Expert Point of View: Virginia Kaklamani, MD

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Virginia Kaklamani, MD

It [the use of denosumab] is a question of access and reimbursement.

—Virginia Kaklamani, MD

Press conference moderator Virginia Kaklamani, MD, commented on these results from the ABCSG-18 trial: “It’s pretty clear that 3 years of adjuvant denosumab not only reduced fracture risk but improved disease-free survival. It’s also pretty clear that adjuvant bisphosphonates improve disease-free survival and overall survival. But at the same time, we don’t use these treatments for our patients. It is a question of access and reimbursement,” she said.

Dr. Kaklamani is leader of the Breast Cancer Program at the Cancer Therapy & Research Center and Professor of Medicine at the University of Texas Health Science Center, San Antonio.

“I try to find an angle so I can put my patients on denosumab, i.e., osteopenia or osteoporosis. The U.S. Food and Drug Administration has not approved this drug in the pure postmenopausal population. Denosumab is extremely expensive, and insurers won’t pay for it. We need two or three large prospective randomized trials for evidence to justify reimbursement,” she concluded. ■

Disclosure: Dr. Kaklamani reported no potential conflicts of interest.


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