FEBRUARY 2011 VOL 2 NO 1
www.ValueBasedCancerCare.com
Combination Anti-HER2 Therapies the Wave of the Future
Healthcare Reform Boosted at ASH
A sea change in the approach to management
By Colin Gittens
By Caroline Helwick
Orlando, FL—Healthcare reform offers a chance to correct course from an unsustainable financial path and offers many benefits, said Ezekiel J. Emanuel, MD, PhD, at a policy forum jointly hosted by the American Society of Hematology (ASH) and the European Hematology Association. But for the reforms to produce maximal benefit, there are a number of things physicians need to do, Dr Emanuel said. Dr Emanuel—a special advisor for health policy to the director of the White House Office of Management and Budget until January 2011—first outlined US healthcare spending and outcomes, noting that in 2009, the United States spent $2.53 trillion on healthcare. Despite that number and the alarming growth rate in spending, overall outcomes are not great—for life expectancy at age 65, the United States ranked 12th for men and 16th for women. In cancer care, however, qual-
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New Cancer Drugs Approved by the FDA, 2000-2010 10
Drugs approved, N
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Photo courtesy of the American Society of Hematology
a novel monoclonal antibody akin to trastuzumab. Neil Spector, MD, director of Translational Oncology Research at the Duke Cancer Institute in North Carolina, remarked that, “Combinations of targeted drugs is the future of oncology. This is a very exciting area. We have gone from HER2-overexpressing disease being the most lethal type of breast cancer to a subtype that we are talking about curing.” In the 4-arm NeoSphere trial, triple
Photo by © SABCS/Todd Buchanan 2010
San Antonio, TX—It turns out that for women with HER2-overexpressing breast cancer, treatment with trastuzumab (Herceptin)—which cuts the risk of recurrence by half—may be just the beginning. At the annual San Antonio Breast Cancer Symposium, several key studies evaluated “combined HER2 blockade,” showing impressive outcomes in the preoperative (neoadjuvant) setting. In these studies, rates of pathologic complete response (pCR)—which means that tumors not only shrink but tumor cells become undetectable— exceeded 50%. The studies used various combinations of trastuzumab, lapatinib (Tykerb), and pertuzumab,
Former White House advisor highlights economic benefits
ity is high, with the United States ranked first in prostate cancer, second in breast cancer, and third in colon cancer outcomes worldwide. The passage of healthcare reform is an “historical event,” Dr Emanuel emphasized. To counteract the myths surrounding the bill, he detailed the ways in which costs will be controlled Continued on page 11
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Weighing In on the Avastin Decision
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Payers’ perspectives from VBCC board members
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Drugs approved in 2010 (in order of approval) were sipuleucel-T (Provenge), cabazitaxel (Jevtana), odansetron (Zuplenz), eribulin (Halaven), and denosumab (Xgeva). Data adapted from CenterWatch web site. www.centerwatch.com/drug-information/fda-approvals/ drug-areas.aspx?AreaID=12.
An organization you’ll want to be part of.
o assess the potential implications, further questions, and next steps concerning bevacizumab (Avastin) use in patients with metastatic breast cancer, we spoke with a number of key constituents as well as our own editorial board members. One important question evoked by the process has been the discrepancy in voting between the US Food and Drug
VOL. 2
The First Annual Stakeholder Integration Conference March 29-30, 2011 • Philadelphia, PA NO. 5
SPECIAL Turn to page ISSUE
26 for the full agenda, and make your plans to attend this meeting. ©2011 Engage Healthcare Communications, LLC
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VALUE PROPOSITIONS . . . . . . . . .
Brachytherapy—what’s the evidence? MEETING COVERAGE . . . . . . . . . . .
A meeting you’ll want to attend.
Administration’s (FDA) Oncologic Drugs Advisory Committee (which voted 12-1 in favor of removing the indication) and the National Comprehensive Cancer Network (NCCN) Breast Cancer Panel, which voted unanimously to affirm its recommendation that Avastin continue to be used for this indication. This has led to
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ASH annual meeting SABCS conference ASTRO annual meeting ASHP clinical meeting PATHWAYS IN ONCOLOGY
VBCC PERSPECTIVES . . . . . . . . . .
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The essential health benefits provision Decision-support tools to guide value-based care CLINICAL TRIALS . . . . . . . . . . . . . . .
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Clinical trials may become nimbler in the future ....
New directions in cancer care
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HEALTH POLICY
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Patients with advanced cancer Healthcare reform repeal
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