Value-Based Cancer Care Issues


January/February 2019, Vol 10, No 1 | Payers’ Perspectives In Oncology: ASH 2018 Highlights

View Additional ASH 2018 Converage on AHDB

Rapid Progress in Aggressive Hematologic Malignancies Highlighted at ASH 2018

Wayne Kuznar

Hematologic Malignancies

San Diego, CA—The 60th Annual Meeting of the American Society of Hematology drew more than 25,000 attendees from across the globe who were seeking information on the rapid pace of progress in hematology. Updates on the panoply of immunotherapies for B-cell malignancies, including chimeric antigen receptor (CAR) T-cell therapy, and the impressive progress made in the management of multiple myeloma and chronic lymphocytic leukemia (CLL) were highlighted in the scientific sessions. [ Read More ]

MURANO: Venetoclax-Rituximab at Fixed Duration Beats Chemo­immunotherapy in Relapsed/Refractory CLL

Phoebe Starr

Leukemia

San Diego, CA—A 2-year duration of combination immunotherapy with ven­etoclax (Venclexta) and rituximab (Ri­tuxan) improved survival compared with standard-of-care chemoimmunotherapy combination with bendamustine (Ben­deka) plus rituximab in patients with relapsed or refractory chronic lymphocytic leukemia (CLL), according to follow-up data from the MURANO clinical trial presented at ASH 2018. Early results were first presented at ASH 2017. [ Read More ]

Explosive Development of BCMA CAR T-Cell Therapies for Multiple Myeloma

Phoebe Starr

Immunotherapy, Multiple Myeloma

San Diego, CA—A dizzying array of new chimeric antigen receptor (CAR) T-cell therapies targeting the B-cell maturation antigen (BCMA) designed specifically for the treatment of multiple myeloma was presented at ASH 2018. BCMA-targeted CAR T-cell therapies are designed to improve T-cell persistence, depth of response, and tolerability. Response rates reported at ASH 2018 range from 70% to 100%, depending on the patient population and the use of previous regimens. [ Read More ]

Durable Responses to CAR T-Cell Therapy in B-Cell Lymphomas

Phoebe Starr

Immunotherapy

San Diego, CA—Longer-term follow-up of 2 large pivotal clinical trials in B-cell malignancies has demonstrated continuing remissions after chimeric antigen ­receptor (CAR) T-cell therapy: the ELIANA study in pediatric patients and young adults with relapsed or refractory B-acute lymphoblastic leukemia (B-ALL) and the JULIET study in adult patients with diffuse large B-cell lymphoma (DLBCL). Both updates were presented at a press conference at ASH 2018. [ Read More ]

First-Line Ibrutinib Improves Outcomes Compared with Current Standard of Care in Older Patients with Chronic Lymphocytic Leukemia

Wayne Kuznar

Leukemia

San Diego, CA—Front-line ibrutinib (Imbruvica) therapy results in a lower rate of disease progression or death than the current standard-of-care chemoimmunotherapy with bendamustine (Ben­deka) and rituximab (Rituxan) in older patients with chronic lymphocytic leukemia (CLL). Adding rituximab to ibrutinib did not improve outcomes compared with ibrutinib alone, reported Jennifer A. Woyach, MD, Associate Professor, Ohio State University Comprehensive Cancer Center, Columbus, at ASH 2018. [ Read More ]

Olaparib Maintenance Extends Progression-Free Survival in Advanced Ovarian Cancer

In the Literature

Currently, there are limited therapies to prevent or delay recurrence in advanced ovarian cancer, with approximately 70% of patients having a recurrence within 3 years. The effectiveness of olaparib, an oral poly (ADP-ribose) polymerase inhibitor, in relapsed disease has been well-established; however, its benefit as a maintenance therapy in newly diagnosed advanced ovarian cancer is uncertain. In a recent study, researchers evaluated the efficacy of upfront maintenance therapy with olaparib in patients with newly diagnosed, advanced BRCA-positive ovarian cancer. [ Read More ]

Ibrutinib Superior to Standard Chemoimmunotherapy in Older Patients with CLL

In the Literature

Chemoimmunotherapy with chlor­ambucil plus obinutuzumab or bendamustine plus rituximab is standard frontline treatment for older patients with chronic lymphocytic leukemia (CLL). However, chemoimmunotherapy is associated with toxic effects, and the risk increases with age. For patients with CLL, frontline ibrutinib monotherapy is widely used in clinical practice. The benefit of this Bruton’s tyrosine kinase (BTK) inhibitor versus standard chemoimmunotherapy remains a critical consideration, which led researchers to conduct a head-to-head phase 3 study to evaluate the efficacy of ibrutinib, either alone or in combination with rituximab, relative to chemoimmunotherapy. [ Read More ]

Hospital Readmissions for Venous Thromboembolism a Substantial Cost in Patients with Cancer

Chase Doyle

Value-Based Care

San Diego, CA—Real-world data highlight the significant clinical and economic burden associated with venous thromboembolism (VTE) in patients with cancer. The data come from a study of 12,785 patients hospitalized with acute illnesses, of which 2002 patients had cancer. The results were presented at ASH 2018 and showed that 3.9% of patients with cancer experienced a VTE event requiring rehospitalization—the highest proportion of patients among the study population. Moreover, 28.2% of VTE-related readmissions occurred within the first 30 days of initial hospital discharge. [ Read More ]