News in brief: Cancer drugs win unrestricted PBS listing after MOGA request; New tool calculates breast cancer risk using epigenetic factors; AMA calls for healthcare staff to receive boosters

Thursday, 21 Oct 2021

Cancer drugs win unrestricted PBS listing after MOGA request

A request from the Medical Oncology Group of Australia seeking the complete PBS derestriction of raltitrexed (Tomudex) and an unrestricted listing for liposomal doxorubicin (Caelyx ) has been approved by the Pharmaceutical Benefits Advisory Committee.

At its September meeting the PBAC recommended the PBS listings for raltitrexed and doxorubicin (as pegylated liposomal) be changed to Unrestricted Benefit listings.

For raltitrexed, the PBAC considered that an unrestricted listing would enable more effective ongoing combination chemotherapy if there is fluorouracil cardiotoxicity. For doxorubicin, the PBAC considered that a potential benefit of an unrestricted listing would be improved access for patients with rare sarcomas, endometrial cancer, and frail patients unable to tolerate standard treatment.

The PBAC also recommended an unrestricted PBS listing for rituximab, saying this would provide subsidised access to treatment for patients with conditions where there are no alternative PBS listed medicines.

The PBAC recommendations are subject to approval by the Federal minister for health

New tool calculates breast cancer risk using epigenetic factors

A tool that differentiates breast cancer risk in women of the same age based on blood DNA methylation could rival the best current polygenic risk scoring (PRS) system, according to Melbourne-based epidemiologists.

The tool leverages research linking DNA methylation at certain sites to breast cancer risk factors; methylation-based age prediction measures; and artificial intelligence to output a methylation-based breast cancer risk score (mBCRS) that is one of the “strongest known breast cancer risk-stratifiers” available, University of Melbourne Centre for Epidemiology and Biostatistics Professor John Hopper and his colleagues wrote in Molecular Oncology.

With an Odds PER Adjusted standard deviation (OPERA) of 1.58 and area under the curve of 0.63, the mBCRS matches the PRS’ detection abilities and is “shaded only by new mammogram risk scores based on measures other than conventional mammographic density, such as Cirrocumulus and Cirrus, which when combined have an OPERA as high as 2.3 (AUC = 0.72)”, they wrote.

While there are some outstanding questions about the mBCRS, including whether its strength of association differs by age, it’s familial and how it combines with PRS and new mammogram risk scores, the authors believe it is a “powerful” tool and offers a “potential mechanism for how genetic and environmental factors combine to cause breast cancer”.

AMA calls for healthcare staff to receive boosters

The AMA has urged immunisation advisers to provide recommendations for COVID-19 booster doses for healthcare professionals.

AMA Victorian president Dr Rod McRae said the Australian Technical Advisory Group on Immunisation (ATAGI) should consider whether immunity may already be waning for medical staff who had their primary course of vaccinations at the start of the year.

“They should be looking after healthcare workers to ensure that they’re as protected as they possibly can be as they have made the decision to open up the community,” he said.

However Professor Robert Booy of the  National Centre for Immunisation Research and Surveillance (NCIRS) said there was no need to panic as evidence from overseas showed protection against the virus remained strong even if markers of immunity appeared to be waning.

“I’ve been doing vaccine research for over 30 years. I always see a decline in antibody at six to 12 months. That’s normal,” he said.

“If you’re a standard, run of the mill person who is reasonably healthy you retain immunity – and that’s after six to 12 months,” he said.

Professor Booy told the Nine Network that a booster would probably be delivered in after March 2022 at the same time as a flu jab.

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