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Lumere Pharmacy Researcher Shirley Dehn recently attended the 2018 annual meeting of the American Society of Clinical Oncology (ASCO) in Chicago. Below she highlights some key findings based on this year’s theme, “Delivering discoveries and expanding the reach of precision medicine.”

Immune checkpoint inhibitors (ICIs) are making waves in many oncology and solid tumor settings, particularly in non–small cell lung cancer (NSCLC). What were the takeaways from ASCO?

ICIs blocks certain proteins made by some cancer cells, allowing the immune system to more effectively attack those cells. Over the past year, they’ve begun to be included as part of standard care for some NSCLC patients. However, patients can still receive chemotherapy alone as first-line treatment.

In the KEYNOTE-042 trial presented at ASCO, pembrolizumab, which blocks PD-1 protein, was found to extend median overall survival compared to standard chemotherapy alone as initial treatment, with the greatest benefit seen in patients with the highest expression of PD-L1.

These results may indicate a change in standard of care for these patients, with chemotherapy alone no longer being the preferred treatment. However, many questions remain, including when is stand-alone ICI therapy appropriate vs ICI combined with chemotherapy, and which combination should clinicians use? Hopefully, further research currently underway will give us more answers.

What was the discussion around biosimilars? It’s becoming clear that they still face many obstacles in the market.

Mylan and Biocon released positive results from studies of their recently approved biosimilars, Ogivri (reference product Herceptin) and Fulphila (reference product Neulasta). While these trials highlighted the expansion of biosimilars in the US, we’ve generally seen a delay in market uptake of biosimilars.

It’s important to note that, unlike generic drugs, biosimilars are not considered “interchangeable” to their branded products; no trial has evaluated a treatment switch from the reference product to biosimilar, or vice versa. Additionally, it is unclear how these antibodies will fare when used in common treatment combinations.

Finally, cost is still a huge question. How will payers cover these treatments? Will there be similar support and financial assistance programs that are available for reference products? As clinical societies begin to incorporate statements on biosimilars in their treatment guidelines, further education initiatives will be needed for physicians to become comfortable using them effectively.

The Lumere research team will keep these and similar topics on our watch list as we continue to review indications and outcomes.

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