Oncology experts from around the world flocked to Chicago to share the latest findings in cancer care and therapy.
The 55th annual meeting of the American Society of Clinical Oncology (ASCO) heard about advances in targeted pancreatic, prostate, and pediatric cancer treatments, as well as new approaches to overcoming limited access to care.
More than 2,400 abstracts were accepted for presentation at the meeting, and another 3,200 were published online. Here are some of our top picks for cancer patient advocates:
Medicaid expansion has improved health disparities1
The expansion of Medicaid under the Affordable Care Act (ACA) has improved African American cancer patients’ receipt of timely treatment and reduced the racial disparities in access to care.
Researchers looked at data from 34,067 people with advanced or metastatic NSCLC, melanoma or breast, urothelial, gastric, colorectal, renal cell or prostate cancer. The median age was 57 and 12 per cent were African American.
All were on the Flatiron Health electronic health record-derived database and diagnosed between January 2011 and December 2018. Timely treatment was defined as within 30 days of diagnosis.
Before the expansion of Medicaid, African Americans were 4.9 percent less likely than other groups to receive timely treatment. This difference was no longer observed following expansion of Medicaid, and there was a trend toward improved access to care across all groups, but particularly for African American (+6.9%; p<0.05) versus white patients (+1.8%).
ASCO-Friends trial criteria would significantly expand access2
Adoption of the ASCO and Friends of Cancer Research (ASCO-Friends) expanded clinical trial eligibility criteria could enable almost twice as many people with advanced non-small cell lung cancer (aNSCLC) to participate in studies.
Researchers identified 10,500 aNSCLC patients from ASCO’s CancerLinQ database. Under traditional criteria, 5,005, or 47.7 percent, would be excluded from studies. But the ASCO-Friends criteria allows those with brain metastases or prior/concurrent malignancies to participate, meaning just 1.5 percent would be excluded.
The authors recommended that the narrower inclusion criteria only be used with based on “compelling scientific rationale for exclusion”.
Affordable Care Act linked to early detection and timely treatment of ovarian cancer3
Under the Affordable Care Act, women with ovarian cancer were more likely to be diagnosed early and receive treatment within 30 days.
Using the National Cancer Database, researchers compared the data of 35,842 21 to 64-year-old women diagnosed before the reform in 2010, with those of 37,145 cases from after. They also compared the records of 28,895 over 65s diagnosed before 2010 with 30,604 diagnosed post-reform.
The ACA was associated with increased early-stage diagnosis for women aged 21-64 years compared to women 65 and older (p-for-trend=0.001), and with more women receiving treatment within 30 days of diagnosis (p<0.001).
Among those with public insurance, the ACA was associated with a significant improvement in early-stage diagnosis and receipt of treatment within 30 days of diagnosis. These improvements were seen across race, income, and education groups. The authors say the findings from this study, and the gains seen under the ACA, “may have long-term impacts on women with ovarian cancer”.
- Adamson BJS, Cohen AB, M Estevez, et al. J Clin Oncol 37, 2019 (suppl; abstr LBA1) https://abstracts.asco.org/239/AbstView_239_257961.html
- Harvey RD, WS Rubinstein, G Ison, et al. J Clin Oncol 37, 2019 (suppl; abstr LBA108) https://abstracts.asco.org/239/AbstView_239_265909.html
- Smith AJ and A Nickels. J Clin Oncol 37, 2019 (suppl; abstr LBA5563) https://abstracts.asco.org/239/AbstView_239_263531.html