News in brief: Darolutamide listed on PBS for nmCRPC; AMA ‘secession’ move slammed; COVID-19 boosters now available for doctors

Darolutamide listed on PBS for nmCRPC

Darolutamide (Nubeqa) is now PBS-listed for the treatment of men with non-metastatic castration resistant prostate cancer (nmCRPC).

From 1 November the oral androgen receptor inhibitor will be subsidised for the treatment of patients with m0CRPC at risk of progression because of rising PSA levels, in combination with standard androgen deprivation therapy.

According to manufacturer Bayer, darolutamide is the first in this class of medicine to be made available through the PBS for the treatment of nmCRPC, and the first novel prostate cancer medicine to be listed in seven years. In a statement released by the company, Associate Professor David Pook, a medical oncologist at the Cabrini Hospital, Melbourne, said access to darolutamide would allow treatment to start sooner to delay the appearance of metastases and prolong survival, while also maintaining quality of life in men who no longer respond to ADT alone.

He noted that darolutamide was generally well tolerated, and had little effect on physical capacity or cognitive functioning.

“Men with nmCRPC typically have few cancer symptoms and lead fairly active lives,” he said. “Balancing the clinical benefit of a therapy with its impact on quality of life becomes more of a consideration the earlier it is used in the treatment path and the longer the patients are expected to be on therapy.”

AMA ‘secession’ move slammed

A move by AMA Victoria to offer cheaper ‘Associate’ membership that does not include membership of the Federal AMA has been condemned by some senior figures as effectively seceding from the national medical union.

The state branch is offering a ‘low cost membership option’ that is 40% cheaper than the full annual membership rates of $1582, and which provides the benefits and services of the AMA Victoria branch.

AMA Victoria told the ABC it had simply created an “additional membership category which offers doctors more choice, flexibility and pricing transparency”.

However Dr Stephen Parnis, a former AMA Victoria President and Vice President of the Federal AMA said the move would undermine the authority of the Federal AMA and also irreparably diminish the resources and policy strength of the AMA at state level

The move was also opposed by Federal AMA president Dr Omar Khorshid, who urged doctors to maintain their full membership while the Federal body sought to resolve its issues with the Victorian arm.

ATAGI advises COVID-19 boosters for doctors

Doctors and other healthcare staff at increased occupational risk of COVID-19 are among the high priority groups to receive booster doses of COVID-19 vaccine, according to new recommendations from the Australian Technical Advisory Group on Immunisation (ATAGI).

In advice released on 27 October, ATAGI said an additional vaccine dose after the primary vaccine course was warranted for people with risk factors for severe COVID-19 and/or those at increased occupational risk of COVID-19.

For people at increased occupational risk of COVID-19, ATAGI states that a booster dose is expected to reduce their likelihood of SARS-CoV-2 infection and associated occupation-related impacts, “acknowledging that infection will be mostly mild in these individuals due to prior vaccination and younger age. Booster doses may also reduce the potential for infected individuals to transmit SARS-CoV-2, although evidence for this is currently limited.”

“To facilitate implementation of the national COVID-19 vaccine booster program, ATAGI supports the use of a single booster dose for those who completed their primary COVID-19 vaccine course ≥6 months ago. This will initially include, but not be limited to, the groups above who were prioritised in the rollout of the vaccine program from early 2021,” it said

Pfizer (Comirnaty) vaccine is recommended as a single booster dose, irrespective of the primary COVID-19 vaccine used. Although not preferred, AstraZeneca (Vaxzevria) can also be used as a booster dose for people who received it for their first two doses, and also for people who had a significant adverse reaction after a previous mRNA vaccine dose.


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