Cancer Centers in the News
The following links highlight some of the most up-to-date news from the 27 NCCN Member Institutions. The media coverage below includes major national news outlets, industry magazines, medical journals, and press releases.
The news is listed in reverse chronological order for ease of use.
Payers Weigh the Implications of Multigene Testing Coverage in New UCSF Study
A recent study from the UCSF Center for Translational and Policy Research on Personalized Medicine and the UCSF Helen Diller Family Comprehensive Cancer Center identified opportunities to address the barriers to coverage of hereditary cancer panels, as published in JNCCN.
(FORT WASHINGTON, PA – February 15, 2017) Innovation in precision medicine has introduced an amalgam of testing options, of which hereditary cancer panels—multigene tests—are a major component. Additionally, the importance of inherited cancer genomics was further bolstered by Former President Barack Obama’s Precision Medicine Initiative in 2015. Controversy lay, however, in the lack of formal insurance coverage policy for such tests. To expose the major roadblocks to coverage, researchers from the UCSF Center for Translational and Policy Research on Personalized Medicine (TRANSPERS) and the UCSF Helen Diller Family Comprehensive Cancer Center, interviewed 11 major U.S. payers covering 160 million lives.
The results of their study, “Payer Coverage for Hereditary Cancer Panels: Barriers, Opportunities, and Implications for the Precision Medicine Initiative,” are available in the February issue of JNCCN – Journal of the National Comprehensive Cancer Network.
“We believe that understanding payers’ coverage decision-making is imperative to ensuring future patient access to potentially transformative modalities and informing genetic research,” said lead author Julia R. Trosman, PhD, Adjunct Assistant Professor, TRANSPERS, UCSF Department of Clinical Pharmacy; Adjunct Assistant Professor, Northwestern University Feinberg School of Medicine; and Director at the Center for Business Models in Healthcare, an independent research organization. “We focused on private payers, as they collectively cover two-thirds of the insured U.S. population, and their coverage decisions affect public payer policy. The 11 major payers involved in our study collectively cover over 160 million enrollees in the U.S.”
Researchers also believe that payers’ hereditary cancer panel coverage considerations have implications on the Precision Medicine Initiative and its efforts to assemble more than one million volunteers to contribute genomic, clinical, and lifestyle data to advance genetic science. Based on the findings from the study, the paper discusses how the Precision Medicine Initiative design can incorporate payer feedback to ensure patient access.
A majority of payers noted that novel hereditary cancer panel features present a unique appeal to patients and clinicians, but 100 percent of those interviewed cited that the panels do not fit within current coverage frameworks and lack necessary evidence, while more than 90 percent noted that the hereditary cancer panels represented departed from pedigree/family-history–based testing toward genetic screening.
Payers shared not only barriers to hereditary cancer panel coverage, but also opportunities to address them. For instance, participants shared insight into how evidentiary requirements for the plans can be met, noting that, in many cases, randomized controlled trials may not be required. Rather, observational and pooled studies and registry data may be acceptable to confirm statistical significance. Some also suggested that coverage and evidence evaluation frameworks could potentially be modified to align with panel features and benefits.
In addition to clinical and evidentiary concerns, more than 80 percent of those interviewed expressed concern about patient engagement and understanding of the ramifications of such panels. Despite completion of the informed consent form, it remains a challenge to ensure that patients understand the emergent state of evidence for many genes in panels and express their wishes regarding being re-contacted in the future when new evidence becomes available.
“We hope that our findings bring attention to the topic of insurance coverage for cancer panels and contribute to a productive dialogue among various stakeholders on framing an approach to address payers’ concerns,” stated Dr. Trosman. “Many previous studies on reimbursement for genomic technologies, including our own, were focused on barriers to coverage. We are encouraged that the present study also identified opportunities that could be pursued to mitigate barriers.”
Identified within the article are three target areas where the Precision Medicine Initiative design can incorporate payer feedback, and, therefore, strengthen its impact on patients and genetic science: address insurance coverage barriers to secure access to future Precision Medicine Initiative discoveries; incorporate payers’ evidentiary requirements to the Precision Medicine Initiative research agenda to increase relevance of research to future coverage decisions; and leverage payer recommendations and experience to keep patients informed and engaged.
"This study represents another step forward in understanding the discordant needs between health care providers and payers with regard to coverage of hereditary cancer panels. Many of the barriers to coverage cited by the payers interviewed in this study, including gaps in evidence on gene penetrance and questionable actionability are shared by the genetics community. The concern of the payers that availability of hereditary cancer panels will lead to 'indiscriminant genetic screening,' however, is likely unfounded. Instead, considerable effort on the part of the genetics community has been, and continues to be, devoted to evolving counseling models and encouraging patient participation in testing decisions to deal with the inherent uncertainties involved with genetic risk. On the other hand, it is promising that the payers support the need for pre- and post-test counseling, and they are open to the development of novel models to address the current barriers to coverage," said Mary B. Daly, MD, Fox Chase Cancer Center, Chair, NCCN Guidelines Panel for Genetic/Familial High-Risk Assessment: Breast and Ovarian.
Complimentary access to the study, “Payer Coverage for Hereditary Cancer Panels: Barriers, Opportunities, and Implications for the Precision Medicine Initiative,” is available until May 31, 2017 at JNCCN.org.
About JNCCN – Journal of the National Comprehensive Cancer Network
More than 24,000 oncologists and other cancer care professionals across the United States read JNCCN–Journal of the National Comprehensive Cancer Network. This peer-reviewed, indexed medical journal provides the latest information about best clinical practices, health services research, and translational medicine. JNCCN features updates on the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), review articles elaborating on guidelines recommendations, health services research, and case reports highlighting molecular insights in patient care. JNCCN is published by Harborside Press. Visit JNCCN.org. To inquire if you are eligible for a FREE subscription to JNCCN, visit http://www.nccn.org/jnccn/subscribe.asp
Deep-Learning Algorithm Matches Dermatologists’ Ability to Identify Skin Cancer (Stanford Cancer Institute)
Scientists Identify Aggressive Pancreatic Cancer Cells and Their Vulnerability (The University of Texas MD Anderson Cancer Center)
Memorial Sloan Kettering Researchers Publish Roadmap to Precision Medicine (Memorial Sloan Kettering Cancer Center)
Roswell Park Study Sheds Light on Recurrent Prostate Cancer (Roswell Park Cancer Institute)
New Technique Slashes Diagnosis Time during Brain Surgery (University of Michigan Comprehensive Cancer Center)
New Treatment Guides from NCCN Help Patients with Waldenström’s Macroglobulinemia Make Informed Care Decisions
NCCN has published the NCCN Guidelines for Patients® and NCCN Quick Guide™ sheet for Waldenström’s Macroglobulinemia—a rare, but manageable type of Non-Hodgkin’s Lymphoma.
(FORT WASHINGTON, PA – February 3, 2017) — A very rare sub-type of Non-Hodgkin’s Lymphoma, Waldenström’s Macroglobulinemia affects approximately 1,500 – 2,000 people in the United States each year. While it is not curable, Waldenström’s Macroglobulinemia is slow growing, and in many patients, manageable as a chronic disease. To that end, it is important that patients diagnosed with Waldenström’s Macroglobulinemia have access to up-to-date disease management information in order to work alongside their treatment teams to make informed care decisions.
To give patients access to the same treatment information their doctors use, the National Comprehensive Cancer Network® (NCCN®) has published the NCCN Guidelines for Patients® and NCCN Quick Guide™ sheet for Waldenström’s Macroglobulinemia/Lymphoplasmacytic Lymphoma. Provided through support from the NCCN Foundation®, these education resources inform patients and caregivers about available treatment options.
“The treatment approach to patients with Waldenström’s Macroglobulinemia has significantly changed in the recent years with better understanding of the disease biology and its natural history and availability of new drugs, allowing for a more individualized approach. The revised guidelines reflect these changes and will be a valuable guide for patients in shared decision-making with their oncologists,” said Shaji Kumar, MD, Mayo Clinic Cancer Center, Chair, NCCN Guidelines Panel for Waldenström’s Macroglobulinemia.
These resources are accessible free of charge on NCCN.org/patients, as well as on the free NCCN Patient Guides for Cancer mobile app, available for Android and iOS devices.
NCCN Guidelines for Patients, patient-friendly adaptations of the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®), are easy-to-understand resources based on the same clinical practice guidelines used by health care professionals around the world to determine the best way to treat a patient with cancer. Each resource features unbiased expert guidance from the nation’s leading cancer centers designed to help people living with cancer talk to their physicians about the best treatment options for their disease.
NCCN Guidelines for Patients and NCCN Quick Guide™ sheets—one-page summaries of key points in the patient guidelines—are written in plain language and include patient-friendly elements, such as questions to ask your doctor, a glossary of terms, and medical illustrations of anatomy, tests, and treatment. NCCN Guidelines for Patients and NCCN Quick Guide™ sheets DO NOT replace the expertise and clinical judgment of the clinician.
NCCN currently offers NCCN Guidelines for Patients for the following: Brain, Breast, Colon Esophageal, Kidney, Non-Small Cell Lung, Ovarian, Pancreatic, Prostate, and Stomach Cancers; Acute Lymphoblastic Leukemia; Adolescents and Young Adults with Cancer; Chronic Lymphocytic Leukemia; Chronic Myelogenous Leukemia; Hodgkin Lymphoma; Lung Cancer Screening; Malignant Pleural Mesothelioma; Melanoma; Multiple Myeloma; Nausea and Vomiting; Non-Hodgkin’s Lymphomas; Soft Tissue Sarcoma; and Waldenström’s Macroglobulinemia.
The NCCN Guidelines for Patients and NCCN Quick Guide™ sheet for Waldenström’s Macroglobulinemia/Lymphoplasmacytic Lymphoma are available to download for free from NCCN.org/patients and on the NCCN Patient Guides for Cancer mobile app.
About NCCN Foundation
NCCN Foundation® was founded by the National Comprehensive Cancer Network® (NCCN®) to empower people with cancer and advance oncology innovation. NCCN Foundation supports people with cancer and their caregivers at every step of their treatment journey by delivering unbiased expert guidance from the world’s leading cancer experts through the library of NCCN Guidelines for Patients® and other patient education resources. NCCN Foundation is also committed to advancing cancer treatment by funding the nation’s promising young investigators at the forefront of cancer research, initiating momentum in their careers and furthering the betterment of patients through their groundbreaking innovations. For more information about NCCN Foundation, visit NCCNFoundation.org.
Precision-Medicine Approach Could Revive Prostate Cancer Test (UCSF Helen Diller Family Comprehensive Cancer Center)
Lung Cancer Patients May Benefit from Delayed Chemotherapy after Surgery (Yale Cancer Center/Smilow Cancer Hospital)
Cancers Evade Immunotherapy by “Discarding the Evidence” of Tumor-Specific Mutations (The Sidney Kimmel Comprehensive Cancer Center at Johns Hopkins)
Hospice Care Linked to Higher Family Satisfaction (Reuters Health)
Little Survival Benefit and Higher Costs in Advanced Non-Small Cell Lung Cancer Associated with New Drugs (University of Colorado Cancer Center)
Comprehensive Study of Esophageal Cancer Reveals Several Molecular Subtypes, Provides New Insight into Increasingly Prevalent Disease (Dana-Farber Cancer Institute)
Vaccine Shows Promising Results for Early-Stage Breast Cancer Patients (Moffitt Cancer Center)
Obamacare Plans Don't Always Include Top Cancer Centers (NPR Shots Blog)
For Some Patients in Marketplace Plans, Access to Cancer Centers Is Elusive (Kaiser Health News/NPR)
Getting cancer is scary. Discovering that your marketplace plan doesn’t give you access to leading cancer centers may make the diagnosis even more daunting. As insurers’ shrink their provider networks and slash the number of plans that offer out-of-network coverage, some consumers are learning that their treatment options can be limited.
This article features commentary from Dr. Robert Carlson, CEO of NCCN, and representatives from several NCCN Member Institutions.
Fatty Acids May Help Target Ovarian Cancer (Robert H. Lurie Comprehensive Cancer Center of Northwestern University)
In a recent publication, Northwestern Medicine scientists and collaborators at Purdue University proposed a new marker to identify ovarian cancer stem cells, which may lead to the development of a new class of drugs that could target those cells for eradication.
Robert H. Lurie Comprehensive Cancer Center of Northwestern University is one of the 27 NCCN Member Institutions.
New Study Highlights Role for Immune Cells in Cancer’s Ability to Evade Immunotherapy (Roswell Park Cancer Institute)
One of the main reasons cancer remains difficult to treat is that cancer cells have developed a multitude of mechanisms that allow them to evade destruction by the immune system. One of these escape mechanisms involves a type of immune cell called myeloid-derived suppressor cells (MDSCs). A recent study led by Sharon Evans, PhD, Professor of Oncology and Immunology at Roswell Park Cancer Institute, provides new insight into how MDSCs enable tumor cells to circumvent immune attack and offer the potential for improving cancer immunotherapy.
Roswell Park Cancer Institute is one of the 27 NCCN Member Institutions.
Experimental Brain Cancer Treatment Is a Success (TIME Magazine)
Using the immune system to beat cancer is quickly becoming a promising new strategy for battling tumors. But most of the success so far has been with blood cancers like lymphomas and leukemias. Immunotherapy, as it’s called, has yet to prove itself with solid tumors like breast, prostate, lung, colon and brain cancers.
But in a report published in the New England Journal of Medicine, researchers led by Dr. Behnam Badie from the City of Hope Beckman Research Institute and Medical Center say that the same immune-based therapy that is successful against blood cancers also helped a patient with advanced brain cancer.
City of Hope Comprehensive Cancer Center is one of the 27 NCCN Member Institutions.
Reducing Radiation Successfully Treats HPV-Positive Oropharynx Cancers and Minimizes Side Effects (Yale Cancer Center/Smilow Cancer Hospital)
Human papillomavirus-positive oropharynx cancers (cancers of the tonsils and back of the throat) are on rise. After radiation treatment, patients often experience severe, lifelong swallowing, eating, and nutritional issues. However, new clinical trial research shows reducing radiation for some patients with HPV-associated oropharyngeal squamous cell carcinomas can maintain high cure rates while sparing some of these late toxicities.
Yale Cancer Center/Smilow Cancer Hospital is one of the 27 NCCN Member Institutions.