The promise of Immuno-oncology: implications for defining the value of cancer treatment

J Immunother Cancer. 2019 May 17;7(1):129. doi: 10.1186/s40425-019-0594-0.

Abstract

The rapid development of immuno-oncology (I-O) therapies for multiple types of cancer has transformed the cancer treatment landscape and brightened the long-term outlook for many patients with advanced cancer. Responding to ongoing efforts to generate value assessments for novel therapies, multiple stakeholders have been considering the question of "What makes I-O transformative?" Evaluating the distinct features and attributes of these therapies, and better characterizing how patients experience them, will inform such assessments. This paper defines ways in which treatment with I-O is different from other therapies. It also proposes key aspects and attributes of I-O therapies that should be considered in any assessment of their value and seeks to address evidence gaps in existing value frameworks given the unique properties of patient outcomes with I-O therapy. The paper concludes with a "data needs catalogue" (DNC) predicated on the belief that multiple key, unique elements that are necessary to fully characterize the value of I-O therapies are not routinely or robustly measured in current clinical practice or reimbursement databases and are infrequently captured in existing research studies. A better characterization of the benefit of I-O treatment will allow a more thorough assessment of its benefits and provide a template for the design and prioritization of future clinical trials and a roadmap for healthcare insurers to optimize coverage for patients with cancers eligible for I-O therapy.

Keywords: Immuno-oncology; Immunotherapy; Patient experience; Patient reported outcomes (PROs); Value.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Clinical Trials as Topic
  • Evidence-Based Medicine / economics
  • Evidence-Based Medicine / methods*
  • Evidence-Based Medicine / trends
  • Humans
  • Immunotherapy / economics
  • Immunotherapy / methods*
  • Immunotherapy / trends
  • Insurance Coverage
  • Medical Oncology / economics
  • Medical Oncology / methods*
  • Medical Oncology / trends
  • Neoplasms / economics
  • Neoplasms / immunology
  • Neoplasms / therapy*
  • Research Design
  • Treatment Outcome
  • Value-Based Health Insurance*