Immunotherapy Needs a New Math

Excerpt:

“A group of doctors and other healthcare industry professionals have set out to develop a more efficient tool for assessing the true value of immuno-oncology (I/O) drugs. They note that these drugs often come with high prices that may distract from their advantages over other types of therapy. For example, Kroger Pharmacy is selling the checkpoint inhibitor ipilimumab (Yervoy) for $140 per mg. At the recommended dose of 3 mg/kg for melanoma patients, the total expense can be high. However, ipilimumab is one of the class of I/O drugs that have improved expectations on supportive care costs and survival benefit. The old measures of value may not apply. Therefore, how does one determine whether $140/mg is a fair price for the drug?”

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Nab-Paclitaxel Paired With Anti-PD-L1 Immunotherapies in TNBC Studies

Excerpt:

“Combination regimens that pair nab-paclitaxel (Abraxane) with PD-L1 checkpoint blockade immunotherapy agents are emerging as a robust area of investigation in triple-negative breast cancer (TNBC), bolstered by clinical trial results that establish the chemotherapeutic agent as an effective partner for other therapies.

“Although nab-paclitaxel has been combined in some studies with other chemotherapies, the focus is shifting to regimens that include immunotherapies as the efficacy of that approach continues to grow. Nab-paclitaxel, an albumin-bound form of paclitaxel, is indicated for patients with metastatic breast cancer after prior chemotherapy.”

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Novel HER2 Inhibitor Offers Manageable Toxicity, Anti-Tumor Activity in Metastatic Breast Cancer

Excerpt:

“A phase I trial found that the HER2 inhibitor ONT-380 had a lower incidence of certain adverse events associated with this class of agent and notable anti-tumor activity in heavily pretreated patients with HER2-positive metastatic breast cancer (MBC).

” ‘Though existing targeted therapies are improving outcomes in patients with HER2-positive MBC, disease resistance does eventually develop in most patients,’ wrote study authors led by Stacy Moulder, MD, of the MD Anderson Cancer Center in Houston. Also, some agents preclude combination with other regimens due to off-target effects such as skin rash and diarrhea.”

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Breast Cancer Patients with Dense Breast Tissue More Likely to Develop Contralateral Disease

Excerpt:

“Breast cancer patients with dense breast tissue have almost a two-fold increased risk of developing disease in the contralateral breast, according to new research from The University of Texas MD Anderson Cancer.

“The study, published in the journal Cancer, is among the first to find the association between breast density (BD) and contralateral breast cancer (CBC).

“According to study author Isabelle Bedrosian, M.D., a big challenge in the management of this patient population, especially as they are making surgical decisions, is trying to counsel women appropriately on their risk of developing breast cancer in the other breast.”

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The Next Few Years Will Bring Stunning Progress for TNBC, Expert Says

Excerpt:

“The treatment landscape for triple-negative breast cancer (TNBC) is transforming, experts say, with the potential additions of immunotherapy and PARP inhibitors. These agents are being explored both as monotherapy and in combination regimens with standard chemotherapy options.

“At the 2016 San Antonio Breast Cancer Symposium, treatment with pembrolizumab (Keytruda) continued to show a consistent durable benefit with an additional year of follow-up for heavily pretreated patients with recurrent PD-L1–positive TNBC, according to findings from the phase Ib KEYNOTE-012 trial.”

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Breast Conserving Surgery Plus RT Better Than Mastectomy in Some Patients

Excerpt:

“A large registry study found that certain breast cancer patients gain a significant survival benefit with breast conserving surgery plus radiation therapy (BCT) compared with mastectomy. This includes patients over the age of 50 with T1–2N0–1 disease, and other factors.

“Studies comparing those options have often excluded elderly patients, or those with existing comorbidities. The new study involved two time cohorts from a Netherlands registry, one with 55,802 patients diagnosed between 1999 and 2005, and another with 65,394 patients diagnosed between 2006 and 2012. The results were presented by Mirelle Lagendijk, MD, of the Erasmus MC Cancer Institute in Rotterdam, at the European Cancer Congress 2017 in Amsterdam.”

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Trial Explores Eliminating Breast Cancer Surgery in Exceptional Responders to Neoadjuvant Therapy

Excerpt:

“A prospective study is investigating whether breast cancer surgery can be eliminated in patients who respond well to neoadjuvant systemic therapy.

“The phase II single-center trial, conducted out of The University of Texas MD Anderson Cancer Center (NCT02945579), aims to determine how often breast cancer recurs in patients who previously received chemotherapy and follow-up radiation therapy, but not surgery, and have no evidence of disease. Forty patients with early-stage, triple-negative or HER2-positive breast cancer care underwent image-guided biopsy after completing chemotherapy and before beginning radiation therapy to see if surgery is necessary.”

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Understanding When Eating Soy Might Help or Harm in Breast Cancer Treatment

Excerpt:

“Georgetown Lombardi Comprehensive Cancer Center researchers have used animal models to reveal new information about the impact – positive and negative – that soy consumption could have on a common breast cancer treatment.

“The scientists have uncovered the biological pathways in rats by which longtime soy consumption improves effectiveness of tamoxifen and reduces recurrence. But they also show why eating or drinking soy-based foods for the first time while being treated with tamoxifen can, conversely, reduce effectiveness of the drug, and promote recurrence.

“The study, published in Clinical Cancer Research, uncovers the molecular biology behind how soy consumption, especially its most active isoflavone, genistein, affects tamoxifen—both positively and negatively.”

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Humana Issues Positive Coverage Decision for NanoString’s Prosigna® Breast Cancer Assay

Excerpt:

“NanoString Technologies, Inc. (NASDAQ:NSTG), a provider of life science tools for translational research and molecular diagnostic products, today announced that Humana has issued a positive coverage decision for the Prosigna® Breast Cancer Gene Signature Assay. Humana and its more than 13 million members join other payors now covering Prosigna, collectively representing more than 175 million covered lives throughout the United States.

“This positive coverage decision is in line with updated ASCO guidelines released in February of 2016, wherein Prosigna is considered medically necessary to assess the necessity of adjuvant chemotherapy in ER-positive, HER2-negative, node-negative breast cancer patients, when adjuvant chemotherapy is not precluded due to any other factor.”

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