The American Society of Clinical Oncology (ASCO) begins its annual conference in Chicago today. Be aware that there will be news items over the next few days that relate to all kinds of cancer care and research reports. Be very aware that the media tends to hype things that are actually more subtle and promise more than the science can deliver. In other words, read it all with a big grain of salt (and does anyone know where that expression comes from?). Here is a report from Med Scape re some of the expected news:
What's Hot at ASCO 2010
From Medscape Medical News
June 3, 2010 — An exclusive interview with the outgoing president of the American Society of Clinical Oncology (ASCO) provides a glimpse of some of the exciting research due to be presented at this year's annual meeting.
Advancing quality through innovation is the theme for this year's meeting; quality of cancer care has been a focus throughout the past year, when Douglas Blayney, MD, professor of internal medicine at the University of Michigan Medical School in Ann Arbor, served as president of ASCO. "Our whole field is moving toward personalized medicine — which was the theme of last year's ASCO meeting," Dr. Blayney said in an interview with Medscape Oncology. "The quality aspect is trying to make sure that the right medicine gets to the right patient at the right time," he said. "There is a need for continual innovation and a continuation of personalization of medicine."
Several new studies looking into personalization of medicine will be reported during the meeting, he said. One study looking into the possibility of personalizing medicine in lung cancer will be unveiled at the plenary session on Sunday, when results will be reported for a novel compound, an oral ALK inhibitor (PF-02341066), in ALK-positive patients with nonsmall-cell lung cancer (abstract 3). Other research that might lead to personalized medicine is on the HER2-specific agent lapatinib (Tykerb) in the treatment of head and heck cancer (abstract 5505). HER2 was first shown to be important in breast cancer, and at
the 2009 ASCO meeting it was shown to be important in gastric cancer in a trial with trastuzumab (Herceptin), as reported by Medscape Oncology at the time.
Phase 3 Trials at Plenary Session
The plenary session will also feature new data from 2 phase 3 clinical trials, one with bevacizumab (Avastin) in ovarian cancer (abstract LBA1), and the other with the novel immunomodulatory compound ipilimumab in metastatic
melanoma (abstract 4).
There was excitement about the potential for ipilimumab in the treatment of melanoma when data from several phase 2 clinical trials were presented at ASCO 2008, as reported at the time by Medscape Oncology. Since then, this drug has shown activity in prostate cancer that has been described as "dramatic," but the report was based on only 2 patients.
Another phase 3 clinical trial features a new device for use in the treatment of liver cancer. The device offers percutaneous hepatic perfusion, which isolates the liver from the circulatory system. "There have been a number of devices that have been tried in this cancer," said Dr. Blayney. "Primary hepatic cancer is one of the most common
cancers worldwide, and we don't do very well in treating it."
Other clinical data of note feature new chemotherapy agents, including new data on eribulin in metastatic breast cancer (abstract CRA1004^) and updated data on cabazitaxel in prostate cancer (abstract 4058^).
Maintenance Therapy in Hematology
In the hematology field, there are 2 large trials showing benefits from maintenance therapy with rituximab in follicular lymphoma (abstract 8004) and with lenalinomide in multiple myeloma (abstract 8018). Both of these studies were highlighted in an ASCO presscast last week, and the results have already been reported by Medscape Oncology:
rituximab and lenalinomide both showed a halving of the risk for relapse when used for maintenance. Maintenance therapy for myeloma is already common clinical practice, said Dr. Blayney, but there remain questions about which agent to use. One advantage of lenalinomide is that it is taken orally, whereas one of the alternative therapies, bortezomib, needs to be administered intravenously.
With follicular lymphoma, the need for maintenance therapy is less well established; relapses are not as devastating as they are in multiple myeloma. There are 2 schools of thought, Dr. Blayney explained: some clinicians favor maintenance therapy with rituximab to prevent relapses, and others do not use maintenance but treat the relapses as and when they occur.
Other studies that will be presented at the meeting were highlighted in the presscast:
a study of children cancer survivors that found a genetic susceptibility to the cardiotoxic effects of anthracyclines, even when given at low doses (abstract 9512)
a study that found little benefit from radiotherapy in elderly patients with early-stage breast cancer treated with lumpectomy and tamoxifen (abstract 507)
a study showing benefits from yoga on sleep and fatigue in cancer (mostly breast cancer) survivors (abstract 9013)
a study on screening for ovarian cancer with the CA-125 blood test (abstract 5003).