Results of a new multinational survey of healthcare providers revealed that the majority of participants expect immunotherapy to have a positive impact on the treatment landscape for patients with earlier-stage cancers in the adjuvant (after surgery), neo-adjuvant (before surgery) and peri-operative (both before and after surgery) settings, if approved by regulatory bodies. The survey, commissioned by Bristol Myers Squibb (NYSE: BMY), included over 250 oncologists, surgeons and specialists in the U.S., Japan, Germany, Italy and France who currently treat patients with stage I-III disease across eight different types of cancer. While healthcare providers surveyed are more satisfied with current treatments in cancers where earlier options are well established, they do not always use treatment before or after surgery, and the vast majority of respondents express enthusiasm for the potential of immunotherapy in earlier-stage cancers.
“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,” said Michele Maio, M.D., Ph.D., Director of Medical Oncology and Immunotherapy, University Hospital of Siena. “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.”
Current Treatment Approaches in Earlier Stages of Cancer
Today, treatment in the neoadjuvant, adjuvant or peri-operative settings may consist of chemotherapy, radiation, targeted therapy, chemoradiation therapy, and increasingly in a subset of tumors, immunotherapy. The survey identified a number of trends on the current use, satisfaction and drivers of treatment choices in earlier-stage cancers.
- HCPs 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.
- HCPs surveyed 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, like breast cancer (87% satisfaction in the neoadjuvant/adjuvant settings) and melanoma (77% satisfaction in adjuvant). In 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.
- HCPs surveyed use immunotherapy in earlier stages (either as approved therapies or in clinical trials), but not as often as other treatments: Currently, 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 Potential of Immunotherapy for the Future of Earlier-Stage Treatment
To better understand the future landscape of neoadjuvant, adjuvant and peri-operative treatment, the survey explored HCPs’ perceptions of immunotherapy and found:
- Many HCPs surveyed see potential for a positive impact with immunotherapy in earlier stages of disease: Participants see the greatest 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).*
- HCPs surveyed believe the potential benefits of immunotherapy align with what currently drives treatment preferences in earlier settings: Selecting from a list, HCPs surveyed state 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%). These responses align with the factors HCPs surveyed report as most important in making treatment decisions in patients with operable tumors (long-term survival, prevention of relapse or recurrence and quality of life).
- HCPs surveyed cite the need for more data as a leading barrier to 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.
“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,” said Jonathan Cheng, senior vice president, head of Oncology Development, Bristol Myers Squibb. “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. Oncologists, surgeons and specialists who responded to this survey are similarly optimistic about the potential of bringing immunotherapy into earlier stages of cancer.”
*Tumor-specific results are based on responses from HCPs who currently treat these types of cancer, a subset of the full sample.
About the Survey
On behalf of Bristol Myers Squibb, Ipsos MORI carried out an online survey on treatment perceptions and practices in earlier stages of cancer. A total of 256 healthcare providers across five countries (France n=50, Germany n=50, Italy n=50, U.S. n=56 and Japan n=50) chose to take part in the online survey. Fieldwork took place between June 3 and July 2, 2021. Respondents included medical oncologists, surgeons (general, thoracic, breast, respiratory and gastroenterological surgeons) and specialists (urologists, dermatologists, pulmonologists, gastroenterologists and otolaryngologists) who treat patients with stage I-III disease across eight different cancer types (bladder/urothelial cancer, breast cancer, gastroesophageal cancers, head and neck cancer, kidney cancer, liver cancer, lung cancer and melanoma). A quota was set to obtain a minimum of 25 medical oncologists in France (n=28), Germany (n=29), Italy (n=29) and U.S. (n=25). The sample included a mix of hospital-, university- and community-based HCPs. The respondents were sampled from pre-existing panels of self-selecting HCPs, managed by M3 and SHC.
Bristol Myers Squibb: Creating a Better Future for People with Cancer
Bristol Myers Squibb is inspired by a single vision — transforming patients’ lives through science. The goal of the company’s cancer research is to deliver medicines that offer each patient a better, healthier life and to make cure a possibility. Building on a legacy across a broad range of cancers that have changed survival expectations for many, Bristol Myers Squibb researchers are exploring new frontiers in personalized medicine, and through innovative digital platforms, are turning data into insights that sharpen their focus. Deep scientific expertise, cutting-edge capabilities and discovery platforms enable the company to look at cancer from every angle. Cancer can have a relentless grasp on many parts of a patient’s life, and Bristol Myers Squibb is committed to taking actions to address all aspects of care, from diagnosis to survivorship. Because as a leader in cancer care, Bristol Myers Squibb is working to empower all people with cancer to have a better future.
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