Conference Reports
Advances in Cancer: 43rd Annual Meeting of the American Society of Clinical Oncology
1st-5th June 2007
The McCormick Place in Chicago was the location for the 43rd Meeting of the American Society of Clinical Oncology, consisting of multitudinous poster and oral sessions, symposia and general discussions with the main intention of living up to ASCO's "translating research into practice" campaign for treating cancer. Nearly 25000 cancer specialists from all parts of the world attended the conference collaborating and discussing results from more than 4000 cancer research trials, as well as opinions on treatment and prevention for a wide range of cancers from adrenal to uterine.
The conference kicked off on the first day with promising results announced in squamous cell carcinoma of the head and neck, when Merck KGaA's cetuximab (Erbitux), a chimaeric MAb specific for epidermal growth factor receptor, was shown in a multinational 442-patient Phase III trial (EXTREME) to reduce risk of dying by 20%. Patients receiving cetuximab + 5-fluorouracil with either carboplatin/cisplatin chemotherapy survived a median of 10.1 months compared to 7.4 months for those receiving chemotherapy alone. The side-effect profiles were similar for both treatment and placebo arms of the study. This serves to highlight the value of integrating novel targeted biologicals into established chemotherapeutic routines.
A similarly highly-targeted approach, in this case against raf kinase, was demonstrated by Bayer & Onyx Pharmaceutials' sorafenib tosylate (Nexavar). Sorafenib tosylate was being tested in a 602-patient trial in advanced liver cancer, a type of cancer becoming ever more common worldwide. In the Phase III trial, an orally-administered dose of 400mg twice-daily gave more than a 40% improvement in survival time of 10.7 months for patients on sorafenib tosylate, compared with 7.9 months for those on placebo. This increase was clearly significant and the trial was stopped early because preliminary results were so favourable.
Although the ASCO meeting covers almost every type of cancer under the sun in one way or another, drugs under development for a the particularly prevalent and high-profile breast cancer and nsclc were noticeably most dominant. One blockbuster drug, bevacizumab (Avastin), was shown to improve progression-free survival by 33 and 22% in the AVAIL trial in 1043 nsclc patients, when dosed at two separate levels in combination with gemcitabine hydrochloride and cisplatin, compared with chemotherapy alone. Although already launched for this indication, Genentech is hoping to prove the efficacy of bevacizumab in combination chemotherapy. Investigating bevacizumab in other cancers, Genetech also reported results from the AVOREN trial in 306 patients with untreated advanced kidney cancer, in this case administered in combination with IFN-alpha2a. In this study, 59% of patients improved their progression-free survival to 10.2 months compared with a figure almost half that of 5.4 months on IFN-\alpha2a alone, with tumour response rates of 31 and 13%, respectively.
The pursuit of disease expansions from another blockbuster drug was seen with Novartis' imatinib mesylate (Gleevec). The multikinase inhibitor has been launched for the treatment of leukaemia since 2001, although in this case results were presented regarding its efficacy in the recurrence of gastrointestinal stromal tumours following surgical removal. The trial followed 230 patients for a year; however, while 97% of patients on imatinib mesylate did not experience disease recurrence, compared to 83% of patients on placebo, no difference in overall survival was observed. Further ongoing trials may hopefully reveal some benefit to patients with this disease.
This year's ASCO annual meeting was a huge success, stimulating optimism in the field of cancer research and the all-to necessary and vital translation of this research into tangible clinical benefits and practices. Judging from the size and astmosphere of this year's get-together, we eagerly look forward to the 44th ASCO annual meeting and the hopes that it can build on the progress made this year.
The 44th ASCO Annual Meeting will take place in Chicago, IL, USA, on the 30th May - 3rd June 2008.
Thomas Stirzaker
Pharmaprojects Analyst
