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The expansion of Medicaid may mitigate health disparities in cancer diagnosis, according to a recent study that found state variation in reductions in the percentage of uninsured patients aged 18 to 64 years diagnosed with cancer. The researchers said that the results have implications for future disparities in state mortality rates, because health insurance coverage is linked to the ability to have better treatment and survival after diagnosis.

This week, the top managed care news included a panel mostly endorsed the use of patient-reported outcomes for coverage of chimeric antigen receptor T-cell therapy; the US Preventive Services Task Force released new recommendations for cervical cancer screening; research found accountable care organization penetration may be changing how physicians work.

The first chimeric antigen receptor (CAR) T-cell therapy was approved just a year ago, changing the face of treatment for certain types of leukemias and lymphomas but carrying with it the downsides of toxicity and cost. A year later, scientists from a major cancer center said that they’ve made headway to discovering more about the T-cell signaling patterns and that understanding more about the biological pathways could help design the next generation of CAR-T treatments.

Next week, a CMS committee will hold a day-long meeting to discuss a national coverage determination (NCD) for chimeric antigen receptor (CAR) T-cell immunotherapies, and in Thursday’s New England Journal of Medicine, Peter B. Bach, MD, MAPP, reviewed several strategies open to CMS as it continues to try to determine how to pay for CAR T.

For insights on this issue, Evidence-Based Oncology™ spoke with Lynda Kwon Beaupin, MD, a pediatric hematologist-oncologist who recently became the director of CanSurvive, the pediatric cancer survivorship program at Johns Hopkins All Children’s Hospital in St. Petersburg, Florida. Beaupin and her colleagues in the Consortium of Adolescent and Young Adult Cancer Centers, which includes oncologists from major cancer centers including Johns Hopkins, are working to address the nuances that come with treating adolescent and young adult cancer patients and looking for ways to increase their quality of life.

Thea Danze lights up the room wherever she goes; she loves space and music and fire trucks. Since 2012, she has been the namesake and spokesperson for a foundation created to raise funds and awareness about pediatric brain tumors. Called Thea’s Star of Hope, the foundation supports development of therapies that will treat brain tumors without the toxic adverse effects that Thea has endured.

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