ASCO 2014: The highlights and what they mean for patients

ASCO 2014: The highlights and what they mean for patients

The American Society of Clinical Oncology (ASCO) recently held its annual meeting in Chicago, USA. In the congress, attended by more than 30,000 doctors and medical professionals from around the world, new knowledge and information for cancer diagnosis, treatment and outcomes was extensively discussed.

This article provides the key outcomes and their impact on patients.

Lung Cancer
• In patients with ALK-positive adenocarcinoma, the targeted drug Crizotinib was found highly effective compared to chemotherapy, as it significantly improved “progression-free survival”. Similarly, the same drug Crizotinib proved effective in those rare cases of patients with adenocarcinoma with significant molecular expression of the MET gene. In both cases the drug toxicity was mild and well tolerated by patients.
• The targeted drug Ramucirumab enhanced the efficacy of the chemotherapy drug Docetaxel as second-line therapy in Non-Small Cell Lung Cancer.
• A very significant announcement was made for patients with adenocarcinoma who have the mutation EGFR. In particular, two studies showed that the targeted drug Afatinib has superior efficacy against chemotherapy. Moreover, Afatinib also improved the overall survival of those patients who had the mutation in a specific section of the EGFR receptor. (This section is called “exon 19”).
• Ceritinib is a new targeted drug, which is effective for patients with ALK-positive lung adenocarcinoma, as well as those patients who have relapsed following Crizotinib due to development of resistance.

Breast Cancer

• Trastuzumab remains the most important drug in women with HER-2 positive breast cancer, have been previously operated and due to receive additional drug treatment. Attempts to replace it by Lapatinib, or combine it with Lapatinib, did not introduce significant benefit according to the ALTTO study.
• In pre-menopausal women with breast cancer sensitive to hormones, administration of Exemestane and inhibition of ovarian function was considered an alternative option (compared to the conventional administration of Tamoxifen and inhibition of ovarian function). Indeed, women who received Exemestane had slightly longer progression-free survival. The toxicity associated with this treatment is a potential concern, but it remains an alternative that time will show its value.
• An interesting study was presented, which focused on improving fertility in premenopausal women without hormonal sensitivity who received chemotherapy. Co-administration of a so-called “LHRH analog” drug that inhibits ovarian function increased the likelihood that these women become pregnant later in life.

Prostate Cancer
• An analysis of results from a very important study in patients with high risk advanced prostate cancer was presented. The outcome was that the combination of chemotherapy (Docetaxel) with hormone therapy was more effective than hormone therapy alone. These results are potentially critical for this group of patients, as they indicate a higher possibility of longer survival.

Ovarian Cancer
• A study was dedicated to the group of women with serous ovarian cancer (an aggressive form of the tumor) who have previously received platinum and have relapsed, but are still sensitive to Platinum. In these women, co-administration of innovative medicines Olaparib and Cediranib showed increased efficacy over Olaparib alone. This effect increases the optimism for replacing chemotherapy, or administering it in combination with other drugs.

• The combination of Nivolumab with Ipilimumab has been especially effective in patients with advanced melanoma, regardless of whether a mutation in the BRAF gene exists or not. This combination will be tested in more patients.
• The specific monoclonal antibody SR-3475 was tested in 411 patients with advanced melanoma, and had satisfactory results. The tests will continue.
• The approved drug for advanced melanoma Ipilimumab was tested in people who were operated on at an early stage, and had a high risk of relapse. Early results showed that the drug reduces the possibility of recurrence. The analysis of the study will continue.

Colorectal Cancer
• The parallel administration of Cetuximab or Bevacizumab, with chemotherapy with FOLFOX or FOLFIRI, in patients with advanced colorectal cancer without K-RAS mutation gave similar results. The choice of treatment, therefore, depends on the clinical characteristics of each patient.
• In rectal cancer patients who have been treated with chemo-radiotherapy before surgery, post-operative chemotherapy with the addition of Oxaliplatin has beneficial results, compared to the administration of Fluorouracil or Leucovorin alone.

Thyroid Cancer
• In differentiated thyroid cancer which has shown resistance to radioiodine administration, Lenvatinib improved the time of progression-free survival.

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