In the Literature

Patient navigation is an increasingly recognized component of high-quality, patient-centered care. However, patient navigation in cancer programs is limited, often because of uncertainty about sustainable financial models to support these programs and defining the scope of practice. To demonstrate the benefits of patient navigation programs, researchers analyzed 5 real-world case studies (Kline RM, et al. J Oncol Pract. 2019;15:585-590).

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In the phase 2 STORM Part 1 clinical trial, 21% of patients with refractory multiple myeloma had a partial or better response to oral selinexor (Xpovio) plus dexamethasone. Those findings were the basis for the pivotal phase 2 STORM Part 2 study (Chari A, et al. N Engl J Med. 2019;381:727-738).
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The introduction of BRAF- and MEK-targeted therapies and immune checkpoint inhibitors has significantly improved outcomes in patients with metastatic melanoma. However, many patients have drug resistance—acquired or primary—which results in death from underlying disease.
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In a new analysis, researchers examined the estimated cost of lost earnings that resulted from cancer-related deaths in the United States, nationally and by state (Islami F, et al. JAMA Oncol. 2019 Jul 3 [Epub ahead of print].).
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The 2 chimeric antigen receptor (CAR) T-cell therapies available so far—axicabtagene ciloleucel (Yescarta) and tisagenlecleucel (Kymriah)—may be considered cost-effective treatments for adults with diffuse large B-cell lymphoma (DLBCL), depending on the long-term outcomes of these patients, according to a recent cost-effective analysis (Lin JK, et al. J Clin Oncol. 2019 Jun 3. Epub ahead of print).
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Until recently, patients with newly diagnosed multiple myeloma who are ineligible for autologous stem-cell transplantation (ASCT), the multiagent regimen with lenalidomide (Revlimid) and dexamethasone was the standard of care. Results of the prespecified interim analysis of the MAIA trial demonstrated the benefit of adding daratumumab (Darzalex) to this combination therapy (Facon T, et al. N Engl J Med. 2019;380:2104-2115).
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Approximately 40% of patients with hormone receptor (HR)-positive, HER2-negative breast cancer have mutations in the PIK3CA gene. Although endocrine­based therapy is the standard treatment, acquired resistance remains a challenge.
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Patients with diffuse large B-cell lymphoma (DLBCL) who have not responded to available therapies, with relapsed or primary resistant disease, have a poor prognosis.
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Currently, there are limited therapies to prevent or delay recurrence in advanced ovarian cancer, with approximately 70% of patients having a recurrence within 3 years. The effectiveness of olaparib, an oral poly (ADP-ribose) polymerase inhibitor, in relapsed disease has been well-established; however, its benefit as a maintenance therapy in newly diagnosed advanced ovarian cancer is uncertain. In a recent study, researchers evaluated the efficacy of upfront maintenance therapy with olaparib in patients with newly diagnosed, advanced BRCA-positive ovarian cancer.
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Chemoimmunotherapy with chlor­ambucil plus obinutuzumab or bendamustine plus rituximab is standard frontline treatment for older patients with chronic lymphocytic leukemia (CLL). However, chemoimmunotherapy is associated with toxic effects, and the risk increases with age.
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