American Society of Clinical Oncology, June 2-6

The annual meeting of the American Society of Clinical Oncology was held from June 2 to 6 in Chicago and attracted more than 34,000 participants from around the world, including clinicians, academicians, allied health professionals, and others interested in oncology. The conference featured the latest advances in clinical cancer research, including oral abstract presentations and poster presentations in disease-based and specialty tracks. Presentations focused on novel targeted therapies as well as improvements in chemotherapy and radiation therapy approaches.

As part of the phase 3 PROSPECT trial, Deb Schrag, M.D., of the Memorial Sloan Kettering Cancer Center in New York City, and colleagues found that patients with clinical T3 node-negative and clinical T2 and T3 node-positive rectal cancers who are candidates for sphincter-sparing surgery may be treated with neoadjuvant mFOLFOX chemotherapy followed by only the selective use of pelvic chemoradiation rather than the universal application of chemoradiation.

The study cohort included 1,194 patients with locally advanced rectal cancer eligible for preoperative chemoradiation prior to a sphincter-sparing surgery with a low anterior resection and total mesorectal excision. The authors randomly assigned patients to a chemoradiation therapy group or to a group receiving mFOLFOX6 chemotherapy with selective use of chemoradiation therapy. The researchers found that intermediate-risk rectal cancer (clinic T2N+, T3N0, or T3N+) can be treated with chemotherapy and surgery with the omission of radiation. The de-escalation of treatment did not adversely affect recurrence or survival and was associated with acceptable toxicity. Patients reported improved bowel, bladder, and sexual function compared with those treated with radiation.

"This has the potential to spare a considerable number of patients the long-term toxicity of pelvic radiation. This is especially important given the rising incidence of early-onset rectal cancer before the age of 50," Schrag said. "Patients now have an alternative to pelvic chemoradiation. When patients have options, it's a win. Disease-free survival, overall survival, and local recurrence rates were identical with chemoradiation (the standard) and with FOLFOX and selective chemoradiation."

Several authors disclosed financial ties to the pharmaceutical industry.

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As part of the ADAURA study, Roy S. Herbst, M.D., Ph.D., of the Yale Cancer Center and Yale School of Medicine in New Haven, Connecticut, and colleagues observed a significant clinical overall survival benefit by adding osimertinib in patients with EGFR-mutated (EGFRm) stage IB to IIIA non-small cell lung cancer (NSCLC) after complete tumor resection, with or without adjuvant chemotherapy.

The authors randomly assigned patients with EGFRm stage IB to IIIA NSCLC after complete tumor resection, with or without adjuvant chemotherapy, to osimertinib 80 mg once daily or placebo until disease recurrence, treatment completion, or a discontinuation criterion was met. The researchers found that patients with IB to IIIA NSCLC who received osimertinib after surgery had a 51 percent lower risk for mortality compared with patients who received placebo. In addition, the five-year survival rate in patients with IB to IIIA NSCLC who received osimertinib after surgery was 88 percent compared with 78 percent in patients who received placebo.

"Over the last 25 years, we've seen drugs evolve to be better and more active with fewer side effects. ADAURA used osimertinib in the setting of non-small cell lung cancer where patients already had surgery, and the results are impressive," Herbst said. "We're moving this effective drug therapy into the earliest stages of lung cancer. In this trial, there was a 51 percent decrease in death for patients with this pill versus the placebo."

Several authors disclosed ties to pharmaceutical companies, including AstraZeneca, which manufactures osimertinib and funded the study.

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Dennis J. Slamon, M.D, Ph.D., of the UCLA Jonsson Comprehensive Cancer Center in Los Angeles, and colleagues found that adding ribociclib to hormonal therapy among patients with hormone receptor (HR)-positive, human epidermal growth factor receptor 2 (HER2)-negative early-stage breast cancer improves invasive disease-free survival (iDFS).

The authors randomly assigned patients with HR-positive, HER2-negative early-stage breast cancer to adjuvant ribociclib for three years with hormonal therapy for at least five years (2,549 patients) or hormonal therapy alone (2,552 patients). The researchers found that adding ribociclib to hormonal therapy showed a significant improvement in iDFS.

"Currently approved targeted treatments can only be used in a small population of patients diagnosed with HR-positive, HER2-negative early breast cancer, leaving many without an effective treatment option for reducing risk of the cancer returning," Slamon said in a statement. "Thus, there is a significant unmet need for both reducing the risk of recurrence and providing a tolerable treatment option that keeps patients cancer-free without disrupting their daily life."

Several authors disclosed ties to pharmaceutical companies, including Novartis, which manufactures ribociclib and funded the study.

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ASCO: FOLFOX Noninferior to Chemoradiotherapy for Overall Survival in Rectal Cancer

FRIDAY, June 9, 2023 (HealthDay News) -- Neoadjuvant chemotherapy with fluorouracil, leucovorin, and oxaliplatin is noninferior to preoperative chemoradiotherapy with respect to overall survival for patients with locally advanced rectal cancer who are eligible for sphincter-sparing surgery, according to a study published online June 4 in the New England Journal of Medicine to coincide with the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

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ASCO: Adding Atezolizumab to Cabozantinib No Benefit in Advanced Renal Cancer

FRIDAY, June 9, 2023 (HealthDay News) -- For patients with locally advanced or metastatic renal cell carcinoma with disease progression on or after immune checkpoint inhibitor treatment, the addition of atezolizumab to cabozantinib does not improve clinical outcomes, according to a study published online June 5 in The Lancet to coincide with the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

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ASCO: Cilta-Cel Beneficial for Lenalidomide-Refractory Multiple Myeloma

THURSDAY, June 8, 2023 (HealthDay News) -- For patients with lenalidomide-refractory multiple myeloma, a single cilta-cel infusion results in lower risk of disease progression or death compared with standard care, according to a study published online June 5 in the New England Journal of Medicine to coincide with the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

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ASCO: Drug Combo Ups Progression-Free Survival for Metastatic Prostate Cancer

THURSDAY, June 8, 2023 (HealthDay News) -- For patients with metastatic castration-resistant prostate cancer, talazoparib plus enzalutamide results in improvement in radiographic progression-free survival, according to a study published online June 4 in The Lancet to coincide with the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

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ASCO: Extended Lymph Node Removal Not Beneficial for Bladder Cancer

THURSDAY, June 8, 2023 (HealthDay News) -- For patients with localized muscle-invasive bladder cancer undergoing radical cystectomy, extended lymphadenectomy is not associated with improved disease-free or overall survival, according to a study presented at the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

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ASCO: Germline Testing Underused in Cancer Patients

TUESDAY, June 6, 2023 (HealthDay News) -- Few patients diagnosed with cancer between 2013 and 2019 in California and Georgia underwent germline testing, according to a study published online June 5 in the Journal of the American Medical Association to coincide with the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

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ASCO: Lack of Benefit Seen for Indefinite-Duration Immunotherapy in NSCLC

TUESDAY, June 6, 2023 (HealthDay News) -- For patients with advanced non-small cell lung cancer, indefinite duration of immunotherapy treatment does not seem to offer benefits over fixed-duration therapy for two years, according to a study published online June 4 in JAMA Oncology to coincide with the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

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ASCO: Vorasidenib Improves Progression-Free Survival in Grade 2 IDH-Mutant Glioma

TUESDAY, June 6, 2023 (HealthDay News) -- Vorasidenib significantly improves progression-free survival among patients with grade 2 isocitrate dehydrogenase-mutant glioma, according to a study published online June 4 in the New England Journal of Medicine to coincide with the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

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ASCO: Direct Oral Anticoagulant Therapy Feasible for Cancer Patients

TUESDAY, June 6, 2023 (HealthDay News) -- Direct oral anticoagulant treatment is noninferior to low-molecular-weight heparin for preventing recurrent venous thromboembolism in cancer patients, according to a study published online June 2 in the Journal of the American Medical Association to coincide with the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

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ASCO: Microbiome Varies for Early-Onset, Late-Onset Colorectal Cancer

FRIDAY, June 2, 2023 (HealthDay News) -- The microbiome of patients with colorectal cancer varies between those diagnosed with early- or late-onset disease, according to a study presented at the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

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ASCO: Phone-Based Coaching Helps Breast Cancer Patients Lose Weight

FRIDAY, June 2, 2023 (HealthDay News) -- A telephone-based weight-loss coaching intervention can help overweight or obese patients with breast cancer lose weight, according to a study presented at the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

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ASCO: Adding Pembrolizumab to Chemo Improves Survival in Cervical Cancer

THURSDAY, June 1, 2023 (HealthDay News) -- For women with persistent, recurrent, or metastatic cervical cancer, adding pembrolizumab to chemotherapy, with or without bevacizumab, is associated with improved overall and progression-free survival, according to a study presented at the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

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ASCO: Minimally Invasive Noninferior to Open Surgery for Pancreatic Cancer

THURSDAY, June 1, 2023 (HealthDay News) -- For patients with resectable pancreatic cancer, minimally invasive distal pancreatectomy is noninferior to open distal pancreatectomy, according to a study presented at the annual meeting of the American Society of Clinical Oncology, held from June 2 to 6 in Chicago.

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