Articles

Dose-optimized nilotinib (Tasigna) increased the rates of major molecular response in patients with newly diagnosed chronic myeloid leukemia (CML) in the chronic phase (CP) in the Evaluating Nilotinib Efficacy and Safety in Clinical Trials-Extending Molecular Responses (ENESTxtnd) study. According to the final results of this study presented at ASH 2015, the cumulative major molecular response rates were 70.8% by 12 months and 81.0% by 24 months in patients managed with the dose optimization strategy.

With the accelerated FDA approval in December 2015 of the anti-CD38 monoclonal antibody daratumumab (Darzalex) for patients with multiple myeloma who received ≥3 previous therapies, studies of the drug presented at ASH 2015 were of great interest.

The immunostimulatory monoclonal antibody elotuzumab (Empliciti), which was approved by the FDA in December 2015, is being studied in combination with immunomodulatory drugs and proteasome inhibitors in patients with relapsed or refractory multiple myeloma. Results presented at ASH 2015 show continued benefit from these regimens.

With the recent FDA approval of the first oral proteasome inhibitor ixazomib (Ninlaro), patients with relapsed or refractory multiple myeloma who have received previous treatment now have access to an all-oral regimen. The FDA-indicated triplet regimen of ixazomib, lenalidomide (Revlimid), and dexamethasone (Decadron) significantly improved progression-free survival (PFS) compared with the doublet of lenalidomide and dexamethasone, reported Philippe Moreau, MD, University of Nantes, France, at ASH 2015.

Medicare is poised to incorporate new quality metrics as a guide for payments. At ASH 2015, Helen Burstin, MD, MPH, Chief Scientific Officer, National Quality Forum, Washington, DC, discussed the need for measures and reporting systems that reflect patient care and care coordination.

Given the high cost of care for acute leukemia, innovative payment strategies that reward longitudinal care and create economic incentives for data-driven care delivery are needed, according to Joseph Alvarnas, MD, Director of Value-Based Analytics, and Associate Clinical Professor of Hematology and Hematopoietic Cell Transplantation, City of Hope, Duarte, CA.

Medicare has initiated several programs in the past decade to encourage value, but questions remain regarding their effectiveness. At ASH 2015, Andrew Ryan, PhD, MA, Associate Professor of Health Management and Policy, University of Michigan School of Public Health, Ann Arbor, addressed the implications of using financial incentives to drive care quality and reduce cost.

Many presentations at ASH 2015 focused on novel therapies currently in development for the treatment of patients with hematologic malignancies, including a second generation of new agents recently approved by the FDA for a variety of hematologic cancers.

With $137 billion and growing spent on treatment in the US healthcare annually, cancer care delivery poses a significant challenge. At a special session at ASH 2015 on new payment models, Michael Kolodziej, MD, National Medical Director for Oncology Solutions at Aetna, discussed pathways and the medical home as transitional solutions to value in cancer care.

The multikinase inhibitor midostaurin is the first targeted therapy to improve overall survival (OS) in patients with acute myeloid leukemia (AML) and the FLT3 mutation.