Immunotherapy: Integrating Latest Research Results into Clinical Practices

Introduction

In an effort to provide you with timely market feedback from ASCO 2013, OBR and MDoutlook are pleased to share results from MDoutlook’s fourth OncoPoll™ from the meeting exploring immunotherapy.

OncoPoll™ Methodology

  • Primary research phase involved a global survey to verified and validated medical oncologists and multi-disciplinary physicians with an identified clinical interest in immunotherapy utilizing targeting parameters within the proprietary MDoutlook® global cancer treater database
  • Timing: June 2013. Launched two days after close of 2013 American Society of Clinical Oncology (ASCO) Annual Meeting, held in Chicago, IL., May 31-June 4, 2013
  • Fielding via <10 minute long interactive internet survey utilizing proven effective methodology via the MDoutlook® survey tool
  • Links to discussed abstracts on the ASCO website were provided within the survey
  • Reponses at data collection: 103 on June 27th
  • No financial incentives provided for participation

Geographic Distribution of Respondents

Attendance at 2013 ASCO Annual Meeting

Key Conclusions

  • About half of all survey respondents attended this year’s ASCO annual meeting
  • Proportionally, Ex-US respondents had slightly more attendees than US respondents
  • In-line with results from previous years

Importance of Immunotherapy: US and Ex-US View Immunotherapy as an Important Treatment Approach

Key Conclusions

  • US and Ex-US oncologists perceive immunotherapy as playing an important role in the treatment approach for their patients
    • A majority of US and Ex-US oncologists rated the importance of  selecting immunotherapies as a treatment approach at 8 out of 10
    • Mostly consistent between US and Ex-US physicians, and between their own view and their patients’ perspectives

PD-1/PD-1L Antibody Treatments: Majority of Patients are Expected to Benefit from New Treatments

Key Conclusions

  • US oncologists anticipate PD-1 targeted immunotherapies to impact a majority of their patients with RCC, melanoma, and NSCLC
    • 50% of US oncologists expect PD-1 targeted immunotherapies to have a large impact on a majority of their melanoma patients compared to 33% for RCC and NSCLC patients
    • <10% of US oncologists expect PD-1 directed therapies to have little to no impact on their RCC, melanoma, and NSCLC patients

PD-1/PD-1L Antibody Treatments: Majority of Patients are Expected to Benefit from New Treatments

Key Conclusions

  • Ex-US oncologists anticipate PD-1 targeted immunotherapies to impact a majority of their patients with RCC, melanoma, and NSCLC
    • 55% of Ex-US oncologists expect PD-1 targeted immunotherapies to have a large impact on a majority of their melanoma patients compared to ~33% for RCC and NSCLC patients
    • ~10% of Ex-US oncologists expect PD-1 directed therapies to have little to no impact on their RCC, melanoma, and NSCLC patients

Clinical Importance of PD-1L Expression: US and Ex-US Oncologists Have Differing Views on the Importance of PD-1L Expression

Key Conclusions

  • Ex-US oncologists have greater concerns than US oncologists regarding the importance of PD-1L expression
    • 62% of Ex-US oncologists have a great concern that PD-1L expression does not  appear to be required for clinical response
    • US oncologists are divided over the importance of PD-1L expression; 42% with little concern and 42% with great concern

Using Multiple Immune Checkpoint Blockade Strategies: Combinatorial is Anticipated to be the Preferred Methodology

Key Conclusions

  • 70% of Ex-US oncologists believe that a combinatorial treatment is the best approach when anti-PD1 targeted treatments become commercially available
  • Largest proportion of US physicians require more data before making a decision on the best treatment strategy
    • Of the US physicians that have decided on an approach, ~60% prefer combinatorial treatment
    • 20% of US treaters will use known entity (anti-CTLA-4 mAb) first

Impact of T-VEC Vaccine for Melanoma: Most Believe Its Use Will Be Limited to Minority of Patients with Unresectable Melanoma

Key Conclusions

  • Most melanoma treaters believe T-VEC will be used in fewer than half of melanoma patients with unresectable disease
    • The expected magnitude of its impact is split in the marketplace, with US treaters expecting a little greater usage than the Ex-US treaters
  • About 1 in 5 melanoma treaters expect T-VEC to be used in majority of cases with unresectable melanoma
  • Few melanoma treaters see no role what-so-ever for this therapeutic approach

Conclusions: Impact of ASCO 2013 on Clinical Practices for Immunotherapy

  • Overall, US and Ex-US oncologists view the selection of immunotherapies to be of great importance for the treatment of their patients
    • A majority of oncologists rated importance 8 out of 10; limited variability between regions
  • Oncologists have a favorable view of PD-1 targeted immunotherapies for the treatment of patients with RCC, melanoma, and NSCLC
    • 50% of US oncologists expect PD-1 targeted immunotherapies to have a large impact on a majority of their melanoma patients compared to 33% for RCC and NSCLC patients
    • 55% of Ex-US oncologists expect PD-1 targeted immunotherapies to have a large impact on a majority of their melanoma patients compared to ~33% for RCC and NSCLC patients
  • Ex-US oncologists have greater concerns than US oncologists regarding the importance of PD-1L expression
  • Most treaters expect the T-VEC vaccine to be used as a treatment of unresectable melanoma, but in a minority of cases
    • Roughly even split in the expected size of impact T-VEC will have for these patients, with US treaters a little more enthusiastic
  • When using PD-1 targeted immunotherapy 70% of Ex-US oncologists believe a combinatorial approach with anti-CTLA-4 treatment is the best strategy
  • Largest proportion of US melanoma treaters (43%) are unsure whether sequential or combinatorial approach is the best strategy
    • This suggest US oncologists need more clinical data before drawing a conclusion
    • Of the US oncologists that have decided on a treatment approach, 60% prefer the combinatorial approach

Submitted by Jan Heybroek, President and Robert Stephan, Sr. Director Medical Services and Luan Dao, Global Medical Analyst, MDoutlook

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