Get up to date with this short video where our experts provide their perspectives on key late-breaking data in breast cancer, sarcoma, rectal cancer and myeloma


Watch this short video where our Experts provide their perspectives on the key late-breaking data in colorectal cancer, sarcoma, breast cancer and multiple myeloma.

Quickly hear the main conclusions from the trials and how the experts think these trials will impact clinical practice.

  • Dr. Rebecca Dent: DESTINY-Breast04 trial in breast cancer. Results present a paradigm shift in the treatment of metastatic breast cancer, with T-DXd as a new standard of care for patients with HER2-low (IHC 1+, IHC 2+/ISH-) disease
  • Prof. Jonathan C Trent: rEECur trial in Ewing sarcoma. High-dose ifosfamide demonstrated as a standard of care for recurrent and primary refractory Ewing sarcoma
  • Prof. Chiara Cremolini: PD-1 blockade trial in rectal cancer. Results suggest an immunotherapy strategy could help avoid chemoradiation and surgery for locally advanced, MMR, MSI-high, rectal cancer patients
  • Dr. Hans Lee: DETERMINATION trial in MM. Results confirm the first-line standard of care of early ASCT with triplet induction and lenalidomide maintenance, but also support personalised approaches in NDMM

Visit GI CONNECT to watch and listen to Prof. Cremolini continue her summary and provide her summary and provide her perespective on 'PD-1 blockade in mismatch repair deficient locally advanced rectal cancer'.

Dr. Trent also includes an extra summary of his thoughts on a clinicaly symposium topic "Circulating tumor DNA (ctDNA) analyses of the phase III VOYAGER trial in GIST" which can be seen by visiting SARCOMA CONNECT.

 

Breast Cancer Update from ASCO 2022

My name is Rebecca Dent, and I'm delighted to be here today at ASCO 2022 in Chicago, where I've just come from the plenary session where Dr Shanu Modi presented the data from DESTINY-Breast04, looking at the role of T-DXd in HER2-low metastatic breast cancer.

This really is a game changer, really raises the bar for our patients, with ER-positive HER2-low IHC 1-2+, and even ER-negative, basically triple-negative with IHC 1-2+. Here we saw an improvement in overall survival of over 6 months, in the ER-positive and of almost 10 months in the triple-negative. Now this was a small group of patients, but what it really tells us is that HER2 really is being used a surrogate pathway, to deliver potent chemotherapy to the tumour cell.

So the mechanism of action is very different than we're used to thinking about. We normally think about HER2 inhibition, but really this is a surrogate pathway to get, again these potent drugs into the cell, and so this bystander effect really is much more important that we ever imagined, and so I think we are seeing a paradigm shift in how we're treating breast cancer, but also potentially many other tumours as was eloquently described by Pat LoRusso in her discussion session right after Shanu Modi's presentation.

So I think we're going to see a paradigm shift in how we approach metastatic breast cancer, HER2-low and even HER2-zero. We saw data from recently the phase 1 and some of the other trials that have been done that really showed, how low can we go, in terms of looking at the benefits of T-DXd, and so we anxiously await some of the ongoing trials and also combinations; in combination with immune-checkpoint inhibition, to really change the outcomes from all our patients with metastatic breast cancer.

Read the publication online in the NEJM

SARCOMA CONNECT Update from ASCO 2022

Hi. This is Dr. John Trent here at ASCO to discuss the results of the rEECur trial.

Patients with refractory and relapsed Ewing sarcoma only have less than 15% five-year survival rate.

Treatment is controversial. In this update of the rEECur trial patients were randomised to either topotecan plus Cytoxan (cyclophosphamide) vs high-dose ifosfamide 15 g/m2 (3g/m2 D1-5).

As it turns out, patients who were randomised to topotecan plus Cytoxan (cyclophosphamide) had a 10.5 month median overall survival and a 45% one year survival rate.

On the other hand, those patients randomised to high-dose ifosfamide 15 g/m2 (3g/m2 D1-5) enjoyed a 15.4 month overall survival and a 55% one year survival rate.

All of these benefits from high-dose ifosfamide were statistically significant.

This data is applicable to the standard of care of therapy and is indeed practice changing today. Thank you.

GI CONNECT Update from ASCO 2022

I am Chiara Cremolini and today I bring to you from ASCO 2022 some interesting results that have been presented.

In particular an interesting phase 2 trial conducted by the Memorial Sloan Kettering Cancer Center Group was presented today dealing with the treatment of patients with locally advanced rectal cancer, but in particular of patients with deficient mismatch repair or microsatellite unstable tumours.

We already knew about the impressive results achieved with immunotherapy in the metastatic setting in dMMR patients. But now we have evidence from 14 patients enrolled in this trial that using immunotherapy may avoid operative management of these patients. Only 14 patients with dMMR rectal cancer in clinical stage 2 or 3 received up to six months of an anti PD-1 monoclonal antibody, dostarlimab, and then underwent a reassessment of their disease by means of pelvic MRI, digital examination and endoscopic assessment. In all of these patients a complete clinical response was observed.

So definitely we have only preliminary results at the relatively short follow up but definitely these results are potentially practice changing. Tomorrow in my clinic, I would pretty much love to offer an immunotherapy approach, an immunotherapy strategy to locally advanced dMMR, MSI high patients in order to avoid both chemo radiation and surgery in their therapeutic route.

Read the publication online in the NEJM

LYMPHOMA & MYELOMA CONNECT Update from ASCO 2022

I'm Hans Lee, coming to you from the ASCO 2022 annual meeting in Chicago and I'll be providing my perspective on the late breaking abstract plenary that was just presented of the phase 3 DETERMINATION study.

Now the phase 3 DETERMINATION study really sought to answer a key question of what is the role of upfront high dose melphalan and autologous stem cell rescue in newly diagnosed multiple myeloma patients that receive optimal triplet based induction therapy with bortezomib, lenalidomide and dexamethasone followed by lenalidomide maintenance therapy until disease progression.

The key results of this study demonstrate that there is a significant improvement of progression free survival of approximately 21 months in patients who underwent upfront high dose chemotherapy and autologous stem cell rescue compared to those patients who didn't.

However, at the time that the study is being reported, there was no difference in overall survival between the patients who underwent upfront versus delayed high dose chemotherapy and autologous stem cell rescue.

From my perspective, the data from the DETERMINATION study impact my clinical practice in two main ways.

First, it confirms that upfront high dose chemotherapy and autologous stem cell rescue remains the standard of care in newly diagnosed multiple myeloma patients that receive optimal induction therapy with bortezomib, lenalidomide and dexamethasone.

Secondly, it confirms the role of maintenance lenalidomide after induction therapy until disease progression.

However, without an overall survival benefit seen between those patients who underwent upfront transplant versus those who didn't, it's still important to have a discussion with patients regarding the benefits and risks of autologous stem cell transplant and future analysis from the DETERMINATION study and also the future prospective studies will be very informative to define the right groups of patients that will benefit optimally from upfront stem cell transplant.

Thank you.

Read the publication online in the NEJM

Dr Rebecca Dent has received financial support/sponsorship for research support, consultation, or speaker fees from the following companies:

AstraZeneca, Eisai, Genentech, Lilly, Merck, Novartis, Pfizer and Roche. 

Dr Chiara Cremolini is a Medical Oncologist at Santa Chiara University Hospital in Pisa, Italy. Chiara completed her M.D. Degree in 2008, and gained an M.Sc. in Clinical Trials in 2011, and the Specialty in Medical Oncology in 2014 at the University of Pisa. She is mainly committed to the clinical management of patients affected by gastrointestinal malignancies and is involved in clinical and translational research projects in the field of colorectal oncology. She actively contributes to clinical trials by the cooperative Gruppo Oncologico Nord Ovest (GONO) group and is interested in the identification of molecular predictors of benefit from systemic treatments. Chiara is co-author of about 60 peer-reviewed papers and received merit awards at the following meetings: American Society of Clinical Oncology (ASCO) 2010, 2012−2015; European Society for Medical Oncology (ESMO) 2011 and 2014; European CanCer Organisation (ECCO) 2013.

Dr Hans Lee is currently an Assistant Professor and Director of Multiple Myeloma Clinical Research in the Department of Lymphoma/Myeloma at MD Anderson Cancer Center, where his clinical and research efforts are focused on advancing the care and treatment of patients with multiple myeloma.   Specifically, his primary research goals are directed towards novel approaches to treating multiple myeloma through early phase investigator-initiated and industry-sponsored clinical trials.

Asst. Prof. Hans Lee has received financial support/sponsorship for research support, consultation, or speaker fees from the following companies:

Amgen, Bristol Myers Squibb, Celgene, Genentech, GlaxoSmithSkine, Legend Biotech, Pfizer, Regeneron, Sanofi and Takeda Pharmaceuticals. 

Dr Jonathan C. Trent earned his MD and PhD in cancer biology from The University of Texas Health Science Center where he also completed a residency in internal medicine. He then completed a fellowship in medical oncology at The University of Texas M. D. Anderson Cancer Center while serving as chief fellow. Prior to joining the University of Miami, Sylvester Comprehensive Cancer Center, he held an appointment as associate professor of medicine in the Department of Sarcoma Medical Oncology, Division of Cancer Medicine at the University of Texas M. D. Anderson Cancer Center in Houston. Dr Trent is currently the Associate Director for Clinical Research, the Director of the Bone and Soft-tissue Sarcoma Group and Medical Director of the Precision Medicine Initiative at the Sylvester Comprehensive Cancer Center. Dr Trent’s interests are in the clinical and translational research of sarcomas, direct care of sarcoma patients, and education about sarcoma. As Associate Director for Clinical Research, his goal is to help Sylvester Faculty develop clinical trials that provide clinically effective and scientifically exciting therapy to cancer patients of South Florida and beyond. The major focus of his clinical, educational and research efforts are with gastrointestinal stromal tumor (GIST), chondrosarcoma, and other sarcomas. The major efforts of Dr Trent’s research focus on understanding the mechanisms of action and resistance of imatinib in GIST and other sarcomas while striving toward improved therapeutic options. His work involves the use of novel preoperative/postoperative clinical trials, prospectively acquired tumor tissue, cell lines, archival tissue, as well as collaborations with disciplines such as the genomics facility, surgical oncology, pathology, radiology and interventional radiology.

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