Value-Based Cancer Care Issues


May 2015, Vol 6, No 4

Promising Therapies in Multiple Drug Classes Being Explored for B-Cell Lymphomas

Wayne Kuznar

NCCN 2015 Updates

Hollywood, FL—Targeted therapy in B-cell lymphoma is rapidly expanding beyond anti-CD20 antibodies. Some of the emerging therapies are conjugated antibodies, treatments that target signaling pathways or apoptosis, immunomodulatory drugs (IMiDs), and immune checkpoint inhibitors, said Andrew D. Zelenetz, MD, PhD, Vice Chair, Medical Informatics, Department of Medicine, Memorial Sloan Kettering Cancer Center, New York, at the 2015 National Comprehensive Cancer Network conference. [ Read More ]

Pembrolizumab Scores Big Over Ipilimumab in Advanced Melanoma

Phoebe Starr

AACR Meeting Highlights

Philadelphia, PA—As new immunotherapies become available for the treatment of melanoma and other cancers, head-to-head trials of these agents shed more light on how best to use them. In the phase 3 KEYNOTE-006 trial, pembrolizumab (Keytruda) outperformed ipilimumab (Yervoy)—a current standard of care—as upfront treatment for patients with unresectable advanced melanoma. The data were presented at the 2015 American Association for Cancer Research annual meeting. [ Read More ]

Value of Cancer Care for Most Tumors Lower in United States than in Western Europe

Rosemary Frei, MSc

Economics of Cancer Care

A reevaluation of the value of cancer care between 1982 and 2010 in the United States versus Western Europe (Soneji S, Yang JW. Health Aff [Millwood]. 2015;34:390-397) paints an entirely different picture from a similar analysis published in 2012 (Philipson T, et­ al. Health Aff [Millwood]. 2012;­­31:667-675). The earlier study found significant improvements in breast and prostate cancer survival in the United States relative to Western Europe, concluding that the high costs in the United States were worth it. [ Read More ]

Value Propositions – May 2015

Value Propositions

  • New Genetic Tests for Breast Cancer on the Horizon, May Challenge Current Screening Strategy
  • Turbo-Charging the Immune System Potential Game-Changer in Killing Cancer
  • New Immuno-oncology Collaboration to Promote CAR T-Cell Therapies
[ Read More ]

Two Immunotherapies Are Better Than One in Advanced Melanoma

Phoebe Starr

AACR Meeting Highlights

Philadelphia, PA—Combination immunotherapy with ipilimumab (Yervoy) plus nivolumab (Opdivo) was superior to ipilimumab monotherapy in previously untreated patients with advanced melanoma in a phase 2 randomized clinical trial, according to lead investigator F. Stephen Hodi, MD, Director of the Melanoma Center, Dana-Farber Cancer Institute, Boston, MA, who presented the study at the 2015 American Association for Cancer Research (AACR) annual meeting. [ Read More ]

Projections for 2030: Increase in ER-Positive, Decrease in ER-Negative Breast Cancer

Phoebe Starr

AACR Meeting Highlights

Philadelphia, PA—Over the next 15 years, up to a 50% increase is projected in the number of breast cancer cases, according to a study from the National Cancer Institute (NCI). The incidence of estrogen receptor (ER)-positive breast cancers, diagnosed mostly by mammography, is projected to increase, whereas cases of ER-negative cancers, the more-difficult-to-treat cancers, are projected to decrease. ER-positive in situ cancers are expected to increase by approximately 50% and ER-negative cancers are expected to decrease by approximately 50% by 2030. [ Read More ]

Metformin May Not Improve Survival in Patients with Pancreatic Cancer

Christine Erickson

AACR Meeting Highlights

Philadelphia, PA—Several retrospective studies have shown that metformin is associated with longer survival in patients with cancer, including pancreatic cancer. However, in a new study led by Roongruedee Chaiteerakij, MD, PhD, Division of Gastroenterology and Hepatology, Mayo Clinic Cancer Center, Rochester, MN, metformin did not improve survival for patients with pancreatic ductal adenocarcinoma (PDAC). The results were presented at the 2015 American Association for Cancer Research meeting. [ Read More ]

Olaparib-Carboplatin Combination Shows Promise for Patients with Ovarian or Triple-Negative Breast Cancer

Dana Taylor

AACR Meeting Highlights

Philadelphia, PA—The use of the poly (ADP-ribose) polymerase (PARP) inhibitor, olaparib (Lynparza), plus carboplatin chemotherapy shows promising activity in patients with recurrent breast or ovarian cancer; furthermore, the order of administration of these therapies did not affect the occurrence of side effects, according to new data from a phase 1 clinical trial presented at the 2015 American Association for Cancer Research (AACR) meeting. [ Read More ]

New Hope for Patients with Advanced Lung Cancer?

Phoebe Starr

AACR Meeting Highlights

Philadelphia, PA—Immunotherapy with pembrolizumab (Keytruda) was safe and effective in the treatment of patients with previously treated as well as treatment-naïve patients with advanced non–small-cell lung cancer (NSCLC), according to results of the KEYNOTE-001 trial, said Edward B. Garon, MD, Assistant Professor of Medicine, David Geffen School of Medicine, University of California, Los Angeles, Santa Monica, who presented these data at the 2015 American Association for Cancer Research (AACR) meeting. [ Read More ]

Many Targeted Drugs in Development for Multiple Myeloma: Monoclonal Antibodies Close to Approval

Wayne Kuznar

NCCN 2015 Updates

Hollywood, FL—New targeted agents in multiple myeloma will turn it into a chronic illness, with sustained complete response possible in a significant fraction of patients, predicted Kenneth C. Anderson, MD, Director, Jerome Lipper Multiple Myeloma Center, Dana-Farber Cancer Institute, Boston, at his presentation at the 2015 National Comprehensive Cancer Network (NCCN) conference. [ Read More ]

In CML, Assess Response to First-Line TKI at 3 Months

Wayne Kuznar

NCCN 2015 Updates

Hollywood, FL—Switching therapy in patients with chronic myelogenous leukemia (CML) should be considered in those who have a suboptimal response to a first-line tyrosine kinase inhibitor (TKI) at 3 months, said Jerald P. Radich, MD, Director of the Molecular Oncology Laboratory, Fred Hutchinson Cancer Research Center, Seattle, WA, and Vice Chair of the National Comprehensive Cancer Network (NCCN) guideline panel on CML. He discussed the management of patients with CML at the 2015 NCCN conference. [ Read More ]

Value of MRI in Smoldering Myeloma Stressed by the International Myeloma Working Group

Charles Bankhead

Multiple Myeloma

All patients with smoldering or asymptomatic multiple myeloma should undergo whole-body magnetic resonance imaging (MRI), or pelvic and spinal MRI if whole body is unavailable, according to recommendations from the International Myeloma Working Group (IMWG). The presence of >1 focal lesions >5 mm should be considered diagnostic for symptomatic myeloma requiring therapy. [ Read More ]

Pathways Have the Potential to Deliver Personalized Medicine

Wayne Kuznar

AVBCC 2015 5th Annual Conference

Washington, DC—The institution of cancer treatment pathways is not incompatible with personalized medicine, but rather it has the potential to offer access to a rapid learning system that can promote personalized therapy, said Michael Kolodziej, MD, National Medical Director, Oncology Solutions, Aetna, at the Fifth Annual Conference of the Association for Value-Based Cancer Care. [ Read More ]

In the Literature – May 2015

In the Literature

  • Patient-Reported Outcomes Needed in Clinical Trials of Cancer Therapies for Accurate Drug Safety Evaluations
  • Ibrutinib Highly Active in Patients with Waldenström’s Macroglobulinemia
  • PIK3CA Mutations Associated with Poor Response to HER2-Targeted Breast Cancer Therapies
  • Better Outcomes with Nivolumab plus Ipilimumab than with Ipilimumab Monotherapy for Untreated Melanoma
[ Read More ]

US Oncologists Favor Establishment of NICE-Like Body to Determine Medicare Cancer Drugs Reimbursement

Rosemary Frei, MSc

Economics of Cancer Care

According to a recent study, 63.6% of oncologists surveyed favor the establishment of an independent panel of health experts to decide which treatments Medicare will pay for based on a cost-benefit analysis (Gogineni K, et al. J Clin Oncol. 2015;­33:846-853). Less than 50% of patients and members of the general public think this is a good idea. The United Kingdom’s National Institute for Health and Care Excellence (NICE) is one model for such a panel. [ Read More ]

Medicare’s Sustainable Growth Rate Repeal Met with Relief

Laura Morgan

Economics of Cancer Care

The April 14, 2015, repeal of the sustainable growth rate (SGR) formula for physician payments under Medicare is being welcomed by the healthcare community, including the American Society of Clinical Oncology (ASCO). The 392 to 37 vote to pass H.R. 2, called the Medicare Access and Children’s Health Insurance Program Reauthorization Act of 2015, came just in time to avoid the 21% cut in Medicare fees that would have come into effect after the most recent SGR patch expired on March 31, 2015. [ Read More ]

Revised Survivorship Care Plan Template Reduces Time and Resource Commitments

Charles Bankhead

Survivorship

A revised survivorship care plan template addresses obstacles that have limited the use of survivorship plans in clinical practice, suggested an American Society of Clinical Oncology (ASCO) expert panel headed by Deborah K. Mayer, PhD, MSN, RN, Professor of Nursing and Director of Survivorship Care, Lineberger Comprehensive Cancer Center, University of North Carolina, Chapel Hill. [ Read More ]

Akynzeo (Netupitant and Palonosetron), a Dual-Acting Oral Agent, Approved by the FDA for the Prevention of Chemotherapy-Induced Nausea and Vomiting

Loretta Fala

Drug Updates

One of the most fear-inducing side effects of chemotherapy is nausea and vomiting. Without appropriate antiemetic prophylaxis, 70% to 80% of all patients with cancer who receive chemotherapy experience nausea and/or vomiting. Consequently, preventing and managing chemotherapy­induced nausea and vomiting (CINV) is a crucial part of care planning for patients with cancer. [ Read More ]