VBCC Oct 2013

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OCTOber 2013 VOL 4 NO 8

INTEGRATING ONCOLOGISTS, PAYERS, AND THE ENTIRE CANCER CARE TEAM www.ValueBasedCancerCare.com VBCC Perspective

Cancer Prehabilitation May Reduce Healthcare Costs and Improve Outcomes By Julie Silver, MD Associate Professor, Department of Physical Medicine and Rehabilitation, Harvard Medical School, Boston

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rehabilitation (or “prehab”) has a long history as an important part of the rehabilitation care continuum. For example, patients who are electing to have a total hip or knee arthroplasty may have preoperative assessments and interventions that are sometimes grouped together and called “joint camp.” Prehabilitation has also

been gaining traction in the oncology community, because of the potential it may have to improve cancer care. In general, prehabilitation is used in anticipation of an upcoming stressor to improve outcomes; it typically should not delay the start of cancer treatment but rather use the available time between diagnosis and surgery or Continued on page 23

ESMO Annual Congress

MPDL3280A: Responses Better in Smokers than in Nonsmokers in Advanced Lung Cancer

First ever therapy to show advantage for patients who smoke By Phoebe Starr Amsterdam, The Netherlands—For the first time, a therapy for non–smallcell lung cancer (NSCLC) has achieved responses in smokers better than in nonsmokers. The antibody MPDL3280A also achieved good responses in squamous and adenoma histologic types of NSCLC. These results of a phase 1 study in ©2013 Engage Healthcare Communications, LLC

patients with metastatic NSCLC were so encouraging that experts suggested bypassing phase 2 studies and going on to phase 3 clinical trials directly. Recruitment for this human monoclonal antibody is ongoing for phase 2 and 3 trials in NSCLC. “We are at the beginning of a new

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IOM Cites Looming Cancer Care Crisis, Recommends Course-Correcting Strategies By Charles Bankhead

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Patricia A. Ganz, MD

n evolving crisis in cancer care will reach a critical mass over the next 15 to 20 years without a transition to a more patient-centered, evidence-based delivery system, warn the authors of a report from the Institute of Medicine (IOM). A conflagration of factors will stretch

cancer care to the breaking point, including the rapidly aging patient population, a growing case volume that will overwhelm the oncology workforce, and the rising cost of care. The 315page report, “Delivering High-Quality Cancer Care: Charting a New Course Continued on page 14

Growing Pressures on Oncolytics to Demonstrate Value

Doug Long

Oncology trends through the lens of IMS Health By Caroline Helwick Hollywood, FL—Oncology growth for the next couple of years will be driven by several strong trends, according to Doug Long, Vice President of Industry Relations, IMS Health, who described these trends at the 3rd Annual Conference of the Association for Value-Based Cancer Care. IMS analyses of the oncology landscape indicate the following trends:

• A continual increase in all tumor types, with high unmet needs for many of them • A strong cancer drug pipeline, with more than 470 new chemical entities in phase 2 trials or later development • Fierce competition as a result of the robust pipeline, which includes Continued on page 29

inside FROM THE EDITOR . . . . . . . . . . . 4 Is cancer care in crisis? The IOM Report FDA UPDATE . . . . . . . . . . . . . . . . . . Perjeta first drug approved for neo­ adjuvant breast cancer therapy

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IN THE LITERATURE . . . . . . . . . . . . 20 PD-1 inhibitor lambrolizumab: durable responses in advanced melanoma 3RD CONFERENCE . . . Community oncology practices

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VALUE PROPOSITIONS . . . . . . . . . 5 Value-based care will change medicine

PERSONALIZED MEDICINE . . . . . 42 Genomics of acute myeloid leukemia

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DRUG UPDATE . . . . . . . . . . . . . . . 44 Revlimid for relapsed/progressing MCL

ESMO ANNUAL CONGRESS . . . . . The state of cancer globally in 2013

ECONOMICS OF CANCER CARE . 14 Outpatient vs community-based care

EMERGING THERAPIES . . . . . . . . 46 Idelalisib, ibrutinib show promise


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