NCCN Task Force Report: Evaluating the Clinical Utility of Tumor Markers in Oncology Published
At the end of November 2011, JNCCN published the NCCN Task Force Report: Evaluating the Clinical Utility of Tumor Markers in Oncology, which provides information and guidance on molecular testing, including validation, types of markers used in oncology practice, and an outline of current and developing biomarkers used in breast, colon, brain, lung, and prostate cancers and acute myeloid leukemia. The report grew out of the discussion held by the group in May 2011, when NCCN assembled the task force, comprising oncologists and pathologists from the NCCN Member Institutions and expert participants from the NCI and FDA, to discuss the use of biomarkers in cancer care with goals of educating the community on the terminology of contemporary tumor markers and with providing the current state of biomarker validation for the most common forms of cancer. Continuing education credit is available for participation.
NCCN Molecular Testing White Paper Published
At the end of December 2011, JNCCN published the NCCN Molecular Testing White Paper: Effectiveness, Efficiency, and Reimbursement, which provides guidance regarding the challenges health care providers and other key stakeholders face regarding the use of molecular testing in oncology practice in the United States. The FDA is expected to release draft guidance regarding laboratory-developed tests (LDTs) in the coming months. The NCCN White Paper is based on the recommendations of the NCCN Molecular Testing Work Group, composed of multidisciplinary thought leaders from NCCN Member Institutions and other groups, and discussion at the July 2011 NCCN Oncology Policy Summit: Molecular Testing – Effectiveness, Efficiency, and Reimbursement.
NCCN Holds Patient Advocacy Summit
On Tuesday, November 29, 2011, NCCN convened the NCCN Patient Advocacy Summit: Ensuring Optimal Care for Patients at the National Press Club in Washington, DC. This invitation-only Summit was attended by patient advocates, providers, employers, and industry representatives within the oncology community. Increasingly, treatment options for people with cancer are being influenced by public and private payors and regulatory bodies. This shift in decision-making, which has inevitably impacted the clinician’s influence over the care of patients, has also raised an important question regarding who should be deciding “optimal” care for patients with cancer.
Opening remarks focused on the challenge of achieving effectiveness with efficiency in health care delivery and also introduced the collaboration between NCCN and the National Business Group on Health to develop tools for employers to design health insurance benefit plans for cancer care for their employees.
The Patient Advocacy Summit featured three expert roundtable discussions. The first roundtable focused on the FDA and what reforms are needed to help patients with cancer receive timely, safe, and effective care. Panelists included Scott Gottlieb, MD, American Enterprise Institute; James Pluda, MD, Merck; Sara Radcliffe, MPH, Biotechnology Industry Organization; M. Alma Rodriguez, MD, The University of Texas MD Anderson Cancer Center; Mark Rubin, MD, Florida Cancer Specialists; and Cara Tenenbaum, Ovarian Cancer National Alliance. Conversation centered on balancing uncertainty of benefit with timely access to new drugs and biologics. The panelists discussed what expertise is available to the FDA in regard to the Oncology Drug Advisory Committee and what should constitute conflict of interest. Although much uncertainty exists, the panelists agreed that every patient wants safe, effective, and affordable medications.
The second roundtable, focusing on how coverage and reimbursement impact patient care, included Joe Bailes, MD, American Society of Clinical Oncology; Al Benson III, MD, Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Nancy Davenport-Ennis, Patient Advocate Foundation; Jim Frame, MD, David Lee Cancer Center; Pam Germain, MBA, Roswell Park Cancer Institute; Len Lichtenfeld, MD, American Cancer Society; Michelle Martin, MBA, CBS Corporation; and Sam Silver, MD, PhD, University of Michigan Comprehensive Cancer Center, as panelists. The panelists agreed that the resource needs of patients are large and can be overwhelming for physicians, their staff, and patient advocacy groups to meet. These stakeholders wish to ensure that patients receive the care they need despite their insurance coverage and its financial implications.
Al Benson III, MD, Robert H. Lurie Comprehensive Cancer Center of Northwestern University; Nancy Davenport-Ennis, Patient Advocate Foundation; Jim Frame, MD, David Lee Cancer Center; Ray Muller, MS, RPh, Memorial Sloan-Kettering Cancer Center; and Diana Rowden, Susan G. Komen for the Cure, participated in the final roundtable of the day. The panelists discussed how clinical decision-making can be challenged in the face of issues such as drug shortages, coverage and reimbursement problems, and other policy concerns.
NCCN Education Program for Case Managers Successful in Its Sixth Year and Planning for 2012
Since 2006, NCCN has offered oncology education programs designed to meet the needs of case managers and medical directors in managed care organizations and other settings. The NCCN Oncology Case Management Program began with one in-person session presented to a group of approximately 35 nurses and has continued to grow steadily, offering more in-person programs and adding webinars in order to reach a much larger and more diverse audience.
More than 550 people attended programs in 2008. Attendance increased to more than 1,050 in 2009 and 2,200 in 2010. In 2011, through expanded contacts with various organizations, NCCN reached 3,200 participants, including record high numbers of attendees for the NCCN Oncology Case Management Program Webinar: An Overview of Breast Cancer and the NCCN Oncology Case Management Program Webinar: Techniques for Telephone-Based Case Managers.
This series was originally designed to address the needs of case managers working with patients through telephonic programs offered by managed care organizations. Today, it continues to meet the needs of this audience, but attendees represent other groups as well, including case managers who work with patients in hospitals and clinics, utilization review nurses, practicing physicians, managed care medical directors, and pharmacists.
Most of the programs provide clinical information intended to keep participants abreast of the current state of knowledge about specific types of cancer and evidence-based treatment. Others focus on more general topics, such as understanding and using the NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines) and the NCCN Drugs & Biologics Compendium (NCCN Compendium) and clinical trials.
This year, for the first time, NCCN offered a webinar on case management techniques for telephonic case managers, presented by 2 experienced oncology nurses who manage teams of oncology case management nurses. This program drew a record number of participants and, in 2012, NCCN plans to offer a second webinar that will provide more in-depth content on techniques for managing symptoms and reducing complications.
Pending sufficient funding, the 2012 series will include four components under the new title NCCN Cancer Case Manager and Medical Director Education Program, including:
Two live, in-person programs focusing primarily on the needs of case managers, which will also be suitable for medical directors and others
Eight webinars focusing primarily on the needs of case managers, which will also be suitable for medical directors and others, on such new topics as cancer survivorship, techniques for telephonic case managers, non-Hodgkin’s lymphomas, acute myeloid leukemia, and malignant melanoma
Two webinars offered to managed care medical directors focusing specifically on their needs, for example, for information to understand emerging therapies and make coverage decisions
A presentation (topic to be determined) at the Case Management Society of America (CMSA) Annual Conference to be held in San Francisco in June 2012.