updates on managing chronic myelogenous leukemia, the late effects of cancer therapies, and most recently, small renal tumors...
We are mindful of our role in providing our readers with quality research- and literature-based articles about emerging therapies and diagnostic and palliative approaches that will have a positive impact on how they practice. So far this year, we have brought you articles on current therapies for metastatic melanoma and hairy cell leukemia as well as updates on managing chronic myelogenous leukemia, the late effects of cancer therapies, and most recently, small renal tumors...
On being up to date and linked in
We are mindful of our role in providing our readers with quality research- and literature-based articles about emerging therapies and diagnostic and palliative approaches that will have a positive impact on how they practice. So far this year, we have brought you articles on current therapies for metastatic melanoma and hairy cell leukemia as well as updates on managing chronic myelogenous leukemia, the late effects of cancer therapies, and most recently, small renal tumors...
Click on the PDF icon at the top of this introduction to read the full article.
We are mindful of our role in providing our readers with quality research- and literature-based articles about emerging therapies and diagnostic and palliative approaches that will have a positive impact on how they practice. So far this year, we have brought you articles on current therapies for metastatic melanoma and hairy cell leukemia as well as updates on managing chronic myelogenous leukemia, the late effects of cancer therapies, and most recently, small renal tumors...
Click on the PDF icon at the top of this introduction to read the full article.
We are mindful of our role in providing our readers with quality research- and literature-based articles about emerging therapies and diagnostic and palliative approaches that will have a positive impact on how they practice. So far this year, we have brought you articles on current therapies for metastatic melanoma and hairy cell leukemia as well as updates on managing chronic myelogenous leukemia, the late effects of cancer therapies, and most recently, small renal tumors...
Click on the PDF icon at the top of this introduction to read the full article.
To screen or not to screen: lung and breast cancer
Although the incidence of lung cancer in the United States has been falling in recent years because of a decrease in cigarette smoking, the disease is still the third most common cancer, and the leading cause of cancer death. In March 2014, the US Preventive Services Task Force (USPSTF) updated its 2004 recommendations for lung cancer screening by commissioning a systematic evidence review of low-dose computed tomography (CT) by focusing on new evidence from randomized clinical trials published since 2004. In addition, a modeling study provided information about the optimum screening age, screening interval, and the risk-benefit ratio for screening.
Click on the PDF icon at the top of this introduction to read the full article.
Although the incidence of lung cancer in the United States has been falling in recent years because of a decrease in cigarette smoking, the disease is still the third most common cancer, and the leading cause of cancer death. In March 2014, the US Preventive Services Task Force (USPSTF) updated its 2004 recommendations for lung cancer screening by commissioning a systematic evidence review of low-dose computed tomography (CT) by focusing on new evidence from randomized clinical trials published since 2004. In addition, a modeling study provided information about the optimum screening age, screening interval, and the risk-benefit ratio for screening.
Click on the PDF icon at the top of this introduction to read the full article.
Although the incidence of lung cancer in the United States has been falling in recent years because of a decrease in cigarette smoking, the disease is still the third most common cancer, and the leading cause of cancer death. In March 2014, the US Preventive Services Task Force (USPSTF) updated its 2004 recommendations for lung cancer screening by commissioning a systematic evidence review of low-dose computed tomography (CT) by focusing on new evidence from randomized clinical trials published since 2004. In addition, a modeling study provided information about the optimum screening age, screening interval, and the risk-benefit ratio for screening.
Click on the PDF icon at the top of this introduction to read the full article.
Targeting B-cell signaling pathways: a central role for Bruton’s tyrosine kinase
B-cell cancers constitute a large group of diseases with diverse clinical and pathological characteristics that arise from the B (bursal- or bone marrow-derived) lymphocytes of the immune system. B cells are involved in humoral immunity as part of the adaptive immune response. They display a unique B-cell receptor (BCR) on their surface which binds to a specific antigen. Antigen- binding activates the process of clonal expansion, during which the B cell reproduces to form an army of clones that secrete the same antibody. These antibodies then bind to the target antigen on foreign cells and initiate a range of immune responses that ultimately lead to the destruction of that cell.
Click on the PDF icon at the top of this introduction to read the full article.
B-cell cancers constitute a large group of diseases with diverse clinical and pathological characteristics that arise from the B (bursal- or bone marrow-derived) lymphocytes of the immune system. B cells are involved in humoral immunity as part of the adaptive immune response. They display a unique B-cell receptor (BCR) on their surface which binds to a specific antigen. Antigen- binding activates the process of clonal expansion, during which the B cell reproduces to form an army of clones that secrete the same antibody. These antibodies then bind to the target antigen on foreign cells and initiate a range of immune responses that ultimately lead to the destruction of that cell.
Click on the PDF icon at the top of this introduction to read the full article.
B-cell cancers constitute a large group of diseases with diverse clinical and pathological characteristics that arise from the B (bursal- or bone marrow-derived) lymphocytes of the immune system. B cells are involved in humoral immunity as part of the adaptive immune response. They display a unique B-cell receptor (BCR) on their surface which binds to a specific antigen. Antigen- binding activates the process of clonal expansion, during which the B cell reproduces to form an army of clones that secrete the same antibody. These antibodies then bind to the target antigen on foreign cells and initiate a range of immune responses that ultimately lead to the destruction of that cell.
Click on the PDF icon at the top of this introduction to read the full article.
Short-term outcomes of the implementation of a computer-based breast cancer risk assessment program during screening mammography
Background Barriers to assessing a patient’s risk for breast cancer include the inadequate documentation of family history, the complexity of risk calculation and model selection, and a lack of awareness of risk on the part of the patient and/or provider. We have established computer-based, real-time assessment of a patient’s risk for breast cancer at the time of having a mammogram.
Objective To facilitate identification of high-risk patients who need genetic counseling and testing and magnetic resonance imaging screening based on the results of the risk assessment.
Methods Since November 23, 2010, all mammogram patients have completed questionnaires using a wireless tablet. On the basis of a real-time calculation for a patient’s risk of BRCA1/BRCA2 mutation (Myriad, Tyrer-Cuzick, BRCAPRO) and lifetime risk of breast cancer (Gail, Claus, Tyrer-Cuzick, BRCAPRO) using Hughes riskApps, patients were categorized as high risk (≥ 10% BRCA mutation or ≥ 20% lifetime breast cancer risk) or average risk and received a risk assessment letter. The risk data was integrated into our mammography information system (PenRad) at the same time. High-risk patients were contacted to facilitate evaluation.
Results As of June 30, 2012, a total of 24,213 unaffected patients completed the risk assessment. There were 2,196 patients (9.1%) identified as high risk: 1,051 (4.3%) had a BRCA mutation risk, 1,570 (6.5%) had lifetime breast cancer risk, and 425 (1.8%) had risk for both. Of the high-risk patients, 416 (18.7%) were evaluated by our APN and/or genetic counselor. Of the 231 who were evaluated by a genetic counselor, 97 had genetic testing and 9 (8.3%) were BRCA positive. Annual MRI screening was recommended to 254 patients.
Conclusions We have successfully implemented breast cancer risk assessment through our screening mammography service. Results suggest that 9.1% of our patients can benefit from risk assessment, 4.3% should consider genetic testing, and 6.5% may benefit from screening MRI. We strive to improve compliance through patient education.
Click on the PDF icon at the top of this introduction to read the full article.
Background Barriers to assessing a patient’s risk for breast cancer include the inadequate documentation of family history, the complexity of risk calculation and model selection, and a lack of awareness of risk on the part of the patient and/or provider. We have established computer-based, real-time assessment of a patient’s risk for breast cancer at the time of having a mammogram.
Objective To facilitate identification of high-risk patients who need genetic counseling and testing and magnetic resonance imaging screening based on the results of the risk assessment.
Methods Since November 23, 2010, all mammogram patients have completed questionnaires using a wireless tablet. On the basis of a real-time calculation for a patient’s risk of BRCA1/BRCA2 mutation (Myriad, Tyrer-Cuzick, BRCAPRO) and lifetime risk of breast cancer (Gail, Claus, Tyrer-Cuzick, BRCAPRO) using Hughes riskApps, patients were categorized as high risk (≥ 10% BRCA mutation or ≥ 20% lifetime breast cancer risk) or average risk and received a risk assessment letter. The risk data was integrated into our mammography information system (PenRad) at the same time. High-risk patients were contacted to facilitate evaluation.
Results As of June 30, 2012, a total of 24,213 unaffected patients completed the risk assessment. There were 2,196 patients (9.1%) identified as high risk: 1,051 (4.3%) had a BRCA mutation risk, 1,570 (6.5%) had lifetime breast cancer risk, and 425 (1.8%) had risk for both. Of the high-risk patients, 416 (18.7%) were evaluated by our APN and/or genetic counselor. Of the 231 who were evaluated by a genetic counselor, 97 had genetic testing and 9 (8.3%) were BRCA positive. Annual MRI screening was recommended to 254 patients.
Conclusions We have successfully implemented breast cancer risk assessment through our screening mammography service. Results suggest that 9.1% of our patients can benefit from risk assessment, 4.3% should consider genetic testing, and 6.5% may benefit from screening MRI. We strive to improve compliance through patient education.
Click on the PDF icon at the top of this introduction to read the full article.
Background Barriers to assessing a patient’s risk for breast cancer include the inadequate documentation of family history, the complexity of risk calculation and model selection, and a lack of awareness of risk on the part of the patient and/or provider. We have established computer-based, real-time assessment of a patient’s risk for breast cancer at the time of having a mammogram.
Objective To facilitate identification of high-risk patients who need genetic counseling and testing and magnetic resonance imaging screening based on the results of the risk assessment.
Methods Since November 23, 2010, all mammogram patients have completed questionnaires using a wireless tablet. On the basis of a real-time calculation for a patient’s risk of BRCA1/BRCA2 mutation (Myriad, Tyrer-Cuzick, BRCAPRO) and lifetime risk of breast cancer (Gail, Claus, Tyrer-Cuzick, BRCAPRO) using Hughes riskApps, patients were categorized as high risk (≥ 10% BRCA mutation or ≥ 20% lifetime breast cancer risk) or average risk and received a risk assessment letter. The risk data was integrated into our mammography information system (PenRad) at the same time. High-risk patients were contacted to facilitate evaluation.
Results As of June 30, 2012, a total of 24,213 unaffected patients completed the risk assessment. There were 2,196 patients (9.1%) identified as high risk: 1,051 (4.3%) had a BRCA mutation risk, 1,570 (6.5%) had lifetime breast cancer risk, and 425 (1.8%) had risk for both. Of the high-risk patients, 416 (18.7%) were evaluated by our APN and/or genetic counselor. Of the 231 who were evaluated by a genetic counselor, 97 had genetic testing and 9 (8.3%) were BRCA positive. Annual MRI screening was recommended to 254 patients.
Conclusions We have successfully implemented breast cancer risk assessment through our screening mammography service. Results suggest that 9.1% of our patients can benefit from risk assessment, 4.3% should consider genetic testing, and 6.5% may benefit from screening MRI. We strive to improve compliance through patient education.
Click on the PDF icon at the top of this introduction to read the full article.
Practice challenges affecting optimal care as identified by US medical oncologists who treat renal cell carcinomas
Background Approval of new agents provides alternative treatment options for medical oncologists and their patients with renal cell carcinoma (RCC). Treatment decisions remain challenging in the absence of clear evidence supporting optimal selection and sequencing of treatment for different patient or tumor characteristics.
Objective To assess the clinical practice gaps of medical oncologists treating patients with RCC.
Methods Medical oncologists practicing in the United States with a case load of 1 or more RCC patient(s) a year were recruited to participate in either an online case-based survey followed by a 45-minute interview (phase 1) or a 15-minute online survey with case vignettes (phase 2). Respondents’ answers were compared with treatment guidelines and faculty experts’ recommendations.
Results Qualitative interviews (n = 27) and quantitative surveys (n = 142) were compiled. Clinical performance gaps demonstrating oncologists’ difficulties to optimally adjust their treatment plan were identified. When presented with an RCC patient with treatment-related hypertension, 34% of respondents did not select an expert-recommended option. In a scenario focused on recognizing clinical signs and symptoms as an important component of treatment decision-making, 40% of respondents agreed with the expert-recommended approach. For a progressive patient with chronic obstructive pulmonary disease, 78% of respondents were misaligned with evidence-based treatment options.
Limitations Self-selection and respondent bias may have occurred. Sample size may have limited the statistical power.
Conclusions This study identified clinically relevant performance gaps among US oncologists treating RCC patients. Education to assure familiarity with the most recent changes is needed.
Funding/sponsorship Pfizer Medical Education Group provided financial support through an educational research grant.
Click on the PDF icon at the top of this introduction to read the full article.
Background Approval of new agents provides alternative treatment options for medical oncologists and their patients with renal cell carcinoma (RCC). Treatment decisions remain challenging in the absence of clear evidence supporting optimal selection and sequencing of treatment for different patient or tumor characteristics.
Objective To assess the clinical practice gaps of medical oncologists treating patients with RCC.
Methods Medical oncologists practicing in the United States with a case load of 1 or more RCC patient(s) a year were recruited to participate in either an online case-based survey followed by a 45-minute interview (phase 1) or a 15-minute online survey with case vignettes (phase 2). Respondents’ answers were compared with treatment guidelines and faculty experts’ recommendations.
Results Qualitative interviews (n = 27) and quantitative surveys (n = 142) were compiled. Clinical performance gaps demonstrating oncologists’ difficulties to optimally adjust their treatment plan were identified. When presented with an RCC patient with treatment-related hypertension, 34% of respondents did not select an expert-recommended option. In a scenario focused on recognizing clinical signs and symptoms as an important component of treatment decision-making, 40% of respondents agreed with the expert-recommended approach. For a progressive patient with chronic obstructive pulmonary disease, 78% of respondents were misaligned with evidence-based treatment options.
Limitations Self-selection and respondent bias may have occurred. Sample size may have limited the statistical power.
Conclusions This study identified clinically relevant performance gaps among US oncologists treating RCC patients. Education to assure familiarity with the most recent changes is needed.
Funding/sponsorship Pfizer Medical Education Group provided financial support through an educational research grant.
Click on the PDF icon at the top of this introduction to read the full article.
Background Approval of new agents provides alternative treatment options for medical oncologists and their patients with renal cell carcinoma (RCC). Treatment decisions remain challenging in the absence of clear evidence supporting optimal selection and sequencing of treatment for different patient or tumor characteristics.
Objective To assess the clinical practice gaps of medical oncologists treating patients with RCC.
Methods Medical oncologists practicing in the United States with a case load of 1 or more RCC patient(s) a year were recruited to participate in either an online case-based survey followed by a 45-minute interview (phase 1) or a 15-minute online survey with case vignettes (phase 2). Respondents’ answers were compared with treatment guidelines and faculty experts’ recommendations.
Results Qualitative interviews (n = 27) and quantitative surveys (n = 142) were compiled. Clinical performance gaps demonstrating oncologists’ difficulties to optimally adjust their treatment plan were identified. When presented with an RCC patient with treatment-related hypertension, 34% of respondents did not select an expert-recommended option. In a scenario focused on recognizing clinical signs and symptoms as an important component of treatment decision-making, 40% of respondents agreed with the expert-recommended approach. For a progressive patient with chronic obstructive pulmonary disease, 78% of respondents were misaligned with evidence-based treatment options.
Limitations Self-selection and respondent bias may have occurred. Sample size may have limited the statistical power.
Conclusions This study identified clinically relevant performance gaps among US oncologists treating RCC patients. Education to assure familiarity with the most recent changes is needed.
Funding/sponsorship Pfizer Medical Education Group provided financial support through an educational research grant.
Click on the PDF icon at the top of this introduction to read the full article.