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At the 2016 American Society of Clinical Oncology in Chicago, Illinois, researchers from the VA submitted new abstracts on more than 20 different research projects focused on veteran’s oncology care. The researchers conducted studies with the scope of veteran diagnosis, treatment, and quality of care. The abstracts were presented at the annual ASCO meeting during poster sessions and online.
General Oncology
The Impact of a Veterans Administration NURSE Disease Management Program: the Oncology Aspect
Author(s): George Anthony Dawson, et al.
Background: In an effort to decrease time to diagnosis and/or treatment intervention in newly diagnosed veteran cancer patients, Hudson Valley administrators chose the disease case management team model as a potential useful solution to enhance and / or expedite health care delivery. This disease management program began in 2008. The team consists of 3 registered nurses who work under the auspices of the quality management division rather than a specific oncology clinic. This report will show the clinical impact of Hudson Valley VA’s disease management team.
To read the full abstract click here: http://meetinglibrary.asco.org/content/161764-176
Implementation of a Nurse Communication Strategy to Improve Perception of Nurse-Patient Communication at the Bedside on an Inpatient Oncology Unit
Author(s): Lyn Cain Zehner, et al.
Background: Patients spend more time with nurses when in the hospital than with any other health care professional. Patient experience scores have been used as a measure of quality patient outcomes. The Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) score communication with nurses, correlates with improvements in 4 other dimensions: pain, communication about medications, responsiveness of staff, and overall rating. As patient experience scores are tied to Medicare reimbursement, nurses have an impact on reimbursement. The nurse communication scores on the inpatient 29 bed oncology unit reflected an opportunity for improvement. The purpose of this project was to develop a communication strategy that staff would implement at the bedside. The goal was to achieve an improvement in the HCAHPS Communication with Nurses question.
To read the full abstract click here: http://meetinglibrary.asco.org/content/166250-176
Modified Ketogenic Diet in Advanced Malignancies–Final Results of a Safety and Feasibility Trial Within the Veterans Affairs Healthcare System
Author(s): Jocelyn Tan-Shalaby, et al.
Final report of a safety and feasibility trial within the Pittsburgh Veteran Affairs HealthCare System- Modified Ketogenic Diet in Advanced Cancer.
Background: Malignant cells have dysfunctional mitochondria, which limit their ability to use energy from fatty acids and ketones. Preclinical animal studies using a ketogenic diet in cancer show encouraging results. The authors tested safety and feasibility of the modified ketogenic diet in a veteran population of advanced cancer patients across a variety of solid tumors.
To read the full abstract click here: http://meetinglibrary.asco.org/content/170081-176
[Click through for : Prostate Cancer, Liver, Radiation Oncology, Lung Cancer, Colorectal, HIV and Cancer, Palliative Care, Esophageal]
Prostate Cancer
Improving Risk Stratification Among Veterans With Newly Diagnosed, Clinically Low-Risk Prostate Cancer Using the 17-Gene Genomic Prostate Score Assay.
Author(s): Julie Ann Lynch, et al.
Background: Active surveillance (AS) is a recommended treatment option for low risk prostate cancer (PCa). Studies have shown high rates of AS in the VA yet treatment variation exists between VAMCs, likely due to concern about missing aggressive disease. The 17-gene Genomic Prostate Score (GPS) has been validated to predict likelihood of favorable pathology in men with low risk PCa. This study compares treatment patterns before and after introduction of the GPS to determine if the assay assists in risk-stratification. Men with PCa who met National Comprehensive Cancer Network criteria for very low, low, or intermediate risk PCa were eligible. Chart review of men across 6 VAMCs established baseline treatment in untested patients in 2013-2014. In 2015, Veterans at the same VAMCs were offered the assay in a prospective study. Treatment recommendations and treatment implemented were captured.
To read the full abstract click here: http://meetinglibrary.asco.org/content/170703-176
Trends in Utilization of Novel Oral Therapeutic Agents for Men With Metastatic Castrate-Resistant Prostate Cancer Within the United States Veteran’s Affairs Health System.
Author(s): Elizabeth Henry, et al.
Background: Therapeutic options for men with metastatic castrate resistant prostate cancer (mCRPC) have expanded significantly over the past 5 years with several new agents demonstrating improved survival, including two oral agents. Abiraterone acetate, a CYP-17 androgen synthesis inhibitor, obtained initial FDA approval in 2011 for post-docetaxel (D) use, and gained expanded approval in 2012 for pre-D use. Enzalutamide, an androgen receptor signaling inhibitor, also gained FDA approval in 2012 (post-D) and indication was expanded in 2014 (pre-D). Due to the relatively recent approvals of these agents, there is limited data on rates of uptake and prescribing patterns for patients with mCRPC.
To read the full abstract click here: http://meetinglibrary.asco.org/content/157970-172
Liver
A Comparison of Liver Cancer Patients Receiving Palliative Care at Two Veteran Affairs Medical Centers.
Author(s): Sarah Lee, Zhen Wang, et al.
Background: Liver cancer is a leading cause of death. Lack of data exists on palliative care in this group, and care varies by location. The authors aim to determine if there are differences in palliative care for liver cancer patients by VA site.
To read the full abstract click here: http://meetinglibrary.asco.org/content/171726-176
[Click through for : Radiation Oncology, Lung Cancer, Colorectal, HIV and Cancer, Palliative Care, Esophageal]
Radiation Oncology
A Cross-Sectional View of Radiation Dose Fractionation Schemes Used for Treating Painful Bone Metastases (PBM) Within Veterans Health Administration’s Radiation Oncology Centers.
Author(s): George Anthony Dawson, et al.
Background: The use of single fraction radiotherapy in the treatment of PBM in the United States is now gaining clinical acceptance, especially at large institutional levels. In this cross-sectional report, the authors report the varying dose fractionation schemes used to treat PBM by VHA radiation oncology centers.
To read the full abstract click here: http://meetinglibrary.asco.org/content/161496-176
Will Academic and Community Physicians Engage and Share Knowledge in an Online Physician Social Network? Lessons from the Radiation Oncology Community.
Author(s): Nadine Housri, et al.
Background: The exponential growth of medical knowledge has made it increasingly difficult for clinicians to make sense of new information and recognize how to incorporate new research results into clinical practice. The authors sought to determine whether a social question and answer website designed to connect academic and community physicians would consistently engage radiation oncologists to share evidence based information and clinical insights with each other.
To read the full abstract click here: http://meetinglibrary.asco.org/content/171497-176
Lung Cancer
Non–Small Cell Lung Cancer in Veterans: Disparities in Prevalence and Survival Among Different Histologic Subtypes.
Author(s): Hussein Assi, Efstratios Koutroumpakis, et al.
Background: Since the 1980s, adenocarcinoma (AC) of the lung has become more common than squamous cell carcinoma (SCC). Given the differences in smoking patterns, it is unclear if the same holds true among veterans. In this study, the authors compare the distribution of lung AC and SCC in the veterans’ population to that in the general population. They also looked at the survival of patients with different histologies in the VA population.
To read the full abstract click here: http://meetinglibrary.asco.org/content/167505-176
VA Oncologists’ Attitudes and Behaviors Regarding Genomic-Based Targeted Therapy for the Management of Advanced Lung Cancer.
Author(s): Jennifer Arney, et al.
Background: Genomic-based targeted therapy (GBTT) has emerged as a treatment option for patients with advanced lung cancer. Clinical practice guidelines of the National Comprehensive Cancer Network and the American Society of Clinical Oncology recommend testing all metastatic adenocarcinomas for EGFR mutation, and use of EGFR-TKIs (erlotinib) as first-line therapy for advanced adenocarcinoma lung cancer patients with EGFR mutation positive. Little is known about how oncologists utilize genomic testing and GBTT in a clinical setting. Drawing from the Cabana and colleagues theoretical framework on providers’ adherence to guidelines, this study aims to elicit provider and facility-level barriers and facilitators to using GBTT in VA healthcare delivery system.
To read the full abstract click here: http://meetinglibrary.asco.org/content/166517-176
[Click through for: Colorectal, HIV and Cancer, Palliative Care, Esophageal]
Colorectal
Survival Advantage for Hepatectomy With or Without Hemicolectomy in Colorectal Liver Metastases.
Author(s): Dalia A. Mobarek, et al.
Background: Surgical resection of colorectal liver metastases offers the greatest chance of long-term survival. The authors aimed to study survival in patients presenting with hepatic metastasis at the outset and rates of surgical intervention in the VHA.
To read the full abstract click here: http://meetinglibrary.asco.org/content/171640-176
Colorectal Liver Metastases Management in the Veterans Health Administration: Geographic Disparity.
Author(s): Dalia A. Mobarek, et al.
Background: Multidisciplinary management including surgical resection of colorectal liver metastases offers the greatest chance of long-term survival. The authors aimed to study surgical intervention types, rates and factors affecting the decision making in the VHA.
To read the full abstract click here: http://meetinglibrary.asco.org/content/160233-173
HIV and Cancer
Gleason Grade in HIV+ Versus Uninfected Prostate Cancer Patients in the Veterans Aging Cohort Study.
Author(s): Roxanne Jimmy Wadia, et al.
Background: Little is known about how the biology of prostate cancer in HIV+ men compares to that of uninfected men. The purpose of this study was to compare the Gleason grade (GL) of prostate adenocarcinoma (PrCA) in HIV+ vs uninfected patients in the combination antiretroviral therapy (ART) era (1997-present).
To read the full abstract click here: http://meetinglibrary.asco.org/content/162980-176
Disparities in AIDS-Related Kaposi Sarcoma Incidence and Survival.
Author(s): Firas El Chaer, et al.
Background: With advances in combined antiretroviral therapy (ART), Kaposi’s sarcoma (KS) incidence has decreased over the past decade. Geographical and racial disparities may contribute to variation in the incidence and outcomes of multiple cancers in the U.S., including KS. Using the Surveillance, Epidemiology, and End Results (SEER) database, the authors analyzed KS incidence and survival by race and geographical region in the ART era.
To read the full abstract click here: http://meetinglibrary.asco.org/content/168953-176
[Click through for : Palliative Care, Esophageal]
Palliative Care
Palliative Care Interventions and EOL Care Outcomes for Hepatocellular Patients (pts) at 2 VA Medical Centers.
Author(s): Zhen Wang, et al.
Background: Palliative care interventions and its effect on EOL outcomes for liver cancer pts have not been described. The authors investigated the association between palliative care intervention and EOL care outcomes.
To read the full abstract click here: http://meetinglibrary.asco.org/content/167081-176
Esophageal
Characteristics of Esophageal Carcinoma in a Veteran Population.
Author(s): Theresa Ratajczak, et al.
Background: Esophageal cancer is projected to increase by approximately 35% through 2025 in the U.S. The authors investigated the characteristics of esophageal carcinoma in a veteran population.
To read the full abstract click here: http://meetinglibrary.asco.org/content/162712-176
At the 2016 American Society of Clinical Oncology in Chicago, Illinois, researchers from the VA submitted new abstracts on more than 20 different research projects focused on veteran’s oncology care. The researchers conducted studies with the scope of veteran diagnosis, treatment, and quality of care. The abstracts were presented at the annual ASCO meeting during poster sessions and online.
General Oncology
The Impact of a Veterans Administration NURSE Disease Management Program: the Oncology Aspect
Author(s): George Anthony Dawson, et al.
Background: In an effort to decrease time to diagnosis and/or treatment intervention in newly diagnosed veteran cancer patients, Hudson Valley administrators chose the disease case management team model as a potential useful solution to enhance and / or expedite health care delivery. This disease management program began in 2008. The team consists of 3 registered nurses who work under the auspices of the quality management division rather than a specific oncology clinic. This report will show the clinical impact of Hudson Valley VA’s disease management team.
To read the full abstract click here: http://meetinglibrary.asco.org/content/161764-176
Implementation of a Nurse Communication Strategy to Improve Perception of Nurse-Patient Communication at the Bedside on an Inpatient Oncology Unit
Author(s): Lyn Cain Zehner, et al.
Background: Patients spend more time with nurses when in the hospital than with any other health care professional. Patient experience scores have been used as a measure of quality patient outcomes. The Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) score communication with nurses, correlates with improvements in 4 other dimensions: pain, communication about medications, responsiveness of staff, and overall rating. As patient experience scores are tied to Medicare reimbursement, nurses have an impact on reimbursement. The nurse communication scores on the inpatient 29 bed oncology unit reflected an opportunity for improvement. The purpose of this project was to develop a communication strategy that staff would implement at the bedside. The goal was to achieve an improvement in the HCAHPS Communication with Nurses question.
To read the full abstract click here: http://meetinglibrary.asco.org/content/166250-176
Modified Ketogenic Diet in Advanced Malignancies–Final Results of a Safety and Feasibility Trial Within the Veterans Affairs Healthcare System
Author(s): Jocelyn Tan-Shalaby, et al.
Final report of a safety and feasibility trial within the Pittsburgh Veteran Affairs HealthCare System- Modified Ketogenic Diet in Advanced Cancer.
Background: Malignant cells have dysfunctional mitochondria, which limit their ability to use energy from fatty acids and ketones. Preclinical animal studies using a ketogenic diet in cancer show encouraging results. The authors tested safety and feasibility of the modified ketogenic diet in a veteran population of advanced cancer patients across a variety of solid tumors.
To read the full abstract click here: http://meetinglibrary.asco.org/content/170081-176
[Click through for : Prostate Cancer, Liver, Radiation Oncology, Lung Cancer, Colorectal, HIV and Cancer, Palliative Care, Esophageal]
Prostate Cancer
Improving Risk Stratification Among Veterans With Newly Diagnosed, Clinically Low-Risk Prostate Cancer Using the 17-Gene Genomic Prostate Score Assay.
Author(s): Julie Ann Lynch, et al.
Background: Active surveillance (AS) is a recommended treatment option for low risk prostate cancer (PCa). Studies have shown high rates of AS in the VA yet treatment variation exists between VAMCs, likely due to concern about missing aggressive disease. The 17-gene Genomic Prostate Score (GPS) has been validated to predict likelihood of favorable pathology in men with low risk PCa. This study compares treatment patterns before and after introduction of the GPS to determine if the assay assists in risk-stratification. Men with PCa who met National Comprehensive Cancer Network criteria for very low, low, or intermediate risk PCa were eligible. Chart review of men across 6 VAMCs established baseline treatment in untested patients in 2013-2014. In 2015, Veterans at the same VAMCs were offered the assay in a prospective study. Treatment recommendations and treatment implemented were captured.
To read the full abstract click here: http://meetinglibrary.asco.org/content/170703-176
Trends in Utilization of Novel Oral Therapeutic Agents for Men With Metastatic Castrate-Resistant Prostate Cancer Within the United States Veteran’s Affairs Health System.
Author(s): Elizabeth Henry, et al.
Background: Therapeutic options for men with metastatic castrate resistant prostate cancer (mCRPC) have expanded significantly over the past 5 years with several new agents demonstrating improved survival, including two oral agents. Abiraterone acetate, a CYP-17 androgen synthesis inhibitor, obtained initial FDA approval in 2011 for post-docetaxel (D) use, and gained expanded approval in 2012 for pre-D use. Enzalutamide, an androgen receptor signaling inhibitor, also gained FDA approval in 2012 (post-D) and indication was expanded in 2014 (pre-D). Due to the relatively recent approvals of these agents, there is limited data on rates of uptake and prescribing patterns for patients with mCRPC.
To read the full abstract click here: http://meetinglibrary.asco.org/content/157970-172
Liver
A Comparison of Liver Cancer Patients Receiving Palliative Care at Two Veteran Affairs Medical Centers.
Author(s): Sarah Lee, Zhen Wang, et al.
Background: Liver cancer is a leading cause of death. Lack of data exists on palliative care in this group, and care varies by location. The authors aim to determine if there are differences in palliative care for liver cancer patients by VA site.
To read the full abstract click here: http://meetinglibrary.asco.org/content/171726-176
[Click through for : Radiation Oncology, Lung Cancer, Colorectal, HIV and Cancer, Palliative Care, Esophageal]
Radiation Oncology
A Cross-Sectional View of Radiation Dose Fractionation Schemes Used for Treating Painful Bone Metastases (PBM) Within Veterans Health Administration’s Radiation Oncology Centers.
Author(s): George Anthony Dawson, et al.
Background: The use of single fraction radiotherapy in the treatment of PBM in the United States is now gaining clinical acceptance, especially at large institutional levels. In this cross-sectional report, the authors report the varying dose fractionation schemes used to treat PBM by VHA radiation oncology centers.
To read the full abstract click here: http://meetinglibrary.asco.org/content/161496-176
Will Academic and Community Physicians Engage and Share Knowledge in an Online Physician Social Network? Lessons from the Radiation Oncology Community.
Author(s): Nadine Housri, et al.
Background: The exponential growth of medical knowledge has made it increasingly difficult for clinicians to make sense of new information and recognize how to incorporate new research results into clinical practice. The authors sought to determine whether a social question and answer website designed to connect academic and community physicians would consistently engage radiation oncologists to share evidence based information and clinical insights with each other.
To read the full abstract click here: http://meetinglibrary.asco.org/content/171497-176
Lung Cancer
Non–Small Cell Lung Cancer in Veterans: Disparities in Prevalence and Survival Among Different Histologic Subtypes.
Author(s): Hussein Assi, Efstratios Koutroumpakis, et al.
Background: Since the 1980s, adenocarcinoma (AC) of the lung has become more common than squamous cell carcinoma (SCC). Given the differences in smoking patterns, it is unclear if the same holds true among veterans. In this study, the authors compare the distribution of lung AC and SCC in the veterans’ population to that in the general population. They also looked at the survival of patients with different histologies in the VA population.
To read the full abstract click here: http://meetinglibrary.asco.org/content/167505-176
VA Oncologists’ Attitudes and Behaviors Regarding Genomic-Based Targeted Therapy for the Management of Advanced Lung Cancer.
Author(s): Jennifer Arney, et al.
Background: Genomic-based targeted therapy (GBTT) has emerged as a treatment option for patients with advanced lung cancer. Clinical practice guidelines of the National Comprehensive Cancer Network and the American Society of Clinical Oncology recommend testing all metastatic adenocarcinomas for EGFR mutation, and use of EGFR-TKIs (erlotinib) as first-line therapy for advanced adenocarcinoma lung cancer patients with EGFR mutation positive. Little is known about how oncologists utilize genomic testing and GBTT in a clinical setting. Drawing from the Cabana and colleagues theoretical framework on providers’ adherence to guidelines, this study aims to elicit provider and facility-level barriers and facilitators to using GBTT in VA healthcare delivery system.
To read the full abstract click here: http://meetinglibrary.asco.org/content/166517-176
[Click through for: Colorectal, HIV and Cancer, Palliative Care, Esophageal]
Colorectal
Survival Advantage for Hepatectomy With or Without Hemicolectomy in Colorectal Liver Metastases.
Author(s): Dalia A. Mobarek, et al.
Background: Surgical resection of colorectal liver metastases offers the greatest chance of long-term survival. The authors aimed to study survival in patients presenting with hepatic metastasis at the outset and rates of surgical intervention in the VHA.
To read the full abstract click here: http://meetinglibrary.asco.org/content/171640-176
Colorectal Liver Metastases Management in the Veterans Health Administration: Geographic Disparity.
Author(s): Dalia A. Mobarek, et al.
Background: Multidisciplinary management including surgical resection of colorectal liver metastases offers the greatest chance of long-term survival. The authors aimed to study surgical intervention types, rates and factors affecting the decision making in the VHA.
To read the full abstract click here: http://meetinglibrary.asco.org/content/160233-173
HIV and Cancer
Gleason Grade in HIV+ Versus Uninfected Prostate Cancer Patients in the Veterans Aging Cohort Study.
Author(s): Roxanne Jimmy Wadia, et al.
Background: Little is known about how the biology of prostate cancer in HIV+ men compares to that of uninfected men. The purpose of this study was to compare the Gleason grade (GL) of prostate adenocarcinoma (PrCA) in HIV+ vs uninfected patients in the combination antiretroviral therapy (ART) era (1997-present).
To read the full abstract click here: http://meetinglibrary.asco.org/content/162980-176
Disparities in AIDS-Related Kaposi Sarcoma Incidence and Survival.
Author(s): Firas El Chaer, et al.
Background: With advances in combined antiretroviral therapy (ART), Kaposi’s sarcoma (KS) incidence has decreased over the past decade. Geographical and racial disparities may contribute to variation in the incidence and outcomes of multiple cancers in the U.S., including KS. Using the Surveillance, Epidemiology, and End Results (SEER) database, the authors analyzed KS incidence and survival by race and geographical region in the ART era.
To read the full abstract click here: http://meetinglibrary.asco.org/content/168953-176
[Click through for : Palliative Care, Esophageal]
Palliative Care
Palliative Care Interventions and EOL Care Outcomes for Hepatocellular Patients (pts) at 2 VA Medical Centers.
Author(s): Zhen Wang, et al.
Background: Palliative care interventions and its effect on EOL outcomes for liver cancer pts have not been described. The authors investigated the association between palliative care intervention and EOL care outcomes.
To read the full abstract click here: http://meetinglibrary.asco.org/content/167081-176
Esophageal
Characteristics of Esophageal Carcinoma in a Veteran Population.
Author(s): Theresa Ratajczak, et al.
Background: Esophageal cancer is projected to increase by approximately 35% through 2025 in the U.S. The authors investigated the characteristics of esophageal carcinoma in a veteran population.
To read the full abstract click here: http://meetinglibrary.asco.org/content/162712-176
At the 2016 American Society of Clinical Oncology in Chicago, Illinois, researchers from the VA submitted new abstracts on more than 20 different research projects focused on veteran’s oncology care. The researchers conducted studies with the scope of veteran diagnosis, treatment, and quality of care. The abstracts were presented at the annual ASCO meeting during poster sessions and online.
General Oncology
The Impact of a Veterans Administration NURSE Disease Management Program: the Oncology Aspect
Author(s): George Anthony Dawson, et al.
Background: In an effort to decrease time to diagnosis and/or treatment intervention in newly diagnosed veteran cancer patients, Hudson Valley administrators chose the disease case management team model as a potential useful solution to enhance and / or expedite health care delivery. This disease management program began in 2008. The team consists of 3 registered nurses who work under the auspices of the quality management division rather than a specific oncology clinic. This report will show the clinical impact of Hudson Valley VA’s disease management team.
To read the full abstract click here: http://meetinglibrary.asco.org/content/161764-176
Implementation of a Nurse Communication Strategy to Improve Perception of Nurse-Patient Communication at the Bedside on an Inpatient Oncology Unit
Author(s): Lyn Cain Zehner, et al.
Background: Patients spend more time with nurses when in the hospital than with any other health care professional. Patient experience scores have been used as a measure of quality patient outcomes. The Hospital Consumer Assessment of Healthcare Providers and Systems Survey (HCAHPS) score communication with nurses, correlates with improvements in 4 other dimensions: pain, communication about medications, responsiveness of staff, and overall rating. As patient experience scores are tied to Medicare reimbursement, nurses have an impact on reimbursement. The nurse communication scores on the inpatient 29 bed oncology unit reflected an opportunity for improvement. The purpose of this project was to develop a communication strategy that staff would implement at the bedside. The goal was to achieve an improvement in the HCAHPS Communication with Nurses question.
To read the full abstract click here: http://meetinglibrary.asco.org/content/166250-176
Modified Ketogenic Diet in Advanced Malignancies–Final Results of a Safety and Feasibility Trial Within the Veterans Affairs Healthcare System
Author(s): Jocelyn Tan-Shalaby, et al.
Final report of a safety and feasibility trial within the Pittsburgh Veteran Affairs HealthCare System- Modified Ketogenic Diet in Advanced Cancer.
Background: Malignant cells have dysfunctional mitochondria, which limit their ability to use energy from fatty acids and ketones. Preclinical animal studies using a ketogenic diet in cancer show encouraging results. The authors tested safety and feasibility of the modified ketogenic diet in a veteran population of advanced cancer patients across a variety of solid tumors.
To read the full abstract click here: http://meetinglibrary.asco.org/content/170081-176
[Click through for : Prostate Cancer, Liver, Radiation Oncology, Lung Cancer, Colorectal, HIV and Cancer, Palliative Care, Esophageal]
Prostate Cancer
Improving Risk Stratification Among Veterans With Newly Diagnosed, Clinically Low-Risk Prostate Cancer Using the 17-Gene Genomic Prostate Score Assay.
Author(s): Julie Ann Lynch, et al.
Background: Active surveillance (AS) is a recommended treatment option for low risk prostate cancer (PCa). Studies have shown high rates of AS in the VA yet treatment variation exists between VAMCs, likely due to concern about missing aggressive disease. The 17-gene Genomic Prostate Score (GPS) has been validated to predict likelihood of favorable pathology in men with low risk PCa. This study compares treatment patterns before and after introduction of the GPS to determine if the assay assists in risk-stratification. Men with PCa who met National Comprehensive Cancer Network criteria for very low, low, or intermediate risk PCa were eligible. Chart review of men across 6 VAMCs established baseline treatment in untested patients in 2013-2014. In 2015, Veterans at the same VAMCs were offered the assay in a prospective study. Treatment recommendations and treatment implemented were captured.
To read the full abstract click here: http://meetinglibrary.asco.org/content/170703-176
Trends in Utilization of Novel Oral Therapeutic Agents for Men With Metastatic Castrate-Resistant Prostate Cancer Within the United States Veteran’s Affairs Health System.
Author(s): Elizabeth Henry, et al.
Background: Therapeutic options for men with metastatic castrate resistant prostate cancer (mCRPC) have expanded significantly over the past 5 years with several new agents demonstrating improved survival, including two oral agents. Abiraterone acetate, a CYP-17 androgen synthesis inhibitor, obtained initial FDA approval in 2011 for post-docetaxel (D) use, and gained expanded approval in 2012 for pre-D use. Enzalutamide, an androgen receptor signaling inhibitor, also gained FDA approval in 2012 (post-D) and indication was expanded in 2014 (pre-D). Due to the relatively recent approvals of these agents, there is limited data on rates of uptake and prescribing patterns for patients with mCRPC.
To read the full abstract click here: http://meetinglibrary.asco.org/content/157970-172
Liver
A Comparison of Liver Cancer Patients Receiving Palliative Care at Two Veteran Affairs Medical Centers.
Author(s): Sarah Lee, Zhen Wang, et al.
Background: Liver cancer is a leading cause of death. Lack of data exists on palliative care in this group, and care varies by location. The authors aim to determine if there are differences in palliative care for liver cancer patients by VA site.
To read the full abstract click here: http://meetinglibrary.asco.org/content/171726-176
[Click through for : Radiation Oncology, Lung Cancer, Colorectal, HIV and Cancer, Palliative Care, Esophageal]
Radiation Oncology
A Cross-Sectional View of Radiation Dose Fractionation Schemes Used for Treating Painful Bone Metastases (PBM) Within Veterans Health Administration’s Radiation Oncology Centers.
Author(s): George Anthony Dawson, et al.
Background: The use of single fraction radiotherapy in the treatment of PBM in the United States is now gaining clinical acceptance, especially at large institutional levels. In this cross-sectional report, the authors report the varying dose fractionation schemes used to treat PBM by VHA radiation oncology centers.
To read the full abstract click here: http://meetinglibrary.asco.org/content/161496-176
Will Academic and Community Physicians Engage and Share Knowledge in an Online Physician Social Network? Lessons from the Radiation Oncology Community.
Author(s): Nadine Housri, et al.
Background: The exponential growth of medical knowledge has made it increasingly difficult for clinicians to make sense of new information and recognize how to incorporate new research results into clinical practice. The authors sought to determine whether a social question and answer website designed to connect academic and community physicians would consistently engage radiation oncologists to share evidence based information and clinical insights with each other.
To read the full abstract click here: http://meetinglibrary.asco.org/content/171497-176
Lung Cancer
Non–Small Cell Lung Cancer in Veterans: Disparities in Prevalence and Survival Among Different Histologic Subtypes.
Author(s): Hussein Assi, Efstratios Koutroumpakis, et al.
Background: Since the 1980s, adenocarcinoma (AC) of the lung has become more common than squamous cell carcinoma (SCC). Given the differences in smoking patterns, it is unclear if the same holds true among veterans. In this study, the authors compare the distribution of lung AC and SCC in the veterans’ population to that in the general population. They also looked at the survival of patients with different histologies in the VA population.
To read the full abstract click here: http://meetinglibrary.asco.org/content/167505-176
VA Oncologists’ Attitudes and Behaviors Regarding Genomic-Based Targeted Therapy for the Management of Advanced Lung Cancer.
Author(s): Jennifer Arney, et al.
Background: Genomic-based targeted therapy (GBTT) has emerged as a treatment option for patients with advanced lung cancer. Clinical practice guidelines of the National Comprehensive Cancer Network and the American Society of Clinical Oncology recommend testing all metastatic adenocarcinomas for EGFR mutation, and use of EGFR-TKIs (erlotinib) as first-line therapy for advanced adenocarcinoma lung cancer patients with EGFR mutation positive. Little is known about how oncologists utilize genomic testing and GBTT in a clinical setting. Drawing from the Cabana and colleagues theoretical framework on providers’ adherence to guidelines, this study aims to elicit provider and facility-level barriers and facilitators to using GBTT in VA healthcare delivery system.
To read the full abstract click here: http://meetinglibrary.asco.org/content/166517-176
[Click through for: Colorectal, HIV and Cancer, Palliative Care, Esophageal]
Colorectal
Survival Advantage for Hepatectomy With or Without Hemicolectomy in Colorectal Liver Metastases.
Author(s): Dalia A. Mobarek, et al.
Background: Surgical resection of colorectal liver metastases offers the greatest chance of long-term survival. The authors aimed to study survival in patients presenting with hepatic metastasis at the outset and rates of surgical intervention in the VHA.
To read the full abstract click here: http://meetinglibrary.asco.org/content/171640-176
Colorectal Liver Metastases Management in the Veterans Health Administration: Geographic Disparity.
Author(s): Dalia A. Mobarek, et al.
Background: Multidisciplinary management including surgical resection of colorectal liver metastases offers the greatest chance of long-term survival. The authors aimed to study surgical intervention types, rates and factors affecting the decision making in the VHA.
To read the full abstract click here: http://meetinglibrary.asco.org/content/160233-173
HIV and Cancer
Gleason Grade in HIV+ Versus Uninfected Prostate Cancer Patients in the Veterans Aging Cohort Study.
Author(s): Roxanne Jimmy Wadia, et al.
Background: Little is known about how the biology of prostate cancer in HIV+ men compares to that of uninfected men. The purpose of this study was to compare the Gleason grade (GL) of prostate adenocarcinoma (PrCA) in HIV+ vs uninfected patients in the combination antiretroviral therapy (ART) era (1997-present).
To read the full abstract click here: http://meetinglibrary.asco.org/content/162980-176
Disparities in AIDS-Related Kaposi Sarcoma Incidence and Survival.
Author(s): Firas El Chaer, et al.
Background: With advances in combined antiretroviral therapy (ART), Kaposi’s sarcoma (KS) incidence has decreased over the past decade. Geographical and racial disparities may contribute to variation in the incidence and outcomes of multiple cancers in the U.S., including KS. Using the Surveillance, Epidemiology, and End Results (SEER) database, the authors analyzed KS incidence and survival by race and geographical region in the ART era.
To read the full abstract click here: http://meetinglibrary.asco.org/content/168953-176
[Click through for : Palliative Care, Esophageal]
Palliative Care
Palliative Care Interventions and EOL Care Outcomes for Hepatocellular Patients (pts) at 2 VA Medical Centers.
Author(s): Zhen Wang, et al.
Background: Palliative care interventions and its effect on EOL outcomes for liver cancer pts have not been described. The authors investigated the association between palliative care intervention and EOL care outcomes.
To read the full abstract click here: http://meetinglibrary.asco.org/content/167081-176
Esophageal
Characteristics of Esophageal Carcinoma in a Veteran Population.
Author(s): Theresa Ratajczak, et al.
Background: Esophageal cancer is projected to increase by approximately 35% through 2025 in the U.S. The authors investigated the characteristics of esophageal carcinoma in a veteran population.
To read the full abstract click here: http://meetinglibrary.asco.org/content/162712-176