Independent News on Advances in Hematology/Oncology CLINICALONCOLOGY.COM • March 2013 • Vol. 8, No. 3
INSIDE
NEW Column The Tumor Board: Is laparoscopic distal pancreatectomy the new ‘gold standard’? ................ 10
SOLID TUMORS
Gastrointestinal Cancers Symposium Colorectal subtypes: Ready for prime time? ...... 13
ESMO Debate: Should neoadjuvant data be used to accelerate drug approval? ................... 20 Multi-targeted TKI promising second-line neuroendocrine option ...................................... 24 Stage III colorectal cancer: Adding cetuximab gives no benefit .............................. 24
HEMATOLOGIC DISEASE Phase III data supports bendamustine in NHL and MCL ................................... 4 Rituximab Improves B-Cell Lymphoma Survival ............ 16
CURRENT PRACTICE Maurie Markman, MD: Diagnostic imaging: A double-edged sword ...... 3 FDA drug actions ............... 26 Clinical Conundrums ......... 29
“Blossom Tree,” an alternate view of mucinous carcinoma.
Vogl, NY...
Cyclophosphamide Prices Skyrocket Causes and effects
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n October 2012, my office manager announced that I can no lo nger gi ve IV cyclophosphamide to Medicare patients because I will lose about $100 Steven Vogl, MD on every 500 mg given. For a large lymphoma patient, this can add up to a loss of $400 for each dose of R-CHOP chemotherapy given, far more than I get paid for caring for this patient. Medicare rules forbid me from billing the patient as a result of see VOGL, NY, Y page 5
‘We Prevent Complications, Rather Than Chase Them’ Medical home model begins to change community oncology practice
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oday, oncology practices interested in becoming oncology medical homes (OMHs) are lucky in one respect: They don’t have to reinvent the wheel. They can seek advice from existing OMHs and oncology management consultant groups. So, what is involved in transforming a clinic? There isn’t one formula, but several common themes emerged when Clinical Oncology News talked to experts about what it takes to create an OMH, a patient-focused system that delivers quality, coordinated and efficient cancer care. Key aspects include the use of team-based care, streamlined electronic medical records, software that allows tracking of physician compliance with pathways and prompting for real-time evidencebased decision making, and a telephone triage system. At the foundation, the transition see MEDICAL HOME, E page 8
RE VIE WS & COMMENTAR IES
Expert Insights From Mayo Clinic Cancer Center Bevacizumab effective, tolerable in older CRC patients .................. 18 Axel Grothey, MD
Cabozantinib promising for castration-resistant prostate cancer ...... 19 Manish Kohli, MD