What's Hot at the ASCO Annual Meeting This Year?

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What's Hot at the ASCO Annual Meeting This Year?

Zosia Chustecka
May 23, 2014

Although it's still a week away, there is already a lot of buzz about the forthcoming 2014 Annual Meeting of the American Society of Clinical Oncology® (ASCO).
Some of it is speculation about data that have already been released in abstract form online. This early abstract release always stirs up a frenzy of media and financial analyst reports, creating a hype about the meeting long before it starts, but ASCO holds back some of the most important data and releases them only at the meeting.
Among the most anticipated data are results from major clinical trials that will be presented at the plenary session on June 1. These include conclusions from clinical trials in 2 types of breast cancer, specifically the TEXT and SOFT trials in hormone-receptor positive early breast cancer in premenopausal women (abstract LBA1) and the ALLTO trial of HER2-targeted drugs in HER2-positive early breast cancer (abstract LBA4). In addition, there will be results from phase 3 trials conducted in metastatic prostate cancer (abstract LBA2) and in metastatic colorectal cancer (abstract LBA3).
Celebrating 50 Years
This year, ASCO celebrates its fiftieth anniversary, and this meeting is a little different from previous years, in that there will be quite a bit of reflection.
"I think that's a natural instinct to look back and reflect, and we have a lot to be proud of," ASCO president Clifford Hudis, MD, commented in an interview with Medscape Medical News.
There is a vote on the ASCO Web site where members can share what they think are the most significant accomplishments of the first 50 years, and during the course of the meeting, there will be numerous sessions that take a look back at progress that has been made, discussing where the latest research fits in, but also looking ahead to the work that still needs to be done.
"But we are all appropriately humbled by the fact that there is so much still to do, and mostly this meeting looks forward," Dr. Hudis commented. "Despite the pause to reflect, we want to accelerate the progress that we have begun to make," Dr. Hudis commented.
The theme of this year's meeting is "Science and Society: The Next 50 Years."
One of the education sessions marked with the "50" logo, which takes place on June 1, will cover "Immunotherapy: Transforming Frustration to Cure in the Next 50 Years," and will be chaired by David Hafler, MD, MSc, from Yale University School of Medicine in New Haven, Connecticut.
Immunotherapy is one of the buzzwords at the meeting, and indeed has been a buzzword in oncology for the past few years, with cancer immunotherapy being hailed as the "breakthrough of the year" at the end of 2013 by the editors of Science.
"This is not the year of first reports," commented Dr. Hudis. "We already know that there is activity."
There is already a lot of reported data on clinical efficacy with immune-checkpoint inhibitor drugs — such as ipilimumab (Yervoy) approved for melanoma and investigational agents acting on the programmed death (PD) pathways — as well as activity seen with vaccines (such a Provenge,approved for prostate cancer), and also with cellular products, such as the ex vivo cellular expansion and reinfusion regimens, for example, using chimeric antigen receptor cell engineering.
"There is going to be a lot of expansion of the tools that we know are effective, and also expansion of the understanding of where it works, when it works, and when it doesn't work so well. So at the meeting we'll see a lot more detailed analysis of the more nuanced aspects of immunotherapy," Dr. Hudis commented.
"But what is clear now, unlike decades earlier when it was an idea, it is now an established fact that immunotherapy is an effective treatment for some cancers," said Dr. Hudis. "Now, we are entering a second wave of establishing the details."
A lot of interest is focused on the investigational PD inhibitors, several of which are in late stages of development, and could be available for clinical use within the next year or so. They include nivolumab (Bristol-Myers Squibb), MPDL3280A (Genentech), and MK-3475 (Merck), now known as pembrolizumab (and formerly known as lambrolizumab).
These drugs have already shown activity in several cancer types, including melanoma and lung and renal cancer, but there is intense interest in identifying which patients will respond. Also at the annual meeting, there will be new data on the clinical effects of combining this PD inhibition with ipilimumab, including some long-term survival data with this combination in melanoma (abstract LBA9003).
ASCO has already highlighted several other investigational therapies, including PLX3397 (Plexxikon), which has shown "profound activity" in the treatment of pigmented villonodular synovitis, a rare joint proliferative neoplasm that involves the synovium of joints or tendons (abstract 10503).
Also offering new hope for patients who are running out of options is AZD9291 (AstraZeneca) (abstract 8009) and the similar drug CO-1686 (Clovis), both of which have been granted breakthrough designation by the US Food and Drug Administration for use in the treatment of patients with EGFR-positive non-small cell lung cancer who have stopped responding to EGFR inhibitors and who have developed a T790M mutation. At present, there is no standard therapy for such patients, and they often receive palliative chemotherapy. These 2 new drugs, both third-generation EGFR inhibitors with activity against this T790M mutation, overcome the resistance and produce responses in about 65% of patients who were previously resistant.