Early Impressions From OCPC 2021

J Clin Pathways. 2021;7(8):8.

The Fall season is here! We’re fresh off the 2021 Oncology Clinical Pathways Congress (OCPC). Early impressions were positive, though I think we’re all looking forward to next year meeting live in Boston. Highlights for me were Friday’s “Pathways in Integrated Delivery Systems - Part 1” and Saturday’s “Integration of Genetic Testing and Counseling Into Cancer Care,” while the Journal of Clinical Pathways (JCP) staff favorites included, “Utilizing Pathways to Advance Equity in Cancer Care” and “Pathways to Guide Appropriate and Safe Cancer Pain Management.” Let us know which sessions you enjoyed, as it helps us drive future content in print and online.

We’ll be recapping the OCPC meeting, including session coverage, a profile of this year’s Excellence in Pathways award winner, and results from our 2021 Clinical Pathways Survey next month. I, and the entire JCP staff, would like to thank Gordon Kuntz for doing a great job moderating, and also thank the OCPC Steering Committee for pulling together such a robust program

We welcome and encourage reader feedback. This month, we are excited to publish a Letter to the Editor that was sent in response to a video that was offered online entitled “Atezolizumab Plus Bevacizumab Unlikely Cost-Effective for Advanced HCC.”  The authors posed several questions pertaining to the cost analysis conducted by the presenter, and offered their own cost-effective analysis based upon their revised set of cost parameters.  Their analysis resulted in demonstrating that Atezolizumab Plus Bevacizumab would be cost-effective when compared to sorafenib.

Our first feature article this month covers a new technology that may help guide treatment decisions for patients with metastatic breast cancer. In 2019,  the US Food and Drug Administration approved F-18 16 alpha-fluoroestradiol positron emission tomography (FES-PET) to identify heterogeneity in metastatic tumor lesions and predicting response to endocrine therapy.  The clinical utility of FES-PET centers around identification of endocrine sensitive metastatic disease and initiation of appropriate treatment. Manahoor and colleagues compared FES-PET with biopsy to determine estrogen receptor status in patients with metastatic breast cancer. They discovered that FES-PET and biopsy resulted in appropriate endocrine therapy selection for 63.7% vs 51.5% of patients, respectively. The potential for cost-effectiveness of FES-PET was demonstrated with an increased quality adjusted-life-years and a decreased cost when compared with biopsy.

The second feature examines the differences in referral patterns and treatment preferences between oncologists and urologists for patients with prostate cancer. Gajra and colleagues polled a group of mostly community-based medical oncologist and urologists throughout the US. They found that urologists prefered to treat prostate cancer with non-chemotherapy options, and when chemotherapy was needed, the vast majority of the urologists will co-manage the patient with the medical oncologist.  Their findings imply that urologists, as a group, will stay involved in the treatment decision-making and provide care to men with prostate cancer, even when surgical treatment is not a treatment option. However, the impact of these provider preferences upon patient outcomes in the real world needs further research.