National Cancer Policy Forum's Books

The National Cancer Policy Summit

Opportunities and Challenges in Cancer Research and Care

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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The National Cancer Policy Summit

Opportunities and Challenges in Cancer Research and Care

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

Many ongoing changes are likely to have an impact on cancer research and care. For example, technological advances are rapidly changing the way cancer research is conducted, and the recently passed healthcare reform legislation has many implications for cancer care. Technological advances are altering the way cancer research is conducted and cancer care is delivered, and the recently passed healthcare reform legislation has many implications for cancer care. There is a growing emphasis on molecularly targeted therapies, information technology (IT), and patient-centered care, and clinical cancer research has become a global endeavor. At the same time, there are concerns about shrinking research budgets and escalating costs of cancer care. Considering such changes, the National Cancer Policy Forum (NCPF) of the Institute of Medicine held a National Cancer Policy Summit on October 25, 2010. The Summit convened key leaders in the cancer community to identify and discuss the most pressing policy issues in cancer research and cancer care. The National Cancer Policy Summit: Opportunities and Challenges in Cancer Research and Care is a summary of the summit. The report explores policy issues related to cancer research, the implementation of healthcare reform, delivery of cancer care, and cancer control and public health needs. Expert participants suggested many potential actions to provide patient-centered cancer care, to foster more collaboration, and to achieve other goals to improve research and care.

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National Academies Press

Published Date

ISBN 10

0309187397

ISBN 13

9780309187398

The National Cancer Policy Summit

Opportunities and Challenges in Cancer Research and Care

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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The National Cancer Policy Summit

Opportunities and Challenges in Cancer Research and Care

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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National Academies Press

Published Date

ISBN 10

0309215935

ISBN 13

9780309215930

Facilitating Collaborations to Develop Combination Investigational Cancer Therapies

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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Facilitating Collaborations to Develop Combination Investigational Cancer Therapies

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

Advances in biomedical research have increased our understanding of the complex nature of disease and the interaction of multiple molecular pathways involved in cancer. Combining investigational products early in their development is thought to be a promising strategy for identifying effective therapies. The IOM's National Cancer Policy Forum held a workshop to discuss challenges and identify potential solutions to improve collaboration and advance the development of combination investigational cancer therapies.

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118

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National Academies Press

Published Date

ISBN 10

0309220645

ISBN 13

9780309220644

Implementing a National Cancer Clinical Trials System for the 21st Century

Second Workshop Summary

By: Board on Health Care Services,National Cancer Policy Forum,Institute of Medicine,An American Society of Clinical Oncology and Institute of Medicine Workshop

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Implementing a National Cancer Clinical Trials System for the 21st Century

Second Workshop Summary

By: Board on Health Care Services,National Cancer Policy Forum,Institute of Medicine,An American Society of Clinical Oncology and Institute of Medicine Workshop

The National Clinical Trials Network (NCTN) supported by the National Cancer Institute (NCI) has played an integral role in cancer research and in establishing the standard of care for cancer patients for more than 50 years. Formerly known as the NCI Clinical Trials Cooperative Group Program, the NCTN is comprised of more than 2,100 institutions and 14,000 investigators, who enroll more than 20,000 cancer patients in clinical trials each year across the United States and internationally. Recognizing the recent transformative advances in cancer research that necessitate modernization in how cancer clinical trials are run, as well as inefficiencies and other challenges impeding the national cancer clinical trials program, the NCI asked the IOM to develop a set of recommendations to improve the federally funded cancer clinical trials system. These recommendations were published in the 2010 report, A National Cancer Clinical Trials System for the 21st Century: Reinvigorating the NCI Cooperative Group Program. In early 2011, the NCPF and the American Society of Clinical Oncology (ASCO) held a workshop in which stakeholders discussed the changes they planned to implement in response to the IOM goals and recommendations. Two years later, on February 11-12, 2013, in Washington, DC, the NCPF and ASCO reconvened stakeholders to report on the changes they have made thus far to address the IOM recommendations. At this workshop, representatives from the NCI, the NCTN, comprehensive cancer centers, patient advocacy groups, the Food and Drug Administration (FDA), industry, and other stakeholders highlighted the progress that has been made in achieving the goals for a reinvigorated national cancer clinical trials system. Implementing a National Cancer Clinical Trials System for the 21st Century is a summary of that workshop.

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111

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National Academies Press

Published Date

ISBN 10

0309287278

ISBN 13

9780309287272

Implementation of Lung Cancer Screening

Proceedings of a Workshop

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,National Cancer Policy Forum

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Implementation of Lung Cancer Screening

Proceedings of a Workshop

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,National Cancer Policy Forum

The public health burden from lung cancer is substantial: it is the second most commonly diagnosed cancer and the leading cause of cancer-related deaths in the United States. Given the individual and population health burden of lung cancer, especially when it is diagnosed at later stages, there has been a push to develop and implement screening strategies for early detection. However, many factors need to be considered for broad implementation of lung cancer screening in clinical practice. Effective implementation will entail understanding the balance of potential benefits and harms of lung cancer screening, defining and reaching eligible populations, addressing health disparities, and many more considerations. In recognition of the substantial challenges to developing effective lung cancer screening programs in clinical practice, the National Academies of Sciences, Engineering, and Medicine held a workshop in June 2016. At the workshop, experts described the current evidence base for lung cancer screening, the current challenges of implementation, and opportunities to overcome them. Workshop participants also explored capacity and access issues; best practices for screening programs; assessment of patient outcomes, quality, and value in lung cancer screening; and research needs that could improve implementation efforts. This publication summarizes the presentations and discussions from the workshop.

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129

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National Academies Press

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ISBN 10

0309451353

ISBN 13

9780309451352

Patient-Centered Cancer Treatment Planning

Improving the Quality of Oncology Care: Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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Patient-Centered Cancer Treatment Planning

Improving the Quality of Oncology Care: Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

Each year approximately 1.5 million people are diagnosed with cancer in the United States, most of whom inevitably face difficult decisions concerning their course of care. Recognizing challenges associated with cancer treatment, the National Coalition for Cancer Survivorship (NCCS) and the National Cancer Policy Forum (NCPF) of the Institute of Medicine (IOM) hosted a public workshop in Washington, DC on February 28 and March 1, 2011, entitled Patient-Centered Cancer Treatment Planning: Improving the Quality of Oncology Care. This workshop summary includes an overview of patient-centered care and cancer treatment planning, as well as subject areas on shared decision making, communication in the cancer care setting, and patient experiences with cancer treatment. Best practices, models of treatment planning, and tools to facilitate their use are also discussed, along with policy changes that may promote patient-centeredness by enhancing patient's understanding of and commitment to the goals of treatment through shared decision-making process with their healthcare team from the moment of diagnosis onward. Moreover, Patient-Centered Cancer Treatment Planning emphasizes treatment planning for patients with cancer at the time diagnosis.

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National Academies Press

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ISBN 10

0309212731

ISBN 13

9780309212731

Nanotechnology and Oncology

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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Nanotechnology and Oncology

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

One way scientists are working to overcome challenges in cancer treatment and improve cancer care is through nanotechnology. Nanotechnology, engineered materials that make use of the unique physical properties, presents a new array of medical prospects that will revolutionize cancer prevention, diagnosis, and treatment practices. Giving new hope to patients, practitioners, and researchers alike, nanotechnology has the potential to translate recent discoveries in cancer biology into clinical advances in oncology. While public investments in nanotechnology for cancer continue to increase, medical products based on nanotechnology are already on the market. The National Cancer Policy forum held a workshop July 12-13, 2010, to explore challenges in the use of nanotechnology in oncology. Nanotechnology and Oncology evaluates the ongoing discussion on the role of nanotechnology in cancer as it relates to risk management, treatment, and regulatory policy. Assessments on nanomedicine and the physical properties of nanomaterials were presented during the workshop, along with an appraisal of the current status of research and development efforts.

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118

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National Academies Press

Published Date

ISBN 10

0309163218

ISBN 13

9780309163217

The Role of Obesity in Cancer Survival and Recurrence

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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The Role of Obesity in Cancer Survival and Recurrence

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

Recent research suggests that obesity and excess weight can play a prominent role in the incidence and progression of various cancers. Obesity results from an energy imbalance - that is, energy intake that is higher than energy expenditure - could also influence the growth of cancers. Recognizing the impact that current findings on obesity and cancer could have on future cancer prevention and care, the National Cancer policy Forum (NCPF) of the Institute of Medicine (IOM) help a 2-day workshop on "The Role of Obesity in Cancer Survival and Recurrence," in Washington, DC, on October 31 and November 1, 2011. The Role of Obesity in Cancer Survival and Recurrence: Workshop Summary reviews each presenter's latest clinical evidence on the obesity-cancer link and the molecular mechanisms that might explain that link. Clinicians, researchers, cancer survivors, and policy makers also discussed potential interventions to counter the effects of obesity on cancer, and research and policy measures needed to stem the rising tide of cancer mortality predicted by an increasingly overweight and older population worldwide. The Role of Obesity in Cancer Survival and Recurrence: Workshop Summary explores the complex web of molecular mechanisms that underlie the obesity-cancer link, the ways to design future studies to acquire the information needed to guide patient care, what to advise cancer patients about weight loss, diet, exercise, and other measures to reduce their risk of cancer progression or recurrence and policy suggestions related to research, education, and dissemination of the findings on obesity and cancer.

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126

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National Academies Press

Published Date

ISBN 10

0309253365

ISBN 13

9780309253369

Ensuring Patient Access to Affordable Cancer Drugs

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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Ensuring Patient Access to Affordable Cancer Drugs

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

In recent years, patients' out-of-pocket costs for cancer care have been rising rapidly. These costs include health insurance deductibles, coinsurance, and copayments for covered services, as well as services that are not covered by insurance. Many cancer patients are especially vulnerable financially because their illness and/or treatment impedes their ability to work, with some patients losing employment altogether. Even with insurance, cancer patients often experience financial hardships, such as going into debt, depleting all assets to pay for cancer treatment, and personal bankruptcy. Although many elements contribute to the cost of cancer care, one important component is the cost of new cancer drugs, which has been escalating rapidly in recent years. To explore the issue of cancer drug costs and patient access to affordable, appropriate drug therapies, the Institute of Medicine's National Cancer Policy Forum convened a workshop on ensuring patient access to affordable cancer drugs in June 2014. Affordability was considered from both individual and societal perspectives. The workshop featured discussion panels as well as invited presentations from clinicians, researchers, representatives from the health insurance and pharmaceutical industries, and patient advocates. Ensuring Patient Access to Affordable Cancer Drugs summarizes the presentation and discussion of the workshop.

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ISBN 10

0309312736

ISBN 13

9780309312738

Cancer-Related Genetic Testing and Counseling

Workshop Proceedings

By: Institute of Medicine,National Cancer Policy Forum

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Cancer-Related Genetic Testing and Counseling

Workshop Proceedings

By: Institute of Medicine,National Cancer Policy Forum

These proceedings of a workshop presented to the Institute of Medicine's (IOM) National Cancer Policy Forum on March 30, 2007, are the result of forum discussions about genetic testing and counseling at its meetings on June 16 and October 30, 2006. Those discussions, led by forum members Betty Ferrell and Patricia Ganz, noted that genetic testing and counseling are becoming more complex and important for informing patients and families of risks and benefits of certain courses of action, and yet organized expert programs are in short supply. The subject matter involves not only the scientific and clinical aspects but also workforce and reimbursement issues, among others. Drs. Ferrell and Ganz proposed that the forum could provide a useful review of the various important implications of these issues by holding and reporting a workshop on the subject. They volunteered to work with staff to organize and lead such a workshop. The agenda for the workshop is reproduced in the appendix to these proceedings. It includes the presentations of the invited speakers and the comments of speakers, forum members, and others in attendance as transcribed and edited to eliminate redundancies, grammatical errors, and otherwise make them more readable. Cancer-Related Genetic Testing and Counseling : Workshop Proceedings summarizes the workshop.

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134

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National Academies Press

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ISBN 10

0309109973

ISBN 13

9780309109970

Improving Cancer Diagnosis and Care

Clinical Application of Computational Methods in Precision Oncology: Proceedings of a Workshop

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,National Cancer Policy Forum

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Improving Cancer Diagnosis and Care

Clinical Application of Computational Methods in Precision Oncology: Proceedings of a Workshop

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,National Cancer Policy Forum

A hallmark of high-quality cancer care is the delivery of the right treatment to the right patient at the right time. Precision oncology therapies, which target specific genetic changes in a patient's cancer, are changing the nature of cancer treatment by allowing clinicians to select therapies that are most likely to benefit individual patients. In current clinical practice, oncologists are increasingly formulating cancer treatment plans using results from complex laboratory and imaging tests that characterize the molecular underpinnings of an individual patient's cancer. These molecular fingerprints can be quite complex and heterogeneous, even within a single patient. To enable these molecular tumor characterizations to effectively and safely inform cancer care, the cancer community is working to develop and validate multiparameter omics tests and imaging tests as well as software and computational methods for interpretation of the resulting datasets. To examine opportunities to improve cancer diagnosis and care in the new precision oncology era, the National Cancer Policy Forum developed a two-workshop series. The first workshop focused on patient access to expertise and technologies in oncologic imaging and pathology and was held in February 2018. The second workshop, conducted in collaboration with the Board on Mathematical Sciences and Analytics, was held in October 2018 to examine the use of multidimensional data derived from patients with cancer, and the computational methods that analyze these data to inform cancer treatment decisions. This publication summarizes the presentations and discussions from the second workshop.

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ISBN 10

0309490847

ISBN 13

9780309490849

Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum

Proceedings of a Workshop

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,National Cancer Policy Forum

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Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum

Proceedings of a Workshop

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,National Cancer Policy Forum

The National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a public workshop, Incorporating Weight Management and Physical Activity Throughout the Cancer Care Continuum, on February 13 and 14, 2017, in Washington, DC. The purpose of this workshop was to highlight the current evidence base, gaps in knowledge, and research needs on the associations among obesity, physical activity, weight management, and health outcomes for cancer survivors, as well as to examine the effectiveness of interventions for promoting physical activity and weight management among people living with or beyond cancer. Workshop sessions also reviewed the opportunities and challenges for providing weight management and physical activity interventions to cancer survivors. This publication summarizes the presentations and discussions from the workshop.

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139

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National Academies Press

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ISBN 10

0309466946

ISBN 13

9780309466943

Assessing and Improving Value in Cancer Care

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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Assessing and Improving Value in Cancer Care

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

Unlike many other areas in health care, the practice of oncology presents unique challenges that make assessing and improving value especially complex. First, patients and professionals feel a well-justified sense of urgency to treat for cure, and if cure is not possible, to extend life and reduce the burden of disease. Second, treatments are often both life sparing and highly toxic. Third, distinctive payment structures for cancer medicines are intertwined with practice. Fourth, providers often face tremendous pressure to apply the newest technologies to patients who fail to respond to established treatments, even when the evidence supporting those technologies is incomplete or uncertain, and providers may be reluctant to stop toxic treatments and move to palliation, even at the end of life. Finally, the newest and most novel treatments in oncology are among the most costly in medicine. This volume summarizes the results of a workshop that addressed these issues from multiple perspectives, including those of patients and patient advocates, providers, insurers, health care researchers, federal agencies, and industry. Its broad goal was to describe value in oncology in a complete and nuanced way, to better inform decisions regarding developing, evaluating, prescribing, and paying for cancer therapeutics.

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164

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National Academies Press

Published Date

ISBN 10

0309138140

ISBN 13

9780309138147

The Role of Clinical Studies for Pets with Naturally Occurring Tumors in Translational Cancer Research

Workshop Summary

By: National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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The Role of Clinical Studies for Pets with Naturally Occurring Tumors in Translational Cancer Research

Workshop Summary

By: National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

Traditional preclinical mouse models of cancer have been very useful for studying the biology of cancer, however they often lack key characteristics of human cancers. As a result, many novel drug candidates fail in human clinical trials despite evidence of drug efficacy in those preclinical models. Thus, researchers are seeking new approaches to augment preclinical knowledge before undertaking clinical trials for human patients. Recently, there has been renewed interest in comparative oncology - the study of naturally developing cancers in animals as models for human disease - as one way to improve cancer drug development and reduce attrition of investigational agents. Tumors that spontaneously develop in pet dogs and other companion animals as a result of normal aging share many characteristics with human cancers, such as histological appearance, tumor genetics, biological behavior, molecular targets, and therapeutic response. In June 2015 the Institute of Medicine hosted a workshop to examine the rationale and potential for integrating clinical trials for pet patients with naturally occurring cancers into translational cancer research and development. Participants discussed the research needs, strategies, and resources to support greater integration of clinical trials for pets with cancer into translational research pathways, and challenges and potential solutions for facilitating that integration. This report summarizes the presentations and discussions from the workshop.

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National Academies Press

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ISBN 10

0309379903

ISBN 13

9780309379908

Cancer Care in Low-Resource Areas

Cancer Prevention and Early Detection: Workshop Summary

By: National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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Cancer Care in Low-Resource Areas

Cancer Prevention and Early Detection: Workshop Summary

By: National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

Though cancer was once considered to be a problem primarily in wealthy nations, low- and middle-income countries now bear a majority share of the global cancer burden, and cancer often surpasses the burden of infectious diseases in these countries. Effective low-cost cancer control options are available for some malignancies, with the World Health Organization estimating that these interventions could facilitate the prevention of approximately one-third of cancer deaths worldwide. But these interventions remain inaccessible for many people in the world, especially those residing in low-resource communities that are characterized by a lack of funds â€" on an individual or societal basis â€" to cover health infrastructure and care costs. Few guidelines and strategies for cancer control consider the appropriateness and feasibility of interventions in low-resource settings, and may undermine the effectiveness of these efforts. For example, interventions that are designed for high-resource settings may not account for important considerations in low-resource settings, such as resource constraints, infrastructure requirements, or whether a community has the capacity to deliver downstream cancer care. Patients in resource-constrained communities continue to face delayed diagnoses of cancer, potentially resulting in the diagnosis of later stage cancers and worsened patient outcomes. In addition, social stigmas, geopolitical issues, and cultural norms may limit access to cancer care in certain communities. Recognizing the challenges of providing cancer care in these settings, the National Academies of Sciences, Engineering, and Medicine developed a workshop series examining cancer care in low-resource communities. This report summarizes the presentations and discussions from the first workshop, which focused on cancer prevention and early detection.

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127

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National Academies Press

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ISBN 10

0309391016

ISBN 13

9780309391016

Developing Biomarker-Based Tools for Cancer Screening, Diagnosis, and Treatment

The State of the Science, Evaluation, Implementation, and Economics: Workshop Summary

By: Institute of Medicine,National Cancer Policy Forum

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Developing Biomarker-Based Tools for Cancer Screening, Diagnosis, and Treatment

The State of the Science, Evaluation, Implementation, and Economics: Workshop Summary

By: Institute of Medicine,National Cancer Policy Forum

Research has long sought to identify biomarkers that could detect cancer at an early stage, or predict the optimal cancer therapy for specific patients. Fueling interest in this research are recent technological advances in genomics, proteomics, and metabolomics that can enable researchers to capture the molecular fingerprints of specific cancers and fine-tune their classification according to the molecular defects they harbor. The discovery and development of new markers of cancer could potentially improve cancer screening, diagnosis, and treatment. Given the potential impact cancer biomarkers could have on the cost effectiveness of cancer detection and treatment, they could profoundly alter the economic burden of cancer as well. Despite the promise of cancer biomarkers, few biomarker-based cancer tests have entered the market, and the translation of research findings on cancer biomarkers into clinically useful tests seems to be lagging. This is perhaps not surprising given the technical, financial, regulatory, and social challenges linked to the discovery, development, validation, and incorporation of biomarker tests into clinical practice. To explore those challenges and ways to overcome them, the National Cancer Policy Forum held the conference "Developing Biomarker-Based Tools for Cancer Screening, Diagnosis and Treatment: The State of the Science, Evaluation, Implementation, and Economics" in Washington, D.C., from March 20 to 22, 2006. At this conference, experts gave presentations in one of six sessions. In addition, seven small group discussions explored the policy implications surrounding biomarker development and adoption into clinical practice. Developing Biomarker-based Tools for Developing Cancer Screening, Diagnosis, and Treatment: The State of the Science, Evaluation, Implementation, and Economics-Workshop Summary presents the conference proceedings and will be used by an Institute of Medicine (IOM) committee to develop consensus-based recommendations for moving the field of cancer biomarkers forward.

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112

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National Academies Press

Published Date

ISBN 10

0309180619

ISBN 13

9780309180610

Effect of the HIPAA Privacy Rule on Health Research

Proceedings of a Workshop Presented to the National Cancer Policy Forum

By: Institute of Medicine,National Cancer Policy Forum

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Effect of the HIPAA Privacy Rule on Health Research

Proceedings of a Workshop Presented to the National Cancer Policy Forum

By: Institute of Medicine,National Cancer Policy Forum

The Health Insurance Portability and Accountability Act (HIPAA) of 1996 was enacted to improve the portability and continuity of health insurance; promote medical savings accounts; improve access to long-term care services and coverage; and simplify the administration of health insurance. HIPAA's Administrative Simplification provisions focus on facilitating the electronic exchange of information for financial and administrative functions related to patient care. However, the very advances that make it easier to transmit information also present challenges to preserving the confidentiality of potentially sensitive personal information contained in medical records. In 2003, the President's Cancer Panel discovered HIPAA Privacy Rule slowed research on cancer survivors, as well as causing increased bureaucracy, informed consent problems, and complications for clinical trials. Effect of the HIPAA Privacy Rule on Health Research evaluates the impact of HIPAA provisions and provides guidance to legislators on amendments needed to make this law better serve the interests of cancer survivors and others.

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102

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National Academies Press

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ISBN 10

030910291X

ISBN 13

9780309102919

Ensuring Quality Cancer Care Through the Oncology Workforce

Sustaining Care in the 21st Century: Workshop Summary

By: Institute of Medicine,National Cancer Policy Forum

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Ensuring Quality Cancer Care Through the Oncology Workforce

Sustaining Care in the 21st Century: Workshop Summary

By: Institute of Medicine,National Cancer Policy Forum

The American Society of Clinical Oncology (ASCO) predicts that by 2020, there will be an 81 percent increase in people living with or surviving cancer, but only a 14 percent increase in the number of practicing oncologists. As a result, there may be too few oncologists to meet the population's need for cancer care. To help address the challenges in overcoming this potential crisis of cancer care, the National Cancer Policy Forum of the Institute of Medicine (IOM) convened the workshop Ensuring Quality Cancer Care through the Oncology Workforce: Sustaining Care in the 21st Century in Washington, DC on October 20 and 21, 2008.

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ISBN 10

0309177561

ISBN 13

9780309177566

Comprehensive Cancer Care for Children and Their Families

Summary of a Joint Workshop by the Institute of Medicine and the American Cancer Society

By: National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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Comprehensive Cancer Care for Children and Their Families

Summary of a Joint Workshop by the Institute of Medicine and the American Cancer Society

By: National Academies of Sciences, Engineering, and Medicine,Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

Childhood cancer is an area of oncology that has seen both remarkable progress as well as substantial continuing challenges. While survival rates for some pediatric cancers present a story of success, for many types of pediatric cancers, little progress has been made. Many cancer treatments are known to cause not only significant acute side effects, but also lead to numerous long-term health risks and reduced quality of life. Even in cases where the cancer is considered curable, the consequences of treatment present substantial long-term health and psychosocial concerns for children, their families, their communities, and our health system. To examine specific opportunities and suggestions for driving optimal care delivery supporting survival with high quality of life, the National Cancer Policy Forum of the Institute of Medicine and the American Cancer Society co-hosted a workshop which convened experts and members of the public on March 9 and 10, 2015. At this workshop, clinicians and researchers in pediatric oncology, palliative, and psychosocial care, along with representatives from the U.S. Food and Drug Administration, National Cancer Institute, Children's Oncology Group, pharmaceutical companies, and patient advocacy organizations, discussed and developed a menu of options for action to improve research, quality of care, and outcomes for pediatric cancer patients and their families. In addition, parents of children with cancer and pediatric cancer survivors shared their experiences with care and provided poignant personal perspectives on specific quality of life concerns and support needs for children and families across the life spectrum. This report summarizes the presentations and discussion of the workshop.

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ISBN 10

0309374448

ISBN 13

9780309374446

Multi-Center Phase III Clinical Trials and NCI Cooperative Groups

Workshop Summary

By: Institute of Medicine,National Cancer Policy Forum

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Multi-Center Phase III Clinical Trials and NCI Cooperative Groups

Workshop Summary

By: Institute of Medicine,National Cancer Policy Forum

The NCI-sponsored cooperative groups have made important contributions to improving treatment for many types of cancer, including breast, ovarian, colorectal, and childhood cancers. Cooperative group research has been instrumental in establishing innovative treatments that improve outcomes and quality of life. Despite these successes, the Cooperative Group Program has faced a number of challenges that threaten its effectiveness. To address this problem, the National Cancer Policy Forum (NCPF) convened a workshop titled "Multi-Center Phase III Clinical Trials and NCI Cooperative Groups" in Washington, DC, on July 1-2, 2008. The purpose of the workshop was to outline the challenges that the public clinical cancer research enterprise faces, and to identify possible solutions to these challenges.

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134

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National Academies Press

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ISBN 10

0309128676

ISBN 13

9780309128674

Contemporary Issues for Protecting Patients in Cancer Research

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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Contemporary Issues for Protecting Patients in Cancer Research

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

In the nearly 40 years since implementation of federal regulations governing the protection of human participants in research, the number of clinical studies has grown exponentially. These studies have become more complex, with multisite trials now common, and there is increasing use of archived biospecimens and related data, including genomics data. In addition, growing emphasis on targeted cancer therapies requires greater collaboration and sharing of research data to ensure that rare patient subsets are adequately represented. Electronic records enable more extensive data collection and mining, but also raise concerns about the potential for inappropriate or unauthorized use of data, bringing patient protections into a new landscape. There are also long-standing concerns about the processes and forms used to obtain informed consent from patients participating in clinical studies. These changes and challenges raise new ethical and practical questions for the oversight of clinical studies, and for protecting patients and their health information in an efficient manner that does not compromise the progress of biomedical research. Contemporary Issues for Protecting Patients in Cancer Research is the summary of a workshop convened by the National Cancer Policy Forum of the Institute of Medicine in February 2014 to explore contemporary issues in human subjects protections as they pertain to cancer research, with the goal of identifying potential relevant policy actions. Clinical researchers, government officials, members of Institutional Review Boards, and patient advocates met to discuss clinical cancer research and oversight. This report examines current regulatory provisions that may not adequately protect patients or may be hindering research, and discusses potential strategies and actions to address those challenges.

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125

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National Academies Press

Published Date

ISBN 10

0309306698

ISBN 13

9780309306690

Cancer in Elderly People

Workshop Proceedings

By: Institute of Medicine,National Cancer Policy Forum

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Cancer in Elderly People

Workshop Proceedings

By: Institute of Medicine,National Cancer Policy Forum

A high proportion of cancer occurs primarily in older persons, and incidence of the major cancers is greater. This, combined with the expansion of an aging America, is bound to have far reaching effects on the nation's healthcare industry. This summary of a workshop held in October 2006, reviews the various important implications of changing demographics and the cancer disease burden in the United States.

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106

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National Academies Press

Published Date

ISBN 10

0309179645

ISBN 13

9780309179645

Reducing Tobacco-Related Cancer Incidence and Mortality

Workshop Summary

By: National Cancer Policy Forum,Board on Health Care Services,Institute of Medicine

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Reducing Tobacco-Related Cancer Incidence and Mortality

Workshop Summary

By: National Cancer Policy Forum,Board on Health Care Services,Institute of Medicine

Tobacco use is the leading cause of preventable death in United States, causing more than 440,000 deaths annually and resulting in $193 billion in health-related economic losses each year--$96 billion in direct medical costs and $97 billion in lost productivity. Since the first U.S. Surgeon General's report on smoking in 1964, more than 29 Surgeon General's reports, drawing on data from thousands of studies, have documented the overwhelming and conclusive biologic, epidemiologic, behavioral, and pharmacologic evidence that tobacco use is deadly. This evidence base links tobacco use to the development of multiple types of cancer and other life-threatening conditions, including cardiovascular and respiratory diseases. Smoking accounts for at least 30 percent of all cancer deaths, and 80 percent of lung cancer deaths. Despite the widespread agreement on the dangers of tobacco use and considerable success in reducing tobacco use prevalence from over 40 percent at the time of the 1964 Surgeon General's report to less than 20 percent today, recent progress in reducing tobacco use has slowed. An estimated 18.9 percent of U.S. adults smoke cigarettes, nearly one in four high school seniors smoke, and 13 percent of high school males use smokeless tobacco products. In recognition that progress in combating cancer will not be fully achieved without addressing the tobacco problem, the National Cancer Policy Forum of the Institute of Medicine (IOM) convened a public workshop, Reducing Tobacco-Related Cancer Incidence and Mortality, June 11-12, 2012 in Washington, DC. In opening remarks to the workshop participants, planning committee chair Roy Herbst, professor of medicine and of pharmacology and chief of medical oncology at Yale Cancer Center and Smilow Cancer Hospital, described the goals of the workshop, which were to examine the current obstacles to tobacco control and to discuss potential policy, outreach, and treatment strategies that could overcome these obstacles and reduce tobacco-related cancer incidence and mortality. Experts explored a number of topics, including: the changing demographics of tobacco users and the changing patterns of tobacco product use; the influence of tobacco use on cancer incidence and cancer treatment outcomes; tobacco dependence and cessation programs; federal and state level laws and regulations to curtail tobacco use; tobacco control education, messaging, and advocacy; financial and legal challenges to tobacco control efforts; and research and infrastructure needs to support tobacco control strategies, reduce tobacco related cancer incidence, and improve cancer patient outcomes. Reducing Tobacco-Related Cancer Incidence and Mortality summarizes the workshop.

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131

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National Academies Press

Published Date

ISBN 10

0309264022

ISBN 13

9780309264020

Implementing Colorectal Cancer Screening

Workshop Summary

By: Institute of Medicine,National Cancer Policy Forum

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Implementing Colorectal Cancer Screening

Workshop Summary

By: Institute of Medicine,National Cancer Policy Forum

The IOM's National Cancer Policy Board estimated in 2003 that even modest efforts to implement known tactics for cancer prevention and early detection could result in up to a 29 percent drop in cancer deaths in about 20 years. The IOM's National Cancer Policy Forum, which succeeded the Board after it was disbanded in 2005, continued the Board's work to outline ways to increase screening in the U.S. On February 25 and 26, 2008, the Forum convened a workshop to discuss screening for colorectal cancer. Colorectal cancer screening remains low, despite strong evidence that screening prevents deaths. With the aim to make recommended colorectal cancer screening more widespread, the workshop discussed steps to be taken at the clinic, community, and health system levels. Workshop speakers, representing a broad spectrum of leaders in the field, identified major barriers to increased screening and described strategies to overcome these obstacles. This workshop summary highlights the information presented, as well as the subsequent discussion about actions needed to increase colorectal screening and, ultimately, to prevent more colorectal cancer deaths.

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128

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National Academies Press

Published Date

ISBN 10

0309121396

ISBN 13

9780309121392

Long-Term Survivorship Care After Cancer Treatment

Proceedings of a Workshop

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,National Cancer Policy Forum

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Long-Term Survivorship Care After Cancer Treatment

Proceedings of a Workshop

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,National Cancer Policy Forum

The 2006 Institute of Medicine (IOM) consensus study report From Cancer Patient to Cancer Survivor: Lost in Transition made recommendations to improve the quality of care that cancer survivors receive, in recognition that cancer survivors are at risk for significant physical, psychosocial, and financial repercussions from cancer and its treatment. Since then, efforts to recognize and address the unique needs of cancer survivors have increased, including an emphasis on improving the evidence base for cancer survivorship care and identifying best practices in the delivery of high-quality cancer survivorship care. To examine progress in cancer survivorship care since the Lost in Transition report, the National Cancer Policy Forum of the National Academies of Sciences, Engineering, and Medicine held a workshop in July 2017, in Washington, DC. Workshop participants highlighted potential opportunities to improve the planning, management, and delivery of cancer survivorship care. This publication summarizes the presentations and discussions from the workshop.

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161

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National Academies Press

Published Date

ISBN 10

0309473012

ISBN 13

9780309473019

Advancing Progress in the Development of Combination Cancer Therapies with Immune Checkpoint Inhibitors

Proceedings of a Workshop

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,National Cancer Policy Forum

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Advancing Progress in the Development of Combination Cancer Therapies with Immune Checkpoint Inhibitors

Proceedings of a Workshop

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,National Cancer Policy Forum

In recent years, significant progress has been made in the clinical development and use of various types of cancer immunotherapy, all of which rely on the immune system to fight cancer. The majority of new cancer drug applications submitted to the Food and Drug Administration (FDA) are for immunotherapies or combinations involving immunotherapies. One type of immunotherapy is an immune checkpoint inhibitor. Cells in the human body have proteins that regulate the immune system response to foreign invaders (e.g., cancer cells, microorganisms). However, cancer cells can coopt these "checkpoint" proteins and thwart the immune system's ability to recognize and attack cancer cells. To help promote an immune response to cancer, researchers have developed immune checkpoint inhibitors that enable T-cells to recognize cancer cells as foreign and to prevent deactivation of an immune system response. To examine the challenges and opportunities to develop combination cancer therapies that include immune checkpoint inhibitors, the National Cancer Policy Forum held a workshop on July 16â€"17, 2018, in Washington, DC. This workshop convened stakeholders with a broad range of expertise, including cancer researchers, clinicians, patient advocates, and representatives from industry, academia, and government. This publication summarizes the presentations and discussions from the workshop.

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National Academies Press

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ISBN 10

0309490863

ISBN 13

9780309490863

Delivering Affordable Cancer Care in the 21st Century

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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Delivering Affordable Cancer Care in the 21st Century

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

Rising health care costs are a central fiscal challenge confronting the United States. National spending on health care currently accounts for 18 percent of gross domestic product (GDP), but is anticipated to increase to 25 percent of GDP by 2037. The Bipartisan Policy Center argues that "this rapid growth in health expenditures creates an unsustainable burden on America's economy, with far-reaching consequences". These consequences include crowding out many national priorities, including investments in education, infrastructure, and research; stagnation of employee wages; and decreased international competitiveness.In spite of health care costs that far exceed those of other countries, health outcomes in the United States are not considerably better. With the goal of ensuring that patients have access to high-quality, affordable cancer care, the Institute of Medicine's (IOM's) National Cancer Policy Forum convened a public workshop, Delivering Affordable Cancer Care in the 21st Century, October 8-9, 2012, in Washington, DC. Delivering Affordable Cancer Care in the 21st Century summarizes the workshop.

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National Academies Press

Published Date

ISBN 10

030926944X

ISBN 13

9780309269445

Informatics Needs and Challenges in Cancer Research

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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Informatics Needs and Challenges in Cancer Research

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

As information technology becomes an integral part of health care, it is important to collect and analyze data in a way that makes the information understandable and useful. Informatics tools-which help collect, organize, and analyze data-are essential to biomedical and health research and development. The field of cancer research is facing an overwhelming deluge of data, heightening the national urgency to find solutions to support and sustain the cancer informatics ecosystem. There is a particular need to integrate research and clinical data to facilitate personalized medicine approaches to cancer prevention and treatment-for example, tailoring treatment based on an individual patient's genetic makeup as well as that of the tumor-and to allow for more rapid learning from patient experiences. To further examine informatics needs and challenges for 21st century biomedical research, the IOM's National Cancer Policy Forum held a workshop February 27-28, 2012. The workshop was designed to raise awareness of the critical and urgent importance of the challenges, gaps and opportunities in informatics; to frame the issues surrounding the development of an integrated system of cancer informatics for acceleration of research; and to discuss solutions for transformation of the cancer informatics enterprise. Informatics Needs and Challenges in Cancer Research: Workshop Summary summarizes the workshop.

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146

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National Academies Press

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ISBN 10

0309259517

ISBN 13

9780309259514

Implementing Cancer Survivorship Care Planning

Workshop Summary

By: The National Cancer Institute,The Lance Armstrong Foundation,Institute of Medicine

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Implementing Cancer Survivorship Care Planning

Workshop Summary

By: The National Cancer Institute,The Lance Armstrong Foundation,Institute of Medicine

One of the key recommendations of the joint IOM and NRC book, From Cancer Patient to Cancer Survivor: Lost in Transition, is that patients completing their primary treatment for cancer be given a summary of their treatment and a comprehensive plan for follow-up. This book answers practical questions about how this "Survivorship Care Plan," including what exactly it should contain, who will be responsible for creating and discussing it, implementation strategies, and anticipated barriers and challenges.

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320

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National Academies Press

Published Date

ISBN 10

0309103185

ISBN 13

9780309103183

Improving the Quality of Cancer Clinical Trials

Workshop Summary

By: Institute of Medicine,National Cancer Policy Forum

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Improving the Quality of Cancer Clinical Trials

Workshop Summary

By: Institute of Medicine,National Cancer Policy Forum

Scientists and clinicians seek a new paradigm that could improve the efficiency, cost-effectiveness, and overall success rate of cancer clinical trials, while maintaining the highest standards of quality. To explore innovative paradigms for cancer clinical trials and other ways to improve their quality, the National Cancer Policy Forum held a workshop, Improving the Quality of Cancer Clinical Trials, in Washington, DC. The main goals of the workshop were to examine new approaches to clinical trial design and execution that would: (1) better inform decisions and plans of those responsible for developing new cancer therapies (2) more rapidly move new diagnostic tests and treatments toward regulatory approval and use in the clinic (3) be less costly than current trials The resulting workshop summary will serve as input to the deliberations of an Institute of Medicine committee that will develop consensus-based recommendations for moving the field of cancer clinical trials forward.

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136

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National Academies Press

Published Date

ISBN 10

0309116686

ISBN 13

9780309116688

Implementing a National Cancer Clinical Trials System for the 21st Century

Second Workshop Summary

By: Board on Health Care Services,National Cancer Policy Forum,Institute of Medicine,An American Society of Clinical Oncology and Institute of Medicine Workshop

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Implementing a National Cancer Clinical Trials System for the 21st Century

Second Workshop Summary

By: Board on Health Care Services,National Cancer Policy Forum,Institute of Medicine,An American Society of Clinical Oncology and Institute of Medicine Workshop

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111

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National Academies Press

Published Date

ISBN 10

0309287278

ISBN 13

9780309287272

Ensuring Quality Cancer Care Through the Oncology Workforce

Sustaining Care in the 21st Century: Workshop Summary

By: Institute of Medicine,National Cancer Policy Forum

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Ensuring Quality Cancer Care Through the Oncology Workforce

Sustaining Care in the 21st Century: Workshop Summary

By: Institute of Medicine,National Cancer Policy Forum

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ISBN 10

0309136717

ISBN 13

9780309136716

The National Cancer Policy Summit

Opportunities and Challenges in Cancer Research and Care

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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The National Cancer Policy Summit

Opportunities and Challenges in Cancer Research and Care

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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National Academies Press

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ISBN 10

0309215935

ISBN 13

9780309215930

Policy Issues in the Clinical Development and Use of Immunotherapy for Cancer Treatment

Proceedings of a Workshop

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,National Cancer Policy Forum

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Policy Issues in the Clinical Development and Use of Immunotherapy for Cancer Treatment

Proceedings of a Workshop

By: National Academies of Sciences, Engineering, and Medicine,Health and Medicine Division,Board on Health Care Services,National Cancer Policy Forum

Immunotherapy is a form of cancer therapy that harnesses the body's immune system to destroy cancer cells. In recent years, immunotherapies have been developed for several cancers, including advanced melanoma, lung cancer, and kidney cancer. In some patients with metastatic cancers who have not responded well to other treatments, immunotherapy treatment has resulted in complete and durable responses. Given these promising findings, it is hoped that continued immunotherapy research and development will produce better cancer treatments that improve patient outcomes. With this promise, however, there is also recognition that the clinical and biological landscape for immunotherapies is novel and not yet well understood. For example, adverse events with immunotherapy treatment are quite different from those experienced with other types of cancer therapy. Similarly, immunotherapy dosing, therapeutic responses, and response time lines are also markedly different from other cancer therapies. To examine these challenges and explore strategies to overcome them, the National Academies of Sciences, Engineering, and Medicine held a workshop in February and March of 2016. This report summarizes the presentations and discussions from the workshop.

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135

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National Academies Press

Published Date

ISBN 10

030944232X

ISBN 13

9780309442329

Policy Issues in the Development and Adoption of Biomarkers for Molecularly Targeted Cancer Therapies

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

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Policy Issues in the Development and Adoption of Biomarkers for Molecularly Targeted Cancer Therapies

Workshop Summary

By: Institute of Medicine,Board on Health Care Services,National Cancer Policy Forum

A long-held goal in oncology has been to develop therapies that target the specific abnormalities in each patient's cancer rather than simply treating cancers based on the tissue of origin. In the past decade, advances in technology have enabled researchers to relatively quickly and inexpensively determine, in minute detail, the genetic makeup of tumors. Although relatively few targeted cancer therapies are currently available in the clinic and it is not yet clear whether all cancers are driven by genetic changes that can be targeted, there is widespread optimism in the cancer community that this new ability to assess the genetic abnormalities in tumors will ultimately lead to better cancer treatments and improved patient outcomes. Policy Issues in the Development and Adoption of Biomarkers for Molecularly Targeted Cancer Therapies is the summary of a workshop convened in November 2014 by the Institute of Medicine's National Cancer Policy Forum to discuss recent trends in the development and implementation of molecularly targeted cancer therapies and explore potential policy actions to address specific challenges. This report highlights the presentations and discussions at the workshop.

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