Zosia Chustecka

June 02, 2011

June 2, 2011 — "Patients. Pathways. Progress" is the theme of the American Society of Clinical Oncology (ASCO) 2011 Annual Meeting, being held once again in Chicago, Illinois, from June 3 to 7.

Progress is being emphasized in many of the press materials released by ASCO that highlight abstracts that have been selected as newsworthy. Taken together, these press releases look like a direct riposte to some of the media's lamentations about the lack of progress in "the war against cancer," which is now 40 years old.

"This year marks the fortieth anniversary of the signing of the National Cancer Act," a law that has led to major new investments in cancer research, said ASCO president George Sledge, Jr., MD, professor of oncology at the Indiana University School of Medicine in Indianapolis.

"Every day in our offices . . . we are seeing the results of those investments," he said. "People with cancer are living longer, with a better quality of life, than ever before."

"Cancer is becoming a chronic disease that a growing number of patients can live with for many years," he said during a presscast prior to the meeting.

Diverse Focus in Plenary Session

Melanoma will dominate the headlines this year, as it did last year. After a decades-long stalemate, in which none of the therapies tested in advanced disease had any impact on survival, suddenly in the few past years there has been 1 breakthrough, the immunotherapeutic ipilimumab (Yervoy, which was approved recently in the United States), and another promising agent, the BRAF inhibitor from Plexxikon, PLX4032, now known as vemurafenib, which is not yet approved.

Results presented at the meeting will feature data for both of these products, and will be featured in the plenary session on Sunday, June 5 (vemurafenib abstract LBA4, ipilimumab abstract LBA5).

Other presentations at the plenary session include a study that compares 3 years with 1 year of imatinib (Gleevec) therapy after surgery for gastrointestinal stromal tumors (abstract LBA1), and a trial that compares a higher-dose methotrexate regimen with the standard escalating regimen in children with high-risk B-precursor acute lymphoblastic leukemia (abstract 3).

A new approach to breast cancer prevention in women at high risk is reported in the huge Mammary Prevention 3 trial, which enrolled women in the United States, Canada, Spain, and France (abstract LBA504, to be presented June 5). Although previous data on breast cancer prevention were obtained with estrogen antagonists, such as tamoxifen and raloxifene, this new trial used the aromatase inhibitor exemestane (Aromasin).

The first large study to explore "continuation maintenance" therapy in patients with nonsmall-cell lung cancer reports on a new approach in which patients were given maintenance treatment with pemetrexed (Alimta) after an initial chemotherapy regimen that also used pemetrexed (abstract CRA7510, to be presented June 5).

A study from the National Cancer Institute will report on the incidence of oropharyngeal cancers and human papillomavirus among men in the United States (abstract 5529, to be presented Friday, June 3).

Provocative Results in Ovarian Cancer

In ovarian cancer, 2 trials with "very provocative results" are highlighted in the Markman on Oncology blog by Maurie Markman, MD, from the Cancer Treatment Centers of America, in Philadelphia, Pennsylvania.

Billed as negative are some of the latest results coming out of the Prostate, Lung, Colorectal, and Ovarian (PLCO) Cancer Screening Trial, with "even some evidence of harm with respect to evaluation of ovarian cancer in the screening setting," Dr. Markman notes. The data show that using a CA-125 blood test and transvaginal ultrasound for the early detection of ovarian cancer did not reduce the risk of dying from the disease, and resulted in a large number of false positives and related follow-up procedures (abstract 5001, to be presented Saturday, June 4).

Billed as positive is a phase 2 study of women with ovarian cancer who relapsed after chemotherapy and who then showed improved progression-free survival with the experimental product olaparib (AstraZeneca), an oral PARP inhibitor (abstract 5003, to be presented June 4). At the same session, results will be presented from another experimental drug in the same class, iniparib (Sanofi-Aventis), in patients with recurrent and platinum-resistant ovarian cancer (abstracts 5004 and 5005).

However, iniparib recently disappointed in a phase 3 clinical trial of breast cancer, which was a surprise because striking results in a phase 2 trial made headline news at the ASCO meeting 2 years ago. The top-line results were released by Sanofi-Aventis earlier this year, but now there is a chance to hear the details of these data (abstract 1007, to be presented Monday, June 6), to try to figure out what happened, according to Kathy Miller, MD, from the Indiana University School of Medicine, in her Miller on Oncology blog.

Further results from bevacizumab (Avastin) in ovarian cancer will be presented, building on the data that have already accrued from 2 phase 3 trials in this disease. If approved, this would be a new indication for the drug. The new data come from a study in which bevacizumab was added to carboplatin and gemcitabine in women with recurrent disease (abstract LBA5007, to be presented June 4), and from another study in women newly diagnosed with ovarian cancer (abstract LBA5006, to be presented June 4).

New drugs for the treatment of sarcoma include ridaforolimus (Merck & Co), with data from a phase 3 trial (abstract 10005, to be presented June 6), and a phase 2 trial of cixutumumab (Lilly) (abstract 10004, to be presented June 6).

In addition, there will be clinical data on ruxolitinib (Novartis) in the treatment of myelofibrosis (abstract LBA6501, to be presented June 5).

Dr. Sledge has disclosed no relevant financial relationships. Dr. Markman reports acting as a speaker for Eli Lilly and receiving honoraria from Boehringer Ingelheim, Celgene Corporation, Genentech, Hana Biosciences, Morphotech, and Sanofi-Aventis. Dr. Miller reports serving as a speaker for Genentech and Roche.