David J. Kerr, MD


June 17, 2011

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Hello. I'm David Kerr. I'm Professor of Cancer Medicine for the University of Oxford and I'm President of the European Society of Medical Oncology. This is an opportunity for me to discuss some of the highlights of this ASCO® meeting that we are still enjoying in Chicago.

A Gathering of the Global Cancer Community

There is no doubt that we inhabit an increasingly small cancer village. The global community has gathered more than 30,000 oncologists at this important meeting and more than 50% of these come from outside the United States. Therefore it is an opportunity for us to come together, for us to share practice and knowledge, and hoping to see what trials might be practice-changing and how we might return from this meeting with new ideas that allow us to benefit the community of patients that we serve.

Melanoma Breakthroughs

Of course, at the plenary session there have been some fantastic new breakthroughs and achievements in melanoma, and this is a particularly refractory tumor type. It is one that is becoming increasingly more common, perhaps, because of us being less safe in our use of solar tanning beds, and so forth, but it is a very aggressive tumor type. It is wonderful to see, at last, that we have some new effective treatments and 2 positive randomized studies that really are going to make a difference in the treatment of this disease.[1,2]

Refining Treatment of GI Cancer

My particular practice is gastrointestinal (GI) oncology, and therefore I spent the most time at those sessions. As always, they were interesting; perhaps, not practice-changing but most interesting. We had some really important updates in the use of bevacizumab in the adjuvant setting for colorectal cancer[3] and some important intergroup studies suggesting that bevacizumab doesn't add serious benefit when given with chemotherapy in the adjuvant setting, but some ideas are starting to emerge as to why that might be. There were some interesting hypotheses coming out as to what biomarkers would allow us to predict and which patients might benefit most.

In GI cancer there is a very strong theme coming through in personalized medicine and the use of molecular biology. There is some beautiful work presented from the group from Leuven[4] in which they are looking at subsets of KRAS mutations and allowing us to predict how our patients individually might respond to treatment with epidermal growth factor receptor antagonists.

There are some very strong showings from the Far East, some Korean investigators with a very important study for the first time demonstrating that second-line chemotherapy in advanced gastric cancer with either single-agent irinotecan or a taxane can significantly prolong survival.[5]This was the largest and therefore most informative study of its type in this area, and we are grateful to them for presenting these data and giving us a feel for what is happening.

Similarly, from Charlie Fuchs,[6] a great friend of mine, there were some important studies in the treatment of gastroesophageal cancer in which he looked at a fairly complex regimen of chemoradiation therapy and managed to demonstrate that relatively simple chemoradiation therapy with 5-FU [fluorouracil] leucovorin seemed to be performing as well as more complex infusion combination chemotherapy with epirubicin, cisplatin, and 5-FU.

Closing Remarks

So there were some great advances in melanoma, and we are holding the fort, one would say, in terms of GI oncology. There was a real sense at this meeting that we, in cancer, are the standard of flag bearers for molecular medicine in moving forward.

So as always we have come to the meeting more enthralled. The melanoma physicians will be more delighted than anybody else from this meeting, but thank you for listening. Again, we welcome all your comments. Thank you.


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