Data from the phase 2 trial ROCKstar clinical trial (NCT03640481) demonstrated that patients with chronic graft-versus-host-disease (GVHD) and were treated with belumosudil (Rezurock) experienced clinically meaningful, durable responses. These results were consistent among patients despite differences in prior treatments, severity of disease and number of organs affected, according to the published study in 

The best overall response rate (ORR) achieved with belumosudil at a once-daily dose of 200 mg was 74% (95% CI, 62%-84%) and 77% (95% CI, 65%-87%) when given at a twice-daily dose of 200 mg. High ORRs, ranging from 61% to 85%, were reported in all subgroups analyzed.

The efficacy demonstrated with belumosudil was maintained, regardless of previous treatment with ibrutinib (Imbruvica; n = 46) or ruxolitinib (Jakafi; n = 38). The ORRs in the ruxolitinib and ibrutinib subsets were 68% (95% CI, 51%-83%) and 74% (95% CI, 59%-86%), respectively.

Additionally, best ORR was observed across all affected organs. The ORRs observed in the skin, eyes, mouth, liver, lungs, joint/fascia, upper gastrointestinal (GI) tract, lower GI tract, and the esophagus at 37%, 42%, 55%, 39%, 26%, 71%, 52%, 69%, and 45%, respectively.

“Belumosudil is very effective in inducing responses across all organs affected by chronic GVHD and is safe and well tolerated. It is exciting to see the development of new interventions that can help patients,” study investigator Corey Cutler, MD, MPH, FRCPC, associate professor of medicine at Harvard Medical School and medical director of the Adult Stem Cell Transplantation Program at Dana-Farber Cancer Institute, stated in a press release.

An oral selective inhibitor of ROCK2, belumosudil was designed to reduce type 17 and follicular helper T cells through downregulation of STAT3 and to strengthen regulatory T cells through the upregulation of STAT5.

In July 2021, the FDA approved belumosudi

 for use in adult and pediatric patients aged 12 years and older with chronic GVHD following failure of at least 2 prior lines of systemic therapy.

The regulatory decision was supported by data from ROCKstar.

In the multicenter registration phase 2 trial, investigators examined 2 doses of belumosudil, at 200 mg daily (n = 66) and 200 mg twice daily (n = 66) in patients with chronic GVHD who had previously received 2 to 5 lines of treatment.

To be eligible for participation, patients needed to have received an allogeneic hematopoietic cell transplant, be at least 12 years of age, and have persistent chronic GVHD manifestations following 2 to 5 previous systemic lines of therapy. Patients needed to be on stable corticosteroids for 2 weeks before screening, and they needed to have a Karnofsky or Lansky Performance Status Scale score of 60 or higher.

If patients experienced a relapse of their underlying malignancy, had a National Institutes of Health (NIH) lung symptom score of 3, and had developed lymphoproliferative disease following transplant, they were excluded. Other exclusion criteria included liver transaminases greater than 3 times the upper limit of normal (ULN), a total bilirubin of more than 1.5 times the ULN for any reason, current receipt of ibrutinib.

Study participants received belumosudil at either once-daily 200 mg or twice-daily 200 mg in patients with chronic GVHD. Patients were stratified 1:1 by chronic GVHD severity and previous exposure to ibrutinib. Patients received belumosudil continuously until significant disease progression or intolerable toxicity.

The primary end point of the trial was best ORR at any time, and important secondary end points comprised duration of response (DOR), time to response (TTR), changes in Lee Symptom Scale (LSS), failure-free survival (FFS), corticosteroid dose reductions, overall survival, and safety.

A total of 132 patients were enrolled to the trial between October 2018 and August 2019. Baseline demographics and clinical characteristics were found to be comparable across the arms. The median age of participants was 56 years (range, 21-77), and the overall median time from diagnosis to enrollment was 28 months (range, 2-162).

At the time of screening, 31% of patients had moderate disease and 67% had severe disease. Moreover, 52% had involvement of 4 or more organs. Additionally, 36% of patients were found to have lung involvement at baseline; 38% of these patients had a NIH lung symptom score of 2. Patients received a median of 3 prior systemic lines of treatment. Additionally, 72% of patients had disease that was refractory to their last systemic line of treatment received, 34% had prior ibrutinib, 29% had prior ruxolitinib, and 72% had 3 or more prior lines of therapy. The median corticosteroid dose at baseline was 0.2 mg/kg/day of prednisone equivalent; the mean dose was 0.25 mg/kg/day.

At the time of the data analysis, 37% of patients were still on belumosudil treatment. Patients who discontinued treatment did so because of disease progression (n = 21), voluntary withdrawal (n = 13), toxicities (n = 16), physician decision (n = 11), progression of an underlying malignancy (n = 5), death because of an underlying malignancy or progression (n = 4), other (n = 7), and nonadherence to treatment (n = 3).

Additional data from the study showed that 7 patients experienced a complete response (CR) in all affected organs. Of 12 patients with lung responses based on normalization of FEV1, 3 achieved a CR and there were an additional 3 CRs based on a reduction in NIH lung symptom score from 1 to 0. Six additional patients achieved a partial response (PR).

Of the 41 patients who experienced skin responses, 11 were noted to have a decrease in sclerotic features, 15 had a decrease in body surface area (BSA) involvement, and 13 had improvements in both BSA involvement and sclerotic features.

Responses were found to occur rapidly. The median TTR was 5 weeks (range, 4-66). Within 6 months of treatment, 91% of patients experienced responses; the remaining 9% of patients experienced responses after 6 to 12 months of treatment. Notably, 59% of patients who responded to belumosudil continued to respond for 20 weeks or longer. The median DOR was 54 weeks in responders. The FFS rates achieved with the agent at 6 months and 12 months were 75% (95% CI, 66%-81%) and 56% (95% CI, 47%-64%), respectively.

With belumosudil, 65% of patients reduced their corticosteroid dose. The mean dose resulted in a 45% reduction in the modified intention-to-treat (mITT) population; the mean dose reduction was 54% in responders. Moreover, 21% of patients discontinued treatment with corticosteroids. Twenty-two percent of patients were able to discontinue treatment with calcineurin inhibitors; 20% discontinued sirolimus (Rapamune) and 21% discontinued mycophenolate mofetil.

Lastly, treatment with belumosudil at a daily-dose of 200 mg and a twice-daily dose of 200 mg improved the 7-day LSS summary score by 59% and 62%, respectively, from baseline in the mITT population. Among responders, the rates with the once-daily and twice-daily doses were 69% and 71%, respectively; in nonresponders, these rates were 29% and 33%, respectively.

Belumosudil was well tolerated, with toxicities consistent with those expected in patient with chronic GVHD who were receiving corticosteroid therapy. Thirty-eight percent of patients experienced 1 or more serious adverse effects (AEs), with pneumonia being the most frequently reported (7%). The most common grade 3 or 4 toxicities comprised pneumonia (8%), hypertension (6%), and hyperglycemia (5%).

Of 83 patients who discontinued treatment with belumosudil, 21% did so because of toxicity, 12% because of potential drug-related toxicities, 4% because of progression of underlying malignant disease, and 16% because of progression of chronic GVHD.

“Based on the similar efficacy and safety observed in this study, 200 mg once daily is the preferred dosage for the treatment of chronic GVHD. Although the 200-mg twice-daily dose showed higher responses in certain organs, such as the skin, and slightly fewer AEs, the difference compared with the 200-mg twice-daily dose was not deemed significant,” the studfy authors concluded. “Because of its unique mechanism of action, belumosudil may have broad therapeutic potential beyond chronic GVHD and is currently being studied in systemic sclerosis, with plans for additional studies in other immune disorders.”

Cutler CS, Lee SJ, Arai S, et al. Belumosudil for chronic graft-versus-host disease (cGVHD) after 2 or more prior lines of therapy: the ROCKstar study. 

. Published online July 15, 2021. doi:10.1182/blood.2021012021

Kadmon announces pivotal trial data published in the journal Blood for REZUROCK (belumosudil) in chronic graft-versus-host disease (cGVHD). News release. Kadmon Holdings, Inc. July 19, 2021. Accessed July 19, 2021. 

US FDA grants full approval of REZUROCK (TM) (belumosudil) for the treatment of patients with chronic graft-versus-host disease (cGVHD). News release. Kadmon Holdings, Inc. July 16, 2021. Accessed July 19, 2021. 

This article was originally published as 

“Belumosudil Represents Promising Newly-Approved Option for Chronic GVHD”

Articles

A recent study showed that belumosudil induced clinically meaningful, durable responses among a varied cohort of patients with chronic graft-versus-host-disease. 

Newly-Approved Belumosudil Yields High Overall Response Rate in Patients with Chronic Graft-Versus-Host-Disease

Plinabulin, an investigational, first-in-class, selective immunomodulating microtube binding agent (SIMBA), has demonstrated a potential capability to prevent chemotherapy-induced neutropenia (CIN) as well as serve as an anticancer agent in treating non-small cell lung cancer (NSCLC). 

 The drug’s status as a potential preventative and active drug is based on its highly differentiated mechanism of action.

Plinabulin binds to the vicinity of the colchicine binding domain of the ß-tubulin in αβ-tubulin heterodimers. The binding occurs at a site and with kinetics that is unique from other tubulin targeting agents.

Moreover, by binding to tubulin, GEF-H1, an immune defense protein, is released by plinabulin. This activates a signaling transduction pathway that leads to dendritic cell (DC) maturation. In turn, DC maturation elicits innate and adaptive immune activity. DC maturation also results in increased antigen presentation and T-cell activation, which appears to contribute to plinabulin’s anticancer activity.

On June 1, 2021, the FDA granted a priority review designation to a new drug application for plinabulin plus granulocyte colony-stimulating factor (G-CSF) for the prevention of CIN.2 The regulatory designation is based on findings from the phase 3 PROTECTIVE-2 trial (Study 106; NCT03294577), as well as 5 supportive trials that enrolled over 1200 patients.

In PROTECTIVE-2, the combination of plinabulin and pegfilgrastim (Neulasta) was 53% more effective in reducing the incidence of CIN vs pegfilgrastim alone in patients with early-stage or stage III breast cancer receiving high–febrile neutropenia risk chemotherapy (n = 221).

The final results of the study, which were presented during the 2021 ASCO Annual Meeting, confirmed that the combination elicited superior CIN protection compared with pegfilgrastim alone.5 The addition of plinabulin also reduced adverse clinical sequalae, did not add toxicity, reduced the severity of grade 4 treatment-emergent adverse effects (AEs), and significantly reduced bone pain (

“We think that the combination protects [patients] throughout the chemotherapy cycle. We know from a long experience that there is a vulnerability or lack of protection within the first week after chemotherapy with pegfilgrastim. Adding plinabulin to pegfilgrastim seems to mitigate that vulnerability or increase the protection in the first week after chemotherapy,” said lead study author of the PROTECTIVE-2 study Douglas W. Blayney, MD, a medical oncologist at Stanford Health Care and a professor of medicine at Stanford Medicine, in an interview during an episode of 

“This will help oncologists and their patients receive more chemotherapy during both weeks of the chemotherapy cycle before the bone marrow recovers normally,” Blayney added.

Plinabulin’s activity has also been evaluated in lung cancer. The agent is currently being evaluated in combination with docetaxel for patients with advanced NSCLC who have measurable lung lesions in the phase 3 DUBLIN-3 trial (Study 103; NCT02504489).

The anticancer results for overall survival are expected in the final quarter of 2021, according to Blayney.

Plinabulin is also being evaluated in combination with the PD-1 inhibitor nivolumab (Opdivo) with the rationale that adding the agent will elicit synergistic immune-enhancing effects.1 Historically, cumulative toxicity has been a concern with nivolumab in combination with other checkpoint inhibitors; however, it is thought that plinabulin/nivolumab may demonstrate improved antitumor activity vs nivolumab alone without significantly increased toxicity. An ongoing phase 1/2 study (NCT02812667) is evaluating the combination in patients with metastatic NSCLC.

Triplet combinations are also under study with plinabulin.

 The combination of plinabulin, nivolumab, and ipilimumab (Yervoy) is being evaluated in a phase 1/2 study (NCT03575793) in patients with recurrent small cell lung cancer to determine whether plinabulin will be synergistic with nivolumab and ipilimumab while limiting immune-related AEs associated with the agents.

Finally, research is ongoing to test the potential benefits of adding plinabulin to PD-1 inhibitors and radiation therapy.

“Given the high incidence of progression with PD-1/PD-L1 antibody therapies in the majority of cancers, we believe this novel triplet approach will restore or enable the immune targeting of cancer in patients that have progressed on checkpoint [inhibitor] therapy,” according to BeyondSpring Pharmaceuticals.

Plinabulin. BeyondSpring Pharmaceuticals. 2021. Accessed July 14, 2021. https://bit.ly/3rjFXPu.

BeyondSpring announces US FDA acceptance and priority review of new drug application for plinabulin and G-CSF combination for the prevention of chemotherapy-induced neutropenia (CIN). News release. BeyondSpring. June 1, 2021. Accessed July 14, 2021. https://bit.ly/2SQVl8U.

Blayney DW, Huang L, Mohanlal R. Superior and clinically meaningful protection against profound neutropenia with the plinabulin/pegfilgrastim (Plin/Peg) combination versus peg in breast cancer patients receiving TAC chemotherapy: phase 3 results from Protective-2 (BPI-2358-106). Presented at: 2020 San Antonio Breast Cancer Symposium; December 8-11, 2020; virtual. Abstract PS13-53-01.

BeyondSpring announces new positive PROTECTIVE-2 phase 3 registrational trial results at the 2020 San Antonio Breast Cancer Symposium. News release. BeyondSpring. December 10, 2020. Accessed July 14, 2021. 

Blayney DW, Shi Y, Adamchuk H, et al. Clinical trial testing superiority of combination plinabulin (Plin) and pegfilgrastim (Peg) versus peg alone in breast cancer treated with high-risk febrile neutropenia risk chemotherapy (chemo): Final results of the phase 3 protective-2 in chemo-induced neutropenia (CIN) prevention. 

. 2021;39(suppl 15):533. doi:10.1200/JCO.2021.39.15_suppl.533

Docetaxel + plinabulin compared to docetaxel + placebo in patients with advanced NSCLC. ClinicalTrials.gov. Updated May 21, 2021. Accessed July 14, 2021. 

https://clinicaltrials.gov/ct2/show/NCT02504489

Nivolumab in combination with plinabulin in patients with metastatic non-small cell lung cancer (NSCLC). ClinicalTrials.gov. Updated February 23, 2021. Accessed July 14, 2021. 

https://clinicaltrials.gov/ct2/show/NCT02812667

A phase I/II study of nivolumab, ipilimumab and plinabulin in patients with recurrent small cell lung cancer. ClinicalTrials.gov. Updated May 28, 2021. Accessed July 14, 2021. 

https://clinicaltrials.gov/ct2/show/NCT03575793

This article was originally published on OncLive as “

Unique Mechanism of Action Positions Plinabulin as a Preventive and Active Therapy in Breast Cancer, NSCLC”


Study results have posited plinabulin as a potentially effective preventative and active therapy due to its unique mechanism of action.


Distinct Mechanism of Action Makes Plinabulin a Potentially Powerful Therapy in Treating Breast Cancer

Data from the prospective COVIDSurg-Cancer study (NCT04384926) demonstrated that patients with urological cancer who were infected with COVID-19 were more likely to develop respiratory complications and to be at an increased risk of dying following elective surgery for their disease, compared to patients with urological cancer who had not contracted the virus. 

The study results, which were presented during the 36th Annual European Association of Urology (EAU) Congress, demonstrated that those with SARS-CoV-2 positivity were significantly more likely to experience postoperative respiratory complications such as adult respiratory distress syndrome (n = 3; 21.4%; P < .01), pneumonia (n = 4; 28.6%; P < .01), oxygen therapy (n = 10; 71.4%; P < .01), and pulmonary embolism (n = 1; 7.1%; P < .01) within 30 days of their operation.


Moreover, 2 of 412 patients (0.5%) who did not have the virus died within 30 days following their surgical procedure vs 3 of 14 patients (21.4%) with COVID-19 (P <.01). The rates of postoperative Clavien-Dindo Grade III+ complications were 1.7% (n = 2/119), 7.6% (n = 4/53), and 3.3% (n = 2/61) for nephrectomy, cystectomy, and prostatectomy, respectively.


In the international, multicenter, prospective, observational study, investigators set out to examine the impact of the COVID-19 pandemic on the 30-day outcomes of patients with urological cancers such as kidney cancer, bladder cancer, and prostate cancer, who had undergone elective cancer surgery.


To be included, patients must have been planned for curative cancer surgery and underwent the procedure during the pandemic or they had their procedure delayed or cancelled during the pandemic.


Patients needed to be at least 18 years of age and have a confirmed diagnosis of an included cancer type. They could not have surgery planned with non-curative intent. Moreover, patients could not have planned neoadjuvant therapy without a set date for surgery, nor could they be awaiting restaging.


The primary outcome measure for the trial was mortality within 30 days, and key secondary outcomes comprised COVID-19 infections, respiratory complications, and postoperative complications within 30 days.


Prospective data from 436 consecutive patients with urological cancer were collected from several centers between March 11, 2020, and April 19, 2020. Of those patients, 39.7% had kidney and upper tract urothelial cancer (UTUC; n = 173), 28.9% had bladder cancer (n = 126), and 31.4% had prostate cancer (n = 137).


Of the 173 patients with kidney cancer and UTUC, 172 underwent elective cancer surgery. The majority, or 98.8% (n = 170) of these patients were alive at 30 days after the procedure, but 2 patients died. One of the patients who died (50.0%) were positive for COVID-19.


Among the 126 patients with bladder cancer, 120 underwent surgery; 115 patients were alive at 30 days and 3 had died at that time point. Two of the 3 patients (66.6%) who died had COVID-19. Of the 137 patients with prostate cancer, all patients received elective cancer surgery and no patients died at 30 days.


“To continue elective cancer surgery throughout future waves of the pandemic, it would be sensible to take precautions to minimize the risk of patients developing COVID-19 perioperatively,” lead study author Chuanyu Gao, of the British Urology Researchers in Surgical Training, and colleagues, concluded.


1.	Gao C. Characteristics and 30-day outcomes for urological cancer patients operated on during the COVID-19 pandemic. Presented at: 36th Annual European Association of Urology (EAU) Congress; July 9-12, 2021; virtual. Abstract P0186. https://bit.ly/2TNz6l3
2.	Outcomes of elective cancer surgery during the COVID-19 pandemic crisis (CovidSurg-Can). ClinicalTrials.gov. Updated May 12, 2020. Accessed July 10, 2021. https://clinicaltrials.gov/ct2/show/NCT04384926
This article was originally published on OncLive as “Patients With Urological Cancer and COVID-19 Undergoing Elective Surgery at Higher Risk for Mortality”


This article was originally published on OncLive as 

“Patients With Urological Cancer and COVID-19 Undergoing Elective Surgery at Higher Risk for Mortality”

A diagnosis of COVID-19 was associated with an increased risk of respiratory problems and mortality in patients with urological cancer undergoing elective procedures for their disease. 

 COVID-19 Heightens Mortality Risk in Patients with Urological Cancer Undergoing Elective Procedures

An updated consensus on liquid biopsy to detect non-small cell lung cancer (NSCLC) use has been published by the International Association for the Study of Lung Cancer (IASLC).

The statement argues that liquid biopsy is now a favored method of molecular testing in various clinical settings and that it has demonstrated that it is effective in conjunction with tumor tissue testing.

 In addition, liquid biopsy offers unique opportunities such as serial monitoring and detection of minimal residual disease, according to the statement. Going forward, the IASLC expects a significant increase in the use of liquid biopsy.

The report discusses the inherent limitations of tumor tissue testing, which has traditionally been considered the gold standard for molecular analyses and argues that liquid biopsy approaches allow more varied methods of circulating analytes. According to the report, plasma circulating tumor DNA (ctDNA) represents the most widely studied and generally accepted alternative to tumor genotyping in solid tumors, including NSCLC.

“It is notable that the IASLC has taken the lead in detailing the current state of the art in this rapidly expanding field,” stated Gandara, MD, director of thoracic oncology, professor of medicine emeritus, in a news release. “Non-small cell lung cancer, in particular, is an ideal disease area for application of liquid biopsy due to the increasing availability of targeted therapies for this genomically complex malignancy. Liquid biopsy, and especially plasma ctDNA, can be used in many clinical settings where tissue is not applicable, such as the detection of minimal residual disease (MRD).”

The report builds upon a statement released by the IASLC in 2018 and was coauthored by a group of distinguished international lung cancer clinicians and experts.

In the report, the recommendations are as follows:

In clinical practice, ctDNA collection, sample handling and automated processing should be performed using standardized and clinically validated procedures to reduce operator variability and false-negative results.

Due to the growing number of guideline-recommended oncogene targets to be assessed in advanced NSCLC, testing of plasma ctDNA should be performed by a clinically-validated next-generation sequencing (NGS) platform rather than single gene PCR-based approaches, both in treatment-naïve patients and those associated with multiple mechanisms of acquired resistance to targeted agents. Where plasma NGS is not available due to technical and/or economic constraints, single gene or low multiplex-based approaches may represent appropriate alternatives. Use of limited PCR analysis for 

mutations as the initial step in molecular assessment, for example, remains highly relevant in areas of the world where the 

mutation rate is high. However, single gene testing should not be considered complete, and if negative, serial testing for additional actionable biomarkers must be pursued.

The benefit of tissue and plasma NGS is now established in several clinical practice settings. It is anticipated, due to broad-based coverage of requisite oncogenes, decreased turn-around times and emerging data on cost effectiveness, that in the near future NGS will become increasingly available worldwide. Implementation of a multidisciplinary MTB to assist clinicians in treatment decision-making is advisable, as described above.

Plasma ctDNA can now be considered a valid tool for genotyping of newly diagnosed patients with advanced NSCLC, and results are often complementary to tissue analysis. At the time of acquired resistance after tyrosine kinase inhibitor (TKI) therapy in an oncogene-driven NSCLC, initial use of ctDNA is preferred for determination of mechanisms of resistance ("plasma-first”), with repeat tissue biopsy if plasma ctDNA is uninformative. Due to ease of serial sampling and high patient acceptance, ctDNA is also emerging as the preferred method for real time monitoring.

In patients with oncogene-addicted NSCLC, liquid biopsy is emerging as not only complementary to tissue-based analysis but also acceptable as the initial approach (“plasma first”) for biomarker evaluation at the time of diagnosis, as well as for monitoring the efficacy of targeted therapies. Finally, a plasma-first approach is appropriate for identification of mechanisms of acquired resistance to targeted therapies in many clinical settings.

Indications for liquid biopsy in patients with non-oncogene addicted NSCLC are less well-defined at this time, although there are several promising areas of investigation. As noted above, tumor mutation burden is an emerging biomarker, pending completion of ongoing prospective randomized trials and refinement of methodology.

The 2021 World Conference on Lung Cancer, which will be held this upcoming September, will present a series of abstracts related to liquid biopsy methodologies and offer information regarding lung cancer screening, diagnoses, and therapeutic efficacy.

IASLC issues consensus updated report on liquid biopsies. IASLC. Press release. July 8, 2021.

Rolfo C, Mack P, Scagliotti GV, Aggarwal C, Arcila ME, Barlesi F, Bivona T, Diehn M, Dive C, Dziadziuszko R, Leighl N, Malapelle U, Mok T, Peled N, Raez LE, Sequist L, Sholl
L, Swanton C, Abbosh C, Tan D, Wakelee H, Wistuba I, Bunn R, Freeman-Daily J, Wynes M, Belani
C, Mitsudomi T, Gandara D, Liquid Biopsy for Advanced Non-Small Cell Lung Cancer: A Consensus Statement from The International Association for the Study of Lung Cancer (IASLC), Journal of Thoracic Oncology (2021), doi: https://doi.org/10.1016/j.jtho.2021.06.017.

The International Association for the Study of Lung Cancer (IASLC) has published an updated consensus on the use of liquid biopsy in screening non-small cell lung cancer (NSCLC).

Updated IASLC Report Calls Liquid Biopsy Preferred Method of Molecular Testing

An ongoing four-year study based out of the University of Wisconsin-Madison Carbona Cancer Center seeks to determine the best way to improve colorectal cancer screening rates in rural areas.

“Our goal is to learn from the clinics that are doing it correctly and doing well and see if we can take their strategies and help disseminate them to lower-performing health care settings that have similar access to resources, similar patient populations,” said lead researcher Dr. Jennifer Weiss, a gastroenterologist at the UW Carbone Cancer Center and associate professor at the University of Wisconsin School of Medicine and Public Health.



Researchers will survey, tour and interview at more than 200 rural primary care clinics in the upper Midwest. They’ll use early data showing which clinics are high performing (having successfully screened 80% or more eligible patients) to then identify common best practices at those clinics. They also plan to examine the potential causes or barriers leading to lower screening rates at certain clinics.

Weiss said that during her time as a gastroenterologist, she has seen a number of cases where a patient received a colorectal cancer diagnosis that could have been prevented with appropriate or timely screening.

“I think one of the things that people don't understand is we can actually prevent colorectal cancer,” she said. “Most people talk about breast cancer screening – with breast cancer screening, we're trying to identify a breast cancer at the earliest stage possible. With colorectal cancer screening, we can actually identify the precancerous lesion, which is a colon polyp, and take it out before it turns into a cancer.”

Weiss became more interested in health care system- and patient-level interventions to address screening issues. She and fellow researchers began their work in 2008, studying whether multilevel interventions at a large academic health center in a midsize city would help increase screening rates.

“We were able to increase our screening rates over 20% so that we’ve maintained over 80% screening rates for the last five years” Weiss said. “But I started to realize that what we were doing here at an academic health center might not be immediately applicable or transferable to other types of health care settings.”

As Wisconsin has a large rural community, Weiss set out to find a way to translate the lessons they’d learned from the 2008 study to rural clinics. The research is funded by a $1.2 million grant from the American Cancer Society in partnership with the Wisconsin Collaborative for Healthcare Quality.

Though the researchers won’t know for sure until the study is complete, Weiss hypothesizes that one reason that certain rural clinics have not been able to achieve adequate colorectal cancer screening rates may be due to lack of regular access to care.

“Or they access care only for urgent or immediate concerns and are not really doing that yearly preventive exam where there’s time to sit down and talk about the prevention strategies that they can do to help with their health care,” Weiss said.

She added that in many places, regardless of being a rural or urban setting, there’s a difference in how colorectal cancer screening is portrayed and talked about by primary care providers in terms of what tests are available.

“In the United States, we talk a lot about colonoscopy,” said Weiss. “And as a gastroenterologist, I definitely agree colonoscopy is a great colon cancer screening test. But there's also data to show that offering multiple types of screening tests is one way to increase colon cancer screening rates.”

Patients in rural settings may have decreased access to providers who perform colonoscopies due to distance, she explained. However, their providers could explain or offer another reasonable alternative, such as an at-home stool test. This is also a more affordable option than a colonoscopy, which is significant considering that a lack of insurance coverage may be another reason preventing these patients from getting screened.

“I think there's also just issues potentially about this sensitive topic,” said Weiss. “So ideas about talking about a colonoscopy with your provider or with family members may not be felt to be appropriate, or people might have a bit of a stigma about colorectal cancer. Especially if their doctors are really only talking about colonoscopies. So, I think that the discussion needs to be had, I think people really need to talk about their family history. They need to find out who else in their family has had colon cancer, because that increases their potential risk.”

This article was originally published on Cure® as “

New Initiative Explores How to Increase CRC Screening Rates in Rural Areas

Novel research at University of Washington aims to improve the rate of colorectal cancer screenings in rural America. 

New Strategies Aim to Expand Preventative CRC Screenings in Rural America

The FDA has granted a breakthrough therapy designation for venetoclax following interim results from the ongoing M15-531 trial. 

Venetoclax Receives Breakthrough Therapy Designation for Treatment of Myelodysplastic Syndrome (MDS)

 is the leading national organization providing free, professional support services and information to help people manage the emotional, practical and financial challenges of cancer. Our comprehensive services include counseling and support groups over the phone, online and in-person, educational workshops, publications and financial and co-payment assistance. All Cancer

 services are provided by oncology social workers and world-leading cancer experts.

In order to meet the multifaceted needs of cancer patients, the role of case management in cancer care has recently grown.

The Role of Case Management:  Improving Outcomes and Addressing Health Disparities in Cancer Care

Lisa Cusaac never planned on being an oncology nurse. However, 25 years later she has spent her entire career providing care for patients with cancer and being an Oncology Nurse Champion. 

Oncology Nurse Champion: Lisa Cusaac

The impact of the pandemic in regard to specialty care remains to be fully realized. 

Urologic Care Rates Decrease Throughout Climax of COVID-19 Pandemic   

Researchers observed a similar tumor size reduction between 2 arms of patients with hepatocellular carcinoma who were stratified by their liver function class and treated with lenvatinib.  

Patients with Unresectable Hepatocellular Carcinoma with Moderately Impaired Liver Function May Continue Lenvatinib Therapy  

Videos

The reality of the COVID-19 pandemic will force lawmakers to firmly act on behalf of antibiotic policies, according to an expert with Pew Charitable Trusts. 

Antibiotic Overuse During COVID-19 Pandemic Exacerbates Need for Firmer Prescription Policies, Expert Says

Preliminary study results recently presented at the 2021 European Association of Urology Congress demonstrate that the safety profile of the combination of Bacillus Calmette-Guérin (BCG) and mitomycin is comparable to BCG alone. 

 Preliminary Results Show Novel Combo Appears Safe in High-Risk Non-Muscle-Invasive Bladder Cancer

The FDA has approved belumosudil for the treatment of patients aged 12 years and older with chronic graft-versus-host disease following failure of at least 2 prior lines of therapy.

Belumosudil Receives Full FDA Approval for Chronic Graft-Versus-Host Disease

More data are needed regarding the duration of response associated with this combination to make it a “mainstream” treatment option for patients, according to an expert from the University of Michigan Rogel Cancer Center. 



Copanlisib Plus Rituximab May Be ‘Viable Option’ Across Indolent Non-Hodgkin Lymphoma 

The combination of ficlatuzumab and chemotherapy demonstrated some promising results in a small group of patients with relapsed/refractory acute myeloid leukemia. 

 Early Evidence Shows Investigational Therapy-Chemo Combo May Be Effective in Acute Myeloid Leukemia

The efficacy and health-related quality of life benefits associated with the combination of lenvatinib and pembrolizumab make it a favorable treatment for advanced renal cell carcinoma, says an expert from Memorial Sloan Kettering Cancer Center. 

Lenvatinib-Pembrolizumab Combo Induces ‘Impressive’ Results in Patients with Advanced Kidney Cancer

Podcasts

There’s No Place Like Home: The Launch of In-Home Infusion Programs

The preliminary results of an early-phase study of rigosertib combined with nivolumab for the treatment of advanced metastatic KRAS-mutated non-small cell lung cancer are scheduled to be presented at an upcoming medical conference. 

Early Study Results Show Novel Combo Therapy May Be Effective in Lung Cancer Subtype

Adjuvant radiation therapy treatment yielded strong results in reducing all-cause mortality in patients with high-risk prostate cancer. 

Adjuvant Radiation Therapy Associated with Reduced Risk of Death in High-Risk Prostate Cancer

Despite significant concerns from many oncologists regarding the effects of drug resistant bacteria, many pharmaceutical companies have recently stopped developing antibiotics. 



Top Medical News

Newly-Approved Belumosudil Yields High Overall Response Rate in Patients with Chronic Graft-Versus-Host-Disease

Distinct Mechanism of Action Makes Plinabulin a Potentially Powerful Therapy in Treating Breast Cancer

COVID-19 Heightens Mortality Risk in Patients with Urological Cancer Undergoing Elective Procedures

Updated IASLC Report Calls Liquid Biopsy Preferred Method of Molecular Testing

New Strategies Aim to Expand Preventative CRC Screenings in Rural America

Most Recent