Tejas P. Desai, MD


June 29, 2016

Hamilton is considered the hottest show on Broadway this year. Among medical meetings, it could be argued that the American Society of Clinical Oncology (ASCO) annual meeting is the place to be.

The ASCO meeting has been very well attended for years, but this year's social media activity using #ASCO16 achieved record-breaking highs in many categories. With 72,698 tweets, #ASCO16 by far was the most active medical conference Twitter channel this year to date (Figure 1a). The diversity of authors is perhaps as impressive as the sheer volume of tweets they created (Figure 1b). #ASCO16 was a multinational effort by 15,796 authors who came from various backgrounds: physicians, researchers, pharmaceutical representatives, patient advocates, government officials, and more. Amazingly, even a Twitter channel as large as #ASCO16 can be lost in cyberspace if it isn't analyzed and archived. With that in mind, here is an analysis of #ASCO16—its tweets, topics, and authors.

Figures 1 A. ( view larger image )

Figures 1 B. ( view larger image )

Hot Topics: Immunotherapy

More than 500 distinct topics were discussed on #ASCO16 from the nearly 73,000 tweets that were available for analysis (Figure 2). The year-over-year growth has been substantial; just 5 years ago, #ASCO12 contained 9800 total tweets from 1863 authors. Immunotherapy and immuno-oncology together represented the hottest topic this year. Drugs like ipilimumab, nivolumab, and pembrolizumab were frequently discussed (Figure 3).

Figure 2. ( view larger image )

Figure 3. ( view larger image )

The combination of nivolumab-ipilimumab made headlines for promising results in a number of cancers. In patients with MSI-high metastatic colon cancer, the combination resulted in an overall survival of 81% at 17 months ( Figure 4 ). It was also tested in recurrent small cell lung cancer with promising results: 43% survival at 1 year and an overall survival rate of 7.7 months. In patients with PD-L1-positive non–small cell lung cancer, the combination produced an overall response rate just shy of 60% ( Figure 5 ). Finally, in both the CheckMate-032 and CheckMate-064 trials, sequential use of nivolumab and ipilimumab led to better response rates at 25 weeks ( Figure 6 ).

Preliminary studies of ipilimumab monotherapy suggest that it does worse than concurrent radiation therapy and ipilimumab for the treatment of metastatic melanoma: a near ninefold difference in complete remission rates ( Figure 7 ). Rumors about ipilimumab's ineffectiveness in treatment of prostate cancer surfaced on #ASCO16 but could not be confirmed ( Figure 8 ).

Nivolumab monotherapy showed promising results against kidney cancer ( Figure 9 ), advanced bladder cancer ( Figure 10 ), anal squamous cell carcinoma ( Figure 11 ), early glioblastoma, and Hodgkin lymphoma, among others.

Not to be outdone, pembrolizumab showed some positive results in patients with advanced endometrial cancer, though the trial was small. There were also survival benefits in patients with advanced melanoma, refractory Hodgkin lymphoma ( Figure 12 ), and cervical cancer ( Figure 13 ). @TarmoSeliste summed it up best ( Figure 14 ).


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