HER2-Positive Breast Cancer
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| B.J. Kennedy Lecture at ASCO
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| Cost of Cancer Drugs
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VOLUME 5, ISSUE 11
JULY 10, 2014
Editor-in-Chief, James O. Armitage, MD | ASCOPost.com
ASCO Annual Meeting
The More Things Change, the More They Stay the Same
‘Impressive’ Outcomes Achieved With Pembrolizumab in Advanced Melanoma By Caroline Helwick
By Jimmie C. Holland, MD, and James F. Holland, MD
T
he latest bit of good news for the programmed death receptor-1 (PD-1)–targeting antibodies in advanced melanoma comes for pembrolizumab (MK-3475). While the results came from only a phase I study, they were among those chosen for presentation at an ASCO press briefing during the Annual Meeting. “We were excited to see that pembrolizumab was effective in previously untreated patients as well as in those who had multiple prior therapies, including ipilimumab (Yervoy). These are early data, but they tell us we are onto something really important,” said Antoni Ribas, MD, PhD, Professor of Medicine at the David Geffen School of Medicine at the University of California, Los Angeles. Steven O’Day, MD, Director, Clinical Research, Beverly Hills Cancer Center, Beverly Hills, California, who moderated the press briefing on progress in immunotherapy, commented, “The remarkable thing
is that almost 90% of the patients that respond are having durable responses with a toxicity profile that is almost unheard of in metastatic cancer. This is really extraordinary about this class of drugs.” Pembrolizumab is an Antoni Ribas, MD, PhD antibody designed to block the interaction of PD-1 on T cells and reactivate antitumor immunity. In April 2013, the U.S. Food and Drug Administration (FDA) had previously granted a Breakthrough Therapy designation to pembrolizumab (previously known as lambrolizumab) for advanced melanoma. In May 2014, the FDA granted pembrolizumab a Priority Review designation under its Accelerated Approval program. continued on page 15
Health-Care Policy
Disclaimer: This commentary represents the views of the authors and may not necessarily reflect the views of ASCO.
By Margot Fromer ancer patients’ out-of-pocket costs are rising dramatically, and insurance premiums, cost sharing, and ancillary expenses can be devastating. Many people go bankrupt as a result of the high costs of health care. Drugs are among the most serious economic culprits. They grow more expensive every year, and every year, more patients cannot pay. This was the subject of a recent Institute of Medicine (IOM) National Cancer Policy Forum workshop, held in Washington, DC.
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Dr. Jimmie C. Holland is Wayne E. Chapman Chair in Psychiatric Oncology, Memorial Sloan Kettering Cancer Center, New York. Dr. James F. Holland is Distinguished Professor of Neoplastic Diseases at Mount Sinai Medical Center, New York.
IOM Workshop Explores Growing Problems in Patient Access to Cancer Drugs
C
T
he ASCO Annual Meeting in June confirmed—and expanded—the excitement of the oncology community about molecular medicine and its future. The complex molecular pathways were pictured in living color on many slides in many large auditoriums. Newspapers across the country were equally enthusiastic as they attempted to describe the science behind the new targeted therapies. Needless to say, the public, always eager to hear good news, bought in, and the hype was on for this “new era of cancer cures.”
The Worst Problems
Shortages of some drugs, especially older ones that have gone off patent, have left many cancer patients out in the cold, mainly because the profit margin for some generics is too small to make continuing manufacture worthwhile. The end is similar, but the means are different for specialty pharmaceuticals—drugs and biologicals that are the hope of the future. A. Mark Fendrick, MD, Professor, Departments of Internal Medicine and Health Management and Policy, and Director, CenCost-containment efforts should ter for Value-Based Insurnot produce preventable reductions in ance Design, University of Michigan, Ann Arbor, said quality of care. that these drugs will com—A. Mark Fendrick, MD prise about half of all pharmaceutical reimbursement
MORE IN THIS ISSUE Oncology Meetings Coverage ASCO 50th Annual Meeting ������������ 1, 3, 4–6, 8, 13, 15, 72 Rev 2014 Forum on Navigating Cancer in the Era of Personalized Medicine ����������������������������������������������������23 American Society of Pediatric Hematology/Oncology ����������������������������� 51 Amy Abernethy, MD, on Discontinuing Statins at End of Life ��������� 90 Lisa A. Carey, MD, on Ado-Trastuzumab Emtansine in HER2-Positive Breast Cancer ��������������� 31 Panitumumab in Metastatic Colorectal Cancer ��������������������������������������42 Direct From ASCO �������������������������� 44–47
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