This slide show highlights some of the top studies and news on cancer to come out of the 2014 American Society of Clinical Oncology (ASCO) Annual Meeting, held in Chicago.
1. Garcia-Albeniz X, Chan JM, Paciorek AT, et al. Immediate versus deferred initiation of androgen deprivation therapy in prostate cancer patients with PSA-only relapse. 2014 American Society of Clinical Oncology Annual Meeting; Abstract 5003.
2. Pagani O, Regan MM, Walley B, et al. Randomized comparison of adjuvant aromatase inhibitor (AI) exemestane (E) plus ovarian function suppression (OFS) vs tamoxifen (T) plus OFS in premenopausal women with hormone receptor-positive (HR+) early breast cancer (BC): Joint analysis of IBCSG TEXT and SOFT trials. 2014 American Society of Clinical Oncology Annual Meeting; Abstract LBA1.
3. Piccart-Gebhart MJ, Holmes AP, Baselga J, et al. First results from the phase III ALTTO trial (BIG 2-06; NCCTG [Alliance] N063D) comparing one year of anti-HER2 therapy with lapatinib alone (L), trastuzumab alone (T), their sequence (T→L), or their combination (T+L) in the adjuvant treatment of HER2-positive early breast cancer (EBC). 2014 American Society of Clinical Oncology Annual Meeting; Abstract LBA4.
4. Moore HCF, Unger JM, Phillips K-A, et al. Phase III trial (Prevention of Early Menopause Study [POEMS]-SWOG S0230) of LHRH analog during chemotherapy (CT) to reduce ovarian failure in early-stage, hormone receptor-negative breast cancer: An international Intergroup trial of SWOG, IBCSG, ECOG, and CALGB (Alliance). 2014 American Society of Clinical Oncology Annual Meeting; Abstract LBA505.
5. Hortobagyi GN, Lipton A, Chew HK, et al. Efficacy and safety of continued zoledronic acid every 4 weeks versus every 12 weeks in women with bone metastases from breast cancer: Results of the OPTIMIZE-2 trial. 2014 American Society of Clinical Oncology Annual Meeting; Abstract LBA9500.
6. Hinrichs CS, Stevanovic S, Draper L, et al. HPV-targeted tumor-infiltrating lymphocytes for cervical cancer. 2014 American Society of Clinical Oncology Annual Meeting; Abstract LBA3008.
7. Eggermont AM, Chiarion-Sileni V, Grob JJ, et al. Ipilimumab versus placebo after complete resection of stage III melanoma: Initial efficacy and safety results from the EORTC 18071 phase III trial. 2014 American Society of Clinical Oncology Annual Meeting; Abstract LBA9008.
Slide 1: Delaying ADT Found Safe for Prostate Cancer Patients:
Based on the results of the large prospective, observational CaPSURE study, prostate cancer patients who had a prostate-specific antigen (PSA)-based relapse could delay androgen deprivation therapy (ADT) until symptoms presented, without affecting long-term survival. The estimated 5-year overall survival among the group of men who had delayed ADT was 87.2% compared with 85.1% for those who had immediate ADT following a PSA-based relapse. The 10-year survival was 71.6% for both groups, and prostate cancer–specific mortality was also similar for the two groups. Because this study was observational, the results still need to be confirmed in a randomized trial, said Xabier Garcia-Albeniz, PhD.
Image source: Xabier Garcia-Albeniz, PhD, department of epidemiology and biostatistics, Harvard School of Public Health, Boston, Massachusetts.
Slide 2: Exemestane Better Than Tamoxifen for Some Early Breast Cancer Patients:
The results of the Tamoxifen and Exemestane Trial (TEXT) and the Suppression of Ovarian Function Trial (SOFT) demonstrated that combining exemestane with ovarian function suppression (OFS) in women with premenopausal hormone-sensitive breast cancer results in a 34% reduction in the risk of breast cancer recurrence, compared with treatment with tamoxifen in combination with OFS. After 5.7 years, exemestane-treated patients had a 28% reduced risk of having invasive disease (
= .0002). Disease-free survival was 91.1% in the exemestane arm compared with 87.3% in the tamoxifen arm.
Image source: Olivia Pagani, MD, Oncology Institute of Southern Switzerland, Bellinzona, Switzerland.
Slide 3: Second HER2-Targeted Therapy Doesn’t Add Benefit in Adjuvant Breast Cancer Trial:
According to the ALTTO clinical trial-the largest adjuvant breast cancer trial ever-adjuvant therapy with trastuzumab alone is just as effective as trastuzumab combined with lapatinib after surgery for women with early-stage human epidermal growth factor receptor 2 (HER2)-positive breast cancer. “This is the first adjuvant study reported [on the combination of lapatinib plus trastuzumab], which unfortunately, did not corroborate the hypothesis that an improvement in neoadjuvant pathologic complete responses correlates with longer-term disease-free survival,” said Edith Perez, MD, one of the authors of the study.
Image source: Edith Perez, MD, Mayo Clinic Cancer Center, Jacksonville, Florida.
Slide 4: Drug Can Preserve Fertility in Women Undergoing Cancer Treatment:
Using the gonadotropin-releasing hormone agonist goserelin concurrently with chemotherapy in early breast cancer patients can preserve a woman’s ability to have children, protecting the ovaries from the damage of chemotherapy. The results also confirmed the improved overall survival and disease-free survival in women given goserelin. According to the study authors, women beginning chemotherapy should consider this newer option to prevent premature ovarian failure during cancer therapy. The study, which included 257 premenopausal women, was sponsored by the National Institutes of Health.
Image source: Halle C. F. Moore, MD, Cleveland Clinic, Cleveland, Ohio.
Slide 5: Less Frequent Dosing of Bone Metastasis Drug for Breast Cancer Just as Efficacious:
Results of the OPTIMIZE-2 trial showed that zoledronic acid given every 12 weeks was just as efficacious as the drug administered at the standard dosing schedule of every 4 weeks for breast cancer patients with bone metastases. The rate of skeletal-related events (SREs) was similar in both treatment arms-22% in the every 4 week arm and 23.2% in the every 12 week arm (
= .724). The time to first on-study SRE and the mean skeletal morbidity rates (SMRs) were also similar for both treatment arms (
= .792 and
= .854, respectively). “That it is safe to give therapy every 12 weeks will be welcomed,” said Don S. Dizon, MD, of Massachusetts General Hospital Cancer Center, who was not involved in the study.
Image source: Gabriel N. Hortobagyi, MD, department of breast medical oncology, The University of Texas MD Anderson Cancer Center, Houston, Texas.
Slide 6: Immunotherapy Shows Positive Results in Advanced Cervical Cancer:
A proof-of-principle, nine-patient study demonstrated that women with advanced metastatic cervical cancer can respond to immunotherapy. An adoptive T-cell technique is used in which a patient’s own immune cells are harvested-specific T-cells that can respond to two viral antigens that target human papillomavirus (HPV) are selected and expanded, and then billions of these cells are infused back into the patient. Two of the women are currently in complete remission (for 15 and 22 months, respectively), after a single T-cell infusion. One patient had a partial response. The results are exciting for a disease that has a typical median survival of only 3.5 months. Many more studies are needed to better test the methods of this approach.
Image source: Christian S. Hinrichs, MD, National Cancer Institute, Bethesda, Maryland.
Slide 7: Ipilimumab Active in Stage III Melanoma:
The European Organisation for Research and Treatment of Cancer (EORTC) 18071 clinical trial of 951 melanoma patients tested whether ipilimumab at 10 mg/kg could delay recurrence in those with stage III disease. Median relapse-free survival was improved in patients in the ipilimumab arm compared with placebo (26.1 months vs 17.1 months). The immune checkpoint antibody treatment decreased the risk of relapse by 25% compared with placebo (hazard ratio = 0.75;
= .001). At 2 years, the relapse-free survival was 51.5% in the ipilimumab arm compared with 43.8% in the placebo arm-a 7.7% improvement. Side effects were similar to the metastatic patient trials. There were five treatment-related deaths in the trial.
Image source: Alexander Eggermont, MD, PhD, Gustave Roussy Cancer Campus Grand Paris, Villejuif, France.