What is ASCO?
Founded in 1964, the American Society of Clinical Oncology (ASCO) aims to conquer cancer through research, education, awareness and promotion of the highest-quality patient care. It represents nearly 45,000 oncology professionals who care for people living with cancer. ASCO’s activities are various and consist of offering educational resources for professionals in the oncology field, publishing scientific resources, and offering curricula for oncology professionals. In 1984, ASCO also initiated a charitable organization, which has so far granted more than $90 million in funding to accelerate cancer research. Other ASCO initiatives entail a patient information website (cancer.net) and a data platform (CancerLinQ) that collects and analyzes data from patients in order to help oncologists deliver the best quality of care to their patients.
This year, ASCO went Virtual
Each year, ASCO holds its Annual Meeting which is considered to be the biggest annual cancer conference. It is attended by 30,000 professionals from the oncology field who gather to exchange information about the latest advances made in cancer research and cancer care. The meeting is usually held in Chicago, however due the coronavirus pandemic, it was decided that the 2020 edition would be held virtually.
Despite the fact that numerous cancer clinical trials around the globe have been impacted by the coronavirus pandemic, many pharmaceutical companies and other biotech players were able to maintain their fight against cancer and showcased their advances at the meeting from May 29 to May 31, 2020.
Ancora.ai’s highlights from the annual meeting
We have curated a selective list of some of the most exciting data that were reported at ASCO 2020:
Cancer advances by cancer type
- Keytruda (pembrolizumab) for colorectal cancer[1]:
- Data from a phase 3 trial in patients with advanced colorectal cancer with specific genetic mutations showed that treatment with Keytruda more than doubled the time to disease progression compared to chemotherapy.
- Patients treated with Keytruda had their risk of disease progression or death reduced by 40% compared to patients treated with a standard regimen of multiple chemotherapy drugs.
- At the median, Keytruda-treated patients went 16.5 months without their tumors progressing compared to 8.2 months in the chemotherapy group.
- Moderate to serious side effects were reported in 22% of Keytruda patients compared to 66% in the chemotherapy arm.
- Data from a phase 3 trial in patients with advanced colorectal cancer with specific genetic mutations showed that treatment with Keytruda more than doubled the time to disease progression compared to chemotherapy.
- Keytruda (pembrolizumab) in metastatic triple negative breast cancer (mTNBC)[2]:
- A phase 3 trial showed that Keytruda in combination with several chemotherapy drugs led to a statistically significant and clinically meaningful improvement in progression-free survival (PFS) compared with chemotherapy alone as a first-line treatment for patients with locally recurrent, inoperable, or metastatic triple-negative breast cancer (TNBC) whose tumors expressed PD-L1.
- At a median follow-up of 26.1 months, results showed that the Keytruda/chemotherapy combination led to a median PFS of 9.7 months compared with 5.6 months for chemotherapy alone in patients with a high expression of PD-L1, translating to a 35% reduction in the risk of disease progression or death.
- These findings suggest a role for the addition of pembrolizumab to standard chemotherapy for the first-line treatment of metastatic TNBC.
- A phase 3 trial showed that Keytruda in combination with several chemotherapy drugs led to a statistically significant and clinically meaningful improvement in progression-free survival (PFS) compared with chemotherapy alone as a first-line treatment for patients with locally recurrent, inoperable, or metastatic triple-negative breast cancer (TNBC) whose tumors expressed PD-L1.
- Tagrisso (Osimertinib) in lung cancer[3]:
- A phase 3 trial showed that treatment with Tagrisso of patients with early-stage EGFR-mutated non-small cell lung cancer after surgery with curative intent reduced the risk of lung cancer recurrence or death by 83% compared to patients who received a placebo – the strongest result ever reported for a clinical trial of this type.
- At two years, 89% of patients in the trial treated with Tagrisso remained alive and disease free versus 53% of patients on placebo.
- The disease-free survival results are extraordinary and data suggest that Tagrisso will be useful in patients with stage II and III disease and in those with stage IB disease as well.
- A phase 3 trial showed that treatment with Tagrisso of patients with early-stage EGFR-mutated non-small cell lung cancer after surgery with curative intent reduced the risk of lung cancer recurrence or death by 83% compared to patients who received a placebo – the strongest result ever reported for a clinical trial of this type.
- Tiragolumab for lung cancer[4]:
- Tiragolumab is an injectable antibody that blocks a novel checkpoint protein called TIGIT found on the surface of immune cells and that acts as a “brake” to stop T cells from attacking tumors. TIGIT expression strongly correlates with PD-1 expression.
- A phase 2 trial showed that for patients with lung cancer that expresses high levels of the immune biomarker PD-L1 (>50% of PD-L1 positive cells), the combination of tiragolumab added to Tecentriq (Roche’s already FDA-approved checkpoint inhibitor) showed an overall response rate of 66% versus 24% with atezolizumab alone. At a six-month follow-up, the median progression-free survival was not reached for the combination compared with 4.11 months for placebo.
- Tiragolumab is an injectable antibody that blocks a novel checkpoint protein called TIGIT found on the surface of immune cells and that acts as a “brake” to stop T cells from attacking tumors. TIGIT expression strongly correlates with PD-1 expression.
- Enhertu (trastuzumab deruxtecan) for gastric and lung cancers[5,6,7]:
- Enhertu is an antibody-drug conjugate (ADC), which is composed of the HER-2 targeting trastuzumab antibody attached to a topoisomerase inhibitor payload.
- It targets HER-2 overexpressing cells and interferes with cells ability to replicate.
- It is approved in Japan and the US for use in breast cancer.
- Results from a phase 2 trial yielded promising results for patients with metastatic HER-2 gastric cancer:
- Enhertu shrank tumors in 42.9% of patients with HER2-positive stomach cancer that had progressed after at least two lines of treatment, more than three times that of the 12.5% posted by investigator’s choice of chemotherapy.
- Enhertu cut the risk of death by 41% compared with chemotherapy, as patients who received the ADC lived a median 12.5 months, versus 8.4 months for chemo.
- More than half of Enhertu patients were still alive after one year, versus less than 29% of patients in the chemotherapy group.
- Enhertu also reduced the size of tumours by 45.3% in patients with HER2-positive advanced colorectal cancer who had tried at least two prior therapies.
- Enhertu shrank tumors in 42.9% of patients with HER2-positive stomach cancer that had progressed after at least two lines of treatment, more than three times that of the 12.5% posted by investigator’s choice of chemotherapy.
- Results from an ongoing Phase 2 trial showed that Enhertu helped shrink the size of tumours in 61.9% of patients with a type of rare lung cancer that had relapsed and spread beyond the lungs.
- Enhertu is an antibody-drug conjugate (ADC), which is composed of the HER-2 targeting trastuzumab antibody attached to a topoisomerase inhibitor payload.
- Imfinzi (durvalumab) in small cell lung cancer:
- Imfinzi is an immunotherapy and is already approved for the treatment of certain types of cancer of the bladder, urinary tract and lungs.
- In 2019, a phase 3 trial showed that treatment with Imfinzi in combination with chemotherapy led to a reduced risk of death of 27% for patients with extensive-stage small cell lung cancer (ES-SCLC) treated in the 1st-line setting.
- After a median follow-up of more than two years, the latest ASCO data showed sustained efficacy as more than 10% of patients treated with Imfinzi plus chemotherapy did not see their cancer progress versus 2.9% of the patients on chemotherapy alone.
- About 22% of patients treated with Imfinzi plus chemotherapy were alive at 24 months versus 14.4% of patients treated only with chemotherapy.
- Imfinzi is an immunotherapy and is already approved for the treatment of certain types of cancer of the bladder, urinary tract and lungs.
- Larotrectinib (Vitrakvi) in solid cancers with TRK gene fusion pathology[9]:
- Vitrakvi is approved under accelerated approval based on overall response rate and duration of response in the U.S., Canada, Brazil and the European Union (EU).
- In the U.S., Vitrakvi is approved for the treatment of adult and pediatric patients with solid tumors that test positive for neurotrophic receptor tyrosine kinase (NTRK) genes, which can help cancerous tumors grow. The drug is to be used to treat tumors that have spread or can’t be surgically removed and that have grown during previous treatments. Vitraki slows cancer progression by blocking TRK proteins.
- Updated data in 116 adult patients with TRK fusion cancer across 17 tumor types showed that Vitraki continues to show multi-cancer effects:
- 10% of patients with advanced cancers achieved complete responses
- 60% had partial responses
- 16% achieved disease stabilization
- 9% had progressive disease
- Median duration of response for all the adults in the study was 35.2 months, and median progression-free survival was 25.8 months.
- The median age of participants was 56 and 53% were women. Patients had thyroid cancer (22% of participants), salivary gland cancer (19%), soft tissue sarcoma (16%), lung cancer (12%), colon cancer (7%), melanoma (5%), breast cancer (5%), gastrointestinal stromal tumor (3%), and nine other cancer types (2% or less each). In 14 patients with brain metastases, partial responses were observed in 10 of these individuals.
- Vitrakvi is approved under accelerated approval based on overall response rate and duration of response in the U.S., Canada, Brazil and the European Union (EU).
- Kisqali (ribociclib) in breast cancer[10]:
- Two phase 3 trials showed that Kisqali (ribociclib), a CDK4/6 inhibitor, combined with endocrine therapy prolongs the overall survival of women with HR-positive, HER2-negative, advanced or metastatic breast cancer with visceral metastases (in the soft internal organs).
- The studies showed a ~47% and 37% reduction in the risk of death.
- The studies showed a ~47% and 37% reduction in the risk of death.
- These results are consistent with the benefit seen in the overall study population presented at ASCO 2019 and ESMO 2019, that showed a statistically significant overall survival benefit in two phase III trials with two distinct patient populations (pre/perimenopausal or postmenopausal women with HR+/HER2- advanced breast cancer).
- Kisqali is approved for use in more than 75 countries around the world, including the United States and European Union member states.
- Two phase 3 trials showed that Kisqali (ribociclib), a CDK4/6 inhibitor, combined with endocrine therapy prolongs the overall survival of women with HR-positive, HER2-negative, advanced or metastatic breast cancer with visceral metastases (in the soft internal organs).
- Apalutamide (Erleada) for prostate cancer[11]:
- A phase 3 trial showed that the addition of the androgen receptor inhibitor apalutamide to androgen deprivation therapy improves overall survival (OS) among patients with nonmetastatic castration-resistant prostate cancer.
- Median OS was significantly longer with the addition of apalutamide, at 73.9 versus 59.9 months, corresponding to a relative reduction of 21.6% in the risk of death.
- Discontinuation rates due to progressive disease were 42.7% with apalutamide and 73.9% with placebo. Discontinuation due to adverse events were 15.2% with apalutamide and 8.4% with placebo.
- A phase 3 trial showed that the addition of the androgen receptor inhibitor apalutamide to androgen deprivation therapy improves overall survival (OS) among patients with nonmetastatic castration-resistant prostate cancer.
- Pembrolizumab plus Axitinib in treating advanced renal cell carcinoma[12]:
- A large phase 3 clinical trial showed that patients with advanced renal cell carcinoma (RCC) who received a combination of pembrolizumab plus axitinib had survived significantly longer compared to patients who were treated with sunitinib (one of the standard treatment of care for the treatment of RCC).
- Overall, 74% of patients in the trial treated with pembrolizumab plus axitinib remained alive at 2 years after starting the treatment versus 66% of patients who received sunitinib.
- Progression-free survival (PFS) also showed positive results for the pembrolizumab plus axitinib versus sunitinib with median durations of 15.4 versus 11.1 months.
- Moreover, patients who received the combination therapy had a higher objective response rate (ORR) than those given the monotherapy (60.2 versus 30.9%).
- These results are consistent with the benefit seen in the overall study population presented at ASCO 2019 that showed a statistically significant overall survival benefit at 1 year, with an improved survival for 90% of patients treated with pembrolizumab plus axitinib versus 78% of patients who received sunitinib.
- A large phase 3 clinical trial showed that patients with advanced renal cell carcinoma (RCC) who received a combination of pembrolizumab plus axitinib had survived significantly longer compared to patients who were treated with sunitinib (one of the standard treatment of care for the treatment of RCC).
- These results continue to support pembrolizumab plus axitinib as a standard of care for patients with previously untreated advanced renal cell carcinoma.
Many of these innovative therapies are still being investigated in various clinical trials around the world and trials investigators are regularly looking to enroll more patients in order to evaluate them.
If you are interested in knowing more about clinical trials and how you can participate, make sure you register and save a search on Ancora.ai and you will be notified every time a new clinical trial matching your needs is enrolling patients.
References
- Andre T, Shiu K-K, Kim TW, et al: Pembrolizumab vs chemotherapy for microsatellite instability-high/mismatch repair deficient metastatic colorectal cancer: The phase 3 KEYNOTE-177 study.
ASCO20 Virtual Scientific Program. Abstract LBA4. Presented in pre-meeting press briefing on May 26, 2020.
Accessed: 2020-06-11 - Cortes J, Cescon DW, Rugo HS, et al. KEYNOTE-355: Randomized, double-blind, phase III study of pembrolizumab + chemotherapy versus placebo + chemotherapy for previously untreated locally recurrent inoperable or metastatic triple-negative breast cancer. Presented at: ASCO20 Virtual Scientific Program. J Clin Oncol. 2020;38(suppl):abstr 1000.
Accessed: 2020-06-10 - Herbst RS, Tsuboi M, John T, et al: Osimertinib as adjuvant therapy in patients with stage IB-IIIA EGFR mutation positive NSCLC after complete tumor resection: ADAURA.
ASCO20 Virtual Scientific Program. Abstract LBA5. Presented in pre-meeting press briefing on May 26, 2020.
Accessed: 2020-06-11 - Rodriguez-Abreu, D et al. Primary analysis of a randomized, double-blind, phase II study of the anti-TIGIT antibody tiragolumab (tira) plus atezolizumab (atezo) versus placebo plus atezo as first-line (1L) treatment in patients with PD-L1-selected NSCLC (CITYSCAPE).
ASCO Virtual Meeting, 29-31 May 2020, Abstract 9503.
Accessed: 2020-06-11 - Salvatore Siena, Maria Di Bartolomeo et al. A phase II, multicenter, open-label study of trastuzumab deruxtecan (T-DXd; DS-8201) in patients (pts) with HER2-expressing metastatic colorectal cancer (mCRC): DESTINY-CRC01.
ASCO Virtual Meeting, 29-31 May 2020, Abstract 4000. Journal of Clinical Oncology, 38, 15_suppl, 5 2020
Accessed: 2020-06-11 - Egbert F. Smit, Kazuhiko Nakagawa et al. Trastuzumab deruxtecan (T-DXd; DS-8201) in patients with HER2-mutated metastatic non-small cell lung cancer (NSCLC): Interim results of DESTINY-Lung01. ASCO Virtual Meeting, 29-31 May 2020, Abstract 9504. Journal of Clinical Oncology, 38, 15_suppl, 5 2020
Accessed: 2020-06-11 - Kohei Shitara, Yung-Jue Bang et al. Trastuzumab deruxtecan (T-DXd; DS-8201) in patients with HER2-positive advanced gastric or gastroesophageal junction (GEJ) adenocarcinoma: A randomized, phase II, multicenter, open-label study (DESTINY-Gastric01).
ASCO Virtual Meeting, 29-31 May 2020, Abstract 4513. Journal of Clinical Oncology, 38, 15_suppl, 5 2020
Accessed: 2020-06-10 - Paz-Ares L, Dvorkin M, Chen Y, et al. Durvalumab ± tremelimumab + platinum-etoposide in first-line extensive-stage SCLC (ES-SCLC): updated results from the phase III CASPIAN study. J Clin Oncol. 2020;38 (suppl; abstr 9002). doi:10.1200/JCO.2020.38.15_suppl.9002
Updated results from the CASPIAN trial were presented during the 2020 American Society of Clinical Oncology ASCO20 Virtual Scientific Program on May 29-31, 2020.
Accessed: 2020-06-10 - Drilon AE, et al. Activity and safety of larotrectinib in adult patients with TRK fusion cancer: An expanded data set.
ASCO Virtual Meeting, 29-31 May 2020, Abstract 3610.
Accessed: 2020-06-10 - Denise A. Yardley, Arnd Nusch et al. Overall survival (OS) in patients (pts) with advanced breast cancer (ABC) with visceral metastases (mets), including those with liver mets, treated with ribociclib (RIB) plus endocrine therapy (ET) in the MONALEESA (ML) -3 and -7 trials.
ASCO Virtual Meeting, 29-31 May 2020, Abstract 1054. Journal of Clinical Oncology, 38, 15_suppl, 5 2020
Accessed: 2020-06-10 - Eric Jay Small, Fred Saad et al. Final survival results from SPARTAN, a phase III study of apalutamide (APA) versus placebo (PBO) in patients (pts) with nonmetastatic castration-resistant prostate cancer (nmCRPC).
ASCO Virtual Meeting, 29-31 May 2020, Abstract 5516. Journal of Clinical Oncology, 38, 15_suppl, 5 2020
Accessed: 2020-06-10 - Elizabeth R. Plimack, Brian I. Rini et al., Pembrolizumab plus axitinib versus sunitinib as first-line therapy for advanced renal cell carcinoma (RCC): Updated analysis of KEYNOTE-426.
ASCO Virtual Meeting, 29-31 May 2020, Abstract 5001. Journal of Clinical Oncology, 38, 15_suppl, 5 2020
Accessed: 2020-06-18