medonline
Elisabeth Glitzner-Zeis, PhD
Elisabeth Glitzner-Zeis, PhD
27 May 2019Preview

ASCO 2019: Individualized care in focus

Another shot at golden hour of my favorite city skyline. Chicago in his glory!
gettyimages/remodaut

As this year’s ASCO Annual Meeting draws near, we provide an outlook of the world’s largest oncology meeting in 2019. As always, we will report directly and on-site.

From May 31 to June 4, more than 32,000 cancer experts from across the globe will meet at the 55th Annual Meeting of the American Society of Clinical Oncology (ASCO), taking place in Chicago.

Over 2,400 abstracts have been accepted for presentation, and 3,200 additional ones will be published online-only. The abstracts, the majority of which is already available here, cover clinical research such as advances in targeted therapies for pancreatic, prostate, and pediatric cancers, as well as new approaches to overcome limited access to cancer care.

Combating limited access to cancer care

This year’s theme is Caring for Every Patient, Learning From Every Patient. “I selected this theme to help address how we can provide every patient with equal access to the highest quality of care,” commented ASCO president Monica M Bertagnolli MD, during a press briefing held ahead of the meeting. The theme echoes throughout the meeting’s program: The first of four presentations of the plenary session on Sunday, June 2, is dedicated to the impact of the American Medicaid expansion of the Affordable Care Act and racial disparities on time to cancer treatment. In general, social, racial and financial disparities and their relationship with cancer care are discussed in various talks, posters and educational sessions. What is also remarkable about the plenary session program is that a trial with negative results (the ANNOUNCE trial in sarcoma, abstract LBA3, see list below) is scheduled as one of the four, responding to the increasing criticism condemning one-sided coverage of clinical trials with positive outcomes only on the plenary stage of other conferences.

Focus on physician wellbeing and integrative patient care

In addition to scientific sessions, attendees can benefit from sessions featuring how to indirectly improve patient care – as how to stay healthy as a caregiver in oncology. “Fostering Moral Resilience: Steps You Can Take to Manage Moral Distress and Burnout in Oncology” is one of them, taking place on Monday, June 3, between 8:00 AM and 9:00 AM, that educates participants about this widespread problem. An interactive session will furthermore discuss how primary care physicians can be re-introduced to cancer care (“Bringing the Primary Care Physician ‘Back’ Into Cancer Care”, May 31, 1:00 PM – 2:00 PM).

Plenary Sessions

Featured in the Plenary Sessions, taking place on Sunday, June 2 between 1:00 PM and 4:00 PM, these four abstracts will be presented:

LBA1: An analysis of electronic health records is looking into the relationship between affordable health insurance (i.e. the Medicaid expansion of the American Affordable Care Act) as well as racial disparities and the time to cancer treatment (Adamson BJS et al. Affordable Care Act (ACA) Medicaid expansion impact on racial disparities in time to cancer treatment.)

LBA2: The randomized phase 3 ENZAMET (ANZUP 1304) trial of an international group cooperative led by ANZUP examined the addition of the androgen receptor signaling inhibitor enzalutamide to standard-of-care therapy for metastatic hormone-sensitive prostate cancer. (Sweeney C et al. Overall survival (OS) results of a phase III randomized trial of standard-of-care therapy with or without enzalutamide for metastatic hormone-sensitive prostate cancer (mHSPC): ENZAMET (ANZUP 1304), an ANZUP-led international cooperative group trial.)

LBA3: The randomized phase 3 trial ANNOUNCE comparing Olaratumab plus doxorubicine versus doxorubicine alone for patients with advanced soft tissue sarcoma had been required by regulatory agencies after the combination had been approved in 2016 based on a small phase 2 trial. The gross results have already been announced, and have led to the discontinuation of the drug. (Tap WD et al. ANNOUNCE: A randomized, placebo (PBO)-controlled, double-blind, phase (Ph) III trial of doxorubicin (dox) + olaratumab versus dox + PBO in patients (pts) with advanced soft tissue sarcomas (STS).)

LBA4: The randomized phase 3 trial POLO explored maintenance therapy with the PARP inhibitor olaparib in patients with metastatic pancreatic cancer with a germline BRCA mutation following first-line platinum-based chemotherapy. (Kindler HL et al. Olaparib as maintenance treatment following first-line platinum-based chemotherapy (PBC) in patients (pts) with a germline BRCA mutation and metastatic pancreatic cancer (mPC): Phase III POLO trial.)

Breakfast briefs: What do doctors say?

Every morning, we are going to discuss key studies, controversies and highlights of the day with opinion leaders from Switzerland, including:

  • Richard Cathomas, MD, Kantonsspital Graubuenden
  • Prof. Olivier Michielin, MD, PhD, Centre hospitalier universitaire vaudois Lausanne
  • Prof. Reinhard Dummer, MD, Universitätsspital Zürich
  • Prof. Solange Peters, MD, PhD, Centre hospitalier universitaire vaudois Lausanne
  • Sacha Rothschild, MD, PhD, Universitätsspital Basel

Key publications according to cancer type

Breast Cancer
  • Hurvitz SA et al. Phase III MONALEESA-7 trial of premenopausal patients with HR/HER2-advanced breats cancer (ABC) treated with endocrine therapy +/-ribociclib: overall survival (OS) results. Abstract LBA 1008
  • Hurvitz SA et al. Neoadjuvant trastuzumab (H), pertuzumab (P), and chemotherapy versus trastuzumab emtansine (T-DM1) and P in human epidermal growth factor receptor 2 (HER2)-positive breast cancer (BC): Final outcome results from the phase III KRISTINE study. Abstract 500
  • Bergh JCS et al. Docetaxel, trastuzumab, pertuzumab versus trastuzumab emtansine as neoadjuvant treatment of HER2-positive breast cancer: Results from the Swedish PREDIX HER2 trial identifying a new potential de-escalation standard? Abstract 501
  • Metzger Filho O et al. HER2 heterogeneity as a predictor of response to neoadjuvant T-DM1 plus pertuzumab: Results from a prospective clinical trial. Abstract 502
  • Rugo HS. et al. SOPHIA primary analysis: A phase 3 (P3) study of margetuximab (M) + chemotherapy (C) versus trastuzumab (T) + C in patients (pts) with HER2+ metastatic (met) breast cancer (MBC) after prior anti-HER2 therapies (Tx).
  • Jiang Z et al. Pyrotinib combined with capecitabine in women with HER2+ metastatic breast cancer previously treated with trastuzumab and taxanes: A randomized phase III study. Abstract 1001
  • Saura C et al. Neratinib + capecitabine versus lapatinib + capecitabine in patients with HER2+ metastatic breast cancer previously treated with ≥ 2 HER2-directed regimens: Findings from the multinational, randomized, phase III NALA trial. Abstract 1002
Central Nervous System Tumors
  • Van Den Bent MJ et al. Second interim and first molecular analysis of the EORTC randomized phase III intergroup CATNON trial on concurrent and adjuvant temozolomide in anaplastic glioma without 1p/19q codeletion. Abstract 2000
  • Balana C et al. Randomized phase IIb clinical trial of continuation or non-continuation with six cycles of temozolomide after the first six cycles of standard first-line treatment in patients with glioblastoma: A Spanish research group in neuro-oncology (GEINO) trial. Abstract 2001
Colorectal Cancer
  • Sougklakos I et al. Three versus six months adjuvant FOLFOX or CAPOX for high risk stage II and stage III colon cancer patients: The efficacy results of Hellenic Oncology Research Group (HORG) participation to the International Duration Evaluation of Adjuvant chemotherapy (IDEA) project. Abstract 3500
  • Iveson T et al. Prospective pooled analysis of four randomized trials investigating duration of adjuvant (adj) oxaliplatin-based therapy (3 vs 6 months {m}) for patients (pts) with high-risk stage II colorectal cancer (CC). Abstract 3501
  • Shi Q et al. Re-evaluating disease-free survival (DFS) as an endpoint versus overall survival (OS) in adjuvant colon cancer (CC) trials with chemotherapy +/- biologics: An updated surrogacy analysis based on 18,886 patients (pts) from the Accent database. Abstract 3502
  • Pogue-Geile KL et al. Association of colon cancer (CC) molecular signatures with prognosis and oxaliplatin prediction-benefit in the MOSAIC Trial (Multicenter International Study of Oxaliplatin/5FU-LV in the Adjuvant Treatment of Colon Cancer). Abstract 3503
Developmental Immunotherapy
  • Uldrick TS et al. Phase I study of pembrolizumab in people with HIV and cancer. Abstract 2500
  • Pai SI et al. A phase II study of pembrolizumab for HPV-associated papilloma patients with laryngeal, tracheal, and/or pulmonary involvement. Abstract 2502
Gastrointestinal (noncolorectal) Cancer
  • Tempero MA et al. APACT: phase III, multicenter, international, open-label, randomized trial of adjuvant nab-paclitaxel plus gemcitabine (nab-P/G) vs gemcitabine (G) for surgically resected pancreatic adenocarcinoma. Abstract 4000
  • Park SH et al. ARTIST 2: Interim results of a phase III trial involving adjuvant chemotherapy and/or chemoradiotherapy after D2-gastrectomy in stage II/III gastric cancer (GC). Abstract 4001
  • Izumi N et al. A multicenter randomized controlled trial to evaluate the efficacy of surgery vs. radiofrequency ablation for small hepatocellular carcinoma (SURF trial). Abstract 4002
Genitourinary (nonprostate) Cancer
  • Rini BI et al. Pembrolizumab (pembro) plus axitinib (axi) versus sunitinib as first-line therapy for metastatic renal cell carcinoma (mRCC): Outcomes in the combined IMDC intermediate/poor risk and sarcomatoid subgroups of the phase 3 KEYNOTE-426 study. Abstract 4500
  • Gao J et al. A pilot randomized study evaluating nivolumab (nivo) or nivo + bevacizumab (bev) or nivo + ipilimumab (ipi) in patients with metastatic renal cell carcinoma (MRCC) eligible for cytoreductive nephrectomy, metastasectomy or post-treatment biopsy (Bx). Abstract 4501
  • Appleman LJ et al. Randomized, double-blind phase III study of pazopanib versus placebo in patients with metastatic renal cell carcinoma who have no evidence of disease following metastasectomy: A trial of the ECOG-ACRIN cancer research group (E2810). Abstract 4502
  • Petrylak DP et al. EV-201: Results of enfortumab vedotin monotherapy for locally advanced or metastatic urothelial cancer previously treated with platinum and immune checkpoint inhibitors. Abstract LBA4505
Gynecologic Cancer
  • Powell MA et al. A randomized phase 3 trial of paclitaxel (P) plus carboplatin  (C) versus paclitaxel plus ifosfamide (I) in chemotherapy-naive patients with stage I-IV, persistent or recurrent carcinosarcoma of the uterus or ovary: An NRG oncology trial. Abstract
  • Antill YC et al. Activity of durvalumab in advanced endometrial cancer (AEC) according to mismatch repair (MMR) status: The phase II PHAEDRA trial (ANZGOG1601). Abstract 5501
  • Konstantinopoulos PA et al. Phase 2, two-group, two-stage study of avelumab in patients (pts) with microsatellite stable (MSS), microsatellite instable (MSI), and polymerase epsilon (POLE) mutated recurrent/persistent endometrial cancer (EC). Abstract 5502
Head and Neck Cancer
  • Rischin D et al. Protocol-specified final analysis of the phase 3 KEYNOTE-048 trial of pembrolizumab (pembro) as first-line therapy for recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). Abstract 6000
  • Li BT et al. Ado-trastuzumab emtansine in patients with HER2 amplified salivary gland cancers (SGCs): Results from a phase II basket trial. Abstract 6001
  • Guigay J et al. TPExtreme randomized trial: TPEx versus Extreme regimen in 1st line recurrent/metastatic head and neck squamous cell carcinoma (R/M HNSCC). Abstract 6002
Hematologic Malignancies
  • Levis MJ et al. Effect of gilteritinib on survival in patients with FLT3-mutated (FLT3mut+) relapsed/refractory (R/R) AML who have common AML co-mutations or a high FLT3-ITD allelic ratio. Abstract 7000
  • Kovacsovics T et al. A randomized phase II trial of CX-01 with standard therapy in elderly patients with acute myeloid leukemia (AML). Abstract 7001
  • Alfayez M et al. Association of smoking with poor risk ELN 2017, cytogenetics/molecular profile, and survival outcomes in acute myeloid leukemia. Abstract 7002
  • San Miguel J et al. Updated risk stratification model for smoldering multiple myeloma (SMM) incorporating the revised IMWG diagnostic criteria. Abstract 8000
  • Lonial S et al. E3A06: Randomized phase III trial of lenalidomide versus observation alone in patients with asymptomatic high-risk smoldering multiple myeloma. Abstract 8001
  • Gay F et al. Efficacy of carfilzomib lenalidomide dexamethasone (KRd) with or without transplantation in newly diagnosed myeloma according to risk status: Results from the FORTE trial. Abstract 8002
  • Woyach JA et al. Acalabrutinib with obinutuzumab (Ob) in treatment-naive (TN) and relapsed/refractory (R/R) chronic lymphocytic leukemia (CLL): Three-year follow-up. Abstract 7500
  • Siddiqi T et al. TRANSCEND CLL 004: Minimal residual disease (MRD) negative responses after lisocabtagene maraleucel (Liso-Cel; JCAR017), a CD19-directed CAR T cell product, in patients (pts) with relapsed/refractory chronic lymphocytic leukemia or small lymphocytic lymphoma (CLL/SLL). Abstract 7501
  • Fischer K et al. Effect of fixed-duration venetoclax plus obinutuzumab (VenG) on progression-free survival (PFS), and rates and duration of minimal residual disease negativity (MRD–) in previously untreated patients (pts) with chronic lymphocytic leukemia (CLL) and comorbidities. Abstract 7502
Lung Cancer
  • Tsutani Y et al. Adjuvant chemotherapy for pathological stage I non-small cell lung cancer with high-risk factors for recurrence: A multicenter study. Abstract 8500
  • Kenmotsu H et al. Randomized phase III study of pemetrexed/cisplatin (Pem/Cis) versus vinorelbine /cisplatin (Vnr/Cis) for completely resected stage II-IIIA non-squamous non-small-cell lung cancer (Ns-NSCLC): The JIPANG study. Abstract 8501
  • Tsakiridis T et al. Initial reporting of NRG-LU001 (NCT02186847), randomized phase II trial of concurrent chemoradiotherapy (CRT) +/- metformin in locally advanced Non-Small Cell Lung Cancer (NSCLC). Abstract 8502
  • Nakagawa K et al. RELAY: A multinational, double-blind, randomized Phase 3 study of erlotinib (ERL) in combination with ramucirumab (RAM) or placebo (PL) in previously untreated patients with epidermal growth factor receptor mutation-positive (EGFRm) metastatic non-small cell lung cancer (NSCLC). Abstract 9000
  • Noronha V et al. Phase III randomized trial comparing gefitinib to gefitinib with pemetrexed-carboplatin chemotherapy in patients with advanced untreated EGFR mutant non-small cell lung cancer (gef vs gef+C). Abstract 9001
  • Ramalingam SS et al. ECOG-ACRIN 5508: Pemetrexed, bevacizumab or the combination as maintenance therapy for advanced non-squamous NSCLC. Abstract 9002
  • Seto T et al. A randomized phase III study of continuous maintenance bevacizumab with or without pemetrexed after induction therapy with carboplatin (Car), pemetrexed (Pem), and bevacizumab (Bev) for advanced non-squamous non-small cell lung cancer (nSQ-NSCLC) without sensitizing EGFR mutations: The COMPASS study (WJOG5610L). Abstract 9003
Prostate Cancer
  • Fizazi K et al. Impact of darolutamide (DARO) on pain and quality of life (QoL) in patients (Pts) with nonmetastatic castrate-resistant prostate cancer (nmCRPC). Abstract 5000
  • Carrie C et al. Interest of short hormonotherapy (HT) associated with radiotherapy (RT) as salvage treatment for metastatic free survival (MFS) after radical prostatectomy (RP): Update at 9 years of the GETUG-AFU 16 phase III randomized trial (NCT00423475). Abstract 5001
Pediatric Oncology
  • Defachelles AS et al. Randomized phase 2 trial of the combination of vincristine and irinotecan with or without temozolomide, in children and adults with refractory or relapsed rhabdomyosarcoma (RMS). Abstract 1000
  • Moreno L et al. Temozolomide versus irinotecan-temozolomide for children with relapsed and refractory high risk neuroblastoma (RR-HRNB): Results of the BEACON-Neuroblastoma randomized phase 2 trial – A European Innovative Therapies for Children with Cancer (ITCC) – International Society of Pediatric Oncology Europe Neuroblastoma Group (SIOPEN) trial. Abstract 1001
  • van Tilburg CM et al. Larotrectinib efficacy and safety in pediatric TRK fusion cancer patients. Abstract 10010
  • Parsons DW et al. Identification of targetable molecular alterations in the NCI-COG Pediatric MATCH trial. Abstract 1011
Sarcoma
  • Gronchi A et al. Neoadjuvant chemotherapy in high-risk soft tissue sarcomas: Final results of a randomized clinical trial from the Italian Sarcoma Group, the Spanish Sarcoma Group (GEIS), the French Sarcoma Group (FSG), and the Polish Sarcoma Group (PSG). Abstract 11000
  • Bonvalot S et al. STRASS (EORTC 62092): A phase III randomized study of preoperative radiotherapy plus surgery versus surgery alone for patients with retroperitoneal sarcoma. Abstract 11001
  • Weiss AR et al. Preoperative chemoradiation +/- pazopanib in non-rhabdomyosarcoma soft tissue sarcoma (NRSTS): A report from Children’s Oncology Group (COG) and NRG Oncology. Abstract 11002
Skin Cancers
  • Fogarty G et al. Phase 3 international trial of adjuvant whole brain radiotherapy (WBRT) or observation (Obs) following local treatment of 1-3 melanoma brain metastases (MBMs). Abstract 9500
  • Tawbi HAB et al. Efficacy and safety of the combination of nivolumab (NIVO) plus ipilimumab (IPI) in patients with symptomatic melanoma brain metastases (CheckMate 204). Abstract 9501

Links

To the conference Website

To the conference program