Metastatic Renal Cell Carcinoma 3, 4 | HER2-Positive Breast Cancer
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| Managing Cancer Pain
56, 57
VOLUME 5, ISSUE 4
MARCH 1, 2014
Editor-in-Chief, James O. Armitage, MD | ASCOPost.com
Genitourinary Cancers Symposium
PREVAIL Trial Shows Enzalutamide to Be a Promising Option for Metastatic Castration-Resistant Prostate Cancer
The Future of Biomedical Research A Conversation With Francis S. Collins, MD, PhD
By Alice Goodman
E
ncouraging results of the large phase III PREVAIL trial represent another positive milestone for men with metastatic castration-resistant prostate cancer. Enzalutamide (Xtandi) improved overall survival by 29% and reduced the risk of radiographic progression of disease by 81% in men who had not received chemotherapy. An interim analysis of the trial data in 2013 was so favorable that the Independent Data Monitoring Committee halted the trial prematurely and offered all placebo recipients enzalutamide. Complete trial results were reported at the 2014 Genitourinary Cancers Symposium in San Francisco.1
Potential Treatment Standard “In my view, enzalutamide provides clinically meaningful benefit for men with [metastatic castration-resistant prostate cancer]. It is approved by the
FDA in men previously treated with docetaxel, but not yet approved for use prior to docetaxel. If it does get expanded approval for this indication, it is likely to become an important standard option for use in patients with asymptomatic or minimally Tomasz M. Beer, MD symptomatic advanced prostate cancer,” said lead author Tomasz M. Beer, MD, Professor of Medicine and Deputy Director of the Knight Cancer Institute at Oregon Health & Science University, Portland. Between September 2010 and September 2012, PREVAIL included 1,717 patients with asymptomatic or mildly symptomatic metastatic castration-resistant prostate cancer who had not received previous chemomotherapy. continued on page 8
Health-Care Policy
Congress Agrees on Repeal of Sustainable Growth Rate By Ronald Piana
T
he U.S. Congress recently did something rarely seen on Capitol Hill: Leaders from both sides of the aisle agreed on a piece of legislation. On February 6, 2014, the House Energy and Commerce and Ways and Means Committees and the Senate Finance Committee announced its agreement on a bill—the SGR Repeal and Medicare Provider Payment Modernization Act—that would repeal the Medicare sustainable growth rate (SGR) formula, hopefully ending the
year-by-year threat of physician fee cuts that could severely hamper oncologists’ ability to treat their Medicare patients. Funding for the repeal remains to be resolved, and the bill still needs to be approved by both the House and the Senate. For more than a decade, ASCO and other major oncology organizations have lobbied on Capitol Hill for repeal of the SGR. “It’s critical to community oncology practices that Congress fix the broken SGRbased Medicare system and pass real payment It’s critical to community oncology reform—not just to avert another looming SGR cut, practices that Congress fix the broken but because oncology is SGR-based Medicare system and pass way out in front of actually real payment reform—not just to avert implementing payment reform. Congress needs another looming SGR cut, but because to fulfill its responsibility oncology is way out in front of actually and pass a real fix, not duck and simply patch the SGR implementing payment reform. once again,” Ted Okon, —Ted Okon, Executive Director Executive Director of the Community Oncology Alliance
I
n January, Congress approved a $1 trillion appropriations bill for the rest of fiscal year 2014. While the new bill includes $29.9 billion for the National Institutes of Health (NIH)—$1 billion above FY2013 levels after sequestration—including $4.9 billion for the National Cancer Institute (NCI), it does not restore NIH funding to presequestration spending levels. In addition, the budget leaves the NIH with about 10% less purchasing power in current dollars compared to FY2007. In a wide-ranging interview with The ASCO Post, Francis S. Collins, MD, PhD, Director of the National Institutes of Health, addressed the continued on page 70
Dr. Francis S. Collins is Director of the National Institutes of Health. Disclaimer: This commentary represents the views of the author and may not necessarily reflect the views of ASCO.
MORE IN THIS ISSUE Oncology Meetings Coverage Genitourinary Cancers Symposium ����� 3, 4 Gastrointestinal Cancers Symposium �������������9, 11, 13, 16 San Antonio Breast Cancer Symposium �������������������24, 26, 39 American Society of Hematology ��� 40, 45 JADPRO Live–Advanced Practitioners ������������������������������ 50, 51, 60 Direct From ASCO ���������������������������32–35 Michael J. Fisch, MD, MPH, on Cancer Pain ��������������������������������������������56 Steven T. Rosen, MD, on His New Role at City of Hope ��������������� 67
continued on page 59
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