American Society of Clinical Oncology, May 29-June 2, 2009

American Society of Clinical Oncology 45th Annual Meeting

The American Society of Clinical Oncology's 45th Annual Meeting took place May 29 to June 2 in Orlando, Fla., and attracted more than 30,000 attendees from around the world. The meeting featured more than 4,000 abstracts on advances in cancer prevention, treatment and care, and its theme -- "Personalizing Cancer Care" -- was reflected in multiple sessions that addressed advances in tailoring treatments to the unique genetics of the patient or the tumor.

"It's very exciting year this year," said ASCO president, Richard L. Schilsky, M.D., of the University of Chicago. "There's a lot of good research coming out showing that we can really individualize treatment based on genetic testing or we can identify and hit new targets with very effective new treatments."

"One of our plenary sessions introduced a new class of drugs that we think are going to find an important place in treating cancer," Schilsky said. "These are drugs called PARP inhibitors, and they basically work by preventing cancer cells from repairing the damage that's done by chemotherapy. They work particularly well in women who have triple-negative breast cancer, a type of cancer for which we don't have any good targeted therapies. This is also a promising new therapy for women who have the BRCA1 mutation and who develop breast cancer."

In one study, Joyce O'Shaughnessy, M.D., of the Baylor-Charles A. Sammons Cancer Center in Dallas, and colleagues randomly assigned women with metastatic triple-negative breast cancer to receive either standard chemotherapy with gemcitabine and carboplatin plus the PARP inhibitor BSI-201 or standard treatment alone. They found that combination therapy group had a higher overall response rate, median survival, and progression-free survival.

Financial disclosure was made for BiPar Sciences Inc.

In a second study, Andrew Tutt, Ph.D., of Kings College in London, U.K., and colleagues studied the effects of the PARP inhibitor olaparib in 54 women whose breast cancer was deficient in BRCA1 or BRCA2 and did not respond to several rounds of standard chemotherapy. They observed tumor shrinkage in nearly 40 percent of the women who were treated with the highest of two doses used in the study.

"This drug is in a very early stage of development, and additional clinical trials are necessary to determine the best way to use olaparib in women with BRCA-deficient breast cancer," Tutt said in a statement. "We are actively discussing the design of future PARP inhibitor studies for women with BRCA1 and BRCA2 mutations."

Financial disclosure was made for AstraZeneca, Myriad Genetics.

Abstract - O'Shaughnessy
Abstract - Tutt

"The meeting presented many advances in the treatment of advanced malignant melanoma," Schilsky said. "Some of the most interesting research was presented in a phase I study of a new targeted agent that hits a specific genetic mutation that commonly occurs in melanoma: a mutation in the BRAF gene called V600E."

In that study, Keith Flaherty, M.D., of the Vanderbilt University Medical Center in Nashville, Tenn., and colleagues studied the effects of PLX4032, an oral selective inhibitor of the V600E mutant BRAF kinase in 49 patients with advanced melanoma and five other patients with advanced thyroid, rectal, and ovarian cancers. Among the melanoma patients, they observed tumor regression in five of the seven patients with V600E and in two of the four patients with unknown V600E status. Among the thyroid cancer patients, they observed tumor regression in three patients with V600E. After a follow-up of four to 14 months, they found that all 10 of these patients were progression-free.

Financial disclosure was made for Roche.

Abstract - Flaherty

Another noteworthy study, presented by William K. Oh, M.D., and Robert W. Ross, M.D., of Source MDx in Boulder, Colo., showed that a new six-gene whole blood RNA transcript-based diagnostic test -- when combined with conventional prostate-specific antigen (PSA) screening -- can dramatically increase the accuracy of prostate cancer diagnoses. The researchers studied men, with known prostate cancer or benign prostatic hypertrophy, and healthy controls. They found that the combined tests had a greater specificity and sensitivity compared to PSA testing alone, and also that the combined results eliminated a majority of the false-positives seen with PSA testing.

"These findings are very encouraging and suggest that this new test could spare tens of thousands of men from undergoing an unnecessary biopsy," Oh said in a statement. "However, until we can verify our findings, it is important to recognize that the PSA test, despite its limitations, is still the best test available for diagnosing prostate cancer at this time."

Abstract - Oh & Ross

In other developments, ASCO announced its new Quality Oncology Practice Initiative Certification Program, which will be available to all practices that meet rigorous and specific performance requirements and pass a new site assessment. Under the voluntary, self-assessment program, practices collect abstract data from medical charts twice a year, and enter it into a secure database which ASCO analyzes for adherence to more than 80 evidence-based and consensus quality measures.

"Increasingly, oncology practices are being asked by payors, patients, and others to attest to the quality of care they provide," incoming ASCO president, Douglas W. Blayney, M.D., said in a statement. "ASCO Quality Oncology Practice Initiative Certification will demonstrate a practice's commitment to delivering high-quality cancer care."

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ASCO: Gastrointestinal Cancer Treatments Analyzed

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