Disease Management Update
Volume V, No. 19
September 4, 2008

Dear Healthcare Intelligence Network Client,

Ovarian cancer ranks fifth in cancer deaths among women, and prostate cancer is the leading cause of cancer death in American men, second only to lung cancer. With these unsettling statistics in mind, and as Prostate Cancer and Ovarian Cancer Awareness Months continue, this week's Disease Management Update sheds some light on related research.

Your colleague in the business of healthcare,
Laura Greene
Editor, Disease Management Update

Please pass this along to any of your colleagues or, better yet, have them sign up to receive their own copy at http://www.hin.com/freenews2.html where you can also learn about our other complimentary news services.

Table of Contents

  1. Scientists Find Second Site for Prostate Cancer Gene
  2. Disease Management Q&A: Educating the Resistant Patient
  3. HealthSounds Podcast: Breast Cancer Survivor Toolkits
  4. Ovarian Cancer Trial Design
  5. Survey of the Month: Healthcare Trends in 2009
  6. Better Health Outcomes Through DM and Case Management Services

1. Scientists Find Second Site for Prostate Cancer Gene

Scientists at Wake Forest University School of Medicine and colleagues who are studying a prostate cancer gene called HNF1B have found a second independent site within the HNF1B gene on chromosome 17 (17q12) — increasing the number of genetic variants that may contribute to risk of developing the disease.

After comparing the newly discovered site with a previously discovered site in the same gene among two large groups of patients in Sweden and at Johns Hopkins Hospital in Baltimore, “these data strongly suggest that the two sites are genetically independent,” said Dr. Jianfeng Xu, M.D., Ph.D., senior researcher on the study. “We found another genetic variant associated with prostate cancer risk,” Dr. Xu said. “The more genetic variants we discover, the better off we are. As we find more of these, it improves our ability to predict prostate cancer risk.”

Dr. Xu said that as the number of genetic variants associated with prostate cancer risk continues to mount, it improves the precision of risk prediction. But he predicted that prostate cancer will be found to be polygenic, “not dependent on one gene, but a group of genes.”

To learn more about this research, please visit:

2. Disease Management Q&A: Educating the Resistant Patient

Each week, a healthcare professional responds to a reader's query on an industry issue. This week's expert is Barbara Rutkowski, Ed.D., medical manager for St. Mary’s Managed Care Services.

Question: What are some cost-effective strategies to help motivate different types of patients, with special emphasis on chronic illnesses?

Response: (Barbara Rutkowski): Education is so important. People don’t even understand the name of the test they need to watch their diabetes, so we educate a lot. People have a completely wrong idea about nutrition. If they haven’t stayed current with the changes over the last couple of years, they’ll be behind. We ask members to sign a contract, and we show them how to get the most from the (average) eight minutes of their doctor’s visit. They have all their test results, which are explained when they receive them. They maintain their own files and records such as blood pressure readings to take along to their medical visits. They have to have their blood pressure taken 12 times a year.

For more details on motivating patients with chronic illnesses, please visit:

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3. HealthSounds Podcast: Breast Cancer Survivor Toolkits

A patient navigation kit accented with artwork and writings by breast cancer survivors took top honors in the first annual Healthcare Toolkits contest sponsored by HIN. The MyHealth, MyJourney breast cancer post-diagnosis toolkit developed by the Eden Communications Group for Pfizer Oncology was awarded first prize among nearly 60 print, Web-based and multi-media healthcare toolkits submitted by health plans, hospitals and employers.

To listen to this complimentary HIN podcast, please visit:

4. Ovarian Cancer Trial Design

Curis, Inc., a drug development company focused on developing the next generation of proprietary targeted medicines for cancer treatment, announced that its collaborator Genentech, Inc. expects to initiate a Phase II clinical trial of GDC-0449, an orally administered small molecule Hedgehog antagonist, as a maintenance therapy for ovarian cancer patients in second or third complete remission.

GDC-0449 will be evaluated in approximately 100 patients with ovarian cancer in second or third complete remission in a randomized, placebo-controlled, double-blind, multi-center Phase II trial. Patients will be randomized in a one-to-one ratio to receive either GDC-0449 or a placebo comparator and will be stratified based on whether their cancer is in a second or third complete remission. The primary endpoint of the trial is progression-free survival, and secondary outcome measures include overall survival, the amount of Hedgehog protein expression in archival tissue and tracking of adverse events. Genentech expects to initiate this Phase II trial during the second half of 2008. Trial details are posted at http://www.ClinicalTrials.gov.

"We believe that the dysregulation of developmental pathways such as Hedgehog may play a role in the formation or recurrence of cancer. Therefore, we are hopeful that a Hedgehog inhibitor, such as GDC-0449, may be a useful therapeutic tool in preventing cancer from returning in these ovarian cancer patients and may prove useful as a maintenance therapy," said Dan Passeri, Curis president and CEO. "GDC-0449 is currently in Phase II testing in first-line metastatic colorectal cancer and Genentech has indicated that it expects to initiate an additional Phase II clinical trial in advanced basal cell carcinoma in the second half of 2008."

To learn more about this research, please visit:

5. Survey of the Month: Healthcare Trends in 2009

A faltering economy, a presidential election and a number of other factors continue to drive changes in the healthcare industry. Want to know how other healthcare organizations are preparing for what the healthcare industry will bring in 2009? Complete HIN's Survey of the Month on Healthcare Trends in 2009 by September 30 and you’ll get a free executive summary of the compiled results.

To participate in this survey and receive its results, please visit:

6. Better Health Outcomes Through DM and Case Management Services

McKesson Corporation and CMS Health Integrated are providing CoverColorado with the nation’s first integrated care program for high-risk health plan participants. More than 3,000 people with chronic and high-cost health conditions now have access to an around-the-clock, integrated care program that includes both DM and case management services. To download this complimentary white paper, please visit:
Contact HIN:
Editor: Laura M. Greene, lgreene@hin.com;
Sales & Marketing Coordinator: Deirdre McGuinness, dmcguinness@hin.com;
Publisher: Melanie Matthews, mmatthews@hin.com

For more information on the products and services available through the Healthcare Intelligence Network, contact us at (888) 446-3530 / (732) 528-4468, fax (732) 292-3073 or email us at info@hin.com.
All contents of this message Copyright 2008