2012 ASCO Annual Meeting: Immediate Impact on Clinical Practices

Introduction:

In an effort to provide you with timely market feedback from ASCO 2012, OBR and MDOutlook Oncology Intelligence are pleased to share results from MDOutlook’s 5th Annual post-ASCO survey fielded among its global network of more than 62,000 cancer providers.

The first Quick-Poll to be published in the OBR blog explores melanoma, and stay tuned to our blog in the coming weeks as we publish QuickPolls on the other tumor types as well.

Quick Poll Methodology and Respondents’ Geographic Distribution

  • 2012 American Society of Clinical Oncology (ASCO) Annual Meeting was held in Chicago, IL. May 31st-June 4th, 2012
  • Melanoma Quick Poll was launched by email in the Morning of Friday, June 8, 2012
  • Sent to global distribution of Medical Oncologists and physicians with a clinical interest in Melanoma
  • Data taken on June 12th with 101 complete responses
    • ~1/2 of responses from USA
    • Responses received from 15 different countries in total
  • No financial incentives provided for participation

Survey Results:

1) Attendance at 2012 ASCO Annual Meeting

Attendance at ASCO Annual Meeting

Key Conclusions:

  • ~50% of all survey respondents attended this year’s ASCO annual meeting
  • US had slightly more attendees than Ex-US physicians

2) Melanoma Treaters Plan to Increase Use of BRAF Mutational Testing

Key Conclusions:

  • Melanoma treaters in both the US and Ex-US plan to increase BRAF mutational testing for both stage III and stage IV melanoma
  • In the next year, expect a 50-100% increase in BRAF testing in stage III melanoma treaters
    • Largest increase seen for those who plan to test 76-100% of their stage III patients, from 11% in the US and 8% Ex-US in the past year to 42% and 43%, respectively
  • In the next year, ~10% more patients with stage IV melanoma will be tested for BRAF V600E mutation

3) Virtually All Melanoma Patients With BRAF V600E Mutation Will Receive Targeted Therapy

Key Conclusions:

  • Melanoma treaters in the US and Ex-US used vemurafenib in ~50% of their V600E positive melanoma patients
    • Few patients received vemurafenib prior to being tested for BRAF mutation; 63% of US and 89% of Ex-US physicians will not give vemurafenib to patients with unknown BRAF status (data not shown)
  • Vemurafenib usage expected to be slightly higher (10-20% more) than dabrafenib
    • Likely due to the current availability of and experience with vemurafenib

4) Melanoma Treaters Find Clinical Data on MEK Inhibitors in Combination With BRAF Inhibitors To Be of High Clinical Importance

Key Conclusions:

  • Both US and Ex-US melanoma treaters find the data on MEK inhibitors in combination with BRAF inhibitors to have higher clinical importance than usage of MEK inhibitors alone
  • MEK inhibitors alone  for the treatment of NRAS mutated melanoma will play an important role in the armamentarium for melanoma treaters

Key Conclusions:

  • Largest proportion of melanoma treaters gave use of MEK inhibitors alone in BRAF mutated melanoma an average rating
  • US and Ex-US melanoma treaters have differing views on clinical importance of MEK inhibitors in combination with BRAF inhibitors in melanoma patients
    • Over 50% of Ex-US melanoma treaters rated clinical importance 5 out of 5
    • US melanoma treaters divided on their view, 1/3 rated 5 out of 5 and 1/4 rated 1 out of 5
  • US treaters find data on MEK inhibitors usage in NRAS melanoma more important than Ex-US treaters

5) Anticipated Impact of PD-1 Blocking on Treatment of Melanoma

Key Conclusions:

  • Ex-US melanoma treaters are more aware of PD-1 for the treatment of melanoma than US physicians
  • Majority of melanoma treaters expect PD-1 blockade strategies will play an important future role in the treatment of melanoma
    • Nearly 2/3 expect this approach will play a large or very large role in the treatment algorithm
    • Only 10-15% of melanoma treaters believe it will have no to little impact on the treatment of melanoma
    • Overall, slightly higher enthusiasm outside of the US (corresponds to higher level of awareness)

Conclusions from the ASCO 2012 Quick Poll on Melanoma

  • Melanoma treaters in both the US and Ex-US plan to increase BRAF mutational testing for their stage III and stage IV melanoma patients
    • In the next year melanoma treaters in the US and Ex-US plan to test 49% and 38% of their stage III melanoma patients, respectively
    • Physicians plan to test ~70% of their patients in the next year
  • When dabrafenib becomes available, virtually all metastatic BRAF V600E melanoma will be treated with a targeted therapy
    • Vemurafenib is currently used in ~50% of their V600E positive metastatic melanoma patients
    • Vemurafenib usage is expected to be slightly higher than dabrafenib alone
    • Will also see expanded use of these agents in non-metastatic melanoma
  • Both US and Ex-US melanoma treaters find the data on MEK inhibitors in combination with BRAF inhibitors to have higher clinical importance than usage of MEK inhibitors alone
    • Over 50% of Ex-US melanoma treaters gave this approach the highest clinical importance
    • US melanoma treaters divided on their view, 1/3 rated 5 out of 5 and 1/4 rated 1 out of 5
  • MEK inhibitors are expected to be an important treatment option for NRAS mutated melanoma
  • Majority of melanoma treaters expect PD-1 blockade to have a large or very large impact in the treatment of melanoma
    • Slightly higher awareness and excitement outside of the US

Final Thoughts

Quick polls are a fast way of measuring expected acceptance of clinical data post major medical meetings, and perhaps can be used to make some assumptions about adoption amongst providers. In today’s information hungry environment, the speed at which these polls can be conducted and analyzed can be advantageous for market planning and “pressure testing” acceptance of data amongst key stakeholders.

Submitted by Jan Heybroek, President and Robert Stephan, Sr. Director Medical Services, The Arcas Group

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