May 2014, Vol 5, No 4

According to a new systematic review of the risks and benefits of breast cancer screening, regular mammography is associated with a 19% reduction in breast cancer mortality, but it is also associated with a 61% cumulative risk of a false-positive result, and approximately 19% of the cases are, in fact, considered overdiagnoses (Pace LE, Keating NL. JAMA. 2014;311:1327-1335).
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The American Society of Clinical Oncology (ASCO) has issued new guidelines for the use of sentinel node biopsy (SNB) in patients with early-stage breast cancer (Lyman GH, et al. J Clin Oncol. 2014;32:1365-1383. The newer version expands the use of SNB to a larger group of patients, based on evidence from 9 randomized trials and 13 cohort studies conducted since 2005, when the first SNB guidelines were published.
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In passing the Affordable Care Act (ACA) in 2010, Congress had as one of its central goals the creation of new, innovative ways of paying for and delivering healthcare services. With this goal in mind, the ACA established the Center for Medicare and Medicaid Innovation (CMMI), which is tasked with developing new payment and service delivery models to “demo” and, if successful, to eventually roll out nationwide.
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In recent years, an increasing number of drug shortages have threatened public health by reducing—if not eliminating—patient access to critical pharmaceuticals.
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Las Vegas, NV—Researchers are making a compelling case for screening women at high risk for breast cancer for more than BRCA mutations. In fact, 4 genetic mutations are well recognized in genetic-based breast cancer, including CDH1, PTEN, STK11, and TP53.
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San Diego, CA—A preliminary study from a highly respected group of researchers suggests that a simple blood test for the androgen receptor splice variant-7 (AR-V7) in the AR gene can identify men with castrate-resistant prostate cancer (CRPC) who will not respond to enzalutamide (Xtandi).
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San Diego, CA—Two studies, one in melanoma and one in non–small-cell lung cancer (NSCLC), presented at the 2014 American Association for Can­-cer Research meeting attempted to correlate response to the anti–programmed cell death (PD)-1 inhibitor MK-3475 with the biomarker PD-L1. The hope is that the level of PD-L1 expression will be a biomarker for the selection of patients for treatment with this new agent.
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Studies with the tyrosine kinase inhibitor crizotinib (Xalkori) have shown significant improvement in clinical outcomes for the treatment of echinoderm microtubule-associated protein-like 4 and anaplastic lymphoma kinase (EML4-ALK) fusion-positive non–small-cell lung cancer (NSCLC), but researchers recently questioned its cost-effectiveness.
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Epidermal growth factor receptor (EGFR) tyrosine kinase inhibitors (TKIs) are the preferred treatment option for patients with advanced non–small-cell lung cancer (NSCLC) who have tested positive for EGFR mutations, because of better outcomes than conventional chemotherapy.
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Non–small-cell lung cancer (NSC LC) harboring anaplastic lymphoma kinase (ALK) rearrangement is sensitive to the ALK inhibitor crizotinib (Xalkori). Despite initial responses to crizotinib, resistance ultimately occurs. In preclinical studies, ceritinib (Zykadia), a novel, oral adenosine triphosphate–competitive inhibitor of the ALK tyrosine kinase, has shown greater antitumor potency than crizotinib.
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