Today "leaders from large pharma including Celgene and Amgen, biotech including NantWorks, NantKwest, Etubics, Altor Bioscience, and Precision Biologics, major academic cancer centers and community oncologists announced the launch of The National Immunotherapy Coalition (NIC), a historic alliance--in collaboration with Independence Blue Cross, one of the nation’s largest payers and Bank of America, one of the largest self-insured companies in the U.S.--with a singular focus: accelerating the potential of combination immunotherapies as the next generation standard of care in patients with cancer."
This is perhaps the most important scientific initiative undertaken in human history for reasons I will elaborate in another post.
For now, here are the three most important features of this initiative:
1. The QUILT (QUantitative Integrative Lifelong Trial) program is designed to harness and orchestrate all the elements of the immune system (including dendritic cell, T cell and NK cell therapies) by testing novel combinations of vaccines, cell-based immunotherapy, metronomic chemotherapy, low dose radiotherapy and immunomodulators -- including check point inhibitors-- in patients who have undergone next generation whole genome, transcriptome and quantitative proteomic analysis, with the goal of achieving durable, long-lasting remission for patients with cancer.
2. Multiple randomized Phase 2 trials testing genomically and proteomically informed novel combinations of immunotherapy agents, will pave the way to identifying cancer therapy combinations with the lowest toxicity and the highest quality of life.
3. Insurers will be covering whole genome transcriptomic tests in patients receiving immunotherapy. Independence Blue Cross is the first health plan to cover next generation sequencing. The coalition is talking to others, who I think will have to follow.
This is good for patients and innovation. And this approach -- which should be replicated for other illnesses where combinations of treatments - old, new and emerging -- will be gold standard of care.
That mean groups that seek to measure the value of a single cancer drug based on average response -- like ICER, the ASCO Value Framework, and Peter Bach's comical Cancer Drug Abacus etc. will become obsolete. That means Express Scripts effort to use the aforementioned comical Cancer Drug Abacus to establish indication based pricing should be discarded and ignored. Any entity claiming it wants to establish value that does not seek to promote payment and access to precision medicine to match patients to treatments that control and prevent disease most effectively should be considered outdated and obstructionist.
This is a great day for those committed to cures. And that should include everybody.