Book reviewAdvances in Medical Oncology, Research in Education (UICC). General Editors: CanonicoA., EstevezO., ChaconR. and BargF., Volume VI: Basis for Cancer Therapy II, Editor MooreM., pp. xi + 317, 1979. (Pergamon Press, Oxford), £25, $50. ISBN 0–08–024389–4

1980 ◽  
Vol 53 (628) ◽  
pp. 356-356
Author(s):  
R. J. Berry
Keyword(s):  
Cancer Therapy ◽  
Medical Oncology ◽  
Oncology Research ◽  
Research In Education

A new model of early supportive care and symptoms management: The experience of Pisa medical oncology.

2013 ◽  
Vol 31 (15_suppl) ◽  
pp. e20711-e20711 ◽  
Author(s):  
Andrea Antonuzzo ◽  
Enrico Vasile ◽  
Maurizio Lucchesi ◽  
Laura Ginocchi ◽  
Luca Galli ◽  
...  
Keyword(s):  
Supportive Care ◽  
Medical Oncology ◽  
Median Number ◽  
Main Question ◽  
Day Hospital ◽  
Early Management ◽  
Oncology Research ◽  
Phone Calls ◽  
Number Of Patients ◽  
Oncologic Patients

e20711 Background: Recent advances in medical oncology research and new possibilities of care create a growing number of treatment-related complications. Due to these clinical relevant toxicities a significative number of patients have to admit to our hospital emergency rooms in the recent years. Data from different institutions in Italy suggest that an integrated model of supportive care dedicated to symptoms management and not only, is more effective for cancer patient’s care. Methods: In the last seven months of 2012 we started the “supportive care-team” activity giving a dedicated-room inside the day hospital offering to the patients a direct and early management of chemotherapy toxicities (mucositis, febrile neutropenia, etc.) and “new drugs” induced toxicities (cutaneous, hypertension/cardiovascular, infective, etc.). The medical and nurse team does receive the patient without appointment, based on the severity of clinical problems and give a mobile phone consult all days in the morning. Patients receive symptomatic therapy, i.v. fluid infusions, collecting of blood samples, corrections of medical therapies (e.g. pain therapy), venous accesses management for one-day or more until resolution and physicians are able to organize further specialists evaluations. Moreover, there are strictly linked specialists such as anesthesiology involved in all cases of severe drugs adverse reactions. Other two ancillary support activities the for patients are offered by the psychologist and chaplain daily inside the day hospital. Results: During all 2012 we have delivered 13.365 courses of anticancer therapies in 1,358 patients. All these were outpatients. During the last 7 months of 2012 we have made 761 unplanned visits (median number/day 6, range 0-13) and the team did respond to 1,138 phone calls (median number/day 9, range 2-24). Conclusions: These analysis does attempt to answer to the main question of reducing hospitalizations and their related costs. Our new organizative model prompt to maintain much more the management of oncologic patients inside the oncologic department and to increase the feasibility of patient’s continuos care, improving symptoms control and patient’s quality of life.

Impact of preexisting cardiovascular disease (CVD) on treatments and outcomes of patients with breast or lung cancer.

2020 ◽  
Vol 38 (15_suppl) ◽  
pp. 12063-12063
Author(s):  
Atul Batra ◽  
Shiying Kong ◽  
Rodrigo Rigo ◽  
Winson Y. Cheung
Keyword(s):  
Lung Cancer ◽  
Logistic Regression ◽  
Cancer Therapy ◽  
Proportional Hazards ◽  
Early Stage ◽  
Geriatric Oncology ◽  
Cox Proportional Hazards ◽  
Cancer Treatments ◽  
Cardiac Health ◽  
Oncology Research

12063 Background: Prior cardio-oncology and geriatric oncology research has mainly focused on cancer treatments and their late effects on cardiac health, but little information is known about how cardiac health may influence subsequent cancer treatments. This real-world study aimed to evaluate the associations of pre-existing CVD on treatment adherence and survival in patients with breast or lung cancer. Methods: We linked administrative data from the population-based cancer registry, electronic medical records, and billing claims in a large province (Alberta, Canada) over a 10-year time period (2006-2015). Multivariable logistic regression analyses were performed to identify associations of CVD with cancer treatments. Multivariable Cox proportional hazards models were constructed to determine the effect of CVD on overall survival (OS), while adjusting for receipt of cancer treatments. Results: We identified 46,227 patients with breast or lung cancer, of whom 77% were women and median age was 65 years. While 82% of patients with breast cancer were early stage, 50% with lung cancer had metastasis. The prevalence of pre-existing CVD was 20% where congestive heart failure was most frequent. In logistic regression, CVD was associated with lower odds of receiving appropriate chemotherapy (OR, 0.60, 95% CI, 0.56-0.65, P<.0001), radiotherapy (OR, 0.76, 95% CI, 0.72-0.81, P<.0001), and surgery (OR, 0.60, 95% CI, 0.54-0.66, P <.0001), irrespective of tumor site (Table). The 5-year OS was lower in patients with baseline CVD as compared to those without (46% vs 58%, P<0.0001). Upon adjusting for stage and treatment, CVD continued to correlate with worse OS (HR, 1.23, 95% CI, 1.19-1.26; P<.0001). Conclusions: Cancer patients with prior CVD were less likely to receive standard cancer therapy. Even among those who underwent cancer treatments, worse outcomes were observed in those with CVD. Early cardio-oncology and geriatric oncology engagement may reduce treatment bias and ensure that carefully selected patients with a cardiac history are still offered appropriate cancer therapy. [Table: see text]

scholarly journals Accurate Triage of Oncological Patients for Safely Continuing Cancer Therapy During the SARS-CoV-2 Pandemic

2021 ◽  
Vol 11 ◽  
Author(s):  
Cristina Gurizzan ◽  
Rebecca Pedersini ◽  
Carla Fornaro ◽  
Chiara Sardini ◽  
Manuel Zamparini ◽  
...  
Keyword(s):  
Cancer Therapy ◽  
Medical Oncology ◽  
Nasal Congestion ◽  
Signs And Symptoms ◽  
Nasopharyngeal Swab ◽  
Grey Zone ◽  
Symptomatic Disease ◽  
Oncological Patients ◽  
Antineoplastic Treatment ◽  
Oncology Unit

ObjectiveTo evaluate the efficacy of clinical triage of oncological patients for safe continuation of cancer therapy implemented during the first SARS-CoV-2 outbreak.MethodsBetween 25 February and 21 April 2020, patients attending the Medical Oncology Unit, Spedali Civili Hospital, Brescia (Italy) for cancer therapy underwent triage to identify those with no signs and symptoms suspicious for SARS-CoV-2 infection in which antineoplastic treatment could be continued as scheduled. Triage questions investigated common symptoms (e.g., fever, cough, dyspnea, anosmia, dysgeusia, headache, nasal congestion, conjunctival congestion, sore throat, diarrhea, nausea and vomiting); body temperature and pulse oximetry were also recorded. All patients were followed-up for overt SARS-CoV-2 through to 18th May 2020.ResultsOverall, 1180 patients (median age 65 years) underwent triage during the study period. The most frequent primary malignances were breast (32%), gastrointestinal (18%), and lung (16.5%) cancer. Thirty-one (2.5%) presented with clinically evident SARS-CoV-2 infection and tested positive on nasopharyngeal swab testing and/or radiological imaging. Triage identified 69 (6%) grey zone patients with symptoms suspicious for SARS-CoV-2; 5 (7.2%) subsequently developed symptomatic disease. Neither the symptomatic nor the grey zone patients received their scheduled treatment; instead, they were referred for hospitalization or home quarantine.ConclusionTriage of oncological patients at our Unit provided for safe continuation of scheduled cancer treatment in 91.5% of patients during the initial SARS-CoV-2 outbreak.

Clinical trials networks and enrollment of historically underrepresented populations in medical oncology trials

2009 ◽  
Vol 27 (15_suppl) ◽  
pp. e20598-e20598
Author(s):  
J. L. Berkowitz ◽  
A. Fernandez ◽  
R. A. Dichmann ◽  
K. A. Kennedy ◽  
B. DiCarlo
Keyword(s):  
Clinical Trials ◽  
Medical Oncology ◽  
Cancer Center ◽  
Underrepresented Populations ◽  
Oncology Research ◽  
Academic Center ◽  
Clinical Investigations ◽  
Number Of Patients ◽  
Bony Metastases ◽  
Two Populations

e20598 Background: Oncology research is limited by the very low number of patients accrued into clinical trials. Clinical trials networks may help to overcome this limitation by allowing investigations designed through academic centers to be available to patients seen in community practices that are far from these centers. This allows for increased accrual and access for these patients while potentially increasing the pace of progress in clinical oncology research. Methods: In this study, we attempted to determine the effect that clinical trials networks can have on the accrual of cancer patients into clinical investigations. We retrospectively analyzed the records from 2002–2008 of a private practice located over 150 miles from an academic center for accrual into trials. This practice is a member of a clinical trials network affiliated with a major academic cancer center. Accrued patients were divided into subgroups based upon type of malignancy, ethnicity and whether or not they were elderly. In addition, from 2007–2008, the percentage of patients accrued into trials relative to the total number treated onsite was calculated and compared to national averages. Results: In this period, a total of 139 patients at this practice were accrued into clinical trials. By malignancy, they were as follows: breast 36%, colorectal 22%, lung 13%, prostate 8.4%, gastric and lymphoma each 3.0%, pancreatic 1.8%, melanoma 1.2% and ovarian 0.6%. The other 18 patients were in trials for either chemotherapy related anemia 7.8% or bony metastases 3.0%. Of the 139 patients, 45% were elderly and 16% were Hispanic, both markedly higher than national averages. For 2007–2008, 12% of patients that received on site treatment were accrued on to trials. For lung, colorectal, and breast cancer, the number of patients on trial as a percentage of all treated onsite were also higher than the national averages. Conclusions: Clinical trial networks allow a higher percentage of total patients to be accrued than the national average and greatly enhance the potential for both minority and elderly enrollment, two populations that have been historically underrepresented in major clinical trials. It may also help to accelerate the progress of medical oncology research towards better treatments for all patients. No significant financial relationships to disclose.

scholarly journals Impact of dose rounding of cancer therapy on cost avoidance: a pilot study

2013 ◽  
Vol 14 (4) ◽  
pp. 169-172 ◽  
Author(s):  
Nagwa Ibrahim
Keyword(s):  
Targeted Therapy ◽  
Cancer Therapy ◽  
Cost Saving ◽  
Medical Oncology ◽  
Cost Savings ◽  
Potential Cost ◽  
Biologic Drugs ◽  
The Past ◽  
Chemotherapy Agents ◽  
Theoretical Cost

BACKGROUND: A significant and progressive cost rising in medical oncology due to the incorporation of novel and highly expensive drugs into clinical practice have been seen in the past ten years. Dose rounding is an option might be used in oncology settings to avoid extra cost. The purpose of this project is to determine the theoretical cost saving related to a dose rounding process for biological and chemotherapy agents in adult oncology settings and to determine the opinion of oncologists about dose rounding.MATERIALS AND METHODS: Data was obtained prospectively during April 2011. All chemotherapy and targeted therapy orders prescribed in adult oncology outpatient clinics as well as in-patient wards have been collected. We considered rounding to an amount within 15% for targeted therapy and 10% for cytotoxic drugs. Chemotherapy dosing was calculated according to body surface area. Prescriptions that include cancer therapy in doses that might be rounded according to study criteria were identified.RESULTS: Two hundred and thirty three orders of chemotherapy and targeted therapy were processed by Adult Oncology Satellite Pharmacy during the period of data collection. Forty percent of the collected prescriptions fulfilled the criteria. The potential cost savings from dose rounding per year was $192,800. Data was extrapolated from the determined monthly cost savings. The highest cost saving was for breast cancer orders $80,820 (42%), followed by colorectal cancer $47,965 (25%), while in non-Hodgkin's lymphoma cost savings was $ 45,107 (23%) and for other types of cancer that include non small cell lung cancer, prostate and ovarian cancer, in addition to head and neck cost savings was $18,867 (10%).CONCLUSIONS: Our experience confirms the significant cost savings of cancer therapy by applying dose rounding to chemotherapy and biologic drugs prescriptions. While clinical impact of the suggested percentage needs to be evaluated.

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