Immunotherapy Needs New Value Framework, Say SITC 2016 Attendees

Immunotherapy Needs New Value Framework, Say SITC 2016 Attendees

Immunotherapy has changed the oncology field in an unprecedented way, but typical value models used to assess cancer treatments can’t grasp the unique characteristics of this therapy.

That’s the consensus of experts at SITC 2016, the annual meeting of the Society for Immunotherapy of Cancer (SITC).

New oncology therapeutics average more than $10,000 a month, said Peter P. Yu, MD, physician-in-chief of the Hartford Healthcare Cancer Institute, who was at the Nov. 9-13 gathering at Maryland’s National Harbor.

All available models to assess the value of a cancer treatment look at cost, effectiveness and population health impact. But no model can perfectly be applied to immunotherapy because of the tendency to overestimate the impact of acute but reversible toxicities, as well as the costs of treatment.

Moreover, these models tend of underestimate the benefits of long-term and treatment-free survival, said Michael B. Atkins, MD, deputy director of Georgetown University Medical Center’s Lombardi Comprehensive Cancer Center.

Regarding toxicity, roughly half of patients getting the Opdivo-Yervoy combination develop serious immune toxicities (in the liver, colon or endocrine organs), but about 80 percent of these consequences are resolved in four to six weeks, said Atkins. In addition, these effects do not interfere with patient response to therapy.

Atkins added that immunotherapy combinations might actually be less expensive than single agents if they work faster. Immunotherapy helps not only patients but also society, as the annual benefit of curing just 1 percent more cancers is estimated at $500 billion, he said.

But these models could also be used as a basis to develop a new value framework for immunotherapy, the researchers said.

This new model could include benefits shown via positive clinical trial results, as well as patient-reported outcomes (PROs), say Heather S. Jim, PhD, associate member at Moffitt Cancer Center, and Adam P. Dicker, MD, PhD, senior vice president and chair of radiation oncology at Thomas Jefferson University.

According to these researchers, PROs might help show clinical benefit in reducing disease-related symptoms, providing more accurate estimates of toxicity, enhancing value frameworks, helping model treatment costs and improving symptom management, through computer or smartphone technology, or activity trackers, for instance.

Please read the full press release for examples of studies that helped show some of the results presented here.