ASCO Annual Meeting: Existing Treatments Used in New Ways

2016 ASCO Annual Meeting: Collective Wisdom #ASCO16
June 3, 2016
Greg Guthrie, ASCO staff

The American Society of Clinical Oncology (ASCO) Annual Meeting is here! From June 3 to June 7, more than 30,000 oncology professionals from around the world will meet to discuss the latest research in state-of-the-art treatments, new therapies, and patient care.

The theme for this year’s meeting is Collective Wisdom: The Future of Patient-Centered Care and Research. According to ASCO President Julie M. Vose, MD, MBA, FASCO, “the patient is at the center of a very complex system trying to assist them through their journey of cancer care. I selected the theme of collective wisdom to represent the importance of the multimodality care that is necessary for our patients.”

To improve cancer care for patients, researchers aren’t just developing new treatments. They’re also looking for better ways to use existing treatments. Sometimes the results come from surprising places. In all of the studies in this blog post, an existing medication is used in a new and interesting way.

Read below to learn about the research released today:

  • Mixing old and new chemotherapies to treat pancreatic cancer

  • Adding temozolomide (Temodar) to radiation therapy for anaplastic glioma helps patients live longer

  • Advanced ovarian cancer: Giving chemotherapy in 2 ways

  • Biosimilar for breast cancer shows effectiveness

Mixing old and new chemotherapies to treat pancreatic cancer ”share

Researchers found that adding capecitabine to standard treatment with gemcitabine helped patients live longer. Gemcitabine is the chemotherapy typically used to treat pancreatic cancer after surgery. Capecitabine is a chemotherapy most commonly used to treat breast and colorectal cancers. Adding capecitabine is a new approach to treating pancreatic cancer. Both gemcitabine and capecitabine are available as generic drugs.

Patients who had had surgery for early-stage pancreatic ductal adenocarcinoma in the previous 12 weeks were assigned to receive just gemcitabine or gemcitabine and capecitabine. In people who received the combined drugs, the median survival was about 2 months longer than in those who only took gemcitabine (28 months compared with almost 26 months). The median is the midpoint, which means that half of patients lived longer and half lived for a shorter time. The serious side effects of the new treatment were comparable to those of taking just gemcitabine.

What does this mean? This was a large study of pancreatic cancer, with 732 patients, so the study’s results suggest that these effects may also apply to the larger population with pancreatic cancer. “Pancreatic cancer remains one of the most under-studied, hard-to-treat cancers,” says ASCO Expert Smitha Krishnamurthi, MD. “It is a major win to find that adding a generic chemotherapy not only improves survival for these patients, but does so with little effect on patients’ quality of life.”

“Unfortunately, most patients are not candidates for surgery when they are diagnosed with pancreatic cancer. These findings are significant because they show that those patients who can undergo surgery have a fighting chance of surviving this cancer with the combination of 2 commonly used chemotherapies.”

—lead study author John P. Neoptolemos, MA, MB, BChir, MD, FMedSci, University of Liverpool, Liverpool, United Kingdom

Adding temozolomide (Temodar) to radiation therapy keeps anaplastic glioma stable”share

Anaplastic glioma is an uncommon and aggressive form of brain tumor. It accounts for nearly 2% of primary brain cancers. These tumors are often missing the 1p and 19q arms of the chromosome. This is called a co-deletion. Chemotherapy generally works better for patients who have tumors with this co-deletion. Tumors without this co-deletion are usually only treated with radiation therapy because chemotherapy does not work as well. As part of this study, 748 people who did not have this co-deletion received temozolomide (Temodar) during radiation therapy, after radiation therapy, or both during and after radiation therapy. Temozolomide is currently the standard of care for patients with glioblastoma, which is a very aggressive form of brain tumor.

The researchers found that the patients who received temozolomide after radiation therapy or both during and after radiation therapy had tumors that stopped growing for a median time of nearly 43 months. For patients who did not take temozolomide, the median time it took for the tumor to start growing again was 19 months. This approach stopped or slowed the tumor’s growth for almost 2 years longer than treatment with only radiation therapy.

What does this mean? Anaplastic glioma is both rare and hard to treat, so the effectiveness of temozolomide added to radiation therapy is promising. This could be a new standard way of treating anaplastic glioma in patients who currently have few treatment options. These results suggest that people may be able to live longer without the disease worsening.

“These findings should expand treatment choices and change the way we treat patients with this rare form of brain cancer.”

—lead study author Martin J. van den Bent, MD, Erasmus MC Cancer Center, Rotterdam, The Netherlands

Advanced ovarian cancer: Giving chemotherapy in 2 ways ”share 

Early results from a recent study suggest that giving chemotherapy in 2 different ways may be a good option for women with advanced ovarian cancer. Chemotherapy may be given in different ways for advanced ovarian cancer:

  • Directly into the abdomen, called intraperitoneal (IP) chemotherapy

  • Directly into a blood vessel, called intravenous (IV) chemotherapy

IP chemotherapy allows higher doses of chemotherapy to get to the tumor and helps other parts of the body avoid side effects. After surgery, 200 women received either IV chemotherapy only or combined IV and IP chemotherapy.

Researchers found that about 23% of women who received the IV-IP combination had the disease worsen after 9 months, compared with about 42% of those who received only IV chemotherapy.

What does this mean? This study may help patients feel more comfortable that IP chemotherapy with carboplatin is an effective option. But, according to Don Dizon, MD, ASCO Expert, “we need to further define those who derive the greatest benefit from this approach and to identify better options for all women with ovarian cancer.”  

“At this early time frame, we already see that women are doing better with IP chemotherapy, without a significant difference in toxicity. However, women should consider the side effects of IP and IV chemotherapy, as well as recovery from cancer surgery, when discussing this option with their doctors.”

—lead study author Helen Mackay, MD, Sunnybrook Odette Cancer Centre, Toronto, Canada

Biosimilar for breast cancer shows effectiveness ”share

In a recent study, researchers looked at how well a new form of trastuzumab worked for breast cancer. This new form is known as a biosimilar. A biosimilar is a product that the U.S. Food and Drug Administration (FDA) says must be “highly similar” to a product that has already been approved and licensed for use in the United States in terms of safety, purity, and strength. Biosimilars can make highly specialized cancer drugs more widely accessible. But every biosimilar cancer drug must be rigorously tested to make sure that it is safe and effective for patients. A biosimilar drug is not the same as a generic drug.

Trastuzumab (Herceptin) is a targeted therapy for the treatment of HER2-positive advanced breast cancer.  About 1 out of every 4 breast cancers is HER2 positive. Trastuzumab is added to chemotherapy and has been shown to help patients live longer and reduce the risk of the cancer coming back.

The trastuzumab biosimilar in this study, MYL-1401O, stopped tumor growth in just under 70% of patients. In patients who received trastuzumab, tumor growth stopped in 64% of patients. Biosimilars must also be tested for safety. In patients who received the biosimilar, 38% had serious side effects. Among those who took trastuzumab, 36% had serious side effects. These data show that the biosimilar is very close to trastuzumab in terms of effectiveness and safety.

What does this mean? There are no biosimilars available right now. This may be the first trial to show strong similarity between a patented cancer drug and a biosimilar. A trastuzumab biosimilar could increase the availability of this effective treatment for breast cancer worldwide.

“Trastuzumab has markedly improved survival of women with HER2-positive breast cancer, but many women around the world can’t benefit from trastuzumab due to its high cost. We hope that the introduction of biosimilars will expand patient access to this effective drug, which has already benefited the lives of thousands of people across the globe.”

—lead study author Hope S. Rugo, MD, University of California San Francisco, San Francisco, CA

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