OBR Daily Commentary - ASCO Conference Coverage

forumImage

How An Old Diabetes Drug Made A Big Splash At The Biggest Cancer Confab

(Forbes) June 7, 2018 - At the recently concluded annual meeting of the American Society of Clinical Oncology (ASCO) a group of researchers from Mexico City described a surprising discovery: In a phase 2 trial in patients with stage 4 lung cancer, a 24-year-old diabetes drug significantly improved survival when added to a standard therapy.

H. Jack West, MD (Posted: June 07, 2018)

quotesThis work is certainly provocative, but there are several issues that should lead us to be cautious about concluding that this should change practice. Not only was this not a large trial, but the patients in the control arm who received erlotinib alone demonstrated a response rate that was remarkably low for EGFR mutation-positive cancer, about half of what is more commonly seen. There have also been other trials that have been far less impressive but not publicized. Overall, it merits further study but needs validation before being considered a combination approach to pursue outside of an investigational strategy.quotes

Read Article arrow
Add Comment 1 Comment
forumImage

Roche Immunotherapy Combination Increases Lung Cancer Survival - Study

(Reuters) May 16, 2018 - Roche’s immunotherapy Tecentriq, given with its older drug Avastin and chemotherapy, improved survival of advanced lung cancer patients by about 30 percent over the combination without Tecentriq, according to interim results of a late stage trial released on Wednesday.

H. Jack West, MD (Posted: May 17, 2018)

quotesIt looks like we're going to have data from the IMpower150 trial released in small bits every few months, without any new electrifying developments. Here, the most notable finding is the hazard ratio for OS of 0.54 among patients with an EGFR mutation or ALK rearrangement who received carbo/paclitaxel/bevacizumab + atezolizumab, compared to carbo/pac/bev alone. Patients with liver mets also had the same HR for OS of 0.54 with chemo/bev/atezo. The reality is that the real comparator for the IMpower150 four-drug regimen is carbo/pemetrexed/pembro (as per KEYNOTE-189), and I think for a broad population, the KEYNOTE-189 regimen is more compelling. However, for patients with an EGFR mutation especially, and to a lesser extent those with an ALK rearrangement, the carbo/pac/bev/atezo regimen deserves to be considered as a compelling option AFTER patients have progressed on initial targeted therapy. Importantly, these patients were to have already received an EGFR or ALK TKI, and the IMpower150 approach should not replace highly effective targeted therapy as first line treatment. We should expect to see far more work on immunotherapy in patients with a driver mutation. One of the most significant effects of IMpower150 will be that it leads to a re-opening of this question, after the data we had in 2nd line NSCLC led most lung cancer specialists to conclude that checkpoint inhibitors don't have meaningful activity in these patients. Finally, we need to clarify if the benefit requires bevacizumab, which can be answered by seeing how Arm A of IMpower150 (carbo/pac/atezo, no bev) does. That hasn't been reported yet but can help us understand the contribution of the bev component on Arm B.quotes

Read Article arrow
Add Comment 1 Comment

Meet the Editorial Board

Prostate Cancer
member photo
Tomasz M. Beer, MD, FACP

Professor of Medicine, Division of Hematology/Medical O...

Community Oncology
member photo
Dean Gesme, MD

FACP FACPE FASCO President, Minnesota Oncology...

Breast Cancer
member photo
Debu Tripathy, MD

Professor and Chair, Department of Breast Medical Oncol...

Lung Cancer
member photo
H. Jack West, MD

Medical Director, Thoracic Oncology Program, Swedish Ca...

Gastrointestinal Cancers
member photo
Howard S. Hochster, MD

Distinguished Professor of Medicine, Rutgers Robert Woo...

Radiation Oncology
member photo
Howard Sandler, MD, MS, FASTRO

Ronald H. Bloom Chair in Cancer Therapeutics
Pr...

Community Oncology
member photo
Jeff Patton, M.D.

CEO Tennessee Oncology...

Precision Medicine Section Editor
member photo
Jennifer Levin Carter, MD, MPH

Chief Medical Officer and Founder, N-of-One...

Financial Sector
member photo
Michael G. King Jr.

Managing Director and Senior Biotechnology Analyst...

Gastrointestinal Cancers
member photo
Richard Goldberg, MD

Director WVU Cancer Institute Director of Cancer Signa...

Editor-In-Chief
member photo
Robert A. Figlin, MD., FACP

Professor and Director, Division of Hematology Oncology...

Health Policy
member photo
Ted Okon

Executive Director Community Oncology Alliance...

Community Oncology
member photo
Thomas Marsland, MD

Vice President Integrated Community Oncology Network ...

Community Oncology
member photo
William Harwin MD

Florida Cancer Specialists President and Managing Part...

Health Policy
member photo
William McGivney, PhD

National Health Policy Expert...

Payer
member photo
Winston Wong, PharmD

President, W-Squared Group...