DOCSLIB.ORG

NCCN Guidelines for Acute Lymphoblastic Leukemia V.1.2021 – Annual on 02/10/2021

Total Page：16

File Type：pdf, Size：1020Kb

Download full-text PDF Read full-text
NCCN Guidelines for Acute Lymphoblastic Leukemia V.1.2021 – Annual on 02/10/2021 NCCN Guidelines for Acute Lymphoblastic Leukemia v.1.2021 – Annual on 02/10/2021 Guideline Page Institution Vote Panel Discussion/References and Request YES NO ABSTAIN ABSENT Internal request: Consider the inclusion of the following statement: “An The panel consensus was to include the statement 22 0 0 6 FDA-approved biosimilar is an appropriate substitute “An FDA-approved biosimilar is an appropriate for rituximab” to be added for all current rituximab substitute for rituximab” for all current rituximab indications in the Guidelines. indications in the Guidelines. This is a category 2A recommendation. ALL-D 5 of 10 Internal request: The panel consensus was to include bortezomib + 19 2 1 6 Consider the inclusion of bortezomib + chemotherapy chemotherapy as an option for relapsed/refractory T- as an option for relapsed/refractory T-ALL. ALL. This is a category 2A, other recommended regimen. Reference: 1. Horton TM, Whitlock JA, Lu X, et al. Bortezomib reinduction chemotherapy in high-risk ALL in first relapse: a report from the Children's Oncology Group. Br J Haematol 2019;186:274-285. ALL-D 5 of 10 Internal request: The panel consensus was to include HiDAC (high- 19 2 1 6 Consider the inclusion of HiDAC (high-dose cytarabine) dose cytarabine) as an option for relapsed/refractory as an option for relapsed/refractory T-ALL. T-ALL. This is a category 2A, other recommended regimen. ALL-D 5 of 10 Internal request: The panel consensus was to include mitoxantrone, 19 2 1 6 Consider the inclusion of mitoxantrone, etoposide, and etoposide, and cytarabine as an option for cytarabine as options for relapsed/refractory T-ALL. relapsed/refractory T-ALL. This is a category 2A, other recommended regimen. Reference: 1. Liedtke M, Dunn T, Dinner S, et al. Salvage therapy with mitoxantrone, etoposide and cytarabine in relapsed or refractory acute lymphoblastic leukemia. Leuk Res 2014;38:1441- 1445. NCCN Guidelines for Acute Lymphoblastic Leukemia v.1.2021 – Annual on 02/10/2021 ALL-D 5 of 10 Internal request: The panel consensus was to include nelarabine 22 0 0 6 Consider the inclusion of nelarabine alone or in alone or in combination with etoposide and combination with etoposide and cyclophosphamide as cyclophosphamide as an option for options for relapsed/refractory T-ALL. relapsed/refractory T-ALL. This is a category 2A, preferred recommendation. References: 1. DeAngelo DJ, Yu D, Johnson JL, et al. Nelarabine induces complete remissions in adults with relapsed or refractory T-lineage acute lymphoblastic leukemia or lymphoblastic lymphoma: Cancer and Leukemia Group B study 19801. Blood 2007;109:5136-5142. 2. Zwaan CM, Kowalczyk J, Schmitt C, et al. Safety and efficacy of nelarabine in children and young adults with relapsed/refractory T-lineage acute lymphoblastic leukaemia or T-lineage lymphoblastic lymphoma: results of phase 4 study. Br J Haematol 2017;179:284-293. 3. Gokbuget N, Basara N, Baumann H, et al. High single-drug activity of nelarabine in relapsed T-lymphoblastic leukemia/lymphoma offers curative option with subsequent stem cell transplantation. Blood 2011;118:3504-3511. 4. Candoni A, Lazzarotto D, Ferrara F, et al. Nelarabine as salvage therapy and bridge to allogeneic stem cell transplant in 118 adult patients with relapsed/refractory T-cell acute lymphoblastic leukemia/lymphoma. A CAMPUS ALL study. Am J Hematol 2020;95:1466-1472. 5. Luskin MR, Ganetsky A, Landsburg DJ, et al. Nelarabine, cyclophosphamide and etoposide for adults with relapsed T-cell acute lymphoblastic leukemia and lymphoma. BR J Haematol 2016;174:332-334. 6. Commander LA, Seif AE, Insogna IG, Rheingold SR. Salvage therapy with nelarabine, etoposide, and cyclophosphamide in relapsed/refractory paediatric T-cell lymphoblastic leukaemia and lymphoma. Br J Haematol 2010;150:345-351. 7. Whitlock J, dalla Pozza L, Goldberg JM, et al. Nelarabine in combination with etoposide and NCCN Guidelines for Acute Lymphoblastic Leukemia v.1.2021 – Annual on 02/10/2021 cyclophosphamide is active in first relapse of childhood T-acute lymphocytic leukemia (T-ALL) and T-lymphoblastic lymphoma (T-LL). Blood 2014;124:795. ALL-D 5 of 10 Internal request: The panel consensus was to include venetoclax + 15 6 1 6 Consider the inclusion of venetoclax + chemotherapy chemotherapy (eg, decitabine, hyper-CVAD, (eg, decitabine, hyper-CVAD, nelarabine, mini-hyper- nelarabine, mini-hyper-CVD) as an option for CVD) as options for relapsed/refractory T-ALL. relapsed/refractory T-ALL. This is a category 2B, other recommended regimen. References: 1. Richard-Carpentier G, Jabbour E, Short NJ, et al. Clinical experience with venetoclax combined with chemotherapy for relapsed or refractory T-Cell acute lymphoblastic leukemia. Clin Lymphoma Myeloma Leuk 2020;20:212-218. 2. Parovichnikova E, Gavrilina O, Troitskaya V, et al. Venetoclax plus decitabine in the treatment of MRD-persistent and relapsed/refractory T-cell acute lymphoblastic leukemia. European Hematology Association Congress 2020;EP427. 3. Rubnitz J, Alexander TB, Laetsch TW, et al. Venetoclax and navitoclax in pediatric patients with acute lymphoblastic leukemia and lymphoblastic lymphoma. ASH Annual Meeting Abstracts 2020;Abstract #466. 4. Jain N, Stevenson KE, Winer ES, et al. A multicenter phase I study combining venetoclax with mini-hyper-CVD in older adults with untreated and relapsed/refractory acute lymphoblastic leukemia. Blood 2019;134:3867. ALL-D 5 of 10 Internal request: The panel consensus was to include regimens for 21 1 0 6 Consider the inclusion of regimens for relapsed/refractory Ph-negative ALL as an option for relapsed/refractory Ph-negative ALL as options for relapsed/refractory T-ALL. This is a category 2A, relapsed/refractory T-ALL. other recommended regimen. NCCN Guidelines for Acute Lymphoblastic Leukemia v.1.2021 – Annual on 02/10/2021 ALL-D 5 of 10 Internal request: The panel consensus was to include daratumumab 12 8 2 6 Consider the inclusion of the daratumumab as an as an option for relapsed/refractory T-ALL. This is a option for relapsed/refractory T-ALL. category 2B, other recommended regimen. References: 1. Ofran Y, Ringerstein-Harlev S, Slouzkey I, et al. Daratumumab for eradication of minimal residual disease in high-risk advanced relapse of T-cell/CD19/CD22-negative acute lymphoblastic leukemia. Leukemia 2020;34:293- 295. 2. Ruhayel SD, Valvi S. Daratumumab in T-cell acute lymphoblastic leukemia: A case report and review of the literature. Pediatr Blood Cancer 2020;e28829. 3. Cerrano M, Castella B, Lia G, et al. Immunomodulatory and clinical effects of daratumumab in T-cell acute lymphoblastic leukemia. Br J Haematol 2020;191:e28-e32. 4. Mirgh S, Ahmed R, Agrawal N, et al. Will daratumumab be the next game changer in early thymic precursor-acute lymphoblastic leukemia? Br J Haematol 2019;187:e33-e35. 5. Bonda A, Punatar S, Gokarn A, et al. Daratumumab at the frontiers of post-transplant refractory T-acute lymphoblastic leukemia-a worthwhile strategy? Bone Marrow Transplant 2018;53:1487-1489. .
Load more

Recommended publications
  • The New Therapeutic Strategies in Pediatric T-Cell Acute Lymphoblastic Leukemia
    International Journal of Molecular Sciences Review The New Therapeutic Strategies in Pediatric T-Cell Acute Lymphoblastic Leukemia Marta Weronika Lato 1 , Anna Przysucha 1, Sylwia Grosman 1, Joanna Zawitkowska 2 and Monika Lejman 3,* 1 Student Scientific Society, Laboratory of Genetic Diagnostics, Medical University of Lublin, 20-093 Lublin, Poland; [email protected] (M.W.L.); [email protected] (A.P.); [email protected] (S.G.) 2 Department of Pediatric Hematology, Oncology and Transplantology, Medical University of Lublin, 20-093 Lublin, Poland; [email protected] 3 Laboratory of Genetic Diagnostics, Medical University of Lublin, 20-093 Lublin, Poland * Correspondence: [email protected] Abstract: Childhood acute lymphoblastic leukemia is a genetically heterogeneous cancer that ac- counts for 10–15% of T-cell acute lymphoblastic leukemia (T-ALL) cases. The T-ALL event-free survival rate (EFS) is 85%. The evaluation of structural and numerical chromosomal changes is important for a comprehensive biological characterization of T-ALL, but there are currently no ge- netic prognostic markers. Despite chemotherapy regimens, steroids, and allogeneic transplantation, relapse is the main problem in children with T-ALL. Due to the development of high-throughput molecular methods, the ability to define subgroups of T-ALL has significantly improved in the last few years. The profiling of the gene expression of T-ALL has led to the identification of T-ALL subgroups, and it is important in determining prognostic factors and choosing an appropriate treatment. Novel therapies targeting molecular aberrations offer promise in achieving better first remission with the Citation: Lato, M.W.; Przysucha, A.; hope of preventing relapse.
    [Show full text]
  • Nelarabine) Injection • Severe Neurologic Reactions Have Been Reported
    HIGHLIGHTS OF PRESCRIBING INFORMATION --------------------- DOSAGE FORMS AND STRENGTHS -------------- These highlights do not include all the information needed to use 250 mg/50 mL (5 mg/mL) vial (3) ARRANON safely and effectively. See full prescribing information for -------------------------------CONTRAINDICATIONS------------------------ ARRANON. None. ----------------------- WARNINGS AND PRECAUTIONS ---------------- ARRANON (nelarabine) Injection • Severe neurologic reactions have been reported. Monitor for signs and Initial U.S. Approval: 2005 symptoms of neurologic toxicity. (5.1) WARNING: NEUROLOGIC ADVERSE REACTIONS • Hematologic Reactions: Complete blood counts including platelets should See full prescribing information for complete boxed warning. be monitored regularly. (5.2) Severe neurologic adverse reactions have been reported with the use of • Fetal harm can occur if administered to a pregnant woman. Women should ARRANON. These adverse reactions have included altered mental states be advised not to become pregnant when taking ARRANON. (5.3) including severe somnolence, central nervous system effects including ------------------------------ ADVERSE REACTIONS ----------------------- convulsions, and peripheral neuropathy ranging from numbness and The most common (≥ 20%) adverse reactions were: paresthesias to motor weakness and paralysis. There have also been • Adult: anemia, thrombocytopenia, neutropenia, nausea, diarrhea, reports of adverse reactions associated with demyelination, and ascending vomiting, constipation, fatigue,
    [Show full text]
  • ARRANON Safely and Effectively
    HIGHLIGHTS OF PRESCRIBING INFORMATION -------------------------------------CONTRAINDICATIONS------------------------ These highlights do not include all the information needed to use None. (4) ARRANON safely and effectively. See full prescribing information for ARRANON. -------------------------WARNINGS AND PRECAUTIONS---------------------- Neurologic Adverse Reactions: Severe neurologic reactions have been ARRANON® (nelarabine) injection, for intravenous use reported. Monitor for signs and symptoms of neurologic toxicity. (5.1) Initial U.S. Approval: 2005 Hematologic Reactions: Complete blood counts including platelets should WARNING: NEUROLOGIC ADVERSE REACTIONS be monitored regularly. (5.2) See full prescribing information for complete boxed warning. Embryo-Fetal Toxicity: Can cause fetal harm. Advise females of reproductive potential of the potential risk to the fetus and to use effective Severe neurologic adverse reactions have been reported with the use of contraception; and advise males to use condoms. (5.3, 8.1, 8.3) ARRANON. These adverse reactions have included altered mental states Effects on Ability to Drive and Use Machines: Somnolence may occur. including severe somnolence, central nervous system effects including Advise patients to refrain from these activities until somnolence has convulsions, and peripheral neuropathy ranging from numbness and resolved. (5.6) paresthesias to motor weakness and paralysis. There have also been reports of adverse reactions associated with demyelination, and ascending ------------------------------------ADVERSE REACTIONS------------------------- peripheral neuropathies similar in appearance to Guillain-Barré The most common (≥ 20%) adverse reactions were: syndrome. (5.1) Adult: anemia, thrombocytopenia, neutropenia, nausea, diarrhea, vomiting, constipation, fatigue, pyrexia, cough, and dyspnea. (6.1) Full recovery from these adverse reactions has not always occurred with Pediatric: anemia, neutropenia, thrombocytopenia, and leukopenia. (6.1) cessation of therapy with ARRANON.
    [Show full text]
  • Chemotherapy: Drugs E-O Policy (Chemo Drug E-O)
    chemo drug e-o 1 Chemotherapy: Drugs E-O Policy Page updated: September 2020 This section contains policy related to billing for injection services, listed in alphabetical order by generic drug name or drug type. For general billing policy information regarding injections services, refer to the Chemotherapy: An Overview section in this manual. Additional policy information for chemotherapy drug services can be found in the Chemotherapy: Drugs A-D Policy and Chemotherapy: Drugs P-Z Policy sections in this manual. Elotuzumab Elotuzumab is a humanized IgG1 monoclonal antibody that specifically targets the SLAMF7 (signaling lymphocytic activation molecule family member 7) protein. SLAMF7 is expressed on myeloma cells independent of cytogenetic abnormalities. SLAMF7 is also expressed on natural killer cells, plasma cells and at lower levels on specific immune cell subsets of differentiated cells within the hematopoietic lineage. Elotuzumab directly activates natural killer cells through both the SLAMF7 pathway and Fc receptors. Elotuzumab also targets SLAMF7 on myeloma cells and facilitates the interaction with natural killer cells to mediate the killing of myeloma cells through antibody-dependent cellular cytotoxicity (ADCC). Indications Elotuzumab is indicated in combination with lenalidomide and dexamethasone for the treatment of patients ages 18 years or older, with multiple myeloma who have received one to three prior therapies. Pre-medicate with dexamethasone, diphenhydramine, ranitidine and acetaminophen. Advise patients that lenalidomide has the potential to cause fetal harm. Authorization An approved Treatment Authorization Request (TAR) is required for reimbursement. The TAR must state that the treatment is for a patient with multiple myeloma who has received one to three prior therapies.
    [Show full text]
  • 2015 Antiemesis.Pdf
    NCCN Clinical Practice Guidelines in Oncology (NCCN Guidelines®) Antiemesis Version 2.2015 NCCN.org Continue Version 2.2015, 09/22/15 © National Comprehensive Cancer Network, Inc. 2015, All rights reserved. The NCCN Guidelines® and this illustration may not be reproduced in any form without the express written permission of NCCN®. Printed by Alexandre Ferreira on 10/25/2015 6:12:07 AM. For personal use only. Not approved for distribution. Copyright © 2015 National Comprehensive Cancer Network, Inc., All Rights Reserved. NCCN Guidelines Version 2.2015 Panel Members NCCN Guidelines Index Antiemesis Table of Contents Antiemesis Discussion David S. Ettinger, MD/Chair † Steve Kirkegaard, PharmD Σ Eric Roeland, MD The Sidney Kimmel Comprehensive Huntsman Cancer Institute UC San Diego Moores Cancer Cancer Center at Johns Hopkins at the University of Utah Center Michael J. Berger, PharmD/Vice Chair, BCOP Σ Dwight D. Kloth, PharmD, BCOP Σ Hope S. Rugo, MD † ‡ The Ohio State University Comprehensive Fox Chase Cancer Center UCSF Helen Diller Family Cancer Center - James Cancer Hospital Comprehensive Cancer Center and Solove Research Institute Ruth Lagman, MD £ Mayo Clinic Cancer Center Bridget Scullion, PharmD, BCOP Jonathan Aston, PharmD, BCOP, BCPS Σ Dana-Farber/Brigham and Women’s Vanderbilt-Ingram Cancer Center Dean Lim, MD † Cancer Center | Massachusetts City of Hope Comprehensive Cancer Center General Hospital Cancer Center Sally Barbour, PharmD, BCOP, CCP Σ Duke Cancer Institute Cynthia Ma, MD, PhD † John Timoney, PharmD, BCOP † Siteman Cancer Center at Barnes-Jewish Memorial Sloan Kettering Cancer Philip J. Bierman, MD † ‡ Hospital and Washington University School Center Fred & Pamela Buffet Cancer Center of Medicine Barbara Todaro, PharmD Σ Debra Brandt, DO Belinda Mandrell, PhD, RN † Roswell Park Cancer Institute Yale Cancer Center/Smilow Cancer Hospital St.
    [Show full text]
  • Chemotherapy and Polyneuropathies Grisold W, Oberndorfer S Windebank AJ European Association of Neurooncology Magazine 2012; 2 (1) 25-36
    Volume 2 (2012) // Issue 1 // e-ISSN 2224-3453 Neurology · Neurosurgery · Medical Oncology · Radiotherapy · Paediatric Neuro- oncology · Neuropathology · Neuroradiology · Neuroimaging · Nursing · Patient Issues Chemotherapy and Polyneuropathies Grisold W, Oberndorfer S Windebank AJ European Association of NeuroOncology Magazine 2012; 2 (1) 25-36 Homepage: www.kup.at/ journals/eano/index.html OnlineOnline DatabaseDatabase FeaturingFeaturing Author,Author, KeyKey WordWord andand Full-TextFull-Text SearchSearch THE EUROPEAN ASSOCIATION OF NEUROONCOLOGY Member of the Chemotherapy and Polyneuropathies Chemotherapy and Polyneuropathies Wolfgang Grisold1, Stefan Oberndorfer2, Anthony J Windebank3 Abstract: Peripheral neuropathies induced by taxanes) immediate effects can appear, caused to be caused by chemotherapy or other mecha- chemotherapy (CIPN) are an increasingly frequent by different mechanisms. The substances that nisms, whether treatment needs to be modified problem. Contrary to haematologic side effects, most frequently cause CIPN are vinca alkaloids, or stopped due to CIPN, and what symptomatic which can be treated with haematopoetic taxanes, platin derivates, bortezomib, and tha- treatment should be recommended. growth factors, neither prophylaxis nor specific lidomide. Little is known about synergistic neu- Possible new approaches for the management treatment is available, and only symptomatic rotoxicity caused by previously given chemo- of CIPN could be genetic susceptibility, as there treatment can be offered. therapies, or concomitant chemotherapies. The are some promising advances with vinca alka- CIPN are predominantly sensory, duration-of- role of pre-existent neuropathies on the develop- loids and taxanes. Eur Assoc Neurooncol Mag treatment-dependent neuropathies, which de- ment of a CIPN is generally assumed, but not 2012; 2 (1): 25–36. velop after a typical cumulative dose. Rarely mo- clear.
    [Show full text]
  • 1. Recommendations of the Ndac (Oncology and Hematology) Held on 10.12.2011
    1. RECOMMENDATIONS OF THE NDAC (ONCOLOGY AND HEMATOLOGY) HELD ON 10.12.2011:- The NDAC (Oncology and Hematology) deliberated the proposals on 10.12.2011 and recommended the following:- AGENDA NAME OF DRUG RECOMMENDATIONS NO. Global Clinical Trials Recommended for giving permission for clinical trial subject to condition that trasuzumab naive patient arm should be excluded from the study, as patients cannot be left untreated of trastuzumab therapy / or 1 Afatinib treated with only investigational drug. Patients aged 18 to 65 years should be included in the study. Recommended for giving permission for clinical trial subject to the following conditions:- ICD is very extensive and too technical for the 2 Netupitant/ patient to understand. It should be simplified. Palonosetron Definite statistical tests for the comparison of primary and secondary endpoints should be incorporated in the protocol. Recommended for giving permission for clinical trial subject to the following conditions:- Periodic ophthalmic examination should be performed at every visit as the drug is reported to have ophthalmological side effects in 53 % cases in 3 Crizotinib phase 2 study. Patients aged 18 to 65 years should be included in the protocol. Method for causality assessment by the investigator should be included in the protocol. New Drugs Approved with the condition that structured post marketing trial (Phase 4) should be conducted in 4. Indian population. Report of post marketing trials Crizotinib ongoing in other countries when completed should be submitted. 5. Abiraterone Approved with condition of conducting Post Acetate Marketing trial (Phase IV) in Indian population to monitor the adverse effects. Report of post marketing trials ongoing in other countries when completed should be submitted.
    [Show full text]
  • Acute Lymphoblastic Leukemia (ALL) (Part 1 Of
    LEUKEMIA TREATMENT REGIMENS: Acute Lymphoblastic Leukemia (ALL) (Part 1 of 12) Note: The National Comprehensive Cancer Network (NCCN) Guidelines® for Acute Lymphoblastic Leukemia (ALL) should be consulted for the management of patients with lymphoblastic lymphoma. Clinical Trials: The NCCN recommends cancer patient participation in clinical trials as the gold standard for treatment. Cancer therapy selection, dosing, administration, and the management of related adverse events can be a complex process that should be handled by an experienced healthcare team. Clinicians must choose and verify treatment options based on the individual patient; drug dose modifications and supportive care interventions should be administered accordingly. The cancer treatment regimens below may include both U.S. Food and Drug Administration-approved and unapproved indications/regimens. These regimens are only provided to supplement the latest treatment strategies. The NCCN Guidelines are a work in progress that may be refined as often as new significant data becomes available. They are a consensus statement of its authors regarding their views of currently accepted approaches to treatment. Any clinician seeking to apply or consult any NCCN Guidelines is expected to use independent medical judgment in the context of individual clinical circumstances to determine any patient’s care or treatment. The NCCN makes no warranties of any kind whatsoever regarding their content, use, or application and disclaims any responsibility for their application or use in any
    [Show full text]
  • Standard Oncology Criteria C16154-A
    Prior Authorization Criteria Standard Oncology Criteria Policy Number: C16154-A CRITERIA EFFECTIVE DATES: ORIGINAL EFFECTIVE DATE LAST REVIEWED DATE NEXT REVIEW DATE DUE BEFORE 03/2016 12/2/2020 1/26/2022 HCPCS CODING TYPE OF CRITERIA LAST P&T APPROVAL/VERSION N/A RxPA Q1 2021 20210127C16154-A PRODUCTS AFFECTED: See dosage forms DRUG CLASS: Antineoplastic ROUTE OF ADMINISTRATION: Variable per drug PLACE OF SERVICE: Retail Pharmacy, Specialty Pharmacy, Buy and Bill- please refer to specialty pharmacy list by drug AVAILABLE DOSAGE FORMS: Abraxane (paclitaxel protein-bound) Cabometyx (cabozantinib) Erwinaze (asparaginase) Actimmune (interferon gamma-1b) Calquence (acalbrutinib) Erwinia (chrysantemi) Adriamycin (doxorubicin) Campath (alemtuzumab) Ethyol (amifostine) Adrucil (fluorouracil) Camptosar (irinotecan) Etopophos (etoposide phosphate) Afinitor (everolimus) Caprelsa (vandetanib) Evomela (melphalan) Alecensa (alectinib) Casodex (bicalutamide) Fareston (toremifene) Alimta (pemetrexed disodium) Cerubidine (danorubicin) Farydak (panbinostat) Aliqopa (copanlisib) Clolar (clofarabine) Faslodex (fulvestrant) Alkeran (melphalan) Cometriq (cabozantinib) Femara (letrozole) Alunbrig (brigatinib) Copiktra (duvelisib) Firmagon (degarelix) Arimidex (anastrozole) Cosmegen (dactinomycin) Floxuridine Aromasin (exemestane) Cotellic (cobimetinib) Fludara (fludarbine) Arranon (nelarabine) Cyramza (ramucirumab) Folotyn (pralatrexate) Arzerra (ofatumumab) Cytosar-U (cytarabine) Fusilev (levoleucovorin) Asparlas (calaspargase pegol-mknl Cytoxan (cyclophosphamide)
    [Show full text]
  • The Cost Burden of Blood Cancer Care a Longitudinal Analysis of Commercially Insured Patients Diagnosed with Blood Cancer
    MILLIMAN RESEARCH REPORT The cost burden of blood cancer care A longitudinal analysis of commercially insured patients diagnosed with blood cancer October 2018 Gabriela Dieguez, FSA, MAAA Christine Ferro, CHFP David Rotter, PhD Commissioned by The Leukemia & Lymphoma Society Table of Contents EXECUTIVE SUMMARY ............................................................................................................................................... 2 BACKGROUND ............................................................................................................................................................. 1 FINDINGS ...................................................................................................................................................................... 2 PREVALENCE AND COST OF BLOOD CANCER BY AGE GROUP ....................................................................... 2 INCIDENCE OF BLOOD CANCER ........................................................................................................................... 4 BLOOD CANCER CARE SPENDING FOLLOWING INITIAL DIAGNOSIS ............................................................... 5 PATIENT OUT-OF-POCKET COSTS FOLLOWING A BLOOD CANCER DIAGNOSIS ........................................... 9 The impact of insurance plan design on patient OOP costs .......................................................................... 10 CONSIDERATIONS FOR PAYERS ...........................................................................................................................
    [Show full text]
  • Harnessing DNA Replication Stress for Novel Cancer Therapy
    G C A T T A C G G C A T genes Review Harnessing DNA Replication Stress for Novel Cancer Therapy 1, 2, 1 1,3, Huanbo Zhu y, Umang Swami y , Ranjan Preet and Jun Zhang * 1 Division of Medical Oncology, Department of Internal Medicine, University of Kansas Medical Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA; [email protected] (H.Z.); [email protected] (R.P.) 2 Division of Oncology, Department of Internal Medicine, Huntsman Cancer Institute, University of Utah, 2000 Circle of Hope, Salt Lake City, UT 84112, USA; [email protected] 3 Department of Cancer Biology, University of Kansas Cancer Center, 3901 Rainbow Blvd, Kansas City, KS 66160, USA * Correspondence: [email protected]; Tel.: +1-(913)-588-8150; Fax: +1-(913)-588-4085 H.Z. and U.S. contributed equally. y Received: 2 July 2020; Accepted: 20 August 2020; Published: 25 August 2020 Abstract: DNA replication is the fundamental process for accurate duplication and transfer of genetic information. Its fidelity is under constant stress from endogenous and exogenous factors which can cause perturbations that lead to DNA damage and defective replication. This can compromise genomic stability and integrity. Genomic instability is considered as one of the hallmarks of cancer. In normal cells, various checkpoints could either activate DNA repair or induce cell death/senescence. Cancer cells on the other hand potentiate DNA replicative stress, due to defective DNA damage repair mechanism and unchecked growth signaling. Though replicative stress can lead to mutagenesis and tumorigenesis, it can be harnessed paradoxically for cancer treatment.
    [Show full text]
  • Cancer Drug Costs for a Month of Treatment at Initial Food
    Cancer drug costs for a month of treatment at initial Food and Drug Administration approval Year of FDA Monthly Cost Monthly cost (2013 Generic name Brand name(s) approval (actual $'s) $'s) Vinblastine Velban 1965 $78 $575 Thioguanine, 6-TG Thioguanine Tabloid 1966 $17 $122 Hydroxyurea Hydrea 1967 $14 $97 Cytarabine Cytosar-U, Tarabine PFS 1969 $13 $82 Procarbazine Matulane 1969 $2 $13 Testolactone Teslac 1969 $179 $1,136 Mitotane Lysodren 1970 $134 $801 Plicamycin Mithracin 1970 $50 $299 Mitomycin C Mutamycin 1974 $5 $22 Dacarbazine DTIC-Dome 1975 $29 $125 Lomustine CeeNU 1976 $10 $41 Carmustine BiCNU, BCNU 1977 $33 $127 Tamoxifen citrate Nolvadex 1977 $44 $167 Cisplatin Platinol 1978 $125 $445 Estramustine Emcyt 1981 $420 $1,074 Streptozocin Zanosar 1982 $61 $147 Etoposide, VP-16 Vepesid 1983 $181 $422 Interferon alfa 2a Roferon A 1986 $742 $1,573 Daunorubicin, Daunomycin Cerubidine 1987 $533 $1,090 Doxorubicin Adriamycin 1987 $521 $1,066 Mitoxantrone Novantrone 1987 $477 $976 Ifosfamide IFEX 1988 $1,667 $3,274 Flutamide Eulexin 1989 $213 $399 Altretamine Hexalen 1990 $341 $606 Idarubicin Idamycin 1990 $227 $404 Levamisole Ergamisol 1990 $105 $187 Carboplatin Paraplatin 1991 $860 $1,467 Fludarabine phosphate Fludara 1991 $662 $1,129 Pamidronate Aredia 1991 $507 $865 Pentostatin Nipent 1991 $1,767 $3,015 Aldesleukin Proleukin 1992 $13,503 $22,364 Melphalan Alkeran 1992 $35 $58 Cladribine Leustatin, 2-CdA 1993 $764 $1,229 Asparaginase Elspar 1994 $694 $1,088 Paclitaxel Taxol 1994 $2,614 $4,099 Pegaspargase Oncaspar 1994 $3,006 $4,713
    [Show full text]