Kathy D. Miller, MD


May 23, 2013

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Hi. This is Dr. Kathy Miller from Indiana University, coming to you today with a brief preview of the American Society of Clinical Oncology (ASCO®) Plenary Session. It should be a fascinating session this year, about conditions we don't often talk about at ASCO and certainly not in the plenary forum.

First, we will consider cervical cancer, with 2 studies on cervical cancer.[1,2] One of these studies looked at adding bevacizumab to standard therapies[1]; the other, fascinating study, with huge world health implications, looked at screening patients for cervical cancer in areas with limited technology and limited resources.[2]This second study describes the training of healthcare workers in India to use acetic acid to screen for cervical leukoplakia as a way of identifying women with dysplasia or abnormal lesions, who would then proceed to additional screening. If this is a successful technique, it could be employed around the globe for a problem that may not be an issue in the United States and other developed countries but which has huge world health implications.

This will be the second year that we talk about brain tumors during the plenary session. Investigators will present a study that looked at adding bevacizumab to treatment of patients with glioblastoma.[3] We will also hear about another rare tumor -- radioactive iodine-refractory thyroid cancer -- and whether a novel therapy, sorafenib, is helpful for those patients.[4]

Finally, in my arena, we will hear about the aTTom trial,[5] the second really large trial looking at 5 vs 10 years of tamoxifen in women with early estrogen receptor(ER)-positive breast cancer. That will be a particularly important trial. We had grown accustomed to treating patients for 5 years with tamoxifen, based on a relatively small NSABP (National Surgical Adjuvant Breast and Bowel Project) study in lymph node-negative patients. That practice was tipped on its head with results of the ATLAS Trial,[6] published in December 2012, suggesting that 10 years of treatment had greater benefits, and more women alive, than treatment for 5 years.

The aTTom trial,[5]focused in the United Kingdom, has a very similar design, comparing 5 vs 10 years of treatment with tamoxifen in women with ER-positive breast cancer. If those results confirm that 10 years is better, that will clearly identify a new standard of care, especially for premenopausal women. If the results do not confirm the earlier findings, it will be slightly "wild and crazy" out there in breast cancer world, trying to figure out what to do for those patients.

This plenary session is our best and brightest, highlighting the studies that show where we have been, where we are going, and the studies that have the biggest impact on our patients. I am particularly excited to see such a wide variety of studies highlighted this year.

I hope to see you there and get your feedback on whether the plenary lives up to the promise of the preview.


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