The American Society of Clinical Oncology (ASCO) released its report, Clinical Cancer Advances 2009: Major Research Advances in Cancer Treatment, Prevention and Screening, an independent assessment of the most significant clinical cancer research studies of the past year, including 15 major advances.
The report also makes policy recommendations for increasing investment in cancer research funding, accelerating progress in clinical cancer research, and ensuring that Americans with cancer receive high-quality care.
"These continuing research advances should encourage people with cancer and those who care for them," said ASCO President Douglas W. Blayney, MD. "As this report demonstrates, investment in clinical cancer research is paying off. Since 1990, cancer death rates have declined 15%. Today, two-thirds of patients survive at least 5 years after diagnosis, compared to just half 40 years ago, and they have a dramatically higher quality of life."
This year, ASCO identified 15 major cancer research advances in four key areas. (Note: Advances in the report are not ranked.):
1. Advances in Personalized Medicine and Targeted Therapies:
• The targeted drug trastuzumab (Herceptin), initially successful against breast tumors that overexpress the HER2 protein, was found to improve survival for HER2+ gastric cancer.
• Researchers identified the first effective immunotherapy for neuroblastoma—chimeric anti-GD2 antibody ch.14.18.
• For the first time in 30 years, a randomized trial identified a regimen—initial chemotherapy combined with EGFR-targeted cetuximab (Erbitux)—that increases survival for metastatic head and neck cancer patients.
• Researchers identified a specific subset of patients with non–small-cell lung cancer (NSCLC) who benefit from first-line treatment with the targeted drug gefitinib (Iressa).
• The US Food and Drug Administrtion (FDA) approved new indications for targeted drugs to treat glioblastoma and advanced kidney cancer. Bevacizumab (Avastin) was approved as a single agent for treatment of glioblastoma and when combined with interferon, for treatment of advanced kidney cancer. Additionally, everolimus (Afinitor) was approved for kidney cancer in patients whose disease has progressed despite treatment with other targeted drugs.
2. New Standards of Care:
• Results from the largest clinical trial to date for advanced biliary cancer showing that combination gemcitabine (Gemzar) and cisplatin treatment increases survival and slows cancer progression, compared with gemcitabine treatment alone. This is the first-ever standard of care for advanced biliary cancer.
• Data from a late-stage trial reporting that maintenance therapy with pemetrexed (Alimta) extends survival for patients with nonsquamous forms of advanced NSCLC—a finding that establishes a new standard and gives patients a long-term, easily-administered treatment option with low toxicity.
• Practice-changing findings showing that radiation following prostatectomy improves survival and reduces risk of metastasis for men with early-stage prostate cancer.
3. Cancer Prevention/Screening:
• Interim results from two large trials showing that routine prostate-specific antigen (PSA) testing has a minimal effect on reducing prostate cancer mortality—findings that add new insight to a long-time debate.
• A large trial showing that treating relapsed ovarian cancer based on rising levels of CA125 does not improve outcomes, compared with monitoring for physical symptoms of ovarian cancer relapse. These findings will help spare women the anxiety and costs of frequent CA125 testing, as well as the toxicity of earlier treatment.
• Research suggesting that more women may benefit from HPV vaccination than previously thought, based on findings showing that Gardasil reduces the risk of HPV infection, cervical cancer, and other HPV-related disease in women aged 25 to 45.
4. Large Trials Settle Key Debates in Colon, Breast Cancer Treatment:
• Standard three-drug chemotherapy is more effective and less toxic than single-drug treatment with capecitabine (Xeloda) in women age 65 and older undergoing adjuvant treatment for early-stage breast cancer. Researchers had thought that single-drug treatment may be more tolerable for older women, but this was not found to be the case.
ASCO also makes three key recommendations for accelerating progress in cancer research and ensuring that people with cancer have access to high-quality care:
• Increase federal investment in cancer research funding.
• Strengthen the nation’s clinical research system.
• Ensure patients receive high-quality care.