The American Society of Clinical Oncology (ASCO) recently held its annual meeting in Chicago, Illinois. The meeting brought together oncologists, payers, and other stakeholders to discuss the latest updates and therapeutic advances in cancer care. Here are 5 of the biggest takeaways from the meeting.
1. Medicaid expansion associated with reduction of racial disparities in cancer care
A study presented at the 2019 ASCO Annual Meeting found that Medicaid expansion under the Affordable Care Act nearly eliminated
racial disparities in access to cancer care in states that expanded coverage. White patients in states without Medicaid expansion received chemotherapy within 1 month of their cancer diagnosis 48.3% of the time, whereas African American patients received it only 43.5% of the time. However, in states with Medicaid expansion, this difference was reduced to only a 0.8-point difference. Additionally, Medicaid expansion also increased the percentage of white patients who received chemotherapy in 1 month by 2 points, while increasing it by 6 points for African Americans.
2. Olaparib in BRCA-mutated metastatic pancreatic cancer
findings that patients with advanced pancreatic cancer linked to BRCA
mutations did not see their disease worsen for an additional 3.6 months when treated with olaparib, but an early interim analysis did not show a statistically significant difference in overall survival. The analysis found a median 18.9 months overall survival for the olaparib group and 18.1 months for the placebo group.
3. Tensions ran high at ASCO town hall on drug pricing
During a town hall on drug pricing
, Jeffrey Ward, MD, FASCO, and Rodney Whitlock, PhD, took the stage to lead a fireside chat on the topic. The discussion included topics such as the International Pricing Index and trying to pinpoint who or exactly what is to blame for ever-increasing drug costs. When Michael Kolodziej, MD, asked the presenters why the government isn’t interesting in pursuing outcomes-based contracting, Whitlock put the question back on Kolodziej and every other oncologist in the room stating that, “If you as an organization want to drive that conversation, you’re better equipped than someone else at the ‘mothership’ in Baltimore, where CMS is located, to come up with the idea.”
4. Adding clinical risk to genomic tests benefits therapy choices in breast cancer
The 21-gene assay, Oncotype DX
, found a year ago to help many women with a common type of breast cancer avoid chemotherapy, may also be used alongside an assessment of tumor size and stage. By adding “clinical risk” to the equation—tumor size and histologic grade—offers additional prognostic value, “that, when added to the 21-gene recurrence score, could be used to identify premenopausal women who could benefit from more effective therapy,” said Joseph Sparano, MD.
5. Venetoclax–obinutuzumab superior to chlorambucil combination in CLL
A new study compared
venetoclax in combination with obinutuzumab to the combination of chlorambucil and obinutuzumab and found that the venetoclax combination is associated with longer progression-free survival among previously untreated patients with chronic lymphocytic leukemia. At 24 months, progression-free survival was 88.2% among patients receiving venetoclax–obinutuzumab compared with 64.1% among patients receiving chlorambucil–obinutuzumab. Importantly, this benefit was seen regardless of TP53
deletion, mutation, or both, in patients with unmutated IGHV
, and in other subgroups.