American Society of Clinical Oncology, May 30-June 3, 2008

American Society of Clinical Oncology's 44th Annual Meeting

The American Society of Clinical Oncology's 44th Annual Meeting took place May 30-June 3 in Chicago, attracted more than 31,000 attendees from around the world, and presented nearly 4,300 abstracts. Key topics included advances in personalized medicine and in treatments for breast, lung and testicular cancers.

"We're moving toward more targeted therapy," said Julie Gralow, M.D., of the University of Washington in Seattle, chair of ASCO's cancer communications committee. "Because we better understand the tumor and better understand the patient, we're coming up with treatment regimens that are a little less one-size-fits-all and a little more individualized."

A major study presented at the plenary session demonstrated the growing importance of pharmacogenetics. In that study, Eric Van Cutsem, M.D., of University Hospital Gasthuisberg in Leuven, Belgium, and colleagues assessed tumor samples from 587 patients who were newly diagnosed with metastatic colorectal cancer. They detected the normal form of the KRAS gene in 64.4 percent of the samples and KRAS mutations in 35.6 percent.

When the researchers looked at how the patients responded to treatment with either chemotherapy plus cetuximab -- a targeted therapy that blocks the epidermal growth factor receptor -- or chemotherapy alone, they found that KRAS status predicted who would benefit from the combination therapy. In patients with normal KRAS, tumors shrank by more than half in 59.3 percent of those receiving combination therapy compared to 43.2 percent of those receiving chemotherapy alone. But in patients with KRAS mutations, there was no difference in response rates between those receiving combination therapy or chemotherapy alone.

"That's an important finding because it means we can avoid treating about one-third of colorectal cancer patients with an ineffective drug," Gralow said. "In all trials of cetuximab, researchers are now enrolling only KRAS-normal patients. So clearly the colorectal community has already decided that this is practice changing."

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Another major study showed that a bisphosphonate drug -- zoledronic acid -- dramatically reduced recurrence rates in women with early-stage breast cancer who were treated with hormone therapy. Michael Gnant, M.D., of the Medical University of Vienna in Vienna, Austria, and colleagues randomly assigned 1,803 women who had previously undergone surgery and whose cancer had spread to 10 or fewer lymph nodes to receive either zoledronic acid plus hormone therapy or hormone therapy alone.

After a median follow-up of 60 months, the researchers found that the combination therapy reduced the risk of relapse by 35 percent compared to hormone therapy alone. "Future research will focus on optimizing the administration schedule and the dose, and determining which patients will benefit the most from treatment with zoledronic acid," Gnant said in a statement.

"Breast cancer cells like to migrate through the blood to the bone marrow," Gralow said. "This trial suggests that if we can make the bone an environment that's inhospitable to cancer cells, we can impact recurrences overall. At least in a subset of early-stage breast cancer patients, we will probably be adding bisphosphonate drugs to reduce recurrences, so this study is practice changing.

"We're awaiting the results of some big trials in the next six to 12 months, which will define whether zoledronic acid is applicable to all patients or just a minority of patients," Gralow added. "It's administered twice a year, it's cheap, and there are hardly any side effects. It also reduces the risk of osteoporosis. So I think there will be some uptake among clinicians to use bisphosphonate drugs to reduce bone metastases."

Another important study demonstrated that adding bevacizumab -- an antiangiogenic drug -- to the chemotherapy drug docetaxel significantly slowed cancer growth in women patients who were newly diagnosed with advanced breast cancer. David Miles, M.D., of the Mount Vernon Cancer Centre in London, U.K., and colleagues randomly assigned 736 patients to one of three arms: placebo plus docetaxel, a high dose of bevacizumab (15 mg/kg) plus docetaxel, or a lower dose of bevacizumab (7.5 mg/kg) plus docetaxel.

After a median follow-up of 11 months, the researchers found that disease progression was significantly less likely in the high-dose and low-dose bevacizumab groups (28 percent and 21 percent, respectively) than in the control group. They also found that tumor shrinkage was significantly higher in the high-dose and low-dose bevacizumab groups (63.1 percent and 55.2 percent, respectively) than in the control group (44.4 percent). "We found it does not add a great deal to the toxicity of chemotherapy, which should be reassuring to physicians recommending this course of treatment," Miles said in a statement.

"This is another example of a therapy that's targeting the environment instead of the tumor cells directly," Gralow said. "By preventing the formation of blood vessels that bring oxygen and nutrients to the tumor, we can prolong progression-free survival and improve responses. We're moving antiangiogenic drugs into the early-stage setting as well."

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ASCO: Breast Cancer Drug Cocktail Improves Survival

TUESDAY, June 3 (HealthDay News) -- Treating advanced HER2-positive breast cancer with a combination of three drugs may improve survival rates, according to study findings presented at the annual meeting of the American Society of Clinical Oncology in Chicago.

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ASCO: Vaccine Appears Beneficial for Glioblastoma

MONDAY, June 2 (HealthDay News) -- In newly diagnosed patients with glioblastoma multiforme, treatment with CDX-110 -- an epidermal growth factor receptor variant III (EGFRvIII)-specific peptide vaccine -- in combination with standard of care temozolomide, induces an immune response and prolongs time to progression, according to research presented at the annual meeting of the American Society of Clinical Oncology in Chicago.

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ASCO: Narcolepsy Drug Relieves Some Cancer Fatigue

MONDAY, June 2 (HealthDay News) -- Modafinil -- a eugeroic agent with stimulatory properties and no peripheral effects or potential for addiction and abuse -- may help relieve severe fatigue in cancer patients undergoing chemotherapy, according to research presented at the annual meeting of the American Society of Clinical Oncology in Chicago.

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ASCO: Maintenance Drug Benefits Lung Cancer Patients

MONDAY, May 26 (HealthDay News) -- In patients with advanced non-small cell lung cancer, maintenance therapy with pemetrexed significantly improves progression-free survival and overall survival, according to research presented May 30-June 3 at the annual meeting of the American Society of Clinical Oncology in Chicago.

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ASCO: Infusions Reduce Oxaliplatin Neurotoxicity

MONDAY, May 26 (HealthDay News) -- In colon cancer patients, co-administration of intravenous calcium and magnesium significantly reduces neurotoxicity associated with oxaliplatin treatment, according to research presented May 30-June 3 at the annual meeting of the American Society of Clinical Oncology in Chicago.

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ASCO: Childhood Cancer Survivors Face Heart Risks

MONDAY, May 26 (HealthDay News) -- Survivors of childhood and adolescent cancer are up to 10 times as likely as their healthy siblings to develop heart disease in early adulthood, according to research presented May 30-June 3 at the annual meeting of the American Society of Clinical Oncology in Chicago.

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ASCO: Aggressive Regimen Beneficial in Ewing's Sarcoma

MONDAY, May 26 (HealthDay News) -- In patients with Ewing's sarcoma, a chemotherapy regimen administered every two weeks produces better outcomes than a regimen administered every three weeks, and is not associated with increased toxicity, according to research presented May 30-June 3 at the annual meeting of the American Society of Clinical Oncology in Chicago.

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ASCO: Vitamin D Linked to Breast Cancer Outcome

MONDAY, May 26 (HealthDay News) -- Vitamin D deficiency is common among newly diagnosed breast cancer patients and is associated with poor long-term outcomes, according to research presented May 30-June 3 at the annual meeting of the American Society of Clinical Oncology in Chicago.

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ASCO: Mastectomy Rates May Be Increasing

MONDAY, May 26 (HealthDay News) -- In women with stage 0-2 breast cancer treated at the Mayo Clinic in Rochester, Minn., mastectomy rates plummeted between 1997 and 2003, but sharply increased between 2004 and 2006, according to research presented May 30-June 3 at the annual meeting of the American Society of Clinical Oncology in Chicago.

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ASCO: Gene Signature Linked to Lung Cancer Outcomes

MONDAY, May 26 (HealthDay News) -- In patients with early-stage non-small cell lung cancer, a 15-gene "signature" may identify those who are likely to benefit most from chemotherapy after surgery, according to research presented May 30-June 3 at the annual meeting of the American Society of Clinical Oncology in Chicago.

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ASCO: New Drug Promising in Kidney Cancer

MONDAY, May 26 (HealthDay News) -- In patients with renal cell carcinoma who have progressed despite treatment with sorafenib, sunitinib or both, treatment with RAD001 -- an intracellular kinase that regulates cell proliferation and angiogenesis -- significantly improves progression-free survival and has a favorable safety profile, according to research presented May 30-June 3 at the annual meeting of the American Society of Clinical Oncology in Chicago.

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Physician's Briefing