A multinational survey commissioned by pharmaceutical firm Bristol Myers Squibb (BMS) reveals that the majority of cancer doctors, surgeons, and specialists believe that immunotherapy is likely to have a positive impact on the treatment landscape, when it comes to patients with earlier-stage cancers, regardless of pre- or post-surgery status. The survey checked in with more than 250 cancer care providers in the US, Japan, Germany, Italy, and France currently treating patients diagnosed with Stage I to Stage III disease, across eight different types of cancer.
While the healthcare providers responding to the survey question said they are more satisfied with current treatments in cancers where earlier options are well established, the majority of respondents expressed enthusiasm regarding the potential of employing immunotherapy in earlier-stage cancers.
Michele Maio, director of medical oncology and immunotherapy for the University Hospital of Siena in Italy, said consideration of immunotherapy is in line with the oncology field’s perpetual interest in new and elevated solutions.
“Cancer recurrence often marks the transition from curable to incurable disease and can be life-altering for patients, which is why we continually investigate ways to improve upon the standard of care,” Maio said. “Optimizing cancer treatment in its early phases, before the disease returns or spreads, represents a significant opportunity and unmet need.
“Research with immunotherapy in these settings is growing, and the survey results announced today reinforce that a majority of healthcare providers surveyed are enthusiastic about its future potential,” Maio added.
Jonathan Cheng, BMS senior vice president and head of the oncology department, remarked that the field of oncology care has seen notable changes in recent years.
“Over the past decade, immunotherapy research has evolved, starting with a focus on metastatic cancers, and more recently, expanding to explore the role of these treatments in earlier stages of the disease,” Cheng said. “We hope that by addressing cancer in earlier stages, when the immune system may be more responsive and intact, immunotherapy may have the potential to prevent recurrence and ultimately lead to patients living longer.”
Treatment for cancers in neoadjuvant, adjuvant, or peri-operative settings frequently consists of chemotherapy, radiation, targeted therapy, chemoradiation therapy, and (increasingly in a subset of tumors) immunotherapy. The survey pinpointed several trends on current use, satisfaction, and drivers of treatment choices in earlier-stage cancers.
For example, providers surveyed do not always use treatment beyond surgery: The majority of HCPs surveyed report that they “sometimes” use neoadjuvant (62%), adjuvant (55%), or peri-operative (54%) treatments for patients with earlier stages of cancer, highlighting the opportunity for earlier intervention.
Also, the care providers surveyed indicate they are more satisfied with current treatments in cancers where earlier options are well established. Six out of 10 or more survey respondents are “very” or “fairly” satisfied with current neoadjuvant (67%), adjuvant (70%), and peri-operative (61%) treatment options as a whole.
However, satisfaction varies by tumor and is highest among cancers with well-established therapies, such as breast cancer (87% satisfaction in the neoadjuvant/adjuvant settings) and melanoma (77% satisfaction in adjuvant). Regarding kidney and liver cancers, satisfaction is noticeably lower (less than 35% satisfaction with neoadjuvant, adjuvant, and peri-operative options), signaling the need for additional research.
Providers responding to the BMS survey indicated they tend to use immunotherapy in earlier stages (either as approved therapies or in clinical trials), but typically not as often as other treatments. The respondents report more experience using chemotherapy (85%, 86%, and 73% for neoadjuvant, adjuvant, and peri-operative, respectively) than immunotherapy (48%, 65%, and 39%, respectively), likely reflecting that immunotherapy remains under investigation in a number of tumor types and only recently emerged as an approved option in others.
The survey explored perceptions of immunotherapy and found many providers see the potential for a positive impact with immunotherapy in earlier stages of disease. They indicated seeing the highest potential for positive outcomes in melanoma (92% report positive potential impact in the adjuvant setting), lung cancer (89% in the neoadjuvant setting), and bladder or urothelial cancer (84% in the adjuvant setting).
What’s more, those surveyed believe the potential benefits of immunotherapy align with what currently drives treatment preferences in earlier settings. Choosing from a list of benefits, the said the most important potential benefits of immunotherapy as longer overall survival (64%), increased disease-free, event-free, or recurrence-free survival (57%), and maintenance of quality of life (54%).
Finally, the respondents said the need for more data is a top barrier to the adoption of immunotherapy in earlier stages of cancer. From a list, surveyed participants selected the need for long-term and overall survival data as leading barriers to adoption of immunotherapy in earlier stages of cancer (53% and 50%, respectively), reinforcing the importance of ongoing research and follow-up analyses.