U.S. clears Arkansas Medicaid expansion proposal

n">(Reuters) - The U.S. government approved Arkansas' proposal to use federal money targeted for expanding the Medicaid health program for the poor to help low-income residents buy private insurance under President Barack Obama's healthcare law.

The request was approved by the U.S. Centers for Medicare and Medicaid Services, the agency said on Friday. It will allow more than 200,000 uninsured state residents to receive government help to access health coverage.

"Arkansas and CMS worked together to find flexibilities that gave the state the tools to build a program that worked for them and their residents," CMS said in a statement.

Arkansas Governor Mike Beebe received a call Friday morning from Health and Human Services Secretary Kathleen Sebelius, who oversees CMS, informing him of the approval, according to his office.

"Now we will focus on getting this insurance to the Arkansans who need it to lead healthier, more productive lives," Beebe said in a statement.

Obama's Patient Protection and Affordable Care Act calls for expanding Medicaid eligibility to Americans earning up to 138 percent of the federal poverty level. A Supreme Court decision last year allowed each state to decide whether it would participate in the expansion.

Arkansas, Iowa and Pennsylvania have been seeking to modify the expansion, including the option of using the federal funds for the expansion to help their residents buy insurance on their own. Including Arkansas, 23 states and the District of Columbia have agreed to expand Medicaid under Obamacare.

The affordable care law aims to reduce the number of America's uninsured by almost half, or about 25 million people, in the next 10 years through the Medicaid expansion and state-based marketplaces offering subsidized coverage.

About 8.7 million new beneficiaries are expected to enroll in Medicaid in 2014 alone, while another 7 million are expected to buy insurance through the state exchanges. CMS said the Arkansas decision meant that most of the newly eligible Medicaid beneficiaries will buy their insurance on the state exchange.

(Reporting by Lewis Krauskopf; Editing by Lisa Von Ahn and Tim Dobbyn)

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Roche immunotherapy drug may be 'game changer' in lung cancer

A logo of Swiss pharmaceutical company Roche is pictured in front of a company's building in Rotkreuz, April 12, 2012.

Credit: Reuters/Michael Buholzer

By Kate Kelland

AMSTERDAM | Sun Sep 29, 2013 5:34am EDT

AMSTERDAM (Reuters) - An experimental Roche drug that seems to work particularly well against lung cancer in smokers may be a "game changer" for these normally difficult-to-treat patients, researchers said on Sunday.

Presenting detailed data from an early-stage trial of the drug, called MPDL3280A, in patients with a form of the disease called non-small cell lung cancer (NSCLC), investigators said what they had found was "great news for lung cancer patients".

Of 53 patients with NSCLC tumours treated with the drug, 23 percent saw their tumours shrink, according to results presented at the European Cancer Congress (ECC) in Amsterdam.

But the most encouraging numbers were among smokers, where the response rate was 26 percent compared with 10 percent of patients who had never smoked, said Professor Jean-Charles Soria of France's Institut Gustave Roussy, who led the study.

Lung cancer, which is usually caused by smoking, is extremely difficult to treat successfully and once it has started to spread to other parts of the body, it is incurable.

Roche's MPDL3280A is an engineered antibody that targets a protein called PD-L1 - a defence mechanism that tumours use to trick the immune system's T-cells into being inactive.

By blocking PD-L1, the drug allows the T-cells to wake up and recognize the cancer, and then grow and multiply to attack it more efficiently.

Rival drugmakers including Merck and Bristol-Myers Squibb are developing immunotherapy drugs in a similar class of drugs known as PD-1 inhibitors, also designed to mobilize the body's own immune system to fight cancer.

Soria's team suspected that because lung tumours in smokers have a higher rate of genetic mutations than tumours of lung cancer patients who have never smoked, their immune systems may be more likely to respond vigorously when PD-L1 is blocked.

So they drilled down into the data more closely, separating out the 81 percent of the 53 patients who were smokers or former smokers, and the 19 percent of them who were not.

"And bingo, this is the first targeted agent (drug) that shows more activity in smokers than in non-smokers," Soria told reporters in a briefing at the ECC.

Cora Sternberg, co-chair of the ECC's scientific committee and an oncologist at the San Camillo and Forlanini hospitals in Rome who was not involved in the study, said that although the results were from very early-stage trials, they suggested the drug was "definitely a game changer" in lung cancer.

Roche is also investigating MPDL3280A's potential for treating a range of other cancers, including melanoma skin cancer and kidney cancer, where it has already shown some promise in early trials.

Cornelis van de Velde, an oncologist at Leiden University Medical Centre in the Netherlands and president of the European Cancer Organisation, said Soria's was an extremely important study for NSCLC patients, who currently have very few treatment options that make much impact on their disease.

"Hundreds of millions of euros have been spent chasing the dream of immunotherapy for lung cancer patients, but with zero results." he said. "These early findings..suggest that it has the potential to open new therapeutic approaches."

(Editing by David Cowell)

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