ASCO Highlights 7 Studies in Advanced Release

May 16, 2013

ASCO highlighted studies on treatment with ipilimumab and nivolumab in advanced melanoma, radiation in NSCLC, and idelalisib in chronic lymphocytic leukemia.

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Men who are fit in their fifties have a lower risk of developing and dying from common cancers

New immunotherapy is active against a number of advanced cancers

Early trial suggests a combination of two immunotherapy drugs may be better than either drug alone

Lower-dose radiation is safer and more effective than higher-dose radiation for advanced NSCLC

Surveillance following surgery for cancer recurrences is a safe long-term strategy for patients with stage I seminoma

Routine surveillance imaging scans may not be needed for many lymphoma survivors

New targeted drug shows promising activity against treatment-resistant CLL in early trial

Findings from a 20-year follow-up study of over 17,000 men indicate that being fit in middle age protects men against developing and dying from lung and colorectal cancers later in life. Researchers observed that even a modest improvement in cardiovascular fitness reduces the risk of dying from cancer by 14%.A phase I study of the PD-L1 targeted antibody MPDL3280A reports tumor shrinkage in 21% of patients with advanced melanoma and lung, kidney, colorectal, and stomach cancer. Therapy responses are still ongoing for 26 out of 29 patients who have been on the study between 3-15 months.A phase I trial shows that concurrent treatment with ipilimumab (Yervoy) and the PD-1 targeted drug nivolumab led to substantial tumor shrinkage in roughly half of patients with difficult-to-treat, advanced melanoma. The authors state this is the strongest immunotherapy response observed in this setting to date.A phase III trial shows standard-dose radiation therapy (60 Gy) is superior to high-dose (74 Gy) in terms of both treatment effectiveness and survival. Standard-dose was also associated with significantly fewer treatment-related deaths. Many doctors have been using higher dose therapy, expecting better patient outcomes. These results should discourage this approach and reinforce existing recommendations.The largest study to date of men with this common form of testicular cancer finds that 99.6% of patients followed on surveillance alone after surgery are alive at 10 years. Roughly half of U.S. men currently undergo chemotherapy and radiation following surgery to improve outcomes; these findings suggest such treatments may not be necessary for most patients.A large study reports that only 1.5 % of diffuse large B cell lymphoma relapses are detected through scheduled CT surveillance scans alone. While CT scans have been a routine part of follow-up care for many years, the great majority of relapses in this study were detected through symptoms, abnormal findings on physical exams or abnormal blood tests.Final results from a phase I study in patients with relapsed or refractory chronic lymphocytic leukemia (CLL) indicate that treatment with idelalisib, a new PI3K-delta inhibitor, led to tumor shrinkage in half of the patients treated, stalling disease progression by 17 months on average. The encouraging results point to a possible alternative to traditional chemotherapy for delaying CLL progression.

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