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Presenters: Diane K. Hammon, Elizabeth A. Souza, Anne Chiang, and Lawrence N. Shulman

Moderator : Timothy Kubal

As difficult as it may be to comprehend, quality affordable healthcare, particularly cancer care, is not accessible to every individual in every region of the United States. Without timely use of the full range of cancer care services, the best health outcomes cannot be achieved. To explore the scope of this contemporary scenario in cancer care and share ongoing efforts to improve access to cancer care for all, a distinguished panel shared their views at the NCCN 2022 Annual Conference. From the varied perspectives of patients, providers, and researchers, the panel featured a discussion of shared-care models at Massachusetts General Hospital and Penn Medicine Cancer Care to enable patients to expand their access to cancer care and receive that care closer to where they live. In addition, the panel explored initiatives to build and expand the network of clinical trials to enable patients to access such trials in their communities.

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Jessica M. Sugalski, Theresa Franco, Lawrence N. Shulman, Elizabeth Souza, Ephraim Hochberg, Anne Chiang, Scott Lawrence, Diana Krause, and Timothy Kubal

The NCCN Best Practices Committee, which is composed of senior physician, nursing, and administrative leaders from NCCN Member Institutions, evaluated the status of cancer center operations after 1 year of operating during the COVID-19 pandemic. Two major initiatives stood out: the increase in the utilization of network sites, and the gains made in telemedicine operations and reimbursement. Experts from NCCN Member Institutions participated in a webinar series in June 2021 to share their experiences, knowledge, and thoughts on these topics and discuss the impact on the future of cancer care.

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Victoria S. Blinder, Elizabeth Garrett-Mayer, Paul B. Jacobsen, Mary May Kozlik, Merry Jennifer Markham, Robert D. Siegel, Arif H. Kamal, Stephanie T.S. Crist, Jon Rosenthal, Anne C. Chiang, and on behalf of the ASCO Quality Publications Task Force

Background: Oral chemotherapy performance measures were first introduced into ASCO’s Quality Oncology Practice Initiative (QOPI) in 2013. This study examined performance on these measures among QOPI-participating practices and evaluated whether it differed among practices based on meeting QOPI Certification Program standards. Methods: A total of 192 QOPI-participating practices (certified, n=50 [26%]; not certified, n=142 [74%]) reported performance on oral chemotherapy measures in 2017 and 2018. Inclusion was limited to practices reporting on ≥3 charts for ≥1 oral chemotherapy measure. Performance was defined as the percentage of charts examined that adhered to the measure. Descriptive analyses were used to characterize performance within and across practices, and mixed-effects logistic regression models were conducted to compare performance based on certification status. Results: Median performance across practices for the 9 oral chemotherapy measures examined ranged from 44% (education before the start of treatment addressing missed doses, toxicities, and clinical contact instructions [composite measure]) to 100% (documented dose, documented plan, and education about toxicities). Certified practices were more likely to provide education about clinic contact instructions than noncertified practices (odds ratio, 4.87; 95% CI, 1.00–24.0). Performance on all other measures was not significantly associated with certification status. Conclusions: There is wide variability in quality related to performance on oral chemotherapy measures across all QOPI-participating practices, and several areas were identified in which administration of oral chemotherapy could be improved. Our findings highlight the need for the development and implementation of appropriate standards that apply to oral chemotherapy and address the complexities that set it apart from parenteral treatment.

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Apar Kishor P. Ganti, Billy W. Loo Jr., Michael Bassetti, Collin Blakely, Anne Chiang, Thomas A. D'Amico, Christopher D'Avella, Afshin Dowlati, Robert J. Downey, Martin Edelman, Charles Florsheim, Kathryn A. Gold, Jonathan W. Goldman, John C. Grecula, Christine Hann, Wade Iams, Puneeth Iyengar, Karen Kelly, Maya Khalil, Marianna Koczywas, Robert E. Merritt, Nisha Mohindra, Julian Molina, Cesar Moran, Saraswati Pokharel, Sonam Puri, Angel Qin, Chad Rusthoven, Jacob Sands, Rafael Santana-Davila, Michael Shafique, Saiama N. Waqar, Kristina M. Gregory, and Miranda Hughes

The NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) for Small Cell Lung Cancer (SCLC) provide recommended management for patients with SCLC, including diagnosis, primary treatment, surveillance for relapse, and subsequent treatment. This selection for the journal focuses on metastatic (known as extensive-stage) SCLC, which is more common than limited-stage SCLC. Systemic therapy alone can palliate symptoms and prolong survival in most patients with extensive-stage disease. Smoking cessation counseling and intervention should be strongly promoted in patients with SCLC and other high-grade neuroendocrine carcinomas. The “Summary of the Guidelines Updates” section in the SCLC algorithm outlines the most recent revisions for the 2022 update, which are described in greater detail in this revised Discussion text.