Value-Based Cancer Care Issues


October 2019, Vol 10, No 5

Oral Parity Laws Could Reduce Disparities in Cancer Care

Chase Doyle

Disparities in Oncology

San Diego, CA—Great progress has been made in the fight against cancer, but not all patients have benefited equally. Disparities exist among specific populations in terms of survival and cancer-related mortality, incidence and prevalence, as well as adverse health conditions, according to Karen M. Winkfield, MD, PhD, Director, Office of Cancer Health Equity, Wake Forest Baptist Medical Center Comprehensive Cancer Center, Winston-Salem, NC. Dr Winkfield discussed the topic at the 2019 ASCO Quality Care Symposium. [ Read More ]

Oral Cancer and Sex in the Era of HPV Infection

Meg Barbor, MPH

Head and Neck Cancer

San Francisco, CA—The increasing rate of infection with the human papilloma­virus (HPV) in the United States has changed the field of head and neck cancer, or oral cancer, and HPV infection now causes a growing majority (70%-90%) of oropharyngeal squamous-cell carcinomas. As its incidence is rising, so is patients’ curiosity about what sets this cancer apart from other malignancies. [ Read More ]

Adding CDK4/6 Inhibitor to Endocrine Therapy Improves Survival in Advanced Breast Cancer: New Standard of Care

Phoebe Starr

ESMO 2019

Barcelona, Spain—Late-breaking data from 2 clinical trials presented at ESMO 2019 will likely change the treatment paradigm for pre- or postmenopausal women with hormone receptor (HR)-­positive, HER2-negative breast cancer, regardless of menopausal status. The MONALEESA-3 study and the MONARCH-2 study showed an improved overall survival (OS) with the addition of the CDK4/6 inhibitor ribociclib (Kisqali) or abemaciclib (Verzenio) to endocrine therapy as first- or second-line therapy. The results were presented at the Presidential Session of the meeting. [ Read More ]

Rozlytrek Third FDA-Approved Tumor-Agnostic Drug and Second Treatment for Patients with NTRK Fusion Tumors

FDA Approvals, News & Updates

On August 15, 2019, the FDA accelerated the approval of entrectinib (Rozlytrek; Genentech), an oral kinase inhibitor, for the treatment of adults and adolescents whose cancer involves neurotrophic tyrosine receptor kinase (NTRK) gene fusion that has no effective treatments. The FDA granted entrectinib a priority review and breakthrough therapy and orphan drug designations. This is the third cancer drug approved by the FDA based on a common biomarker and the second drug for patients with NTRK gene fusion. [ Read More ]

Turalio First FDA-Approved Systemic Therapy for Tenosynovial Giant-Cell Tumor

FDA Approvals, News & Updates

On August 2, 2019, the FDA approved pexidartinib (Turalio; Daiichi Sankyo) capsules, a kinase inhibitor, for adults with symptomatic tenosynovial giant-cell tumor (TGCT), which is associated with severe morbidity or functional limitations, who are not candidates for surgery. Pexidartinib is the first systemic therapy approved for patients with TGCT. The FDA granted pexidartinib a priority review and breakthrough therapy and orphan drug designations. [ Read More ]

Keytruda plus Lenvima Combo FDA Approved for Advanced Endometrial Carcinoma with No MSI-H or dMMR Tumors

FDA Approvals, News & Updates

On September 17, 2019, the FDA accelerated the approval of a new combination of pembrolizumab (Keytruda; Merck) plus lenvatinib (Lenvima; Eisai) for patients with advanced endometrial carcinoma that is not associated with microsatellite instability high (MSI-H) or mismatch repair–deficient (dMMR) tumors in patients whose disease progressed after systemic therapy and who are candidates for curative surgery or radiation. The FDA granted this application priority review and a breakthrough therapy designation. [ Read More ]

FDA Approves Daratumumab Combination for First-Line Treatment of Transplant-Eligible Patients with Multiple Myeloma

FDA Approvals, News & Updates

On September 26, 2019, the FDA approved daratumumab (Darzalex; Janssen Biotech), in combination with bortezomib (Velcade), thalidomide (Thalomid), and dexamethasone, for first-line treatment of multiple myeloma in patients eligible for autologous stem-cell transplant (ASCT). In June 2019, the FDA approved the combination of daratumumab plus lenalidomide (Revlimid) and dexamethasone for the treatment of patients with newly diagnosed multiple myeloma who are ineligible for ASCT. The FDA granted this application a priority review. [ Read More ]

Delivering High-Value Personalized Interventions

Chase Doyle

Value-Based Care

San Diego, CA—As the treatment landscape in oncology changes on a seemingly daily basis, providers face increasingly complex decisions, and it is not just the myriad of therapies available: oncologists must balance drug efficacy and toxicity, clinical outcomes, and patient quality of life, all while providing value-based care. Enter clinical pathways, a multidisciplinary management tool used to guide evidence-­based care for subgroups of patients with predictable clinical courses. [ Read More ]

Patient-Centered Clinical Pathways Should Incorporate the Patient’s Voice

Chase Doyle

Clinical Pathways

San Diego, CA—Patient-centered clinical pathways may hold the promise of truly personalized medicine, improving value-based care and clinical outcomes. However, according to Cary P. Gross, MD, Director, Cancer Outcomes, Public Policy and Effectiveness Research Center, Yale School of Medicine, New Haven, CT, substantial challenges still stand in the way of including the patient’s voice in these pathways. [ Read More ]

Lost Earnings from Cancer-Related Deaths Cost the United States $94 Billion in 2015

In the Literature

In a new analysis, researchers examined the estimated cost of lost earnings that resulted from cancer-related deaths in the United States, nationally and by state. This study is not the first to examine the economic burden of cancer deaths in the United States. However, the study does provide contemporary estimates of person-years of life lost (PYLL) as a result of cancer deaths and the associated lost earnings at the national and state levels for all cancers combined (Islami F, et al. JAMA Oncol. 2019 Jul 3 [Epub ahead of print].). [ Read More ]

Long-Term Data Confirm Survival Benefit for Pembrolizumab in Advanced NSCLC

Phoebe Starr

Lung Cancer

Chicago, IL—Treatment with the immune checkpoint inhibitor pembroliz­umab (Keytruda) dramatically improved 5-year survival for patients with advanced non–small-cell lung cancer (NSCLC) compared with expected survival in the preimmunotherapy era, according to the 5-year follow-up data from the phase 1b KEYNOTE-001 clinical trial. The study was presented at ASCO 2019 and was published simultaneously in the Journal of Clinical Oncology. [ Read More ]

Neoantigens Are Effective Targets for Developing Cancer Vaccines

Wayne Kuznar

Emerging Therapies

Chicago, IL—Tumor-specific antigens provide personalized targets for immunotherapy. Neoantigen vaccines are a new type of immunotherapy that can elicit immune response and achieve remission. Evidence is compelling to support neoantigens as the target of effective immune responses against cancer and to support an association between neoantigen load with improved clinical outcome, said Patrick Alexander Ott, MD, PhD, Clinical Director, Center for Immuno-Oncology, Dana-Farber Cancer Institute, Boston, MA, at ASCO 2019. [ Read More ]

Patients with Medicaid or No Insurance Have Worse Survival in Clinical Trials

Chase Doyle

Clinical Trials

San Diego, CA—New research sponsored by the National Cancer Institute highlights the uphill battle faced by patients with limited financial resources even in clinical trials. According to data presented at the 2019 ASCO Quality Care Symposium, patients with Medicaid or with no insurance had significantly worse overall survival in positive clinical trials compared with privately insured patients. [ Read More ]

Noninvasive Molecular Diagnosis Using Circulating DNA Sequencing Improves Outcomes in Cholangiocarcinoma Management

Wayne Kuznar

Cholangiocarcinoma

Diagnosis of cholangiocarcinoma (CCA) is often identified at a late stage. Analyzing the tumor-specific mutation profile of a patient with CCA can improve the diagnosis and treatment for the individual patient. The molecular profile of CCA can be done through the use of circulating tumor (ct) DNA sequencing, which may help to target specific mutations and improve treatment selection for this rare type of cancer. [ Read More ]

Inaugural Employer-Provider Interface Council Conference Explores Value in Healthcare

Zachary R. Babcock, PhD; F. Randy Vogenberg, PhD

Employers’ Perspective

In today’s fast-paced healthcare environment, managing health benefits requires dexterity, foresight, and collaboration. At the inaugural multistakeholder Employer-Provider Interface Council (EPIC) of the Hospital Quality Foundation interactive Leadership Conference that took place on June 11, 2019, the relationships among employer plan sponsors, employee healthcare consumers, and healthcare providers were explored. To understand how health benefits are managed to deliver value to stakeholders, several speakers discussed the importance of how to define and derive value in the rapidly changing healthcare industry. Each presentation was followed by reactions from a stakeholders panel from various segments of the healthcare industry, including consumer advocacy, employer, payer, government, and provider. [ Read More ]