ASCO 2016: Where Cancer Breakthroughs Happen

June 3, 2016 | by Sumanta Kumar Pal, M.D.

Sumanta Pal 256x256 Sumanta Kumar Pal, M.D., is co-director of the Kidney Cancer Program

Each year, more than 40,000 oncology professionals descend upon Chicago for the annual meeting of the American Society of Clinical Oncology (ASCO).  Cancer researchers look forward to this as the largest forum in which to present their work, and the findings often have far reaching implications – FDA approvals, changes in treatment guidelines, and so on.  The next few days will be nothing short of overwhelming, with literally thousands of lectures and presentations.  

Staying on top of it all can be incredibly challenging, so I’ve distilled some of the main themes here: 

  1. The Cancer Moonshot Program is front and center.  Vice President Joe Biden will be visiting the meeting on Monday to give us an update on how the $1 billion dollar pledge for cancer research is manifesting. I’ve previously shared some perspectives on this, and our chief scientific officer and provost Steven Rosen, M.D., has been at the table with Vice President Biden and other to discuss specifics of the proposal.  

    Look for some of the key elements of the moonshot program to be unveiled here. 
     
  2. Personalized medicine manifests in unique diseases.  For years, oncologists have talked about changing our current treatment paradigm by using treatments that cater to specific cancer mutations in an individual.  This goal has remained elusive in several cancer types, one of them being bladder cancer.

    I will be presenting data for BGJ398, an oral drug that treats bladder cancer patients who have a mutation in a gene called FGFR3.  FGFR3 is mutated in about 20 percent of patients with advanced bladder cancer. We’ve seen some of the highest response rates to date using this approach.  
     
  3. Personalized medicine trumps personalized medicine.  Unlike bladder cancer, targeted therapies for lung cancer have been in use for quite some time now.  However, patients with advanced lung cancer inevitably become resistant to currently available targeted therapies. Karen Reckamp, M.D., M.S., from our Thoracic Medical Oncology team is a key player in several studies that use next generation targeted therapies to overcome this resistance.  Her team is exploring the role of brigantinib in patients with mutations in the ALK gene that no longer respond to the FDA-approved crizotinib. Further, she is involved in looking at rociletinib, a drug that may be active in patients with mutations in the EGFR gene that do not respond to erlotinib. 
     
  4. Geriatric oncology needs our attention. Arti Hurria, M.D., City of Hope professor and international authority in geriatric oncology, will present data from National Cancer Institute funded trials that very clearly delineates poor enrollment of older adults.  This is a critical problem, as older adults represent an ever-growing proportion of individuals with cancer. Understanding how novel cancer drugs work in this population in of the essence. Hurria will also be presenting data from the Cancer and Aging Research Group (CARG), a national alliance of geriatric oncology investigators that she created several years ago.  

    This work provides some novel predictors of toxicity in older adults receiving a variety of treatment regimens, giving oncologists new tools to evaluate risks and benefits in this population. 
     
  5. New ways to harness the immune system. Last year, immunotherapy was the highlight of ASCO, with a class of agents known as checkpoint inhibitors splashing onto the scene. This year, several new ways to target the immune system will be showcased.  Mihaela Cristea, M.D., is a part of a team investigating modified T-cells in patients with advanced cancers. T-cells can drive an autoimmune response against cancer – the modified T-cells used in Cristea’s clinical trial may exude a far more vigorous response.  Modified T-cell therapies for a variety of diseases are being developed internally at City of Hope in a program led by Stephen Forman, M.D., F.A.C.P.  

    My estimation is that these treatments may be transformative in a number of otherwise resistant cancer types. 

 

While the above themes will dominate the meeting, ASCO is always full of surprises. Stay tuned for a recap of major study findings following the meeting. 

 

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