OBR Daily Commentary

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Merck KGaA, Pfizer's Immunotherapy Fails In Lung Cancer Trial

(Reuters) Feb 15, 2018 - Merck KGaA and Pfizer’s cancer drug Bavencio could not be shown to improve survival in lung cancer patients that had previously undergone unsuccessful chemotherapy, Merck said.

H. Jack West, MD (Posted: February 15, 2018)

quotesOn its face, the report that a trial of avelumab vs. docetaxel in chemotherapy-pretreated NSCLC seems surprising unless it's a clearly inferior checkpoint inhibitor to the ones that have already demonstrated positive results and similar efficacy in very similar trials -- namely nivolumab, pembrolizumab, and atezolizumab. We have presumed that these agents are all far more similar than different. The JAVELIN Lung 200 trial did note that the cross-over of such a higher proportion of patients to subsequent immunotherapy in this trial (26.4% on docetaxel arm, vs. 5.7% on avelumab arm) vs. other ones that have been positive is likely to be a relevant factor that compromised the ability to detect an improvement in OS in the broad study population. Frankly, I think it's disappointing that only just over 25% of patients received access to clearly very effective immunotherapy that has been a standard of care now for a few years. In my clinic, nearly 100% of patients who were ever eligible for a checkpoint inhibitor receive it over the course of their illness. The only question is whether it is delivered first line, second line, or later. And while this trial was conducted in a different time and place, the evidence should lead us to conclude that only 26% of patients receiving immunotherapy is gross under-treatment. It is also notable that the effects were reportedly greater in those patients with high level PD-L1 expression, as we've generally seen, with a positive survival benefit in that subset. We will need to see the actual data in an upcoming meeting, but I believe that it is premature to conclude that avelumab is a less effective therapy than the similar checkpoint inhibitors that have been approved in this setting already. I think the results may be most instructive in demonstrating that the timing of immunotherapy is not critical for many/most patients to achieve the same overall survival. In the contemporary practice of treating lung cancer, we should expect and aspire to have nearly all eligible patients receive one of these agents at some point over the course of their disease. quotes

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New Group Plans Midterm Spending Against High Drug Prices

(The Hill) Feb 1, 2018 - A new patient group says it plans to spend seven figures this year backing candidates who support policies to lower drug prices in what it hopes will be a counter to the pharmaceutical industry.

Winston Wong, PharmD (Posted: February 14, 2018)

quotesUnfortunately, this is reality. All of these tactics are being used to delay the release of generics. Holding back the reference product is a big thing in the biosimilar world. Recall it was not so far back that we heard of lawsuits files against the innovator companies for paying the generic manufacturer to delay their release. The only thing different today is that with the release of the generic, especially the Revlimid, the generic might not be that less costly. Keep in mind that only a 10% break in cost will support a generic designation. quotes

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Walgreens Awarded U.S. Patent for its Connected Care® Oncology Program

(Walgreens) Jan 29, 2018 - Walgreens has received a U.S. patent for new proprietary technology that its Walgreens community specialty pharmacists and AllianceRx Walgreens Prime’s specialty pharmacists will use to facilitate communication with and counseling of patients prescribed oral oncology medicines.

Winston Wong, PharmD (Posted: February 14, 2018)

quotesMedication Therapy Management programs have proven that they can improve patient compliance and adherence. Having a program focused on oral Oncology drugs is needed. My only concern is that for years, MTM programs have been promoted. In the real world, MTM program have failed, especially in the chain pharmacies due to the lack of time available to talk to the patient. Time allocation and productivity measure for the provision of MTM services have not been integrated into the pharmacy workflow. Hence, is frequently neglected. Yes the pharmacist asks if there are any questions. If the patient responds affirmatively, prescription filling slows down, especially if the medication is an oral oncolytic. So while I applaud Walgreens for developing a patient support program, I question if it will actually be put into place on a widespread basis.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

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
Pr...

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...