PD-L1 Expression
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| Smoldering Multiple Myeloma
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| AURELIA Trial in Ovarian Cancer
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VOLUME 5, ISSUE 7
MAY 1, 2014
Editor-in-Chief, James O. Armitage, MD | ASCOPost.com
American Association for Cancer Research Annual Meeting
PALOMA-1 Trial Finds Palbociclib/Letrozole Doubles Progression-Free Survival in Metastatic Breast Cancer
Maintenance Therapy in Multiple Myeloma By S. Vincent Rajkumar, MD
By Alice Goodman
F
irst-line treatment with the combination of palbociclib plus letrozole extended progression-free survival by approximately 50% in patients with metastatic estrogen receptor–positive, HER2-negative breast cancer, according to final results of the PALOMA-1 trial, a randomized phase II study presented at the American Association for Cancer Research (AACR) Annual Meeting 2014 in San Diego. Palbociclib plus letrozole achieved progression-free survival of 20.2 months vs 10.2 months with letrozole alone (P = .0004). Overall survival was trending in favor of the combination but was not statistically significant at the time of the progression-free survival analysis. “These data give us the confidence to move ahead with a phase III study. To put the data in perspective, no study of aromatase inhibitors alone in metastatic
breast cancer showed as dramatic a progression-free survival improvement as this study,” said presenting author Richard S. Finn, MD, Associate Professor of Medicine, Geffen School of Medicine at the University of California, Los Angeles. Richard S. Finn, MD Dennis Slamon, MD, PhD, Professor of Medicine and Director of the Revlon/ UCLA Women’s Cancer Program, was the senior author. Palbociclib, being developed by Pfizer, Inc, is a first-inclass cyclin-dependent kinase (CDK) 4/6 inhibitor that inhibits cell proliferation and cellular DNA synthesis by preventing cell-cycle progression. Other companies are also pursuing CDK4 and CDK6 inhibitors in breast cancontinued on page 3
Issues in Oncology
ASCO Speaks Out on Release of Medicare Physician Payment Data
Statement by the American Society of Clinical Oncology
T
he American Society of Clinical Oncology (ASCO) is deeply concerned about [the recent] release of Medicare physician payment data. ASCO is committed to the delivery of high-quality, high-value care for all people with cancer in the United States. This data release solely focuses attention on the dollars paid to practices for the medical care and treatment of patients on Medicare, rather than contributing to the ongoing national conversation about value and quality in health care. While ASCO strongly supports transparency in health care and sharing information with patients,
the data released by Medicare was issued with no context or explanation about the complexity of the payment system, the value of the services provided, and the needs of patients with cancer. The Medicare release makes health-care delivery less transparent than it initially may seem. Compounding this situation are the extensive inaccuracies in the data for many oncologists throughout the United States.
Unique Among Specialties
Cancer care is unique among specialties in the way it is reimbursed by Medicare. Oncology practices must purchase very expensive chemotherapy This data release solely focuses attention on the drugs for their patients dollars paid to practices for the medical care and prior to receiving reimbursement for those treatment of patients on Medicare, rather than drugs from Medicare. contributing to the ongoing national conversation Cancer patients also have life-threatening illnesses about value and quality in health care.
I
n 2012, three randomized placebo-controlled trials reported a significant prolongation of progression-free survival with lenalidomide (Revlimid) as maintenance therapy for multiple myeloma.1-3 Two of these trials tested lenalidomide maintenance after stem cell transplantation, and one investigated maintenance following conventional melphalan-based therapy. One of the three trials, a post-transplant study conducted in the United States, found an improvement in overall survival, while in the others, no survival benefit was seen. All three trials showed a significant increase in the incidence of second cancers. Following the publication of these trials, continued on page 58
Dr. Rajkumar is a hematologist at Mayo Clinic College of Medicine, Rochester, Minnesota. 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 AACR Annual Meeting ������������������������� 3–5 Society of Surgical Oncology Annual Meeting ��������������������������� 6, 12, 13 NCCN Annual Conference ��������������� 14,15 Society of Gynecologic Oncology Annual Meeting �� 20, 22, 24, 26 FDA Update ��������������������������������������� 17–19 Direct From ASCO ��������������������������� 27–31
Teresa A. Gilewski, MD, on Palliative Care ��������������������������������������� 41 Ongoing Clinical Trials ���������������������������45
continued on page 57
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