NCCN Annual Conference Sheds Light on Treatment Disparities, Significance of the Doctor-Patient Relationship, Supportive Care Issues, and the Latest Guidelines Updates
More than 1,600 oncology professionals attended the NCCN 22nd Annual Conference in Orlando, Florida
[FORT WASHINGTON, PA – March 29, 2017] The National Comprehensive Cancer Network® (NCCN®) hosted its 22nd Annual Conference: Improving the Quality, Effectiveness, and Efficiency of Cancer Care™ on March 23 – 25, 2017 at the Rosen Shingle Creek in Orlando, Florida.
Best practices from the field
Ruben Mesa, MD, Mayo Clinic Cancer Center, presents the new NCCN Guidelines for Myeloproliferative Neoplasms.
Key to the content of the NCCN Annual Conference were presentations from esteemed NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) panel members about the latest best practices in the management of patients with cancer, as well as NCCN Guidelines® updates for various diseases, including Bladder, Breast, Colorectal, Kidney, Lung, and Pancreatic Cancers, as well as Chronic Lymphocytic Leukemia, Gynecologic Malignancies, Hodgkin Lymphoma, Neuroendocrine Tumors, Non-Hodgkin’s Lymphomas, Soft Tissue Sarcoma, and the latest NCCN Guideline—Myeloproliferative Neoplasms.
In addition to disease-specific presentations, NCCN experts discussed front-line supportive care and screening issues, including, but not limited to, genetic testing, smoking cessation, and management of immunotherapy-related toxicities.
Kenneth Offit, MD, MPH, of Memorial Sloan Kettering Cancer Center, discussed personalized medicine during his presentation, Multi-Gene Testing for Hereditary Cancer: When, Why, and How. Dr. Offit noted that practitioners could reduce deaths by up to 60% by paying attention to known risk genetic and lifestyle risk factors for cancer. He discussed specific genetic mutations linked to both common and rare forms of cancer. Dr. Offit indicated that 5-40% of results from multi-gene panels may report genomic variants that are difficult to interpret, and highlighted the importance of providers referring patients to registries such as PROMPT (Prospective Registry of Multiplex Testing) to improve accuracy of cancer risk estimation. He also presented the 2017 NCCN Guidelines, which have begun to incorporate data to guide screening based on age-specific risks of genes included on multi-gene panels.
Smoking Cessation in Patients with Cancer: Treatment Advances and the Oncologist’s Role, was presented by Paul Cinciripini, PhD, of The University of Texas MD Anderson Cancer Center. Dr. Cinciripini noted that smoking rates have leveled off at 15% of the U.S. population; however, those who smoke are among the most vulnerable with the least resources. Furthermore, smoking is highly correlated with mental illness, he said. Because smoking has negative effects on treatment, patients should be offered both counseling and medical intervention to aid in their smoking cessation, he said, noting that consistent engagement with the patient is the most important avenue for intervention.
Stephanie Andrews, MS, ANP-BC, of Moffitt Cancer Center, discussed the management of adverse events for immunotherapy and how to identify them. Her presentation, When to Hold and When to Fold, noting that enthusiasm for immunotherapy agents should be tempered by a healthy respect for their power. Ms. Andrews discussed the importance of considering three key areas at the onset of symptoms: disease progression, unrelated events, and immune-related adverse events, and explained that patient education is key to early recognition. NCCN has devised a teaching and monitoring tool for immunotherapy available at NCCN.org and is in the process of developing clinical practice guidelines in collaboration with ASCO specifically for the management of immunotherapy-related toxicities in patients with cancer.
Addressing disparities in cancer care
From left to right: Dr. Goodman, Dr. Allen, Dr. Chen, Ms. Filipic, Dr. Mitchell, Ms. Pettit Nassi.
This year’s conference opened with a timely expert roundtable about disparities in oncology care. Moderated by Clifford Goodman, PhD, the session featured the following panelists: Shauntice Allen, PhD, University of Alabama at Birmingham Comprehensive Cancer Center; Moon S. Chen, Jr, PhD, MPH, University of California Davis Comprehensive Cancer Center; Anne Filipic, Enroll America; Edith Mitchell, MD, Sidney Kimmel Cancer Center at Jefferson; and Phyllis Pettit Nassi, MSW, Huntsman Cancer Institute at the University of Utah.
Dr. Chen noted that cancer is the leading cause of death among Asian, Latino, and American Indian communities, and there is an opportunity to make real gains by applying current medical knowledge to these populations.
Dr. Mitchell spoke of overcoming biases in order to deliver what the individual needs. “With older patients, we have conscious and unconscious biases,” she said. “For patients of a certain age it may be assumed they won’t want treatment, but it’s not the chronological age that matters. Assessment must include the physiological age and comorbidities. Similarly, biases occur with religious and racial/ethnic populations. It’s frequently assumed that African Americans won’t participate in clinical trials but patients actually want to participate. Therefore, as providers, we must focus on our own biases.”
“As cancer centers, we have to accept the challenges,” Ms. Pettit Nassi said. “Huntsman is the catchment for five states. Once you make the commitment and...go beyond just collecting the data and getting the grants….it can be done. The doctors get out of the silo. You have to go and see. See with your eyes, you will see how you can make a difference. If we don’t start bringing clinical trials out into the rural and frontier areas we’re going to miss whole populations.”
Panelists challenged attendees to share their opinions with lawmakers so that their voices can be heard.
A summary of the roundtable is available on NCCN.org/news.
Patient, provider, caregiver
From left to right: Dr. Wakelee, Dr. Kalanithi, Dr. Carlson.
During Friday’s highly anticipated keynote session moderated by NCCN Chief Executive Officer Robert W. Carlson, MD; Lucy Kalanithi, MD, widow of the late Paul Kalanthi, MD, author of When Breath Becomes Air, joined Paul’s oncologist, Heather Wakelee, MD, Stanford Cancer Institute, for the first time in public. Together, they recalled the moments with Paul that most influenced their lives and the way they practice medicine.
“Paul faced his cancer in a very, very brave manner,” said Wakelee, who had worked with Paul Kalanithi at Stanford but didn’t get to know him until he was her patient. “What he captures in the book is the essence of what we try to do to help our patients with cancer. Even though he was dying since the time I met him, he really lived.”
“Time stood still and sped up at the same time, especially when [Paul] was getting really sick,” Dr. Lucy Kalanithi said. “He said that time used to feel linear and now it feels like a space. There was this sense of time standing still that came out of the [realization] that the future is not guaranteed, and that's especially poignant when you have a newborn. [There was this feeling that] this is our family right now and this is all we have and how great is that. At the same time, Paul was really goal directed the whole time. As a chief resident, your identity is wrapped up in your future…when he was diagnosed he said the future he imagined had evaporated. That really messes up your identity; he kept having to reshape his identity.”
A summary of the keynote is available on NCCN.org/news.
On Thursday, March 23, NCCN launched its latest resource, the NCCN Radiation Therapy Compendium™. The radiation therapy recommendations contained in the Compendium are derived directly from the library of NCCN Guidelines, and the Compendium provides guidance on all RT modalities recommended within the NCCN Guidelines, including Intensity Modulated Radiation Therapy (IMRT), Intra-Operative Radiation Therapy (IORT), Stereotactic Radiosurgery (SRS)/Stereotactic Body Radiotherapy (SBRT)/Stereotactic Ablative Radiotherapy (SABR), Image-guided Radiotherapy (IGRT), Low dose-rate brachytherapy (LDR)/High dose-rate brachytherapy (HDR), Radioisotope, and Particle Therapy. More information about the NCCN Radiation Therapy Compendium™ is available at NCCN.org/RTcompendium.
NCCN Foundation Board Officers, from left to right: Jack Gentile, Secretary; Dr. Heather Kopecky, Vice-Chair; Gena Cook, Chair; Ray Lynch, Treasurer.
On Friday, March 24, Gena Cook, Co-Founder and Chief Executive Officer, Navigating Cancer, and Heather Kopecky, PhD, MBA, Senior Client Partner, Korn Ferry, were been named Chair and Vice-Chair, respectively, of the NCCN Foundation® Board of Directors. More information is available at NCCN.org/news.
The 2017 NCCN Young Investigator Award recipients were named during the opening remarks of the Conference on Friday, March 24. Following are this year’s awardees:
- Kemi Doll, MD, MSCR, Fred Hutchinson Cancer Research Center/Seattle Cancer Care Alliance, “Racial Disparities in Endometrial Cancer”
- Saad Kenderian, MB, CHB, Mayo Clinic Cancer Center, “Chimeric Antigen Receptor T-Cell Therapy in Chronic Lymphocytic Leukemia: Mechanisms of Resistance and Strategies to Enhance Efficacy”
- Florian Muller, PhD, The University of Texas MD Anderson Cancer Center, “ENO1-Deletion as a Target for Personalized Oncology: Collateral Lethality to the Clinic”
- Elizabeth Stewart, MD, St. Jude Children’s Research Hospital/University of Tennessee Health Science Center, “Preclinical Match”
NCCN Foundation Young Investigator Awards provide grants of $150,000 over a two-year period for research initiatives focused on assessing and improving outcomes in cancer care. More information is available at NCCN.org/news.
Additional on-site activities
In conjunction with the NCCN 22nd Annual Conference general session, NCCN hosted its annual Nursing Program: Advancing Oncology Nursing™, the NCCN Fellows Recognition Program: New Horizons in Quality Cancer Care™, and various lunch and dinner symposia.
2015 NCCN Foundation Young Investigator Awardees, from left to right: Dr. Morgan, Dr. El-Jawahri, Dr. Veenstra, and Dr. Blachly. Not pictured: Dr. Johnson.
The NCCN General Poster Session featured more than 95 original studies focused on clinical oncology, pre-clinic oncology, epidemiology/risks, correlative/genomic, best practices in implementation and use of clinical practice guidelines, quality improvement, outcomes and health services research, and BIOinformatics/information technology sciences.
The poster session included research presented by the 2015 NCCN Foundation Young Investigator Awardees:
- James Blachly, MD, The Ohio State University Comprehensive Cancer Center – James Cancer Hospital and Solove Research Institute
- Areej El-Jawahri, MD, Massachusetts General Hospital Cancer Center
- Douglas Johnson, MD, Vanderbilt-Ingram Cancer Center
- Todd Morgan, MD, University of Michigan Comprehensive Cancer Center
- Christine M. Veenstra, MD, MSHP, University of Michigan Comprehensive Cancer Center
The NCCN 23rd Annual Conference will be held March 22 – 24, 2018, at the Rosen Shingle Creek in Orlando, Florida.
Certain 2017 conference sessions will be recorded and archived as part of NCCN’s continuing education program. Stay tuned for further updates.
More information about the NCCN Annual Conference is available at NCCN.org/conference.