Cancer  
 June 8, 2015

Advances in Cancer at ASCO 2015

riccardo-braglia

The American Society of Clinical Oncology (ASCO) annual meeting is the place and time to present new advances in technology and science in the cancer therapeutical area.

In Chicago this year, from the May 30th through June 2nd, more than 30,000 healthcare professionals and industry representatives met to discuss and present new updates in the fight against cancer.

An important topic of this year’s annual meeting was cancer prevention, and the cancer survivors behavior and suggested changes. In this area, some companies have presented new supports available for cancer patients in the area of supportive care such as specific high-quality food supplements.

In breast cancer chemoprevention, with the prophylactic use of anti-estrogen therapies in women at high risk of breast cancer, a new study showed that taking tamoxifen is associated with reduced breast cancer incidence over a median 16-year follow-up.  A clinical trial is currently underway to test whether this therapy is effective in increasing chemoprevention, and the results are expected in the next few years. Additionally, new data suggest that the prophylactic use of chemo drugs could also play a role in the prevention of colorectal cancer.  Further, another new study showed that aspirin is associated with improved survival in colorectal cancer patients.

One of the main focuses of ASCO’s annual meeting this year has been the immunotherapy against cancer and different companies such as BMS, AstraZeneca, Roche, Merck, and Amgen, has each presented their new drugs.  New studies on the use of immunotherapy to treat melanoma, have shown an improvement in survival by years.  Further, a new study showed that nivolumab alone or combined with ipilimumab is associated with longer progression-free survival than ipilimumab alone in patients with advanced melanoma. The combination of both drugs led to a reduction in tumor size in the majority of patients.

Another new clinical trial highlighted the potential of nivolumab for treating lung cancer and showed that the drug more than doubles overall survival in patients with non-small cell lung cancer.

Another breast cancer trial showed that palbociclib more than doubles progression-free survival in patients with hormone receptor-positive, HER2-negative breast cancer.

Merck and Amgen are testing a combination of their immunotherapies, pembrolizumab and talimogene laherparepvecin, in patients with head and neck cancer. The Phase I trial will involve patients with recurrent or metastatic squamous cell carcinoma of the head and neck and investigate whether the two drugs could offer a new treatment option.

Pfizer’s sirolimus, an immunosuppressant, received a new indication from the FDA to treat rare progressive lung cancer, called lymphangioleiomyomatosis. This is the first drug approved to treat this disease, based on data from a trial which showed that those who received the drug for one year had stabilization of lung function.

Roche’s immunotherapy drug, MPDL3280A, doubled the survival rate of lung cancer patients in a study. In the mid-stage of the trial patients with non-small-cell lung cancer, who received the drug were for the majority less likely to experience fatality than those who received another chemotherapy drug.

Bear in mind, the progress made at ASCO is not only related to drugs, but in fact also the progression on the exchange of information and increased communication.  This year at ASCO the first beta software of Cancer Link, a new cancer database, was presented and attendees realized with the support of private donations towards this software, that we will have millions of cancer patient records in the U.S. in the near future.  These patient records will help doctors to make the correct and most effective choice of therapy, as well as lead to better compliance with the oncology guidelines (conquerCancerFoundation.org).

Moreover, it is also important to mention the efforts for better information about the molecular nature of tumors, to better personalize treatment options. Many pharma companies are working on this idea, and are looking to select patients for clinical trials based on whether their tumors carry certain specific biomarkers. As an example, the Foundation Medicine built a DNA sequencing technology that helps doctors find common genetic abnormalities that drive tumors.  They then demostrated that targeting these abnormalities led to promising new treatment against biliary tract cancer.

Another issue common to many companies and to accessing new therapies is the reimbursement challenges with new expensive medicines and molecular tests. The consumers have the option to pay out of pocket, however, this is quite expensive.  This is a barrier to getting genetic information that could help guide their treatment for cancer or other diseases. High prices of the new therapies is becoming a major burden for patients and payors.

Other outcomes from ASCO 2015 include information from Immunogen, a company that makes targeted antibodies loaded with toxins, making very potent tumor-killers.  Immunogen presented some encouraging results in the therapy against ovarian cancer.

Additionally, a group of breast cancer surgeons had presented at ASCO about a study which showed that if they sliced out just a little more tissue when removing a tumor, the patients performed better, without noticing any cosmetic difference.

The company Oncothyreon offered some preliminary results from small trials that enrolled heavily pre-treated patients with tumors that over express the HER2 protein. The company’s drug appeared to help some patients whose tumors had spread to the brain.

The Puma Biotechnology company presented data from a Phase III study that offered a marginal benefit for HER2-positive patients, along with significant diarrhea as a side effect.

Another technology that is important to mention is the medical device from the company Novocure, that is a revolutionary tool for the treatment of recurrent glioblastoma in adult patients with cancer.

In the area of managing side effects, some important advances were presented by the company Helsinn. Helsinn provides the new and only combination product which helps with nausea and vomiting induced by chemotherapy by targeting two different receptors, and they discussed a new product for the treatment of cachexia/anorexia syndrome in non-small cell lung cancer patients.

Riccardo Braglia, Lyfebulb board member