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18 June 2018

ASCO 2018: Headlines and Highlights

ASCO 2018: Headlines and Highlights

All eyes were on the American Society of Clinical Oncology (ASCO) Annual conference last week in Chicago watching for the latest clinical trial updates and translational innovations that will be tomorrow’s breakthrough cancer treatments and tests.

Each year, the event attracts thousands working in the cancer field. And each year, the research presented at ASCO sets the tone for the cancer community in terms of what’s hot, and what’s not.

If you didn’t attend the conference this year, you’ll want to know what you’ve missed. And if you did attend, covering the vast amount of data presented at this premier forum for the oncology community is some mean feat. We’ve compiled a snapshot from ASCO to get you up to speed, covering the major stories you need to know, and some other highlights you may not have heard about.

The Headlines
  • Chimeric antigen receptor (CAR) T-cell therapy, which involves taking immune cells from a patient and genetically engineering them to recognize and respond to their cancer cells, was named ASCO 2018 advance of the year. This follows the approval in August 2017 of the first CAR T-cell therapy approach to treat a type of blood and bone marrow cancer which was heralded by the FDA as ‘the first gene therapy in the US’.
  • Merck and Bristol-Myers Squibb continue in their race to develop the winning checkpoint inhibitor combination for first line lung cancer treatment. BMS presented promising data on its Opdivo/chemo/Yervoy combination, but many are still backing Keytruda, especially as Merck presented more positive data for Keytruda from two landmark clinical trials.
  • Continuing the omnipresence of IO, Nektar Therapeutics presented data on its drug NKTR-214, which caused much excitement at ASCO 2017. This year though it was the topic of much debate over the latest reported response rates.
  • Celgene and bluebird bio presented a highly anticipated update on bb2121, an anti–B-cell maturation antigen (BCMA)-targeting CAR-T for multiple myeloma. Industry-watchers were hoping that the latest data would show progression-free survival (PFS) as high as 15 months. Instead, PFS came in at 11.8 months, or just under the anticipated 12-month to 15-month range.
  • Loxo Oncology had already impressed the ASCO audience in 2017 with data for its tropomyosin receptor kinase inhibitor in TRK-fusion cancers. This year, it did it again with better than expected overall response rates with a second drug, LOXO-292.
  • Also hitting the headlines was the latest data from Grail on their blood tests for detecting lung cancer earlier. Grail reported being able to spot cancer in about 40% of patients with early stage lung cancer and 90% of patients with late-stage lung cancer from a relatively small 127-patient group. It’s been received as a promising proof-of-principle, but more results are needed.
The Highlights

Several studies reported data from using CT measurements as prognostic biomarkers. Parameters such as loss of skeletal muscle density and skeletal muscle index were found to be independent predictors of early progression and overall survival in patients with advanced non-small cell lung cancer (NSCLC) (abstract #e24166).

Vol-PACT shared results of their study benchmarking images from four phase III trials in metastatic colorectal cancer against four phase III trials in other solid tumors. They report that continuous response metrics extracted from CT correlated strongly with progression-free survival and may be more informative than RECIST. This attracted our attention as Median’s platform is one of few that can seamlessly integrate volumetric data with other measures (abstract #3581).

Novel applications of MRI to tumor prognosis were also presented: for tracking PI3K/mTor activity in liver tumors (abstract #e24168) to assessing methylation status of the MGMT promoter (abstract #2051) tumor grade and isocitrate-dehydrogenase (IDH) mutation status in glioma (abstracts #e24173 and #12063).

Extracting high quality data from images was a key theme of the conference too. Presentations ranged from the use of artificial intelligence for enhanced radiomics feature extraction to aid prognosis in early stage lung cancer (abstract #8528), to the application of machine learning algorithms to radiomic features in glioma (abstract #2031) and using computer-extracted features relating to the spatial arrangement of tumor infiltrating lymphocytes to predict response to nivolumab in NSCLC (abstract #12115).

Other studies used quantitative CT texture assessment of tumors and machine learning to predict clinical outcomes in gastric cancer (abstract #e16091) or to identify patients with advanced NSCLC who will benefit from immunotherapy (abstract #e21027).    Studies such as these are conducted using imaging solutions like Median’s to help identify, quantify and track lesions over time.

And finally, we are beginning to see AI become the new normal. In 2017, there were only a handful of abstracts on this topic. This year, that’s doubled, with topics ranging from its use in imaging analysis, to clinical decision-making. If 2018 was the year of IO, will 2019 be the year of AI?

What’s Next?

Smaller “Best of ASCO” meetings are taking place throughout the country over next two months: July 13-14 in San Diego, August 3-4 in Washington in Boston, August 10-11 in Chicago.

ASCO 2018 Annual Meeting videos and slides are available for purchase on the ASCO website.

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