American Society of Clinical Oncology Technology Assessment: Chemotherapy Sensitivity and Resistance Assays

2004 ◽  
Vol 22 (17) ◽  
pp. 3631-3638 ◽  
Author(s):  
Deborah Schrag ◽  
Harinder S. Garewal ◽  
Harold J. Burstein ◽  
David J. Samson ◽  
Daniel D. Von Hoff ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Clinical Oncology ◽  
Technology Assessment ◽  
Working Group ◽  
Literature Search ◽  
Chemotherapeutic Agents ◽  
Treatment Preferences ◽  
Chemotherapy Sensitivity ◽  
American Society ◽  
Oncology Practice

Purpose To develop a technology assessment of chemotherapy sensitivity and resistance assays in order to define the role of these tests in routine oncology practice. Methods The American Society of Clinical Oncology (ASCO) established a Working Group to develop the technology assessment. The Working Group collaborated with the Blue Cross and Blue Shield Association (BCBSA) Technology Evaluation Center. The Working Group developed independent criteria for selecting articles for inclusion in the ASCO assessment, and developed a structured data abstraction tool to facilitate review of selected manuscripts. One Working Group member and an ASCO staff member independently reviewed the 1,139 abstracts identified by the BCBSA comprehensive literature search, and by an updated literature search performed by ASCO using the BCBSA search strategy (1966 to January 2004). Of the 12 articles included in this technology assessment, eight were identified by the original BCBSA systematic review, one was provided by industry, and three were identified by the ASCO updated literature review. Results Review of the literature does not identify any CSRAs for which the evidence base is sufficient to support use in oncology practice. Recommendations The use of chemotherapy sensitivity and resistance assays to select chemotherapeutic agents for individual patients is not recommended outside of the clinical trial setting. Oncologists should make chemotherapy treatment recommendations on the basis of published reports of clinical trials and a patient's health status and treatment preferences. Because the in vitro analytic strategy has potential importance, participation in clinical trials evaluating these technologies remains a priority.

American Society of Clinical Oncology Clinical Practice Guideline Update on the Use of Chemotherapy Sensitivity and Resistance Assays

2011 ◽  
Vol 29 (24) ◽  
pp. 3328-3330 ◽  
Author(s):  
Harold J. Burstein ◽  
Pamela B. Mangu ◽  
Mark R. Somerfield ◽  
Deborah Schrag ◽  
David Samson ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Randomized Controlled Trials ◽  
Clinical Oncology ◽  
Chemotherapeutic Agents ◽  
Cochrane Library ◽  
Treatment Preferences ◽  
Controlled Trials ◽  
Chemotherapy Sensitivity ◽  
Randomized Controlled ◽  
American Society

Purpose To update the American Society of Clinical Oncology (ASCO) Technology Assessment guidelines on chemotherapy sensitivity and resistance assays (CSRAs) published in 2004. Methods An Update Working Group reviewed data published between December 1, 2003, and May 31, 2010. MEDLINE and the Cochrane Library were searched. The literature search yielded 11,313 new articles. The limits for “human and English” were used, and then standard ASCO search strings for randomized controlled trials, meta-analyses, guidelines, and reviews were added, yielding 1,298 articles for abstract review. Of these, only 21 articles met predefined inclusion criteria and underwent full text review, and five reports of randomized controlled trials were included for data extraction. Results Review of the literature does not identify any CSRAs for which the evidence base is sufficient to support use in oncology practice. Recommendations The use of CSRAs to select chemotherapeutic agents for individual patients is not recommended outside of the clinical trial setting. Oncologists should make chemotherapy treatment recommendations based on published reports of clinical trials and a patient's health status and treatment preferences. Because the in vitro analytic strategy has potential importance, participation in clinical trials evaluating these technologies remains a priority.

Outcomes of cancer treatment for technology assessment and cancer treatment guidelines. American Society of Clinical Oncology.

1996 ◽  
Vol 14 (2) ◽  
pp. 671-679 ◽  
Keyword(s):  
Quality Of Life ◽  
Cancer Treatment ◽  
Clinical Oncology ◽  
Patient Outcomes ◽  
Technology Assessment ◽  
Working Group ◽  
Treatment Guidelines ◽  
Guideline Development ◽  
American Society

In 1993, the Health Services Research Committee of the American Society of Clinical Oncology (ASCO) charged an Outcomes Working Group with defining the outcomes of adult and pediatric cancer treatment to be used for technology assessment and development of cancer treatment guidelines. The Working Group defined by consensus outcomes for technology assessment and guideline development, focusing on cancer treatments. The Working Group considered a variety of perspectives on outcomes, including those of patients, physicians, clinical investigators, ASCO, and policy makers. Because ASCO's guidelines will define what constitutes the best treatment and not whether that treatment should be paid for, the Working Group gave higher priority to the clinical and clinical research perspectives than to the health policy perspective. Survival is the most important outcome of cancer treatment. An improvement in at least disease-free survival is a prerequisite for recommending adjuvant therapy. In the case of metastatic cancer, treatment can be recommended even without an improvement in survival, if it improves quality of life. Quality of life includes global quality of life, as well as its physical, psychologic, and social dimensions. To be an outcome of cancer treatment, quality-of-life measures must be sensitive to clinically meaningful changes produced by treatment; evaluations must control for placebo effects and determinants of quality of life not related to cancer or its treatment. Toxicity, both short and long term, is vitally important, with the latter being particularly critical in children. The value of cancer outcomes like tumor response (eg, complete or partial response) and biomarkers (eg, CA-125) for technology assessment and guideline development depends on their ability to predict patient outcomes (survival and quality of life) or to influence decisions about treatment. Complete response is an important outcome when it predicts survival. Progression is important because it signals the need to change or stop treatment. Cost-effectiveness is an especially important outcome to consider when the benefits of treatment are modest or the costs are high. Patient outcomes (eg, survival and quality of life) should receive higher priority than cancer outcomes (eg, response rate), but both types of outcomes are important in technology assessment and guideline development. Multiple outcomes should be considered because no single outcome adequately describes the results of cancer treatment. In general, there is no minimum benefit above which treatments are justified; rather, benefits should be balanced against toxicity and cost.

American Society of Clinical Oncology Technology Assessment Working Group Update: Use of Aromatase Inhibitors in the Adjuvant Setting

2003 ◽  
Vol 21 (13) ◽  
pp. 2597-2599 ◽  
Author(s):  
Eric P. Winer ◽  
Clifford Hudis ◽  
Harold J. Burstein ◽  
John Bryant ◽  
Rowan T. Chlebowski ◽  
...  
Keyword(s):  
Clinical Oncology ◽  
Aromatase Inhibitors ◽  
Technology Assessment ◽  
Working Group ◽  
Adjuvant Setting ◽  
American Society

Clinical Oncology Practice 2015: Preparing for the Future

2015 ◽  
pp. e622-e627 ◽  
Author(s):  
Michael P. Kosty ◽  
Anupama Kurup Acheson ◽  
Eric D. Tetzlaff
Keyword(s):  
Clinical Oncology ◽  
Nurse Practitioners ◽  
Cancer Care ◽  
Medical Knowledge ◽  
Physician Assistants ◽  
The United States ◽  
Practice Model ◽  
American Society ◽  
Oncology Practice

The clinical practice of oncology has become increasingly complex. An explosion of medical knowledge, increased demands on provider time, and involved patients have changed the way many oncologists practice. What was an acceptable practice model in the past may now be relatively inefficient. This review covers three areas that address these changes. The American Society of Clinical Oncology (ASCO) National Oncology Census defines who the U.S. oncology community is, and their perceptions of how practice patterns may be changing. The National Cancer Institute (NCI)-ASCO Teams in Cancer Care Project explores how best to employ team science to improve the efficiency and quality of cancer care in the United States. Finally, how physician assistants (PAs) and nurse practitioners (NPs) might be best integrated into team-based care in oncology and the barriers to integration are reviewed.

scholarly journals Recommendations for Obesity Clinical Trials in Cancer Survivors: American Society of Clinical Oncology Statement

2015 ◽  
Vol 33 (33) ◽  
pp. 3961-3967 ◽  
Author(s):  
Jennifer A. Ligibel ◽  
Catherine M. Alfano ◽  
Dawn Hershman ◽  
Rachel M. Ballard ◽  
Suanna S. Bruinooge ◽  
...  
Keyword(s):  
Clinical Trials ◽  
Cancer Survivors ◽  
Clinical Oncology ◽  
American Society

scholarly journals Advancing Performance Measurement in Oncology: Quality Oncology Practice Initiative Participation and Quality Outcomes

2011 ◽  
Vol 7 (3S) ◽  
pp. 31s-35s ◽  
Author(s):  
Francis X. Campion ◽  
Leanne R. Larson ◽  
Pamela J. Kadlubek ◽  
Craig C. Earle ◽  
Michael N. Neuss
Keyword(s):  
Performance Measurement ◽  
End Of Life ◽  
Clinical Oncology ◽  
End Of Life Care ◽  
Life Care ◽  
Quality Outcomes ◽  
American Society ◽  
Oncology Practice

American Society of Clinical Oncology Quality Oncology Practice Initiative has grown to include 973 practices as of 2010. Practices demonstrated rates of end-of-life care and other measures of quality.

Initial Hormonal Management of Androgen-Sensitive Metastatic, Recurrent, or Progressive Prostate Cancer: 2007 Update of an American Society of Clinical Oncology Practice Guideline

2007 ◽  
Vol 25 (12) ◽  
pp. 1596-1605 ◽  
Author(s):  
D. Andrew Loblaw ◽  
Katherine S. Virgo ◽  
Robert Nam ◽  
Mark R. Somerfield ◽  
Edgar Ben-Josef ◽  
...  
Keyword(s):  
Prostate Cancer ◽  
Clinical Trials ◽  
Clinical Oncology ◽  
Specific Antigen ◽  
Survival Advantage ◽  
Controlled Trials ◽  
Moderate Increase ◽  
Specific Mortality ◽  
American Society ◽  
Androgen Blockade

Purpose To update the 2004 American Society of Clinical Oncology (ASCO) guideline on initial hormonal management of androgen-sensitive, metastatic, recurrent, or progressive prostate cancer (PCa). Methods The writing committee based its recommendations on an updated systematic literature review. Recommendations were approved by the Expert Panel, the ASCO Health Services Committee, and the ASCO Board of Directors. Results Seven randomized controlled trials (four new), one systematic review, one meta-analysis (new), one Markov model, and one delta-method 95% CI procedure for active controlled trials (new) informed the guideline update. Recommendations Bilateral orchiectomy or luteinizing hormone–releasing hormone agonists are recommended initial androgen-deprivation treatments (ADTs). Nonsteroidal antiandrogen monotherapy merits discussion as an alternative; steroidal antiandrogen monotherapy should not be offered. Combined androgen blockade should be considered. In metastatic or progressive PCa, immediate versus symptom-onset institution of ADT results in a moderate decrease (17%) in relative risk (RR) for PCa-specific mortality, a moderate increase (15%) in RR for non–PCa-specific mortality, and no overall survival advantage. Therefore, the Panel cannot make a strong recommendation for early ADT initiation. Prostate-specific antigen (PSA) kinetics and other metrics allow identification of populations at high risk for PCa-specific and overall mortality. Further studies must be completed to assess whether patients with adverse prognostic factors gain a survival advantage from immediate ADT. For patients electing to wait until symptoms for ADT, regular monitoring visits are indicated. For patients with recurrence, clinical trials should be considered if available. Currently, data are insufficient to support use of intermittent androgen blockade outside clinical trials.

The Role of Prevention in Oncology Practice: Results From a 2004 Survey of American Society of Clinical Oncology Members

2006 ◽  
Vol 24 (18) ◽  
pp. 2948-2957 ◽  
Author(s):  
Patricia A. Ganz ◽  
Lorna Kwan ◽  
Mark R. Somerfield ◽  
David Alberts ◽  
Judy E. Garber ◽  
...  
Keyword(s):  
Clinical Practice ◽  
Cancer Prevention ◽  
Risk Reduction ◽  
Clinical Oncology ◽  
Prevention And Control ◽  
Cancer Prevention And Control ◽  
Prevention Activities ◽  
American Society ◽  
Oncology Practice ◽  
And Control

Purpose In 2004, the American Society of Clinical Oncology (ASCO) Cancer Prevention Committee surveyed the members to describe involvement in clinical prevention activities. Methods A previously administered survey, with updated items on genetics, chemoprevention, and survivorship, was mailed to a stratified random sample of 2,000 domestic members and a convenience sample of 3,144 international members. Results A total of 49.7% of domestic members contacted and survey eligible responded (n = 851). Nonresponders were younger (50.5 v 51.7 years; P < .01); 465 international members responded. Overall, 35% had received formal instruction in cancer prevention and control, and most respondents expected increased use of prevention, screening/early detection, and risk reduction/genetic counseling in their practices in the next 5 years. Most reported caring for cancer survivors, including providing general medical care. They also either directly provide or refer patients for cancer prevention and control services (eg, cancer screening, tobacco and nutrition counseling, risk reduction, and chemoprevention). Multivariable modeling found fewer perceived barriers to inclusion of cancer prevention activities in clinical practice among those practicing in an academic setting, seeing a higher proportion of patients without a cancer diagnosis, having formal training in prevention and control, expecting an increase in prevention activities in the next 5 years, and providing community advice on prevention. Conclusion Barriers to the inclusion of cancer prevention and control activities in oncology clinical practice exist. Nevertheless, a substantial proportion of both domestic and international ASCO members report an interest in cancer prevention and control activities, with a desire for more specific educational programs in this emerging area of oncology practice.

scholarly journals American Society of Clinical Oncology/American Society of Hematology Clinical Practice Guideline Update on the Use of Epoetin and Darbepoetin in Adult Patients With Cancer

2010 ◽  
Vol 28 (33) ◽  
pp. 4996-5010 ◽  
Author(s):  
J. Douglas Rizzo ◽  
Melissa Brouwers ◽  
Patricia Hurley ◽  
Jerome Seidenfeld ◽  
Murat O. Arcasoy ◽  
...  
Keyword(s):  
Clinical Oncology ◽  
Information Storage And Retrieval ◽  
Chemotherapeutic Agents ◽  
Concurrent Chemotherapy ◽  
Information Storage ◽  
Cochrane Library ◽  
Patients With Cancer ◽  
Increased Risk ◽  
American Society ◽  
Meta Analyses

Purpose To update American Society of Clinical Oncology/American Society of Hematology recommendations for use of erythropoiesis-stimulating agents (ESAs) in patients with cancer. Methods An Update Committee reviewed data published between January 2007 and January 2010. MEDLINE and the Cochrane Library were searched. Results The literature search yielded one new individual patient data analysis and four literature-based meta-analyses, two systematic reviews, and 13 publications reporting new results from randomized controlled trials not included in prior or new reviews. Recommendations For patients undergoing myelosuppressive chemotherapy who have a hemoglobin (Hb) level less than 10 g/dL, the Update Committee recommends that clinicians discuss potential harms (eg, thromboembolism, shorter survival) and benefits (eg, decreased transfusions) of ESAs and compare these with potential harms (eg, serious infections, immune-mediated adverse reactions) and benefits (eg, rapid Hb improvement) of RBC transfusions. Individual preferences for assumed risk should contribute to shared decisions on managing chemotherapy-induced anemia. The Committee cautions against ESA use under other circumstances. If used, ESAs should be administered at the lowest dose possible and should increase Hb to the lowest concentration possible to avoid transfusions. Available evidence does not identify Hb levels ≥ 10 g/dL either as thresholds for initiating treatment or as targets for ESA therapy. Starting doses and dose modifications after response or nonresponse should follow US Food and Drug Administration–approved labeling. ESAs should be discontinued after 6 to 8 weeks in nonresponders. ESAs should be avoided in patients with cancer not receiving concurrent chemotherapy, except for those with lower risk myelodysplastic syndromes. Caution should be exercised when using ESAs with chemotherapeutic agents in diseases associated with increased risk of thromboembolic complications. Table 1 lists detailed recommendations. This guideline was developed through a collaboration between the American Society of Clinical Oncology and the American Society of Hematology and has been published jointly by invitation and consent in both Journal of Clinical Oncology and Blood. Copyright © 2010 American Society of Clinical Oncology and American Society of Hematology. All rights reserved. No part of this document may be reproduced or transmitted in any form or by any means, electronic or mechanical, including photocopy, recording, or any information storage and retrieval system, without written permission by the American Society of Clinical Oncology or the American Society of Hematology.

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