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A common conundrum that community oncologists face in their practices is whether to bill a first encounter with a new patient referred by another physician as a consultation or as a new patient visit. Making the distinction may seem like splitting hairs, but the Centers for Medicare and Medicaid Services (CMS) has very specific billing criteria on this issue.

Annually, adverse drug reactions (ADRs) result in costs of $3.6 billion and 140,000 deaths.1 Yet in 2005, only 15,107 reports of fatalities linked to potential drug toxicity were reported to the US Food and Drug Administration.2 This low number suggests that, despite significant morbidity and morality, ADRs remain underappreciated by clinicians. This is particularly troublesome when it comes to ADRs associated with oncology drugs.

Radiation is often considered immunosuppressive, an activity that is most likely a result of the complex interplay of hormesis and the abscopal effect. The abscopal effect, also called the “distant bystander” effect, is a paradoxical effect of radiation on cellular systems whereby local radiation may have an antitumor effect on tumors distant from the site of radiation.

CHICAGO-Sunday, June 1 marked the 15th annual Cancer Survivors’ Celebration and Walk, sponsored by the Robert H. Lurie Cancer Center of Northwestern University as part of National Cancer Survivors Day. More than 800 cancer survivors participated in the walk (see photograph).

Long-term survivors of testicular cancer treated with cisplatin-based chemotherapy have evidence of endothelial injury and dysfunction, compared with those who did not receive chemotherapy, according to a University of Pennsylvania study (Cancer 112:1949-1953, 2008).

RCELONA-Colon cancer patients who received oral capecitabine (Xeloda) after surgery had significantly better 5-year survival rates than those given IV 5-FU/LV chemotherapy, according to a preplanned multivariate analysis of the X-ACT trial data presented at the 2008 World Congress on Gastrointestinal Cancer (Twelves et al: poster 0-033).

UVEN, Belgium-ThromboGenics NV and BioInvent International AB (Lund, Sweden) have entered into a license agreement with Roche for their jointly developed anticancer agent TB-403, a novel monoclonal antibody that blocks PIGF, one of the growth factors responsible for angiogenesis.

In May 2008, ONI reviewed an article by Herman Suit, MD, and colleagues in which they argued that randomized trials of proton beam therapy vs standard radiotherapy are not needed prior to a wider use of proton beam therapy. In an ONI reader poll, 81% disagreed with Dr. Suit, as does Dr. Robert Parker, of SUNY Stony Brook, in his letter below.

The authors of this article accomplished their goal to provide an overview of physical long-term / late effects. Similar to most available literature published since the Institute of Medicine report in November 2005, it provided a descriptive summary of the epidemiologic data. While vital to increasing the knowledge base of nurses on the frontlines, it provides little guidance as to how to change or improve practice.

In cancer treatment these days, the immediate-what needs to be done for the patient right now toward achieving long-term survival-is coupled with planning post-treatment surveillance, care, and support for patients who will likely survive their disease.

Drug is indicated for rescue of normal cells following high dose methotrexate administration for osteosarcoma. It is also indicated to diminish and counteract methotrexate toxicity if the drug is not effectively eliminated, or for inadvertent overdose of folic acid antagonists.

Who’s News

Matthew Ringel, MD, and colleagues have received an $11.9 million NCI grant for their research in thyroid cancer. The 5-year grant will fund the group’s work on genetics and signaling pathways in epithelial thyroid cancer. Dr. Ringel is co-director of the thyroid cancer unit at Ohio State University in Columbus.

The article by Khatcheressian and colleagues addresses the important topic of futility in chemotherapy use. While extensive previous literature has addressed the use of futile treatment by oncologists, Khatcheressian and coauthors pose interesting perspectives on patient persistence in seeking futile treatment.

CHICAGO-For breast cancer patients whose tumors have become resistant to available agents, restoring the sensitivity to treatment is an important goal. Preclinical studies have suggested that drugs that inhibit the mTOR protein kinase-which acts as a central regulator of tumor cell division, cell metabolism, and blood vessel growth-may be able to do so.

Over the past 2 decades, advances in cancer treatment have greatly improved survivorship statistics in the United States. As the oncology community works to ensure that this upward survival trend continues, it’s important for us to recognize the serious challenges that lie ahead.

CHICAGO-Newly diagnosed patients with metastatic colorectal cancer are most likely to benefit from cetuximab (Erbitux) when their tumors contain the normal version of the KRAS gene, compared to patients with KRAS mutations, according to a conclusive analysis from the phase III CRYSTAL trial presented at the ASCO 2008 plenary session (abstract 2).

Colon cancer patients who had abundant levels of vitamin D were less likely to die during a follow-up period than those who were deficient in the vitamin, according to a study by scientists at Dana-Farber Cancer Institute and the Harvard School of Public Health (J Clin Oncol 26:2984-2991, 2008).

CHICAGO-Sorafenib (Nexavar) is safe and prolongs overall survival and time to progression in Asian patients with advanced hepatocellular carcinoma (HCC), finds the randomized phase III Asia-Pacific liver cancer study. Moreover, efficacy was similar to that in the Western population even though the Asian patients had more adverse prognostic factors.