Value-Based Cancer Care Issues


June 2019, Vol 10, No 3

Expert Panel Discusses Access to CAR T-Cell Therapy

Wayne Kuznar

2019 NCCN Conference

Orlando, FL—With price tags approaching $1 million or more for delivery of certain immune cell therapies, new payment models will be needed to ensure access to these therapies and to further innovations. This was a key issue addressed at a roundtable discussion at the 2019 National Comprehensive Cancer Network (NCCN) Conference. Ensuring access to chimeric antigen receptor (CAR) T-cell therapy emerged as a top area of concern. [ Read More ]

Call to Action: Greater Focus on Metastatic Cancer Survivors Is Needed

Eileen Koutnik-Fotopoulos

Metastatic Cancer

Two cancer experts at Johns Hopkins Kimmel Cancer Center in Baltimore, MD, are advocating for greater focus on metastatic cancer survivorship and its impact on those living with incurable cancer, a situation they know all too well. Both are living with metastatic cancer and are urging the medical community to increase the study and awareness of this condition and improve the lives of this growing population. [ Read More ]

Assessment of Opioid Misuse and Abuse Should Be Part of Cancer Pain Management

Wayne Kuznar

2019 NCCN Conference

Orlando, FL—Maintaining patient safety and minimizing the risks for opioid misuse and abuse in the management of cancer pain require proper assessment and new strategies for pain management that include integrative interventions, according to Judith A. Paice, PhD, RN, Director, Cancer Pain Program, Robert H. Lurie Comprehensive Cancer Center, Northwestern University, Chicago. She discussed this topic at the 2019 National Comprehensive Cancer Network (NCCN) Conference. [ Read More ]

New Targeted Therapies for Metastatic Colorectal Cancer Recommended in the Updated NCCN Guideline

Wayne Kuznar

2019 NCCN Conference, Colorectal Cancer

Orlando, FL—A growing number of targeted therapies and immunotherapies are now recommended in the updated National Comprehensive Cancer Network (NCCN) guideline for metastatic colorectal cancer (CRC). New first-line immunotherapy options for patients with mismatch repair deficiency (dMMR) and microsatellite instability-high (MSI-H) CRC are also listed in the new guideline. [ Read More ]

CAR T-Cell Therapy Augments Response to Ibrutinib in Chronic Lymphocytic Leukemia

Phoebe Starr

Leukemia

San Diego, CA—Results with chimeric antigen receptor (CAR) T-cell therapy have been less robust in chronic lymphocytic leukemia (CLL) compared with B-cell acute lymphocytic leukemia and diffuse large B-cell lymphoma. Preliminary studies presented at ASH 2018 suggested that a strategy of using CAR T-cell therapy to augment the response to ibrutinib (Imbruvica) holds promise in patients with CLL. [ Read More ]

Paradigm Shift: Ibrutinib plus Rituximab Front-Line Therapy for Patients Age 70 or Younger with CLL

Phoebe Starr

Leukemia

San Diego, CA—The combination of the targeted therapy ibrutinib (Imbruvica), a protein kinase inhibitor, and the monoclonal antibody rituximab (Rituxan) extends disease-free survival by 65% and overall survival (OS) by 83% compared with standard-of-care chemotherapy with the fludarabine plus cyclophosphamide and rituximab (FCR) regimen as first-line therapy in patients with chronic lymphocytic leukemia (CLL) under age 70, according to results of the phase 3 ECOG-ACRIN 1912 trial presented at a late-breaking abstract session at ASH 2018. [ Read More ]

Osimertinib plus Savolitinib Promising for Advanced Non–Small-Cell Lung Cancer and MET-Driven Resistance

Phoebe Starr

Lung Cancer

Atlanta, GA—The combination of the investigational MET inhibitor savolitinib plus the EGFR inhibitor osimertinib (Tagrisso) achieved encouraging responses in patients with MET-amplified, EGFR-positive non–small-cell lung cancer (NSCLC) and acquired, MET-driven resistance to previous therapies, with an acceptable side-effect profile. These findings represent interim results of 2 expansion cohorts of a phase 1b clinical trial presented at the 2019 American Association for Cancer Research meeting. [ Read More ]

Balversa First Targeted Drug FDA Approved for Metastatic Bladder Cancer with FGFR Genetic Alterations

FDA Approvals, News & Updates

On April 12, 2019, the FDA accelerated the approval of erdafitinib (Balversa; Janssen), a fibroblast growth factor receptor (FGFR) kinase inhibitor, for the treatment of adults with locally advanced or metastatic urothelial carcinoma and a susceptible FGFR3 or FGFR2 genetic alteration, as detected by an FDA-approved test, whose disease progressed after platinum-containing chemotherapy, making it the first targeted drug to receive approval for this patient population. [ Read More ]

Tibsovo Now Indicated for First-Line Treatment of Patients with AML and IDH1 Mutation

FDA Approvals, News & Updates

On May 2, 2019, the FDA approved ivosidenib (Tibsovo; Agios) for patients with newly diagnosed acute myeloid leukemia (AML) and a susceptible IDH1 mutation, as detected by an FDA-approved test, in patients aged ≥75 years or those who have comorbidities that preclude the use of intensive induction chemotherapy. Ivosidenib was originally approved in 2018 for relapsed or refractory AML with IDH1 mutation. [ Read More ]

Piqray First PI3K Inhibitor Approved by the FDA for Metastatic Breast Cancer and PI3KCA Mutation

FDA Approvals, News & Updates

On May 24, 2019, the FDA approved Piqray (alpelisib; Novartis), an oral PIK3 inhibitor, in combination with endocrine therapy with fulvestrant (Faslodex), for the treatment of postmenopausal women, as well as men, with hormone receptor (HR)-positive, HER2-negative advanced or metastatic breast cancer and PIK3CA mutation (as detected by an FDA-approved test) that progressed during or after an ­endocrine-based treatment regimen. The FDA used its priority review designation to consider the application of alpelisib. [ Read More ]

Infigratinib a Novel, Potent Selective TKI Targeting FGFR Fusions in Different Tumor Types

Phoebe Starr

Emerging Therapies

Atlanta, GA—Preclinical and clinical data support the potential for the investigational novel tyrosine kinase inhibitor (TKI) infigratinib for the treatment of different FGFR-driven tumor types, according to Sameek Roychowdhury, MD, PhD, Associate Professor, Medical Oncology, the Ohio State University, Columbus, who presented a poster with the preclinical results at the 2019 American Association for Cancer Research (AACR) meeting. [ Read More ]

First Positive Showing for Mesothelin-Directed CAR T-Cell Therapy in Solid Tumors

Phoebe Starr

Immunotherapy

Atlanta, GA—Chimeric antigen receptor (CAR) T-cell therapy has had dramatic results in hematologic malignancies, but so far, getting CAR T-cells to work in solid tumors has proved elusive. That may be about to change if promising results from a phase 1 clinical trial are confirmed by further studies. The results of this pivotal study were presented at the 2019 American Association for Cancer Research (AACR) annual meeting. [ Read More ]

Can Immunotherapy Work in Ovarian Cancer?

Wayne Kuznar

Immunotherapy, Ovarian Cancer

San Francisco, CA—Patients with ovarian cancer can respond to immunotherapy, but rationally designed synergistic combinations will be necessary to enhance upfront efficacy and to sustain durability, said Daniel J. Powell Jr, PhD, Scientific Director of Immunotherapy, Division of Gynecologic Oncology, Center for Cellular Immunotherapy, University of Pennsylvania, Philadelphia, at the 2019 ASCO-SITC Clinical Immuno-Oncology Symposium. [ Read More ]

Evolving Immuno-Oncology Strategies in Renal-Cell Carcinoma

Wayne Kuznar

Immunotherapy

San Francisco, CA—The era of immunotherapy has opened new perspectives in renal-cell carcinoma (RCC), which is one of the tumors most highly infiltrated with CD T-cells and PD-1 expression, partially accounting for its sensitivity to immunotherapy. Other mechanisms to explain its sensitivity include myeloid infiltration, metabolic alterations, loss-of-function mutations, and human endogenous retroviruses. [ Read More ]

Durvalumab plus Tremelimumab Immunotherapy Combination Extends Survival in Refractory Colorectal Cancer

Wayne Kuznar

Immunotherapy

San Francisco, CA—The combination of the PD-1 inhibitor durvalumab ­(Imfinzi) and the investigational CTLA-4 inhibitor tremelimumab plus best supportive care improved overall survival (OS) by more than 2 months versus best supportive care alone in a phase 2 clinical trial of patients with refractory colorectal cancer (CRC), reported Eric Xueyu Chen, MD, PhD, Staff Oncologist, Princess Margaret Cancer Centre, Toronto, Canada, at the 2019 Gastrointestinal Cancers Symposium. [ Read More ]

Adding PARP Inhibitor to Immune Checkpoint Blockade Improves Responses in Ovarian Cancer with BRCA Mutations

Wayne Kuznar

Ovarian Cancer

San Francisco, CA—Ovarian cancers with BRCA mutations are less immunogenic than other DNA repair–deficient tumors. Targeting the DNA damage response using PARP inhibitors may help to improve the modest responses of ovarian cancer seen with single-agent immune checkpoint inhibitors, said ­Panagiotis A. Konstantinopoulos, MD, PhD, Director of Translational Research, Division of Gynecologic Oncology, Dana-Farber Cancer Institute, Boston, at the 2019 ASCO-SITC Clinical Immuno-Oncology Symposium. [ Read More ]

T-DM1 Reduces Residual Invasive Disease in Patients with HER2-Positive Breast Cancer After Chemotherapy

Phoebe Starr

Breast Cancer

The adjuvant use of the antibody-drug conjugate trastuzu­mab emtansine (T-DM1; Kadcyla) led to a clinically meaningful and significant improvement in disease-free survival versus trastuzumab (Herceptin) in patients with HER2-positive early breast cancer and residual invasive disease, despite the use of neoadjuvant chemotherapy plus HER2-targeted therapy. [ Read More ]