Catching Up After Summer Break

J Clin Pathways. 2021;7;(6):5.

It’s been a few months since the last issue of the Journal of Clinical Pathways. Hope your summer has gone well as we are moving into fall and the kids are back in school. Since our last issue,  The American Society of Clinical Oncology (ASCO) successfully ran its virtual meeting at the beginning of June. Our coverage of some of the research highlights presented during the conference begins on page 26. This year’s conference showcased many potential breakthroughs in breast, gastric, ovarian, prostate, and many other cancers, as well as presentations on real-world research and cost-effective analysis. We’ve showcased a bit of the research here, but visit us online at www.hmpgloballearningnetwork.com/site/jcp for more of our comprehensive coverage of this year’s ASCO virtual conference.

The world continues to battle COVID-19 with the growing presence of the delta variant causing a resurgence of infection spikes, after what looked like the beginning of a turnaround in early summer. Our COVID-19 coverage this month begins on page 32. Woodruff and colleagues provide an in-depth examination of the impact of a SAR-CoV-2 infection on patients who were previously diagnosed with immune-mediated inflammatory diseases. Given the key role of hyperinflammation in COVID-19 pathogenesis, this real-world study explored treatment journeys and outcomes for hospitalized COVID-19 patients with rheumatoid arthritis, psoriatic arthritis, psoriasis, Crohn’s disease, or ulcerative colitis. Their analysis evaluated ICU admission, length of stay, mechanical ventilation, oxygen use, mortality, and use of targeted immunomodulatory therapies (TIMs). The team found that hospitalized COVID-19 patients with immune-mediated inflammatory diseases had journeys similar to those of other COVID-19 patients, although with increased targeted immunomodulatory therapy use. Outcomes improved among patients hospitalized on or after May 1, 2020, which may reflect various factors related to the dynamic nature of the early phase of the COVID-19 pandemic, such as resource constraints, changes in patient behavior (eg, greater urgency in seeking care), or improvements in disease management. Nevetheless, the results are meaningful indicating that while the patient journeys are similar, more focused studies are needed to inform optimal management of COVID-19 disease in this population.

Kupsh and colleagues look at potential cost savings associated with alternative dosing regimen of nivolumab (NIVO) plus ipilimumab (IPI) for the treatment of metastatic melanoma on page 44. The authors compared the original dosing schedule of NIVO 1 mg/kg plus IPI 3 mg/kg with a NIVO 3 mg/kg plus IPI 1 mg/kg. based upon the CHECKMATE-511 trial demonstrating decreased toxicity without any notable differences in efficacy.  The authors analyzed a cohort of 21 patients treated with the alternative nivolumab and ipilimumab regimen. Using current institutional practice of dose-banding and AWP pricing, they found a potential cost savings of 47.2% (or about $70,000 per patient) when compared with original NIVO1 plus IPI3 regimen, which represents a total savings of nearly $1.5 million to their organization. 

Finally, I would like to welcome Rob Fee to the JCP team as its new Senior Managing Editor and congratulate Amanda Del Signore as she moves into a new and exciting position. Rob comes to us from a respected journal and is taking on Amanda’s role with JCP.  Amanda will remain in the JCP family as she has been promoted to the role of Associate Editorial Director, Special Projects. Welcome Rob and congratulations Amanda, and best of luck to both of you.  To our readers, thank you for your continued support.  Don’t forget to visit us online at www.journalofclinicalpathways.com for daily news and insights into clinical pathway utilization and applications, and we hope to see you at the Oncology Clinical Pathway Congress virtual meeting.