ECC 2015

Prof Mark Lawler - Chair of the EAPM Research Subgroup Prof Lawler talks to ecancertv at ECC 2015 about his investigation into disparities across Europe. He discusses what discoveries he has made, and how economics and resources can affect treatment of cancer patients.

Prof Priscilla Brastianos - Massachusetts General Hospital, Boston, USA Prof Brastianos talks to ecancertv at ECC 2015 about how unravelling the genetic sequences of cancer that has spread to the brain could offer unexpected targets for treatment. In the interview she highlights the results of a study that compared samples of brain metastases, primary tumours and normal tissue from the same patients and subjected these to whole exome sequencing. Genetic alterations in brain metastases that could affect treatment decisions in more than half of the patients studied were found. These alterations were not seen in the primary tumour, suggesting that, when clinically possible, genetic characterization of even a single brain metastasis could be superior to that of a primary tumour.

Prof Peter Naredi - University of Gothenburg, Gothenburg, Sweden Prof Naredi talks to ecancertv at ECC 2015 about the use of surgery in synchronous oligometastatic disease. In the interview he highlights that two to three decades ago it was rare that patients with metastatic disease would be referred for surgery. Today, however, patients who have multiple metastatic sites may still be considered candidates for surgery, particularly if the metastases are all in the same organ such as the liver or lung. Prof Naredi emphasizes the importance of the multidisciplinary team when treating patients with oligometastatic disease.

Prof Riccardo Audisio - President of the European Society for Surgical Oncology Prof Audisio talks to ecancertv at ECC 2015 about optimising education about cancer surgery and the need to improve current standards as only 25% of patients receive adequate surgical care. He also talks about the treatment of elderly patients, many of whom do not receive surgery even through they may be eligible. Assessing patients for frailty is important, he says, to determine their fitness to receive appropriate cancer care.

Prof Martin Schrappe - University Medical Center Schleswig-Holstein, Kiel, Germany Prof Schrappe talks to ecancertv at ECC 2015 about improving both the cure rate and the quality of life for survivors of childhood cancers over the next ten years, with the ultimate aim of increasing disease-free and late-effect free survival. He also discusses using new technology such as a electronic app to put the tools into the patients hands, creating a 'survivor passport' in which patients can pass the details of their disease onto doctors later in life.

Prof Noel Clarke and Dr Bertrand Tombal Prof Noel Clarke (The Christie Hospital, Manchester, UK) and Dr Bertrand Tombal (Saint-Luc Hospital, Brussels, Belgium) discuss the evolving treatment landscape in prostate cancer for ecancertv at ECC 2015, with a particular focus on new data and dialogue arising from the conference. They first comment on the potential of TAK-385, a new oral gonadotropin-releasing hormone antagonist. Phase II study findings presented at the meeting showed that it had a good efficacy and safety profile and might thus offer an alternative to existing GnRH androgen deprivation therapies that currently have to be injected. They also discuss new findings on neoadjuvant therapy for patients undergoing prostatectomy and the results of the STAMPEDE trial. The STAMPEDE trial looked at using docetaxel, zoledronic acid, or both, versus standard of care for hormone-naïve, high-risk, localized or metastatic prostate cancer.

Prof Peter Naredi - University of Gothenburg, Gothenburg, Sweden Dr Naredi, Scientific Chair of the ECC 2015 meeting, gives his highlights. Including comment on: Cabozantinib improves survival in patients with advanced kidney cancer: results from the METEOR trial Nivolumab improves overall survival in patients with advanced kidney cancer: results from the CheckMate 025 trial 
Rare cancer responds unusually well to new treatment: results from the NETTER-1 trial Everolimus for non-functional neuroendocrine tumours Dabrafenib and trametinib combo shows significant survival benefit in melanoma

Prof Gilles Vassal - University Paris-Sud, Orsay, France Prof Vassal talks to ecancertv at ECC 2015 about research looking at expanding patient access to crizotinib and the work of the AcSé Program initiated by the French National Cancer Institute. Crizotinib is currently only approved for use in patients with ALK-positive nonsmall-cell lung cancer. As it also targets MET and ROS1, however, it has the potential to be used in many more malignancies that affect both adults and children. Prof Vassal discusses the results of a 5284-patient trial that was conducted across 168 centres in which a biomarker-driven approach was used to identify and then treat tumours expressing the three genetic targets of crizotinib.

Prof Gilles Vassal - University Paris-Sud, Orsay, France Prof Vassal talks to ecancertv at ECC 2015 about the 'SIOPE strategic plan' working along side the European Community of Paediatric Haematology Oncology to improve both the cure rate and the quality of life for survivors of childhood cancers over the forthcoming ten years, with the ultimate aim of increasing disease-free and late-effect free survival.

Dr Michael A. Carducci - Johns Hopkins University, Baltimore, USA Dr Carducci talks to ecancertv at ECC 2015 about a phase3, randomised, double­-blind, placebo­ controlled study of tasquinimod (TASQ) in men with metastatic castrate resistant prostate cancer (mCRPC).

Prof Eleni Efstathiou, Dr Maria De Santis, Dr Nina Tunariu Prof Efstathiou (MD Anderson Cancer Center, Houston, USA) chairs a discussion for ecancertv at ECC 2015 with Dr De Santis (University of Warwick, Coventry, UK) and Dr Tunariu (Royal Marsden Hospital, London, UK) about advances in prostate cancer, including chemoprevention and imaging. In particular, they discuss the ways in which different patient subgroups react to treatments. Dr De Santis argues that chemotherapy with docetaxel is beneficial for all patients with metastatic disease, including those who are hormone-sensitive, and Dr Tunariu argues the need to better utilise imaging for more personalised and thus more effective treatment strategies. They also consider the directions that treatment may go in, 5 years from now.

Prof Amant talks to ecancertv at ECC 2015 about the results of an ongoing, observational, case-control study that show pregnant women diagnosed with cancer can start treatment for their disease immediately and do not need to terminate their pregnancy due to worries over the effects that their therapy on the development of their child.

Prof Michael Baumann - University Hospital Carl Gustav Carus, Dresden, Germany Prof Schrappe talks to ecancertv at ECC 2015 about the final results of the prospective DDFMISO-trial validating hypoxia-specific PET imaging during radiochemotherapy for local control of locally advanced head-and-neck cancer.

Prof Gordon McVie - ecancer Managing Editor Prof Gordon McVie gives a roundup of the best content from ECC 2015 in Vienna Austria. This includes updates in prostate and gastrointestinal cancers and a session on the cost of cancer care and why this is becoming increasingly important. Prof McVie acknowledges that the everyday clinician may not have access to or be able to afford some of the new approaches, drugs or technologies highlighted at the meeting, but emphasises that there are still many lifestyle factors and approaches that can be addressed. He also highlights the importance of continuing to manage patients with appropriate multidisciplinary care. The ecancer highlights cover a breath of presentations at the meeting and it is hoped that you will find these informative, educational, and in some cases, potentially practice changing.

Prof David Dearnaley - Institute of Cancer Research, London, UK Prof Dearnaley talks to ecancertv at ECC 2015 about the results of a phase III trial that compared hypofractionated high-dose intensity-modulated radiotherapy (IMRT) to conventional IMRT for localised prostate cancer. The results of the randomized, non-inferiority trial show that using the hypofractionated radiotherapy regimen could result in 45% fewer hospital visits as the frequency of treatments needed was reduced from 37 to 20. Dr. Dearnaley says that there was a high standard of radiotherapy delivered throughout the trial. However, not all of the 70 centres that took part were highly specialized. This shows that given the right guidance and support, smaller centers could perform hypofractionated radiotherapy safety and effectively.

Charlotte Oude Ophuis - Erasmus MC Cancer Institute, Rotterdam, Netherlands Charlotte Oude Ophuis talks to ecancertv at ECC 2015 about the EORTC Melanoma Group study, which looked at the time interval between primary melanoma excision and sentinel node biopsy. It is currently advised that this staging process is performed as soon as possible, and within 6-weeks in the Dutch guidelines, but there is little evidence for this time limit. The difference in time interval was not found to affect survival regardless of patients’ sentinel node biopsy status in this study and the team’s conclusion was that there is no scientific rationale to advocate a strict time limit.

Dr Catherine Pietanza - Memorial Sloan Cancer Center, New York, USA Dr Pietanza talks to ecancertv at ECC 2015 about a phase I study with the investigational agent rovalpituzumab tesirine (Rova-T) in patients with small cell lung cancer (SCLC). During the interview she explains how Rova-T may offer new hope for patients with SCLC in whom treatment options can be limited due to diagnosis at a late stage when the disease has already metastasized.

Andy Powrie-Smith talks to ecancertv at ECC 2015 about his work with the European Federation of Pharmaceutical Industries and Associations (EFPIA) and why, from early 2016, its members will begin disclosing payments made to health professionals for various activities. These activities would include declaring honoraria paid for consultancy services, attending advisory boards, speaking at educational meetings, and travel, accommodation and registration fees for congresses.

Prof Toni Choueiri - Dana-Farber Cancer Institute, Boston, USA Prof Choueiri talks to ecancertv at ECC 2015 about how patients with advanced kidney cancer live for nearly twice as long without their disease progressing if they are treated with cabozantinib, a small molecule tyrosine kinase inhibitor (TKI) that targets c-MET, VEGFR2 and AXL.. In the interview he discussed the results of the open-label METEOR trial, which compared the TKI against everolimus, a standard of care in mRCC.

Dr Richard McNally - Newcastle University, Newcastle, UK Dr McNally talks to ecancertv at ECC 2015 about study findings, suggesting that living in overcrowded conditions protects children and young adults against developing a particular type of Hodgkin lymphoma. This protective effect seems to be derived from children experiencing infections earlier in life that stimulate the immune system to deal with future infections and cancerous cells more efficiently.

Prof Rifat Atun - Harvard University, Boston, USA Prof Atun talks to ecancertv at ECC 2015 about the results of a Lancet Oncology Commission report looking at access to radiotherapy around the world. During the interview he highlights how how millions of people are dying from potentially treatable cancers because of a chronic underinvestment in radiotherapy resources.

Ms Martine Frouws - Leiden University Medical Center, Leiden, The Netherlands Ms Martine Frouws talks to ecancertv at ECC 2015 about the findings of a large observational study of approximately 14,000 patients that has shown that aspirin, given after a cancer diagnosis, improves survival in patients with tumours situated throughout the gastrointestinal (GI) tract. While the beneficial effects of aspirin for the prevention of colorectal cancer have been well studied, this is the first time that patients with any cancer of the GI tract have been studied in a single trial. Survival rates at 5 years were almost doubled in patients who took aspirin after they were diagnosed when compared with those who did not take the drug, at 75% and 42%, respectively.

Prof Johan Vansteenkiste - University Hospital Leuven, Leuven, Belgium Dr Vansteenkiste talks to ecancertv at ECC 2015 about POPLAR, a randomised phase II study comparing atezolizumab and docetaxel as second- and third-line treatment for non-small cell lung cancer (NSCLC). The study findings show that atezolizumab monotherapy was associated with better survival than the standard-of-care chemotherapy in the overall population of NSCLC patients studied. The findings also suggest that PD-L1 expression on tumour cells and tumour-infiltrating immune cells could be used as a marker to select patients who may get the most benefit from atezolizumab treatment..

Dr Matteo Lambertini - Ospedale San Martino, Genoa, Italy Dr Lambertini talks to ecancertv at ECC 2015 about the results of a meta-analysis suggesting that young women undergoing chemotherapy for breast cancer that may be more likely to remain fertile if they receive temporary treatment with a hormone-releasing hormone agonist (LHRHa). The results suggest that current guidelines on fertility preservation should now consider the use of LHRHa during chemotherapy as an option to increase the likelihood of resuming menses and eventually become pregnant after chemotherapy.

Dr Jennifer Yearley - Merck Research Labs, Biologics Discovery, Palo Alto, USA Dr Yearley talks to ecancertv at ECC 2015 about the finding that PD-L2 may be expressed within human tumours in the absence of PD-L1. This could impact the understanding of the effectiveness of different targeted therapies to anti-PD-1 therapy, she explains in this interview. She describes the results of a study that looked at the prevalence and distribution of PD-L2 in several tumour types, including renal cell carcinoma, melanoma, nonsmall-cell lung cancer and triple negative breast cancer, that are already being treated with anti-PD-1 therapy.

Dr Jonathan E. Rosenberg - Memorial Sloan Kettering Cancer Center, New York, USA Dr Rosenberg discusses data he presented at ECC 2015 demonstrating that the investigational immunotherapy atezolizumab may prevent progression of metastatic urothelial bladder cancer in all age groups by 2.1 months. This phase II, open-label study (IMvigor 210) is the first trial of its kind in metastatic bladder cancer to show that inhibiting PD-L1 increases the activity of the immune system to prevent disease progression and may improve patient survival in a heavily pre-treated population.

Prof Cuzick talks to ecancertv at ECC 2015 about his research into HPV Vaccination and related cancer prevention and screening.

Prof Martin Reck - Lung Clinic Grosshansdorf, Grosshansdorf, Germany Dr Reck talks to ecancertv at ECC 2015 giving an overview of immunotherapy for lung cancer; both non-small cell lung cancer (NSCLC) and small cell lung cancer (SCLC). Results have shown that the drug, nivolumab, improves survival for patients with NSCLC and now updated results from the CheckMate 057 phase III clinical trial, show that nivolumab continues to show an overall survival benefit compared to docetaxel. Dr Reck also discusses a phase I/II study of erlotinib, carboplatin, pemetrexed and bevacizumab in chemotherapy-naïve patients with advanced NSCLC harbouring epidermal growth factor receptor (EGFR) mutations. He also highlights a phase II trial of erlotinib and bevacizumab in patients with advanced NSCLC with activating EGFR mutations with and without the T790M mutation – The Spanish Lung Cancer Group (SLCG) and the European Thoracic Oncology Platform (ETOP) BELIEF trial. And finally, he highlights the promising results of a phase I trial examining the use of the antibody-drug conjugate rovalpituzumab tesirine (Rova-T) in SCLC.

Dr Claire Vale - MRC Clinical Trials Unit at UCL, London, UK Dr Vale talks to ecancertv at ECC 2015 about the results of a systematic review and meta-analysis that examined the role of combining docetaxel or bisphosphonates with androgen deprivation therapy (ADT) in hormone-sensitive prostate cancer. She notes that slightly different conclusions were drawn for metastatic and non-metastatic disease. Adding docetaxel to ADT not only improved patients overall survival (OS) but also reduced the failure rate in metastatic disease. In the non-metastatic setting, failure-free survival was again improved with the chemotherapy but no clear OS benefit was seen. Bisphosphonates had a moderate benefit in the metastatic setting but there was no evidence of any benefit in non-metastatic disease.

Dr Brian Rini - Cleveland Clinic Foundation, Cleveland, USA Dr Rini talks to ecancertv at ECC 2015 about the development of a multi-peptide vaccine (IMA901) for metastatic renal cell carcinoma (mRCC). In the interview he discusses the results of an open-label, phase III study involving more than 300 patients with mRCC who were previously untreated and randomized to treatment with sunitinib with or without the vaccine. While the development of other vaccines and immunotherapies continues to be explored as an option for treating advanced kidney cancer, sunitinib remains the standard of care, Dr Rini observes.

Brandon Higgs - MedImmune, Gaithersburg, USA Brandon Higgs, associate director of bioinformatics and principal scientist in translational sciences at MedImmune, talks to ecancertv at ECC 2015 about the PD-L1 inhibitor durvalumab and the potential for determining which patients with nonsmall-cell lung cancer (NSCLC) will respond to treatment. In the interview he discusses the results of a phase I/2 study that examined how high tumour expression of interferon gamma RNA, the PD-¬L1 protein, or both, was associated with NSCLC patients’ likely response to durvalumab monotherapy.

Prof Andrew Hill - University of Liverpool, Liverpool, UK Prof Hill talks to ecancertv at ECC 2015 about his research into the possibilities of lowering the cost of cancer drugs.

Dr Benjamin Besse - Institut Gustave Roussy, Villejuif, France Dr Besse talks to ecancertv at ECC 2015 about the phase II, single-arm BIRCH trial of atezolizumab as first-line or subsequent therapy for patients with locally advanced or metastatic non-small cell lung cancer (NSCLC) whose tumours express PD-L1. Results showed that atezolizumab has clinically meaningful efficacy as monotherapy in patients with PD-L1-selected, advanced NSCLC with no unexpected toxicities and suggest that PD-L1 selection may provide a way to identify patients most likely to benefit from treatment with this investigational agent.

Dr Giulia Veronesi - Humanitas Research Hospital, Milan, Italy Dr Veronesi talks to ecancertv at ECC 2015 about her presentation at ECC 2015 ‘Are we ready for screening to be implemented in Europe?’ that overviewed lung cancer screening trials performed in Europe.

Dr Giulia Veronesi - Humanitas Research Hospital, Milan, Italy Dr Veronesi talks to ecancertv at ECC 2015 about how robotic surgery has been introduced over the last decade, and has shown promising results.

Prof Philip Poortmans - Radboud University Medical Center, Nijmegen, The Netherlands Prof Poortmans talks to ecancertv at ECC 2015 about his work looking at the benefits of regional lymph node irradiation in women with early breast cancer. In the interview he discusses the results of a study (N Engl J Med 2015; 373:317-327) in which more than 4000 women were randomized to localised breast cancer therapy alone or with additional irradiation of the internal mammary and medial supraclavicular lymph nodes.

Prof Richard Sullivan - King's College London, London, UK Prof Sullivan talks to ecancertv at ECC 2015 about his research into delivering safe and affordable cancer surgery to all. Prof Sullivan discusses how to deliver safe and affordable cancer surgery to all patients who need it during a press conference at ECC 2015. During his presentation he outlines the work of the Lancet Oncology Commission on the current state of global cancer surgery and future solutions to improving access to safe surgery.

Prof Stefan Bielack - Klinikum Stuttgart, Stuttgart, Germany Prof Bielack talks to ecancertv at ECC 2015 about his work and research on paediatric oncology and bone cancer.

Prof Philip Poortmans - University Medical Center, Nijmegen, The Netherlands Dr Poortmans talks to ecancertv at ECC 2015 about tackling the global shortfall in radiotherapy seen in a Lancet Oncology Commission report. He also discusses the 20-year follow-up of the EORTC 'boost no-boost' trial. The results showed that young age, high-grade invasive disease and ductal carcinoma in situ were all markers for benefit from a later boosted radiation dose in women with early breast cancer undergoing radiotherapy after breast conserving surgery.

Prof Mieke van Hemelrijck - Kings College London, London, UK Prof Hemelrijck talks to ecancertv at ECC 2015 about the outcomes of the AMORIS study. The study was conducted in Stockholm, it yielded biomarker data from over 800,000 men and women.

Dr Fernardo Rivera - Hospital Universitario Marques de Valdecilla, Santander, Spain Dr Rivera talks to ecancertv at ECC 2015 about the final analysis of the PEAK randomized phase II study in patients with metastatic colorectal cancer and ways of improving upon current therapy. The primary endpoint was progression-free survival, which was significantly improved in patients receiving first-line treatment with panitumumab versus bevacizumab used on top of a backbone of FOXFOLX6. An overall survival benefit was also seen and although overall response rates were similar for the two agents, exploratory analyses suggest that panitumumab may induce tumour responses earlier and that these may also be deeper and last longer.

Prof Philippe Ruszniewski - Paris Diderot University, Paris, France Prof Ruszniewski talks to ecancertv at ECC 2015 about how patients with advanced gastrointestinal neuroendocrine tumours (NETs) in the mid gut have limited treatment options and there are few oncologists who are specialised in this relatively rare disease. He then talks about the results of the NETTER-1 trial, which have shown that the radiolabeled somatostatin analogue 177Lutetium-DOTATATE can prolong progression-free survival for longer than octreotide LAR in these patients.