(Reuters) Sept 24, 2018 - Swiss drugmaker Roche upped its bet on personalized cancer treatment on Monday, saying it is now ready to sell a blood test around the world that can identify common gene mutations from solid tumors from a patient’s blood. The blood test, called FoundationOne Liquid, is among initial products to emerge from Foundation Medicine after Roche spent $2.4 billion on the U.S.-based genetic profiling company this year on the conviction that future cancer treatment will be tailored to individual characteristics of a patient’s tumor. Foundation’s new blood test can identify circulating tumor DNA as 70 of the most commonly mutated genes in solid tumors, Roche said, including features which may help identify patients most likely to benefit from cancer immunotherapy.

Winston Wong, PharmD (Posted: October 15, 2018)

From a payer perspective, I do not think the clinical utility of the liquid biopsy has been show to warrant wide spread coverage. While I am a proponent of the liquid biopsy, I do not think it has gain "prime time" status. It has shown utility in only a few solid tumors, those of which are know to be active cell shedders. It will be interesting to see if payers will pick up coverage of the test.

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(Medscape Medical News) Sept 17, 2018 - A debate has intensified about cutting the dose — and hence the cost — of the oral prostate cancer drug abiraterone acetate (Zytiga, Janssen) by taking it with food.

Winston Wong, PharmD (Posted: October 15, 2018)

I believe the difficulty here is not so much that a lower dose of drug when taken with a low-fat meal can produce a similar clinical effect, but rather, we are encouraging one to take their medications with food. The lower dose almost becomes a second issue. How many times are we telling patients to take their medication on an empty stomach e.g. antibiotics, biphosphonates? With that aside, in the patients who cannot afford their medication, this is an option. Education on a low-fat meal can serve 2 purposes: 1) offers an affordable option for abiraterone, and 2) promotes a more healthy diet.

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(Bristol-Myers) Oct 12, 2018 - Bristol-Myers Squibb Company today announced topline results from the Phase 3 CheckMate -331 study evaluating Opdivo (nivolumab) versus the current standard of care, topotecan or amrubicin (where approved), in patients with small cell lung cancer (SCLC) who relapsed following platinum-based chemotherapy. The study did not meet its primary endpoint of overall survival (OS) with Opdivo versus chemotherapy. The safety profile of Opdivo in this trial was consistent with that observed in previously reported monotherapy studies involving patients with SCLC.

H. Jack West, MD (Posted: October 12, 2018)

Disappointing result, especially since treatment with either topotecan or amrubicin in relapsed SCLC represents a very low bar for any competing idea. This represents an area where the standard of care is particularly unimpressive, so for nivolumab to have failed to beat chemotherapy here represents a major disappointment. With the positive OS data seen with IMpower133 that added atezolizumab to standard first line chemotherapy in NSCLC, we are likely to see immunotherapy move overwhelmingly into the first line setting, but here nivolumab suffers in comparison by failing to beat even a weak competitor.

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