Part 1 of our manuscript focused on comparing newer oral oncolytics to older ones in chronic myelogenous leukemia, advanced kidney cancer, medullary thyroid cancer, and metastatic melanoma. Part 2 focuses on comparing newer oral chemotherapies to current intravenous (IV) chemotherapy. There are several aspects to consider when comparing oral to IV chemotherapeutic options. A positive aspect of oral therapy is the decreased need for bolus/continuous infusions and associated cost savings, while a negative aspect is a lack of individualized dosing due to flat dosing of oral agents. Nevertheless, patients who are not candidates for oral chemotherapy will still benefit from IV chemotherapy. Therefore, the primary objective of this article is to offer formulary decision-makers with information to comprehensively evaluate newer oral oncolytic therapies versus IV therapies in patients with non–small-cell lung cancer, breast cancer, prostate cancer, and colorectal cancer. The newer oral oncolytic agents discussed will be limited to those introduced into the market since 2007.
Oral oncolytics are relatively new to the field of cancer therapy. However, they now make up about 25% of the oncology market and their use is continually expanding. The current insurance system is not efficiently equipped to handle their rapid entry into the market.