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Top 10 Key Presentations at ASCO 2014: Join Us for Discussion at Upcoming #LCSM Chat 5/22

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Top10ListEvery year, many of the most important developments in cancer care are presented at ASCO. This year, we’ve got what I think is a very important year in lung cancer, with several practice-changing results/. Impressively, this is a year in which the most important trials include some focusing on first line treatment of patients with an EGFR mutation, some on acquired resistance in EGFR mutation-positive patients, some work on MET as a target, a couple on patients with squamous NSCLC or general NSCLC that includes squamous and non-squamous NSCLC, one striking finding in stage III resected NSCLC, and even a couple of most immediately practice-changing results in small cell lung cancer.

I’ll clarify that, working within the limit of a top 10 list , I couldn’t include some notable but negative trials, particularly those for which we’ve already learned of their negativity in press releases. And while immunotherapies continue to demonstrate their promise, the presentations at ASCO this year really just reinforce what we’ve already seen.  Because they don’t break significant new ground, this isn’t a year when immunotherapy trials are in the top 10 — though I expect at leasat one or two among next year’s top 10 list.

I welcome people to check out my preview of top 10 key presentations, but also to participate in a discussion about the upcoming ASCO meeting at this week’s #LCSM tweet chat, which will Thursday, May 22, at 8 PM Easter, 5 PM Pacific for an hour (just add the #LCSM hashtag to your tweets and search for them, or go to http://www.tchat.io/rooms/lcsm to follow (and hopefully participate in) the conversation).  In that time, people can ask questions and add comments about the ones listed, as well as raise others for consideration as attention-worthy presentations you may have heard or read about. You can find the entire collection of ASCO abstracts here.

I hope you find the top 10 list provocative and interesting. As always, I welcome your questions and comments here, as well as during the upcoming #LCSM chat.

 

 


14 Responses to Top 10 Key Presentations at ASCO 2014: Join Us for Discussion at Upcoming #LCSM Chat 5/22

  • ssflxl says:

    Dr. West

    Thanks for the update. What about Bavituximab? I hear there is Phase III trial on this now.

    ssflxl

  • Dr West
    Dr West says:

    Bavituximab is being studied in a phase III trial, but it’ll be a few years before we see results of the trial. I’m featuring material being presented this year.

    -Dr. West

  • taylor473 says:

    Thanks!

    This is really useful… can I just check though… on the ASCO website abst #8005 has PFS for exon 21 as 13.9mo BE vs 7.1mo E… not 17.1 as here… which is correct?

  • Dr West
    Dr West says:

    Thanks for catching that. I made a mistake (must have been a type) and will make the change.

    -Dr. West

  • texandave says:

    Dr. West, I noted omission in the top ten included any results involving heat shock proteins. I realize that there are many treatment angles being explored in the treatment of lung cancer, but I have been hopeful after reading some earlier findings with AUY-922 (I know that later data didn’t look as good). There tended to be some degree of optimism with researchers in examining the mechanism and the early findings. Perhaps in ASCO 2015 with ms-2248.

  • Dr West
    Dr West says:

    I’m not saying that work isn’t ongoing, but there is nothing on heat shock proteins being presented in the lung cancer sessions at ASCO 2014 that is near being practice-changing. Let’s see what the future shows.

    -Dr. West

  • texandave says:

    This was in a business journal:

    http://www.businesswire.com/news/home/20140519006502/en/Clovis-Oncology-Receives-Breakthrough-Therapy-Designation-CO-1686#.U3ycQKVOWpr

    Hmmm..

    Please respond if you see a reason. I know that you are busy.

  • kirkwood4 says:

    I am not sure how to compare two trials. In November 2013 Roche/Genentech did a study of over 1,000 patients comparing Avastin with and without Erlotinib and the results were poor (PFS of 3.7 vs 4.8 months) and they decided not to move on. Now we have a trial of 154 Japanese patients comparing Erlotinib with and without Avastin and not only are the results good (PFS of 9.7 vs 16.0 months) but vastly different (Erlotnib + Avastin 4.8 vs 16.0 months). I have a hard time believing the only difference is Japanese patients. What other differences are there in the trial that might explain this? I am sure I am missing something obvious like first line vs third line but I don’t see it. Thanks

  • kirkwood4 says:

    Is the difference that in the first trial there was no screening of patients to make sure they had the EGFR mutation? If so then that shows the power of the right drugs for the right patients and I would have thought Genentech / Roche would have highlighted the difference.

  • kirkwood4 says:

    Would this be the first positive results of a targeted cocktail for the “right” patients we are seeing in the clinic?

  • Dr West
    Dr West says:

    Sorry for my absence — I’m really tied up at the ongoing ASCO conference.

    Yes, this trial from Japan is specifically of EGFR mutation-positive patients, while preceding trials have been of molecularly unselected patients. I suppose it does represent the first highly positive result for a combination in the targeted therapy/targeted population setting.

    and texandave, I think the breakthrough designation for Clovis only underscores the sense that I and others in the lung cancer community have had that both this agent and AZD9291 are exceptionally promising and have avery significant probability of proving a benefit that could well lead to FDA approval on an expedited basis. I look forward to having one or more of these trials available for my patients as soon as feasible.

    -Dr. West

  • texandave says:

    Dr. West, thank you for your role at ASCO and your effort for big-time multitasking. Do you see the decision tree for EGFR+ patients changing notably with this sizable Japanese population?

  • texandave says:

    To clarify, will the results from the Japanese study have a lot of bearing on when Avastin is used with EGFR+ patients in a clinical setting?

  • ssflxl says:

    Dr. West

    I also wonder if the combo of Avastin and Tarceva work better than Tarceva alone when you take Tarceva 2nd time around.

    thanks

    ssflxl

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