2012 ASCO Annual Meeting

Dr William Tap talks with ecancer about three clinical trials at the ASCO 2012 Annual Meeting, Chicago. Chemotherapy has difficulty penetrating into the hypoxic area of tumours and the drug TH302 aims to exploit hypoxia by diffusing chemotherapy into hypoxic areas. The drug then reduces to a phosphoramide type agent. In the phase III trial, TH302 is given with doxorubicin. The second is a phase II study looking at CDK4 inhibitor which targets liposarcoma. The promising results from this study show that the drug changes the biology of the tumour and course of treatment. The final study looks at refractory, soft tissue sarcoma with monoclonals, as well as insulin growth factor pathways and combination therapy.

Dr Samantha Jaglowski talks to ecancer at the ASCO 2012 Annual Meeting, Chicago, about the early phase ibrutinib trial. Ibrutinib, an irreversible inhibitor of the Bruton’s tyrosine kinase, treats chronic lymphocytic leukaemia by blocking the activation of B cells, ultimately leading to apoptosis. Patients were treated in both a refractory and frontline setting with ibrutinib used as a single agent and in combination with ofatumumab. Early results showed response in all patients.

Dr Tom Waddell discusses the results from a randomised clinical trial that examined the efficacy of panitumumab against oesophageal-gastro cancer and carcinomas. The data was presented at the ASCO 2012 Annual meeting in Chicago. In the study, panitumumab, a monoclonal antibody, was used with the UK standard chemotherapy treatment. Patients had untreated, advance tumours and were randomly selected. The dosage of chemotherapy was reduced to combat toxicity in the panitumumab + standard treatment arm. Unfortunately, the trial was halted due to early data showing that panitumumab had an inferior survival rate. The results did prove that there is a need to look at biomarkers prior to recruiting in order to find new uses for the drug.

Phase I study of twice-weekly dosing of the investigational oral proteasome inhibitor MLN9708 in patients with relapsed and/or refractory multiple myeloma. Similar to bortezomib, but administered orally, MLN9708 is the first oral drug to go into clinical trial for myeloma. MLN9708 is boron-based making it a reversible inhibitor. Current trials using the experimental drug aim to determine the dosage and efficacy in myeloma. Patients receiving the drug have already been heavily treated with commonly available agents and had high efficacy, with very low rates of neuropathy, when used in combination with other drugs. en Español

Dr Erica Mayer discusses the EMILIA trial at the ASCO 2012 Annual Meeting, Chicago, with ecancer. The EMILIA trial involves TDM1, a new class of immuno-conjugates, in conjunction with traditional trastuzumab and maytansine. TDM1, in combination with maytansine, originally too toxic for clinical use, and trastuzumab, directly targets the tumour and release cyto-toxins, at a higher concentration, into the tumour. As the drug targets the tumour specifically, toxicity to the patient is dramatically lower than intravenous chemotherapy. Response rates with the treatment are 30 to 40 with little toxicity presenting. The trial used patients who had already been through treatment with trastuzumab and had the ultimate goal of moving towards FDA approval. Dr Mayer also discusses her presentation 'Systemic Challenges with Neoadjuvant Therapy' and costly drugs versus paclitaxel as first line therapy for locally advanced or metastatic breast cancer. A phase III randomised trial found that weekly administration of either of two newer and significantly more costly agents, nanoparticle albumin bound (“nab”) paclitaxel (Abraxane) and ixabepilone (Ixempra), was not superior to standard weekly dosing of paclitaxel as first-line therapy for locally advanced or metastatic breast cancer.

Half of melanoma patients have V6003 BRAF mutation in their tumour. Last year preliminary results showed that patients treated with vemurafenib had an increased response and survival. Dr Paul Chapman talks to ecancer at the ASCO 2012 Annual Meeting about extended follow up results for treatment with vemurafenib. After preliminary results the FDA approved treatment only in melanoma cases with V6003 BRAF mutation as tumours without this mutation encounter accelerated growth if treated with vemurafenib. Currently, ipilimumab is the only other option for treatment in these cases. Moving forward doctors must now understand the genetics of the tumour prior to treatment.

Dr Saga Lonial talks to ecancer about the first oral proteasome inhibitor at the ASCO 2012 Annual meeting in Chicago. Similar to bortezomib, but administered orally, MLN9708 is the first oral drug to go into clinical trial for myeloma. MLN9708 is boron-based making it a reversible inhibitor. Current trials using the experimental drug aim to determine the dosage and efficacy in myeloma. Patients receiving the drug have already been heavily treated with commonly available agents and had high efficacy, with very low rates of neuropathy, when used in combination with other drugs.

ecancer talks to Dr Karen Gelmon about working with two HER2 blocking agents, trastuzumab and lapatinib. Data presented at the ASCO 2012 Annual Meeting, Chicago, showed that patients lived longer with trastuzumab as compared to lapatinib, in cases with HER2 centrally confirmed, by 4.7 months. Reasons for this are that lapatinib targets HER1 and HER2 while trastuzumab targets only HER2. Results from this study give doctors the ability to clearly choose an appropriate course of treatment for patients as lapatinib is still recommended for refractory treatment.

ecancer talks to Dr Don Dizon at the ASCO 2012 Annual Meeting in Chicago about whether or not age is a determinant in cervical cancer treatment. In cases of women with early stage cervical cancer, where treatment had curative intent, it appeared that age was a determinant at how doctors approach disease. The study found that as women get older surgery was less prominent and that women who have surgery fair worse in terms of both all-cause and disease-specific mortality. Women over 65 had a mortality rate seven times higher with surgery as a treatment, but cancer related mortality was only three times higher than all-cause mortality. These findings show that doctors need to consider non-surgical treatment for curative purposes, but also consider other factors in a patient’s life.

Dr Andrei Iagaru talks about the development of novel PET agents at the ASCO 2012 Annual Meeting in Chicago. The Society of Nuclear Medicine and ASCO organised three sub-sessions on novel imaging methods and the potential new developments in the clinic. The three sub-sessions looked at the basics of PET imaging, PET response criteria and new PET based radiopharmaceuticals. Agent development is set to continue to get more and more specific and analyse more subsets as time goes on.