Advancing Oncology Treatment and Health Equity – An ASCO Recap

The annual meeting of the American Society of Clinical Oncology (ASCO) was held last month and I am excited to share with you my thoughts on the highlights from this year’s cutting-edge research presentations. The theme of this year’s meeting was “Equity: Every Patient. Every Day. Everywhere.” In addition to the R&D presentations, this year’s meeting focused on the importance of equity in healthcare and cancer treatment. As the healthcare community continues to work hard to find better and more effective therapies for cancer, we all have the responsibility to do our part to address and correct disparities in cancer care, treatment, and research. 

Research Advancements 

This year’s ASCO meeting featured over 2500 abstract presentations. I considered the presentations in terms of scientific impact, likelihood to bring a change in the treatment landscape, as well as the potential impact on market dynamics. In this light, some of the most impactful highlights focused on targeted cancer drugs, the introduction of a new class of checkpoint inhibitors, and increasing developments for CAR T-cell therapies for multiple myeloma. 

Targeted Cancer Drugs

Targeted cancer therapy uses drugs designed to target specific genetic changes that happen within cancer cells. ASCO provided the opportunity for updates on several targeted cancer therapies that won accelerated FDA approval this past year.  First-up, Amgen’s sotorasib (Lumakras) for non-small cell lung cancer (NSCLC) is the first drug approved to treat cancers driven by a KRAS gene mutation. New data presented at ASCO showed a significant median overall survival of 12.5 months as of the cutoff date. In addition, Johnson & Johnson reported data for their recently approved Rybrevant for NSCLC patients whose tumors have an alteration of the EGFR gene within the exon 20 region. Notably, the overall response rate was 40% in the 81-patient open-label study with a median overall survival rate of 22.8 months compared to 13.1 months in patients treated with real-world therapies. 

Other noteworthy targeted advancements include Novartis’s Phase 3 data for 177LU-PSMA-617 radiation therapy for prostate cancer with a 4-month improvement in overall survival vs standard of care. In addition, Merck and AstraZeneca’s Lynparza adjuvant treatment for breast cancer associated with BRCA1 or BRCA2 mutations reported preliminary Phase 3 study results demonstrating a 42% reduction in cancer recurrence or patient death after one year compared to placebo. 

Cancer Immunotherapy

Checkpoint inhibitors are an effective form of cancer immunotherapy that works by releasing a natural brake on your immune system so that your immune cells can recognize and attack tumors. Bristol Myers Squibb presented phase 3 results for its novel checkpoint inhibitor, the anti-LAG3 antibody relatlimab. This candidate adds a third checkpoint inhibitor to the class in addition to PD1 and PDL1 inhibitors. Relatlimab data from the RELATIVITY-47 trial presented the impact of a fixed-dose combination of checkpoint inhibitors relatlimab and Opdivo (nivolumab) in melanoma first-line treatment. This is the first late-stage trial globally to demonstrate the efficacy of a combination of anti-LAG-3/PD-1 agents compared with nivolumab (Opdivo) alone. The results demonstrated that the combination was better at stopping melanoma progression compared to nivolumab alone. This data bodes well for other companies pursuing LAG3 as a target, including Merck (favezlimab) and Regeneron (ianlimab).

CAR T-cell Therapy

CAR T-cell therapy is a way to get the T-cells of your immune system to fight cancer by genetically altering them in the lab so that they can specifically target cancer cells. This is a recent class of cancer therapies: the first CAR T-cell therapy was approved by the FDA in 2017. Ide-cel (Abecma) is the first BCMA-directed CAR T-therapy approved for the treatment of multiple myeloma. Longer-term efficacy and safety results reported at ASCO showed that 73% of patients treated with ide-cel had a partial response and 33% had a complete response (no detectible cancer) two years after treatment. 

Off-the-shelf CAR T-therapies represent an opportunity for lower costs and quicker, more efficient patient access to this class of therapy. Progress has been made in the study of allogeneic CAR T-cell therapies which use healthy donor T cells instead of re-engineering a patient’s own cells. While early in clinical testing, a study reported at ASCO studied 41 patients treated with ALLO-501, and investigational anti-CD19 CAR T therapy. The results showed 75% of patients responded to treatment and half achieved a complete response. This is encouraging because the results show a similar response to already approved CAR-Ts that use the patient’s own T-cells. 

Equity in Cancer Treatment

Equally as important as the research advancements outlined above, is the importance that patients in need of these cutting-edge therapies are able to access them. This year’s ASCO meeting focused on the importance of equity in healthcare and how we in the healthcare industry can change the status-quo to ensure that medically underserved patients can access the care they need. It is essential that all stakeholders in the healthcare community work together in order to achieve equity in cancer care.

In her opening remarks, ASCO President Dr. Lori Pierce described ASCO’s commitment to health equity describing the mission pillars of research, education, and quality of care as guiding lights to our North Star “which is that every patient, everywhere should receive cancer care that results in the best possible outcome.”  Several initiatives are underway in support of this mission including a commitment to increased diversity in clinical trials, educational programs, mentoring and resources to build an oncology workforce that reflects the demographics of the US population it serves.

At OptimizeRx we are committed to developing innovative technology solutions to ensure that all patients have timely, affordable access to their doctor’s first choice of therapy. Our newest technology focuses on enrollment and onboarding for specialty medications. It removes access barriers by simplifying the specialty prescribing process for healthcare professionals (HCPs). Streamlining the process increases the success rate of patients getting on therapy and reduces time-to-fill so that patients can start medication sooner. The OptimizeRx platform provides opportunities for manufacturers to support and engage with providers at all points of care in new ways, both within and outside electronic health record (EHR) systems e. Our recent partnerships have significantly increased the platform’s touchpoints with oncologists, providing opportunities for pharmaceutical manufacturers to provide resources to more than 50% of all oncologists in the U.S.   

We are aligned to the ASCO mission to help ensure that patients have affordable and easy access to the therapies that they need.

References

1. https://www.cancernetwork.com/view/median-pfs-extended-in-advanced-melanoma-treated-with-frontline-relatlimab-nivolumab

In 2021, roughly 1.9 million people will be diagnosed with cancer in the United States.