September 2016, Vol 7, No 8

Total drug spending in the United States, based on invoice prices, reached $425 billion in 2015, according to the IMS Institute for Healthcare Informatics report, “Medicines Use and Spending in the U.S.: A Review of 2015 and Outlook to 2020.” When adjusted for net price spending, $310 billion went to drug and biotech companies, but where the other $115 billion went is often omitted from media coverage.

Immunotherapies have changed the way many patients with cancers, including patients with renal-cell carcinoma (RCC), are treated. Although some patients have a dramatic response to immunotherapies that appears to be sustained over the long-term, a large proportion of patients do not respond to treatment with programmed death (PD)-1 or PD ligand 1 (PD-L1) inhibitors. Therefore, the search continues for biomarkers that can help to determine which patients will likely respond to available checkpoint inhibitors, optimizing treatment selection.

When combined with systemic ipilimumab (Yervoy), the investigational oncolytic viral immunotherapy HF10, a mutation of the HF strain of the herpes simplex virus type 1 (HSV-1), has local and systemic activity in patients with metastatic melanoma, said Robert Andtbacka, MD, CM, Huntsman Cancer Institute, Salt Lake City, during a poster presentation at the 2016 American Society of Clinical Oncology meeting. He added that HF10 substantially improves the response rate of ipilimumab alone and does not exacerbate ipilimumab toxicity.

Collaborative oncology care, which involves incorporating an advanced practitioner (AP) into an oncology practice, will help meet the growing burden of complex care and improve patient satisfaction.

A meta-analysis of overall survival (OS) in 3 clinical trials of lenalidomide (Revlimid) maintenance therapy after high-dose melphalan (Alkeran) and autologous stem-cell transplantation (ASCT) for multiple myeloma showed long-term disease control and prolonged OS. A slightly increased risk for a secondary primary malignancy is outweighed by the OS benefit, said lead investigator Philip McCarthy, MD, Roswell Park Cancer Institute, Buffalo, NY, in an oral presentation at the 2016 American Society of Clinical Oncology annual meeting.

Venetoclax (Venclexta) monotherapy has significant clinical activity in patients with acute myelogenous leukemia (AML) whose disease has relapsed or is resistant to chemotherapy and in those deemed unable to tolerate chemotherapy, according to a new study. The overall response rate (ORR) for venetoclax in the phase 2 single-arm study was 19%, with complete remissions in some patients. This was the first study to examine venetoclax monotherapy in patients with relapsed or refractory AML or untreated AML who are unfit for intensive therapy.

Adding capecitabine chemotherapy to gemcitabine after pancreatic cancer resection was associated with longer overall survival (OS) than gemcitabine chemotherapy alone, according to results from the European Study Group for Pancreatic Cancer (ESPAC)-4 clinical trial. For the small proportion of patients with pancreatic cancer who are candidates for surgery, adjuvant gemcitabine chemotherapy is the current standard of care worldwide, said John P. Neoptolemos, MD, Chair of Surgery, University of Liverpool, United Kingdom, during an oral abstract session at the 2016 American Society of Clinical Oncology annual meeting. “We thought that the combination of gemcitabine plus capecitabine…may be better than gemcitabine alone, and launched the phase 3 ESPAC-4 trial,” he stated.

Pancreatic cancer is the third leading cause of cancer-related death in the United States. Nearly half of patients with locoregional pancreatic cancer do not undergo potentially curative surgery, primarily because of nonclinical factors, according to the results of an analysis of data from the National Cancer Institute database by Amy T. Cunningham, MPH, a doctoral candidate at Thomas Jefferson University in Philadelphia, and colleagues.