Value-Based Cancer Care Issues


November 2016, Vol 7, No 10

FDA News – November 2016

FDA Approvals, News & Updates

  • Tecentriq Approved by the FDA for Metastatic NSCLC
  • Keytruda Receives New FDA Indication for First-Line Treatment of Metastatic NSCLC
  • Lartruvo First Drug in 40 Years to Receive FDA Approval for Soft-Tissue Sarcoma
  • FDA Revises the Indication for Tarceva for Treatment of NSCLC
  • FDA Awards $23 Million Worth of Grants to Encourage Drug Development for Rare Diseases
[ Read More ]

In the Literature – November 2016

In the Literature

  • Gaps in Use of Tyrosine Kinase Inhibitors in Medicare Beneficiaries with Chronic Myeloid Leukemia
  • Adding Daratumumab to Standard Regimen Extends Progression-Free Survival in Patients with Multiple Myeloma
  • Mutations Responsible for Relapse Despite PD-1 Therapy Uncovered in Melanoma
  • Ricolinostat Shows Promise in Patients with Relapsed or Refractory Multiple Myeloma
[ Read More ]

Palliative Care Program Eases Patient Symptoms and Hospital Costs

Chase Doyle

Value in Oncology

San Francisco, CA—In addition to improving quality of care and patient satisfaction, palliative care can also save hospitals millions of dollars, according to a study presented by lead investigator Sarina Isenberg, PhD candidate, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD. The study’s final analysis showed that expanded patient access to palliative care demonstrated substantial savings to the Johns Hopkins Hospital and Health System and could lead to approximately $20 million in savings in 5 years, said Ms Isenberg at the 2016 Palliative Care in Oncology Symposium. [ Read More ]

Budget Impact Concerns Volume, Not Value: Prevention Is Key to Winning the War on Cancer

Jessica Miller

Value in Oncology

Boston, MA—Are we winning the war on cancer? According to Joshua J. Ofman, MD, MSHS, Senior Vice President, Global Value, Access and Policy, Amgen, the answer is yes. Dr Ofman discussed the economics of cancer, including challenges facing insurance providers and ways to impact the rising cost of cancer care, at the War on Cancer forum hosted by The Economist. [ Read More ]

Angiogenesis Inhibitor Has Modest Effect on Progression-Free Survival in Metastatic Colorectal Cancer

Charles Bankhead

ESMO 2016

Copenhagen, Denmark—Patients with previously treated metastatic colorectal cancer (mCRC) had a small but significant improvement in progression-free survival (PFS) but no overall survival (OS) benefit after receiving the multikinase inhibitor nintedanib (Ofev), according to results from the LUME-Colon 1 clinical trial reported by principal investigator Eric Van Cutsem, MD, Clinical Digestive Oncology, University Hospitals Leuven, Belgium, at the 2016 European Society for Medical Oncology Congress. [ Read More ]

Nivolumab Improves Quality of Life versus Chemotherapy in Patients with Head and Neck Cancer

Phoebe Starr

ESMO 2016

Copenhagen, Denmark—In recent years, the personal experience of patients with cancer has been recognized as an important factor in determining the value of a treatment. According to patient-reported outcomes from the CheckMate-141 clinical trial presented at the 2016 European Society for Medical Oncology (ESMO) Congress, patients’ quality of life (QOL) remained stable with the immunotherapy nivolumab (Opdivo), whereas it significantly deteriorated with chemotherapy. [ Read More ]

Pembrolizumab Succeeds, Nivolumab Fails, as First-Line Therapy for Advanced NSCLC

Phoebe Starr

Lung Cancer

Copenhagen, Denmark—Patients with non–small-cell lung cancer (NSCLC) who lack targetable EGFR or ALK mutations typically receive platinum-based doublet chemotherapy as first-line therapy. Two phase 3 clinical trials presented at the 2016 European Society for Medical Oncology (ESMO) Congress compared immunotherapy and platinum-based chemotherapy as first-line treatment for ­patients with NSCLC. In KEYNOTE-024, pembrolizumab (Keytruda) was superior to chemotherapy in terms of progression-free survival (PFS) and overall survival (OS), whereas in CheckMate-026, nivolu­mab (Opdivo) failed to improve PFS compared with chemotherapy. [ Read More ]

Ceritinib, a Newer ALK Inhibitor, Improves Progression-Free Survival After Crizotinib Failure in NSCLC

Charles Bankhead

Lung Cancer

Copenhagen, Denmark—Patients with heavily pretreated ALK mutation and non–small-cell lung cancer (NSCLC) had significant improvement in progression-free survival (PFS) after receiving the next-generation ALK inhibitor ce­ritinib, according to results from the ASCEND-5 study reported at the 2016 European Society for Medical Oncology Congress by Giorgio Scagliotti, MD, Professor of Respiratory Medicine, University of Torino, Italy. [ Read More ]

Immunotherapy with Atezolizumab Outperforms Chemotherapy in Previously Treated NSCLC

Charles Bankhead

Lung Cancer

Copenhagen, Denmark—Immunotherapy competition in non–small-cell lung cancer (NSCLC) continued to heat up as atezolizumab (Tecentriq) improved overall survival (OS) versus docetaxel, according to results from the randomized, phase 3 OAK clinical trial reported at the 2016 European Society for Medical Oncology Congress by Fabrice Barlesi, MD, Professor of Medicine, Aix-Marseille University, France. [ Read More ]

Adding Pembrolizumab to Chemotherapy as First-Line Treatment Significantly Improves Outcomes in Patients with Advanced NSCLC

Charles Bankhead

Lung Cancer

Copenhagen, Denmark—Immunotherapy for advanced non–small-cell lung cancer (NSCLC) took a step toward first-line indication as results from a randomized clinical trial showed that patients who received pembrolizumab (Keytruda) plus chemotherapy had a significantly higher response rate compared with patients who received chemotherapy alone, reported Corey J. Langer, MD, Abramson Cancer Center of the University of Pennsylvania, Philadelphia, at the 2016 European Society for Medical Oncology (ESMO) Congress. The clinical trial results (KEYNOTE-021) were also published in Lancet Oncology, and are available online. [ Read More ]

Adjuvant Sunitinib Therapy Improves Outcomes in Clear-Cell Renal-Cell Carcinoma

Phoebe Starr

Renal-Cell Carcinoma

Copenhagen, Denmark—For the first time, a randomized clinical trial has shown that adjuvant therapy improves outcomes in patients with clear-cell renal-cell carcinoma (RCC). Adjuvant treatment with sunitinib (Sutent) improved disease-free survival (DFS) by >1 year in patients with high-risk locoregional RCC after nephrectomy, according to results from the S-TRAC clinical trial. Although this is encouraging news, at the 2016 European Society for Medical Oncology Congress some experts noted they were not ready to adopt it as a new standard of care, because of the associated toxicity and lack of an overall survival benefit. [ Read More ]

Rethinking Radiotherapy for Early-Stage Hodgkin Lymphoma

Nick Bryant

NCCN Hematologic Cancers Highlights

New York, NY—In a presentation at the 2016 National Comprehensive Cancer Network (NCCN) Congress on Hematologic Malignancies, Ranjana H. Advani, MD, Saul Rosenberg Professor of Lymphoma, Stanford University Medical Center, CA, and Vice Chair of the NCCN’s non-Hodgkin and Hodg­kin lymphoma guidelines panel questioned the necessity of using radiotherapy in patients with stage I or stage II Hodgkin lymphoma. [ Read More ]

NCCN Unveils New Clinical Guidelines for Myelofibrosis

Nick Bryant

NCCN Hematologic Cancers Highlights

New York, NY—Myeloproliferative neoplasms (MPNs) include myelofibrosis, polycythemia vera, and essential thrombocytopenia, and affect an estimated 295,00 individuals in the United States. MPNs represent a diverse array of diseases. This has led to the generation of various treatment guidelines that are often contradictory and difficult to interpret. However, the National Comprehensive Cancer Network (NCCN) is developing a unified field theory on the diagnosis and treatment of MPNs. [ Read More ]

Disparities in Rehospitalization Rates Among Patients with Advanced Cancer

Chase Doyle

Palliative Care

San Francisco, CA—In addition to being costly for public and private payers, hospital readmissions can lead to increased risk for complications, hospital-acquired infections, and psychological distress in patients with advanced cancer. Although preventing readmissions would improve patient outcomes and decrease healthcare costs, the underlying causes of rehospitalization are not completely understood, suggested Robin L. Whitney, RN, PhD, Betty Irene Moore School of Nursing, University of California, Davis, and colleagues in a poster presentation at the 2016 Palliative Care in Oncology Symposium. [ Read More ]

Trajectory of Illness and Distress in Patients Undergoing Stem-Cell Transplantation

Chase Doyle

Palliative Care

San Francisco, CA—As a result of recent advances in therapy, indications for stem-cell transplant are expanding, along with the number of patients eligible for the procedure. However, the intense and cure-oriented nature of transplants can lead to various forms of distress in patients who undergo this treatment, said Christina K. Ullrich, MD, MPH, Pediatric Oncology, Dana-Farber Cancer Institute, Boston, MA, at the 2016 Palliative Care in Oncology Symposium. [ Read More ]

Managing Delirium in Patients with Cancer

Meg Barbor, MPH

Symptom Management

Delirium is an exceedingly prevalent syndrome among patients with cancer, but is underrecognized and undertreated, according to Alan Valentine, MD, Chair, Department of Psychiatry, The University of Texas M.D. Anderson Cancer Center, Houston, and Darryl Etter, PsyD, Clinical Psychologist, VA Eastern Colorado Health Care System, Denver, at a webinar hosted by the American Psychosocial Oncology Society in July 2016. [ Read More ]

SGX942 Decreases Duration of Severe Oral Mucositis in Patients with Head and Neck Cancer

Meg Barbor, MPH

Symptom Management

Adelaide, Australia—SGX942, a novel agent that is first in its class, decreased the incidence of severe oral mucositis in patients with head and neck cancer undergoing chemoradiation, according to new research led by Oreola Donini, PhD, Senior Vice President and Chief Scientific Officer, Soligenix, Princeton, NJ, and Mahesh R. Kudrimoti, MD, Professor of Radiation Medicine, University of Kentucky, Lexington. [ Read More ]

Certain Measures Can Lower the High Cost of USP 800 Compliance

Meg Barbor, MPH

USP 800 Compliance

Chicago, IL—Maintaining a clean room compliant with US Pharmacopeial Convention Chapter 800 (USP 800) can come with a significant price tag, but noncompliance can drive up costs to oncology practices and institutions. However, certain measures can contribute to the successful construction, renovation, and maintenance of hazardous drug sterile compounding spaces in an oncology setting, according to Ryan A. Forrey, PharmD, MS, FASHP, Director of Pharmacy, Emory University Hospital Midtown, Atlanta, GA. Dr Forrey provided practical tips related to USP 800 compliance in clinical practice at the 2016 Annual Hematology/Oncology Pharmacy Association (HOPA) Oncology Pharmacy Practice Management Program. [ Read More ]