Top 5 Takeaways From ASCO 2017

As oncologists, scientists, payers, health economists, and patients all descended into Chicago for the American Society of Clinical Oncology (ASCO) Annual Meeting from June 2-7, a collaborative sentiment was high on everyone’s mind, reflecting the theme of this year’s meeting: Making a Difference in Cancer Care With You. The following are a few reflection points from the meeting:

1. The latest treatment advances for NHL. Craig Portell, MD, of the University of Virginia Health System, believes that some of the new treatments for non-Hodgkin’s lymphoma (NHL) are changing the standard rituximab antibody and are developing novel ways of targeting CD20 in NHL. He also believes that chimeric antigen receptor T-cells and targeted therapies, particularly venetoclax, will revolutionize NHL treatment.

2. Earlier diagnosis for several cancers post ACA. Analysis of data available within a national hospital-based registry showed that the diagnosis of stage I disease increased for female breast cancer, colorectal cancer (CRC), and lung cancer following implementation of the Affordable Care Act (ACA). The study identified a shift to early stage diagnosis for CRC and lung cancer, primarily in Medicaid expansion states, while the shift observed for female breast cancer was independent of the states’ Medicaid expansion status.

3. Biomarker-based patient selection important in NSCLC. Several oncologists shared their experiences and provided an update on the use of immunotherapy agents—specifically, the programmed death-1 and programmed death ligand-1 inhibitors—in non-small cell lung cancer (NSCLC). A key takeaway was the importance of biomarkers in patient selection. For example, Edward B. Garon, MD, director of the thoracic oncology program and associate professor of medicine at the David Geffen School of Medicine at University of California Los Angeles, highlighted that:

• Patients with staining in at least 50% of their tumor cells should be eligible for frontline pembrolizumab
• Those with staining in less than half of their tumor cells should receive standard chemotherapy as frontline

Read more from the session here.

4. MACRA is here, and you would better be prepared. The Medicare Access and CHIP Reauthorization Act (MACRA) replaced the Sustainable Growth Rate formula through the Quality Payment Program (QPP). At ASCO, oncologists received a 101 on how to prepare their practice to meet CMS’ demands for quality reporting from expert speakers, including Blase N. Polite, MD, MPP, associate professor of medicine, The University of Chicago, and Barbara McAneny, MD, chief medical officer of New Mexico Oncology Hematology Consultants.

Addressing some of the challenges associated with new CMS-proposed payment models, McAneny said, “We need to talk to CMS to devise a more realistic system and develop targets that we can achieve.”

5. A single solution for financial toxicity. Yousuf Zafar, MD, MHS, associate professor of medicine, Duke University Medical Center, who has published a considerable amount of work on the financial effects of cancer care on patients and their families, chaired a discussion on the topic at the annual meeting. Panelists, who represented pharma, payer, physician, and patient viewpoints, discussed practical solutions to address the financial toxicity of cancer care and identified leads for future intervention studies aimed at prevent or reducing this patient burden.

You can access our complete meeting coverage here.