OBR Daily Commentary

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Cancer Patients With Blood Clots Gain No Benefit From Addition of a Vena Cava Filter to Treatment With Fondaparinux

(IASLC) July 7, 2011 - Cancer patients with blood clots -- which occur in one of every 200 cancer patients and are the second most common cause of death among cancer patients -- gain no benefit from the insertion of an inferior vena cava filter (IVCF) to the anticoagulant medication fondaparinux (Arixtra), according to research presented today at the 14th World Conference on Lung Cancer, hosted by the International Association for the Study of Lung Cancer.

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Winston Wong, PharmD (Posted: July 07, 2011)

quotesThese finding are interesting from the standpoint that the insertion of a filter is not only costly, but also is an invasive procedure. It would be interesting to conduct additional studies with the other low-molecular weight heparins to determine if the same results are achieved. This would be of significance from the standpoint that each of the different LMWH are dosed differently (ranging from a flat dose to a dose/kg), which had lead some to believe that this is a point of differentiation in terms of clinical benefit. As well, one of the LMWH is now available as a generic product.quotes

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Opinion: Extremely Expensive Cancer Drugs

(New York Times) July 6, 2011 - Many patients with advanced cancer must feel great relief after last week’s decisions by Medicare to pay for two drugs that provide limited medical benefits. For these patients, even a few more months of life is beyond price.

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Winston Wong, PharmD (Posted: July 07, 2011)

quotesAs a payor, situations like this are almost a daily occurence. What makes our jobs difficult is that we are dealing with a highly sensitive and emotional disease. The decision to cover, or under what clinical presentation is needed to be covered, is not as black and white as many are lead to believe. For instance, in the case of Provenge, we have an approved FDA indication that is rather subjective with respect to the presence of symptoms. Yes, we are looking at a cost of $93,000 for 4-6 months of survival, but there are other alternatives that produce the same results and are less costly. Provenge may be more appropriate in later lines of treatment. Avastin is a similar bottom line from the standpoint of cost of therapy, but the clinical relevance is a bit different. While the blanket statement is there, there is no difference in survival when combined with other medications, meaning that Avastin did slow disease progression when combined wiith Taxol. I do not believe there was any similar result when combined wiith other drugs. Thus it does seem prudent to still cover the use of Avastin in situations of progession of advanced metastatic disease. Bottomline is that , yes, these drugs are expensive. We must strive to bridge a collaboration between payor and physician to maintain the stability of the healthcare system and use these drugs appropriately. Coverage cannot be simply determined upon hitting a cost threshold.quotes

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CytRx Announces Safe Administration of High Doses of Doxorubicin with Its Tumor-Targeted Drug, INNO-206

(TheStreet) July 6, 2011 - CytRx Corporation, a biopharmaceutical company specializing in oncology, today announced that its tumor-targeted doxorubicin conjugate, INNO-206, is delivering doxorubicin safely at doses over 4 times higher than the standard doxorubicin dose in the Company's open-label Phase 1b safety and dose escalation clinical trial.

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Winston Wong, PharmD (Posted: July 06, 2011)

quotesThis sounds like a technological breakthrough similar to what Abraxane did for Taxol. Since the dose limitation of the medication is due to clinical toxicity, as opposed to a vehicle sensitivity, use of this preparation should be more clinically accepted and signficantly improve outcomes. Let's hope that the manufacturer does not go crazy creating their "premium" price.quotes

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Meet the Editorial Board

Community Oncology
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Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
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Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
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H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
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Howard S. Hochster, MD

Associate Cancer Center Director, Yale Cancer Center P...

Community Oncology
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Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
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Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Financial Sector
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Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
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Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

Editor-In-Chief
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Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Health Policy
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Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
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Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
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William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
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William McGivney, PhD

National Health Policy Expert...

Payer
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Winston Wong, PharmD

President, W-Squared Group...