Value-Based Cancer Care Issues


August 2017, Vol 8, No 4 | Payers’ Perspectives In Oncology: ASCO 2017 Highlights

For additional coverage from the 2017 ASCO annual meeting, check out our Conference Correspondent highlights.

ASCO 2017 Conference Correspondent

Oncologists Must Begin to Discuss Financial Toxicity with Patients

Chase Doyle

Value-Based Care

Chicago, IL—The issues underlying financial toxicity are undoubtedly complex, but for oncologists looking to help their patients cope, simply noting the cost of treatment from the outset may be the best place to start. As the cost of cancer care continues to rise, greater transparency throughout the process of drug pricing and drug payment needs to become part of the clinical discussion, said Leonard Saltz, MD, Chief, Gastrointestinal Oncology Service, Memorial Sloan Kettering Cancer Center, New York City, at the 2017 ASCO annual meeting. [ Read More ]

Adoptive T-Cell Therapy: Ready for Prime Time

Chase Doyle

Immunotherapy

Chicago, IL—Chimeric antigen receptor (CAR) T-cell therapy is changing cancer care. In 2010, there were just 3 CAR T-cell clinical trials. As of May 2017, 183 clinical trials are underway, and for the first time, there are more clinical trials in China than in the United States, according to Carl H. June, MD, Director, Translational Research Program, University of Penn­­sylvania, Philadelphia, at the 2017 ASCO annual meeting. Dr June discussed how this rapidly evolving technology is taking immuno-oncology to the “next level” of precision medicine. [ Read More ]

Novel Drug “Home Run” for TRK Mutation–Positive Tumors

Phoebe Starr

Emerging Therapies

Chicago, IL—Larotrectinib (LOXO-101), an investigational agent that targets tropomyosin receptor kinase (TRK) fusions, has demonstrated excellent, consistent, and durable antitumor activity in a range of tumor types in adults and children, reported lead investigator David M. Hyman, MD, Chief, Early Drug Development Service, Memorial Sloan Kettering Cancer Center, New York City, at the 2017 ASCO annual meeting. Larotrectinib was called “the first oral tumor-agnostic therapy,” because of its unprecedented high response rates in 17 tumor types that express TRK. [ Read More ]

Dacomitinib Represents Potential New Targeted Therapy for EGFR Mutation–Positive Lung Cancer

Wayne Kuznar

Emerging Therapies

Chicago, IL—The investigational, second-generation EGFR inhibitor dacomitinib reduced the risk for disease progression compared with gefitinib as first-line therapy for patients with advanced non–small-cell lung cancer (NSCLC) and EGFR mutation. Results from the phase 3 ARCHER 1050 clinical trial demonstrated a >40% reduction in the risk for disease progression and an average 6.5-month improvement in the duration of response with dacomitinib versus gefitinib. [ Read More ]

Novel Assay Provides 100 Times More Information Than Current Liquid Biopsies for Early Cancer Detection

Phoebe Starr

Emerging Therapies

Chicago, IL—A new high-intensity genomic sequencing strategy (developed by Grail Inc) detects circulating tumor DNA (ctDNA) at a high rate. The new approach is a major improvement on previous tests using ctDNA, which focus on a limited number of driver mutations to inform treatment strategies for metastatic disease or to monitor disease burden. The new test offers ultra-deep sequencing with a broad genomic coverage, but it is not ready for prime time to detect occult cancer. At present, the test is a research platform and is not commercially available. [ Read More ]

In Chronic Myeloid Leukemia, Selection of Tyrosine Kinase Inhibitors Depends on Variables Other Than Survival

Wayne Kuznar

Leukemia

Chicago, IL—Survival with the use of a tyrosine kinase inhibitor (TKI) approved for the treatment of chronic myeloid leukemia (CML) in the chronic phase is comparable among the available drugs, so other variables should come into play when selecting a specific TKI. In some instances, a treatment-free remission is possible, said CML experts at the 2017 ASCO annual meeting. [ Read More ]

FDA News – August 2017

FDA News & Updates

  • Enasidenib, a New Targeted Therapy Approved for Relapsed or Refractory AML, Shows Complete Remission in Some Patients
  • Ibrutinib First Treatment Approved by the FDA for Chronic Graft-versus-Host Disease
  • Vyxeos First Treatment Approved Specifically for 2 Types of High-Risk AML
  • First CAR T-Cell Therapy Unanimously Recommended by FDA Advisory Committee for Treatment of B-Cell ALL in Children and Young Adults
[ Read More ]

Checkpoint Inhibitors Show Promise in Patients with Mesothelioma

Phoebe Starr

Immunotherapy

Chicago, IL—Immunotherapy holds promise as second-line or third-line treatment of patients with malignant pleural mesothelioma, a rare cancer with increasing incidence. Early findings from the ongoing, phase 2 MAPS-2 clinical trial showed that immunotherapy slowed the growth of malignant pleural mesothelioma after relapse, reported lead investigator Arnaud Scherpereel, MD, PhD, Head, Pulmonary and Thoracic Oncology Department, University Hospital of Lille, France, at the 2017 ASCO annual meeting. MAPS-2 is the largest clinical trial to date of immune checkpoint inhibitor therapy in patients with malignant pleural mesothelioma. [ Read More ]

Daratumumab Added to Carfilzomib, Lenalidomide, and Dexamethasone: Safe and Tolerable in Patients with Newly Diagnosed Multiple Myeloma

Chase Doyle

Multiple Myeloma

Chicago, IL—In patients with newly diagnosed multiple myeloma, the addition of daratumumab to carfilzomib (Kyprolis), lenalidomide (Revlimid), and dexamethasone (ie, the KRd regimen) is showing promise as a frontline treatment regimen. According to the results of an open-label, phase 1b study presented at ASCO 2017, induction therapy with the KRd regimen was well-tolerated, and the overall safety profile was consistent with previous reports for KRd, with no additional toxicity observed with the addition of daratumumab. Moreover, the study investigators reported that the regimen was very effective, with 100% overall response rate observed. [ Read More ]

Olaparib First PARP Inhibitor to Show Advantage in BRCA-Positive Breast Cancer

Wayne Kuznar

Breast Cancer

Chicago, IL—The PARP inhibitor olaparib (Lynparza) significantly improved progression-free survival (PFS) compared with standard chemotherapy in women with HER2-negative metastatic breast cancer with a germline BRCA mutation. Disease progression was delayed by approximately 3 months with olaparib in the multinational, randomized, open-label, phase 3 OlympiAD clinical trial, reported Mark E. Robson, MD, Clinic Director, Clinical Genetics Service, Memorial Sloan Kettering Cancer Center, New York City, at the 2017 ASCO annual meeting. [ Read More ]

Osimertinib Extends Progression-Free Survival in EGFR T790M–Positive Lung Cancer with CNS Metastases

Wayne Kuznar

Lung Cancer

Chicago, IL—Osimertinib (Tagrisso) extends progression-free survival (PFS) compared with standard chemotherapy in patients with EGFR T790M mutation–positive non–small-cell lung cancer (NSCLC) who have central nervous system (CNS) metastases, reported Marina C. Garassino, MD, Thoracic Oncology Unit, Medical Oncology Department, Fondazione IRCCS Istituto Nazionale dei Tumori, Milan, Italy, at the 2017 ASCO annual meeting. [ Read More ]

Abemaciclib, a New CDK4/CDK6 Inhibitor, Added to Fulvestrant Extends PFS in Advanced HR-Positive, HER2-Negative Breast Cancer

Phoebe Starr

Breast Cancer

Chicago, IL—The addition of the investigational CDK4/CDK6 inhibitor abemaciclib to fulvestrant (Faslodex) extended progression-free survival (PFS) by 7 months in women with hormone receptor (HR)-positive, HER2-negative advanced breast cancer, reported George W. Sledge, Jr, MD, Professor, Medical Oncology, Stanford University Medical Center, Palo Alto, CA, who presented the results of a large study at the 2017 ASCO annual meeting. [ Read More ]

Less Is More: Low-Risk Stage III Colon Cancer Safely Treated with Only 3 Months of Adjuvant Chemotherapy

Phoebe Starr

Colon Cancer

Chicago, IL—The global International Duration Evaluation of Adjuvant Chemotherapy (IDEA) study suggests that some patients with surgically resected stage III colon cancer can safely and effectively receive only 3 months of chemotherapy instead of the standard 6 months. The data were particularly convincing for patients with low-risk, surgically resected stage III colon cancer. These data set a new standard for the treatment of patients with stage III colon cancer, according to expert opinion presented at the 2017 ASCO annual meeting. [ Read More ]