The cancer drug pipeline is bursting with promising new therapies for a variety of tumors. Of the many investigational drugs presented at ASCO 2011, some of the most promising agents now in phase 2 or 3 clinical trials are discussed below and throughout this special issue.

Patients are more willing than their oncologists to discuss the cost of cancer care, according to a recent survey of patients with cancer.

Erin W. Hofstatter, MD

A survey-based study from Duke University and the Dana-Farber Cancer Institute reveals that insured patients with cancer often face high out-of-pocket (OOP) expenses for their very expensive treatments and prescription drugs.

As patients are working less and insurers are shifting more costs to patients, the overall ranks of the underinsured have grown—to 20% in 2007 and likely much more in 2011, said S. Yousuf Zafar, MD, Division of Medical Oncology, Duke University, Durham, NC.

For antiemetic prophylaxis, a model of shared cost-savings using incentives such as cash rebates might reduce the high cost of some pharmaceuticals while maintaining patient access to optimal care, according to oncologists from Michigan.

Ronald D. Ennis, MD

The number of cancer diagnoses and the number of patients adhering to cancer treatments decline with high unemployment rates during an economic recession, based on a new an alysis presented by Ronald D. Ennis, MD, Director of Radiation Oncology, St Luke’s-Roosevelt Hospital, New York City.

Targeted drugs are very effective in patients with a well-specified molecular target. Examples include imatinib (Gleevec) in patients with chronic myelog enous leukemia and trastuzumab (Herceptin) in HER-2– positive breast cancer.

However, evidence has shown only modest improvements in outcomes when targeted agents are given to “unselected patients,” that is, those lacking a tumor characteristic (or mutation) that is specifically addressed by a given drug.

Most end-of-life costs accrued by patients with cancer are related to health services rather than the use of drugs, according to an analysis of claims from a large health plan (UnitedHealth).

Surviving is just one hurdle for cancer survivors. A new study funded by the National Cancer Institute shows that the risk of bankruptcy is a serious threat for those who survive cancer and increases along with the length of survival.

“On average, bankruptcy rates increased 4-fold within 5 years of diagnosis,” said the study’s lead investigator, Scott Ramsey, MD, PhD, a healthcare economist and internist at Fred Hutchinson Cancer Research Center, Seattle, WA.

Jonas A. de Souza, MDOne of 8 patients with metastatic colon cancer receives therapy with antineoplastic agents not supported by evidence-based medicine or outside of clinical practice guidelines from the National Com prehensive Cancer Net work (NCCN), found Jonas A. de Souza, MD, an oncology/hematology fellow at the University of Chicago, and colleagues.

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