ASCO/ ESMO joint session on access to cancer care- value scales

ASCO VALUE FRAME WORK
Lowell Schnipper

Interest to listen to Lowell Schnipper- their primary motivation was to reduce out-of-pocket expenses for patients.

ASCO framework includes costs, but only rudimentarily and focuses on the out-of-pocket costs of the patients.

Should frameworks differ according to purpose? Lowell Schnipper says YES.

Should patients bear the cost if they derive no benefit from the therapy? NO.



ESMO Magnitude of Clinical Benefit Scale 
Elisabeth De Vries

earlier study could only score comparative studies- needs to be able to grade single arm studies for 'orphan disease' and 'high unmet need'

There will be a workshop for patients (rather patient advocates though ;-))

Where the scale is used:

1. ESMO organisation
- included in the ESMO Guidelines (so this will affect Melanoma patients)
- also used for mapping access: valuable drugs not available, not valuable drugs were available 

2. Doctors in patient care
Physicians use the scale to explain the benefit of medicines to patients

3. Training of oncologists

4. Academic groups 

5. Industry
'uses the scale to advertise for drugs. When the scores are good'

6. Organisations

WHO considers it a valuable tool
Countries begin to use the scale for policy decisions
EHA performing field-testing
Tested for radio-therapy


The Value of Pathways
Russell Hoverman

Aetna Medicare Project reduced hospitalisation and costs with the same outcomes. 

• Pathway planning
• Tight follow-up
• Advanced care planning

Five interesting scientific abstracts to be followed at ASCO

Five interesting scientific abstracts that will to be followed at ASCO in a Medscape interview with Dr. Jeffrey Weber, a medical oncologist at the New York University Langone Medical Center in New York City:

1) KEYNOTE-006 clinical trial update: 50% of patients with inoperable metastatic disease treated with pembrolizumab lives up to 3 years. Also, data suggest that patients who stopped because of toxicity or after 2 years of treatment could continue to respond to the therapy (Caroline Robert, Institut Gustave Roussy in Paris, France);

2) Combi-d update: 28% of the patients receiving the combination Dabrafenib /Trametinib are alive after 5 years. A higher overall survival rate of 51% could be seen for patients that started the treatment with normal levels of LDH and three or fewer sites of disease (LDH or lactate dehydrogenase is here a biomarker for the progress of the disease), (Georgina Long, University of Sydney, Australia).

3) Combi-MB trial update shows a response rate of 55% and a median overall survival of 10,5 months for patients with brain metastasis treated with the combination dabrafenib/trametinib. So, patients with brain metastasis will do well on the combination, but ‘’probably not so well as the patients who start the treatment without brain metastasis (Mike Davies from MD Anderson Cancer Center in Houston, Texas).

4) CheckMate 204 study update will be presented by Hussein Tawbi, from MD Anderson Cancer Center. 
In this study, 40% of the patients with brain metastasis, treated with a combination of immunotherapy (ipilimumab/nivolumab) responded to the therapy.

5) And finally, the ECOG/intergroup 1609 clinical trial has (unplanned!) shown no significant differences in the Relapse Free Survival at 3 years, between 10 mg/kg (54%) and 3-mg/kg ipilimumab (56%). This result could lead to using the 3 mg/kg ipilimumab dose as adjuvant therapy, but not 10 mg/kg, with a higher toxicity (ECOG Intergoup 1609 trial compares ipi versus interferon- but data not out yet).

Short Update on Screening and Early Detection

Melanoma Screening: Review of Current Evidence and Guidelines
SancyAnn Leachman

The guidelines are not providing the optimal number of check per year. For the population at risk 3-12 months or in Germany, every 2 years.

An overview of melanoma detection methods: 

no one is perfect.

Defining patient who should be considered at risk

Example: proposed criteria to define the patients that could be at high risk to get skin cancer and therefore could qualify for the a monitoring program UPSTF (US preventing Service Task Force)

Some Melanoma Previews before ASCO2017

Jeff Weber on what to look forward to at ASCO : Targeted therapy Updates, High Dose Pembro updates, Ipi/Nivo updates and what is doing well for Brain Mets ...

Preview of melanoma at ASCO 2017

2 more weeks and abstracts are out!

Only 2 more weeks till the next trip to the windy city

so high time to check the ASCO abstracts here

Same procedure as every year, so please add the talks, abstracts and posters that you find particularly relevant as comments to this very post. 

And we will do our best to cover them on the blog!

ASCO 2017 is coming up!

The annual conference of the American Society of Clinical Oncology, ASCO, will take place in Chicago, 2nd- 6th June 2017.

You will find the full program here:
https://iplanner.asco.org/am2017/#/