Value-Based Cancer Care Issues

November 2015, Vol 6, No 10

FDA News – November 2015

FDA Approvals, News & Updates

  • Imlygic, First-of-Its-Kind Oncolytic Virus Therapy Approved for Melanoma
  • Yondelis a New Treatment Option for Patients with Soft-Tissue Sarcoma
  • Onivyde Receives Expedited Approval for Metastatic Pancreatic Cancer
  • Abemaciclib Receives Breakthrough Therapy Status for Refractory Metastatic Breast Cancer
  • Opdivo Gets Second Indication for Metastatic Lung Cancer
[ Read More ]

Oncology News – November 2015

Oncology News

  • Medicare Will Now Reimburse Physicians for End-of-Life Discussions with Patients
  • New Scoring System Can Improve Lung Cancer Diagnosis
  • First Consensus Statement on High-Quality Palliative Care Issued by ASCO/AAHPM
[ Read More ]

The NCCN New Tool to Assess Value Discourages Patients’ Hope

Robert Goldberg, PhD

VBCC Perspectives

In October, the National Comprehensive Cancer Network (NCCN) released its first set of “flash cards” or “Evidence Blocks” as a tool for evaluating treatment decisions, seeking to solve a drug cost problem that does not exist, by adding to a problem that does: insurers shifting the cost of cancer treatment to patients. In so doing, the NCCN could inadvertently increase the rate at which patients with cancer choose assisted suicide. [ Read More ]

Significant Benefits Seen with 2 New Options for Patients with Renal-Cell Carcinoma

Phoebe Starr

Emerging Therapies

Vienna, Austria—Patients with advanced, pretreated renal-cell carcinoma (RCC) who have limited treatment options got good news from 2 important practice-changing trials, CheckMate 025 and METEOR, which were presented as late-breaking abstracts at the 2015 European Cancer Congress (ECC). CheckMate 025 showed a survival benefit for nivolumab (Opdivo) over standard therapy with everolimus (Afinitor) in patients with previously treated advanced RCC. This is the first trial to show a survival benefit for an immune checkpoint inhibitor after standard therapy has failed. METEOR showed that cabozantinib (Cometriq) nearly doubled progression-free survival (PFS) compared with standard everolimus in patients with advanced RCC whose disease progressed with previous vascular endothelial growth factor (VEGF) receptor (VEGFR)-targeted therapy. [ Read More ]

MRI Screening of Women at Average Risk for Breast Cancer Improves Detection

Corbin Davis

Cancer Screening

San Francisco, CA—Magnetic resonance imaging (MRI) screening of women who are at average risk for breast cancer had a mean additional cancer diagnosis yield of 15.8 per 1000 patients, surpassing the yields for digital breast tomosynthesis and ultrasound in a new study. The results were presented at the 2015 Breast Cancer Symposium, by Christiane K. Kuhl, MD, Department of Diagnostic and Interventional Radiology, RWTH Aachen University, Germany. This suggests that breast MRI screening alone every 3 years may be sufficient for women at average risk. [ Read More ]

Screening in Younger First-Degree Relatives of Patients with CRC

Rosemary Frei, MSc

Cancer Screening

A study from the Centers for Disease Control and Prevention documented an average 38% colorectal cancer (CRC) screening rate among people aged 40 to 49 years, and a 69.7% rate in those aged ?50 years with a first-degree relative with CRC. An earlier analysis of National Health Interview Survey (NHIS) data from 2005 and 2010 showed that first-degree relatives of patients with CRC were 70% more likely to have a colonoscopy than their counterparts. [ Read More ]

Ramucirumab Confers Survival Benefit in Some Patients with Hepatocellular Carcinoma

Walter Alexander

GI Cancers

Barcelona, Spain—In the REACH trial evaluating ramucirumab (Cyramza) as second-line treatment in patients with advanced hepatocellular carcinoma after first-line therapy with sorafenib (Nexavar), overall survival (OS) was improved in the subgroup population with baseline α-fetoprotein of ?400 ng/mL (Child-Pugh class A). The OS benefits in the overall population (Child-Pugh classes A and B) did not reach significance, said lead investigator Andrew X. Zhu, MD, PhD, Massachusetts General Hospital Cancer Center, Boston. [ Read More ]

Systemic Therapy plus Radiofrequency: Ablation Survival Benefit in Colorectal Liver Metastases

Walter Alexander

GI Cancers

Barcelona, Spain—The first randomized study prospectively investigating the efficacy of radiofrequency ablation (RFA) added to standard systemic treatment in patients with unresectable colo­rectal cancer (CRC) liver metastases revealed progression-free survival (PFS) and overall survival (OS) benefits, according to Theo J.M. Ruers, MD, PhD, Department of Surgery, The Netherlands Cancer Institute-Antoni van Leeuwenhoek Ziekenhuis, Amsterdam. [ Read More ]

Aprepitant Improves Emesis Control in Patients with Colorectal Cancer

Walter Alexander

GI Cancers

Barcelona, Spain—Controlling and minimizing nausea and vomiting enables patients with cancer to continue their chemotherapy. A clinical trial reported at the 2015 European Society for Medical Oncology (ESMO) World Congress on Gastrointestinal Cancer shows that the newly approved agent aprepitant (Emend), an oral neurokinin (NK)1 antagonist, improved antiemetic control in patients with colorectal cancer (CRC) who were receiving oxaliplatin-based chemotherapy, according to Junichi Nishimura, MD, Assistant Professor, Osaka University, Japan. [ Read More ]

Chemotherapy Safe During Pregnancy in Second and Third Trimesters

Phoebe Starr

Pregnancy & Cancer

Vienna, Austria—Results from a new study provide reassurance to women who have cancer while pregnant that they can safely receive treatment during the second or third trimester with chemotherapy or radiation without compromising their unborn child. The study showed that children born to mothers who receive chemotherapy or radiation during pregnancy had no impairment in general health, cognition, or cardiac function compared with children born to healthy mothers, said lead investigator Frédéric Amant, MD, PhD, Department of Gynecologic Oncology, University Hospitals Leuven, Belgium. [ Read More ]

Value-Based Oncology Center of Excellence Model

Kelly Blair, MPA

Value in Oncology

“Centers of Excellence” (COEs) is not a new concept in healthcare. The underlying hypothesis is that providers who specialize in a particular procedure or service will produce superior, predictable outcomes. Payers have developed COE networks to manage cost and quality for complex medical conditions for more than 2 decades, steering volume to high-performing providers in exchange for discounted contractual rates. Under significant pressure to reduce the burden of cancer spending, payers are beginning to make bold network decisions, including narrowing networks, but they need precision tools to ensure that quality of care is uncompromised, and even improved, while reining in unsustainable cost trends. [ Read More ]

Men’s Health Supplements Have No Value for Patients with Prostate Cancer

Phoebe Starr

Prostate Cancer

San Antonio, TX—Supplements that are often sold in supermarkets and health food stores to promote “men’s health” or “prostate health” do not provide any clinical benefits to men with prostate cancer, according to the results of a retrospective study presented at the 2015 American Society for Radiation Oncology annual meeting. Men’s health supplements did not significantly prevent distant metastasis, prostate cancer–related death, or treatment-related adverse events in this first-of-its-kind study. [ Read More ]

80-Gene Assay Identifies Distinct Triple-Positive Breast Cancer Subtypes, Guides Therapy Selection

Corbin Davis

Personalized Medicine

San Francisco, CA—A new genetic test may allow clinicians to improve their therapy decisions by better categorizing patients into specific subtypes compared with conventional immunohistochemistry (IHC) and fluorescence in situ hybridization (FISH) subtyping. According to data presented at the 2015 Breast Cancer Symposium, the BluePrint 80-gene assay reclassifies approximately 23% of tumors, allowing for more effective therapy selection, particularly in patients with triple-positive (HER2-positive/hormone receptor–positive) disease. [ Read More ]