- Are Payers Ready, Willing, and Able to Provide Access to New Durable Gene Therapies? [Journal Article]
- VHValue Health 2019; 22(6):642-647
- CONCLUSIONS: Access to new gene therapies may be impacted by payer ability to absorb the cost of coverage. Variation exists in awareness of new gene therapies and level of incorporation of new costs into future plan coverage. The sustainability of current financing mechanisms varies by payer segment, profitability, and size; smaller plans and Medicaid are likely to be impacted first. Government reinsurance, commercial reinsurance, and stop-loss insurance backstop current reimbursement models, dampening the need for urgent action. The tipping point for action may be severe premium inflation in stop loss and reinsurance. Payers are open to innovative financing models that improve financial predictability and reward clinical performance.
- Watchful Waiting after Radiochemotherapy in Rectal Cancer: When Is It Feasible? [Review]
- VMVisc Med 2019; 35(2):119-123
- A "watch and wait" strategy in rectal cancer is increasingly considered in patients who achieve an excellent response to radiotherapy. While a growing number of studies have shown the feasibility of …
A "watch and wait" strategy in rectal cancer is increasingly considered in patients who achieve an excellent response to radiotherapy. While a growing number of studies have shown the feasibility of this strategy in selected patients, the optimal therapeutic regimen to maximize response rates still needs to be established. Furthermore, accurate response prediction and the management of minor residual findings after radiotherapy remain a matter of debate. Finally, concerns regarding the long-term oncological safety of the "watch and wait" approach have been expressed. Therefore, the present review aims to address the open questions in the context of a "watch and wait" strategy and focuses on the diagnosis of a clinical complete response and the ideal management thereafter.
- [Presence of prostate cancer, but absence of active treatment]. [Journal Article]
- NTNed Tijdschr Geneeskd 2019 May 31; 163
- Prostate cancer is the most common cancer in men. Because these tumours are usually detected by early diagnosis, prostate cancer is often limited to the prostate when diagnosed. Withholding active tr…
Prostate cancer is the most common cancer in men. Because these tumours are usually detected by early diagnosis, prostate cancer is often limited to the prostate when diagnosed. Withholding active treatment, with active surveillance or watchful waiting are full options for men with this diagnosis. In active surveillance, men receive a structured follow-up with repeated determinations of the prostate-specific antigen (PSA) and prostate biopsies, often supported by MRI. When the tumour develops, active treatment can still be initiated. With this approach, the 10-year survival rate is high and a significant proportion of men remain untreated. With watchful waiting no structural monitoring takes place; instead one waits until the prostate cancer becomes symptomatic. This mainly concerns bone pain due to metastasis and obstruction of the urethra due to local growth. Explanation about these options is essential and GPs can play an important role in this.
- Treatment-associated outcomes of patients with primary ocular adnexal MALT lymphoma after accurate diagnosis. [Journal Article]
- IJInt J Clin Oncol 2019 Jun 06
- CONCLUSIONS: Our results indicate that radiotherapy-based treatment strategies for patients with POA-MALT lymphoma show a low rate of recurrence and may improve their prognosis even after the accurate diagnosis. However, contamination of the cases with reactive (polyclonal) lymphoid hyperplasia into those with MALT lymphoma should be carefully removed to avoid unnecessary treatment for malignancies that do not exist.
- Lesion detection by [89Zr]Zr-DFO-girentuximab and [18F]FDG-PET/CT in patients with newly diagnosed metastatic renal cell carcinoma. [Journal Article]
- EJEur J Nucl Med Mol Imaging 2019 Jun 06
- CONCLUSIONS: The addition of [89Zr]Zr-DFO-girentuximab-PET/CT and [18F]FDG-PET/CT to CT increases lesion detection compared to CT alone in newly diagnosed good and intermediate prognosis mccRCC patients eligible for watchful waiting.
- Sentinel Lymph Node Targeted Therapy by Oncolytic Sendai Virus Suppresses Micrometastasis of Head and Neck Squamous Cell Carcinoma in an Orthotopic Nude Mouse Model. [Journal Article]
- MCMol Cancer Ther 2019 Jun 06
- In clinical N0 cases with head and neck squamous cell carcinoma (HNSCC), a treatment selection is still controversial: elective neck dissection or watchful waiting. We focused on sentinel lymph node …
In clinical N0 cases with head and neck squamous cell carcinoma (HNSCC), a treatment selection is still controversial: elective neck dissection or watchful waiting. We focused on sentinel lymph node (SLN)-targeted therapy using the urokinase-type plasminogen activator (uPA)-dependent oncolytic Sendai virus "BioKnife". The objectives of this study were to investigate BioKnife migration into SLNs and elucidate its anti-tumor effect on lymph node metastases (LNM). We established an orthotopic nude mouse model of HNSCC, with LNM being frequently induced. We inoculated HSC-3-M3, human highly metastatic tongue SCC cells, in the tongue of the nude mice, and after two weeks, we injected BioKnife into the primary tumor. We tracked BioKnife migration into the SLNs by immunostaining, RT-PCR, and an in vivo imaging system. We also examined its anti-tumor effects and mechanisms through serial section analysis of LNs. GFP reporter expression was clearly visible in the LNs of virus groups, which corresponded to SLNs. Relative GFP mRNA was significantly increased in both the tongues and LNs in the virus groups compared to that in the control groups (p < 0.05). Serial section analysis showed that BioKnife infected cancer cells and exhibited significant anti-tumor effect against LNM compared to the control groups (p < 0.05). We detected apoptosis in LNM infected by BioKnife. BioKnife migrated into SLNs after its injection into the primary tumor and effectively suppressed LNM, suggesting that SLN-targeted therapy using BioKnife has great potential to provide a novel and promising alternative to elective neck dissection in clinical N0 patients with HNSCC.
- Use and early mortality outcomes of active surveillance in patients with intermediate-risk prostate cancer. [Journal Article]
- CCancer 2019 May 31
- CONCLUSIONS: The use of AS for patients with intermediate-risk PCa is increasing across the United States, particularly for older men and those with favorable intermediate-risk disease. Early estimates of cancer-specific and overall mortality rates are low with AS, although significantly higher compared with treatment.
- Risk of multiple early gastric cancers in a patient with precursor lesions and endoscopic surveillance for 7 years: A case report. [Case Reports]
- MMedicine (Baltimore) 2019; 98(22):e15686
- CONCLUSIONS: Long-term, meticulous endoscopic surveillance is needed to monitor risk factors associated with multiple EGCs in patients with severe mucosal atrophy or intestinal metaplasia despite successful Helicobacter pylori eradication.
- Case report and systematic review of iatrogenic left atrial dissection in different cardiovascular specialties: A common treatment for an uncommon complication? [Journal Article]
- CCCatheter Cardiovasc Interv 2019 May 29
- CONCLUSIONS: According to systematic literature review, a watchful-waiting strategy supported by multimodality imaging could be a safe and effective management in stable LatD.
New Search Next
- Watchful Waiting Doesn't Mean No Puberty Blockers, and Moving Beyond Watchful Waiting. [Comment]
- AJAm J Bioeth 2019; 19(6):W3-W4