Ovarian and Cervical Cancers: Changes in Management as Result of New Data

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 third OncoPoll™ from the meeting exploring Ovarian and Cervical cancers.

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 gynecological cancers 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: 91 on June 25th
  • 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

US Survey Participants’ Gynecologic Cancer Patient Flow:  Average Over 27 Cases Each Month

Key Conclusions

  • US survey participants* averaged nearly 15 cases of ovarian cancer last month
    • More than all other gynecologic cancers combined
    • Over half of the cases involved metastatic disease
  • Four cases of cervical cancer was the average monthly volume for US participants
    • Over a third of the cervical cancers involved metastatic disease

* Survey Participants = Medical Oncologists and multi-disciplinary physicians with an identified clinical interest in gynecological cancers

Ex-US Survey Participants’ Gynecologic Cancer Patient Flow: Average Nearly 27 Cases Each Month

Key Conclusions

  • Ex-US survey participants* also averaged nearly 15 cases of ovarian cancer last month
    • More than all other gynecologic cancers combined
    • Nearly two thirds of the cases involved metastatic disease
  • Five cases of cervical cancer was the average monthly volume for  Ex-US participants
    • Over half of the cervical cancers involved metastatic disease

* Survey Participants = Medical Oncologists and multi-disciplinary physicians with an identified clinical interest in gynecological cancers

Dosing Schedule for 1st Line Chemotherapy for Ovarian Cancer: Improved Schedule Is Clinically Important to Oncologists

Key Conclusions

  • A majority of oncologists agree that an improved 1st line chemotherapy dosing schedule for advanced ovarian cancer is important to their practice
    • ~1/3 believe this a very important information (rate as 6 or 7)
  • Slightly higher ratings from Ex-US respondents

Neoadjuvant Chemotherapy for Advanced Ovarian Cancer: No Consensus as to Its Impact on Clinical Practice

Key Conclusions

  • EX-US oncologists have a more favorable view of the CHORUS trial than US oncologists
  • Outside of the US, over a third of oncologists think this neoadjuvant approach will become a standard of care
    • Only 1 in 8 US oncologists believe the same wide impact on clinical practice
  • Few Ex-US oncologists believe the neoadjuvant approach used in the CHORUS trial will not be used in clinical practice
  • 1 in 5 US oncologists think that the CHORUS trial will have little to no impact on their practice

Maintenance Therapy for Advanced Ovarian Cancer: Large Increase in Pazopanib Usage Expected

Key Conclusions

  • 40 to 50% of all patients with advanced ovarian cancer are expected to receive some type of maintenance therapy
    • Represents about a doubling from current levels
    • Slightly higher proportional increase  outside of the US due to the slightly lower current usage of maintenance therapy
  • A 5-fold increase in the usage of pazopanib as a maintenance therapy is expected
    • About a third of ovarian cancer patients are expected to receive maintenance therapy with pazopanib
    • Similar  changes in US and Ex-US treaters

Adding Bevacizumab to Chemotherapy for Cervical Cancer: Wide Integration into Clinical Practice; New Standard of Care in US?

Key Conclusions

  • Addition of bevacizumab to chemotherapy for cervical is expected to grow by 8 fold in the US to be used in half of all patients with metastatic or recurrent / persistent disease
  • Ex-US physicians anticipate adding bevacizumab to chemotherapy for 1/3 of their patients with recurrent/persistent disease or metastatic disease
  • Little difference in the treatment of patients with persistent/recurrent disease or metastatic disease

Conclusions: Impact of ASCO 2013 on Clinical Practices for Gynecologic Cancers

  • Ovarian cancer is the main type of gynecologic cancers seen in clinical practices
    • Oncologists’ patient flow in ovarian cancer is ~3-4x greater than cervical cancer
    • Most of oncologists’ gynecologic cancer practice involves metastatic disease, especially concerning ovarian cancer
  • New information on the dosing schedule for 1st line chemotherapy for ovarian cancer is seen as important by most treaters of this cancer type and will likely be integrated into clinical practice right away
    • Few think this new data has no importance to their practice
  • Splitting planned chemotherapy into a neoadjuvant and adjuvant approach for advanced ovarian cancer is widely seen as having an impact on clinical practices
    • No real consensus as to how much of an impact or for how many patients
    • Outside of the US, over a third of treaters say this will have a large impact for most patients
  • A 5-fold increase in the usage of pazopanib maintenance therapy for advanced ovarian cancer is expected
    • About a third of patients will receive pazopanib in the maintenance setting
    • Overall usage of any type of maintenance therapy will double to 40-50% of these patients
    • Increases are roughly similar between those in and outside of the US, although overall levels will remain slightly higher in the US
  • A large increase in the usage of bevacizumab with chemotherapy will be seen in cases of advanced cervical cancer
    • ~50% of patients in US and nearly a third of patients outside of the US will receive bevacizumab
    • Usage is expected to be mostly equal between recurrent / persistent and metastatic disease

Submitted by Jan Heybroek, President and Robert Stephan, Sr. Director Medical Services, MDoutlook

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