The 2012 annual meeting of the American Society of Clinical Oncology (ASCO) had a significant impact on the treatment plans of oncologists and hematologists in attendance. According to a post-event survey conducted by Encuity Research, 76% of physicians in attendance indicated they are likely to change their patient treatment plans.

New breast cancer and prostate cancer treatment plans gained the most traction. Among the ASCO-attending physicians surveyed by Encuity, 45% intended to change their breast cancer treatment plan once Genentech’s T-DM1 becomes available, while 44% intended to increase their use of Johnson & Johnson’s prostate cancer treatment, Zytiga®. Other treatments noted include Genentech’s Avastin® for the treatment of colon and ovarian cancer, as well GSK’s dabrafenib for the treatment of melanoma.

T-DM1 also captured the best overall product information ratings. Unaided, 44% of attendees surveyed ranked T-DM1 as having “the most important piece of clinical information.” This was followed by Avastin (17%), Zytiga (16%), Cephalon’s Treanda® (13%), and Bayer/Onyx’s regorafenib (12%).

The majority of physicians surveyed (86%) gave the highest overall “presentation of information” scores to T-DM1. Zytiga closely followed, earning “very or extremely valuable” ratings from 73% of the respondents.

While Genentech ranked highest in “company perception,” others with favorable product scores did not rank among the top 10 in terms of overall company performance. The majority, 83%, of ASCO-attending physicians named Genentech as the company providing the most valuable information. Novartis was second with 37% of mentions, followed by BMS, Pfizer, and Amgen.  Interestingly, despite high product-related mentions, Johnson & Johnson and Bayer did not rank among the top 10.

Meanwhile, ASCO attendees recognized Seattle Genetics and Celgene as “up-and-coming” in the treatment of cancer. Unaided, 18% of physicians surveyed mentioned Seattle Genetics as an up-and-coming company in the treatment of cancer, while 17% mentioned Celgene. These were followed by Millennium, Dendreon, and Onyx.

Overall, oncologists and hematologists surveyed gave the conference high ratings for its value, and many physicians perceive the value of the ASCO conference to be growing. Two thirds of survey respondents report that they had attended the 2011 ASCO conference as well, with 74% rating this year’s event as having equal value to the previous year and 20% rating the event as having more value than before.

For participating pharmaceutical and biotech companies, perception is everything. According to data from Encuity’s Physician Meeting and Event Audit, pharmaceutical and biotech companies spent $2.9 billion on events in the past 12 months, with 11% of their budgets going to symposia like ASCO. In the overcrowded oncology marketplace, a promotional “swing and miss” at events designed to reach oncology treatment decision makers comes at great cost. To achieve the intended comprehension of clinical data and uptake of new treatment plans, it is imperative that companies measure and refine the impact of their presence at critical venues such as ASCO. Turnkey research can quickly reveal the influence of clinical information and promotional efforts on physicians’ perceptions, understanding, and intent to prescribe.

Download the ASCO Impact Report

Encuity Research—the market research and analytics subsidiary of Campbell Alliance—conducted this survey to evaluate the relevancy and effectiveness of company-sponsored clinical data and promotions. The full results of the survey are summarized in the ASCO Impact Report, which provides an encompassing view of ASCO attendees’ intent to change treatment plans, their perceptions of clinical information presented, and their ratings of information offered by pharmaceutical and biotech companies. For a full version the ASCO Impact Report, please visit http://www.encuity.com/asco.

By Dave Johnson, Vice President, Encuity Research

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.

This second Quick-Poll to be published in the OBR blog explores Non-Small Cell Lung Cancer (NSCLC) & Renal Cell Carcinoma (RCC), 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

• Primary research phase involved a global survey to medical oncologists and multi-disciplinary physicians with an identified clinical interest in lung cancer and / or renal cell carcinoma utilizing targeting parameters within the proprietary MDOUTLOOK global cancer treater database
• Timing: June 2012. One week after 2012 American Society of Clinical Oncology (ASCO) Annual Meeting, held in Chicago, IL., May 31-June 4, 2012
• Fielding via <10 minute long interactive internet survey utilizing proven effective methodology via the MDOUTLOOK survey tool
• Survey closed 4 days after fielding
• Reponse:102 on June 18th
• No financial incentives provided for participation

Attendance at 2012 ASCO Annual Meeting

Key Conclusions:

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

NSCLC Survey Results:

1) Crizotinib Will Be the Standard Treatment Approach for NSCLC with ROS1 Gene Rearrangements

Key Conclusions:

• Lung cancer treaters rate highly the findings that crizotinib has significant clinical activity in NSCLC patients with a ROS1 rearrangement
  • Over 80% rate it as very important or important
  • Only 4% rate it as not very important or not at all important
  • Little to no difference in responses between US and Ex-US oncologists (data not shown)

2) Testing for ROS1 Gene Rearrangements Will Become Standard Diagnostic Procedures in US for NSCLC

Key Conclusions:

• Testing for ROS1 rearrangements in NSCLC are expected to increase 6-8 fold in the next year
  • Up from only 6-12% of patients in past year
  • Higher usage of testing by US oncologists (77% vs. 50%)
  • Sequential testing of ROS1 after ALK will be preferred diagnostic algorithm
    • In 1/5 – 1/3 of cases, diagnostic assays will be run at the same time

3) Awareness of PD-1 Blockade Strategy for NSCLC is Mixed;
Consistent Inside and Outside of the US

• Awareness about PD-1 blockade strategy for the treatment of NSCLC is consistent across geographies
• 1/3 of physicians who treat NSCLC reported high level of awareness of PD-1 blockade strategies for NSCLC
• Almost 1/2 of NSCLC treaters reported little to no awareness of PD-1 blockade strategies for NSCLC

4) Majority of NSCLC Treaters Anticipate PD-1 Blockades Will Have an  Impact on Clinical Treatment  Practices for NSCLC

• Majority of NSCLC treaters expect PD-1 blockade strategies will play some future role in their treatment armamentarium
  • Nearly1/3 expect this approach will play a large or very large role in the treatment algorithm
  • About 40% believe it will have some impact on their treatment practices
  • Less than a third of respondents believe it will have little or no success in its clinical development

Renal Cell Carcinoma (RCC) Survey Results:

1) Tivozanib Will Be a Widely-Used Therapeutic Agent for the Initial Treatment of Good and Intermediate Risk RCC

• Physicians expect to use tivozanib as front-line treatment for ~1/3 of their RCC patients
  • Slightly more usage in patients with intermediate risk disease over those with good risk RCC
  • Slightly higher levels of usage outside rather than inside of the US
  • Very few individuals expect to use tivozanib in all of these patients or expect not to use it at all (data not shown)

2) Usage of Pazopanib as Front-Line Therapy for RCC Will Increase Due to the Results of the PISCES Trial

• Due to the patients’ reported preference for pazopanib over sunitinib as a treatment for RCC, its usage as 1st line therapy will increase dramatically
  • Most of its increased usage will come at the expense of sunitinib
• For only ~ 1/4 of RCC treaters did these results not change their opinion of these agents
• Little to no difference among US and Ex-US respondents (not shown)

3) The Results from Non-Efficacy Clinical Trials Are Integrated Into the Clinical Decision Process

• Results from non-efficacy clinical trials play some role in a physicians decision on the treatment of choice
  • Somewhat more important to US oncologists than to those outside of the US
• For 25-30% of oncologists, these results play a large role (rated 8 or higher) in their decisions
  • For only ~10% do these types of studies offer little to no help

4) Awareness of PD-1 Blockade Strategy for mRCC is Slightly Higher Outside of the US

• Ex-US RCC treaters reported higher awareness of PD-1 blockade strategies than US counterparts
  • 70% of Ex-US treaters reported Some or Large/very large awareness compared to 50% of US treaters
• 1/2 of US treaters have no to little awareness of PD-1 blockade strategies
• 1/3 of Ex-US treaters reported having no to little awareness

5) Most Treaters of mRCC Anticipate PD-1 Blockades To Have a Positive  Impact on Treatment of mRCC

• Majority of RCC treaters expect PD-1 blockade strategies will play an important future role in the treatment of metastatic RCC
  • Nearly half expect this approach will play a large or very large role in the treatment algorithm
  • Only 20-30% of respondents believe it will have no to little impact on the treatment of mRCC
  • Overall, relatively equal levels of enthusiasm for this treatment inside and outside of the US

Conclusions from the ASCO 2012 Quick Poll on Non-Small Cell Lung Cancer and Renal Cell Carcinoma

• For NSCLC, the usage of crizotinib for patients with ROS1 gene rearrangements represents a significant clinical development for the global oncology community
• Correspondingly, there will be a large increase in the amount of diagnostic testing for ROS1 rearrangements in NSCLC samples
  • In most cases, testing of ROS1 will be done for those patients with a normal ALK gene
• These patients would otherwise be considered non-candidates for treatment with crizotinib
  • Concurrent testing of ALK and ROS1 genes at same time will also be used in up to a third of patients
• Additional work is needed to understand the rationale behind sequential vs. concurrent testing
• In RCC, tivozanib will be a commonly used 1st line treatment for both good and intermediate risk disease by US and Ex-US physicians
• Pazopanib will likely see an increase in its usage as front-line therapy for RCC, largely at sunitinib’s expense, due to the reported patient’s preference for it in the PISCES trial
  • Results from clinical trials with non-efficacy endpoints, such as the PISCES trial, do play an important role in the physicians treatment decision process
    • Slightly higher level of importance for those in the US
• Both NSCLC treaters and RCC treaters expect PD-1 blockade to have an important impact in the future treatment of these cancers
  • Relatively low amount of awareness for this approach in either disease at the present time

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

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

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

OBR readers are oncology stakeholders – oncologists and oncology focused health care professionals, pharmaceutical developers and manufacturers, investment bank analysts, consultants, and even patients too. In consideration of the OBR audience, what were the most read articles in OBR daily over the span of the annual ASCO meeting, and how does that compare to what the media thought were the big stories?

Here is a list of the most read stories on OBR daily since Saturday:

Costly Newer Drugs No Better in Breast Cancer Study
(Reuters) June 4, 2012 – A pair of newer drugs proved no better, and by some measures inferior, to the older and cheaper chemotherapy agent paclitaxel in patients with locally advanced or metastatic breast cancer, according to results of a late stage study.
read article

A Drug for Advanced Melanoma Is Found to Prolong Patients’ Lives
(New York Times) June 4, 2012 – A new type of drug prolonged the lives of patients with advanced melanoma in a clinical trial, potentially adding to a growing number of therapies for a disease that was once nearly untreatable.
read article

Roche Smart-Bomb Cancer Drug Delays Breast-Tumor Growth
(Bloomberg Businessweek) June 3, 2012 – An experimental breast cancer drug from Roche Holding AG that carries chemotherapy directly into malignant cells while bypassing healthy ones delayed tumors longer and with fewer side effects than an established therapy.
read article

J&J Scores Big With Prostate Cancer Pill
(TheStreet) June 2, 2012 – Johnson & Johnson’s Zytiga improved survival in “pre-chemo” prostate cancer patients by 33% and more than doubled the time before cancer worsened compared to control, according to results from a phase III study to be presented today at the American Society of Clinical Oncology (ASCO) annual meeting.
read article

US FDA Rejects Merck/Ariad Sarcoma Drug
(Reuters) June 5, 2012 – U.S. drugs regulators rejected an experimental sarcoma medicine from Merck and Ariad Pharmaceuticals on Tuesday, asking for more clinical trials, Merck said.
read article

In contrast, here are the stories that our editors think made the biggest splash in the media outlets:

Bristol Immune Drug Shows Promise in Three Cancers
(Reuters) June 2, 2012 – An experimental Bristol-Myers Squibb drug helped shrink tumors in patients with advanced melanoma, kidney and lung cancers in a preliminary trial, raising hopes for yet another drug that can wake up the immune system and train it to attack cancer cells.
read article

Roche Smart-Bomb Cancer Drug Delays Breast-Tumor Growth
(Bloomberg Businessweek) June 3, 2012 – An experimental breast cancer drug from Roche Holding AG that carries chemotherapy directly into malignant cells while bypassing healthy ones delayed tumors longer and with fewer side effects than an established therapy.
read article

A Drug for Advanced Melanoma Is Found to Prolong Patients’ Lives
(New York Times) June 4, 2012 – A new type of drug prolonged the lives of patients with advanced melanoma in a clinical trial, potentially adding to a growing number of therapies for a disease that was once nearly untreatable.
read article

Ariad’s Ponatinib Shown to Aid Leukemia Patients in Study
(Bloomberg Businessweek) June 4, 2012 – Ariad Pharmaceuticals Inc. said its experimental leukemia drug ponatinib helped patients with a mutation resistant to other therapies in a study the company will use to seek approval from U.S. and European regulators.
read article

Bayer Drug Stalls Stomach Tumors After Standard Treatment
(Bloomberg Businessweek) June 4, 2012 – Bayer AG’s experimental cancer drug regorafenib delayed progression of stomach cancer in patients who weren’t benefiting from standard treatments, potentially giving doctors a third weapon to battle gastrointestinal tumors.
read article

Why the difference? Probably because OBR readership is full of people toiling in the industry everyday. Maybe the media outlets view things differently than others, or have other motives? Either way you look at it, it was a strong annual meeting this year for exciting news, data, and studies.

by Don Sharpe