On May 19, 2021 Dana-Farber Cancer Institute researchers reported that they are presenting dozens of research studies at the 2021 Annual Meeting of the American Society of Clinical Oncology (ASCO) (Free ASCO Whitepaper) (Press release, Dana-Farber Cancer Institute, MAY 19, 2021, View Source [SID1234580471]). The studies will be presented during the virtual program on June 4-8, 2021. ASCO (Free ASCO Whitepaper) is the world’s largest clinical cancer research meeting, attracting more than 30,000 oncology professionals from around the world.
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Toni K. Choueiri, MD, the director of the Lank Center for Genitourinary Oncology at Dana-Farber, will present results from the randomized, double-blind, phase III KEYNOTE-564 trial evaluating pembrolizumab versus placebo after surgery in patients with renal cell carcinoma (abstract LBA5) during ASCO (Free ASCO Whitepaper)’s Plenary Session on Sunday, June 6, 2021, 1:00pm-4:00pm ET. The plenary session features five studies deemed to have the greatest potential impact on patient care.
F. Stephen Hodi, MD, the director of the Melanoma Center and Center for Immuno-Oncology at Dana-Farber is co-senior author on the RELATIVITY-047 study evaluating combination treatment with two immunotherapies (relatlimab plus nivolumab) versus nivolumab alone in first-line treatment for patients with advanced melanoma (abstract 9503). Findings from the RELATIVITY-047 study will be presented during the Melanoma/Skin Cancers Oral Abstract Session on Sunday, June 6, 2021, 8:00am-11:00am ET. The study is included in the ASCO (Free ASCO Whitepaper) Press Program.
Other key research shows new treatments and diagnostic advances in lung cancer, leukemia, head and neck cancer, pediatrics, and many others. Some of the research highlights include:
Antibody drug conjugate shows promise against non-small cell lung cancer resistant to targeted therapy
An antibody fused to a targeted drug has produced impressive results in a Phase I clinical trial involving patients with advanced non-small cell lung cancer (NSCLC) whose tumors had become resistant to a standard targeted therapy. Dana-Farber’s Pasi A. Jänne, MD, PhD, is lead author of the study.
The trial evaluated the safety and effectiveness of patritumab deruxtecan, an antibody drug conjugate consisting of an antibody targeting the protein HER3 and an inhibitor of the topoisomerase 1 enzyme, in 57 patients whose NSCLC carried an EGFR gene mutation but no longer responded to EGFR-targeting drugs. Patients who become resistant to such drugs and to platinum-based chemotherapy usually have few treatment options.
After a median treatment time of 5.5 months, 39% of the participants had a confirmed clinical response to the conjugate – a reduction in tumor size or extent. Among these patients, the median progression-free survival was 8.2 months. The antitumor effect occurred in patients whose resistance to EGFR inhibitors arose from a range of molecular mechanisms and in those with no clear identifiable resistance mechanism.
The most common severe side effects were decreased blood platelet counts, lowered counts of neutrophils (a type of white blood cell), and fatigue – all consistent with previous safety studies.
The results have prompted investigators to open a Phase 2 trial of the conjugate for patients with EGFR-mutant NSCLC whose disease has become resistant to EGFR-targeting drugs and chemotherapy.
Title: Efficacy and safety of patritumab deruxtecan (HER3-DXd) in EGFR inhibitor-resistant, EGFR-mutated (EGFRm) non-small cell lung cancer (NSCLC)
Abstract: 9007
Presenter: Pasi A. Jänne, MD, PhD
Session/Time: Oral Abstract Session: Lung Cancer – Non-Small Cell Metastatic; Broadcasting: June 4, 1:00pm-4:00pm
PET scans following initial treatment help many patients with bulky early-stage Hodgkin lymphoma avoid radiotherapy
Many early-stage patients with bulky classic Hodgkin lymphoma (cHL) can avoid radiotherapy treatment and still have excellent outcomes, according to a clinical study in which treatment was adapted to findings on PET imaging. Bulky disease – characterized by large tumors typically in the center of the chest – is associated with poorer outcomes in cHL and is traditionally treated with radiotherapy following chemotherapy. However, radiation treatment to the chest can have long-term toxic effects including an increased risk of breast cancer and heart problems.
The results, presented by Ann LaCasce, MD, MMSc, of Dana-Farber, included 94 patients with stage IA-IIB cHL and disease bulk greater than 10 cm or .33 maximum intrathoracic diameter on chest X-ray. Patients received two cycles of chemotherapy (ABVD) and then underwent PET imaging. Patients whose disease showed uptake less than liver on interim PET scan (PET2-) – 78% of the patients — received four additional cycles of chemotherapy, but no radiotherapy. Patients classed as PET2+ received intensified chemotherapy with four cycles of escBEACOPP plus radiation therapy.
The estimated progression-free survival (PFS) was 93.1% in the PET2- patients and 89.7% in PET2+ patients. With a median follow-up of 5.5 years, estimated 3-year overall survival was 98.6% in PET2- patients and 94.4% in PET2+ patients. (Overall survival was not a primary or secondary outcome of the study).
The investigators said the PET-adapted approach achieved excellent PFS outcomes "that allowed omission of radiotherapy in 78 percent of patients." The PET2+ patients who received BEACOPP and radiotherapy "did not have inferior outcomes."
Title: CALGB 50801 (Alliance): PET adapted therapy in bulky stage I/II classic Hodgkin lymphoma (cHL)
Abstract: 7507
Presenter: Ann S. LaCasce, MD, MMSc
Session/Time: Oral Abstract Session: Hematologic Malignancies – Lymphoma and Chronic Lymphocytic Leukemia; Broadcasting: June 7, 11:30am-2:30pm
Additional cycle of pembrolizumab before surgery improves response rates in locally advanced head and neck cancer
Increasing neoadjuvant pembrolizumab from one to two cycles prior to surgery improved pathological response rates in patients with surgically resectable locally advanced, HPV-negative head and neck squamous cell carcinoma, reported Ravindra Uppaluri, MD, PhD, Dana-Farber/Brigham and Women’s Cancer Center. A previous study in which patients (36 total) received one neoadjuvant cycle of pembrolizumab followed by surgery two to three weeks later yielded a 22% rate of >50% pathologic response (tumor cell death and other evidence of response designated as pTR-2) and a 22% pTR-1 rate (10-49% pathologic response). The new report was on a 28-patient phase 2 trial in which patients received two cycles of pembrolizumab 42 and 21 days prior to surgery. Twelve of 28 patients (43%) experienced a pTR-2 and four (16%) of these patients had a major pathologic response including 1 complete response at the primary site.
Neoadjuvant therapy was well tolerated and clinical outcomes in this advanced disease population were excellent with only one recurrence noted to date. The researchers said the data suggest that the frequency of pathologic responses to neoadjuvant pembrolizumab can be improved by increasing the number of cycles and the treatment interval.
Title: Enhanced pathologic tumor response with two cycles of neoadjuvant pembrolizumab in surgically resectable, locally advanced HPV-negative head and neck squamous cell carcinoma (HNSCC)
Abstract: 6008
Presenter: Ravindra Uppaluri, MD, PhD
Session/Time: Oral Abstract Session: Head and Neck Cancer; Broadcasting: June 7, 2:45pm-5:45pm
Molecular profiling of tumor tissue can benefit many young patients with cancer, study suggests
Testing solid tumors for genetic changes that can be targeted by drugs has revolutionized the treatment of many adults with cancer. New research by scientists at Dana-Farber/Boston Children’s Cancer and Blood Disorders Center suggests it can have significant benefits for many younger patients as well.
Alanna J. Church, MD, Dana-Farber/Boston Children’s Cancer and Blood Disorders Center, will present results from the GAIN/iCat2 consortium study, which is evaluating the use of genomic profiling of solid tumors in children and young adults. The report includes data on 345 study participants with molecular profiling, who were diagnosed with solid, non-brain tumors at age 30 or younger. 299 patients (87%) had at least one genomic alteration that could impact the diagnosis, treatment, and prognosis of their disease, the researchers found.
Thirty-one patients were treated with matched targeted therapies and six patients had extraordinary responses to treatment. All patients with extraordinary responses matched to a gene fusion, and 78% of diagnostically significant alterations were fusions.
Molecular tumor profiling has a significant impact on diagnosis and treatment recommendations for young patients with solid tumors. These results emphasize the importance of fusion detection for patients with sarcomas and rare tumors,said Church, the lead author of the study, which was the highest rated pediatric oncology abstract at the ASCO (Free ASCO Whitepaper) conference, and winner of the Conquer Cancer Nachman Award.
Title: Clinical impact of molecular tumor profiling in pediatric, adolescent, and young adult patients with extra-cranial solid malignancies: An interim report from the GAIN/iCat2 study
Abstract: 10005
Presenter: Alanna J. Church, MD
Session Time: Oral Abstract Session: Pediatric Oncology I; Broadcasting: June 5, 10:00am-1:00pm
A full list of Dana-Farber Oral Presentations at the 2021 ASCO (Free ASCO Whitepaper) Annual Meeting is available here.
Additionally, Dana-Farber researchers are recipients of ASCO (Free ASCO Whitepaper)’s Special Awards, the Society’s highest honors.
Jennifer A. Ligibel, MD, director of the Leonard P. Zakim Center for Integrative Therapies and Healthy Living and the director of the Center for Faculty Well-Being at Dana-Farber, is the recipient of the Hologic, Inc Endowed Women Who Conquer Cancer Mentorship Award.
Tracy A. Balboni, MD, MPH, FAAHPM, radiation oncologist at Dana-Farber/Brigham and Women’s Cancer Center and a professor of radiation oncology at Harvard Medical School, is the recipient of the Walther Cancer Foundation Palliative and Supportive Care in Oncology Endowed Award. Her award lecture is available for on-demand viewing during the ASCO (Free ASCO Whitepaper) conference, starting June 4, 2021, 9:00am ET.
Read more about this year’s Dana-Farber ASCO (Free ASCO Whitepaper) Special Awards here.