This slide show features some of the top highlights on neuroendocrine tumors, breast cancer, and renal cell carcinoma to come out of the 2015 European Cancer Congress in Vienna.
1. Yao JC, Fazio N, Singh S, et al. Everolimus in advanced nonfunctional neuroendocrine tumors (NET) of lung or gastrointestinal (GI) origin: Efficacy and safety results from the placebo-controlled, double-blind, multicenter, phase 3 RADIANT-4 study. Presented at the 2015 European Cancer Congress; Abstract 5LBA.
2. Brastianos PK, Carter S, Santagata S, et al. Genomic characterization of brain metastases and paired primary tumors reveals branched evolution and potential therapeutic targets. Presented at the 2015 European Cancer Congress; Abstract 2905.
3. Choueiri T, Escudier B, Powles T, et al. Cabozantinib versus everolimus in patients with advanced renal cell carcinoma: Results of the randomized phase 3 METEOR trial. Presented at the 2015 European Cancer Congress; Abstract 4LBA.
4. Van Dam L, Dierickx D, Peccatori F, et al. Obstetrical complications and neonatal outcome in patients diagnosed with acute myeloid and acute lymphoblastic leukemia during pregnancy: Results from the International Network on Cancer, Infertility and Pregnancy (INCIP) study. Presented at the 2015 European Cancer Congress; Abstract 3205.
5. Sparano J, Gray R, Zujewski JA, et al. Prospective trial of endocrine therapy alone in patients with estrogen-receptor positive, HER2-negative, node-negative breast cancer: Results of the TAILORx low risk registry. Presented at the 2015 European Cancer Congress; Abstract 5BA.
6. Yates L, Knappskog S, Martincorena I, et al. The driver landscape of breast cancer metastasis and relapse. Presented at the 2015 European Cancer Congress; Abstract 1804.
Slide 1: Everolimus Effective for Certain Neuroendocrine Tumors
-Nonfunctional neuroendocrine tumors (NETs) that originated in the gastrointestinal tract or the lungs were effectively treated with everolimus, resulting in a median 7.1-month improvement in progression-free survival (PFS). Patients in the phase III trial who received the mTOR inhibitor had a median PFS of 11 months compared with 3.9 months in the placebo group. The significant difference in PFS was seen for all factors, including tumor origin, prior somatostatin analog treatment, age, and poorer performance status. In an interim analysis, the difference in overall survival did not reach statistical significance. Another interim overall survival analysis is expected in 2016. Image Source: James C. Yao, MD, department of gastrointestinal medical oncology, University of Texas MD Anderson Cancer Center, Houston, Texas.
Slide 2: Genetic Study of Brain Metastases Reveals Potential Drug Targets
-Brain metastases are genetically distinct from primary tumors, according to an analysis of genomes from matched pairs of primary tumors and brain metastases from 104 patients. In 56% of the patients analyzed, unique genetic alterations found in brain metastases-but not the primary tumor-could potentially be targeted with drugs. The whole-exome sequencing revealed that 52% of mutations unique to the brain metastases could be sensitive to cyclin-dependent kinase (CDK) inhibitors, while 43% of the alterations may be sensitive to PI3K or mTOR inhibitors. The study’s findings-that brain metastases are clinically distinct tumors with unique oncogenic driving mutations-could lead to novel therapies for brain metastasis. Image Source: Priscilla K. Brastianos, MD, Central Nervous System Metastasis Program, Massachusetts General Hospital Cancer Center, Boston, Massachusetts.
Slide 3: Cabozantinib Increases PFS in Renal Cell Carcinoma
-Previously treated advanced clear cell renal cell carcinoma patients lived almost twice as long when treated with the tyrosine kinase inhibitor cabozantinib compared with the control treatment of everolimus. The median progression-free survival (PFS) among the 658 patients in the phase III METEOR trial was 7.4 months in the cabozantinib arm compared with 3.8 months in the control arm (
Slide 4: Chemo During Pregnancy Did Not Appear to Affect Early Child Development
-Children exposed to cancer, radiologic imaging, and chemotherapy neonatally did not appear to suffer cognitive impairment, cardiac issues, or general developmental problems in early childhood. The study assessed the general health, cardiac function, and cognition of 129 children between the ages of 18 and 36 months who were born to mothers with cancer during pregnancy. This cohort was then compared to the development and function of 129 children born following an uncomplicated pregnancy. The number of cycles of chemotherapy during pregnancy ranged from 1 to 10 and did not appear to affect children’s outcomes. According to the study authors, there is more concern about premature labor in cancer patients treated with chemotherapy. Image Source: FrÃ©dÃ©ric Amant, MD, PhD, gynecologic oncologist at the University Hospitals Leuven, Belgium, and the Antoni van Leeuwenhoek Hospital, Amsterdam.
Slide 5: Not All Early-Stage Breast Cancers Need Chemotherapy
-Some women with early-stage hormone receptorâpositive breast cancer can be treated with adjuvant hormone therapy alone, avoiding chemotherapy without increasing their risk of recurrence, according to results of a new study. In the TAILORx study, forgoing chemotherapy in patients with a low risk of recurrence, as deemed by the Oncotype Dx recurrence score genetic assay, did not increase the risk of disease recurrence or disease spread at 5 years. During the 5-year period there were 88 cases of either invasive cancer or death as well as 30 deaths from other causes among the 10,253 breast cancer patients studied. The rate of invasive disease-free survival at 5 years was 93.8%. The overall survival rate was 98%. Image Source: European Cancer Organisation.
Slide 6: Genetics Provide Hints of Breast Cancer Relapse
-Researchers have identified mutations that may predispose women with breast cancer to disease relapse. Better characterizing these genetic factors and identifying new ones may facilitate the identification of patients at the highest risk of recurrence. According to the study authors, cancer driver mutations have predominantly been identified in the primary tumor while less is known about the effect of these mutations upon either local recurrence or metastasis. The researchers analyzed data from 1,000 breast cancer patients and identified 365 genes associated with the cancer. Then, they analyzed 161 local recurrence and metastatic patient samples and compared these to previously published primary tumor data. Among others, mutations in
JAK2, STAT3, TP53, ARID1A
genes were often present in metastatic tumors but not in the primary tumors. The study underscores the difference in the molecular biology of recurring and metastatic tumors. Image Source: European Cancer Organisation.