It’s the second week of June and like anyone else who’s interested in clinical oncology, we’re just about recovering from the ASCO conference. Around 30,000 clinical oncologists descended on to Chicago for this year’s meeting along with an army of industry representatives from 500 pharmaceutical companies, and countless journalists, bloggers and medical publishers.
The theme for the 2015 Annual Meeting was ‘Illumination and Innovation: Transforming Data into Learning’ and there were certainly plenty of novel data to learn from, with exactly 4,882 abstracts published in conjunction with the meeting.
Brandcast Media were at the conference reporting for The European Medical Journal and OncologyTube – we captured the latest news opinions from the experts at the conference and generated a lot of fascinating content. I’ve listed some of the highlights here.
We saw promising data for melanoma this year. Nivolumab alone and in combination with ipilimumab were significantly more effective at delaying cancer progression than ipilimumab alone in the first phase III trial to compare a combination of immune checkpoint inhibitors with ipilimumab alone. Immunotherapy has already revolutionised care for melanoma patients and the results of this study tell us they could become even more effective when combined.
Despite exciting data and some extensive coverage from popular news channels on this new drug combination, physicians should exercise caution. The combinations result in greater side effects and this might offset the advantages for some patients.
We also saw interesting results from combinations of targeted therapies, such as those from COMBI-d, where we saw the dabrafenib and trametinib combination showing significant improvement in patients with BRAFV600E/K mutation-positive cutaneous melanoma.
We’re seeing a lot of progress in melanoma but there is still a long way to go. Despite all these promising therapeutic agents and their various combinations, there is still progress to be made in finding markers that will tell us which specific patients will benefit from each strategy. Matching the correct management strategy to the correct patient will be a major challenge for physicians in the coming years.
There was also good news for the blood cancer community with a number of positive trials being presented, particularly in myeloma, NHL and CLL.
A phase II trial suggested that the anti-CD38 antibody, daratumumab, the first in its class, is effective as a standalone therapy for heavily treated multiple myeloma; a phase III trial found that adding obinutuzumab to bendamustine more than doubles the duration of remission of patients with indolent NHL; and the interim analysis of a large phase III study suggests that adding ibrutinib to the standard bendamustine/rituximab regimen may improve outcomes for patients with treatment-resistant CLL. Finally, a novel JAK inhibitor, pacritinib was found to be more effective than current therapies for myelofibrosis.
The data weren’t the only thing that were positive, there seems to be very real excitement and enthusiasm from the world’s blood cancer experts. There are more and more options for blood cancer patients now; whilst it has traditionally been a terrible chronic burden for patients, for the first time many will be able to live a full and normal life, and do all the things they wanted to do before they were diagnosed. This is a fantastic milestone and one we hope to reach in other areas of oncology soon.
As expected, this year’s congress provided a host of new immunotherapy data.
We heard about a potential marker for the anti-PD-1 antibody, pembrolizumab – this marker predicted responses in patients with colorectal, endometrial and several other types of cancer; a phase I/II study identified a potential new role for nivolumab in advanced liver cancer – a disease where just one FDA-approved treatment currently exists; and another new study identified a promising role for pembrolizumab in patients with head and neck cancer.
Finally, a randomized phase III study established nivolumab as a possible standard second-line treatment option for non-squamous non-small cell lung cancer. Patients treated with nivolumab were more likely to respond, lived longer and saw fewer side effects than those treated with standard docetaxel chemotherapy – especially those with high PD-L1 levels.
What did we learn?
With so many positive data, new classes of anti-cancer agent, novel combinations and sequencing strategies, physicians are better equipped than ever before to help patients beat their cancers. However, despite these new innovative treatment regimes, we must remember that only specific patients may see an advantage from each particular agent or combination. Even when we do see significant results, the side effects that come with some of these drugs may outweigh the benefits. And, of course, there is the cost – clinical trials and development of biologically complex medicines cost a lot of money and so someone will need to pay for these drugs if they are to be used widely in the clinic.
Overall, there is a lot for patients to be hopeful for. What really resonated with me was the lack of chemotherapy seen in many of the clinical trials presented at ASCO. We’re moving so fast that patients who enrol on clinical trials will often receive a new targeted agent rather than a traditional chemotherapy as standard of care, and that’s a huge opportunity for those who are eligible.