Top Takeaways from the 2021 ASCO Annual Meeting

June 18, 2021 Andrew Hertler, MD, FACP

Revenues from oncology drugs increased by a staggering 96% — from $52.8 billion in 2010 to $103.5 billion in 2019 — among the top 10 pharmaceutical companies, according to researchers from the University of Calgary in Alberta, Canada. Over the same period, oncology drugs increased from 13% to 27% of total revenues for these companies.

The findings raise questions about the value that patients are getting from the rapid proliferation of novel cancer therapies. While new oncology drugs cost an average of $150,000 a year, they have a survival benefit of 2.9 to 3.7 months. 

Beyond this, here are the top presentations from the Annual Meeting that caught my attention.

  • COVID-19 infections among cancer patients. Among more than 3,000 women treated for breast cancer in New York City at the height of the pandemic, only 64 women, or 2% of the study population, contracted the virus, according to a study. Of those infected, 10 died of COVID-19, a number the researchers said is low and expected for this age group, regardless of cancer.
  • Efficacy of hypofractionation. Research investigating hypofractionation has spanned decades, but during the COVID-19 pandemic it has gained additional attention. Fewer fractions (days of treatment) of radiation therapy, but in higher daily doses, can limit patient visits and thus their potential exposure to the virus. Recently, results from the United Kingdom's FAST-Forward trial, presented at ASCO, showed no difference in ipsilateral breast tumor relapse rate in groups treated via 15 fractions or five fractions. Researchers noted that five-fraction hypofractionation has been more widely adopted during the pandemic and has maintained increased use even as many restrictions have lifted.
  • Underuse of genetic testing. Two presentations explored the use of biomarker testing in the United States. One, focused on a network of community oncology practices that span more than 1,000 providers, found that less than 50% of patients were tested for five major biomarkers for non-small cell lung cancer. Another study reported that while 50% of White patients with metastatic non-small cell lung cancer underwent next-generation sequencing, just 40% of Black patients did. Such results may help to explain why a higher percentage of more White patients with NSCLC enroll in clinical trials, as many trials use molecular targets as inclusion criteria.
  • Cost savings from automated prior authorization. Provider adherence to National Comprehensive Cancer Network recommendations and implementation of an automated regimen-level prior authorization tool was associated with lower cost and more efficient oncology care in patients with non–small-cell lung cancer.
  • Reducing the risk of recurrence and death in renal cell carcinoma. Patients who received the immunotherapy drug pembrolizumab following surgery for high-risk clear cell renal cell carcinoma had 32% lower risk of disease recurrence or death than those who received a placebo. Researchers with the international phase III KEYNOTE-564 study also report 77% disease-free survival with pembrolizumab vs. 68% with the placebo.

Check out more on the forces shaping the future of oncology >>


About the Author

Andrew Hertler, MD, FACP

As the chief medical officer of Evolent, Dr. Andrew Hertler is responsible for the advancement of the company's clinical quality and value-based strategy, utilization management policies and clinical thought leadership initiatives. A practicing board-certified oncologist for 30 years, he is a nationally recognized leader in oncology clinical practice. Dr. Hertler has volunteered on a number of American Society of Clinical Oncology (ASCO) committees, including the Clinical Practice, Quality of Care and Payment Reform Committees, as well as the Quality Oncology Practice Initiative Certification Program Oversight Council.

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