Kelly Brassil Ph.D., RN
Director, Medical Affairs
Time: 10 min
What happens when you gather over 40,000 representatives from the world of oncology research, clinical care, industry, and advocacy? An extraordinary intersection of new and evolving science, insights, and outcomes. And with the rapid evolution of cancer treatments, including 20 new FDA approvals in 2019 alone, this year’s American Society of Clinical Oncology (ASCO) Annual Meeting did not disappoint.
Pharmaceutical companies in attendance highlighted a broad portfolio of agents both FDA-approved and in the pipeline – attacking cancer at the molecular level, targeting specific tumor antigens, as well as genetic mutations such as FMS-like tyrosine kinase 3 (FLT3) and Phosphoinositide 3-kinase (PI3K). Continued development of immune effector cells(IECs), which include chimeric antigen receptor (CAR) T cells, with new targets beyond CD19 is anticipated to lead to new immune effector cell approvals in 2019 (Worcester, 2018). The list of advances goes on and on.
From Bench to Bedside: Translating Science to Real World Practice
The theme of the 2019 American Society of Clinical Oncology (ASCO) Annual Meeting was “Caring for Every Patient, Learning from Every Patient” – putting individuals with a cancer diagnosis and care delivery conversations front and center. In many of the plenary sessions and poster presentations, the dialogue focused on optimizing cancer care delivery through the thoughtful engagement of all stakeholders– most importantly patients and their caregivers. In 2019, leading researchers are diving deeper into topics such as symptom management, survivorship, and social determinants of health.
In this vein, and as a new addition to the Pack Health team, I had three key takeaways from my ASCO experience. First, how care delivery models can adapt to improve access and experience. Second, how data can best be leveraged to address health disparities. And finally, the need to make emerging, evidence-based solutions to these key questions scalable – beyond institutional demonstration projects.
Health Policy in Practice: Leveraging Data to Close Care Gaps
One particularly compelling plenary presentation highlighted data on access to care and time to cancer treatment among racial minorities following the implementation of the Affordable Care Act (ACA). A retrospective analysis of data demonstrated that African American patients were 4.9% less likely to receive timely access to cancer care prior to the ACA. Following ACA implementation this gap was no longer statistically significant in states that had adopted Medicaid expansion.
How do we address health disparities? In his discussion Yousuf Zafar (Duke Cancer Institute) emphasized that health disparities are both a policy and a data issue, requiring meaningful data that can help us trend and identify oncology care access across diverse populations based on real-world evidence. His practical recommendations to immediately address these issues include:
- Make the invisible visible
- Share data
- Institute patient navigation
- Engage and advocate
Optimizing Clinical Advancements for the Real World Experience
Among the thousands of scientific posters presented, a number of sessions focused on survivorship and symptoms explored interventions and clinical best practices to support individuals with cancer in the context of their treatment. Of particular interest was a session on the Top 10 Innovative Institutional Solutions to manage immune-toxicity. These include deploying education about immuno-toxicities to non-oncology practice settings in which individuals receiving these therapies are present for care, such as emergency rooms, and cross-disciplinary collaboration across professional societies to increase awareness of these unique toxicity presentations and management.
Other presentations on the topic of supporting patients beyond treatment and into survivorship highlighted the value of support beyond clinic doors, including:
- Transition to community-based centers
- Navigation support
- Lifestyle and behavior change support
- Telehealth and M-Health interventions
- Patient Reported Outcome (PRO) monitoring
Addressing Scalability: From an Institutional to an Ecosystem Approach
The physiologic and psychosocial benefits of Patient Reported Outcomes and symptom monitoring across the cancer trajectory demonstrated in research demand a rapid translation to standard of care practice. Many of the abstracts presented at ASCO focused on the development of such interventions at the system level. Given that the average time from research to standard of care adoption is 17 years, leveraging relationships between individuals with cancer, scientists, clinicians and industry partners is paramount to more quickly define, test, and implement real-world solutions. This requires partnerships with programs that have ready-made platforms that are scalable to accommodate patient support and monitoring from community settings through large, academic medical centers.
As an investigator coming to Pack Health from an academic medical center, the need for these partnerships and a scalable, patient-centered intervention resonated with me. Pack Health is in a unique position to take the burden off of Health Systems and bridge gaps on behalf of providers. These demonstration projects solidify the evidence behind our PRO monitoring, psychosocial support, and care coordination capabilities and present a profound opportunity to work across systems. In the spirit of the Cancer Moonshot, we can apply this collaborative model to advance evidence-based engagement for individuals with cancer to improve their outcomes. This is the moment to establish a standard of care beyond clinic doors, to connect the dots for symptom management and address social determinants at any stage in the treatment journey.
Like this? Check out similar articles: