May 18, 2010
January 2010 Issue: In September 2009, ASCO President Douglas W. Blayney, MD, delivered the Society’s annual report to the National Cancer Institute (NCI) National Cancer Advisory Board (NCAB) about priorities and activities related to cancer research and quality care.
He opened his presentation by describing the ASCO mission and providing an overview of Society demographics. ASCO represents more than 27,000 members in 126 countries, comprising all specialties and disciplines in oncology. Dr. Blayney’s address presented ASCO activities to correspond with the theme of his presidential year—Advancing Quality Through Innovation.
Dr. Blayney emphasized the challenges to the health care system. The national debate on health care reform has underscored a concern about the growth in health spending and a desire for cost savings, leaving the critical clinical trials infrastructure vulnerable to a loss of funding. Oncologists struggle under the regulatory burden of conducting clinical research while trying to conduct important trials. The impending shortfall in the oncology workforce continues to be an area of concern.
But these challenges, Dr. Blayney believes, will lead to new opportunities. Advances in molecular biology have identified potential targets for therapeutic development, allowing for more closely defined populations of patients likely to benefit from a given intervention. The health care debate has brought public attention to cancer and oncology research. There is a growing interest in comparative effectiveness research, which can help inform optimal treatment decisions.
There is also support for “learning health care systems,” in which discoveries move through a cycle of bench research, translational and clinic research, into clinical care, and then to outcomes and health services research, which in turn informs new bench research. This process is what enables advancement of quality care through innovation.
Dr. Blayney went on to describe ASCO’s activities in support of cancer research in the past year, such as advocating for budget increases for NCI and the National Institutes of Health (NIH), supporting investigators through The ASCO Cancer Foundation® grants program, and collaborating with the U.S. Food and Drug Administration (FDA) to promote use of innovative clinical trial designs.
He highlighted the value of federally funded clinical research, from which practice-changing science is generated, and highlighted the importance of NCI and the oncology research and treatment communities working together to advance the quality of cancer care.
Dr. Blayney recommended that the NCAB concentrate its efforts for the next year in four areas.
First, it is critical that NCAB work to enhance NCI support for clinical trials. The results of an ASCO poll of sites that participate in the Cooperative Group clinical trials system demonstrated that 40% of the 478 respondents have considered limiting, or are already planning to limit, their participation in NCI-funded trials. Seventy-five percent of these sites indicated that the decision to limit their involvement is necessitated by NCI’s inadequate percase reimbursement. Approximately 42% of these sites intend to increase their participation in industry-sponsored trials, although they noted that they prefer the trials offered through the Cooperative Group system. Dr. Blayney urged the NCAB to advise the NCI to increase the current $2,000 per-case reimbursement to more adequately compensate for research costs.
Second, the NCAB and its partners should explore and enhance innovative training partnerships to help oncologists stay abreast of new discoveries. Dr. Blayney highlighted ASCO’s growth in the area of online training and information sharing through sites like ASCO University™, which features interactive modules on various cancer-related topics that can be applied toward continuing medical education (CME) and maintenance of certification (MOC) credit, and the ASCO Exchange social networks, which focus on oncology-specific topics such as EHR implementation.
Third, it is important to encourage efforts to harmonize federal regulatory requirements for research. Federal agencies impose a vast array of requirements, which can become a burden on the investigator and take valuable time away from research activities. ASCO is developing case-based documents to assist institutions in complying with federal privacy rule requirements. ASCO is also developing recommendations to harmonize and streamline federal research requirements.
Finally, Dr. Blayney recommended that the NCAB leverage existing data collection projects. He outlined the potential for collaboration between NCI and ASCO’s Breast Cancer Registry and the Quality Oncology Practice Initiative (QOPI®).
The NCAB was formed following the passage of the 1971 National Cancer Act, with the mission of advising the Director of NCI—who in turn makes recommendations to the President of the United States—on priorities, activities, and new initiatives to reduce the burden of cancer in the United States. It is composed of a diverse group of Presidentially appointed scientists, business experts, and laypersons. ASCO presidents have delivered annual reports to the NCAB since 2006.
To request a copy of Dr. Blayney’s presentation slides or for more information on ASCO’s policy activities, send an e-mail to email@example.com.