Market Adoption Trends Coming Out of ASCO 2010

In keeping pace with today’s fast information outlets, MDOUTLOOK, powered by the ARCAS Group conducted a series of exclusive quick polls immediately after this year’s ASCO annual meeting exploring market adoption trends based on data presented at the meeting. Complete responses were received by 70 medical and hematologic oncologists for the immunotherapy quick poll and 120 for the hematology-oncology quick polls. Below is a summary of their findings.


Based on the presentations at ASCO, physicians found that the Phase 3 trial data on ipilimumab to be of high clinical importance.

The trial data presented on ipilimumab at ASCO showed improved overall survival (OS) in patients with unresectable stage III or IV melanoma, whose disease had progressed while they were receiving therapy for metastatic disease with treatment with the anti-CTLA4 monoclonal antibody. According to the MDOUTLOOK survey, melanoma treaters will rapidly integrate ipilimumab in their armament (assuming it is approved) and virtually all of them will use the drug in at least some of their stage III melanoma patients. Additionally, all of the respondents said they will use ipilimumab at least in some of their stage IV patients. Roughly one-third will try ipilimumab in the majority of their late-stage patients.


Renal Cell Carcinoma

The respondents also responded positively to the data presented on metastatic renal cell carcinoma (mRCC). Results from the SELECT trial—identifying patients with mRCC likely to respond to treatment with high-dose IL-2—showed improved patient selection doubles the response rate to HD IL-2 in mRCC. Although the excitement on the data from the SELECT trial is viewed optimistically by oncologists, it was not met with the same level of “excitement” as ipilimumab.

Prostate Cancer

Approved by the FDA on April 30, 2010 for the treatment of prostate cancer resistant to standard hormone therapy, the active cellular immunotherapy Provenge [sipuleucel-T; Dendreon] had a moderate market adoption response by physicians. There were 2 main groups of initial users: 1) those using in a small (<10%) group of patients; and 2) those using in about one-fourth of their patients. Few, if any, physicians see sipuleucel-T as a main therapy option, at least initially. This could simply be due to manufacturing issues. According to Dendreon COO Hans Bishop, in a June 28 Bloomberg Businessweek article, he stated that currently the company can only make enough Provenge to treat about 2% of eligible patients until manufacturing increases in mid-2011.

Follicular Lymphoma

In another post-ASCO quick poll of hematologists and medical oncologists with an interest in hematologic malignancies (N=120), MDOUTLOOK found that when it comes to follicular lymphoma (FL), roughly 70% of physicians use rituximab [Rituxan; Genentech] in the vast majority of their FL patients—(81%-100% of patients receiving treatment).

Based on new information presented at ASCO 2010, the use of rituximab as maintenance therapy in FL is predicted to increase.

Multiple Myeloma

Also expected to increase in use is lenalidomide [Revlimid; Celgene] as maintenance therapy in patients with multiple myeloma (MM) as a result of data presented at ASCO. About three-fourths of physicians are already using lenalidomide as maintenance therapy for MM, and following the ASCO presentations on lenalidomide the use of the therapy is expected to increase to >90% of physicians. More importantly, over half of MM patients are predicted to receive lenalidomide maintenance—up from the one-third that currently receive the drug—primarily due to a large increase in physicians who will use this treatment strategy for most of their MM patients.

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.

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  1. It would be very interesting to see if the predicted adoption rates for ipilimumab are the same for physicians who heard the plenary session and those who read about the response rates. Those who heard the presentation tended to be very impressed with the unusual and significant adverse events–ones not usually encountered by medical oncologists. Sometimes these type of quick reads, without proper context, can lose their predictive value. It will be interesting to see.

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