Cancer Basket Therapy

Cancer Basket Therapy for Genetically Targeted Drug Treatment

The Dallas RO, CFD policy staff and medical consultants are submitting the following comments about the above topic:

#1

Although, clinical trials are under way each tumor must be sequenced in “precision medicine”, and large trials of treatment of a certain mutation are far from reality. Only anecdotal successes/failures will be known for some time, which cannot be translated to overall effectiveness of an agent for that tumor mutation, let alone for all patients with that tumor mutation, since other mutations are often involved (some active in the cause or growth of the cancer, some not).

Other than perhaps considering precision chemo as a modality for listings requiring “multimodal” therapy as criteria, I do not see precision/genetically targeted therapy as affecting the disability program any time in the near future.

CMRyan MD, DAL RO

#2

Without having done an extensive review of the medical literature to research the effectiveness and outcome of the multiple (27 types of cancer involving over 100 therapeutic agents as noted on the NCI website alone) medical trials:

1. Time to effectiveness is unknown, but when it becomes known and is the accepted medical practice, there may be listings considered to be under disability for more than 12 months from the date of diagnosis/initiation of treatment that might be reduced to 12 months. Too early to tell.

2. Response to treatment in the setting of metastatic disease is unknown, but in some cases, trials may show resolution of metastatic disease within weeks to months, so that simply having metastatic lesions would no longer be a reason to satisfy listing level severity. Again, these are early days.

3. Language including genetically targeted therapy as a form of multimodal treatment would need to be considered.

 

Overall, it seems too early to change very much in the listings.

MLRees, M.D.

Voting

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Idea No. 89