Access to Adjuvant Therapy for Stage III Patients

ANNETTE CYR Three-time melanoma survivor. Chair & Founder,
Melanoma Network of Canada with melanoma survivor Sandy Hodder
At MNC Toronto Sunnybrook Melanoma Information Session 2018

This fall has been exceptionally busy for all of us at MNC and our patient community. Progress is being made to bring therapies currently only available for metastatic stage IV patients to stage III and stage IV patients who have had their melanoma fully resected (removed with no further evidence of disease). As many of you likely know, trials have been running in the country over the past two years for adjuvant therapies in the hopes of preventing any future recurrence of disease. Data from clinical trials has shown very strong results in reducing recurrence rates, which is a comfort to patients, their families and our health care providers. We are entering another new period of hope and improved health outcomes for many with the expectation of reducing the numbers of metastatic patients in the future. This will save lives and also reduce long term health care costs.

We have been working one on one with many patients and their caregivers to help with drug access issues again in 2018. Thanks to so many of you that participated in our survey, Melanoma Network of Canada submitted the results of the feedback from our patient survey conducted in August and September to the Pan Canadian Drug Oncology Review pCODR https://cadth.ca/pcodr. This submission helps the decision making body understand the unmet need for these specific drug therapies. pCODR then spends several months reviewing the data on this submission – from us, from the medical community and the drug manufacturer, to come to a recommendation for the provinces as to whether or not the provinces should consider funding this drug therapy.

In this case, melanoma is once again at the forefront for opening up adjuvant treatment in the immuno-oncology world by providing treatment for stage III and IV fully resected patients. One of our submissions was for the targeted combination therapy of Dabrafenib (Tafinlar) and Trametinib (Mekinist) for BRAF positive patients. This combination also received Health Canada approval in September, which means that stage III patients who currently cannot get access through private insurance coverage, or a clinical trial, have the possibility to pay out of pocket for the drug therapy. More often than not, this is just not in the realm of affordability for patients, so, of course our hope is that this file proceeds quickly and that provincial governments look to fund these therapies where private insurance is not available, and as quickly as possible.

The second submission in September was for Nivolumab (Opdivo), again, for use in the adjuvant setting for stage III and IV fully resected patients. We are pleased to announce that Bristol-Myers Squibb Canada received Health Canada approval November 16th, 2018 – NOC (notice of compliance), which now provides a compassionate access bridge program to allow stage III patients that are within 12 weeks of surgery to be able to access Opdivo, where there is limited or no private insurance coverage. This is such wonderful news and so important for patients. If you have any questions about access, please speak to your medical oncologist or contact our offce directly (905) 901-5121 x 105. Charlene will be pleased to help. As well, in December, we will be providing our submission to pCODR for pembrolizumab (Keytruda), which is also looking to be available in the adjuvant setting for stage III patients. We are hopeful there will also be a program available to help patients with access while we wait for government approvals. Thanks to all of you for the signiffcant response to our patient survey for adjuvant access for these needed therapies.

It is such a privilege to work so closely with our dedicated and compassionate healthcare providers, our volunteers and our exceptionally talented staff at MNC, who also give freely of their time to support MNC with our outreach and educational materials and programs. On behalf of our Board of Directors, we wish you all a wonderful Christmas and holiday season and may the New Year bring you and your family’s health and happiness. Thank you for your continued support.

Chair & Founder, Melanoma Network of Canada

CLINICAL TRIALS

For those seeking clinical trials in Canada, you can visit the Canadian-based registry for cancer trials at Canadian Cancer Trials. www.canadiancancertrials.ca/ or in the US at www.clinicaltrials.gov/ and www.Clinical Trials.gov
For more information on clinical trials visit www.melanomanetwork.ca/clinical-trials or call 1-877-560-8035