ASCO Annual Meeting: Latest Advances Could Lead to New Standard Treatments

2016 ASCO Annual Meeting: Collective Wisdom #ASCO16
June 5, 2016
Lindsay Dudbridge, 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.”

Read below to learn about the research highlighted today. Plus, find more of today’s highlights from the ASCO Annual Meeting.

  • Extending hormonal therapy for breast cancer to 10 years

  • Daratumumab: A potential addition to standard care for multiple myeloma

  • Longer lives for older patients with glioblastoma

  • Double stem cell transplant keeps neuroblastoma away longer

Extending hormonal therapy for breast cancer to 10 years ”share 

Taking hormonal therapy longer may work better to keep breast cancer from coming back (called a recurrence) and cause few additional side effects. Hormonal therapy for early breast cancer has been used after breast cancer treatment for many years. It reduces the amount of the hormones estrogen and progesterone in the body. The hormones can fuel the growth of many breast cancers. The goal is to keep the cancer from returning by lowering the levels of the hormones it uses to grow. The hormonal therapy options available include tamoxifen (Nolvadex) and 3 aromatase inhibitors (AIs), anastrozole (Arimidex), exemestane (Aromasin), and letrozole (Femara).

All the women who participated in this study had already received an AI for 5 years. Some had also received tamoxifen before initial AI treatment. Then, for this study, they received either a specific AI called letrozole (Femara) for an additional 5 years or a placebo. A placebo is an inactive treatment. All women had also been through menopause, which is an important consideration when choosing hormonal therapy. In addition, most women participating in the study completed a questionnaire designed to assess their physical and mental health and a menopause-specific questionnaire. 

Researchers found that adding 5 more years of letrozole treatment reduced breast cancer recurrences by about one-third. And, after 5 years 95% of women who received the added letrozole remained free from breast cancer, compared with 91% of women who received the placebo. Researchers also found that women who received the placebo were more than twice as likely to develop a new breast cancer in the other breast. However, for both groups of women, the risk of developing a new breast cancer in the other breast was less than 1%. Researchers also found that there were no major differences in quality of life for patients who took additional letrozole.

What does this mean? Extending hormonal therapy may lower the chance of recurrence without increasing side effects for many women. According to ASCO expert, Harold Burstein, MD, “10 years of any therapy is a long time, and side effects can be different for each woman. Results of this study are very good news for women who are tolerating AI therapy with few side effects, but for women who find hormone therapy more difficult to tolerate, these findings will help them make informed decisions to extend therapy, or not.”

“The study provides direction for many patients and their doctors, confirming that prolonging aromatase inhibitor therapy can further reduce the risk of breast cancer recurrences. Longer AI therapy also showed a substantial breast cancer preventative effect in the opposite, healthy breast.”

—lead study author Paul Goss, MD, FRCP, PhD, Massachusetts General Hospital, Boston, MA

Daratumumab: A potential addition to standard care for multiple myeloma ”share

Adding daratumumab (Darzalex) to standard treatment for multiple myeloma could significantly lower the chance of the disease worsening. Standard treatment for multiple myeloma includes a combination of the drugs bortezomib (Velcade) and dexamethasone (multiple brand names). Daratumumab is a newly approved targeted therapy that directly destroys myeloma cells. It may also stimulate the immune system to attack the myeloma.

Patients participating in this study had multiple myeloma that had come back (called recurrent) or worsened (called refractory). Those who received daratumumab were 70% less likely to have the disease worsen than those who had only standard treatment. In addition, patients taking daratumumab were twice as likely to experience a decrease in the amount of abnormal cells associated with multiple myeloma.

What does this mean? Daratumumab was approved by the U.S. Food and Drug Administration in November 2015. It is likely that it may be added to the current standard treatment for multiple myeloma.

“Daratumumab is a fast-acting drug—in many cases tumors shrank in just a month. As a result of shrinkage and slower tumor growth, patients had less pain and a better quality of life.”

— lead study author Antonio Palumbo, MD, University of Torino, Torino, Italy

Longer lives for older patients with glioblastoma ”share

Adding chemotherapy with temozolomide (Temodar) to radiation therapy may lengthen the lives of older patients with glioblastoma. Glioblastoma is a very aggressive form of brain tumor. It is more common in older adults, who make up about half of the people diagnosed with this disease.

The patients who participated in this study were older than 65, with most being older than 70. They received either radiation therapy for 3 weeks along with temozolomide or only radiation therapy.

Researchers found that the combination treatment lengthened patients’ lives by about 2 months. Researchers also found that the combined treatment worked better for patients with a specific genetic change called MGMT promoter methylation. This change is linked with how well chemotherapy works. Among patients with this change, those who received the combination treatment lived about 6 months longer than those who received only radiation therapy.

What does this mean? Currently, there are no guidelines on the best treatment options for older adults with glioblastoma. This study is the first to look at temozolomide plus radiation therapy for older adults, and the results suggest it could be a promising option.

“Although the difference in median survival seems modest, temozolomide significantly increased the chances of surviving 2 or 3 years. For an individual patient, that can mean being able to be part of another family holiday or celebration.”

—lead study co-author James R. Perry, MD, FRCPC, Odette Cancer and Sunnybrook Health Sciences Centres, Toronto, Canada

Double stem cell transplant keeps neuroblastoma away longer ”share

Using 2 stem cell transplants for high-risk neuroblastoma increases the chance that children will stay cancer-free longer. Neuroblastoma is a cancer that starts in the nerves outside of the brain. Overall it is a rare tumor, but it is the second most common solid tumor in children.

In this study, patients received an initial round of chemotherapy followed by either 1 or 2 autologous stem cell transplants (ASCT). Autologous stem cell transplants use replacement stem cells taken from the patient’s own body instead of a donor. Those who received ASCT twice received both over the course of 6 to 8 weeks. After ASCT, both groups of patients were offered additional treatment with a drug called dinutuximab (Unituxin) plus immunotherapy.

Researchers measured the success of treatment by using event-free survival. For this study, an “event” is defined as having the disease worsen or come back, a second cancer diagnosis, or death. After 3 years, about 61% of patients who received 2 transplants had not had an event compared with about 48% of patients who received 1 transplant. Patients who received additional treatment after ASCT also fared better if they had received the double transplant. About 73% of these patients did not have an event in 3 years, compared with about 56% of those who had 1 transplant.

What does this mean? Less than half of children with the high-risk form of neuroblastoma live 5 or more years after diagnosis. This is why it is so important to find treatments that can lengthen these patients’ lives. While this study is very promising, it is too early to know if this approach will accomplish that. Researchers will continue to monitor the health of the children participating in this study for 10 years to learn more about the long-term effects.

“This finding will change the way we treat children with high-risk neuroblastoma in North America, which still claims many young lives and is in urgent need of better treatments. However, the regimen we use for high-risk neuroblastoma is also the most aggressive and toxic regimen we give to children with cancer. For that reason, future research needs to focus on both exploring possible late effects of current therapy and developing newer less toxic therapies.”

—lead study author Julie R. Park, MD, of Seattle Children’s Hospital and the University of Washington School of Medicine, Seattle, WA

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