OBR Daily Commentary

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UK's Body NICE Blocks Novartis's Kidney Cancer Drug Afinitor

(SmartMoney/Dow Jones Newswires) Nov 25, 2010 - The U.K. health cost body Friday said it refuses to back Novartis AG's kidney cancer drug Afinitor as a second line treatment due to lingering cost and efficiency concerns even as the Swiss pharma giant, which said it will appeal the verdict, has cut the price for the drug.

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Robert A. Figlin, MD., FACP (Posted: November 29, 2010)

quotesThis decision is just another example that highlights the challenges in drug development. In this case we have a drug Afinitor that has demonstrated clinical efficacy following prior VEGFr TKI therapy in metastatic renal cell carcinoma and is approved for use in the United States and the EU. It is not that the data is being questioned as much as the value added to this patient population of the treatment effects. The medical oncology community (ie: physicians, industry, patient advocate groups, health care providers) will consistently be asked to not only prove a drugs effectiveness using standard metrics of benefit (ie: PFS, OS )but also demonstrate why a health care dollar should be used for this intervention vs another. This is a challenging time for drug development as the clinical trials often ask questions that answer only part of the effectiveness question for a particular therapy. It should be the oncology community at large including all interested parties that set the agenda for what constitutes "effectiveness" when the health care dollar is not unlimited. This announcement today will be just one of the many future similar challenges we all face in caring for our patients.quotes

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Pfizer: Cancer Drug Does Well in Late-stage Study

(North Jersey/AP) Nov 19, 2010 - Pfizer Inc., the world's largest pharmaceutical company, said Friday its potential kidney cancer treatment axitinib performed well in a late-stage study compared to another drug.

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Robert A. Figlin, MD., FACP (Posted: November 19, 2010)

quotesThe current report suggests that Axitinib compared favorably to Sorafenib in a trial in patients with RCCa who had progressed following prior antiangiogenic therapy. Although no specifics were given this trial will form the basis for a future FDA submission of this drug. The kidney cancer research community also awaits the results of a front line trial of Axitinib therapy in previously untreated patients. Axitinib is a "next generation", VEGFr TKI with nanomolar inhibitory concentrations against the targets most important in RCC biology, and if approved will add to the 6 FDA approved drugs over the past 5 years in this disease. The clinical community treating these patients awaits comparative effectiveness studies to place these therapies in context.quotes

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CT Scans Can Reduce Lung Cancer Deaths, Study Finds

(New York Times) Nov 4, 2010 - Annual CT scans of current and former heavy smokers reduce the risk that they will die from lung cancer by 20 percent, a huge government-financed study has found.

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Robert A. Figlin, MD., FACP (Posted: November 04, 2010)

quotesThis long awaited trial performed by the National Cancer Institute demonstrates the benefits of low dose spiral CT scanning in patients at risk for lung cancer when compared to chest x-ray. A 20 percent reduction in mortality allowed the DSMB to stop the trial and inform the results. These results will be presented more formally in a peer reviewed journal but will allow patients at risk to have the promise of an earlier identification of their cancer. Challenges to this effort will be the balanced discussion about the risk of pursuing false positive results that might allow for the additional risks of unnecessary biopsies, surgeries, producing potential morbidity. In balance the results of this long awaited study will change the paradigm for the identification of patients at risk for getting lung cancer by using low dose spiral CT scanning with the hopes of this extending to reducing mortality from lung cancer. These approaches are often best offered by multidisciplinary teams composed of diagnostic and interventional radiologists, thoracic oncologic surgeons, and lung cancer medical oncologists.quotes

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Meet the Editorial Board

Prostate Cancer
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Tomasz M. Beer, MD, FACP

Professor of Medicine, Division of Hematology/Medical O...

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

Associate Clinical Professor, Medical Oncology Executi...

Gastrointestinal Cancers
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Howard S. Hochster, MD

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
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Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics Professo...

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

Steven Spielberg Family Chair in Hematology Oncology P...

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Stephen M. Schleicher, M.D., MBA

Community Oncology, Medical Oncologist, OneOncology...

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 ...

Health Policy
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William McGivney, PhD

National Health Policy Expert...