Saturday, 31 May 2014

Value in Cancer Care- ASCO session

I went to the industry and oncologist perspective on value in cancer care- very insightful!

While the speaker from industry stressed the need for return for investment, he also acknowledged the need for a re-thinking of the system. There are already a number of interesting pricing systems out there, e.g. only paying if a therapy works- need to look into that.

The oncologist made the point that oncologists have the responsibility to try and save unnecessary costs (like unnecessary imaging) to reduce health care cost, before limited budgets lead to the limitation of access to potentially beneficial treatments. He made very insightful comparisons about the size of the health budgets- if you think it's enormous, it is even more than that! He didn't have slides but I will see whether I can get the clip, I really liked the examples he gave but want to double-check before posting!

Unfortunately, I couldn't make it to the first part of the session but will definitely watch them later as I think that this is an important topic.
The theatre was packed demonstrating the interest in the topic- the last speakers said: 10 years ago such a session wouldn't have existed- and I think the BIG point here is to get all stakeholder together and to discuss this problem while respecting everyone's perspective because let's face it, things will only change if everyone gains in the process!

What I think what is increasing is the recognition that there must be an incentive for innovation (why do it otherwise?) and this is something we as advocates will have to think harder about as well.
If Melanoma patients and others with similarly desperate cancers want to live- and there is no doubt about that- they need new therapies. While in times of unlimited resources, 'just' throwing money at the problem might have looked like a solution (but even then, we need the RIGHT new drugs, not just new drugs), we all know that this is not the reality but that we have to accept a limited budget (besides, who even as a patient wants to pay even more health insurance?).
So we have to find a way to get new therapies that are BOTH profitable AND affordable- to make sure that we get new therapies coming in the first place and then actually also get access to them- now that would be something to advocate for.

Somehow I think that the economy of innovation will be a topic to work on :-)

The program below, I will see whether there is a way to access the clips from the sessions-

Can We Find Common Ground? Stakeholder Perspectives on Value in Cancer Care

3:45 PM - 4:05 PM
Value in Cancer Care: What's the Problem?
Neal J. Meropol, MD Disclosure
University Hospitals Seidman Cancer Center and Case Western Reserve University
4:05 PM - 4:25 PM
Defining Value: An ASCO Initiative
Lowell E. Schnipper, MD Disclosure
Beth Israel Deaconess Medical Center
4:25 PM - 4:45 PM
The Patient Perspective
4:45 PM - 5:05 PM
Using Value for Coverage
Lee Nisley Newcomer, MD Disclosure
United Health Group
5:05 PM - 5:25 PM
Industry Perspective: Drug Development, Costs, and Return on Investment
Gregory P. Rossi, PhD Disclosure
Astrazeneca UK
5:25 PM - 5:45 PM
How Should Oncologists Become Value-Based Providers?
Ezekiel J. Emanuel, MD, PhD Disclosure
Perelman School of Medicine and The Wharton School, University of Pennsylvania
5:45 PM - 6:00 PM
Panel Question and Answer
Panel Discussion

Friday, 30 May 2014

Long-term survival of ipilimumab-naive patients (pts) with advanced melanoma (MEL) treated with nivolumab (anti-PD-1, BMS-936558, ONO-4538) in a phase I trial.

This is a Phase 1 study in advanced Melanoma with patients without prior Ipi.

In comparison, after 1 year on the Merck PD1, 86% of patients with PDL1 positive tumours and 72% of patients with PDL1 negative tumours were still alive as presented at AACR earlier this year.

This is early data, so it is worth checking what the patient populations look like- if one was considerably sicker, that has obviously an influence on the result!

OS rate*

n=107% (95% CI)Pts at risk
1 y 63 (53, 71)63
2 y 48 (38, 57)44
3 y 41 (31, 51)22

*September 2013 analysis

FDA special session for patient representatives and advocates

On Sunday, I will be going to a special session organised by the FDA where they will talk about

- What’s New at FDA: Breakthrough Therapy and other Expedited Approval Pathways

- Expanded Access & Patient-Focused Drug Development        

- Opportunities & Challenges in Global Oncology Drug Development   

  So the main topic will be how to accelerate drug approval and how to ensure patients can access new drugs faster- and as we all know, this is something that would make all the difference for patients with cancers like Melanoma!

We'll be a group of European cancer advocates going, so these are problems we share with other cancers.

If you've got questions you would like me to ask, let me know!


Thursday, 29 May 2014

Wished you were here?

Attend ASCO as a patient advocate:

There are even opportunities to apply for financial support when applying well ahead of time (so note for next year!), unfortunately, I can't find the link right now!

Approach to BRAF pos metastatic Melanoma

Approach to BRAF pos metastatic Melanoma

An article from the ASCO 2014 educational book written by known Melanoma oncologists on the steps to take when diagnosed with Melanoma and a good discussion about the possible therapy options.

Interleukin-2 is used less in Europe than in the US, notorious for its side effects and I am sure this ASCO will give interesting results on PD-1!

Just arrived!

Just landed in Chicago and now on the way into town- 8 hours flight are a long time but it gave me a chance to have a closer look at the ASCO abstracts- there are some interesting news for Melanoma out there!

You can read them yourself under

Will keep you posted!