OBR Daily Commentary

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Lung Cancer May Grow Faster During Immunotherapy

(Medscape Medical News) Nov 13, 2017 - A retrospective analysis from France found that 14% of patients with advanced lung cancer showed an acceleration of tumor growth while receiving immunotherapy.

H. Jack West, MD (Posted: November 14, 2017)

quotesThis is interesting and somewhat helpful for turning a clinical observation at the anecdotal level into retrospective data that actually characterize the frequency of this issue in a clinical population. However, we also need to ask what we do with this information. The report indicates that hyper-progression is seen a little more commonly with immunotherapy than with chemo in advanced NSCLC. However, we can't reliably predict who will demonstrate hyper-progression. The authors find that patients with a higher number of metastatic sites have higher risk, but the absolute difference isn't enough to make this a clinically helpful predictor. Given the clear survival benefit with several immune checkpoint inhibitors over chemo in previously treated NSCLC, this information doesn't/shouldn't dissuade an oncologist from favoring a checkpoint inhibitor based on the far more clear prospective clinical trial data. That said, it's a valuable starting point for further study of this issue.quotes

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Hospitals Sue HHS to Stop Cuts to Medicare Drug Payment Program

(Bloomberg) Nov 13, 2017 - Hospitals and several of their trade organizations sued the U.S. Department of Health and Human Services to stop cuts to a Medicare program that lets facilities that serve low-income patients buy drugs at a discount and then get reimbursed at a higher rate.

Ted Okon (Posted: November 14, 2017)

quotesThis injunction filed by 3 hospital organizations and 3 hospitals will be interesting to watch. Regardless, 340B hospitals are clearly in the crosshairs of this Administration and Congress. On the other side, the hospitals are fighting mad to retain all the 340B profits available to them. As I have said many times during the past few years, 340B is a financial bubble that has to pop. It is simply not sustainable.quotes

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COA Applauds CMS on 340B Reforms in Final Medicare Rule

(COA) Nov 1, 2017 - The Community Oncology Alliance (COA) applauds the Centers for Medicare & Medicaid Services (CMS) on its recent policy change to curb abuses of the 340B Drug Discount Program.

Thomas Marsland, MD (Posted: November 08, 2017)

quotesCertainly the original intent of the 340B program is laudable. Throughout the years the program grew and became subject to along list of abuses. Through numerous loop holes this became a vehicle for hospitals to expand costly cancer programs at the expense of more efficient community practices. This ruling is a welcome first step in helping to save the integrity of the program and its transparency. As the article suggests the patients and tax payers will benefit. Hospitals now will have to compete on a more even playing field with private practices and perhaps will learn some of the efficiency community physician had to learn the hard way when the original ASP rule went into effect.quotes

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Meet the Editorial Board

Community Oncology
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Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
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Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
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H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
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Howard S. Hochster, MD

Associate Cancer Center Director, Yale Cancer Center P...

Radiation Oncology
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Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics
Pr...

Community Oncology
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Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
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Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Financial Sector
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Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
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Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

Editor-In-Chief
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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Health Policy
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Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
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Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
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William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
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William McGivney, PhD

National Health Policy Expert...

Payer
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Winston Wong, PharmD

President, W-Squared Group...