News in brief: Cabozantinib a new treatment option in thyroid cancer; Oncologists’ views on exercise; Call for Medicare review of procedural specialist incomes

13 Jul 2021

Cabozantinib shows promise as radioiodine-refractory DTC treatment

Cabozantinib could offer a new treatment option for radioiodine-refractory differentiated thyroid cancer (DTC) patients who have no available standard of care.

The tyrosine kinase inhibitor significantly prolonged progression-free survival over placebo (median not reached [96% CI: 5.7–not estimable NE] versus 1.9 months [1.8–3.6], HR: 0.22 [96% CI: 0.13–0.36, P < 0.0001]) at interim analysis (median 6.2 months’ follow up).

The COSMIC-311 trial evaluated cabozantinib efficacy in 125 DTC patients who were previously treated with VEGFR-targeted therapy and had aggressive disease and no standard of care.

Cabozantinib’s safety profile was “manageable”, “predictable” and consistent with known adverse events, the study said.

Published in Lancet Oncology, “these findings support cabozantinib as a new treatment option in patients with previously treated radioiodine-refractory DTC for whom there is no standard of care and a high unmet medical need,” the study concluded.

Oncology, exercise professionals share role in patient activity

Oncology professionals have high awareness of exercise’s role in cancer care, but less so, the role of exercise professionals, a recent study revealed.

Of 67 doctors, nurses and allied health professionals surveyed, 92% agreed that exercise “can attenuate symptoms developed due to cancer and treatment”, yet only 64% “understand the role of exercise professionals in optimising cancer care”.

Exercise physiologists and physiotherapists can help oncologists motivate cancer survivors to be active, and develop safe, effective and individualised programs that help patients meet evidence-based exercise guidelines, the study said.

Promoting exercise and “implementing formal referral pathways to exercise professionals in cancer care may facilitate improved patient outcomes”, the study said.

Call for Medicare review of procedural specialist incomes

Procedural specialists are overpaid compared to other specialists and there needs to be a review of the inequities in the Medicare Benefits Schedule, according to two senior physicians.

The high incomes for procedural specialists are not justified by their long years of training, level of skill or the hours worked compared to other physicians or GPs, according to Dr Kerry Breen and Dr Kerry Goulston.

Writing in Pearls and Irritations, they say the imbalance in incomes between specialties has become wider and more distorted in recent years because of a flaw in the original MBS when Medicare was set up favoured procedural work over consultations.

The distortion is now deterring medical graduates from working in low income specialities, and there is an urgent need for the federal health department to commission a new study to review the 2005 Productivity Commission report on how to address  the income bias.

“Such a study should also be invited to examine whether the earning differentials between various groups of doctors are justifiable and are in the best interests of the health care system and patients,” they suggest.

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