?Fifty years of modern oncology has delivered dramatic progress, offering our patients better treatments, more cures and a better quality of life during and after therapy,” said Bruce J. Roth, MD, Chair of the ASCO?s Cancer Communications Committee. ?Studies being presented at this year?s Annual Meeting of the American Society of Clinical Oncology embody a new era of precision medicine, in which we?re taking better aim at vital targets on cancer and immune cells. Several studies also suggest that ?less is more? for some cancer treatments, sparing patients unnecessary side-effects and costs.?

The meeting will once again take place in Chicago, between Friday, May 31 and Tuesday, June 4, and attract more than 30,000 oncology professionals from around the world. This year more than 5,000 abstracts will be presented or published at the meeting.The extensive program at this yearsASCOmeetingcovers research in both solid tumors and hematologic cancers, and data from phase III clinical trials as well as promising early data from more preliminary or experimental studies. The data being presented also covers a wide range of subject areas including the latest findings in precision medicine, new prevention findings for cervical and breast cancers, phase III trials that are exploring strategies to prevent disease recurrence, studies that focus on improving the quality and value of cancer care and maximizing quality of life, and data looking at cost of care.

Phase III and Long Term
The results of a phase III study that compared standard-dose and high-dose radiation therapy in patients with advanced non-small cell lung cancer (NSCLC) undergoing chemotherapy will also be presented. [1] It showed that standard-dose radiation therapy (60 Gy) is superior to high-dose (74 Gy) in terms of both treatment effectiveness and survival. Treatment with standard-dose treatment was also associated with significantly fewer treatment- related deaths.

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A long-term study explored whether surveillance-alone is sufficient for men in remission of stage I seminoma [2]. Investigators found that surveillance following surgery for primary cancer is safe, and a suitable long-term strategy for men with stage I disease. These data represent the largest study to date of men with this type of testicular cancer, and showed that 99.6% of patients followed on surveillance alone after surgery are alive at 10 years. In the US, roughly half of all men currently undergo chemotherapy and radiation following surgery to improve outcomes, but these results suggest these interventions may not be necessary for most patients.

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An observational study that assessed the effect of cardiorespiratory fitness on cancer incidence and mortality in men 50 and older found that being fit in middle age protects men against developing and dying from lung and colorectal cancers later in life. These results from a long term, 20-year follow-up study that included more than 17,000 men. The investigators note that even a modest improvement in cardiovascular fitness reduces the cancer specific mortality risk by 14%. [3]

Also being presented will be the results from a phase III trial evaluating the targeted drug pazopanib (Votrient) as a maintenance therapy for advanced epithelial ovarian, fallopian tube or primary peritoneal cancer [4], and a phase III study comparing two widely used dosing schedules of adjuvant paclitaxel (Taxol) chemotherapy for breast cancer. [5]

At the plenary session, the final results from a phase III trial of bevacizumab (Avastin, Genentech/Roche) in the treatment of glioblastoma [6] will be presented, which is an approved indication in the United States but not in Europe. The first presentation of results for adding bevacizumab to standard chemotherapy for recurrent and metastatic cervical cancer will also be highlighted [7], which is not yet a licensed indication for this agent.

The plenary session will also feature results of a large, randomized cervical cancer screening trial conducted in India that assessed the impact of bi-annual cervical cancer screening with simple vinegar (acetic acid), that was conducted by public health workers [8]. The result of a long term study looking at the effects of continuing tamoxifen therapy for 10 years, versus standard 5-year therapy, among women who have successfully completed breast cancer therapy will also be presented (abstract 5), along with new results for using the targeted agent sorafenib (Nexavar) in thyroid cancer (abstract 4), a drug currently approved for use in kidney and liver cancer.

Early Data
A number of papers will report on early but promising data. A phase I study of the PD-L1 targeted antibody MPDL3280A reports tumor shrinkage in 21% of patients with advanced melanoma and lung, kidney, colorectal, and stomach cancer. The responses to therapy were still ongoing for 26 out of 29 patients who have been on the study between 3-15 months. [9]

Another early study evaluated idelalisib (GS-1101), a first-in-class PI3K? inhibitor, for patients with relapsed or treatment-resistant chronic lymphocytic leukemia [10] The final results from this phase I study in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) indicate that treatment with idelalisib, led to tumor shrinkage in half of the patients treated, and stopped disease progression by 17 months on average. The investigators note that these encouraging results point to a possible alternative to traditional chemotherapy for delaying CLL progression.

Findings from a study on the new anti-CD20 antibody-drug conjugateobinutuzumab will be presented, which is also is being tested in chronic lymphocytic leukemia [11], Early trial also suggests that a combination of two immunotherapy drugs may be better than either drug alone. This was demonstrated in a phase I trial showing that co
ncurrent treatment with ipilimumab (Yervoy) and the PD-1 targeted drug nivolumab led to substantial tumor shrinkage in roughly half of patients with difficult-to-treat, advanced melanoma. The authors report that this is the strongest immunotherapy response observed in this setting to date. [12]

Other new drugs coming down the pipeline include the early results of data on antibody-drug conjugates (ADCs). Genentech currently has nine ADCs in clinical trials, and will be presenting early stage clinical data on investigational ADCs for lung, ovarian and prostate cancer: RG7599 (anti-NaPi2b) and RG7450 (anti-STEAP1).

References
[1] Bradley JD, Paulus R, Komaki R, Gregory A. Masters, Kenneth Forster, Steven E. Schild, Jeffrey Bogart, et al.A randomized phase III comparison of standard-dose (60 Gy) versus high-dose (74 Gy) conformal chemoradiotherapy with or without cetuximab for stage III non-small cell lung cancer: Results on radiation dose in RTOG 0617.J Clin Oncol 31, 2013 (suppl; abstr 7501)
[2] Mortensen MS, Gundgaard MG, Lauritsen J, Agerbaek M, Holm NV, von der Maase H, Daugaard G, et al. A nationwide cohort study of surveillance for stage I seminoma. J Clin Oncol 31, 2013 (suppl; abstr 4502)
[3] Lakoski SG, Barlow C, Gao A, DeFina L, Radford N, Farrell S, Willis B, et al. Cardiorespiratory fitness and risk of cancer incidence and cause-specific mortality following a cancer diagnosis in men: The Cooper Center longitudinal study. J Clin Oncol 31, 2013 (suppl; abstr 1520)
[4] Du Bois A, Floquet A, Kim JW, Rau J, Del Campo JM, Friedlander M, Pignata S, et al. Randomized, double-blind, phase III trial of pazopanib versus placebo in women who have not progressed after first-line chemotherapy for advanced epithelial ovarian, fallopian tube, or primary peritoneal cancer (AEOC): Results of an international Intergroup trial (AGO-OVAR16). J Clin Oncol 31, 2013 (suppl; abstr LBA5503)
[5] Budd GT, Barlow WE, Moore HCF, Hobday TJ, Stewart JA, Isaacs C, Salim M, et al. S0221: Comparison of two schedules of paclitaxel as adjuvant therapy for breast cancer. J Clin Oncol 31, 2013 (suppl; abstr CRA1008)
[6] Gilbert MR, Dignam J, Won M, Blumenthal DT, Vogelbaum MA, Aldape KD, Colman H, et al. RTOG 0825: Phase III double-blind placebo-controlled trial evaluating bevacizumab (Bev) in patients (Pts) with newly diagnosed glioblastoma (GBM). J Clin Oncol 31, 2013 (suppl; abstr 1)
[7] Tewari KS, Sill M, Long HJ, Ramondetta LM, Landrum LM, Oaknin A, Reid TJ, et al. Incorporation of bevacizumab in the treatment of recurrent and metastatic cervical cancer: A phase III randomized trial of the Gynecologic Oncology Group. J Clin Oncol 31, 2013 (suppl; abstr 3)
[8] Shastri SS, Mittra I, Mishra G, Gupta S, Dikshit R, Badwe RA. Effect of visual inspection with acetic acid (VIA) screening by primary health workers on cervical cancer mortality: A cluster randomized controlled trial in Mumbai, India. J Clin Oncol 31, 2013 (suppl; abstr 2)
[9] Herbst RS, Gordon MS, Fine GD, Sosman JA, Soria JC, Hamid O, Powderly, JD, et al. A study of MPDL3280A, an engineered PD-L1 antibody in patients with locally advanced or metastatic tumors. J Clin Oncol 31, 2013 (suppl; abstr 3000)
[10] Brown JR, Furman RR, Flinn I, Coutre SE, Wagner-Johnston ND, Kahl BS, Spurgeon SEF, et al. Final results of a phase I study of idelalisib (GS-1101) a selective inhibitor of PI3K?, in patients with relapsed or refractory CLL.J Clin Oncol 31, 2013 (suppl; abstr 7003)
[11] Goede V, Fischer K, Humphrey K, Asikanius E, Busch R, Engelke A, Wendtner CM, et al. Obinutuzumab (GA101) plus chlorambucil (Clb) or rituximab (R) plus Clb versus Clb alone in patients with chronic lymphocytic leukemia (CLL) and preexisting medical conditions (comorbidities): Final stage 1 results of the CLL11 (BO21004) phase III trial. J Clin Oncol 31, 2013 (suppl; abstr 7004)
[12]Wolchok JD, Kluger HM, Callahan MK, Postow MA, Gordon RA, Segal NH, et al. Safety and clinical activity of nivolumab (anti-PD-1, BMS-936558, ONO-4538) in combination with ipilimumab in patients (pts) with advanced melanoma (MEL).J Clin Oncol 31, 2013 (suppl; abstr 9012^)

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This page was last updated on June 3, 2013

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