August 2016 Vol 9, Special Issue: Payers' Perspectives in Oncology

A gene-expression signature assay called ColDx (Almac Diagnostics) successfully identified high-risk patients with stage II colon cancer who would benefit from chemotherapy, according to results of a new, prospective analysis of the previously published phase 3 Alliance C9581 clinical trial. For patients with stage I colon cancer, surgery is the treatment of choice, whereas for stage III disease, patients receive adjuvant chemotherapy. For patients with stage II disease, however, the best approach to the therapy has not been well-defined.

Atezolizumab (Tecentriq) shows promise as primary therapy in patients with cisplatin-ineligible, locally advanced metastatic urothelial (bladder) cancer, according to data from the IMvigor210 study presented at ASCO 2016.

Extending aromatase inhibitor therapy with letrozole for an additional 5 years beyond standard treatment with letrozole improved disease-free survival (DFS) and reduced the rate of new contralateral breast cancer in postmenopausal women with estrogen receptor (ER)-positive breast cancer. Prolonged letrozole did not improve overall survival. These were the main findings of the large MA.17R trial, which were presented at the plenary session at ASCO 2016.

A durable complete response was achieved in a high proportion of adults with refractory B-cell malignancies who received CD19+ chimeric antigen receptor (CAR) T-cells made up of a defined 1:1 ratio of CD8+ and CD4+ cells.

Chimeric antigen receptor (CAR) T-cells have saved lives in some patients with acute lymphoblastic leukemia (ALL) who had run out of other treatment options. This type of immunotherapy is making inroads in other hematologic malignancies as well, but it is still being studied in very sick patients.

Adding the recently approved daratumumab (Darzalex), a human, CD38-directed monoclonal antibody, to a standard regimen of bortezomib (Velcade) and dexamethasone improved progression-free survival (PFS) by >60% compared with the standard regimen in patients with relapsed or refractory multiple myeloma, according to Antonio Palumbo, MD, Chief of the Multiple Myeloma Unit, University of Torino, Italy.

Interim results from a phase 1b study indicate that the investigational monoclonal antibody isatuximab, in combination with lenalidomide and dexamethasone, achieves responses in >50% of patients with relapsed or refractory multiple myeloma, including those with disease refractory to immunomodulatory drugs (IMiDs).

Evidence is mounting that 2 immunotherapies are better than 1 as first-line treatment of patients with advanced melanoma. A phase 3 clinical trial showed that nivolumab plus ipilimumab was superior to ipilimumab or nivolumab alone, and a phase 1 trial suggests that pembrolizumab can be safely and effectively used in combination with other drugs as first-line treatment in this setting. Both studies were presented at ASCO 2016.

The first randomized trial to compare robotic-assisted prostatectomy with conventional open radical prostatectomy found no meaningful differences between these techniques in urinary and sexual function or in the rate of positive surgical margins in men with localized prostate cancer in the first 12 weeks after surgery (Yaxley JW, et al. Lancet. 2016 Jul 26. Epub ahead of print). The 24-month results will be published at a later time.

Men with intermediate-risk prostate cancer can safely undergo radiation administered in larger fractions for 4 weeks (moderate hypofractionation) as an alternative to conventional radiation administered for 8 weeks, according to the results of a randomized, controlled, noninferiority clinical trial presented at ASCO 2016.

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  •  Association for Value-Based Cancer Care
  • Oncology Practice Management
  • Value-Based Cancer Care
  • Value-Based Care in Rheumatology
  • Rheumatology Practice Management
  • Urology Practice Management
  • Lynx CME