Breaking Research News from sources other than Breastcancer.org
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Congress Passes "Right to Try" Bill
House lawmakers passed a 'right-to-try' bill last week, clearing the path for the president to sign it.
http://nursing.advanceweb.com/congress-passes-righ...
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Three breast cancer abstracts to watch at ASCO Annual Meeting
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Came via email this morning:
Community Oncology Alliance Files Lawsuit Against Federal Government to Stop Unconstitutional Cut to Cancer Drug Reimbursement Application of 2% Sequester Cut to Medicare Part B Drug Reimbursement is Unconstitutional and Illegal; Costing Seniors and Taxpayers Billions The Community Oncology Alliance (COA) has filed a lawsuit in the U.S. District Court for the District of Columbia to stop the United States Department of Health and Human Services (HHS) and the White House Office of Management and Budget (OMB) from applying the Medicare sequester cut to reimbursement for Part B drugs. In the lawsuit, COA, which represents more than 5,000 independent, community-based oncologists, shows the sequester cut has harmed patients, decimated the nation's independent community cancer care system, and cost seniors and taxpayers billions in unnecessary health care spending.
Sequestration is an automatic cut to Federal government spending triggered because Congress was unable to negotiate a balanced budget in 2011. The blunt budget cutting gimmick has been extended multiple times, with the current sequester scheduled to continue through 2027. Beginning in 2013, the Centers for Medicare & Medicaid Services (CMS) began to apply a 2% budget sequester cut to all Medicare Part B reimbursement, including for drugs. The lawsuit seeks injunctive relief to specifically stop CMS from applying the sequester cut to Part B drug reimbursement.
The application of the sequester cut to cancer drug payment set up the nation's cancer care system for the closure or consolidation of independent community oncology practices, where the majority of Americans with cancer are treated. This has created access problems for patients as cancer care moves into the much more expensive hospital system, driving up costs for seniors with limited mobility and fixed incomes, as well as all taxpayers who fund Medicare.
As the 2018 Community Oncology Practice Impact Report notes, since the sequester started in 2013, approximately 135 independent community cancer clinics – many comprised of multiple locations – have been forced to close their doors, and approximately 190 clinics have been acquired by hospitals. Research has found that the consolidation of community cancer practices into hospitals cost Medicare and taxpayers an extra $2 billion in 2014 alone. In addition, Medicare beneficiaries responsible for the 20% coinsurance saw their bills rise by $500 million in that same year.
The lawsuit notes that application of the sequester cut to Part B drug reimbursement is both illegal and unconstitutional. This is because Part B drug reimbursement was set by Congress at average sales price (ASP) plus 6% in law in the Medicare Modernization Act of 2003. By applying the sequester cut to Part B drug reimbursement, the Administration has bypassed Congress and the law by lowering Part B drug payments to ASP plus 4.3%. As such, HHS and OMB are violating the separation-of-powers doctrine of the Constitution. Simply put, the Executive Branch cannot amend legislation passed by Congress under the guise of executing the laws.
In conjunction with the complaint, COA also sent a letter to HHS Secretary Alex Azarexplaining why legal action was a last resort, providing preliminary input on why proposed Medicare Part B changes in the President's blueprint on drug prices will be harmful to cancer patients, and outlining some of COA's solutions to increasing cancer drug prices, as well as reiterating community oncology's desire to work together with the Trump Administration.
"We are filing this lawsuit on behalf of the millions of Americans who face cancer and should be able to get high-quality, affordable, cancer care close to home. The sequester has been one of the biggest reasons why they can't do that, and it is time for this to stop," said Jeff Vacirca, MD, FACP, president of COA and CEO of NY Cancer Specialists. "I see the impact of the sequester cut to Part B drug reimbursement to patients and practices on a daily basis. Because of it, our country is left with less access to cancer care in communities – particularly in rural and underserved regions – as well as unnecessarily high spending to receive it in hospitals."
"Filing this lawsuit was a last resort after numerous meetings, discussions, and letters to HHS and OMB that went nowhere. We had hoped that the current Administration would have fixed what is a constitutional violation that is clearly harming seniors with cancer," said Ted Okon, executive director of COA."Community oncologists support and want to work together with the Administration on solutions to reduce drug prices and health care spending. However, the sequester cut does not do that. It has backfired in spectacular fashion, costing seniors and Medicare billions. It is time for this madness to stop."
Independent community oncology practices and providers are dedicated to lowering the escalating cost of cancer care. They have been pioneering oncology payment reform for years, including private payer programs based on the Oncology Medical Home, the Medicare Oncology Care Model (OCM), and working on the next-generation, improved OCM 2.0 model that includes payment for cancer drugs based on value.
The Community Oncology Alliance (COA) is a non-profit organization dedicated solely to preserving and protecting access to community cancer care, where the majority of Americans with cancer are treated. COA leads community cancer clinics in navigating an increasingly challenging environment to provide efficiencies, patient advocacy, and proactive solutions to Congress and policymakers. Learn more about COA at www.CommunityOncology.org. 0 -
Guys.. this is getting political. I understand the passion, but this should be about Research, NOT LAWSUITS..
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While I agree that I'd strongly prefer that we not descend into bickering about the politics surrounding health-related issues, I think that a simple reference (link) to credible news sources covering issues that may affect access to cancer-related health care is fair game for posting. Factual vs. editorial material would seem more suitable. I'm betting most of us hope that reporting on research will remain the focus of posted content.
On that note....
After Years of Trying, Virginia Finally Will Expand Medicaid
https://www.nytimes.com/2018/05/30/health/medicaid...
Why Virginia's Medicaid expansion is a big deal
https://www.washingtonpost.com/news/powerpost/palo...
{editor's note: These articles do address the political environment surrounding expansion. Access at your own risk.}
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Lumpie, I was directing my post more to the article Lilac posted about a lawsuit - which has nothing to do with Research. The Right to Try bill that you posted about is about Research and cutting edge medicine, so in my opinion it belongs. The others though... have nothing to do with research and should be on a separate thread that deals with 'Medicaid and such'.. This is a Breaking Research thread, not 'all issues related to health care" thread.
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Lisey, understand your point, yet, as stated before, what I posted is completely health-care cancer related and I'm not deleting. Feel free to scroll.
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About that teaser Healio blurb regarding the upcoming release of phase 3 TAILORx results--Oncotype DX scores of 11-17 are NOT "intermediate." Genomic Health's own classification specifies 0-17 as "low risk," 18-24 as "intermediate risk" and anything above that as "high risk" for recurrence. The only thing "intermediate" about the 11-17 ODX cohort is that it lies between the first group of 0-10 scoring women (per Genomic's classification, very low risk who should definitely skip chemo) for which data was released and the high-risk cohort for whom chemo is definitely beneficial. I would not use the term "intermediate" for scores of 11-17 because it connotes a risk that the test's own developer concedes doesn't exist. But if laypeople (or non-oncologist physicians) read that article, they may not realize that its term "intermediate" is unrelated to the actual risk category.
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Lilac, this post isn't for 'all things health care related' but for RESEARCH NEWS only. Make your own thread with lawsuits and medicare and other healthcare related items from whatever sites you want, but I think this thread should JUST be about Research, which is why I have it as a favorite. I have no desire to read about politics and lawsuits due to politics.
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Lisey, I have this thread as a favorite too.
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There’s plenty of room for everyone. Sometimes threads evolve, wander, return... or take off in a new direction.
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Engineered antibody summons immune system to kill cancer cells
Published TodayFact checked by Jasmin Collier
https://www.medicalnewstoday.com/articles/322007.p...0 -
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Conference Coverage > 2018 ASCO Annual Meeting >Dr. Mohile on Using a Geriatric Assessment in Older Patients With Cancer
Supriya Gupta Mohile, MD, MSPublished: Saturday, Jun 02, 2018
Supriya Gupta Mohile, MD, MS, professor of medicine and surgery, James Wilmot Cancer Institute, director, Geriatric Oncology Clinic, University of Rochester, discusses clustered findings with a geriatric assessment for older patients with cancer in an interview with OncLive during the 2018 ASCO Annual Meeting.
A geriatric assessment is a standardized tool to assess health status in older adults, using age, comorbidity, and performance status. However, those characteristics are not the most effective way to identify patients at highest risk of poor outcomes, Mohile explains. Evidence suggest that geriatric assessments can help oncologists identify patients who are at the highest risk of adverse outcomes, such as toxicity from treatment, hospitalization, mortality, and functional decline. These have also been published in recent ASCO guidelines, she adds.
Patients aged 70 and older may have medical conditions other than cancer that would make them unlikely candidates for clinical trials, but their life expectancy is often long enough to warrant cancer treatment; however, there are limited data for these patients. Mohile questions how oncologists can improve conversations about issues that older patients and caregivers care about, and how the geriatric assessment can be used to do that.
The clustered study showed that providing a geriatric assessment summary to oncologists increases the number and quality of discussions about age-related concerns and improves patient satisfaction.0 -
So radiation causes increased toxicity and morbidity, interesting. But a little confusing
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View more on OncLive TV >>Dr. Kubicky on the Optimal Use of Radiation in Patients With Breast Cancer
Charlotte Kubicky, MD, PhDPublished: Tuesday, May 29, 2018
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Extending Adjuvant Endocrine Therapy in Patients With ER-Positive Breast Cancer
AAARGHH!!! More bait-and-switch. The second paragraph mentions "...and more recently, aromatase inhibitors." BUT the article goes on to describe a few studies, ALL of which involved only tamoxifen. Even discussion of non-adherence to endocrine therapy specified tamoxifen intolerance in older women--not one word about AIs, which are now the gold standard for postmenopausal ER+ patients.
Still waiting to see what phase 3 of the TAILORx study will say about the appropriateness of chemo for those of us with OncotypeDX scores of 11-17. Betcha it'll still be equivocal, and not distinguish between us and the truly "intermediate-risk" (18-25) patients--but will simply lump us all together. Hope to be pleasantly surprised and helpfully informed, but fully expect to be frustrated and have to wait yet another year for accurate answers.
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Radiotherapy offers new treatment option for liver cancerA novel technique that delivers high doses of radiation to tumors while sparing the surrounding normal tissue shows promise as a curative treatment option for patients with early-stage liver cancer, according to a study published ...
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Cancer researchers are now studying whether fitness trackers can be tools to measure a patient's quality of life: https://www.theguardian.com/technology/2018/jun/01/cancer-fitbit-treatment-chemotherapy
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TAILORx Results Published Today in New England Journal of Medicine Identifies the 70% of Women with Early-stage Breast Cancer Who Receive No Benefit from Chemotherapy
“The TAILORx study definitively established that chemotherapy may be spared in about 70 percent of these patients, including all women older than 50 with Breast Recurrence Score® results of 0 to 25 and all women age 50 or younger with Breast Recurrence Score results of 0 to 15.
Importantly, 30 percent of early-stage breast cancer patients will derive benefit from chemotherapy, including women of any age with Breast Recurrence Score results of 26 to 100, and in women younger than 50, where a modest (2 percent) benefit from chemotherapy was observed with Breast Recurrence Score results of 16 to 20, which gradually grew as scores increased up to and above 25. This important finding reveals a new level of precision of chemotherapy benefit for younger patients that only the Oncotype DX® test can provide."
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I don’t have much faith in the Oncotype DX. I scored a 6 did chemo and now stage IV.
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Thank you Diana Rose. They wouldn’t give me the Oncotype test because I turned down chemo. So sorry you are stage IV
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So sorry Diana Rose. That is a low score. Mine was 11. Stage 1b, grade 1 IDC. I didn’t have chemo either only radiation +Tamoxifen for 5 years. Currently 6 1/2 years out.
Diane
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Dianarose, I am sorry. Nothing is for certain it seems. They didn't give me the test because my Grade was low, and perhaps because I am older. Not sure if is a good thing or not but I was glad not to have chemo.
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Thank you April! Wonderful news. I don't find it ironic at all!
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I posted this on another thread and then found this one. Apologize if it is old news. From a Guardian article published today:
"A woman with advanced breast cancer which had spread around her body has been completely cleared of the disease by a groundbreaking therapy that harnessed the power of her immune system to fight the tumours.
It is the first time that a patient with late-stage breast cancer has been successfully treated by a form of immunotherapy that uses the patient's own immune cells to find and destroy cancer cells that have formed in the body.
Judy Perkins, an engineer from Florida, was 49 when she was selected for the radical new therapy after several rounds of routine chemotherapy failed to stop a tumour in her right breast from growing and spreading to her liver and other areas. At the time, she was given three years to live.
Doctors who cared for the woman at the US National Cancer Institute in Maryland said Perkins's response had been "remarkable": the therapy wiped out cancer cells so effectively that she has now been free of the disease for two years."
The complete article can be read here: https://www.theguardian.com/science/2018/jun/04/do...
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Thanks April, wonderful news for the treatment of cancer... I hope they get plenty of funding to continue their research
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I cheered in the car driving home when listening the news of Judy Perkins successful immunotherapy broke on BBC radio. So many dying for a cure..could this be it?
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New Immunotherapy Treatment Removes All Tumors In Woman With Advanced Metastatic Breast Cancer
https://www.forbes.com/sites/victoriaforster/2018/...
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Thanks for the insights TectonicShift.
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