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CLINICAL NEWS One Nation, Fighting Cancer Fewer Americans are dying from cancer, according to the 2018 “Annual Report to the Nation on the Status of Cancer,” a collaborative effort by the National Cancer Institute (NCI) and other federal agencies. Between 1999 and 2015, overall cancer death rates decreased by 1.8 % per year among men and by 1.4 % per year among women. These improvements in survival were seen across many types of the most common cancers in the U.S.: From 2011 to 2015, death rates decreased for 11 of the 18 most common cancer types in men and for 14 of the 20 most common cancer types in women. However, over the same period, death rates for cancers of the liver, pancreas, and brain and other nervous system increased in both men and women. “This year’s report is an encouraging indicator of progress we’re making in cancer research,” said NCI Director Ned Sharpless, MD. “As overall death rates continue to decline for all major racial and ethnic groups in the United States, it’s clear that interventions are having an impact.” Sources: National Cancer Institute press release, May 22, 2018; Cronin KA, Lake AJ, Scott S, et al. Annual Report to the Nation on the Status of Cancer, part I: National cancer statistics. Cancer. 2018 May 22. [Epub ahead of print] Sleep Tight! Sleep is critical to maintaining cancer patients’ health and quality of life, but insomnia is a common disorder among survivors. According to a study supported by the Patient-Centered Outcomes Research Institute, non- pharmacologic treatments like acupuncture and cognitive behavioral therapy (CBT) may help patients sleep more soundly – without the side effects associated with traditional medicines. Among 160 post-treatment cancer survivors with clinically diagnosed in- somnia disorder (defined as an Insomnia Severity Index score of 15 to 28): • 8 weeks of acupuncture reduced insomnia severity by 8.3 points • 8 weeks of CBT (including sleep restriction, stimulus control, cognitive restructuring, and relaxation training) reduced insomnia severity by 10.9 points Patients reported maintaining these improvements for up to 20 weeks after starting therapy. Source: Mao JJ, Xie S, Duhamel K, et al. The effect of acupuncture versus cognitive behavior therapy on insomnia in cancer survivors: a randomized clinical trial. Abstract #10001. Presented at the 2018 ASCO Annual Meeting, June 3, 2018; Chicago, IL. Sticker Shock Chimeric antigen receptor (CAR) T-cell therapy sounds like a concept plucked from science fiction, but the costs of this revolutionary treatment are straight from a horror film. An analysis published in JAMA Oncology estimated that the mean expected annual costs of treatment (accounting for leukapheresis, lymphodepletion therapy, and potential adverse effects) for the two U.S. Food and Drug Administration–approved CAR T-cell therapies were: $ 510,963 for tisagenlecleucel (which has a list price of $475,000) $ 402,647 for axicabtagene ciloleucel (which has a list price of $373,000) If a patient develops grade 3 or higher cytokine release syndrome, the price can climb to $531,823 for tisagenlecleucel. Source: Hernandez I, Prasad V, Gellad WF. Total costs of chimeric antigen receptor T-cell immunotherapy. JAMA Oncol. 2018 April 26. [Epub ahead of print] ASHClinicalNews.org ASH Clinical News 29