Researchers in laboratory viewing into microscope

City of Hope to Share Breakthrough Research at ASCO

Highlights include investigational treatments for colorectal, kidney and blood cancers; new options for advanced cancers; as well as data backing the importance of supportive care services

World-renowned physicians and researchers from City of Hope® will present new data and offer expert perspectives on leading-edge cancer research and treatments in development at the 2024 ASCO Annual Meeting, which will take place in Chicago from May 31 to June 4. Highlights include the following:

•    2024 Best of ASCO® program: New data on mismatched unrelated donor peripheral blood stem cell transplantation
•    Late-breaking data on the phase 3 CodeBreaK 300 trial for metastatic colorectal cancer
•    Glofitamab monotherapy for patients with advanced mantle cell lymphoma
•    An oral inhibitor monotherapy for people with advanced kidney cancer
•    Interventions for older adults with cancer who traditionally have not had access to supportive care treatments that could improve quality of life

About 40,000 oncology professionals will attend the meeting. City of Hope experts will share 64 presentations, including oral sessions, clinical science symposiums and education discussions.

City of Hope Los Angeles President Marcel van den Brink, M.D., Ph.D.
Marcel van den Brink, M.D., Ph.D.

This year’s ASCO theme, “The Art and Science of Cancer Care: From Comfort to Cure,” aptly describes the ethos of City of Hope, according to Marcel van den Brink, M.D., Ph.D., president of City of Hope Los Angeles and City of Hope National Medical Center, chief physician executive and Deana and Steve Campbell Chief Physician Executive Distinguished Chair.

“At City of Hope, we treat individuals, not disease,” he said. “We integrate breakthrough treatments with supportive care services to give patients not only access to the best therapies, but the most reassuring and helpful environment. At this year’s ASCO, our scientists will present leading-edge research on liquid and solid tumors, including promising data on stem cell transplantation and blood cancers as well as colorectal, breast and kidney cancer. Our researchers will also share compelling data on therapies and practices developed to optimize patients’ experiences during what is often the most challenging time of their lives.”

'It is encouraging to see people who were told by others that there is not much more to be done live months and even years longer with this treatment.'
Tycel Phillips, M.D., on a promising new therapy for mantle cell lymphoma

Notable City of Hope presentations, including oral abstracts, clinical science symposia and educational discussions, include the following:

Expanding access to stem cell transplants to older patients

Access to potentially lifesaving stem cell transplants traditionally has been limited due to the need for a donor whose stem cells match the recipient’s genes. However, Monzr M. Al Malki, M.D., City of Hope hematologist-oncologist, co-led a multicenter phase 2 trial that demonstrates encouraging overall survival one year after older patients with advanced blood cancers received donor stem cells originating from someone who was not a relative and not a complete HLA match.

Monzr M. Al Malki, M.D.
Monzr M. Al Malki, M.D.

While the 13-site ongoing trial includes adults and children, this interim analysis, which will be presented as an oral abstract presentation, evaluated the first 70 older adult patients with advanced blood cancers who received this type of transplant and underwent both reduced intensity conditioning and post-transplant cyclophosphamide, which is a method used to prevent a potentially life-threatening side effect called graft-versus-host disease (GVHD). City of Hope has performed over 19,000 transplants, is one of the nation’s leading transplant programs and is at the forefront of using transplants to treat older adults with blood cancers.

Overall survival at one year post-stem cell transplant was 79%. Rates of GVHD and other complications were comparable to those of recipients who received HLA-matched donor stem cells, suggesting HLA-mismatched unrelated donor peripheral blood stem cell transplantation may one day be used more widely, expanding access to the lifesaving therapy.

“This data, supported by the National Marrow Donor Program, is promising and is the reason why I continue to work to expand access to stem cell transplantation for older patients, underrepresented people and patients with blood cancers,” Dr. Al Malki said.

The adult cohorts of this trial recruitment have closed, with more than 200 patients in follow-up. The pediatric arm of the trial is ongoing.

Bispecific Antibody Demonstrates Sustained Response Rates  

In an updated efficacy and safety phase 1/2 trial, the bispecific antibody glofitamab continues to demonstrate compelling response rates with a fixed-duration treatment among a group of mantle cell lymphoma patients who have nearly exhausted approved treatment options due to aggressive disease.

Tycel Phillips
Tycel Phillips, M.D.

The researchers evaluated close to 60 participants who had received two or more previous treatments — the majority of whom had stopped responding to treatment before they enrolled in this study. Patients received about 7.4 months of glofitamab. Analyses indicated that most patients with a complete response at the end of treatment were alive without disease progression 15 months after the end of treatment. The median duration of complete response was 12.6 months, and median progression-free survival was 8.6 months.

“People with mantle cell lymphoma have a rare form of non-Hodgkin lymphoma that is currently incurable, so it is encouraging to see people who were told by others that there is not much more to be done live months and even years longer with this treatment,” said Tycel Phillips, M.D., City of Hope hematologist-oncologist and presenting author. “We at City of Hope continuously develop leading-edge treatments for people diagnosed with lymphoma and other blood cancers.”

New Therapy for Advanced Kidney Cancer Shows Efficacy

People with an advanced kidney cancer called clear cell renal cell carcinoma (ccRCC) appeared to experience positive medicinal affects from the targeted therapy pill DFF332 while encountering manageable side effects in an ongoing first-in-human phase 1/1B multicenter trial.

Sumanta Pal 256x256
Sumanta "Monty" Pal, M.D.

Sumanta “Monty” Pal, M.D., a City of Hope medical oncologist, will share preliminary data on 40 advanced kidney cancer patients who took DFF332, an oral hypoxia-inducible factor (HIF)-2α inhibitor that has been shown in preclinical models to be effective in reducing ccRCC tumors. All study participants had received at least one other type of therapy before joining the clinical trial. 

At data cutoff, 16 patients continued to be treated, while 19 patients (48%) stopped receiving the treatment due to disease progression. The most common side effects were fatigue (33%), anemia (30%), increased blood cholesterol and constipation (15%). No extreme adverse effects have been observed so far. At cutoff, 18 patients (45%) had stable disease and two patients (5%) achieved partial response.

“While the study is still in process, so far, we have seen a promising safety profile for monotherapy DFF332 with indications of clinical activity,” Dr. Pal said. “We are conducting analysis on how the medicine moves within the body as well as collecting biomarker data that will be shared at our ASCO presentation.”

Telehealth Aids Access to Supportive Care Services

A study at City of Hope | Antelope Valley found that telehealth can be leveraged to offer older adults living in high-poverty, lower resourced communities with a specialized evaluation developed at City of Hope called a geriatric assessment, which identifies supportive care services older adults with cancer need to manage vulnerabilities, better define care goals and improve quality of life.

Tanyanika Phillips
Tanyanika Phillips, M.D., M.P.H.

This quality improvement study included 251 participants who were 65 years or older with newly diagnosed or advanced cancer. The patients underwent a baseline geriatric assessment and most had initial visits with a geriatric nurse practitioner, 197 via televideo and 45 via telephone. The assessment identified vulnerabilities in 209 patients and, after review, the nurse practitioner made 460 necessary referrals for supportive care services, 86% of which were implemented. The most common referrals were to pharmacy (177), social work (142), occupational therapy (76) and physical therapy (48). More than 92% of patients reported they were satisfied with the telehealth services that resulted in supportive care interventions.

“In my experience, if you don’t do a geriatric assessment, the patient pays for it later,” said Tanyanika Phillips, M.D., M.P.H., presenting author and City of Hope medical oncologist and hematologist in Antelope Valley, California. Phillips noted that if care is prescribed without accurate health information, the result could be serious side effects or even hospitalization, which could lead not only to more costly care but also cancer treatment outcomes that are not the best for patients.

“In a general visit, patients often will say they feel well and are fine because they’re incentivized to answer in the affirmative and move forward with treatment,” Phillips added. “Place this same patient in a different environment where they are answering geriatric assessment questions, and they may be more forthcoming and detailed about their lifestyle and abilities. This candor will help physicians prescribe the most appropriate care for that individual based on their circumstances.”

Geriatric Assessment Improves Quality of Life

A randomized trial at a Brazilian cancer center under the guidance of City of Hope’s internationally renowned cancer and aging expert William Dale, M.D., Ph.D., found that older adults with metastatic cancer reported experiencing significant improvements in the performance of daily activities, emotional well-being and quality of life after receiving a telehealth-based geriatric assessment (GA) that resulted in supportive care interventions. This data extends City of Hope’s prior work in GA-guided supportive care beyond the borders of the United States.

William Dale, M.D. Ph.D.
William Dale, M.D.

“Our studies continue to prove that patients and families win when care teams ask older adults with cancer the right questions at the outset to guide care. This is true even when telehealth is used in a low-resource environment. Guidance from a GA can change care choices and improve outcomes — all without making cancer therapy less effective. It’s a form of precision medicine: more appropriate supportive care interventions, better daily functioning, higher quality of life and the same great cancer care results. It’s a winning formula for patients, families, providers and the health system,” said Dr. Dale, senior author of the study.

Geriatric, Palliative Care Experts Honored

Also of note, Dr. Dale is this year’s recipient of the prestigious B.J. Kennedy Geriatric Oncology Award by the American Society of Clinical Oncology in recognition of his leadership in cancer and aging, supportive care medicine, cancer survivorship and medical decision-making. Dale, who is the first non-oncologist to receive this honor, is vice chair for academic affairs in the Department of Supportive Care Medicine at City of Hope. He is first author of ASCO’s recent cancer and aging guideline update.

Betty Ferrell Bio
Betty Ferrell, Ph.D., M.S.N., CHPN

In addition, Betty Ferrell, Ph.D., M.S.N., CHPN, director and professor in the Division of Nursing Research and Education, Department of Population Sciences, is senior author of ASCO’s new guideline, “Palliative Care for Patients With Cancer: ASCO Guideline Clinical Insights.” In this first update in eight years, Ferrell provides recommendations reflecting new evidence published since the 2016 guideline, addresses new research questions and further clarifies the role of palliative care in oncology. Specifically, she recommends that oncology clinicians refer patients with advanced solid tumors and hematologic malignancies, as well as patients in clinical trials, to specialized interdisciplinary palliative care teams that provide inpatient and outpatient care early in the course of disease alongside active cancer treatment.

“The ASCO palliative care guidelines represent the commitment of City of Hope and other cancer centers to provide leading-edge cancer treatment while also providing the best support for patients and families,” Ferrell said.

Dr. Ferrell is a pioneer in the field of pain management, quality of life and palliative care. A member of the National Academy of Medicine, she is principal investigator of the End-of-Life Nursing Education Consortium project, which launched in 2000 to provide evidence-based training in palliative care for nurses and other clinicians. To date, the project has taught 1.4 million clinicians in all 50 states as well as 114 countries.