Recap of the 2021 ASCO Annual Meeting
A recap of the 2021 ASCO Annual Meeting
From June 4-8, 2021, the American Society of Clinical Oncology (ASCO) held its Annual Meeting with the theme “Equity: Every Patient. Every Day. Everywhere.” This theme is a personal passion of ASCO President Lori Pierce, MD, FASTRO, FASCO, radiation oncologist, professor, and Vice Provost for Academic and Faculty Affairs at the University of Michigan. The meeting featured over 2,500 abstracts, many available on-demand, and 48 virtual sessions with real-time engagement and live Q&A. There were also discussion sessions, symposia and education sessions.
Here’s what we learned.
Equity of care takes center stage
While equity of care has always been an important component of ASCO’s mission, Pierce believes it hasn’t always received the attention it deserves.
“We have all of these amazing therapies, but if they’re not delivered equitably, then we’ve not done what we need to do to promote health for all of our cancer patients,” said Pierce in an interview with Mabel Jong for HealthDay Now.
Instead of offering separate equity sessions, which Pierce says aren’t always well-attended because there are too many interesting sessions happening at the same time, presenters wove equity into sessions throughout the meeting. She hopes that this new model will be adopted at future meetings, providing all attendees with information and education on equity in every session they attend.
Immunotherapy drugs are changing lives
This year, a wide range of randomized trials have demonstrated significant advances in immunotherapy treatments. Specifically, these treatments improve a patient’s chances of disease-free and progression-free survival for many types of cancers, including brain tumors, advanced-stage melanoma, cervical cancer and advanced-stage esophageal cancer.
“This is a major advance,” said Pierce during the HealthDay Now interview. “We’ve found these drugs can reinvigorate our immune system. The cancer cells have found ways to shut down our immune system, and these drugs release the immune system to be very effective against cancer cells. It’s a very exciting time.”
When it comes to immunotherapy, brain tumor research has advanced more slowly. But, according to Ashley Love Sumrall, MD, FACP, of Atrium Health, there are new, promising data available for three unique subtypes of brain tumors: NTRK-positive primary CNS tumors, BRAFV600E-positive papillary craniopharyngiomas and mIDH1 lower-grade glioma.
Long-term follow-up data looks promising for advanced melanoma, such as the phase 3 CheckMate 067 trial of patients with advanced melanoma. Six and a half years after treatment, patients who received both nivolumab and ipilimumab had an objective response rate (ORR) of 58% and a median overall survival (OS) rate of 72.1 months. According to Pauline Funchain, MD, of Cleveland Clinic, this is the best data they’ve seen to date.
For cervical cancer, research has shown positive advancements when combining immunotherapy with other forms of treatment. For example, a combination of single-agent immune checkpoint inhibitors combined with immunotherapies might offer superior results than using either one alone. And it looks as though combining radiotherapy with immunotherapy can provide stable local tumor control and possibly improve the systemic immune response to the treatment.
In the phase 3 CheckMate 648 study, results have shown that patients who receive first-line treatment with nivolumab and chemotherapy or nivolumab and ipilimumab, may live longer than those who are only treated with chemotherapy. In general, the median overall survival rate of patients who receive chemotherapy alone is 10.7 months. For patients who received nivolumab and chemotherapy, the median overall survival was 13.2 months. Those who received nivolumab and ipilimumab had an overall survival of 12.8 months.
A previously untreatable form of advanced lung cancer may now be treatable
Previously, researchers considered the mutated KRAS G12C gene, which is found in advanced lung cancer, “undruggable.” But Sotorasib by Amgen, which was approved by the U.S. Food and Drug Administration on May 28, 2021, is changing that. Thanks to the CodeBreak 100 trial results, Sotorasib is the first-ever direct KRAS inhibitor to earn regulatory approval.
In a June 5 article by ASCO Post staff, lead author Ferdinandos Skoulidis, MD, PhD, Assistant Professor of Thoracic/Head & Neck Medical Oncology at The University of Texas MD Anderson Cancer Center, explained why these results are so promising.
“This trial provides convincing evidence that mutant KRAS can be successfully and selectively targeted, resulting in meaningful prolongation of survival without compromising quality of life,” he said. “These results, along with the regulatory approval of Sotorasib, represent a major landmark for patients with KRAS G12C-mutated lung cancer, who now have an approved targeted therapy option.”
More FDA approvals for targeted cancer treatments
Over the past year, several targeted cancer therapies have earned accelerated FDA approval, such as Sotorasib (mentioned above) for the KRAS gene mutation. Another therapy that received FDA approval over the past year was Johnson & Johnson’s Rybrevant, designed to treat non-small cell lung cancer with a specific genetic signature.
And, there are more on the horizon, such as Novartis’ 177LU-PSMA-617. Researchers studying this radiation therapy for prostate cancer cells recently released phase 3 data showing an increase in overall survival of four months, compared to patients who receive the standard treatment. They’ve also announced that they plan to explore the effectiveness of this treatment for other types of cancer.
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