ASCO 2013 Is Almost Here!
Kantar Health Previews the Top Abstracts
By Josh Garcia
The annual meeting of the American Society of Clinical Oncology (ASCO) is just around the corner, and Kantar Health is excited to preview the top abstracts that will be presented at the conference. The 2013 ASCO annual meeting promises to be packed with the latest data and trends from the world of oncology, but it may not have an overwhelming number of practice-changing, blockbuster presentations compared with conferences in the recent past. The following is a brief synopsis of the 10 abstracts that we think are likely to generate the most discussion and have the highest impact.
1. Avastin in Newly Diagnosed Glioblastoma
Avastin® (bevacizumab, Roche/Genentech) was granted accelerated FDA approval in 2009 for the treatment of relapsed glioblastoma (GBM). The fact that this accelerated approval was granted based on two non-controlled studies highlights the lack of effective agents for the treatment of GBM. Avastin with or without irinotecan have since become the therapies of choice in relapsed patients, while Avastin combinations are gaining some use as treatment for newly diagnosed patients (approximately 25% utilization according to the latest CancerMPact® Treatment Architecture data). Roche/Genentech are now looking at two Phase III studies to convert the accelerated approval, expand into approval in newly diagnosed patients and boost market share.
In November 2012, results for the Phase III AVAglio trial showed that adding Avastin to chemoradiotherapy for the treatment of newly diagnosed GBM patients improved progression-free survival (PFS; HR=0.64; P<0.0001), but the interim overall survival (OS) results did not reach statistical significance (HR=0.89; P=0.2135). This data was presented at the 2012 meeting of the Society for Neuro-Oncology (Chinot, Abstract OT-03), which means that the updated presentation at ASCO may be the first opportunity for a larger population of physicians and industry professionals to scrutinize the data as well as view the updated OS results.
Also at ASCO this year is the presentation of the results from the RTOG 0825 trial that has a nearly identical trial design as AVAglio. This study could serve to provide a more convincing narrative for the use of Avastin in the newly diagnosed GBM setting. These RTOG study results were given top billing at the plenary session this year.
Physicians are becoming familiar with the common Avastin phenomenon of the drug showing a PFS benefit but not significantly affecting OS. This may give some physicians pause after the announcement of the AVAglio results followed this same pattern. Will the RTOG 0825 trial change that perception, or will we see a similar pattern of PFS without OS? The availability and high use of Avastin in relapsed GBM may certainly be confounding the OS results from these studies, so it will be interesting to see whether there is any trend in the data and how subsequent therapy might have affected the OS outcomes. Given the high unmet need in GBM and the complete lack of active agents beyond temozolomide, the PFS benefit could be enough to maintain Avastin as a new option in newly diagnosed patients, but lacking OS could hinder its ability to become the new standard of care. Presentations: RTOG 0825, Abstract 1, Sunday, June 2, 1:50 PM; AVAglio, Abstract 2005, Saturday, June 1, 4:30 PM