Jacob* is a 61-year-old man who received a diagnosis of stage III non-small-cell lung cancer last year. EviCore approved an evidence-based treatment that included chemotherapy and radiation therapy at a community cancer center. Jacob experienced an excellent response to treatment.
Nine months later, Jacob’s follow-up CT scan shows a cancerous tumor in his adrenal gland.
Facing Complications
Jacob benefits from an expert second opinion consultation and avoids the health and financial consequences of medically unnecessary treatment.
Avoiding Unnecessary Care & Costs
Achieving Better Outcomes
During the review, the expert determines that the tumor is in fact PD-L1 negative and unlikely to respond to Keytruda.
Treating Jacob
Along with radiation, Jacob’s oncologist requests Keytruda® (pembrolizumab), an immunotherapy that inhibits PD-L1, a protein that protects some cancer cells from attack by the immune system. The tumor is believed to be PD-L1 positive, meaning it would respond positively to the medication.
The expert recommends no further treatment as Jacob shows no evidence of cancer after the radiation therapy. Jacob’s oncologist reviews the recommendation with Jacob. Together they decide not to pursue Keytruda and proceed with observation.
There are many different facets to cancer care, which can create fragmentation. Achieving the best outcomes takes advanced, efficient coordination— from radiology and lab testing to medication regimen selection and care delivery.
Learn more at evicore.com
What happens now?
Clinical Consult Service
Due to the complex nature of Jacob’s cancer, and with the consent of both Jacob and his oncologist, EviCore engages a lung cancer expert from a National Cancer Institute-designated comprehensive cancer center to review Jacob’s medical records, including his PD-L1 test.
Our Comprehensive Oncology solution goes beyond utilization management, encompassing Clinical Consult, Case Management and other vital services that support patients and providers throughout the cancer care journey.
Comprehensive Oncology
*Not patient’s real name. Images are for illustration purposes only.
What’s the right treatment?
EviCore’s Comprehensive Oncology solution works together with providers and payers to foster the latest evidence-based care for patients and achieve better clinical and financial outcomes.
Meet Jacob
