Saturday, 30 May 2015

Value-based Health Care Delivery


Sitting in a really good session by Michael Porter, Harvard Business School, on Value-based Health Care Delivery who takes a very high-level perspective at Health Care Delivery.

He argues that previous attempts of improving Health care haven't really moved the needle in order to address the real challenges of how Health Care is delivered. He therefore advocates for Health Care delivery based on Value.


He defines Value in Healthcare like this-

Value =     Health outcomes that matter to patients
                     Costs of delivering the outcomes


And argues for a Holistic approach in looking at Health care delivery-

OUTCOMES are the FULL set of health results that matter to a patient
COSTS are the FULL set of costs of care for the patient's condition


He defines a

Strategic Agenda

1. organize care around Patient conditions- Integrated Practice Units instead of organisation by discrete speciality

2. measure outcomes and costs for every patients

3. move to bundle payments for conditions

4. integrate multi-site Care Delivery Systems

5. expand Geographic Reach in areas of excellence

6. build an enabling Information Technology Platform



I think that we have come across most of these- in the specialised centres and multi-disciplinary teams Melanoma should be treated- but might be a good idea to have a more systematic look at it from an advocacy perspective: how does what we see very specifically in our countries compare against e.g. this agenda?
What do we miss? What do we want to see? And how do we measure what Value means for Melanoma patients?




Wednesday, 27 May 2015

ASCO daily news online



You an follow ASCO's daily news on this special website here  -

very worth reading to start with: the Melanoma pathway and the drugs targeting it- MAPK pathway

Tuesday, 26 May 2015

Noteworthy ASCO findings



Let's collect anything interesting you picked up when going through the ASCO abstracts or online communication or publications or anything else related to ASCO 2015 under here- together we see more!





Name your topics of interest


This time, I plan to collect interesting updates per topic- in addition to single updates- so if you had particular areas of interest, please add them under comments here!

Nothing promised but I'll do my best :-)

For very specific questions- e.g. regarding a single new drug or the follow up of a basic research paper you've seen- please check the ASCO abstracts here first.

And please should you find anything of relevance in the abstracts/ ASCO documentation online that you feel the wider Melanoma community should read, please directly comment on the relevant post or the extra post 'Noteworthy ASCO findings'.


Topics planned so far-


  • Acquired resistance to targeted therapy
  • Combination of Ipi and PD1
  • Adjuvant options for Stage 3 Melanoma



Monday, 25 May 2015

Overview of current Melanoma drugs


Melanoma has gotten a number of new drugs during the last years- in order to follow what is what, this is a broad overview, extract from the MPNE website:



Targeted therapies

Currently available in Melanoma for patients whose tumors carry the BRAF mutation. Drugs are small molecules coming in the form of pills that one needs to take daily and that specifically block the mutated protein- so they only work for these patients.
In the future, there will hopefully also be other targeted therapies for patients with BRAF wild-type, NRAS- or c-KIT mutated Melanoma available.
Combining a BRAF inhibitor with a MEK inhibitor has been shown to increase the effect on the signalling pathway the Melanoma crucially depends on by providing a double road-block instead of a single one.


BRAF inhibitors

VEMURAFENIB , marketed as Zelboraf.
DABRAFENIB, marketed as Taflinar.

MEK inhibitors

TRAMETINIB, marketed as ​Mekinist.


Immune therapies

Antibody-based immune therapies use the bodies own immune system to flight Melanoma. They are antibodies requiring a perfusion every 2 or 3 weeks and there are a number of different schemes, some with an induction and/ or maintenance. 
Normally, our immune system has in-built 'brakes' to prevent over-shooting immune activity (which would become an auto-immune disease). These immune therapies block specific brakes- after which the body continues to attack the Melanoma.


CTL-4 antibody

IPILIMUMABmarketed as Yervoy.

PD-1 antibodies

PEMBROLIZUMAB, marketed as Keytruda.
NIVOLUMAB, marketed as Opdivo.


ASCO 2015 meeting abstracts- Melanoma



ASCO 2015 meeting abstracts are available now, these are the ones if you search for Melanoma !



421 results!


The complete listing for Melanoma is available here !

Saturday, 23 May 2015

ASCO 2015



The 2015 ASCO Annual Meeting will start in Chicago at the end of next week.

Title this time- Illumination & Innovation- transforming data into learning 


Very relevant to Melanoma indeed as we still have way to go before advanced Melanoma will be considered a curable disease!

Like last year, I'll be attending the conference and write about the most interesting Melanoma findings and general observations of interest for our community on this blog but please, I'm just one person, so make sure you check out all other options how to follow! As you know, everyone keeps the latest findings for events like this!!

So

You will find the program overview here, and search by session here -particularly relevant will be obviously the Melanoma/Skin Cancer track, but also the Developmental Therapeutics and Translational Research track tends to have information relevant for Melanoma. 

You can search for abstracts here

For a quick overview, print the track program here - the pdf is also available on the MPNE forum.

It is worth browsing the poster abstracts as one tends to find very interesting observations there.

And they even made a video to explain how to most effectively search the program!

There is a special page for patient advocates and please check out these options how to stay updated about the latest news via social media and mailings.

On twitter, make sure you follow @ASCO, @ASCOpost and the meeting under #ASCO2015 - and obviously tag your own posts accordingly to contribute :-). And we are @MPNE, just in case!


And please let me know should you be there and wanted to meet up for a coffee!

Bettina