Mar 5, 2013 02:50PM gpawelski wrote:
According to comments given from experts to Medscape Medical News (MMN), there is concern and frustration that this new drug is very expensive, leading to speculation that there will be a backlash against it, as there was with Zaltrap (aflibercept). The Memorial Sloan-Kettering Cancer Center very publicly refused to use Zaltrap because it was much more expensive than another approved drug for the treatment of colorectal cancer, which had similar efficacy.
Dr. Ann Partridge, from the Dana-Farber Cancer Institute and Harvard Medical School, told MMN that "all of these drugs are very expensive, making it difficult for some patients to get them even when they are approved and available." All four of the targeted therapies approved by the FDA for the treatment of HER2-positive metastatic breast cancer come with a high price tag. Drug prices seem to be set at the estimated maximum the market will bear.
Private practitioner Dr. Steven Vogl told MMN that the data on Kadcyla (T-DM1) are not as clear as they should be. The study's control regimen (Tykerb and Xeloda) was "distinctly suboptimal" and not a standard of care, even though it is an FDA-approved treatment option in this setting. The 5.8 month difference in overall survival in the two study groups might have been inflated by this control regimen. He would have preferred to see the control patients also receive Herceptin, which he believes to be a necessary complement to Tykerb.
He goes on to say that Kadcyla (T-DM1) does not meet the goals of a major advance, explaining that such an advance, in his opinion, must cure some patients, increase the rate of clinical complete remission, or produce a high rate of very long partial response.
This all should remind physicians that it is the good outcome of the patient not the therapy applied that constitute successful application of the healing arts. We must remember that the best medical care is not always the most expensive. We can still hope for a good outcome if you use all the available drugs at our disposal that best meet the needs of the patient.