ACCC Precision Medicine: Transforming Complex to Clear

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All Precision Medicine OI Articles

From Oncology Issues

  • From the Editor
    Mark Liu, MHA
    ACCC’s 2024 Trending Now in Cancer Care report discusses the evolving landscape of cancer care, with focuses on the integration of AI and machine learning, precision medicine and personalized care, and the oncology workforce shortage.
  •  Implementation of a Centralized Model for Precision Medicine with EHR Integration
    Michelle Eichelmann, Jay Carlson, Damon Broyles, and Gautum Agarwal
    As part of its mission to provide the right care at the right time for the right patient, Mercy established a new Center for Precision Medicine to better serve its predominantly rural communities.
  •  2024 Trending Now in Cancer Care Part 2
    Monique J. Marino and Rachel Radwan
    Examine artificial and business intelligence technology; EHR integration in precision medicine; payer, manufacturer, and supply chain challenges; and key partnerships in research and clinical trials.
  •  e-Consults for Immune-Related Toxicities Improve Patient Access and Reduce Costs
    By Carrie Diamond, Harsh Patolia, Donna Phinney, and Afreen Idris Shariff
    Duke Cancer Institute improved patient access and reduced healthcare utilization by implementing e-consults for patients experiencing endocrine immune-related adverse events.
  •  If They RECUR You Should Refer
    By Peter Riedell, et al.
    This multidisciplinary discussion seeks to develop a standardized framework that allows community oncologists to easily assess patients for CAR T-cell therapy, with a focus on large B cell lymphoma.
  •  Trending Now in Cancer Care Part 2
    By Monique Marino
    A deep dive into 4 topics discussed during a series of interactive sessions at the ACCC 49th Annual Meeting and Cancer Center Business Summit: business and artificial intelligence technology, research and clinical trials, and precision medicine.
  •  Emerging Biomarkers: Innovative Therapies for Rare Disease – NTRK Fusions
    By Joseph Kim, MD, MPH, MBA, FACHE
    ACCC shares a look at the current NTRK testing landscape and identifies effective ways to optimize comprehensive biomarker testing in practice.
  •  Evolving Biomarkers in Non-Small Cell Lung Cancer: Strategies for Keeping Up with Precision Medicine
    As part of this ACCC educational program, 6 community cancer programs worked to assess and improve their biomarker testing program.
  • Precision Medicine Stewards: Applying Precision Principles to Biomarker Testing Processes to Improve Patient Access
    With the proper support and infrastructure from a cancer program or practice, precision medicine stewards can be important members of the multidisciplinary cancer care team—as they improve operational processes and increase efficiency.
  • AI's Role in Advancing Cancer Prevention Detection Diagnosis Treatment and Precision Medicine
    Amanda Patton, MA
    An interview with Picture Health’s Anant Madabhushi, PhD, and Trishan Arul on the expanding role of AI and healthcare professionals in the fields of biomedical engineering and computer science.
  • Exploring Current Perceptions of Multi Cancer Early Detection Testing Among Healthcare Providers
    ACCC conducted a comprehensive survey and a series of four focus groups to explore current attitudes, beliefs, and concerns related to multi-cancer early detection.
  • Precision Medicine Stewards: A Case Study from Sanford Health
    ACCC shares how Sanford Health introduced its own “precision medicine steward” through the development of a pilot Oncology Nurse Navigator, Genomics (ONNG) role, which has improved coordination of its biomarker testing program.
  •  Changing the Tune for CAR T-Cell Therapy
    Brittney M. Baer, BSN, RN, and Nancy C. Long, MSN, AGACNP-BC
    Learn how Vanderbilt-Ingram Cancer Center in Nashville, Tenn. has been using monitoring devices for patients undergoing chimeric antigen receptor (CAR) T-cell therapy. Thanks to this technology, these high-risk patients can be remotely monitored 24/7.
  •  Anti-Cancer Therapy Privileging for Oncology Nurse Practitioners and Physician Assistants
    By Archana Ajmera
    Advanced Practice Providers able to sign anti-cancer therapy orders practice at the top of their license and can help free up physician time to see more new patients, streamline clinic workflows, and improve the patient experience.
  •  Home as a Site of Care for Acutely Ill Patients with Cancer
    By Amanda Patton
    An interview with Kathi Mooney, PhD, RN, FAAN, about the Huntsman at Home model, including the development and implementation of Symptom Care at Home.
  •  The Home as a New Site of Cancer Care
    By David R Penberthy, MD, MBA
    The COVID-19 pandemic brought renewed attention to the concept of the home being a site of care. Looking to the future, certain strategies can be implemented for cancer programs aiming to offer care to patients in their homes.
  •  An APP-Physician Model Improves Risk Stratification and Palliative Care
    By Jia Conway, DNP, CRNP, AOCNP
    Cancer Care Associates of York, implemented an autonomous APP model of care designed to allow these clinicians to work at the top of their license, facilitate effective physician and APP partnerships, and improve overall patient satisfaction.
  •  Oncology Capture of ED Patients with Incidental Radiologic Findings
    By Nicholas Garland and Katie Klar
    Vanderbilt-Ingram Cancer Center shares details about how it shifted from a push to a pull model of care for patients who present at the emergency department with incidental findings.
  •  Technology Solutions in Practice
    By Sibel Blau, MD
    The successful deployment of technology in cancer practices, promises to improve the quality of patient care and the patient experience, while also alleviating excessive burdens on clinicians and staff.
  •  Tech Solutions Ahead!
    By David R. Penberthy, MD, MBA
    Technology-drive solutions will be essential in the future of cancer care, and providing the information, education and resources health care providers need to implement those solutions is important.
  •  Holy Smokes! Developing a Cannabis Clinic for Patients with Cancer
    By Sarah Jax, Katherine Schmiechen, and Dylan M. Zylla
    The HealthPartners Frauenshuh Cancer Center has safely incorporated cannabis in the treatment of patients with cancer.
  •  Auricular Acupuncture for the Treatment of Cancer-Related Pain
    By Heather Jackson and Karline Peal
    Vanderbilt-Ingram Cancer Center shares how auricular acupuncture, a safe, feasible, and cost-effective therapy, that stimulates points on the ear, can reduce the pain and psychological distress experienced by patients with cancer.
  •  Technology and Cancer Care
    By David R. Penberthy, MD, MBA
    As technological innovation expands, it is important that cancer care finds ways to incorporate new technology that will make life easier for both the patient and healthcare provider- as well as create increasingly efficient cancer care.
  •  Biomarker Testing in Patients With Non-Small Cell Lung Cancer
    Leigh M. Boehmer, PharmD, BCOP, et al.
    A mix-method approach to understand clinician use of biomarker testing for patients with non-small cell lung cancer.
  •  Patient Perceptions of Biomarker Testing
    Nikki Martin, MA, et al.
    As precision medicine becomes more common in the management of lung cancer, little is understood about the patient experience with biomarker testing, particularly of underserved patients. This study used survey and focus group methodology to determine patient perspectives on the educational needs within this community.
  •  Improving Care for Patients with Advanced Non-Small Cell Lung Cancer
    Brendon Stiles, MD, et al.
    This ACCC education program shares key highlights from a national survey of thoracic surgeons, radiation oncologists, and medical oncologists on the barriers that exist in the ideal management of patients with NSCLC.
  •  Issues: Biosimilars are Overcoming Challenges of a Turbulent, Unfriendly Marketplace
    Blake McCreery-Cullifer, CPRP
    In addition to the global pandemic, ongoing lawsuits from referenced biologics' manufacturers suing biosimilar manufacturers are having a negative impact on the development and approval of new biosimilars.
  •  A Framework for Defining High Quality Care for Patients with NSCLC
    Mark A. Socinski, MD, and Leigh M. Boehmer, PharmD, BCOP
    An expert ACCC Steering Committee shares 32 informed treatment and care delivery recommendations for the ideal care of patients with non-small cell lung cancer.
  •  Collaborative Learning Workshops Explore Best Practices for Implementing Cancer Immunotherapies in the Community
  •  Issues: The Need for Increased Access to Genetic Counselors
    Kristin Marie Ferguson, DNP, RN, OCN
    ACCC, along with other stakeholders, signed a letter of support for legislation to recognize certified genetic counselors as healthcare providers, giving beneficiaries improved access to these services.
  •  The Evolving Immunotherapeutic Landscape in Renal Cell Carcinoma
    Robert A. Figlin, MD, FACP; Jocelyn Mohs, PharmD, BCOP; and Laura S. Wood, RN, MSN, OCN
    In 2019 the Association of Community Cancer Centers developed an education program to provide all members of the multidisciplinary care team knowledge and resources to help successfully integrate immunotherapies into the treatment of patients with RCC.
  •  Maine Cancer Genomics Initiative: A Model for Translational Outreach
    Jens Rueter, MD, et al.
    Read about this model that engages oncology stakeholders in advancing biomarker testing and application into practice, increasing access to state-of-the-art genomic testing and clinical trials.
  •  Management of Hospital Admissions for Checkpoint Inhibitor Immune-Related Adverse Events at a Regional Cancer Center
    Andrew Li, PharmD, and Michela Altergott, PharmD
    With the rise of immunotherapies, it is critical to ensure patient safety, as the toxicity profiles of immunotherapy agents are vastly different from traditional cytotoxic chemotherapies.
  •  Avoidable and Unavoidable ER Utilization by Cancer Patients on Systemic Therapy
    Leonard R. Henry, et al.
    In the current transition to value-based care, avoidable ER utilization represents an opportunity for cost savings, but difficulties remain in determining what visits are and are not avoidable based on coding and billing data alone.
  •  Education Interventions Improve Management of irAEs, Study Shows
    Matthew R. Zibelman, MD
    Since the approval of the programmed death-1 (PD-1) inhibitors pembrolizumab and nivolumab for the treatment of metastatic melanoma in 2014, the oncology community has seen a tidal wave of new approvals and indications for immunotherapies to treat cancer.
  •  Views: Celebrating Life Through City of Hope’s Bone Marrow Transplant Program
    Stephen J. Forman, MD
    City of Hope’s bone marrow transplant program has performed more than 16,000 transplants and continues to be one of the largest and most successful programs in the nation.
  •  Highlights from a Virtual ASCO 2020
    Cary A. Presant, MD, FACP, FASCO
    Listed are my highlights of the ASCO 2020 abstracts, which were chosen if they were a practice-changing study or trial with important new advances.
  •  Making the Business Case for Hiring a Board-Certified Genetic Counselor
    Stephanie A. Cohen, MS, LCGC
    Today, genetic counseling is a key service along the entire cancer care continuum, from prevention to screening to treatment and into survivorship.
  •  The In-Betweeners: A Focus on Young Adults with Cancer
    Kristin S. Donahue, MSN, RN, OCN, et al.
    Our team of young adult administrators quietly agreed that we were not doing all that we could for our young adult cancer patients. This session was our call to action. When we returned to our program, our team pledged do more for this often forgotten about patient population—the In-Betweeners.
  •  Right to Try: Two Years In
    Jennie Crews, MD, MMM, FACP
  •  Views: Hiring a Genetic Counselor in a Lean Labor Market
    Stephanie A. Cohen, MS, LCGC
    Given the demand for their skills and the competitive market, genetic counselors can afford to be selective in their employment choices. Hospitals and clinics must therefore be creative in their recruiting efforts and offer competitive packages.
  •  From Invisible Experts to Active Caregivers: Pathologists Emerge from the Shadows
    Barbara A. Gabriel
    Dr. Lija Joseph, a pathologist at Lowell General Hospital, Mass., implemented a pathology consultation program to help cancer patients better understand how the disease affects their bodies. Based on strong patient interest, Dr. Joseph established a Twitter presence to spread the word about the benefits of patient and pathologist interactions.
  •  Genetic Counselor Extenders Help Meet Growing Demand for Services
    By Dawn M. Nixon, MS, LCGC, et al.
    St. Vincent Hospital implemented a collaborative method of care that uses genetic counselor extenders to increase patient access to risk assessment and genetic testing.
  •  Development of a Model Precision Cancer Therapies Program in a Community Setting
    Marc R. Matrana, MD, MS, FACP, and Julia L. Cook, PhD
    In Louisiana, cancer incidence and death rates are greater than the national average. However, access to early phase clinical trials was nearly impossible to find. 2018 ACCC Innovator Award winner Ochsner Health System partnered with the Translational Genomics Research institute to establish a dedicated center to that accelerated treatment development and expanded patient access to precision medicines.
  •  Implementation of Drug Vial Optimization to Reduce Drug Waste
    Amerine LB, et al.
    In the Department of Pharmacy at the University of North Carolina North Carolina Cancer Hospital, discarding partial drug vials was a significant source of waste. With their Innovator Award–winning drug vial optimization program, the program maximized the lifespan of drugs within single-dose vials and realized an annual cost savings of more than $40 million.
  •  Robotic Bronchoscopy
    Amy Hindman
    Early identification, staging, and diagnosis of lung cancer is critical to improving patient outcomes. However, current diagnostic options are limited in accuracy, safety, and invasiveness—only 15 percent of patients with lung cancer are diagnosed at an early stage. Read how Fox Chase Cancer Center has implemented new flexible robotic endoscopic technology to diagnose hard-to-reach lung nodules with greater precision than ever before.
  •  CRISPR-Directed Gene Editing in a Community Cancer Center
    Eric B. Kmiec, PhD
    CRISPR, a gene editing tool, has entered the scientific arena and public discourse at an astounding speed. Eric B. Kmiec, PhD, director of the Gene Editing Institute at the Helen F. Graham Cancer Center & Research Institute, discusses the emergence of gene editing, how it can be utilized as a tool in the battle against cancer, and the challenges facing its transition from bench to bedside.
  •  The Inherited Cancer Registry (ICARE) Initiative
    Tuya Pal, MD, FACMG; Cristi Radford, MS, CGC; Anne Weidner, MPH; Ann Louise Tezak, MA, MPH; Deborah Cragun, PhD, MS, CGC; and Georgia Lowrey Wiesner, MD, MS
    The Inherited Cancer Registry (ICARE) is an academic-community partnership among healthcare providers, researchers, and individuals at an increased risk for inherited cancer. Learn about ICARE’s research registry for high-risk individuals and education efforts on inherited cancer for both patients and providers.
  •  Best Practices for Implementing Cancer Immunotherapy in the Community
    The Association of Community Cancer Centers (ACCC) recently hosted live continuing medical education (CME)-certified learning workshops at two community cancer programs to review current barriers to immunotherapy implementation in the community setting. During the workshops, an expert faculty panel engaged participants in discussion on the challenges that they may face as they integrate immunotherapy into their clinical practice, as well as practical solutions and strategies they can apply to overcome these barriers. This article summarizes the guidance and information provided by the faculty on the various issues raised during the workshop discussions.
  •  Building a Personalized Medicine Program
    Thomas D. Brown, MD, MBA
    The Swedish Cancer Institute (SCI) has a long history of providing the nurturing care of a community-based hospital while giving patients access to the latest cancer therapies. In 2013 we took on the question of how to integrate personalized, genomic medicine into our program.
  •  How Molecular Subtyping is Changing Our Understanding of Breast Cancer
    James V. Pellicane, MD, FACS
    This article describes molecular subtyping and shows how it is changing both the understanding of breast cancer and how to treat it. The article summarizes the most important new studies and details the impact of this new information for community cancer centers.
  •  Molecular Testing in the Community Setting
    In 2013, ACCC proceeded with Phase II, Learning Labs for Process Improvement, a program for member institutions that focused on improving molecular testing at the system level through experiential learning labs.
  •  How Lean Methodology can Improve Molecular Testing Processes in Advanced NSCLC
    Lawrence D. Wagman, MD, FACS; Raymond Casciari, MD; John Maurice, MD; Peggy J. Crabtree, MBA, RN; and Ruslan Horblyuk, PhD, MBA
    To see how lean methodology could be used to evaluate current molecular testing processes, identify waste, and design an improved process for advanced non-small cell lung cancer (NSCLC) in the community setting, a pilot study was conducted at St. Joseph Hospital, Orange, Center for Cancer Prevention and Treatment (SJH), located in Orange County, Calif.
  •  Using a Collective Brain to Defeat the Deadliest Brain Tumor
    David F. Arons, JD
    Sometimes referred to as the “terminator,” glioblastoma (GBM) is one of the deadliest forms of brain cancer.
  •  Best of ASCO 2017
    Cary A. Presant, MD, FACP, FASCO
    ASCO 2017 was filled with new information and long lines as 39,000 oncologists worldwide came together to hear the latest advances in cancer care.
  •  A Model for Tissue Banking in the Community Setting
    Viorela Pop; Lavinia Dobrea; Sandra Brown; Noah Gonzalez; Rachelle Alquitela; Ron Bati; Martha French; Sonia Labeet; Melinda Lima; Virginia Trujillo Castro; Nancy Walter; Sarah M. Barrett; Aaron Sassoon; and Lawrence D. Wagman
    Banking of biological specimens can advance oncology research efforts by providing valuable resources from participants and promoting collaborative partnerships.
  •  The Study of High-Cost Oncology Patients to Improve Care & Curb Costs
    Matthew A. Manning, MD
    This article shares how Cone Health System identified high-cost patients, or “hot-spotters,” and put processes and systems in place to not only improve care for these patients but also reduce costs.
  •  Prostate Cancer Detection & Diagnosis: Opening Up New Therapeutic Avenues
    James S. Wysock, MD, and Herbert Lepor, MD
    The challenge providers face is to screen and detect “smarter” in order to minimize the burden of unnecessary biopsy and treatment. Ideally, the goal is to identify men who would benefit from aggressive therapy.
  •  Best of ASCO 2016
    Cary A. Presant, MD, FACP, FASCO
    The 2016 ASCO Annual Meeting was filled with information, practice advice, and exciting results that will change oncology for the coming year.
  •  Delivering Pharmacogenetic Testing in the Community Setting
    Mark Wagner, PharmD; Jennifer Eichmeyer, MS, CGC; Paul G. Montgomery, MD; Jessica Monitz, PharmD; Jesslie Modlin, PharmD; and Natalie Perry, BA
    In November 2014, St. Luke’s Mountain States Tumor Institute (MSTI), Boise, Idaho, initiated a pilot program to determine the feasibility of a pharmacogenetic testing program in a community cancer program.
  •  ORIEN: Reshaping Cancer Research & Treatment
    Michael A. Caligiuri, MD; William S. Dalton, PhD, MD; Lorna Rodriguez, MD, PhD; Thomas Sellers, PhD, MPH; and Cheryl L. Willman, MD
    Extending precision cancer clinical trials to community cancer programs is a primary goal of the Oncology Research Information Exchange Network (ORIEN), a partnership of some of the leading NCI-designated Cancer Centers nationwide.